[Pseudotumorous "skip area" in subtotal hepatic steatosis. Echographic and computed tomographic aspects]

In 75 patients ultrasound (US) demonstrated fatty infiltration of the liver with diffuse increased echogenicity except for a solitary hypoechogenic area located in the quadrate lobe. The liver was also followed-up with US, computed tomography (CT), radionuclide scintigraphy, and fine needle biopsy: a skip area unaffected by steatosis was thus demonstrated. This study and further information found in literature allowed the authors to identify the particular US features which lead to a correct interpretation of these findings, which might otherwise be incorrectly diagnosed as suggestive of substitutive lesions (primary or secondary). These features are: 1) the location of skip areas, usually in the IV segment, in close relationship to a portal vessel; 2) their morphology, triangular, or inverted-V shaped; 3) the absence of mass effects upon the hepatic border and/or upon the adjacent vessels; 4) the presence of fatty liver infiltration; 5) the coexistence of a biohumoral pattern significant for diffuse hepatopathy; 6) the lack of change in US patterns during the follow-up.