How is an ultrasound of the abdominal organs performed on children: how to prepare for the examination and what does it show? Ultrasound examination of a child Norms for the size of abdominal organs in children
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Ultrasound of the abdominal cavity of a child is a non-invasive (non-penetrating) technique for diagnosing the most important internal organs of children. Moreover, this procedure can be done not only for adult children, but also for newborns.
This pediatric diagnostic test is carried out quickly (15-20 minutes) and without any pain. The procedure itself does not cause complications, which means it can be done even for infants.
In this article we will talk about how to prepare children for this procedure, how it goes and how the results are deciphered. We will also talk about how much it costs to do such an ultrasound.
For children over three years of age, ultrasound examination of the abdominal organs done according to the following indications:
- Any childhood infectious disease of the abdominal organs (including mononucleosis).
- Pain in any area of the abdomen.
- Children have a feeling of persistent heaviness in the right hypochondrium.
- Belching sour or bitter, bad breath.
- Girdle pain in internal organs.
- Jaundice.
- Constipation or flatulence.
- Injury to internal organs (even against the background of complete well-being after injury).
- To monitor the effectiveness of prescribed therapy for internal organs.
For newborns and children under 3 years of age Ultrasound examination of the abdominal organs is prescribed for the following indications:
- routine diagnosis of congenital anomalies in newborns;
- with frequent regurgitation (in the absence of diseases of the baby’s brain);
- children who experience a decrease in normal monthly weight gain after birth;
- if pathologies such as pylorospasm and pyloric stenosis are suspected;
- with frequent and profuse loose stools, which are not associated with the baby having an intestinal infection or fever.
But how much does the procedure itself cost?? According to data for 2016, in state medical institutions such diagnostics can be performed for 1,500 rubles. In private clinics, its price is higher and amounts to 2000 rubles + transcript 50 rubles.
What can be determined by ultrasound?
Using an ultrasound examination of a child’s abdominal organs, many diseases can be detected:
- Acute or chronic hepatitis.
- Stagnation of blood in the liver.
- Various liver tumors (including cysts).
- Stones, strictures, narrowings and various anomalies of the biliary tract.
- Enlarged size of the spleen, additional lobes in it, residual effects of spleen injury, infarction.
- The presence of so-called free fluid in the abdominal region (which most often in children indicates peritonitis).
- An increase in the size of the retroperitoneal lymph nodes.
- Circulatory disorders of the abdominal aorta and its individual branches.
- Clinical signs of pancreatitis.
Preparation for the procedure
Preparing a child for an ultrasound examination of the abdominal organs is very specific. At the same time, the preparation of children has two options: for children over three years old and, accordingly, under three years old. The most important thing is to prepare in terms of nutrition.
A child over three years old should take three days before the procedure limit consumption following products:
- any legumes;
- black bread (only second-grade white bread can be given, but in limited quantities);
- raw fruits and vegetables;
- any sparkling water, including kvass (you can only use plain water);
- any sweets and juices;
- fresh flour products (can be replaced with yesterday’s baked goods, but within reasonable limits);
- sauerkraut;
- any dairy products (including cottage cheese).
At the same time, children are allowed to eat any porridge cooked in water (except dairy), boiled chicken or rabbit meat. In addition, you are allowed to eat no more than one hard-boiled egg per day.
It is also important to note that ultrasound examination of the abdominal cavity in children over three years of age is in all cases carried out after a six-hour fast. And an hour or two before the procedure prohibited from consuming even liquid.
Preparing babies
Preparation for ultrasound examination of children under three years of age is carried out after complete elimination of complementary foods and a subsequent 4-hour fast. For such young children, it is not necessary to follow a three-day diet.
However, on the day of the procedure, the child should limit the consumption of fruit and vegetable purees. Only porridge and small amounts of lean meat are allowed. The last consumption of liquid is allowed one and a half hours before diagnosis.
Particular attention should be paid to preparation if there is a suspicion of aortic disease and its examination should be carried out extremely scrupulously. In this case, it is very important to prevent the baby’s intestines from overflowing with gases.
The fact is that due to intestinal gases, the intestines themselves eventually swell, thereby obscuring the abdominal part of the aorta and all incomplete organs. Moreover, eating immediately before the procedure increases blood circulation to the pancreas.
Because of this, the gallbladder is partially or completely emptied, releasing a large amount of bile, which will distort the final ultrasound result. Therefore, it is recommended that children with flatulence be given Espumisan or Bobotik tablets at an age-appropriate rate the day before the procedure.
Ultrasound results
Interpretation of liver examination results:
- size of the right lobe (norm): 60 millimeters (every subsequent year the norm becomes +6 mm larger);
- dimensions of the left lobe (normal): 33 – 40 millimeters;
Interpretation of the results of examination of the gallbladder:
- standard size for 2-5 years: 50.5 x 17 mm (length and width);
- standard size for 6-8 years: 61 x 18 mm;
- standard size for 9-11 years: 64 x 23 mm;
- standard size for 12-16 years: 65 x 24 mm;
- We can talk about normal values of wall thickness if it does not exceed 1 millimeter.
Interpretation of pancreatic examination results:
- normal dimensions according to the head (mm) x body (mm) x tail (mm) scheme for a child under 1 month of age: 10-14 x 6-8 x 10-14 mm;
- 1 month – 1 year: 15-19 x 8-11 x 12-16 mm;
- 1 year – 5 years: 17-20 x 10-12 x 18-22 mm;
- 6 years – 10 years: 16-20 x 10-13 x 18-22 mm;
- 11 years - 18 years: 20-25 x 11-14 x 20-24 mm.
Interpretation of the results of examination of the spleen:
- Newborns: 40 x 38 mm;
- 1 – 3 years: 68 x 50 mm;
- 3 – 7 years: 80 x 60 mm;
- 8 – 12 years: 90 x 60 mm;
- 12 – 15 years: 100 x 60 mm;
- v. lienalis is normally no more than 9 mm;
- The S of the spleen should be in the range of 40 to 45 centimeters.
Interpretation of kidney examination results:
- height 50 cm: 48 (length) x 22 (width) mm;
- height 60 cm: 50 x 23 mm;
- height 80 cm: 62 x 25 mm;
- height 100 cm: 70 x 26 mm;
- height 120 cm: 77 x 28 mm.
Ultrasound of the baby's abdomen (video)
Diagnostic features
There are some nuances to this procedure. So, if you suspect so-called pyloric stenosis, you should take a bottle of water or mixture with you to the ultrasound. The liquid is useful for provocative tests of the abdominal organs (they are also called stress tests).
When specifically diagnosing the contractility of the biliary tract, you need to take yogurt, any chocolate, or a few bananas at your appointment. These foods may be required during the procedure for the same provocative tests as in the case of pyloric stenosis.
You should also tell your doctor in advance what medications your child is taking. These can be cardiac or intestinal (to affect peristalsis) medications. You should definitely notify the diagnostician whether your child is taking antispasmodics.
But in general, if your child is taking antispasmodic medications, it is advisable to stop them the day before the procedure. They quite distort the results of the examination and can be used before it is carried out only in cases where the child needs them for serious reasons.
The price of the procedure itself in public medical institutions is 1,400 rubles. In private clinics the price is about 2,500 rubles. The figures given correspond to prices for 2016.
The ultrasound research method is very informative. An abdominal ultrasound of a child includes examination of the liver, spleen, pancreas and gallbladder. All of these organs are involved in the digestion process, so it is necessary to identify possible problems associated with digestion as early as possible and help the child cope with them as quickly as possible.
Ultrasound waves reflecting from organs make it possible to provide accurate information about the size and density of organs, structure, and wall thickness. Ultrasound diagnostics has been used in pediatric practice for more than 20 years and is a safe examination even for children.
Indications for ultrasound of the abdominal cavity.
A referral for an ultrasound examination of the abdominal organs of a child is given by a pediatrician or gastroenterologist. Infants undergo an ultrasound at 1-1.5 months to identify any pathology or make sure that everything is in order.
If your child is bothered by pain or discomfort in the epigastric region, in the upper abdomen, or a feeling of heaviness in the right or left hypochondrium.
Worrying pain in the abdomen, a feeling of bitterness in the mouth, yellowness of the sclera of the eyes. Having such complaints, it is necessary to undergo an ultrasound examination of the abdominal organs.
Preparing a child for an ultrasound of the abdominal organs.
An ultrasound scan of the abdominal cavity requires preparation in order to reduce gas formation, which can distort the picture of the examination.
To do this, you need to exclude: legumes, brown bread, milk, apples, soda, sweets (cakes, pastries). You can also take enzymes (Festal, Mezim-Forte, Microzim, Creon.) 2-3 days before the ultrasound. The examination is performed on an empty stomach 8-10 hours after eating.
For infants, everything is much simpler; the procedure is carried out immediately before the next feeding. Breast milk is digested in 3 hours, formula in 3.5 hours, fruit puree and vegetables take much longer to digest, so it is not recommended to give them.
Until the digestion process is completed in the stomach, the organs are in an altered state, for example, the pancreas is enlarged due to blood flow, and the gallbladder is in a contracted state, which prevents the doctor from correctly assessing them and determining their size.
How it is carried out.
The child must be dressed so that the upper abdomen is easy to open; during the examination, the baby will lie on the couch, and the doctor will apply a special gel to the sensor and move it slowly over the abdomen.
After the examination, the gel is easily removed without leaving any traces. During the examination, the doctor will ask you to turn on your side or hold your breath. All this is necessary to obtain a clearer image on the monitor screen.
Ultrasound of the liver in children.
The liver is one of the most important organs in a child’s body. The function of the liver is to neutralize and remove almost all toxic substances, to control energy balance (the liver pumps blood about 350 times per day).
What can be determined by ultrasound of a child’s liver? The structure is homogeneous or heterogeneous, attention is paid to the diameter of large vessels, size, existing changes (granularity, cysts, fatty degeneration). This method is, first of all, safe, painless and informative.
Liver pathology in children.
Causes of liver pathology in children.
- Inflammatory processes, intoxication,
- Metabolic disorders, unhealthy diet.
- Benign enlargement of liver cells (excess vitamin A), sepsis.
- Congenital fibrosis, multicystic disease, biliary cirrhosis.
- Leukemia, malignant tumors, metastases.
- Impaired outflow of blood and bile, obstruction of the bile ducts, venous stenosis or thrombosis, Wilson's disease, cirrhosis of the liver .
Liver sizes in children according to ultrasound:
Right lobe–1 year –60 mm, each subsequent year +6 cm, 15 years –100 mm, 18 years –120 mm.
Left lobe–1 year –33-40 mm, each subsequent year +2 mm, 15 years –50 mm.
Normally, the liver parenchyma should be homogeneous.
Enlarged liver (Hepatomegaly) in newborns and children under 7 years of age, age-related hepatomegaly is observed, in which the lower border protrudes from under the edge by 1 - 2 centimeters. If hepatomegaly is diagnosed in older children, this is a pathology.
Heterogeneous liver structure
Diffuse changes in the liver parenchyma give a picture of a heterogeneous structure. A normal liver has a homogeneous structure, there is no compaction or tissue deformation. A diffuse changes liver tissue occurs when the structure of the organ is disrupted while its function is preserved or is accompanied by severe liver failure with frequent bleeding and increasing intoxication.
The causes are various diseases (hepatitis, lipomatosis) and are characterized by changes in the structure of the entire tissue; there is also a so-called general disease associated with metabolic disorders.
Liver granularity.
Found on liver ultrasound in children grain, may also indicate some kind of pathology.
Fine-grained liver structure determined in a healthy child.
Coarse grain develops during pathological processes (hepatitis, toxic damage, diabetes mellitus) there is a proliferation of connective tissue structures, and it also happens when there is swelling of the intercellular space with such a pathology, the granularity increases. When the causative factors are eliminated, the structure can be restored.
Condition of blood vessels.
During an ultrasound of the liver in children, the condition of large vessels plays an important role, namely, the portal vein is assessed; its normal diameter ranges from 8 to 12 millimeters; if it is more than 14 millimeters, this indicates the onset of portal hypertension. This occurs in infectious and viral diseases. The vascular network of biliary patency is also visualized.
Fatty degeneration (hepatosis).
Fat is deposited in the liver lobules; there are several stages of fatty degeneration.
Initial stage - the size of the liver is slightly increased, the edge is slightly rounded, and islands of granularity appear in the liver tissue.
In the second stage, the liver is enlarged, diffuse changes in the organ tissue appear, tissue compaction appears, and small focal changes appear.
In the third stage, the structure of the liver is significantly densified (echogenicity is increased) and the vessels are poorly visible.
The fourth stage of cirrhosis - there is a change in size, uneven contours, rounded edges, poor elasticity, an increase in the diameter of the veins.
Liver cyst in a child.
Finding a cyst during an ultrasound of a child’s abdominal organs is a fairly common occurrence, especially in newborns. It is quite rare in older children.
The liver cyst itself in a child is a benign formation that looks like a cavity filled with liquid; the diameter can reach 230 millimeters. Inside there is a colorless liquid, but quite often it can have a brown or yellowish-green tint.
Cysts develop during the intrauterine formation of the fetus, so they are common in newborns and, as a rule, they resolve on their own by the first year of life or even before the baby is born.
Most often they have a round shape and are found in the lower part of the liver, in the right lobe or on the surface of the organ itself. A liver cyst in a child is asymptomatic, although ruptures with peritonitis are possible. Cysts can be congenital or acquired. Acquired rather rare phenomenon; their causes are:
- Injuries to the liver and other organs
- Surgical interventions
- Liver abscess
A newborn with a liver cyst may have:
- Lack of weight.
- Nausea, vomiting.
- Bloating.
- Poor appetite.
- Abdominal asymmetry
Cysts up to 3 centimeters found during liver ultrasound in children cannot be operated on; such neoplasms are usually treated with medications and special diets. Polycystic liver disease requires constant monitoring by a pediatrician. When the cyst reaches an impressive size, it is removed surgically; in the severe stage of polycystic disease, the newborn may need a liver transplant.
Ultrasound of the gallbladder in a child.
The gallbladder is a reservoir for the accumulation of bile. It has the shape of a “drop” or “pear”, and is filled with olive-colored bile; the gallbladder is located at the bottom of the liver. Bile takes part in digestion, namely in the digestion of fats, stimulates the intestines to work well, serves for the so-called “hygiene” of the intestines, both to suppress putrefactive processes and to fight protozoa and worms. Therefore, any dysfunction of this organ disrupts the digestive processes. As you know, ultrasound is the most effective and safe examination method. It is necessary to do an ultrasound of the child’s gallbladder if:
- Pain in the right hypochondrium.
- Suspicion of inflammation of the gallbladder (cholecystitis).
- Abdominal injuries.
- Presence of bitterness in the mouth.
- Feeling of constant nausea or nausea with vomiting, especially bile.
The preparation is the same as for an ultrasound of the abdominal cavity of a child: foods that cause gas formation (brown bread, peas, beans, cabbage, soda, cakes), spicy, salty, smoked foods are excluded. For better visibility on the device screen, you can take enzymes (Festal, Mezim-Forte, Creon) and carminatives (Espumizan, Dill water).
The procedure is carried out on an empty stomach, dinner the day before no later than 19:00, which should be light; In the morning, before the examination, you should not drink water. As for infants, it is better for them to be examined before the next feeding. And for older children, you can take food with you. If there is a suspicion of the presence of stones or acute pain appears, in this case no special preparation is carried out.
A diagnostician conducting an ultrasound examination of a child’s gallbladder evaluates the shape, wall thickness, size and volume of the gallbladder. The size of the gallbladder in children depends on its age:
From 2-5 years, length 30-50 mm, width 13-24 mm;
6-8 years, length 45-75, width 10-20;
9-11 years, length 35-64, width 11-30;
12-16 years, length 40-80, width 12-27;
If the gallbladder has a drop-shaped shape, the walls are not enlarged, there is no stagnation of bile, there are no kinks, sand, and especially stones, then this is a normal variant.
- The diagnosis of Discension can be made if there are such deviations in the bladder: there is stagnation of bile, that is, the motility (work) of the gallbladder is disrupted and the tone of the bladder itself and the bile ducts is reduced, the neck of the gallbladder is bent, the walls of the bladder are thickened.
- The diagnosis of Cholelithiasis (Cholelithiasis) is made when there are stones in the cavity and bile ducts and a change in the position of the body of the organ; they move noticeably inside the gallbladder and give an acoustic shadow, in this case the boundaries of the organ become uneven, and thickening of the walls is diagnosed.
- Diagnosis Polyps, they are on the walls of the organ and have a round shape; do not give an acoustic shadow and are detected by chance, since they do not manifest themselves in any way.
Ultrasound of villageszenki in children.
The spleen is part of the circulatory system; the main function of the spleen is to fight microorganisms that have penetrated into the body, which worsen the general well-being of the child. Serves as a place for the accumulation of unnecessary blood cells, stores blood elements, and takes part in the integration of proteins.
How to prepare a child for an ultrasound of the spleen?
Preparation, as for an ultrasound of the abdominal organs of a child, the examination is carried out on an empty stomach (with a break of about 7-8 hours), before the ultrasound you should not drink water for 3 hours, do not take foods that increase gas formation for 3 days.
The ultrasound examination of the spleen in children is painless and takes about 5 minutes. The examination is carried out while lying on your back, the doctor moves the sensor in the area of the left hypochondrium, then lying on your side. After the examination, the diagnostician issues a conclusion with which it is necessary to contact the pediatrician about further treatment or further diagnostics and identifying the cause of its increase.
Norms of the spleen in children according to ultrasound.
Age Length (mm) Width (mm)
Newborn 38 40
1-3 years 62 30
3-5 years 76 42
5-7 years 88 43
7-10 years 92 46
10-15 years 102 51
If, according to ultrasound of the spleen in children, the size differs from the norm, then this indicates its enlargement.
The spleen is an important organ; it is a source of immune cells-lymphocytes. Human immunity depends on the spleen. More often, an enlarged spleen is caused by infections (hepatitis, infectious mononucleosis, typhoid fever), oncology, and a disease associated with blood disease with liver damage. It can also be increased with anemia and rickets, and even in newborns with congenital cytomegalovirus infection.
Ultrasound of the pancreas in children.
It is necessary to undergo this examination if the child has complaints about:
- Pain and discomfort in the left side with radiation to the left shoulder, back area;
- Abnormal stool, indigestible food in the child’s stool;
- Sudden weight loss;
- Intense thirst;
- Suspicion of acute or chronic pancreatitis;
- Heaviness, bloating after eating;
- Changes in blood and urine tests;
Ultrasound of the pancreas in children is performed in the supine position. The doctor applies a special gel to the abdomen, which is used to make the sensor glide better. Since the pancreas is located deep, to better view it, the child will be asked to take a deep breath and hold his breath; Also, if necessary, the examination may be carried out on the right side or you may be asked to stand on your feet. The duration of the procedure itself is within 5-10 minutes. Attention is also drawn to the contours of the organ; normally they are clear and even.
Dimensions of the pancreas according to ultrasound in a child.
Age Head Body Tail
Up to 1 month 11 7 11
1 month - 1 year. 16 9 13
1-5 years 18 11 19
6-10 years 17 11 19
11-18 years old 21 12 21
If ultrasound echogenicity is increased, this indicates chronic pancreatitis or a tumor, as well as fatty tissue degeneration.
If the echogenicity is reduced, then this indicates an acute form of pancreatitis.
If diffuse changes are detected during an ultrasound of the pancreas in children, this indicates that changes have occurred in the entire organ, and not in a separate part of it, which serves as an additional signal to the doctor for further examination of the child. This can occur due to circulatory disorders of the organ, liver disease, gallbladder, bile ducts.
If there is an increase in tissue density, increased echogenicity, but the gland remains normal in size or has a slight decrease in size, then most likely you have suffered inflammation in the gland or a metabolic disorder has occurred (when normal tissue is replaced by connective tissue).
Ultrasound examination of the liver and other internal organs allows us to identify structural pathology and also measure them. Normal liver sizes in children vary widely, depending on height, body weight and type of constitution. Increased length or width of the organ indicates the presence of pathology.
Features of the structure and functioning of the liver in children
The liver is an unpaired parenchymal organ, which is located mainly in the right hypochondrium and occupies a small part of the left. In a newborn baby, this organ accounts for up to 4.5% of the total body area and weighs on average about 120-140 grams. This is explained by the fact that in the prenatal period it performed a hematopoietic function, which ceases after birth.
By about 10 months of life, the weight of the “digestive gland” doubles, and by 3 years it triples, which is 360-400 grams. It is also important to remember that in infants and preschool children, the lower edge of the organ normally protrudes slightly (2-3 cm) from under the costal arch, so the doctor can easily palpate it during the examination.
In adults and children, the liver consists of 4 lobes:
- tailed, square.
- right, left;
They are separated from each other by ligaments, grooves and gates - the place in the organ where the vessels enter and exit from (portal, vena cava, hepatic veins, arteries). The gallbladder “lies” on the visceral surface, the main duct of which flows into the lumen of the duodenum. The liver itself consists of hepatocytes, which form hepatic beams surrounded by small capillaries and bile ducts.
The main functions of the parenchymal organ in childhood:
- synthesis of bile, which is an important component of the digestive process;
- participation in carbohydrate, protein and fat metabolism;
- neutralization of poisonous, toxic substances;
- production of proteins, some factors of the blood coagulation system;
- formation of reserves of vitamins, glucose in the form of glycogen;
- participation in hormonal metabolism.
The size of a child’s liver correlates with his height, body weight and, to a lesser extent, with age. They can increase with congenital anomalies of the hepatobiliary tract, against the background of acute infectious pathology, as a result of tumor damage.
Children's liver is richer in small vessels, and its cells are just finishing differentiation, which causes easy development of stagnation in it against the background of a banal ARVI or acute intestinal infection.
Organ sizes in children of different ages
Age-related changes in the liver mainly concern its size; the structure and location of the organ does not change. To do this, measure the length, width of the left and right lobes. There are several options for tables of normal liver sizes in children: by age, height.
The right lobe of a one-year-old baby is within 60 mm, after which every year it increases on average by 5-6 mm. The anteroposterior size of a child at 12 months normally does not exceed 40 mm, and each subsequent year increases by 2 mm.
Approximate liver parameters depending on age:
- 3-4 years: right lobe – 70-75 mm, left – 44-46 mm.
- 6-7 years: right lobe – 85-90 mm, left – 50-54 mm.
- 9-10 years: right lobe – 100-110 mm, left – 60-62 mm.
- 14-15 years: right lobe – 110-115 mm, left – 65-67 mm.
- 18 years old: right lobe – 120 mm, left – 70 mm.
Table of norms for abdominal ultrasound in children by age
Normal ultrasound readings
Modern domestic sonologists in their practice use special tables according to Dvoryakovsky or Pykov, which reflect the normal sizes of the lobes and help determine whether an organ is enlarged or, conversely, pathologically reduced.
Norms for liver size in children according to ultrasound:
Height | Anteroposterior size of PD in mm | Anteroposterior LD size in mm |
50-69 cm | 48-66 | 29-37 |
70-99 cm | 62-82 | 39-42 |
100-129 cm | 87-93 | 43-48 |
130-159 cm | 99-109 | 49-58 |
160 cm and above | 119-126 | 54-62 |
When measuring this organ, do not forget about the influence of body mass index and body morphotype on its size. Thus, in tall, thin children, the length of both lobes may exceed the normal average. In hypersthenics, it can be elongated in an oblique size.
Disruption of the thyroid gland is a widespread phenomenon in our time. The thyroid gland reacts painfully and quickly to many unfavorable external factors. Timely diagnosis of this organ in children is very important, since it produces hormones necessary for the healthy development of the child.
An ultrasound of a child’s thyroid gland allows doctors to accurately diagnose and select the correct treatment for the disease.
In what cases is ultrasound diagnostics of the thyroid gland indicated?
Ultrasound of the thyroid gland will exclude the presence of functional and organic dysfunction and determine treatment tactics. It should be remembered that many endocrine diseases in the initial stages occur without visible symptoms.
Indications for performing an ultrasound of the thyroid gland in a child are the following:
- aggravated medical history of endocrine pathology;
- asthenic state (weakness, loss of strength, drowsiness);
- difficulty swallowing, feeling of a lump in the throat;
- unexplained weight loss or gain;
- increased irritability, excessive aggression, emotional lability;
- cardiac conduction disturbance;
- swelling in the neck area;
- difficulty breathing, apnea;
- decrease in body temperature;
- dry skin;
- bradycardia or tachycardia;
- tremor of hands, tongue.
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If even one of these symptoms occurs, you should consult a therapist and endocrinologist. The doctor will issue a referral for an ultrasound scan and prescribe the necessary tests.
Norms of the thyroid gland in children of different ages
Ultrasound of the thyroid gland is performed quickly. The child is placed on his back, the throat is lubricated with a special composition and the sensor is pressed against it. The conclusion will be ready in about 20 minutes. When assessing the results, the doctor focuses on the size of the gland, its location, the presence of nodes and other formations.
It is worth remembering that organ standards according to ultrasound may vary slightly depending on the gender and body type of the baby. The specialist determines the size of the thyroid gland in children and compares it with a regulated table.
Norms of ultrasound of the thyroid gland inchildren from 1 to 15 years:
Age (years) | Girls (cc) | Boys (cc) |
1 | 0,84+0,38 | 0,84+0,38 |
2 | 2+0,5 | 2+0,5 |
3 | 1,3 – 1,7 | 1,4 – 2 |
4 | 2 – 2,6 | 1,8 – 2,5 |
5 | 2 – 2,7 | 2,1 – 2,7 |
6 | 2,1 – 2,9 | 2,3 – 3 |
7 | 2,4 – 3,4 | 2,8 – 3,8 |
8 | 3,1 – 4,3 | 3,1 – 4,3 |
9 | 3,2 – 5 | 3,2 – 5,2 |
10 | 4 – 5,8 | 3,6 – 5,5 |
11 | 4,4 – 6,5 | 4,2 – 6 |
12 | 6,3 – 7,5 | 5 – 6,1 |
13 | 7 – 8 | 6,3 – 7,4 |
14 | 7,2 – 10 | 6,9 – 10 |
15 | 9 – 10,5 | 8,1 – 10,8 |
When performing an ultrasound for children, not only the size of the thyroid gland is taken into account, but also other parameters:
- Doppler scanning allows you to assess blood supply;
- Normally, the structure of the thyroid gland in children is homogeneous, with normal echogenicity;
- the boundaries of the organ's lobes are clear and well visualized.
Transcript of the study: what do deviations from the norm indicate?
During examination, deviations from the norm may be detected in children. If a child’s thyroid gland is reduced in size according to ultrasound, this indicates hypothyroidism, a process caused by a persistent decrease in thyroid hormones.
Hormone deficiency affects the development of organs and systems, as well as the intelligence of children. The extreme degree is cretinism. Babies are prone to constipation, bradycardia, low body temperature, edema, and developmental delays.
The opposite condition is hyperthyroidism. The disease is caused by excessive function of the thyroid gland and the production of large amounts of hormones - triiodothyronine and thyroxine. The child will lose weight for no reason and sleep restlessly. Symptoms of the disease also include tachycardia, severe nervousness, tearfulness, hyperactivity and convulsions.
An ultrasound scan of the thyroid gland may reveal other abnormalities:
- Hashimoto's thyroiditis (gradual destruction of the organ by one's own immune cells);
- oncological formations;
- nodular or diffuse toxic goiter;
- calcifications and cysts.
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Classmates
The presence of liver problems can be determined using conventional ultrasound diagnostics. This study allows you to assess the nature of the disease, obtain information about its course, and also prescribe and adjust treatment.
Every doctor specializing in ultrasound knows what you need to pay attention to first. So, the diagnostician evaluates the density and structure of the organ, and checks for pathological inclusions. In addition, be sure to look at the size of the liver on an ultrasound. The norm for adults is established for each of its lobes. Its oblique transverse size is also assessed. During the study, the doctor looks at the condition of the bile ducts and large vessels passing inside the liver.
Such an examination allows you to clarify the diagnosis if several different diseases are suspected. And the established norm for liver size by ultrasound makes it possible to determine the presence or absence of pathological changes in this organ or deviations from its physiological development at different ages in children.
Indicative figures
Specialists know what data to focus on when examining and making a diagnosis. But if you want to find out for yourself whether you have problems, then you need to know the normal size of the liver by ultrasound. It is also important to understand where this organ is located.
The lower edge of the right lobe is located in the area of the right costal arch. But in the presence of inflammatory diseases of the lungs and lower respiratory tract, it may shift slightly downward. But after resection of the lungs, with flatulence or tumors in the kidneys, it can rise.
In order to assess whether everything is in order with this organ, you need to know what the norm is for an ultrasound of the liver, what are the normal liver indicators. It should be of a homogeneous structure, without compactions, large veins should be easily visualized. Its contours should be clear and even. The gallbladder and ducts should also be visible. The inferior vena cava should be visualized along its entire length; its diameter can be from 9 to 15 mm. But the intrahepatic ducts should normally be difficult to trace.
Normal sizes
In addition to assessing the structure and location of the largest gland in the body, it is important to determine its other parameters. Thus, the normal size of the liver according to ultrasound should be as follows:
- left lobe - 6-8 cm;
- diameter - from 20 cm, an increase to 22.5 cm is permissible;
- right lobe - up to 12.5 cm;
— organ width (measurement from right to left) 23-27 cm;
- length (from the posterior blunt edge to the anterior sharp) varies from 14 to 20 cm.
The doctor should also evaluate the diameter of the hepatic common duct: normally it is 3-5 mm.
The doctor must know not only the norms for liver ultrasound. In addition, the gallbladder is also assessed. Its length in an adult is 7-10 cm, width 3-5, and diameter - 3-3.5 cm. The diameter of the bile duct should be 6-8 mm, the thickness of the walls of the organ - up to 4 mm, and the internal diameter of the lobar bile ducts – up to 3 mm. Normally there should be no formations in it.
Diagnosis in children
You can also assess the health of a child’s liver using ultrasound. It is important to understand that the size of this organ directly depends on the age of the child. So, the right lobe in babies under one year old should be 60 mm, it increases annually by 6 mm. At 15 years old, its size is 10 cm, and at 18 – about 12 cm. The right lobe in children under one year old should be 32-40 mm, it grows by 2 mm every year. At 15-18 years old, the size of this area should be about 5 cm. You should not try to diagnose the baby, even if you know what the normal size of the liver should be according to ultrasound. The protocol must be deciphered by a doctor. He will evaluate all indicators together and, if there are deviations, prescribe appropriate treatment.
It is also important to know that, regardless of age, it should be of a homogeneous structure and interrupted only by the portal vein and its branches. The bile ducts should also be visualized normally.
Conducting a survey
If you want the diagnosis to be performed as accurately as possible, then you need to prepare for an ultrasound. It is advisable to adhere to a certain diet for three days prior to the study. It is better to exclude high-calorie dishes and foods that cause increased gas formation. If you are overweight, have long-term constipation, or are bloated, it is better to do an enema before an ultrasound.
It is also advisable to drink adsorbent before diagnosis. This could be smecta, activated carbon or chamomile infusion.
The examination is usually carried out on an empty stomach. It is advisable not to eat for at least 8 hours before the ultrasound. If you feel thirsty, you are allowed to drink ordinary clean water.
To carry out the diagnosis, the patient must lie on his back. The doctor applies a special gel to the area of the right hypochondrium and moves the device’s sensor over it. The procedure is absolutely painless. Children can be examined not only in the supine position, but also on the right or left side; sometimes the doctor asks the child to be seated for better visualization of the picture.
Indications for examination
There are a number of problems for which ultrasound of the liver is one of the mandatory examinations. It is necessary to carry out such a diagnosis if you or your child:
- a jaundiced coloration of the whites of the eyes and skin appeared;
- pain occurs in the area of the right hypochondrium;
— the doctor suspects the presence of tumors in the liver;
— deviations in blood tests indicating pathology of the specified organ;
— there was an injury, and possible damage to the abdominal organs.
It is also recommended to periodically examine the liver when taking certain medications or drinking alcohol, or having chronic problems with this organ, gallbladder or pancreas.
If you know what the normal size of the liver should be according to ultrasound, you can even understand for yourself what is written in the examination report.
Possible problems
Any deviations from the norm are the reason that the doctor can make a specific diagnosis depending on the condition of the organ being examined. By performing an ultrasound, you can determine helminthic infestation (giardiasis in the liver), fatty degeneration of the gland, and see tumors and cysts. Also, with the help of this examination, diagnoses such as cirrhosis and hepatitis can be established. Each of these problems causes certain characteristic changes in the organ.
Diagnosis of diseases
With hepatitis, the liver begins to display waves worse; on the screen it looks quite dark. In addition, the disease is characterized by the fact that the edges of the organ are rounded, one or both of its lobes increase in size. Its structure becomes heterogeneous, and dilated portal and splenic veins are also visualized.
For example, knowing what the normal size of the liver should be according to ultrasound, you can establish a diagnosis such as cirrhosis. With this disease, the left lobe or the entire organ as a whole enlarges. In the later stages, on the contrary, it decreases due to the fact that cells begin to die. In addition, the density of tissues increases, their structure is heterogeneous. An ultrasound shows that the liver looks like a mosaic. This picture appears due to the presence of areas where tissues are restored. The edges of the liver become not smooth, but lumpy, and the diameter of the portal vein increases.
The helminthic infestation caused by Giardia is indicated by dark spots on the liver - these are places where worms are concentrated, and light areas are calcifications that appear in the later stages of the disease.
Tumors appear as dark (hypoechoic) or light (hyperechoic) spots. Also, with malignant formations, a dark rim is visible around them. Also, with tumors, the gallbladder is displaced and the lymph nodes become enlarged.
With fatty degeneration of the liver, increased echogenicity is noted, the picture on the ultrasound machine monitor is light, and the structure of the organ is motley. There is also an increase in the size of the organ, blurred contours, and rounded edges.
The liver is a huge gland, without which almost no process in the body can occur. For this reason, the condition of the organ is of vital importance. As soon as any pathological process begins to develop in it, the size of the liver also changes. At the initial stages, such changes can only be traced with the help of special diagnostic methods, and when the pathology reaches a more serious stage, the changes are visualized.
Liver size: normal
First, let's figure out together what the normal size of an organ should be. In its natural state, the lower edge of the right lobe of the liver is at the level of the right costal arch, protruding up to 6 cm along the midline, and 1-2 cm along the midclavicular line. Even if the organ is not enlarged, some prolapse is allowed. It is observed in bronchial asthma, massive pleurisy or asthmatic bronchitis.
If lung resection or flatulence is noted, the liver may be located high. Normally, the angle of the lower edge of the left lobe is about 30 degrees (maximum - up to 45 degrees), and the right lobe is 75 degrees or more. Today, experts say that in healthy people, the vertical oblique size of the right part of the liver is within 15 cm, and the height (craniocaudal size) is 8.5-12.5 cm. But the height of the left hepatic lobe is up to 10 cm. Thickness the right lobe is about 11-12.5 cm, the left lobe is up to 8 cm.
During an echogram, you can count on the following liver sizes:
- Length in the transverse plane – 14 – 19 cm (average – 17 cm);
- The length of the right lobe is 11-15 cm (on average 13 cm).
This difference in rates is due to differences in data in the medical literature itself. The indicators differ against the background of the use of differential techniques. Also, the size of the liver is directly affected by the height, age, constitution of a person and the depth of inspiration at which the echogram was taken. For this reason, in situations where the study records borderline dimensions, the conclusion cannot be categorical. It indicates a digital value (usually the vertical size of one of the lobes of the organ).
The structure of the liver parenchyma is normally homogeneous, fine-grained, and low-intensity. It visualizes the vascular network and bile ducts. The size of the veins of the organ is also of great importance. Normally, the diameter of the portal vein, according to various sources, ranges from 8 to 14 mm, and its branches - up to 1 mm.
Liver vein size
Of course, the correct parameters of the organ itself are of enormous importance, but you also need to pay attention to the condition of the veins. Very often, specialists have to conduct a general analysis of the state of the portal system. To do this, you need to evaluate the splenic vein and mesenteric superior vein. The first is located behind the pancreas, located ventral to the large vessels. The splenic vein has a lumen of about 8-10 mm on inspiration, and on exhalation it decreases to 4-6 mm. The diameter of the mesenteric superior vein on inspiration is 8-11 mm, and on exhalation – 4-6 mm.
It is especially important to correctly analyze the diameter of each of the portal vessels during deep and relaxed inspiration. The veins of this gland consist of main trunks - left, right and middle, as well as small branches. All of them have a smooth internal contour. At a distance of 2 cm from the mouths, the diameter of such vessels ranges from 6 to 10 mm. The structure of the inferior vena cava is tubular in nature, its diameter changes during breathing and is 2-2.5 cm.
Organ sizes in children of different ages
The normal parameters of this huge gland in children are determined using numerous formulas, including volumetric ones. They should be used by professionals in specialized medical centers. The fact is that the size of the liver at different ages in children can vary. The right lobe may be located up to the lower pole of the kidney; it can be lowered even lower in the presence of the Riedel lobe. In one-year-old babies, the left lobe most often extends beyond the midline during transverse scanning, and in older children - to the aorta.
With hepatomegaly, the left lobe of the organ in children reaches the spleen, slightly displacing it downward. Moreover, the organ itself is divided into three lobes: right, left, caudate. Each lobe has its own segments. The right lobe of the liver has posterior and anterior segments. The border between them is the right hepatic vein. The left lobe is divided by the left hepatic vein into lateral and medial segments. Each of these areas has a separate blood circulation.
The size of the liver in young children can vary under the influence of a large number of factors. The table will help you get acquainted with the average statistical indicators.
About ultrasound of the liver for a child
The liver is one of the most important organs in a child’s body. The liver neutralizes and removes almost all toxic substances, synthesizes biologically active substances and controls energy balance. To obtain all the necessary data or obtain reliable information about its condition and operation, it is necessary to do an ultrasound examination.
Ultrasound of the liver allows you to accurately determine the structure of the organ, diameter, size of existing changes, as well as analyze all deviations from the norm. Ultrasound of the liver is the safest, painless and informative research method. Most often, this is the only way to diagnose a disease.
Indications for liver ultrasound in children:
Preparation for ultrasound examination of the liver in children:
- Follow a certain diet for three days before the procedure;
- Do not eat foods rich in fiber;
- If you are overweight, you should give your child an enema the evening before the procedure;
- For two days, exclude from the diet all foods that contribute to gas formation, as well as exclude high-calorie foods;
- The procedure must be carried out on an empty stomach;
- Do not eat food 6 hours before the procedure;
- When thirsty, give only clean water to drink.
The liver ultrasound procedure is as follows:: the child lies on his back, the doctor applies a special gel to the area being examined, which helps the sensor slide over the skin and begins to carry out diagnostics.
If necessary, an ultrasound scan of the child’s liver can be performed not only on the back, but also on the right or left side, or in a sitting position.
Norms of liver ultrasound in children
When performing an ultrasound of the liver in children, the doctor pays special attention to the structure and homogeneity of the liver, pays attention to large vessels, small branches and bile ducts. The normal liver ultrasound for children is:
- Parenchyma of a homogeneous structure, which is interrupted by the portal vein with branches;
- All veins are clearly visible;
- The bile ducts are clearly visible.
- 1 year - 60 mm, each subsequent year + 6 mm;
- 15 years - 100 mm;
- 18 years - 120 mm.
- 1 year - 33-40 mm, each subsequent year 2 mm;
- 15 years - 50 + 1.5 mm;
- 18 years old - 50 + 1.5 mm.
Interpretation of ultrasound of the liver in a child
After receiving all the readings, the doctor begins interpreting the ultrasound of the child’s liver.. Ultrasound is the most important method for examining children who have diseases or suspicions of their presence in the digestive organs. Ultrasound for children is the most informative diagnostic method, which is widely used in outpatient practice, in specialized gastroenterological clinics and has no restrictions on its use.
After deciphering the ultrasound readings, it is possible to identify a large number of hidden diseases of the digestive system (ultrasound of the abdominal cavity is used for this) or any other diseases of the child’s body. The interpretation of the ultrasound and the doctor’s testimony help formulate the exact treatment tactics. This allows you to begin treating existing pathologies as soon as possible.
Get an ultrasound of the liver in our center
The equipment in our “Cradle of Health” center for liver ultrasound is constantly being improved, this allows us to make this method very informative and completely safe for a small patient. The liver is a very important organ that is responsible for the entire digestive system of the body. Keeping your liver healthy is key to your baby's health. and a guaranteed successful future life. If your child has indications for an ultrasound examination, contact our Cradle of Health center and experienced specialists will help you.
We have a large staff of highly qualified workers who are fluent in the technique of performing ultrasound procedures. After receiving the conclusion, our doctors will draw up a comprehensive treatment plan for existing diseases and give recommendations for changing the baby’s lifestyle. It is important to remember that the human digestive system is one of the most important systems of the body. Therefore, you should not postpone a visit to a consulting pediatrician (pediatrician) and the liver ultrasound procedure itself.
Advantages of performing an ultrasound of a child's liver in our center “Cradle of Health”:
- The procedure is performed by highly qualified doctors with extensive practical experience;
- The procedure is carried out using modern equipment;
- The procedure has no contraindications;
- The procedure is easy to perform, which is a huge plus for a small child;
- The procedure provides research data over time;
- The procedure is completely safe for the baby.
In our center you can easily and quickly undergo an ultrasound of a child’s liver, an ultrasound of a child’s head, with us you will receive high-quality ultrasound diagnostics and consultation with an experienced pediatrician.
Ultrasound diagnostic doctors at our center
Kazantseva Marina Anatolyevna
Functional diagnostics doctor. Candidate of Medical Sciences. Assistant professor.
Graduated from Kemerovo State Medical Institute with a degree in pediatrics. Has valid certificates in ultrasound diagnostics and functional diagnostics.
Having extensive experience and the highest qualifications, he never ceases to improve his professional knowledge.
Menzelintseva Svetlana Konstantinovna
Ultrasound diagnostics doctor. Total work experience 24 years
She graduated from the Karaganda State Medical Institute in 1992 with a degree in pediatrics.
She is a highly qualified specialist, attentive, quickly finds an approach to children, and enjoys great respect among her colleagues.
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