CT imaging features and frequency of left ventricular myocardial fat in patients with CT findings of chronic left ventricular myocardial infarction

Aim

To determine the frequency of left ventricular myocardial fat in patients with computed tomography (CT) findings of chronic left ventricular myocardial infarction, and to review the typical CT imaging features.

Materials and methods

A retrospective search of the CT and nuclear scintigraphy reports from 1998–2005 for chronic left ventricular myocardial infarction was performed. The study group comprised those cases with available CT examinations revealing findings of chronic left ventricular myocardial infarction. Assessment for the presence of various imaging characteristics of left ventricular myocardial fat was performed in all cases.

Results

The frequency of left ventricular myocardial fat in 47 patients with CT evidence of chronic left ventricular myocardial infarction was 51%. Typical CT imaging features include thin linear or curvilinear fat attenuation within left ventricular myocardium, most commonly subendocardial, often associated with left ventricular wall thinning and/or calcification, predominantly in elderly men.

Conclusions

Fat in the left ventricular myocardium is a common additional finding in patients with CT findings of chronic left ventricular myocardial infarction. The potential, but as yet unproven, use of this CT imaging finding is that the radiologist may be able to suggest a potential diagnosis of chronic left ventricular myocardial infarction on unenhanced, thick-section, non-gated or non-triggered chest CT imaging where identification of myocardial wall thinning may be difficult.