Skip to main content
. 2021 Feb 28;15(2):25–34. doi: 10.3941/jrcr.v15i2.3901

Table 2.

Differential diagnosis table for Hemorrhagic Cholecystitis.

Entity Ultrasound CT MRI Angiography
Hemorrhagic Cholecystitis

  • Layering, echogenic debris

  • Usually seen in presence of gallstone(s)

  • Wall edema, pericholecystic fluid

  • Distended GB

  • Enhancing cystic artery PSA

  • Layering hyperdensity

  • Hemoperitoneum (if ruptured)

 Layering blood products:

  • Hyperintense on T1 weighted sequences

  • Isointense/hypointense on T2 weighted sequences

  • Cystic artery PSA (most specific finding)

  • +/− Active extravasation
Acute Cholecystitis

  • Wall edema, pericholecystic fluid

  • +/− Gallstones

  • Distended GB

  • Mural or mucosal enhancement

  • Subserosal edema

  • Distended GB

 Pericholecystic fluid collection:

  • Hypointense on T1 weighted sequences

  • Hyperintense on T2 weighted sequences

  • No cystic artery PSA
Intraluminal Gallbladder Mass/Carcinoma

  • Non-layering, echogenic mass along the dependent or nondependent portion of GB

  • Doppler may show internal flow within mass lesion

  • Intraluminal soft tissue density mass

  • Focal or diffuse mural thickening

  • Post contrast enhancement

 Intraluminal GB Carcinoma:

  • Intermediate on T1 weighted sequences

  • Hyperintense on T2 weighted sequences

  • Post gadolinium enhancement

  • No cystic artery PSA
Biliary Sludge

  • Layering, echogenic debris

  • No internal vascular flow

  • Layering hyperdensity

 Gallbladder Sludge:

  • Hyperintense on T1 weighted sequences

  • Isointense to mildly hyperintense on T2 weighted sequences

  • No cystic artery PSA