From the Department of Radiology, University Hospital Bonn, Bonn.
Siemens Healthcare GmbH, Erlangen.
Invest Radiol. 2020 Sep;55(9):531-542. doi: 10.1097/RLI.0000000000000678.
Today's health care environment is shifting rapidly, driven by demographic change and high economic pressures on the system. Furthermore, modern precision medicine requires highly accurate and specific disease diagnostics in a short amount of time. Future imaging technology must adapt to these challenges.Demographic change necessitates scanner technologies tailored to the needs of an aging and increasingly multimorbid patient population. Accordingly, examination times have to be short enough that diagnostic images can be generated even for patients who can only lie in the scanner for a short time because of pain or with low breath-hold capacity.For economic reasons, the rate of nondiagnostic scans due to artifacts should be reduced as far as possible. As imaging plays an increasingly pivotal role in clinical-therapeutic decision making, magnetic resonance (MR) imaging facilities are confronted with an ever-growing number of patients, emphasizing the need for faster acquisitions while maintaining image quality.Lastly, modern precision medicine requires high and standardized image quality as well as quantifiable data in order to develop image-based biomarkers on which subsequent treatment management can rely.In recent decades, a variety of approaches have addressed the challenges of high throughput, demographic change, and precision medicine in MR imaging. These include field strength, gradient, coil and sequence development, as well as an increasing consideration of artificial intelligence. This article reviews state-of-the art MR technology and discusses future implementation from the perspective of what we know today.
当今的医疗保健环境正在迅速变化，这是由人口结构变化和系统面临的高经济压力所驱动的。此外，现代精准医学需要在短时间内进行高度准确和特定的疾病诊断。未来的成像技术必须适应这些挑战。人口结构变化需要针对老龄化和日益多病共存的患者群体的需求进行调整的扫描仪技术。因此，检查时间必须足够短，即使对于因疼痛或低呼吸能力而只能在扫描仪中短暂停留的患者，也可以生成诊断图像。出于经济原因，应尽可能降低因伪影导致的非诊断性扫描率。由于成像在临床治疗决策中发挥着越来越关键的作用，磁共振（MR）成像设备面临着越来越多的患者，这强调了在保持图像质量的同时需要更快的采集速度。最后，现代精准医学需要高标准化的图像质量和可量化的数据，以便开发基于图像的生物标志物，以便后续的治疗管理可以依赖这些生物标志物。在过去几十年中，各种方法已经解决了 MR 成像中的高通量、人口结构变化和精准医学的挑战。这些方法包括场强、梯度、线圈和序列开发，以及对人工智能的日益重视。本文回顾了最先进的 MR 技术，并从我们今天所知道的角度讨论了未来的实施。
