Dual-energy CT-cholangiography in potential donors for living-related liver transplantation: Improved biliary visualization by intravenous morphine co-medication

• Published in: European journal of radiology 2012-09, Vol.81 (9), p.2007-2013
• Main Authors: Sommer, C.M, Schwarzwaelder, C.B, Stiller, W, Schindera, S.T, Heye, T, Stampfl, U, Bellemann, N, Holzschuh, M, Schmidt, J, Weitz, J, Grenacher, L, Kauczor, H.U, Radeleff, B.A
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon - methods; Analgesics, Opioid - administration & dosage; Bile Ducts; Biliary system; Cholangiography; Cholangiography - methods; Contrast Media - administration & dosage; Donor Selection - methods; Dual-energy; Female; Humans; Image Enhancement - methods; Injections, Intravenous; Liver Transplantation - diagnostic imaging; Living Donors; Male; Middle Aged; Morphine; Morphine - administration & dosage; Radiology; Reproducibility of Results; Sensitivity and Specificity; Tomography, X-Ray Computed - methods; Young Adult
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2011.05.016

Abstract Purpose To prospectively evaluate whether intravenous morphine co-medication improves bile duct visualization of dual-energy CT-cholangiography. Materials and 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). Conclusion Intravenous morphine co-medication significantly improved biliary visualization on dual-energy CT-cholangiography in potential donors for living-related liver transplantation.