Diagnosing and Quantification of Acute Alcohol Intoxication – Comparison of Dual-Energy CT with Biochemical Analysis: Initial Experience

Abstract

Purpose: To quantify the correlation between fat content of an acute alcohol intoxication and the difference of computer tomography attenuation value in dual-energy CT in comparison to biochemical triglyceride analysis and to evaluate qualitatively the value of DECT in the diagnosis of fatty liver caused by ethanol-dosage in rats.

Materials and Methods: DECT at 140 kV and 80 kV was performed on 20 rats before and two days after the administration of 3 ml of 50 % ethanol. The CT attenuation value in the livers at 140 kV, 80 kV and the differences between them in Hounsfield units (ΔH) were collected. Parts of the liver (100 mg) were measured in biochemical triglyceride analysis as the reference standard. A blood sample was also taken to measure specific liver enzymes.

Results: Linear correlation between biochemical triglyceride analysis and CT density of ΔH was found (r = 0.949). 140 kV attenuation data were between 44 HU and 61.3 HU, 80 kV attenuation data were between 58.4 HU and 64.7 HU, and ΔH data were between 3.4 HU and 14.4 HU (p ≤ 0.037). The biochemical triglyceride analysis data were between 7.1 mg/g and 41.1 mg/g. The hepatic enzymes serum aspartate (ASAT) aminotransferase and alanine aminotransferase (ALAT) were elevated in all rats. ASAT correlated directly with ΔHU (r = –0.86).

Conclusion: DECT provides a non-invasive method to determine and evaluate hepatic fat content after acute alcohol intoxication. It provides the possibility to detect and quantify the hepatic fat content of liver graft.

Zusammenfassung

Ziel: Quantifizierung des Fettanteils einer akuten Alkoholvergiftung anhand von Messungen mit der Dual-Energy-Computer-Tomografie (DECT) und der biochemischen Triglyceride-Analyse sowie qualitative Bewertung der DECT als diagnostisches Mittel zur Erkennung einer Fettleber bei Ratten verursacht durch Ethanolgabe.

Material und Methoden: Messungen der DECT wurden bei 140 kV und 80 kV bei 20 Ratten 2 Tage nach Applikation von 3 ml 50 %igem Ethanol durchgeführt. Die CT-Werte bei 140 kV, 80 kV und deren Differenz der Hounsfield-Einheiten (ΔH) wurden bestimmt. Proben der Leber (100 mg) wurden mit der biochemischen Triglyceride-Analyse als Goldstandard gemessen. Zur Auswertung bestimmter Leberenzyme wurde eine Blutprobe genommen.

Ergebnisse: Eine lineare Beziehung zwischen der biochemischen Triglyceride-Analyse und der CT-Dichte von ΔH war festzustellen (r = 0,949). Die Werte bei 140 kV lagen zwischen 44 HU und 61,3 HU, bei 80 kV lagen die Werte zwischen 58,4 HU und 64,7 HU und bei ΔH zwischen 3,4 HU und 14,4 HU (p ≤ 0,037). Die Werte der biochemischen Triglyceride-Analyse lagen zwischen 7,1 mg/g und 41,1 mg/g. Die Werte der Leberenzyme Aspartat-Aminotransferase (ASAT) und Alanin-Aminotransferase (ALAT) waren bei allen Ratten erhöht. ASAT korrelierte direkt mit ΔHU (r = –0,86).

Schlussfolgerung: Die DECT stellt eine nicht invasive Methode zur Feststellung und Bewertung des hepatischen Fettgehalts nach akuter Alkoholvergiftung dar. Es bietet die Möglichkeit, den Fettgehalt von Transplantatlebern quantitativ zu bestimmen.

Key words

abdomen - CT - CT-quantitative - biological effects

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