Monday, 1 June 2026

Focal Fatty Sparing

Hepatic Pseudolesion

Focal Fatty Sparing

Focal Fatty Sparing refers to localized areas of normal liver parenchyma within a diffusely fatty liver. These regions appear relatively hypoechoic compared to the surrounding steatotic liver and commonly occur adjacent to the gallbladder fossa, porta hepatis, or falciform ligament. It is a benign finding and should not be mistaken for a focal hepatic mass.

Focal Fatty Sparing is a benign hepatic imaging finding characterized by localized regions of normal echogenicity within a background of diffuse hepatic steatosis. These spared areas commonly appear hypoechoic relative to the fatty liver and may mimic focal hepatic lesions on ultrasound. Typical locations include the gallbladder fossa, porta hepatis, and adjacent to the falciform ligament. Recognition of characteristic appearance and location helps avoid misdiagnosis.


Localized hypoechoic area is noted within the diffusely fatty liver parenchyma, consistent with focal fatty sparing. No focal hepatic mass lesion is identified.

Focal Fatty Sparing – MCQs

1. What is focal fatty sparing?
A. Hepatic malignancy
B. Area of normal liver within fatty liver
C. Liver abscess
D. Calcified hepatic lesion

2. Focal fatty sparing is commonly seen in:
A. Normal liver
B. Fatty liver disease
C. Cirrhotic liver
D. Hepatic trauma

3. On ultrasound, focal fatty sparing usually appears:
A. Hyperechoic
B. Anechoic
C. Hypoechoic relative to fatty liver
D. Calcified

4. Common site of focal fatty sparing includes:
A. Gallbladder fossa
B. Renal cortex
C. Pancreatic tail
D. Splenic hilum

5. Focal fatty sparing is considered:
A. Malignant
B. Infective
C. Benign
D. Traumatic

6. Which ligament is commonly associated with focal fatty sparing?
A. Coronary ligament
B. Falciform ligament
C. Round ligament of uterus
D. Broad ligament

7. Focal fatty sparing may mimic:
A. Hepatic mass lesion
B. Renal stone
C. Gallstone
D. Pancreatitis

8. Recognition of focal fatty sparing helps avoid:
A. Liver enlargement
B. Misdiagnosis of tumor
C. Portal hypertension
D. Ascites

9. The background liver in focal fatty sparing is usually:
A. Normal
B. Fatty
C. Fibrotic
D. Calcified

10. Focal fatty sparing most commonly affects which organ?
A. Kidney
B. Pancreas
C. Liver
D. Spleen

📝 Focal Fatty Sparing – Answer Sheet

1. __________

2. __________

3. __________

4. __________

5. __________

6. __________

7. __________

8. __________

9. __________

10. __________

✅ Correct Answers

1. B, 2. B, 3. C, 4. A, 5. C, 6. B, 7. A, 8. B, 9. B, 10. C

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