Gallbladder Imaging Interpretation Pearls and Pitfalls

The gallbladder is a source of common disease processes with a wide variety of presentations. Common pathologies include acute or chronic cholecystitis, adenomyomatosis, cancer, polyps, and postoperative complications. Accurate imaging assessment of the gallbladder can be very challenging and fraught with potential pitfalls. Ultrasound is the imaging modality of choice for the initial evaluation of patients who present with right upper quadrant pain. CT is often used as part of a broader evaluation of patient's abdominal pain if nongallbladder pathologies are also suspected. MRI/MRCP is typically reserved for problem-solving and evaluating patients who present with cholestatic presentation. We discuss common pitfalls, diagnostic challenges, and problem-solving approaches to the imaging evaluation of common gallbladder patho logies.