MRI features of symptomatic amputation neuromas

Area of Science:

• Radiology
• Orthopedic Surgery
• Neurology

Background:

• Amputation neuromas are common sequelae of peripheral nerve injury.
• Symptomatic neuromas can cause significant neuropathic pain and impact quality of life.
• Accurate identification of symptomatic neuromas is crucial for effective treatment.

Purpose of the Study:

• To characterize the magnetic resonance imaging (MRI) features of amputation neuromas in lower extremity amputees.
• To identify independent MRI predictors for symptomatic neuromas.
• To correlate MRI findings with clinical symptoms of neuroma pain.

Main Methods:

• Retrospective analysis of 45 amputation neuromas in 44 lower extremity amputees.
• Radiological assessment of MRI features including shape, size, signal intensity, heterogeneity, and enhancement patterns.
• Clinical categorization of neuromas into symptomatic or asymptomatic based on pain characteristics and physical examination findings.
• Statistical analysis, including univariate and multivariate analyses, to determine independent predictive MRI features.

Main Results:

• End-bulb neuromas (80%) were more common than spindle-type (20%).
• Heterogeneity on T2-weighted images (T2-WIs) was observed in 80% of neuromas.
• Significant differences in T2-WIs heterogeneity and enhancement ratios were found between symptomatic and asymptomatic groups (p < 0.05).
• Multivariate analysis identified T2-WIs heterogeneity as an independent predictor of symptomatic neuromas (p < 0.001).

Conclusions:

• Heterogeneity on T2-weighted MRI is a significant predictor of symptomatic amputation neuromas in lower extremity amputees.
• MRI features, particularly T2-WIs heterogeneity, can aid in differentiating symptomatic from asymptomatic neuromas.
• Improved prediction of symptomatic neuromas via MRI can facilitate targeted management strategies for stump pain.