Hepatic steatosis, also known as fatty liver disease, refers to abnormal accumulation of fat within hepatocytes, most commonly manifesting as non-alcoholic fatty liver disease (NAFLD).
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.
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.
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.
| Grade | Features |
|---|---|
| Mild | Slight echogenicity increase |
| Moderate | Impaired vessel wall visualization |
| Severe | Poor diaphragm/portal vein visibility |
Management targets underlying causes (weight loss, diabetes control). Steatosis alone carries excellent prognosis without fibrosis; NASH risks progression to cirrhosis (20-30%).
* RadioGraphics 2006: Fatty Liver * Ultrasound Med 2019 * AJR Am J Roentgenol 2012 * Radiology 2021 * World J Gastroenterol 2014 * Eur J Radiol 2007
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