Focal Gallbladder Compression Sign during Abdominal Sonography: What Does This Mean?

Abstract

Several conditions show mass effects on the outline of the gallbladder wall with an internal protrusion onto the gallbladder lumen. Sometimes, this mass effect may be a sole sign detecting the lesion during abdominal sonography. The purposes of this exhibit are to demonstrate several conditions causing the focal gallbladder compression sign during abdominal sonography and to discuss its clinical significances. We retrospectively reviewed the abdominal sonographic results. We selected the patients who showed the focal gallbladder compression sign in abdominal sonography. The medical records and other imaging findings of selected patients were also reviewed. In this exhibit, we demonstrated intrahepatic isoechoic conditions that show focal gallbladder compression, including the normal hepatic lobule, nodular regeneration of a cirrhotic liver, hepatocellular carcinoma, hemangioma, and metastases. We also demonstrated extrahepatic conditions, including prominent pericholecystic fat and adjacent bowel. In addition, we found a gallbladder adenomyomatosis mimicking the lesion causing focal gallbladder compression. Most of the conditions were correlated with CT imaging findings. The clinical significance of focal gallbladder compression was also discussed. Although a focal gallbladder compression sign is the non-specific finding, it may be a useful sign for detecting a small isoechoic mass in segment 4 and segment 5 of the liver.