Radiologic Evaluation of the Nasopharynx: A Comprehensive Review.

The nasopharynx is a critical component of the upper aerodigestive tract and has essential roles in respiration, auditory tube function, and speech resonance. Accurate imaging evaluation of this region allows assessment of deeper structures that cannot be evaluated by clinical examination alone. A thorough understanding of nasopharyngeal anatomy, embryology, and the spectrum of benign and malignant diseases is vital for accurate diagnosis. Key imaging features may be identified across CT and MRI modalities. Although CT effectively delineates local bone and soft-tissue structures, MRI provides superior soft-tissue characterization and allows better assessment of soft-tissue lesions and tumor extension. Disorders affecting the nasopharynx and surrounding structures include eustachian tube dysfunction, cystic lesions, anatomic variations of the clivus, and inflammatory and infectious conditions, as well as neoplasms such as nasopharyngeal carcinoma and lymphoma. Recognizing imaging pearls and pitfalls is useful for accurate diagnosis and to distinguish benign from malignant entities. Optimal patient management-including accurate radiologic diagnosis, early detection of malignancies, differential diagnosis, assessment of disease extent, and posttreatment surveillance-can be achieved through comprehensive radiologic evaluation. ©RSNA, 2026 Supplemental material is available for this article.