Synopsis

Clinical 7T MRI is a relatively new tool for the evaluation of medically refractory epilepsy. Offering improved signal to noise ratio and spatial resolution over MRI at 1.5 and 3.0 Tesla field strengths, 7T MRI can potentially identify very subtle epileptogenic lesions such as cortical dysplasias in patients that have previously been classified as "MRI negative". Additional epileptogenic pathologies better demonstrated with 7T MRI include mesial temporal sclerosis, tuberous sclerosis, and cavernomas. 7T fMRI may improve mapping of eloquent cortex in preparation for epilepsy surgery. Ongoing challenges with this technique include B1 inhomogeneity artifacts and safety concerns regarding metallic implants .