Segmental Adenomyomatosis of Gallbladder: CT Assessment of the Patterns of Cholecystolithiasis

Abstract

PURPOSE: To clarify the relationship between the pattern of cholecystolithiasis and the gross features of segmental adenomyomatosis of the gallbladder. MATERIALS AND METHODS: Fifty-five consecutive patients with segmental adenomyomatosis with calcified gallbladder stones defined on CT were retrospectively analyzed in terms of (i) stone location (fundal vs. neck compartment) and (ii) size of the largest stone as a function of the extent of segmental mural thickening (type A, limited at the narrow segment; type B, partially extended in the fundal direction; type C, involving the entire fundal compartment). The extent of segmental mural thickening in patients with cholecystolithiasis was compared with a control group (n = 48) lacking stones. RESULTS: Stones were found more frequently in the fundal compartment in 48 patients compared to the neck compartment in 12 patients (p<0.001). The mean size of the largest stone in type C (5.4 +/- 4.9 mm) was larger than in type A (2.3 +/- 2.2 mm) (p=0.033). In patients with cholecystolithiasis, type C segmental thickening was predominant (69%) compared to the control group (42%) (p=0.012). CONCLUSION: In addition to a higher prevalence of stones, a wide extent of mural thickening combined with large stone size in the fundal compartment suggests the contribution of segmental adenomyomatosis to stone formation and chronic inflammation