title: Diagnostic value of colour Doppler twinkling artefact in sites negative for stones on B mode renal sonography.
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.
authors.affiliation: Department of Radiology, Lecco Hospital, Lecco, Italy. turrin.be@ospedale.lecco.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Turrin
authors.forename: Paolo
authors.initials: P
authors.lastname: Minola
authors.forename: Fortunato
authors.initials: F
authors.lastname: Costa
authors.forename: Luciana
authors.initials: L
authors.lastname: Cerati
authors.forename: Simeone
authors.initials: S
authors.lastname: Andrulli
authors.forename: Alberto
authors.initials: A
authors.lastname: Trinchieri
mesh_terms: D000818:Animals; D016477:Artifacts; D016022:Case-Control Studies; D002417:Cattle; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging*; D008297:Male; D018615:Ultrasonography, Doppler, Color