E-145 Revolutionizing the evaluation of neurological pathologies with magnetic resonance elastography
Year: 2024
Type: conference-abstract
Abstract: Introduction/Purpose Neurological disorders present a significant burden on global healthcare systems. Accurate diagnosis and monitoring of these conditions are imperative for optimizing patient management and improving outcomes. MR elastography (MRE) is a non-invasive imaging technique to assess brain tissue stiffness. The incorporation of this can provide valuable information about the presence and progression of certain neurological disorders, including intracranial tumors, idiopathic intracranial hypertension, normal pressure hydrocephalus, and spontaneous intracranial hypotension, to ultimately assist physicians in identifying and making more informed decisions about treatment options as well as monitor the effectiveness of interventions. Materials and Methods This project involves a comprehensive literature review to summarize the different utilities of MRE to provide education to neuroendovascular proceduralists and garner awareness of its full spectrum of capabilities. Some of the more publicized researched areas that have incorporated MRE include neurodegenerative disorders, normal pressure hydrocephalus (NPH), evaluation of brain tumors, idiopathic intracranial hypertension, and spontaneous intracranial hypotension. Summarizing these different utilizations of MRE in clinical practice and presenting supporting evidence will be included in an ePoster for attendees to review. Results After a thorough literature review, it is apparent that MRE is expanding as a unique and beneficial adjunct to diagnosing and managing neurological pathologies. For example, MRE can be used to evaluate idiopathic intracranial hypertension (IIH) to assess the stiffness of the brain tissue, which may be relatively more rigid due to the increased CSF pressure. In a 2022 study by Cogswell et al, the median stiffness pattern score on MRE was significantly greater in patients with IIH than in the controls, and the stiffness decreased after chronic intervention. In cases where IIH is complicated by venous sinus stenosis or venous outflow obstruction, neuroendovascular procedures such as venous sinus stenting may be considered. MRE can also be helpful in spontaneous intracranial hypotension (SIH). These patients can often have normal findings on traditional brain MR imaging, as well as a normal opening CSF pressure, further complicating the diagnosis. In a 2024 study by Mark et al, 15 patients with SIH due to confirmed CSF-venous fistula (type 3) underwent MRE, which showed that patients with SIH have distinct brain stiffness and damping ratio patterns relative to controls, including increased brain stiffness in the periventricular structures and decreased stiffness toward the cerebellum and the frontal lobe around the ventricle. These findings may prove that MRE is a valuable imaging modality for triaging patients for myelography, which is currently used to diagnose CSF-venous fistulas. Conclusion This literature review and summarization of the clinical utility of MRE aims to educate providers on the variety of applications of MRE as a valuable adjunct in patient care and the supporting evidence behind each application. In conclusion, MRE represents a transformative imaging modality to noninvasively quantify tissue stiffness and provide valuable biomarkers for disease diagnosis, prognosis, and treatment response assessment. Future research endeavors should focus on standardizing MRE protocols, validating and further assessing its clinical utility, and integrating MRE into routine neuroimaging workflows. Disclosures O. Richardson: None. A. Richardson: None.
Authors: O Richardson, A Richardson
Institutions: University of Virginia, University of Louisville
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4400893597