Development of a Pediatric Age-Based and Weight-Adjusted Nomogram for Bladder Volumes Associated With Successful...

Area of Science:

• Pediatric Radiology
• Diagnostic Imaging
• Pelvic Ultrasound

Background:

• Transabdominal pelvic ultrasound (TPU) is crucial for diagnosing pelvic pain in pediatric patients.
• Adequate bladder filling is essential for successful TPU, but target volumes are not well-defined for pediatric populations.
• Variability in bladder volume can lead to repeat examinations and delayed diagnoses.

Purpose of the Study:

• To develop a pediatric nomogram for bladder volumes required for successful transabdominal pelvic ultrasound (TPU).
• To establish age- and weight-based guidelines for optimal bladder filling in female pediatric patients presenting with pelvic pain.
• To hypothesize that target bladder volumes for successful TPU vary by age and weight.

Main Methods:

• Retrospective analysis of 1030 successful transabdominal pelvic ultrasound (TPU) studies in female patients aged 8-18 years.
• Ellipsoid bladder volume formula used, calculating volumes from transverse and longitudinal cine clips.
• Quantile regression model employed to correlate bladder volume with age, adjusting for patient weight.

Main Results:

• Bladder volumes increase with age and weight up to approximately 13 years and 60 kg, with minimal change thereafter.
• Median bladder volume showed the most significant decrease in younger, non-overweight children.
• A nomogram was developed based on age and weight percentiles for optimal bladder volumes.

Conclusions:

• A pediatric age- and weight-adjusted nomogram for bladder volumes in transabdominal pelvic ultrasound (TPU) has been developed.
• This nomogram can potentially reduce inefficiencies in bladder preparation for TPU.
• Further evaluation is recommended to improve diagnostic timeliness for pediatric pelvic emergencies.