[Irregular hepatic steatosis. Clinical and imaging study of 6 cases]

Irregular fatty infiltration of the liver is an entity that may be confused with liver metastasis. Since ultrasonography and computed tomography of the liver are frequently performed, it seems to be a relatively commonly encountered lesion. The features of this syndrome are described herein in six patients in whom a liver biopsy confirmed diagnosis. Clinical and biological findings were non-specific. In 3 cases ultrasound examination of the liver showed increased echogenic areas. In 3 cases of large lesions, the remaining normal liver was seen as areas of decreased echogenicity and the fatty infiltration was considered falsely normal. The scanographic features of this entity were much more typical than those seen on ultrasonography. With CT, irregular fatty liver usually has a distinctive appearance characterized by a non-spherical shape, absence of mass effect and a density close to water (3 cases). When the fatty lesions are focal (3 cases) and less characteristic on CT, liver biopsy should be performed to confirm the diagnosis. Repeated CT examinations can demonstrate partial or total resolution of the lesions when conditions known to be associated with fatty liver have been treated.