![]() Macrocalcification can be distinguished from microcalcifications and comet tail artifact because they are larger and there is posterior shadowing.Ĭomet tail artifact appears as a bright echogenic line with an echogenic triangle or lines reverberating posterior to it (See image below). Some have called this the “starry sky at night” because of this twinkling appearance. As the ultrasound probe is moved back and forth, microcalcifications come in and out of view. They are often more readily seen while performing ultrasound in real-time and often less obvious on still images. Microcalcifications are tiny and without posterior shadowing. Some echogenic foci such as microcalcifications are associated with increased risk for malignancy, while others such as comet tail artifact are associated with low risk. If you continue to have this issue please contact to HealioĮchogenic foci are commonly identified on thyroid ultrasound. She will return in 12 to 18 months for a repeat thyroid ultrasound exam.We were unable to process your request. With our patient, we discussed the very low risk of malignancy of her thyroid nodules noted on ultrasound and recommended against biopsy in favor of watchful waiting. The 2009 revised American Thyroid Association guideline does not address this specific type of colloid cysts, but these data are only recently published. The second confirmatory study of 811 nodules contained 28 “cyst with colloid clot.” The cytology of all these nodules were benign. Cytology showed 52 of the nodules to be colloid nodule and one to be consistent with Hashimoto’s thyroiditis. carotid artery.Ī confirmatory retrospective study showed this colloid clot pattern in 53 of 500 nodules. Sagittal image with another example of a comet tail colloid nodule. Transverse image of the thyroid showed a nodule with a reverberation artifact called comet tail (also known as colloid clot or cat eye) artifact (yellow arrows). COMET TAIL ARTIFACT MEANING SERIESReverberation artifact of the ultrasound beam resulting in a regularly spaced series of reverberation bands called the ring-down effect (red arrows). One of the 10 morphologic patterns was the “cyst with colloid clot” described as cystic nodule with a hyperechoic foci with linear echoes, no solid component and no vascularity by Doppler.Įxamples of reverberation artifact in thyroid ultrasound. Cyst with colloid clotīonavita characterized the sonographic patterns of 500 benign and malignant thyroid nodules. This finding is predictive of a benign cystic thyroid colloid nodule with the caveat that the nodule cannot be vascular and does not contain any solid material and as sharp margins. This form of reverberation artifact in thyroid nodules is called by several names, including comet tail artifact, colloid clot and cat-eye nodules that appears as a dense tapering V-shaped trail of echoes beyond strong reflectors (Figures 1 and 2, yellow arrows). ![]() Short-range rapid reverberations can occur between the walls of a hollow structure or within inspissated colloid in thyroid cysts. The sound beam makes multiple round trips between the air interface in the trachea and the transducer face, producing a regularly spaced series of reverberation bands on the ultrasound image called a ring-down effect (Figures 1 and 2, red arrows). Lee, MD, PhD.Īn example is seen on transverse ultrasounds images of the trachea during thyroid examination. ![]() Reprinted with permission from: Stephanie L. Enlarged view of the colloid comets in panel B (red box). Sagittal view with a nodule with a colloid comet. Air in the trachea (TR) causes an adder of bright reflections and a ring-down artifact (red arrows). This finding is indicative of a benign cystic thyroid nodule. Transverse image of the thyroid gland shows two cysts that contains a bright comet tail (also known as colloid clot or cat eye) artifact (yellow white arrows) produced by thyroid colloid. ![]()
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