Simulation of the twinkling artifact in color flow Doppler sonography: A phase noise hypothesis validation

Twinkling artifact is a color flow Doppler sonography artifact appearing as rapidly changing color patterns, surprisingly at location of some non-moving objects such as sediments within tissue. Most studies in this area are as clinical trials and qualitative reports. Although the origin of this artifact is not completely known yet, there are two basic hypotheses suggested by Rahmouni and Kamaya in this regard. None of these hypotheses has been validated through computer simulation in the past. Simulation of twinkling artifact can play an important role in better understanding its origin. In this paper, we have simulated the twinkling artifact based upon the phase noise hypothesis as one of the major theories about its origin, for the first time. Our simulations have been implemented for both the single scan-line pulsed Doppler structure and the B-mode color flow Doppler. In both cases, the twinkling artifact was observed within the expected locations. The results indicate that the intrinsic phase noise in the pulse generation and transmission systems can cause twinkling artifact without considering any motion for the subject or transducer. This is a support for Kamaya's hypothesis.