No abstract

The purpose of this study was to determine the prevalence and localization of focal areas of sparing in a population of patients with fatty infiltration (steatosis) of the liver. We also sought to determine if the blood supply of the gallbladder has an effect on fatty infiltration of the liver adjacent to it. We studied 290 patients with sonographic signs of fatty infiltration of the liver with gray scale sonography. In 58 of the patients, the gallbladder had been removed previous· ly. A zone of focal sparing was found in 67% of patients with liver steatosis (78~ in patients with an intact gallbladder versus 33% in patients with previ· ous cholecystectomy). In patients with an intact gallbladder, segments 4 and 5 were spared most often. These segments were rarely spared in patients with previous cholecystectomy. Other sites of focal sparing were observed with the same frequency in the two groups. We conclude that focal sparing occurs frequently in patients with liver steatosis, especially in segments 4 and 5. When the gallbladder is absent, areas of focal sparing are less frequent, and they rarely involve segments 4 and 5. This suggests that the blood supfly of the gallbladder plays a role in the distribution o the fat in the adjacent liver. Focal sparing might serve as an additional sign in the diagnosis of steatosis of the liver, especially in patients with an intact gallbladder. KEY WORDS: Steatosis; Liver, fatty infiltration; Gallbladder.diffuse, but focal areas of sparing have been described in several small series, in what appears to be exceptional cases.2-6 We attempted to determine (1) the prevalence of focal sparing in a large population of patients with steatosis; (2) whether there are areas in the liver that are usually spared, and (3) whether the gallbladder and its vascularization favor the sparing of liver parenchyma from fatty infiltration. MATERIAL AND METHODSOver a period of 12 months, all patients undergoing abdominal sonography were examined by two experienced radiologists. Patients in whom sonographic signs of steatosis were found were included in the study. Patients with metastasis or a liver tumor were excluded. The study group consisted of 137 men

A decreased diameter of segment 4 may be a helpful adjunct sign of cirrhosis in the US investigation of chronic liver disease.

Two cases of liver angiomyolipoma (AML) are presented. The first case has the classical imaging findings previously reported. The second case has no fat content on the various imaging modalities. AML should probably be included in the differential diagnosis of any hypervascular lesion of the liver. Preoperative diagnosis with core biopsy is possible.