Operative trends following the adoption of nonoperative management of rectal cancer.

Background: Differentiating clinical near-complete and complete responses (cCR) after neoadjuvant therapy (NT) is challenging in rectal cancer patients. We hypothesized that magnetic resonance imaging staging limitations for low rectal cancers may increase the proportion of abdominoperineal resection (APR) with permanent colostomy for those without a cCR.

Methods: Single institution retrospective analysis of rectal cancer cases before and after adoption of nonoperative "watch and wait" (W&W) pathway.

Left Ventricular Hypertrophy: Evaluation With Cardiac MRI.

Objective: Left ventricular hypertrophy (LVH) is a frequent problem in clinical practice and can be caused by diverse conditions including hypertension, aortic stenosis, hypertrophic cardiomyopathy, athletic training, infiltrative heart muscle disease, storage and metabolic disorders. Identification of the precise etiology can be challenging and is a common cause of referral for cardiac MRI (CMR). In this article, CMR findings in various causes of LVH will be reviewed with an emphasis on determination of etiology and emerging role of CMR in risk stratification.

Characteristic Cerebrovascular Findings Associated with ACTA2 Gene Mutations.

A specific mutation (Arg179) of the ACTA2 gene has previously been described to cause a syndrome of multisystemic smooth muscle dysfunction with an extremely characteristic cerebrovascular appearance.1 Accurate neuroimaging diagnosis of this entity is important as this syndrome predisposes to complications such as early-onset ischemic stroke and ascending thoracic aortic aneurysm.2,3 The following case demonstrates a previously undescribed ACTA2 mutation (Met46) with an identical cerebrovascular imaging appearance to that of Arg179 mutations, but a less severe overall phenotype.