Neurosurgeons at Montefiore Einstein are able to use a new type of MRI, called Magnetic Resonance Elastography (MRE), to “virtually palpate” the brain and quantitatively assess the structure, stiffness and mechanical properties of the tissue without ever stepping foot in the operating room. By combining MRI with special vibrations, or mechanical shear waves, this technique can further elucidate underlying properties of the brain that static imaging may not currently define. This can allow clinicians to better understand what is happening to the brains of patients suffering from a variety of neurological conditions, including hydrocephalus, multiple sclerosis and dementia, and to better understand the problems that may be arising from these conditions. This past year, we conducted research using MRE to identify the role that brain compliance plays in the progression and response to therapy (and failure thereof) in pediatric hydrocephalus and to elucidate the previously unappreciated consequences of shunt failures.

MRE is also being used for the objective staging and monitoring of neurological diseases, as well as the preoperative evaluation of intracranial tumors. It could allow surgeons who are planning to remove a brain tumor to understand its softness or firmness, as well as  how adherent it is to the surrounding tissue, in order to ensure safer surgery and provide a more accurate estimate of how long the surgery may take. While magnetic resonance elastography has been used for the clinical evaluation of liver disease and fibrosis, as well as other organs, including the breast, kidney and spleen, we are one of only a few centers in the nation utilizing this technology to evaluate the brain.