MRI features of symptomatic amputation neuromas
Autor: | Guen Young Lee, Young Kyung Lee, Sung Bin Park, Wan Tae Kim, Injoong Kim, Bo Mi Chung |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Asymptomatic Amputation Surgical 030218 nuclear medicine & medical imaging Neuroma 03 medical and health sciences 0302 clinical medicine otorhinolaryngologic diseases medicine Humans Radiology Nuclear Medicine and imaging Tibial nerve Retrospective Studies Neuroradiology medicine.diagnostic_test business.industry Amputation Stumps Ultrasound Magnetic resonance imaging Interventional radiology General Medicine medicine.disease Magnetic Resonance Imaging Amputation 030220 oncology & carcinogenesis sense organs Radiology medicine.symptom business |
Zdroj: | European Radiology. 31:7684-7695 |
ISSN: | 1432-1084 0938-7994 |
Popis: | To demonstrate the magnetic resonance imaging (MRI) features of amputation neuromas in lower extremity amputees and investigate independent predictive MRI features for symptomatic neuromas. This retrospective study included 45 amputation neuromas in 44 lower extremity amputees. Two radiologists assessed the imaging features, including shape, size, type (end-bulb or spindle), signal intensity (SI), heterogeneity, margins, enlarged fascicles, dark outer rim, tail sign, target sign, enhancement, perilesional fibrosis, and muscle denervation. The neuromas were categorized into symptomatic (n = 24) or asymptomatic (n = 21). Symptomatic neuromas were determined based on neuropathic pain characteristics, the presence of Tinel’s sign or tenderness, and response to local anesthetic injection. Univariate and multivariate analyses were performed to identify independent predictive MRI features. Of 45 neuromas, 80% (36/45) were end-bulb neuromas and 20% (9/45) were spindle-type neuromas. Eighty percent of the neuromas (36/45) were heterogeneous on T2-weighted images (WIs). Enlarged fascicles were present in 42% (19/45) and dark outer rims in 27% (12/45) of the neuromas. Among the 23 neuromas with enhanced images, 78% (18/23) showed enhancement. Heterogeneity on T2-WIs and enhancement ratios were significantly different between the asymptomatic and symptomatic neuroma groups (p < 0.05). The multivariate analyses indicated that heterogeneity on T2-WIs was an independent factor associated with symptomatic neuromas (p < 0.001). Heterogeneity on T2-WIs could be a predictive indicator for symptomatic neuromas in lower extremity amputees. • Amputation neuromas are classified as either end-bulb or spindle-type. They can show enlarged fascicles, dark outer rims, and enhancement. • Heterogeneity on T2-weighted images could be a predictive indicator for symptomatic neuromas. • Predicting the symptomatic neuroma on MRI would help in effective management of stump pain. |
Databáze: | OpenAIRE |
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