Enlarged lymph nodes in porta hepatis: Sonographic sign of chronic hepatitis B and C infections

Purpose. Enlarged lymph nodes in the hepatoduodenal ligament are prevalent in chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV); however, the clinical significance of this sonographic finding in an endemic area is unknown. Methods. Six hundred outpatients were categorized into 4 groups (nonviral, HBV, HCV, and HBV and HCV) using viral markers. The prevalence and size of enlarged lymph nodes were compared. Correlation between clinical parameters and nodal size was evaluated. Results. The incidence of detectable nodes in both the HBV group and the HCV group was significantly increased (56.9% and 69.4%, respectively; both p < 0.001) compared with the nonviral group; this rate was independent of aminotransferase levels. Nodal width was the only significant parameter when viral and nonviral groups were compared (p < 0.05). If a width of more than 5 mm was used to predict HBV or HCV infection, the positive predictive rate was 88% and the specificity was 89%. Conclusions. Lymph nodes in the hepatoduodenal ligament, especially those wider than 5 mm, suggest chronic HBV or HCV infection instead of only chronic hepatitis, especially in an endemic area such as Taiwan. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound 34:211–216, 2006