Background-Cardiac magnetic resonance (MR) perfusion imaging during the first pass after intravenous administration of extracellular contrast agents is hampered by the spatial and temporal resolution achievable and by the artifacts seen in ultrafast MR imaging. Furthermore, time-consuming quantitative data analysis is often added. The use of molecular MR imaging with a target-specific contrast agent with perfusion-dependent binding to myocardium may enable prolonged visualization of perfusion defects and thus may help to overcome limitations of currently used first-pass extracellular MR imaging. EP-3600 is a new gadolinium-containing molecular contrast agent that binds reversibly to myocardial collagen. Methods and Results-A significant but nonocclusive coronary artery stenosis was modeled in 7 domestic swine with an undersized MR-compatible balloon positioned in the left anterior descending artery as verified by x-ray angiography. Two animals died before contrast injection as a result of arrhythmias. In 5 swine, high-spatial-resolution gradient echo imaging (Ϸ1ϫ1 mm 2 in-plane resolution) was performed before and 5, 20, 40, and 60 minutes after intravenous administration of 12.3 mol/kg EP-3600. Contrast was administered during stress induced by an infusion of 250 mol · kg Ϫ1 · min Ϫ1 adenosine. Yb-DTPA was administered simultaneously for comparison of myocardium-to-plasma ratios. Images were assessed subjectively by 2 investigators, and signal-to-noise and contrast-to-noise ratios over time were calculated. Normal myocardium showed a significant signal-to-noise ratio increase during the entire examination time. In all animals (nϭ5), the perfusion defect in the left anterior descending artery territory could be visualized with a high contrast-to-noise ratio for at least 20 minutes after contrast injection. A significantly higher myocardium-to-plasma ratio was found for EP-3600 compared with the control agent Yb-DTPA (0.85Ϯ0.26 versus 0.22Ϯ0.08, respectively; PϽ0.01). Conclusion-EP-3600 is a new molecular MR imaging contrast agent that binds to the myocardium and enables prolonged, high-contrast, high-spatial-resolution visualization of myocardial perfusion defects. (Circulation. 2009;119:1768-1775.)

Enterostomy formation and closure in the pediatric age group with severe underlying disease is still associated with substantial morbidity.

Fast contrast-enhanced time-resolved 3D MRA of the foot at 3 T is feasible and of high clinical value for the preoperative evaluation of the arterial supply of the foot.

ECG-triggered MRI is a reliable method for the evaluation of postoperative anatomy and function following implantation of a left ventricular apico-aortic conduit.

Despite containing an increasing amount of medical information, the Internet provides only rare benefits for surgical patients. Using "inguinal hernia" as a catchword, an amateur search was imitated on the British Internet market. Sixty-five pages, standardised regarding quality and efficiency, were evaluated. A comparison to the German Internet market was added. In summary, the broad majority of the pages revealed poor results. Technical appearance, quality of content, and target grouping show big deficiencies. The applicable laws on the European market are not yet established. The ranking lists of the search engines do not reflect the quality of the pages. Patients need competent guides to process surgical information from the Internet. The establishment of specialised institutions to control surgical Web sites according to quality, content, and legality on the European level is urgent.