Fatty Foci in the Myocardium in Patients with Tuberous Sclerosis Complex: Common Finding at CT1

• Published in: Radiology Vol. 253; no. 2; p. 359
• Main Authors: Miraude E. A. P. M. Adriaensen, Cornelia M. Schaefer-Prokop, Debbie A. C. Duyndam, Bernard A. Zonnenberg, Mathias Prokop
• Format: Journal Article
• Language: English
• Published: Radiological Society of North America 01-11-2009
• ISSN: 0033-8419; 1527-1315
• DOI: 10.1148/radiol.2533082118

Purpose: To examine the morphologic characteristics of focal fatty foci in the myocardium of patients with tuberous sclerosis complex
(TSC) at computed tomography (CT).
Materials and Methods: Institutional review board approval was obtained, and patient informed consent was waived. Fifty-five patients with TSC (mean
age, 37 years; range, 16–67 years; 22 male patients) who had CT results available that included at least the basal portions
of the heart were included. Fifty-five age- and sex-matched control subjects without TSC were selected from a CT database.
Images were reviewed for the presence of areas of fat attenuation in the depicted portions of the myocardium. Descriptive
statistics and the McNemar test for case-control comparisons were used.
Results: CT results demonstrated foci of fat attenuation within the myocardium in 35 (64%) of 55 patients with TSC. Foci were well
circumscribed and focal and located in the interventricular septum, left ventricle wall, right ventricle wall, and papillary
muscles. Size varied between 3 × 1 mm and 62 × 31 mm. Multiple lesions were seen in 19 patients. In the control group, only
one (2%) lesion with fat attenuation was found ( P < .001). Its linear shape and subendocardial location in the left ventricular wall differed from the morphology of fatty
foci seen in patients with TSC.
Conclusion: 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.
© RSNA, 2009