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Psychosomatic Medicine 63:631-637 (2001)
© 2001 American Psychosomatic Society

ORIGINAL ARTICLES

Magnetic Resonance Spectroscopic and Relaxometric Determination of Bone Marrow Changes in Anorexia Nervosa

Franziska Geiser, MD, Dipl-Psych, Petra Mürtz, PhD, Dipl-Phys, Götz Lutterbey, MD, Frank Träber, PhD, Dipl-Phys, Wolfgang Block, Dipl-Biol, Katrin Imbierowicz, MD, Guntram Schilling, MD, Dipl-Psych, Hans Schild, MD and Reinhard Liedtke, MD

From the Psychosomatic Clinic (F.G., K.I., G.S., R.L.) and the Clinic for Radiology (P.M., G.L., F.T., W.B., H.S.), University of Bonn, Bonn, Germany.

Address reprint requests to: Dr. Franziska Geiser, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie der Universität Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany. Email: Reinhard.Liedtke{at}ukb.uni-bonn.de

OBJECTIVE: The objective of this study was to assess and quantify bone marrow changes in patients with anorexia nervosa using 1H magnetic resonance spectroscopy and relaxometry.

METHODS: The bone marrow fat fraction and the longitudinal and transverse relaxation times (T1 and T2, respectively) of water were measured in the lumbar and femoral marrow of 20 patients with anorexia nervosa and 19 healthy control subjects.

RESULTS: Patients with anorexia nervosa showed significant hyperhydration and reduction of the fat fraction in their bone marrow, predominantly in the proximal femur. These changes were associated with hematological abnormalities. In a retest of seven patients after psychotherapy and gain of weight, the pathological changes in marrow proved to be largely reversible in correlation with the increase in body mass index.

CONCLUSIONS: Fat depletion and excess of tissue water in the bone marrow in anorexia nervosa can be quantified by 1H magnetic resonance spectroscopy and relaxometry. The distribution of the pathological changes in the lumbar and femoral marrow follows the pattern of normal bone marrow conversion from hematopoietic to cellular during childhood.

Key Words: anorexia nervosa • bone marrow • magnetic resonance • 1H spectroscopy • relaxometry

Abbreviations: AN = anorexia nervosa; BMI = body mass index; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, fourth edition; MR = magnetic resonance; SCL-90-R = revised Symptom Checklist-90; SE = spin echo; T1 = longitudinal (spin-lattice) relaxation time; T2 = transverse (spin-spin) relaxation time; TE = echo delay time; TI = inversion delay time; TR = repetition time; TSE = turbo spin echo.




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