Surgical management of anterior clinoidal meningiomas: consensus statement on behalf of the EANS skull base section.

BACKGROUND: The optimal management of clinoidal meningiomas (CMs) continues to be debated. METHODS: We constituted a task force comprising the members of the EANS skull base committee along with international experts to derive recommendations for the management of these tumors. The data from the literature along with contemporary practice patterns were discussed within the task force to generate consensual recommendations. RESULTS AND CONCLUSION: This article represents the consensus opinion of the task force regarding pre-operative evaluations, patient's counselling, surgical classification, and optimal surgical strategy. Although this analysis yielded only Class B evidence and expert opinions, it should guide practitioners in the management of patients with clinoidal meningiomas and might form the basis for future clinical trials.

Petroclival meningiomas: update of current treatment and consensus by the EANS skull base section.

BACKGROUND: The optimal management of petroclival meningiomas (PCMs) continues to be debated along with several controversies that persist. METHODS: A task force was created by the EANS skull base section along with its members and other renowned experts in the field to generate recommendations for the management of these tumors. To achieve this, the task force reviewed in detail the literature in this field and had formal discussions within the group. RESULTS: The constituted task force dealt with the existing definitions and classifications, pre-operative radiological investigations, management of small and asymptomatic PCMs, radiosurgery, optimal surgical strategies, multimodal treatment, decision-making, and patient's counselling. CONCLUSION: This article represents the consensually derived opinion of the task force with respect to the management of PCMs.

Fat Quality Index and Risk of Cardiovascular Disease in the Sun Project.

OBJECTIVES: To examine the association between a dietary fat quality index (FQI), and the risk of incident cardiovascular events or deaths in the Seguimiento Universidad de Navarra (SUN) cohort. DESIGN: Longitudinal analysis during 10.1 years of median follow-up. Cox models were used to estimate adjusted hazard ratios (HR) of incident cardiovascular diseases (CVD) according to tertiles of FQI and of different fat subtypes. SETTING: University of Navarra, Spain. PARTICIPANTS: 19,341 middle-aged adults. MEASUREMENTS: Fat intake was measured with a validated food-frequency questionnaire. The FQI was calculated according to the ratio: (monounsaturated+polyunsaturated) / (saturated+trans fatty acids). RESULTS: We observed 140 incident cases of CVD. No association was found for FQI (HR=0.94, 95 %CI 0.61-1.47 for the highest vs the lowest tertile, p for trend=0.884). No significant associations were found for different dietary fat subtypes on CVD risk. The results suggest no clear association between a higher FQI and a higher amount of energy from fat and incidence of CVD (p for interaction: 0.259 and p for trend only among participants with a percentage of energy from fat ≥35% of total energy: 0.272). CONCLUSION: In this Mediterranean cohort, the FQI was not associated with cardiovascular events. A "heart-healthy diet" should focus its attention on dietary fat sources and should use an overall dietary pattern approach, rather than limiting the focus on fat subtypes. More research is needed to validate dietary advice on specific fatty acids intake or saturated fatty acids replacements for reducing CVD risk.

Self-perceived level of competitiveness, tension, and dependency and lifestyles in the 'Seguimiento Universidad de Navarra' cohort study.

OBJECTIVE: The objective of this study is to assess the differences in lifestyles according to levels of self-perceived competitiveness, psychological tension, and dependency in a Mediterranean cohort of university graduates. STUDY DESIGN: Levels of personality traits, food consumption, nutrient intake, eating attitudes, physical activity, sedentary lifestyle, and alcohol and tobacco consumption were assessed through a questionnaire administered at baseline. This was a cross-sectional study in the context of the Seguimiento Universidad de Navarra cohort. Participants are 15,346 Spanish adults. RESULTS: Participants with a high level of self-perceived competitiveness consumed more vegetables and fish but less refined grains; they had higher protein intake and healthier eating attitudes. They were more physically active and less likely to be smokers. Participants with a high level of tension or dependency were less physically active, and participants more dependent also had poorer adherence to the Mediterranean diet. CONCLUSIONS: Self-perceived personality traits, especially the trait of competitiveness, are likely to be associated with healthier dietary patterns, better nutrient profile, better eating attitudes, physical activity, and less exposure to smoking. The use of short questions about self-perceived levels of competitiveness, psychological tension, and dependency can contribute to add additional information when assessing lifestyles and diet in adults.

Association between a dietary carbohydrate index and cardiovascular disease in the SUN (Seguimiento Universidad de Navarra) Project.

BACKGROUND AND AIMS: Beyond the quantity of carbohydrate intake, further research is needed to know the relevance of carbohydrate quality following operational indices. No previous longitudinal study has assessed the association between an index for quality of dietary carbohydrate intake and the risk of cardiovascular disease (CVD). Here, we examined the association between a carbohydrate quality index (CQI) and the risk of CVD. METHODS AND RESULTS: We used a validated semi-quantitative 136-item food-frequency questionnaire (FFQ) in a prospective follow-up study of 17,424 middle-aged adults from Spain. The CQI was defined by four criteria: dietary fiber intake, glycemic index, whole-grain/total-grain carbohydrate ratio, and solid/total carbohydrate ratio. We observed 129 incident cases of CVD during 10.1 y of median follow-up. An inverse association for CQI was found (hazard ratio = 0.44, 95% confidence interval (CI): 0.25-0.78 for the highest versus the lowest tertile, p for trend = 0.008). Participants in the highest tertile of the whole-grain/total-grain carbohydrate ratio had 47% lower risk of CVD (95% CI: 0.33-0.85, p for trend = 0.008). Participants with higher baseline CQI and higher baseline energy from carbohydrates had the lowest risk of CVD. CONCLUSION: In this Mediterranean cohort, a better quality of dietary carbohydrates measured by the CQI, showed a significant inverse association with the incidence of CVD. Specially, a higher proportion of carbohydrates from whole grains was strongly inversely associated with CVD. "Heart-healthy" diets should be focused not only on carbohydrate quantity but also on a multidimensional assessment of the type and quality of carbohydrates.

Dietary inflammatory index and anthropometric measures of obesity in a population sample at high cardiovascular risk from the PREDIMED (PREvención con DIeta MEDiterránea) trial.

The dietary inflammatory index (DII) is a new tool to assess the inflammatory potential of the diet. In the present study, we aimed to determine the association between the DII and BMI, waist circumference and waist:height ratio (WHtR). We conducted a cross-sectional study of 7236 participants recruited into the PREvención con DIeta MEDiterránea trial. Information from a validated 137-item FFQ was used to calculate energy, food and nutrient intakes. A fourteen-item dietary screener was used to assess adherence to the Mediterranean diet (MeDiet). Sex-specific multivariable linear regression models were fitted to estimate differences (and 95 % CI) in BMI, waist circumference and WHtR across the quintiles of the DII. All nutrient intakes, healthy foods and adherence to the MeDiet were higher in the quintile with the lowest DII score (more anti-inflammatory values) except for intakes of animal protein, saturated fat and monounsaturated fat. Although an inverse association between the DII and total energy was apparent, the DII was associated with higher average BMI, waist circumference and WHtR after adjusting for known risk factors. The adjusted difference in the WHtR for women and men between the highest and lowest quintiles of the DII was 1·60 % (95 % CI 0·87, 2·33) and 1·04 % (95 % CI 0·35, 1·74), respectively. Pro-inflammatory scores remained associated with obesity after controlling for the effect that adherence to a MeDiet had on inflammation. In conclusion, the present study shows a direct association between the DII and indices of obesity, and supports the hypothesis that diet may have a role in the development of obesity through inflammatory modulation mechanisms.

Carbohydrate quality, weight change and incident obesity in a Mediterranean cohort: the SUN Project.

BACKGROUND/OBJECTIVES: To evaluate the association between the carbohydrate quality index (CQI) and weight change or incident overweight/obesity (body mass index ⩾25 kg/m(2)) in the 'Seguimiento Universidad de Navarra (SUN)' cohort. SUBJECTS/METHODS: A total of 8741 participants who were initially free of overweight/obesity were followed up for a median of 7.9 years. We evaluated at baseline the CQI according to four criteria: dietary fiber intake, glycemic index, whole grains/total grains ratio and solid carbohydrates/total carbohydrates ratio. Subjects were classified into quintiles according to CQI. Weight was recorded at baseline and updated every 2 years during follow-up. RESULTS: Increasing CQI of diet was not significantly associated with lower weight gain, although participants in the highest quintile had the lowest average crude weight gain (+211 g/year). We observed 1862 incident cases of overweight/obesity during follow-up. CQI was significantly associated (P for trend 0.006) with a lower risk of overweight/obesity; adjusted odds ratio for the fourth and fifth quintiles were 0.81 (95% confidence interval (CI): 0.66-0.99) and 0.74 (95% CI: 0.60-0.92), respectively. CONCLUSIONS: In this Mediterranean cohort, CQI showed a significant inverse association with the incidence of overweight/obesity, which highlights that carbohydrate intake guidelines related to obesity prevention should be focused on improving the CQI of the diet.

Parity implications for anthropometrical variables, lifestyle behaviors and dietary habits in pregnant women / Influencia de la paridad sobre variables antropométricas, estilos de vida y hábitos alimentarios en mujeres embarazadas

Background: Maintaining an adequate health status and appropriate lifestyles during pregnancy is of great importance to prevent adverse outcomes for both mother and baby. The present study aimed to assess the nutritional status, socio-demographic features, lifestyle behaviors and dietary habits of pregnant women in Spain, and to identify the influence of parity on these profiles. Methods: This cross-sectional study included pregnant women from regions all over Spain. The information was collected through a 40 item questionnaire, previously validated, by community health professionals. Results: The 5,087 pregnant women analyzed had an average age of 31.9 years with an adequate nutritional status. The distribution of the sample was 56% nulliparous and 44% multiparous. The nulliparous reported a better self-perceived health status and nutritional balance, and a lower incidence of gestational diabetes mellitus. However, the multiparous showed healthier lifestyle habits (lower rates of smoking and alcohol consumption) and more physically active patterns. Regarding diet, nulliparous pregnant women consumed more dairy products, fresh fruit and nuts, and less bread, rice/pasta/potatoes, meat, sausage and buns/pastries than multiparous pregnant women. Conclusions: Differences between analyzed patterns were observed in anthropometrical variables, lifestyle behaviors and dietary habits, which may require different nutritional messages to nulliparous as compared to multiparous from a public health point of view (AU)

Fundamento: Durante el embarazo, el mantenimiento de un adecuado estado de salud y estilos de vida, es de gran importancia para prevenir resultados adversos tanto para la madre como para el bebé. El presente estudio tuvo como objetivos evaluar el estado nutricional, características sociodemográficas, estilos de vida y hábitos alimentarios de mujeres embarazadas en España, e identificar la influencia de la paridad sobre estos perfiles. Material y método: Este estudio transversal incluyó mujeres embarazadas de todas las comunidades autónomas de España. La información se recogió a través de un cuestionario de 40 preguntas, previamente validado, por profesionales de la salud comunitarios. Resultados: Las 5.087 mujeres embarazadas presentaron una edad media de 31,9 años y un adecuado estado nutricional. De la muestra un 56% fueron nulíparas y un 44% multíparas. Las mujeres nulíparas declararon mejor autopercepción de su estado de salud y estado nutricional, y menor incidencia de diabetes mellitus gestacional. Sin embargo, las mujeres multíparas mostraron estilos de vida más saludables (tasas de consumo de tabaco y alcohol más bajas) y un patrón de actividad física más activo. En cuanto a la dieta, las nulíparas consumieron más lácteos, fruta fresca y frutos secos, y menos pan, arroz/pasta/patatas, carne, embutidos y bollos/pasteles que las multíparas. Conclusiones: Se observaron diferencias entre los grupos analizados en cuanto a variables antropométricas, estilos de vida y hábitos alimentarios, que pueden requerir distintos mensajes nutricionales para mujeres nulíparas y multíparas, desde un punto de vista de Salud Pública (AU)

Situación ponderal, hábitos alimentarios y deportivos en población castellano-manchega de 6 a 12 años / Weight status, dietary habits and physical activity among 6-12 year-old children in Castile-La Mancha

INTRODUCCIÓN: La obesidad infantil es una enfermedad multifactorial en la que una alimentación inadecuada y el sedentarismo tienen un papel decisivo. El objetivo de este trabajo ha sido evaluar la situación ponderal, los hábitos alimentarios y de actividad física en escolares de Castilla-La Mancha. Sujetos y métodos: Estudio transversal en 3.061 niños de entre 6 y 12 años participantes en el plan «Alimenta su salud», mediante la aplicación de una encuesta sobre variables antropométricas, frecuencia de consumo de alimentos, hábitos alimentarios y actividad física, analizando diferencias por sexo, grupos de edad y provincias. RESULTADOS: La prevalencia de sobrecarga ponderal fue del 24,0% y la de obesidad del 14,3%, encontrando diferencias en la distribución por provincias. Las chicas realizan más frecuentemente la toma de media mañana, consumen más suplementos y practican menos deporte que los chicos. El seguimiento de dietas especiales y la realización de actividades deportivas es menor en el grupo de 6 a 9 años respecto al de 10-12. En relación con las recomendaciones, el consumo de verduras y frutas es bajo, y elevado para embutidos, bollería, aperitivos salados, golosinas y comida rápida, encontrando diferencias por grupos de edad. CONCLUSIONES: En la población infantil estudiada, la sobrecarga ponderal afecta casi a uno de cada 4 niños, no alcanzándose las recomendaciones de frutas y verduras, y existiendo un consumo elevado de alimentos que se asocian con riesgo de obesidad. El sedentarismo es más frecuente el fin de semana y entre las chicas

INTRODUCTION: Childhood obesity is a multifactorial disease, in which unhealthy dietary patterns and sedentary lifestyles play a decisive role. The aim of this study was to assess the weight status, dietary habits and physical activity in Castile-La Mancha children. Subjects and methods: A cross-sectional study was conducted on 3061 children 6-12 years-old who were participating in the programme, «Alimenta su salud». Anthropometric measurements, food consumption frequency, dietary habits and physical activity were assessed by a questionnaire, including gender, age and geographical influences. RESULTS: The prevalence of subjects with excess weight-for-height was 24.0% and obesity was14.3%, with geographical differences. Girls more often have mid-morning snacks, consume more supplements, and reported to be less active than boys. Special diets and sports activities were lower in children aged 6-9 years as compared to the 10-12 years old group. The intake of vegetables and fruit is low, while there is overconsumption of sausages, pastries, salted snacks, sweets and fast food, with some differences by age group. CONCLUSIONS: One out of four children is overweight or obese in this population. Children do not meet recommendations for fruit and vegetables and there is a high consumption of foods associated with obesity risk. Physical inactivity was more prevalent during the weekends, and among girls

[Weight status, dietary habits and physical activity among 6-12 year-old children in Castile-La Mancha]. / Situación ponderal, hábitos alimentarios y deportivos en población castellano-manchega de 6 a 12 años.

INTRODUCTION: Childhood obesity is a multifactorial disease, in which unhealthy dietary patterns and sedentary lifestyles play a decisive role. The aim of this study was to assess the weight status, dietary habits and physical activity in Castile-La Mancha children. SUBJECTS AND METHODS: A cross-sectional study was conducted on 3061 children 6-12 years-old who were participating in the programme, "Alimenta su salud". Anthropometric measurements, food consumption frequency, dietary habits and physical activity were assessed by a questionnaire, including gender, age and geographical influences. RESULTS: The prevalence of subjects with excess weight-for-height was 24.0% and obesity was 14.3%, with geographical differences. Girls more often have mid-morning snacks, consume more supplements, and reported to be less active than boys. Special diets and sports activities were lower in children aged 6-9 years as compared to the 10-12 years old group. The intake of vegetables and fruit is low, while there is overconsumption of sausages, pastries, salted snacks, sweets and fast food, with some differences by age group. CONCLUSIONS: One out of four children is overweight or obese in this population. Children do not meet recommendations for fruit and vegetables and there is a high consumption of foods associated with obesity risk. Physical inactivity was more prevalent during the weekends, and among girls.

Parity implications for anthropometrical variables, lifestyle behaviors and dietary habits in pregnant women.

BACKGROUND: Maintaining an adequate health status and appropriate lifestyles during pregnancy is of great importance to prevent adverse outcomes for both mother and baby. The present study aimed to assess the nutritional status, socio-demographic features, lifestyle behaviors and dietary habits of pregnant women in Spain, and to identify the influence of parity on these profiles. METHODS: This cross-sectional study included pregnant women from regions all over Spain. The information was collected through a 40 item questionnaire, previously validated by community health professionals. RESULTS: The 5,087 pregnant women analyzed had an average age of 31.9 years with an adequate nutritional status. The distribution of the sample was 56% nulliparous and 44% multiparous. The nulliparous reported a better self-perceived health status and nutritional balance, and a lower incidence of gestational diabetes mellitus. However, the multiparous showed healthier lifestyle habits (lower rates of smoking and alcohol consumption) and more physically active patterns. Regarding diet, nulliparous pregnant women consumed more dairy products, fresh fruit and nuts, and less bread, rice/pasta/potatoes, meat, sausage and buns/pastries than multiparous pregnant women. CONCLUSIONS: Differences between analyzed patterns were observed in anthropometrical variables, lifestyle behaviors and dietary habits, which may require different nutritional messages to nulliparous as compared to multiparous from a public health point of view.

Perinatal and parental determinants of childhood overweight in 6-12 years old children.

UNLABELLED: INTRODUCTION & AIMS: The identification of determinants of childhood overweight is crucial to early diagnosis and prevention. The aim of this study was to assess perinatal and parental related risk factors concerning children for having excessive body weight. METHODS: Cross-sectional study involving 3,101 children participating in the programme "Alimenta su salud" conducted in Castilla-La Mancha (Spain). Anthropometric and sociodemographic data were obtained from a general questionnaire. Analysed factors as potential predictors of childhood overweight were sex, age, birth weight, infant feeding, number of siblings, as well as parental marital status, educational level and obesity. Prevalence of overweight stratified by potential determinants was assessed. Univariate and multivariate logistic regression analyses were used to examine the associations between variables and the likelihood of being overweight. RESULTS: The overweight prevalence (including obesity) was 30.3% in boys and 28.3% in girls, according to the IOTF criteria. Higher rates in younger subjects and some gender differences were observed. Parental obesity was the most important predictive variable for childhood overweight in both sexes and birth weight over 3,500 g in girls (OR 1.8, 95% CI 1.3-2.3). Having one or more siblings (OR 0.7, 95% CI 0.5-0.9) and higher paternal education (OR 0.8, 95% CI 0.6-0.9) in boys, and older age in girls (OR 0.7, 95% CI 0.5-.09), resulted protective factors against childhood overweight. No independent effects of marital status, maternal education and infant feeding patterns on childhood excess weight were identified. CONCLUSIONS: Perinatal and parental factors could contribute to predict the risk of being overweight/obese in children aged 6 to 12 years, which should be considered when formulating obesity prevention and intervention strategies, stressing the importance of targeting obese parents with young children.

Perinatal and parental determinants of childhood overweight in 6-12 years old children / Determinantes perinatales y paternos asociados al riesgo de sobrepeso en niños de 6 a 12 años

Introduction & aims: The identification of determinants of childhood overweight is crucial to early diagnosis and prevention. The aim of this study was to assess perinatal and parental related risk factors concerning children for having excessive body weight. Methods: Cross-sectional study involving 3,101 children participating in the programme "Alimenta su salud" conducted in Castilla-La Mancha (Spain). Anthropometric and sociodemographic data were obtained from a general questionnaire. Analysed factors as potential predictors of childhood overweight were sex, age, birth weight, infant feeding, number of siblings, as well as parental marital status, educational level and obesity. Prevalence of overweight stratified by potential determinants was assessed. Univariate and multivariate logistic regression analyses were used to examine the associations between variables and the likelihood of being overweight. Results: The overweight prevalence (including obesity) was 30.3% in boys and 28.3% in girls, according to the IOTF criteria. Higher rates in younger subjects and some gender differences were observed. Parental obesity was the most important predictive variable for childhood overweight in both sexes and birth weight over 3,500 g in girls (OR 1.8, 95% CI 1.3-2.3). Having one or more siblings (OR 0.7, 95% CI 0.5-0.9) and higher paternal education (OR 0.8, 95% CI 0.6-0.9) in boys, and older age in girls (OR 0.7, 95% CI 0.5-.09), resulted protective factors against childhood overweight. No independent effects of marital status, maternal education and infant feeding patterns on childhood excess weight were identified. Conclusions: Perinatal and parental factors could contribute to predict the risk of being overweight/obese in children aged 6 to 12 years, which should be considered when formulating obesity prevention and intervention strategies, stressing the importance of targeting obese parents with young children (AU)

Objetivos: Identificar los determinantes del sobrepeso infantil resulta clave para la prevención y diagnóstico precoz. El objetivo de este trabajo fue evaluar factores perinatales y paternos asociados al riesgo de sobrepeso y obesidad infantil. Métodos: Estudio transversal en 3.101 niños participantes en el programa "Alimenta su salud" llevado a cabo en Castilla-La Mancha. Los datos antropométricos y sociodemográficos fueron obtenidos mediante la aplicación de una encuesta. Las variables consideradas como potenciales predictores de sobrepeso infantil fueron sexo, edad, peso al nacer, lactancia recibida y número de hermanos de los niños, así como estado civil, nivel educativo y obesidad en los padres. El estudio analizó la frecuencia de sobrepeso estratificada por los potenciales factores de riesgo y se empleó regresión lineal univariante y multivariante para estudiar la asociación entre las variables candidatas y la probabilidad de tener sobrepeso. Resultados: La prevalencia de sobrecarga ponderal (incluyendo obesidad) fue del 30,3% en los varones y el 28,3% en las niñas, de acuerdo con los criterios de IOTF. Los mayores porcentajes de exceso de peso se observaron en edades más tempranas con diferencias en función del sexo. La obesidad en los padres resultó el factor de riesgo más importante de sobrepeso y obesidad infantil en ambos sexos y en las chicas además, un peso al nacer mayor de 3.500 g (OR 1,8 IC 95% de 1,3-2,3). Por otro lado, tener uno o más hermanos (OR 0,7 IC 95% de 0,5-0,9) y un mayor nivel educativo paterno (OR 0,8 IC 95% de 0,6-0,9) resultaron factores protectores frente al sobrepeso infantil en chicos. La probabilidad de tener sobrepeso fue menor en las chicas de mayor edad (OR 0,7 IC 95% de 0,5 a 0,9). No se identificó un efecto independiente del estado civil, la educación materna o la lactancia recibida asociado al riesgo de sobrepeso infantil. Conclusiones: Ciertos factores perinatales y paternos pueden contribuir a predecir el riesgo de sobrepeso/obesidad en niños de 6 a 12 años, por lo que deberían ser considerados en el diseño de estrategias orientadas a la prevención e intervención precoz, haciendo hincapié en aquellas dirigidas a los padres obesos con niños pequeños (AU)

Egg consumption and risk of cardiovascular disease in the SUN Project.

BACKGROUND/OBJECTIVES: Egg consumption has been associated with the risk of cardiovascular diseases (CVDs), but evidence is scarce and inconsistent. Our aim was to examine the association between egg consumption and incidence of CVD in a prospective dynamic Mediterranean cohort of 14,185 university graduates. SUBJECTS/METHODS: Egg intake was assessed using a 136-item-validated food-frequency questionnaire. Baseline consumption was categorized into no consumption or <1 egg/week, 1 egg/week, 2-4 eggs/week and >4 eggs/week. The presence of cardiovascular risk factors was assessed by questionnaire at baseline, and the incidence of CVD was assessed using biennial assessments. The median follow-up was 6.1 years. Cox regression models were fitted to estimate multivariable-adjusted hazard ratios (HRs) for CVD (myocardial infarction, revascularization procedures or stroke). Outcomes were confirmed by review of medical records. RESULTS: During a median follow-up of 6.1 years, 91 new confirmed cases of CVD were observed. No association was found between egg consumption and the incidence of CVD (HR: 1.10, 95% confidence interval: 0.46-2.63) for the highest versus the lowest category of egg consumption after adjusting for age, sex, total energy intake, adherence to the Mediterranean food pattern and other cardiovascular risk factors. Results were robust to different analytical scenarios. CONCLUSIONS: No association between egg consumption and the incidence of CVD was found in this Mediterranean cohort.

Papel de la difusión en la evaluación de los meningiomas: correlación radiopatológica / The role of diffusion-weighted imaging in the evaluation of meningiomas: radio-pathologic correlation

Objetivo: Estudiar el comportamiento de los meningiomas en secuencias de difusión y su correlación histopatológica. Material y métodos: Se incluyeron prospectivamente pacientes operados de meningiomas durante 2 años en nuestro hospital. Se estudiaron 30 meningiomas en 28 pacientes entre 31 y 85 años. Todos los pacientes fueron estudiados en una unidad de resonancia magnética de 1,5T antes de la intervención, incluyendo imágenes potenciadas en difusión (IPD). La intensidad de señal se valoró en imágenes potenciadas en T2, IPD (b=1.000) y mapas del coeficiente de difusión aparente (CDA), dentro del tumor y en la sustancia blanca parietal como referencia. En el estudio histopatológico se analizaron la celularidad, el índice de proliferación, el grado histológico y la invasión cerebral. Resultados: De los 30 meningiomas, 22 fueron grado I de la Organización Mundial de la Salud y 8 atípicos o grado II. El valor medio del CDA fue 89.19±13,95×10–3mm2/s. En el grupo de meningiomas atípicos fue de 82±13,69×10–3mm2/s, y en el grupo de típicos de 92,21±13,21×10–3mm2/s. No se encontraron diferencias estadísticamente significativas entre los 2 grupos. Dos subtipos de meningiomas típicos, los secretores y el angiomatoso, presentaron los valores más altos en los mapas CDA. En el análisis histológico se observó una asociación significativa entre la celularidad tumoral y la señal en el mapa CDA. Conclusión: Los meningiomas presentan una restricción moderada de la difusión. La señal en el mapa CDA se asocia con la celularidad tumoral pero no se ha demostrado su utilidad para predecir el grado histológico (AU)

Objectives: To describe the ultrasonographic findings in liver abscesses after the administration of a second generation agent. To perform the differential diagnosis of liver abscesses with other focal liver lesions. Material and methods: We evaluated 28 liver abscesses in 5 patients before and after the administration of SonoVue. We also evaluated liver lesions in six patients in whom the differential diagnosis with liver abscess was considered in the baseline ultrasonographic examination. Results: A typical enhancement pattern consisting of peripheral ring enhancement in the arterial phase and absence of central enhancement was observed in 21 (75%) abscesses. In another 6 (21.4%) abscesses, arterial enhancement was seen in large areas of the lesion, while other areas showed no uptake. One case (3.6%) had a multiseptated pattern of enhancement. Segmental hepatic enhancement was observed in 6 abscesses. In the liver lesions in which the differential diagnosis with abscess was carried out, 5 of the 6 showed no enhancement in any phase. The other lesion, a cystic metastasis, had irregular peripheral enhancement in the arterial phase. None of these lesions had segmental hepatic enhancement in the arterial phase. Conclusions: Contrast administration improves the performance of ultrasonography in the diagnosis of liver abscesses. There are three patterns of enhancement and these correlate well with the findings at CT and MRI. Contrast-enhanced ultrasonography is very useful for defining the internal architecture of the abscess, which is important for choosing the type of treatment. Contrast-enhanced ultrasonography also enables the differential diagnosis with other focal liver lesions (AU)

[Symptomatic xanthogranuloma of the lateral ventricle]. / Xantogranuloma sintomático del ventrículo lateral. A propósito de un caso.

Xanthogranulomas of the choroid plexus is a benign tumour of uncertain etiology, usually asymptomatic. We report a case of symptomatic xanthogranuloma of the left lateral ventricle with edema in adjacent white matter, in a 62-year-old man with seizures.

[The role of diffusion-weighted imaging in the evaluation of meningiomas: radio-pathologic correlation]. / Papel de la difusión en la evaluación de los meningiomas: correlación radiopatológica.

OBJECTIVE: To study the behavior of meningiomas in diffusion-weighted sequences and the correlation of these findings with the histological findings. MATERIAL AND METHODS: We prospectively included all patients operated on for meningiomas at our hospital during two years. We studied 30 meningiomas in 28 patients aged 31 to 85 years old. All patients underwent MRI prior to surgery, including diffusion-weighted sequences, in a 1.5 T scanner. We evaluated the signal intensity in T2-weighted images, diffusion-weighted images (b=1,000), and apparent diffusion coefficient (ADC) maps within the tumor and in the parietal white matter as a reference. In the histological study, cellularity, proliferation index, histological grade, and cerebral invasion were evaluated. RESULTS: Of the 30 meningiomas, 22 were World Health Organization (WHO) grade I and 8 were atypical or WHO grade II. The overall mean value of the ADC was 89.19+/-13.95x10(-3) mm2/s; the mean ADC value was 82+/-13.69x10(-3) mm2/s in the atypical group and 92.21+/-13.21x10(-3) mm2/s in the typical group. No statistically significant differences were found between the 2 groups. Two subtypes of typical meningiomas, secretory and angiomatous meningiomas, had the highest values in the ADC maps. In the histological analysis, there was a significant association between tumor cellularity and the signal in the ADC map. CONCLUSION: Meningiomas show moderately restricted diffusion. The signal on the ADC map is associated with tumor cellularity but we have not demonstrated its usefulness for predicting the histological grade.

Xantogranuloma sintomático del ventrículo lateral. A propósito de un caso / Symptomatic xanthogranuloma of the lateral ventricle

El xantogranuloma del plexo coroideo es un tumorbenigno de etiología incierta, que generalmente esasintomático. Presentamos un caso de xantogranulomadel atrio ventricular izquierdo sintomático con edemade la sustancia blanca adyacente, en un paciente varónde 62 años con crisis comiciales de inicio reciente (AU)

Xanthogranulomas of the choroid plexus is a benigntumour of uncertain etiology, usually asymptomatic.We report a case of symptomatic xanthogranuloma ofthe left lateral ventricle with edema in adyacent whitematter, in a 62-year-old man with seizures (AU)