T2 hypointense lesions in the parapharyngeal space: a diagnostic challenge

The parapharyngeal space is a complex anatomical site in the head and neck which may harbour clinically occult pathology given its deep-seated location. The vast majority of parapharyngeal space lesions are of intermediate or hyperintense signal on T2W sequences. This review focuses on T2 hypointense parapharyngeal space lesions which are rare and may constitute a diagnostic dilemma. We present the differential diagnosis of these lesions, highlighting the pertinent radiological findings and identifying a histological correlation for the low T2 signal. A brief discussion of the physics principles accounting for these imaging features is also included. We propose a diagnostic algorithm to facilitate diagnosis and avoid unnecessary biopsy, whenever possible.

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Publication Details

Journal
La radiologia medica
Published
2025-11-13
DOI
https://doi.org/10.1007/s11547-025-02149-x
Primary Topic
Salivary Gland Tumors Diagnosis and Treatment
Type
article
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article

T2 hypointense lesions in the parapharyngeal space: a diagnostic challenge

Roberto Maroldi, Giulia Petrilli, Marco Ravanelli, Lorenzo Ugga et al.
La radiologia medica
Salivary Gland Tumors Diagnosis and Treatment
article

T2 hypointense lesions in the parapharyngeal space: a diagnostic challenge

Roberto Maroldi, Giulia Petrilli, Marco Ravanelli, Lorenzo Ugga, Emma Tabone, Ivan Zorza, Valerio Mazza, Davide Farina, Reuben Grech, E Vassallo, Minerva Becker
article en

Abstract

The parapharyngeal space is a complex anatomical site in the head and neck which may harbour clinically occult pathology given its deep-seated location. The vast majority of parapharyngeal space lesions are of intermediate or hyperintense signal on T2W sequences. This review focuses on T2 hypointense parapharyngeal space lesions which are rare and may constitute a diagnostic dilemma. We present the differential diagnosis of these lesions, highlighting the pertinent radiological findings and identifying a histological correlation for the low T2 signal. A brief discussion of the physics principles accounting for these imaging features is also included. We propose a diagnostic algorithm to facilitate diagnosis and avoid unnecessary biopsy, whenever possible.

La radiologia medicaVol. 131(3)
University of Geneva (CH), Cardiff and Vale University Health Board (GB), University of Campania "Luigi Vanvitelli" (IT), University Hospital of Wales (GB), Mater Dei Hospital (MT), Ospedale Santa Chiara (IT), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), University of Campania "Luigi Vanvitelli" (IT), University of Brescia (IT)
Openalex Percentile: Top 47%
Salivary Gland Tumors Diagnosis and Treatment
DOIOpen Access PDFOpenAlex
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T2 hypointense lesions in the parapharyngeal space: a diagnostic challenge — Roberto Maroldi, Giulia Petrilli, et al. · La radiologia medica (2025) | TGRS Research Map | TGRS