Fatty liver deposition and sparing: a pictorial review

OBJECTIVE: Fatty liver deposition is a very common finding, but it has many atypical patterns of distribution that can represent diagnostic pitfalls. The purpose of this pictorial essay is to review different patterns of fatty liver deposition and sparing. METHODS: We searched our archive retrospectively, reviewed the literature, and identified six patterns of liver steatosis. RESULTS: Steatosis may be diffuse, geographic, focal, subcapsular, multifocal or perivascular. CONCLUSIONS: Previous knowledge of atypical patterns of steatosis distribution may prevent misdiagnosis of infiltrative disease or focal liver lesions. When an unusual form of fatty liver deposition is suspected on ultrasound or computed tomography, magnetic resonance imaging may be used to confirm the diagnosis.