Relationship between Twinkle Artefacts and in vivo Biochemical Composition of Kidney Stones

Urol Int. 2016;96(2):212-6. doi: 10.1159/000441701. Epub 2016 Jan 6.


Introduction: Our aim was to predict the chemical composition of kidney stones according to their twinkle artefact (TA) features obtained by in vivo color Doppler ultrasonography and to determine the potential factors affecting the formation and intensity of TAs.

Materials and methods: A total of 101 patients who met the inclusion criteria were included in the study. All patients were evaluated for TAs using color Doppler ultrasonography. All stones were subjected to chemical analysis. The relationships between the TA and the size and chemical composition of the stone, presence of hydronephrosis and body mass index (BMI) were evaluated statistically.

Results: According to the results of the chemical analysis, 66 (65.3%) were calcium oxalate stones. It was found that the in vivo TA intensity did not predict cystine and calcium oxalate monohydrate stones (p > 0.05) and the intensity of TAs increases with increasing BMI (p = 0.002).

Conclusion: The present study is the first to show that TAs may not be reliable in overweight patients. The TAs could not predict the chemical composition of stones; so future comprehensive in vivo studies will clarify the role of TAs in the prediction of the stone type preoperatively.

MeSH terms

  • Adult
  • Artifacts*
  • Body Mass Index
  • Calcium Oxalate / analysis*
  • Female
  • Humans
  • Kidney Calculi / chemistry*
  • Kidney Calculi / diagnostic imaging*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Reproducibility of Results
  • Ultrasonography, Doppler, Color*


  • Calcium Oxalate