Abstract
Fatty liver is a benign condition to start with and is characterized by excess triglyceride
in the hepatocytes. However, in the long term, it can lead to increased oxidative
stress & inflammation, with resultant steatohepatitis. This can subsequently progress
to cirrhosis and eventually an increased risk of developing hepatocellular carcinoma
(HCC). Liver biopsy is the gold standard for quantification of fat and assessing the
degree of fibrosis, however, it is invasive and cannot be applied to a wider patient
population. Conventional modalities like ultrasound offer a qualitative assessment
of fat and are more subjective. Non-enhanced CT scan has been effectively used for
fat quantification based on Hounsfield values. MRI & more recently MRI PDFF (proton
density fat fraction) offers accurate diagnosis, quantification, and monitoring of
fatty liver disease in a noninvasive manner. This acts like an Imaging biomarker.
Newer techniques like USG Elastography & MR Elastography help in the detection of
fibrosis. Steatohepatitis and early liver fibrosis are reversible and it is crucial
to detect and quantify to guide disease management. The radiologist can play a vital
role in quantifying fat, detecting fibrosis, and early signs of chronic liver disease.
Keywords
fatty liver - steatohepatitis - elastography
