title: Steady-state free-precession (SSFP) cine MRI in distinguishing normal and bicuspid aortic valves.
abstract: OBJECTIVE
  To assess the diagnostic sensitivity and specificity of double-oblique true fast imaging with steady-state precession (SSFP) cine MRI in distinguishing normal and bicuspid aortic valves.
  
  
  METHODS
  Echocardiograms on patients referred for MRI of the heart and thoracic aorta over a four-year period were reviewed retrospectively. A total of 17 patients with bicuspid aortic valve were identified and compared to 21 randomly chosen control patients. All patients had double-oblique SSFP (True FISP) cine MRI of the aortic valve independently assessed by two radiologists in a blinded fashion, and graded as bicuspid or normal. Image quality was graded as 1, 2, or 3. Discordance was resolved by consensus.
  
  
  RESULTS
  A total of 38 cases were reviewed (27 men, 11 women; age range = 15-67 years, mean = 25.33 years). Interobserver agreement was 0.97 (36/38 cases). One case of normal tricuspid valve was reported as bicuspid by both readers (false-positive). All cases in which disparity arose were rated suboptimal by both readers (grade 2 or 3). Consensus review yielded sensitivity = 100%, specificity = 95.2%, positive predictive value = 94.4%, and negative predictive value = 100%; overall diagnostic accuracy was 97.36%. Interobserver agreement was 0.97.
  
  
  CONCLUSIONS
  Double-oblique True FISP cine MR imaging of the aortic valve is 100% sensitive and 95% specific in distinguishing normal and bicuspid aortic valves.
authors.affiliation: Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland. tadhggleeson@hotmail.com
authors.forename: Tadhg G
authors.initials: TG
authors.lastname: Gleeson
authors.forename: Irene
authors.initials: I
authors.lastname: Mwangi
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Horgan
authors.forename: Andrea
authors.initials: A
authors.lastname: Cradock
authors.forename: Patricia
authors.initials: P
authors.lastname: Fitzpatrick
authors.forename: John G
authors.initials: JG
authors.lastname: Murray
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000002:abnormalities* / Q000033:anatomy & histology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity