Agrawal Mukta D, Mennitt Kevin W, Zhang Honglei, Samstein Benjamin, Kato Tomoaki, Emond Jean C, Dutruel Silvina P, Thimmappa Nanda Deepa, Prince Martin R
Department of Radiology, Weill Cornell Medical College & New York Presbyterian Hospital, New York, USA.
J Magn Reson Imaging. 2014 Mar;39(3):584-9. doi: 10.1002/jmri.24188. Epub 2013 May 30.
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.
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.
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.
Intravenous low-dose morphine distends and improves visualization of bile ducts on T1 gadoxetate MRC.
评估低剂量吗啡用于潜在肝脏供体术前成像中T1加权磁共振胰胆管造影（MRC）时扩张肝内胆管并改善其可视化效果。
对69例连续转诊进行移植前MRI评估的潜在活体亲属肝脏供体（平均年龄39岁；年龄范围20至59岁）进行评估，其中30例未注射（n = 30）、39例注射了静脉吗啡（0.04 mg/kg）（n = 39）。在MRI检查前建立静脉通路时注射吗啡，以便在T1加权MRC检查前约1小时使胆管扩张。三名放射科医生对肝内胆管分支顺序可视化、胆总管（CBD）直径和整体图像质量进行评估。在25例接受肝脏捐赠手术的患者中，将T1加权MRC检查结果与术中发现进行关联。本回顾性研究经机构审查委员会批准。
注射吗啡后胆管可视化得到改善，45分钟和60分钟时胆管分支顺序可视化评分分别为3.2和3.3，而未注射吗啡时为2.7（P < 0.002）；CBD直径分别为5.3和5.5 mm，未注射吗啡时为4.1 mm（P < 0.005），整体图像质量评分分别为2.4和2.6，未注射吗啡时为1.8（P < 0.0006）。手术记录证实，未注射吗啡的11例供体中有6例、注射吗啡的14例供体中有14例的T1加权MRC检查结果与术中发现相符。
静脉注射低剂量吗啡可扩张肝内胆管并改善T1加权钆塞酸二钠MRC检查时胆管的可视化效果。
