Fatty Foci in the Myocardium in Patients with Tuberous Sclerosis Complex: Common Finding at CT

Abstract

Despite incomplete depiction of the heart with CT, the majority of patients with TSC demonstrated well-circumscribed foci of fat attenuation in the myocardium that were not present in age- and sex-matched control subjects. This suggests that such fatty foci may be another characteristic of TSC.

Myocardial Fatty Foci in Adult Patients with Tuberous Sclerosis Complex: Association with Gene Mutation and Multiorgan Involvement

“…The distribution of MFF in our patients, evaluated according to the segmentation scheme of the American Heart Association (16), enabled us to confirm the main involvement of the left ventricle. The myocardial location was related to the presence of a relatively hyperattenuated layer of muscle between the focus and the epicardial fat, both of which were relatively hypoattenuated (7)(8)(9)(10)(11). Notably, our results revealed robust intra-and interobserver reproducibility (k = 0.411-0.978) in the detection of MFF in each of the 17 segments.…”

“…A prenatal diagnosis of cardiac rhabdomyoma confers a 75%-80% probability for TSC (1). Myocardial fatty foci (MFF) have been incidentally reported in patients with TSC (7)(8)(9)(10)(11)(12). A case-control study demonstrated a prevalence of 64% on abdominal computed tomographic (CT) images, suggesting a relationship with this disorder (8).…”

“…0.2) or linear (B/A  0.2), and mass effect (8). Potential foci were excluded from analysis if relevant artifacts from breathing, heart rate, or partial volume effects (especially for the cardiac apex) were present.…”

Cardiac MR Findings and Potential Diagnostic Pitfalls in Patients Evaluated for Arrhythmogenic Right Ventricular Cardiomyopathy

“…The presence of myocardial fatty or fibrofatty infiltration is not included in either the revised or the original task force criteria because of (a) artifactual fat resulting from limited imaging techniques (22) and (b) the presence of fatty infiltration in physiologic (20)(21)(22)(23)(24) and other pathologic states, such as healed myocardial infarction (18,(24)(25)(26)(27)(28)(29)(30) (Fig 3), cardiac lipoma (31,32), lipomatous hypertrophy of the interatrial septum (33), tuberous sclerosis complex (34), and dilated cardiomyopathy. Isolated and marked lipomatous infiltration of the RV appears to be a separate condition from ARVC (35).…”

Fatty lesions in and around the heart: a pictorial review

“…These lesions are unique in location and appearance, occurring as unencapsulated deposits of mid-myocardial fat often within the interventricular septum or left ventricular wall (Figure 13). 9 This differentiates them from true intramyocardial lipomas that tend to be irregular and capsulated, and arrhythmogenic right ventricular dysplasia (ARVD) that tends to show more diffuse fatty infiltration of the ventricles.…”