title: [Twinkling artifact in kidney stone disease].
abstract: BACKGROUND
  Ultrasonography artifacts are false representations of the image caused by the interaction between the ultrasound and the tissues. The ability to identify artifacts is an important source of information that can help the clinician in performing a correct diagnosis. The twinkling artifact (called 'Effetto Arlecchino' by the Italians) consists of a series of colored pixels that appear inside, around and often along the shadow cone of the calculi.
  
  
  METHODS
  We evaluated the clinical effectiveness of this artifact in the diagnosis of kidney stone disease. In 107 ultrasonography cases of hyperechogenic formations with clinical features of kidney stones, we used the color box to evoke the twinkling artifact. Of the 107 cases, 102 cases (95%) presented this artifact, while five cases did not. Moreover, this artifact was present in all urethral and bladder stones and in 62/67 kidney stone cases.
  
  
  CONCLUSIONS
  In our experience, we found that the twinkling artifact is often positive in urinary stone disease, and the ability to identify it adds useful information to the diagnosis of urinary kidney stone disease.
authors.affiliation: Servizio di Nefrologia e Dialisi, Distretto Sanitario Sorgono Isili, Ospedale San Camillo, Viale IV Novembre, 08038 Sorgono (NU), Italy. logias@tiscali.it
authors.forename: F
authors.initials: F
authors.lastname: Logias
authors.forename: E M
authors.initials: EM
authors.lastname: Manca
authors.forename: P
authors.initials: P
authors.lastname: Carta
authors.forename: A
authors.initials: A
authors.lastname: Granata
authors.forename: A
authors.initials: A
authors.lastname: Barracca
authors.forename: O
authors.initials: O
authors.lastname: Manca
mesh_terms: D016477:Artifacts; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging*; D014463:Ultrasonography