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Review
. 2016 Feb;18(2):129-135.
doi: 10.1016/j.hpb.2015.09.006. Epub 2016 Jan 6.

A literature review of radiological findings to guide the diagnosis of gallbladder adenomyomatosis

Abdulrahman Y Hammad  1 , John T Miura  1 , Kiran K Turaga  1 , Fabian M Johnston  1 , Mark D Hohenwalter  2 , T Clark Gamblin  3
Affiliations
Review

A literature review of radiological findings to guide the diagnosis of gallbladder adenomyomatosis

Abdulrahman Y Hammad et al. HPB (Oxford). 2016 Feb.

Abstract

Background: Gallbladder adenomyomatosis (GA) is a benign gallbladder entity discovered as an asymptomatic gallbladder mass. Since gallbladder cancer is in the differential diagnosis for gallbladder masses, the ability to differentiate benign disease avoids a more extensive oncologic resection. This study sought to review imaging modalities used to diagnose GA.

Methods: PubMed and SciVerse Scopus were systematically searched using the terms: "gallbladder adenomyomatosis" and "gallbladder imaging" for articles published between January 2000 and January 2015.

Results: A total of 14 articles were reviewed in this analysis. Contemporary series report the use of ultrasound (US), computed tomography (CT) or magnetic resonance imaging (MRI) in GA imaging. Ultrasound detection of Rokitansky-Aschoff sinuses, visualized as small cystic spaces with associated "comet-tail" or "twinkling" artifact, is pathognomonic for GA. A "Pearl-Necklace" sign of small connected sinuses on MRI or "Rosary" sign on CT are additional characteristics that may assist in establishing a diagnosis.

Conclusion: Ultrasound is the most commonly used tool to investigate GA. If not diagnostic, CT or MRI are effective in attempting to differentiate a benign or malignant cholecystic mass. Characteristic signs should lead the surgeon to perform a laparoscopic cholecystectomy in symptomatic patients or manage non-operatively in asymptomatic patients.

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Figures

Figure 1
Figure 1
PRISMA flow chart demonstrating selection process of included articles. GA, Gallbladder adenomyomatosis
Figure 2
Figure 2
“Comet-tail” artifact seen on ultrasound examination (left); and “twinkling” artifact seen on color flow ultrasound (right)
Figure 3
Figure 3
CT scan of the abdomen showing gallbladder adenomyomatosis with fundal thickening
Figure 4
Figure 4
MRI examination of the gallbladder showing cystic spaces on coronal (left), transverse view (right)
See this image and copyright information in PMC

Comment in

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