Objective To determine whether subtle changes in hyperechoic findings from low-/high-frequency ultrasound analysis of liver biopsy specimens from patients with chronic hepatitis correlate with differences in liver parenchyma morphology associated with presence and extent of fibrosis.Methods Spatially-matched liver parenchyma biopsy specimens from 216 patients with chronic hepatitis (hepatitis b virus infection) were subjected to both low-and high-frequency ultrasound, as well as conventional histological analysis, which was used to score the extent of fibrosis (progressive staging: S1, no fibrosis, through S4, cirrhosis) .The low-and high-frequency point-like echo and echo performance, respectively, were used to classify samples among one of five fractionating features (fine, thick, coarse/crude, irregular/nonlinear, cable stripes) .Significance of intergroup differences was assessed by Chi-squared test.Spearman′s correlation coefficient was used to assess the correlation between the ultrasound findings and histological fibrosis stage.Results The changes in echoic findings paralleled progressive deterioration in fibrosis stage: from fine to thicker, uneven, and cable stripe shapes along stages S0 to S4.Both the low-and high-frequency ultrasound findings could differentiate changes in liver parenchyma morphology associated with S1 (low-frequency: χ2=76.52 vs.S2, χ2=71.91 vs.S3, χ2=59.43 vs.S4;high-frequency: χ2=76.52 vs.S2, χ2=71.91 vs.S3, χ2=59.43 vs.S4;all P<0.01) and S2 (low-frequency: χ2=5.17 vs.S3, χ2=21.25 vs.S4;high frequency: χ2=23.67 vs.S3, χ2=34.80 vs.S4;all P<0.01) .There were no significant differences associated with either low-or high-frequency ultrasound findings for S3 or S4.The low-and high-frequency ultrasound liver parenchyma fractionation were postively correlated to liver fibrosis staging (r=0.4858 and r=0.5513, respectively) .The high-frequency ultrasound had a significantly higher positive rate of detecting nodules than the low-frequency ultrasound (61.67% vs.27.31%;χ2=49.96, P<0.01) , and the positive rates were positively correlated with liver fibrosis stage (low-frequency: r=0.5437;high-frequency: r=0.3021) .Conclusion While both low-and high-frequency ultrasound allow for detection of liver fibrosis and differentiation of some fibrotic stages, the high-frequency ultrasound findings are superior for detecting fibrotic nodules.
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