Ovaries
Normal Ovarian Size as a Function of Age
Age Group | Mean Ovarian volume (ml)* | SD (ml) | 95% Confidence Interval | % Ovaries Imaged |
1 day to 3 months1 | 1.06 | 0.96 | 0.03-3.56 | 70 |
4-12 months1 | 1.05 | 0.67 | 0.18-2.71 | 100 |
13-24 months1 | 0.67 | 0.35 | 0.15-1.68 | 90 |
2 -12 years3 | 0.46 | -- | 0.13-0.9(range) | --** |
13-20 years3 | 4.0 | -- | 1.8-5.7(range) | -- |
Note: Cysts: >80% of girls 1 day to 24 months.
<70% of girls between 2 and 12 years.
macrocysts (>9mm) may be seen in <20% of cystic ovaries. 1
Small cysts are seen in more than 80% of patients older than 5 years of age (mean <7.5 mm).
Cysts were seen in 68% of premenarcheal 2 to 12 year olds, 90 -95% of which were < 9mm (mean 6 mm).
*ovarian volume = 0.523 x length x width x depth (ml)
** > 80% ovaries seen over age 5 years2
Ovarian Volume correlated with Age4
Adrenal Gland
Normal Adrenal Gland Size as a Function of Age1
Age | Length (cm) | Thickness (cm) | Width (cm) |
Neonate | 0.9 - 3.6 | 0.2 - 0.5 | -- |
Adult | 4 - 6 | 0.2 - 0.6 | 2 -3 |
ref 1.
Adrenal Gland: Sonographic features of normal adrenal glands versus age2
Age | Shape and Size | Echogenicity |
Newborn | Cortex >>Medulla thickness | Cortex hypoechoic Medulla hyperchoic |
1.5 to 2 months | Changes gradually to medulla>cortex thickness | Cortex hypoechoic Medulla hyperechoic |
5-6 months | Decreasing size | Hyperechoic, loss of corticomedullary differentiation |
> 1 year | Adult appearance | Entirely hypoechoic |
Ovarian Doppler
1
Age | Type of flow/menstrual phase | Arterial waveform pattern |
pre-pubertal | low diastolic flow | low diastolic flow |
post-pubertal* | follicular (0-7 days) | low to absent diastolic flow |
follicular/luteal (11-17 days) | increasing diastolic flow | |
late luteal | decreasing diastolic flow |
*flow detectable in 90% of adolescents
*arterial flow can be detected occasionally in twisted adnexa
Testicle
Normal Size of the Testicle as a Function of Age
Age | Width (cm) | Length (cm) | Volume ± SE(cm3) |
At Birth | 1.0 | 1.5 | 1.1 ± 0.14 |
1-3 months | 1.2 | 2.0 | 1.9 ± 0.11 |
4-6 months | 1.7 ± 0.11 | ||
1-10 years | 1.6 | 0.7 - 0.9 | |
11-12 years |
| 1.7 increasing to 1.9 | 1.5 incr to 2.0 |
13-16 years |
| 2.3 increasing to 3.5 | 5.0 incr 13.0 |
Adult | 2 - 3 | 3 - 5 | 15-20 |
Doppler Flow in Testes* 1
Testicular Volume | % detectable color flow |
< 1 cc | 70 (capsular arteries) |
> 1 cc | +/- 100 (central&capsular) |
* - waveforms typically low resistance, high diastolic flow.
- compare for symmetry
- lack of flow may be due to gain settings/high wall filter/high PRF etc.2
Renal Ultrasound Measurements
Graph of Normal Renal Volume vs Weight1
Length vs. Age1
Uterus
Normal Uterine Appearance and Dimensions
Uterine Stage | Gross Features | Length (cm) | Fundal Width of Body (cm) | Cervical Width (cm) |
Neonatal*1 | Cervix > Fundus | 2.3 - 4.6 | 0.8 - 2.1 | 0.8 - 2.2 |
Prepubertal+ | Fundus/Body < Cervix | 2.0 - 3.3 | 0.5 - 1.0 | |
Postpubertal | Fundus > Cervix | 5 - 8 | 1.6 - 3.0 |
*neonatal uterus regresses to about 2.5 cm at 1 month1.
+After 7 years of age, there is uterine growth4.
Neonatal uterus: 30% of neonatal uteri have a hypoechoic halo surrounding the endometrial canal, which is thought to represent the inner third of the myometrium, which is vascularly engorged1.
Uterine Volume correlated with Age2
Urinary Bladder
Volume calculation:
V = (H x W x D) X 0.625 mL1
H=height, W= width, D=depth
Volume by age = (age in years + 2) x 30 mL
Bladder wall thickness2
(ages 1 day to 19 years)
Site of measurement: sagittal plane: posterior inferior wall (away from rectum)
transverse plane: lateral to trigone
Degree of distention | Thickness (mm) | SD (mm) | Range (mm) |
Full | 1.55 | 0.56 | 1-3 |
Empty | 2.76 | 0.58 | 2-4.5 |
Appendix
Normal Appendix
Modality | Transverse Diameter (mm) | Appendiceal wall thickness (mm) |
US | < 6 (and compressible) | Usually < 2 |
CT | < 8 |
Sonographic Measurements of the Normal Pediatric Gallbladder and Biliary Tract
Normal Gallbladder Measurements vs. Age1
Age (y) | AP Diameter (cm) Mean | AP Diameter (cm) Range | Coronal Diameter (cm) Mean | Coronal Diameter (cm) Range | Length (cm) Mean | Length (cm) Range | Wall Thickness (mm) Mean | Wall Thickness (mm) Range |
0-1 | 0.9 | 0.5-1.2 | 0.9 | 0.7-1.4 | 2.5 | 1.3-3.4 | 1.7 | 1.0-3.0 |
2-5 | 1.7 | 1.4-2.3 | 1.8 | 1.0-3.9 | 4.2 | 2.9-5.2 | 2.0 | None |
6-8 | 1.8 | 1.0-2.4 | 2.0 | 1.2-3.0 | 5.6 | 4.4-7.4 | 2.2 | 2.0-3.0 |
9-11 | 1.9 | 1.2-3.2 | 2.0 | 1.0-3.6 | 5.5 | 3.4-6.5 | 2.0 | 1.0-3.0 |
12-16 | 2.0 | 1.3-2.8 | 2.1 | 1.6-3.0 | 6.1 | 3.8-8.0 | 2.0 | 1.0-3.0 |
Normal Sonographic Common Hepatic Duct Sizes vs. Age1
Age (y) | Common Hepatic Duct Size (mm) Mean | Common Hepatic Duct Size (mm) Range |
0-1 | 1.3 | 1.0 - 2.0 |
2-5 | 1.7 | 1.0 - 3.0 |
6-8 | 2.0 | None |
9-11 | 1.8 | 1.0 - 3.0 |
12-16 | 2.2 | 1.0 - 4.0 |
Normal GI Tract: Wall Thickness on CT
Organ | Wall Thickness (mm) |
Stomach | 3 - 5 |
Duodenum | < 3 |
Colon | < 3 |
Normal Lymph Nodes Seen on CT
Normal Abdominal Lymph Nodes in Adolescents and Adults: CT1
Location | Short Axis Nodal Diamter(mm) |
Retrocural | < 6 |
Paracardiac | < 8 |
Mediastinal | <102 |
Gastrohepatic ligament | < 8 |
Upper paraaortic | < 9 |
Portacaval | < 10 |
Portahepatis | < 7 |
Lower paraaortic | < 11 |
Pancreas
Normal Pancreas Size as a Function of Age (Ultrasound)*1
Age | Head in cm (± 1 | Body in cm (± 1 SD) | Tail in cm (± 1 |
< 1 month | 1.0 ± 0.4 | 0.6 ± 0.2 | 1.0 ± 0.4 |
1 month to 1 year | 1.5 ± 0.5 | 0.8 ± 0.3 | 1.2 ± 0.4 |
1 to 5 years | 1.7 ± 0.3 | 1.0 ± 0.2 | 1.8 ± 0.4 |
5 to 10 years | 1.6 ± 0.4 | 1.0 ± 0.3 | 1.8 ± 0.4 |
10 to 19 years | 2.0 ± 0.5 | 1.1 ± 0.3 | 2.0 ± 0.4 |
*Measured as maximum AP on transverse scan
The normal pancreatic duct is less than 2 mm in diameter
Portal Vein
Normal Main Portal Vein Size on Ultrasound as a Function of Age
Age | Main Portal Vein Transverse Diameter (mm) |
<10 years | 8.5 ± 2.7 |
10 to 20 years | 10 ± 2 |
Pylorus
Pyloric channel length | < 17 mm |
Muscle thickness | < 3.0 mm |
Muscle wall thickness: measured as a single hypoechoic layer between serosa and echogenic submucosa. (muscle thickness exaggerated for illustration)
Note: PRETERM INFANTS. Borderline muscle thickness measurements are more likely to occur in premature infants than in term infants. In preterm infants, the thickness of the pyloric muscle relative to the rest of the stomach and the pyloric canal length is more important than the absolute muscle thickness.
Spleen
Ultrasound: Normal Spleen Size versus Age1
Age | Spleen Length (cm)* |
0 - 3 months | < 6 |
3 - 6 months | < 6.5 |
6 - 12 months | < 7 |
1 - 2 years | < 8 |
2 - 4 years | < 9 |
4 - 6 years | < 9.5 |
6 - 8 years | < 10 |
8 - 10 years | < 11 |
10 - 12 years | < 11.5 |
12 - 15 years | < 12 |
15 - 20 years (female) | < 12 (female) |
15 - 20 years (male) | < 13 ( male) |
*Measurement obtained in the coronal longitudinal plane
Thyroid
Sonographic Normal Thyroid Lobe Measurements (cm)
Age | Transverse (cm) | Longitudinal (cm) | AP (cm) |
Infants and Young Children | 1 - 1.5 | 2 - 3 | 0.2 - 1.2 |
Adolescents & Adults | 2 - 4 | 5 - 8 | 1 - 2.5 |
Neonatal Brain
Sonographic Normal Cerebral Ventricle Measurements by Age
Age | Frontal Horn (mm) | Body (mm) | Third Ventricle ( mm) |
Premature infant | -- | < 10* |
|
Term infant | -- | 10 - 11* |
|
Newborn | < 3 | -- | < 4 |
*Body --Measured in a transaxial view from its lateral edge to the midline. (This is not truly the width of the lateral ventricle but the distance from the superolateral ventricular wall to the falx).
Sinuses
Visualization of the Paranasal Sinuses*
Maxillary | 2 - 3 mo |
Ethmoidal | 3 - 6 mo |
Sphenoidal | 1 - 2 y |
Frontal | 8 -10 y |
* The radiographic visualization of the sinuses lags the actual gross appearance based on autopsy.
Normal Acetabular Angles* (Caffey)
AP radiograph of pelvis
Age | Acetabular Angle --Female (Degrees) | Acetabular Angle--Male (Degrees) |
Newborn | 28.8 ± 4.8 | 26.4 ± 4.4 |
3 Month Old | 25 ± 3.5 | 22 ± 4 |
Six Month Old | 23.2 ± 4.0 | 20.3 ± 3.7 |
One Year Old | 21.2 ± 3.8 | 19.8 ± 3.6 |
Two Year Old | 18 ± 4 | 19 ± 3.6 |
*Acetabular angle defined as the angle made from line through the Y synchondroses and another line through the superior and inferior points of the iliac portion of the acetabulum.
Normal sonographic appearance of Infant Hip
Sonographic Hip Type | Alpha angle* |
I Normal | > 60° |
2A Physiologic Immaturity < 3 months old | 50 - 59° |
2B Delayed ossification > 3 months old | 50 - 59° |
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