The list of entities associated with a high signal intensity on T1-wei
ghted images is extensive and classically includes fat, proteins, hemo
rrhage, melanin and gadolinium. However, additional entities may be re
sponsible for abnormally high signal intensity on T1-weighted images.
These include ion deposition in metabolic disorders, free radicals, in
creased proton density, flow phenomena, some artifacts, and new contra
st agents. The aim of this article is to display both the common and u
ncommon causes for a high T1 signal intensity and to discuss the under
lying mechanisms or attributable pathophysiology for this phenomenon.