Color Doppler twinkling artifacts in various conditions during abdominal and pelvic sonography.
OBJECTIVE
The aims of this study were to describe the mechanisms likely to be responsible for color Doppler twinkling artifacts and their associated machine factors and to illustrate the various conditions that cause twinkling artifacts and those pitfalls.


METHODS
We evaluated various sonographic machine-associated factors that influence artifact appearance and identified various conditions that display twinkling artifacts during abdominal and pelvic sonography.


RESULTS
The presence of twinkling artifacts was found to be dependent on focal zones, gray scale gains, color write priorities, and pulse repetition frequencies. Twinkling artifacts were found to be associated with calcified lesions in the liver, gallbladder adenomyomatosis, hepatic bile duct hamartoma, gallstones and choledocholithiasis, chronic pancreatitis, urinary stones, encrusted indwelling urinary stents, bowel gas, and metallic foreign bodies. However, some of the twinkling artifacts were found to be associated with false-negative and -positive results.


CONCLUSIONS
Color Doppler twinkling artifacts are additional useful sonographic signs in the diagnosis of calcified lesions, urinary and biliary stones, gallbladder adenomyomatosis, and some miscellaneous conditions.
Kim
Hyun Cheol
HC
Department of Radiology, East-West Neo Medical Center, Kyung Hee University, 149 Sangil-dong, Gangdong-gu, Seoul 134-727, Korea. khcppp@lycos.co.kr
Yang
Dal Mo
DM
Jin
Wook
W
Ryu
Jung Kyu
JK
Shin
Hyeong Cheol
HC
D000293:Adolescent; D000328:Adult; D000368:Aged; D016477:Artifacts; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging; D005705:Gallbladder Diseases / Q000000981:diagnostic imaging*; D006222:Hamartoma / Q000000981:diagnostic imaging*; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color / Q000295:instrumentation / Q000379:methods*; D014545:Urinary Calculi / Q000000981:diagnostic imaging*