A hyperattenuating gallbladder may occur from a number of different etiologies:
- sludge in the gallbladder
- vicarious excretion of intravenous contrast (iodinated contrast or gadolinium contrast)
- hyperconcentrated bile
- noncalcified gallstones
- medications I.e ceftriaxone associated gallbladder psuedolithiasis
- hemorrhage
Radiographic features
- gallbladder measures between 20-100 HU
Treatment and prognosis
If there are no other concerning features (e.g. gallbladder wall thickening), then a hyperattenuating gallbladder does not need to be followed up. Otherwise, ultrasound would be useful for further evaluation.