Understanding T2 Hyperintensity: Causes & MRI Significance
T2 Signal Basics
On T2-weighted MRI, signal intensity reflects water content: more free water = brighter (hyperintense).
Signal Patterns
- Hyperintense: Edema, inflammation, demyelination, tumors, cysts, acute infarct, infection. Most pathologies increase water.
- Hypointense: Low free water – calcification, chronic infarct (gliosis), hemorrhage (chronic), air, bone, proteinaceous fluid.
- Isointense: Similar to surrounding tissue; may indicate chronic stable lesion or normal structure.
Clinical Correlation Is Essential
T2 hyperintensity is nonspecific. Diagnosis requires integration with T1, FLAIR, DWI, contrast enhancement, clinical history, and location.
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