From the Guidelines
Focal fat deposition along the falciform ligament is typically a benign incidental finding on imaging studies that does not require further evaluation or treatment. This common radiological finding represents normal adipose tissue accumulation in the falciform ligament, which is a fold of peritoneum that connects the liver to the anterior abdominal wall. It is often seen on CT scans or MRI as a hypodense or hyperintense area, respectively, along the course of the ligament. The appearance may sometimes raise concern for pathology, but its characteristic location and imaging features help differentiate it from true lesions. According to the American College of Radiology Appropriateness Criteria 1, accurate characterization of incidentally detected liver lesions is of paramount clinical importance, and the use of various imaging modalities for characterization of these lesions is discussed in the context of several clinical scenarios. Some key points to consider when evaluating focal fat deposition along the falciform ligament include:
- Its characteristic location along the course of the falciform ligament
- Its typical appearance on imaging studies, such as CT scans or MRI
- The potential for variation in appearance among individuals, particularly those with higher body mass index or metabolic conditions
- The importance of recognizing this as a normal variant to prevent unnecessary additional testing or interventions, as supported by the American College of Radiology Appropriateness Criteria 1. While generally insignificant, if the appearance is atypical or changing over time, further imaging might occasionally be warranted to exclude other pathologies.
From the Research
Focal Far Deposition Along the Falciform Ligament
- Focal fat deposition along the falciform ligament can signify a rare condition known as fatty-falciform ligament appendage torsion (F-FLAT) 2, 3, 4.
- F-FLAT is characterized by torsion of the extraperitoneal fat within the falciform ligament, leading to fat infarction 2, 3, 4.
- This condition can present with abdominal pain, nausea, and reduced appetite, and may be diagnosed using imaging techniques such as ultrasound, CT scan, or MRI 2, 3, 4.
- Focal fat deposition in the liver, including along the falciform ligament, can also be a benign entity that can be confused with a malignant lesion 5, 6.
- The prevalence of focal fatty infiltration of the liver, including along the falciform ligament, increases with advancing age, and is more common in adults than in children 6.
- Imaging techniques such as chemical-shift MRI or contrast-enhanced ultrasound (CEUS) can be useful for non-invasive diagnosis of focal fat deposition 5.