FOCAL HEPATIC FATTY INFILTRATION IN THE POSTERIOR EDGE OF THE MEDIAL SEGMENT ASSOCIATED WITH ABERRANT GASTRIC VENOUS DRAINAGE - CT, US, ANDMR FINDINGS

Objective: The purpose of this study is to demonstrate the relation be tween focal hepatic fatty infiltration and aberrant gastric venous dra inage (AGVD) in the posterior edge of the medial segment (PEMS) of the liver. Materials and Methods: We present two cases of focal hepatic f atty infiltration with AGVD in the PEMS and discuss their imaging feat ures. Results: In both cases the focal fatty infiltration areas were h yperechoic on sonography, hypodense on CT, and hyperintense on T1-weig hted MRI. Computed tomography during arterial portography (CTAP) showe d nodular perfusion defects corresponding to the areas in both cases, and early enhancement of the area was observed with dynamic MRI in one case. Although the findings on CTAP and dynamic MRI suggested a neopl astic nature for the lesions, focal fatty infiltration was confirmed w ith surgical resection in one case and with imaging follow-up in the o ther. Aberrant gastric venous drainage into the area was demonstrated on arteriography in both cases. Conclusion: The variation in blood sup ply caused by AGVD may play an important role in fatty metabolism in t he PEMS of the liver and may influence imaging features.