case_images: PMC9891182_01
case_images: Multiple liver Ultrasound Images (A-D) reveal hyperechoic diffuse fatty liver with several focal hypoechoic masslike lesions (red arrows)
case_images: cureus-0015-00000033254-i01.jpg
case_images: PMC9891182_01_cureus-0015-00000033254-i01.jpg
case_images: FIG1
case_images: In addition, there were several hypoechoic masslike focal lesions in both liver lobes; the largest lesion is in the right hepatic lobe and measures 27 x 18 mm (Figure 1).
case_images: Axial T1W In-phase gradient-echo MR images (A and C) and axial Opposed-phase gradient-echo MR images (B and D) at two levels within the upper abdomen reveal a signal drop of the liver with focal areas (red arrows) of a maintained signal appearing relatively hyperintense to the fatty liver in the opposed-phase images.
case_images: cureus-0015-00000033254-i02.jpg
case_images: PMC9891182_01_cureus-0015-00000033254-i02.jpg
case_images: FIG2
case_images: The MRI showed hepatomegaly with diffuse fatty deposition evident by hepatic parenchymal signal drop on opposed-phase T1- weighted images (T1WI) with several focal areas of maintained normal signal appeared relatively hyperintense in opposed-phase T1WI (Figure 2), and T1WI fat saturation MRI images (Figure 3). All these focal areas are faintly visualized in the T1W image (Figure 2A) and T2W fat sat image (figure 3B) with no diffusion restriction (Figures 3C, 3D).
case_images: Multiple MRI sequences demonstrate the lesion in segment 6 (red arrows), which appears hypointense on T2-weighted image (A) and slightly hyperintense on T2 - weighted image fat saturation (B) with no diffusion restriction (C, diffusion-weighted images & D, ADC map).
case_images: cureus-0015-00000033254-i03.jpg
case_images: PMC9891182_01_cureus-0015-00000033254-i03.jpg
case_images: FIG3
case_images: The MRI showed hepatomegaly with diffuse fatty deposition evident by hepatic parenchymal signal drop on opposed-phase T1- weighted images (T1WI) with several focal areas of maintained normal signal appeared relatively hyperintense in opposed-phase T1WI (Figure 2), and T1WI fat saturation MRI images (Figure 3). All these focal areas are faintly visualized in the T1W image (Figure 2A) and T2W fat sat image (figure 3B) with no diffusion restriction (Figures 3C, 3D).
case_images: Dynamic gadolinium-enhanced T1-weighted images (A: precontrast, B: arterial, C: venous, D: delayed phases), The lesion in segment 6 appears relatively hyperintense on the precontrast fat-suppressed image (red arrow in A) with suppression of fatty signal intensity of the surrounding liver parenchyma. This lesion appears homogenously hyperintense on all three post-contrast phases with no washout relative to liver parenchyma (red arrows in B-D). Subtraction images (A: arterial & F: Venous) show mild homogenous enhancement and no washout.
case_images: cureus-0015-00000033254-i04.jpg
case_images: PMC9891182_01_cureus-0015-00000033254-i04.jpg
case_images: FIG4