title: [Contrast-enhanced ultrasound of focal fatty sparing].
abstract: METHODS
  A 52-year-old man went to his family doctor because of nonspecific abdominal complaints. The physical findings were unremarkable. The abdominal ultrasound unexpectedly showed a nonhomogeneous focal fatty sparing around the gallbladder fossa, which was the reason why the patient was referred for contrast-enhanced ultrasonography (CEUS).
  
  
  METHODS
  The native ultrasound showed focal fatty sparing around the gallbladder fossa, while the CEUS demonstrated a high-flow hemangioma with subsequent peritumoral fatty sparing caused by arterioportal shunts. MRI of the liver confirmed the hemangioma.
  
  
  CONCLUSIONS
  Focal fatty sparing which is nonspecific and not typical in its localization should be carefully investigated, because it could be a peritumoral fatty sparing. The same is true for nonhomogeneous fatty sparing at a typical position. Special attention should be given to signs of shunting. The CEUS in low-MI mode provides a dynamic real-time examination and is the method of choice in this situation.
authors.affiliation: Medizinische Klinik II, Klinikum Am Gesundbrunnen, SLK-Kliniken Heilbronn GmbH.
authors.forename: M
authors.initials: M
authors.lastname: Schuldes
authors.forename: U
authors.initials: U
authors.lastname: Weickert
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D005704:Gallbladder / Q000000981:diagnostic imaging; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging*; D006391:Hemangioma / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D033162:Incidental Findings; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D014463:Ultrasonography
chemical_list: D003287:Contrast Media