de Vries Elisabeth, Hagbohm Caroline, Ouellette Russell, Granberg Tobias
Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
J Intern Med. 2025 Mar;297(3):244-261. doi: 10.1111/joim.20059. Epub 2025 Jan 8.
Magnetic resonance imaging (MRI) is a cornerstone of non-invasive diagnostics and treatment monitoring, particularly for diseases of the central nervous system. Although 1.5- and 3 Tesla (T) field strengths remain the clinical standard, the advent of 7 T MRI represents a transformative step forward, offering superior spatial resolution, contrast, and sensitivity for visualizing neuroanatomy, metabolism, and function. Recent innovations, including parallel transmission and deep learning-based reconstruction, have resolved many prior technical challenges of 7 T MRI, enabling its routine clinical use. This review examines the diagnostic impact, patient value, and practical considerations of 7 T MRI, emphasizing its role in facilitating earlier diagnoses and improving care in conditions, such as amyotrophic lateral sclerosis (ALS), epilepsy, multiple sclerosis (MS), dementia, parkinsonism, tumors, and vascular diseases. Based on insights from over 1200 clinical scans with a second-generation 7 T system, the review highlights disease-specific biomarkers such as the motor band sign in ALS and the new diagnostic markers in MS, the central vein sign, and paramagnetic rim lesions. The unparalleled ability of 7 T MRI to study neurological diseases ex vivo at ultra-high resolution is also explored, offering new opportunities to understand pathophysiology and identify novel treatment targets. Additionally, the review provides a clinical perspective on patient handling and safety considerations, addressing challenges and practicalities associated with clinical 7 T MRI. By bridging research and clinical practice, 7 T MRI has the potential to redefine neuroimaging and advance the understanding and management of complex neurological disorders.
磁共振成像（MRI）是非侵入性诊断和治疗监测的基石，尤其对于中枢神经系统疾病。尽管1.5特斯拉和3特斯拉的场强仍是临床标准，但7T MRI的出现代表了向前迈出的变革性一步，在可视化神经解剖结构、代谢和功能方面提供了卓越的空间分辨率、对比度和灵敏度。最近的创新，包括并行传输和基于深度学习的重建，已经解决了7T MRI之前的许多技术挑战，使其能够常规用于临床。这篇综述探讨了7T MRI的诊断影响、患者价值和实际考量因素，强调其在促进早期诊断以及改善诸如肌萎缩侧索硬化症（ALS）、癫痫、多发性硬化症（MS）、痴呆、帕金森症、肿瘤和血管疾病等病症的治疗方面所起的作用。基于使用第二代7T系统进行的1200多次临床扫描所获得的见解，该综述重点介绍了特定疾病的生物标志物，如ALS中的运动带征以及MS中的新诊断标志物、中央静脉征和顺磁性边缘病变。还探讨了7T MRI在超高分辨率下对离体神经疾病进行研究的无与伦比的能力，为理解病理生理学和确定新的治疗靶点提供了新机会。此外，该综述从临床角度阐述了患者处理和安全考量因素，讨论了与临床7T MRI相关的挑战和实际问题。通过将研究与临床实践相结合，7T MRI有潜力重新定义神经影像学，并推动对复杂神经疾病的理解和管理。
