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(A) Transverse sonographic image of the right kidney shows small echogenic focus (arrow) in the right kidney, without definite acoustical shadowing. (B)

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Presentation on theme: "(A) Transverse sonographic image of the right kidney shows small echogenic focus (arrow) in the right kidney, without definite acoustical shadowing. (B)"— Presentation transcript:

1 (A) Transverse sonographic image of the right kidney shows small echogenic focus (arrow) in the right kidney, without definite acoustical shadowing. (B) Transverse sonographic image of the right kidney, with color Doppler, shows a twinkling artifact (arrow) arising from the echogenic focus, compatible with a renal stone. Twinkling artifact sign appears as a quickly fluctuating mixture of Doppler signals that imitate turbulent flow with an associated characteristic flat Doppler spectrum suggestive of noise, behind a strongly reflecting granular interface such as urinary tract stones (A) or parenchymal calcifications. (C) Transverse computed tomographic image of the right kidney shows small renal stone (arrow). (Photo contributor: John Amodio, MD.) Source: Chapter 16. Nephrology, Atlas of Pediatric Emergency Medicine, 2e Citation: Shah BR, Lucchesi M, Amodio J, Silverberg M. Atlas of Pediatric Emergency Medicine, 2e; 2013 Available at: Accessed: December 16, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved

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