PEDİATRIK YAŞ GRUBUNDA KARACİĞER, DALAK VE BÖBREK BOYUTLARININ ULTRASONOGRAFİK NOMOGRAMLARI

ÖZETAmaç: Bu çalışmada Türk toplumunda 0-15 yaş arası çocuklarda karaciğer, böbrekler ve dalak standart boyutlarının ultrasonografik olarak yaş, cinsiyet, boy ve kiloya göre hesaplanması amaçlandı. Gereç ve Yöntem: Çalışma için sistematik veya organospesifik hastalığı olmayan 302 sağlıklı çocuğun karaciğer için sağ lob organ derinliği, böbrekler için longütudinal uzunluk, genişlik ve hilus-korteks derinliği, dalak için poller arası maksimum uzunluk ve hilus düzeyinde maksimum genişlik ölçümleri yapıldı. Ayrıca çocukların yaş, cinsiyet, boy ve kilo değerleri kaydedildi. Bulgular: Karaciğer derinliği ortalamasının 100,49±18.46, sağ böbrek longitudinal uzunluğu ortalamasının 80.04 ±14.33, sol böbrek longitudinal uzunluğu ortalamasının 81.22±14.92, dalak longitudinal uzunluğu ortalamasının ise 81.24±15.51 olduğu gözlendi. Bulunan değerler ile somatik morfometrik parametreler (boy, kilo) ve yaş arasındaki lineer korelasyon değerleri anlamlı bulundu. Ölçülen her bir parametre için iki cinsiyet arasında anlamlı fark saptanmadı. Sonuç: Karaciğer, dalak ve böbrek boyutlarının yaşa, boy ve kiloya bağlı değiştiği normal değerlerin bu özelliklere göre modifiye edilmesi gerektiği görüldü. Her yaş grubunda Türk çocuklarda normal sınırlardaki değerler literatürde yer alan çalışmalarla büyük oranda benzerlik gösteriyordu.

Anahtar Kelimeler:

ultrasonografi, karaciğer, dalak, böbrek boyutları

ULTRASONOGRAPHİC NOMOGRAMS OF LIVER, SPLEEN AND KIDNEY DIMENSIONS IN PEDIATRIC AGE GROUP

ABSTRACTAim: The aim of this study was to determine the standard dimensions of liver, kidneys and spleen in children aged 0-15 years in Turkey by ultrasonography according to age, sex, height and weight.Material and Method: 302 healthy children without systemic or organ specific disease were measured for right lobe organ depth for liver, longitudinal length for kidney, width and depth of hilus-cortex, maximum length of pole for spleen and maximum width of hilus for spleen. In addition, age, gender, height and weight values of the children were recorded.Results: Mean liver depth was 100.49 ± 18.46, right renal longitudinal length was 80.04 ± 14.33, left renal longitudinal length was 81.22 ± 14.92, and splenic longitudinal length was 81.24 ± 15.51. Linear correlation values between somatic morphometric parameters (height, weight) and age were found to be significant. There was no significant difference between the two genders for each parameter measured. Conclusion: It was seen that liver, spleen and kidney dimensions changed according to age, height and weight and normal values should be modified according to these characteristics. The normal range values of Turkish children in each age group were highly similar to the studies in the literature.

Keywords:

ultrasonography, liver, spleen, kidney,

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1. Sippel S, Muruganandan K, Levine A, Shah S. Use of ultrasound in the developing world. International journal of emergency medicine. 2011;4(1):1-11.
2. Dhingra B, Sharma S, Mishra D, Kumari R, Pandey RM, Aggarwal S. Normal values of liver and spleen size by ultrasonography in Indian children. Indian pediatrics. 2010;47(6):487-92.
3. Rosenberg H, Markowitz R, Kolberg H, Park C, Hubbard A, Bellah R. Normal splenic size in infants and children: sonographic measurements. AJR American journal of roentgenology. 1991;157(1):119-21.
4. Carpentieri U, Gustavson L, Leach T. Liver size in normal infants and children. Southern medical journal. 1977;70(9):1096-7.
5. Niederau C, Sonnenberg A, Müller J, Erckenbrecht J, Scholten T, Fritsch W. Sonographic measurements of the normal liver, spleen, pancreas, and portal vein. Radiology. 1983;149(2):537-40.
6. Walker WA, Mathis RK. Hepatomegaly. An approach to differential diagnosis. Pediatric Clinics of North America. 1975;22(4):929-42.
7. Mimouni F, Merlob P, Ashkenazi S, Litmanovitz I, Reisner SH. Palpable spleens in newborn term infants. Clinical pediatrics. 1985;24(4):197-8.
8. Behrman A, Kliegman K, Jenson L. Nelson text book of pediatrics, 19th edn, Saunders. Elsevier; 2011.
9. Rosenbaum DM, Korngold E, Teele RL. Sonographic assessment of renal length in normal children. American Journal of Roentgenology. 1984;142(3):467-9.
10. Larson DB, Meyers ML, O'Hara SM. Reliability of renal length measurements made with ultrasound compared with measurements from helical CT multiplanar reformat images. American Journal of Roentgenology. 2011;196(5):W592-W7.
11. Achim O, Vestemean I. Ultrasound relation between the dimension of the spleen and left kidney in children. Acta Medica Transilvanica. 2010;2(4):251-2.
12. Atalabi OM, Umeh E, Adeniji-Sofoluwe AT, Adekanmi AJ. Normal sonographic dimensions for liver, spleen and kidneys in healthy South West Nigerian children-a pilot study. West African Journal of Ultrasound. 2015;16(1).
13. Blane C, Bookstein FL, DiPietro M, Kelsch R. Sonographic standards for normal infant kidney length. American journal of roentgenology. 1985;145(6):1289-91.
14. Holloway H, Jones T, Robinson A, Harpen M, Wiseman H. Sonographic determination of renal volumes in normal neonates. Pediatric Radiology. 1983;13(4):212-4.
15. Konuş O, Ozdemir A, Akkaya A, Erbaş G, Celik H, Işik S. Normal liver, spleen, and kidney dimensions in neonates, infants, and children: evaluation with sonography. AJR American journal of roentgenology. 1998;171(6):1693-8.
16. da Rocha SMS, Ferrer APS, de Oliveira IRS, et al. Determinação do tamanho do fígado de crianças normais, entre 0 e 7 anos, por ultrassonografia. Radiologia Brasileira. 2009;42(1):7-13.
17. Amatya P, Shah D, Gupta N, Bhatta NK. Clinical and ultrasonographic measurement of liver size in normal children. The Indian Journal of Pediatrics. 2014;81(5):441-5.
18. Thapa N, Shah S, Pradhan A, Rijal K, Basnet S. Sonographic assessment of the normal dimensions of liver, spleen, and kidney in healthy children at tertiary care hospital. Kathmandu University Medical Journal. 2015;13(4):286-91.
19. Özdikici M. The relationship between splenic length in healthy children from the Eastern Anatolia Region and sex, age, body height and weight. Journal of ultrasonography. 2018;18(72):5.
20. Megremis S, Alegakis A, Koropouli M. Ultrasonographic spleen dimensions in preterm infants during the first 3 months of life. Journal of ultrasound in medicine. 2007;26(3):329-35.
21. Vujic A, Kosutic J, Bogdanovic R, Prijic S, Milicic B, Igrutinovic Z. Sonographic assessment of normal kidney dimensions in the first year of life—a study of 992 healthy infants. Pediatric Nephrology. 2007;22(8):1143-50.
22. Otiv AS, Mehta K, Ali U, Nadkarni M. Sonographic measurement of renal size in normal Indian children. Indian pediatrics. 2012;49(7):533-6.
23. Zuzuárregui J-RP, Mallios R, Murphy J. The effect of obesity on kidney length in a healthy pediatric population. Pediatric Nephrology. 2009;24(10):2023-7.
24. Megremis SD, Vlachonikolis IG, Tsilimigaki AM. Spleen length in childhood with US: normal values based on age, sex, and somatometric parameters. Radiology. 2004;231(1):129-34.
25. Rousan LA, Fataftah J, Al-Omari M, Hayajneh W, Miqdady M, Khader Y. Sonographic assessment of liver and spleen size based on age, height, and weight: evaluation of jordanian children. Minerva pediatrica. 2015.
26. Dittrich M, Milde S, Dinkel E, Baumann W, Weitzel D. Sonographic biometry of liver and spleen size in childhood. Pediatric radiology. 1983;13(4):206-11.
27. Holder LE, Strife J, Padikal TN, Perkins PJ, Kereiakes JG. Liver size determination in pediatrics using sonographic and scintigraphic techniques. Radiology. 1975;117(2):349-53.
28. Kim J-H, Kim M-J, Lim SH, Kim J, Lee M-J. Length and volume of morphologically normal kidneys in Korean children: ultrasound measurement and estimation using body size. Korean journal of radiology. 2013;14(4):677-82.
29. Friis H, Ndhlovu P, Mduluza T, et al. Ultrasonographic organometry: liver and spleen dimensions among children in Zimbabwe. Tropical Medicine & International Health. 1996;1(2):183-90.
30. Han BK, Babcock DS. Sonographic measurements and appearance of normal kidneys in children. American Journal of Roentgenology. 1985;145(3):611-6.
31. Assadamongkol K, Phuapradit P, Udompanich O, Varavithya W. Liver size and serum alkaline phosphatase in normal Thai school-aged children. Journal of the Medical Association of Thailand= Chotmaihet thangphaet. 1989;72:88-93.
32. Bacopoulos C, Papahatzi-Kalmadi M, Karpathios T, Thomaidis T, Matsaniotis N. Renal-vertebral index in normal children. Archives of disease in childhood. 1981;56(5):390-1.