Welcome to Classifications and Online Calculators in Radiology

This site was build along with the Atlas of Radiology Images to support your knowledge in radiology.

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that are used in radiology and related fields with free access.

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The concept of this website is based on a previous site that was founded in 2008 and is still up and running. The website is composed as a book, where all sources are properly referenced, according to a good practice in scientific publications.

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    Balthasar score of acute pancreatitis on unenhanced CT scan, CT severity index, CTSI

    The original Balthasar score was developed and published in 1985. Originally, the score was based on unehnaced CT scans. It was later extended with the necrosis score to reflect also necrotic changes of the pancreatic parenchyma on contrast enhanced CT and their prognostic relevance and named CT severity index (CTSI).

    Balthasar score

    Grade Description CTSI points
    Grade A Normal CT 0
    Grade B Focal or diffuse enlargement of the pancreas 1
    Grade C Pancreatic gland abnormalities and peripancreatic inflammation 2
    Grade D Fluid collection in a single location 3
    Grade E Two or more fluid collections and/or gas bubbles in or adjacent to pancreas 4

    Necrosis Score

    Description - necrosis percentage CTSI points
    No necrosis 0
    0 - 30% necrosis 2
    30 - 50% necrosis 4
    >50% necrosis 6

    CT severity index

    CT severity index additively combines CTSI points from the Balthasar score and the necrosis score.
    CTSI = Balthasar score + necrosis score

    References:

    1. Balthazar EJ. Acute Pancreatitis: Assessment of Severity with Clinical and CT Evaluation1. Radiology. 2002 Jun 1;223(3):603–13.
    2. Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990 Feb;174(2):331–6

    3. Balthazar EJ, Ranson JH, Naidich DP, Megibow AJ, Caccavale R, Cooper MM. Acute pancreatitis: prognostic value of CT. Radiology. 1985 Sep;156(3):767–72.

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