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Methods for assessing intrahepatic fat content and steatosis

Fabbrini, Elisaa,b; Conte, Caterinaa,c; Magkos, Faidond

Current Opinion in Clinical Nutrition & Metabolic Care: September 2009 - Volume 12 - Issue 5 - p 474–481
doi: 10.1097/MCO.0b013e32832eb587
Assessment of nutritional status and analytical methods: Edited by Dwight E. Matthews and Labros S. Sidossis

Purpose of review Intrahepatic fat content is increasingly being recognized as an integral part of metabolic dysfunction. This article reviews available methods for the assessment of hepatic steatosis.

Recent findings Apart from liver biopsy, there are several noninvasive radiologic modalities for evaluating nonalcoholic fatty liver disease. Ultrasonography, computed tomography, and traditional MRI remain largely qualitative methods for detecting mild to severe degrees of steatosis rather than quantitative methods for measuring liver fat content, even though novel attempts to collect objective quantitative information have recently been developed. Still, their sensitivity at mild degrees of steatosis is poor. Undoubtedly, most methodological advances have occurred in the field of MRI and magnetic resonance spectroscopy, which currently enable the accurate quantification of intrahepatic fat even at normal or near normal levels. Xenon computed tomography was also recently shown to offer another objective tool for the quantitative assessment of steatosis, although more validation studies are required.

Summary Several modalities can be used for measuring intrahepatic fat and assessing steatosis; the choice will ultimately depend on the intended use and available resources.

aCenter for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri, USA

bCenter for Clinical and Basic Research, Department of Medical Sciences, IRCCS San Raffaele, Italy

cDepartment of Clinical Medicine, Sapienza University of Rome, Rome, Italy

dDepartment of Nutrition and Dietetics, Harokopio University, Athens, Greece

Correspondence to Elisa Fabbrini, MD, PhD, Center for Human Nutrition, Division of Geriatrics and Nutritional Science, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8031, St. Louis, MO 63110, USA Tel: +1 314 362 8156; fax: +1 314 362 8230; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.