Gümbel Denis, Schneidler Frank, Frank Matthias, Bockholdt Britta, Hinz Peter, Napp Matthias, Spitzmüller Romy, Ekkernkamp Axel, Langner Sönke
Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany; Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin gGmbH (ukb), Warener Str. 7, 12683 Berlin, Germany.
Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany.
Alcohol. 2017 Dec;65:45-50. doi: 10.1016/j.alcohol.2017.07.004. Epub 2017 Sep 23.
The aim of this study was to investigate whether urinary bladder volume (UBV) and blood alcohol concentration (BAC) correlate in a cohort of emergency trauma patients. Furthermore, the feasibility of semi-automated 3D-CT volumetry for urinary bladder volumetry calculations in whole-body CT examinations was elucidated.
Whole-body CT scans of 831 individuals treated in the emergency department with suspected multiple injuries were included. Manual 3D-CT volumetry of the urinary bladder was performed and the mechanism of injury, patient demographics, BAC, serum creatinine, and hematocrit were retrospectively analyzed. Semi-automated calculation of UBV was performed in 30 patients. Statistical analysis included ROC analysis to calculate cut-off values, sensitivity, and specificity. The Mann-Whitney test and Spearman's correlation coefficient were used to detect significant correlations between UBV and BAC.
Manual 3D-CT volumetry showed maximum sensitivity and specificity with a cut-off value for urinary bladder volume of 416.3 mL (sensitivity 50.9%; specificity 76.3%; AUC 0.678). With a cut-off value of 4.2 mL/μmol for the creatinine quotient (quotient of serum creatinine and UBV), the sensitivity was 64.2% (specificity 67.0%; AUC 0.681). Semi-automated 3D-CT volumetry resulted in lower UBV values compared to those obtained with manual 3D-CT volumetry.
Semi-automated 3D-CT volumetry is a reliable method to quantify UBV. UBV correlates with positive BAC results. A UBV above 416 mL seen on an initial whole-body CT must raise suspicion of alcohol intoxication. The creatinine quotient is an even more sensitive and specific parameter for the detection of alcohol intoxication.
本研究旨在调查急诊创伤患者队列中膀胱容量（UBV）与血液酒精浓度（BAC）之间是否存在相关性。此外，还阐明了在全身CT检查中使用半自动3D-CT容积测量法计算膀胱容积的可行性。
纳入831例在急诊科接受治疗的疑似多处受伤患者的全身CT扫描。对膀胱进行手动3D-CT容积测量，并回顾性分析损伤机制、患者人口统计学特征、BAC、血清肌酐和血细胞比容。对30例患者进行了UBV的半自动计算。统计分析包括ROC分析以计算临界值、敏感性和特异性。使用Mann-Whitney检验和Spearman相关系数来检测UBV与BAC之间的显著相关性。
手动3D-CT容积测量显示，膀胱容积临界值为416.3 mL时，敏感性和特异性最高（敏感性50.9%；特异性76.3%；AUC 0.678）。肌酐商（血清肌酐与UBV的商）临界值为4.2 mL/μmol时，敏感性为64.2%（特异性67.0%；AUC 0.681）。与手动3D-CT容积测量获得的值相比，半自动3D-CT容积测量得出的UBV值较低。
半自动3D-CT容积测量法是量化UBV的可靠方法。UBV与BAC阳性结果相关。初次全身CT显示UBV高于416 mL时，必须怀疑酒精中毒。肌酐商是检测酒精中毒更敏感和特异的参数。
