Investigation of the effect of signal amplitude on twinkling artifact.

Twinkling artifact on color Doppler ultrasound is the color labeling of hard objects, such as kidney stones, in the image. The origin of the artifact is unknown, but clinical studies have shown that twinkling artifact can improve the sensitivity of detection of stones by ultrasound. Although Doppler detection normally correlates changes in phase with moving blood, here the effect of amplitude on the artifact is investigated. Radio‐frequency and in‐phase and quadrature (IQ) data were recorded by pulse‐echo ensembles using a software‐programmable ultrasound system. Various hard targets in water and in tissue were insonified with a linear probe, and rectilinear pixel‐based imaging was used to minimize beam‐forming complexity. In addition, synthesized radio‐frequency signals were sent directly into the ultrasound system to separate acoustic and signal processing effects. Artifact was observed both in onscreen and post‐processed images, and as high statistical variance within the ensemble IQ data. Results showed that twinkling artifact could be obtained from most solid objects by changing the Doppler gain, yet signal amplitude did not have to be sufficiently high to saturate the receive circuits. In addition, low signal but high time gain compensation created the largest variance. [Work supported by NIH DK43881, DK086371, and NSBRI through NASA NCC 9‐58.]