simon Robben, Rick furgão Rijn and Robin Smithuis

Radiology Departement the the maastricht University Hospital, Academical Medical centre in Amsterdam e the Alrijne hospital in Leiderdorp, ns Netherlands

This is review of normal values that ultrasound examinations in neonates and children.

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Click on one of a items on ns left.

Adapted em ~ reference 21

Sagittal measure up of ns adrenal gland.

Causes that enlargement the adrenal glands:

Congenital Adrenal HyperplasiaAdrenal HemorrhageAdrenal Neuroblastoma

The length (L) of a gland is characterized as a maximum cephalocaudal dimension (either coronal or sagital plane).

The broad is characterized as ns maximum thickness of uma of ns limbs.

Adapted from reference 14

Materials and method

In this ultrasonographic estude 146 consecutive patient (62 boys e 84 girls; typical age, 7 years; açao range, 2-15 years) to be included.

Children com cystic fibrosis, acute abdominal pain, with previous appendectomy and below the age of 2 years (because of an obstacle in performing a examination) to be excluded.

In 120 crianças the appendix era visualized.


Ultrasonographic anteroposterior measurement of the appendix.

Casues that enlarged appendix:

AppendicitisCystic fibrosisLymphoid hypertrophy (Immune deficiency, vírus enteritis)Intraluminal gas, mucus of faecesMucocele

Bladder volume

Material and methodA bruta of 3376 crianças were recruited in this ultrasonographic study.

The bruta number of patient does not include up come the total number of patient in this pesquisar because not todos age-subgroups were contained in a table.

The bladder intervalo was calculated primeiro by measuring ns maximum length (L) of ns urinary bladder top top the vertical scan, which ser estar obtained from the neck to ns fundus of a bladder.Depth (D) foi ~ measured, perpendicular to the o primeiro dia plane at ns level of a maximum area, in ns midline a partir de the anterior to depois de mucosal surface of ns bladder.The width (W) era taken perpendicular come D in ~ its mid-point.Bladder tonelada as presented in the table was recalculated em ~ the encontro in this aprender using a equation para an ellipsoïd: L×D×W (in centimetres) x 0.523.

Adapted a partir de reference 17

Bladder wall thickness

Materials and method:

A bruta of 3376 crianças were recruited.Bladder wall surface thickness was só measured when the residual bladder volume was cystitisdysfunctional voidingurethral valves

The bladder wall surface thickness era measured from a zoomed picture of ns transverse aircraft of a voided bladder at 3 points: anterolaterally, laterally e posterolaterally (figure). Ns mean ser estar taken para these three measurements.

The bladder wall thickness depends on the degree of pour it until it is full of a bladder and the capacity.

Therefore a bladder wall thickness is expressed as the bladder volume wall thickness table of contents (BVWI).


Adapted from reference 13

Materials e method

The pesquisar population had 128 patient (57 male and 71 female).Of this population 86 were between ns ages of 1-19 year (only encontro pertaining to this selection is presented).

Bowel wall surface thickness era measured top top transverse sections and comprised the mucosa, lamina propria, muscularis mucosa, submucosa, and muscularis propria.

Ultrasonographic measure up of wall thickness of terminal ileum in a 12-year-old boy with cystic fibrosis.

Causes of tiny bowel wall surface thickening:

Henoch Schönlein PurpuraCrohn"s diseaseLymphoma
Adapted em ~ reference 13

In ns same aprender the wall thickness of ns colon era measured.

Causes of colon wall surface thickening:

Inflammatory bowel condition (IBD)Hemolytic Uremic syndromePseudomembranous colitis

Common bile Duct

Adapted from reference 8

Materials e method

One hundred e seventy-three continuous children, referred ao abdominal ultrasonography not concerned hepato-biliary pathology, were had in this study (100 boys and 73 girls), lei range 1 day - 13 years (median açao 5.0 years).

The diameter of a common velhice duct was ≤ 3.3 mm in all patients.

Transverse ultrasonographic image of common mel duct e surrounding anatomy


Adapted a partir de reference 10

Materials e method

Ultrasonographic gallbladder tom assessment (length x broad x elevation x 0,52) was performed in 50 preterm (mean GA 31.7 ± 2.5 weeks e mean birth weight 1556 ± 441 g) and 46 term babies (mean GA 38.3 ± 1.2 weeks 3253 ± 440 g).

Data were accumulated soon after ~ delivery and at 6-h fasting, and at the agir of 5-7 days at 3-h and 6-h fastening following regulatório milk feeding.

Causes of little gallbladder:

Biliary atresiaFatty enjoy the meal


Adapted a partir de reference 22

Anterior recess

Materials and method

Ultrasonographic study of 58 healthy and balanced children and 105 crianças with unilateral transient synovitis (age range 1.7-12.8 years).The crianças were examined in a supine position com hips in neutral position.

Adapted em ~ reference 22

The children ser estar examined in the supine position com hips in neutral position.The antes de joint capsule ser estar measured, including both of its materials (the anterior e posterior layer).Also the anterior contour of ns joint casule is evaluated.

There was durante statistically significant correlation between açao and thickness that the anteriormente joint capsule.

A distinction >2mm or one effusion >2mm is considered abnormal.

Shape of the border of the anterior joint capsule

The anterior contour of a joint capsule can be evaluated.Ultrasonographic measurement of the anterior joint capsule. Both anterior (a) and posterior (p) layer have the right to be identified.

Causes of hip share effusion:

Transient synovitisSeptic arthritisJuvenile Idiopathic Arthritis
Adapted são de reference 23

Graf"s classification

kind I:Mature centred i know well joint.Well emerged acetabular roof.Angular or slightly dull bony rim.Type II:Centred joint.Deficiently developed acetabular roof Rounded bony rimType III:Decentred joint.Poorly arisen acetabular roof. Flattened bony rim.

Click here ao article on Developmental Dysplasia of the Hip.

Normal ultrasonographic anatomia of a hip share in the coronal aircraft (a).Measurement the α angle (b)


Adapted são de reference 6

Preterm and Term babies

Material and methodsUS aprender in 261 healthy newborn infants.

Craniocaudal measurement of the kidneys foi ~ determined com ultrasonography.

Ultrasonographic measurement of the length of a neonatal kidney.

Note ns increased echogenicity that the rim parenchyma contrasted to liver parenchyma.This is usual at this age.

Adapted em ~ reference 16


Materials and method

Two hundred e three patients were included in this ultrasonography study.

Patients to be excluded if lock had naquela history of malignancy, usar of steroids, top urinary tract abnormality, VUR greater than harrow I, urological surgical treatment or if sonography of the kidney era regarded as abnormal.

On average ns left kidney foi ~ 1.9 mm bigger than ns right kidney.

Causes the enlarged kidneys:

Duplicated collecting systemNephritis (Infectious e non-infectious)Leukemia e LymphomaARPKCD

Ultrasonographic measure of ns length of der kidney.

Adapted a partir de reference 17

Kidney volume

Material and method

A rude of 3376 crianças were recruited in this ultrasonographic study.Kidney tonelada was calculation using the ellipsoid formula as length x width x Depth x 0.523.

In this study, the bruta renal intervalo was derived by including together both kidney volumes but there is no mentioning a separate values ao the left e right kidney.The values in the table were acquired by dividing the bruta renal volume by two.

Ultrasonographic measure of ns length, broad an depth of naquela kidney.

Kidney volume is calculate using a ellipsoid formula as length x width x Depth x 0.523.

Adapted from reference 18

Thickness of the wall of ns collecting system

Material e MethodsUltrasonographic study of 48 renal collecting equipment in 24 healthy crianças (age variety 3 dia to 12.6 years).The collecting sistema could be identified in tudo kidneys and its wall thickness varied in between 0 (not visible) and 0.8 mm.

Thickening of a wall ≥ 1mm is be considered as abnormal.

Causes of wall thickening:

urinary street infectionintermittent dilatation (e.g. Vesicoureteric reflux)dilatation in a recent past.


Craniocaudal dimension of ns liver on the midclavicular line era measured with ultrasonography (figure).

Causes that hepatomegaly

LeukemiaStorage diseases(neonatal) Hepatitis
Adapted a partir de reference 6


Material e methods

US study in 261 healthy newborn infants. Craniocaudal dimension of ns liver on a midclavicular line ser estar determined com ultrasonography.

Adapted a partir de reference 7


Material e methodsUS estude in 307 healthy and balanced children.

Mesenteric lymph nodes

Adapted a partir de reference 15

Materials e method

In this retrospective study in 61 crianças (36 boys and 25 girls, mean agir 10.7 years, selection 1.1-17.3 years) quem underwent non-contrast ab CT examination for evaluation of suspected or known renal stones abdominal lymph node size ser estar evaluated.

It is assumed the these CT findings have the right to be extrapolated to ultrasonography.

Enlarged mesenteric lymph nodes (short axis > 5 mm) were found in 33 (54%) of ns 61 children.The bulk of a enlarged mesenteric lymph nodes were found in a right reduced quadrant (88%).Based on your findings ns authors state that: using naquela short-axis diameter that >8 mm might be naquela more suitable definition para mesenteric lymphadenopathy in children.

False-positive rate ao enlarged mesenteric lymph nodes com varying lymph node threshold size is checked out in the table.

Pathologically enlarged lymph nodes:

Intestinal lymphomaLymphogenic metastasisSpecific enteritis (e.g. TBC)


Adapted from reference 20

Material and Method

Ultrasonographic measure of uterine e ovarian intervalo was performed in 178 healthy girls.

Causes that enlarged ovaries:

Precocious pubertyOvarian torsionPolycystic ovarian diseaseTeratoma/dermoid

Ovarian tonelada is calculation using ns formula:

Length x width x elevation x 0.523.


Adapted a partir de reference 12

Materials and method

Two hundred e seventy-three patients (differentiation in sex no mentioned) were contained in this retrospective ultrasonography study.

The preferably anteroposterior (AP) diameters of the head, body e tail of ns pancreas to be measured ~ above transverse/oblique images.

Echogenicity ser estar low in 27 (10%), isoechoic in 145 (53%) and high in 101 (37%).

The preferably anteroposterior (AP) diameters of a head, body e tail of ns pancreas were measured ~ above transverse/oblique images.

Causes the enlargement of the pancreas:

Traumatic pancreatitisViral pancreatitisDrug-induced pancreatitis

Portal vein

Adapted a partir de reference 9

Materials e method

One hundred and fifty children aged 0-16 years, there is no clinical evidence of liver or minister disease, which were referred porque o abdominal ultrasound were consisted of in the study.

Measurement of portal vein diameter

The portal vein is visualized in the longitudinal axis são de the splenomesenteric junction to the liver hilum.

The biggest anteroposterior diameter is measured at the localização where the hepatic artery the cross the portal vein.


Adapted from reference 6

Preterm and term babies

Material e methods

US estude in 261 healthy and balanced newborn infants. Craniocaudal measurement of the spleen era determined com ultrasonography.

Adapted a partir de reference 11


Materials and method

These ultrasonography studies made up of 512 healthy children - 238 boys e 274 girl - com ages ranging from 1 work (full-term neonate) to 17 years and 96 premature birth infants com gestational ages são de 25-35 weeks.

None the the children had a problem the could impact spleen size.Ultrasonography era performed using traditional probes matched for age.

Causes of splenomegaly:

Portal hypertensionLeukemiaSystemic epidemic (e.g. EBV or CMV)Hematologic disease (e.g. Spherocystosis or thalassemia)Storage diseases

The measure of spleen length is the optically maximal distance -ideally at the hilum - top top the longitudinal coronal view between ns most superomedial and the most inferolateral point out (figure).

Subarachnoid space

Adapted em ~ reference 5

The subarachnoid space ser estar assessed using ultrasonography in 278 full-term healthy and balanced Chinese infants. Dimensions were bring away in the coronal airplane at a level of a foramen the Monro (figures)

The typical values in the table were calculated em ~ the equations offered in ns article, ns 95% trust levels were derived são de the graphs in ns article.

Ultrasonographic coronal representation of ns subarchnoid an are at the level of the foramen the Monro.

SCW = Sino Cortical WidthCCW = Cranio Cortical WidthIHW = inter Hemispherical Width.

Causes of enlargement of ns subarachnoid spaces:

BESSI (benign enlargement the subarachnoid room of infancy)Brain atrophyDural sinus thrombosis


Adapted from reference 19

Materials e method

A rude of 344 boys em ~ different ethnic cultures were studied.There were no differences in between ethnic teams or between right e left testicle.

Causes of enlargement of the testis:

LeukemiaPrecocious pubertyTesticular torsionEpididymo-orchitis

Testicular intervalo was calculate using ns formula:

Length x broad x height x 0.523.


Adapted são de reference 22

Materials and method

Mediastinal ultrasonography was performed in 151 infants (79 boys e 72 girls).

All crianças were healthy and had no stress factors affecting your thymic size.

Causes of enlarged thymus:

Rebound thymus hyperplasiaT-cell lymphoma the leukemiaThymomaLangerhans cabinet histiocytosis

The preferably transverse diameter, best lobe anteroposterior, left lobe anteroposterior.Perpendicular to the transverse plane the longest craniocaudal measurement (length) is assessed.

The thymic index was calculated by multiplying the transverse diameter (a) by the largest sagittal area (b).


Adapted são de reference 1-3

Material e methods

US aprender in 100 English newborn babies in the first week the life, a subset the iodine enough European crianças from naquela study of 5709 children, age 6-15 years 1 and a subset that German crianças from a study the 252 crianças aged 2-4 years 2 <1-3>.

The thyroid intervalo was a sum of a volumes the both lobes.

The volume of the isthmus era not included.

Causes that enlargement of thyroid gland:

Thyroiditis (Hashimoto, Graves)Multinodular goiter

The intervalo of der thyroid lobe is calculated by a formula of one ellipsoid (length x width x height x 0,52).


Adapted a partir de reference 20

Material and Method

Ultrasonographic measure up of uterine e ovarian volume was perform in 178 healthy and balanced girls.

Causes of enlargement of uterus:

Precocious pubertyHydro(hemato)metrocolpos

Uterine intervalo was calculated using ns formula:

Length x width x elevation x 0.523.


Adapted são de reference 4

Adapted a partir de an ultrasonographic pesquisar of 1483 neonates, gestational agir range 25-42 weeks.

The neonates were examinded at day 3.All neonates com perinatal asphyxia, epidemic of the central nervous system, intracranial hemorrhages of craniospinal malformation to be excluded.

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Causes of ventriculomegaly:

Congenital (e.g. Holoprosencephaly)Obstructive hydrocephalusCommunicating hydrocephalusAtrophy

The antes de horn width and the ventriculo-hemspheric ratio is measure up on the coronal view at ns level of a foramen of Monro.