Skip to main content
Erschienen in: Pediatric Radiology 8/2019

16.05.2019 | Original Article

Normative values for ultrasound measurements of the female pelvic organs throughout childhood and adolescence

verfasst von: Leah A. Gilligan, Andrew T. Trout, James G. Schuster, Beth I. Schwartz, Lesley L. Breech, Bin Zhang, Alexander J. Towbin

Erschienen in: Pediatric Radiology | Ausgabe 8/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

Normative data from pelvic ultrasonography (US) of the pediatric female reproductive organs are outdated and limited by sample size.

Objective

The purpose of this study was to report normal uterine and ovarian volumes and endometrial stripe thickness in children and young adults and throughout the menstrual cycle in post-menarchal adolescents.

Materials and methods

Females ages 0 through 20 years who underwent pelvic US between January 2010 and May 2014 were identified. After excluding patients with pelvic and/or endocrine pathology, nomograms of uterine and ovarian volumes and endometrial thickness by age year were created. Data for patients ages 12 years and older with a recorded day of last menstrual period were used to create additional nomograms of volumes/thickness throughout the menstrual cycle. Student’s t-tests and linear regression were performed to assess differences in measurements between groups and association of volumes/thickness with age.

Results

During our study period, 5,647 patients underwent 6,953 pelvic US examinations. After further review, 907 examinations from 889 patients were included (mean age: 11.3±6.0 years). Mean pelvic US volumes (cm3) per organ were 25.5±27.0 (uterus), 4.5±4.7 (right ovary) and 4.0±4.1 (left ovary). Mean endometrial thickness was 4.5±3.7 mm. Right ovarian volume was significantly larger than the left (P=0.0126). Uterine volume, ovarian volume and endometrial thickness were significantly associated with age (P-values<0.0001). Plots of mean organ measurements with respect to week of menses are provided.

Conclusion

We report normal volumes of the uterus and ovaries and endometrial stripe thickness measured by pelvic US throughout childhood and adolescence with reference to the menstrual cycle. These values are significantly associated with age and vary visually by menstrual cycle week.
Literatur
1.
Zurück zum Zitat Bridges NA, Cooke A, Healy MJ et al (1993) Standards for ovarian volume in childhood and puberty. Fertil Steril 60:456–460CrossRefPubMed Bridges NA, Cooke A, Healy MJ et al (1993) Standards for ovarian volume in childhood and puberty. Fertil Steril 60:456–460CrossRefPubMed
2.
Zurück zum Zitat Cohen HL, Shapiro MA, Mandel FS, Shapiro ML (1993) Normal ovaries in neonates and infants: a sonographic study of 77 patients 1 day to 24 months old. AJR Am J Roentgenol 160:583–586CrossRefPubMed Cohen HL, Shapiro MA, Mandel FS, Shapiro ML (1993) Normal ovaries in neonates and infants: a sonographic study of 77 patients 1 day to 24 months old. AJR Am J Roentgenol 160:583–586CrossRefPubMed
3.
Zurück zum Zitat Griffin IJ, Cole TJ, Duncan KA et al (1995) Pelvic ultrasound measurements in normal girls. Acta Paediatr 84:536–543CrossRefPubMed Griffin IJ, Cole TJ, Duncan KA et al (1995) Pelvic ultrasound measurements in normal girls. Acta Paediatr 84:536–543CrossRefPubMed
4.
Zurück zum Zitat Haber HP, Mayer EI (1994) Ultrasound evaluation of uterine and ovarian size from birth to puberty. Pediatr Radiol 24:11–13CrossRefPubMed Haber HP, Mayer EI (1994) Ultrasound evaluation of uterine and ovarian size from birth to puberty. Pediatr Radiol 24:11–13CrossRefPubMed
5.
Zurück zum Zitat Ivarsson SA, Nilsson KO, Persson PH (1983) Ultrasonography of the pelvic organs in prepubertal and postpubertal girls. Arch Dis Child 58:352–354CrossRefPubMedPubMedCentral Ivarsson SA, Nilsson KO, Persson PH (1983) Ultrasonography of the pelvic organs in prepubertal and postpubertal girls. Arch Dis Child 58:352–354CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Orsini LF, Salardi S, Pilu G et al (1984) Pelvic organs in premenarcheal girls: real-time ultrasonography. Radiology 153:113–116CrossRefPubMed Orsini LF, Salardi S, Pilu G et al (1984) Pelvic organs in premenarcheal girls: real-time ultrasonography. Radiology 153:113–116CrossRefPubMed
8.
Zurück zum Zitat Cesario SK, Hughes LA (2007) Precocious puberty: a comprehensive review of literature. J Obstet Gynecol Neonatal Nurs 36:263–274CrossRefPubMed Cesario SK, Hughes LA (2007) Precocious puberty: a comprehensive review of literature. J Obstet Gynecol Neonatal Nurs 36:263–274CrossRefPubMed
9.
Zurück zum Zitat Euling SY, Herman-Giddens ME, Lee PA et al (2008) Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings. Pediatrics 121(Suppl 3):S172–S191CrossRefPubMed Euling SY, Herman-Giddens ME, Lee PA et al (2008) Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings. Pediatrics 121(Suppl 3):S172–S191CrossRefPubMed
10.
Zurück zum Zitat McDowell MA, Brody DJ, Hughes JP (2007) Has age at menarche changed? Results from the national health and nutrition examination survey (NHANES) 1999-2004. J Adolesc Health 40:227–231CrossRefPubMed McDowell MA, Brody DJ, Hughes JP (2007) Has age at menarche changed? Results from the national health and nutrition examination survey (NHANES) 1999-2004. J Adolesc Health 40:227–231CrossRefPubMed
11.
Zurück zum Zitat Badouraki M, Christoforidis A, Economou I et al (2008) Sonographic assessment of uterine and ovarian development in normal girls aged 1 to 12 years. J Clin Ultrasound 36:539–544CrossRefPubMed Badouraki M, Christoforidis A, Economou I et al (2008) Sonographic assessment of uterine and ovarian development in normal girls aged 1 to 12 years. J Clin Ultrasound 36:539–544CrossRefPubMed
12.
Zurück zum Zitat Bridges NA, Cooke A, Healy MJ et al (1995) Ovaries in sexual precocity. Clin Endocrinol 42:135–140CrossRef Bridges NA, Cooke A, Healy MJ et al (1995) Ovaries in sexual precocity. Clin Endocrinol 42:135–140CrossRef
13.
Zurück zum Zitat Hagen CP, Mouritsen A, Mieritz MG et al (2015) Uterine volume and endometrial thickness in healthy girls evaluated by ultrasound (3-dimensional) and magnetic resonance imaging. Fertil Steril 104:452–459 e452CrossRefPubMed Hagen CP, Mouritsen A, Mieritz MG et al (2015) Uterine volume and endometrial thickness in healthy girls evaluated by ultrasound (3-dimensional) and magnetic resonance imaging. Fertil Steril 104:452–459 e452CrossRefPubMed
14.
Zurück zum Zitat Herter LD, Golendziner E, Flores JA et al (2002) Ovarian and uterine sonography in healthy girls between 1 and 13 years old: correlation of findings with age and pubertal status. AJR Am J Roentgenol 178:1531–1536CrossRefPubMed Herter LD, Golendziner E, Flores JA et al (2002) Ovarian and uterine sonography in healthy girls between 1 and 13 years old: correlation of findings with age and pubertal status. AJR Am J Roentgenol 178:1531–1536CrossRefPubMed
15.
Zurück zum Zitat Herter LD, Golendziner E, Flores JA et al (2002) Ovarian and uterine findings in pelvic sonography: comparison between prepubertal girls, girls with isolated thelarche, and girls with central precocious puberty. J Ultrasound Med 21:1237–1246CrossRefPubMed Herter LD, Golendziner E, Flores JA et al (2002) Ovarian and uterine findings in pelvic sonography: comparison between prepubertal girls, girls with isolated thelarche, and girls with central precocious puberty. J Ultrasound Med 21:1237–1246CrossRefPubMed
16.
Zurück zum Zitat Orbak Z, Sagsoz N, Alp H et al (1998) Pelvic ultrasound measurements in normal girls: relation to puberty and sex hormone concentration. J Pediatr Endocrinol Metab 11:525–530PubMed Orbak Z, Sagsoz N, Alp H et al (1998) Pelvic ultrasound measurements in normal girls: relation to puberty and sex hormone concentration. J Pediatr Endocrinol Metab 11:525–530PubMed
17.
Zurück zum Zitat Stanhope R, Adams J, Jacobs HS, Brook CG (1985) Ovarian ultrasound assessment in normal children, idiopathic precocious puberty, and during low dose pulsatile gonadotrophin releasing hormone treatment of hypogonadotrophic hypogonadism. Arch Dis Child 60:116–119CrossRefPubMedPubMedCentral Stanhope R, Adams J, Jacobs HS, Brook CG (1985) Ovarian ultrasound assessment in normal children, idiopathic precocious puberty, and during low dose pulsatile gonadotrophin releasing hormone treatment of hypogonadotrophic hypogonadism. Arch Dis Child 60:116–119CrossRefPubMedPubMedCentral
18.
19.
Zurück zum Zitat Garel L, Dubois J, Grignon A et al (2001) US of the pediatric female pelvis: a clinical perspective. Radiographics 21:1393–1407CrossRefPubMed Garel L, Dubois J, Grignon A et al (2001) US of the pediatric female pelvis: a clinical perspective. Radiographics 21:1393–1407CrossRefPubMed
20.
Zurück zum Zitat Ziereisen F, Guissard G, Damry N, Avni EF (2005) Sonographic imaging of the paediatric female pelvis. Eur Radiol 15:1296–1309CrossRefPubMed Ziereisen F, Guissard G, Damry N, Avni EF (2005) Sonographic imaging of the paediatric female pelvis. Eur Radiol 15:1296–1309CrossRefPubMed
21.
22.
Zurück zum Zitat Andolf E, Jorgensen C (1990) A prospective comparison of transabdominal and transvaginal ultrasound with surgical findings in gynecologic disease. J Ultrasound Med 9:71–75CrossRefPubMed Andolf E, Jorgensen C (1990) A prospective comparison of transabdominal and transvaginal ultrasound with surgical findings in gynecologic disease. J Ultrasound Med 9:71–75CrossRefPubMed
23.
Zurück zum Zitat Nazario AC, Nicolau SM, Nishimura CM (1991) Comparison between pelvic endovaginal and transabdominal sonography in the measurement of the uterus and ovaries. Rev Paul Med 109:51–54PubMed Nazario AC, Nicolau SM, Nishimura CM (1991) Comparison between pelvic endovaginal and transabdominal sonography in the measurement of the uterus and ovaries. Rev Paul Med 109:51–54PubMed
24.
Zurück zum Zitat Levine D, Brown DL, Andreotti RF et al (2010) Management of asymptomatic ovarian and other adnexal cysts imaged at US: Society of Radiologists in Ultrasound consensus conference statement. Ultrasound Q 26:121–131 Levine D, Brown DL, Andreotti RF et al (2010) Management of asymptomatic ovarian and other adnexal cysts imaged at US: Society of Radiologists in Ultrasound consensus conference statement. Ultrasound Q 26:121–131
25.
Zurück zum Zitat Langer JE, Oliver ER, Lev-Toaff AS, Coleman BG (2012) Imaging of the female pelvis through the life cycle. Radiographics 32:1575–1597CrossRefPubMed Langer JE, Oliver ER, Lev-Toaff AS, Coleman BG (2012) Imaging of the female pelvis through the life cycle. Radiographics 32:1575–1597CrossRefPubMed
27.
Zurück zum Zitat Saxton DW, Farquhar CM, Rae T et al (1990) Accuracy of ultrasound measurements of female pelvic organs. Br J Obstet Gynaecol 97:695–699CrossRefPubMed Saxton DW, Farquhar CM, Rae T et al (1990) Accuracy of ultrasound measurements of female pelvic organs. Br J Obstet Gynaecol 97:695–699CrossRefPubMed
29.
Zurück zum Zitat Kelsey TW, Ginbey E, Chowdhury MM et al (2016) A validated normative model for human uterine volume from birth to age 40 years. PLoS One 11:e0157375CrossRefPubMedPubMedCentral Kelsey TW, Ginbey E, Chowdhury MM et al (2016) A validated normative model for human uterine volume from birth to age 40 years. PLoS One 11:e0157375CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Nalaboff KM, Pellerito JS, Ben-Levi E (2001) Imaging the endometrium: disease and normal variants. Radiographics 21:1409–1424CrossRefPubMed Nalaboff KM, Pellerito JS, Ben-Levi E (2001) Imaging the endometrium: disease and normal variants. Radiographics 21:1409–1424CrossRefPubMed
31.
Zurück zum Zitat Fukuda M, Fukuda K, Andersen CY, Byskov AG (2000) Right-sided ovulation favours pregnancy more than left-sided ovulation. Hum Reprod 15:1921–1926CrossRefPubMed Fukuda M, Fukuda K, Andersen CY, Byskov AG (2000) Right-sided ovulation favours pregnancy more than left-sided ovulation. Hum Reprod 15:1921–1926CrossRefPubMed
32.
Zurück zum Zitat Shazly SA, Badee AY, Ali MK et al (2013) The laterality of ovulation: how far does it matter? Eur J Obstet Gynecol Reprod Biol 167:8–13CrossRefPubMed Shazly SA, Badee AY, Ali MK et al (2013) The laterality of ovulation: how far does it matter? Eur J Obstet Gynecol Reprod Biol 167:8–13CrossRefPubMed
33.
Zurück zum Zitat Check JH, Dietterich C, Houck MA (1991) Ipsilateral versus contralateral ovary selection of dominant follicle in succeeding cycle. Obstet Gynecol 77:247–249CrossRefPubMed Check JH, Dietterich C, Houck MA (1991) Ipsilateral versus contralateral ovary selection of dominant follicle in succeeding cycle. Obstet Gynecol 77:247–249CrossRefPubMed
34.
Zurück zum Zitat Potashnik G, Insler V, Meizner I, Sternberg M (1987) Frequency, sequence, and side of ovulation in women menstruating normally. Br Med J (Clin Res Ed) 294:219CrossRef Potashnik G, Insler V, Meizner I, Sternberg M (1987) Frequency, sequence, and side of ovulation in women menstruating normally. Br Med J (Clin Res Ed) 294:219CrossRef
35.
Zurück zum Zitat Queenan JT, O'Brien GD, Bains LM et al (1980) Ultrasound scanning of ovaries to detect ovulation in women. Fertil Steril 34:99–105CrossRefPubMed Queenan JT, O'Brien GD, Bains LM et al (1980) Ultrasound scanning of ovaries to detect ovulation in women. Fertil Steril 34:99–105CrossRefPubMed
36.
Zurück zum Zitat Fleischer AC, Kalemeris GC, Machin JE et al (1986) Sonographic depiction of normal and abnormal endometrium with histopathologic correlation. J Ultrasound Med 5:445–452CrossRefPubMed Fleischer AC, Kalemeris GC, Machin JE et al (1986) Sonographic depiction of normal and abnormal endometrium with histopathologic correlation. J Ultrasound Med 5:445–452CrossRefPubMed
37.
Zurück zum Zitat Randall JM, Fisk NM, McTavish A, Templeton AA (1989) Transvaginal ultrasonic assessment of endometrial growth in spontaneous and hyperstimulated menstrual cycles. Br J Obstet Gynaecol 96:954–959CrossRefPubMed Randall JM, Fisk NM, McTavish A, Templeton AA (1989) Transvaginal ultrasonic assessment of endometrial growth in spontaneous and hyperstimulated menstrual cycles. Br J Obstet Gynaecol 96:954–959CrossRefPubMed
Metadaten
Titel
Normative values for ultrasound measurements of the female pelvic organs throughout childhood and adolescence
verfasst von
Leah A. Gilligan
Andrew T. Trout
James G. Schuster
Beth I. Schwartz
Lesley L. Breech
Bin Zhang
Alexander J. Towbin
Publikationsdatum
16.05.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Radiology / Ausgabe 8/2019
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-019-04419-z

Weitere Artikel der Ausgabe 8/2019

Pediatric Radiology 8/2019 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.