{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T11:49:20Z","timestamp":1789213760112,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T00:00:00Z","timestamp":1692403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with type\u20102 diabetes (T2DM) are at increased risk of developing diabetic foot ulcers (DFU) and experiencing impaired wound healing related to underlying microvascular disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate the sensitivity of intra\u2010voxel incoherent motion (IVIM) and blood oxygen level dependent (BOLD) MRI to microvascular changes in patients with DFUs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Case\u2013control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>20 volunteers who were age and body mass index matched, including T2DM patients with DFUs (<jats:italic>N<\/jats:italic>\u2009=\u200910, mean age\u2009=\u200957.5\u2009years), T2DM patients with controlled glycemia and without DFUs (DC, <jats:italic>N<\/jats:italic>\u2009=\u20095, mean age\u2009=\u200957.4\u2009years) and healthy controls (HC, <jats:italic>N<\/jats:italic>\u2009=\u20095, mean age\u2009=\u200952.8\u2009years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Field strength\/Sequence<\/jats:title><jats:p>3T\/multi\u2010<jats:italic>b<\/jats:italic>\u2010value IVIM and dynamic BOLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>Resting IVIM parameters were obtained using a multi\u2010<jats:italic>b<\/jats:italic>\u2010value diffusion\u2010weighted imaging sequence and two IVIM models were fit to obtain diffusion coefficient (<jats:italic>D<\/jats:italic>), pseudo\u2010diffusion coefficient (<jats:italic>D*<\/jats:italic>), perfusion fraction (<jats:italic>f<\/jats:italic>) and microvascular volume fraction (MVF) parameters. Microvascular reactivity was evaluated by inducing an ischemic state in the foot with a blood pressure cuff during dynamic BOLD imaging. Perfusion indices were assessed in two regions of the foot: the medial plantar (MP) and lateral plantar (LP) regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Effect sizes of group mean differences were assessed using Hedge's <jats:italic>g<\/jats:italic> adjusted for small sample sizes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>DFU participants exhibited elevated <jats:italic>D*<\/jats:italic>, <jats:italic>f<\/jats:italic>, and MVF values in both regions (<jats:italic>g<\/jats:italic>\u2009\u2265\u20091.10) and increased <jats:italic>D<\/jats:italic> (<jats:italic>g<\/jats:italic>\u2009=\u20091.07) in the MP region compared to DC participants. DC participants showed reduced <jats:italic>f<\/jats:italic> and MVF compared to HC participants in the MP region (<jats:italic>g<\/jats:italic>\u2009\u2265\u20091.06). Finally, the DFU group showed reduced tolerance for ischemia in the LP region (<jats:italic>g<\/jats:italic>\u2009=\u2009\u22121.51) and blunted reperfusion response in both regions (<jats:italic>g<\/jats:italic>\u2009&lt;\u2009\u22122.32) compared to the DC group during the cuff\u2010occlusion challenge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>The combined use of IVIM and BOLD MRI shows promise in differentiating perfusion abnormalities in the feet of diabetic patients and suggests hyperperfusion in DFU patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>1<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 1<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.28955","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T21:31:02Z","timestamp":1692653462000},"page":"1555-1566","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Feasibility of Multiparametric Perfusion Assessment in Diabetic Foot Ulcer Using Intravoxel Incoherent Motion and Blood Oxygenation\u2010Level Dependent <scp>MRI<\/scp>"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4772-8359","authenticated-orcid":false,"given":"Scott J.","family":"Edwards","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering Emory University and Georgia Institute of Technology  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingting","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Sciences Emory 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