Identification of lipomatous metaplasia in old infarcted myocardium by cardiovascular magnetic resonance and computed tomography

Lipomatous metaplasia of myocardium after myocardial infarction (MI) is less reported, and the exact prevalence and clinical implications of this phenomenon are unclear. A case of lipomatous metaplasia after MI evaluated with cardiovascular magnetic resonance (CMR) and computed tomography (CT) is presented. The presence of lipomatous metaplasia could not be easily differentiated from scar simply by the delayed-enhanced images. Loss of signal on TrueFISP cine MRI can be a hint. A pre-contrast T1-weighted image with or without frequency-selective fat suppression is useful in order to verify the existence of lipomatous metaplasia on CMR.