Focal fatty infiltration - chemical shift MRI

Case contributed by Dr Varun Babu

Presentation

Health check up revealed focal liver lesion, identified on plain CT as a hypodense lesion.

Patient Data

Age: 65 years
Gender: Female

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. 

Case Discussion

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. 

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