Fig. 14. Adenomyomatosis of the gallbladder: imaging features. (A) Transverse right upper quadrant sonogram shows a thick gallbladder wall and echogenic intramural foci that produce "ring-down" reverberation artifacts (arrow). These foci are caused by the cholesterol crystals within RASs. (B) Coronal MRCP image shows multiple high signal intensity structures (arrows) within the gallbladder wall, which represent the RASs. This produces a so-called string of pearls appearance.

difficult to differentiate from carcinoma because they appear as focal mural thickening or as a fundal mass. Ultrasonography has the advantage of being able to show the ring-down artifact related to the RASs.2,3

MRI Findings

Because MRI offers more complete visualization of the gallbladder and more definitive identification of RASs, MRI has become the primary imaging examination in patients with known or suspected gallbladder adenomyomatosis. The RASs appear as small intramural foci of low signal intensity on Tl-weighted images and of high signal intensity on T2-weighted images. The RASs imaged longitudinally can produce a so-called string of pearls appearance (see Fig 14B), a sign that is 92% specific for adenomyomatosis. In one study, MRI was more accurate than CT or ultrasonography (93%, 75%, 66%, respectively) in establishing this diagnosis.72

Get Rid of Gallstones Naturally

Get Rid of Gallstones Naturally

One of the main home remedies that you need to follow to prevent gallstones is a healthy lifestyle. You need to maintain a healthy body weight to prevent gallstones. The following are the best home remedies that will help you to treat and prevent gallstones.

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