Diagnostic accuracy of fetal choroid plexus length to head biometry ratio at 11 to 13 weeks for open spina bifida
| Autor: | Asma Khalil, Lei Ting, Erkan Kalafat, B. Thilaganathan, Aris T. Papageorghiou |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Gestational Age Ultrasonography Prenatal 03 medical and health sciences Fetus 0302 clinical medicine Pregnancy medicine Humans 030212 general & internal medicine Retrospective Studies Longest Diameter 030219 obstetrics & reproductive medicine business.industry Spina bifida Multiple of the median Area under the curve Obstetrics and Gynecology Gestational age Retrospective cohort study medicine.disease Spina Bifida Cystica Dimensional Measurement Accuracy Choroid Plexus Female Choroid plexus Nuclear medicine business Head |
| Zdroj: | American Journal of Obstetrics and Gynecology. 224:294.e1-294.e14 |
| ISSN: | 0002-9378 |
| Popis: | Background Open spina bifida is a major congenital anomaly with an estimated incidence of Objective This study aimed to assess the predictive accuracy of mean choroid plexus length to occipitofrontal diameter ratio recorded at 11 to 13 weeks’ gestation for the detection of open spina bifida. Study Design This was a retrospective cohort of patients treated in a tertiary referral center. Fetuses in which open spina bifida was detected at 16 to 24 weeks’ gestation and normal fetuses were included in the cohort. Biparietal diameter and occipitofrontal diameter were measured in an axial view. The length of choroid plexus was measured along its longest diameter in the same plane. Ultrasound images were examined offline, and the operator was blinded to the clinical diagnosis. The predictive accuracy was evaluated using the area under the curve and positive and negative predictive values. Results We included 3300 pregnant women, of whom 24 (0.73%) had the fetuses affected by open spina bifida. The area under the curve values were 0.921 for mean choroid plexus length to occipitofrontal diameter ratio and 0.933 for its multiple of the median. Mean choroid plexus length to biparietal diameter ratio indicated similar results, with area under the curve values of 0.928 and 0.931 for raw ratio and multiple of the median ratio models, respectively. The optimal cutoffs of the mean choroid plexus to occipitofrontal diameter ratio and multiple of the median ratios were 0.662 and 1.263, respectively. The optimal mean choroid plexus to occipitofrontal diameter ratio and multiple of the median ratio cutoffs provided a positive predictive value of 90.9% and a negative predictive value of 99.6%. The number of affected spinal segments was significantly higher in fetuses with a ratio above 0.662 (P=.022). Conclusion The mean choroid plexus length to occipitofrontal diameter ratio at 11 to 13 weeks’ gestation is a promising tool for the prenatal detection of open spina bifida. |
| Databáze: | OpenAIRE |
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