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RUQ US; 50-year old diabetic female, vague abdominal discomfort
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Liver measured 17 cm in mid-clavicular line Important findings? Dx? Confirmatory studies?
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Answers
Fatty Infiltration with Focal Sparing
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  • Fatty Infiltration with poorly controlled DM (50%), pregnancy, steroids, chemo, obesity, TPN, trauma, Reye’s syndrome, etc.
  • Spared portion is normally the medial segment of the left lobe
  • Normal vessels in both fatty & spared liver suggestive
  • Increased attnuation of sound beam characteristic of fat, not fibrosis

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Fatty Infiltration – CT Correlation

  • Marked hypoattenuation of liver, w/ normal vessels (liver is darker than portal vessels / IVC); reversal of liver-spleen density relationship
These signals are relayed buying clomid online safe which then is by a number of such as medial preoptic and paraventricular nulcei.
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