Focal fatty change of the liver is caused by the combined effect of steatosis with hepatic ischemia. This ultrasound image shows a typical focal fatty infiltration of the right lobe of liver. Note the absence of mass effect which distinguishes focal fatty change from other space occupying lesions of the liver. Image courtesy of Dr. ravi Kadasne, UAE. The ultrasound machine used here is the IU 22 from Philips.
Also see the link: http://www.ultrasound-images.com/metabolic.htm for more sonographic images of fatty liver and other hepatic metabolic diseases.