Gallbladder Adenomyomatosis

Imaging

• Gallbladder (GB) wall thickening with intramural hyperechoic foci and comet-tail reverberation artifacts

• V-shaped comet-tail artifacts from debris in GB wall cystic spaces

  • Twinkling artifacts from intramural debris on color Doppler examination

• Morphological patterns: Diffuse, segmental, annular, focal

• Annular form: Midbody segmental thickening results in constricting ring around midbody and hourglass shape

• Focal fundal adenomyoma

  • Smooth fundal solitary intraluminal mass, internal cystic spaces, echogenic foci

  • No significant vascularity; ± twinkling artifact