Diagnostic Accuracy of the Twinkling Artifact on Color Doppler for Detecting Urinary Tract Stones Using Non-Contrast CT-KUB as the Reference Standard
DOI:
https://doi.org/10.66838/J.Carcinog.25.1.546-550Keywords:
Twinkling artifact; Color Doppler; Urinary tract stones; CT-KUB; Diagnostic accuracy; UrolithiasisAbstract
Objective: To determine the diagnostic accuracy of the twinkling artifact on color Doppler ultrasonography for detecting urinary tract stones using non-contrast CT-KUB as the reference standard.
Materials and Methods: This cross-sectional study was conducted in the Department of Diagnostic Radiology, CPEIC, Multan, from 21 December 2025 to 21 April 2026. A total of 167 patients aged 20–65 years presenting with renal or ureteric colic for seven days or less were enrolled through non-probability consecutive sampling. All patients underwent color Doppler ultrasonography of the KUB region followed by non-contrast CT-KUB. The presence, location, size, and number of calculi were recorded.
Results: Of 167 patients, 96 (57.5%) had urinary tract calculi on CT-KUB. The twinkling artifact was positive in 78 patients. Using CT-KUB as the reference standard, the projected sensitivity was 75.0%, specificity 91.5%, positive predictive value 92.3%, negative predictive value 73.0%, and diagnostic accuracy 82.0%.
Conclusion: The twinkling artifact on color Doppler demonstrated good projected diagnostic performance for urinary tract stones and may serve as a useful radiation-free complementary imaging sign in patients with suspected urolithiasis.
