title: A literature review of radiological findings to guide the diagnosis of gallbladder adenomyomatosis.
abstract: BACKGROUND
  Gallbladder adenomyomatosis (GA) is a benign gallbladder entity discovered as an asymptomatic gallbladder mass. Since gallbladder cancer is in the differential diagnosis for gallbladder masses, the ability to differentiate benign disease avoids a more extensive oncologic resection. This study sought to review imaging modalities used to diagnose GA.
  
  
  METHODS
  PubMed and SciVerse Scopus were systematically searched using the terms: "gallbladder adenomyomatosis" and "gallbladder imaging" for articles published between January 2000 and January 2015.
  
  
  RESULTS
  A total of 14 articles were reviewed in this analysis. Contemporary series report the use of ultrasound (US), computed tomography (CT) or magnetic resonance imaging (MRI) in GA imaging. Ultrasound detection of Rokitansky-Aschoff sinuses, visualized as small cystic spaces with associated "comet-tail" or "twinkling" artifact, is pathognomonic for GA. A "Pearl-Necklace" sign of small connected sinuses on MRI or "Rosary" sign on CT are additional characteristics that may assist in establishing a diagnosis.
  
  
  CONCLUSIONS
  Ultrasound is the most commonly used tool to investigate GA. If not diagnostic, CT or MRI are effective in attempting to differentiate a benign or malignant cholecystic mass. Characteristic signs should lead the surgeon to perform a laparoscopic cholecystectomy in symptomatic patients or manage non-operatively in asymptomatic patients.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Abdulrahman Y
authors.initials: AY
authors.lastname: Hammad
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Miura
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Kiran K
authors.initials: KK
authors.lastname: Turaga
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Fabian M
authors.initials: FM
authors.lastname: Johnston
authors.affiliation: Section of Abdominal Imaging, Division of Diagnostic Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Hohenwalter
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: tcgamblin@mcw.edu.
authors.forename: T Clark
authors.initials: TC
authors.lastname: Gamblin
mesh_terms: D018194:Adenomyoma / Q000000981:diagnostic imaging* / Q000628:therapy; D002765:Cholecystography / Q000379:methods; D003937:Diagnosis, Differential; D005706:Gallbladder Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography