Most common cause of increased hepatic echogenicity

What is the most common cause of increased hepatic echogenicity?

An echogenic liver is defined as increased echogenicity of the liver parenchyma compared with the renal cortex.

The most common cause is hepatic steatosis.

There are numerous causes of hepatic steatosis, including obesity, alcohol abuse, diabetes mellitus, corticosteroid use, malnutrition, and chemotherapy.

Causes of generalized increase in hepatic echogenicity include:

  • diffuse fatty change
  • cirrhosis: and/or coarsening
  • chronic hepatitis : and/or coarsening
  • diffuse infiltration or deposition
    • malignant process
    • granulomata 
      • tuberculosis
      • brucellosis
      • sarcoidosis
    • glycogen storage disease
    • hemochromatosis

Increased hepatic echogenicity is detected when the liver is considerably more echogenic than the kidney.

The prevalence of echogenic liver is approximately 13% to 20%. In most clinical settings, increased liver echogenicity is simply attributed to hepatic steatosis.

It is important to recognize other hepatic and systemic diseases including cirrhosis, viral hepatitis, glycogen storage disease, and hemochromatosis that may also cause an echogenic liver and to identify the associated findings to distinguish them from hepatic steatosis.


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