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Several semiquantitative
morphologic methods have been described that evaluate extracellular matrix in biopsy
specimens stained with either hematoxylin and eosin, or connective tissue stains such as
Masson's trichrome, reticulin silver impregnation, or Van Gieson. Even these methods are
not perfect, and can be prone to sampling error if the fibrosis is patchy.
Semiquantitative methods include the Knodell-Ishak score, the French Metavir system, and
others [3, 17]. Fewer scoring stages within the system leads to more agreement among
pathologists. These methods may be complemented by more accurate morphometric approaches
using image analysis, in which tissue is stained with picrosirius red [7], www.uptodate.com/patient_info/topicpages/topics/Cirrhosi/9999.asp#13 |