Ultrasound examination of lymph nodes in the hepato-duodenal ligament with special emphasis on patients with chronic liver diseases

Abstract: The significance of finding lymph nodes in the hepato-duodenal ligament on ultrasound, with special emphasis on patients with inflammatory liver disease, has been evaluated. In one study a comparison was made with magnetic resonance imaging (MRI), which is another non-invasive imaging modality without the hazards of ionizing radiation. Lymph nodes in the hepato-duodenal ligament were found in benign as well as in malignant disease. In patients with abnormal biochemical test results regarding liver function, enlarged lymph nodes as the only pathological finding on ultrasound examination indicate the presence of chronic inflammatory liver disease and indicate the need for a liver biopsy. In patients with primary biliary cirrhosis, lymph node size, as well as changes in node size at a follow-up examination after two years, correlated with laboratory values reflecting cholestasis, hepatocellular damage and immunoreactivity. Changes in node size also correlated with changes in intralobular inflammation, as seen in the liver biopsies. In patients with chronic active hepatitis, a tendency towards a positive correlation between the size of the lymph nodes and laboratory values reflecting cholestasis and humoral immunoreactivity was seen, as well as a tendency towards an association with liver inflammation in the liver biopsies. These findings support our hypothesis that size and change in size of the hepatic nodes are valuable diagnostic parameters in patients with chronic liver diseases. Compared with basic low-field MRI (0.2 T), ultrasound seems superior for evaluation of lymph nodes in the liver hilus.

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