Collectively, these results demonstrate FP-DDE benefits from greater specificity for acute axonal damage in predicting functional and histological outcomes with rapid acquisition and fully automated analysis, improving over standard DWI. FP-DDE is a promising technique compatible with clinical settings, with potential research and clinical applications for evaluation of spinal cord pathology. Ann Neurol 2018;83:37-50.

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Purpose: Diffusion MRI provides unique contrast important for the detection and examination of pathophysiology after acute neurologic insults, including spinal cord injury. Diffusion weighted imaging of the rodent spinal cord has typically been evaluated with axial EPI readout. However, Diffusion weighted imaging is prone to motion artifacts, whereas EPI is prone to susceptibility artifacts. In the context of acute spinal cord injury, diffusion filtering has previously been shown to improve detection of injury by minimizing the confounding effects of edema. We propose a diffusion-preparation module combined with a rapid acquisition with relaxation enhancement readout to minimize artifacts for sagittal imaging. Methods: Sprague-Dawley rats with cervical contusion spinal cord injury were scanned at 9.4 Tesla. The sequence optimization included the evaluation of motioncompensated encoding diffusion gradients, gating strategy, and different spinal cordspecific diffusion-weighting schemes. Results: A diffusion-prepared rapid acquisition with relaxation enhancement achieved high-quality images free from susceptibility artifacts with both second-order motioncompensated encoding and gating necessary for reduction of motion artifacts. Axial diffusivity obtained from the filtered diffusion-encoding scheme had greater lesionto-healthy tissue contrast (52%) compared to the similar metric from DTI (25%). Conclusion: This work demonstrated the feasibility of high-quality diffusion sagittalimaging in the rodent cervical cord with diffusion-prepared relaxation enhancement.The sequence and results are expected to improve injury detection and evaluation in acute spinal cord injury. K E Y W O R D Sartifact reduction, diffusion imaging, motion preparation, spinal cord | INTRODUCTIONTraumatic spinal cord injury (SCI) is a catastrophic event that can permanently impair sensorimotor function, but accurate diagnosis and prognosis of injury severity are limited. There remains a medical need for improved prognostic metrics that can stratify early injury severity to guide clinical treatment and enrollment in clinical trials. Diffusion weighted imaging How to cite this article: Lee S-Y, Meyer BP, Kurpad SN, Budde MD. Diffusion-prepared fast spin echo for artifact-free spinal cord imaging.

Surgical myelotomy, a procedure intended to relieve pressure on an acutely-injured spinal cord, improves long-term functional and pathologic outcomes in animal models. However, the direct consequences of myelotomy on the cord pathophysiology have not been evaluated in the acute setting. In this work, we used multimodal MRI tailored for the spinal cord to monitor changes in edema, hemorrhage, axonal injury, and perfusion immediately before and 24 hours after surgical myelotomy. The results demonstrate spatial and temporal changes and provide unique insight into the pathophysiology of acute injury and its intervention.