Top

Published in:

01-04-2015 | Case Report

MR Imaging in a case of severe anorexia nervosa: the ‘flip-flop’ effect

Authors: Amy D. DiVasta, Robert V. Mulkern, Catherine M. Gordon, Kirsten Ecklund

Published in: Pediatric Radiology | Issue 4/2015

Abstract

We report an MR imaging phenomenon that can lead to misinterpretation. The unique appearance of the soft tissues and bone marrow in a 19-year-old severely malnourished woman with anorexia nervosa raised concerns about technical failure or systemic pathology. Due to extreme fat depletion, the T1-weighted images appeared to be fat-suppressed and the fat-suppressed fluid-sensitive images appeared to be non-fat-suppressed (“flip-flopped”). Failure to recognize the influence of a patient’s overall nutritional status on MR images may cause confusion and misdiagnosis.

Katzman DK, Misra M (2013) Bone health in adolescent females with anorexia nervosa: what is a clinician to do? Int J Eat Disord 46:456–460CrossRefPubMed

Ecklund K, Vajapeyam S, Feldman HA et al (2010) Bone marrow changes in adolescent girls with anorexia nervosa. J Bone Miner Res 25:298–304CrossRefPubMedCentralPubMed

Mulkern RV, Meng J, Oshio K et al (1995) Spectroscopic imaging of the knee with line scan CPMG sequences. J Comput Assist Tomogr 19:247–255CrossRefPubMed

Moore SG, Dawson KL (1990) Red and yellow marrow in the femur: age-related changes in appearance at MR imaging. Radiology 175:219–223CrossRefPubMed

Vande Berg BC, Malghem J, Devuyst O et al (1994) Anorexia nervosa: correlation between MR appearance of bone marrow and severity of disease. Radiology 193:859–864CrossRefPubMed

Abella E, Feliu E, Granada I et al (2002) Bone marrow changes in anorexia nervosa are correlated with the amount of weight loss and not with other clinical findings. Am J Clin Pathol 118:582–588CrossRefPubMed

Bredella MA, Fazeli PK, Miller KK et al (2009) Increased bone marrow fat in anorexia nervosa. J Clin Endrocrinol Metab 94:2129–2136CrossRef

Geiser F, Murtz P, Lutterbey G et al (2001) Magnetic resonance spectroscopic and relaxometric determination of bone marrow changes in anorexia nervosa. Psychosom Med 63:631–637CrossRefPubMed

Title: MR Imaging in a case of severe anorexia nervosa: the ‘flip-flop’ effect
Authors: Amy D. DiVasta
Robert V. Mulkern
Catherine M. Gordon
Kirsten Ecklund
Publication date: 01-04-2015
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Radiology / Issue 4/2015
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-014-3145-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

MR Imaging in a case of severe anorexia nervosa: the ‘flip-flop’ effect

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2015

Use of PET/CT instead of CT-only when planning for radiation therapy does not notably increase life years lost in children being treated for cancer

Paediatric and perinatal postmortem imaging: the need for a subspecialty approach

Postmortem magnetic resonance appearances of congenital high airway obstruction syndrome

Hermes

The ESPR Board is searching for your support

Common normal variants of pediatric vertebral development that mimic fractures: a pictorial review from a national longitudinal bone health study