fatty liver CT manifestations

Written by Shen Jiang Chao
Radiology
Updated on September 11, 2024
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Fatty liver, also known as hepatic steatosis, is a metabolic and functional abnormality of the liver that leads to abnormal deposition of fat in liver cells. Fatty liver typically presents characteristic features on a CT scan, generally starting with a decrease in density. The reference standard for decreased density is based on the spleen. Normally, the CT value of the liver is greater than that of the spleen. If the CT value of the liver is lower than that of the spleen, it can be diagnosed as fatty liver. Some focal fatty liver changes can also be diagnosed by CT, mainly manifested by a decrease in density in a particular lobe or segment of the liver, but the blood vessels can still be normally visualized.

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Written by Tang Li
Cardiology
1min 17sec home-news-image

Is hyperlipidemia fatty liver disease?

Hyperlipidemia and fatty liver are actually two different concepts. Hyperlipidemia is essentially dyslipidemia, which refers to abnormal quality and quantity of lipids in the plasma. The tests for blood lipids include total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. With our medical history, physical signs, and laboratory tests, diagnosing hyperlipidemia is not difficult. The current diagnostic criteria are mainly based on the 2017 Chinese guidelines for the prevention and treatment of dyslipidemia in adults, where low-density lipoprotein greater than 4.14 mmol/L suggests elevated low-density lipoprotein. Fatty liver, on the other hand, refers to excessive fat accumulation within liver cells due to various reasons, and is a common pathological change in the liver, rather than an independent disease. Patients with hyperlipidemia are prone to fatty liver.

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Written by Ren Zheng Xin
Gastroenterology
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Do fatty livers need to be treated?

Fatty liver refers to the excessive accumulation of fat in liver cells. For mild fatty liver, clinical symptoms are not obvious, and there are not many abnormal indicators during physical examinations. In such cases, one can adjust the diet and increase exercise appropriately to promote the consumption of fat in the body. If there is a significant liver function abnormality, increased transaminases, and symptoms of nausea and vomiting, one can choose to use medications that protect the liver, reduce lipids, and provide antioxidants for treatment. At the same time, it is important to maintain a positive mindset and regularly visit the hospital for follow-up checks. (The use of medications should be under the guidance of a doctor.)

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Written by Si Li Li
Gastroenterology
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How to treat severe fatty liver?

The treatment of severe fatty liver is not significantly different from that of mild to moderate fatty liver in terms of medication. The main aspects of treating severe fatty liver include: Firstly, general treatment, which encompasses a healthy diet, appropriate exercise, weight control, and avoiding liver damage. Secondly, medication treatment: Due to large individual differences, there is no absolute, best, quickest, or most effective medication. Apart from using common over-the-counter drugs, it is important to select the appropriate medication based on individual circumstances. Additionally, surgical treatment options are available. For patients with severe obesity and type 2 diabetes, or for those with moderate cases but ineffective control of blood sugar through conservative treatment, weight loss surgery can be considered. Furthermore, combining treatment with traditional Chinese medicine and herbs can also yield excellent results for severe fatty liver.

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Written by Shen Jiang Chao
Radiology
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Fatty liver MRI manifestations

Fatty liver, also known as hepatic steatosis, typically appears normal in most cases on MRI. However, a minority of cases may show high signals on T1 and T2. In fat-suppressed sequences, the high signals disappear after the fat is suppressed, appearing as low signal shadows. MRI has a specific sequence for examining fatty liver, known as the dual-echo sequence, which includes two sequences: one is the in-phase sequence and the other is called the opposed-phase sequence. The in-phase sequence examines the liver parenchyma, while a characteristic feature in the opposed-phase sequence is the significant decrease in signal in areas of fatty metamorphosis.

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Written by Li Xue Qing
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What foods should people with fatty liver avoid?

People with fatty liver should avoid overly greasy foods such as fatty meat, pig trotters, braised chicken, and braised duck. It is also important not to consume too much meat or foods high in sugar. Excessive intake of meat and sugar can be converted into fat and stored in the body, leading to high levels of fat. Therefore, control is also needed over the consumption of meat and fruits or foods that are high in sugar.