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Score of Cuadrado et al for Grading Changes Seen on the Brain MRI of a Patient with Multiple Sclerosis

Purpose: To evaluate an MRI of the brain to determine the severity of involvement in multiple sclerosis or similar conditions.

Description

The changes seen on a brain MRI can be used to grade the severity of central nervous system (CNS) involvement in patients with multiple sclerosis or other similar diseases. The authors are from St. Thomas' Hospital (London) and Hospital La Paz (Madrid).


Imaging method: MRI

 

Parameters:

(1) number of lesions

(2) diameter of the lesions

 

Parameter

Finding

Points

number of lesions

none seen

0

 

1

1

 

2 to 5

2

 

6 to 10

3

 

11+ but not confluent

4

 

confluent

5

size of the lesions

none seen

0

 

barely seen (<= 2 mm)

1

 

2.1 to 5 mm

2

 

5.1 to 10 mm

3

 

> 10 mm but not confluent

4

 

confluent

5

 

where:

• Not all lesions will be of the same size. Grading for size could be based on the largest or average size.

 

total severity grade =

= (points for number of lesions) * (points for size)

 

Interpretation:

• minimum severity grade: 0

• maximum severity grade: 25

• The higher the score the more extensive the CNS involvement.

• Different anatomic regions can be scored.

• A score of 20 should not be seen since at least one parameter would need to be confluent. This would mean that the next total severity score after 16 would be 25.


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Specialty

Objective

ICD-10