Magnetic resonance imaging and localized in vivo proton spectroscopy in patients with fulminant hepatic failure.

Magnetic resonance imaging (MRI) and in vivo proton spectroscopic changes in the brain in three patients with fulminant hepatic failure are described. MRI showed cerebral atrophy in two and changes somewhat similar to what have been described in chronic hepatic encephalopathy. MR spectroscopy showed low myoinositol with high glutamine in grade IV coma, which returned to normal as patient showed clinical recovery. We conclude that these techniques will be useful in understanding the complex pathophysiology of fulminant hepatic failure.