PMC4898294_01
A 55-year-old man with chronic hepatitis C and multifocal nodular steatosis. US shows multiple focal hyperechoic hepatic masses.
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US demonstrated a diffusely fatty liver but no focal liver lesions to suggest HCC. US tests performed at the time of presentation showed multiple small round homogeneous hyperechoic liver masses in both lobes without associated mass effect or posterior acoustic enhancement (Fig. 1).
A 55-year-old man with chronic hepatitis C and multifocal nodular steatosis. Axial MRI images at two levels show multiple small, irregular areas of signal loss on the opposed-phase compared to the in-phase sequence, consistent with multifocal areas of focal fat deposition
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Subsequent magnetic resonance imaging (MRI) showed multiple small, irregular areas of signal loss on the opposed-phase compared to the in-phase sequence (Figs. 2A-D), consistent with multifocal areas of focal fat deposition. A fat-suppressed T2-weighted fast-spin-echo (FSE) image sequence showed homogeneous liver parenchyma without any focal lesions (Fig. 2E). Contrast-enhanced axial 3-D fat-suppressed fast-gradient-echo (GRE) images using gadobenate dimeglumine (MultiHance, Bracco) did not show arterial phase enhancement or washout on the portal venous phase (Fig. 2F, G) to suggest HCC.