背景:在2017年批准临床使用后,超高场腹部磁共振成像(MRI)的早期研究已经证明了其可行性以及在神经影像学中的诊断能力。然而,很少有系统评价涵盖其神经外科应用的全部内容以及有关上述应用的文献趋势。
目的:评估7特斯拉MRI(7TMRI)对神经外科的影响,专注于其在诊断中的应用,治疗计划,和术后评估,并系统分析和识别现有文献中与在神经外科环境中使用7TMRI相关的模式和趋势。
方法:使用与7TMRI和神经外科相关的MeSH术语,对2017年1月1日至2023年12月31日之间发表的研究进行了PubMed的系统搜索。纳入标准是:涉及所有年龄段患者的研究,荟萃分析,系统评价,原创性研究。排除标准是:预打印,数据不足的研究(例如,病例报告和信件),非英语出版物,以及涉及动物受试者的研究。数据合成涉及标准化的提取表格,并进行了叙事合成。
结果:我们在定义的时间段内从PubMed中识别出219条记录,筛选前没有重复或排除。筛选后,125条因不符合纳入标准而被排除在外,留下94份报告。其中,2个与神经外科无关,7个是动物研究,导致85项研究纳入我们的系统评价.数据按神经外科手术和使用7TMRI治疗的疾病进行分类。我们还按国家分析了出版物,并介绍了每个国家7TMRI设施的数量。根据7TMRI是否与较低的场强进行比较,将实验研究分为比较研究和非比较研究。
结论:7TMRI在改善各种神经和精神疾病的定性和理解方面具有巨大的潜力,这些疾病可以通过神经外科治疗。这些包括癫痫,垂体腺瘤,帕金森病,脑血管疾病,三叉神经痛,颅脑外伤,多发性硬化症,神经胶质瘤,和精神疾病。在图像质量方面证明了7TMRI在较低场强上的优越性,病变检测,和组织表征。研究结果表明,需要加快7T磁共振系统的全球分布,并增加对放射科医师的培训,以确保安全有效地整合到常规临床实践中。
BACKGROUND: After approval for clinical use in 2017, early investigations of ultra-high-field abdominal magnetic resonance imaging (MRI) have demonstrated its feasibility as well as diagnostic capabilities in neuroimaging. However, there are no to few systematic reviews covering the entirety of its neurosurgical applications as well as the trends in the literature with regard to the aforementioned application.
OBJECTIVE: To assess the impact of 7-Tesla MRI (7T MRI) on neurosurgery, focusing on its applications in diagnosis, treatment planning, and postoperative assessment, and to systematically analyze and identify patterns and trends in the existing literature related to the utilization of 7T MRI in neurosurgical contexts.
METHODS: A systematic search of PubMed was conducted for studies published between January 1, 2017, and December 31, 2023, using MeSH terms related to 7T MRI and neurosurgery. The inclusion criteria were: Studies involving patients of all ages, meta-analyses, systematic reviews, and original research. The exclusion criteria were: Pre-prints, studies with insufficient data (e.g., case reports and letters), non-English publications, and studies involving animal subjects. Data synthesis involved standardized extraction forms, and a narrative synthesis was performed.
RESULTS: We identified 219 records from PubMed within our defined period, with no duplicates or exclusions before screening. After screening, 125 articles were excluded for not meeting inclusion criteria, leaving 94 reports. Of these, 2 were irrelevant to neurosurgery and 7 were animal studies, resulting in 85 studies included in our systematic review. Data were categorized by neurosurgical
procedures and diseases treated using 7T MRI. We also analyzed publications by country and the number of 7T MRI facilities per country was also presented. Experimental studies were classified into comparison and non-comparison studies based on whether 7T MRI was compared to lower field strengths.
CONCLUSIONS: 7T MRI holds great potential in improving the characterization and understanding of various neurological and psychiatric conditions that may be neurosurgically treated. These include epilepsy, pituitary adenoma, Parkinson\'s disease, cerebrovascular diseases, trigeminal neuralgia, traumatic head injury, multiple sclerosis, glioma, and psychiatric disorders. Superiority of 7T MRI over lower field strengths was demonstrated in terms of image quality, lesion detection, and tissue characterization. Findings suggest the need for accelerated global distribution of 7T magnetic resonance systems and increased training for radiologists to ensure safe and effective integration into routine clinical practice.