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Updated: May 30, 2026

Novel In Vivo Micro-Computed Tomography Imaging Techniques for Assessing the Progression of Non-Alcoholic Fatty Liver Disease
Published on: March 24, 2023
[Contrast-enhanced ultrasound of focal fatty sparing]
1Medizinische Klinik II, Klinikum Am Gesundbrunnen, SLK-Kliniken Heilbronn GmbH.
History And Clinical Findings:
A 52-year-old man went to his family doctor because of nonspecific abdominal complaints. The physical findings were unremarkable. The abdominal ultrasound unexpectedly showed a nonhomogeneous focal fatty sparing around the gallbladder fossa, which was the reason why the patient was referred for contrast-enhanced ultrasonography (CEUS).
Investigations:
The native ultrasound showed focal fatty sparing around the gallbladder fossa, while the CEUS demonstrated a high-flow hemangioma with subsequent peritumoral fatty sparing caused by arterioportal shunts. MRI of the liver confirmed the hemangioma.
Conclusion:
Focal fatty sparing which is nonspecific and not typical in its localization should be carefully investigated, because it could be a peritumoral fatty sparing. The same is true for nonhomogeneous fatty sparing at a typical position. Special attention should be given to signs of shunting. The CEUS in low-MI mode provides a dynamic real-time examination and is the method of choice in this situation.
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