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
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