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Table 1: Imaging criteria for grading the nasopharynx by MRI^{^a}
MRI Grade MRI Appearance
Grade 1 = normal Symmetric mucosa <3 mm thick with or without small retention cysts
Grade 2 = low index of suspicion of NPC 1) Symmetric mucosal thickening >3 mm thick (marked contrast enhancement > NPC) with or without small retention cysts or a Thornwaldt cyst, or 2) symmetric enlargement of the adenoid in the central roof/upper posterior wall with a striped appearance ± a smooth band (mild contrast enhancement < NPC) extending from the roof down the posterior and lateral nasopharyngeal walls
Grade 3 = high index of suspicion of NPC Asymmetric: asymmetry between the right and left sides of the nasopharynx in grade 1 or 2 appearance
Grade 4 = NPC Asymmetric mucosal thickening of homogeneous intermediate signal intensity on T2-weighted images and moderate contrast enhancement on T1-weighted images (performed without fat saturation), with or without infiltration outside the nasopharynx, or a focal homogeneous enhancing mass with or without infiltration outside the nasopharynx
↵a Grades 1 and 2 were negative for NPC; grades 3 and 4 were positive for NPC.