| Abstract: | OBJECTIVES: The purpose of this study was to investigate whether focal fatty sparing can arise in preexisting nonalcoholic diffuse homogeneous fatty liver and its clinical implications. METHODS: This prospective study consisted of 2 parts. In the first part, 8598 people (5202 men and 3396 women; mean age ± SD, 43.4 ± 28.3 years; range, 18-82 years) were consecutively evaluated with sonography for abnormal liver findings; in the second part, participants with diffuse homogeneous fatty liver were followed over approximately 3 years. Sonographic findings of the participants in the first year and findings of the participants with diffuse homogeneous fatty liver in the first and third years were analyzed. RESULTS: In the first part, 778 of 8598 participants (9.05%) were found to have fatty liver, including 752 cases of nonalcoholic diffuse fatty liver (8.75%) and 26 cases of alcoholic fatty liver (0.30%). Of the 752 cases of nonalcoholic diffuse fatty liver, 301 participants had nonalcoholic diffuse homogeneous fatty liver, and 68 (9.04%) had focal fatty sparing. In the second part, the 301 participants with nonalcoholic diffuse homogeneous fatty liver (205 men and 96 women; mean age, 39.6 ± 10.4 years; range, 18-60 years) were followed. In the third year, 2 cases of fatty liver (0.67%) had resolved, 2 cases (0.67%) had inflammatory pseudotumors, and no focal fatty sparing was found (P < .001). CONCLUSIONS: The findings of this study suggest that focal fatty sparing usually does not arise in preexisting nonalcoholic diffuse homogeneous fatty liver, and a newly emerging abnormality is more likely a true lesion. |
