title: Shear wave elastography results correlate with liver fibrosis histology and liver function reserve.
abstract: OBJECTIVE
  To evaluate the correlation of shear wave elastography (SWE) results with liver fibrosis histology and quantitative function reserve.
  
  
  METHODS
  Weekly subcutaneous injection of 60% carbon tetrachloride (1.5 mL/kg) was given to 12 canines for 24 wk to induce experimental liver fibrosis, with olive oil given to 2 control canines. At 24 wk, liver condition was evaluated using clinical biochemistry assays, SWE imaging, lidocaine metabolite monoethylglycine-xylidide (MEGX) test, and histologic fibrosis grading. Clinical biochemistry assays were performed at the institutional central laboratory for routine liver function evaluation. Liver stiffness was measured in triplicate from three different intercostal spaces and expressed as mean liver stiffness modulus (LSM). Plasma concentrations of lidocaine and its metabolite MEGX were determined using high-performance liquid chromatography repeated in duplicate. Liver biopsy samples were fixed in 10% formaldehyde, and liver fibrosis was graded using the modified histological activity index Knodell score (F0-F4). Correlations among histologic grading, LSM, and MEGX measures were analyzed with the Pearson linear correlation coefficient.
  
  
  RESULTS
  At 24 wk liver fibrosis histologic grading was as follows: F0, n = 2 (control); F1, n = 0; F2, n = 3; F3, n = 7; and F4, n = 2. SWE LSM was positively correlated with histologic grading (r = 0.835, P < 0.001). Specifically, the F4 group had a significantly higher elastic modulus than the F3, F2, and F0 groups (P = 0.002, P = 0.003, and P = 0.006, respectively), and the F3 group also had a significantly higher modulus than the control F0 group (P = 0.039). LSM was negatively associated with plasma MEGX concentrations at 30 min (r = -0.642; P = 0.013) and 60 min (r = -0.651; P = 0.012), time to ½ of the maximum concentration (r = -0.538; P = 0.047), and the area under the curve (r = -0.636; P = 0.014). Multiple comparisons showed identical differences in these three measures: significantly lower with F4 (P = 0.037) and F3 (P = 0.032) as compared to F0 and significantly lower with F4 as compared to F2 (P = 0.032).
  
  
  CONCLUSIONS
  SWE LSM shows a good correlation with histologic fibrosis grading and pharmacologic quantitative liver function reserve in experimental severe fibrosis and cirrhosis.
authors.affiliation: Yan-Hong Feng, Xiang-Dong Hu, Lin Zhai, Lan-Yan Qiu, Yuan Zu , Si Liang, Yu Gui, Lin-Xue Qian, Department of Ultrasound Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Yan-Hong
authors.initials: YH
authors.lastname: Feng
authors.affiliation: Yan-Hong Feng, Xiang-Dong Hu, Lin Zhai, Lan-Yan Qiu, Yuan Zu , Si Liang, Yu Gui, Lin-Xue Qian, Department of Ultrasound Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Xiang-Dong
authors.initials: XD
authors.lastname: Hu
authors.affiliation: Yan-Hong Feng, Xiang-Dong Hu, Lin Zhai, Lan-Yan Qiu, Yuan Zu , Si Liang, Yu Gui, Lin-Xue Qian, Department of Ultrasound Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhai
authors.affiliation: Yan-Hong Feng, Xiang-Dong Hu, Lin Zhai, Lan-Yan Qiu, Yuan Zu , Si Liang, Yu Gui, Lin-Xue Qian, Department of Ultrasound Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Ji-Bin
authors.initials: JB
authors.lastname: Liu
authors.affiliation: Yan-Hong Feng, Xiang-Dong Hu, Lin Zhai, Lan-Yan Qiu, Yuan Zu , Si Liang, Yu Gui, Lin-Xue Qian, Department of Ultrasound Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Lan-Yan
authors.initials: LY
authors.lastname: Qiu
authors.affiliation: Yan-Hong Feng, Xiang-Dong Hu, Lin Zhai, Lan-Yan Qiu, Yuan Zu , Si Liang, Yu Gui, Lin-Xue Qian, Department of Ultrasound Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zu
authors.affiliation: Yan-Hong Feng, Xiang-Dong Hu, Lin Zhai, Lan-Yan Qiu, Yuan Zu , Si Liang, Yu Gui, Lin-Xue Qian, Department of Ultrasound Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Si
authors.initials: S
authors.lastname: Liang
authors.affiliation: Yan-Hong Feng, Xiang-Dong Hu, Lin Zhai, Lan-Yan Qiu, Yuan Zu , Si Liang, Yu Gui, Lin-Xue Qian, Department of Ultrasound Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Gui
authors.affiliation: Yan-Hong Feng, Xiang-Dong Hu, Lin Zhai, Lan-Yan Qiu, Yuan Zu , Si Liang, Yu Gui, Lin-Xue Qian, Department of Ultrasound Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Lin-Xue
authors.initials: LX
authors.lastname: Qian
mesh_terms: D000818:Animals; D004285:Dogs; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D008012:Lidocaine / Q000031:analogs & derivatives / Q000097:blood; D008099:Liver / Q000473:pathology / Q000503:physiopathology*; D008106:Liver Cirrhosis, Experimental / Q000097:blood / Q000473:pathology* / Q000503:physiopathology; D008297:Male
chemical_list: D008012:Lidocaine; C001173:monoethylglycinexylidide
keywords: Experimental study; Histologic grading; Liver fibrosis; Monoethylglycinexylidide test; Shear wave elastography