Abstract

Background: Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are highly sensitive and specific modalities for diagnosing fatty liver disease (FLD). However, evidence on their application for the quantitative assessment of hepatic steatosis and related associations in Vietnam remains limited.

Methods: This retrospective cross-sectional study included 92 patients who underwent MRI for quantitative liver fat assessment or CT for visceral fat evaluation at the Institute of Gastroenterology and Hepatology, and Hoang Long General Clinic between April 2024 and April 2025.

Results: The median total fat area, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) measured by CT were 318.1 cm², 132.6 cm², and 192.0 cm², respectively. The median liver fat fraction (FF%) and fat percentage (FP%) on MRI were 15.0% and 18.0%. Significant positive correlations were observed between total fat area, SAT, and body mass index (BMI) (rₛ = 0.65; rₛ = 0.73, respectively; p < 0.001). FF% correlated positively with AST and ALT, while FP% correlated with ALT (p < 0.05). Both FF% and FP% showed significant positive correlations with the grade of hepatic steatosis on ultrasound (p = 0.001).

Conclusions: CT and MRI are valuable tools for quantitative assessment of hepatic and visceral fat in patients with FLD. Total fat area and SAT are positively associated with BMI, whereas FF% and FP% correlate with liver enzymes and ultrasound steatosis grade, supporting their role in disease assessment and clinical follow-up.