1
00:00:00,000 --> 00:00:04,300
Let's evaluate white matter hyperintensities (WMHs).

2
00:00:04,300 --> 00:00:05,820
The first patient.

3
00:00:07,250 --> 00:00:11,050
We usually look on Flair, as they show this lesion best.

4
00:00:11,050 --> 00:00:18,200
They are bilateral, almost symmetrical hyperintense areas on T2-weighted and FLAIR images.

5
00:00:19,740 --> 00:00:27,050
We use the Fazekas scale to rate the severity of PVHs and DWMHs, separately.

6
00:00:28,850 --> 00:00:36,930
PVHs seeing as "caps" or pencil-thin lining;

7
00:00:37,300 --> 00:00:42,420
DWMHs appearing as punctate foci;

8
00:00:42,420 --> 00:00:47,050
So both PVH and DWMH score 1.

9
00:01:20,800 --> 00:01:26,450
A second patient. PVHs showed smooth "halo".

10
00:01:29,520 --> 00:01:34,900
DWMHs showed small confluents.

11
00:01:34,900 --> 00:01:40,425
So PVHs scored 2, DWMHs scored 2 as well.

12
00:02:00,600 --> 00:02:07,526
A third patient. Irregular signal extending into the deep white matter

13
00:02:09,400 --> 00:02:13,225
large confluent areas

14
00:02:13,850 --> 00:02:18,625
so the PVH and DWMH score are both 3.

15
00:02:27,750 --> 00:02:30,900
Let's look at other sequences.

16
00:02:59,920 --> 00:03:03,670
here, we have Flair, T2 and T1.

17
00:03:03,670 --> 00:03:12,525
Flair high intensity; T2 high intensity; T1 low intensity 

18
00:03:27,650 --> 00:03:35,675
The PVH and DWMH scores are the same for these patients, just for demonstration convenience.

19
00:03:38,720 --> 00:03:44,775
PVH and DWMH often scored different in the same patient.

20
00:03:46,570 --> 00:03:48,700
For example, this patient.

21
00:04:00,600 --> 00:04:10,275
The patient had a PVH score of 3 and a DWMH score of 1.