Magnetic Resonance Elastography Sequence Research Articles

Overhauser-enhanced magnetic resonance elastography.

Magnetic resonance elastography (MRE) is a powerful technique to assess the mechanical properties of living tissue. However, it suffers from reduced sensitivity in regions with short T2 and T2 * such as in tissue with high concentrations of paramagnetic iron, or in regions surrounding implanted devices. In this work, we exploit the longer T2 * attainable at ultra-low magnetic fields in combination with Overhauser dynamic nuclear polarization (DNP) to enable rapid MRE at 0.0065 T. A 3D balanced steady-state free precession based MRE sequence with undersampling and fractional encoding was implemented on a 0.0065 T MRI scanner. A custom-built RF coil for DNP and a programmable vibration system for elastography were developed. Displacement fields and stiffness maps were reconstructed from data recorded in a polyvinyl alcohol gel phantom loaded with stable nitroxide radicals. A DNP enhancement of 25 was achieved during the MRE sequence, allowing the acquisition of 3D Overhauser-enhanced MRE (OMRE) images with (1.5 × 2.7 × 9) mm(3) resolution over eight temporal steps and 11 slices in 6 minutes. In conclusion, OMRE at ultra-low magnetic field can be used to detect mechanical waves over short acquisition times. This new modality shows promise to broaden the scope of conventional MRE applications, and may extend the utility of low-cost, portable MRI systems to detect elasticity changes in patients with implanted devices or iron overload.

Scattering and Diffraction of Elastodynamic Waves in a Concentric Cylindrical Phantom for MR Elastography.

The focus of this paper is to report on the design and construction of a multiply connected phantom for use in magnetic resonance elastography (MRE)-an imaging technique that allows for the noninvasive visualization of the displacement field throughout an object from externally driven harmonic motion-as well as its inverse modeling with a closed-form analytic solution which is derived herein from first principles. Mathematically, the phantom is described as two infinite concentric circular cylinders with unequal complex shear moduli, harmonically vibrated at the exterior surface in a direction along their common axis. Each concentric cylinder is made of a hydrocolloid with its own specific solute concentration. They are assembled in a multistep process for which custom scaffolding was designed and built. A customized spin-echo-based MR elastography sequence with a sinusoidal motion-sensitizing gradient was used for data acquisition on a 9.4 T Agilent small-animal MR scanner. Complex moduli obtained from the inverse model are used to solve the forward problem with a finite-element method. Both complex shear moduli show a significant frequency dependence (p 0.001) in keeping with previous work. The novel multiply connected phantom and mathematical model are validated as a viable tool for MRE studies. On a small enough scale much of physiology can be mathematically modeled with basic geometric shapes, e.g., a cylinder representing a blood vessel. This study demonstrates the possibility of elegant mathematical analysis of phantoms specifically designed and carefully constructed for biomedical MRE studies.

Interplatform reproducibility of liver and spleen stiffness measured with MR elastography.

To assess interplatform reproducibility of liver stiffness (LS) and spleen stiffness (SS) measured with magnetic resonance elastography (MRE) based on a 2D gradient echo (GRE) sequence. This prospective Health Insurance Portability and Accountability Act (HIPAA)-compliant and Institutional Review Board (IRB)-approved study involved 12 subjects (five healthy volunteers and seven patients with liver disease). A multislice 2D-GRE-based MRE sequence was performed using two systems from different vendors (3.0T GE and 1.5T Siemens) on the same day. Two independent observers measured LS and SS on confidence maps. Bland-Altman analysis (with coefficient of reproducibility, CR), coefficient of variability (CV), and intraclass correlation (ICC) were used to analyze interplatform, intra- and interobserver variability. Human data were validated using a gelatin-based phantom. There was excellent reproducibility of phantom stiffness measurement (CV 4.4%). Mean LS values were 3.44-3.48 kPa and 3.62-3.63 kPa, and mean SS values were 7.54-7.91 kPa and 8.40-8.85 kPa at 3.0T and 1.5T for observers 1 and 2, respectively. The mean CVs between platforms were 9.2%-11.5% and 13.1%-14.4% for LS and SS, respectively, for observers 1 and 2. There was excellent interplatform reproducibility (ICC >0.88 and CR <36.2%) for both LS and SS, and excellent intra- and interobserver reproducibility (intraobserver: ICC >0.99, CV <2.1%, CR <6.6%; interobserver: ICC >0.97, CV and CR <16%). This study demonstrates that 2D-GRE MRE provides platform- and observer-independent LS and SS measurements.

A new method for quantification of aortic stiffness in vivo using magnetic resonance elastography (MRE): a translational study from sequence design to implementation in patients

Background Aortic stiffness is an important risk factor in the development of cardiovascular disease. Early detection of stiffening is important so that appropriate medical and behavioural interventions can be implemented. Applanation tonometry pulse wave velocity is the current non-invasive reference standard but this only provides spatially-averaged measurements. Local measurements may be more important, particularly in the ascending aorta due to aorto-ventricular coupling effects. MRE usually requires a surface transducer to generate shear waves in the tissues but these are expensive, uncomfortable and not available in all centres. The aim of this study was to develop a new transducer-free MRE sequence to measure aortic stiffness in vivo using aortic valve closure, an intrinsic source for elastography, to generate shear waves in the aortic wall.

Rapid acquisition technique for MR elastography of the liver

Magnetic resonance elastography (MRE) of the liver is a novel noninvasive clinical diagnostic tool to stage fibrosis based on measured stiffness. The purpose of this study is to design, evaluate and validate a rapid MRE acquisition technique for noninvasively quantitating liver stiffness which reduces by half the scan time, thereby decreasing image registration errors between four MRE phase offsets. In vivo liver MRE was performed on 16 healthy volunteers and 14 patients with biopsy-proven liver fibrosis using the standard clinical gradient recalled echo (GRE) MRE sequence (MREs) and a developed rapid GRE MRE sequence (MREr) to obtain the mean stiffness in an axial slice. The mean stiffness values obtained from the entire group using MREs and MREr were 2.72±0.85 kPa and 2.7±0.85 kPa, respectively, representing an insignificant difference. A linear correlation of R2=0.99 was determined between stiffness values obtained using MREs and MREr. Therefore, we can conclude that MREr can replace MREs, which reduces the scan time to half of that of the current standard acquisition (MREs), which will facilitate MRE imaging in patients with inability to hold their breath for long periods.

Estimation of the absolute shear stiffness of human lung parenchyma using 1H spin echo, echo planar MR elastography

PurposeTo develop a rapid proton MR elastography (MRE) technique that can quantify the absolute shear stiffness of lung parenchyma, to investigate the ability to differentiate respiration‐dependent stiffness variations of the lung, and to demonstrate clinical feasibility.Materials and MethodsA spin‐echo echo planar imaging MRE sequence (SE‐EPI MRE) with a very short echo time was developed and tested in a series of five healthy volunteers at three different lung volumes: (i) residual volume (RV), (ii) total lung capacity (TLC), (iii) and midway between RV and TLC (MID). At each volume, lung density was quantified using a MR‐based density mapping sequence. For reference, data were acquired using the previously described spin‐echo lung MRE sequence (SE‐MRE). MRE data were also acquired in a patient with proven Idiopathic Pulmonary Fibrosis (IPF) to test clinical feasibility.ResultsThe SE‐EPIMRE sequence reduced total acquisition time by a factor of 2 compared with the SE‐MRE sequence. Lung parenchyma median shear stiffness for the 5 volunteers quantified with the SE‐EPI MRE sequence was 0.9 kPa, 1.1 kPa, and 1.6 kPa at RV, MID, and TLC, respectively. The corresponding values obtained with the SE‐MRE sequence were 0.9 kPa, 1.1 kPa, and 1.5 kPa. Absolute shear stiffness was also successfully measured in the IPF patient.ConclusionThe results indicate that stiffness variations due to respiration could be measured with the SE‐EPIMRE technique and were equivalent to values generated by the previously described SE‐MRE approach. Preliminary data obtained from the patient demonstrate clinical feasibility.J. Magn. Reson. Imaging 2014;40:1230–1237. © 2013 Wiley Periodicals, Inc.

Correlation of MR elastography with morphometric quantification of liver fibrosis (Fibro-C-Index) in chronic hepatitis B

We evaluated the correlation of MR Elastography (MRE) with morphometric assessment of liver fibrosis in chronic hepatitis B (CHB). Thirty-two patients with CHB underwent both MRE and a liver biopsy within a 6-month interval. MRE was performed using standard MRE sequence on a 1.5 Tesla clinical scanner. The liver stiffness (LS) was measured on automatically generated stiffness maps. Morphometric quantification of fibrosis of liver biopsies was performed using a semi-automated image analysis program and expressed as percentage area (Fibro-C-Index). Correlations between MRE, Fibro-C-Index, and histologic fibrosis stages were evaluated. Receiver operating curve (ROC) analysis of MRE and Fibro-C-index for differentiating fibrosis (≥F1), significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4) was performed. MRE showed excellent correlation with both Fibro-C-Index (r = 0.78, 95% confidence interval [CI], 0.59-0.88, P < 0.001) and histologic staging (rho = 0.87, 95% CI, 0.72-0.94, P < 0.0001). Significant differences in MRE (P = 0.0001) and Fibro-C-Index (P = 0.003) among different stages of liver fibrosis was found. MRE and Fibro-C-Index had similar accuracies for differentiating fibrosis stages: ≥F1 (0.87 versus 0.81, P = 0.6), ≥F2 (0.95 versus 0.94, P = 0.78), ≥F3 (0.98 versus 0.96, P = 0.76), and F4 (1.00 versus 0.92, P = 0.10). MRE is an excellent noninvasive indicator of liver fibrosis burden in CHB.

Rapid acquisition of multifrequency, multislice and multidirectional MR elastography data with a fractionally encoded gradient echo sequence

In MR elastography (MRE), periodic tissue motion is phase encoded using motion-encoding gradients synchronized to an externally applied periodic mechanical excitation. Conventional methods result in extended scan time for quality phase images, thus limiting the broad application of MRE in the clinic. For practical scan times, researchers have been relying on one-dimensional or two-dimensional motion-encoding, low-phase sampling and a limited number of slices, and artifact-prone, single-shot, echo planar imaging (EPI) readout. Here, we introduce a rapid multislice pulse sequence capable of three-dimensional motion encoding that is also suitable for simultaneously encoding motion with multiple frequency components. This sequence is based on a gradient-recalled echo (GRE) sequence and exploits the principles of fractional encoding. This GRE MRE pulse sequence was validated as capable of acquiring full three-dimensional motion encoding of isotropic voxels in a large volume within less than a minute. This sequence is suitable for monofrequency and multifrequency MRE experiments. In homogeneous paraffin phantoms, the eXpresso sequence yielded similar storage modulus values as those obtained with conventional methods, although with markedly reduced variances (7.11 ± 0.26 kPa for GRE MRE versus 7.16 ± 1.33 kPa for the conventional spin-echo EPI sequence). The GRE MRE sequence obtained better phase-to-noise ratios than the equivalent spin-echo EPI sequence (matched for identical acquisition time) in both paraffin phantoms and in vivo data in the liver (59.62 ± 11.89 versus 27.86 ± 3.81, 61.49 ± 14.16 versus 24.78 ± 2.48 and 58.23 ± 10.39 versus 23.48 ± 2.91 in the X, Y and Z components, respectively, in the case of liver experiments). Phase-to-noise ratios were similar between GRE MRE used in monofrequency or multifrequency experiments (75.39 ± 14.93 versus 86.13 ± 18.25 at 28 Hz, 71.52 ± 24.74 versus 86.96 ± 30.53 at 56 Hz and 95.60 ± 36.96 versus 61.35 ± 26.25 at 84Hz, respectively).

Magnetic resonance elastography using an air ball-actuator

The purpose of this study was to develop a new technique for a powerful compact MR elastography (MRE) actuator based on a pneumatic ball-vibrator. This is a compact actuator that generates powerful centrifugal force vibrations via high speed revolutions of an internal ball using compressed air. This equipment is easy to handle due to its simple principles and structure. Vibration frequency and centrifugal force are freely adjustable via air pressure changes (air flow volume), and replacement of the internal ball. In order to achieve MRI compatibility, all parts were constructed from non-ferromagnetic materials. Vibration amplitudes (displacements) were measured optically by a laser displacement sensor. From a bench test of displacement, even though the vibration frequency increased, the amount of displacement did not decrease. An essential step in MRE is the generation of mechanical waves within tissue via an actuator, and MRE sequences are synchronized to several phase offsets of vibration. In this system, the phase offset was detected by a four-channel optical-fiber sensor, and it was used as an MRI trigger signal. In an agarose gel phantom experiment, this actuator was used to make an MR elastogram. This study shows that the use of a ball actuator for MRE is feasible.

Magnetic resonance elastography: Feasibility of liver stiffness measurements in healthy volunteers at 3 T

To demonstrate the feasibility of obtaining liver stiffness measurements with magnetic resonance elastography (MRE) at 3T in normal healthy volunteers using the same technique that has been successfully applied at 1.5 T. The study was approved by the local ethics committee and written informed consent was obtained from all volunteers. Eleven volunteers (mean age 35 ± 9 years) with no history of gastrointestinal, hepatobiliary, or cardiovascular disease were recruited. The magnetic resonance imaging (MRI) protocol included a gradient echo-based MRE sequence using a 60 Hz pneumatic excitation. The MRE images were processed using a local frequency estimation inversion algorithm to provide quantitative stiffness maps. Adequate image quality was assessed subjectively by demonstrating the presence of visible propagating waves within the liver parenchyma underlying the driver location. Liver stiffness values were obtained using manually placed regions of interest (ROI) outlining the liver margins on the gradient echo wave images, which were then mapped onto the corresponding stiffness image. The mean stiffness values from two adjacent sections were recorded. Eleven volunteers underwent MRE. The quality of the MRE images was adequate in all the volunteers. The mean liver stiffness for the group was 2.3 ± 0.38 kPa (ranging from 1.7-2.8 kPa). This preliminary work using MRE at 3T in healthy volunteers demonstrates the feasibility of liver stiffness evaluation at 3T without modification of the approach used at 1.5 T. Adequate image quality and normal MRE values were obtained in all volunteers. The obtained stiffness values were in the range of those reported for healthy volunteers in previous studies at 1.5 T. There was good interobserver reproducibility in the stiffness measurements.

Portal hypertension correlates with splenic stiffness as measured with MR elastography

To investigate the correlation between MR elastography (MRE) assessed spleen stiffness and direct portal vein pressure gradient (D-HVPG) measurements in a large animal model of portal hypertension. Cholestatic liver disease was established in adult canines by common bile duct ligation. A spin echo based echo planar imaging (EPI) MRE sequence was used to acquire three-dimensional/three axis (3D/3-axis) abdominal MRE data at baseline, 4 weeks, and 8 weeks. Liver biopsies, blood samples, and D-HVPG measurements were obtained simultaneously. Animals developed portal hypertension (D-HVPG: 11.0 ± 5.1 mmHg) with only F1 fibrosis after 4 weeks. F3 fibrosis was confirmed after 8 weeks despite no further rise in portal hypertension (D-HVPG: 11.3 ± 3.2 mmHg). Mean stiffnesses of the spleen increased over two-fold from baseline (1.72 ± 0.33 kPa) to 4 weeks (3.54 ± 0.31 kPa), and stabilized at 8 weeks (3.38 ± 0.06 kPa) in a pattern consistent with changes in portal pressure. A positive correlation was observed between spleen stiffness and D-HVPG (r(2) = 0.86; P < 0.01). These findings indicate a temporal relationship between portal hypertension and the development of liver fibrosis in a large animal model of cholestatic liver disease. The observed direct correlation between spleen stiffness and D-HVPG suggest a noninvasive MRE approach to diagnose and screen for portal hypertension.

Magnetic resonance elastography of the liver: preliminary results and estimation of inter-rater reliability

The aim of this study was to estimate inter-rater reliability and validate magnetic resonance elastography (MRE) as a tool to measure liver elasticity. The study protocol was approved by the institutional review board at our institution. In all, 10 normal volunteers and 110 patients, who provided written informed consent, were enrolled. The pathological fibrosis score was applied as a standard reference of liver fibrosis in 21 patients. MRE was performed with a 1.5-T magnetic resonance imaging scanner with a cylindrical passive longitudinal shear wave driver placed over the right chest wall to deliver vibrations. A gradient-echo MRE sequence was used to acquire axial wave images, which were automatically converted to elastograms representing elasticity (in kilopascals, or kPa). The region of interest was placed in the right lobe of the liver on elastograms by two raters independently. To evaluate interrater reliability, the intraclass correlation coefficient was calculated. The elasticity measurements correlated with the pathological fibrosis score (F1-F4) in 21 patients. The intraclass correlation coefficient was almost perfect (0.993) between the elasticities measured by the two raters. The mean elasticity value for patients with F4 was 5.7 kPa; F3, 4.4 kPa; F2, 3.1 kPa; F1, 2.2 kPa; and F0, 2.1 kPa. MRE is a reliable tool to measure liver elasticity.

MR Elastography: Spleen Stiffness Measurements in Healthy Volunteers—Preliminary Experience

The purpose of this article is to establish the range of normal splenic stiffness in healthy volunteers using MR elastography (MRE) and to investigate any correlation with physiologic parameters and driver position. Sixteen volunteers (mean [+/- SD] age, 37 +/- 9 years) with no history of gastrointestinal, hepatobiliary, or cardiovascular disease were recruited. The MRI protocol included T2-weighted axial and gradient-echo MRE sequences using steady-state 60-Hz excitation. Two MRE acquisitions were performed, one with the driver placed on the right side of the abdomen and the other with the driver placed on the left side. Volunteers' body mass index (BMI), arterial mean blood pressure, age, spleen volume, and liver stiffness were also determined. Two radiologists independently measured the spleen stiffness on the MRE inversion images. The correlations between spleen stiffness and BMI, arterial mean blood pressure, age, spleen volume, and liver stiffness were quantified. Sixteen volunteers underwent MRE. With the driver placed on the right side of the abdomen, the mean splenic stiffness was 3,565 +/- 586 Pa (range, 2,353-4,442 Pa); with the driver on the left side of the abdomen, the mean splenic stiffness was significantly (p < 0.004) different (4,255 +/- 625 Pa; range, 3,194-5,581 Pa). No significant correlation was found between spleen stiffness and BMI, arterial mean blood pressure, age, spleen volume, and liver stiffness (all p > 0.05) These preliminary results in a small number of healthy volunteers show that spleen stiffness is not significantly correlated with BMI, arterial mean blood pressure, spleen volume, or liver stiffness. A significant difference was observed using different driver positions.

Application of DENSE‐MR‐elastography to the human heart

Typically, MR-elastography (MRE) encodes the propagation of monochromatic acoustic waves in the MR-phase images via sinusoidal gradients characterized by a detection frequency equal to the frequency of the mechanical vibration. Therefore, the echo time of a conventional MRE sequence is typically longer than the vibration period which is critical for heart tissue exhibiting a short T(2). Thus, fast acquisition techniques like the so-called fractional encoding of harmonic motions were developed for cardiac applications. However, fractional encoding of harmonic motions is limited since it is two orders of magnitude less sensitive to motion than conventional MRE sequences for low-frequency vibrations. Here, a new sequence is derived from the so-called displacement encoding with stimulated echoes (DENSE) sequence. This sequence is more sensitive to displacement than fractional encoding of harmonic motions, and its spectral specificity is equivalent to conventional MRE sequences. The theoretical spectral properties of this new motion-encoding technique are validated in a phantom and excised pork heart specimen. An excellent agreement is found for the measured displacement fields using classic MRE and displacement encoding with stimulated echoes MRE (8% maximum difference). In addition, initial in vivo results on a healthy volunteer clearly show propagating shear waves at 50 Hz. Thus, displacement encoding with stimulated echoes MRE is a promising technique for motion encoding within short T(2)* materials.

In vivo MR elastography of the prostate gland using a transurethral actuator

Conventional approaches for MR elastography (MRE) using surface drivers have difficulty achieving sufficient shear wave propagation in the prostate gland due to attenuation. In this study we evaluate the feasibility of generating shear wave propagation in the prostate gland using a transurethral device. A novel transurethral actuator design is proposed, and the performance of this device was evaluated in gelatin phantoms and in a canine prostate gland. All MRI was performed on a 1.5T MR imager using a conventional gradient-echo MRE sequence. A piezoceramic actuator was used to vibrate the transurethral device along its length. Shear wave propagation was measured transverse and parallel to the rod at frequencies between 100 and 250 Hz in phantoms and in the prostate gland. The shear wave propagation was cylindrical, and uniform along the entire length of the rod in the gel experiments. The feasibility of transurethral MRE was demonstrated in vivo in a canine model, and shear wave propagation was observed in the prostate gland as well as along the rod. These experiments demonstrate the technical feasibility of transurethral MRE in vivo. Further development of this technique is warranted.

Magnetic resonance elastography in the liver at 3 Tesla using a second harmonic approach

Magnetic resonance elastography (MRE) using mechanical stimulation has demonstrated diagnostic value and clinical promise in breast, liver, and kidney at 1.5 Tesla (T). However, MRE at 1.5T suffers from long imaging times and would benefit from greater signal-to-noise for more robust postprocessing. We present an MRE sequence modified for liver imaging at 3.0T. To avoid artifacts in the phase images, the sequence maintains a short TE by using a second harmonic approach, including stronger motion encoding gradients, shorter radio frequency pulses and an echo-planar readout. Scan time was decreased by a factor of approximately 2 relative to 1.5T by using an EPI readout and a higher density sampling of the phase waveform was used to calculate shear stiffness and viscosity. Localized (small region of interest) and global (whole-liver region of interest) measurements in normal healthy subjects compared very favorably with previously published results at 1.5T. There was no significant difference between global and localized measures.

Brain magnetic resonance elastography on healthy volunteers: A safety study

Magnetic resonance elastography (MRE) is a recently developed imaging technique that can directly visualize and quantitatively measure tissue elasticity. To evaluate the safety of brain MRE on human subjects. The study included 20 healthy volunteers. MRE sequence scan (drive signal not applied to external force actuator) and MRE study were separately performed on each volunteer at an interval of more than 24 hours. The heart rate and blood pressure of each volunteer were measured immediately before and after MRE sequence scan and MRE study. Electroencephalography (EEG) was also performed within 2 hours after each scan. The volunteers were asked about their experience of the two scans. Randomized-block analysis of variance (ANOVA) was used to analyze the data of blood pressure and heart rate. Paired t test was used to analyze the data of the two EEG examinations. The volunteers were followed up 1 week after the examination. All procedures were performed on each volunteer, and no one complained of obvious discomfort. No related adverse events were reported during follow-up. There was no statistically significant difference in heart rate or blood pressure. There was a statistically significant difference (P<0.05) in EEG results in the right temporoparietal region. Increased power was found in the theta, delta, alpha, and beta2 bands. No brain injury was detected by the EEG examinations. Based on the study results, brain MRE examinations are safe to perform on human subjects.

MR elastography as a method for the assessment of myocardial stiffness: Comparison with an established pressure–volume model in a left ventricular model of the heart

Magnetic resonance elastography (MRE) measurements of shear stiffness (mu) in a spherical phantom experiencing both static and cyclic pressure variations were compared to those derived from an established pressure-volume (P-V)-based model. A spherical phantom was constructed using a silicone rubber composite of 10 cm inner diameter and 1.3 cm thickness. A gradient echo MRE sequence was used to determine mu within the phantom at static and cyclic pressures ranging from 55 to 90 mmHg. Average values of mu using MRE were obtained within a region of interest and were compared to the P-V-derived estimates. Under both static and cyclic pressure conditions, the P-V- and MRE-based estimates of mu ranged from 98.2 to 155.1 kPa and 96.2 to 150.8 kPa, respectively. Correlation coefficients (R(2)) of 0.98 and 0.97 between the P-V and MRE-based estimates of shear stiffness measurements were obtained. For both static and cyclic pressures, MRE-based measures of mu agree with those derived from a P-V model, suggesting that MRE can be used as a new, noninvasive method of assessing mu in sphere-like fluid-filled organs such as the heart.

MR elastography of the human heart: Noninvasive assessment of myocardial elasticity changes by shear wave amplitude variations

Many cardiovascular diseases and disorders are associated with hemodynamic dysfunction. The heart's ability to contract and pump blood through the vascular system primarily depends on the elasticity of the myocardium. This article introduces a magnetic resonance elastography (MRE) technique that allows noninvasive and time-resolved measurement of changes in myocardial elasticity over the cardiac cycle. To this end, low-frequency shear vibrations of 24.3 Hz were induced in the human heart via the anterior chest wall. An electrocardiograph (ECG)-triggered, steady-state MRE sequence was used to capture shear oscillations with a frame rate of eight images per vibration cycle. The time evolution of 2D-shear wave fields was observed in two imaging planes through the short axis of the heart in six healthy volunteers. Correlation analysis revealed that wave amplitudes were modulated in synchrony to the heartbeat with up to 2.45 +/- 0.18 higher amplitudes during diastole than during systole (interindividual mean +/- SD). The reduction of wave amplitudes started at 75 +/- 9 ms prior to changes in left ventricular diameter occurring at the beginning of systole. Analysis of this wave amplitude alteration using a linear elastic constitutive model revealed a maximum change in the myocardial wall stiffness of a factor of 37.7 +/- 10.6 during the cardiac cycle.

Cardiac Magnetic Resonance Elastography

To develop cardiac magnetic resonance elastography (MRE) for noninvasively measuring left ventricular (LV) pressure-volume (P-V) work. The anterior chest wall of 8 healthy volunteers was vibrated by 24.3-Hz acoustic waves for stimulating oscillating shear deformation in myocardium and adjacent blood. The induced motion was recorded by an electrocardiogram-gated, vibration-synchronized and segmented gradient-recalled echo MRE sequence acquiring 360 phase-contrast wave images with a temporal resolution of 5.16 milliseconds in the short-axis view during controlled breathing. Relative changes in wave amplitudes served as a measure of LV pressure variation during the cardiac cycle. MRE pressure data were combined with LV volumes obtained from segmentation of 3D cine-steady-state free precession data sets. Shear wave amplitudes decreased from diastole to systole, which reflects the dynamics of myocardial shear modulus variations during the cardiac cycle. Assuming spherical shear stress, a linear relationship between myocardial stiffness and LV pressure was derived. The MRE-measured pressure was plotted as a function of LV volumes. Characteristic P-V cycles displayed an isovolumetric increase in pressure during early systole, whereas less pronounced volume conservation was observed in early diastole. Mean cardiac P-V work in all volunteers was 0.85 +/- 0.11 J. In vivo cardiac MRE is a noninvasive method for measuring pressure-related heart function determined by shear modulus variations in the LV wall. This is the first noninvasive mechanical test of cardiac work in the human heart and is potentially useful for assessing pathologies associated with increased myocardial stiffness such as diastolic dysfunction.