Presentation
History of cholecystectomy presenting with recurrent abdominal pain.
Patient Data
CT showed multiple bi-lobar hepatic branching areas of low CT density on all phases attaining a dominant peri-portal distribution with less fatty parenchymal bridges (pseudo-septations). They are exerting no mass effect on the surrounding structures with vessels passing via these areas (vessel penetration sign). CT density of the aforementioned areas had a mean attenuation value - 30 HU (fat density)
The aforementioned bilobar hepatic parenchymal areas showed hyperintense signal on T1 with signal drop out on the out-of-phase sequence confirming its fatty nature.
Case Discussion
Bilobar hepatic parenchymal lobar areas of low CT density reading a fat density. MRI showed high T1 signal with a drop in signal on out-of-phase images.
The CT and MR picture pathognomonic of focal fatty infiltration.