title: Morphine three-dimensional T1 gadoxetate MR cholangiography of potential living related liver donors.
abstract: OBJECTIVE
  To assess low-dose morphine for distension and improved visualization of intrahepatic bile ducts on T1 MR cholangiography (MRC) in preoperative imaging of potential liver donors.
  
  
  METHODS
  Sixty-nine consecutive potential living related liver donors (mean age, 39 years; age range, 20 to 59 years) referred for pre-transplant MRI evaluation were evaluated without (n=30) or with (n=39) intravenous morphine injection (0.04 mg/kg). Morphine was injected pre-MRI while establishing intravenous access to allow ∼1 h for biliary distension before T1 MRC. Three radiologists reviewed intrahepatic biliary branch order visualization, common bile duct (CBD) diameter, and overall image quality. In 25 patients undergoing liver donation surgery, T1 MRC findings were correlated with intraoperative findings. This retrospective study was approved by the institutional review board.
  
  
  RESULTS
  Biliary visualization was improved post-morphine administration with biliary duct branch order visualization score of 3.2 and 3.3 at 45 and 60 min, respectively, compared with 2.7 without morphine (P<0.002); CBD diameter measured 5.3 and 5.5 versus 4.1 mm (P<0.005), and overall image quality score was 2.4 and 2.6 versus 1.8 (P<0.0006). Operative notes confirmed T1 MRC findings in 6/11 donors without morphine and 14/14 donors with morphine.
  
  
  CONCLUSIONS
  Intravenous low-dose morphine distends and improves visualization of bile ducts on T1 gadoxetate MRC.
authors.affiliation: Department of Radiology, Weill Cornell Medical College & New York Presbyterian Hospital, New York, USA.
authors.forename: Mukta D
authors.initials: MD
authors.lastname: Agrawal
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Mennitt
authors.forename: Honglei
authors.initials: H
authors.lastname: Zhang
authors.forename: Benjamin
authors.initials: B
authors.lastname: Samstein
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kato
authors.forename: Jean C
authors.initials: JC
authors.lastname: Emond
authors.forename: Silvina P
authors.initials: SP
authors.lastname: Dutruel
authors.forename: Nanda Deepa
authors.initials: ND
authors.lastname: Thimmappa
authors.forename: Martin R
authors.initials: MR
authors.lastname: Prince
mesh_terms: D000328:Adult; D001653:Bile Ducts, Intrahepatic / Q000187:drug effects; D016009:Chi-Square Distribution; D002758:Cholangiography / Q000379:methods*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D005190:Family; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007262:Infusions, Intravenous; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D011300:Preoperative Care / Q000379:methods; D012016:Reference Values; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: C073590:gadolinium ethoxybenzyl DTPA; D009020:Morphine; D019786:Gadolinium DTPA
keywords: MR cholangiography; gadoxetate; hepatic MRI; living related liver donor