Mortele Modified CT Severity Index (CTSI)for scoring acute pancreatitis
|Intrinsic pancreatic abnormalities with or without inflammatory changes in peripancreatic fat.||2|
|Pancreatic or peripancreatic fluid collection or peripancreatic fat necrosis||4|
|Extra Pancreatic Complications|
|One or more of the following: Pleural Effusion, ascites, vascular complications, parenchymal complications, or gastrointestinal tract involvement.||2|
Atlanta Classification for Acute Pancreatitis
|Type of acute pancreatitis||Duration||Collections||CT description|
|Interstitial edematous pancreatitis||< 4 weeks||Acute Peripancreatic Fluid Collections (APFC)||Homogeneous fluid density collection confined by normal peripancreatic fascial planes. No definable wall encapsulating. Adjacent to the pancreas (no intrapancreatic extension)|
|>4 weeks||Pseudocyst||Well circumscribed, usually round or oval homogeneous fluid density. No non-liquid component. Well defined wall; completely encapsulated|
|Necrotizing pancreatitis||< 4 weeks||Acute Necrotic Collections (ANC)||Heterogeneous, non-liquid density of varying degrees (some appear homogeneous early in the course). No definable wall encapsulating the collection.Location: Intrapancreatic and/ or extrapancreatic|
|>4 weeks||Walled-off Necrosis (WON||Heterogeneous, liquid, and non-liquid density with varying degrees of loculations (some may appear homogeneous). Well-defined wall; completely encapsulated. Location:Intrapancreatic and/or extrapancreatic|
References and further reading:
- A modified CT severity index for evaluating acute pancreatitis: improved correlation with patient outcome.
- Revised Atlanta Classification for Acute Pancreatitis: A Pictorial Essay
Thanks to Dr. Pradosh Kumar Sarangi for the corrections.
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