MR diagnosis of adenomyomatosis of the gallbladder and differentiation from gallbladder carcinoma: importance of showing Rokitansky-Aschoff sinuses.
OBJECTIVE
We evaluated the MR imaging features of adenomyomatosis of the gallbladder with particular emphasis on Rokitansky-Aschoff sinuses.


METHODS
MR images of 17 patients with histologically proven adenomyomatosis were retrospectively reviewed. The presence of Rokitansky-Aschoff sinuses was evaluated and analyzed; four T2-weighted (fast spin-echo with a surface coil, with or without breath-holding, fast spin-echo with a phased-array coil with breath-holding, and half-Fourier rapid acquisition with relaxation enhancement with breath-holding) and two contrast-enhanced dynamic pulse sequences were studied. These six pulse sequences were separately rated on a 5-point scale by two radiologists for comparison. Interobserver differences were evaluated. Other MR findings were also analyzed.


RESULTS
Among the six pulse sequences studied, three T2-weighted with breath-holding sequences were found to be superior to the other three sequences in showing Rokitansky-Aschoff sinuses. In particular, the half-Fourier rapid acquisition with relaxation enhancement was scored the highest by the two observers and received the highest kappa coefficient in our statistical analysis of the scoring. Diffuse-type adenomyomatosis typically showed early mucosal and subsequent serosal enhancement. Localized adenomyomatosis exhibited homogeneous enhancement, showing smooth continuity with the surrounding gallbladder epithelium.


CONCLUSIONS
MR imaging may be able to provide important information in the diagnosis of adenomyomatosis.
Yoshimitsu
K
K
Department of Radiology, Kyushu University Hospital, Fukuoka, Japan.
Honda
H
H
Jimi
M
M
Kuroiwa
T
T
Hanada
K
K
Irie
H
H
Tajima
T
T
Takashima
M
M
Chijiiwa
K
K
Shimada
M
M
Masuda
K
K
D018194:Adenomyoma / Q000175:diagnosis*; D000328:Adult; D002277:Carcinoma / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D005583:Fourier Analysis; D005704:Gallbladder / Q000473:pathology*; D005706:Gallbladder Neoplasms / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D012119:Respiration; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
D003287:Contrast Media