title: Dual-energy CT-cholangiography in potential donors for living-related liver transplantation: improved biliary visualization by intravenous morphine co-medication.
abstract: OBJECTIVE
  To prospectively evaluate whether intravenous morphine co-medication improves bile duct visualization of dual-energy CT-cholangiography.
  
  
  METHODS
  Forty potential donors for living-related liver transplantation underwent CT-cholangiography with infusion of a hepatobiliary contrast agent over 40 min. Twenty minutes after the beginning of the contrast agent infusion, either normal saline (n=20 patients; control group [CG]) or morphine sulfate (n=20 patients; morphine group [MG]) was injected. Forty-five minutes after initiation of the contrast agent, a dual-energy CT acquisition of the liver was performed. Applying dual-energy post-processing, pure iodine images were generated. Primary study goals were determination of bile duct diameters and visualization scores (on a scale of 0 to 3: 0--not visualized; 3--excellent visualization).
  
  
  RESULTS
  Bile duct visualization scores for second-order and third-order branch ducts were significantly higher in the MG compared to the CG (2.9±0.1 versus 2.6±0.2 [P<0.001] and 2.7±0.3 versus 2.1±0.6 [P<0.01], respectively). Bile duct diameters for the common duct and main ducts were significantly higher in the MG compared to the CG (5.9±1.3 mm versus 4.9±1.3 mm [P<0.05] and 3.7±1.3 mm versus 2.6±0.5 mm [P<0.01], respectively).
  
  
  CONCLUSIONS
  Intravenous morphine co-medication significantly improved biliary visualization on dual-energy CT-cholangiography in potential donors for living-related liver transplantation.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany. christof.sommer@med.uni-heidelberg.de
authors.forename: C M
authors.initials: CM
authors.lastname: Sommer
authors.forename: C B
authors.initials: CB
authors.lastname: Schwarzwaelder
authors.forename: W
authors.initials: W
authors.lastname: Stiller
authors.forename: S T
authors.initials: ST
authors.lastname: Schindera
authors.forename: T
authors.initials: T
authors.lastname: Heye
authors.forename: U
authors.initials: U
authors.lastname: Stampfl
authors.forename: N
authors.initials: N
authors.lastname: Bellemann
authors.forename: M
authors.initials: M
authors.lastname: Holzschuh
authors.forename: J
authors.initials: J
authors.lastname: Schmidt
authors.forename: J
authors.initials: J
authors.lastname: Weitz
authors.forename: L
authors.initials: L
authors.lastname: Grenacher
authors.forename: H U
authors.initials: HU
authors.lastname: Kauczor
authors.forename: B A
authors.initials: BA
authors.lastname: Radeleff
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D001652:Bile Ducts; D002758:Cholangiography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D046148:Donor Selection / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007275:Injections, Intravenous; D016031:Liver Transplantation / Q000000981:diagnostic imaging*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D003287:Contrast Media; D009020:Morphine