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Updated: Sep 10, 2025
Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
Published on: February 19, 2021
7 Tesla MRI in Multiple Sclerosis: Insights From Its Use in Clinical Routine
A León Betancourt1, F Messmer2, A Chan1
1Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Background:
7 Tesla (7 T) magnetic resonance imaging (MRI) offers higher spatial resolution and signal-to-noise ratio, enhancing visualization of multiple sclerosis (MS) lesions, including cortical and deep gray matter lesions. It improves detection of MS biomarkers like paramagnetic rim lesions (PRLs) and central vein sign (CVS). Costs have impacted its adoption and experience in clinical practice.
Objectives:
To present real-life data on the routine clinical use of 7 T MRI and its impact on patient management from a single-center perspective.
Methods:
This retrospective study, approved by the local ethics committee (KEK Bern No 2020-02902), analyzed referrals for 7 T MRI (06/2020-06/2024) at University Hospital Bern for suspected CNS inflammatory disorders. Imaging reports were compared to clinical data from medical records. Statistical analysis evaluated the diagnostic value of 7 T MRI, focusing on sensitivity, specificity, Negative Predictive Value (NPV), and Positive Predictive Value (PPV). Exclusions included contraindications for 7 T MRI, incomplete medical records, or non-CNS conditions.
Findings:
61 patients underwent 7 T MRI, enabling lesion reclassification and MS diagnosis in 19/47 patients with indefinite diagnosis despite extensive diagnostic workup with adequate 3 T MRI. In 14 MS patients, it clarified diagnostic uncertainties, leading to diagnosis revision in 1/14 patients and informed treatment decisions in 4/14 (including treatment escalation (3/14) and discontinuation (1/14)). 7 T MRI showed 89.5% sensitivity and 78.6% specificity for MS (PPV 73.9%, NPV 91.7%). MS patients were more likely to exhibit CVS and PRLs compared to non-MS patients (p < 0.05).
Interpretation:
7 T MRI enhances MS diagnosis certainty in diagnostically challenging cases, potentially impacting clinical practice.
Insights
Seven Tesla (7T) MRI improves multiple sclerosis (MS) diagnosis in challenging cases by enhancing lesion visualization and identifying key biomarkers. This advanced imaging aids in clarifying diagnoses and informing patient treatment decisions.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Seven Tesla (7T) MRI offers superior spatial resolution and signal-to-noise ratio compared to lower field strengths.
- This advancement facilitates enhanced visualization of multiple sclerosis (MS) lesions, including cortical and deep gray matter lesions.
- 7T MRI improves the detection of specific MS biomarkers such as paramagnetic rim lesions (PRLs) and the central vein sign (CVS), though cost and clinical experience remain adoption barriers.
Purpose of the Study:
- To evaluate the real-world clinical utility of 7T MRI in diagnosing and managing patients with suspected central nervous system (CNS) inflammatory disorders.
- To assess the impact of 7T MRI on patient management and diagnostic certainty from a single-center perspective.
Main Methods:
- A retrospective analysis of 61 patients referred for 7T MRI between June 2020 and June 2024 at University Hospital Bern.
- Comparison of 7T MRI findings with clinical data and previous 3T MRI reports to assess diagnostic value.
- Statistical evaluation of sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) for MS diagnosis.
Main Results:
- 7T MRI enabled lesion reclassification and confirmed MS diagnosis in 19 out of 47 patients with previously indefinite diagnoses.
- In 14 MS patients, 7T MRI clarified diagnostic uncertainties, leading to one diagnosis revision and informing treatment decisions in four patients (including escalation or discontinuation).
- 7T MRI demonstrated 89.5% sensitivity and 78.6% specificity for MS, with a PPV of 73.9% and NPV of 91.7%. MS patients were significantly more likely to exhibit CVS and PRLs.
Conclusions:
- Routine clinical use of 7T MRI enhances diagnostic certainty in complex MS cases.
- The findings suggest that 7T MRI has the potential to significantly impact clinical practice by improving the accuracy and timeliness of MS diagnosis and management.
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