|Longitudinal images of the left kidney show a stone (arrow) in the lower pole with posterior acoustic shadowing and the color Doppler twinkling artifact (short arrows).|
- Rapidly alternating red and blue signal behind a highly reflective structure on color Doppler US
- Useful diagnostic signs especially for urinary calculi detection and improved diagnostic confidence
- Can also be seen in calcifications in various tissues, biliary stones, encrusted indwelling urinary stents, gallbladder adenomyomatosis and bile duct hamartomas
- Two proposed mechanisms:
- Phase jitter - intrinsic machine noise causing random fluctuation of acoustic waves
- Acoustic waves hitting a rough interface producing complex beam pattern with multiple reflections
Kim HC, et al. Color Doppler twinkling artifacts in various conditions during abdominal and pelvic sonography. J Ultrasound Med 2010; 29:621.