Multimodality Imaging of the Gallbladder: Spectrum of Pathology and Associated Imaging Findings

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• 作者：Marc Tubay ; Scott Zelasko
• 关键词：Gallbladder ; Cholecystitis ; Adenomyomatosis ; Porcelain gallbladder ; Gallbladder polyps
• 刊名：Current Radiology Reports
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：4
• 期：5
• 全文大小：1,931 KB
• 参考文献：1.Cafasso DE, Smith RR. Symptomatic cholelithiasis and functional disorders of the biliary tract. Surg Clin N Am. 2014;94(2):233–56.CrossRef PubMed
  2.Knab LM, Boller AM, Mahvi DM. Cholecystitis. Surg Clin North Am. 2014;94(2):455–70.CrossRef PubMed
  3.Privette TW Jr, Carlisle MC, Palma JK. Emergencies of the liver, gallbladder, and pancreas. Emerg Med Clin N Am. 2011;29(2):293–317 viii–ix.CrossRef
  4.• Revzin MV, et al. The gallbladder: uncommon gallbladder conditions and unusual presentations of the common gallbladder pathological processes. Abdom Imaging. 2015;40(2):385–99. This article provides a comprehensive review of less common gallbladder pathologies with a detailed discussion of imaging findings on multiple modalities.
  5.Baldwin SL. Gallbladder disease: imaging and treatment. Radiol Technol. 2008;80(2):131–45.PubMed
  6.Boscak AR, Al-Hawary M, Ramsburgh SR. Best cases from the AFIP: adenomyomatosis of the gallbladder. Radiographics. 2006;26(3):941–6.CrossRef PubMed
  7.Wernberg JA, Lucarelli DD. Gallbladder cancer. Surg Clin N Am. 2014;94(2):343–60.CrossRef PubMed
  8.van Breda Vriesman AC, et al. Diffuse gallbladder wall thickening: differential diagnosis. Am J Roentgenol. 2007;188(2):495–501.CrossRef
  9.Jung SE, et al. Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern. Eur Radiol. 2005;15(4):694–701.CrossRef PubMed
  10.Bilgin M, et al. Magnetic resonance imaging of gallbladder and biliary system. Top Magn Reson Imaging. 2009;20(1):31–42.CrossRef PubMed
  11.Bannas P, Pickhardt PJ. MR evaluation of the nontraumatic acute abdomen with CT correlation. Radiol Clin N Am. 2015;53(6):1327–39.CrossRef PubMed
  12.Elsayes KM, et al. Magnetic resonance imaging of the gallbladder: spectrum of abnormalities. Acta Radiol. 2007;48(5):476–82.CrossRef PubMed
  13.• Yam BL, Siegelman ES. MR imaging of the biliary system. Radiol Clin N Am. 2014;52(4):725–55. The authors provide detailed discussion of MR findings of not only gallbladder disease, but of the biliary system as a whole.
  14.Karam AR, Kim YH, Corwin MT. Gadoxetate disodium-enhanced liver MRI: gallbladder opacification patterns during hepatobiliary phase. Clin Imaging. 2014;38(1):42–9.CrossRef PubMed
  15.• Bennett GL. Evaluating patients with right upper quadrant pain. Radiol Clin N Am. 2015;53(6):1093–1130.While this article covers a range of entities that cause right upper quadrant pain, it provides a good discussion of acute and chronic diseases of the gallbladder and their associated imaging findings.
  16.Catalano OA, et al. MR imaging of the gallbladder: a pictorial essay. Radiographics. 2008;28(1):135–55 quiz 324.CrossRef PubMed
  17.Stinton LM, Myers RP, Shaffer EA. Epidemiology of gallstones. Gastroenterol Clin N Am. 2010;39(2):157–69 vii.CrossRef
  18.Masselli G, et al. Evaluating the acute abdomen in the pregnant patient. Radiol Clin N Am. 2015;53(6):1309–25.CrossRef PubMed
  19.Venneman NG, van Erpecum KJ. Pathogenesis of gallstones. Gastroenterol Clin N Am. 2010;39(2):171–83 vii.CrossRef
  20.Glanc P, Maxwell C. Acute abdomen in pregnancy: role of sonography. J Ultrasound Med. 2010;29(10):1457–68.PubMed
  21.Gore RM, et al. Gallbladder imaging. Gastroenterol Clin N Am. 2010;39(2):265–87 ix.CrossRef
  22.Rybicki FJ. The WES sign. Radiology. 2000;214(3):881–2.CrossRef PubMed
  23.Bennett GL, Balthazar EJ. Ultrasound and CT evaluation of emergent gallbladder pathology. Radiol Clin N Am. 2003;41(6):1203–16.CrossRef PubMed
  24.Gore RM, et al. Imaging benign and malignant disease of the gallbladder. Radiol Clin N Am. 2002;40(6):1307–23 vi.CrossRef PubMed
  25.Charalel RA, Jeffrey RB, Shin LK. Complicated cholecystitis: the complementary roles of sonography and computed tomography. Ultrasound Q. 2011;27(3):161–70.CrossRef PubMed
  26.Allen TW, Tulchinsky M. Nuclear medicine tests for acute gastrointestinal conditions. Semin Nucl Med. 2013;43(2):88–101.CrossRef PubMed
  27.Morris BS, et al. The CT appearances of gallbladder perforation. Br J Radiol. 2007;80(959):898–901.CrossRef PubMed
  28.Badea R, et al. Ultrasound in the examination of the gallbladder—a holistic approach: grey scale, Doppler, CEUS, elastography, and 3D. Med Ultrason. 2014;16(4):345–55.PubMed
  29.Ralls PW, et al. Real-time sonography in suspected acute cholecystitis. Prospective evaluation of primary and secondary signs. Radiology. 1985;155(3):767–71.CrossRef PubMed
  30.Ziessman HA. Hepatobiliary scintigraphy in 2014. J Nucl Med Technol. 2014;42(4):249–59.CrossRef PubMed
  31.Pilgrim CH, et al. An often overlooked diagnosis: imaging features of gallbladder cancer. J Am Coll Surg. 2013;216(2):333–9.CrossRef PubMed
  32.Richmond BK, DiBaise J, Ziessman H. Utilization of cholecystokinin cholescintigraphy in clinical practice. J Am Coll Surg. 2013;217(2):317–23.CrossRef PubMed
  33.Grand D, Horton KM, Fishman EK. CT of the gallbladder: spectrum of disease. Am J Roentgenol. 2004;183(1):163–70.CrossRef
  34.Smith EA, et al. Cross-sectional imaging of acute and chronic gallbladder inflammatory disease. Am J Roentgenol. 2009;192(1):188–96.CrossRef
  35.Patel NB, Oto A, Thomas S. Multidetector CT of emergent biliary pathologic conditions. Radiographics. 2013;33(7):1867–88.CrossRef PubMed
  36.Soyer P, et al. Acute cholecystitis: quantitative and qualitative evaluation with 64-section helical CT. Acta Radiol. 2013;54(5):477–86.CrossRef PubMed
  37.Cheng S-M, Ng S-P, Shih S-L. Hyperdense gallbladder wall sign. Clin Imaging. 2004;28(2):128–31.CrossRef PubMed
  38.An C, et al. Usefulness of the tensile gallbladder fundus sign in the diagnosis of early acute cholecystitis. Am J Roentgenol. 2013;201(2):340–6.CrossRef
  39.• Runner GJ, et al. Gallbladder wall thickening. AJR Am J Roentgenol. 2014;202(1):W1–W12. The authors discuss the multitude of causes of diffuse and focal gallbladder wall thickening, including extra-cholecystic diseases.
  40.Hakansson K, et al. MR imaging in clinically suspected acute cholecystitis. A comparison with ultrasonography. Acta Radiol. 2000;41(4):322–8.CrossRef PubMed
  41.Watanabe Y, et al. MR imaging of acute biliary disorders. Radiographics. 2007;27(2):477–95.CrossRef PubMed
  42.• Choi IY, et al. Diagnosis of acute cholecystitis: value of contrast agent in the gallbladder and cystic duct on Gd-EOB-DTPA enhanced MR cholangiography. Clin Imaging. 2014;38(2):174–8. The authors describe the utility of MR cholangiography with hepatobiliary specific contrast agents in the evaluation of acute cholecystitis. The absence of contrast within the cystic duct was highly associated with acute cholecystitis, but not chronic cholecystitis or healthy patients.
  43.Zemour J, et al. Gallbladder tumor and pseudotumor: diagnosis and management. J Visc Surg. 2014;151(4):289–300.CrossRef PubMed
  44.Barie PS, Eachempati SR. Acute acalculous cholecystitis. Gastroenterol Clin N Am. 2010;39(2):343–57 x.CrossRef
  45.Hansel SL, DiBaise JK. Functional gallbladder disorder: gallbladder dyskinesia. Gastroenterol Clin N Am. 2010;39(2):369–79.CrossRef
  46.Barr RG, Kido T, Grajo JR. Comparison of sonography and scintigraphy in the evaluation of gallbladder functional studies with cholecystokinin. J Ultrasound Med. 2009;28(9):1143–7.PubMed
  47.DiBaise JK, et al. Cholecystokinin-cholescintigraphy in adults: consensus recommendations of an interdisciplinary panel. Clin Nucl Med. 2012;37(1):63–70.CrossRef PubMed
  48.Yabanoglu H, et al. Diagnosis and treatment of xanthogranulomatous cholecystitis. Eur Rev Med Pharmacol Sci. 2014;18(8):1170–5.PubMed
  49.Menias CO, et al. Mimics of cholangiocarcinoma: spectrum of disease. Radiographics. 2008;28(4):1115–29.CrossRef PubMed
  50.Zhao F, et al. CT and MR features of xanthogranulomatous cholecystitis: an analysis of consecutive 49 cases. Eur J Radiol. 2013;82(9):1391–7.CrossRef PubMed
  51.Yoon JH, et al. Gallbladder adenomyomatosis: imaging findings. Abdom Imaging. 2006;31(5):555–63.CrossRef PubMed
  52.Stunell H, et al. Imaging of adenomyomatosis of the gall bladder. J Med Imaging Radiat Oncol. 2008;52(2):109–17.CrossRef PubMed
  53.• Bang SH, 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(2):226–34. The authors describe utilizing high-resolution transabdominal ultrasound (HRUS) in the differentiation of adenomyomatosis and gallbladder carcinoma. Though limited in some patients, HRUS had similar performance to MRI/MRCP in identifying adenomyomatosis.
  54.Haradome H, et al. The pearl necklace sign: an imaging sign of adenomyomatosis of the gallbladder at MR cholangiopancreatography. Radiology. 2003;227(1):80–8.CrossRef PubMed
  55.Maldjian PD, et al. Adenomyomatosis of the gallbladder: another cause for a “hot” gallbladder on 18F-FDG PET. Am J Roentgenol. 2007;189(1):W36–8.CrossRef
  56.Khan ZS, Livingston EH, Huerta S. Reassessing the need for prophylactic surgery in patients with porcelain gallbladder: case series and systematic review of the literature. Arch Surg. 2011;146(10):1143–7.CrossRef PubMed
  57.Stephen AE, Berger DL. Carcinoma in the porcelain gallbladder: a relationship revisited. Surgery. 2001;129(6):699–703.CrossRef PubMed
  58.Sebastian S, et al. Managing incidental findings on abdominal and pelvic CT and MRI, Part 4: white paper of the ACR Incidental Findings Committee II on gallbladder and biliary findings. J Am Coll Radiol. 2013;10(12):953–6.CrossRef PubMed
  59.Spence SC, Teichgraeber D, Chandrasekhar C. Emergent right upper quadrant sonography. J Ultrasound Med. 2009;28(4):479–96.PubMed
  60.• Mellnick VM, et al. Polypoid lesions of the gallbladder: disease spectrum with pathologic correlation. Radiographics. 2015;35(2):387–99. This article provides a comprehensive discussion of gallbladder polyps and their relationship to carcinomas. The authors also provide a useful management algorithm for incidentally detected polyps.
  61.Ito H, et al. Polypoid lesions of the gallbladder: diagnosis and followup. J Am Coll Surg. 2009;208(4):570–5.CrossRef PubMed
  62.Corwin MT, et al. Incidentally detected gallbladder polyps: is follow-up necessary?–Long-term clinical and US analysis of 346 patients. Radiology. 2011;258(1):277–82.CrossRef PubMed
  63.Gallahan WC, Conway JD. Diagnosis and management of gallbladder polyps. Gastroenterol Clin N Am. 2010;39(2):359–67 x.CrossRef
  64.• Kim JH, et al. High-resolution sonography for distinguishing neoplastic gallbladder polyps and staging gallbladder cancer. Am J Roentgenol. 2015;204(2):W150–9. This article describes the use of transabdominal high resolution US (HRUS) in the characterization of gallbladder carcinomas as well as the risk stratification of polyps. HRUS was similar to endoscopic US in the assessment of the T stage of gallbladder carcinomas.
  65.Furlan A, et al. Gallbladder carcinoma update: multimodality imaging evaluation, staging, and treatment options. Am J Roentgenol. 2008;191(5):1440–7.CrossRef
  66.Augustine MM, Fong Y. Epidemiology and risk factors of biliary tract and primary liver tumors. Surg Oncol Clin N Am. 2014;23(2):171–88.CrossRef PubMed
  67.Corona-Villalobos CP, Pawlik TM, Kamel IR. Imaging of the patient with a biliary tract or primary liver tumor. Surg Oncol Clin N Am. 2014;23(2):189–206.CrossRef PubMed
  68.Hussain HM, Little MD, Wei S. AIRP best cases in radiologic-pathologic correlation: gallbladder carcinoma with direct invasion of the liver. Radiographics. 2013;33(1):103–8.CrossRef PubMed
  69.Oikarinen H. Diagnostic imaging of carcinomas of the gallbladder and the bile ducts. Acta Radiol. 2006;47(4):345–58.CrossRef PubMed
  70.• Kim SJ, et al. Role of diffusion-weighted magnetic resonance imaging in the diagnosis of gallbladder cancer. J Magn Reson Imaging. 2013;38(1):127–37. With some exceptions, the authors report gallbladder carcinomas tend to have lower ADC values than benign entities. Using DWI/ADC in the evaluation of gallbladder disease may help confirm a suspected carcinoma or suggest a benign etiology in equivocal cases.
  71.Lee NK, et al. Diffusion-weighted MRI for differentiation of benign from malignant lesions in the gallbladder. Clin Radiol. 2014;69(2):e78–85.CrossRef PubMed
  72.Deshmukh SD, et al. CT of gallbladder cancer and its mimics: a pattern-based approach. Abdom Imaging. 2013;38(3):527–36.CrossRef PubMed
  73.Rodriguez-Fernandez A, et al. Positron-emission tomography with fluorine-18-fluoro-2-deoxy-d -glucose for gallbladder cancer diagnosis. Am J Surg. 2004;188(2):171–5.CrossRef PubMed
  74.Ramos-Font C, et al. Ability of FDG-PET/CT in the detection of gallbladder cancer. J Surg Oncol. 2014;109(3):218–24.CrossRef PubMed
  75.Lim KS, et al. The varying faces of gall bladder carcinoma: pictorial essay. Acta Radiol. 2012;53(5):494–500.CrossRef PubMed
  76.Martel JP, McLean CA, Rankin RN. Melanoma of the gallbladder. Radiographics. 2009;29(1):291–6.CrossRef PubMed
  77.Barretta ML, et al. Gallbladder metastasis: spectrum of imaging findings. Abdom Imaging. 2011;36(6):729–34.CrossRef PubMed
  78.Paraskevas GK, et al. Duplicated gallbladder: surgical application and review of the literature. Ital J Anat Embryol. 2011;116(2):61–6.PubMed
  79.Roldan-Valadez E, et al. Asymptomatic true gallbladder duplication: a case report and review of the literature. Acta Radiol. 2004;45(8):810–4.CrossRef PubMed
  80.Gocmen R, Yesilkaya Y. Imaging findings of gallbladder duplication due to two cases: case report and review of literature. Med Ultrason. 2012;14(4):358–60.PubMed
  81.Reilly DJ, Kalogeropoulos G, Thiruchelvam D. Torsion of the gallbladder: a systematic review. HPB (Oxford). 2012;14(10):669–72.CrossRef
  82.Lubner MG, et al. Emergent and nonemergent nonbowel torsion: spectrum of imaging and clinical findings. Radiographics. 2013;33(1):155–73.CrossRef PubMed
  83.Chung JC, Song OP, Kim HC. Gallbladder torsion diagnosed by MDCT and MRCP. Abdom Imaging. 2010;35(4):462–4.CrossRef PubMed
  84.Gabizon S, et al. Gallbladder torsion: a diagnostic challenge. Case Rep Surg. 2014;2014:902814.PubMed PubMedCentral
  85.Wittenberg A, Minotti AJ. CT diagnosis of traumatic gallbladder injury. AJR Am J Roentgenol. 2005;185(6):1573–4.CrossRef PubMed
  86.Chen X, Talner LB, Jurkovich GJ. Gallbladder avulsion due to blunt trauma. Am J Roentgenol. 2001;177(4):822.CrossRef
  
• 作者单位：Marc Tubay (1) (2) (3)
  Scott Zelasko (2) (4)
  
  1. Department of Radiology, US Air Force Academy Medical Clinic, 4102 Pinion Drive, US Air Force Academy, Colorado Springs, CO, 80840, USA
  2. Department of Radiology, US University of the Health Sciences, Bethesda, MD, USA
  3. Department of Radiology, University of Utah School of Medicine, Salt Lake City, UT, USA
  4. Department of Radiology, David Grant Medical Center, 101 Bodin Circle, Travis AFB, Fairfield, CA, 94535, USA
  
• 刊物主题：Imaging / Radiology;
• 出版者：Springer US
• ISSN：2167-4825

文摘

A wide variety of inflammatory and neoplastic processes may affect the gallbladder. Gallstones are commonly encountered, and can result in both acute and chronic cholecystitis. Advanced acute cholecystitis can lead to a variety of complications, each with unique imaging findings. Adenomyomatosis and xanthogranulomatous cholecystitis can result in gallbladder wall thickening which may mimic carcinoma. Polyps are frequently encountered and are typically benign. However, some imaging features of polyps are more suggestive of suspected carcinoma and necessitate surveillance or intervention. Gallbladder carcinoma usually presents as a subhepatic mass with liver invasion, generally portending a poor prognosis. Congenital anomalies, torsion, and traumatic injury are additional less-common entities that may affect the gallbladder. This article will describe the various diseases that affect the gallbladder and discuss the associated imaging appearances across multiple modalities.