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Table 4: Proposed MR imaging criteria for primary NPC detection
Grade Condition Appearance
1 Normal Thin mucosa ≤3 mm; adenoid absent, vestigial or composed almost entirely of cysts
2 Probably benign Diffusely thickened >3-mm symmetric mucosa either homogeneously enhancing (benign hyperplasia type 1) or with greater contrast enhancement in the deep layer (mucosal white line) compared with the superficial layer (benign hyperplasia type 2); adenoid with intact contrast-enhancing septa (benign hyperplasia type 2)
3 Indeterminate Diffusely thickened >3-mm mucosa asymmetric in thickness; adenoid asymmetric in thickness
4 Suspicious 1) Diffusely thickened >3-mm mucosa asymmetric in signal intensity; adenoid asymmetric in signal intensity
2) Diffusely thickened mucosa >3 mm with focal loss of the mucosal white line; absence/distortion of the thin contrast-enhancing adenoidal septa (not attributed to cysts)
3) Focal mass confined within the nasopharynx
5 Probably malignant Superficial extension to the nasal cavity/oropharynx or deep extension to the sites bordering the nasopharynx