Magnetic resonance elastography (MRE) is a new way to image the body. It works by combining MRI imaging with sound waves to create a visual map (elastogram) showing the stiffness of body tissues.
MRE is used to detect hardening of the liver caused by many kinds of chronic liver disease. MRE also has potential as a noninvasive way to diagnose diseases in other parts of the body.
MRE was invented at Mayo Clinic. The test is available there and at various other centers. It's usually done as part of a conventional MRI exam.
MRE measures the stiffness of liver tissue in people with known or suspected liver disease. Liver disease can result in scarring of the liver (fibrosis), which increases the stiffness of liver tissue.
Often, people with liver fibrosis don't experience any signs or symptoms. But untreated liver fibrosis may progress to cirrhosis, which can be fatal. If diagnosed, liver fibrosis often can be treated to halt progression and sometimes to reverse the condition.
Studies have shown that MRE is highly accurate at ruling out liver fibrosis. If you have liver fibrosis, MRE can help your doctor gauge the severity of your liver disease, guide treatment decisions and assess your response to treatment.
The traditional test for liver fibrosis uses a needle to extract a sample (biopsy) of liver tissue. MRE offers several advantages:
- It's noninvasive and generally safer and more comfortable than biopsy is.
- It assesses the entire liver, not just the portion of liver tissue that is biopsied or imaged by other noninvasive tests.
- It can detect fibrosis at an earlier stage than can other imaging methods.
- It's effective in people who are obese or who have fluid accumulation in the abdomen (ascites).
The presence of metal in your body may be a safety hazard or affect a portion of the MRE image. Before receiving an MRE, tell the technologist if you have any metal or electronic devices in your body, such as:
- Metallic joint prostheses
- Artificial heart valves
- An implantable heart defibrillator
- A pacemaker
- Metal clips
- Cochlear implants
- A bullet, shrapnel or any other type of metal fragment
Before you schedule an MRE, tell your doctor if you think you're pregnant. The effects of magnetic fields on fetuses aren't well-understood. Your doctor may recommend choosing an alternative exam or postponing the MRE.
Before an MRE exam, eat normally and continue to take your usual medications, unless otherwise instructed. You will be asked to change into a gown and to remove:
- Hearing aids
- Underwire bras
MRE is usually done as part of a conventional MRI examination. A standard MRI liver examination takes 30 to 45 minutes. The MRE portion of the test takes less than five minutes.
In MRE, a small pad is placed on the surface of your body. The pad emits low-frequency vibrations that pass through your liver. The speed at which the vibrations pass through the liver is measured. Vibrations travel faster through stiff tissue.
After the MRE procedure, a computer program creates a color-coded map showing the stiffness in your liver tissue.
A doctor specially trained to interpret MRE (radiologist) will analyze the images from your scan and report the findings to your doctor. Your doctor will discuss any important findings and next steps with you.
- Experience. Mayo Clinic doctors and scientists invented MRE. Each year, Mayo specialists perform MRE on more than 600 people. MRE is available at all three Mayo Clinic locations.
- Early detection. Magnetic resonance elastography can accurately identify liver fibrosis at an early stage, when treatment can still be effective.
- Noninvasive. MRE offers a noninvasive alternative to taking a liver biopsy. Magnetic resonance elastography is easier, more comfortable and safer.
- New ideas. Mayo imaging researchers are working with doctors from many specialties to improve this new technique and explore applications in other diseases, including Alzheimer's, heart failure and breast cancer.
Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.
Specialists in radiology at Mayo Clinic in Arizona perform magnetic resonance elastography.
For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
Specialists in radiology at Mayo Clinic in Florida perform magnetic resonance elastography.
For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
Specialists in radiology at Mayo Clinic in Minnesota perform magnetic resonance elastography.
For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.
- U.S. Patients
- International Patients
See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.
Mayo Clinic researchers are working to expand the range of tissue and organ systems that can be noninvasively imaged using MRE. Conditions for which MRE might someday be used include:
- Breast cancer. Researchers are working on using MRE to distinguish benign from cancerous tumors.
- Musculoskeletal disease. Researchers are using MRE to measure the stiffness of muscle as a way to noninvasively assess muscle in normal and disease states.
- Alzheimer's disease. MRE has potential to show changes in brain mechanical properties, possibly leading to new methods for diagnosing Alzheimer's disease at an earlier stage.
- Brain tumors. Mayo researchers are testing MRE for evaluating brain tumors, as an aid to surgical planning.
- Heart disease. Mayo investigators have adapted MRE to assess the mechanical properties of the heart. This technology has potential to help in diagnosis of heart failure.
- Kidney disease. MRE may provide new ways to diagnose kidney fibrosis and to assess disease progression.
Read more about research in the Mayo Clinic Magnetic Resonance Imaging Laboratory.
See a list of publications by Mayo doctors on magnetic resonance elastography on PubMed, a service of the National Library of Medicine.
June 06, 2014
- AskMayoExpert. What is magnetic resonance elastography (MRE) and what are the indications for an MRE examination? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
- Venkatesh SK, et al. Magnetic resonance elastography of liver: Clinical applications. Journal of Computer Assisted Tomography. 2013;37:887.
- Venkatesh SK, et al. Magnetic resonance elastography of liver: Technique, analysis, and clinical applications. Journal of Magnetic Resonance Imaging. 2013;37:544.
- Glaser KJ, et al. Review of MR elastography applications and recent developments. Journal of Magnetic Resonance Imaging. 2012;36:757.
- Curry MP, et al. Tests used for the noninvasive assessment of hepatic fibrosis. http://www.uptodate.com/home. Accessed Jan. 30, 2014.
- De Souza DAT, et al. Modern imaging evaluation of the liver: Emerging MR imaging techniques and indications. Magnetic Resonance Imaging Clinics of North America. 2013;21:337.
- Patient safety: Magnetic resonance imaging (MRI). RadiologyInfo.org. http://www.radiologyinfo.org/en/safety/index.cfm?pg=sfty_mr. Accessed Feb. 6, 2014.
- Korsmo MJ, et al. Magnetic resonance elastography noninvasively detects in-vivo renal medullary fibrosis secondary to swine renal artery stenosis. Investigative Radiology. 2013;48:61.