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CT severity index (Balthazar)

Balthazar 1990CTPancreas

Balthazar grade (0–4) plus necrosis score (0–6) gives CTSI 0–10.

Balthazar gradeFindingPoints
ANormal pancreas0
BFocal or diffuse enlargement1
CPancreatic abnormality with peripancreatic inflammation2
DSingle fluid collection3
ETwo or more collections and/or gas4
NecrosisPoints
None0
≤30%2
30–50%4
>50%6
Score
CTSI–
Severity: 0–3 mild, 4–6 moderate, 7–10 severe. The modified CTSI (Mortele 2004) adds extrapancreatic complications and simplifies necrosis to ≤30% / >30%.

Sources

  1. Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174:331–336.PubMed ↗
  2. Mortele KJ, Wiesner W, Intriere L, et al. A modified CT severity index for evaluating acute pancreatitis. AJR Am J Roentgenol. 2004;183:1261–1265.PubMed ↗
PreviousRevised Atlanta: pancreatitis collectionsNextPI-RADS v2.1

Radessential summarizes published classification systems for practicing radiologists. Summaries are condensed; confirm details against the cited source before relying on them for patient care.