{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:06:25Z","timestamp":1781276785942,"version":"3.54.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T00:00:00Z","timestamp":1615939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Shanghai Pujiang Program","award":["2019PJD052"],"award-info":[{"award-number":["2019PJD052"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81572332"],"award-info":[{"award-number":["81572332"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the Youth initiative fund of naval medical university","award":["2018QN05"],"award-info":[{"award-number":["2018QN05"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Imaging"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study is aimed to explore the factors influencing the visualization of the anterior peritoneal reflection (APR) and evaluated the feasibility of measuring the distance from the anal verge to APR (AV-APR), the tumor height on MRI and the accuracy of determining the tumor location with regard to APR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 110 patients with rectal cancer. A univariate and multivariate logistic regression was performed to identify the independent factors (age, sex, T stage, the degree of bladder filling, pelvic effusion, intraoperative tumor location, BMI, uterine orientation, the distance from seminal vesicle\/uterus to rectum) associated with the visualization of the APR on MRI. The nomogram diagram and receiver operating characteristic curve (ROC curve) were established. Intraclass correlation coefficient (ICC) was used to evaluate the consistency of the distance of AV-APR. The Pearson correlation coefficient was used to characterize the agreement between measurements of the tumor height by colonoscopy and MRI. The Kappa statistics was used to evaluate the value of MRI in the diagnosis of the tumor location with regard to the APR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Multivariate logistic regression showed that BMI (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.031, odds ratio, OR\u2009=\u20091.197), pelvic effusion (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.020, OR\u2009=\u20097.107) and the distance from seminal vesicle\/uterus to the rectum (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001, OR\u2009=\u20093.622) were correlated with the visualization of APR. The cut-off point of BMI and the distance from seminal vesicle\/uterus to the rectum is 25.845\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and 1.15\u00a0cm. The area under curve (AUC) (95% Confidence Interval, 95% CI) of the combined model is 0.840 (0.750\u20130.930). The favorable calibration of the nomogram showed a non-significant Hosmer\u2013Lemeshow test statistic (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.195). The ICC value (95% CI) of the distance of AV-APR measured by two radiologists was 0.981 (0.969\u20130.989). The height measured by MRI and colonoscopy were correlated with each other (r\u2009=\u20090.699,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). The Kappa value was 0.854.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BMI, pelvic effusion, and the distance from seminal vesicle\/uterus to rectum could affect the visualization of APR on MRI. Also, it\u2019s feasible to measure the distance of AV-APR, the tumor height, and to evaluate the tumor location with regard to APR using MRI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12880-021-00583-7","type":"journal-article","created":{"date-parts":[[2021,3,17]],"date-time":"2021-03-17T07:03:01Z","timestamp":1615964581000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["MRI-based nomogram analysis: recognition of anterior peritoneal reflection and its relationship to rectal cancers"],"prefix":"10.1186","volume":"21","author":[{"given":"Shaoting","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangying","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolu","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minjie","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanyu","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8596-9563","authenticated-orcid":false,"given":"Fu","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianhua","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianping","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,17]]},"reference":[{"key":"583_CR1","doi-asserted-by":"publisher","first-page":"394","DOI":"10.3322\/caac.21492","volume":"68","author":"F Bray","year":"2018","unstructured":"Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. 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