Learning objectives
Learning objectives
To review the various spectrum of ultrasound presentations of fatty liver sparing
To present variable case reports and perform a differential diagnosis of atypical patterns of fatty liver sparing
To investigate the clinical guidelines of management of fatty liver sparing as a finding on US
Background
Fatty infiltration of the liver usually has a diffuse pattern.
It may be associated withwith focal sparing/focal fat accumulation.
Focal fatty sparing representing normal areas in fatty liver,
appear hypoechoic on sonography.Focal fatty sparing on a background fatty liver are also called ˝skip areas˝ or pseudolesions[1].
Hepatic steatosis can also present as heterogeneous or nonuniform distribution of fat,
consisting in various atypical patterns of distribution.
Atypical patterns of FFS and focal steatosis can be misdiagnosed as infiltrative or nodular benign or malignant lesions (FLL),
and...
Findings and procedure details
In this exhibit we provide an illustrated summary of US findings of typical and atypical,
confusing patterns of focal fatty liver and its clinical implications.
Patrick- Olivier Decarie et al [4] identified six patterns of liver steatosis:
diffuse- most prevalent,geographic,focal,
subcapsular,
multifocal and perivascular
Common patternsof hepatic steatosis include:
diffuse fat accumulation
diffuse fat accumulation with focal sparing
focal fat accumulation in an otherwise normal liver.
The typical manifestations of focal fatty sparing are:
ageographic configuration,
apoorly delineatedmargin,no space-occupying effect,no displacement of adjacent vessels,
and...
Conclusion
Fatty liver is a very common US finding but it has many atypical patterns,that can mimic malignancies and cause diagnostic challenges.
Patients with FFS discovered incidentally on US mostly require only follow-up.
Inconclusive US findings,
where FFS and other benign lesions cannot be ruled out require further work-up.
Previous US findingsof the liver may be very useful as a reference when a tumorlike abnormality is identified on follow-up sonography.
US is the first imaging modality for the screening and follow up for patients,
especially with...
Personal information
Author: Vivian Milotic et al.
Email:
[email protected]
Workplace: General hospital Pula,
Croatia
References
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Hamer et al.
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4.Décarie PO,
Lepanto L,
Billiard JS et al.
Fatty liver deposition and sparing: a pictorial review.Insights Imaging 2011; 2: 533-8.
5.Chen K,Hirayama Y,Yunoki M,Hirano Y.
Focal sparing around the...
