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Abdominal Radiology

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20.12.2016 | Pictorial Essay

Imaging patterns and focal lesions in fatty liver: a pictorial review

verfasst von: Sudhakar K. Venkatesh, Tiffany Hennedige, Geoffrey B. Johnson, David M. Hough, Joel G. Fletcher

Erschienen in: Abdominal Radiology | Ausgabe 5/2017

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Abstract

Non-alcoholic fatty liver disease is the most common cause of chronic liver disease and affects nearly one-third of US population. With the increasing trend of obesity in the population, associated fatty change in the liver will be a common feature observed in imaging studies. Fatty liver causes changes in liver parenchyma appearance on imaging modalities including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) and may affect the imaging characteristics of focal liver lesions (FLLs). The imaging characteristics of FLLs were classically described in a non-fatty liver. In addition, focal fatty change and focal fat sparing may also simulate FLLs. Knowledge of characteristic patterns of fatty change in the liver (diffuse, geographical, focal, subcapsular, and perivascular) and their impact on the detection and characterization of FLL is therefore important. In general, fatty change may improve detection of FLLs on MRI using fat suppression sequences, but may reduce sensitivity on a single-phase (portal venous) CT and conventional ultrasound. In patients with fatty liver, MRI is generally superior to ultrasound and CT for detection and characterization of FLL. In this pictorial essay, we describe the imaging patterns of fatty change in the liver and its effect on detection and characterization of FLLs on ultrasound, CT, MRI, and PET.

Vernon G, Baranova A, Younossi ZM (2011) Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther 34:274–285CrossRef

Boyce CJ, Pickhardt PJ, Kim DH, et al. (2010) Hepatic steatosis (fatty liver disease) in asymptomatic adults identified by unenhanced low-dose CT. AJR Am J Roentgenol 194:623–628CrossRef

Ong JP, Elariny H, Collantes R, et al. (2005) Predictors of nonalcoholic steatohepatitis and advanced fibrosis in morbidly obese patients. Obes Surg 15:310–315CrossRef

Paredes AH, Torres DM, Harrison SA (2012) Nonalcoholic fatty liver disease. Clin Liver Dis 16:397–419CrossRef

Lazo M, Clark JM (2008) The epidemiology of nonalcoholic fatty liver disease: a global perspective. Semin Liver Dis 28:339–350CrossRef

Younossi ZM, Stepanova M, Afendy M, et al. (2011) Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008. Clin Gastroenterol Hepatol 9:524–530 ((e521; quiz e560))CrossRef

Hamaguchi M, Kojima T, Takeda N, et al. (2005) The metabolic syndrome as a predictor of nonalcoholic fatty liver disease. Ann Intern Med 143:722–728CrossRef

Hamer OW, Aguirre DA, Casola G, et al. (2006) Fatty liver: imaging patterns and pitfalls. Radiographics 26:1637–1653CrossRef

Wilson SR, Rosen IE, Chin-Sang HB, Arenson AM (1982) Fatty infiltration of the liver—an imaging challenge. J Can Assoc Radiol 33:227–232PubMed

10.

Bashist B, Hecht HL, Harley WD (1982) Computed tomographic demonstration of rapid changes in fatty infiltration of the liver. Radiology 142:691–692CrossRef

11.

Brunt EM (2007) Pathology of fatty liver disease. Mod Pathol 20(Suppl 1):S40–S48CrossRef

12.

Quinn SF, Gosink BB (1985) Characteristic sonographic signs of hepatic fatty infiltration. AJR Am J Roentgenol 145:753–755CrossRef

13.

Onishi H, Theisen D, Dietrich O, Reiser MF, Zech CJ (2014) Hepatic steatosis: effect on hepatocyte enhancement with gadoxetate disodium-enhanced liver MR imaging. J Magn Reson Imaging 39:42–50CrossRef

14.

Schwenzer NF, Springer F, Schraml C, et al. (2009) Non-invasive assessment and quantification of liver steatosis by ultrasound, computed tomography and magnetic resonance. J Hepatol 51:433–445CrossRef

15.

Fishbein M, Castro F, Cheruku S, et al. (2005) Hepatic MRI for fat quantitation: its relationship to fat morphology, diagnosis, and ultrasound. J Clin Gastroenterol 39:619–625CrossRef

16.

Needleman L, Kurtz AB, Rifkin MD, et al. (1986) Sonography of diffuse benign liver disease: accuracy of pattern recognition and grading. AJR Am J Roentgenol 146:1011–1015CrossRef

17.

Strauss S, Gavish E, Gottlieb P, Katsnelson L (2007) Interobserver and intraobserver variability in the sonographic assessment of fatty liver. AJR Am J Roentgenol 189:W320–W323CrossRef

18.

Sasso M, Beaugrand M, de Ledinghen V, et al. (2010) Controlled attenuation parameter (CAP): a novel VCTE™ guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes. Ultrasound Med Biol 36:1825–1835CrossRef

19.

Limanond P, Raman SS, Lassman C, et al. (2004) Macrovesicular hepatic steatosis in living related liver donors: correlation between CT and histologic findings. Radiology 230:276–280CrossRef

20.

Piekarski J, Goldberg HI, Royal SA, Axel L, Moss AA (1980) Difference between liver and spleen CT numbers in the normal adult: its usefulness in predicting the presence of diffuse liver disease. Radiology 137:727–729CrossRef

21.

Ricci C, Longo R, Gioulis E, et al. (1997) Noninvasive in vivo quantitative assessment of fat content in human liver. J Hepatol 27:108–113CrossRef

22.

Johnston RJ, Stamm ER, Lewin JM, Hendrick RE, Archer PG (1998) Diagnosis of fatty infiltration of the liver on contrast enhanced CT: limitations of liver-minus-spleen attenuation difference measurements. Abdom Imaging 23:409–415CrossRef

23.

Reeder SB, Cruite I, Hamilton G, Sirlin CB (2011) Quantitative assessment of liver fat with magnetic resonance imaging and spectroscopy. J Magn Reson Imaging 34:729–749CrossRef

24.

Yu H, McKenzie CA, Shimakawa A, et al. (2007) Multiecho reconstruction for simultaneous water-fat decomposition and T2* estimation. J Magn Reson Imaging 26:1153–1161CrossRef

25.

Reeder SB, Hu HH, Sirlin CB (2012) Proton density fat-fraction: a standardized MR-based biomarker of tissue fat concentration. J Magn Reson Imaging 36:1011–1014CrossRef

26.

Cassidy FH, Yokoo T, Aganovic L, et al. (2009) Fatty liver disease: MR imaging techniques for the detection and quantification of liver steatosis. Radiographics 29:231–260CrossRef

27.

Yu H, Shimakawa A, McKenzie CA, et al. (2008) Multiecho water-fat separation and simultaneous R2* estimation with multifrequency fat spectrum modeling. Magn Reson Med 60:1122–1134CrossRef

28.

Yu H, Shimakawa A, Hines CD, et al. (2011) Combination of complex-based and magnitude-based multiecho water-fat separation for accurate quantification of fat-fraction. Magn Reson Med 66:199–206CrossRef

29.

Décarie PO, Lepanto L, Billiard JS, et al. (2011) Fatty liver deposition and sparing: a pictorial review. Insights Imaging 2:533–538CrossRef

30.

Hamer OW, Aguirre DA, Casola G, Sirlin CB (2005) Imaging features of perivascular fatty infiltration of the liver: initial observations. Radiology 237:159–169CrossRef

31.

Kröncke TJ, Taupitz M, Kivelitz D, et al. (2000) Multifocal nodular fatty infiltration of the liver mimicking metastatic disease on CT: imaging findings and diagnosis using MR imaging. Eur Radiol 10:1095–1100CrossRef

32.

Sohn J, Siegelman E, Osiason A (2001) Unusual patterns of hepatic steatosis caused by the local effect of insulin revealed on chemical shift MR imaging. AJR Am J Roentgenol 176:471–474CrossRef

33.

Valls C, Iannacconne R, Alba E, et al. (2006) Fat in the liver: diagnosis and characterization. Eur Radiol 16:2292–2308CrossRef

34.

Marin D, Iannaccone R, Catalano C, Passariello R (2006) Multinodular focal fatty infiltration of the liver: atypical imaging findings on delayed T1-weighted Gd-BOPTA-enhanced liver-specific MR images. J Magn Reson Imaging 24:690–694CrossRef

35.

Yeom SK, Byun JH, Kim HJ, et al. (2013) Focal fat deposition at liver MRI with gadobenate dimeglumine and gadoxetic acid: quantitative and qualitative analysis. Magn Reson Imaging 31:911–917CrossRef

36.

Matsui O, Kadoya M, Takahashi S, et al. (1995) Focal sparing of segment IV in fatty livers shown by sonography and CT: correlation with aberrant gastric venous drainage. AJR Am J Roentgenol 164:1137–1140CrossRef

37.

Tom WW, Yeh BM, Cheng JC, et al. (2004) Hepatic pseudotumor due to nodular fatty sparing: the diagnostic role of opposed-phase MRI. AJR Am J Roentgenol 183:721–724CrossRef

38.

Itai Y (2000) Peritumoral sparing of fatty liver: another important instance of focal sparing caused by a hepatic tumor. AJR Am J Roentgenol 174:868–870CrossRef

39.

Grossholz M, Terrier F, Rubbia L, et al. (1998) Focal sparing in the fatty liver as a sign of an adjacent space-occupying lesion. AJR Am J Roentgenol 171:1391–1395CrossRef

40.

Chung JJ, Kim MJ, Kim JH, Lee JT, Yoo HS (2003) Fat sparing of surrounding liver from metastasis in patients with fatty liver: MR imaging with histopathologic correlation. AJR Am J Roentgenol 180:1347–1350CrossRef

41.

Gabata T, Kadoya M, Matsui O, et al. (2001) Peritumoral spared area in fatty liver: correlation between opposed-phase gradient-echo MR imaging and CT arteriography. Abdom Imaging 26:384–389CrossRef

42.

Martí-Bonmatí L, Peñaloza F, Villarreal E, Martinez MJ (2005) Nonspecificity of the fat-sparing ring surrounding focal liver lesion at MR imaging. Acad Radiol 12:1551–1556CrossRef

43.

Torres DM, Harrison SA (2012) Nonalcoholic steatohepatitis and noncirrhotic hepatocellular carcinoma: fertile soil. Semin Liver Dis 32:30–38CrossRef

44.

Baffy G, Brunt EM, Caldwell SH (2012) Hepatocellular carcinoma in non-alcoholic fatty liver disease: an emerging menace. J Hepatol 56:1384–1391CrossRef

45.

Schütte K, Schulz C, Poranzke J, et al. (2014) Characterization and prognosis of patients with hepatocellular carcinoma (HCC) in the non-cirrhotic liver. BMC Gastroenterol 14:117CrossRef

46.

van Kessel CS, Buckens CF, van den Bosch MA, et al. (2012) Preoperative imaging of colorectal liver metastases after neoadjuvant chemotherapy: a meta-analysis. Ann Surg Oncol 19:2805–2813CrossRef

47.

Berger-Kulemann V, Schima W, Baroud S, et al. (2012) Gadoxetic acid-enhanced 3.0 T MR imaging versus multidetector-row CT in the detection of colorectal metastases in fatty liver using intraoperative ultrasound and histopathology as a standard of reference. Eur J Surg Oncol 38:670–676CrossRef

48.

Kulemann V, Schima W, Tamandl D, et al. (2011) Preoperative detection of colorectal liver metastases in fatty liver: MDCT or MRI? Eur J Radiol 79:e1–e6CrossRef

49.

Reiter MJ, Hannemann NP, Schwope RB, Lisanti CJ, Learn PA (2015) Role of imaging for patients with colorectal hepatic metastases: what the radiologist needs to know. Abdom Imaging 40:3029–3042CrossRef

50.

Goodwin MD, Dobson JE, Sirlin CB, Lim BG, Stella DL (2011) Diagnostic challenges and pitfalls in MR imaging with hepatocyte-specific contrast agents. Radiographics 31:1547–1568CrossRef

51.

Grazioli L, Morana G, Kirchin MA, Schneider G (2005) Accurate differentiation of focal nodular hyperplasia from hepatic adenoma at gadobenate dimeglumine-enhanced MR imaging: prospective study. Radiology 236:166–177CrossRef

52.

Ronot M, Paradis V, Duran R, et al. (2013) MR findings of steatotic focal nodular hyperplasia and comparison with other fatty tumours. Eur Radiol 23:914–923CrossRef

53.

Bioulac-Sage P, Rebouissou S, Thomas C, et al. (2007) Hepatocellular adenoma subtype classification using molecular markers and immunohistochemistry. Hepatology 46:740–748CrossRef

54.

Alexander J, Torbenson M, Wu TT, Yeh MM (2013) Non-alcoholic fatty liver disease contributes to hepatocarcinogenesis in non-cirrhotic liver: a clinical and pathological study. J Gastroenterol Hepatol 28:848–854CrossRef

55.

Farges O, Ferreira N, Dokmak S, et al. (2011) Changing trends in malignant transformation of hepatocellular adenoma. Gut 60:85–89CrossRef

56.

Chang CY, Hernandez-Prera JC, Roayaie S, Schwartz M, Thung SN (2013) Changing epidemiology of hepatocellular adenoma in the United States: review of the literature. Int J Hepatol 2013:604860CrossRef

57.

Iannaccone R, Piacentini F, Murakami T, et al. (2007) Hepatocellular carcinoma in patients with nonalcoholic fatty liver disease: helical CT and MR imaging findings with clinical-pathologic comparison. Radiology 243:422–430CrossRef

58.

Bruix J, Sherman M, Diseases AAftSoL (2011) Management of hepatocellular carcinoma: an update. Hepatology 53:1020–1022CrossRef

59.

Bruix J, Sherman M, Practice Guidelines Committee AeAftSoLD (2005) Management of hepatocellular carcinoma. Hepatology 42:1208–1236CrossRef

60.

Liver EAFTSOT, Cancer EOFRATO (2012) EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 56:908–943CrossRef

61.

Omata M, Lesmana LA, Tateishi R, et al. (2010) Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma. Hepatol Int 4:439–474CrossRef

62.

Wu S, Tu R, Nan R, et al. (2016) Impact of variations in fatty liver on sonographic detection of focal hepatic lesions originally identified by CT. Ultrasonography 35:39–46CrossRef

63.

Van Vledder MG, Boctor EM, Assumpcao LR, et al. (2010) Intra-operative ultrasound elasticity imaging for monitoring of hepatic tumour thermal ablation. HPB 12:717–723CrossRef

64.

Esensten ML, Shaw SL, Pak HY, Gildenhorn HL (1983) CT demonstration of multiple intraperitoneal teratomatous implants. J Comput Assist Tomogr 7:1117–1118CrossRef

65.

Basaran C, Karcaaltincaba M, Akata D, et al. (2005) Fat-containing lesions of the liver: cross-sectional imaging findings with emphasis on MRI. AJR Am J Roentgenol 184:1103–1110CrossRef

66.

Lin CY, Lin WY, Lin CC, et al. (2011) The negative impact of fatty liver on maximum standard uptake value of liver on FDG PET. Clin Imaging 35:437–441CrossRef

67.

Bural GG, Torigian DA, Burke A, et al. (2010) Quantitative assessment of the hepatic metabolic volume product in patients with diffuse hepatic steatosis and normal controls through use of FDG-PET and MR imaging: a novel concept. Mol Imaging Biol 12:233–239CrossRef

68.

Abele JT, Fung CI (2010) Effect of hepatic steatosis on liver FDG uptake measured in mean standard uptake values. Radiology 254:917–924CrossRef

69.

Keramida G, Potts J, Bush J, et al. (2014) Accumulation of (18)F-FDG in the liver in hepatic steatosis. AJR Am J Roentgenol 203:643–648CrossRef

70.

Abikhzer G, Alabed YZ, Azoulay L, Assayag J, Rush C (2011) Altered hepatic metabolic activity in patients with hepatic steatosis on FDG PET/CT. AJR Am J Roentgenol 196:176–180CrossRef

71.

Moon SH, Hong SP, Cho YS, et al. (2015) Hepatic FDG uptake is associated with future cardiovascular events in asymptomatic individuals with non-alcoholic fatty liver disease. J Nucl Cardiol. doi:10.1007/s12350-015-0297-y CrossRefPubMed

72.

Kim YH, Kim JY, Jang SJ, et al. (2011) F-18 FDG uptake in focal fatty infiltration of liver mimicking hepatic malignancy on PET/CT images. Clin Nucl Med 36:1146–1148CrossRef

73.

Le Y, Chen Y, Huang Z, Cai L, Zhang L (2014) Intense FDG activity in focal hepatic steatosis. Clin Nucl Med 39:669–672CrossRef

74.

Harisankar CN (2014) Focal fat sparing of the liver: a nonmalignant cause of focal FDG uptake on FDG PET/CT. Clin Nucl Med 39:e359–e361PubMed

75.

Purandare NC, Rangarajan V, Rajnish A, et al. (2008) Focal fat spared area in the liver masquerading as hepatic metastasis on F-18 FDG PET imaging. Clin Nucl Med 33:802–805CrossRef

76.

Han N, Feng H, Arnous MM, Bouhari A, Lan X (2016) Multiple liver focal fat sparing lesions with unexpectedly increased (18)F-FDG uptake mimicking metastases examined by ultrasound (18)F-FDG PET/CT and MRI. Hell J Nucl Med 19:173–175PubMed

77.

Lubezky N, Metser U, Geva R, et al. (2007) The role and limitations of 18-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) scan and computerized tomography (CT) in restaging patients with hepatic colorectal metastases following neoadjuvant chemotherapy: comparison with operative and pathological findings. J Gastrointest Surg 11:472–478CrossRef

Titel: Imaging patterns and focal lesions in fatty liver: a pictorial review
verfasst von: Sudhakar K. Venkatesh
Tiffany Hennedige
Geoffrey B. Johnson
David M. Hough
Joel G. Fletcher
Publikationsdatum: 20.12.2016
Verlag: Springer US
Erschienen in: Abdominal Radiology / Ausgabe 5/2017
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-016-1002-6

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Imaging patterns and focal lesions in fatty liver: a pictorial review

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