Ultrasound demonstration of lymph nodes in the hepatoduodenal ligament ('Daisy Chain nodes') in normal subjects.

We describe the ultrasound appearances of lymph nodes in the hepatoduodenal ligament ('Daisy Chain Nodes') in normal subjects. Nodes were identified in 69 of 116 patients referred for abdominal ultrasound, who had no underlying reason for lymphadenopathy. Patients with primary malignancy or inflammatory pathologies were excluded from the sample. In 26 patients, the hepatoduodenal ligament (HDL) was not visualized. Therefore Daisy Chain nodes were visualized in 77% of patients where the HDL was visualized. Nodes were seen more frequently in younger patients; this was attributed to more homogeneous hyperechoic perinodal fat in the younger age group and the larger size of nodes in young patients. Study of normal lymph nodes will help to determine criteria for the appearances of pathological nodes in the abdomen.