This review deals with magnetization transfer (MT) effects observed in in v
ivo NMR spectroscopy. The basic experimental methods of MT experiments, the
underlying kinetic mechanisms as well as the evaluation of measured data b
y fits to two- or three-pool models are described, Experimental results of
both P-31 and H-1 in vivo MRS are reviewed showing the potential of MT expe
riments to characterize kinetic equilibrium reactions. This includes reacti
ons where all involved components are MR visible, as well as situations whe
re one indirectly measures pools of bound spins which cannot directly be ob
served in vive. In particular, MT effects are described which have been obs
erved in in vivo H-1 NMR spectra measured on the animal or human brain or o
n skeletal muscle. Possible mechanisms for the strong MT effects observed f
or the signals of creatine/phosphocreatine, lactate, alcohol and other meta
bolites are discussed. It is also emphasized that MT effects caused by wate
r suppression techniques may lead to systematic errors in the quantificatio
n of in vive H-1 NMR spectra. Copyright (C) 2001 John Wiley & Sons, Ltd.