Young Jin Kim MD, Presenter: Nothing to Disclose

Jin Hur MD, Abstract Co-Author: Nothing to Disclose

Hye-Jeong Lee MD, Abstract Co-Author: Nothing to Disclose

Hua Sun Kim, Abstract Co-Author: Nothing to Disclose

Ji Eun Nam MD, Abstract Co-Author: Nothing to Disclose

Byoung Wook Choi MD, Abstract Co-Author: Nothing to Disclose

Tae Hoon Kim MD, Abstract Co-Author: Nothing to Disclose

Kyu Ok Choe MD, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

The purpose of our study was (1) to determine the utility of India ink artifact (fat-water cancellation artifact) on cine MRI to detect myocardial fat, compared to T1-weighted imaging (T1WI) with and without fat saturation, and (2) to assess clinical correlates of lipomatous mataplasia in patients with myocardial infarction.

Thirty-nine MI patients who underwent both cardiac CT and MRI (SSFP cine, T1 weighted, and delayed enhancement) within one month were retrospectively evaluated. The presence of myocardial fat was concluded when intramyocardial focal low attenuation can be detected in both non-enhanced and enhanced CT. India ink artifact within infarcted region on cine imaging and high signal area which was suppressed with fat saturation on T1WI was considered to represent myocardial fat. The diagnostic accuracies of cine imaging and T1WI were compared. We also compared the clinical parameters of the patients with and those without myocardial fat.

Patients were divided into two groups; MI patients with myocardial fat (n=22) and those without fat (n=17) according to CT results. All patients with myocardial fat showed India ink artifact within the infarcted myocardium on cine imaging (sensitivity 100% and specificity 100%), while sensitivity of T1 weighted imaging was relatively low (sensitivity 71.4%, specificity 100%). Myocardial fat was more frequently associated with a greater infarct age (p=0.0313), more severe regional wall motion abnormalities (p=0.0283), and larger transmural extent (p=0.0025). Patients with myocardial fat had fewer number of diseased vessels (p=0.0186). Age, sex, incidence of dyslipidemia, DM, and hypertension were not significantly different between the two groups.

The presence of India ink artifact within the infarcted myocardium on cine MRI is indicative of myocardial fat in MI. Lipomatous metaplasia in MI patients is more frequently associated with greater infarct age, larger transmural extent, more severe regional wall motion abnormalities, and fewer number of diseased vessels.

Cine imaging can be a powerful tool to detect lipomatous metaplasia in patients with myocardial infarction, without need to acquire additional sequence to detect fat component.

Kim, Y, Hur, J, Lee, H, Kim, H, Nam, J, Choi, B, Kim, T, Choe, K, et al, 0, Clinical Impact of Lipomatous Metaplasia in Patients with Myocardial Infarction: Evaluation with Cardiac MRI.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8014219.html