title: Focal thickening at the fundus of the gallbladder: computed tomography differentiation of fundal type adenomyomatosis and localized chronic cholecystitis.
abstract: OBJECTIVE
  The objective of our study was to identify useful computed tomography (CT) findings for differentiating fundal type adenomyomatosis from localized chronic cholecystitis involving the fundus of the gallbladder.
  
  
  METHODS
  We retrospectively identified cases of 41 patients with pathologically proven adenomyomatosis (n=21) or chronic cholecystitis (n=20) who had fundal thickening of the gallbladder on preoperative abdominal CT. Analysis of the CT findings included evaluation of the thickness, contour, border, intralesional cystic area, adjacent gallbladder wall thickening, presence of inner layer enhancement, enhancement grade, enhancement pattern, and presence of stones. Statistical analyses were performed using the Mann-Whitney U test and Fisher exact test.
  
  
  RESULTS
  Oval contour, inner layer enhancement and intralesional cystic area were more frequently noted in adenomyomatosis than in chronic cholecystitis (p<0.05 for each finding). Flat contour and adjacent gallbladder wall thickening were more frequently observed in chronic cholecystitis than in adenomyomatosis. No differences between adenomyomatosis and chronic cholecystitis in terms of the thickness, enhancement grade, enhancement pattern and presence of stones were apparent.
  
  
  CONCLUSIONS
  CT may help to differentiate fundal type adenomyomatosis from localized chronic cholecystitis involving the fundus of the gallbladder.
authors.affiliation: Department of Radiology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Bo Sung
authors.initials: BS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jong Young
authors.initials: JY
authors.lastname: Oh
authors.affiliation: Department of Radiology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Kyung Jin
authors.initials: KJ
authors.lastname: Nam
authors.affiliation: Department of Radiology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jin Han
authors.initials: JH
authors.lastname: Cho
authors.affiliation: Department of Radiology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Kwon
authors.affiliation: Department of Radiology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Seong Kuk
authors.initials: SK
authors.lastname: Yoon
authors.affiliation: Department of Pathology, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Jin Sook
authors.initials: JS
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Myung Hwan
authors.initials: MH
authors.lastname: Noh
mesh_terms: D018194:Adenomyoma / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D000368:Aged; D002764:Cholecystitis / Q000000981:diagnostic imaging / Q000473:pathology*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D005704:Gallbladder; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Adenomyomatosis; Chronic cholecystitis; Computed tomography; Fundal type