The effect of crystal chemical composition on the color Doppler ultrasound twinkling artifact

Abstract

The color Doppler ultrasound twinkling artifact, or localized areas of rapid color shifts, has been used to aid in the diagnosis of kidney stones. Gallstones and some atherosclerotic plaques have also been shown to twinkle, suggesting that crystals, regardless of chemical composition, may harbor the stable microbubbles that are hypothesized to cause twinkling. Here, uric acid, cholesterol, and calcium phosphate crystals, which are often present in sites of pathological biomineralization, were grown in the lab using previously developed techniques and imaged with the Verasonics® research ultrasound system using Philips/ATL P4-2 and Verasonics L22-14 transducers. The magnitude of the Doppler signals was quantified and compared amongst the three crystal chemical compositions. Preliminary results show that all three crystal types displayed twinkling with the strongest magnitude appearing in the cholesterol crystals. These results suggest that twinkling is very sensitive in the presence of crystals regardless of the chemical composition. Future work will explore the use of histotripsy to mechanically fractionate crystals as a novel treatment for pathological biomineralization.The color Doppler ultrasound twinkling artifact, or localized areas of rapid color shifts, has been used to aid in the diagnosis of kidney stones. Gallstones and some atherosclerotic plaques have also been shown to twinkle, suggesting that crystals, regardless of chemical composition, may harbor the stable microbubbles that are hypothesized to cause twinkling. Here, uric acid, cholesterol, and calcium phosphate crystals, which are often present in sites of pathological biomineralization, were grown in the lab using previously developed techniques and imaged with the Verasonics® research ultrasound system using Philips/ATL P4-2 and Verasonics L22-14 transducers. The magnitude of the Doppler signals was quantified and compared amongst the three crystal chemical compositions. Preliminary results show that all three crystal types displayed twinkling with the strongest magnitude appearing in the cholesterol crystals. These results suggest that twinkling is very sensitive in the presence of crystals regardless ...