Palabras clave
Resonancia magnética
Lesión hepática Multifocal liver steatosis
MRI
Hepatic lesion
Cómo citar
Resumen
La esteatosis hepática es una entidad frecuente en nuestro medio que se asocia a múltiples patologías como obesidad, diabetes mellitus, consumo de corticoides o alcoholismo. La presentación más frecuente es la infiltración difusa que puede diagnosticarse fácilmente por su apariencia típica en estudios de imágenes. La forma focal, generalmente única, debe diferenciarse de otro tipo de lesiones benignas y malignas que comprometen el parénquima hepático. La resonancia magnética, especialmente las secuencias eco gradiente en fase y fuera de fase, juegan un papel primordial en el diagnóstico definitivo de esta entidad y pueden evitar la realización de una biopsia hepática innecesaria. A continuación se presenta un caso de esteatosis hepática multifocal y su apariencia en las diferentes modalidades diagnósticas de imagen.
Citas
Hamer OW, Aguirre DA, Casola G, Lavine JE, Woenckhaus M, et al. Fatty liver: Imaging patterns and pitfalls. Radiographics, 26:1637-1653, 2006. https://doi.org/10.1148/rg.266065004
Décarie PO, Lepanto L, Billiard JS, Olivié D, Murphy-Lavallée J, et al. Fatty liver deposition and sparing: a pictorial review. Insights Imaging, 2:533-538, 2011. https://doi.org/10.1007/s13244-011-0112-5
Kröncke TJ, Taupitz M, Kivelitz D, Scheer I, et al. Multifocal nodular fatty infiltration of the liver mimicking metastatic disease on CT: Imaging findings and diagnosis using MR Imaging. European Radiology, 10:1095-1100, 2000. https://doi.org/10.1007/s003300000360
Kammen BF, Pacharn P, Thoeni RF, Lu Y, Qayyum A. Focal fatty infiltration of the liver: analysis of prevalence and CT findings in children and young adults. American Journal of Roentgenoloty, 177:1035-1039, 2001. https://doi.org/10.2214/ajr.177.5.1771035
Foley WD, Jochem RJ, Computed tomography: focal and diffuse liver disease. Radiologic Clinics of North America, 29(6): 1213-1233,1991.
Bugianesi E. Non-alcoholic steatohepatitis and cancer. Clinics in Liver Disease, 11:191-207, 2007. https://doi.org/10.1016/j.cld.2007.02.006
Kröncke TJ, Taupitz M, Kivelitz D, Scheer I, Daberkow U, Rudolph B, et al. Multifocal nodular fatty infiltration of the liver mimicking metastatic disease on CT: imaging findings and diagnosis using MR Imaging. European Journal of Radiology. 10:1095-1100, 2000. https://doi.org/10.1007/s003300000360
Marn, CS, Bree RL, Silver TM. Ultrasonography of liver: Technique and focal and diffuse disease. Radiologic Clinics of North America, 29(6): 1151-1170,1991.
Venkataraman S, Braga L, Semelka R. Imaging the fatty liver. Magnetic Resonance Imaging Clinics of Norh America, 10(1), 93 - 103, 2002. https://doi.org/10.1016/S1064-9689(03)00051-5
Ferrucci JT. Liver tumor imaging: current concepts. AJR, 155:473-484, 1990. https://doi.org/10.2214/ajr.155.3.2117343
Merkle EM, Nelson RC. Dual Gradient-Echo In-Phase and opposed-phase hepatic MR imaging: a useful tool for evaluatin more than fatty infiltration or fatty sparing. Radiographics, 26:1409-1418, 2006. https://doi.org/10.1148/rg.265055711
Fasih N, Shanbhoque AK, Thipphavong S, Surabhi VR, Papadatos D, et al. Gamut of focal fatty lesions in the liver: imaging manifestations with emphasis on MRI. Current Problems in Diagnostic Radiology. 39(4):137-51, 2010. https://doi.org/10.1067/j.cpradiol.2009.05.001
Merkle EM, Nelson RC. Dual gradient-echo in-phase and opposed-phase hepatic MR imaging: a useful tool for evaluating more than fatty infiltration. Radiographics, 25:1409-1418, 2006. https://doi.org/10.1148/rg.265055711
Pedro MS, Semelka RC, Braga L. MR imaging of hepatic metastases. Magnetic Resonance Imaging Clinics of North America, 10(1):15-29, 2002." https://doi.org/10.1016/S1064-9689(03)00047-3