Hepatitis C virus (HCV) infection is one of the most comInflammatory processes in organs frequently lead to hypermon causes of chronic hepatitis and cirrhosis. 1,2 HCV is an plasia of regional lymph nodes. In the present study, we inves-RNA virus that preferentially replicates in hepatocytes; howtigated whether lymph node enlargement within the hepatoever, mononuclear lymphocytes may serve as a possible exduodenal ligament may reflect the inflammatory activity trahepatic site for HCV replication.3-5 Kinetic analysis of virus within the liver of patients chronically infected with the hepaturnover revealed that HCV replicates continuously and is titis C virus (HCV). In 114 patients with chronic hepatitis C highly productive in vivo. In chronically infected patients, and 49 healthy controls, the total lymph node volume within approximately 10 10 hepatitis C virions are produced and subthe hepatoduodenal ligament was prospectively investigated sequently degraded by antigen-specific and nonspecific proby ultrasound. In patients with chronic hepatitis C, a liver cesses every day. 6biopsy was taken at the same occasion, and specimens were Inflammatory processes in organs frequently lead to hypersemiquantitatively evaluated by the histological activity index plasia of regional lymph nodes. Lymph node enlargement (HAI). Hepatitis C viremia was assessed by quantitative rewithin the hepatoduodenal ligament may be present in paverse transcription-polymerase chain reaction (RT-PCR). Getients with acute or chronic liver disease, and could reflect notyping was performed by a reverse hybridization assay. In the inflammatory activity and/or the immunological response 104 of 114 patients (91.2%) and in 45 of 49 healthy controls of the host. Lymph nodes in the hepatoduodenal ligament (91.8%), adequate visualization of the region of the hepatoducan noninvasively be detected using modern imaging techodenal ligament was achieved by ultrasound. Lymph nodes niques such as ultrasound. 7-15were detected in all patients with chronic hepatitis C and in In the present study, we investigated the size of lymph 33 of 45 controls. The mean perihepatic lymph node volume nodes within the hepatoduodenal ligament in patients with in healthy controls (2.2 { 1.8 mL) was lower than in HCVchronic hepatitis C and healthy controls. The lymph node infected patients with mild to moderate inflammatory activity, status in the hepatoduodenal ligament was correlated with severe inflammatory activity, and patients with cirrhosis liver histology, HCV genotype, hepatitis C viremia, and liver (5.8 { 2.2 mL, 18.1 { 10.4 mL, and 22.8 { 18.8 mL, respecfunction tests. tively). In patients with HCV-RNA levels of less than 10 6 copies/mL, the total lymph node volume was 5.8 { 1.6 mL PATIENTS AND METHODS and was significantly increased in patients with higher viremia (20.3 { 13.8 mL; P õ 10 06 ). No correlation was found bePatients and Controls. Between February 1995 and May 1996, 114 tween the total lymph node volume within the hepatoduodeconsecutive patients with ch...

EUS-elastography of the pancreas has the potential to obtain some complementary information that would improve tissue characterization. Its clinical utility, however, remains questionable, and it seems unlikely that the information provided will obviate the necessity of obtaining tissue samples for confirmation of a final pathologic diagnosis.

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Recent advances in technology have supported the development of new echo-endoscopic systems making it possible to use real-time, low mechanical index, contrast-enhanced imaging techniques with endoscopic ultrasound. We have preliminarily shown that arterial, portal venous and parenchymal contrast enhancement is possible.

CEUS has a high diagnostic accuracy for the differential diagnosis of small and subcentimetric FLLs in clinical practice.