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 Release 22.0, Sept. 2008
 
Chapter : ch11. Hepatobiliary & Pancreas Section : Diagnosis and Prognosis of Pancreatitis
  Criteria of Sarner and Cotton for Imaging Grading of Chronic Pancreatitis

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Overview :

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

 

 

  References:

Sarner M, Cotton PB. Classification of pancreatitis. Gut. 1984; 25: 756-759 (Table, page 758)

 

 

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