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Fundus of gallbladder

The fundus of the gallbladder is the rounded, blind-ended distal portion of the gallbladder that extends beyond the inferior border of the liver. It usually lies in contact with the anterior abdominal wall at the level of the 9th right costal cartilage, where it meets the lateral edge of the rectus abdominis muscle (the gallbladder point).

Unlike the body and neck, the fundus is not completely covered by the liver, making it more exposed. This anatomical feature makes the fundus the most common site of gallstone impaction, chronic cholecystitis, and carcinoma of the gallbladder. The fundus is also the first part visualized during cholecystectomy.

Synonyms

  • Distal end of gallbladder

  • Gallbladder dome

Function

  • Acts as a storage reservoir for bile produced by the liver

  • Participates in the concentration of bile prior to its release

  • Plays a role in biliary pressure regulation during gallbladder contraction

Nerve Supply

  • Parasympathetic: Vagus nerve

  • Sympathetic: Celiac plexus

  • Sensory pain fibers: Right phrenic nerve (referred pain to right shoulder)

Arterial Supply

  • Cystic artery (branch of right hepatic artery, usually arising from hepatic artery proper)

Venous Drainage

  • Drains through the cystic veins into the portal vein

  • Some small veins from the fundus drain directly into the hepatic sinusoids

MRI Appearance

T1-weighted images:

  • Gallbladder lumen normally appears as low signal (dark) due to bile

  • Wall is thin and low-to-intermediate signal; thickening suggests inflammation

T2-weighted images:

  • Fundus and lumen appear hyperintense (bright bile)

  • Gallstones appear as signal voids (dark) within bright bile

  • Wall edema shows as intermediate-to-high signal

STIR:

  • Suppresses fat, making the gallbladder wall and pericholecystic edema stand out

  • Useful for detecting acute cholecystitis

T1 Fat-Saturated (Pre-contrast):

  • Lumen remains low signal; wall shows intermediate signal against suppressed fat

T1 Fat-Saturated Post-Contrast (Gadolinium):

  • Wall enhances thin and uniform in normal gallbladder

  • Heterogeneous or irregular enhancement suggests cholecystitis or carcinoma

MRI Non-Contrast 3D MRCP (Magnetic Resonance Cholangiopancreatography):

  • Demonstrates gallbladder fundus, lumen, and biliary connections

  • Useful in detecting stones, obstruction, and congenital anomalies

CT Appearance

CT Pre-Contrast:

  • Fundus appears as a fluid-density structure projecting beyond the liver margin

  • Gallstones appear hyperdense; polyps or tumors may appear as mural nodules

CT Post-Contrast:

  • Normal wall enhances thin and uniformly

  • Wall thickening or irregularity suggests inflammation, adenomyomatosis, or malignancy

  • Pericholecystic fat stranding indicates acute cholecystitis

MRI images

fundus of gallbladder MRI coronal anatomy image -img-00000-00000

MRI images

fundus of gallbladder MRI sag anatomy image -img-00000-00000

CT image

fundus of gallbladder CT coronal anatomy image -img-00000-00000