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Pediatric Radiology
Published in: Pediatric Radiology 8/2017

01-07-2017 | Original Article

Bone marrow fat content in 70 adolescent girls with anorexia nervosa: Magnetic resonance imaging and magnetic resonance spectroscopy assessment

Authors: Kirsten Ecklund, Sridhar Vajapeyam, Robert V. Mulkern, Henry A. Feldman, Jennifer M. O’Donnell, Amy D. DiVasta, Catherine M. Gordon

Published in: Pediatric Radiology | Issue 8/2017

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Abstract

Background

Adolescents and women with anorexia nervosa have increased bone marrow fat and decreased bone formation, at least in part due to hormonal changes leading to preferential stem cell differentiation to adipocytes over osteoblasts.

Objective

The purpose of this study was to evaluate marrow fat content and correlate with age and disease severity using knee MRI with T1 relaxometry (T1-R) and MR spectroscopy (MRS) in 70 adolescents with anorexia nervosa.

Materials and methods

We enrolled 70 girls with anorexia nervosa who underwent 3-T knee MRI with coronal T1-W images, T1-R and single-voxel proton MRS at 30 and 60 ms TE. Metaphyses were scored visually on the T1-W images for red marrow. Visual T1 score, T1 relaxometry values, MRS lipid indices and fat fractions were analyzed by regression on age, body mass index (BMI) and bone mineral density (BMD) as disease severity markers. MRS measures included unsaturated fat index, T2 water, unsaturated and saturated fat fractions.

Results

All red marrow measures declined significantly with age. T1-R values were associated negatively with BMI and BMD for girls ≤16 years (P=0.03 and P=0.002, respectively) and positively for those≥17 years (P=0.05 and P=0.003, respectively). MRS identified a strong inverse association between T2 water and saturated fat fraction from 60 ms TE data (r=−0.85, P<0.0001). There was no association between unsaturated fat index and BMI or BMD.

Conclusions

The association between T1 and BMI and BMD among older girls suggests more marrow fat in those with severe anorexia nervosa. In contrast, the physiological association between marrow fat content and age remained dominant in younger patients. The strong association between T2 water and saturated fat may relate to the restricted mobility of water with increasing marrow fat.
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Metadata
Title
Bone marrow fat content in 70 adolescent girls with anorexia nervosa: Magnetic resonance imaging and magnetic resonance spectroscopy assessment
Authors
Kirsten Ecklund
Sridhar Vajapeyam
Robert V. Mulkern
Henry A. Feldman
Jennifer M. O’Donnell
Amy D. DiVasta
Catherine M. Gordon
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Radiology / Issue 8/2017
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-017-3856-3

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