🩻 CT Severity Index (CTSI, Balthazar)
Grade acute pancreatitis severity on CT with the Balthazar CT Severity Index.
CT Severity Index (CTSI, Balthazar)
Balthazar CT grade
Extent of pancreatic necrosis
When to use
Assess prognosis in acute pancreatitis from imaging.
How it works
CTSI = Balthazar grade (A–E = 0–4) + necrosis extent (0/2/4/6), total 0–10. 0–3 mild, 4–6 moderate, 7–10 severe.
Key points
- Assess contrast-enhanced CT > 72 h after onset to avoid underestimating necrosis.
- Higher scores carry higher complication and mortality rates.
- The modified CTSI (Mortele) adds extrapancreatic complications.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.