MR Spectroscopy: Truly Molecular Imaging; Past, Present and Future

      MR imaging has its origins in nuclear MR (NMR) examinations. NMR examinations give typically one- and two-dimensional maps of peaks, which represent a manifestation of the underlying molecular structure. In this way, it is like a map or jigsaw puzzle that suggests the structure of the molecule(s) within the sample chamber. After years of study and innumerable technical innovations, NMR begat MR imaging, and images of organs such as the brain could be obtained. The legendary story goes that patients did not like the word nuclear in the description of the examination, and thus the name changed to MR imaging. For awhile, one- and two-dimensional spectra were no longer obtained or provided with clinical MR imaging examinations. In recent years, it became evident that further characterization of tissues evaluated on MR imaging with such techniques as classical NMR may be useful. That is, MR imaging provided anatomical data and the NMR data may be useful to determine what may be the dominant molecular structure in a region examined clinically. Thus, NMR technology became attractive to clinicians yet again, and its resurgence is manifested as MR spectroscopy. This is MR spectroscopy's past. Its present use involves a plethora of technical variations and predominant use in neuroimaging to complement anatomical data provided by the conventional and functional clinical MR imaging examinations. Its future is uncertain, but many are optimistic that technological advances will continue to make the examination work more universally and provide more clinical impact to a greater number of patients.
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