Focal fatty infiltration - chemical shift MRI
Health check up revealed focal liver lesion, identified on plain CT as a hypodense lesion.
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Geographic T2 hyperintense area involving segment IV. Hepatic vascular channels freely traverse this area. Out of phase T1 images show signal drop in the region. Post contrast study does not reveal any abnormal hepatic parenchymal enhancement.
Chemical shift MRI is a handy tool to diagnose heterogeneous fatty deposition in liver. A conscious effort should be made to narrow down fatty changes in the list of differentials especially at common sites of involvement - along the falciform ligament, portal hepatis and pericholecystic bed. Quite often a trans abdominal ultrasound suffices to make the diagnosis.
- 1. Cassidy FH, Yokoo T, Aganovic L, Hanna RF, Bydder M, Middleton MS, Hamilton G, Chavez AD, Schwimmer JB, Sirlin CB. Fatty liver disease: MR imaging techniques for the detection and quantification of liver steatosis. Radiographics : a review publication of the Radiological Society of North America, Inc. 29 (1): 231-60. doi:10.1148/rg.291075123 - Pubmed
- 2. Hamer OW, Aguirre DA, Casola G, Lavine JE, Woenckhaus M, Sirlin CB. Fatty liver: imaging patterns and pitfalls. Radiographics : a review publication of the Radiological Society of North America, Inc. 26 (6): 1637-53. doi:10.1148/rg.266065004 - Pubmed