Multi-shot EPI diffusion tensor imaging of the human lumbar spinal cord is sensitive to microstructural tissue changes in multiple sclerosis

Motivation: Lumbar spinal cord diffusion tensor imaging (DTI) could provide insight into lower extremity dysfunction in multiple sclerosis; however, susceptibility artifacts and geometric distortions cause challenges. Goal(s): Our goal was to deploy a multi-shot, reduced field-of-view, 2D-navigated DTI sequence in the lumbar enlargement to compare healthy and multiple sclerosis findings. Approach: 28 healthy controls and 35 multiple sclerosis patients were imaged, and difference in DTI indices were explored both within-subject and between-subject. Results: Significant DTI lesion and white matter differences were found between healthy controls and multiple sclerosis patients, and heterogeneity in DTI indices was found throughout the healthy lumbar spinal cord. Impact: Evaluation of multi-shot, reduced field-of-view, 2D-navigated DTI of the lumbar spinal cord of healthy volunteers and multiple sclerosis patients provides a unique way to study tissue heterogeneity, and identifying specific lesion locations is necessary to evaluate disease-related damage.