Recently, there has been interest in the use of diffusion-weighted imaging (DWI) for quantifying inflammation of the skeleton. In spondyloarthritis, inflammatory exudates in the bone marrow increase the apparent diffusion coefficient (ADC), likely reflecting increased extracellular water. However, the ADC is a simplistic ‘summary’ measure and fails to disentangle the complex pathophysiological changes occurring at inflamed sites. Here, we show that the intravoxel incoherent motion (IVIM) model captures both the rapid ‘perfusion’ component and the slower ‘tissue’ components of the bone marrow diffusion signal, and thus provides a more accurate description of the signal than monoexponential and kurtosis models.
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