Peer-review started: September 1, 2015
First decision: November 6, 2015
Revised: November 14, 2015
Accepted: December 3, 2015
Article in press: December 4, 2015
Published online: January 28, 2016
Processing time: 151 Days and 13.5 Hours
Magnetic resonance elastography (MRE) is an innovative imaging technique for the non-invasive quantification of the biomechanical properties of soft tissues via the direct visualization of propagating shear waves in vivo using a modified phase-contrast magnetic resonance imaging (MRI) sequence. Fundamentally, MRE employs the same physical property that physicians utilize when performing manual palpation - that healthy and diseased tissues can be differentiated on the basis of widely differing mechanical stiffness. By performing “virtual palpation”, MRE is able to provide information that is beyond the capabilities of conventional morphologic imaging modalities. In an era of increasing adoption of multi-parametric imaging approaches for solving complex problems, MRE can be seamlessly incorporated into a standard MRI examination to provide a rapid, reliable and comprehensive imaging evaluation at a single patient appointment. Originally described by the Mayo Clinic in 1995, the technique represents the most accurate non-invasive method for the detection and staging of liver fibrosis and is currently performed in more than 100 centers worldwide. In this general review, the mechanical properties of soft tissues, principles of MRE, clinical applications of MRE in the liver and beyond, and limitations and future directions of this discipline -are discussed. Selected diagrams and images are provided for illustration.
Core tip: Magnetic resonance elastography (MRE) is a non-invasive technique for probing the mechanical properties of biologic tissues. The three main steps involved in the MRE technique include the production of mechanical waves in soft tissues, the adoption of a modified phase-contrast MR sequence to image wave motion, and the application of an inversion algorithm to convert the wave image into an elastogram. MRE has received validation for the non-invasive assessment and grading of fibrosis in chronic liver disease patients. MRE also has potential diagnostic applications in other organ systems and may help further the understanding of disease processes.