Fact-sheet: Fatty liver


Updated on 08/25/2020 at 5:13 PM

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Definition

Liver disease corresponding to lipid accumulation in hepatocytes.

The most common etiologies are alcohol abuse, diabetes, obesity, and hyperlipidemia.

Clinical features

  • Asymptomatic
  • Uniform hepatomegaly

Laboratory findings

Correlated with the etiology of fatty liver.

Ultrasound

  • Markedly hyperechoic, homogeneous liver
  • Sometimes heterogeneous areas of fatty change, with geographic contours
  • Hepatorenal gradient: the renal cortex appears more hypoechoic than the adjacent liver.
  • Homogeneous hepatomegaly
  • No mass effect on vascular structures

CT

  • Hypodensity < 30 HU in the liver
  • Liver-spleen density difference < -9 HU
  • Inversion of parenchyma-vessel contrast on unenhanced imaging
  • No mass effect on vascular structures

MRI

  • Out-of-phase sequence: signal drop

The presence of iron overload interferes with the analysis.

Management

  • Lifestyle and dietary measures
  • Treatment of the underlying cause
  • Reversibility and rapid progression of this condition.

Differential diagnosis

  • Pseudotumoral appearance of geographic fatty liver