Decreased hepatic CT value on immediate postmortem CT after CPR: Comparison with antemortem CT and correlation with liver enzymes changes

Abstract

Purpose We compared hepatic antemortem CT (AMCT) and postmortem CT (PMCT) values obtained in the same subjects. The correlations between the changes in hepatic CT values and changes in aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) values were also investigated.

Materials and methods Fifty subjects (20 males, 30 females; mean age: 85.9 ± 7.9 years; range: 67–100 years) who were transported to the emergency room in cardiopulmonary arrest (CPA) and underwent PMCT immediately after unsuccessful cardiopulmonary resuscitation (CPR) comprised the study population. The hepatic AMCT and PMCT values were both measured, and the differences between the two were calculated. The differences between AST, ALT, and LDH values at CPR and antemortem were also calculated. The correlations between the hepatic CT value differences and AST, ALT, and LDH value differences also were assessed.

Results The hepatic AMCT and PMCT values of 61.7 ± 6.8 Hounsfield Unit (HU) and 46.2 ± 8.2 HU, respectively, were significantly different. The AST, ALT, and LDH values were significantly higher at CPR than at antemortem. The differences in the hepatic CT values and in the AST, ALT, and LDH values were moderately correlated.

Conclusion The hepatic values were significantly lower on PMCT than on AMCT. The changes in hepatic CT values correlated with the changes in the liver deviation enzyme values. These results indicate the possibility that ischemic, hypoxic injury, and anerobic glycolysis of the liver at CPR after CPA are the cause of decreased hepatic PMCT values.