Diverticular disease (adenomyomatosis) of the gallbladder: a radiological pathological survey

Williams, Ifor; Slavin, G; Cox, AlanG.; Simpson, Peter; Lacey, Gerald de

doi:10.1259/0007-1285-59-697-29

Cited by 63 publications

(37 citation statements)

References 20 publications

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“…Adenomyomatosis of the gallbladder occurs in up to 5% of cholecystectomy specimens [10]. Adenomyomatosis has no malignant potential and may involve the gallbladder in a focal, segmental or diffuse form.…”

Section: Adenomyomatosismentioning

confidence: 99%

Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound

Meacock

Sellars²,

Sidhu³

2010

BJR

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ABSTRACT. Ultrasound examination of the gallbladder is accepted as the primary imaging modality in the assessment of gallbladder disease, with inherent superiority in comparison to other imaging modalities. Contrast-enhanced ultrasound is established as a reliable tool in the detection and characterisation of focal liver lesions. It is less well recognised in gallbladder and biliary disease but can be a valuable complement to baseline ultrasound examination. Contrast-enhanced ultrasound provides the advantages of real-time, repeatable, multiplanar imaging without compromising patient safety or exposing patients to radiation. It can provide specific information as pathology often becomes more conspicuous following the administration of contrast, allowing detailed assessment of benign and malignant conditions arising in the gallbladder and biliary tree. This review illustrates the application of contrast-enhanced ultrasound in the evaluation of a variety of gallbladder and biliary duct diseases. The examination allows clearer delineation of the disease process and more confident diagnosis.

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Section: Adenomyomatosismentioning

confidence: 99%

Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound

Meacock

Sellars²,

Sidhu³

2010

BJR

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“…Pathological [1][2][3] and radiological [1][2][3][4][5] findings in adenomyomatosis of the gallbladder have been previously reported. Pathologically, the amount of subserosal fat surrounding the normal gallbladder is quite variable [6].…”

mentioning

confidence: 79%

“…Adenomyomatosis of the gallbladder is frequently seen in ordinary operative specimens [2]. It shows microscopic thickening of the muscular layer and proliferation of the mucosal epithelium with formation of intramural diverticula (Rokitansky-Aschoff sinuses).…”

Section: Discussionmentioning

confidence: 99%

Adenomyomatosis of the gallbladder with subserosal fatty proliferation: CT findings in two cases

Aikawa

Hori

Mori

et al. 1992

Gastrointest Radiol

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Adenomyomatosis of the gallbladder is frequently seen in ordinary operative specimens. Subserosal fat may proliferate in the presence of adenomyomatosis, but the amount of subserosal fat may be quite variable. Typical and atypical computed tomographic (CT) findings in two cases of adenomyomatosis with subserosal fatty proliferation of the gallbladder are presented. The thick fatty layer surrounding the thickened gallbladder wall with intramural diverticula and stones, typical of CT findings, was seen in one case, and fat interspersed in the periphery of the thickened gallbladder wall without intramural stones, atypical of CT findings, was seen in a second case.

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“…An outpouching of the gallbladder mucosa into the thickened muscular layer is termed Rokitansky-Aschoff sinus (2). ADM may be further divided into three subtypes: Fundal, segmental and diffuse (3).…”

Section: Introductionmentioning

confidence: 99%

Negative signals for adenomyomatosis of the gallbladder upon diffusion-weighted whole body imaging with background body signal suppression/T2-weighted image fusion analysis

Tomizawa

Shinozaki

Fugo

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. Differentiation between adenomyomatosis (ADM) and cancer of the gallbladder is necessary during diagnosis. Diffusion-weighted whole body imaging with background body signal suppression (DWIBS) images are able to indicate cancer and inflammation. The fusion of a DWIBS with a T2 weighted image (DWIBS/T2) facilitates both functional and anatomical investigations. In the present study, patient records and images from patients with surgically confirmed ADM from April 2012 to October 2014 were analyzed retrospectively. The enrolled patients, including 6 men (64.2±13.1 years) and 4 women (57.3±12.4 years) were subjected to DWIBS/T2 during routine clinical practice. The diagnosis of ADM was based on magnetic resonance cholangiopancreatography, transabdominal ultrasonography, and endoscopic ultrasonography; ADM was diagnosed definitively when cystic lesions were observed, indicating the Rokitansky-Aschoff sinus. A single patient was indicated to be positive by DWIBS/T2 imaging. The Rokitansky-Aschoff sinus revealed a relatively high signal intensity; however, it was not as strong as that of the spleen. The signal intensity was also high on an apparent diffusion coefficient map, suggesting T2 shine-through. The thickened wall displayed low signal intensity. The aforementioned results indicate that ADM may be negative upon DWIBS/T2 imaging; one false positive case was determined to be ADM, accompanied by chronic cholecystitis. The majority of patients with ADM displayed negative findings upon DWIBS/T2 imaging, and chronic cholecystitis may cause false positives. IntroductionAdenomyomatosis of the gallbladder (ADM) is defined as the epithelial proliferation and hypertrophy of the muscles of the gallbladder wall (1). An outpouching of the gallbladder mucosa into the thickened muscular layer is termed Rokitansky-Aschoff sinus (2). ADM may be further divided into three subtypes: Fundal, segmental and diffuse (3). A major challenge in ADM diagnosis arises from the difficulty in distinguishing the disease from gallbladder cancer (4).Recent advances in diagnostic imaging have improved the distinction between ADM and gallbladder cancer. Contrast-enhanced endoscopic ultrasonography (EUS) is beneficial for the differential diagnosis of gallbladder wall thickening (5). High-resolution ultrasound is also advantageous for differentiating gallbladder cancers from ADM (6); however, the challenge of differentiating gallbladder cancer from ADM has yet to be resolved. A primary cause of the challenge is intratumoral cystic components, which create difficulty in discerning between gallbladder cancer and ADM (7).Diffusion-weighted whole body imaging with background body signal suppression (DWIBS) images are acquired through multiple-signal averaging, pre-pulse fat suppression, and heavy diffusion weighting during free breathing (8); DWIBS is based upon diffusion-weighted imaging (DWI), which visualizes and assesses the random movement of water at the molecular level (Brownian motion) (9,10). An advantage of DWIBS is that it provides...

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Diverticular disease (adenomyomatosis) of the gallbladder: a radiological pathological survey

Cited by 63 publications

References 20 publications

Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound

Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound

Adenomyomatosis of the gallbladder with subserosal fatty proliferation: CT findings in two cases

Negative signals for adenomyomatosis of the gallbladder upon diffusion-weighted whole body imaging with background body signal suppression/T2-weighted image fusion analysis

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