Background: First described by Carl Toldt in the late 19th century, the mesorectum has since been a topic of anatomical and surgical debate. Its clinical importance was redefined by Heald’s introduction of Total Mesorectal Excision (TME), nowadays the golden standard in oncologic rectal surgery. This study aims to elucidate the embryological development and adult anatomy of the mesorectum and the mesorectal fascia, with a focus on clinically significant relations, particularly the peritoneum, and components of the hypogastric plexuses. Methods: We performed anatomical dissections on four 12–15-week-old human fetuses and eight formalin-fixed adult cadavers. In addition, a transverse pelvic section was examined to assess the spatial organization of mesorectal and fascial structures. Results: Our findings confirm the presence of a dorsal mesentery at the rectal level during fetal development, illustrating its transformation into the adult mesorectum. We identified the mesorectal contents in the fetus and examined the course and relations of the superior rectal vessels, hypogastric nerves, and pelvic splanchnic nerves, in both fetal and adult specimens. Conclusions: The observed fetal and adult configurations provide a continuous morphological description of the mesorectum and its compartmental organization within the pelvis. This study enhances the understanding of the mesorectum’s embryology, structure, and vital surgical landmarks. By delineating the so-called ‘Holy plane’ of Heald (the natural avascular plane between the mesorectal and presacral fasciae used during total mesorectal excision) and the delicate connective fibers known surgically as ‘angel’s hair’, which become visible when this plane is correctly entered, rectal and presacral fasciae, and neurovascular elements, provides a comprehensive anatomical framework that may inform surgical plane identification and support future clinical investigations into nerve-sparing rectal surgery.

Background: The foramen of Arnold (FA) and foramen of Vesalius (FV) are two inconstant small openings through the greater wing of the sphenoid bone. When FA is present, the lesser petrosal nerve passes through it. FV usually contains an emissary vein that connects the cavernous sinus to the pterygoid plexus. Objectives: To assess the presence, unilaterally or bilaterally, of the aforementioned inconstant foramina in order to gain a better insight into the anatomic variability of the middle cranial fossa. Methods: We analyzed five hundred random unenhanced CT examinations of human dry skulls from the “Francisc I. Rainer” Craniological Collection of the Human Anthropological Institute in Bucharest, Romania. The collection holds substantial anthropological and radiological value, as dry skulls allow the use of higher spatial-resolution imaging parameters and thus better detection of the small osseous structures. All scans were performed on the same Multi-Detector Computed Tomography (MDCT) scanner (Canon Aquilion One 64 slice, Canon Medical Systems Corporation) in the Department of Radiology of the Bucharest Emergency University Hospital. After collecting data, appropriate statistical analysis was performed. Results: FA was absent in 355 (71%) skulls and present in 145 (29%) skulls, bilaterally in 33 (6.6%) skulls, and unilaterally in 112 (22.4%) skulls. FV was absent in 151 (30.2%) skulls and present in 349 (69.8%) skulls, bilaterally in 223 (44.6%) skulls, and unilaterally in 126 (25.2%) skulls. Conclusions: The great variability in the prevalence of these foramina may be partly explained by the different methods of analysis of the skull base, as well as the different population subgroups on which the research has been focused. Knowledge of this variability holds great importance for anatomists, anthropologists, as well as clinicians who interact with this complex area.

Purpose: This study aimed to determine the associations of apparent diffusion coefficient (ADC) values with the molecular and histological subtypes of adult-type diffuse gliomas classified in accordance with the 2021 World Health Organization (WHO) Classification of Tumors of the Central Nervous System, fifth edition (WHO CNS5). Methods: PubMed, Scopus, Cochrane and Google Scholar were searched to identify relevant studies up to December 2025. The search and selection strategies followed the relevant items of the PRISMA 2020 statement. Open-access studies, written in English, that targeted the imaging characterization of adult-type diffuse gliomas classified based on WHO CNS5 and presented quantitative ADC data were included. Studies targeting pediatric gliomas, adult gliomas classified after prior editions of the WHO Classification of Tumors of the Central Nervous System or not presenting numerical ADC values were excluded. Due to high heterogeneity in imaging methodologies, ADC acquisition, ADC quantification and diagnostic targets, meta-analysis was not considered methodologically appropriate. Instead, quantitative data are further presented through a structured narrative synthesis. The quality of the selected studies was analyzed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. This review was not registered and received no funding. Results: Fifteen eligible studies were selected, including a total of 1706 glioma patients. The reported ADC metrics and imaging protocols presented significant variability across studies. IDH-wildtype gliomas exhibited the lowest ADC values (0.78–1.48 × 10⁻ ³ mm ² /s). An inverse correlation between the histological grade and ADC values was observed. The mean ADC sensitivity for IDH status ranged from 65.4% to 85.9%, with a broader range in diagnostic specificity (35–91.4%). Conclusion: ADC may serve as an accessible imaging biomarker for the noninvasive characterization and differential diagnosis of WHO CNS5-classified adult-type diffuse gliomas. However, its stand-alone diagnostic utility remains limited due to the heterogeneity in acquisition, measurement and reporting methods, which show overlapping of ADC values between tumor subtypes and variable diagnostic performance. Furthermore, variability in reporting and methodology limits the standardization of diagnostic thresholds.