The Twinkling Artifact: Kidney Stone Detection with Doppler Ultrasound

Ultrasonic imaging today is a method of kidney stone detection rarely used because of its variability across users and inconsistency, as compared to Computed Tomography (CT) scans. The twinkling artifact is a relatively new solution to this problem, utilizing Doppler ultrasound to signify the presence of renal stones with color. Twinkling is a phenomenon born of abnormal events in the received Doppler signal that highlights the stones using color. The presence of color in the grayscale ultrasonic image allows the sonographer to locate the stone with ease, providing nephrolithiasis patients with an economical and radiation-free option for kidney stone diagnoses. The goal of this research is to understand what causes twinkling and how it can be stabilized in order to ultimately use this method in clinical application. This study provided some insight into factors that improve twinkling presence, and explored difficulties that sonographers may face during scans due to parameters controlled by the machine and features of the kidney stones. It was confirmed that kidney stones with smooth surfaces are less likely to produce twinkling, and there was evidence to suggest that a particular type of kidney stone, uric acid calculi, may also pose a challenge for sonographers.