Functional magnetic resonance imaging in the progression of metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis

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ZHANG Jiarui TANG Shuhong CHEN Kai ZHU Xiangqi SHI Weijun SUN Hongzan

Cite this article as: ZHANG J R, TANG S H, CHEN K, et al. Functional magnetic resonance imaging in the progression of metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated steatohepatitis[J]. Chin J Magn Reson Imaging, 2026, 17(4): 192-198, 213. DOI:10.12015/issn.1674-8034.2026.04.027.

Abstract

[Abstract] Metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive phenotype, metabolic dysfunction-associated steatohepatitis (MASH), represent a chronic spectrum of liver disorders that requires long-term, risk-stratified management, yet current assessment tools remain limited in precise quantification and longitudinal monitoring. MASLD/MASH is a spectrum of chronic liver diseases requiring long-term, stratified management. Current assessment tools fall short in precisely quantifying the degrees of hepatic steatosis, inflammation, and fibrosis, and lack the sensitivity to monitor the dynamic progression of the disease, which hinders its full-cycle precision management. Magnetic resonance functional imaging techniques have emerged as a research focus to address this clinical need, owing to their potential for non-invasive, quantitative, and multi-parameter assessment. This review systematically summarizes recent advances and the current status of clinical translation of functional magnetic resonance imaging in whole-course management of MASLD/MASH. We outline the principles underlying its noninvasive quantitative assessment of key pathological changes, including hepatic steatosis, inflammation, and fibrosis, and synthesize evidence for its utility in disease screening, risk stratification, treatment-response monitoring, and prognostic evaluation. We further discuss major barriers to broader clinical implementation, such as technical standardization, definition of diagnostic thresholds, and validation against clinical outcomes. Functional magnetic resonance imaging holds promise in establishing an objective and reproducible quantitative framework to support precision management of MASLD/MASH. This framework provides a robust theoretical foundation and practical benchmark for non-invasive disease stratification, standardized clinical workflows, longitudinal follow-up monitoring, and the design of high-quality clinical trials.

[Keywords] metabolic dysfunction-associated steatotic liver disease；metabolic dysfunction-associated steatohepatitis；magnetic resonance functional imaging；proton density fat fraction；magnetic resonance elastography；liver fibrosis

Contributor Information

ZHANG Jiarui TANG Shuhong CHEN Kai ZHU Xiangqi SHI Weijun SUN Hongzan^*

The Second Clinical College of China Medical University, Shenyang 110004, China

Corresponding author: SUN H Z, E-mail: sunhongzan@126.com

Conflicts of interest None.

Publication Information

Received 2026-01-30

Accepted 2026-04-10

DOI: 10.12015/issn.1674-8034.2026.04.027

Text

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