In Pre-voiding study, is saw color twinkle with no detectable stone

  • In Pre-voiding study, is saw color twinkle with no detectable stone.
    But color twinkle is sensitive, i followed it.
    .
  • In post-voiding study, nearly same finding seen on TS view.
    But in LS view the stone is finally revealed.
    .
    ___How to improve visualization of such distal ureteric stone:-
  • Partial filling of U.B is better than over filling, allowing more transducer pressure comfortably.
  • Use LS oblique view along the expected course of distal ureter.
  • Zoom the image and lower the gain.
  • Adjust the focus to distal ureter.
  • Increase the frequency to increase the resolution.
    .
    In ours case >> Distal right ureteric stone causing low grade / partial obstruction.
    .
    -Color Twinkle artifact-