Lipomatous metaplasia of the myocardium

Last revised by Vincent Tatco on 27 Jul 2022

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Tatco V, Lipomatous metaplasia of the myocardium. Reference article, Radiopaedia.org (Accessed on 20 Apr 2024) https://doi.org/10.53347/rID-24929

DOI:

https://doi.org/10.53347/rID-24929

Permalink:

https://radiopaedia.org/articles/24929

rID:

24929

Article created:

20 Sep 2013, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

27 Jul 2022, Vincent Tatco

Disclosures:

At the time the article was last revised Vincent Tatco had no recorded disclosures.

View Vincent Tatco's current disclosures

Revisions:

2 times, by 2 contributors - see full revision history and disclosures

Systems:

Cardiac

Tags:

cases

Synonyms:

Lipomatous metaplasia (LM) of myocardium
Myocardial lipomatous metaplasia
Myocardial fat replacement
Lipomatous metaplasia of myocardium

Lipomatous metaplasia of the myocardium is a phenomenon where there is fat deposition within the myocardium. It is often seen following a myocardial infarction but can also rarely been seen in conditions such as arrhythmogenic right ventricular dysplasia.

Pathology

The exact etiology of lipomatous metaplasia is not known, but it is not seen in the absence of substitutive myocardial fibrosis.

Radiographic features

Echocardiography

Lipomatous hyperplasia may not be detectable on echocardiography ⁴.

Scintigraphy

Lipomatous hyperplasia may not be detectable on myocardial perfusion imaging as lipophilic myocardial perfusion agents such as tetrofosmin and sestamibi may well be taken up into fat cells ⁴.

Cardiac CT

May show areas of fat attenuation within the affected myocardial region.

Cardiac MRI

T1: affected regions are high signal and show signal dropout in fat suppressed sequences.
IR (inversion recovery): the adipose tissue has high signal intensity
C+ (Gd): may not enhance but affected areas are seen surrounded by areas of myocardial fibrosis demonstrated on late contrast‐enhanced (LCE) images ¹.

References

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2. Arnold JR, Karamitsos TD, Pegg TJ et-al. Left ventricular lipomatous metaplasia following myocardial infarction. Int. J. Cardiol. 2009;137 (1): e11-2. doi:10.1016/j.ijcard.2008.05.039 - Pubmed citation
3. Winer-Muram HT, Tann M, Aisen AM et-al. Computed tomography demonstration of lipomatous metaplasia of the left ventricle following myocardial infarction. J Comput Assist Tomogr. 2004;28 (4): 455-8. Pubmed citation
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