Marked hepatic steatosis (fatty infiltration / fatty change of liver) is noted here with reduced parenchymal attenuation of liver, with -35HU CT attenuation values.
Patient is a 25yr old female with h/o chronic diarrhoea, abdominal pain, Retro -ve.
If there is presence of diffuse steatosis in a patient with hepatomegaly and an enlarged caudate-to-right lobe ratio should raise the possibility of NASH.
'Hepatic attenuation measurement: At unenhanced CT, the attenuation values measured in the normal liver (range, 50–65 HU) typically are higher than those measured in the spleen, a fact that has been attributed to the presence of glycogen in the liver. Fatty infi ltration is diagnosed when the hepatic attenuation is less than 48 HU'. (Ref ; http://pubs.rsna.org/doi/pdf/10.1148/rg.295085186).
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