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Modified CT Severity Index Calculator (CTSI)

Pancreas:



Pancreatic Necrosis:



Extrapancreatic complications (pleural effusion, ascites, vascular complications gastrointestinal tract involvement):


Modified CT severity index:
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Mortele Modified CT Severity Index (CTSI)for scoring acute pancreatitis

Prognostic Indicator Points
Pancreatic Inflammation
Normal pancreas 0
Intrinsic pancreatic abnormalities with or without inflammatory changes in peripancreatic fat. 2
Pancreatic or peripancreatic fluid collection or peripancreatic fat necrosis 4
Pancreatic Necrosis
None 0
≤ 30% 2
≥ 30% 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:

Thanks to Dr. Pradosh Kumar Sarangi for the corrections.

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This page was last updated on Jul 31, 2023 @ 11:21 am

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