Diffusion magnetic resonance imaging (dMRI) proved promising in patients with non-myelopathic degenerative cervical cord compression (NMDCCC), i.e., without clinically manifested myelopathy. Aim of the study is to present a fast multi-shell HARDI-ZOOMit dMRI protocol and validate its usability to detect microstructural myelopathy in NMDCCC patients. In 7 young healthy volunteers, 13 age-comparable healthy controls, 18 patients with mild NMDCCC and 15 patients with severe NMDCCC, the protocol provided higher signal-to-noise ratio, enhanced visualization of white/gray matter structures in microstructural maps, improved dMRI metric reproducibility, preserved sensitivity (SE = 87.88%) and increased specificity (SP = 92.31%) of control-patient group differences when compared to DTI-RESOLVE protocol (SE = 87.88%, SP = 76.92%). Of the 56 tested microstructural parameters, HARDI-ZOOMit yielded significant patient-control differences in 19 parameters, whereas in DTI-RESOLVE data, differences were observed in 10 parameters, with mostly lower robustness. Novel marker the white-gray matter diffusivity gradient demonstrated the highest separation. HARDI-ZOOMit protocol detected larger number of crossing fibers (5-15% of voxels) with physiologically plausible orientations than DTI-RESOLVE protocol (0-8% of voxels). Crossings were detected in areas of dorsal horns and anterior white commissure. HARDI-ZOOMit protocol proved to be a sensitive and practical tool for clinical quantitative spinal cord imaging.

Center for Magnetic Resonance Research Department of Radiology University of Minnesota Minneapolis MN 55414 USA

Central European Institute of Technology Masaryk University 625 00 Brno Czech Republic

Department of Biomedical Engineering University Hospital Olomouc 779 00 Olomouc Czech Republic

Department of Imaging Methods Faculty of Medicine University of Ostrava 701 03 Ostrava Czech Republic

Department of Medicine 3 Clinical Division of Endocrinology and Metabolism Medical University of Vienna 1090 Vienna Austria

Department of Neurology Palacký University 779 00 Olomouc Czech Republic

Department of Neurology University Hospital Brno 625 00 Brno Czech Republic

Department of Neurology University Hospital Olomouc 779 00 Olomouc Czech Republic

Division of Clinical Behavioral Neuroscience Department of Pediatrics University of Minnesota Minneapolis MN 55414 USA

Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

High Field MR Centre Medical University of Vienna Vienna Austria

Institute of Biomedical Engineering Polytechnique Montreal Montreal Canada

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Reproducible Spinal Cord Quantitative MRI Analysis with the Spinal Cord Toolbox

Evidence-based commentary on the diagnosis, management, and further research of degenerative cervical spinal cord compression in the absence of clinical symptoms of myelopathy

Body size interacts with the structure of the central nervous system: A multi-center in vivo neuroimaging study

Quantitative MR Markers in Non-Myelopathic Spinal Cord Compression: A Narrative Review

Semi-automated detection of cervical spinal cord compression with the Spinal Cord Toolbox

Diffusion magnetic resonance imaging reveals tract-specific microstructural correlates of electrophysiological impairments in non-myelopathic and myelopathic spinal cord compression

Generic acquisition protocol for quantitative MRI of the spinal cord

Walk and Run Test in Patients with Degenerative Compression of the Cervical Spinal Cord