Introduction. Today, ultrasound examination (ultrasound), due to a number of advantages over other diagnostic methods (low cost, lack of ionizing radiation, the ability to perform without restrictions on age, gender, body weight, the presence of metal objects, etc.), is widely implemented in clinical practice. However, the accuracy in detecting urinary stones in the gray-scale mode varies from 33 to 95% and depends on the experience of the specialist performing the study and the quality of the ultrasound apparatus. One of the ways to increase the diagnostic accuracy of the method is to detect the twinkling artifact (ТA). However, data on its diagnostic accuracy in detecting urinary tract stones also vary (from 50% to 97%). The reason for this is the methodological features of the conducted scientific research, as well as the technical features of the ultrasound devices used in them, in some of which (devices 2000-2010) the ТA is programmatically turned off to improve vascular visualization. In some devices developed in the last decade, the possibility of obtaining AM has been returned. However, there are no methods for detecting ТA, optimal settings of the Doppler mapping mode for better visualization. In this regard, experimental work was carried out to develop a methodology for testing the ultrasound device in order to determine the possibility of using AM.
Materials and methods. In 2023, the staff of the Lopatkin Research Institute of Urology and Interventional Radiology – a branch of the Federal State Budgetary Institution «NMIC of Radiology» of the Ministry of Health of the Russian Federation and the Bauman Institute conducted a series of experiments and developed a device (phantom) that allows AM to be studied in laboratory conditions. Ultrasonic devices were used to test the device during the development process: Philips Affinity 70 and ALOKA Ultrosound F75. To test the working properties of the device, an assessment was made of the possibility of obtaining AM on a number of ultrasonic scanners: BK Specto 5000, Simens, Samsung RS65, Samsung Rs 85, Mindrey Kesona, Hitachi Arienta 750. Fragments of urinary stones of various chemical compositions were used as the studied material.
Results. A device has been developed, which is a plastic container 4*10*5 see, with a side wall thickness of 0.2 cm. A substrate made of platinum- based silicone is placed inside the device, the size of 10*5*2 cm. Along the central line of the substrate, at a distance of 2 cm from each other, there are 3 recesses for fixing the concretion, with a diameter of < 5 mm. To prevent the migration of the ultrasonic sensor during the study, a fixation system is provided in the form of 2 clamps located in the upper part of the container, connected to each other by means of a toothed connection. ТА was able to register in the area of all stones, including those artificially prepared from calcium sulfate dihydrate. The optimal settings of the color Doppler mapping mode have been determined for visualization. ТА was determined in all contact media, but the most accurate, corresponding to the contours of the concretion, was obtained using ultrasonic gel.
Conclusion. The conducted experimental work on ТА visualization in laboratory conditions has shown that it is possible to obtain AM in vitro using the device developed by us. The developed device greatly simplifies the configuration of the Doppler mapping mode of the ultrasound device for better visualization of ТА and makes it easy to assess the possibility of using ТА on a specific ultrasound scanner.
