• Tadhg G Gleeson, Irene Mwangi, Stephen J Horgan, Andrea Cradock, Patricia Fitzpatrick, and John G Murray.
• Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland. tadhggleeson@hotmail.com
• J Magn Reson Imaging. 2008 Oct 1; 28 (4): 873-8.

PurposeTo 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.Materials And MethodsEchocardiograms 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.ResultsA 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.ConclusionDouble-oblique True FISP cine MR imaging of the aortic valve is 100% sensitive and 95% specific in distinguishing normal and bicuspid aortic valves.(c) 2008 Wiley-Liss, Inc.

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