Identifying Renal Stones with Twinkle Artefact: A Key Ultrasound and Color Doppler Feature

A large renal calculus appears as a highly echogenic structure on ultrasound, casting a posterior acoustic shadow. On color Doppler imaging, the twinkle artefact is seen as a rapidly fluctuating, colorful signal behind the stone. This artefact, caused by the irregular surface of the calculus, occurs due to phase changes in the Doppler signal as sound waves reflect off the rough surface. The twinkling effect is often more prominent than shadowing, making it a valuable diagnostic tool for detecting stones, even when they are small or hard to visualize.
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