Type:
Educational Exhibit
Keywords:
Abdomen, Oncology, Liver, CT, Ultrasound, MR, Diagnostic procedure, Staging, Treatment effects, Cancer, Metastases, Neoplasia
Authors:
K. Carey, S. Power, D. J. Gleeson, P. S. O' Reilly, J. Barry; Cork/IE
DOI:
10.1594/ecr2018/C-1745
Background
Hepatic steatosis or non alcoholic liver disease (NAFLD) is a common condition and it’s incidence has been reported in 10-35% of the population (1).
Histologically it is caused by triglyceride accumulation within the cytoplasm of hepatocytes (2).
The incidence has increased in recent decades in association with the increased prevalence of obesity within the population.
The condition creates a unique conundrum when imaging the liver,
as the sensitivity for detection of focal liver lesions in diffusely steatotic liver is reduced.
More than 10% of hepatic metastases are obscured by hepatic steatosis on conventional grey-scale ultrasound (3).
In addition to this,
focal areas of fatty infiltration can be misinterpreted as malignant deposits (4-7).
Recently,
some authors have suggested that the requirement for liver biopsy has been supplanted by advances in liver imaging and that biopsy may,
in the future,
be reserved for indeterminate cases only (8).