2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL
3. • Fig GI 67-1 Acute cholecystitis. Marked thickening
of the gallbladder neck (1.1 cm between the
cursors). There is a densely echogenic stone
(arrow) with posterior acoustic shadowing in the
neck of the gallbladder.
4. • Fig GI 67-2 Acalculous cholecystitis. Enlarged
gallbladder with a thickened, edematous wall
(arrows). There is no evidence of gallstones or
posterior acoustic shadowing.
5. • Fig GI 67-3 Xanthogranulomatous cholecystitis.
Longitudinal sonogram of the right upper
quadrant shows disruption of the mucosal line of
the gallbladder (arrow), which contains echogenic
material. There is pericholecystic fluid, focal
hypoattenuation in the adjacent liver, and loss of
the normal plane between the gallbladder and
liver.87
6. • Fig GI 67-4 Hypoalbuminemia with marked
ascites. Thickening of the gallbladder wall
(arrow).
7. • Fig GI 67-5 Ascites. A large amount of sonolucent ascitic
fluid (a) separates the liver (L) and other soft-tissue
structures from the anterior abdominal wall. Note the
relative thickness of the gallbladder wall (arrow).
8. • Fig GI 67-6 Congestive heart failure. Sagittal sonogram
shows edema of the wall of the gallbladder
(arrowheads), pericholecystic fluid (FF), and distension
to the inferior vena cava (IVC).88
9. • Fig GI 67-7 Acute viral hepatitis. Sagittal
sonogram shows a tiny, slitlike gallbladder lumen
(*) with massive “onion-peel” edema of the wall
(arrowheads).88
10. Fig GI 67-8 Cirrhosis. Sagittal sonogram shows a thickened
gallbladder wall (arrowheads) and free fluid (FF).88
