Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Mar;8(2):219-23.
doi: 10.5009/gnl.2014.8.2.219. Epub 2013 Dec 24.

Focal thickening at the fundus of the gallbladder: computed tomography differentiation of fundal type adenomyomatosis and localized chronic cholecystitis

Bo Sung Kim  1 , Jong Young Oh  1 , Kyung Jin Nam  1 , Jin Han Cho  1 , Hee Jin Kwon  1 , Seong Kuk Yoon  1 , Jin Sook Jeong  2 , Myung Hwan Noh  3
Affiliations

Focal thickening at the fundus of the gallbladder: computed tomography differentiation of fundal type adenomyomatosis and localized chronic cholecystitis

Bo Sung Kim et al. Gut Liver. 2014 Mar.

Abstract

Background/aims: The objective of our study was to identify useful computed tomography (CT) findings for differentiating fundal type adenomyomatosis from localized chronic cholecystitis involving the fundus of the gallbladder.

Methods: We retrospectively identified cases of 41 patients with pathologically proven adenomyomatosis (n=21) or chronic cholecystitis (n=20) who had fundal thickening of the gallbladder on preoperative abdominal CT. Analysis of the CT findings included evaluation of the thickness, contour, border, intralesional cystic area, adjacent gallbladder wall thickening, presence of inner layer enhancement, enhancement grade, enhancement pattern, and presence of stones. Statistical analyses were performed using the Mann-Whitney U test and Fisher exact test.

Results: Oval contour, inner layer enhancement and intralesional cystic area were more frequently noted in adenomyomatosis than in chronic cholecystitis (p<0.05 for each finding). Flat contour and adjacent gallbladder wall thickening were more frequently observed in chronic cholecystitis than in adenomyomatosis. No differences between adenomyomatosis and chronic cholecystitis in terms of the thickness, enhancement grade, enhancement pattern and presence of stones were apparent.

Conclusions: CT may help to differentiate fundal type adenomyomatosis from localized chronic cholecystitis involving the fundus of the gallbladder.

Keywords: Adenomyomatosis; Chronic cholecystitis; Computed tomography; Fundal type.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Diagrams show (A, B) the type of contour, (C) adjacent wall thickening, and (D) inner layer enhancement (A, flat contour; B, oval contour; C, adjacent gallbladder wall thickening [arrows]; D, presence of inner layer enhancement [arrowheads]).
Fig. 2
Fig. 2
A 51-year-old man with adenomyomatosis. Axial computed tomography scan shows oval-shaped focal thickening at the fundal portion of the gallbladder (arrow).
Fig. 3
Fig. 3
A 70-year-old man with chronic cholecystitis. Axial computed tomography scan shows focal thickening at the fundus of the gallbladder with flat contour (arrow).
Fig. 4
Fig. 4
A 74-year-old woman with adenomyomatosis. (A) Axial computed tomography image shows nodular thickening with multiple cystic foci (arrows) at the fundus of the gallbladder, which represent Rokitansky-Aschoff sinuses. (B) Photomicrograph reveals multiple cystically dilated glandular structures surrounded by hyperplastic smooth muscle (H&E stain, ×40).
Fig. 5
Fig. 5
A 72-year-old man with chronic cholecystitis. Axial computed tomography scan shows focal thickening at the fundal portion of the gallbladder with adjacent wall thickening (arrows).
Fig. 6
Fig. 6
A 57-year-old man with adenomyomatosis. Axial computed tomography scan shows inner layer enhancement (arrows) overlying nodular thickening at the fundus of the gallbladder.
See this image and copyright information in PMC

References

    1. Jutras JA. Hyperplastic cholecystoses; Hickey lecture, 1960. Am J Roentgenol Radium Ther Nucl Med. 1960;83:795–827. - PubMed
    1. Smathers RL, Lee JK, Heiken JP. Differentiation of complicated cholecystitis from gallbladder carcinoma by computed tomography. AJR Am J Roentgenol. 1984;143:255–259. - PubMed
    1. Ching BH, Yeh BM, Westphalen AC, Joe BN, Qayyum A, Coakley FV. CT differentiation of adenomyomatosis and gallbladder cancer. AJR Am J Roentgenol. 2007;189:62–66. - PubMed
    1. Kim SJ, Lee JM, Lee JY, et al. Analysis of enhancement pattern of flat gallbladder wall thickening on MDCT to differentiate gallbladder cancer from cholecystitis. AJR Am J Roentgenol. 2008;191:765–771. - PubMed
    1. Yun EJ, Cho SG, Park S, et al. Gallbladder carcinoma and chronic cholecystitis: differentiation with two-phase spiral CT. Abdom Imaging. 2004;29:102–108. - PubMed

Publication types

LinkOut - more resources