focal fatty sparing adjacent to the gallbladder

PubMed There are only a few studies on the prevalence of FNH [1215]. Kratzer et al. ; Hurley, D.L. Ultraschall Med 31:3742, Varbobitis IC, Pappas G, Karageorgopoulos DE, Anagnostopoulos I, Falagas ME (2010) Decreasing trends of ultrasonographic prevalence of cystic echinococcosis in a rural Greek area. However, it occasionally creates some problems in the diagnosis of hepatic mass lesions. On MR images, the fatty area is hyperintense on T1- and T2-weighted images (not heavily on the latter). An assessment of the safety and efficacy of statins in a randomized controlled cohort will allow for an accurate investigation into this phenomenon that contributes to a secondary health burden for the curative CRC patient population. He had undergone sigmoidectomy for well differentiated adenocarcinoma of the sigmoid colon on September 2, 1993 in our department. Rofo 156:325327, Koseoglu K, Ozsunar Y, Taskin F, Karaman C (2005) Pseudolesions of left liver lobe during helical CT examinations: prevalence and comparison between unenhanced and biphasic CT findings. Association between body mass index and fatty liver risk: A dose-response analysis. permission provided that the original article is clearly cited. Miyake, K.; Hayakawa, K.; Nishino, M.; Morimoto, T.; Mukaihara, S. Effects of oral 5-fluorouracil drugs on hepatic fat content in patients with colon cancer. In our study, this figure fell almost linearly with increasing age and amounted to only 66.8% in the group of patients over 70years of age. Meunier, L.; Larrey, D. Chemotherapy-associated steatohepatitis. Fat accumulation is one of the most common abnormalities of the liver depicted on cross-sectional images. Mittal, S.; El-Serag, H.B. Color and power Doppler sonography were performed in 80 patients with a fatty liver that appeared as a fine echogenic pattern with considerable deep attenuation on sonography. Glucocorticoids and non-alcoholic fatty liver disease. Diffuse fatty liver is a well recognized entity that is easily diagnosable by computed tomography (CT) or sonography. At least one of the lesions to be investigated was diagnosed in 15.1% (n=6839) of the patients of the total population. 4) clearly showed a wedge-shaped hypointese area in the anterior segment, suggesting ischemia in this area. in 2005, there has been some research on the association between steatosis and anti-tumour drugs, although the precise impacts of CRC chemotherapy have largely been unexplored. Our prevalence figure of 3.6% for hemangioma lies in the mid-range compared to the previously published results from ultrasound-based studies [6, 7, 9, 17]. Kaltenbach, T.EM., Engler, P., Kratzer, W. et al. Studies concerning the prevalence of benign focal liver lesions present a quite heterogeneous picture as regards the precise research question posed, the size of the population studied, and the investigative methods used. Lee, J.I. CT during arterial portography (CTAP) (Fig. Although standard MR sequences are less helpful for visualization and characterization of fatty infiltration, chemical shift images (opposed- and in-phase images) are quite useful for depicting fat distribution and assist the diagnosis of focal fatty infiltration or sparing (7). ; Finn, J.P.; Stark, D.D. In order to demonstrate differences between patients with and without a lesion, the Wilcoxon signed rank-sum test was applied for continuous variables and the Peppercorn, P.; Reznek, R.; Wilzon, P.; Slevin, M.L. Allison Forrest, Sam Afshari, Naiim Ali, Ahmad Alizadeh, Fariborz Mansour-Ghanaei, Soheil Hassanipour, Carmelo Corallo, Joshua Bell, Raneem Albazaz, Feiqian Wang, Kazushi Numata, Shin Maeda, Maria Stella Franz, Antonio Bottari, Carlo Saitta, Cheng Fang, Silvia Bernardo, Paul S. Sidhu, Federica Vernuccio, Roberto Cannella, Giuseppe Brancatelli, Antonio Corvino, Fabio Sandomenico, Orlando Catalano, Abdominal Radiology Google Scholar, Linhart P, Bnhof JA, Baqu PE, Pering C (1998) Ultrasound in diagnosis of benign and malignant liver tumors. Br J Radiol 62:335337, Aubin B, Denys A, Lafortune M, Dry R, Breton G (1995) Focal sparing of liver parenchyma in steatosis: role of the gallbladder and its vessels. This study sought to examine hepatic steatosis, an increasingly recognized health concern worldwide. These findings imply that if differentiation between focal fatty sparing and a tumor is undetermined and follow-up is performed, should any change occur, then an abnormality that is no longer appreciable at follow-up is probably focal fatty sparing rather than a true tumor. Close Figure Viewer Return to Figure Previous FigureNext Figure In contrast, in-phase images showed a hypointense area in the entirely hyperintense liver (Fig. Histological examination revealed that the tumor, a well differentiated adenocarcinoma, was surrounded by fibrotic tissue, and that this fibrotic tissue contained fewer fat vacuoles than the rest of the liver parenchyma (Fig. Is hepatic steatosis reversible? With our determined prevalence of 5.8%, we are also here in the mid-range. A characteristic location for focal hepatosteatosis is the medial segment of the left lobe of the liver (segment 4) either anterior to the porta hepatis or adjacent to the falciform ligament 1. In our patient population, the prevalence of hepatic hemangioma was 3.6% (n=1640). Although these four sequences suggested focal sparing, dynamic MR images clearly showed irregular enhancement in the abnormal area of the anterior segment, suggesting a metastatic tumor (image not shown). 2021. Ultraschall Med 30:383389, Bioulac-Sage P, Laumonier H, Couchy G, et al. This study was approved by the St. Michaels Hospital Research Ethics Board (approval number: 18-166). 57% of all liver lesions found by ultrasound are benign [5]. Oncol. Chemotherapy-associated steatosis is pathologically indistinguishable from NAFLD, which has a benign onset as simple hepatic steatosis, but can asymptomatically progress to steatohepatitis [, Despite these risks, current treatment for hepatic steatosis is limited to changes in lifestyle to mitigate cardiovascular risk factors [, In this study, the primary mode of determining steatosis status in patients included a review of the medical records and the abdominal images (CT, ultrasound and MRI) by a single radiologist. In most cases, gallstones blocking the tube leading out of the gallbladder cause cholecystitis. Hepatic steatosis is a benign condition characterized by diffuse or focal fatty infiltration of the liver parenchyma. There are some case reports about this kind of tricks revealed by computed tomography (CT) and magnetic resonance imaging. (2015) Hepatic hemangioma in celiac patients: data from a large consecutive series. Rom J Gastroenterol. At the time the article was created Frank Gaillard had no recorded disclosures. Semin Liver Dis 33:236247, Article The project received a positive opinion from the local ethics committee (No. The gender distribution of hemangioma was almost balanced, with 53.4% (n=879) women/46.6% (n=761) men. Through the division into four different genotypic subtypes, new aspects have emerged concerning prevalence and clinical presentation. Friedman, S.L. Only a very few studies investigated the prevalence of FNH, hepatic adenoma, and focal fatty sparing. (2016) Seminars in ultrasound, CT, and MR. 37 (6): 501-510. Epidemiology Focal hepatic steatosis, also known as focal hepatosteatosis or (erroneously) focal fatty infiltration , represents small areas of liver steatosis. In order to be human-readable, please install an RSS reader. Ultraschall Med 17:175178, Article Available online: Goldberg, D.; Ditah, I.C. The examinations were evaluated for the presence of a focal area of increased attenuation in the liver in locations where focal fatty sparing typically occurs: adjacent to the gallbladder fossa and in the medial segment of the left lobe near the porta hepatis. interesting to readers, or important in the respective research area. All ultrasonographic examinations were performed in the ultrasound unit by experienced physicians. Current Oncology. future research directions and describes possible research applications. Dr. Yvette Kratzberganswered Pediatrics 26 years experience Talk now (b) T2-weighted MR images show an irregularly shaped hypointense area in the anterior segment (TR = 2000, TE = 80). The treatment for ALD focuses on treating alcohol use disorder. The used probes are C2-5, C1-5, and C1-6 (16MHz). Woods, C.P. There was also a hypoechoic mass in segment 6 of the liver measuring, 4.8 3.1 cm. CT during arterial portography showed a wedge-shaped ischemic area in the anterior segment caused by intrahepatic portal vein blockade. ; Arevalos, E.; Rimm, A.A. Focal hepatic masses and fatty infiltration detected by enhanced dynamic CT. Rofsky, N.M.; Fleishaker, H. CT and MRI of diffuse liver disease. The most common site of these pseudo lesions are hepatic segments IV and V, the gallbladder bed, the falciform ligament region, and ventral to the portal vein. is fatty lever curable? Wolfgang Kratzer. An association between the occurrence of benign focal liver lesions and age was observed. Hepatic steatosis secondary to capecitabine: A case report. At least one of the lesions of interest was found in a total of 6851 patients (15.1% of the population examined). 2 test for categorical variables, unless the sample size was too small, in which case Fishers exact test was used. 2001;176 (2): 471-4. The youngest patient group, under 30years of age, was scarcely affected, with an age-specific prevalence of 0.8% (n=21). Baseline and incident steatosis for up to one year from chemotherapy start date was assessed based on radiology. Eur Radiol 21:20742082, Karhunen PJ (1986) Benign hepatic tumors and tumor-like conditions in men. Scand J Gastroenterol 50:355359, Dietrich CF, Sharma M, Gibson RN, Schreiber-Dietrich D, Jenssen C (2013) Fortuitously discovered liver lesions. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. https://doi.org/10.3390/curroncol28040265, Lee, Michelle C. M., Jacob J. Kachura, Paraskevi A. Vlachou, Raissa Dzulynsky, Amy Di Tomaso, Haider Samawi, Nancy Baxter, and Christine Brezden-Masley. Non-enhanced CT demonstrated a fatty liver associated with a wedge-shaped hyperdense area which occupied almost all of the anterior segment of the right lobe (Fig. For example, the prevalence of hepatic hemangioma determined in the studies ranged from 0.1% to 20.0% and that of hepatic cysts from 0.06% to 17.8%. On the other hand, focal sparing in a diffusely fatty liver can be observed most frequently around the gallbladder bed, and its most common shape resembles a spot, band or ring (6). Del pilar fernandez M, Bernardino ME. It is therefore difficult to compare the various study results and apply them to routine ultrasound primary diagnostics. 3) showed an irregularly shaped hypointense area in the anterior segment. The peak age for FNH occurred in the youngest patient group with 34.6% (n=28) of the diagnosed lesions and fell continuously with increasing age. Introduction: Focal fatty sparing is a manifestation of fatty liver. Grieco, A.; Forgione, A.; Miele, L.; Greco, A.V. The aim of the study was to determine the sonographic prevalence of benign focal liver lesions on the basis of a population of hospital patients. 2. 76.67% (n=1157) of diagnosed hemangiomas were solitary, and the average size of the hemangiomas was 20.1mm. The authors declare no conflict of interest. Thus, in this study, we sought to describe the frequency of CAS in stage IIIII CRC patients and to determine the incidence of CAS in patients who were prevalent users of statins during their adjuvant chemotherapy. The diagnosis of FNH was confirmed primarily by CEUS. most exciting work published in the various research areas of the journal. Chalasani, N.; Younossi, Z.; Lavine, J.; Diehl, A.M.; Brunt, E.M.; Cusi, K.; Charlton, M.; Sanyal, A.J. However, the occurrence of a hepatic adenoma is associated with the ingestion of oral contraceptives, which may be reflected in our results, since we found the majority of adenomas in women aged below 50years [34]. Gangi, A.; Lu, S.C. Chemotherapy-associated liver injury in colorectal cancer. The aim of this study was to evaluate the prevalence of hepatic hemangioma, FNH, hepatic cysts, focal fatty sparing, and hepatic adenoma in a large population of university hospital patients and to compare this with the values published in the literature. (2001) Incidence and significance of small focal liver lesions in MRI. The gallbladder is a small, pear-shaped organ on the right side of the belly (abdomen), beneath the liver. Habib, M.B. https://doi.org/10.1007/s00261-015-0605-7, DOI: https://doi.org/10.1007/s00261-015-0605-7. Focal gallbladder wall thickening is an imaging finding that includes both benign and malignant etiologies. On admission, his general condition was good. Alpern, M.B. Demonstration of hepatic steatosis by computerized tomography in patients receiving 5-fluorouracil-based therapy for advanced colorectal cancer. J.J.K. PubMed Correspondence to Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. The aim is to provide a snapshot of some of the Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: A multicenter prospective study. AJR Am J Roentgenol. {"url":"/signup-modal-props.json?lang=gb"}, Gaillard F, Chieng R, Shah V, et al. Case 1: adenomyomatosis of the gallbladder - fundal, View Matt A. Morgan's current disclosures, see full revision history and disclosures, World Health Organization 2001 classification of hepatic hydatid cysts, recurrent pyogenic (Oriental) cholangitis, combined hepatocellular and cholangiocarcinoma, inflammatory myofibroblastic tumor (inflammatory pseudotumor), portal vein thrombosis (acute and chronic), cavernous transformation of the portal vein, congenital extrahepatic portosystemic shunt classification, congenital intrahepatic portosystemic shunt classification, transjugular intrahepatic portosystemic shunt (TIPS), transient hepatic attenuation differences (THAD), transient hepatic intensity differences (THID), total anomalous pulmonary venous return (TAPVR), hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease), cystic pancreatic mass differential diagnosis, pancreatic perivascular epithelioid cell tumor (PEComa), pancreatic mature cystic teratoma (dermoid), revised Atlanta classification of acute pancreatitis, acute peripancreatic fluid collection (APFC), hypertriglyceridemia-induced pancreatitis, pancreatitis associated with cystic fibrosis, low phospholipid-associated cholelithiasis syndrome, diffuse gallbladder wall thickening (differential), focal gallbladder wall thickening (differential), ceftriaxone-associated gallbladder pseudolithiasis, biliary intraepithelial neoplasia (BilIN), intraductal papillary neoplasm of the bile duct (IPNB), intraductal tubulopapillary neoplasm (ITPN) of the bile duct, multiple biliary hamartomas (von Meyenburg complexes), Differential diagnosis focal gallbladder wall thickening, 1. ; McKillop, J.H. The mean maximum measured size of the focal fatty sparing was 20.6mm. At the time the article was last revised Raymond Chieng had A chest X-ray on admission showed no abnormality. Introduction. Google Scholar, Ruiz Guinaldo A, Martn Herrera L, Roldn Cuadra R (1997) Hepatic tumors in patients with cirrhosis: an autopsy study. The mean age of patients at the time of the investigation was 5618.1years (range: 4months105years). Ultrasound features only become apparent when the amount of fat reaches 15-20%. (2009) Hepatocellular adenoma management and phenotypic classification: the Bordeaux experience. A 62-year-old, slightly obese man was referred to us on April 12, 1996 because of suspected liver metastasis. PubMed Central Since drug-induced hepatotoxicity was described by Grieco et al. Patient characteristics including sex, age at diagnosis, and Body Mass Index (BMI), as well as baseline comorbidities including type 2 diabetes mellitus, hyperlipidemia, and hypertension, were collected. This study was approved by the St. Michaels Hospital Research Ethics Board (approval number: 18-166). 5. Among various candidate drugs under investigation, statins have been considered as a potential therapeutic option, and were recently shown to effectively reduce the risk of NAFLD development in a large population-based study [, Colorectal cancer (CRC) consistently ranks as one of the leading causes of cancer-related deaths in Canada [. 4 and 5). Oxaliplatin, Fluorouracil, and Leucovorin as Adjuvant Treatment for Colon Cancer. Kreft, B.P. By definition, fatty sparing occurs in patients with diffuse fatty infiltration of the liver, which may be idiopathic or secondary to obesity, starvation, parenteral nutrition, steroid therapy, diabetes mellitus, alcohol, and hepatitis. (2009) Contrast-enhanced ultrasound (CEUS) for the characterization of focal liver lesionsprospective comparison in clinical practice: CEUS vs. CT (DEGUM multicenter trial). 4. After the operation, the patient suffered from severe jaundice and hyperammonemia. ; Lee, H.S. This proved that the lesion was an adenocarcinoma and right hepatectomy was performed on July 4, 1996. ; Rinella, M.; Sanyal, A.J. PubMed Lower prevalence was again determined in the highest age groups. Canadian Cancer Societys Advisory Committee on Cancer Statistics. However, while elevated levels of liver biochemical tests often correlate with a diagnosis of fatty liver, a high proportion of patients with NAFLD exhibit normal liver profiles, making these tests inappropriate diagnostic markers that may not have drastically impacted the findings presented in our study [. Shepherd, J.; Cobbe, S.; Ford, I.; Isles, C.G. Reversible hepatic steatosis in patients treated with interferon alfa-2A and 5-fluorouracil. From six or more foci upwards, these were combined as more than five lesions. The information about lesion size was based on the maximum measurable diameter in each case. Check for errors and try again. In rare cases, focal fatty sparing has also been described in other liver segments where, in the first instance, it is generally difficult to distinguish from malignant lesions and can hence pose considerable problems for a differential diagnosis [2426]. The liver tissue containes an abnormal number of fat vacuoles (upper left), while the fibrotic liver tissue adjacent to the well differentiated adenocarcinoma contains fewer fat vacuoles than the rest of the liver parenchyma. Please let us know what you think of our products and services. Fatty change frequently shows an irregular distribution, most likely reflecting regional differences in perfusion; in areas of decreased portal flow, less fat tends to accumulate than in better-perfused areas ().This condition, called focal sparing, can occur in . For continuous variables, the mean and standard deviation were calculated, while categorical attributes were presented in absolute and relative frequencies. A full blood count on admission showed normal values. Miwa, M.; Ura, M.; Nishida, M.; Sawada, N.; Ishikawa, T.; Mori, K.; Shimma, N.; Umeda, I.; Ishitsuka, H. Design of a novel oral fluoropyrimidine carbamate, capecitabine, which generates 5-fluorouracil selectively in tumours by enzymes concentrated in human liver and cancer tissue. Slider with three articles shown per slide. The term 'fatty infiltration of the liver' is often erroneously used to describe liver steatosis. It was most often found in the 51-60 years age group; the mean age of the patients with focal fatty sparing was 54.9 14.5 years. Haas, J.T. Histopathology of the resected liver tumor. These conclusions have critical implications on the quality of life and hepatic function of patients not only in the curative setting, but may also be applicable in the setting of treatment of metastatic disease, in particular in context of patients requiring liver resections for metastases in addition to indefinite metastatic treatment which may require up to 60 cycles of 5-FU-based chemotherapy. ; Reif, L.J. In many cases, the phenomenon is believed to be related to the haemodynamics of a third inflow. Ballestri, S.; Nascimbeni, F.; Baldelli, E.; Marrazzo, A.; Romagnoli, D.; Lonardo, A. NAFLD as a Sexual Dimorphic Disease: Role of Gender and Reproductive Status in the Development and Progression of Nonalcoholic Fatty Liver Disease and Inherent Cardiovascular Risk. With only 19 cases and hence a prevalence of 0.04%, hepatic adenoma was the rarest of the liver lesions we investigated. Andr, T.; Boni, C.; Mounedji-Boudiaf, L.; Navarro, M.; Tabernero, J.; Hickish, T.; Topham, C.; Zaninelli, M.; Clingan, P.; Bridgewater, J.; et al. PubMed Furthermore, there is currently a lack of medical treatment for any population affected by steatosis, regardless of etiology, although a recently published population-based study suggests that statins may confer protective benefits against the development of steatosis. This difference can be related to the population size and age of the patients studied [13, 14]. Simple hepatic cysts and hemangiomas are the most common focal liver lesions. In this study, Stage II-III colorectal cancer patients were retrospectively selected to evaluate the frequency of chemotherapy-associated steatosis and to determine whether patients on statins throughout adjuvant chemotherapy develop chemotherapy-associated steatosis at a lower frequency. We thank Ayesha Taqi and Aftab Malik for their generous help in the data collection process. Gut Liver. Volume 33, Issue 8 August 2014 Pages 1447-1452 Information Download PDF 377/13). Srensen, P.; Edal, A.; Madsen, E.; Fenger, C.; Poulsen, M.R. The largest measured cyst diameter averaged 22.3mm. Gandolfi et al. Moertel, C.; Fleming, T.; Macdonald, J.; Haller, D.G. Chin, S.N. In this study, Stage IIIII colorectal cancer patients were retrospectively selected to evaluate the frequency of chemotherapy-associated steatosis and to determine whether patients on statins throughout adjuvant chemotherapy develop chemotherapy-associated steatosis at a lower frequency. Of the remaining 193 cases, patients receiving adjuvant chemotherapy (, Hepatic steatosis is characterized by the infiltration and accumulation of triglyceride within the liver parenchyma [, There is currently no approved pharmacologic treatment for hepatic steatosis, whether metabolic syndrome- or drug-induced. AJR Am J Roentgenol. Endocr Pathol 13:3945, Gandolfi L, Leo P, Solmi L, et al. (12) reported that the basic points suggesting the presence of fatty infiltration are: 1, the abnormal area does not show an overall mass effect; 2, the vessels are normally distributed and are evident in the abnormal area. CTAP showed a wedge-shaped ischemic area. Abdominal ultrasound, particularly of the liver, is a widely available, inexpensive technique that can be rapidly performed without exposing the patient to radiation. You may want to read more about NASH here: https://patient.info/health/non-alcoholic-fatty-liver-disease Advertisement intended for healthcare professionals, For reprints and all correspondence: Motohisa Kato, Second Department of Surgery, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu 500, Japan. methods, instructions or products referred to in the content. ; Congdon, L.; Edwards, K.L. ; Cohen, J.C.; Grundy, S.M. The most common lesion was focal fatty sparing, which was diagnosed in 2839 cases, corresponding to a prevalence of 6.3%. 4) disclosed irregular enhancement in the anterior segment, as seen on dynamic MR images. In general, the treatment of the underlying condition will reverse the findings. (2004) High prevalence of hepatic focal nodular hyperplasia in subjects with hereditary hemorrhagic telangiectasia. ; Sada, Y.H. Abbreviations: BMI (Body Mass Index). ; Foley, W.D. 3) showed a wedge-shaped hypointense area, as seen on non-enhanced CT, and T2-weighted images (Fig. Based on the results of our study, it is necessary to conduct prospective studies that involve a larger cohort of patients, who are controlled for comorbidities that may confound the association between CRC, statin use and the incidence of steatosis. Become a Gold Supporter and see no third-party ads. and Strunk et al. Age-specific prevalence was far less apparent in the younger age groups and in the elderly. 3). Prevalence of benign focal liver lesions: ultrasound investigation of 45,319 hospital patients, https://doi.org/10.1007/s00261-015-0605-7, Prevalence of extra-hepatic incidental findings on ultrasound screening for hepatocellular carcinoma, Imaging Accuracy in Diagnosis of Different Focal Liver Lesions: A Retrospective Study in North of Iran, Suspected focal nodular hyperplasia in male adults: 10-year experience from a large liver centre, Application of new ultrasound techniques for focal liver lesions, Rate of hepatocellular carcinoma diagnosis in cirrhotic patients with ultrasound-detected liver nodules, Characteristics of hepatic solitary necrotic nodules on contrast-enhanced ultrasonography, Contrast-enhanced ultrasound in the diagnosis of pediatric focal nodular hyperplasia and hepatic adenoma: interobserver reliability, Uncommon imaging evolutions of focal liver lesions in cirrhosis, Morphological and dynamic evaluation of complex cystic focal liver lesions by contrast-enhanced ultrasound: current state of the art, http://creativecommons.org/licenses/by/4.0/. The understanding of hepatic adenoma has changed fundamentally in recent years [32, 33]. Prevention of coronary heart diseases with pravastatin in men with hypercholesterolemia: West of Scotland coronary prevention study group. Through higher performance ultrasound equipment and the introduction of contrast-enhanced ultrasound, the diagnosis of FNH can nowadays be made with higher sensitivity and specificity [31]. This research received no external funding. Here, we observed that there is a trend towards a higher rate of CAS development within one year of follow-up among stage IIIII CRC patients who received chemotherapy compared to the no treatment group. Google Scholar, Sanfelippo P, Beahrs O, Weiland L (1974) Cystic disease of the liver. The majority of the more recent ultrasound-based prevalence studies show significantly higher prevalence figures than older ultrasound-based studies (Table4). In our population, a maximum occurred at between 41 and 50years of age. Naturally, these cannot be recorded in retrospective ultrasound prevalence studies. Terminology Eur J Radiol 83:930934, Marin D, Galluzzo A, Plessier A, et al. Lee, M.C.M. acquired and interpreted radiology image data. This is also ultimately reflected in the prevalence rates determined in the respective studies. Current status of imaging in nonalcoholic fatty liver disease. In addition, many studies on the prevalence of benign space-occupying lesions of the liver were conducted in the 1990s or earlier, i.e., at a time when the image quality of the ultrasound devices used was greatly inferior [17, 2123]. Ann Surg 179:922925, Seitz K, Strobel D, Bernatik T, et al. Out of the 269 patients deemed eligible for analysis, 76 (28.3%) had fatty liver at baseline imaging, prior to treatment with adjuvant chemotherapy. ; Kim, T.K. ; Hazlehurst, J.M. Saif, M.W. Our measured mean cyst size of 2.2cm corresponds to the values published in the literature [19, 22, 23, 30]. Motohisa Kato, Shigetoyo Saji, Masayuki Kanematsu, Daizo Fukada, Kiichi Miya, Takao Umemoto, Katsuyuki Kunieda, Yasuyuki Sugiyama, Ikuhide Kuwahara, Kuniyasu Shimokawa, A Case of Liver Metastasis from Colon Cancer Masquerading as Focal Sparing in a Fatty Liver, Japanese Journal of Clinical Oncology, Volume 27, Issue 3, June 1997, Pages 189192, https://doi.org/10.1093/jjco/27.3.189. articles published under an open access Creative Common CC BY license, any part of the article may be reused without those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s).

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focal fatty sparing adjacent to the gallbladder