Peer-reviewed article
Updated Pediatric Sonographic Percentile Curves for Abdominal Organ Size in a Large European Cohort
Elena Höhne, Sebastian Fischer, Jennifer Gotta, Philipp Reschke, Vitali Koch et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study builds age-specific reference curves for the size of the liver, spleen and kidneys in children aged 0-18. It uses 27,696 abdominal ultrasound examinations done for clinical reasons at one large hospital in Germany between 2000 and 2025. The curves are meant to help doctors judge whether a child's organ size is typical for their age. It is a clinical diagnostic reference study. It does not look at children's well-being, rights or any intervention.
Key points
- The data came from 27,696 pediatric abdominal ultrasound examinations: 12,254 livers, 12,703 spleens, 16,254 right kidneys and 16,516 left kidneys.
- All organs showed non-linear growth with age.
- No overall significant sex differences were found for spleen (p = 0.195), liver (p = 0.517), right kidney (p = 0.712) or left kidney (p = 0.797).
- The left kidney was consistently larger than the right, by a mean of 2-5 mm (p<0.0001).
- The authors present percentile curves (P3-P97) as benchmarks for clinical practice.
Limitations
The data come from a single tertiary-care center in Germany and were analysed retrospectively. Children were not excluded for underlying pathology, so the curves are clinical rather than healthy-population references. Sex differences within individual age groups cannot be ruled out. The document says nothing about child well-being outcomes or interventions.
Abstract
PURPOSE: Accurate measurement of liver, spleen, and kidney size plays a central role in pediatric diagnostics. Contemporary sonographic percentile data are needed to support interpretation of organ dimensions in clinical practice. This study aimed to generate age-specific clinical reference percentiles for abdominal organ size based on a large real-world pediatric ultrasound cohort. METHODS AND MATERIALS: This retrospective analysis included 27,696 clinically indicated pediatric abdominal ultrasound examinations conducted between 2000 and 2025 at a major urban tertiary-care center in Germany. Standardized organ measurements were obtained by experienced pediatric radiologists. Patients were not excluded on the basis of underlying pathology. Age-specific clinical percentile curves (P3-P97) were generated using Generalized Additive Models for Location, Scale, and Shape (GAMLSS) to capture non-linear growth patterns. RESULTS: From 27,696 examinations of children aged 0-18, organ-specific measurements comprised 12,254 livers, 12,703 spleens, 16,254 right kidneys, and 16,516 left kidneys. All organs demonstrated non-linear growth trajectories. No overall statistically significant sex differences were observed in this cohort for spleen (p = 0.195), liver (p = 0.517), right kidney (p = 0.712), or left kidney (p = 0.797). Owing to the retrospective design, sex-specific variation within individual age strata cannot be excluded. The left kidney was consistently larger than the right (p<0.0001), with a mean difference of 2-5 mm. CONCLUSION: This study presents contemporary clinical percentile curves for liver, spleen, and kidney dimensions derived from one of the largest Central European pediatric ultrasound datasets published to date. The curves provide population-specific benchmarks for interpreting pediatric abdominal organ dimensions in real-world clinical practice and aim to support standardized assessment across the full pediatric age range.