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Hepatic Pseudotumor Due To Nodular Fatty Sparing: The Diagnostic Role of Opposed-Phase MRI

Wynnson W. Tom1, Benjamin M. Yeh2, Jonathan C. Cheng1,3, Aliya Qayyum2, Bonnie Joe2 and Fergus V. Coakley2

1 Department of Radiology, University of California San Francisco School of Medicine, 513 Parnassus Ave., San Francisco, CA 94143-0410.
2 Department of Radiology, Abdominal Imaging, University of California San Francisco, Box 0628, 505 Parnassus Ave., San Francisco, CA 94143-0628.
3 Present address: Department of Radiology, New York Medical College, Valhalla, NY 10595.



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  		Fig. 1A. —Focal nodular sparing in 13-year-old boy. Transverse sonogram of liver shows diffuse increased echogenicity of liver parenchyma and 1.4-cm hypoechoic focus (between calipers) in right posterior segment.

 


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  		Fig. 1B. —Focal nodular sparing in 13-year-old boy. In-phase axial T1-weighted gradient-echo MR image (TR/TE, 120/4.2) obtained through liver displays unremarkable findings.

 


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  		Fig. 1C. —Focal nodular sparing in 13-year-old boy. Opposed-phase axial gradient-echo MR image (120/2.1) obtained through liver reveals hepatic parenchyma with diffuse loss of signal relative to signal of spleen, consistent with fatty change in liver. Focal areas of high signal intensity (arrow) remain in right lobe of liver.

 


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  		Fig. 2A. —Focal nodular sparing in 20-year-old man. CT scan obtained without IV contrast material shows diffuse low attenuation in liver with relatively dense focus (arrow) near liver dome.

 


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  		Fig. 2B. —Focal nodular sparing in 20-year-old man. In-phase transverse T1-weighted gradient-echo MR image (TR/TE, 140/4.2) reveals isointense focus (arrow) in liver dome.

 


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  		Fig. 2C. —Focal nodular sparing in 20-year-old man. Opposed-phase transverse MR image (140/2.1) shows loss of signal in liver and relative high signal intensity in liver dome (arrow) corresponding to findings on CT scan (A).

 

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