Neuroimaging at Term Equivalent Age: Is There Value for the Preterm Infant? A Narrative Summary

Global trends in neonatal MRI brain neuroimaging research over the last decade: a bibliometric analysis

Background

Neuroimaging plays a central role in the evaluation, treatment, and prognosis of neonates. In recent years, the exploration of the developing brain has been a major focus of research for researchers and clinicians. In this study, we conducted bibliometric and visualization analyses of the related studies in the field of neonatal magnetic resonance imaging (MRI) brain neuroimaging from the past 10 years, and summarized its research status, hotspots, and frontier development trends.

Methods

The Web of Science core collection database was used as the literature source from which to retrieve the relevant papers and reviews in the field of neonatal MRI brain neuroimaging published in the Science Citation Index-Expanded from 2013 to 2022. VOSviewer and CiteSpace were used to conduct bibliometric and visualization analyses of the annual publication volume, countries, institutions, journals, authors, co-cited literature, and the overall distribution of keywords.

Results

We retrieved 3,568 papers and reviews published from 2013 to 2022. The number of publications increased during this period. The United States (US) and the United Kingdom were the largest contributors, with the US receiving the highest H-index and number of citations. The institutions that published the most were the University of London and Harvard University. The research mainly focused on cerebral cortex, brain tissue, brain structure network, artificial intelligence algorithm, automatic image segmentation, and premature infants.

Conclusions

This study reveals the research status and hotspots of magnetic resonance imaging in the field of neonatal brain neuroimaging in the past decade, which helps researchers to better understand the research status, hotspots, and frontier development trends.

Implementation of the Feed and Swaddle Technique as a Non-Pharmacological Strategy to Conduct Brain Magnetic Resonance Imaging in Very Low Birth Weight Infants

Purpose: Magnetic resonance imaging (MRI) is a useful tool for evaluating brain injury and maturation in preterm infants and often requires sedation to acquire images of sufficient quality. Infant sedation is often associated with adverse events, despite extreme precautions. In this study, the swaddling technique was investigated as an alternative non-pharmacological strategy to obtain brain MRIs of sufficient quality.Methods: We applied the feed and swaddle technique during routine brain MRI as a quality improvement project and compared its morbidity with that of sedation in a historic age-matched group. Seventy-nine very low birth weight infants in the neonatal intensive care unit of Ajou University Hospital (Suwon, Korea) were enrolled. Thirty-two (40.5%) infants were in the feed and swaddling group, and 47 (59.5%) were in the sedation group.Results: The morbidity associated with the cardiopulmonary system (swaddling group vs. sedation group: 53.13% [n=17] vs. 63.83% [n=30], P=0.723) and central nervous system (40.63% [n=13] vs. 29.79% [n=14], P=0.217) were not significantly different between groups. The MRI failure rate was not significantly different (swaddling group vs. sedation group: 12.5% [n=4] vs. 4.3% [n=2], P=0.174). The MRI scanning time was longer in the swaddling group than in the sedation group (76.5±20.3 minutes vs. 61.5±13.6 minutes, P=0.001). Cardiopulmonary adverse events were significantly less common in the swaddling group than in the sedation group (3.13% [n=1] vs. 34.04% [n=16], P=0.002).Conclusion: The success rate of MRI was comparable between the swaddling technique and sedation. Furthermore, despite the drawback of prolonged scan time, cardiopulmonary adverse events are fewer with swaddling than with sedative agents. Therefore, swaddling can be an alternative to sedation or anesthesia when performing neonatal MRI scans.