fatty foci in the myocardium in patients with tuberous sclerosis complex common finding at ct purpose to examine the morphologic characteristics of focal fatty foci in the myocardium of patients with tuberous sclerosis complex tsc at computed tomography ctmaterials and methods institutional review board approval was obtained and patient informed consent was waived fiftyfive patients with tsc mean age 37 years range 1667 years 22 male patients who had ct results available that included at least the basal portions of the heart were included fiftyfive age and sexmatched 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 casecontrol comparisons were usedresults 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 x 1 mm and 62 x 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 tscconclusion despite incomplete depiction of the heart with ct the majority of patients with tsc demonstrated wellcircumscribed foci of fat attenuation in the myocardium that were not present in age and sexmatched control subjects this suggests that such fatty foci may be another characteristic of tsc