THE USE OF INTRACRANIAL TRANSLUCENCY IN SCREENING FOR SPINA BIFIDA: A SYSTEMATIC REVIEW

Abstract

Open spina bifida (OSB) is a major congenital neural tube defect whose early detection is essential for prenatal counseling and management. Intracranial translucency (IT), evaluated between 11 and 14 weeks, constitutes a promising ultrasound marker. This systematic review (PRISMA 2020) evaluated the diagnostic accuracy of IT for OSB, searching PubMed, Scopus, and LILACS (2010–2025). Nine studies were included (risk of bias assessed via QUADAS-3) and descriptively synthesized. Isolated IT demonstrated limited sensitivity (36–50%), but high specificity and high value for excluding OSB. Non-visualization of the cisterna magna (50–73% sensitivity) and brainstem displacement (82.7%), when combined with other posterior fossa markers, raised detection rates up to 90%. IT visualization also improved following operator training. In conclusion, IT is a viable tool for early OSB screening, primarily serving as an exclusion marker. Combining IT with other posterior fossa markers and enhancing operator training increases diagnostic accuracy during prenatal care.