Ultrasound study of adenopathies within the hepatoduodenal ligament: The “rosebud” pattern

Weill, Francis S.; Costaz, R; Racle, A; Rohmer, P

doi:10.1007/bf02035056

Cited by 17 publications

(5 citation statements)

References 2 publications

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“…Lymphatic channels in the hepatoduodenal ligament receive lymph from the liver, gallbladder, bile ducts, duodenum, stomach, and pancreas and drain into the paraaortic ganglia near the origin of the superior mesenteric artery. 3 In previous studies, enlarged lymph nodes were observed in the hepatoduodenal ligament in patients with chronic viral hepatitis at varying frequencies (45-100%), which indicated differences in the true status of the lymph node, in the resolution of sonography, and in the technique of the sonographers 20 ; these findings were also confounded by many possible causes. We excluded patients with biliary and pancreatic disease, chronic nonviral liver disease, known malignancy, or other inflammatory processes around the hepatoduodenal ligament to eliminate these confounding factors and to clarify the nodal presentations of subjects with HBV or HCV infection.…”

Section: Discussionmentioning

confidence: 93%

“…2 Hence, lymph nodes depicted in the hepatoduodenal ligament were considered malignant. 3 Abdominal lymphadenopathy attributed to benign reactive hyperplasia was first reported in autopsy studies of individuals who had used heroin or opiates 4,5 and on sonographic examinations of individuals who abused drugs. 6 Forsberg and colleagues 7,8 first emphasized this phenomenon in nonmalignant hepatobiliary disease, especially chronic immunomediated liver disease.…”

mentioning

confidence: 99%

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

Kuo

Lin

Chen

et al. 2006

J of Clinical Ultrasound

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Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 99%

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

Kuo

Lin

Chen

et al. 2006

J of Clinical Ultrasound

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“…Several variations in this relation can occur, some of which are due to aberrant and accessory hepatic arteries. Lymphatic channels in the hepatoduodenal ligament drain the liver, gallbladder, bile ducts, duodenum, stomach, and pancreas into the paraaortic nodes near the origin of the superior mesenteric artery (2). The nerves that course through the porta hepatis are branches of the left vagus nerve and sympathetic branches of the celiac plexus.…”

Section: Radiologic Anatomymentioning

confidence: 99%

Imaging of the Porta Hepatis: Spectrum of Disease

et al. 2014

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A wide array of pathologic conditions can arise within the porta hepatis, which encompasses the portal triad (the main portal vein, common hepatic artery, and common bile ducts), lymphatics, nerves, and connective tissue. Major vascular diseases of the portal triad include thrombosis, stenosis, and aneurysm. Portal vein thrombosis can complicate liver cirrhosis and hepatocellular carcinoma and has important therapeutic implications. Hepatic artery thrombosis and stenosis require immediate attention to reduce graft loss in liver transplant recipients. Congenital (eg, choledochal cyst) and acquired (benign and malignant) diseases of the biliary system can manifest as mass lesions in the porta hepatis. Lymphadenopathy can arise from neoplastic and nonneoplastic entities. Uncommon causes of mass lesions arise from nerves (eg, neurofibroma, neurofibrosarcoma) and connective tissue (sarcomas) and are rare. The hepatoduodenal ligament is a peritoneal reflection at the porta hepatis and is an important route for the spread of pancreatic and gastrointestinal cancers. Imaging plays a major role in diagnosis and enables appropriate management. Ultrasonography accurately demonstrates anatomic variations and pathologic conditions and is the initial modality of choice for detection of vascular and biliary lesions. Multidetector computed tomography and magnetic resonance imaging allow characterization and differentiation of various masses in the porta hepatis. Imaging-guided interventions, including embolization and stent placement, also play a key role in disease management.

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“…Lymphatic channels in the HDL drain the liver, gallbladder, bile ducts, duodenum, stomach, and pancreas into the paraaortic nodes near the origin of the superior mesenteric and celiac artery. [ 13 ] Typical nodes are the hilar node, cystic node (of Lund), pericholedochal node, retroportal node, foramen of Winslow node, superior retropancreaticoduodenal node, and posterior pancreaticoduodenal node. [ 14 ] Regional lymph nodes for perihilar bile duct malignancy are those in the hepatoduodenal ligament: Hilar, cystic node, pericholedochal, hepatic artery node, and retroportal node.…”

Section: Radiologic Anatomy Of Hdl and Portal Hepatismentioning

confidence: 99%

Endoscopic ultrasound of the hepatoduodenal ligament and liver hilum

Sharma

Rameshbabu²,

Dietrich

et al. 2018

Endosc Ultrasound

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The porta hepatis and hepatoduodenal ligament (HDL) are important anatomical pathways of extension of disease to and from the liver. The imaging of this area is difficult. The role of endoscopic ultrasound (EUS) as an imaging modality for hepatoduodenal ligament has not been established so far. All images in the present study have been generated from a detailed review of real time recordings using the curved linear scanning echoendoscope EG -3830 UT (Pentax Corporation, Tokyo, Japan), coupled with a Hitachi avius and Hitach 7500 processor (Hitachi Aloka Medical, Tokyo Japan). Our image orientation is with the cranial aspect of the patient directed toward the right side of the screen. We have illustrated that with a careful technique, a detailed EUS evaluation of the HDL and hepatic hilum is possible. A thorough understanding of the HDL anatomy by curved linear EUS probe may play a crucial role in the accurate diagnosis of a broad spectrum of pathologic conditions of the porta hepatis. EUS examination of the HDL should be a part of the upper abdominal EUS studies. The description and the images described in this article are useful for beginners who want to start imaging of the porta hepatis and hepatoduodenal ligament. This information is useful for staging of malignancies involving common bile duct.

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Ultrasound study of adenopathies within the hepatoduodenal ligament: The “rosebud” pattern

Cited by 17 publications

References 2 publications

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

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

Imaging of the Porta Hepatis: Spectrum of Disease

Endoscopic ultrasound of the hepatoduodenal ligament and liver hilum

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