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Nasopharynx

The nasopharynx is the uppermost portion of the pharynx, located posterior to the nasal cavity and extending from the sphenoid bone superiorly to the soft palate inferiorly. It serves as a respiratory conduit, provides communication between the nasal cavity and oropharynx, and contains the pharyngeal tonsils (adenoids) and the openings of the Eustachian tubes. Understanding its anatomy, function, and imaging characteristics is essential for evaluating infections, tumors, congenital anomalies, and airway pathology.

Synonyms

  • Upper pharynx

  • Epipharynx

  • Nasopharyngeal space

  • Postnasal space

Function

  • Serves as a passageway for air from the nasal cavity to the oropharynx

  • Facilitates drainage and ventilation of the middle ear via the Eustachian tube

  • Contains lymphoid tissue (pharyngeal tonsils) that participates in immune defense

  • Plays a role in resonance during speech and swallowing

MRI Appearance
T1-weighted images:

  • Nasopharyngeal soft tissues appear intermediate signal intensity.

  • Air within the nasopharyngeal cavity appears as a signal void (black), creating natural contrast with the surrounding soft tissues.

  • Adenoidal tissue appears slightly hyperintense compared with muscle, and enhances after contrast administration if inflamed or tumorous.

T2-weighted images:

  • Air remains signal void, clearly defining the nasopharyngeal lumen.

  • Soft tissues, including mucosa and lymphoid tissue, appear intermediate to hyperintense, while edema or fluid collections are bright.

  • Useful for detecting adenoid hypertrophy, inflammation, cysts, or tumors.

STIR (Short Tau Inversion Recovery):

  • Suppresses fat signal from surrounding parapharyngeal space, highlighting edema or soft tissue pathology.

  • Normal nasopharyngeal tissues are intermediate to hyperintens signal, while tumors or inflammatory changes appear bright hyperintense.

CT Appearance

  • Air within the nasopharynx appears hypodense (black), sharply outlining the lumen.

  • Soft tissues, including mucosa, adenoids, and muscles, appear soft tissue density.

  • Adjacent bony structures such as the sphenoid, occipital, and pterygoid bones are hyperdense.

  • CT is particularly useful for evaluating bony erosion, nasopharyngeal masses, airway obstruction, and calcifications.

MRI images

Nasopharynx mri axial image -img-00000-00000

MRI images

Nasopharynx mri sag image -img-00000-00000