Imaging in Fatty Liver (Steatosis) - Radiological Methods

Abstract

Hepatic fatty metamorphosis or steatosis is the metabolic complication of a variety of toxic, ischaemic and infectious insults to the liver. It is the abnormality most frequently seen in liver biopsies of alcoholics and this abnormality can be seen in 50% of patients with diabetes mellitus. With increasing frequency of obesity in the population hepatic steatosis has become a major source of hepatic dysfunction. Macrovesicular fatty disorders of the liver encompass a spectrum of histological disease including macrovesicular fatty liver, non alcoholic steatohepatitis (NASH), steatohepatitis with fibrosis and cirrhosis liver.  

On sonograms the fatty liver appears diffusely echogenic and the degree of echogenicity is roughly proportional to the level of steatosis. The sonographic changes parallel biochemical and clinic dysfunction. The brightness of the parenchymal echoes is increased and there are more number of echogenic foci within the parenchyma. There is increased attenuation of the Ultrasound beam with poor visualization of deep hepatic structures and the hepatic venous system.

Imaging in hepatitis is usually done to ensure that there is no obstructive component to patient's hepatic dysfunction, to rule out hepatocellular carcinoma etc.