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Index / Incidental findings

Incidental gallbladder and biliary findings

ACR 2013CTMRI
Flowchart · click to enlarge
Incidental gallbladder or biliary finding on CT or MRI

Gallbladder polyps by size, porcelain gallbladder, and common duct dilation on CT or MRI.

FindingManagement
Polyp ≤ 6 mmNo evaluation or follow-up
Polyp 7–9 mmUltrasound yearly; surgical consult if it grows
Polyp ≥ 10 mm or massSurgical consult
Wall calcification, no massNo routine follow-up; contrast CT if followed
CBD > 6 mm (< 60 yr, gallbladder in place) or > 10 mm (post-cholecystectomy)Check bilirubin and alkaline phosphatase; no imaging if normal; MRCP, EUS or ERCP if abnormal or stone or mass suspected

Sources

  1. Sebastian S, Araujo C, Neitlich JD, Berland LL. Managing incidental findings on abdominal and pelvic CT and MRI, part 4: white paper of the ACR Incidental Findings Committee II on gallbladder and biliary findings. J Am Coll Radiol. 2013;10:953–956.PubMed ↗
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