Hepatic fatty infiltration
- Reversible, accumulation of triglycerides in the cytoplasma of the hepatocytes,
- Associated with a variety of conditions and diseases.
- Excessive alcohol consumption
- Parenteral nutrition
- Steroids administration or excessive endogeneous production of steroids.
- Fatty infiltration of the liver may be diffuse affecting the whole liver but is commonly nonuniform or focal.
- Fatty infiltration of the liver usually will not cause any clinical symptomatology, although in some persons, vague upper quadrant pain may be reported.
- On clinical examination hepatomegaly may be noted and an elevation of enzymes such as transaminases alkaline phosphatases may be present.
 Imaging Findings
- A decrease in mean hepatic attenuation values proportional to the degree of increase of the hepatic triglycerids.
- Intrahepatic vessels are more clearly distinguished as hyperattenuating structures from the surrounding liver parenchyma
- In normal individuals the attenuation value of the liver is slightly higher than that of the spleen. In fatty liver infiltration the attenuation values of both organs tend to be equal or the ratios may be reversed.
- Does not cause any mass effect nor contour deformation of the organ.
- Intrahepatic vessels follow their normal course through the lesion without deformity.
Patient #2: Perivascular fatty infiltration
Patient #3: Fatty infiltration on ultrasound
Patient #4: Fatty liver on ultrasound. Note that liver is very echogenic when compared to right kidney