Multifocal Nodular Fatty Sparing Mimicking Hepatic Tumors

Abstract

Hepatic steatosis is frequent; however, it may present with unusual patterns, resulting in a diagnostic dilemma. Herein, we present a case of fatty liver and multifocal nodular hepatic lesions that were found to be due to multifocal nodular fatty sparing, which mimics metastasis or primary multifocal tumors. As the differential diagnosis of such lesions can be difficult based on ultrasound alone, the knowledge of Magnetic Resonance Imaging (MRI) findings is crucial. It enables the radiologists to make the correct diagnosis and alleviate the patient from unnecessary biopsies.

Radiopathologic findings of multifocal nodular hepatic steatosis

“…The lesions may be seen on CT images as multiple non-enhancing hypodense geographic or nodular lesions scattered throughout the hepatic parenchyma. On MRI, MFNHS may present as non-enhancing geographic or nodular lesions of variable T1/T2 hyperintensity which do not restrict diffusion [ 5 , [9] , [10] , [11] ]. Importantly, these lesions do not invade the surrounding vasculature or biliary system.…”