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New progress in magnetic resonance imaging for evaluating ectopic fat deposition in type 2 diabetes mellitus
LAI Junren  YANG Xinguan 

Cite this article as: LAI J R, YANG X G. New progress in magnetic resonance imaging for evaluating ectopic fat deposition in type 2 diabetes mellitus[J]. Chin J Magn Reson Imaging, 2026, 17(3): 221-227. DOI:10.12015/issn.1674-8034.2026.03.032.


[Abstract] Type 2 diabetes mellitus (T2DM) has emerged as a significant global public health challenge. While obesity is traditionally considered a core risk factor, mounting evidence indicates that fat distribution patterns—specifically ectopic fat deposition (EFD) in visceral depots and key metabolic organs—play a more pivotal role in the pathophysiology of T2DM. Magnetic resonance imaging (MRI) and its advanced techniques, such as proton density fat fraction (PDFF) and magnetic resonance spectroscopy (MRS), provide powerful tools for the non-invasive and precise quantification of systemic and organ-specific fat content. Despite the established association between obesity and T2DM, traditional systemic obesity metrics fail to capture the high heterogeneity of EFD and its organ-specific pathogenic mechanisms. Current clinical assessments often lag behind microstructural organ damage and lack precise means to monitor these occult fat depots and their dynamic changes during treatment. To address this, this article reviews recent advances in using MRI to evaluate EFD in patients with T2DM. It focuses on fat distribution patterns, the evolution of quantitative MRI techniques, and the specific pathophysiological alterations induced by EFD in the liver, pancreas, skeletal muscle, heart, kidneys, and central nervous system. Furthermore, the review evaluates the clinical value of MRI in assessing the efficacy of therapeutic interventions, including lifestyle modifications, pharmacotherapy, and bariatric surgery. Finally, future research directions are discussed, with the aim of providing imaging-based references to support early precision subtyping and personalized management strategies for T2DM.
[Keywords] type 2 diabetes mellitus；ectopic fat deposition；magnetic resonance imaging；insulin resistance；proton density fat fraction

LAI Junren   YANG Xinguan*  

Department of Radiology, Guilin People's Hospital, Guilin 541002, China

Corresponding author: YANG X G, E-mail: yangxinguan821105@163.com

Conflicts of interest   None.

Received  2025-11-10
Accepted  2026-02-03
DOI: 10.12015/issn.1674-8034.2026.03.032
Cite this article as: LAI J R, YANG X G. New progress in magnetic resonance imaging for evaluating ectopic fat deposition in type 2 diabetes mellitus[J]. Chin J Magn Reson Imaging, 2026, 17(3): 221-227. DOI:10.12015/issn.1674-8034.2026.03.032.

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