Gastrointestinal Measurements
Appendix
Normal Appendix
| Modality | Transverse Diameter (mm) | Appendiceal Wall Thickness (mm) |
|---|---|---|
| US | < 6 (& compressible) | Usually < 2 |
| CT | < 8 | < 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.
Gallbladder and Biliary Tract
Sonographic Measurements of the Normal Pediatric Gallbladder and Biliary Tract
Normal Gallbladder Measurements vs. Age 1
| Age (y) |
AP Diameter Mean (cm) |
AP Diameter Range (cm) |
Coronal Diameter Mean (cm) |
Coronal Diameter Range (cm) |
Length Mean (cm) |
Length Range (cm) |
Wall Thickness Mean (mm) |
Wall Thickness Range (mm) |
|---|---|---|---|---|---|---|---|---|
| 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. Age 1
| Age (y) | Common Hepatic Duct Size Mean (mm) | Common Hepatic Duct Size Range (mm) |
|---|---|---|
| 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 |
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.
GI Tract
Normal GI Tract: Wall Thickness on CT
| Organ | Wall Thickness (mm) |
|---|---|
| Stomach | 3 - 5 |
| Duodenum | ≤ 3 |
| Colon | ≤ 3 |
References:
- Desai RK, Tagliabue JR, Wegryn SA, Einstein DM. CT evaluation of wall thickening in the the alimentary tract. Radiographics 1991;11:771-783.
- 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.
Lymph Nodes on CT
Normal Abdominal Lymph Nodes in Adolescents and Adults:CT¹
| Location | Short Axis Nodal Diameter (mm) |
|---|---|
| Retrocural | ≤ 6 |
| Paracardiac | ≤ 8 |
| Mediastinal | < 10² |
| Gastrohepatic ligament | ≤ 8 |
| Upper paraaortic | ≤ 9 |
| Portacaval | ≤ 10 |
| Portahepatis | ≤ 7 |
| Lower paraaortic | ≤ 11 |
References:
- 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.
- 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 & Pancreatic Duct
Normal Pancreas Size as a Function of Age (Ultrasound)*¹
| Age | Head in cm (± 1 SD) | Body in cm (± 1 SD) | Tail in cm (± 1 SD) |
|---|---|---|---|
| < 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
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
References:
- Siegel MJ, Martin KW, Worthington JL. Normal and abnormal pancreas in children: US studies. Radiology 1987; 165:15-18. Table 1 used with permission.
- 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 Diameter (mm) |
|---|---|
| <10 years | 8.5 ± 2.7 |
| 10 to 20 years | 10 ± 2 |
References:
- Patriquin HB, Perreault G, Grignon A, et al. Normal portal venous diameter in children. Pediatric Radiol 1990; 20: 451-453.
- Weinreb J, Kumari S, Phillips G, Pochaczevsky R. Portal vein measurements by real-time sonography. AJR 1982; 139(3):497-499. In source: Siegel MJ. Pediatric Sonography. Raven Press: New York. 1995 . p 175.
Pylorus
Muscle thickness < 3.0 mm Pyloric channel length < 17mm
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:
- Blumhagen JD, Maclin L, Krauter D, Rosenbaum DM, Weinberger E. Sonographic diagnosis of hypertophic pyloric stenosis. AJR 1988; 150:1367-1370.
- Blumhagen JD, Weinberger E. Pediatric gastrointestinal ultrasounography. In : Ultrasound annual. New York: Raven Press; 1986; 99-140.
- 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.
- Rollins MD, Shields MD, Quinn RJM, et al. Pyloric stenosis: congential or acquired? Arch Dis Child 1989; 64:138-147.
Spleen
Ultrasound: Normal Spleen Size vs. 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
References
- 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.