Skillnader

Här visas skillnader mellan den valda versionen och den nuvarande versionen av sidan.

--- leversteatos [2026/01/13 09:26] – akestorck
+++ leversteatos [2026/01/13 09:28] (aktuell) – akestorck
@@ Rad 4: / Rad 4: @@
 ===== Epidemiology =====
-Hepatic steatosis affects up to 30% of the general population in Western countries [[refs:1]].
+Hepatic steatosis affects up to 30% of the general population in Western countries, with rising prevalence linked to obesity, diabetes, and metabolic syndrome. Prevalence exceeds 70% in patients with type 2 diabetes and reaches 90% in those undergoing bariatric surgery.
+===== Clinical presentation =====
+Most cases remain asymptomatic and are detected incidentally on ultrasound or other imaging. Symptomatic patients may report right upper quadrant discomfort, fatigue, or elevated liver enzymes.
+===== Pathology =====
+Steatosis results from impaired fat metabolism, with triglycerides accumulating in >5% of hepatocytes. Macrovesicular steatosis predominates, featuring a single large cytoplasmic fat droplet displacing the nucleus.
 ===== Radiographic features =====
@@ Rad 10: / Rad 16: @@
 ==== Ultrasonography ====
-  * **Hyperechoic liver parenchyma** ("bright liver") compared to kidney or spleen [[refs:1]]
+  * **Hyperechoic liver parenchyma** ("bright liver") compared to kidney or spleen
-  * **Grading** [[refs:2]]:
+  * **Grading**:
 ^ Grade     ^ Features                                      ^
@@ Rad 20: / Rad 26: @@
 ==== Computed tomography ====
-  * **Unenhanced CT**: Liver attenuation <40 HU absolute or >10 HU lower than spleen [[refs:3]]
+  * **Unenhanced CT**: Liver attenuation <40 HU absolute or >10 HU lower than spleen
-  * **Contrast-enhanced**: Focal sparing appears hyperdense relative to steatotic parenchyma (gallbladder fossa, segment IV) [[refs:3]]
+  * **Contrast-enhanced**: Focal sparing appears hyperdense relative to steatotic parenchyma (gallbladder fossa, segment IV)
-  * Dual-energy CT improves quantification [[refs:4]]
+  * Dual-energy CT improves quantification
 ==== Magnetic resonance imaging ====
-  * **Chemical shift imaging** (in/out-of-phase): Signal dropout on opposed-phase images (>5% fat) [[refs:4]]
+  * **Chemical shift imaging** (in/out-of-phase): Signal dropout on opposed-phase images (>5% fat)
-  * **Proton density fat fraction (PDFF)**: Gold standard for quantification [[refs:4]]
+  * **Proton density fat fraction (PDFF)**: Gold standard for quantification
+  * **Spectroscopy**: Measures fat fraction directly
+===== Treatment and prognosis =====
+Management targets underlying causes (weight loss, diabetes control). Steatosis alone carries excellent prognosis without fibrosis; NASH risks progression to cirrhosis (20-30%).
 ===== Differential diagnosis =====
-  * Glycogen storage disease (US: hyperechoic but vessels clear) [[refs:1]]
+  * Glycogen storage disease (US: hyperechoic but vessels clear)
-  * Iron overload (high attenuation on CT) [[refs:3]]
+  * Acute hepatitis (diffuse hypoechoic)
+  * Focal fat sparing/deposition mimics mass
+  * Iron overload (high attenuation on CT)
 ===== References =====
-[[https://pubs.rsna.org/doi/full/10.1148/rg.266065004|1. RadioGraphics 2006: Fatty Liver]]
+* [[https://pubs.rsna.org/doi/full/10.1148/rg.266065004|RadioGraphics 2006: Fatty Liver]]
-[[https://pmc.ncbi.nlm.nih.gov/articles/PMC6824276/|2. Ultrasound Med 2019]]
+* [[https://pmc.ncbi.nlm.nih.gov/articles/PMC6824276/|Ultrasound Med 2019]]
-[[https://ajronline.org/doi/10.2214/AJR.11.7838|3. AJR Am J Roentgenol 2012]]
+* [[https://ajronline.org/doi/10.2214/AJR.11.7838|AJR Am J Roentgenol 2012]]
-[[https://pubs.rsna.org/doi/full/10.1148/radiol.2021204288|4. Radiology 2021]]
+* [[https://pubs.rsna.org/doi/full/10.1148/radiol.2021204288|Radiology 2021]]
+* [[https://pmc.ncbi.nlm.nih.gov/articles/PMC4064084/|World J Gastroenterol 2014]]
+* [[https://www.sciencedirect.com/science/article/abs/pii/S0720048X06004451|Eur J Radiol 2007]]
 > **Medical Disclaimer**: Portions of this content were AI-generated to facilitate rapid knowledge synthesis. Radiologists and clinicians must independently verify all information against peer-reviewed literature, institutional protocols, and patient-specific factors before clinical application.