Intracranial translucency at 11–13 weeks of gestation: prospective evaluation and reproducibility of measurements

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Abstract

Objective

This paper aimed to determine the feasibility of identification and measurement reproducibility of intracranial translucency (IT) in our population.

Methods

This is a prospective study in which five accredited operators attempted to identify and measure the IT during first-trimester sonographic screening for aneuploidy in 990 fetuses. The presence or absence of spina bifida was determined at the time of the second-trimester scan or after birth. Measurement reproducibility was assessed through intraclass correlation coefficient (ICC) on a subgroup of 150 fetuses.

Results

Identification and measurement of the IT were possible in 961 (97%) cases. The mean IT anteroposterior diameter was 1.8 mm (SD ± 0.37; range 0.8–3.1), and the size increased linearly with advancing gestation (IT = 0.74 + 0.02 × crown–rump length; r2 = 0.15, p < 0.0001). The only fetus with spina bifida in this series presented with absent IT. Intra-observer and inter-observer ICCs were 0.79 and 0.75, respectively (95% confidence intervals 0.72–0.84 and 0.67–0.81, respectively; both p < 0.001).

Conclusions

The IT increases linearly with increasing crown–rump length and seems to be of value in the first-trimester detection of spina bifida. It is easy to identify and measure and shows excellent intra-observer and inter-observer reproducibility measurements. © 2012 John Wiley & Sons, Ltd.

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