Clinical Magnetic Resonance Spectroscopy

1. An Introduction to Medical Magnetic Resonance Spectroscopy.- 1.1. The Magnetic Resonance Phenomenon.- 1.2. Magnetic Resonance in a Clinical Context.- 1.3. Nuclei with Potential Clinical Applications.- 1.3.1. Phosphorus (31P).- 1.3.2. Hydrogen (1H).- 1.3.3. Carbon (13C).- 1.3.4. Nitrogen (15N).- 1.3.5. Oxygen (17O).- 1.3.6. Fluorine (19F).- 1.3.7. Sodium (23Na).- 1.4. The Development of Biological MRS.- 1.4.1. Skeletal Muscle.- 1.4.2. Cardiac Muscle.- 1.4.3. Smooth Muscle.- 1.4.4. Brain.- 1.4.5. Liver.- 1.4.6. Kidney.- 1.4.7. Adipose Tissue.- 1.4.8. Lung(s).- 1.4.9. Testes.- 1.4.10. Ovaries.- 1.4.11. Skin.- 1.4.12. Neoplastic Tissues.- References.- 2. Fundamentals of Clinical Magnetic Resonance.- 2.1. The Origin of the Magnetic Resonance Signal.- 2.1.1. The Behavior of Nuclear Spins in a Magnetic Field.- 2.1.2. The Rotating Frame of Reference.- 2.1.3. The Bloch Equations and Relaxation Phenomena.- 2.2. The Magnetic Resonance Signal.- 2.2.1. The Free Induction Decay.- 2.2.2. The Spin Echo.- 2.2.3. Fourier Transformation.- 2.3. The Spectrum.- 2.3.1. Chemical Shifts.- 2.3.2. The Shapes and Widths of Spectral Peaks.- 2.3.3. Metabolite Concentrations.- 2.4. The Signal-to-Noise Ratio.- 2.4.1. The SNR from a Single 90 Pulse.- 2.4.2. The Effect of T1 and T2 on SNR.- References.- 3. Clinical Studies.- 3.1. Introduction.- 3.2. Studies of the Human Brain.- 3.2.1. Studies of the Neonatal Brain.- 3.2.2. Spectroscopic Studies of the Adult Brain.- 3.3. Studies of Human Skeletal Muscle.- 3.3.1. 31P Spectroscopy of Human Muscle.- 3.3.2. 1H Spectroscopy of Human Muscle.- 3.3.3. 13C Spectroscopy of Muscle.- 3.4. Studies of Human Cardiac Metabolism.- 3.4.1. 31P Studies of Human Cardiac Metabolism.- 3.4.2. 1H Studies of the Human Heart.- 3.5. Studies of the Human Liver.- 3.5.1. 31P Studies of the Human Liver.- 3.5.2. 13C Studies of Human Liver Metabolism.- 3.6. Studies of Human Kidneys.- 3.7. Studies of Human Testes.- 3.8. In Vitro Studies of Human Body Fluids.- 3.8.1. 1H Studies of Urine.- 3.8.2. 1H Studies of Amniotic Fluid.- 3.8.3. 1H Studies of Human Blood Plasma.- 3.9. Studies of Human Red Blood Cells.- 3.9.1. Results from 31P Spectroscopy.- 3.9.2. 1H Spectroscopy of Red Blood Cells.- 3.9.3. 23Na Spectroscopy of Red Blood Cells.- References.- 4. Practical Aspects of Clinical Magnetic Resonance Spectroscopy Systems.- 4.1. An Overview of the System.- 4.2. The Magnet.- 4.2.1. Permanent Magnets.- 4.2.2. Resistive Electromagnets.- 4.2.3. The Liquid-Helium Superconducting Magnet.- 4.2.4. Shim, Gradient, and Profiling Coils.- 4.3. The Spectrometer.- 4.3.1. The RF Probe.- 4.3.2. RF Coils.- 4.3.3. The Preamplifier.- 4.3.4. The Receiver.- 4.3.5. The Analog-to-Digital Converter.- 4.3.6. The Computer System.- 4.4. Safety Requirements.- 4.4.1. The Static Magnetic Field.- 4.4.2. Rapid Magnetic Field Changes.- 4.4.3. Radio-Frequency Fields.- 4.4.4. Other Hazards.- 4.5. Patient Handling.- References.- 5. Data Acquisition in Clinical Magnetic Resonance Spectroscopy.- 5.1. Fundamental Considerations.- 5.1.1. Collecting Data Using Repeated Single Pulses.- 5.1.2. Reduction of Spectrum-Baseline Artifacts.- 5.2. Signal Localization.- 5.2.1. Surface-Coil-Localization Methods.- 5.2.2. Magnetic Field Gradient Techniques.- 5.3. Spin-Echo Techniques.- 5.3.1. Simplification of Spectra.- 5.3.2. Spin Echoes with Surface Coils.- 5.4. Solvent Suppression.- 5.4.1. Composite Pulses.- 5.4.2. Spin Echoes.- 5.4.3. Saturation Methods.- 5.4.4. Binomial Pulses.- 5.5. Spectral Editing.- 5.5.1. Reduction of Bone and Phospholipid Signals.- 5.5.2. Spectral Editing in 1H Spectroscopy.- 5.6. Absolute Quantitation.- 5.6.1. External Concentration References.- 5.6.2. Internal Concentration References.- 5.6.3. Localized Absolute Quantitation.- 5.7. Measurement of Relaxation Constants.- 5.7.1. T1 Measurements in a Uniform RF Field.- 5.7.2. T2 Measurements in a Uniform RF Field.- 5.7.3. Measurements of T1 and T2 with Surface Coils.- References.- 6. Spectrum Analysis.- 6.1. Introduction.- 6.2. Measurement of the Spectrum.- 6.2.1. Raw-Data Baseline Correction.- 6.2.2. Noise Reduction.- 6.2.3. Baseline Smoothing and Resolution Enhancement.- 6.2.4. Phasing the Spectrum.- 6.2.5. Baseline Flattening.- 6.2.6. Area Measurement.- 6.2.7. Position Measurement.- 6.3. Other Analysis Methods.- 6.3.1. FID Fitting.- 6.3.2. The Maximum-Entropy Method.- 6.4. Peak Identification.- 6.5. Data Reduction.- 6.5.1. Correcting for Partial Saturation..- 6.5.2. Data Presentation.- 6.6. Testing the Analysis Methods.- References.