Hepatic Steatosis: Etiology, Patterns and Quantification

Publication date: Available online 12 August 2016 Source:Seminars in Ultrasound, CT and MRI Author(s): Ilkay S. Idilman, Ilknur Ozdeniz, Musturay Karcaaltincaba Hepatic steatosis can occur due to nonalcoholic fatty liver disease (NAFLD), alcoholism, chemotherapy, metabolic, toxic and infectious causes. Pediatric hepatic steatosis is also becoming more frequent and can have distinctive features. Most common pattern is diffuse form, however it can present as heterogenous, focal, multinodular, perilesional, perivascular, subcapsular and lobar forms. Focal steatosis and fat sparing can occur due to presence of veins of Sappey, pancreaticoduodenal, aberrant right and left gastric veins, which drain into the liver as third inflow. Hypersteatosis and multinodular forms can mimic metastasis in cancer patients. Perilesional fat can be seen in insulinoma. Recent introduction of proton density fat fraction (PDFF) enabled easy and reproducible quantification of hepatic fat. Follow-up of NAFLD patients can be performed for the assessment of treatment response using PDFF as biomarker. Multiecho gradient echo techniques also simultaneously calculate T2* maps, which is important to rule out coexisting hepatic iron overload. NAFLD can progress into steatohepatitis (NASH), which can end up with cirrhosis. MR elastography and functional evaluation with Gd-EOB-DTPA are becoming important for monitoring this process. Hepatocellular carcinoma can develop in patients with NAFLD, which is usual...
Source: Seminars in Ultrasound, CT and MRI - Category: Radiology Source Type: research