![]() ![]() There are some known underlying metabolic disturbances which increase the risk of stone development, such as Dent disease, primary hyperoxaluria, or Lesch-Nyhan syndrome ( 4). In view of the fact that the vast majority of pediatric stones are calcium based ( 5), investigating causes should be focused on factors that contribute to an increased calcium excretion ( 4). Renal stones are considered less common in children in comparison to the adult population, and result from a multifactorial process that involves both the patient’s underlying metabolic background and environmental conditions promoting nephrolithiasis, such as volume depletion, infection, or the intake of foods high in lithogenic solutes ( 3, 4). However, it has been noticed that the incidence of renal stones has increased 5 times in comparison to the previous decade in the pediatric age group ( 2). Renal stone is one of the common findings in daily medical practice, and it is usually seen in the adult population rather than the pediatric population ( 1). Conclusion: The twinkle artifact is a sensitive US tool for detecting pediatric kidney and ureter stones, but with a small risk of false positive findings. Specificity for the twinkle artifact could not be calculated due to a lack of true negatives. The twinkle artifact was not dependent on stone size. The twinkle artifact was assessed in all true-positive stones, determining a relatively high PPV of 26/29 (86.7%) for the twinkle artifact. Twinkle artifact sensitivity was found to be 89.7% (95% CI 39.574%–90%). The overall median stone size was 2 mm in the right kidney, and 5 mm in the left kidney (IQR: 6,11 mm), respectively. showed the twinkle artifact and were seen in CT), 4 were false positive (showed the twinkle artifact but were not seen in CT), and 3 were false negative (did not show the twinkle artifact but were seen in CT). US detected 33 hyperechoic foci suspected to be stones 26 were confirmed as true positive (i.e. The median overall age of the patients was 4 years (IQR: 3.125, range: 1– 165 months), The median number of days between the US and CT was 13 (IQR: 26, range: 0–81 days). The interval between the US and CT was <3 months for all patients. Results: Thirty-three abdominal renal US scans of 33 patients (21 males, 12 females) fulfilled the entry criteria. CT examinations done <3 months prior to or after US were retrospectively assessed to confirm the presence of kidney stones as a reference standard. Presence of the twinkle artifact, and stone numbers and sizes were documented. Material and methods: Our retrospective observational study included children who had undergone abdomen/renal ultrasound for kidneys stones in our radiology department between 20. Study results have suggested that the sonographic twinkling artifact may aid in the detection of renal stones with a variety of reference standard imaging modalities, including abdominal radiography, excretory urography, gray-scale sonography, and CT. This is visualized as a random mixture of red and blue pixels in the high-frequency shift spectrum located deep to the interface. Background: Twinkle artifact, also known as color Doppler comet-tail artifact, occurs behind very strong, granular, and irregular reflecting interfaces such as crystals, stones, or calcification. ![]()
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