Radiologic Evaluation of Non-Alcoholic Fatty Liver Disease in Diabetic Patient

Non-alcoholic fatty liver disease (NAFLD), traditionally considered as a disease of hepatologists, has recently become a major concern in patients with type 2 diabetes mellitus (T2DM) as T2DM seems to worsen the course of NAFLD and vice versa. Furthermore, the increasing prevalence of NAFLD in T2DM and the complex mechanisms between these two diseases make physicians caring for patients with T2DM face many uncertainties in the diagnosis of NAFLD. Although the liver biopsy is considered as the gold standard of the diagnosis of NAFLD so far, it has several limitations such as infection, bleeding and cost. Hence, radiologic evaluations have been increasingly accepted as noninvasive alternatives to liver biopsy. Currently, 4 major imaging tools are available for measuring liver fat, including ultrasonography, computed tomography, magnetic resonance imaging and liver fibroscan. This article will describe these methods used to evaluate hepatic steatosis in patients with T2DM, including the diagnostic accuracy, limitations, and practical applicability.