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Twinkling Artifact on Intracerebral Color Doppler Sonography

Haleem G. KhanGo,a, Philippe Gaillouda, Jean-Baptiste Martina, Nathalie Khawa, Luca Spadolaa, Daniel A. Rüfenachta and François Terriera

a From the Division of Diagnostic and Interventional Radiology, Geneva University Hospital, 1211 Geneva 14, Switzerland.



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  		FIG 1. Digital subtraction angiogram, superselective study of the right internal carotid artery, arterial phase, lateral projection, displays the MCA bifurcation.

A, A small saccular aneurysm (arrow) is seen at the right anterior choroidal artery origin. Note also the minute aneurysm at the MCA bifurcation.

B, On late arterial phase image, a characteristic aneurysmal inflow-outflow pattern ("yin-yang") may be observed.



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  		FIG 2. Digital subtraction angiogram, selective study of the right internal carotid artery, arterial phase, lateral projection. After treatment with a single detachable coil, the aneurysmal cavity is totally excluded from the cerebral circulation (arrows).

FIG 3. Transcranial Doppler sonogram, right transtemporal approach. Before treatment, a color Doppler signal is seen within the aneurysmal cavity (arrow). It also shows the typical "yin- yang" appearance, corresponding to the inflow and outflow regions of the aneurysm.



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  		FIG 4. Transcranial Doppler sonogram, right transtemporal approach. After treatment, a twinkling artifact (arrow) is observed immediately behind the hyperechoic signal of the microcoil.

FIG 5. In vitro insonation of a Guglielmi detachable coil enclosed within two hydrated agar sheets. Color Doppler image shows the hyperechoic structure of the coil (arrow) and the twinkling artifact (arrowhead).





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X