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Hypointense head and neck lesions on T2-weighted images: correlation with histopathologic findings

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On T2-weighted images, most solid lesions exhibit nonspecific intermediate signal intensity, whereas most cystic lesions exhibit marked hyperintensity. In contrast, on T2-weighted images, a relatively small number of lesions exhibit hypointensity. This review aimed to differentiate, according to the histopathologic findings, head and neck lesions showing hypointensity on T2-weighted images.


In this review article, hypointense head and neck lesions on T2-weighted images are classified into the following nine categories: calcified or osseous lesions, granulomatous lesions, fibrous lesions, mucous- or proteincontaining lesions, hemosiderin-containing lesions, melanin-containing lesions, thyroglobulin-containing lesions, rapid blood flow, and air-filled spaces.


Knowledge regarding hypointense head and neck lesions on T2-weighted images allows radiologists to make accurate differential diagnoses.

Key points

Hypointense head and neck lesions on T2-weighted images include calcified or osseous lesions, granulomatous lesions, fibrous lesions, mucous- or protein-containing lesions, hemosiderin-containing lesions, melanin-containing lesions, thyroglobulin-containing lesions, rapid blood flow, and air-filled spaces.

Radiologists should recognize the hypointense head and neck lesions on T2-weighted images for the final correct diagnosis, resulting in appropriate patient management.

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Correspondence to Hiroki Kato.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Kato, H., Kawaguchi, M., Ando, T. et al. Hypointense head and neck lesions on T2-weighted images: correlation with histopathologic findings. Neuroradiology 62, 1207–1217 (2020).

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