Purpose: To investigate the potential value of magnetic resonance imaging (MRI) in predicting response relevance to total neoadjuvant treatment (TNT) in locally advanced rectal cancer.Methods: We analyzed MRI of 71 patients underwent TNT from 2015 to 2017 retrospectively. We categorized the response of TNT as CR (complete response) and non-CR, and high, moderate and low sensitivity. Logistic regression analysis was used to identify the best predictors of response. Diagnostic performance was assessed using receiver - operating characteristic curve analysis.Results: Post–ICT (induction chemotherapy) ∆TL (tumor length), post-CRT (concurrent chemoradiotherapy) ∆LNN (the numbers of lymph node metastases), post–CCT (consolidation chemotherapy) ∆SDWI (maximum cross-sectional area of tumor on diffusion-weighted imaging), post-CCT ADCT (the mean apparent diffusion coefficient values of tumor) and post-CCT ∆LNV (volume of lymph node) were the best CR predictors. Post-CRT EMVI (extramural vascular invasion) and post-CCT ∆ST2 (S on T2-weight) were the best significant factors for high sensitivity. Conclusions: Post-ICT ∆TL and post-CRT EMVI may an early predictor of CR and high sensitivity to TNT, respectively. The grouping scheme of CR and non–CR was more suitable for predicting response by MRI parameters than high, moderate and low sensitivity.Trial registration: retrospectively registered
Background: Gastrointestinal hemangiomas are very rare and are even rarer in the mesentery. It is not known whether they originate in the bowel wall or the mesentery currently. Some studies have described mesenteric hemangiomas that originate in the bowel wall and extend into the mesentery. We herein describe a case of cavernous hemangioma of the mesorectum. Case presentation: A 31-year-old male presented with hematochezia and sensation of rectal tenesmus. Both the rectal MRI and contrast-enhanced CT scan of the whole abdomen indicated rectal wall thickening, marked dilated and tortuous vessels around the rectum. In addition, an anomalous vein had arisen from the superior mesenteric vein, extending down to the mesorectum. The patient underwent laparoscopic surgical resection of the mesorectal lesion and the involved portions of the rectum. The surgical samples underwent pathological analysis, and a diagnosis of mesenteric cavernous hemangioma was confirmed. Seven days after surgery, the patient was discharged without postoperative complications.Conclusion: Mesenteric hemangiomas are extremely rare tumors. In our present case, an anomalous vein had arisen from the superior mesenteric vein, extending down to the mesorectum. This findings suggest that the mesenteric hemangioma more likely originated in the mesentery.
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