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| Börjar medFöregående version.Nästa version. | Föregående version. | ||
| leversteatos [2026/01/13 09:18] – akestorck | leversteatos [2026/01/13 09:28] (aktuell) – akestorck | ||
|---|---|---|---|
| Rad 1: | Rad 1: | ||
| ====== Liver steatosis ====== | ====== Liver steatosis ====== | ||
| - | **Hepatic steatosis**, | + | **Hepatic steatosis**, |
| ===== Epidemiology ===== | ===== Epidemiology ===== | ||
| - | Hepatic steatosis affects up to 30% of the general population in Western countries, with rising prevalence linked to obesity, diabetes, and metabolic syndrome.((Radiology 2021 [web: | + | 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 ===== | ===== Clinical presentation ===== | ||
| - | Most cases remain asymptomatic and are detected incidentally on ultrasound or other imaging.((World J Gastroenterol 2014 [web: | + | 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 ===== | ===== Pathology ===== | ||
| - | Steatosis results from impaired fat metabolism, with triglycerides accumulating in >5% of hepatocytes.((Eur J Radiol 2007 [web: | + | Steatosis results from impaired fat metabolism, with triglycerides accumulating in >5% of hepatocytes. Macrovesicular steatosis predominates, |
| ===== Radiographic features ===== | ===== Radiographic features ===== | ||
| Rad 16: | Rad 16: | ||
| ==== Ultrasonography ==== | ==== Ultrasonography ==== | ||
| - | * **Hyperechoic liver parenchyma** (" | + | * **Hyperechoic liver parenchyma** (" |
| * **Grading**: | * **Grading**: | ||
| Rad 22: | Rad 22: | ||
| | Mild | Slight echogenicity increase | | Mild | Slight echogenicity increase | ||
| | Moderate | | Moderate | ||
| - | | Severe | + | | Severe |
| ==== Computed tomography ==== | ==== Computed tomography ==== | ||
| - | * **Unenhanced CT**: Liver attenuation <40 HU absolute or >10 HU lower than spleen((AJR Am J Roentgenol 2012 [web:12])) | + | * **Unenhanced CT**: Liver attenuation <40 HU absolute or >10 HU lower than spleen |
| - | * **Contrast-enhanced**: | + | * **Contrast-enhanced**: |
| - | * Dual-energy CT improves quantification((Radiology 2021 [web:17])) | + | * Dual-energy CT improves quantification |
| ==== Magnetic resonance imaging ==== | ==== Magnetic resonance imaging ==== | ||
| - | * **Chemical shift imaging** (in/ | + | * **Chemical shift imaging** (in/ |
| - | * **Proton density fat fraction (PDFF)**: Gold standard for quantification((Radiology 2021 [web:17])) | + | * **Proton density fat fraction (PDFF)**: Gold standard for quantification |
| * **Spectroscopy**: | * **Spectroscopy**: | ||
| ===== Treatment and prognosis ===== | ===== Treatment and prognosis ===== | ||
| - | Management targets underlying causes (weight loss, diabetes control).((World J Gastroenterol 2014 [web: | + | Management targets underlying causes (weight loss, diabetes control). Steatosis alone carries excellent prognosis without fibrosis; NASH risks progression to cirrhosis (20-30%). |
| ===== Differential diagnosis ===== | ===== Differential diagnosis ===== | ||
| - | * Glycogen storage disease (US: hyperechoic but vessels clear)((RadioGraphics 2006 [web:21])) | + | * Glycogen storage disease (US: hyperechoic but vessels clear) |
| - | * Acute hepatitis (diffuse hypoechoic)((Eur J Radiol 2007 [web:13])) | + | * Acute hepatitis (diffuse hypoechoic) |
| - | * Focal fat sparing/ | + | * Focal fat sparing/ |
| - | * Iron overload (high attenuation on CT)((AJR Am J Roentgenol 2012 [web:12])) | + | * Iron overload (high attenuation on CT) |
| + | |||
| + | ===== References ===== | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| + | * [[https:// | ||
| > **Medical Disclaimer**: | > **Medical Disclaimer**: | ||
leversteatos.1768295897.txt.gz · Senast uppdaterad: av akestorck
