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

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