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MR Imaging of the Gallbladder: A Pictorial Essay¹

¹ From the Department of Radiology, Division of Gastrointestinal Radiology, Massachusetts General Hospital, WHT 270, 55 Fruit St, Boston, MA 02114 (O.A.C., D.V.S., S.P.K., M.S.C., P.F.H.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (J.J.B.); and the Department of Radiology, Northwestern University School of Medicine, Evanston, Ill (R.R.E.). Presented as an education exhibit at the 2004 RSNA Annual Meeting. Received October 23, 2006; revision requested January 23, 2007; final revision received June 7; accepted June 11. The authors discuss an investigational or unlabeled use of a commercial product, device, or pharmaceutical that has not been approved for such purpose by the FDA. D.V.S. is a researcher for GE Healthcare and a consultant with Bracco Diagnostics; S.P.K. received research grants from Johnson & Johnson (Cordis) and Cook and is with the speakers’ bureau of Johnson & Johnson; J.J.B. is a consultant with Tyco Healthcare (Mallinckrodt), Bayer Healthcare, and GE Healthcare and is with the speakers’ bureau of Bracco Diagnostics; and R.R.E. received research support from GE Healthcare and Schering (Berlex); all remaining authors have no financial relationships to disclose. Address correspondence to D.V.S. (e-mail: dsahani{at}partners.org).

The gallbladder serves as the repository for bile produced in the liver. However, bile within the gallbladder may become supersaturated with cholesterol, leading to crystal precipitation and subsequent gallstone formation. The most common disorders of the gallbladder are related to gallstones and include symptomatic cholelithiasis, acute and chronic cholecystitis, and carcinoma of the gallbladder. Other conditions that can affect the gallbladder include biliary dyskinesia (functional), adenomyomatosis (hyperplastic), and postoperative changes or complications (iatrogenic). Ultrasonography (US) has been the traditional modality for evaluating gallbladder disease, primarily owing to its high sensitivity and specificity for both stone disease and gallbladder inflammation. US performed before and after ingestion of a fatty meal may also be useful for functional evaluation of the gallbladder. However, US is limited by patient body habitus, with degradation of image quality and anatomic detail in obese individuals. With the advent of faster and more efficient imaging techniques, magnetic resonance (MR) imaging has assumed an increasing role as an adjunct modality for gallbladder imaging, primarily in patients who are incompletely assessed with US. MR imaging allows simultaneous anatomic and physiologic assessment of the gallbladder and biliary tract in both initial evaluation of disease and examination of the postoperative patient. This assessment is accomplished chiefly through the use of MR imaging contrast agents excreted preferentially via the biliary system.

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