{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T01:28:40Z","timestamp":1768094920403,"version":"3.49.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T00:00:00Z","timestamp":1542326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R21 AR065672"],"award-info":[{"award-number":["R21 AR065672"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01DK105322"],"award-info":[{"award-number":["R01DK105322"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Impaired foot perfusion is a primary contributor to foot ulcer formation. There is no existing device nor method that can be used to measure local foot perfusion during standardized foot muscle exercise in an MRI environment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To develop a new MRI\u2010compatible foot dynamometer and MRI methods to characterize local perfusion in diabetic feet with ulcers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Prospective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population\/Subjects<\/jats:title><jats:p>Seven participants without diabetes and 10 participants with diabetic foot ulcers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>3.0T, arterial spin labeling (ASL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessments<\/jats:title><jats:p>Using a new MRI\u2010compatible foot dynamometer, all participants underwent MRI ASL perfusion assessment at rest and during a standardized toe\u2010flexion exercise. The participants without diabetes were scanned twice to assess the reproducibility of perfusion measurements. The absolute perfusion and perfusion reserve values were compared between two groups and between regions near ulcers (peri\u2010ulcer) and away from ulcers (away\u2010ulcer).<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Bland\u2013Altman methods for the calculation of coefficient of repeatability (CR) and two\u2010sided and unpaired Student's <jats:italic>t<\/jats:italic>\u2010test to compare multiple differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The perfusion reserves measured had the best reproducibility (CR in medial region: 1.6, lateral region: 0.9). The foot perfusion reserve was significantly lower in the participants with diabetes compared with the participants without diabetes (1.34\u2009\u00b1\u20090.32, 95% confidence interval [CI]: 1.1, 1.58 vs. 1.76\u2009\u00b1\u20090.31, 95% CI: 1.53, 1.98, <jats:italic>P<\/jats:italic>\u2009=\u20090.02). Both peri\u2010ulcer exercise perfusion (8.7\u2009\u00b1\u20093.9\u2009ml\/min\/100g) and perfusion reserve (1.07\u2009\u00b1\u20090.39, 95% CI: 0.78, 1.35) were significantly lower than away\u2010ulcer exercise perfusion (12.7\u2009\u00b1\u20093.8\u2009ml\/min\/100g, <jats:italic>P<\/jats:italic>\u2009=\u20090.02) and perfusion reserve (1.39\u2009\u00b1\u20090.37, 95% CI: 1.11, 1.66, <jats:italic>P<\/jats:italic>\u2009=\u20090.03), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>This study demonstrates intravenous contrast\u2010free methods for local perfusion in feet with ulcers by standardized exercise\u2010based MRI. Ischemia regions around foot ulcers can be quantitatively distinguished from normal perfused muscle regions.<\/jats:p><jats:p><jats:bold>Level of Evidence<\/jats:bold>: 2<\/jats:p><jats:p><jats:bold>Technical Efficacy<\/jats:bold>: Stage 2<\/jats:p><jats:p>J. Magn. Reson. Imaging 2019;50:474\u2013480.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.26570","type":"journal-article","created":{"date-parts":[[2018,11,17]],"date-time":"2018-11-17T05:05:14Z","timestamp":1542431114000},"page":"474-480","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Intravenous contrast\u2010free standardized exercise perfusion imaging in diabetic feet with ulcers"],"prefix":"10.1002","volume":"50","author":[{"given":"Masoud","family":"Edalati","sequence":"first","affiliation":[{"name":"Mallinckrodt Institute of Radiology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary K.","family":"Hastings","sequence":"additional","affiliation":[{"name":"Program in Physical Therapy Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Muccigrosso","sequence":"additional","affiliation":[{"name":"Mallinckrodt Institute of Radiology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"Sorensen","sequence":"additional","affiliation":[{"name":"Program in Physical Therapy Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Hildebolt","sequence":"additional","affiliation":[{"name":"Mallinckrodt Institute of Radiology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed A.","family":"Zayed","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Vascular Surgery Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Mueller","sequence":"additional","affiliation":[{"name":"Program in Physical Therapy Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Zheng","sequence":"additional","affiliation":[{"name":"Mallinckrodt Institute of Radiology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,11,16]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67698-2"},{"key":"e_1_2_6_3_1","unstructured":"International Working Group on the Diabetic Foot 2011"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.13.5.513"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.8.1354"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7538.407"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-1226-2"},{"key":"e_1_2_6_8_1","first-page":"103","article-title":"Diabetic foot ulcers: Etiology, treatment and prevention","volume":"37","author":"Grunfeld C","year":"1992","journal-title":"Adv Intern Med"},{"key":"e_1_2_6_9_1","volume-title":"Managing the diabetic foot","author":"Edmonds ME","year":"2000"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.10.004"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2704"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ptsp.2010.08.001"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757-1146-7-26"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2014.10.007"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2014.03.011"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2012.39.3.227"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.20461"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.1880080610"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.215.1.r00ap07189"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-014-3337-0"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1063\/1.1684482"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.03.033"},{"key":"e_1_2_6_23_1","unstructured":"DabovK FoiA KatkovnikV EgiazarianK.Image denoising with block\u2010matching and 3D filtering. In: Proc SPIE Electronic Imaging '06 no. 6064A\u201030 San Jose CA 2006."},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.2307\/2987937"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.53.6.957"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1522-2594(199911)42:5<890::AID-MRM8>3.0.CO;2-8"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2013.11.011"}],"container-title":["Journal of Magnetic Resonance Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjmri.26570","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmri.26570","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T11:06:08Z","timestamp":1694257568000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmri.26570"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,16]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1002\/jmri.26570"],"URL":"https:\/\/doi.org\/10.1002\/jmri.26570","archive":["Portico"],"relation":{},"ISSN":["1053-1807","1522-2586"],"issn-type":[{"value":"1053-1807","type":"print"},{"value":"1522-2586","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,16]]},"assertion":[{"value":"2018-09-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}