Pericaval fat mimicking intracaval deposits on unenhanced and contrast-enhanced helical CT in patients with cirrhosis.

PURPOSE: The purpose of this work was to determine whether there is a significant difference in radiographic depiction of pericaval fat mimicking intracaval deposits on CT scans in patients with cirrhosis versus those without cirrhosis. METHOD: The incidence of radiographic pseudolesions depicted as an intracaval fat mass identified on CT scans in 62 patients with cirrhosis was compared with that in 81 patients without cirrhosis. RESULTS: Pericaval fat depicted as an intracaval fat mass was identified more frequently in patients with cirrhosis (20/62, 32%) than in patients without cirrhosis (4/81, 5%), representing a statistically significant difference (p < 0.0001). A total of 24 lesions were seen in 20 patients with cirrhosis. Lesions were identified at the confluence of the hepatic veins (n = 19), below the confluence (n = 4), and above the confluence (n = 1). Pseudolesions appeared round (n = 5), oval (n = 15), or linear (n = 4). Locations included medial (n = 15), posteromedial (n = 4), anteromedial (n = 1), and posterior (n = 4). The average length was 1.5 cm. CONCLUSION: The cause of pseudolesions depicted as intracaval fat masses on CT is likely secondary to morphologic changes in the liver such as cirrhosis.