ADENOMYOMATOSIS GALL BLADDER-MRCP

Adenomyomatosis is characterized by hyperplastic muscular wall thickening, mucosal overgrowth, and intramural diverticula, crypts or sinus tracts - so called Rokitansky Aschoff sinusus. There are 3 pathologic types – Diffuse, segmental and localized.
Our case seems to be of Localized and segmental variety as it is specifically involving the fundal region and also dividing the lumen into separate interconnected compartments.
T2 weighted coronal, axial and MR cholangiography demonstrate these intramural cystic spaces which appears as bright, high signal intensity areas in the thickened gall bladder wall – the “pearl necklace” sign. Also septated compartments due to focal stricture are well visualized.