The twinkling artifact (TwA) is an intense alternating color signal behind calcifications and stones in different organs. When the length of the stone is less than 5 mm, its detection may be difficult. Ultrasound is a noninvasive method used for the diagnosis of urinary lithiasis. Twinkling artifact is independent of PRF/Scale. Same twinkling artifact was created with low- and high-PRF, with no significant variation. The kappa value of agreement was estimated as 0.96, whereas the Pearson's correlation was significant with the value of 0.001. ![]() There was a significant agreement between low- and high-PRF in the production of color twinkling artifact. The twinkling artifact observed with low-PRF was the same as seen with high-PRF. Data were collected from the observation of twinkling artifact with low- and high-PRF/scale and evaluated with the help of IBM SPSS 24 package, the results were summarized as follow.Ĭhange in scale/PRF could not affect the twinkling artifact. All the patients were examined according to the AIUM guideline for appropriate examination protocol. These structures were also evaluated with low- and high-PRF to determine the effect of PRF on twinkling artifact effectively. A total of 500 other structures were included wherein there was no Doppler twinkling artifact produced by them, with usual optimum PRF settings. During routine ultrasound examination, we observed multiple case of twinkling artifact produced by renal stones, calcifications in the thyroid nodules, bony fragments and intestinal gases, etc., We observed twinkling artifact with low- and high-PRF settings in 500 different structures. We commenced this cross-sectional study for 20 months from November 2014 to July 2016. The aim of this study is to determine the effect of scale/pulse repetition frequency (PRF) on the appearance of color Doppler twinkling artifact. All calculi were identified on CT-N CT-100 failed to detect calculi in 1 patient, and CT-50 failed in 3 patients, where all calculi were Lower ureteric calculi were predominant (40.4%). ![]() Of the 255 patients, 178 (70.1%) reported a first stone episode and 77 had recurrence. ![]() Of the 255 renal units, 117 were between 30 and 44 years of age, 75% were men. Their clinicodemographic and radiological findings were recorded and assessed for significance. All patients were subjected to 3 sequential scans at tube current settings of 250 mA (CT-N/Standard), 100 mA (CT-100), and 50 mA (CT-50) at a constant voltage of 120 kV. Altogether, 222 patients (255 “kidney-ureter” stone-bearing units or “renal units”) with urolithiasis and patients undergoing CT for other reasons with incidental findings of renal/ureteric calculi between 20 were included. Hence, this study aimed to assess the sensitivity of “reduced-radiation” CT imaging by altering scan settings to lower than the “standard” norms. Dose considerations become pertinent because of a 10% lifetime incidence rate and higher than 50% risk of recurrence, necessitating repeated imaging in the lifetime of a stone former. With each scan, a patient receives radiation of 18–34 mGy. ![]() Noncontrast computed tomography (CT) scan of the kidneys, ureter and bladder is the standard investigative modality for diagnosing and following up patients with urolithiasis.
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