Hepatic Steatosis
Accumulation of increasing amount of triglycerides within
hepatocytes.
• Diffuse fatty infiltration
○ Increased echogenicity with liver more echogenic than
kidney.
○ Attenuation of US beam results in poor visualization of diaphragm.
○ Poor visualization of hepatic and portal veins.
• Focal fatty infiltration
○ Hyperechoic nodule or multiple confluent hyperechoic lesions.
○ No mass effect with vessels running undisplaced through lesion.
○ Wedge-shaped/lobar/segmental distribution.
• Focal fatty sparing
○ Direct drainage of hepatic blood into systemic circulation
○ Gallbladder bed: Drained by cystic vein
○ Segment 4 or anterior to portal bifurcation: Drained by aberrant gastric vein
○ No mass effect with undisplaced vessel