Purpose To compare Gadomer, a macromolecular magnetic resonance (MR) contrast agent, and gadolinium diethylenetriamine pentaacetic acid (Gd‐DTPA) for quantifying angiogenesis in tissue‐engineered bladder constructs. Materials and Methods Constructs enhanced with vascular endothelial growth factor (VEGF) were grafted onto the bladder of 12 rabbits (N= 3/VEGF, VEGF = 0,10,15,20 ng/g tissue). After eight days dynamic contrast‐enhanced MRI (DCE‐MRI) was performed in each animal using Gadomer and Gd‐DTPA, separated by a one‐hour interval. DCE‐MRI parameters were calculated from two‐compartment pharmacokinetics (plasma volume fraction, vp; transfer constant, Ktrans) and model‐free analysis, area under the concentration–time curve (AUC). Histology assessment of microvessel density (MVD) and Evans blue permeability were compared to DCE‐MRI. Results MVD was elevated (P < 0.05) at the highest VEGF but not among lower levels; permeability differences were absent. Contrast enhancement increased with VEGF and was better resolved with Gadomer than Gd‐DTPA. Gadomer was the better assay for estimating plasma volume: vp provided the best distinction (P < 0.005), but both vp and AUC were correlated to MVD. With Gd‐DTPA, only AUC distinguished MVD differences (P< 0.05). Changes in Ktrans were insignificant. Conclusion Macromolecular contrast agents are valuable for monitoring angiogenesis in tissue‐engineered bladder grafts. Compared to Gd‐DTPA, Gadomer provides more accurate and precise quantification of microvessel function, and is better suited to pharmacokinetic analysis for accurate physiological quantification. J. Magn. Reson. Imaging 2007. © 2006 Wiley‐Liss, Inc.

In terms of total system reimbursement it is less expensive in our system to treat unilateral vesicoureteral reflux with unilateral extravesical reimplantation than with subureteral Deflux injection using dextranomer-hyaluronic acid. The ability to perform unilateral reimplantation as an outpatient procedure has shifted this relationship.

There appears to be a gradation of familial patterns from peripheral arterial aneurysm to AAA to arteriomegaly among patients with degenerative aneurysmal disease, and there appears to be a predominance among men. Relatives of patients with any of the 3 lesions-peripheral arterial aneurysm, AAA, arteriomegaly--most frequently have AAA. Relatives of patients with AAA, peripheral arterial aneurysm, or arteriomegaly may be screened by means of a physical examination for peripheral aneurysmal disease. Screening by means of ultrasound examination of the aorta should be limited to first-degree relatives of patients with aortic aneurysms or arteriomegaly.

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