The utility of advanced quantitative MRI for assessment of spinal cord tissue damage in multiple sclerosis has not yet been established. In this work, we used T1-mapping as well as quantitative magnetization transfer saturation and echo-planar imaging to quantify the extent of pathologic changes in the cervical cord of multiple sclerosis patients. Our results point to extensive demyelination and axonal loss both in the normal-appearing and lesional cervical cord, as well as to and chronic inflammation of cSCWM lesions in secondary progressive multiple sclerosis. Hence, quantitative spinal cord MRI may provide valuable information about the pathologic substrate of this disease.

A new approach for estimating inner axon radii from intra-axonal T2 relaxation times was recently proposed. However, further validations are required before this technique can be used widely. The main aim of this study is to validate this T2-based pore size estimation technique in phantoms comprising co-electrospun hollow axon-mimicking fibres designed to have non-circular cross-sections and different radii distributions. For this purpose, a diffusion-relaxation MRI dataset was acquired with a 7T preclinical scanner, from which the intra-fibre T2 times and pore sizes were estimated. The resulting pore sizes were compared to those measured from Scanning Electron Microscope images.

In-vivo quantification of axon diameter is an attractive and debated topic in the MRI community. The possibility to resolve submicrometric axon diameters non-invasively yields the potential to push further the boundaries in research and clinics but yet, further work is needed to better explore and validate the existing approaches to estimate the inner axon diameter. Recently, the feasibility of estimating the axon diameter from the intra-axonal transverse relaxation time has been investigated combining a diffusion-relaxation protocol and histological data. In the present study, we apply this approach in a larger in vivo population to assess variability across participants.

We explored the value of multiple longitudinal quantitative MRI (qMRI) measures in detecting microstructural changes occurring in normal-appearing tissue of patients with multiple sclerosis (PwMS). While no differences in qMRI longitudinal changes were measured between PwMS and healthy controls, progressive PwMS showed accelerated T1-relaxometry increase in normal-appearing tissue with respect to both healthy controls and relapsing-remitting PwMS, reflecting increased micro/macrostructural damage. In PwMS the rates of qMRI changes during follow-up were associated with the severity of clinical disability, with higher neurological impairment being associated with qMRI changes reflecting accelerated micro/macrostructural damage, demyelination, and axon/dendrite loss.