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Detection of a Fatty Liver After Binge Drinking

Posted Oct 31, 2011 Updated Apr 10, 2023
By Huedayi Korkusuz MD , Daniel Keese , Bahram Abbas Raschidi , Frank Hübner , Dmitry Namgaladze MD , Gudrun Hintereder MD , Renate Hammerstingl MD , Yuecel Korkusuz MD , Christian Mönch MD , Thomas J. Vogl MD
12 min read

Rationale and Objectives

The purpose of this study was to evaluate the possibility of detecting a fatty liver after binge drinking in an animal model using 1 H magnetic resonance spectroscopy ( 1 H-MRS), dual-energy computed tomography (DECT), biochemistry, and the gold standard of histology.

Materials and Methods

In 20 inbred female Lewis rats, an alcoholic fatty liver was induced; 20 rats served as controls. To simulate binge drinking, each rat was given a dose of 9.3 g/kg body weight 50% ethanol twice, with 24 hours between applications. Forty-eight hours after the first injection, DECT and 1 H-MRS were performed. Fat content as well as triglycerides were also determined histologically and biochemically, respectively. To assess specific liver enzymes, blood was drawn from the orbital venous plexus.

Results

In all 20 animals in the experimental group, fatty livers were detected using 1 H-MRS, DECT, and biochemical and histologic analysis. The spectroscopic fat/water ratio and the biochemical determination were highly correlated ( r = 0.892, P < .05). A significant correlation was found between 1 H-MRS and histologic analysis ( r = 0.941, P < .001). Also, a positive linear correlation was found between the dual-energy computed tomographic density of ΔHU and the biochemical ( r = 0.751, P < .05) and histologic ( r = 0.786, P < .001) analyses.

Conclusions

Quantification of hepatic fat content on 1 H-MRS showed high correlation with histologic and biochemical steatosis determination. In comparison to DECT, it is more suitable to reflect the severity of acute fatty liver.

Binge drinking is a modern form of drinking alcoholic beverages with the primary intention of becoming intoxicated through heavy consumption of alcohol . A standardized conceptual definition of binge drinking was proposed by the National Institute on Alcohol Abuse and Alcoholism in 2004: a “binge” is a pattern of drinking alcohol that elevates the blood alcohol content to ≥0.08 g%. For the typical adult, this pattern corresponds to consuming five or more drinks for men, or four or more drinks for women, in about 2 hours , whereby according to the Centers for Disease Control and Prevention, a standard drink is defined as 0.6 fluid ounces of pure alcohol.

Especially among young people, binge drinking is often regarded as a fun, social activity, with little thought given to the health effects that may follow, and it accounts for a large proportion of all alcohol-related deaths, which makes it an increasingly important topic in alcohol research. In 2004 in the European region, alcohol-attributable deaths in men (11.0%) and woman (1.8%) were above average. Aftereffects were neuropsychiatric disorders, cardiovascular diseases, liver cirrhosis, and cancer . Another study reported that in 2008 in Germany, approximately 25,700 children, teenagers, and adults (aged 10–20 years) had been in hospitals for acute alcohol intoxication, an 11% increase since 2007 and a 170% increase since 2000 .

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Materials and methods

Animals

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Acute Ethanol Intoxication

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Measurements

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DECT

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Figure 1, Transverse dual-energy computed tomographic image at 140 kV of a rat with the gate of the liver, with the mean position of the region of interest (ROI).

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Magnetic Resonance Imaging (MRI)

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1 H-MRS

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Figure 2, Representative coronal T2-weighted magnetic resonance image (repetition time, 3240 ms; echo time, 79 ms; flip angle, 140°) illustrating the position of the region of interest of approximately 10 mm 3 in the rat liver used for calculation of liver fat in vivo.

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Figure 3, (a) Typical proton magnetic resonance spectrum of a healthy rat liver in vivo (echo time, 135 ms; repetition time, 1500 ms; volume of interest, 1 cm 3 ). (b) Proton magnetic resonance spectrum of an in vivo liver of the same rodent (echo time, 135 ms; repetition time, 1500 ms; volume of interest, 1 cm 3 ) after alcohol intoxication. The dominant signal at 4.7 ppm stems from water, while the signal component from fatty acids at 1.3 ppm indicates a fat volume fraction of approximately 4.5%. (c) Expanded view of the proton magnetic resonance spectrum, highlighting resonance from protons of methylene.

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Biochemical Analysis

Determination of Hepatic Triglycerides (TG)

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Liver histology

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Serologic parameters

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Statistical Analysis

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Results

Histologic Results

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Figure 4, Typical histologic slides of liver section from ethanol-treated rats with approximately 20% steatosis. Microvesicular fatty change (small arrow) and macro accumulations of fat in hepatocytes producing “lipocyte-like” cells (large arrow) were observed 24 hours after the second ethanol injection.

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DECT

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Figure 5, (a) Computed tomographic signal intensity (in Hounsfield units [HU]) in relation to biochemical triglyceride analysis according to Folch et al (15) (milligrams of triglycerides per grams of liver tissue). Scatterplot and regression line show correlation between ΔHU (140 kV − 80 kV), calculated with dual-energy computed tomography, and the biochemical triglyceride analysis ( r = 0.751, P < .05). (b) Correlation between ΔHU and histologic values ( r = 0.786 P < .001).

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1 H-MRS

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Figure 6, Reproducibility of fat measurements by 1 H magnetic resonance spectroscopy ( 1 H-MRS) obtained from livers before ethanol intoxication (left box plot) and livers after ethanol intoxication (right box plot) . The number of cases for each group was 20. Measurements were made from tissue volumes of equal size in the liver. The unit of measured liver fat fraction is a ratio of signal from fat to total signal from fat and water. Without ethanol, the mean of measured fat content amounts to 0.5 ± 0.5%. After ethanol intoxication, in vivo measurements showed a mean of 2.1 ± 1.4%. ∗Significantly different data ( P < .01) between liver fat content on 1 H-MRS (percentage) before ethanol and after ethanol intoxication.

Figure 7, Scatterplot and regression line show close correlation between in vivo liver fat content calculated with 1 H magnetic resonance spectroscopic ( 1 H-MRS) (percentage) and that measured biochemically (milligrams of triglycerides per grams of liver tissue) as well as histologically in 20 different subjects. (a) Helium-1 MRS versus biochemistry ( r = 0.892, P < .001). (b) Correlation between in vivo liver fat content ( 1 H-MRS) and histologic assessment (percentage steatotic hepatocytes) ( r = 0.941, P < .001).

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Serologic Parameters

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Table 1

Summary of Correlation Results (and Probability) from 1 H-MRS and Biochemical and Histologic Analyses and Serologic Parameters

Correlation_r__P_ 1 H-MRS vs histology 0.941 <.001 1 H-MRS vs biochemistry 0.892 <.05 1 H-MRS in vivo vs AST 0.862 <.001 1 H-MRS vs ALT 0.528 <.001 ΔHU vs histology 0.786 <.001 ΔHU vs biochemistry 0.751 <.05 ΔHU vs AST −0.743 <.001 ΔHU vs ALT −0.344 <.001

ALT, alanine aminotransferase; AST, aspartate aminotransferase; HU, Hounsfield units; MRS, magnetic resonance spectroscopy.

Correlation coefficients were calculated using Pearson’s correlation test. Significance was established at the 95% confidence level ( P < .05).

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Discussion

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Conclusions

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Academic Radiology, Volume 18, Issue 11
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