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Uploaded on Aug 10, 2011
Twinkling Artifact 2 tiny stones were detected by color Doppler twinkling artefact which they were otherwise unrecognizable on grey scale images. Small renal stones (less than 4 mm) may go undetected at routine ultrasonography due to lack of acoustic shadowing. However, twinkling artefact is a very useful color Doppler artefact that may assist in detecting renal stones as small as 1-2 mm. The twinkling artefact is a random strong reflection of the incident ultrasound beam at a rough surface formed by material such as calcium or cholesterol deposits. The twinkling artifact is independent of the color velocity scale and cardiac cycle. With increasing color velocity scale, the color flow within blood vessels may disappear (as demonstrated in this case where the color velocity scale set at 88 cm/s) while the artifactual color from the stone will continue to twinkle. This is an easy method of differentiating the twinkling artifact from color flow in blood vessels. A large parapelvic cyst is also noted.
Reference Tahmasebpour HR et al: Sonographic Examination of Carotid Arteries. RadioGraphics 2005; 25:1561--1575