Nuclear magnetic resonance in the clinical laboratory

Nuclear magnetic resonance (NMR) which now has widespread clinical use as an imaging technique, may also have significant application to diagnostic pathology. High-field proton NMR spectroscopy can perform rapid multicomponent analysis of serum, urine, cerebrospinal fluid, and even intact cells. This technique allows unusually detailed studies of certain metabolic derangements and toxic ingestions. Phosphorus NMR spectroscopy in vivo can measure ATP and other phosphometabolites, intracellular pH, and free Mg2+. It has been applied to diagnosing inborn errors of metabolism such as glycogen storage disease, monitoring growth and regression of tumors, and assessing tissue viability. The basics of NMR spectroscopy are reviewed in this article, along with a survey of applications in human pathology.