Adenomyomatosis of the gall bladder

3D Model

Benign alteration of the gallbladder wall characterized by excessive epithelial proliferation associated with hyperplasia of the muscularis propria, resulting in gallbladder wall thickening. There is hyperperplasia of the wall with the formation of Rokitansky-Aschoff sinuses (intramural diverticula lined by mucosal epithelium) penetrating the muscular wall of the gallbladder usually with some wall thickening

MRI / MRCP FINDINGS mural thickening fluid-filled intramural diverticula pearl necklace sign refers to the characteristically curvilinear arrangement of multiple rounded hyperintense intramural cavities visualized on T2-weighted MR imaging and MRCP  (present in this case) hourglass configuration in annular types  (present in this case)