Dominant factor analysis of B-flow twinkling sign with phantom and simulation data.
OBJECTIVE
The twinkling sign in B-flow imaging (BFI-TS) has been reported in the literature to increase both specificity and sensitivity compared to the traditional gray-scale imaging. Unfortunately, there has been no conclusive study on the mechanism of this effect.


METHODS
In the study presented here, a comparative test on phantoms is introduced, where the variance of a phase estimator is used to quantify the motion amplitude. The statistical inference is employed later to find the dominate factor for the twinkling sign, which is proven by computer simulation.


RESULTS
Through the analysis, it is confirmed that the tissue viscoelasticity is closely coupled with the twinkling sign. Moreover, the acoustic radiation force caused by tissue attenuation is found to be the trigger of the twinkling sign.


CONCLUSIONS
Based on these findings, the BFI-TS is interpreted as a tissue movement triggering vibration of microcalcifications particle.
GE Global Research, Shanghai, China. AlfredWJLu@gmail.com.
Weijia
http://orcid.org/0000-0002-7899-6034
W
Lu
GE Healthcare, Ultrasound Probes, Phoenix, AZ, USA.
Bruno
B
Haider
D000465:Algorithms; D002113:Calcification, Physiologic; D003198:Computer Simulation; D004548:Elasticity; D005163:Factor Analysis, Statistical; D008962:Models, Theoretical; D019047:Phantoms, Imaging; D012680:Sensitivity and Specificity; D000069453:Ultrasonic Waves; D014463:Ultrasonography / Q000295:instrumentation / Q000379:methods*; D014783:Viscosity
B-flow image; Microcalcification; Twinkling sign
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