title: Perihepatic lymphadenopathy in children with chronic viral hepatitis.
abstract: OBJECTIVE
  To assess whether lymph node enlargement in the hepatoduodenal ligament occurs in children with chronic viral hepatitis B and C in comparison to healthy controls.
  
  
  METHODS
  In 49 patients with chronic viral hepatitis (38 with chronic hepatitis B, 11 with chronic hepatitis C, 31 male, 18 female; age range 1 to 17 years), and in 51 healthy controls (25 male, 26 female; age range 4 to 16 years), the total perihepatic lymph node volume was assessed using transabdominal ultrasonography as previously described in adult patients.
  
  
  RESULTS
  Adequate visualization of the liver hilum was achieved in 46/49 (94%) pediatric patients with chronic viral hepatitis and in 46/51 (90%) pediatric healthy controls. In patients with adequate liver hilum visualization, enlarged perihepatic lymph nodes (longitudinal diameter >14 mm) were detected in 32/46 (70%) patients with chronic viral hepatitis and in 5/46 (11%) healthy controls. The total perihepatic lymph nodes volume [mean ± SD] was 1.0 ± 1.2 mL (0.1-5.4 mL) in patients with chronic viral hepatitis and 0.1 ± 0.1 mL (0.0-0.4 mL) in healthy controls (p < 0.05). A maximal lymph node diameter >14 mm identified patients with chronic viral hepatitis with 70% sensitivity and 89% specificity.
  
  
  CONCLUSIONS
  Transabdominal ultrasound can detect lymph nodes within the hepatoduodenal ligament not only in adults but also in children. Paediatric patients with chronic viral hepatitis have significantly enlarged perihepatic lymph nodes compared to controls. Therefore, sonographic assessment of perihepatic lymphadenopathy might be a non-invasive diagnostic tool to screen paediatric patients for chronic viral hepatitis.
authors.affiliation: Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany ; Medizinische Klinik II, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Schreiber-Dietrich
authors.affiliation: Zentrum der Kinderheilkunde Abteilung für Kindergastroenterologie und Mukoviszidose, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany.
authors.forename: Margret
authors.initials: M
authors.lastname: Pohl
authors.affiliation: Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany.
authors.forename: Xin-Wu
authors.initials: XW
authors.lastname: Cui
authors.affiliation: Translational Gastroenterology Unit, Oxford University Hospitals, Headley Way, Oxford, UK.
authors.forename: Barbara
authors.initials: B
authors.lastname: Braden
authors.affiliation: Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany ; Medizinische Klinik II, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany.
authors.forename: Christoph F
authors.initials: CF
authors.lastname: Dietrich
authors.affiliation: Innere Medizin 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany ; Département d'imagerie médicale, Clinique des Cévennes, Annonay, France.
authors.forename: Liliana
authors.initials: L
authors.lastname: Chiorean
keywords: chronic hepatitis; liver hilum; lymphadenopathy; pediatric; ultrasonography