Chronic hepatitis B: Enlarged perihepatic lymph nodes correlated with hepatic histopathology

摘要

AIM: To assess the value of enlarged perihepatic lymph nodes in determining hepatic histopathology for chronic hepatitis B (CHB) by magnetic resonance imaging (MRI).METHODS: Sixty-seven patients who were clinically and histologically diagnosed with CHB and 18 healthy subjects without history of liver disease underwent abdominal MRI. Histological diagnosis and hepatic inflammation (grade 0-4) and fibrosis (stage 0-4) were assessed by a simplified system for scoring in chronic viral hepatitis. The major imaging protocol included an axial breath-hold fat suppressed fast spoiled gradient echo T2-weighted imaging (T2WI), axial breath-trigger fat suppressed fast recovery fast spin echo T2WI, and axial and coronal fast imaging employing steady-state acquisition. Perihepatic lymph nodes larger than 5 mm in shortest diameter were noted.RESULTS: The numbers and size indexes of lymph nodes greater than 5 mm in shortest diameter in hepatic hilum suggested inflammatory activity for subjects with grade 2 or higher, with a high accuracy of diagnosis (the area under the curves > 0.9, P < 0.001). The numbers of lymph nodes were 2 or more with a sensitivity of 87.27%, a specificity of 90.00%, an accuracy of 88.24%, a positive predictive value of 94.12%, and a negative predictive value of 79.41% in patients with grade 2 or higher, and the size indexes were no less than 180 mm² with a sensitivity of 83.64%, a specificity of 100%, an accuracy of 89.41%, a positive predictive value of 100%, and a negative predictive value of 76.92%. The numbers and size indexes of lymph nodes were not correlated with hepatic fibrosis. The signal intensity indexes of lymph nodes were no significant correlation with histological grading or staging of liver.CONCLUSION: The numbers and size indexes of enlarged perihepatic lymph nodes for patients with CHB suggest inflammatory activity for subjects with grade 2 or higher.