title: Hepatic subcapsular steatosis in diabetic CAPD patients treated with intraperitoneal insulin. Description of a typical pattern.
abstract: OBJECTIVE
  To describe a specific imaging pattern of hepatic fatty change typical of diabetic patients on continuous ambulatory peritoneal dialysis (CAPD) treated with intraperitoneal (i.p.) insulin.
  
  
  METHODS
  Liver ultrasound was applied in 16 CAPD patients with insulin-dependent diabetes mellitus. Presence of hepatic subcapsular steatosis and maximum thickness of the fatty layer were recorded. Liver MR examination was made of 1 patient found to have extensive subcapsular steatosis.
  
  
  RESULTS
  Hepatic ultrasound revealed a typical pattern of subcapsular steatosis ("coating-of-fat") in 7/8 patients treated with i.p. insulin. None (0/8) of the diabetic CAPD patients treated with subcutaneous insulin had subcapsular steatosis.
  
  
  CONCLUSIONS
  Hepatic subcapsular steatosis is specific to CAPD patients on i.p. insulin treatment. To our knowledge this is the first report to describe imaging findings in this particular form of hepatic fatty change.
authors.affiliation: Medical School, University of Tampere, and Department of Radiology, Tampere University Hospital, Tampere, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Kallio
authors.forename: P I
authors.initials: PI
authors.lastname: Nevalainen
authors.forename: J T
authors.initials: JT
authors.lastname: Lahtela
authors.forename: J
authors.initials: J
authors.lastname: Mustonen
authors.forename: A
authors.initials: A
authors.lastname: Pasternack
mesh_terms: D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy; D003928:Diabetic Nephropathies / Q000628:therapy*; D015314:Dialysis Solutions; D005234:Fatty Liver / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D014463:Ultrasonography
chemical_list: D015314:Dialysis Solutions; D007328:Insulin