title: Diagnostic accuracy of intracranial translucency in detecting spina bifida: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of intracranial translucency (IT) in the detection of spina bifida (SB) in the first trimester of pregnancy.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
authors: Giuseppe M
authors: GM
authors: Maruotti
authors: Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
authors: Gabriele
authors: http://orcid.org/0000-0003-0078-2113
authors: G
authors: Saccone
authors: Department of Obstetrics and Gynecology Women's Health and Perinatology Research Group, University Hospital of Northern Norway, University of Northern Norway, Tromsø, Norway.
authors: Francesco
authors: F
authors: D'Antonio
authors: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
authors: Vincenzo
authors: V
authors: Berghella
authors: Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
authors: Laura
authors: L
authors: Sarno
authors: Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
authors: Maddalena
authors: M
authors: Morlando
authors: Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
authors: Antonia
authors: A
authors: Giudicepietro
authors: Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy.
authors: Pasquale
authors: P
authors: Martinelli
mesh_terms: D005260:Female; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012886:Skull / Q000000981:diagnostic imaging*; D016135:Spinal Dysraphism / Q000000981:diagnostic imaging*; D016216:Ultrasonography, Prenatal