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MR Imaging in a case of severe anorexia nervosa: the 'flip-flop' effect
Amy D DiVasta1, Robert V Mulkern, Catherine M Gordon
1Boston Children's Hospital, Division of Adolescent Medicine, Boston, MA, USA.
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.
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