Clinical significance of ultrasonographic imaging of the common hepatic arterial lymph node (No. 8 LN) in chronic liver diseases

Abstract

In chronic liver diseases, the size of the portal lymph node and the common hepatic arterial lymph node (No. 8a LN) is often altered. The objective of this study was to investigate the relationship between the pathology of chronic liver diseases and the common hepatic arterial lymph nodes using an ultrasonographic diagnostic system. The subjects included 115 patients with hepatitis C (chronic hepatitis C, 75; liver cirrhosis C, 40), 31 patients with hepatitis B (chronic hepatitis B, 17; liver cirrhosis B, 14), 16 patients with primary biliary cirrhosis (PBC), 11 patients with autoimmune hepatitis (AIH), 29 patients with alcoholic hepatitis (Alc.LD) and 190 healthy adults with no abnormalities in liver function or inflammatory reactions (100 males and 90 females, age range 26-71 years, mean 49.2). The long and short axes of No. 8 LN were measured, and the value calculated by multiplying the two diameters was designated as the LN index (Fig. 1). The No. 8 LN appearance rate and LN index were significantly higher in the patients with hepatitis C, PBC and AIH than in the healthy subjects. When the LN index cut-off value was set to 50, alanine aminotransferase and aspartate aminotransferase were significantly higher in chronic hepatitis C (CHC) patients than in the healthy subjects. In addition, the LN and splenic indexes were significantly correlated in CHC patients, suggesting that the LX index is related to portal pressure increase with an elevation of sinusoidal pressure. The LN index after interferon therapy was significantly lower in complete responders than in non-responders. The No. 8 LN index may be closely related to the pathology of chronic liver diseases.