Color Doppler Twinkling Artifact and Clinical Use

The color Doppler twinkling artifact manifests as a rapidly changing mixture of red and blue colors behind a strongly reflecting structure. Spectral Doppler analysis of the twinkling artifact does not yield a flow spectrum. It is important to recognize this artifact because it may lead to misdiagnosis of vascular flow within a tissue. Additionally, the artifact may be considered a sonographic sign in the detection of calcifications and calculi. In this article, we review the history of the interesting phenomenon and its clinical use, as well as our personal experiences of the artifact.