Sarner and Cotton reported findings from an International Workshop for classifying pancreatitis. This included a scheme for grading the findings seen on imaging studies. The authors are from King's College at Cambridge.
Parameters:
(1) number of abnormal branches seen on ERCP
(2) abnormality of the main duct on ERCP
(3) additional findings seen on CT, ultrasound or other imaging methods
Number of Abnormal Branches |
Main Duct |
Additional Findings |
Grade |
none |
normal |
absent |
normal (Grade 1) |
1 - 3 |
normal |
0-1 not marked |
equivocal (Grade 2) |
> 3 |
normal |
2+ not marked |
mild (Grade 3) |
> 3 |
abnormal |
2+ not marked |
moderate (Grade 4) |
> 3 |
abnormal |
marked |
marked (Grade 5) |
where:
• Equivocal disease may have 1 mild-to-moderate abnormal finding.
Additional Findings |
Mild-to-Moderate |
Marked |
cavities |
<= 10 mm |
> 10 mm |
gross gland enlargement |
1.1 - 2.0 times normal |
> 2 times normal |
intraduct findings |
|
filling defect or calculi |
duct irregularities |
mild to moderate |
severe |
duct lesions |
increased echoes |
obstruction or stricture |
adjacent organ |
|
invasion into |
main duct enlargement |
< 4 mm |
>= 4 mm |
acute pancreatitis |
focal |
|
parenchyma |
heterogenous |
|
contour of head or body |
irregular |
|
Specialty: Gastroenterology