Quick version
What is fatty liver and why is accurate measurement important?
Fatty liver means too much fat has accumulated in the liver cells. There are two common types: one linked to metabolism (MASLD) and one caused by alcohol. Detecting fatty liver early is crucial because it is reversible in its early stages.
If left untreated, it can lead to liver inflammation (steatohepatitis), scarring (fibrosis), and eventually cirrhosis. Therefore, precise methods are needed to measure fat accumulation and monitor how the liver responds to lifestyle changes.
Why do the lobes look different? The explanation behind asymmetric fat distribution
It might seem strange that one organ has different amounts of fat on the right and left sides, but the answer lies in anatomy and blood flow.
Venous inflow: The liver receives blood from two main sources: the hepatic artery and the portal vein. The portal vein transports nutrient-rich blood from the digestive organs.
"Streamlining effect": Blood from different parts of the intestines does not mix perfectly in the portal vein before reaching the liver. Blood from the spleen and large intestine tends to flow toward the left lobe, while blood from the small intestine—richer in fats and sugars after a meal—is often directed toward the right lobe.
Local variation: This means the right lobe often receives more nutrients, leading to higher fat storage. Some parts of the liver also have different blood supply patterns, which can result in a "patchy" appearance on imaging.
MRI vs. Ultrasound – which method should you choose?
When identifying fatty liver, several methods are available. Here are the key differences:
Ultrasound – The quick first-line method
Ultrasound is often the first step because it is highly accessible. It provides a quick visual overview of the liver and other abdominal organs.
Limitations: The method is sensitive to body composition; in cases of significant abdominal obesity, it can be difficult for sound waves to penetrate, leading to uncertain results.
MRI Scan – The "Gold Standard"
An MRI scan of the liver offers the most advanced technology for identifying and quantifying fat accumulation. Unlike simpler methods, MRI provides a complete and objective view of the entire organ.
Full liver analysis: Because fat is often distributed unevenly, MRI is superior as it analyzes the entire liver volume, reducing the risk of missing localized fat deposits.
Objective assessment: The method provides a standardized image, making it easier to track progress over time, such as responses to lifestyle changes or medical treatment.
What can you do yourself? How to reduce liver fat
The good news is that the liver has an amazing ability to recover. Lifestyle changes can often significantly reduce fat accumulation within just a few months.
- Reduce fast carbohydrates: Sugar (especially fructose) and white flour are primary drivers of fatty liver.
- Physical activity: Both strength and cardio training improve insulin sensitivity.
- Weight loss: A weight loss of just 5–10% can have a dramatic effect on liver fat levels.
