Case 31 Answer

WetReadRad -

You guys are pretty smart!

Answer: subendocardial fat deposition in the posterior LV wall secondary to prior ischemic/infarct

Key point: fat should not extend transmurally if it is from prior infarct. Also, look for Ca++

nice article: http://pubs.rsna.org/doi/full/10.1148/rg.306105519