The Concept of CMR

Key Points

• Non-alcoholic fatty liver disease is a common cause of chronic liver disease and is closely associated with a range of cardiometabolic risk factors as well as diabetes and mortality risk.

• It is unknown how liver fat develops but a number of plausible mechanisms have been proposed, including ‘spillover’ of excess energy from adipose tissue, adiponectin deficiency, a high fat diet, and/or overactivation of the endocannabinoid system.

• Increased liver fat storage is related to hepatic insulin resistance and increased synthesis and secretion of atherogenic lipoproteins.

• The gold standard method for quantifying liver fat is liver biopsy. However, imaging techniques such as magnetic resonance spectroscopy (MRS) and computed tomography (CT) are safe and reliable alternatives.