Fatty Images of the Heart: Spectrum of Normal and Pathological Findings by Computed Tomography and Cardiac Magnetic Resonance Imaging

Figure 9

Postinflammatory lipomatous metaplasia in a 52-year-old man at 6 months from an acute viral lymphocytic myocarditis. Cardiac CT in axial view (a) illustrates linear hypoattenuating stripes with negative attenuation values placed in the subepicardial layer of the left ventricular myocardium, involving the apex (arrow) and the lateral wall (arrowhead). The lateral wall fatty involvement is evident also in short axis multiplanar reconstruction ((b) arrows). A mild enlargement of left ventricle is also noted (a). CMR in the same patient with late gadolinium enhancement T1-weighted sequences, respectively, in four-chamber (a) and short axis (d) planes shows a patchy and curvilinear enhancement in the interventricular septum (arrows), left ventricular apex, and lateral wall (arrowheads), sparing the subendocardial layer and not following a coronary artery perfusion territory, findings compatible with a postinflammatory damage.

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