Maruotti Giuseppe M, Saccone Gabriele, D'Antonio Francesco, Berghella Vincenzo, Sarno Laura, Morlando Maddalena, Giudicepietro Antonia, Martinelli Pasquale
Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
Department of Obstetrics and Gynecology Women's Health and Perinatology Research Group, University Hospital of Northern Norway, University of Northern Norway, Tromsø, Norway.
Prenat Diagn. 2016 Nov;36(11):991-996. doi: 10.1002/pd.4883. Epub 2016 Aug 23.
To evaluate the diagnostic accuracy of intracranial translucency (IT) in the detection of spina bifida (SB) in the first trimester of pregnancy.
We included study assessing the accuracy of sonographic measurements of IT in a mid-sagittal view of the fetal face in prediction of SB in the first trimester of pregnancy. The primary outcome was the accuracy of IT in prediction of spina bifida. Summary estimates of sensitivity, specificity, positive and negative likelihood ratios (LR), and diagnostic odds ratio for the overall predictive accuracy of IT were computed.
Nine studies (21 070 fetuses) were included in the analysis. IT was successfully assessed in the majority of fetuses 97.8% (95% CI 97.6-98.0). The diagnostic performance of IT in detecting SB was as follows: sensitivity: 53.5% (95% CI 42.4-64.3), specificity: 99.7% (95% CI 99.6-99.8), positive LR: 62.1 (95% CI 12.2-317), negative LR:0.55 (95% CI 0.45-0.68), and diagnostic odds ratio: 223 (95% CI 25-2039).
Intracranial translucency had low diagnostic accuracy in prediction of open spina bifida, thus questioning its role as a screening marker for open SB in an unselected population. When looking at the individual study data, it appears that IT assessment for open SB prediction can be affected by a high rate of false positive results potentially leading to unnecessary parental anxiety. © 2016 John Wiley & Sons, Ltd.
评估妊娠早期颅内透明层（IT）检测脊柱裂（SB）的诊断准确性。
我们纳入了评估妊娠早期经胎儿面部矢状中视图超声测量IT预测SB准确性的研究。主要结局是IT预测脊柱裂的准确性。计算了IT总体预测准确性的敏感性、特异性、阳性和阴性似然比（LR）以及诊断比值比的汇总估计值。
9项研究（21070例胎儿）纳入分析。大多数胎儿（97.8%，95%CI 97.6 - 98.0）成功评估了IT。IT检测SB的诊断性能如下：敏感性：53.5%（95%CI 42.4 - 64.3），特异性：99.7%（95%CI 99.6 - 99.8），阳性LR：62.1（95%CI 12.2 - 317），阴性LR：0.55（95%CI 0.45 - 0.68），诊断比值比：223（95%CI 25 - 2039）。
颅内透明层预测开放性脊柱裂的诊断准确性较低，因此质疑其在未选择人群中作为开放性脊柱裂筛查标志物的作用。查看个体研究数据时，似乎开放性脊柱裂预测的IT评估可能受到高假阳性率的影响，这可能导致不必要的父母焦虑。© 2016 John Wiley & Sons, Ltd.
