Diagnostic value of magnetic resonance imaging using contrast enhancement, high-field tomographs in the detection of Morton’s neuroma

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Abstract

BACKGROUND: Magnetic resonance imaging (MRI) is becoming more and more widespread in our country, being one of the leading methods in diagnosing injuries and diseases of the ankle joint and foot. From year to year the number of tomographs and studies is steadily increasing, and the absence of ionising radiation, the possibility of visualising both soft tissue and bone structures makes this procedure more attractive for patients. Reproducibility of the study, the possibility of obtaining a second opinion distinguish MRI as a leading tool in the diagnosis of neuromas. Despite its relatively frequent use, the significance of MRI diagnosis in patients with suspected intertarsal neuroma using paramagnetic imaging, 3 tesla and 1.5 tesla MRI has not been fully reported.

СLINICAL CASES DESCRIPTION: The article presents a series of illustrative studies of patients with intermetatarsal neuroma: using paramagnetic imaging tools, without the use of paramagnetic imaging tools, with large slice thickness, with high-field tomography.

CONCLUSION: Despite the obvious advantages of using high-field imaging in the diagnosis of peripheral nervous system diseases, in our opinion, the informative value of this study in the routine diagnosis of Morton's neuroma does not exceed that of the currently most common 1.5 tesla MRI.

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About the authors

Daria A. Bolshakova

European Clinic of Sports Traumatology and Orthopedics ECSTO; Russian University of Peoples’ Friendship

Author for correspondence.
Email: dasha.bolsh@gmail.com
ORCID iD: 0009-0003-3332-9267
SPIN-code: 9584-9980
Russian Federation, Moscow; Moscow

Andrey A. Kardanov

European Clinic of Sports Traumatology and Orthopedics ECSTO

Email: akardanov@emcmos.ru
ORCID iD: 0000-0003-2866-2295
SPIN-code: 5134-8123

MD, Dr. Sci. (Med.)

Russian Federation, Moscow

Musa N. Maysigov

European Clinic of Sports Traumatology and Orthopedics ECSTO

Email: mmaysigov@emcmos.ru
ORCID iD: 0000-0002-2096-5876

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Andrey V. Korolev

European Clinic of Sports Traumatology and Orthopedics ECSTO; Russian University of Peoples’ Friendship Moscow

Email: korolev.andrey.prof@gmail.com
ORCID iD: 0000-0002-8769-9963
SPIN-code: 6980-6109

MD, Dr. Sci. (Med.)

Moscow; Moscow

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Supplementary files

Supplementary Files
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2. Fig. 1. Patient K., MRI image: a — hypointensive signal compared to surrounding tissues with a T1-weighted sequence, neuroma of the third interdigital space; b — hypointensive signal compared to surrounding tissues with a T2-weighted sequence, neuroma of the third interdigital space; c — area of hyperintense signal on T2-weighted sequence (bursitis), the distal direction from image b; d — mixed hypo- and hyperintense signal (shaded area — edematous nerve sheath, perineural fibrosis surrounding the hypointense signal). T1 FS mode after contrast

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3. Fig. 2. Patient C., MRI imaging, resected portion of the nerve, microscopic specimen: a — MRI: hypointense signal compared to surrounding tissues with a T1-weighted sequence, right foot; neuroma of the third interdigital space; b, c — MRI: uninformative sections in the distal and proximal directions (section thickness 3.5 mm), right foot; T1-weighted sequence; d — MRI: hypointense signal compared to surrounding tissues on T1-weighted sequence, left foot; neuroma of the third interdigital space; e — area of resected material of the fourth interdigital space, left foot (photo); f — “onion skin” fibrosis (photo, microscopic specimen); g — thinning of blood vessels (photo, microscopic specimen)

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4. Fig. 3. Patient G., MRI imaging: a — hypointense signal compared to surrounding tissues with a T1-weighted sequence, right foot; neuroma of the third interdigital space; b — hypointense signal compared to surrounding tissues with a T2-weighted sequence, right foot; neuroma of the third interdigital space; c — area of hyperintense signal on T2-weighted sequence (bursitis), subcutaneous fat edema, slice following image b in the proximal direction, right foot; d — hypointense signal compared to surrounding tissues on T1-weighted sequence, left foot; neuroma of the third interdigital space; e — hypointense signal compared to surrounding tissues on T2-weighted sequence, left foot; neuroma of the third interdigital space

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5. Fig. 4. Patient Z., MRI imaging, resected portion of the nerve: a — hypointense signal compared to the surrounding tissues with a T2-weighted sequence (slice thickness 630 micrometers), neuroma of the third interdigital space; b — T2-weighted sequence (slice thickness 630 micrometers), image a in the distal direction: bifurcation of the common plantar digital nerve on the medial and lateral surfaces of the third and fourth fingers; c — hypointense signal compared to surrounding tissues on T2-weighted sequence (slice thickness 2 mm), neuroma of the third interdigital space; d — resected portion of the nerve

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