Fatty metaplasia of chronic MI in a 67-year-old man with a history of MI many years prior. Cardiac MR images show midwall fatty metaplasia within a chronic near-transmural MI of the basal septum. Short-axis image from cine SSFP MRI, A, shows midwall hyperintensity within the basal anteroseptum (arrow). Water separation, B, and fat separation, C, images confirm that the midwall abnormality is fat. T1 map, D, shows a midwall area in the basal anteroseptum that has a T1 value consistent with that of fat. Early, E, and late, F, gadolinium enhancement images show a near-transmural MI involving the basal anteroseptal wall.