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The Predictive Value of Dry Brain Sign for Open Spina Bifida at First Trimester Anomaly Scan: A Case-Control study.

Hesham Kamal El Din Abd El Fatah El Emam1, Hend Galal Eldeen Mohamed Ali Hassan2, Sahar Mohamed El Feky1

  • 1Department of Diagnostic, Interventional Radiology and molecular imaging, Faculty of Medicine, Ain Shams University, Cairo, Egypt (H.K.E.D.A.E.F.E.E., H.G.E.M.A.H., S.M.E.F., A.M.O.).

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|June 18, 2025
PubMed
Summary

The dry brain sign, characterized by enlarged choroid plexuses, shows promise as an early ultrasound marker for detecting open spina bifida (OSB) in the first trimester.

Keywords:
Dry brain signFirst-trimesterNeural tube defectsOpen spina bifidaUltrasound

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Area of Science:

  • Medical Imaging
  • Prenatal Diagnosis
  • Fetal Abnormalities

Background:

  • Spina bifida is a common neural tube defect.
  • Early detection of spina bifida is crucial for prenatal management.
  • First-trimester sonographic screening is vital for identifying fetal anomalies.

Purpose of the Study:

  • To evaluate the diagnostic utility of the "dry brain sign" in first-trimester screening for open spina bifida (OSB).
  • To assess specific sonographic measurements for OSB detection.

Main Methods:

  • A prospective case-control study involving 50 pregnant women.
  • Divided into 25 controls and 25 cases with the "dry brain sign" (enlarged choroid plexuses without surrounding CSF).
  • Confirmed OSB diagnoses using second and third-trimester ultrasounds.

Main Results:

  • Cases with the dry brain sign showed significantly higher mean choroid plexus (CP) length, CP to occipitofrontal diameter (CP/OFD), and CP to biparietal diameter (CP/BPD) ratios (p=0.001).
  • Biparietal diameter (BPD) and occipitofrontal diameter (OFD) were significantly lower in cases (p=0.001).
  • CP/BPD and CP/OFD ratios demonstrated 100% diagnostic accuracy, sensitivity, and specificity for OSB.

Conclusions:

  • The dry brain sign, particularly the mean CP/BPD and CP/OFD ratios, can serve as reliable sonographic markers for early first-trimester screening of OSB.
  • These ratios offer high diagnostic accuracy for identifying open spina bifida prenatally.