Ultrasound: comet tail artefact: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Ultrasound: comet tail artefact

Sample item

A gallbladder wall shows short, bright, comet-shaped echoes deep to small echogenic foci. In which condition is this classically described?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Adenomyomatosis with cholesterol crystals in Rokitansky-Aschoff sinuses

The comet tail (ring-down) artefact arises from small, highly reflective crystals trapped in Rokitansky-Aschoff sinuses. It indicates adenomyomatosis, a benign hyperplastic condition. It does not point to malignancy.

Option by option

  • A. Gallbladder carcinoma with liver invasion

    Carcinoma presents as a mass or irregular wall thickening.

  • B. Acute viral hepatitis

    Viral hepatitis causes gallbladder wall thickening without comet tails.

  • C. Cholangitis with pus

    Cholangitis involves ductal dilatation and does not produce this artefact.

  • D. Adenomyomatosis with cholesterol crystals in Rokitansky-Aschoff sinuses (correct)

    Correct. Ring-down echoes arise from cholesterol crystals in intramural sinuses.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Adenomyomatosis with cholesterol crystals in Rokitansky-Aschoff sinuses. The comet tail (ring-down) artefact arises from small, highly reflective crystals trapped in Rokitansky-Aschoff sinuses.

Why is "Gallbladder carcinoma with liver invasion" not the answer?

Carcinoma presents as a mass or irregular wall thickening.

Why is "Acute viral hepatitis" not the answer?

Viral hepatitis causes gallbladder wall thickening without comet tails.

Why is "Cholangitis with pus" not the answer?

Cholangitis involves ductal dilatation and does not produce this artefact.

What concept does this question test?

It tests Ultrasound: comet tail artefact in Radiology. It indicates adenomyomatosis, a benign hyperplastic condition. It does not point to malignancy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Ultrasound: comet tail artefact?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.