Presentation
Known diabetic and hypertensive patient presents with epigastric pain and abdominal distension.
Patient Data
The liver has a diffuse increase in echogenicity with relative hypo-echogenicity of the right kidney.
Periportal echogenicity is obscured. Diaphragmatic echogenicity is appreciated, (grade 2 hepatic steatosis).
A well defined, thin walled uniformly anechoic cyst on the inferior pole of the left kidney with posterior acoustic enhancement (uncomplicated renal cyst) is noted.
Case Discussion
Diffuse hepatic steatosis or fatty liver is a condition arising from fat build up in the liver. It is a common condition with 25 % of the population being affected.
Radiologically, three grades of diffuse hepatic steatosis exist depending on the effect of fat infiltration on periportal and diaphragmatic echogenicity.
Renal cysts are usually evaluated by complexity with ultrasound characterization being either uncomplicated or complicated cyst.
The Bosniak classification has been proposed to increase accuracy, named after Professor Morton A Bosniak (1929-2016). The use of ultrasound in the Bosniak classification remains controversial although some radiology and urology specialists do use it due to its high sensitivity to septa in comparison to CT and MRI and newer practices like contrast-enhanced ultrasound can demonstrated vascularization pattern.
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