Magnetic resonance imaging of the fetal musculoskeletal system

Trends in research related to fetal therapy from 2012 to 2022: a bibliometric analysis

Background

The development of prenatal diagnosis technology allows prompt detection of severe fetal diseases. To address adverse factors that threaten fetal survival, fetal therapy came into existence, which aims to preserve the function after birth to a higher degree and improve the quality of life.

Objective

To conduct a comprehensive bibliometric analysis of studies on fetal therapy in the past decade and explore the research trends and hotspots in this field.

Methods

We conducted a systematic search on the Web of Science Core Collection to retrieve studies related to fetal therapy published from 2012 to 2022. VOSviewer and CiteSpace were used to analyze the key features of studies, including annual output, countries/regions, institutions, authors, references, research hotspots, and frontiers.

Results

A total of 9,715 articles were included after eliminating duplicates. The annual distribution of the number of articles showed that the number of articles published in fetal therapy had increased in the past decade. Countries and institutions showed that fetal therapy is more mature in the United States. Author analysis showed the core investigators in the field. Keyword analysis showed the clustering and emergence frequency, which helped summarize the research results and frontier hotspots in this field. The cocited references were sorted out to determine the literature with a high ranking of fetal therapy in recent years, and the research trend in recent years was analyzed.

Conclusions

This study reveals that countries, institutions, and researchers should promote wider cooperation and establish multicenter research cooperation in fetal therapy research. Moreover, fetal therapy has been gradually explored from traditional surgical treatment to gene therapy and stem cell therapy. In recent years, fetoscopic laser surgery, guideline, and magnetic resonance imaging have become the research hotspots in the field.

Fetal MRI at 3 T: Principles to Optimize Success

Fetal MRI has emerged as a cornerstone of prenatal imaging, helping to establish the correct diagnosis in pregnancies affected by congenital anomalies. In the past decade, 3 T imaging was introduced as an alternative to increase the signal-to-noise ratio (SNR) of the pulse sequences and improve anatomic detail. However, imaging at a higher field strength is not without challenges. Many artifacts that are barely appreciable at 1.5 T are amplified at 3 T. A systematic approach to imaging at 3 T that incorporates appropriate patient positioning, a thoughtful protocol design, and sequence optimization minimizes the impact of these artifacts and allows radiologists to reap the benefits of the increased SNR. The sequences used are the same at both field strengths and include single-shot T2-weighted, balanced steady-state free-precession, three-dimensional T1-weighted spoiled gradient-echo, and echo-planar imaging. Synergistic use of these acquisitions to sample various tissue contrasts and in various planes provides valuable information about fetal anatomy and pathologic conditions. In the authors' experience, fetal imaging at 3 T outperforms imaging at 1.5 T for most indications when performed under optimal circumstances. The authors condense the cumulative experience of fetal imaging specialists and MRI technologists who practice at a large referral center into a guideline covering all major aspects of fetal MRI at 3 T, from patient preparation to image interpretation. © RSNA, 2023 Quiz questions for this article are available in the supplemental material.

Indications for magnetic resonance imaging of the fetal body (extra-central nervous system): recommendations from the European Society of Paediatric Radiology Fetal Task Force

The indications for fetal body MRI are amplifying because of the expanding possibilities of fetal and perinatal therapy. However, huge heterogeneity regarding the indications for fetal body MRI is seen among different European countries that is mostly related to local use of US, but also to local fetal MRI expertise and legislation on pregnancy termination. The purpose of this article is to summarize the precise indications for fetal MRI, excluding the central nervous system. MRI indications arise from the sonographic findings, based on the operator's experience and the various practices in the countries and institutions represented on the European Society of Paediatric Radiology Fetal Task Force. We also highlight the strengths and weaknesses of fetal US and MRI of the fetal body.

Fetal MRI Neuroradiology: Indications

Fetal MRI is a safe, noninvasive examination of the fetus and placenta, a complement to ultrasonography. MRI provides detailed CNS evaluation, including depicting parenchymal architecture and posterior fossa morphology, and is key in prenatal assessment of spinal dysraphism, neck masses, and ventriculomegaly. Fetal MRI is typically performed after 22 weeks gestation, and ultrafast T1 and T2-weighted MRI sequences are the core of the exam, with advanced sequences such as diffusion weighted imaging used for specific questions. The fetal brain grows and develops rapidly, and familiarity with gestational age specific norms is essential to MRI interpretation.