Questions: A comet-tail reverberation artifact is seen originating from the anterior gallbladder wall. What gallbladder pathology is most likely causing this artifact? a. gallbladder carcinoma b. adenomyomatosis c. sludge d. gallstone

The answer is b: adenomyomatosis.

Explanation for each option:

a. Gallbladder carcinoma: This is a malignant tumor of the gallbladder. While it can cause various ultrasound findings, it is not typically associated with comet-tail artifacts.

b. Adenomyomatosis: This is a benign condition characterized by hyperplastic changes in the gallbladder wall, often leading to the formation of Rokitansky-Aschoff sinuses. These sinuses can trap bile, cholesterol crystals, or other debris, which can cause the characteristic comet-tail reverberation artifact on ultrasound.

c. Sludge: Gallbladder sludge is a collection of particulate matter in bile, often seen as low-level echoes within the gallbladder. It does not typically cause comet-tail artifacts.

d. Gallstone: Gallstones are solid particles that form in the gallbladder. They usually cause shadowing artifacts rather than comet-tail artifacts on ultrasound.

In summary, the comet-tail reverberation artifact originating from the anterior gallbladder wall is most commonly associated with adenomyomatosis.