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Martínez-Crespo" "autores" => array:1 [ 0 => array:3 [ "nombre" => "J." "apellidos" => "Martínez-Crespo" "email" => array:1 [ 0 => "jmartinezcrespo@telefonica.net" ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Radiología, Hospital Universitario de Getafe, Madrid, Spain" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comentario a: “El artefacto de centelleo en la caracterización de los cálculos urinarios”" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">As a radiologist at a general university hospital, which is dedicated to ultrasonography in patients of different specialties, I have observed the “twinkling sign” in the color Doppler when performing examinations of the excretory system and in calcifications of other organs. It is known that reno-uretheral lithiasis produces a hyperechoic image and acoustic shadow, and sometimes an artifact in color Doppler that causes aliasing and an electrical interference noise in the pulsed Doppler.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">I recently had the pleasure of reviewing the article by Kocoglu et al.,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> which reflects the experience of a Department of Urology in Turkey as regards the meaning of this artifact. This article surprised me for its rigor and thoroughness, and the brilliant idea of trying to characterize the type of lithiasic composition (calcium oxalate monohydrate or dihydrate) in relation to the twinkling artifact produced when the color Doppler is performed, and which, therefore, would provide with information about the behavior of the calculus when performing lithotripsy for its treatment.</p><p id="par0015" class="elsevierStylePara elsevierViewall">I think it is a good and well carried out article, although we will have to wait for other groups to conduct similar studies so that we can have a more global perspective on this issue.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In my experience, I think it is difficult to establish the degree of twinkling when classifying the calculi, and there exist other parameters that can alter the color artifact type, such as the ultrasound scanner preset or the roughness of the calculus itself, which would condition significant changes with regard to the outcome of this type of studies.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">I believe, however, that this is a new line of research in diagnostic imaging. Obviously, this initiative is very attractive because it goes beyond telling us that we have found a calculus to show that the calculus will be harder or softer and, therefore, with a great potential interest in predicting the outcome of the treatment with lithotripsy. We must be expectant before generalizing the conclusions of the study by Kocoglu et al.,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> but once the reproducibility of their findings has been investigated, it may be more systematically established that the calculi with a greater twinkling artifact will need a smaller number of extracorporeal lithotripsy sessions. Thus, we will have applied conclusions derived from the knowledge of imaging techniques to clinical practice.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Martínez-Crespo J. Comentario a: “El artefacto de centelleo en la caracterización de los cálculos urinarios”. Actas Urol Esp. 2011;35:403.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Color and power Doppler twinkling artefact from urinary stones" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.Y. Lee" 1 => "S.H. Kim" 2 => "J.Y. Cho" 3 => "D. 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Commentary
Comment to: “Role of twinkling artifact in characterization of urinary calculi”
Comentario a: “El artefacto de centelleo en la caracterización de los cálculos urinarios”
J. Martínez-Crespo
Servicio de Radiología, Hospital Universitario de Getafe, Madrid, Spain