Hypointense head and neck lesions on T2-weighted images: correlation with histopathologic findings
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REVIEW
Hypointense head and neck lesions on T2-weighted images: correlation with histopathologic findings Hiroki Kato 1
&
Masaya Kawaguchi 1 & Tomohiro Ando 1 & Yo Kaneko 1 & Fuminori Hyodo 1 & Masayuki Matsuo 1
Received: 6 May 2020 / Accepted: 15 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract 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. 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.
Keywords Head and neck . Hypointensity . Low signal intensity . T2-weighted images . MRI
Introduction MR imaging plays an important role in the differential diagnosis of head and neck lesions. In daily practice, radiologists evaluate MR images, focusing on signal intensity, blood flow, and diffusion restriction. The signal intensity on T2-weighted images provides radiologists with a great deal of information. Although hypointense head and neck lesions on T2-weighted images are relatively rare, careful assessment of this
* Hiroki Kato [email protected] 1
Department of Radiology, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
characteristic signal is important to help determine the differential diagnosis. In this article, hypointense head and neck lesions on T2weighted images are described and classified into the following nine categories: 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 (Table 1). In hypointense head and neck lesions on T2-weighted images, the most important imaging findings (Table 2) and diagnostic algorithm for the differential diagnosis (Fig. 1) are useful in daily practice
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