Cardiovascular Magnetic Resonance Elastography: Current Evidence, Challenges, and Future Perspectives
Myocardial and aortic stiffness are increasingly recognized as clinically relevant biomarkers for cardiovascular disease, yet their noninvasive quantification remains challenging. Magnetic resonance elastography (MRE) has emerged as a promising technique for the spatial mapping of tissue biomechanics by visualizing and analyzing propagating shear waves. This narrative review summarizes the current state of cardiovascular MRE, spanning technical developments in wave generation (acoustic, electromagnetic, gravitational, and transducer-free approaches), pulse sequence design (echo-planar imaging, gradient-recalled echo, spiral, and free-breathing three-dimensional acquisitions), and inversion algorithms (local frequency estimation, direct inversion, finite element methods, and multifrequency elastography). We present evidence from phantom validation, animal models (myocardial infarction, hypertension, right ventricular hypertrophy), and human studies encompassing cardiac amyloidosis, hypertrophic cardiomyopathy, diastolic dysfunction, and abdominal aortic aneurysm. Additionally, we discuss current challenges, including waveguide effects, standardization needs, and clinical translation barriers, and highlight emerging solutions through artificial intelligence, multifrequency methods, and transducer-free cardiac MRE.
Authors
- Scherwin Mahmoudi (ORCID: https://orcid.org/0000-0002-4020-1873)
- Teodora Biciusca (ORCID: https://orcid.org/0000-0002-7423-2926)
- Tatjana Gruber‐Rouh (ORCID: https://orcid.org/0000-0001-9724-7744)
- Tommaso D’Angelo (ORCID: https://orcid.org/0000-0003-0004-6378)
- Vitali Koch (ORCID: https://orcid.org/0000-0001-6915-5906)
- Thomas Joseph Vogl (ORCID: https://orcid.org/0000-0001-5218-1075)
- Hatim Kerniss (ORCID: https://orcid.org/0009-0008-6430-0252)
- Ralph Strecker (ORCID: https://orcid.org/0000-0002-8232-8952)
- Leon David Gruenewald (ORCID: https://orcid.org/0000-0001-7959-5008)
- Radhouène Neji (ORCID: https://orcid.org/0000-0002-6543-4390)
- Jennifer Gotta (ORCID: https://orcid.org/0000-0002-0524-6574)
- Simon Bernatz (ORCID: https://orcid.org/0000-0002-7758-8100)
- Iris Burck (ORCID: https://orcid.org/0000-0003-1349-4807)
- Katrin Eichler
- Simon S. Martin (ORCID: https://orcid.org/0000-0003-3347-4520)
- Philipp Reschke (ORCID: https://orcid.org/0009-0006-9123-7581)
- Sebastian M Haberkorn (ORCID: https://orcid.org/0000-0003-3100-2167)
- David Leistner
- R Sinkus
- Marco Ochs
- Maria Johanna Gobertina Tetuanui Vehreschild
- Mohamed Alrahmoun
- Christian Booz
- Omar Darwish
- Alexander Wollandt
Institutions
- Goethe University Frankfurt (DE)
- Siemens (Germany) (DE)
- Inserm (FR)
- King's College London (GB)
- Université Paris Cité (FR)
- Centre de Recherche sur l'Inflammation (FR)
- University Hospital Frankfurt (DE)
- Siemens Healthineers (Germany) (DE)
Publication Details
- Journal
- Diagnostics
- Published
- 2026-07-16
- DOI
- https://doi.org/10.3390/diagnostics16142233
- Primary Topic
- Ultrasound Imaging and Elastography
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Agence Nationale de la Recherche
- Bundesministerium für Bildung und Forschung