ABSTRACT
The first patient was a 33-year-old man with a history of fatty liver disease. Dynamic computerized tomography of a lesion in liver segment IV showed faint staining in the arterial phase and high signal intensity in the portal venous and equilibrium phases. The second patient was a 57-year-old woman also with a history of fatty liver disease. Magnetic resonance imaging (MRI) of a lesion in segment II in T1 out of phase revealed geographic morphology and high signal intensity. Furthermore, Gd-EOB-DTPA-enhanced MRI showed accumulation in the lesion in the hepatobiliary phase. In both cases, an aberrant left gastric vein and focal fat sparing area was diagnosed. Venous inflow to the liver other than via the portal vein may cause fatty degeneration of liver parenchymal cells or focal fat sparing due to imbalanced intrahepatic blood flow. In the present cases, imaging revealed a focal fat sparing area with an aberrant left gastric vein. Focal fat sparing area with aberrant inflow vessel identified in the background of fatty liver does not require biopsy or surgery. Therefore, further detailed evaluation of such images is warranted.