Skip to main content
Log in

Diagnostic value of colour Doppler twinkling artefact in sites negative for stones on B mode renal sonography

  • Original Paper
  • Published:
Urological Research Aims and scope Submit manuscript

Abstract

The aim of the study was to investigate the diagnostic value of the colour Doppler twinkling artefact (TA) in renal stone disease. To enhance the evidence of TA, a preliminary in vitro study was performed to optimise the setting of colour Doppler sonography. In the in vitro study, an oxen kidney was examined using an high-frequency (12.5 MHz) linear array probe in a water bath before and after the inoculation of an aliquot of powder obtained by fragmentation of a calcium oxalate stone. In the clinical study, 67 patients with diagnosis of urinary stone based on B-mode sonography and 67 matched control subjects were examined with colour Doppler sonography using a low-frequency (2.5 MHz) curvilinear phased array probe. In vitro, the injection of calcium oxalate powder in a bovine kidney sample induced the appearance of spots without any back shadowing appearance on B mode but with a large number of TA on colour Doppler. In vivo, TA was much more frequent in patients with stone disease (95.5%) compared to controls (9.0%) (P < 0.001). TA was highly associated to renal stone disease and was also present in renal areas where a stone was undetected with B mode approach suggesting its diagnostic role although further studies are needed to confirm its accuracy. The type of instrumentation and its setting is crucial to obtain reproducible results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Rahmouni A, Bargoin N, Herment A, Bargoin N, Vasile N (1996) Color Doppler twinkling artifact in hyperechoic regions. Radiology 199:269–271

    PubMed  CAS  Google Scholar 

  2. Aytac SK, Ozcan H (1999) Effect of color Doppler system on the twinkling sign associated with urinary tract calculi. J Clin Ultrasound 27:433–439

    Article  PubMed  CAS  Google Scholar 

  3. Lee JY, Kim SH, Cho JY, Han D (2001) Color and power Doppler twinkling artifact from urinary stones. AJR 176:1441–1445

    PubMed  CAS  Google Scholar 

  4. Chelfouh N, Grenier N, Higueret D, et al (1998) Characterization of urinary calculi: in vitro study of Twinkling Artifact” revealed by color flow sonography. AJR 171:1055–1060

    PubMed  CAS  Google Scholar 

  5. Kamaya A, Tuthill T, Rubin JM (2003) Twinkling artifact on color Doppler sonography: dependence on machine parameters and underlying cause. AJR 180:215–222

    PubMed  Google Scholar 

  6. Kahn H.G., Gailloud P, Martin JB, et al (1999) Twinkling artifact on intracerebral color Doppler sonography. Am J Neuroradiol 20:246–247

    Google Scholar 

  7. Ustymovicz A, Krejza J, Mariak Z (2002) Twinkling artifact in color Doppler imaging of the orbit. J Ultrasound Med 21:559–563

    Google Scholar 

  8. Fielding JR, Steele G, Fox LA, Heller H, Loughlin KR (1997) Spiral computerized tomography in the evaluation of acute flank pain: a replacement for excretory urography. J Urol 15:2071–2073

    Google Scholar 

  9. Tublin ME, Murphy ME, Delong DM, Tessler FN, Kliewer MA (2002) Conspicuity of renal calculi at unenhanced CT: effects of calculus composition and size and CT technique. Radiology 225:91–96

    Article  PubMed  Google Scholar 

  10. Streem SB, Yost A, Macha E (1996) Clinical implications of clinically insignificant fragments after extracorporeal shock wave lithotripsy. J Urol 155:1186–1190

    Article  PubMed  CAS  Google Scholar 

  11. Zanetti G, Seveso M, Montanari E, Guarneri A, Del Nero A, Nespoli R, Trinchieri A (1997) Renal stone fragments following shock wave lithotripsy. J Urol 158:352–355

    Article  PubMed  CAS  Google Scholar 

  12. Candau C, Saussine C, Lang H, Roy C, Faure F, Jacqmin D (2000) Natural history of residual renal stone fragments after ESWL. Eur Urol 37:18–22

    Article  PubMed  CAS  Google Scholar 

  13. Cicerello E, Merlo F, Gambaro G, Maccatrozzo L, Fandella A, Baggio B et al (1994) Effect of alkaline citrate therapy on clearance of residual renal stone fragments after extracorporeal shock wave lithotripsy in sterile calcium and infection nephrolithiasis patients. J Urol 151:5–9

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alberto Turrin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Turrin, A., Minola, P., Costa, F. et al. Diagnostic value of colour Doppler twinkling artefact in sites negative for stones on B mode renal sonography. Urol Res 35, 313–317 (2007). https://doi.org/10.1007/s00240-007-0110-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-007-0110-8

Keywords

Navigation