Skip to main content

Advertisement

Log in

Chronic inflammation-related radiological findings of gallbladder adenomyomatosis

  • Original Article
  • Published:
Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to assess radiological findings of adenomyomatosis advancing to chronic inflammation to differentiate between adenomyomatosis with and without chronic inflammation.

Materials and methods

We retrospectively identified 79 patients with pathologically proven adenomyomatosis without (n = 10) or with chronic inflammation (n = 69), who underwent computed tomography (CT) and magnetic resonance imaging (MRI) followed by surgery. MRI analysis included evaluation of GB wall-thickening type, presence and location of intramural cysts, and presence of stones. CT analysis included GB wall-thickening type only. Multivariate logistic regression analysis was used to identify the image-based findings of adenomyomatosis associated with chronic inflammation.

Results

On univariate analysis, MRI-based GB wall-thickening type and presence of stones, and CT-based GB wall-thickening type were significantly different between adenomyomatosis with and without chronic inflammation. On multivariate analysis, only the absence of stones was identified as a significant predictor of adenomyomatosis without chronic inflammation (odds ratio 5.58; 95% confidence interval 1.20–26.01; p = 0.029). There was no significant difference in other MRI- and CT-based findings between adenomyomatosis with and without chronic inflammation.

Conclusion

In patients with adenomyomatosis, the presence of stones was independently associated with chronic inflammation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Colquhoun J. Adenomyomatosis of the gall-bladder (intramural diverticulosis). Br J Radiol. 1961;34:101–12.

    Article  CAS  Google Scholar 

  2. Williams I, Slavin G, Cox A, Simpson P, de Lacey G. Diverticular disease (adenomyomatosis) of the gallbladder: a radiological-pathological survey. Br J Radiol. 1986;59:29–34.

    Article  CAS  Google Scholar 

  3. Golse N, Lewin M, Rode A, Sebagh M, Mabrut JY. Gallbladder adenomyomatosis: diagnosis and management. J Visc Surg. 2017;154:345–53.

    Article  CAS  Google Scholar 

  4. Gerard PS, Berman D, Zafaranloo S. CT and ultrasound of gallbladder adenomyomatosis mimicking carcinoma. J Comput Assist Tomogr. 1990;14:490–1.

    CAS  PubMed  Google Scholar 

  5. Ching BH, Yeh BM, Westphalen AC, Joe BN, Qayyum A, Coakley FV. CT differentiation of adenomyomatosis and gallbladder cancer. Am J Roentgenol. 2007;189:62–6.

    Article  Google Scholar 

  6. Yoon JH, Cha SS, Han SS, Lee SJ, Kang MS. Gallbladder adenomyomatosis: imaging findings. Abdom Imaging. 2006;31:555–63.

    Article  Google Scholar 

  7. Nabatame N, Shirai Y, Nishimura A, Yokoyama N, Wakai T, Hatakeyama K. High risk of gallbladder carcinoma in elderly patients with segmental adenomyomatosis of the gallbladder. J Exp Clin Cancer Res. 2004;23:593–8.

    CAS  PubMed  Google Scholar 

  8. Cariati A, Cetta F. Rokitansky–Aschoff sinuses of the gallbladder are associated with black pigment gallstone formation: a scanning electron microscopy study. Ultrastruct Pathol. 2003;27:265–70.

    Article  Google Scholar 

  9. Nishimura A, Shirai Y, Hatakeyama K. Segmental adenomyomatosis of the gallbladder predisposes to cholecystolithiasis. J Hepatobiliary Pancreat Surg. 2004;11:342–7.

    Article  Google Scholar 

  10. Ootani T, Shirai Y, Tsukada K, Muto T. Relationship between gallbladder carcinoma and the segmental type of adenomyomatosisof the gallbladder. Cancer. 1992;69:2647–52.

    Article  CAS  Google Scholar 

  11. Ash-Miles J, Roach H, Virjee J, Callaway M. More than just stones: a pictorial review of common and less common gallbladder pathologies. Curr Probl Diagn Radiol. 2008;37:189–202.

    Article  Google Scholar 

  12. Tanno S, Obara T, Maguchi H, Fujii T, Mizukami Y, Shudo R, et al. Association between anomalous pancreaticobiliary ductal union and adenomyomatosis of the gall-bladder. J Gastroenterol Hepatol. 1998;13:175–80.

    Article  CAS  Google Scholar 

  13. Chang LY, Wang HP, Wu MS, Huang HT, Wang HH, Lin CC, et al. Anomalous pancreaticobiliary ductal union—an etiologic association of gallbladder cancer and adenomyomatosis. Hepatogastroenterology. 1998;45:2016–9.

    CAS  PubMed  Google Scholar 

  14. Khan SA, Thomas HC, Davidson BR, Taylor-Robinson SD. Cholangiocarcinoma. Lancet. 2005;366:1303–14.

    Article  Google Scholar 

  15. Lin SH, Chang FY, Yang YS, Jin JS, Chen TW. Rare gallbladder adenomyomatosis presenting as atypical cholecystitis: case report. BMC Gastroenterol. 2011;11:106.

    Article  Google Scholar 

  16. Boscak AR, Al-Hawary M, Ramsburgh SR. Best cases from the AFIP: adenomyomatosis of the gallbladder. Radiographics. 2006;26:941–6.

    Article  Google Scholar 

  17. Kim BS, Oh JY, Nam KJ, Cho JH, Kwon HJ, Yoon SK, et al. Focal thickening at the fundus of the gallbladder: computed tomography differentiation of fundal type adenomyomatosis and localized chronic cholecystitis. Gut Liver. 2014;8:219–23.

    Article  Google Scholar 

  18. Lalović N, Cvijanović R, Vladicić ND, Marić R, Jokanović D, Skipina DB. Adenomyomatosis of the gallbladder—case report. Med Pregl. 2011;64:323–6.

    Article  Google Scholar 

  19. Catalano OA, Sahani DV, Kalva SP, Cushing MS, Hahn PF, Brown JJ, et al. MR imaging of the gallbladder: a pictorial essay. Radiographics. 2008;28:135–55.

    Article  Google Scholar 

  20. Yoshimitsu K, Irie H, Aibe H, Tajima T, Nishie A, Asayama Y, et al. Well-differentiated adenocarcinoma of the gallbladder with intratumoral cystic components due to abundant mucin production: a mimicker of adenomyomatosis. Eur Radiol. 2005;15:229–33.

    Article  Google Scholar 

  21. Levy AD, Murakata LA, Abbott RM, Rohrmann CA Jr. From the archives of the AFIP. Benign tumors and tumorlike lesions of the gallbladder and extrahepatic bile ducts: radiologic-pathologic correlation. RadioGraphics. 2002;22:387–413.

    Article  Google Scholar 

  22. Haradome H, Ichikawa T, Sou H, Yoshikawa T, Nakamura A, Araki T, et al. The pearl necklace sign: an imaging sign of adenomyomatosis of the gallbladder at MR cholangiopancreatography. Radiology. 2003;227:80–8.

    Article  Google Scholar 

  23. Shlaer WJ, Leopold GR, Scheible FW. Sonography of the thickened gallbladder wall: a nonspecific finding. Am J Roentgenol. 1981;136:337–9.

    Article  CAS  Google Scholar 

  24. Teefey SA, Baron RL, Bigler SA. Sonography of the gallbladder: significance of striated (layered) thickening of the gallbladder wall. Am J Roentgenol. 1991;156:945–7.

    Article  CAS  Google Scholar 

  25. Bang SH, Lee JY, Woo H, Joo I, Lee ES, Han JK, et al. Differentiating between adenomyomatosis and gallbladder cancer: revisiting a comparative study of high-resolution ultrasound, multidetector CT, and MR imaging. Korean J Radiol. 2014;15:226–34.

    Article  Google Scholar 

  26. Kim SJ, Lee JM, Lee JY, Kim SH, Han JK, Choi BI, et al. Analysis of enhancement pattern of flat gallbladder wall thickening on MDCT to differentiate gallbladder cancer from cholecystitis. Am J Roentgenol. 2008;191:765–71.

    Article  Google Scholar 

  27. Jung SE, Lee JM, Lee K, Rha SE, Choi BG, Kim EK, et al. Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern. Eur Radiol. 2005;15:694–701.

    Article  CAS  Google Scholar 

  28. Yun EJ, Cho SG, Park S, Park SW, Kim WH, Kim HJ, et al. Gallbladder carcinoma and chronic cholecystitis: differentiation with two-phase spiral CT. Abdom Imaging. 2004;29:102–8.

    Article  CAS  Google Scholar 

  29. Smathers RL, Lee JK, Heiken JP. Differentiation of complicated cholecystitis from gallbladder carcinoma by computed tomography. Am J Roentgenol. 1984;143:255–9.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Woo-Suk Chung.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, H., Chung, WS., Kim, J.Y. et al. Chronic inflammation-related radiological findings of gallbladder adenomyomatosis. Jpn J Radiol 38, 463–471 (2020). https://doi.org/10.1007/s11604-020-00931-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11604-020-00931-7

Keywords

Navigation