Calculator Inputs
The page uses a single-column layout overall. The calculator fields use a responsive three, two, and one-column grid.
Example Data Table
| Example Case | Classic Inputs | Classic Score | Modified Inputs | Modified Score | Interpretation |
|---|---|---|---|---|---|
| Mild interstitial pattern | Grade B + no necrosis | 1 / 10 | Intrinsic inflammation + no necrosis + no extras | 2 / 10 | Mild imaging severity |
| Fluid collection with necrosis | Grade D + 30% to 50% necrosis | 7 / 10 | Collection/fat necrosis + ≥ 30% necrosis + pleural effusion | 10 / 10 | Severe imaging severity |
| Inflammation with ascites | Grade C + no necrosis | 2 / 10 | Intrinsic inflammation + no necrosis + ascites | 4 / 10 | Modified score flags moderate severity |
Formula Used
Original CTSI
Original CTSI = Balthazar grade points + necrosis points
- Grade A = 0
- Grade B = 1
- Grade C = 2
- Grade D = 3
- Grade E = 4
- No necrosis = 0
- ≤ 30% necrosis = 2
- 30% to 50% necrosis = 4
- > 50% necrosis = 6
Severity bands: 0–3 mild, 4–6 moderate, 7–10 severe.
Modified CTSI
Modified CTSI = inflammation points + necrosis points + extrapancreatic complication points
- Normal pancreas = 0
- Intrinsic abnormality with inflammation = 2
- Fluid collection or fat necrosis = 4
- No necrosis = 0
- < 30% necrosis = 2
- ≥ 30% necrosis = 4
- Any extrapancreatic complication = 2
Severity bands: 0–2 mild, 4–6 moderate, 8–10 severe.
How to Use This Calculator
- Select whether you want the original index, modified index, or both.
- Enter a case label and, if known, the study day from symptom onset.
- Choose the CT morphology grade for the original CTSI section.
- Select the necrosis category that best matches the imaging report.
- Choose the modified inflammation category for the modified CTSI section.
- Mark any extrapancreatic complications present on the examination.
- Submit the form to display results above the input panel.
- Use the CSV or PDF buttons to export the result summary.
Educational use only. CT severity indices are imaging tools and should be interpreted with the patient’s clinical status, laboratory findings, and physician review.
Frequently Asked Questions
1) What does this calculator estimate?
It estimates imaging severity in acute pancreatitis using CT-based scoring inputs. It summarizes the original CTSI, the modified CTSI, or both together for quick review.
2) Does the score diagnose pancreatitis?
No. Diagnosis depends on symptoms, enzymes, and imaging interpretation. This page only organizes CT findings into structured severity scores after pancreatitis is already being evaluated.
3) Why are there two scoring methods?
The original CTSI focuses on Balthazar grade and necrosis. The modified CTSI simplifies inflammation scoring and adds extrapancreatic complications, which can change the severity category.
4) What counts as an extrapancreatic complication?
Typical examples include pleural effusion, ascites, vascular complications, parenchymal complications, and gastrointestinal tract involvement. In the modified score, any present complication adds two points.
5) Can I use this without necrosis data?
Yes, if necrosis is not reported you can select “no necrosis” or update the entry later. The output is only as accurate as the imaging details entered.
6) Which result should I trust more?
Neither score replaces physician assessment. Many users review both to compare how added extrapancreatic complications affect the modified result and to see the original CT severity estimate.
7) Why might the modified score be higher?
The modified system can increase the final score when pleural effusion, ascites, vascular findings, parenchymal complications, or GI involvement are present, even with limited necrosis.
8) Can I export the result for a report file?
Yes. After calculation, use the CSV or PDF buttons to download a structured summary that includes selected inputs, total scores, severity labels, and any optional clinical note.