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  • Review Article
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Magnetic resonance elastography from fundamental soft-tissue mechanics to diagnostic imaging

Nature Reviews Physics volume 5, pages 25–42 (2023)Cite this article

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Abstract

Magnetic resonance elastography (MRE) is a versatile imaging technique for mapping the viscoelastic properties of soft biological tissues. It has been widely used to detect liver fibrosis and is increasingly being used in the diagnosis of other diseases ranging from cancer to chronic kidney diseases. Many pathologies are associated with or even caused by changes in mechanical properties. For example, fibrosis, hypertension, cellular oedema and hyperplasia have been shown to increase tissue stiffness, and neurodegeneration, neuroinflammation, hypoperfusion and necrosis are associated with softening. Beyond stiffness, measurement of viscosity provides a rich, still widely unexplored, source of image contrast in MRE that is related to intrinsic mechanical friction and the fluid behaviour of soft tissues. This Review summarizes the basic technical concepts of MRE — including hardware requirements, excitation and encoding of harmonic motions and inverse problem solutions to viscoelastic theory — and outlines preclinical and clinical applications in cancer, renal disease and cardiac MRE.

Key points

  • Quantification of the viscoelastic behaviour of soft biological matter provides information on the mechanical integrity of multiscale tissue structures that vary significantly with tissue function and disease.

  • Magnetic resonance elastography (MRE) can noninvasively map the viscoelastic properties of soft tissues in a wide range of diagnostic applications of magnetic resonance imaging (MRI).

  • MRE encodes externally induced harmonic shear waves by vibration-synchronized phase-contrast MRI and uses inversion algorithms for the reconstruction of mechanical parameters.

  • Mechanical parameters measured with MRE include harmonic shear strain, storage and loss moduli, shear wave speed, wave attenuation and loss angle.

  • In vivo MRE provides parameter maps with spatial resolutions ranging from millimetres to sub-millimetres and at dynamic ranges from tens of hertz to kilohertz in patients and small animals, respectively.

  • MRE extends clinical imaging protocols by a few minutes and can be combined with complementary quantitative MRI methods to characterize various mechanofunctional and structural properties of pathologically altered tissues.

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Fig. 1: Multiscale sensitivity of magnetic resonance elastography.
Fig. 2: Motion encoding in magnetic resonance elastography compared with diffusion-weighted and flow-sensitive magnetic resonance imaging.
Fig. 3: Magnetic resonance elastography data acquisition and basic processing.
Fig. 4: Mapping of shear wave speed as surrogate of stiffness in abdominal organs based on tomoelastography compared with conventional imaging such as T2-weighted magnetic resonance imaging (MRI) and T1-weighted MRI and computed tomography.
Fig. 5: Preclinical magnetic resonance elastography (MRE) in biomedical applications that provided insights into time-dependent or immediate parameter changes that could not be studied by clinical MRE.

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Acknowledgements

Support of the German Research Foundation is gratefully acknowledged (GRK2260 BIOQIC, CRC1340 Matrix-in-Vision). The author thanks H. Tzschätzsch for proof reading, B. Herwig for language editing and J. Braun, M. Shahryari and J. Guo for help with the artwork.

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    Ingolf Sack

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I.S. holds patents related to MRE and is a shareholder of Time Harmonic Elastography Applications and Devices.

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Sack, I. Magnetic resonance elastography from fundamental soft-tissue mechanics to diagnostic imaging. Nat Rev Phys 5, 25–42 (2023). https://doi.org/10.1038/s42254-022-00543-2

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