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Significance of twinkling artifact on ultrasound in the diagnosis of cystine urolithiasis.
[cystinuria]
Twinkling
artifact
(
TA
)
refers
to
the
finding
characterized
by
both
a
high
-echoic
mass
upon
B-
mode
ultrasound
(
US
)
and
turbulence-like
signals
over
the
entire
mass
without
significant
blood
flow
on
color
Doppler
US
.
TA
is
a
characteristic
sign
of
urolithiasis
,
and
there
has
been
no
previous
report
on
this
finding
in
the
digestive
tract
.
The
authors
recently
encountered
a
2
-
year
9
-
month
-old
boy
with
cystinuria
presenting
with
an
opacified
abdominal
mass
.
Although
he
was
originally
diagnosed
as
having
calcified
stool
mass
,
the
finding
of
TA
upon
US
led
to
the
correct
diagnosis
of
huge
urolith
(
4
.
2
cm
in
diameter
)
in
the
urinary
bladder
.
Laparotomic
stone
removal
was
successfully
conducted
and
the
calculus
was
confirmed
to
be
composed
of
cystine
.
The
finding
of
TA
upon
US
facilitates
identification
of
the
structure
and
location
of
the
intra-
abdominal
mass
.
