Focal fatty infiltration of the liver: Analysis of prevalence and CT findings in children and young adults

OBJECTIVE. Focal fatty infiltration of the aver, a benign entity that can b e confused with a malignant lesion, is well characterized in adults but not in children. The goal of this study was to determine by CT the prevalence and characteristics of focal fatty infiltration in children and young adult s. MATERIALS AND METHODS. We retrospectively analyzed 305 consecutive contrast -enhanced abdominal CT examinations of 218 children and young adults with n o known liver disease, performed during 2 years at our institution, to iden tify focal fatty infiltration of the liver. The imaging criterion for focal fatty infiltration of the Ever on helical CT was a geometric or ovoid low- attenuation area adjacent to the falciform ligament, gallbladder fossa, or porta hepatis. If a patient's findings met the CT criterion for focal fatty infiltration of the Ever, all previous abdominal CT and MR imaging examina tions performed for that patient were reviewed to assess the evolution of f ocal fatty infiltration of the liver. RESULTS. Of 218 children and young adults, 20 (9.2%) met the CT criterion f or focal fatty infiltration of the liver. In our population, focal fatty in filtration of the liver was identified only adjacent to the falciform ligam ent. The prevalence of focal fatty infiltration of the Ever increased signi ficantly with advancing age: 0% for ages 1 month-4 years; 7.3% for 5-9 year s; 10.2% for 10-14 years. and 25.6% for 15-19 years (p < 0.0001). CONCLUSION. Focal fatty infiltration of the liver was identified in 9.2% of patients in our population, and occurrence of this lesion in children incr eases significantly with advancing age. However, focal fatty infiltration o f the liver is uncommon in infants and young children and should be a diagn osis of exclusion.