title: [Ultrasonographic anomalies of intrahepatic biliary ducts: contribution of the comet-tail image].
abstract: OBJECTIVE
  The aim of this study was to evaluate the sensitivity and specificity of the ultrasound intrahepatic bile duct wall comet-tail artifact for the diagnosis of biliary disease.
  
  
  METHODS
  All subjects who underwent upper abdominal ultrasound examination were included in the study over an 18-month period. The presence or absence of the comet-tail artifact (that is hyperechoic pattern with several parallels lines, constant, lining on the intrahepatic biliary ducts) was noted.
  
  
  RESULTS
  Fourteen thousand four hundred and ninety-eight patients were included. The comet-tail artifact was only found in 10 of the 14 211 patients without biliary tract disease (99.9% specificity), but in 35 of the 287 patients with biliary disease (12.2% sensitivity). The positive predictive value for the diagnosis of biliary tract disease was 77.7%. The artifact was associated with an angiocholitis in 83% of the patients.
  
  
  CONCLUSIONS
  Despite its low sensitivity, the sonographic comet-tail artifact of the intrahepatic bile duct wall was strongly correlated with the presence of biliary disease. This artifact may be related to an enlargement of the bile duct wall.
authors.affiliation: Service de Radiologie, Hôpital Beaujon, Clichy.
authors.forename: M P
authors.initials: MP
authors.lastname: Vullierme
authors.forename: V
authors.initials: V
authors.lastname: Vilgrain
authors.forename: M
authors.initials: M
authors.lastname: Zins
authors.forename: M F
authors.initials: MF
authors.lastname: Deflandre
authors.forename: F
authors.initials: F
authors.lastname: Degos
authors.forename: S
authors.initials: S
authors.lastname: Erlinger
authors.forename: Y
authors.initials: Y
authors.lastname: Menu
mesh_terms: D001649:Bile Duct Diseases / Q000000981:diagnostic imaging; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging*; D002769:Cholelithiasis / Q000000981:diagnostic imaging; D006801:Humans; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography
vernacular_title: Anomalies échographiques des voies biliaires intra-hépatiques: apport de l'image "en queue de comète".