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The twinkling artifact was first described by Rahmouni et al in 1996 as a focus of changing colors on Doppler studies behind reflective surfaces like calcifications giving turbulent flow. The objective of this study was to ascertain the accuracy of Doppler twinkling artifact in the diagnosis of urinary tract calculi keeping plain Computed Tomography of kidney, ureter, and urinary bladder (CT KUB) as a gold standard, and whether it can replace CT KUB or not. The study design was cross- sectional retrospective study carried out in Radiology Departments, Institute of Kidney Diseases and Hayatabad Medical Complex, Peshawar from April 2019 to April 2020. Both male and female patients below and above 40 years of age were included in the study. Sonography was performed on Aplio 300 Color Doppler ultrasound machine. Patient was then referred to Radiology Department, Hayatabad Medical Complex for CT KUB. Data was entered in SPSS version 20. Study included 90 cases presenting with flank pain and dysuria. There were 32(35.6%) females and 58(64.4%) males and males to female ratio was 2.21: 1. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of Doppler twinkling artifact was estimated to be 58.14%, 95.74%, 92.59%, 71.43% and 77.78% respectively. Our study concluded that Doppler twinkling artifact is a reliable sign for diagnosis of urinary tract calculi, but still its sensitivity is inferior and suboptimal to Plain CT KUB.

Keywords: Diagnostic Accuracy, Doppler Twinkling Artifact, Urolithiasis, Computed Tomography of Kidney, Ureter and Bladder (CT KUB).