Nutmeg liver

Nutmeg liver is also known as congestive hepatopathy and chronic passive congestion of the liver. It is the perfusion abnormality of the liver arising due to cardiac dysfunction , most commonly right heart failure (1). Other causes include Bud Chiari syndrome and constrictive pericarditis. Congeston of the hepatic veins prevents normal uniform enhancement of the liver parenchyma in the arterial and early venous phase, giving rise to a mottled appearance. The hypodense areas ( areas of decreased enhancement) are due to decreased portal flow, hepatic congestion and ischaemia. There is a more homogeneous appearance of the liver on the delayed phase. This feature helps differentiation of nutmeg liver from fatty infiltration.