The Computed Tomography Severity Index (CTSI) is a scoring system used to assess the severity of acute pancreatitisbased on contrast-enhanced CT scans. It is the sum of two components:
CTSI = Balthazar score (Inflammation score) + Necrosis score
1. Balthazar score (Inflammation score / Pancreatic inflammation): Grades A-E
|
Grade |
CT Findings |
Points |
|
A |
Normal pancreas |
0 |
|
B |
Enlargement of the pancreas |
1 |
|
C |
Inflammatory changes in pancrease & peripancreatic fat |
2 |
|
D |
Single fluid collection |
3 |
|
E |
Two or more fluid collections or gas in the pancreas |
4 |
2. Necrosis score (Pancreatic necrosis):
|
Necrosis Percentage |
CT grade points |
|
None |
0 points |
|
< 30% |
2 points |
|
30-50% |
4 points |
|
> 50% |
6 points |
CTSI = Balthazar score + Necrosis score
|
CTSI Score |
Severity |
|
0-3 |
Mild acute pancreatitis |
|
4-6 |
Moderate acute pancreatitis |
|
7-10 |
Severe acute pancreatitis |