Hepatic steatosis

  • Increased triglyceride loading of hepatocytes
  • Acute and chronic alcohol abuse
  • Obesity
  • Diabetes mellitus
  • Insulin resistance
  • Cystic fibrosis
  • Malnourishment
  • Total parenteral nutrition
  • Tetracyclines, steroids, ileal bypass
  • US: increased parenchymal reflectivity, obscures portal vein margins
  • CT: helps quantify. Fat reduces 1.6 HU for every mg of triglyceride increase per gram of liver substance. Preserved liver architecture and vascular pattern. Liver enhances normally post i.v. contrast. Reversal of liver-spleen and liver-blood attenuation difference
  • MRI: most sensitive and specific with chemical shift and in- and out-of-phase imaging
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Ma, Xiaozhou, et al. “Imaging-based quantification of hepatic fat: methods and clinical applications.” Radiographics 29.5 (2009): 1253-1277.

Son, Jee-Young, et al. “Hepatic steatosis: assessment with acoustic structure quantification of US imaging.” Radiology 278.1 (2016): 257-264.