{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T10:33:39Z","timestamp":1790332419211,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,9,23]],"date-time":"2013-09-23T00:00:00Z","timestamp":1379894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the contribution of examination of specific anatomical features of the fetal posterior brain on mid\u2010sagittal first\u2010trimester ultrasound examination to the early detection of open spina bifida.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Four independent observers reviewed a series of 260 mid\u2010sagittal first\u2010trimester ultrasound images from 52 cases of open spina bifida and 208 normal fetuses. The following analysis was performed by each reviewer for each image: Herman score calculation, intracranial translucency score (<jats:styled-content style=\"fixed-case\">CFEF\u2010IT<\/jats:styled-content>) calculation and determination of presence or absence of three anatomical criteria: intracranial translucency (<jats:styled-content style=\"fixed-case\">IT<\/jats:styled-content>), caudal displacement of the brainstem and cisterna magna. The sensitivity and the false\u2010positive rate for spina bifida detection were calculated for each of the latter three criteria. A secondary analysis was performed on the subset of images achieving a Herman score \u2265 7.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The highest detection rate for spina bifida was achieved by non\u2010visualization of the cisterna magna, with associated sensitivity of 50\u201373% and 39\u201376%, respectively, for all images and for the subset of images achieving a Herman score \u2265 7. Posterior shift of the brainstem achieved the highest detection rate (86%), but for a single reviewer only. The level of variation in performance between observers was also greatest for this sign. Absence of <jats:styled-content style=\"fixed-case\">IT<\/jats:styled-content> was associated with a lower detection rate for all observers. Overall, an abnormal posterior brain presenting at least one of these three criteria was associated with a detection rate ranging from 50 to 90%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the detection of spina bifida, non\u2010visualization of the cisterna magna achieved the best screening performance. Both non\u2010visualization of the <jats:styled-content style=\"fixed-case\">IT<\/jats:styled-content> and posterior shift of the brainstem were associated with acceptable but lower detection rates. A prospective evaluation of changes in the posterior brain is needed to allow assessment of the most pertinent criteria for first\u2010trimester screening for spina bifida. Copyright \u00a9 2013 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.12463","type":"journal-article","created":{"date-parts":[[2013,3,15]],"date-time":"2013-03-15T06:36:54Z","timestamp":1363329414000},"page":"416-420","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Screening for fetal spina bifida at the 11\u201313\u2010week scan using three anatomical features of the posterior brain"],"prefix":"10.1002","volume":"42","author":[{"given":"R.","family":"Mangione","sequence":"first","affiliation":[{"name":"Coll\u00e8ge Fran\u00e7ais d'Echographie Foetale (CFEF) Paris, France"},{"name":"Polyclinique Bordeaux Nord Aquitaine Department of Women Imaging Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Dhombres","sequence":"additional","affiliation":[{"name":"Coll\u00e8ge Fran\u00e7ais d'Echographie Foetale (CFEF) Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Lelong","sequence":"additional","affiliation":[{"name":"Unit\u00e9 INSERM UMR S953, Recherches \u00c9pid\u00e9miologiques sur la Sant\u00e9 P\u00e9rinatale et la Sant\u00e9 des Femmes et des Enfants Universit\u00e9 Pierre et Marie Curie Paris 6 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Amat","sequence":"additional","affiliation":[{"name":"Coll\u00e8ge Fran\u00e7ais d'Echographie Foetale (CFEF) Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Atoub","sequence":"additional","affiliation":[{"name":"Coll\u00e8ge Fran\u00e7ais d'Echographie Foetale (CFEF) Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Friszer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Khoshnood","sequence":"additional","affiliation":[{"name":"Unit\u00e9 INSERM UMR S953, Recherches \u00c9pid\u00e9miologiques sur la Sant\u00e9 P\u00e9rinatale et la Sant\u00e9 des Femmes et des Enfants Universit\u00e9 Pierre et Marie Curie Paris 6 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.\u2010M.","family":"Jouannic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,9,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10111"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8957"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11079"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.8994"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7552"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1998.12060398.x"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10118"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2632"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.9067"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10128"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00381-003-0792-3"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000071319"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.05.014"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11175"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2002.00660.x"}],"container-title":["Ultrasound in Obstetrics &amp; 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