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e-CASES: Scheltens score for of Alzheimer Disease on MRI

Dr Antoine Micheau , Clinique du Parc - Castelnau Le Lez - Montpellier , Montpellier , Herault , France

The MTA-score (Scheltens) should be rated on coronal T1-weighted images. on a slice through the corpus of the hippocampus (level of the anterior pons).


The scale  is based on a visual score of the width of the choroid fissure, the width of the temporal horn, and the height of the hippocampal formation.

  • score 0: no atrophy
  • score 1: only widening of choroid fissure
  • score 2: also widening of temporal horn of lateral ventricle
  • score 3: moderate loss of hippocampal volume (decrease in height)
  • score 4: severe volume loss of hippocampus


< 75 years: score 2 or more is abnormal.

> 75 years: score 3 or more is abnormal.


Score Width of choroid fissure Width of temporal horn Height of hippocampal formation
0 N N N
1 N N
2 ↑↑ ↑↑
3 ↑↑↑ ↑↑↑ ↓↓
4 ↑↑↑ ↑↑↑ ↓↓↓