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Assessment of the posterior brain at 11–14 weeks for the prediction of open neural tube defects
Author(s) -
Kavalakis Ioannis,
Souka Athena P.,
Pilalis Athanasios,
Papastefanou Ioannis,
Kassanos Dimitrios
Publication year - 2012
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.3973
Subject(s) - cisterna magna , medicine , neural tube defect , neural tube , anatomy , cistern , population , choroid plexus , ultrasound , nuclear medicine , radiology , central nervous system , cerebrospinal fluid , pathology , biology , embryo , history , archaeology , environmental health , microbiology and biotechnology
Objective To evaluate the routine midsagittal view of the posterior brain at the 11–13 weeks' ultrasound examination, for predicting open neural tube defects. Methods Posterior brain was examined midsagittally for normality of the four‐line view (upper and lower border of the brain stem, the choroid plexus of the fourth ventricle and the occipital bone). Intracranial translucency and cisterna magna (CM) were measured. Results The posterior brain was assessed in 1330 cases. The four‐line view was normal in all but one case. In the two cases of open spina bifida contained in the study population, intracranial translucency was within normal range. The CM and the four‐line view were normal in the first case, whereas in the second case, the four‐line view was abnormal, and CM was obliterated and impossible to measure. No other cases of abnormal four‐line view were observed in the study population. Conclusion Obliteration of the CM appears to be the most consistent early sign of open neural tube defects. Attention should focus on either measuring the cisterna magna or simply observing the presence of four lines in the midsagittal view of the posterior brain. However, these early signs of brain herniation are not present in all abnormal cases. © 2012 John Wiley & Sons, Ltd.