Free [Mg2+] determination with 31P NMRS is highly dependent on a precise knowledge of intracellular pH. The pH of Duchenne muscular dystrophy patients as determined by the 31P NMRS chemical shift of inorganic phosphate is abnormally alkaline. We have recently shown that intracellular pH in skeletal muscle could be determined using 1H NMRS of carnosine and that intracellular pH was alkaline in a proportion but not in all the DMD patients with a 31P NMRS-based alkaline pH. We decided to take advantage of this 1H NMRS-based intracellular determination to determine whether free intramuscular [Mg2+] is, in fact, abnormally low in DMD patients and investigate its relation with water T2 and fat fraction.
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