Can Doppler ultrasonography twinkling artifact be used as an alternative imaging modality to non-contrast-enhanced computed tomography in patients with ureteral stones? A prospective clinical study

We aimed to evaluate the use of twinkling artifact (TA) on color Doppler ultrasonography (USG) as an alternative imaging modality to non-contrast-enhanced computed tomography (CT) in patients with ureteral stones in this prospective study. Totally, 106 consecutive patients who had been diagnosed with ureterolithiasis by CT were enrolled in this prospective study. A urinary system color Doppler ultrasonography was performed on the same day with CT by an experienced radiologist who was blinded to the CT scan. TA was graded as 0, 1 and 2. The overall specificity of TA was calculated according to the NCCT as a gold standard method. The size, side and localization of stone and the demographic characteristics of patients were compared with twinkling positivity. TA on color Doppler USG was detected in 92 (86.8 %) patients. Statistically significant difference was found between the TA and localization of ureteral stones (p = 0.044). When we sub-grouped the patients according to the TA grades as 0, 1 and 2, 14 patients were with TA grade 0, 55 with TA grade 1 and 37 with TA grade 2. The mean stone size of groups was significantly different (p = 0.012). Bigger and proximal ureteral stones tended to have more TA on color Doppler USG. TA on color Doppler USG could be a good and safe alternative imaging modality with comparable results between NCCT. It could be useful for the diagnosis and follow-up of patients with ureterolithiasis

Doppler sonographic findings in testicular microlithiasis

OBJECTIVE: The aim of this prospective study was to compare the resistive index (RI) values, which is a parameter of testicular parenchymal perfusion, in testicular microlithiasis (TM) cases and normal cases. MATERIALS AND METHODS: 2179 volunteers, all healthy men (17-42 years of age) from the Annual Army Reserve Officer Training Corps training camp were included in the study. A screening scrotal ultrasound was performed and all men diagnosed with TM underwent a scrotal Doppler ultrasonography scan (US). US examinations were performed for subjects with TM and without TM as a control group and RI was determined. RESULTS: 53 men with TM were identified in the 2179 US. Spectral Doppler examination was applied to 50 randomly selected cases (100 testicles) without TM and 92 testicles with TM, 39 cases (78 testicles) with bilateral and 14 cases with unilateral involvement. However, 48 normal testicles (17 bilateral and 14 unilateral) and 47 testicles with TM (15 bilateral and 17 unilateral, 10 of which were cases with bilateral TM) where flow from the centripetal artery could be obtained and analyzed were included in the statistical analysis for resistive indices. There was no significant difference regarding the RI and spectral examinations between subjects with and without TM. An interesting finding was the twinkling artifact observed in three cases. CONCLUSION: Microliths did not alter the RI values and thus had no influence on testicular perfusion on Doppler US examination