Effect of ultrasound machine settings on twinkling artifact visualization

Study objective: Determination of optimal parameters of ultrasound scanning of urinary stones for effective visualization of Doppler twinkling artifact.

Materials and Methods: A search of modern literature (from 2015 to 2025) devoted to the influence of ultrasound scanner settings on twinkling artifact visualization in Russian and English was conducted in the scientific databases Pubmed, Scopus and Elibrary.

The influence of scanning parameters on the intensity of Doppler twinkling artifact visualization studied using a specially designed phantom, in which a calcium oxalate urinary stone with a diameter of 5 mm placed.

The study performed on the following ultrasound machines: Philips Affinity 70, ALOKA ProSound F75, Canon Aplio i700, Siemens ACUSON NX3 Elite, GE Healthcare LOGIQ E9, Mindray DC-60 Pro X-Insight using a convex abdominal probe in Doppler mapping mode.

The following ultrasound parameters were determined: Transmitter power, Color Doppler reference frequency, B-mode probe frequency, Focal length, Color window width, Harmonic, Pulse repetition frequency, Multibeam scanning, Color-write priority, Doppler signal gain (C-gain), B-mode gain (B-gain), Tissue harmonic mode, Interframe averaging, Color mapping averaging, Flash suppression, and Vessel wall oscillation filter.

Results. The paper analyzes settings such as ultrasound frequency, signal gain level, and time setting parameters, clearly demonstrating how these factors affect image clarity and diagnostic accuracy. The following ultrasound scanner settings have been determined to increase twinkling artifact visualization efficiency: increasing the transmitter power to maximum; decreasing the color Doppler reference frequency; setting the focal zone below the object location depth; decreasing the color window width and increasing the pulse repetition rate. The influence of software solutions aimed at artifact suppression can be reduced by setting the priority to the color value; disabling flash suppression; increasing the wall filter values; disabling flash suppression and tissue harmonics.

Conclusions. Optimization of ultrasound scanning parameters can significantly increase the efficiency of twinkling artifact detection in urinary stones.

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