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We read with great interest the paper by Raptis et al1 regarding the quantification of liver steatosis by chemical-shift MRI. Chemical-shift imaging takes advantage of the difference in resonance frequency between water and fat (more precisely methylene, the most abundant group in triglycerides) to differentiate them. The dual-echo (in-phase/out-of-phase) MR technique used by the authors and derived from one of their previously published papers2 neglects T2* decay and assumes that the signal difference is due to fat–water interference alone.3 Yet, liver iron …
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