TGU

Adrenal Gland

Normal Adrenal Gland Size as a Function of Age¹

Adrenal Gland: Sonographic features of normal adrenal glands versus age²

References:

  1. Oppenheimer DA, Carroll BA, Yousem S. Sonography of the normal neonatal adrenal gland. Radiology 146:157-160, January 1983 Diagram used with permission for this Website.

  2. Kangarloo H, Diament MJ, Gold RH, et al. Sonography of adrenal glands in neonates and children: changes in appearance with age. J Clin ultrasound. 1986; 14: 43-47. (modified)


Ovários e útero


Ovaries

Normal Ovarian Size as a Function of Age

*ovarian volume = 0.523 x length x width x depth (ml)

**> 80% ovaries seen over age 5 years2

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 correlated with Age5

References:

  1. Cohen HL, Shapiro MA, Mandel FS, Shapiro ML. Normal ovaries in neonates and infants: a sonographic study of 77 patients 1 day to 24 months old. AJR 1993; 160: 583-586.

  2. Orsini LF, Salardi S, Pilu G, et al. Pelvic organs in premenarcheal girls: real-time ultrasonography. Radiology 1984; 153:113-116.

  3. Cohen HL, Tice HM, Mandel FS. Ovarian volumes measured by US: bigger than we think. Radiology 1990. 177:189-92.

  4. Siegel MJ. Pediatric Sonography. Raven Press: New York. 1995. pp 438

  5. Ivarsson S-A, Nilsson KO, Persson P-H. Ultrasonography of the pelvic organs in prepubertal and postpubertal girls. Arch Dis Child 1983, 58, 352-354 (Used with permission from BMJ Publishing Group)

Ovaries Tanner Score

Ovaries & Uterus Correlated with Tanner Score¹

Upper Curve = uterine volume

Lower curve = ovarian volume

References:

  1. Ivarsson S-A, Nilsson KO, Persson P-H. Ultrasonography of the pelvic organs in prepubertal and postpubertal girls. Arch Dis Child 1983, 58, 352-354 (Used with permission from BMJ Publishing Group)

Ovarian Doppler

*flow detectable in 90% of adolescents

*arterial flow can be detected occasionally in twisted adnexa

References:

  1. Siegel MJ. Pediatric Sonography 2nd Edition. Raven Press, New York 1995, p 440-441, 458.

Renal Ultrasound

Renal Ultrasound Measurements

Graph of Normal Renal Volume vs Weight1

Length vs Age1


References:

  1. Han BK, Babcock DS. Sonographic measurements and appearance of normal kidneys in children. AJR 1985; 145(3):611-616. Tables used with permission.


Testicle

Normal Size of the Testicle as a Function of Age

Volume testicular

References:

  1. Cassorla Fg, Golden SM, Johnsonbaugh RD, et al. Testicular volume during early infancy. J Pediatrics 1981; 99:742-743.

  2. Daniel WA Jr, Feinstein RA, Howard-Peebles P, et al. Testicular volumes of adolescents. J Pediatrics 1982; 101:1010-1012.

  3. Krone KD, Carroll BA. Scrotal ultrasound. Radiol Clin North Am 1985; 23:121-139.

  4. Siegel MJ, Pediatric Sonography, 2nd Ed. 1995 Raven Press

  5. Atkinson GO, Patrick LE, Ball TI, et al. The normal and abnormal scrotum in children: evaluation with color doppler sonography. AJR 1992;158:613-617

  6. Kaplan SA. Clinical pediatric & adolescent endocrinology. W.B. Saunders. p. 307-308

Graph of Testicular Volume by Chronological Age¹

Comment:

Testicular volume < 5 ml can be considered as infantile¹

Reference:

  1. Rundle AT, Sylvester PE. Measurement of Testicular Volume. It's application to assessment of maturation, and its use in diagnosis of hypogonadism. Arch Dis Child 37:514-517, 1962 (Permission requested from publisher: BMJ Publishing Group)

Testicle-Tanner Score

Testicular Volume correlated with Tanner Score ¹

(based on external physical measurement of length and width)

References:

  1. Daniel WA, Feinstein RA, Howard-Peebles P, Baxley WD. Clinical and laboratory observations. Testicular volumes of adolescents. J Peds Dec 1982:1010-1012 (Modified: Permission requested from publisher)



Testicular Doppler

Doppler Flow in Testes*¹

Testicular Volume

< 1 cc

> 1 cc

% detectable color flow

70 (capsular arteries)

40 (central arteries)

+/- 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 etc²

References:

  1. Atkinson GO, Patrick LE, Ball TI, et al. The normal and abnormal scrotum in children: evaluation with color doppler sonography. AJR 1992;158:613-617

  2. Siegel MJ, Pediatric Sonography, 2nd Ed. 1995 Raven Press

Uterus

Normal Uterine Appearance and Dimensions

*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

References:

  1. Nussbaum AR, Sanders RC, Jones MD. Neonatal uterine morphology as seen on real-time US. Radiology 1986; 160: 641-643.

  2. Ivarsson SA, Nilsson KO, Persson PH. Ultrasonography of the pelvic organs in prepubertal and postpubertalgirls. Arch Dis Child. 1983; 58:352-354. (Used with permission from BMJ Publishing Group)

  3. Sample W, Lippe B, Gyepes M. Gray scale ultrasonography of the normal female pelvis. Radiology 1977; 125:477-483.

  4. Orsini LF, Salardi S, Pilu G, et al. Pelvic organs in premenarcheal girls: real-time ultrasonography. Radiology 1984; 153: 113-116.

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Uterus-Tanner Score

Ovaries & Uterus Correlated with Tanner Score¹

Upper Curve = uterine volume

Lower curve = ovarian volume

References:

  1. Ivarsson S-A, Nilsson KO, Persson P-H. Ultrasonography of the pelvic organs in prepubertal and postpubertal girls. Arch Dis Child 1983, 58, 352-354 (Used with permission from BMJ Publishing Group)


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 thickness*²

*(ages 1 day to 19 years)

Site of measurement:

Sagittal plane: posterior inferior wall (away from rectum)

Transverse plane: lateral to trigone

References:

  1. Haken berg OW, Ryall RL, Langlois SL, et al: The estimation of bladder volume by sonocystography. J Urol 1983; 130:249-251

  2. Jequier S, Rousseau O. Sonographic measurements of the normal bladder wall in children. AJR 149:563-566, Sep 1987

FONTE: https://www.ohsu.edu/school-of-medicine/diagnostic-radiology/pediatric-radiology-normal-measurements