Liver imaging: focal fatty sparing: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Liver imaging: focal fatty sparing

Sample item

A patient with diffuse fatty liver on ultrasound has a hypoechoic, geometric area next to the gallbladder fossa with no mass effect and normal vessels passing through it. What is the explanation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Focal sparing of fat from aberrant venous drainage

In steatosis, areas drained by aberrant gastric or cystic veins can escape fat deposition, and they look relatively hypoechoic with non-spherical borders and no vessel displacement. The gallbladder fossa and segment IV are typical sites.

Option by option

  • A. Focal sparing of fat from aberrant venous drainage (correct)

    Correct. Geometric sparing near the gallbladder without mass effect is a classic pseudolesion.

  • B. A hepatic haemangioma

    A haemangioma is usually echogenic.

  • C. A metastasis

    A metastasis would distort vessels and have a rounded shape.

  • D. A hepatocellular carcinoma

    HCC would show mass effect and typical contrast behaviour.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Focal sparing of fat from aberrant venous drainage. In steatosis, areas drained by aberrant gastric or cystic veins can escape fat deposition, and they look relatively hypoechoic with non-spherical borders and no vessel displacement.

Why is "A hepatic haemangioma" not the answer?

A haemangioma is usually echogenic.

Why is "A metastasis" not the answer?

A metastasis would distort vessels and have a rounded shape.

Why is "A hepatocellular carcinoma" not the answer?

HCC would show mass effect and typical contrast behaviour.

What concept does this question test?

It tests Liver imaging: focal fatty sparing in Radiology. The gallbladder fossa and segment IV are typical sites.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Liver imaging: focal fatty sparing?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.