Fig. 2

A. Rating of medial temporal atrophy (MTA) on MR. Interpretation key. Answers given as (right/ left). Numbers equal the corresponding image in the supplementary PDF file. a/6) MTA0/0. b/16) MTA0 right and MTA0-1 on the left side. c/2) MTA0/1. d/4) MTA1/0-1. Both are normal. e/5) MTA1/1. f/17) MTA1/1. g/11) MTA1/1. Note the small cyst in the right hippocampus. h/8) MTA1/1. i/1) MTA2/2. Artefacts are not disturbing the rating process. The parahippocampal gyri are not atrophied. The sulci are closed. j/10) MTA2/2. k/15) MTA2/2. On the right side the image is too far behind the rating point. Left is optimal here. l/18) MTA2/2 m/14) MTA1/3. On the right side MTA is turning into MTA2 and on the left side MTA just passed from MTA2 into MTA3. n/–12) MTA2/2.The left MTA is turning into MTA3. o/13) MTA2/2. Here you need to have surrounding images to be sure of the grading. Right side might turn into MTA3. p/3) MTA3/2. A fetal band/septum on the left side. Cut it in your mind and the hippocampus will be released. q/9) MTA2-3 /2. Here it is difficult to rate. You need to have several images in a row, but even then it is difficult. The hippocampi are atrophic but there is no passage of cerebrospinal fluid around the hippocampi in this image r/7) MTA3/3. The widening of the ventricles are pronounced and sometimes the distinction between widening of ventricles and hydrocephalus of other reasons is difficult. In this case the entorhinal cortex and parahippocampal gyri are atrophied as well which makes atrophy as a cause more likely. s/19) MTA4/ 3–4. This image is noisy and it’s difficult to distinguish the entorhinal cortex from the hippocampi and parahippocampal gyri. t/20) MTA4/4.The right side is more atrophic than the left side. B. Rating of MTA on CT. Interpretation key. Answers given as (right/ left). Numbers equal the corresponding image in the supplementary PDF file. a/19) MTA0/0. b/10) MTA1/0. c/16) MTA0-1/1. d/7) MTA1/0. Basal artefacts and an acute infarction in the left temporal lobe. e/14) MTA1/1. f/18) MTA1/2. g/11) MTA2/2. Maybe too anterior on the right side for rating. h/12) MTA1/2-3. Difficult to rate on the left side. Hippocampus is thin. MTA3 is more likely. i/20) MTA2/2. j/3) MTA2/2. It is too anterior to rate the right side, parts of amygdala are still remaining and on the left side it is almost too far posteriorly. k/6) MTA1/2.Basal artefacts make it more difficult to rate. Left side is MTA2 but is turning towards MTA3. l/1) MTA3/0.Asymmetric MTA. Note the wider Sylvian fissure on the right side. m/4) MTA2-3.More atrophy on the left side. Thin hippocampi, wide temporal horns, wide sulci beneath, wide hippocampal sulci. n/15) MTA2/3. Difficult to be sure on a single image. o/8) MTA2/3. Right side is between 2 and 3 and left side between 3 and 4. Note the differences in lateral ventricle size. p/2) MTA3/3. Difficult to rate on just one image. The hippocampi adheres to the ventricular wall on both sides. The hippocampi are thin and the fissura hippocampi are wide. The temporal horns are starting to widen. Parahippocampal gyri are thin and the sulci beneath it is wide. q/13) MTA3/3.The hippocampus on the left side has a strange formation - maybe it is not fully rotated. r/17) MTA3/3.Too anterior on both sides. Parts of amygdala are remaining bilaterally. Hippocampi are thin but the sulci beneath are not wide. s/5) MTA4/4. Right side is a bit too anterior for rating. t/9) MTA4/4