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NDT Plus Advance Access published online on October 13, 2009
NDT Plus, doi:10.1093/ndtplus/sfp145
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© The Author 2009. Published by Oxford University Press [on behalf of ERA-EDTA]. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Colour Doppler twinkling in kidney stones: artefact or sign?

Simeone Andrulli1, Alberto Turrin2, Maria Carla Bigi1, Pietro Ravani3, Alberto Trinchieri4 and Francesco Locatelli1

1 Department of Nephrology, Dialysis and Renal Transplantation, A. Manzoni Hospital
2 Radiology Unit, A. Manzoni Hospital, Lecco, Italy
3 Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Canada
4 Department of Urology, A. Manzoni Hospital, Lecco, Italy

Correspondence: Simeone Andrulli; E-mail: s.andrulli{at}ospedale.lecco.it


  Abstract

The twinkling in colour Doppler images is created by a rapidly changing series of coloured horizontal bars that appear beyond the reflex surfaces. Spectral analyses show a typically rectangular time/velocity wave diagram, and an uncomfortably high-pitched audio signal saturates the echo system. The twinkling can be detected in the calcified areas of various tissues and is usually interpreted as an artefact; however, this report describes two cases suggesting that it may be valuable for the early diagnosis and follow-up of kidney stones. This observation may have important diagnostic, epidemiological and clinical implications.

Key Words: bladder stones • colour Doppler • kidney stones • twinkling • ultrasonography

Received for publication September 9, 2009. Accepted for publication September 14, 2009.


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