MRI Findings of Desmoplastic Infantile Ganglioglioma: A Case Report and Analysis.

Desmoplastic infantile gangliogliomas (DIG) are rare intracranial tumors that predominantly affect children. They are characterized by a mixture of glial and neuronal components interspersed with abundant fibrous stroma and are typically located on the surface of the cerebral hemispheres. In this case report, we present a seven-year-old male child with a late presentation of DIG, which is typically diagnosed between zero and 60 months of age. We discuss the MRI findings, clinical symptoms, and differential diagnosis of DIG in patients with this central nervous system tumor.

Whole-Body MRI in Musculoskeletal Oncology: A Comprehensive Review with Recommendations.

Whole-body (WB) MRI has emerged as an attractive method for oncologic evaluation, potentially replacing conventional imaging modalities and providing a one-step wide-coverage assessment of both the skeleton and soft tissues. In addition to providing anatomic information, WB MRI may also yield a functional analysis with the inclusion of diffusion-weighted imaging (DWI). DWI translates microstructural changes, resulting in an excellent alternative to fluorodeoxyglucose PET/CT. WB MRI (with DWI) offers comparable accuracy to PET/CT and has the advantage of avoiding ionizing radiation. Technological advances and the development of faster protocols have prompted greater accessibility of WB MRI, with growing applications in routine practice for the diagnosis, staging, and follow-up of cancer. This review discusses the technical considerations, clinical applications, and accuracy of WB MRI in musculoskeletal oncology. Keywords: Pediatrics, MR Imaging, Skeletal-Axial, Skeletal-Appendicular, Soft Tissues/Skin, Bone Marrow, Extremities, Oncology, Musculoskeletal Imaging © RSNA, 2023.

Similarities and controversies in imaging of pediatric renal tumors: A SIOP-RTSG and COG collaboration.

Malignant renal tumors are rare in children, and Wilms tumors (WTs) are the most common subtype. Imaging plays an essential role in the diagnosis, staging, and follow-up of these patients. Initial workup for staging is mainly performed by cross-sectional imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). Imaging approach within the two core international groups, the Children's Oncology Group (COG, North America) and the International Society of Pediatric Oncology - Renal Tumor Study Group (SIOP-RTSG, Europe), differs. Whereas abdominal ultrasound (US) is used for the initial diagnosis of a suspected pediatric renal tumor globally, COG protocols support the use of CT or MRI for locoregional staging, contrary to the preference for MRI over CT for abdominopelvic evaluation within the SIOP-RTSG. The purpose of this manuscript is to summarize current imaging approaches, highlighting differences and similarities within these core international groups, while focusing on future innovative efforts and collaboration within the HARMONICA initiative.

MRI Characteristics of Pediatric Renal Tumors: A SIOP-RTSG Radiology Panel Delphi Study.

BACKGROUND: The SIOP-Renal Tumor Study Group (RTSG) does not advocate invasive procedures to determine histology before the start of therapy. This may induce misdiagnosis-based treatment initiation, but only for a relatively small percentage of approximately 10% of non-Wilms tumors (non-WTs). MRI could be useful for reducing misdiagnosis, but there is no global consensus on differentiating characteristics. PURPOSE: To identify MRI characteristics that may be used for discrimination of newly diagnosed pediatric renal tumors. STUDY TYPE: Consensus process using a Delphi method. POPULATION: Not applicable. FIELD STRENGTH/SEQUENCE: Abdominal MRI including T1- and T2-weighted imaging, contrast-enhanced MRI, and diffusion-weighted imaging at 1.5 or 3 T. ASSESSMENT: Twenty-three radiologists from the SIOP-RTSG radiology panel with ≥5 years of experience in MRI of pediatric renal tumors and/or who had assessed ≥50 MRI scans of pediatric renal tumors in the past 5 years identified potentially discriminatory characteristics in the first questionnaire. These characteristics were scored in the subsequent second round, consisting of 5-point Likert scales, ranking- and multiple choice questions. STATISTICAL TESTS: The cut-off value for consensus and agreement among the majority was ≥75% and ≥60%, respectively, with a median of ≥4 on the Likert scale. RESULTS: Consensus on specific characteristics mainly concerned the discrimination between WTs and non-WTs, and WTs and nephrogenic rest(s) (NR)/nephroblastomatosis. The presence of bilateral lesions (75.0%) and NR/nephroblastomatosis (65.0%) were MRI characteristics indicated as specific for the diagnosis of a WT, and 91.3% of the participants agreed that MRI is useful to distinguish NR/nephroblastomatosis from WT. Furthermore, all participants agreed that age influenced their prediction in the discrimination of pediatric renal tumors. DATA CONCLUSION: Although the discrimination of pediatric renal tumors based on MRI remains challenging, this study identified some specific characteristics for tumor subtypes, based on the shared opinion of experts. These results may guide future validation studies and innovative efforts. LEVEL OF EVIDENCE: 3 Technical Efficacy Stage: 3.

Dynamic evaluation of swallowing in pediatric patients with dysphagia: The Brazilian perspective.

Dynamic Evaluation of Swallowing (DES) is an exam which provides invaluable information on the swallowing function. This review describes the requirements, protocols and processes for DES in regions of Brazil. Dysphagia is a swallowing abnormality, in one or more swallowing phases, with risk and/or occurrence of aspiration, damage regarding nutrition and/or hydration and possible need of nonoral feeding methods. DES is performed in an armored room, using fluoroscopy, with the patient in lateral and anteroposterior views, in an orthostatic position. Different consistencies and volumes are tested, depending on the patient's age, complaint and clinical conditions. Its main objective is to determine if the patient can safely eat orally, is able to meet his basic nutritional and hydration needs, or if alternative means of feeding are necessary. It allows anatomical observation of structures, and the dynamics of swallowing during oral, pharyngeal and esophageal phases, in real time. The DES is used worldwide for pediatric patients, from newborns to adolescents, for a complete assessment. In Brazil, the exam is the state of the art in the functional evaluation of swallowing, however it is only available to a fraction of the population, mostly in the largest, and economically developed cities, and usually restricted to major health centers and teaching hospitals. Implementing DES in healthcare units requires radiological equipment, infrastructure standards, availability and training of personnel, as well as specialized physicians, and speech-language pathologists. For these reasons, our services face daily challenges while managing long scheduling waiting lists.

Preliminary report from the World Health Organisation Chest Radiography in Epidemiological Studies project.

Childhood pneumonia is among the leading infectious causes of mortality in children younger than 5 years of age globally. Streptococcus pneumoniae (pneumococcus) is the leading infectious cause of childhood bacterial pneumonia. The diagnosis of childhood pneumonia remains a critical epidemiological task for monitoring vaccine and treatment program effectiveness. The chest radiograph remains the most readily available and common imaging modality to assess childhood pneumonia. In 1997, the World Health Organization Radiology Working Group was established to provide a consensus method for the standardized definition for the interpretation of pediatric frontal chest radiographs, for use in bacterial vaccine efficacy trials in children. The definition was not designed for use in individual patient clinical management because of its emphasis on specificity at the expense of sensitivity. These definitions and endpoint conclusions were published in 2001 and an analysis of observer variation for these conclusions using a reference library of chest radiographs was published in 2005. In response to the technical needs identified through subsequent meetings, the World Health Organization Chest Radiography in Epidemiological Studies (CRES) project was initiated and is designed to be a continuation of the World Health Organization Radiology Working Group. The aims of the World Health Organization CRES project are to clarify the definitions used in the World Health Organization defined standardized interpretation of pediatric chest radiographs in bacterial vaccine impact and pneumonia epidemiological studies, reinforce the focus on reproducible chest radiograph readings, provide training and support with World Health Organization defined standardized interpretation of chest radiographs and develop guidelines and tools for investigators and site staff to assist in obtaining high-quality chest radiographs.

Microcephaly and Zika virus: neonatal neuroradiological aspects.

PURPOSE: The aim of this study is to describe some radiological features in the newborns with microcephaly caused by Zika virus infection during pregnancy. METHODS: We radiologically analyzed 13 cases of newborns with microcephaly born to mothers who were infected by the Zika virus in the early stage of pregnancy. RESULTS: The most frequently observed radiological findings were microcephaly and decreased brain parenchymal volume associated with lissencephaly, ventriculomegaly secondary to the lack of brain tissue (not hypertensive), and coarse and anarchic calcifications mainly involving the subcortical cortical transition, and the basal ganglia. CONCLUSIONS: Although it cannot be concluded that there is a definitive pathognomonic radiographic pattern of microcephaly caused by Zika virus, gross calcifications and anarchic distribution involving the subcortical cortical transition and the basal ganglia, in association with lissencephaly and in the absence of hypertensive ventriculomegaly, are characteristic of this type of infection.

Low-dose radiation protocol using 3D mode in a BGO PET/CT.

BACKGROUND: The use of positron emission tomography combined with computed tomography (PET/CT) has brought about significant technological advancement in diagnostic imaging, and a number of PET/CT scanners with bismuth germanate detectors can perform imaging in both 2D and 3D acquisition modes. Nevertheless, certain image acquisition parameters and physical features of patients have to be considered when designing low-dose protocols in the 3D mode. PURPOSE: The aim of this study was to compare images acquired in 2D and 3D modes and establish a low-dose protocol for use in PET/CT imaging, decreasing patient exposure to radiation without compromising results. METHODS: A total of 30 patients, aged 4-72 years, participated in this prospective study, which was conducted at Albert Einstein Hospital, São Paulo, Brazil. Images were evaluated for picture quality, presence/absence of lesions and the number of lesions that were detectable in both acquisition modes. RESULTS: The results consistently showed that the loss in image quality in the 3D mode did not affect exam interpretation and lesion detection when compared with 2D at higher dose and for a longer time. CONCLUSIONS: We therefore conclude that administration of 3.7 MBq [(18)F]-fluorodeoxyglucose (FDG)/kg for an acquisition time of 3 min per FOV (field of view) is optimal for image acquisition in the 3D mode. This protocol, which reduces the acquisition time and radiation dose, is quite beneficial, especially for children.

Análise quantitativa da deglutição de parkinsonianos pré e pós-riboflavina / Quantitative analysis of swallowing in parkinson´s disease before and after riboflavin

Objetivo verificar as mudanças quantitativas na dinâmica da deglutição em pacientes portadores da doença de Parkinson, submetidos à administração de riboflavina e restrição de carnes vermelhas e de aves, no período de um ano. Métodos participaram do estudo 16 pacientes com doença de Parkinson, com media de idade de 67,25 anos, media do nível de severidade da doença de II para III e com media de 3,5 anos de tempo de diagnóstico da doença. As avaliações videofluoroscópicas da deglutição foram realizadas antes e após um ano de administração de riboflavina e restrição de carne vermelha e de aves. Foram analisadas presença de queixas relacionadas à deglutição e análise quantitativa por meio de medidas computadorizadas do deslocamento do osso hióide e da cartilagem cricóidea, abertura da transição faringoesofágica (TFE) e da constrição da faringe. Resultados verificou-se redução no percentual de queixas relacionadas à deglutição no momento pós-administração de riboflavina. Com relação às medidas quantitativas, observou-se no momento pós um discreto aumento na abertura da TFE para todas as consistências oferecidas, aumento da constrição da faringe para a consistência líquido engrossado, discreta redução dos valores de deslocamento do osso hióide, e tanto discreta redução como discreto aumento dos valores de deslocamento da cartilagem cricóidea dependendo da consistência alimentar, sendo redução significante para o líquido. Conclusões as medidas quantitativas realizadas na movimentação dos órgãos relacionados à deglutição não demonstraram diferenças significantes ...

Purpose to verify the quantitative changes in the swallowing dynamics in patients with Parkinson´s disease submitted to treatment with riboflavin, red meat and poultry removed during one year period. Methods sixteen patients with Parkinson´s disease participated in the study; the mean age was 67.25 years, the mean degree of disease severity was II to III, and the mean time since the diagnosis of the disease was 3.5 years. Videofluoroscopic evaluations were performed before and one year after treatment with riboflavin and diet with restriction of read meat and poultry. Analyzed were presence of complaints related to swallowing and quantitative analyses of swallowing includind computerized measurements of hyoid bone and cricoid cartilage displacement, opening of the superior esophageal sphincter and pharyngeal constriction. Results decrease of complaints was observed after administration of riboflavin. About the quantitative measures after riboflavin, there were a increase in the opening of the superior esophageal sphincter for all consistencies offered, an increase in the pharyngeal constriction for the thickened liquid, a reduction in the hyoide bone displacement, and an increase or a reduction in the cricoid cartilage displacement for each consistency, with significant reduction for the liquid. Conclusion quantitative measurements made in the movement of organs associated with swallowing showed no significant differences between pre-and post-riboflavin, and red meat and poultry removed. .

Disfagia associada à disfonia psicogênica: relato de caso / Dysphagia associated to psychogenic dysphonia: case report

O objetivo deste trabalho foi descrever a evolução de um caso de disfagia orofaríngea associada à disfonia psicogênica. Paciente do sexo feminino, 47 anos, com queixa de difi culdade progressiva de deglutição de saliva e de alimentos. Foi submetida às avaliações fonoaudiológica e otorrinolaringológica por meio da videonasoendoscopia da deglutição, sendo diagnosticada disfagia orofaríngea leve. Portanto foi iniciada a fonoterapia. A recuperação total do quadro de disfagia ocorreu após a sexta sessão de fonoterapia. O estudo dinâmico da deglutição por imagem-fluoroscopia revelou resultado normal. Por outro lado, a paciente passou a apresentar quadro de afonia, com tosse presente e sonora, sendo diagnosticada como disfonia psicogênica. Neste momento, o objetivo da fonoterapia foi resgatar a efetividade fonatória. A paciente recebeu alta fonoaudiológica após duas sessões de fonoterapia com enfoque em voz.(AU)

The purpose of this article was to describe the rehabilitation of a case with dysphagia associated to psychogenic dysphonia. A 47 years old female with progressive complaints of difficulties to swallow salivaand food. The patient was submitted to clinical and videonasoendoscopic swallowing evaluations and she was diagnosed with mild oropharyngeal dysphagia. She underwent swallowing rehabilitation therapy. The recovery of the swallowing symptoms occurred after the 6th therapy session. The videofluoroscopy was normal. Although the patient began to present aphonia with strong and sonorous cough, it was diagnosed as psychogenic dysphonia. At this time, the goal of rehabilitation was to reestablish the phonatory effectiveness. The full recovery was after two voice sessions.(AU)

El objetivo de este estudio fue describir la evolución de un caso de disfagia orofaríngea asociada con disfonía psicógena. Paciente de sexo femenino, 47 años, quejándose de difi cultad progresiva para tragar la saliva y los alimentos. Fue sometido a evaluaciones audiológicas y otorrinolaringológicas través de la fibroscopia de la deglución, fue diagnosticado disfagia orofaríngea leve. Así comenzó la terapia. La recuperación total de la disfagia se produjo después del sexto período de sesiones de terapia de la deglución. Después se llevó a cabo la videofluoroscopia de la deglución, que mostró los resultados normales. Sin embargo, el paciente comenzó a mostrar afonía y tose con sonido, que fueron diagnosticadas como disfonía psicógena. En este momento, la meta de la terapia de la deglución era demostrar la eficacia de la fonación. El paciente fue dado de alta después de dos sesiones de terapia con enfoque en la voz.(AU)

Disfagia associada à disfonia psicogênica: relato de caso / Dysphagia associated to psychogenic dysphonia: case report

O objetivo deste trabalho foi descrever a evolução de um caso de disfagia orofaríngea associada à disfonia psicogênica. Paciente do sexo feminino, 47 anos, com queixa de difi culdade progressiva de deglutição de saliva e de alimentos. Foi submetida às avaliações fonoaudiológica e otorrinolaringológica por meio da videonasoendoscopia da deglutição, sendo diagnosticada disfagia orofaríngea leve. Portanto foi iniciada a fonoterapia. A recuperação total do quadro de disfagia ocorreu após a sexta sessão de fonoterapia. O estudo dinâmico da deglutição por imagem-fluoroscopia revelou resultado normal. Por outro lado, a paciente passou a apresentar quadro de afonia, com tosse presente e sonora, sendo diagnosticada como disfonia psicogênica. Neste momento, o objetivo da fonoterapia foi resgatar a efetividade fonatória. A paciente recebeu alta fonoaudiológica após duas sessões de fonoterapia com enfoque em voz...

The purpose of this article was to describe the rehabilitation of a case with dysphagia associated to psychogenic dysphonia. A 47 years old female with progressive complaints of difficulties to swallow salivaand food. The patient was submitted to clinical and videonasoendoscopic swallowing evaluations and she was diagnosed with mild oropharyngeal dysphagia. She underwent swallowing rehabilitation therapy. The recovery of the swallowing symptoms occurred after the 6th therapy session. The videofluoroscopy was normal. Although the patient began to present aphonia with strong and sonorous cough, it was diagnosed as psychogenic dysphonia. At this time, the goal of rehabilitation was to reestablish the phonatory effectiveness. The full recovery was after two voice sessions...

El objetivo de este estudio fue describir la evolución de un caso de disfagia orofaríngea asociada con disfonía psicógena. Paciente de sexo femenino, 47 años, quejándose de difi cultad progresiva para tragar la saliva y los alimentos. Fue sometido a evaluaciones audiológicas y otorrinolaringológicas través de la fibroscopia de la deglución, fue diagnosticado disfagia orofaríngea leve. Así comenzó la terapia. La recuperación total de la disfagia se produjo después del sexto período de sesiones de terapia de la deglución. Después se llevó a cabo la videofluoroscopia de la deglución, que mostró los resultados normales. Sin embargo, el paciente comenzó a mostrar afonía y tose con sonido, que fueron diagnosticadas como disfonía psicógena. En este momento, la meta de la terapia de la deglución era demostrar la eficacia de la fonación. El paciente fue dado de alta después de dos sesiones de terapia con enfoque en la voz...

Lactose malabsorption, calcium intake, and bone mass in children and adolescents.

OBJECTIVES: The objective of the present study was to evaluate the calcium intake and bone mass in children and early adolescents in accordance with their absorption capacity to lactose. PATIENTS AND METHODS: A transversal study was conducted on a sample composed of 76 individuals. Lactose malabsorption status was determined with hydrogen breath test. The hydrogen breath test was applied using 2  g of lactose per kilogram of weight up to a maximum of 50  g. A hydrogen increment ≥20  pm in relation to fasting was used to characterize lactose malabsorption. Two 24-hour recalls were applied for the evaluation of food consumption. Bone mineral content and bone mineral density were evaluated in the lumbar spine by dual-energy x-ray absorptiometry. RESULTS: The prevalence of lactose malabsorption was 61.8%. The participants were divided into 2 groups: lactose malabsorbers (n = 47) and lactose absorbers (n = 29). There was no statistically significant difference (P > 0.05) between the groups with respect to the intake of total calcium, milk calcium, milk, cheese, yogurt, ice cream, and calcium density of the diet. Additionally, there was no difference with respect to the bone mineral content and the bone mineral density of the lumbar spine. Independent from lactose absorption capacity, it was observed that the majority of the children and early adolescents showed calcium intake lower than the recommended value. CONCLUSIONS: There was no relation among lactose malabsorption and bone densities, bone mineral content, or calcium intake within the present study.

Rapid, low-cost MR imaging protocol to document central nervous system and sinus abnormalities prior to pediatric hematopoietic stem cell transplantation.

Patients undergoing bone marrow transplant (BMT) are at risk for infectious complications, including those of the sinus. Central nervous system (CNS) abnormalities related to the chemotherapy or radiation that the patient received for the treatment of underlying malignancy or to transplant-related effects are also commonly seen. The only effective way to differentiate pre- and post-transplant causes is to have a baseline evaluation prior to the admission for transplant. The current method used to evaluate these patients is head CT. However, CT is not accurate to demonstrate CNS abnormalities and exposes the patient to radiation. MRI, despite better sensitivity for white matter abnormalities, has not been routinely used because of the higher cost and longer duration of the exam. Therefore, we designed a fast, low-cost and radiation-free MRI-based protocol to simultaneously evaluate sinus and brain abnormalities.

Temporomandibular joint evaluation with magnetic resonance imaging in children with functional unilateral posterior crossbite, treated with rapid maxillary expansion.

INTRODUCTION: The purpose of this prospective study was to evaluate qualitatively articular disc position and configuration of the temporomandibular joint (TMJ) with magnetic resonance imaging (MRI) in children with functional unilateral posterior crossbite (FUPXB) treated with Haas-type orthopedic appliances. METHODS: The sample included 30 Brazilian children (60 TMJs) of both sexes (8 boys, 22 girls), aged 6.8 to 14.2 years (mean, 10.5 years; SD, 2.1 years). The MRIs were acquired in closed-mouth (CM), maximum-intercuspal (MI), and open-mouth (OM) positions in 3 stages of treatment: initial (T1), at the beginning of treatment; intermediate (T2), immediately after the removal of the expander, and final (T3), 9 months later, at the end of the observation period. RESULTS: No changes were found in articular disc positions of 96.6% of the TMJs in the CM and MI positions, and in 95% in the OM position at T1, T2, and T3. For the articular disc configuration, no changes were observed in 96.66% of the TMJs in the CM and MI positions, and in all TMJs in the OM position, at T1, T2, and T3. CONCLUSIONS: On average, this treatment method did not change articular disc positions and configurations.

Giant pulmonary hamartoma.

A 61-year-old woman presented with dyspnea and intense cough. Chest radiography showed opacity of the entire left hemithorax and computed tomography of the chest confirmed a solid heterogeneous mass extending from apex to base, with foci of calcification and areas of low attenuation. Left upper lobe resection was performed, removing the tumor in large pieces. Histologic characteristics of the lesion were compatible with typical hamartoma. No signs of recurrence were detected 2.5 years after the operation.

Correlação entre a densidade óptica da mandíbula e a densidade óssea do fêmur e da coluna vertebral / Correlation between the mandible optical density and the bone density of the femur and the lumbar vertebrae

Estudo realizado em 25 pacientes do gênero feminino com idade média de 60 anos, com mais de cinco anos de pós-menopausa. Utilizou-se para análise, o T-score do colo do fêmur e da coluna vertebral (L2-L4), obtido pela densitometria óssea e comparou-se com a média dos valores de densidade óptica da mandíbula, nos cortes coronais da tomografia computadorizada, passando pelo forame mentual, abaixo do canal mandibular, na região de interesse (ROI). Resultado: observou-se que existe correlação entre as duas medidas, pelo índice de correlação linear de Pearson, onde explica que 49,9% das pacientes que apresentam baixo T-score da coluna também apresentam baixa densidade na mandíbula e 39,3% das pacientes que apresentam baixo T-score no colo do fêmur também apresentam baixa densidade na mandíbula. Conclusão: Existe correlação, estatisticamente significante, entre o T-score do colo do fêmur e da coluna vertebral L2-L4, e a média da densidade óptica da mandíbula na região de interesse da tomografia computadorizada.

Tratamento multidisciplinar reduz o tecido adiposo visceral, leptina, grelina e a prevalência de esteatose hepática não alcoólica (NAFLD) em adolescentes obesos / Multidisciplinary treatment reduces visceral adiposity tissue, leptin, ghrelin and the prevalence of non-alcoholic fat liver disease (NAFLD) in obese adolescents

O objetivo do presente estudo foi avaliar as alterações promovidas, por intervenção multidisciplinar, nas concentrações plasmáticas de grelina e leptina, adiposidade visceral e prevalência de esteatose hepática não alcoólica (NAFLD), em adolescentes obesos. Foram avaliados 28 adolescentes obesos, 16 meninas (IMC 34,58 ± 3,86kg/m²) e 12 meninos (IMC 37,08 ± 3,17kg/m²), com idade entre 15 e 19 anos, quanto à concentração de leptina, grelina, insulina, assim como a adiposidade visceral e o diagnóstico de NAFLD pelo método de ultra-sonografia. Os resultados demonstraram redução significante na concentração circulante de grelina e leptina e na adiposidade visceral (p < 0,01). Houve ainda redução percentual na prevalência de NAFLD, sendo este um resultado relevante, visto que esta doença pode progredir para cirrose, tanto em crianças quanto em adolescentes obesos. Este tipo de tratamento demonstrou ser eficiente na melhora do perfil metabólico e hormonal, contribuindo para o controle da obesidade e suas co-morbidades em adolescentes obesos.

The aim of this study was to assess the changes promoted by a multidisciplinary therapy in ghrelin and leptin concentrations, visceral adiposity and non-alcoholic fat liver disease-NAFLD, in obese adolescents. A total of 28 obese adolescents, 16 girls (BMI 34.58 ± 3,86 wt/ht²) and 12 boys (BMI 37.08 ± 3.17 wt/ht²), aged between 15 and 19 years old, was evaluated to leptin, ghrelin and insulin concentrations, visceral adiposity and NAFLD through ultrasonography. The results showed a significant decrease in ghrelin, leptin concentrations and visceral adiposity (p < 0.01). Moreover, a decrease in the NAFLD prevalence was observed. It is an important result, since this disease can progress to cirrhosis, not only in children but also in obese adolescents. This kind of treatment can be efficient to improve metabolic and hormonal profile, as well as, to control obesity and related co-morbidities in obese adolescents.

El objetivo del presente trabajo ha sido evaluar las alteraciones promovidas por la intervención multidisciplinar, en las concentra- ciones plasmáticas de grelina y leptina, adiposidad visceral y prevalencia de esteatosis hepática no alcohólica - NAFLD, en adolescentes obesos. 28 adolescentes obesos, 16 chicas (IMC 34,58 ± 3,86 kg/m²) y 12 chicos (IMC 37,08 ± 3,17 kg/m²), con edades entre 15 y 19 años, fueron evaluados respecto a la concentración de leptina, grelina, insulina, así como a la adiposidad visceral y el diagnóstico de NAFLD por el método de ultrasonografía. Los resultados demostraron una reducción significante en la concentra- ción circulante de grelina y leptina y en la adiposidad visceral (p < 0,01). Hubo aún una reducción porcentual en la prevalencia de NAFLD, siendo este un resultado relevante, ya que esta enfermedad puede progresar hasta la cirrosis, tanto en niños como en adolescentes obesos. Este tipo de tratamiento demostró ser eficiente en la mejora del perfil metabólico y hormonal, contribuyendo para el control de la obesidad y su comorbilidad en adolescentes obesos.