Presentation
Mass on ultrasound for further evaluation.
Patient Data
Within liver segment 4 adjacent to the porta hepatis is a geographic region of altered signal, which is mildly T2 high signal with decreased signal on fat suppression, isointense on in-phase T1 with marked dropout on out-of-phase T1. On post-contrast imaging, this region remains hypointense to the background liver and has vessels coursing through. No abnormally restricted diffusion.
Case Discussion
Focal hepatic steatosis is a well-known mimick of hepatic masses, the loss of signal on the fat-suppressed sequences and between the T1 in-phase and out-of-phase sequences is characteristic.