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This study aimed to assess liver fibrosis by contrast-enhanced ultrasound (CEUS) and point shear-wave elastography (pSWE) in rabbits and compare the performance of the two techniques. Eighty rabbits were divided into experimental (n=60) and control group (n=20). In the experimental group, liver fibrosis (F1-F4) was induced by subcutaneous injection of carbon tetrachloride. CEUS and pSWE of the liver was performed for the two groups at a 4-week interval for 40 weeks. The portal vein rise time (PV-RT), time to peak (PV-TTP), mean transit time (PV-MTT) and the maximum signal intensity (PV-Imax) were analyzed with time-intensity curves (TICs). Liver stiffness value (LSV) was obtained through pSWE. Histologic examination of liver specimens of the rabbits was performed to evaluate the fibrosis stage. PV-RT, PV-TTP, PV-Imax and LSV were significantly different among five liver fibrosis stages (F0-F4) (P&lt;0.01). PV-Imax and LSV displayed better diagnostic performance than PV-RT, PV-TTP, PV-MTT. For diagnosing≥F1 stage fibrosis, the area under the receiver operating characteristic curve (AUROC) of PV-Imax was 0.870, which was similar to that of LSV 0.874 (P=0.94). For diagnosing ≥F2, ≥F3 and ≥F4 stage fibrosis, the AUROC of PV-Imax and LSV was 0.845 vs. 0.956 (P=0.04), 0.789 vs. 0.954 (P=0.01) and 0.707 vs. 0.933 (P=0.03). Both CEUS and pSWE had the potential to be complementary imaging tools in the evaluation of liver fibrosis. The performance of pSWE may be better than CEUS.

Assessment of liver fibrosis by ultrasound elastography and contrast-enhanced ultrasound: a randomized prospective animal study