Ultrasound of Gallbladder Adenomyomatosis

In this radiology lecture, we review the ultrasound appearance of adenomyomatosis of the gallbladder!Key teaching points include:Common cause of benign gallbladder wall thickening seen in up to 9% of patientsIncidence increases with ageUsually asymptomatic, but may be associated with sporadic RUQ painHyperplastic changes of gallbladder wall with mucosal overgrowth. Mucosal herniations protrude into muscular layer forming tiny, bile-filled cystic spaces = Rokitansky-Aschoff sinusesIf large, sinuses may appear as discrete cystic spaces in gallbladder wallCholesterol crystals in sinuses cause comet-tail reverberation artifact: Most common finding and highly specific for adenomyomatosis. Can exaggerate comet-tail with addition of color DopplerThree types: Focal/fundal, segmental/annular and diffuse. Regardless of type, comet-tail artifacts and/or cystic spaces are key to diagnosisFocal/fundal type: Most common. Often exhibits an “ovary on the gallbladder” appearance. Can be confused with a gallbladder mass. High-frequency linear transducer may be helpful to identify morphologySegmental/annular type: Narrows waist of gallbladder yielding a figure 8 or hourglass configuration. Gallstones and/or sludge often form in proximal lumen due to increased stasisIf necessary, MRI helpful for problem solving: T2 hyperintense pearl necklace/string of beads appearance sensitive and specificTo learn more about the Samsung RS85 Prestige ultrasound system, please visit: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Click the ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube Community tab⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or follow on social media for bonus teaching material posted throughout the week!Website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://radquarters.com/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/radquarters/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/radquarters/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠X (Twitter): ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://twitter.com/radquarters⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Reddit: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.reddit.com/user/radiologistHQ/⁠⁠This video is for informational purposes only. It does not replace the advice or counsel of a doctor or healthcare professional.