GI Radiology > Liver > Diffuse > Diffuse Fatty Infiltration

Diffuse Hepatic Disease

Diffuse Fatty Infiltration

  1. Pathogenesis:
  • A reversible process in which triglyceride accumulates diffusely in hepatocytes causing abnormal appearance on imaging. Normally, less than 5% of the liver is composed of fat. In diffuse fatty infiltrated liver, fat can make up to 50% of the liver tissue.
     
  • Commonly seen in acute or chronic alcohol abuse (most common), obesity, diabetes, cystic fibrosis, tetracycline, steroids, chemotherapy, malnutrition, and hyperalimentation.
     
  • Clinically, patients are asymptomatic. Liver can be enlarged but without splenomegaly.
     
  • Removal of offending agents reverses the process.
  1. Radiographic findings:
  • U/S: the liver has increased focal or diffuse echogenicity when compared to the surrounding organs such as the kidneys.

  • Noncontrast CT: the liver looks hypodense to the spleen due to fatty infiltration, making the hepatic vasculature more prominent.

  • MRI: the most sensitive and specific technique for detecting hepatic fat infiltration but is primarily used for focal fat infiltration.

 

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