title: CT cholangiography in potential liver donors: effect of premedication with intravenous morphine on biliary caliber and visualization.
abstract: OBJECTIVE
  To retrospectively determine whether premedication with intravenously administered morphine improves bile duct caliber and visualization in potential liver donors undergoing computed tomographic (CT) cholangiography.
  
  
  METHODS
  This was a retrospective single institution study approved by the institutional review board and compliant with requirements of the HIPAA. Multidetector CT cholangiography was performed after slow infusion of 20 mL of iodipamide meglumine 52% diluted in 80 mL of normal saline in 143 consecutive potential liver donors (81 men and 62 women; mean age, 37 years); 43 received premedication with intravenous morphine sulfate (0.04 mg per kilogram of body weight) and 100 did not. Two independent readers recorded common bile duct diameter and area on axial CT images. Readers also scored bile duct visualization, including all second-order biliary branches, on a four-point scale (0, not seen; 3, excellent visualization).
  
  
  RESULTS
  For scans obtained without and those obtained with morphine, there was no significant difference in the mean common bile duct diameter (4.1 vs 4.3 mm for reader 1 and 4.4 vs 4.6 mm for reader 2, respectively; P > .39 for both readers), in common bile duct area (20.7 vs 21.5 mm(2), for reader 1 and 21.3 vs 20.2 mm(2) for reader 2, respectively, P > .60 for both), or in second-order bile duct visualization score (2.34 vs 2.36 for reader 1 and 2.58 vs 2.50 for reader 2, respectively; P > .5 for both).
  
  
  CONCLUSIONS
  The results suggest that premedication with intravenous morphine prior to CT cholangiography in potential liver donors does not increase bile duct caliber or improve biliary visualization.
authors.affiliation: Departments of Radiology and Surgery, University of California San Francisco, 505 Parnassus Ave, Box 0628, San Francisco, CA 94143-0628, USA.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Breiman
authors.forename: Fergus V
authors.initials: FV
authors.lastname: Coakley
authors.forename: Emily M
authors.initials: EM
authors.lastname: Webb
authors.forename: James J
authors.initials: JJ
authors.lastname: Ellingson
authors.forename: John P
authors.initials: JP
authors.lastname: Roberts
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kohr
authors.forename: Juergen
authors.initials: J
authors.lastname: Lutz
authors.forename: Naomi
authors.initials: N
authors.lastname: Knoess
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Yeh
mesh_terms: D000293:Adolescent; D000328:Adult; D001659:Biliary Tract / Q000000981:diagnostic imaging*; D002758:Cholangiography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007458:Iodipamide / Q000008:administration & dosage; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D011292:Premedication; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D009020:Morphine; D007458:Iodipamide