ULTRASOUND NEWS 8-2019

Ultrafast Doppler US can be used to retrospectively analyse the acquired vascular waveforms and that the acquired vascular velocity values are comparable to those acquired with conventional Doppler US. Also, this new technique allows the evaluation of multiple branches with a single acquisition and in shorter time. Therefore, Ultrafast Doppler US is thought to be a feasible and safe method for cranial US in neonates at risk for altered hemodynamic conditions of the brain. Future validation of intra- and interobserver variability may further contribute to supporting the reproducibility of this method.

Comet tail artifact in gallbladder lesions may potentially be a reliable sign suggesting the presence of a benign lesion.

ABSTRACT Purpose: The aim of this study was to evaluate whether the comet tail artifact on ultrasonography can be used to reliably diagnose benign gallbladder diseases. Methods: This retrospective study reviewed the clinical findings, imaging findings, preoperative ultrasonographic diagnoses, and pathological diagnoses of 150 patients with comet tail artifacts who underwent laparoscopic cholecystectomy with pathologic confirmation. The extent of the involved lesion was classified as localized or diffuse, depending on the degree of involvement and the anatomical section of the gallbladder that was involved. This study evaluated the differences in clinical and imaging findings among pathologic diagnoses. Results: All gallbladder lesions exhibiting the comet tail artifact on ultrasound examination were confirmed as benign gallbladder diseases after cholecystectomy, including 71 cases of adenomyomatosis (47.3%), 74 cases of chronic cholecystitis (49.3%), two cases of xanthogranulomatous cholecystitis (1.3%), and three cases of cholesterolosis (2.0%); there were two cases of coexistent chronic cholecystitis and low-grade dysplasia. There were no statistically significant differences in any of the clinical and ultrasonographic findings, with the exception of gallstones (P=0.007), among the four diseases. There were no significant differences in the average length, thickness, or number of comet tail artifacts among the four diagnoses. No malignancies were detected in any of the 150 thickened gallbladder lesions. Conclusion: The ultrasonographic finding of the comet tail artifact in patients with thickened gallbladder lesions is associated with the presence of benign gallbladder diseases, and can be considered a reliable sign of benign gallbladder disease.

In this study, all gallbladder lesions with a comet tail artifact on ultrasonographic imaging, regardless of lesion extent and other suspicious ultrasonographic findings such as irregular margin and loss of the wall layer, were benign, including causes of chronic cholecystitis, adenomyomatosis, xanthogranulomatous cholecystitis, and cholesterolosis. Therefore, the comet tail artifact in gallbladder lesions may potentially be a reliable sign suggesting the presence of a benign lesion. Our results may be applicable to the differential diagnosis of gallbladder diseases through gallbladder ultrasonography.