Advanced Ultrasound in Diagnosis and Therapy ›› 2019, Vol. 3 ›› Issue (3): 87-96.doi: 10.37015/AUDT.2019.190815

• Original Research • Previous Articles     Next Articles

Histological Reference for Shear Wave Elastography in Liver Fibrosis: Collagen Quantification and Scoring System

Yue Zhang, MDab, Hong Ding, MDab*(), Shengdi Wu, MDab, Peili Fan, MDab, Zheng Li, MDab, Wenjiao Zeng, MDab, Wenping Wang, MDab   

  1. a Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
    b Shanghai Institute of Medical Imaging, Shanghai,China.
  • Received:2019-05-15 Online:2019-09-30 Published:2019-09-05
  • Contact: Hong Ding, MD,


Objective: To investigate the significance and value of collagen quantification as an optimized histological standard to evaluate shear wave elastography (SWE) in assessing liver fibrosis.

Methods: Liver fibrosis models of rats were created by intraperitoneal injection of thioacetamide over 12 weeks. Liver stiffness was measured with SWE in 96 rats and 16 controls from week 5 to week 12. After removing, three liver specimens were processed for hematoxylin-eosin staining, reticular fiber staining, and picric-sirius red staining, respectively. Liver fibrosis stage (F0-F4) was assessed with the Scheuer scoring system. Collagen was quantified using collagen proportionate area (CPA) with computer-assisted digital image analysis. The Spearman’s rank correlation analysis was performed to determine the correlation between hepatic stiffness measured by SWE, traditional stages and CPA.

Results: The mean CPAs in different stages of liver fibrosis were 0.221 ± 0.134, 0.425 ± 0.204, 0.775 ± 0.375, 1.293 ± 0.591, and 2.447 ± 0.891 for F0, F1, F2, F3, and F4, respectively. CPAs showed a strong positive correlation with the traditional scoring system (r = 0.819, P < 0.001). Liver stiffness represented by SWE values exhibited a slightly stronger positive correlation with CPA (r = 0.889, P < 0.001) than with traditional fibrosis staging system (r = 0.836, P < 0.001), with no statistic difference.

Conclusion: The accurate and scientific collagen quantification of CPA can be developed as one pathological reference to reliably reflect the diagnostic value of SWE in evaluating liver fibrosis progression.

Key words: Ultrasound; Elastography; Liver fibrosis; Collagen quantification