Exam Requirements: Pediatric Ultrasound (Revised 8-23-2024)

Exam Requirements: Pediatric Ultrasound Accreditation

Neonatal/Infant Neurosonology

Coronal gray scale images to include:

• Frontal lobes anterior to the frontal horns of the lateral ventricles

• Frontal horns or bodies of lateral ventricles and interhemispheric fissure

• Lateral ventricles at level of lateral and third ventricles

• Lateral ventricles slightly posterior to the foramina of Monro, where the lateral and third ventricles communicate

• Level of quadrigeminal plate, quadrigeminal cistern and cerebellum

• Echogenic glomi of choroid plexuses at posterior aspect of the lateral ventricles at level of trigones

• Posterior to occipital horns

Sagittal gray scale images to include:

• Midline sagittal images to include corpus callosum, cavum septi pellucidi, and cavum vergae if present

• Right and left parasagittal images of lateral ventricles including caudothalamic groove

• Right and left parasagittal images of lateral ventricles documenting choroid plexus

• Right and left parasagittal images of the insula

• Right and left parasagittal images of the Sylvian fissure and temporal lobe

Pyloric Stenosis

• Complete documentation in longitudinal

  • Gray scale images of the antrum and duodenal bulb in longitudinal

                                                       OR

• Cine clip of the antrum and duodenal bulb in longitudinal

• At least one static gray scale image of the antrum and duodenal bulb in longitudinal without measurement

• Complete documentation in transverse

  • Gray scale images of the pylorus in transverse  

                                              OR
  

  • Cine clip of the pylorus in transverse

  • At least one static gray scale image of the pylorus in transverse without measurement

• Measurement of muscle thickness in both longitudinal and transverse planes

• Measurements of the length of the pyloric canal

Neonatal/Infant Hip

Exams should be correctly labeled to include organ/anatomy of interest, transducer orientation plane, side, and stress maneuvers

• Flexed coronal imaging outlining anatomic structures, including evaluation of femoral head coverage. The imaging should outline the ilium, transverse Y cartilage, ischium, labrum, and gluteal muscles, as well as the femoral head

• Flexed transverse images with and without stress. The images should show the ossified femoral shaft, the femoral head and underlying ischium. 

  • Without stress: at least one flexed transverse gray scale image of each hip

  • With stress: at least one static flexed transverse gray scale image with stress OR cine clip demonstrating flexed transverse with stress maneuver. 

Note: Abduction/adduction maneuvers do not satisfy the stress requirement

Neonatal/Infant Spine

• Longitudinal and transverse images of spinal cord and vertebral bodies with appropriate image labeling 

• Level of termination of the conus with identification of vertebral body level

• Cord position within the spinal canal

• Termination of the thecal sac and nerve roots of the cauda equina

• Evaluation of the subarachnoid space, dura, and epidural space

• Integrity of the cord, filum of the cord and its thickness should be noted

Revision History for this Article

Date

Section

Description of Revision(s)

12-12-19

All

Article created; FAQs incorporated; No criteria changes

2-26-2020

Pyloric Stenosis

Edited required measurements

6-2-2020

Added complete documentation description

4-20-2021

Pediatric Hip

Added bullet recommending measurements be included on the submitted image set

1-21-2022

Updated exam requirements

11-9-2022

Removed Intussusception. Added Neonatal/Infant Spine

6-21-2023

Neonatal/Infant Spine

Corrected 6th bullet from epicardial to epidural

8-23-2024

Added link to the Modalities with Low Volume or Emergency Use article

Neonatal/Infant Spine

Removed 2nd bullet (longitudinal and transverse images of the cord at the area of interest)