Values Used in Ultrasound

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|LIVER |

Caudo ~ Cranial (CC) length = < 17 cm

Right Lobe

Caudo ~ Cranial (CC) length = < 16 cm
Anterio ~ Posterior (A ~ P) length = < 16 cm

Left Lobe

Width = < 11 cm
Anterio ~ Posterior (A ~ P) length = < 7 cm

Caudate Lobe

Caudo ~ Cranial (CC) length = < 8 cm (5 ~ 8 cm)
Anterio ~ Posterior (A ~ P) length = < 2.5 cm (2.0 ~ 2.5 cm)

Caudate lobe and Right lobe ratio (cc length of caudate lobe/ cc length of right lobe)

> 0.65= 93 % specific for cirrhosis
> 0.73= 99 % specific for cirrhosis

Normally Right lobe : Caudate lobe = 3 : 2

Pediatric liver size (up to 12 years) = < 11 cm

Portal vein

Normal diameter= < 13 mm
In portal hypertension= > 13 mm (> 15 mm is suggestive)

Common bile duct (CBD)

Normal diameter in adult= < 7 mm
In elderly (70 yr) & after cholecystectomy= 8 ~ 10 mm

(In case of older patient 1 mm dilatation with each decade after 40 years of age is normal)

Gallbladder

Length= 8 ~ 12 cm
Width= < 5 cm
Distended (mucocele)= Diameter > 5 cm
Normal wall thickness= < 3 mm

Liver Doppler
PSV of portal vein= 13 ~ 23 cm/sec

Congestive index (CI)=

Normal range of CI = 0.070 + 0.029 cm/sec
In cirrhosis CI= 0.171 + 0.075 cm/sec

Hepatic artery
Normal RI= 0.62 + 0.04
After meal = 0.66 + 0.78

|SPLEEN |

Length (L)= < 13 cm
Width (W)= < 6 cm
Anterio-posterior thickness (A ~P)= < 4 cm

Formula of measuring splenic weight = L X W X A~P X 0.43
(Lengths should be in cm and resultant weight unit expressed in gm)

Normal weight:
▪ Male= < 180 gm
▪ Female= < 150 gm

Splenomegaly (irrespective of sex):

▪ Mild= > 200 gm
▪ Moderate= > 500 gm
▪ Severe= > 2000 gm

Splenic index = L X A~P (expressed in no unit)
Normal range of splenic index= < 45 (no unit)

Pediatric spleen size measurement formula (up to 12 years):
Length (L)= 5.5 + (age in year X 0.31) expressed in cm

Example exercise for measuring pediatric spleen of a 10-year old kid: Length (L)= 5.5 + (10 X 0.31)
= 5.5 + 3.1
= 8.6 cm

Subjective assessment of splenomegaly:

▪ If the spleen is crossing the mid-pole of the left kidney, it assumes as enlarged. ▪ If spleen is going out of the window of ultrasound, it assumes as enlarged.

Normal diameter of the splenic vein= < 10 mm
In portal hypertension= > 10 mm

|PANCREAS |

Length (L)= 12.5 ~ 15.0 cm

Maximum anterio-posterior (A~P) diameter:

▪ Head= 3.0 cm
▪ Neck= 1.0 ~ 2.0 cm
▪ Body = 2.5 cm
▪ Tail= 2.0 cm

Normal diameter of pancreatic duct:

▪ Average= 2.0 mm
▪ Head= 3.0 mm
▪ Body= 2.1 mm
▪ Tail= 1.6 mm

Common site for the pancreatic mass= Head

|GIT |

Esophagus

Length (L)= 25 cm
Width (W)= 2.5 ~ 3.0 cm

Stomach

Four coats of the stomach wall:
a. Serous coat – peritoneum
b. Muscular coat – 3 layers (outer longitudinal, middle circular & inner oblique) c. Submucous coat – connective tissue
d. Mucous coat – mucous membrane

Normal wall thickness= < 5 mm

Hypertrophic pyloric stenosis
Length of pylorus= > 18 mm
Thickness of pyloric muscle= > 4 mm (one wall)

Small Bowel (Duodenum, Jejunum & Ileum)

Length (L)= 6 meter
Diameter= 4 cm (2.5 cm at lower end)
Normal wall thickness= < 3 mm

Large Bowel

The colon
Length (L)= 1.5 meter
Diameter= 6 cm
Normal wall thickness= < 5 mm

In Crohn’s diseae:
(The lesion usually involves the distal ileum and colon)...
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