Magnetic resonance imaging of the nasopharynx

Thirty subjects with normal nasopharyngeal anatomy and 12 patients with a variety of abnormalities were examined with computed tomography (CT) and magnetic resonance imaging (MR), using a prototype 0.35-T superconducting system. A spin-echo technique, a repetition time (TR) of 2.0 sec., and echo times (TE) of 28 and 56 msec. were optimal for depiction of both normal and abnormal anatomy. MR was superior to CT for display of both superficial and deep nasopharyngeal soft tissues in all 30 normal subjects and 10 of the 12 abnormal patients, clearly differentiating mucosal and lymphoid tissue (adenoids, lingual and palatine tonsils) from the surrounding musculature. MR was also superior to CT in distinguishing tumor from soft tissues and more sensitive to carotid sheath adenopathy, permitting a more detailed evaluation of retropharyngeal and deep cervical nodal metastases in 2 cases. Bones, calcification, and subtle abnormalities at the base of the skull were shown better by CT. The specificity of MR and its ability to differentiate nodal metastases from reactive lymphadenopathy require further evaluation.