Review the normal anatomy of the gonads and female genital tract.
Illustrate the imaging findings - with emphasis on ultrasound (US) - of different disorders affecting the pediatric pelvis including:
- Structural congenital anomalies
- Ambiguous genitalia
- Primary amenorrhea and prepubertal bleeding
- Pelvic pain
Ultrasonography (US) is the modality of choice for the evaluation of the pelvis in the pediatric population.
Either with transabdominal,
transperineal or transvaginal approach,
US is fundamental in the investigation of disorders affecting the pediatric female pelvis.
For complex congenital anomalies,
fluoroscopic genitography / cystourethrography can be added to the US evaluation for adequate characterization of the urethra,
urogenital sinus and cloaca.
Findings and procedure details
adnexa and vagina are best imaged with an optimally filled bladder.
Therefore the patients are asked to be well hydrated and not to void in the hour prior to the examination (bearing in mind that overfilling of the bladder can also modify the uterine shape).
In infants and young children who are unable to maintain a full bladder despite adequate fluid ingestion,
it may be necessary to catheterize and fill the bladder with sterile water.
Transabdominal approach is usually adequate for...
Being a readily available and relatively innocuous imaging modality,
US is of great value for evaluation of the pediatric pelvis,
in the great majority of cases allowing the adequate evaluation of the anatomy and the hormonal status of infants and children with sexual precocity/delay,
congenital structural anomalies and ambiguous genitalia,
being also the initial modality in assessing the cause of pelvic pain and the origin of pelvic masses.
Additional imaging with MRI and/or CT imaging are useful for further delineation of the anatomic features in...
European Society of Paediatric Radiology abdominal imaging task force recommendations in paediatric uroradiology,
part IX: Imaging in anorectal and cloacal malformation,
imaging in childhood ovarian torsion,
and efforts in standardising paediatric uroradiology terminology.
Pediatr Radiol (2017) 47: 1369.
US of the Pediatric Female Pelvis: A Clinical Perspective.
Van Vliet G.
Pearls and pitfalls in diagnosis of ovarian torsion.