Morphine- and glucagon-augmented magnetic resonance cholangiopancreatography to evaluate living liver donors
Journal
Liver Transplantation
Journal Volume
15
Journal Issue
9
Pages
1021-1027
Date Issued
2009
Author(s)
Abstract
The purpose of this study was to investigate the effectiveness of the combined use of intravenous morphine and intramuscular glucagon in improving magnetic resonance cholangiopancreatography (MRCP) image quality in donors for living-related liver transplantation. Sixteen healthy donor candidates underwent an MRCP study. Coronal, single-shot, fast spin-echo, heavily T2-weighted dynamic MRCP images were obtained before and 3 minutes after the intravenous administration of morphine HCl with a dose of 0.04 mg/kg. Thirty minutes after the injection of morphine, intramuscular glucagon was used. Another MRCP image of the same pulse sequence was generated 15 minutes after the injection of glucagon with a dose of 1 mg. The diameter, signal intensity, and number of branches of bile ducts in MRCP images taken immediately before and after the injection of morphine and after the injection of glucagon (plus delayed morphine effects) were compared and analyzed. In all 16 donor candidates, the diameters of the right and left hepatic ducts, common bile duct, and main pancreatic duct were significantly increased (P < 0.05) in the MRCP images taken 3 minutes after the injection of morphine and 15 minutes after the injection of glucagon (plus delayed morphine effects) in comparison with MRCP images taken before any drug administration. The qualitative grading scores of the signal intensity and order of branches of bile ducts revealed improvements in the MRCP images after the injection of glucagon (plus delayed morphine effects; P < 0.05). In conclusion, combining the intravenous administration of low-dose morphine and the intramuscular use of glucagon before MRCP examination improves the visualization of the nondilated biliary ductal anatomy, which is important for the preoperative biliary evaluation of donor candidates for living-related liver transplantation. ? 2009 AASLD.
SDGs
Other Subjects
glucagon; morphine; adult; article; clinical article; common bile duct; controlled study; drug efficacy; female; hepatic duct; human; image analysis; image quality; injection; liver transplantation; living donor; low drug dose; magnetic resonance cholangiopancreatography; male; medical assessment; priority journal; qualitative analysis; scoring system; Adolescent; Adult; Cholangiopancreatography, Magnetic Resonance; Common Bile Duct; Female; Glucagon; Hepatectomy; Hepatic Duct, Common; Humans; Image Enhancement; Injections, Intramuscular; Injections, Intravenous; Liver Transplantation; Living Donors; Male; Middle Aged; Morphine; Pancreatic Ducts; Predictive Value of Tests; Preoperative Care; Young Adult
Publisher
John Wiley and Sons Ltd
Type
journal article