Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

63 results found
Article

ABC/2

ABC/2 is a fast and simple method for estimating the volume of intracerebral haemorrhage (or any other ellipsoid lesion for that matter) which does not require volumetric 3D analysis or software. Intracerebral haemorrhage volume is an important predictor of morbidity and mortality (and thus tria...
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Alberta stroke program early CT score

The Alberta stroke programe early CT score (ASPECTS) 1 is a 10-point quantitative topographic CT scan score used in patients with middle cerebral artery (MCA) stroke. Segmental assessment of the MCA vascular territory is made and 1 point is deducted from the initial score of 10 for every region ...
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ASIA impairment scale for spinal injury

The American Spinal Injury Association (ASIA) was developed by the American Spinal Injury Association in 2006, and at the time of writing (July 2016), remains the most widely used scale. This scale is part of the ASIA spinal cord injury classification. It divides spinal cord injuries into 5 cat...
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Barkovich classification of focal cortical dysplasia

Barkovich classifies focal cortical dysplasias among the his extensive classification system for malformations of cortical development, distributing them as follows: Type I and type IIb (transcortical dysplasia - Taylor type with balloon cells) as non-neoplastic malformations due to abnormal ne...
Article

Barrow classification of caroticocavernous fistulae

Barrow caroticocavernous fistula classification divides caroticocavernous fistulas into direct (type A) or indirect (types B-D). This classification was proposed by Barrow et al. in 1985 1 and at the time of writing (mid 2016) remains the most widely used system for describing caroticocavernous ...
Article

Biffl scale for blunt cerebrovascular injury

The Biffl scale or grade illustrates the spectrum of blunt cerebrovascular injury (BCVI) seen on angiography (both CTA and DSA). Some authors refer to the grading scale as the Denver scale, which is not to be confused with the Denver criteria, a set of clinical and risk factors for BCVI.  Class...
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Blumcke classification of focal cortical dysplasia

Blumcke et al. proposed the most recent (2011) 2 and now widely adopted consensus classification system for focal cortical dysplasia, which shares many features with the previously described classifications system by Palmini (2004) and Barkovich (2005).  Unfortunately, as is the case with many ...
Article

Borden classification of dural arteriovenous fistulas

The Borden classification of dural arteriovenous fistulas (DAVF) groups these lesions into three types based upon the site of venous drainage and the presence or absence of cortical venous drainage. It was first proposed in 1995 1. At the time of writing (July 2016), it is probably less popular ...
Article

Bouthillier classification of internal carotid artery segments

Bouthillier et al described (in 1996) 1 a seven segment internal carotid artery (ICA) classification system. It remains the most widely used system for describing ICA segments at the time of writing (mid-2016). There are a few other classifications systems including those proposed by Fisher (19...
Article

Brainstem stroke syndromes

Brainstem stroke syndromes refer to a group of syndromes that occur secondary to occlusion of small perforating arteries of the posterior circulation. The resulted infarction has characteristic clinical picture according to the involved area however, generally there is ipsilateral cranial nerve ...
Article

Classification of cerebral vascular malformations

Cerebral vascular malformations encompass a large variety vascular lesions which differ in haemodynamics, structure and prognosis. Some can be life threatening (e.g. vein of Galen aneurysmal malformations, arteriovenous malformations) whilst others are almost always incidental and asymptomatic (...
Article

Classification of spinal meningeal cysts

Spinal meningeal cysts can be classified according to a system published by Nabor et. al 2: type I: extradural meningeal cyst without neural tissue type Ia: extradural spinal arachnoid cyst type Ib: sacral meningocele type II: extradural meningeal cyst containing neural tissue, e.g. Tarlov c...
Article

Classification system for malformations of cortical development

Classification system for malformations of cortical development organises a myriad of conditions according to one of three major underlying  mechanisms: abnormal cell proliferation abnormal neuronal migration abnormal cortical organisation As is to be expected a number of conditions fall out...
Article

Classification system for malformations of the cerebellum

Classification systems for malformations of the cerebellum are varied and are constantly being revised as greater understanding of the underlying genetics and embryology of the disorders is uncovered. A classification proposed by Barkovich et al in 2009 1 divides cerebellar malformations in two ...
Article

Classification system for midline abnormalities of the brain and skull

Classification systems for midline abnormalities of the brain and skull are varied and constantly changing as the underlying embryology and genetics are uncovered. A relatively simple and robust classification system is based on the location of abnormalities, always remembering that midline abno...
Article

Cognard classification of dural arteriovenous fistulas

The Cognard classification of dural arteriovenous fistulas correlates venous drainage patterns with increasingly aggressive neurological clinical course. It was first described in 1995 1 and at the time of writing (July 2016) is probably the most widely used classification system for dural arter...
Article

Combined conduit score of sinovenous stenosis

The combined conduit score (CCS) is a grading scheme for the assessment of the degree of transverse-sigmoid sinus stenosis in the setting of idiopathic intracranial hypertension. The score was initially developed for ATECO MR venography 1. Parameters Assessment is performed using maximum inten...
Article

Diffuse astrocytoma grading

Diffuse astrocytomas can be graded in according to a number of systems, the most popular being the WHO grading system. In general these grading systems focus on the presence or absence of a number of histological features 3: cellular atypia/anaplasia  mitotic activity microvascular proliferat...
Article

Fazekas scale for white matter lesions

The Fazekas scale is used to simply quantify the amount of white matter T2 hyperintense lesions usually attributed to chronic small vessel ischaemia, although clearly not all such lesions are due to this. This classification was proposed by Fazekas et al. in 1987 1 and at the time of writing (l...
Article

Fisher scale

The Fisher scale is the initial and best known system of classifying the amount of subarachnoid haemorrhage on CT scans, and is useful in predicting the occurrence and severity of cerebral vasospasm, highest in grade 3 2.  Numerous other scales have been proposed, incorporating various paramete...
Article

Galassi classification of middle cranial fossa arachnoid cysts

The Galassi classification of middle cranial fossa arachnoid cysts​ is used to classify arachnoid cysts in the middle cranial fossa, which account for 50-60% of all arachnoid cysts 1. Galassi et al published this classification in 1982, and at the time of writing (June 2016) it remains the most ...
Article

Glasgow coma scale

The Glasgow coma scale (GCS) was developed in 1974 1 to describe the level of consciousness specifically in patients with head injury although it is now used widely as a shorthand for all manner of presentations and has generally been validated, although concerns about its use in certain scenari...
Article

Global cortical atrophy scale

The global cortical atrophy (GCA) scale, also known as the Pasquier scale, is a qualitative rating system developed to assess cerebral atrophy, especially in the context of neurodegenerative diseases. It evaluates atrophy in 13 brain regions assessed separately in each hemisphere and resulting i...
Article

Grading of brachial plexus injuries

According to CT myelography, brachial plexus injuries can be classified into six types 1: N type: normal root sleeve and nerve roots A1 type: slightly deformed root sleeves and nerve roots as compared to unaffected site A2 type: obliteration of the tip of root sleeves and deformed thickened n...
Article

Hunt and Hess grading system

The Hunt and Hess scale describes the severity of subarachnoid haemorrhage, and is used as a predictor of survival. grade 1 asymptomatic or minimal headache and slight neck stiffness 70% survival grade 2 moderate to severe headache; neck stiffness; no neurologic deficit except cranial nerve...
Article

Intraventricular neoplasms and lesions

Intraventricular neoplasms are rare and arise from periventricular structures such as the walls of the ventricular system, the septum pellucidum and the choroid plexus. Many tumour types arise from, or can bulge into the ventricular system, although there are certain lesions that are relatively ...
Article

Kernohan grading system for diffuse astroctyomas

The Kernohan grading system for diffuse astrocytomas is no longer used, superseded by the the WHO grading system.  It was first described in 1949 and divided astrocytomas into 4 grades (I - IV) on the basis of histological features 1.
Article

Lasajunias classification of vein of Galen aneurysmal malformations

The Lasjaunias classification, at the time of writing (mid 2016), is one of the two commonly used systems for classifying vein of Galen malformations. It relies on dividing the entity into choroidal or mural types, depending on the number and origin of feeding arteries.  Classification choroid...
Article

MAGNIMS consensus on MRI diagnosis of multiple sclerosis

The magnetic resonance imaging in multiple sclerosis (MAGNIMS), which is a European collaborative research network, published in 2016 new recommendations to upgrade the imaging diagnosis criteria for multiple sclerosis (MS). These came as a consensus, based on evidence-based and expert opinions ...
Article

Marshall classification of traumatic brain injury

The Marshall classification of traumatic brain injury is a CT scan derived metric using only a few features and has been shown to predict outcome in patients with traumatic brain injury.  This system was first published in 1992 1 building on findings from a large cohort of head injury cases des...
Article

McDonald diagnostic criteria 2001 - 2005

The McDonald's criteria are MRI criteria used in the diagnosis of multiple sclerosis and were initially described in 2001 and revised in 2005 and again recently in 2010 - see McDonald diagnostic criteria 2010. Below are the previously used criteria, which should no longer be employed clinically...
Article

McDonald diagnostic criteria for multiple sclerosis

McDonald diagnostic criteria for multiple sclerosis are MRI criteria used in the diagnosis of multiple sclerosis (MS) were introduced in 2001, revised in 2005, 2010 and more recently in 2016 1. As before the diagnosis of multiple sclerosis requires establishing disease disseminated in both spac...
Article

Medial temporal lobe atrophy score

The medial temporal lobe atrophy (MTA) score is useful in distinguishing patients with mild cognitive impairment and Alzheimer's disease from those without impairment 2 is helpful in the assessment of patients with possible dementia (see neurodegenerative MRI brain - an approach). Classificatio...
Article

Modified Fisher scale

The modified Fisher scale is a method for grading subarachnoid haemorrhage (SAH) seen on CT. It was developed from the original Fisher scale which was modified to account for patients with thick cisternal blood and concomitant intraventricular (IVH) or intraparenchymal haemorrhage. Moreover, th...
Article

Modified Memphis criteria for blunt cerebrovascular injury

The modified Memphis criteria are a set of screening criteria for blunt cerebrovascular injury (BCVI) in trauma. The presence of one or more of these criteria makes necessary a complementary CTA or DSA study to exclude a BCVI. The screening protocol criteria for BCVI are: base of skull fractur...
Article

Modified Rankin scale

The modified Rankin scale or is a commonly used to quantify functional outcome in individuals who suffer a neurological event. The scale was initially described by Rankin in 1957 to assess the outcome of cerebrovascular accidents 1. It has subsequently been modified 2,3 and has been used in a wi...
Article

Modified Ringertz grading system for diffuse astrocytomas

The modified Ringertz grading system has historically been one of the more frequently used grading systems for diffuse astrocytomas, but has not essentially been replaced by the WHO grading system. Unlike the WHO grading system and St Anne-Mayo grading system (also known as the Dumas-Duport gra...
Article

Modified treatment in cerebral ischaemia (mTICI) score

The modified treatment in cerebral infarction (mTICI) score was developed from the original Thrombolysis in Cerebral Infarction (TICI) scale by a consensus group in 2013 1. The recommendations included a name change to better reflect the increasing use of endovascular therapy for stroke, and sim...
Article

Normal bone marrow signal of the clivus

Bone marrow signal of the clivus changes predictably with age and is well assessed with midline T1 non-fat-saturated, non-contrast images. As is seen in the rest of the body the proportion of yellow (fatty) marrow increases with age. Knowledge of these changes allows diagnosis of the abnormal cl...
Article

Periventricular leukomalacia classification

One of the methods used for grading of periventricular leukomalacia based on sonographic appearances is as: grade 1: areas of increased periventricular echogenicity without any cyst formation persisting for more than 7 days grade 2: the echogenicity has resolved into small periventricular cyst...
Article

Posterior atrophy score of parietal atrophy

The posterior atrophy score, a.k.a. Koedam score, has been developed to enable visual assessment of parietal atrophy on MRI, and is useful in the assessment of patients with possible dementia, especially atypical or early onset Alzheimer's disease (see: neurodegenerative MRI brain: an approach) ...
Article

RASopathies

RASopathies are a class of developmental disorders caused by germline mutations in genes that encode for components or regulators of the Ras/mitogen activated protein kinase (MAPK) pathway. Epidemiology As a group, RASopathies represent one of the most common malformation syndromes, with an in...
Article

Raymond–Roy occlusion classification of intracranial aneurysms

The Raymond–Roy occlusion classification (RROC) is an angiographic classification scheme for grading the occlusion of endovascularly treated intracranial aneurysms 1. It is also known as the Raymond class, Montreal scale, modified Montreal scale or the Raymond Montreal scale. class I: complete ...
Article

Rotterdam CT score of traumatic brain injury

The Rotterdam CT score of traumatic brain injury is a relatively recently described classification aimed at improving prognostic evaluation of patients admitted with acute traumatic brain injuries.  It was published in 2006 1 and is gaining in popularity. Along with the Marshall classification ...
Article

Shunt-dependency in symptomatic aneurysmal subarachnoid haemorrhage score

The shunt-dependency in symptomatic aneurysmal subarachnoid haemorrhage (SDASH) score is a harmonized score for the prediction of hydrocephalus requiring shunting after subarachnoid haemorrhage. The tool is employed in the acute phase to predict which patients will require shunting, rather to as...
Article

Simpson grade

The Simpson grade of meningioma resection was described in 1957 and correlated the degree of surgical resection completeness with with symptomatic recurrence 1.  Although the type of resection still plays a part in the likelihood of symptomatic recurrence, other factors (such as the MIB-1 index...
Article

Spetzler-Martin arteriovenous malformation grading system

The Spetzler-Martin arteriovenous malformation (AVM) grading system allocates points for various features of intracranial arteriovenous malformations to give a grade between 1 and 5. Grade 6 is used to describe inoperable lesions. The score correlates with operative outcome. Grading size of ni...
Article

Spinal AVM classification

Spinal arteriovenous malformations can be classified in a number of ways: intramedullary extramedullary: 80% 1 Or into four types 2: type I: single coiled vessel (dural AV fistula) type II: intramedullary glomus AVM type III: juvenile  type IV: intradural perimedullary (AV fistula) sub t...
Article

Spinal cord injury

Spinal cord injury (SCI) can be traumatic or non-traumatic (i.e. neoplastic/stenosis) but the syndromes associated with spinal cord injury can be seen in all aetiologies. Injury to the spinal cord can be incomplete or complete and depends upon the mechanism of injury. This is important as diffe...
Article

Spinal metastases

Spinal metastases is a vague term which can be variably taken to refer to metastatic disease to any of the following:  vertebral metastases (94%) may have epidural extension intradural extramedullary metastases (5%) intramedually metastases (1%) Each of these are discussed separately. Below...
Article

St. Anne-Mayo grading system of astrocytomas

The St. Anne-Mayo grading system, also known as the Daumas-Duport grading system, introduced in 1988 was for a time a popular system for grading diffuse astrocytomas but has now largely been replaced by the WHO grading system which is, however, derived from the St Anne-Mayo system and thus share...
Article

Suzuki staging system for Moyamoya

The staging system for moyamoya disease first described by Suzuki and Takaku in their seminal 1969 article1 is still in use today. Formally, the staging refers to findings on conventional angiography, although there are efforts to apply similar systems to MR angiography.2 Suzuki stage appears t...
Article

Syrinx terminology

There are specific terms used when describing a syrinx or other cystic lesions within the spinal cord 1: hydromyelia: fluid accumulation/dilatation within the central canal, therefore, lined by ependyma syringomyelia: cavitary lesion within cord parenchyma, of any cause (there are many); locat...
Article

Thrombolysis in cerebral infarction (TICI) scale

The thrombolysis in cerebral infarction (TICI) grading system was described in 2003 by Higashida et al 1 as a tool for determining the response of thrombolytic therapy for ischaemic stroke. In neurointerventional radiology it is commonly used for patients post endovascular revascularisation. Lik...
Article

Toast classification in acute ischemic stroke

The TOAST (trial of ORG 10172 in acute stroke treatment) classification denotes five sub types of ischaemic stroke. large-artery atherosclerosis (embolus / thrombosis)* cardioembolism (high-risk / medium-risk)* small-vessel occlusion (lacune)* stroke of other determined aetiology * stroke o...
Article

Tumours of the meninges (differential)

Tumours of the meninges are a heterogeneous group of lesions which usually occur as extra-axial masses.  Although a large number of lesions that can involve meninges are scattered throughout the  WHO classification of CNS tumours, the main entities to be considered include:  meningioma and nume...
Article

VASARI MRI feature set

The VASARI (Visually AcceSAble Rembrandt Images) MRI feature set is a system designed to enable consistent description of gliomas using a set of defined visual features and controlled vocabulary. It is the result of work by The Cancer Imaging Archive (TCIA) who publish relevant guides to use, an...
Article

WFNS grading system

The WFNS (World Federation of Neurosurgical Societies) grading system uses the Glasgow Coma Scale and presence of focal neurological deficits to grade the severity of subarachnoid haemorrhage. This grading system was proposed in 1988, and this is one of the accepted systems (although not conside...
Article

WHO classification of CNS tumours

The WHO classification of CNS tumours is the most widely accepted system for classifying CNS tumours and was based on the histological characteristics of the tumour. Although the most recent version of the 'blue book' is the 4th edition from 2007, an update has been released in 2016 3, which sho...
Article

WHO grading of CNS tumours

WHO (World Health Organisation) grading of CNS tumours is based on histological characteristics such as cellularity, mitotic activity, pleomorphism, necrosis, and endothelial proliferation (neoangiogenesis). It is used in the WHO classification of CNS tumours.  It should be noted that at the ti...
Article

WHO grading system for diffuse astrocytomas

 The WHO grading system is the most widely used system for grading diffuse astrocytomas (at the time of writing i.e. mid 2016), and is an adaptation of the now superseded  St Anne-Mayo grading system (also known as the Daumas-Duport grading system).  Grade I is reserved for localised astrocytom...
Article

Yasargil classification of vein of Galen aneurysmal malformations

The Yasargil classification is one of the two common systems for classifying vein of Galen malformations that is currently in use at the time of writing (mid 2016).  Classification type I: small pure cisternal fistula between the vein of Galen (voG) and either the pericallosal arteries (anteri...
Article

Zabramski classification of cerebral cavernous malformations

The Zabramski classification of cerebral cavernomas has been proposed as a way of classifying cerebral cavernous malformations, and although not used in clinical practice it is useful in scientific publications that seek to study cavernous malformations. The classification was proposed in 1994 ...

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