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The Sonographic Twinkling Artifact in Testicular Calcification

Objective. The twinkling artifact is a color Doppler phenomenon that appears as a rapidly fluctuating red and blue Doppler signal behind a strongly reflecting medium, manifesting as a color signal but without real flow behind the structures. To the untrained eye, the twinkling artifact may lead to the misdiagnosis of vascular flow within a structure. Our objective was to show the occurrence of the twinkling artifact in the testis. Methods. Two patients with calcification in the testis were examined with standard settings on 2 different sonography machines to show this artifact. Results. Calcification in the tunica albuginea and intratesticular macrocalcification both showed this artifact. Conclusions. We report the presence of the twinkling artifact in 2 cases of testicular calcification, which shows that this phenomenon can occur in the testis.