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J Magn Reson Imaging. 2008 Oct;28(4):873-8. doi: 10.1002/jmri.21547.

Steady-state free-precession (SSFP) cine MRI in distinguishing normal and bicuspid aortic valves.

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Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland.



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.


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.


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.


Double-oblique True FISP cine MR imaging of the aortic valve is 100% sensitive and 95% specific in distinguishing normal and bicuspid aortic valves.

[Indexed for MEDLINE]

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