Radojewski Piotr, Piredda Gian Franco, Bonanno Gabriele, Lövblad Karl-Olof, Vargas Maria Isabel, Sutter Reto, Nanz Daniel, Karrer Tanya, Salanti Georgia, Wiest Roland
University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland.
Eur J Neurol. 2025 Jan;32(1):e16557. doi: 10.1111/ene.16557.
Ultra-high-field magnetic resonance imaging (MRI) at a field strength of 7 Tesla (T) has marked a significant milestone in diagnostic imaging since it was approved for clinical use in 2017. Despite the potential to improve image analysis by advances in signal-to-noise ratio, and improved spatial resolution and metabolic imaging, the clinical implementation of 7-T MRI remains limited. Factors that contribute to this limited availability are the high price, the operating costs, the need for specifically educated personnel, and lack of evidence of clinical benefit.
The aim of this scoping review was to evaluate the evidence of the clinical advantages of 7-T MRI versus MRI at lower field strengths, complementary imaging modalities, and diagnostic standard approaches for neurological and musculoskeletal disorders. We searched MEDLINE, CENTRAL, Embase and Web of Science for this review.
We identified 1966 studies, of which 83 were included in our review. Most studies (73 studies, 88%) examined neurological indications, nine studies (11%) examined musculoskeletal indications, and one study reported on peripheral arterial occlusive disease. Of the neuroimaging indications, cerebrovascular diseases were the most frequently investigated (14 studies), followed by multiple sclerosis (13 studies) and epilepsy (11 studies).
The available comparative evidence varied greatly across indications, with the best-documented evidence being for imaging of epilepsy. Risk of bias overall was high, with limitations in blinding information, study design reporting, and patient recruitment details. The identified evidence gaps underscore the need for comparative research to determine appropriate indications and to understand whether the potential diagnostic advantage of 7-T MRI translates to a tangible clinical benefit for patients. Future studies should include clinically relevant patient outcomes that go beyond radiological metrics.
自2017年被批准用于临床以来，7特斯拉（T）场强的超高场磁共振成像（MRI）在诊断成像领域具有重大意义。尽管通过提高信噪比、改善空间分辨率和代谢成像有潜力改善图像分析，但7-T MRI的临床应用仍然有限。导致其可用性受限的因素包括价格高昂、运营成本高、需要经过专门培训的人员以及缺乏临床获益的证据。
本范围综述的目的是评估7-T MRI相对于低场强MRI、补充成像方式以及神经和肌肉骨骼疾病诊断标准方法的临床优势证据。我们检索了MEDLINE、CENTRAL、Embase和Web of Science进行本综述。
我们确定了1966项研究，其中83项纳入了我们的综述。大多数研究（73项研究，88%）检查神经科适应症，9项研究（11%）检查肌肉骨骼适应症，1项研究报告了外周动脉闭塞性疾病。在神经成像适应症中，脑血管疾病是最常研究的（14项研究），其次是多发性硬化症（13项研究）和癫痫（11项研究）。
现有比较证据在不同适应症之间差异很大，记录最充分的证据是癫痫成像。总体偏倚风险较高，在盲法信息、研究设计报告和患者招募细节方面存在局限性。已确定的证据空白强调需要进行比较研究，以确定合适的适应症，并了解7-T MRI的潜在诊断优势是否转化为对患者切实的临床获益。未来的研究应纳入超出放射学指标的临床相关患者结局。
