European Radiology

, Volume 28, Issue 5, pp 2096–2106 | Cite as

Noninvasive assessment of hepatic sinusoidal obstructive syndrome using acoustic radiation force impulse elastography imaging: A proof-of-concept study in rat models

  • So Hyun Park
  • Seung Soo LeeEmail author
  • Ji-Youn Sung
  • Kiyong Na
  • Hyoung Jung Kim
  • So Yeon Kim
  • Beom Jin Park
  • Jae Ho Byun



To determine the feasibility of acoustic radiation force impulse (ARFI) elastography in the evaluation of hepatic sinusoidal obstruction syndrome (SOS) in rat models.


Rat SOS models of various severities were created by monocrotaline gavage (n = 40) or by intraperitoneal injection of 5-fluorouracil, leucovorin and oxaliplatin (FOLFOX) (n = 16). Liver shear-wave velocity (SWV) was measured using ARFI elastography. Liver samples were analysed for the SOS score, steatosis, lobular inflammation and fibrosis.


The liver SWV was significantly elevated in the SOS models (1.29–2.24 m/s) compared with that of the matched control rats (1.01–1.09; p≤.09; veFor seven FOLFOX-treated rats which were longitudinally followed-up, the liver SWV significantly increased at 7 weeks (1.32±0.13 m/s) compared with the baseline (1.08±0.1 m/s, p=.015) and then significantly declined after a 2-week, treatment-free period (1.15±0.13 m/s; p=.048). Multivariate analysis revealed that the SOS score (p<.001) and lobular inflammation (p=.044) were independently correlated with the liver SWV.


Liver SWV is elevated in SOS in proportion to the degree of sinusoidal injury and lobular inflammation in rat SOS models. ARFI elastography has potential as an examination for diagnosis, severity assessment and follow-up of SOS.

Key Points

Liver SWV using ARFI elastography was significantly elevated in SOS rat.

Sinusoidal injury and lobular inflammation grades had correlation with liver SWV.

ARFI elastography has potential for diagnosis, severity assessment, and follow-up of SOS.


Liver Sinusoidal obstruction syndrome Ultrasonography Acoustic radiation force impulse elastography Shear-wave velocity 



Alanine aminotransferase


Acoustic radiation force impulse


Aspartate aminotransferase


Computed tomography


5-Fluorouracil, leucovorin and oxaliplatin combination


Haematoxylin and eosin


Magnetic resonance


Masson trichrome


Sinusoidal obstruction syndrome


Shear-wave velocity





This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2017R1A2B4003114).

Compliance with ethical standards


The scientific guarantor of this publication is Moon Gyu Lee.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Ethical approval

Approval from the institutional animal care committee was obtained.


• prospective

• experimental

• performed at one institution

Supplementary material

330_2017_5179_MOESM1_ESM.docx (969 kb)
ESM 1 (DOCX 968 kb)


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • So Hyun Park
    • 1
    • 5
  • Seung Soo Lee
    • 1
    Email author
  • Ji-Youn Sung
    • 2
  • Kiyong Na
    • 3
  • Hyoung Jung Kim
    • 1
  • So Yeon Kim
    • 1
  • Beom Jin Park
    • 4
  • Jae Ho Byun
    • 1
  1. 1.Department of Radiology and Research Institute of Radiology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  2. 2.Department of Pathology, School of MedicineKyung Hee University HospitalSeoulRepublic of Korea
  3. 3.Department of Pathology, Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea
  4. 4.Department of Radiology, College of MedicineKorea University, Anam HospitalSeoulKorea
  5. 5.Department of Radiology, Gil Medical Center|Gachon UniversityIncheonKorea

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