Color Doppler twinkling artifacts in small-bowel bezoars

Area of Science:

• Gastroenterology
• Medical Imaging
• Diagnostic Ultrasound

Background:

• Small-bowel bezoars, often originating in the stomach, are a known cause of intestinal obstruction.
• Computed tomography (CT) is a reliable method for diagnosing small-bowel bezoars, but ultrasound (US) may also be used.
• Specific sonographic findings for small-bowel bezoars have been reported, though they can be challenging to identify, especially with bowel gas interference.

Observation:

• This study explored the potential of "twinkling artifacts" on color Doppler ultrasound as a diagnostic indicator for small-bowel bezoars.
• Twinkling artifacts manifest as fluctuating red and blue signals behind highly reflective structures.
• The researchers hypothesized that these artifacts could be present in small-bowel bezoars.

Findings:

• The study observed twinkling artifacts in three cases of small-bowel bezoars.
• These bezoars were presenting as causes of small-bowel obstruction.
• The presence of twinkling artifacts on color Doppler may aid in the sonographic diagnosis of small-bowel bezoars.

Implications:

• The identification of twinkling artifacts could improve the accuracy of ultrasound in diagnosing small-bowel bezoars.
• This finding may offer a non-invasive, readily available imaging modality for detecting bezoars.
• Further research could validate these sonographic findings in larger patient cohorts.