Focal Fatty Sparing of the Liver

Ki Deok Yoo; Dae Won Jun

doi:10.4166/kjg.2014.63.6.382

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Yoo and Jun: Focal Fatty Sparing of the Liver

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Korean J Gastroenterol 2014;63(6):382-385.

Published online: 4 October 2014

DOI: https://doi.org/10.4166/kjg.2014.63.6.382

Focal Fatty Sparing of the Liver

Ki Deok Yoo, Dae Won Jun

Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea

Correspondence to: Dae Won Jun, Department of Internal Medicine, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 133-791, Korea. Tel: +82-2-2290-8338, Fax: +82-2-972-0068, E-mail: noshin@hanyang.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

References

1. Preiss D, Sattar N. Nonalcoholic fatty liver disease: an overview of prevalence, diagnosis, pathogenesis and treatment considerations. Clin Sci (Lond). 2008; 115:141–150.

2. Ministry of Food and Drug Safety. Influence of dietary intake on non-alcoholic fatty liver disease in Korean. Cheongwon: Ministry of Food and Drug Safety;2012.

3. Boyce CJ, Pickhardt PJ, Kim DH, et al. Hepatic steatosis (fatty liver disease) in asymptomatic adults identified by unenhanced low-dose CT. AJR Am J Roentgenol. 2010; 194:623–628.

4. Alpern MB, Lawson TL, Foley WD, et al. Focal hepatic masses and fatty infiltration detected by enhanced dynamic CT. Radiology. 1986; 158:45–49.

5. Kratzer W, Akinli AS, Bommer M, et al. Prevalence and risk factors of focal sparing in hepatic steatosis. Ultraschall Med. 2010; 31:37–42.

6. Kemper J, Jung G, Poll LW, Jonkmanns C, Lüthen R, Moedder U. CT and MRI findings of multifocal hepatic steatosis mimicking malignancy. Abdom Imaging. 2002; 27:708–710.

7. McKenzie A, Gill G, McIntosh R, Hennessy O, Pryde D. Computed tomographic and ultrasound appearances of focal spared areas in fatty infiltration of the liver. Australas Radiol. 1991; 35:166–168.

8. Chong VF, Fan YF. Ultrasonographic hepatic pseudolesions: normal parenchyma mimicking mass lesions in fatty liver. Clin Radiol. 1994; 49:326–329.

9. Hamer OW, Aguirre DA, Casola G, Lavine JE, Woenckhaus M, Sirlin CB. Fatty liver: imaging patterns and pitfalls. Radiographics. 2006; 26:1637–1653.

10. Basaran C, Karcaaltincaba M, Akata D, et al. Fat-containing lesions of the liver: cross-sectional imaging findings with emphasis on MRI. AJR Am J Roentgenol. 2005; 184:1103–1110.

11. Valls C, Iannacconne R, Alba E, et al. Fat in the liver: diagnosis and characterization. Eur Radiol. 2006; 16:2292–2308.

12. Mathieu D, Luciani A, Achab A, Zegai B, Bouanane M, Kobeiter H. Les pseudo-lésions hépatiques. Gastroenterol Clin Biol. 2001; 25:B158–B166.

13. Matsui O, Kadoya M, Takahashi S, et al. Focal sparing of segment IV in fatty livers shown by sonography and CT: correlation with aberrant gastric venous drainage. AJR Am J Roentgenol. 1995; 164:1137–1140.

Fig. 1.

Abdominal ultrasonography shows hypoechoic mass with irregular margin at segment IV of liver.

Fig. 2.

Abdominal CT scan reveals 6.6×5.3 cm sized mass-like lesion with enhancing at both pre-enhance phase (A) and portal phase (B) images. Axial contrast enhanced portal phase image shows a diffusely hypodense liver (55 hounsfield units [HU]) in comparison with the spleen (110 HU) with a spared zone (segment IV).

Fig. 3.

Liver MRI. (A) Portal phase shows a lobulating, enhancing mass at segment IV of Liver. There is noted a aberrant right gastric vein in mass at segement IV of liver (arrow). (B) Hepatobiliary phase reveals high signal intensity at segment IV of liver. Diffusion weighted (C) and T2-weighted (D) images show no significant signal changes between segment IV of liver and the other part of liver.

Fig. 4.

Liver MRI. Axial T1-weighted (A) in-phase and out of phase (B) images shows an important signal drop of the liver on the opposed-phase image with the exception of spared zone in segment IV of the liver.

Fig. 5.

Microscopic findings of liver (H&E). (A) Hepatic steatosis was observed but there were noted some regions without fatty changes (×100).(B) In addition to hepatic steatosis, balloon degeneration, periportal inflammation, perisinusoidal fibrosis were also present (×200).

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