ABSTRACT
Hepatic steatosis is a common finding encountered during cross-sectional imaging examinations.
This article reviews the imaging findings of hepatic steatosis as revealed by sonography,
computed tomography, magnetic resonance imaging, and magnetic resonance spectroscopy.
Focal fatty sparing and focal hepatic steatosis are conditions that can create potential
diagnostic challenges for the radiologist. The typical findings, distribution, and
etiology of these focal processes are presented. In the setting of diffuse hepatic
steatosis, hepatic mass lesions can be difficult to discern on both computed tomography
and sonography, with reported decreased sensitivity and specificity of lesion detection.
In such cases, magnetic resonance imaging may be the imaging procedure of choice for
the detection and characterization of both hepatic steatosis and coexistent hepatic
masses. Some hepatocellular neoplasms, particularly hepatic adenoma and well-differentiated
hepatocellular carcinoma, can have intratumoral lipid. By demonstrating the lipid
content of these masses, imaging can add specificity in characterizing them as hepatocellular
in origin because nonhepatocellular neoplasms in general do not contain intracellular
lipid.
KEYWORD
Magnetic resonance imaging - hepatic steatosis - magnetic resonance - chemical shift
