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

Zhang, MD Yue; Ding, MD Hong; Wu, MD Shengdi; Fan, MD Peili; Li, MD Zheng; Zeng, MD Wenjiao; Wang, MD Wenping

doi:10.37015/AUDT.2019.190815

ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY >

2019 , Vol. 3 >Issue 3: 87 - 96

DOI: https://doi.org/10.37015/AUDT.2019.190815

Original Research

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

Zhang, MD Yue ,
Ding, MD Hong ,
Wu, MD Shengdi ,
Fan, MD Peili ,
Li, MD Zheng ,
Zeng, MD Wenjiao ,
Wang, MD Wenping

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^a Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
^b Shanghai Institute of Medical Imaging, Shanghai,China.

Received date: 2019-05-15

Online published: 2019-09-05

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Abstract

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

Cite this article

Zhang, MD Yue , Ding, MD Hong , Wu, MD Shengdi , Fan, MD Peili , Li, MD Zheng , Zeng, MD Wenjiao , Wang, MD Wenping . Histological Reference for Shear Wave Elastography in Liver Fibrosis: Collagen Quantification and Scoring System[J]. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY, 2019 , 3(3) : 87 -96 . DOI: 10.37015/AUDT.2019.190815

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