A literature review of radiological findings to guide the diagnosis of gallbladder adenomyomatosis. HPB (Oxford) 2016 Feb;18(2):129-135
Date
02/24/2016Pubmed ID
26902131Pubmed Central ID
PMC4814619DOI
10.1016/j.hpb.2015.09.006Scopus ID
2-s2.0-84976447914 (requires institutional sign-in at Scopus site) 30 CitationsAbstract
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.
Author List
Hammad AY, Miura JT, Turaga KK, Johnston FM, Hohenwalter MD, Gamblin TCAuthors
Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of WisconsinMark D. Hohenwalter MD Associate Dean, Executive Director, Professor in the Radiology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdenomyomaCholecystography
Diagnosis, Differential
Gallbladder Neoplasms
Humans
Magnetic Resonance Imaging
Predictive Value of Tests
Prognosis
Tomography, X-Ray Computed
Ultrasonography