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A higher liver echogenicity indicates a higher fatty infiltration in the liver. Sound waves more readily bounce off fat cells than healthy liver tissue. Ultrasound technology reveals decreased liver attenuation, which is a measure of healthy liver tissue.
Echogenic liver on ultrasound means the liver is whiter than usual. This can be a result of multiple causes with fatty liver being most common. The treatment of an echogenic liver will depend on the cause. Many causes of fatty liver are reversible as outlined above.
The liver's echogenicity indicates the presence of fat content or possible damage. In most clinical settings, the prevalence of echogenic liver is around 13–20%, attributed especially to hepatic steatosis (fatty liver disease ).
What is echogenicity? Echogenicity is a descriptive term used to describe the picture that the reflected ultrasound waves form. Each organ or body tissue has an expected echogenicity when it is not diseased. Echogenicity can be used to compare an organ to its normal state or to another tissue.
A hyperechoic liver shows areas that reflect more ultrasound waves compared to the rest of the liver or other organs. This increased reflectivity can be indicative of various liver conditions, which may include fatty liver disease, liver fibrosis, or other liver abnormalities.
An echogenic liver is defined as increased echogenicity of the liver parenchyma compared with the renal cortex. The prevalence of echogenic liver is approximately 13% to 20%. In most clinical settings, increased liver echogenicity is simply attributed to hepatic steatosis.
Hepatic steatosis, more commonly known as fatty liver disease, occurs when excess fat accumulates in the liver. Fatty liver disease is one of the most common causes of chronic liver disease in the developed world, affecting up to one in every four individuals.
Assessment of liver echogenicity is of value for detection or exclusion of moderate to pronounced fatty infiltration (correct classification 86.6%) but cannot be relied upon in diagnosing fibrosis, not even cirrhosis in asymptomatic patients with mild to moderately elevated liver transaminases.
As steatosis grade increases from left to right in each row, the following patterns are seen: on ultrasound, increased liver parenchyma echogenicity and decreased definition of intrahepatic structures such as vessel walls; on unenhanced CT, liver density on CT in HU decreases though spleen density in HU is variable; on MR, PDFF values increase.
Hepatic steatosis or fatty liver is the most common abnormal imaging finding in liver imaging, which can be related to alcoholic liver disease and nonalcoholic liver disease, including obesity, insulin resistance, diabetes, hyperlipidemia, and hypertension.