Basic Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2016; 22(46): 10166-10179
Published online Dec 14, 2016. doi: 10.3748/wjg.v22.i46.10166
Non-invasive evaluation of liver stiffness after splenectomy in rabbits with CCl4-induced liver fibrosis
Ming-Jun Wang, Wen-Wu Ling, Hong Wang, Ling-Wei Meng, He Cai, Bing Peng
Ming-Jun Wang, Ling-Wei Meng, He Cai, Bing Peng, Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Wen-Wu Ling, Hong Wang, Department of Ultrasound, West China Hospital, Chengdu 610041, Sichuan Province, China
Author contributions: Wang MJ designed the research; Wang MJ, Ling WW and Wang H performed the research; Meng LW and Cai H analyzed the data; Wang MJ wrote the paper; and Peng B approved the manuscript.
Institutional review board statement: The study protocol was approved by the Ethics Committees of the West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Institutional animal care and use committee statement: The experimental procedures were approved by the Institutional Animal Ethical Committee of Sichuan University (Chengdu, China), and all animals received humane care according to the Guide for the Care and Use of Laboratory Animals published by the US National Institutes of Health (NIH Publication No. 85-23, revised 1996).
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to report.
Data sharing statement: No additional data are available in this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bing Peng, MD, PhD, Department of Pancreatic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu 610041, Sichuan Province, China. wmjjmw01pb@126.com
Telephone: +86-28-85433477 Fax: +86-28-85433474
Received: July 9, 2016
Peer-review started: July 13, 2016
First decision: August 29, 2016
Revised: September 3, 2016
Accepted: September 28, 2016
Article in press: September 28, 2016
Published online: December 14, 2016
Processing time: 156 Days and 6.9 Hours
Abstract
AIM

To investigate the diagnostic performance of liver stiffness measurement (LSM) by elastography point quantification (ElastPQ) in animal models and determine the longitudinal changes in liver stiffness by ElastPQ after splenectomy at different stages of fibrosis.

METHODS

Liver stiffness was measured in sixty-eight rabbits with CCl4-induced liver fibrosis at different stages and eight healthy control rabbits by ElastPQ. Liver biopsies and blood samples were obtained at scheduled time points to assess liver function and degree of fibrosis. Thirty-one rabbits with complete data that underwent splenectomy at different stages of liver fibrosis were then included for dynamic monitoring of changes in liver stiffness by ElastPQ and liver function according to blood tests.

RESULTS

LSM by ElastPQ was significantly correlated with histologic fibrosis stage (r = 0.85, P < 0.001). The optimal cutoff values by ElastPQ were 11.27, 14.89, and 18.21 kPa for predicting minimal fibrosis, moderate fibrosis, and cirrhosis, respectively. Longitudinal monitoring of the changes in liver stiffness by ElastPQ showed that early splenectomy (especially F1) may delay liver fibrosis progression.

CONCLUSION

ElastPQ is an available, convenient, objective and non-invasive technique for assessing liver stiffness in rabbits with CCl4-induced liver fibrosis. In addition, liver stiffness measurements using ElastPQ can dynamically monitor the changes in liver stiffness in rabbit models, and in patients, after splenectomy.

Keywords: Fibrosis stages; Splenectomy; Elastography point quantification; Liver stiffness; Non-invasive technique

Core tip: Elastography point quantification (ElastPQ) is a non-invasive technique for assessing tissue stiffness, and was used in this study. Splenectomy is a surgical intervention for liver cirrhosis patients with hypersplenism. The aim of the current study was to evaluate the diagnostic accuracy of liver stiffness measurement by ElastPQ in animal models and determine the longitudinal changes in liver stiffness by ElastPQ after splenectomy at different stages of fibrosis. We conclude that liver stiffness measurements using ElastPQ can be used to dynamically monitor the changes in liver stiffness in rabbit models, and in patients, after splenectomy.