Proton density fat fraction (PDFF) is a widely-used magnetic resonance imaging (MRI)-based biomarker for noninvasive quantification of hepatic steatosis. PDFF derived from low-flip-angle magnitude-based multi-gradient-echo MRI (MRI-M) without intravenous contrast has been shown to have high accuracy for estimating fat fraction. However, this MRI-M technique has a relatively low signal-to-noise ratio (SNR), which makes it difficult to visualize anatomical features. In this analysis of ninety-two patients, high-flip-angle contrast-enhanced (with either gadoxetate disodium or gadobutrol) MRI-M imaging had no significant difference in fat-grading accuracy from the standard low-flip-angle pre-contrast PDFF, using MR spectroscopy (MRS)-PDFF as the reference standard.
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