Ultrahigh-Field 7-T MRI in Neuroradiology: A Comprehensive Clinical Review

Recent advances in ultrahigh-field MRI have led to accelerated adoption in clinical applications, especially after regulatory approval for 7-T MRI systems. The substantial gains in signal-to-noise ratio, tissue contrast, chemical shift, and susceptibility effects enable unprecedented image resolution and quality, resulting in more accurate diagnoses and improved treatment planning. Despite these inherent advantages of 7-T MRI, several challenges have historically limited its clinical adoption. The authors review recent technical advancements that have further enabled routine clinical implementation of 7-T MRI and highlight its applications across a diverse range of neurologic disorders. They outline key physical principles underpinning 7-T imaging, including susceptibility and chemical shift effects, and describes how innovations such as dynamic parallel transmission and deep-learning reconstructions stand to impact clinical translation by mitigating previous technical barriers. Next, the most common clinical indications are addressed, encompassing epilepsy, multiple sclerosis, pituitary microadenomas, unruptured aneurysms, cerebrovascular disease, brain tumors, neurodegenerative diseases, and applications in planning deep brain stimulation. In each of these conditions, 7-T MRI demonstrates superior lesion detection, enhanced anatomic delineation, and increased diagnostic specificity compared with MRI at lower field strengths. With an expanding body of evidence supporting its utility in both diagnosis and treatment planning, 7-T MRI is poised to play an increasingly pivotal role in clinical neuroradiology. ^©RSNA, 2025 Supplemental material is available for this article.