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Updated: Jan 21, 2026

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[Vascular Color-Coded Duplex Ultrasound in Practice: Artifacts].

Ulrike Hügel1, Alexander Rosenov1, Iris Baumgartner1

  • 11 Universitätsklinik für Angiologie, Inselspital Bern.

Praxis
|August 8, 2019
PubMed
Summary

Ultrasound artifacts in color-coded duplex ultrasound can lead to misdiagnoses. Recognizing common artifacts like twinkling and mirror image is crucial for accurate vascular assessments.

Keywords:
ArtefakteColor-coded duplex ultrasoundFarbkodierte DuplexsonografieKometenschweifartefaktMöwenschreiSpiegelartefaktTwinklingartifactsartéfact de scintillementartéfact en miroirartéfact en queue de comèteartéfact tcri de la mouetteartéfactscomet-tail artifactmirror image artifactseagull crytwinkling artifactÉchographie Doppler couleur

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Area of Science:

  • Medical Imaging
  • Vascular Ultrasound

Background:

  • Ultrasound artifacts are common technical phenomena in medical imaging.
  • These artifacts do not represent actual biological structures and can lead to diagnostic errors.

Purpose of the Study:

  • To discuss common artifacts encountered in color-coded duplex ultrasound.
  • To highlight the potential for misinterpretation and diagnostic mistakes caused by these artifacts.

Main Methods:

  • Review of optical and acoustic phenomena in color-coded duplex ultrasound.
  • Identification and description of specific artifacts, including twinkling, mirror image, and "seagull cry".

Main Results:

  • Twinkling artifact can mimic high-flow velocities and vascularization, potentially leading to misdiagnosis of stenosis.
  • Mirror image artifacts may create the appearance of non-existent vessels.
  • "Seagull cry" artifact is often associated with high-grade stenosis.

Conclusions:

  • Awareness of common ultrasound artifacts is essential for accurate interpretation in vascular imaging.
  • Understanding artifact characteristics helps prevent diagnostic errors in color-coded duplex ultrasound examinations.