Fazal Muhammad Ali, Khan Ishrat, Thomas Cherian
Department of Trauma and Orthopaedics, Chase Farm Hospital, Enfield, Middlesex, England.
J Am Podiatr Med Assoc. 2012 May-Jun;102(3):184-6. doi: 10.7547/1020184.
Magnetic resonance imaging (MRI) and ultrasonography are used widely for the diagnosis of Morton's neuroma. The aim of this study was to assess the accuracy of these two modalities as diagnostic tools in Morton's neuroma.
Fifty feet of 47 consecutive patients (39 women and 8 men; mean age, 46 years; age range, 36-64 years) who presented between January 1, 2005, and June 30, 2008, were included in the study. Twenty-five feet were investigated with ultrasonography and 25 with MRI. Morton's neuroma was confirmed surgically and histologically in all of the patients. A Student unpaired t test was applied.
Twenty-two MRIs were diagnostic (sensitivity, 88%). Three patients with negative MRI findings underwent ultrasonography and were found to have a neuroma smaller than 5 mm. Twenty-four ultrasound scans demonstrated the neuroma (sensitivity, 96%), with five neuromas being smaller than 5 mm.
Ultrasonography has a slightly higher sensitivity in the diagnosis of Morton's neuroma, particularly of neuromas smaller than 5 mm, and should be the preferred imaging modality in suspected cases, and MRI should be reserved for cases with equivocal diagnosis.
磁共振成像（MRI）和超声检查被广泛用于莫顿神经瘤的诊断。本研究的目的是评估这两种检查方式作为莫顿神经瘤诊断工具的准确性。
本研究纳入了2005年1月1日至2008年6月30日期间连续收治的47例患者的50只脚（39名女性和8名男性；平均年龄46岁；年龄范围36 - 64岁）。其中25只脚接受了超声检查，25只脚接受了MRI检查。所有患者均通过手术和组织学检查确诊为莫顿神经瘤。采用成组设计t检验。
22例MRI检查结果具有诊断意义（敏感性为88%）。3例MRI检查结果为阴性的患者接受了超声检查，发现患有小于5毫米的神经瘤。24例超声扫描显示了神经瘤（敏感性为96%），其中5例神经瘤小于5毫米。
超声检查在莫顿神经瘤的诊断中敏感性略高，尤其是对于小于5毫米的神经瘤，在疑似病例中应作为首选的影像学检查方式，而MRI应保留用于诊断不明确的病例。
