Normative values for ureteral diameter in children

Background Assessment of the ureter is a fundamental part of the radiologic evaluation of the urinary tract. Abnormal ureteral dilation warrants further investigation to assess the etiology, which includes obstruction and/or reflux. Despite this fundamental need, there are no established normative v...

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Bibliographic Details
Published in:Pediatric radiology 2022-07, Vol.52 (8), p.1492-1499
Main Authors: Shashi, Kumar K., Lee, Ted, Kurugol, Sila, Garg, Harsha, Ghelani, Sunil J., Nelson, Caleb P., Chow, Jeanne S.
Format: Article
Language:English
Subjects:
Age
Children
Confidence intervals
Diameters
Etiology
Imaging
Magnetic resonance
Medicine
Medicine & Public Health
Neuroradiology
Nuclear Medicine
Oncology
Original Article
Patients
Pediatrics
Radiology
Rank tests
Statistical analysis
Ultrasound
Ureter
Urinary tract
Urography
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Description
Summary:Background Assessment of the ureter is a fundamental part of the radiologic evaluation of the urinary tract. Abnormal ureteral dilation warrants further investigation to assess the etiology, which includes obstruction and/or reflux. Despite this fundamental need, there are no established normative values in children based on imaging. Objective To provide normative values for ureteral diameter in pediatric patients with age-related ranges. Materials and methods We retrospectively reviewed all magnetic resonance (MR) urography studies and chose only normal ureters for assessment. The images were analyzed on commercially available software to assess maximum internal diameter. Manual measurements were done in cases where the images were below the resolution for automated assessment. Maximum intraluminal ureteral diameters were measured in upper, mid and lower thirds and the average of the three maximum ureteral diameters was used to obtain the average widest internal ureteral diameter. Multivariable linear regression was performed to test the association between the calculated diameter and gender. Differences in sizes between the left and right ureter were assessed using paired Wilcoxon signed rank test. Results One hundred twenty-one MR urography studies were selected, which included 160 ureter units. The diameter increases progressively with age, ranging from 3.2 mm during infancy to 5.0 mm in patients older than 16 years of age. After 9 years of age, the average widest internal ureteral diameter is slightly larger in males compared to females (odds ratio [OR]=1.91, 95% confidence interval [CI] [1.63, 2.25], P
ISSN:0301-0449
1432-1998
DOI:10.1007/s00247-022-05349-z