Cholesterolosis of the Gallbladder: Imaging Characteristics and Differential Diagnosis

Imaging Characteristics

• On ultrasound, cholesterol polyps typically appear as small, non-mobile, non-shadowing lesions attached to the gallbladder wall 1
• Cholesterol polyps may show stalk-like central enhancement on contrast-enhanced ultrasound (CEUS) 2
• MRI may show high T1-weighted signal in cholesterol polyps 2

Differential Diagnosis

• Cholesterol polyps must be differentiated from other gallbladder lesions, such as adenomatous polyps (neoplastic) 2
• Cholesterol polyps must be differentiated from gallbladder cancer 2
• Key distinguishing features of cholesterol polyps include that they are typically small, do not shadow on ultrasound, and are non-mobile 1
• Cholesterol polyps may show stalk-like central enhancement on CEUS, which can help differentiate them from other lesions 2