Diagnostic Ultrasound - Abdomen and Pelvis

Hyperplastic Cholecystosis (Adenomyomatosis)
(Left) Longitudinal ultrasound
through the gallbladder shows
multiple hyperechoic foci with
V-shaped, "comet tail'
reverberation artifact st.
(Right) Longitudinal color
Doppler ultrasound in the
same patient shows
characteristic color "comet
tail," "twinkling" artifact st
with associated rough surfaces
of contents (calculi) within the
RA sinuses.
Diagnoses: Biliary System
(Left) Longitudinal ultrasound
shows multiple cystic spaces
ſt in the thickened GB walls,
pathologically shown to
represent bile-filled RA sinuses
in a patient with
adenomyomatosis. (Used with
permission from the American
Institute for Radiologic
Pathology archives, Case ID #
1794.) (Right) Longitudinal
ultrasound shows both a
solitary isoechoic polyp ſt and
fundal adenomyomatosis .
(Used with permission from
the American Institute for
Radiologic Pathology archives,
Case ID # 728.)
(Left) Coronal CECT shows
constriction of the midbody ſt
of the gallbladder,
representing segmental
adenomyomatosis. There are
small cysts st in the wall of
the thick segment. (Right)
Coronal T2 HASTE MR shows a
cluster of fluid-filled
intramural diverticula in the
ſt gallbladder fundus (the
"pearl necklace" sign,
characteristic of fundal
adenomyomatosis).
317