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Fetal Cerebral Ventricular Pointing as a Marker of Spina Bifida
Author(s) -
Wax Joseph R.,
Pinette Michael G.,
Cartin Angelina,
Michaud Janet,
Blackstone Jacquelyn
Publication year - 2009
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2009.28.3.317
Subject(s) - spina bifida , medicine , fetus , pathognomonic , spina bifida occulta , echoencephalography , anatomy , pediatrics , pregnancy , radiology , genetics , disease , biology
Objective. Occipital cerebral ventricular pointing is a promising intracranial marker for spina bifida. We sought to determine (1) the incidence of pointing in fetuses with and without spina bifida and (2) inter‐observer and intraobserver agreement for visualizing pointing. Methods. Second‐trimester transverse axial images of the lateral cerebral ventricles from an equal number of affected and unaffected fetuses were independently reviewed in a blinded fashion by 2 examiners. Results. Sixty‐two fetuses (31 with isolated spina bifida and 31 without) had sonographic examinations at 19.2 ± 1.3 weeks (mean ± SD). Pointing was present in 77.3% of fetuses with spina bifida and 15% of those without by the first examiner and in 78.3% of fetuses with spina bifida and 10% of those without by the second examiner. Interobserver and intraobserver agreement were substantial (κ = 0.69 and 0.78, respectively). Conclusions. Ventricular pointing is a highly agreed‐on finding that is substantially associated with but not pathognomonic for fetal spina bifida.