Spinal cord myelin imaging holds potential to quantify cervical spinal cord tissue myelin loss, and hence, the subtle spinal burden of demyelinating diseases, invisible for conventional magnetic resonance imaging. We present the approach of combined spinal 3D double-inversion recovery imaging with diffusion tensor imaging and myelin sensitive multicomponent driven equilibrium single pulse observation of T1 and T2, with subsequent normal spine space registration and group comparison in different multiple sclerosis courses. Whereas no significant differences were found between the different disease courses using fractional anisotropy, relapsing-remitting and primary-progressive multiple sclerosis were discriminated based on differences in relative cord myelin content.
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