Journal of Magnetic Resonance Imaging, March 2014, Vol.39(3), pp.584-589
Byline: Mukta D. Agrawal, Kevin W. Mennitt, Honglei Zhang, Benjamin Samstein, Tomoaki Kato, Jean C. Emond, Silvina P. Dutruel, Nanda Deepa Thimmappa, Martin R. Prince Keywords: MR cholangiography; gadoxetate; living related liver donor; hepatic MRI Purpose 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. Materials and 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 a1/41 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. Conclusion Intravenous low-dose morphine distends and improves visualization of bile ducts on T1 gadoxetate MRC. J. Magn. Reson. Imaging 2014;39:584-589. [c] 2013 Wiley Periodicals, Inc. Supporting information: Additional Supporting Information may be found in the online version of this article Additional Supporting Information may be found in the online version of this article. CAPTION(S): Supp. Fig. S6. Axial cine loop of 3D spiral LAVA with sliding window reconstruction at 3-s temporal update rate used for dynamic liver MR imaging in living related liver donors.
Mr Cholangiography ; Gadoxetate ; Living Related Liver Donor ; Hepatic Mri