[31-phosphorus magnetic resonance spectroscopy--a new research instrument in urology. Determination of current status and outlook for clinical use]

Abstract

Noninvasive investigation of renal metabolic changes is possible with 31P-MR, which is characterized by the determination of amounts of "free" phosphorus metabolites and intracellular pH and the possibility of measuring enzyme kinetics by the 31P-MR magnetization transfer method. 31P-MR has been extensively used to monitor such alterations in response to kidney ischemia, in which the ratios of anorganic phosphate to ATP and phosphomonoesters change drastically. The stages of ultrastructural ischemic renal damage can already be accurately classified with reference to a scale of 31P-MR-spectrum-derived renal function predictors. The recent application of MR high-resolution imaging may allow further improvement of organ viability assessment. The clinical use of combined MR imaging and spectroscopy is an essential and imminent step.