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Case of the Month

July 2018

Patient Data: Middle aged male patient examined for SONOZORG a primary care ultrasound facility

Clinical Info: Incidental finding


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The lesions are A Metastases B Hemangiomas C Hamartomas D Focal fatty liver


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Here are four images of the same patient


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Here are some more images of the same patient


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Another series of images of the liver


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Here are some more images of the same patient


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Here is the liver of another patient with the same focal fatty liver changes


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This is a third patient with more confluating focal fatty liver changes


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This is the liver of another patient. When focal liver changes look like this it is called multinodular focal liver disease and can very well be mistaken for metastases or haemangiomas.In these cases an MRI can help. Using the combination of in-phase (IP) and opposedphase (OP) gradient-echo imaging (low signal intensity in OP images compared with IP images) Also contrast-enhanced ultrasound has been reported to reliably distinguish MNFIL from metastatic liver

The lesions in these cases all proved to be focal fatty liver changes.

For more cases of focal fatty changes see

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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