Focal fatty sparing

Case contributed by Dr Hanisalam

Presentation

25 year old male patient known case of psoriasis on corticosteroids having elevated liver function test.

Patient Data

Age: 25
Gender: Male
Modality: Ultrasound

Liver US demonstrates diffuse increased echogenicity.The echogenic walls of the portal veins and hepatic veins are lost, due to the liver attenuation having increased. A small focal hypoechoic lesion is noted at segment 6. This most likely represent a focal fatty sparing in the background of diffuse hepatic steatosis. However, due it's atypical location further evaluation was recommended.

Modality: CT

CT scan of the liver demonstrates diffuse reduction of hepatic attenuation. The segment 6 lesion appears hyperdense in the all phases of enhancement. Unfortunately, a Nonenhanced control scan was not taken, so whether this lesion is truly enhancing or it is hyperdense from the start can not be determined.

Modality: MRI

MRI liver was performed which demonstrates increase SI of the liver on T1 in phase sequence, the lesion is not well defined. However, on T1 out of phase sequence there is drop of the SI of the liver with segment 6 lesion become more conspicuous on background of fatty liver representing a focal fatty sparing of the liver.

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Case Information

rID: 12580
Case created: 18th Dec 2010
Last edited: 28th May 2016
Tag: liver
Inclusion in quiz mode: Included

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