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Ultrasound versus magnetic resonance imaging for Morton neuroma: systematic review and meta-analysis
Bianca Bignotti1, Alessio Signori, Maria Pia Sormani
1Radiology Department, University of Genoa, Largo Rosanna Benzi 8, 16138, Genoa, Genova, Italy.
Objectives:
To compare ultrasound (US) and magnetic resonance imaging (MRI) in the diagnosis of Morton's neuroma.
Methods:
Studies that assessed the diagnostic accuracy of US and MRI for Morton's neuroma were retrieved from major medical libraries independently by two reviewers up to 1 April 2014. Predefined inclusion and exclusion criteria were adopted.
Results:
277 studies were initially found, and the meta-analysis was conducted on 14 studies. US sensitivity was studied in five studies, MRI sensitivity in three studies, and bothin six studies. All studies used surgery as the reference standard. A high sensitivity (SE) of diagnostic testing was observed for both US (SE (95 % CI) = 0.91 (0.83-0.96)) and MRI (SE (95 % CI) = 0.90 (0.82-0.96)) with no significant differences between the two modalities in diagnosis (Q test p = 0.88). For MRI, specificity of test was 1.00 with a pooled estimation of 1.00 (0.73-1.00), while the pooled specificity was 0.854 (95 % CI: 0.41-1.00) for US. No differences were observed between US and MRI in study design (p = 0.76).
Conclusion:
This meta-analysis shows that the SE of US (0.91) is equal to (p = 0.88) that of MRI (0.90) for identification of Morton's neuroma.
Key Points:
• For Morton's neuroma, US sensitivity is equal to MRI. • US is as accurate as MRI in diagnosing Morton's neuroma. • US may be the most cost-effective imaging method for Morton's neuroma.
Insights
Ultrasound (US) and magnetic resonance imaging (MRI) show equal sensitivity for diagnosing Morton's neuroma. This meta-analysis indicates US is as accurate as MRI, potentially offering a more cost-effective imaging solution.
Area of Science:
- Radiology and Diagnostic Imaging
- Orthopedics
- Medical Technology Assessment
Background:
- Morton's neuroma is a common cause of forefoot pain, necessitating accurate diagnostic imaging.
- Ultrasound (US) and magnetic resonance imaging (MRI) are frequently used modalities for evaluating Morton's neuroma.
- Comparative studies are essential to determine the optimal imaging technique for clinical practice.
Purpose of the Study:
- To conduct a meta-analysis comparing the diagnostic accuracy of ultrasound (US) versus magnetic resonance imaging (MRI) for Morton's neuroma.
- To evaluate the sensitivity and specificity of both imaging modalities in identifying Morton's neuroma.
Main Methods:
- A systematic literature search was performed across major medical databases up to April 1, 2014.
- Studies assessing the diagnostic accuracy of US and MRI for Morton's neuroma were included based on predefined criteria.
- Meta-analysis was conducted on 14 selected studies, using surgical findings as the reference standard.
Main Results:
- Both US and MRI demonstrated high diagnostic sensitivity for Morton's neuroma, with pooled sensitivities of 0.91 (95% CI: 0.83-0.96) for US and 0.90 (95% CI: 0.82-0.96) for MRI.
- No statistically significant difference in sensitivity was found between US and MRI (p = 0.88).
- MRI showed higher pooled specificity (1.00; 95% CI: 0.73-1.00) compared to US (0.854; 95% CI: 0.41-1.00).
Conclusions:
- Ultrasound (US) exhibits diagnostic sensitivity comparable to magnetic resonance imaging (MRI) for identifying Morton's neuroma.
- US is as accurate as MRI in the diagnosis of Morton's neuroma.
- US may represent a more cost-effective imaging option for diagnosing Morton's neuroma.
