Chemical shift artifact on steady-state free precession cardiac magnetic resonance sequences as a result of lipomatous metaplasia: a novel finding in chronic myocardial infarctions.

Background: Because balanced steady-state free precession (SSFP) sequences are opposed-phase gradient echo techniques, linear low signal due to chemical shift artefact is observed at fat-water interfaces. We observed that some patients with chronic myocardial infarctions had linear low signal along the inner myocardial wall in areas of infarction, which we postulated was due to chemical shift artefact, as a result of lipomatous metaplasia. The purpose of this retrospective review was to evaluate whether subendocardial low signal on SSFP, likely related to chemical shift artifact, could be used to identify chronic myocardial infarctions.