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Normal ureteral diameter in infancy and childhood
Insights
Pediatric ureteral diameter measurements using intravenous urography correlate with age and lumbar spine length. This objective method aids in differentiating normal from dilated ureters in children.
Area of Science:
- Pediatric Radiology
- Urology
- Diagnostic Imaging
Background:
- Accurate assessment of ureteral diameter is crucial for diagnosing pediatric urinary tract abnormalities.
- Existing methods may lack objectivity in differentiating between normal and dilated ureters.
Purpose of the Study:
- To establish normative data for ureteral diameters in children.
- To investigate the correlation between ureteral diameter and patient age/anatomic landmarks.
- To evaluate the utility of ureteral diameter measurement for objective differentiation of ureteral dilation.
Main Methods:
- Intravenous urography films were analyzed in 194 children (0-16 years) excluding those with known urinary tract issues.
- Ureteral diameters were measured on films without abdominal compression, focusing on segments visualized over 50% of their length.
- Correlations were assessed between ureteral diameter, age, and lumbar spine segment length.
Main Results:
- A significant positive correlation was found between ureteral diameter and age (r=0.69) and lumbar spine length (r=0.73).
- The widest ureteral portion was typically located superior to the iliac vessels.
- The right ureter showed a slightly greater diameter than the left; no sex-based differences were observed.
Conclusions:
- Pediatric ureteral diameter measurements correlate well with age and skeletal development.
- Objective measurement of ureteral diameter can assist in distinguishing between normal and dilated ureters.
- Findings align with existing autopsy data, supporting the clinical applicability of this imaging technique.
Abstract:
Ureteral diameters were estimated on films from intravenous urography in 194 children (100 boys and 94 girls) aged 0-16 years. Children with signs of urinary tract infection, calculi, obstruction, duplication or malformation were excluded. Films obtained without abdominal compression were used for measurements, including only ureters visualized over 50 per cent of their lengths. A good correlation was demonstrated between ureteral diameter and age (r = 0.69) and between ureteral diameter and the length of a segment of the lumbar spine (r = 0.73). The widest part of the ureter was most often located just above the crossing of the iliac vessels. The right ureter was slightly wider than the left one. No difference between boys and girls was noted. The results are in good agreement with those of others obtained at autopsy. Bearing in mind the possible physiologic variations, it would seem that measuring the ureteral diameter can be of value for a more objective differentiation between dilated and non-dilated ureters.