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The prevalence of fatty liver
general population is about 15%,
alcohol consumption (>60 g per day) 45%
hyperlipidemia (50%)
obesity (body mass index, >30 kg/m2) (75%),
both obesity and high alcohol consumption (95%)
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 This is the histologic appearance of hepatic macrovesicular steatosis (fatty change). The lipid accumulates in the hepatocytes as vacuoles which appear as clear ‘bubbles” with H&E staining. 02189
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Ultrasound
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MRI
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LIVER FAT
T1 Out of PHASE
The liver darkens on the out of phase indicating diffuse steatosis
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Diffuse Deposition
 Keywords: liver gallbladder steatosis fatty liver normal large hepatisation of the gallbladder Ashley Davidoff MD 37833c
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Focal Deposition and Focal Sparing
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Patchy
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Perivascular
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 CT without contrast at the level of the hepatic veins (a) shows a relatively dense IVC and some of the hepatic vein branches suggesting that the hepatic veins are surrounded by fat. The shape of the IVC (“saber IVC”) is also a sign of fatty liver. In image b and c the veins are in enhancedin the portal and hepatic venous phase and image d is the 5 minute delay showing similar findings. These findings are compatable with the diagnosis of perivascular fatty infiltration around the hepatic veins
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Ashley DAvidoff MD TheCommonVein.net
Ashley DAvidoff MD TheCommonVein.net
Ashley Davidoff MD TheCommonVein.net
References
Radiographics
Okka, W et al
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38 year alcoholic man with abdominal pain liver failure and GI bleedingT1 IN PHASE _T1 OUT of PHASET2 fat sat 005Image a is the in phase study and image b the “out of phase confirming that the perivascular streaking is composed of fatAshley Davidoff MD130305
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38 year alcoholic man with abdominal pain liver failure and GI bleedingUltrasound shows hypodense streaking of the liver hepatopetal blood flow in the portal vein and splenomegaly (16cms)
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38 year alcoholic man with abdominal pain liver failure and GI bleedingCT without contrast at the level of the hepatic veins (a) shows a relatively dense IVC and some of the hepatic vein branches suggesting that the hepatic veins are surrounded by fat. The shape of the IVC (“saber IVC”) is also a sign of fatty liver.In image b and c the veins are in enhancedin the portal and hepatic venous phase and image d is the 5 minute delay showing similar findings. These findings are compatable with the diagnosis of perivascular fatty infiltration around the hepatic veins
38 year alcoholic man with abdominal pain liver failure and GI bleedingCoronal imaging showing hepatic veins and portal veins. Splenomegaly is present.
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38 year alcoholic man with abdominal pain liver failure and GI bleedingCT without contrast at the level of the hepatic veins (a) shows a relatively dense IVC and some of the hepatic vein branches suggesting that the hepatic veins are surrounded by fat. The shape of the IVC (“saber IVC”) is also a sign of fatty liver.In image b and c the veins are in enhancedin the portal and hepatic venous phase and image d is the 5 minute delay showing similar findings. These findings are compatable with the diagnosis of perivascular fatty infiltration around the hepatic veins
38 year alcoholic man with abdominal pain liver failure and GI bleedingCoronal imaging showing hepatic veins and portal veins. Splenomegaly is present.
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38 year alcoholic man with abdominal pain liver failure and GI bleedingCT without contrast at the level of the hepatic veins (a) shows a relatively dense IVC and some of the hepatic vein branches suggesting that the hepatic veins are surrounded by fat. The shape of the IVC (“saber IVC”) is also a sign of fatty liver.In image b and c the veins are in enhancedin the portal and hepatic venous phase and image d is the 5 minute delay showing similar findings. These findings are compatable with the diagnosis of perivascular fatty infiltration around the hepatic veins
38 year alcoholic man with abdominal pain liver failure and GI bleedingCoronal imaging showing hepatic veins and portal veins. Splenomegaly is present.
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38 year alcoholic man with abdominal pain liver failure and GI bleedingCT without contrast at the level of the hepatic veins (a) shows a relatively dense IVC and some of the hepatic vein branches suggesting that the hepatic veins are surrounded by fat. The shape of the IVC (“saber IVC”) is also a sign of fatty liver.In image b and c the veins are in enhancedin the portal and hepatic venous phase and image d is the 5 minute delay showing similar findings. These findings are compatable with the diagnosis of perivascular fatty infiltration around the hepatic veins
38 year alcoholic man with abdominal pain liver failure and GI bleedingCoronal imaging showing hepatic veins and portal veins. Splenomegaly is present.
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fatty change around the hepatic veins. This pattern is known as perivascular fatty infiltrationkey wordsliver heterogeneous vein IVC fx deformed dx fatty liver dx steatosis imaging radiology CTscan ascitesAshley DAvidoff MD24155
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fatty change around the hepatic veins. This pattern is known as perivascular fatty infiltrationkey wordsliver heterogeneous vein IVC fx deformed dx fatty liver dx steatosis imaging radiology CTscan ascitesAshley DAvidoff MD24155
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fatty change around the hepatic veins. This pattern is known as perivascular fatty infiltrationkey wordsliver heterogeneous vein IVC fx deformed dx fatty liver dx steatosis imaging radiology CTscan ascitesAshley DAvidoff MD24155
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fatty change around the hepatic veins. This pattern is known as perivascular fatty infiltrationkey wordsliver heterogeneous vein IVC fx deformed dx fatty liver dx steatosis imaging radiology CTscan ascitesAshley DAvidoff MD24155
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Patchy fatty change in the left lobe by Ultrasound
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Patchy fatty change in the left lobe by Ultrasound
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Axial CT (top) and coronal reconstruction (bottom) showperipheral fatty change ith central sparing .Ashley Davidof MD78207c
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Axial CT (top) and coronal reconstruction (bottom) showperipheral fatty change ith central sparing .Ashley Davidof MD78207c
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Axial CT (top) and coronal reconstruction (bottom) showperipheral fatty change ith central sparing .Ashley Davidof MD78207c
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CT scan shows segmental fatty change and fatty sparing in a patient with acute alcoholic hepatitis.IVC thrombosis and gastric erosion 40277c code pancreas fx enlarged peripancreatic effusion exudate induration code liver fx segmental hypodensity dx fatty change steatosis code stomach fx thick walled code IVC thrombus code dx acute alcoholic pancreatitis complicated by IVC thrombosis gastric erosion imaging radiology CTscan inflammationKeywords:pancreas fx enlarged peripancreatic effusion exudate induration code liver fx segmental hypodensity dx fatty change steatosis code stomach fx thick walled code IVC thrombus code dx acute alcoholic pancreatitis complicated by IVC thrombosis gastric erosion imaging radiology CTscan inflammation
Axial CT shows segmental sparing of segment8 and 4 a and 2 with some sparing of the caudate in the region of the interlobar fissure. However segment 6/7 and 3 show steatosis with segmental pattern in 6/7 and heterogeneous pattern in 2/3Ashley Davidoff MD39659
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CT scan shows segmental fatty change and fatty sparing in a patient with acute alcoholic hepatitis.IVC thrombosis and gastric erosion 40277c code pancreas fx enlarged peripancreatic effusion exudate induration code liver fx segmental hypodensity dx fatty change steatosis code stomach fx thick walled code IVC thrombus code dx acute alcoholic pancreatitis complicated by IVC thrombosis gastric erosion imaging radiology CTscan inflammationKeywords:pancreas fx enlarged peripancreatic effusion exudate induration code liver fx segmental hypodensity dx fatty change steatosis code stomach fx thick walled code IVC thrombus code dx acute alcoholic pancreatitis complicated by IVC thrombosis gastric erosion imaging radiology CTscan inflammation
Axial CT shows segmental sparing of segment8 and 4 a and 2 with some sparing of the caudate in the region of the interlobar fissure. However segment 6/7 and 3 show steatosis with segmental pattern in 6/7 and heterogeneous pattern in 2/3Ashley Davidoff MD39659
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Axial CT shows segmental sparing of segment8 and 4 a and 2 with some sparing of the caudate in the region of the interlobar fissure. However segment 6/7 and 3 show steatosis with segmental pattern in 6/7 and heterogeneous pattern in 2/3Ashley Davidoff MD39659
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Axial CT shows segmental sparing of segment8 and 4 a and 2 with some sparing of the caudate in the region of the interlobar fissure. However segment 6/7 and 3 show steatosis with segmental pattern in 6/7 and heterogeneous pattern in 2/3Ashley Davidoff MD39659
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CT scan shows segmental fatty change and fatty sparing in a patient with acute alcoholic hepatitis.IVC thrombosis and gastric erosion 40277c code pancreas fx enlarged peripancreatic effusion exudate induration code liver fx segmental hypodensity dx fatty change steatosis code stomach fx thick walled code IVC thrombus code dx acute alcoholic pancreatitis complicated by IVC thrombosis gastric erosion imaging radiology CTscan inflammationKeywords:pancreas fx enlarged peripancreatic effusion exudate induration code liver fx segmental hypodensity dx fatty change steatosis code stomach fx thick walled code IVC thrombus code dx acute alcoholic pancreatitis complicated by IVC thrombosis gastric erosion imaging radiology CTscan inflammation
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CT scan shows segmental fatty change and fatty sparing in a patient with acute alcoholic hepatitis.IVC thrombosis and gastric erosion 40277c code pancreas fx enlarged peripancreatic effusion exudate induration code liver fx segmental hypodensity dx fatty change steatosis code stomach fx thick walled code IVC thrombus code dx acute alcoholic pancreatitis complicated by IVC thrombosis gastric erosion imaging radiology CTscan inflammationKeywords:pancreas fx enlarged peripancreatic effusion exudate induration code liver fx segmental hypodensity dx fatty change steatosis code stomach fx thick walled code IVC thrombus code dx acute alcoholic pancreatitis complicated by IVC thrombosis gastric erosion imaging radiology CTscan inflammation
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https://beta.thecommonvein.net/wp-content/uploads/2023/03/39659.jpg
https://liver.thecommonvein.net/wp-content/uploads/2019/11/40277c.jpg
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Normal (above) and Diffuse Fatty Infiltration (below) Images a and b are from a normal patient. Note the density of the liver and compare to the density of the gallbladder in image b. The patient in c and d has diffuse steatosis and an enlarged liver. Note the difference in the liver density of the two cases and the difference in the relative densities of the gall bladders. The liver is normal in size in case A (a,b) and enlarged in case B (c.d) The patient in c and d is known to abuse both alcohol and drugs. The liver in images c and d is the same density as the gallbladder. This is called hepatisation of the gallbladder code liver gallbladder steatosis fatty liver normal largeKeywords:liver gallbladder steatosis fatty liver normal large hepatisation of the gallbladder Ashley Davidoff MD 37833c
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Normal (above) and Diffuse Fatty Infiltration (below) Images a and b are from a normal patient. Note the density of the liver and compare to the density of the gallbladder in image b. The patient in c and d has diffuse steatosis and an enlarged liver. Note the difference in the liver density of the two cases and the difference in the relative densities of the gall bladders. The liver is normal in size in case A (a,b) and enlarged in case B (c.d) The patient in c and d is known to abuse both alcohol and drugs. The liver in images c and d is the same density as the gallbladder. This is called hepatisation of the gallbladder code liver gallbladder steatosis fatty liver normal largeKeywords:liver gallbladder steatosis fatty liver normal large hepatisation of the gallbladder Ashley Davidoff MD 37833c
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Normal (above) and Diffuse Fatty Infiltration (below) Images a and b are from a normal patient. Note the density of the liver and compare to the density of the gallbladder in image b. The patient in c and d has diffuse steatosis and an enlarged liver. Note the difference in the liver density of the two cases and the difference in the relative densities of the gall bladders. The liver is normal in size in case A (a,b) and enlarged in case B (c.d) The patient in c and d is known to abuse both alcohol and drugs. The liver in images c and d is the same density as the gallbladder. This is called hepatisation of the gallbladder code liver gallbladder steatosis fatty liver normal largeKeywords:liver gallbladder steatosis fatty liver normal large hepatisation of the gallbladder Ashley Davidoff MD 37833c
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Normal (above) and Diffuse Fatty Infiltration (below) Images a and b are from a normal patient. Note the density of the liver and compare to the density of the gallbladder in image b. The patient in c and d has diffuse steatosis and an enlarged liver. Note the difference in the liver density of the two cases and the difference in the relative densities of the gall bladders. The liver is normal in size in case A (a,b) and enlarged in case B (c.d) The patient in c and d is known to abuse both alcohol and drugs. The liver in images c and d is the same density as the gallbladder. This is called hepatisation of the gallbladder code liver gallbladder steatosis fatty liver normal largeKeywords:liver gallbladder steatosis fatty liver normal large hepatisation of the gallbladder Ashley Davidoff MD 37833c
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