The major task of the radiologist is to determine the exact tumor extent in patients with nasopharyngeal tumors. The superior soft tissue contrast resolution and the multiplanar imaging capability make MR the method of choice in the evaluation of nasopharyngeal tumor extension. For the same reasons MR is also the best technique to detect small or occult lesions in patients presenting with positive neck nodes but with a negative clinical nasopharynx examination. Detection of tumor extension along nerves and vessels is earlier and better seen with MR than with any other diagnostic technique. Staging of lymph node metastases is as accurate with MR as with CT, but MR evaluation requires more experience. Finally MR performs better than CT in follow-up of irradiated patients and allows differentiation between tumor recurrence and postradiation fibrosis.
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