Description Recommendation Notes
Gallstones, no mass Evaluate with US if symptomatic
Gallbladder wall calcification, no mass No further evaluation
Dense bile (20-100HU) No further evaluation
Diffuse gallbladder wall thickening >3mm, no mass No further evaluation
Focal gallbladder wall thickening or mass Consider US for adenomyomatosis Specific f/u depends on mass size, clinical factors
Gallbladder polyp ≤ 6 mm No further evaluation
Gallbladder polyp 7-9 mm One year followup US
Gallbladder polyp ≥ 10 mm, mass Surgical consult
Distended gallbladder No further evaluation if asymptomatic Further evaluation dependent on symptoms, labs
Common Bile Duct dilation No further evaluation if labs normal If labs abnormal: ERCP, EUS, MRCP or CT Cholangiography



Sebastian, S., et al. (2013). “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 10(12): 953-956.