[No-invasive determination of liver fat with 1H-MR spectroscopy]

Hepatic steatosis is characterized by accumulation of fat in the liver. The prevalence of hepatic steatosis is increasing wordwide due to the close relation between obesity and insulin resistance in non-alcoholic fatty liver disease (NAFLD). The reference standard for determination of hepatic steatosis is liver biopsy with histological assessment. The objections to this are increased risk of complications, patient discomfort and inter-observer variability. Proton MR spectroscopy (1H-MRS) provides information about the chemical constitution of tissues in a spectrum. In this way, 1H-MRS is able to non-invasively measure the amount of fat in the liver. 1H-MRS is precise and reproducible for the assessment of hepatic fat and is useful in all patients for whom an assessment of hepatic steatosis is required, except for those in which MRI is contra-indicated. 1H-MRS is not difficult to learn, but one has to gain some experience with the data-acquisition to obtain good quality MR spectra.