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

Figure 13

Interventricular septal lipoma incidentally detected in a 79-year-old male with concomitant left renal cancer on a staging total body CT exam ((a) asterisk). During thoracic CT scan a hypoattenuating nodular-shaped lesion with negative attenuation values located in the interventricular septum is incidentally noted before ((b) arrow) and after contrast medium administration ((c) arrow). A renal cancer metastatic lesion in the lateral wall of the left ventricle ((c) asterisk) is also present, together with moderate pericardial fluid. CMR in four-chamber views in the bottom line images confirms the nodular area placed within the interventricular septum on cine-SSFP sequences that appears hyperintense and delimited by the characteristic black boundary artefact ((d) arrow), with hyperintense signal also on T1-weighted black blood sequence ((e) arrow) and hypointense appearance on T2-weighted black blood with fat suppression ((f) arrow). These findings are related to an interventricular septal lipoma ((b)–(f) arrow) with a concomitant left ventricular renal cancer metastatic lesion ((c)–(f) asterisk), both histologically proven.

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