title: MR Imaging in a case of severe anorexia nervosa: the 'flip-flop' effect.
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.
authors.affiliation: Boston Children's Hospital, Division of Adolescent Medicine, Boston, MA, USA.
authors.forename: Amy D
authors.initials: AD
authors.lastname: DiVasta
authors.forename: Robert V
authors.initials: RV
authors.lastname: Mulkern
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Gordon
authors.forename: Kirsten
authors.initials: K
authors.lastname: Ecklund
mesh_terms: D000856:Anorexia Nervosa / Q000150:complications / Q000473:pathology*; D016477:Artifacts; D003951:Diagnostic Errors / Q000517:prevention & control*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D044342:Malnutrition / Q000209:etiology / Q000473:pathology*