A Histology Activity Index has been developed which generates a numerical score for liver biopsy specimens obtained from patients with asymptomatic chronic active hepatitis. Biopsies are graded in four categories: periportal necrosis, intralobular necrosis, portal inflammation, and fibrosis. Under code, three pathologists and three hepatologists evaluated 14 liver biopsy specimens obtained from five patients with asymptomatic chronic active hepatitis. Good correlation was seen between severity of liver biopsy lesions as judged by conventional histological descriptions and Histology Activity Index scores. Significant differences in Histology Activity Index score occurred in only 2 or 28 duplicate scorings of biopsy specimens by two observers. This system provides definitive endpoints for statistical analysis of serial changes in liver histology and offers an alternative to the use of conventional pathological descriptions in following the natural history and treatment responses of asymptomatic chronic active hepatitis.

Recent intravascular ultrasound experience challenges the accuracy of ultrasonic measurement of arterial wall thickness. We reevaluated the correlation between histological and sonographic measurements of intima-media thickness using standard transcutaneous vascular technology. Carotid and femoral arterial segments were imaged before and after fixation using a 7-MHz linear-array vascular transducer. Log compression and beam orientation were varied. Mean intima, media, and adventitia thicknesses were measured and compared with corresponding histological tunica. Tissue processing caused 2.5% shrinkage. Intraobserver reading error was 0.7% for histology and 5.4% for sonography. Ultrasound overestimated the thickness of the intima and adventitia and underestimated the thickness of the media. For combined intima-media thickness, the differences between histology and imaging were insignificant, averaging 4% for the carotid artery and 9% for the femoral artery in the far-wall projection. In the near-wall projection, sonographic intima-media thickness was 20% less than that determined histologically. We conclude that ultrasonography is limited mainly by axial resolution in quantifying the dimensions of individual arterial tunica but is capable of accurately measuring far-wall intima-media thickness. ( In the evolution of these applications, the technology has met rigorous standards of reproducibility for measuring carotid intima-media thickness.3 The validity and accuracy of the measurement are based on pathological and clinical correlations described by Pignoli et al 4 in 1986. However, recent data from intravascular ultrasound experience have challenged the accuracy of quantitative transcutaneous vascular sonography. 5 - 9Our purpose was to reevaluate in vitro measurements of arterial wall segment thicknesses obtained by histology and by current vascular sonography. We found systematic differences that are inherent with ultrasound technology but do not invalidate the quantification of intima-media thickness. Methods Segments from common carotid and femoral arteries were taken during the autopsies of 36 male subjects who died at an age of 69 ±8 (mean±l SD) years. After removing fat and loose tissue from the adventitia, the vessels were opened longitudinally. They were then clamped to frames for fixation in 10% formalin and for imaging before and after fixation. The specimens were divided longitudinally in the line of the imaging plane. A block of tissue measuring 20 x 2.5 x thickness of the wall (mm 3 ) was taken from the vertical center of either side of the imaging plane, corresponding with the center of the sonogram (Figure 1). The cut edges were photographed on 35-mm slide film to determine the amount of shrinkage incurred during histological processing. HistologyThe sections were marked with india ink for orientation and placed in perforated plastic cassettes for ethanol dehydration, xylene substitute clearing, and paraffin embedment. Four sections (5 ftm thick) were sectioned by rotary microtome from the imaging ...