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Gallbladder adenomyomatosis

Adenomyomatosis is an acquired, hyperplastic lesion of the gallbladder, characterized by excessive proliferation of the superficial epithelium with invagination into the thickened muscle layer and the formation of internal false diverticula — Rokitansky-Aschoff sinuses Macroscopically, there are three types of gallbladder AMM: focal, segmental and diffuse Adenomyomatosis at US and represents  1 - wall thickening 2 - Expanded sinuses of Rokitansky — Aschoff, that may contain bile, sludge, microliths or stones, this is specific sign of AMM of the gallbladder. The expanded sinuses of Rokitansky — Aschoff are hypoechoic if they contain bile and are hyperechoic if they contain sludge, microliths or concretions. Hyperechogenic foci in the gallbladder wall are manifested by a distal reverberation effect in the form of a "comet tail" (V-like artifacts) 3 - Cysts in the thickened wall of the gallbladder At the presented exam: the wall is significantly diffusely thickened, noticeably layered, multiple hyperechoic inclusions are visualized in the thickned walls, giving a reverberation effect (comet tail) —((expanded Rokitansky — Aschoff sinuses containing sludge and microliths))