Fatty liver disease is increasingly common, yet many people don’t realise they have it. In its early stages, it often causes no obvious symptoms and may only be picked up during routine tests or scans carried out for another reason.
Understanding what fatty liver disease is, and how it’s diagnosed, can help you take informed next steps, particularly as accurate imaging plays a central role in confirming the condition and assessing how advanced it is.
What is fatty liver disease?
Fatty liver disease happens when excess fat builds up in the liver. Small amounts of fat in the liver are normal, but too much can begin to affect how well the liver works.
The condition usually develops gradually and often goes unnoticed at first.
There are two main types of fatty liver disease. The most common is non-alcoholic fatty liver disease (NAFLD), which is linked to weight, metabolism and conditions such as type 2 diabetes. The other type, alcohol-related fatty liver disease (ARLD), is caused by regular or excessive alcohol intake.
Both types can progress over time and may lead to inflammation (swelling) and liver damage.
What causes fatty liver disease?
Fatty liver disease develops when the liver stores more fat than it can process. This build-up can happen for different reasons, and in many cases it’s linked to how the body manages energy, sugar and fats.
For some people, fatty liver disease is associated with metabolic factors, which relate to how your body processes energy and stores fat. Factors such as carrying excess weight, low levels of physical activity, type 2 diabetes, high cholesterol and high blood pressure can all increase the chance of fat building up in the liver. These often occur together and can place extra strain on the liver over time.
Alcohol is another well-recognised cause. Drinking alcohol regularly or in large amounts can interfere with how the liver breaks down fats, leading to a build-up and sometimes inflammation.
There are also less common causes that are outside of your control. Certain genetic conditions and autoimmune diseases, where the immune system mistakenly attacks healthy cells, can affect how the liver works.
Understanding the underlying cause helps guide how the condition is managed and monitored.
Symptoms of fatty liver disease
Fatty liver disease often develops without clear symptoms, especially in its early stages. Because of this, it’s frequently identified through tests or scans rather than how someone feels.
When symptoms do occur, they are usually mild and can be easy to overlook. Some people may notice ongoing tiredness or a feeling of discomfort in the upper right side of the abdomen, where the liver is located. These symptoms are non-specific, meaning they can be linked to a range of other conditions.
As the disease progresses, symptoms may become more noticeable. In more advanced stages, when inflammation or scarring has developed, people may experience more persistent fatigue or general changes in their health. This is why symptoms alone are not enough to assess liver health accurately.
Why early diagnosis matters
Although fatty liver disease can remain stable for some time, it can also progress if it is not identified and managed. In some cases, fat build-up in the liver can lead to inflammation, which may then develop into scarring, known as fibrosis. Over time, this can progress to cirrhosis, where the liver becomes permanently damaged.
As the condition advances, it may also increase the risk of developing liver cancer, particularly in more severe stages of liver damage.
Finding fatty liver disease early gives you the best chance to prevent it from getting worse. Many cases can be improved, and sometimes even reversed, through lifestyle changes and by managing any underlying conditions.
Early diagnosis also provides a more detailed view of your liver health, including how much fat is present. This information is important for planning the most suitable monitoring and care.
How is fatty liver disease diagnosed?
Diagnosing fatty liver disease usually involves a combination of a clinical assessment, blood tests and imaging. Each step helps build a clearer picture of liver health, although not all methods provide the same level of detail.
Blood tests are often the starting point. These can show changes in liver enzymes (substances in the blood that reflect how well the liver is working), which may suggest inflammation or stress in the liver. However, they cannot confirm how much fat is present or how advanced the condition is.
Ultrasound is commonly used as an initial imaging test. It can detect moderate to high levels of fat in the liver and is widely available, but it may miss early-stage disease and cannot measure fat levels accurately.
Computed tomography (CT) scans can also show changes in the liver, although they are not typically used for assessing fatty liver disease. This is because they involve exposure to radiation and are less sensitive when it comes to detecting small amounts of fat.
For a more detailed assessment, magnetic resonance imaging (MRI) scans are increasingly used. They can both confirm fatty liver disease and measure liver fat with a high level of accuracy.
Why MRI is the most accurate way to diagnose fatty liver disease
MRI is considered the most sensitive imaging method for diagnosing fatty liver disease and measuring exactly how much fat is in the liver. Unlike other scans, it doesn’t rely on visual judgement. Instead, it measures liver fat directly, providing an accurate result.
This level of accuracy is particularly important in early-stage disease, when smaller changes may not be visible on an ultrasound. MRI can detect these subtle changes, enabling earlier diagnosis and a clearer understanding of liver health.
MRI is also valuable for monitoring the condition over time. By measuring liver fat precisely, it can track how the disease is changing. This helps assess the impact of lifestyle changes, such as diet and exercise, as well as treatments including weight loss injections or other medications.
At Paul Strickland Scanner Centre, we use a specialist MRI technique called LiverLab as part of a dedicated fatty liver assessment. This allows our clinicians to measure liver fat accurately without invasive tests such as a biopsy, supporting early detection and ongoing monitoring.
What happens during an MRI scan of the liver?
An MRI scan of the liver is a safe and non-invasive procedure that uses magnetic fields and radio waves to create detailed images of the body. It does not involve any radiation.
During the scan, you will lie on a flat bed that moves into the MRI scanner. The process is painless, although the machine can be noisy. A radiographer will guide you throughout and provide support to help you feel comfortable.
For a fatty liver assessment, the scan is typically quick and focused, often taking around 5 to 10 minutes. At certain points, you may be asked to hold your breath for a short time to help capture clear images.
No injections are needed, and the scan is designed to be as straightforward and comfortable as possible.
After the scan, specialist radiologists review the images. Using LiverLab software, they can measure the amount of fat in the liver in detail, giving a clear picture of your liver health. These results can also serve as a baseline, making it easier to track changes over time.
Book a fatty liver assessment with Paul Strickland Scanner Centre
If you’re concerned about fatty liver disease or have been advised to investigate further, an MRI scan can provide a clear and accurate assessment of your liver health. At Paul Strickland Scanner Centre, MRI is used to measure liver fat precisely, helping to confirm a diagnosis and understand the extent of the condition.
The centre combines advanced imaging with consultant-led reporting, so your results are carefully reviewed and clearly explained. Booking a fatty liver assessment can give you the information you need to take the next steps with confidence.
