Correlation of punch liver biopsy with autopsy material

Background Two‐dimensional shear wave elastography (2D‐SWE) can noninvasively evaluate hepatic elastic modulus as shear wave velocity (SWV). Additionally, it may predict the presence of clinical relevant hepatic fibrosis (≥F2) in dogs with hepatic disease. Objectives To investigate whether SWV measured by 2D‐SWE can differentiate between dogs with (≥F2) and without (F0‐1) clinically relevant hepatic fibrosis. Animals Twenty‐eight client‐owned dogs with hepatic disease and 8 normal healthy Beagle dogs were enrolled. Methods In this cross‐sectional prospective study, SWVs were measured using 2D‐SWE in all dogs. Hepatic fibrosis stages and necroinflammatory activity grades were histopathologically evaluated using a histological scoring scheme that was adapted from the Ishak schema used in human medicine. Results Median SWVs were significantly higher in dogs with clinically relevant hepatic fibrosis (2.04 m/s; range, 1.81‐2.26 m/s) than in healthy dogs (1.51 m/s; range, 1.44‐1.66 m/s; P = .007), and dogs without clinically relevant hepatic fibrosis (1.56 m/s; range, 1.37‐1.67 m/s; P < .001). However, no significant difference was found in the SWVs between dogs without clinically relevant hepatic fibrosis and healthy dogs (P = .99). Furthermore, median SWVs were not significantly different among dogs with necroinflammatory activity, those without necroinflammatory activity, and healthy dogs (Kruskal‐Wallis test, P = .12). Conclusions and Clinical Importance The 2D‐SWE may be useful for predicting the presence of hepatic fibrosis in dogs with hepatic disease.

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Usefulness of noninvasive shear wave elastography for the assessment of hepatic fibrosis in dogs with hepatic disease

Tamura

Ohta

Shimbo

et al. 2019

“…Whereas some studies have reported substantial variation in fibrosis 6 and inflammation 12 , others have shown minimal or no significant differences between lobes. [13][14][15] However, the population in this study was not selected for clinical suspicion of liver disease, and the clinical significance of the inflammation and fibrosis in these patients unclear.…”

Section: Discussionmentioning

confidence: 99%

Histopathologic Variation between Liver Lobes in Dogs

Kemp

Zimmerman

Panciera

et al. 2015

BackgroundBiopsy of the liver evaluates a small portion of tissue, with inferences made to the entire organ. The method and number of biopsies obtained are tempered by consideration of the risks and benefits. Recommendations often include biopsy of more than one liver lobe, although the consistency of histopathology among lobes in dogs is unknown.Hypothesis/ObjectivesTo describe the distribution of histopathologic abnormalities between liver lobes. We hypothesized that discordant results would be evenly distributed among all liver lobes.AnimalsSeventy dogs undergoing necropsy.MethodsProspective study. Liver samples were obtained from all lobes. A primary diagnosis was assigned to each liver sample based on the predominant histopathologic abnormality.ResultsIn this population of dogs, biopsy of at least 2 liver lobes identified the predominant histologic abnormality in 98.6% of the cases. Ten (14%) of the dogs had ≤3 lobes in agreement and could not be assigned a predominant diagnosis. The same diagnosis was present in 6/6 lobes in 39 (56.5%) dogs, 5/6 lobes in 10 (14.5%) dogs, 4/6 lobes in 10 (14.5%) dogs, 3/6 lobes in 7 (10.1%) dogs, and 2/6 in 3 (4.3%) dogs. The number of discordant results did not differ between the liver lobes.Conclusion and Clinical ImportanceThe likelihood of obtaining a sample that is reflective of the predominant histologic abnormality in the liver is increased when multiple liver lobes are biopsied.

“…Currently, histopathologic examination of liver tissue is regarded by many clinicians as the most sensitive method of diagnosing hepatic disease and histopathological findings from biopsied tissue in people correlate well with subsequent gross postmortem findings . Histopathology is also regarded as the best indicator of prognosis in hepatic disease in horses and a scoring system has been developed for this purpose .…”

mentioning

confidence: 99%

Serum Bile Acid Concentrations, Histopathological Features, and Short‐, and Long‐term Survival in Horses with Hepatic Disease

Dunkel

Jones

Pinilla

et al. 2015

Background: Serum bile acid concentrations (SBA) and a histopathological biopsy score [Equine Vet J 35 (2003) 534] are used prognostically in equine hepatic disease.Hypothesis: Histopathologic features and scores, but not SBA, differ between survivors and nonsurvivors and correlate with histopathologic evidence of hepatic inflammation and fibrosis.Animals: Retrospective study. Records (1999Records ( -2011 of horses with hepatic disease diagnosed by biopsy and with concurrent measurements of SBA.Methods: Retrospective cohort study. Biopsies were examined for inflammatory cell infiltration including type and distribution, fibrosis, irreversible cytopathology affecting hepatocytes, hemosiderin, or other pigment deposition and bile duct proliferation. SBA, histopathological findings and a histological score [Equine Vet J 35 (2003) 534] were compared between short-(survival to discharge) and long-term (>6 months) survivors and correlations between SBA and histopathological findings investigated.Results: Of 81 cases 90% survived short-term and 83% long-term. Short-term and long-term nonsurvival were associated with SBA (P = .009; P = .006), overall (P = .001; P = .002) and parenchymal (short-term only; P = .01) inflammation, portal and bridging fibrosis (all P < .001), apoptosis or single cell necrosis (P < .001; P = .008), hemosiderin deposition in hepatocytes (P = .011; P = .028), biliary (both P < .001), vascular (P = .003; P = .045) and endothelial (P < .001; P = .02) hyperplasia, nucleic changes (P = .004; P < .001) and the histopathological score (both P < .001). SBA were significantly and positively correlated with overall (P = .001), parenchymal (P < .001) and portal (P = .004) inflammation and portal (P = .036) and bridging (P = .002) fibrosis.Conclusions and Clinical Importance: SBA, histopathological findings and scores differ between survivors and nonsurvivors. SBA concentrations are associated with inflammation and fibrosis suggesting interference with hepatic function. A histopathological score >2 and, less so, SBA >20 lmol/L are specific but not sensitive indicators of nonsurvival.