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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 1. Rosenberg HK, Markowitz RI, Kolbeg H, et al. Normal splenic size in infants and children: sonographic measurements. AJR 1991; 157:119-121. Table modified and used with permission. American Journal of Roentgenology

Appendix
Normal Appendix Modality US CT Transverse Diameter (mm) < 6 (and compressible) <8 Appendiceal wall thickness (mm) Usually < 2 <2-4

References: 1. Kao SC, Smith WL, Abu-Yousef MM, et al. Acute appendicitis in children: sonographic findings. AJR 1989; 153:375-379. 2. Curtin KR, Fitzgerald SW, Nemcek AA, Hoff FL, Vogelzang RL. CT diagnosis of acute appendicitis: imaging findings. AJR 1995; 164:905-909. 3.

Sonographic Measurements of the Normal Pediatric Gallbladder and Biliary

Tract
Normal Gallbladder Measurements vs. Age1 AP Age (y) AP Coronal Diameter (cm) Mean 0.9 1.8 2.0 2.0 2.1 Coronal Wall Length Length Diameter Thickness (cm) Range 0.7-1.4 1.0-3.9 1.2-3.0 1.0-3.6 1.6-3.0 (cm) (cm) (mm) Mean 1.7 2.0 2.2 2.0 2.0 Wall Thickness (mm) Range 1.0-3.0 None 2.0-3.0 1.0-3.0 1.0-3.0

Diameter Diameter (cm) (cm) Mean Range 0.5-1.2 1.4-2.3 1.0-2.4 1.2-3.2 1.3-2.8

Mean Range

0-1 2-5 6-8 9-11 1216

0.9 1.7 1.8 1.9 2.0

2.5 4.2 5.6 5.5 6.1

1.3-3.4 2.9-5.2 4.4-7.4 3.4-6.5 3.8-8.0

Normal Sonographic Common Hepatic Duct Sizes vs. Age1 Common Hepatic Duct Common Hepatic Duct Size Size Age (y) (mm) Mean 0-1 2-5 6-8 9-11 12-16 1.3 1.7 2.0 1.8 2.2 (mm) Range 1.0 - 2.0 1.0 - 3.0 None 1.0 - 3.0 1.0 - 4.0

1. McGahan JP, Phillips HE, Cox KL. Sonography of the normal pediatric gallbladder and biliary tract. Radiology 1982; 144(4): 873-875. Tables modified and used with permission for this Website.

Normal GI Tract: Wall Thickness on CT

Organ Stomach Duodenum Colon

Wall Thickness (mm) 3-5 <3 <3

References: 1. Desai RK, Tagliabue JR, Wegryn SA, Einstein DM. CT evaluation of wall thickening in the the alimentary tract. Radiographics 1991;11:771-783. 2. Fisher JK. Abnormal colonic wall thickening on computed tomography. J comput assist tomogr 1983; 7: 90-97. In Siegel MJ. Pediatric Body CT. Lippincott Williams & Wilkins: Philadelphia. 1999. pp 204, 207, 219.

Normal Lymph Nodes Seen on CT


Normal Abdominal Lymph Nodes in Adolescents and Adults: CT1 Location Retrocural Paracardiac Mediastinal Short Axis Nodal Diamter(mm) <6 <8

<102 Gastrohepatic ligament <8 Upper paraaortic <9 Portacaval < 10 Portahepatis <7 Lower paraaortic < 11 References: < br>1. Dorfman RE, Alpern MB, Gross BH, Sandler MA. Upper abdominal lymph nodes:criteria for normal size determined with CT. Radiology 1991; 180:319-322. Table modified and used with permission for this Website. 2. Newman B, Arcement CM, Siegel MJ. CT and MR imaging of mediastinal masses in children. Current Concepts in Body Imaging at the Millenium. RSNA Syllabus 1999

Pancreas
Normal Pancreas Size as a Function of Age (Ultrasound)*1 Age Head in cm ( 1 Body in cm ( 1 Tail in cm ( 1

< 1 month 1 month to 1 year 1 to 5 years 5 to 10 years 10 to 19 years

SD) 1.0 0.4 1.5 0.5 1.7 0.3 1.6 0.4 2.0 0.5

SD) 0.6 0.2 0.8 0.3 1.0 0.2 1.0 0.3 1.1 0.3

SD) 1.0 0.4 1.2 0.4 1.8 0.4 1.8 0.4 2.0 0.4

*Measured as maximum AP on transverse scan The normal pancreatic duct is less than 2 mm in diameter 1. Siegel MJ, Martin KW, Worthington JL. Normal and abnormal pancreas in children: US studies. Radiology 1987; 165:15-18. Table 1 used with permission. Computed Tomography: The craniocaudal dimension of the head ranges from 2 to 6 cm, while the body and tail ranges from 2 to 4 cm.2 2. Siegel MJ. Pediatric Body CT. Lippincott Williams & Wilkins: Philadelphia. 1999. p 263.

Portal Vein
Normal Main Portal Vein Size on Ultrasound as a Function of Age Age Main Portal Vein Transverse

<10 years 10 to 20 years

Diameter (mm) 8.5 2.7 10 2

References: 1. Patriquin HB, Perreault G, Grignon A, et al. Normal portal venous diameter in children. Pediatric Radiol 1990; 20: 451-453. 2. Weinreb J, Kumari S, Phillips G, Pochaczevsky R. Portal vein measurements by realtime sonography. AJR 1982; 139(3):497-499. In source: Siegel MJ. Pediatric Sonography. Raven Press: New York. 1995 . p 175.

Pylorus
Pyloric channel length Muscle thickness < 17 mm < 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. References: 1. Blumhagen JD, Maclin L, Krauter D, Rosenbaum DM, Weinberger E. Sonographic diagnosis of hypertophic pyloric stenosis. AJR 1988; 150:1367-1370. 2. Blumhagen JD, Weinberger E. Pediatric gastrointestinal ultrasounography. In : Ultrasound annual. New York: Raven Press; 1986; 99-140. 3. O'Keefe FN, Stansberry SD, Swischuk LE, Hayden CK Jr. Antropyloric muscle thickness at US in infants: what is normal? Radiology 1991; 178: 827-830. 4. Rollins MD, Shields MD, Quinn RJM, et al. Pyloric stenosis: congential or acquired? Arch Dis Child 1989; 64:138-147.