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DOI: 10.1055/s-0029-1245583
© Georg Thieme Verlag KG Stuttgart · New York
Letter to the Editor: Kratzer W et al. Prevalence and Risk Factors of Focal Sparing in Hepatic Steatosis. Ultraschall in Med 2010; 31: 37 – 42
Publication History
Publication Date:
11 August 2010 (online)
I would like to respond to the recently published paper of Kratzer W et al. Prevalence and risk factors of focal sparing in hepatic steatosis. Ultraschall in Med 2010; 31: 37 – 42 to discuss the hypothesis that focal hypoechoic areas in the liver hilum in patients with hepatic steatosis are independent of the etiology and are mainly explained by centrally located supplying arteries leading to relatively reduced portal venous blood flow.
The prevalence, localization and potential risk factors of focal sparing were prospectively assessed in subjects with sonographically detectable hepatic steatosis as part of a population-based cross-sectional study. The authors discuss possible causes of hepatic steatosis but excluded patients with significant alcohol consumption, elevated transaminases, chronic hepatitis and other etiologies. This raises the question if the prevalence of focal sparing is (in-)dependend on the etiology.
The authors state that the pathogenesis of focal sparing in hepatic steatosis is not clearly understood. Among possible causes under discussion are a reduced portovenous flow with reduced uptake of triglycerides and nutritients or a vascular hypothesis with aberrant vascular supply [1]. This raises the question if ultrasound might contribute to clarify the etiology.