Focal fatty liver change by sonography.

Focal fatty liver change (FFLC) is a poorly characterized entity whose ultrasound pattern has not yet been properly defined. From our experience based on 12 cases and from the few cases reported in the literature, the following conclusions can be made: (1) FFLC can be of increased and decreased echogenicity with map-like or clearcut margins; (2) rounded lesions with defined margins are indistinguishable from other focal pathology; according to the case, fine needle biopsy, arteriography, computed tomography or nuclear scan should be used; (3) FFLC can change in size or disappear in a short span of time, and (4) a hypoechogenic area with map-like margins in the quadrate lobe (even if it turns out to be a false focal defect in that it corresponds to residual normal liver tissue) of a patient with abnormal values for gamma-glutamyltransferase (GGT) and serum glutamic oxaloacetic transaminase (SGOT) is reasonably indicative of FFLC.