Imaging appearance of severe subcapsular hepatic steatosis: mimicking hepatic embolic infarcts.
We report a case of severe subcapsular hepatic steatosis in a middle-aged woman with diabetic nephropathy requiring continuous ambulatory peritoneal dialysis (CAPD). The CT appearances of the liver were initially suspected to be due to embolic infarcts. However, an accurate diagnosis was made only after a history of intraperitoneal insulin administration was elicited, and this was confirmed on MRI with chemical shift gradient-echo pulse sequences. Haemodialysis was recommenced, and follow-up imaging 4 years later showed complete resolution of subcapsular hepatic steatosis.
H'ng
M W C
MW
Department of Diagnostic Imaging, Tan Tock Seng Hospital, Singapore. theaceofbass@yahoo.com <theaceofbass@yahoo.com>
Kwek
J W
JW
D003928:Diabetic Nephropathies / Q000628:therapy; D003937:Diagnosis, Differential; D004617:Embolism / Q000175:diagnosis; D005234:Fatty Liver / Q000139:chemically induced / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007238:Infarction / Q000175:diagnosis; D007328:Insulin / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000628:therapy; D008099:Liver / Q000098:blood supply*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects* / Q000379:methods; D014057:Tomography, X-Ray Computed
D007004:Hypoglycemic Agents; D007328:Insulin