Proton MR spectroscopy in clinical routine

In vivo magnetic resonance spectroscopy (MRS) addresses metabolic pathways and their steady states in different tissue types. The brain has by tradition, and due to technical limitations in other organs, been one of the tissues most studied by MRS, and both 1H- and 31P-MRS have been used. Although 31P-MRS is outstanding for the evaluation of sources of metabolic energy in the brain, 1H-MRS has become the major clinically applied method in neurospectroscopy, as it provides information on markers of neuronal function, myelin, cell membranes, and metabolic active compounds. Furthermore, MR sensitivity is much greater for protons than it is for phosphorus and 1H-MRS, therefore allowing better spatial resolution. This review focuses on neurospectroscopy and diagnostic insights into diverse neurological problems provided by 1H-MRS applied as a clinical tool.