肝膵の代謝性疾患

Metabolic disorders of the liver and pancreas

代謝性疾患のカテゴリに含まれる疾患は様々あるが，肝臓においては脂肪性肝疾患が最も重要である。2023年に用語の変更があったため，放射線科医も最新の用語を知っておきたい。肝臓ほどは認知されていないが，膵の脂肪沈着も近年注目されてきている。肝膵ともに脂肪性疾患患者は増加傾向にあり，臨床上の重要性が高まっている。そこで本稿では脂肪性肝疾患と脂肪性膵疾患にフォーカスし，それぞれの一般事項とCT，MRIの役割について概説する。

Metabolic disorders comprise a broad spectrum of conditions, but steatotic liver disease is the most clinically relevant in hepatic imaging. Given the terminology update in 2023, radiologists should be familiar with the current nomenclature. Although less recognized than hepatic steatosis, pancreatic fat deposition has recently attracted increasing attention. The prevalence of fatty disorders involving both the liver and pancreas continues to rise, underscoring their growing clinical importance. This article focuses on fatty liver disease and fatty pancreatic disease, summarizing key concepts and the roles of CT and MRI in their assessment. Quantitative fat measurement is essential, and MRI proton density fat fraction is currently the most useful technique. In the liver, evaluation of iron overload and fibrosis is also required, making MRI a practical one-stop examination.