Hepatic steatosis

Last revised by Daniel J Bell on 30 May 2022

Hepatic steatosis, also known as hepatosteatosis, refers to an increase of intracellular fat in the liver and is defined when ≥5% of the weight of the liver is intrahepatic fat 3.

It is widely mischaracterized by both radiologists and sonographers as 'fatty infiltration' but the fat is in the hepatocytes and not in the extracellular matrix.
On imaging grounds, it can broadly be divided into two groups.

A third form, multifocal nodular hepatic steatosis is also rarely seen.

Radiographic features

Ultrasound

Ultrasound B-mode imaging is preferred as the first-line diagnostic modality for hepatic steatosis because of its wide availability, low cost, non-invasive, does not expose to ionizing radiation, repeatable, and well accepted by patients 2.

The degree of diffuse hepatic steatosis can be graded according to several different scoring systems, including the Hamaguchi score, US-FLI score and hepatorenal sonographic index 2.

See also

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Cases and figures

  • Focal hepatic steatosis
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  • Diffuse hepatic steatosis
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  • Diffuse hepatic steatosis with metastases
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  • Case 4: fatty liver: gallbladder equalization
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  • Case 5: Steatohepatitis - masslike steatosis
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