Aims: Defining the most appropriate definition of mesorectal fascia involvement (MRF+) by reviewing literature and using new inclusion criteria to re-evaluate the effectiveness of MRI in the assessment of MRF+ for rectal cancer. Methods: PubMed, Medline, Embase, and the Cochrane Library databases were electronically searched from 1999 to 2012. The bivariate random effects model was used to estimate the pooled outcomes of each subgroup. The definition of MRF+ in MRI and the influence of neoadjuvant chemoradiotherapy (neo-ChRT) were especially discussed. Results: Fourteen studies involving 1,600 patients were included. Different definitions of MRF+ (≤1, ≤2 and ≤5 mm) in MRI exhibited different pooled sensitivity (76, 79 and 92%), specificity (88, 66 and 48%) and diagnostic odds ratio (DOR) (22.4, 6.6 and 16.0). The definition of MRF+ at ≤1 mm showed the highest DOR. The specificity (88 vs. 93%, p = 0.026) and DOR (15.5 vs. 39.0, p = 0.001) were lower in patients who underwent neo-ChRT than those who did not while using ≤1 mm as the definition of MRF+. However, the sensitivity showed no significant difference (67 vs. 74%, p = 0.129). Conclusions: MRI is valuable for the assessment of MRF. The most appropriate definition of MRF+ in MRI is ≤1 mm. The effectiveness is higher in patients who did not undergo neo-ChRT.

Background. To investigate the similarities and differences in the structure and function of the central nerve system (CNS) among normal tension glaucoma (NTG), primary open-angle glaucoma with high intraocular pressure (HTG) and primary angle-closure glaucoma (PACG) patients. Methods. Ophthalmic examinations and multimodal magnetic resonance imaging (MRI) were performed. The results of brain functional connectivity (FC) were obtained based on the resting state MRI (rs-fMRI). Voxel-based morphometry (VBM) was applied to analyze structural images to obtain the volume change in the gray matter on 3D T1-weighted imaging (T1WI). Results. We found that frontal lobe FC increased in all three groups. Temporal lobe FC increased in the NTG group, while the FC of the cingulate gyrus and postcentral gyrus increased in the HTG and PACG groups by rs-fMRI. There were no gray matter volume changes in the NTG, while the gray matter of the frontal gyrus changed in the HTG and PACG. Moreover, the gray matter of the precentral gyrus changed in PACG, and the parietal lobe and supra marginal lobe changed in the HTG. The white matter of the inferior parietal lobe and postcentral gyrus increased, while that in the inferior temporal lobe decreased in the NTG group. The white matter in the HTG and PACG groups showed significant alterations in the medial occipital gyrus. Conclusions. The NTG group had different manifestations compared with the HTG and PACG groups regarding changes in brain structure and function, suggesting that pathogenic processes might differ between patients with normal-tension and high-tension POAG.