**1. Introduction**

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234 Liver Biopsy – Indications, Procedures, Results

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The computer morphometry in histopathology is оnе of the most perspective directions in contemporary medicine including the hepatopathology. The potential advantages of meas‐ urement in histopathology have been recognized for many years [1]. The quantitative esti‐ mation has several advantages over conventional visual assessment such as objectivity and reproducibility [2]. The employment of modern optical equipment and special computer programs creates the possibilities for significant acceleration of quantitative analysis.

At present the computer morphometry has been rather intensively used to study liver changes of the patients with chronic viral hepatitis. The quantitative assessment of the fibro‐ sis was performed mainly in chronic virus hepatitis C [3, 4, 5, 6, 7. 8, 9].

Many investigators considered that the quantitative evaluation of hepatic fibrosis was most‐ ly useful for assessing the origin, location and the stage of fibrosis. Using the morphometric analysis is also very important for the correct evaluation of repeated biopsies [10]. Some in‐ vestigators studied the changes in liver fibrosis after the interferon therapy [11, 12, 13]. This technique can be used in future for therapeutic trials by the estimation of the agents inhibit‐ ing the fibrosis progression [7].

Rates of fibrosis progression differ markedly in patients with HIV/HCV co-infection [14, 15, 16]. The natural history of hepatitis C virus infection in tuberculosis and in human immuno‐ deficiency virus-infected patients has never been studied with the use of the computer mor‐ phometric analysis of liver fibrosis progression. In this chapter the changes of liver biopsies in patients with heroin abuse and infected by hepatitis C virus (HCV), human immunodefi‐

© 2012 Tokin et al.; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2012 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

ciency virus (HIV), pulmonary tuberculosis (TB) were studied by the morphological and computer morphometric analysis.

**Patient**

according to their age.

**2.3. Computer digital analysis**

5.0. Total area of the biopsy is 11449177 pixels

**number Sex Age (years)**

**Biopsy number in next tables**

 male 26 1 1 8 1 7 male 26 fragment 1 11 11 11 male 27 7 1 1 1 3 male 31 8 1 5 5 8 male 31 fragment 1 2 2 4 male 32 fragment 10 1 8 17 male 33 9 12 9 13 15 male 33 3 1 1 1 8 male 34 6 3 18 3 unknown male 34 2 1 7 8 11 male 36 fragment 8 13 1 13 male 37 4 5 1 1 10 male 39 5 1 16 6 16

**Table 1.** Characteristics of patients with heroin abuse and co-infection of TB, HCV, HIV. The patients are arranged

Quantitative morphometric analysis was performed using an image analysis system consist‐ ing of a microscope (Leica DM 2500) with attached digital camera (Leica DFC 320 R2) and a computer. Serial pictures of biopsy slices of patients with co-infection were photographed by light microscope and were saved electronically. Serial microphotographs of biopsies were made by an objective x20. The further process was performed with the computer pro‐ gram Adobe Photoshop CS 5.0. Serial microphotographs were mounted to receive the gener‐ al picture of liver biopsy (Figure 1). The digital image was converted into a binary image. The two-dimensional patterns were measured by direct pixels counting on the binary im‐

**Figure 1.** General picture of the liver biopsy composed by computer microscopy (Obj. x20) using Adobe Photoshop CS

Three main parameters were used for quantitative evaluation: the total area of portal zones, the total area of intralobular infiltrates and necroses, as well as the total area of hepatic

ages under simultaneous visual control of the light microscopy.

**Duration of infections (years) Duration of**

**TB HCV HIV**

Computer Image Analysis of Liver Biopsy Specimens in Patients with Heroin Abuse and Coinfection ...

**heroin abuse (years)** 237

http://dx.doi.org/10.5772/52971
