Case 256

 We present a thirty-four-year-old female for liver dysfunction indicated by a local emergent hospital. Two days before, she felt epigastric pain and thoracic pressure. She asked for an ambulance to take her to the emergent hospital where she was diagnosed swollen liver and liver dysfunction. For further investigation, she was introduced our hospital near her home. Laboratory test revealed white blood cells 6460/mm3, hemoglobin 12.7 mg/dL, CRP 0.16 mg/dL, AST 77 IU/L, ALT 66 IU/L, ALP 124 IU/L, Total bilirubin 0.6 mg/dL.
 She agreed to receive CT and MRI (Figs 1-5).

What causes a lesion at liver S4 with low density on CT and with low signal intensity on out-of-phase MRI in this case ?

1.　Hemangioma

2.　Hepatic cell carcinoma

3.　Metastatic liver tumor

4.　Insulin non-resistant fatty liver

5.　Insulin resistant fatty liver

answer

2022.2.1