Dominant factor analysis of B-flow twinkling sign with phantom and simulation data

Weijia Lu, Bruno Haider

Abstract:

Background and purpose The twinkling sign in B-flow imaging (BFI-TS) has been reported in the literature to increase both specificity and sensitivity compared to the traditional gray-scale imaging. Unfortunately, there has been no conclusive study on the mechanism of this effect.
Methods In the study presented here, a comparative test on phantoms is introduced, where the variance of a phase estimator is used to quantify the motion amplitude. The statistical inference is employed later to find the dominate factor for the twinkling sign, which is proven by computer simulation.
Results Through the analysis, it is confirmed that the tissue viscoelasticity is closely coupled with the twinkling sign. Moreover, the acoustic radiation force caused by tissue attenuation is found to be the trigger of the twinkling sign.
Conclusion Based on these findings, the BFI-TS is interpreted as a tissue movement triggering vibration of microcalcifications particle.