Cardiovascular Magnetic Resonance Elastography: Current Evidence, Challenges, and Future Perspectives

Area of Science:

• Cardiovascular Imaging
• Biomedical Engineering
• Medical Physics

Background:

• Myocardial and aortic stiffness are key cardiovascular disease biomarkers.
• Noninvasive quantification of tissue stiffness remains a significant clinical challenge.
• Magnetic resonance elastography (MRE) shows promise for mapping tissue biomechanics.

Purpose of the Study:

• To provide a narrative review of cardiovascular MRE.
• To cover technical developments, applications, and challenges in the field.
• To highlight emerging solutions and future directions.

Main Methods:

• Review of technical advancements in MRE wave generation (acoustic, electromagnetic, gravitational, transducer-free).
• Analysis of pulse sequence designs (EPI, GRE, spiral, 3D acquisitions) and inversion algorithms (LFE, direct inversion, FEM, multifrequency).
• Evidence synthesis from phantom, animal, and human studies (cardiac amyloidosis, HCM, AAA).

Main Results:

• MRE techniques have advanced significantly in wave generation, pulse sequences, and inversion methods.
• MRE has been validated in phantoms, animal models (MI, hypertension), and human studies for various cardiovascular conditions.
• Current challenges include waveguide effects, standardization, and clinical translation barriers.

Conclusions:

• Cardiovascular MRE is a rapidly evolving field with demonstrated potential for diagnosing and monitoring cardiovascular diseases.
• Emerging solutions like AI and transducer-free MRE may overcome current limitations.
• Further standardization and clinical translation are essential for widespread adoption.