Ultra-High Field 7T MRI in a Drug-Resistant Pediatric Epilepsy Cohort

作者：Katy Vecchiato, Chiara Casella, Ayşe Sıla Dokumacı, Ata Siddiqui, Alexia Egloff, Olivia Carney, Jon O. Cleary, Jozef Jarosz, Pierluigi Di Ciò, Michela Cleri, Kathleen Colford, Rory J. Piper, Tomoki Arichi, Michael Eyre, Fraser Aitken, Raphaël Tomi‐Tricot, Tom Wilkinson, Joseph V. Hajnal, Colm J. McGinnity, Siti N. Yaakub, Sharon Giles, Shaihan Malik, Alexander Hammers, Philippa Bridgen, David W. Carmichael, Jonathan O’Muircheartaigh · 发表于：Neurology · 年份：2025 · DOI：10.1212/wnl.0000000000213921 · 被引用次数：5 · 研究领域：Epilepsy research and treatment、Advanced MRI Techniques and Applications、Advanced Neuroimaging Techniques and Applications

BACKGROUND AND OBJECTIVES: Epileptogenic lesions in focal epilepsy can be subtle or remain undetected on conventional MRI. Ultra-high field (7T) MRI offers higher spatial resolution, contrast, and signal-to-noise ratio compared with conventional field strengths and has shown promise in adult presurgical evaluation. However, its utility in pediatric focal epilepsy, where malformations of cortical development are common, remains unclear. In this study, we directly compared 7T and 3T MRI in children with drug-resistant focal epilepsy, evaluating (1) scan tolerability, (2) image quality, and (3) lesion detection yield. METHODS: test for within-participant cross-field comparisons. Image quality was evaluated by a pediatric neuroradiologist and estimated quantitatively by comparing cortical thickness between field strengths. Lesion detection yield of 7T MRI was assessed by joint review with a multidisciplinary team. RESULTS: = -0.64) hemispheres, with thinner boundaries in temporo-parietal/sensory regions. Although 7T images had increased reported inhomogeneity and artifacts, new lesions were detected in 6 of 26 patients (23%), influencing surgical management in 4 of 26 (15%) (odds ratio 1.86). DISCUSSION: 7T MRI in children with epilepsy is well tolerated and associated with a 23% improvement in lesion detection, directly affecting clinical management and surgical outcomes. Although limited by a preselected cohort with extensive diagnostic workups, our findings underscore the tran...