Remote Palpation of the Human Brain Using Simultaneous MR Elastography and Diffusion Tensor Imaging

"Remote palpation" appears to be an oxymoron, but here we demonstrate a non-contacting MRI method to obtain mechanical stiffness parameters of the human brain solely by measuring deformations caused by the pumping action of the heart. Mechanical stiffness is an important tissue property that is highly sensitive to subtle changes in the tissue milieu; MR elastography (MRE) is among a handful of methods used to measure it, typically via an external driver/tamper that introduces mechanical waves into the tissue. Applying MRE in the brain is challenging due to the use of an external actuator/tamper and the mechanical anisotropy of brain tissue, which requires a 4th-order tensor to describe it. In this study, we use the intrinsic deformation of brain tissue caused by periodic cardiac pulsations to measure the 4th-order elasticity tensor throughout the brain while simultaneously estimating the 2nd-order diffusion tensor in each voxel throughout the cardiac cycle which we use as a priori information in the reconstruction of the elasticity tensor. While the DTI-derived mean diffusivity (MD) appears uniform throughout brain parenchyma, stiffness maps obtained at about 1 Hz (i.e., at the fundamental cardiac frequency) show that brain tissue is very soft within gray matter, and within white matter pathways, such as along the corpus callosum, corona radiata, etc. Generally, stiffness differences at internal tissue boundaries are expected to produce local stress concentration there, which may predispose tissues to damage, e.g., in traumatic brain injury (TBI). Therefore, our novel tamperless MRE method has the potential to not only identify such interfaces, but assess and follow changes in tissue stiffness there that might occur following injury.