Echogenecity

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Shagufta Batool
What is Echogenicity?
● Echogenicity is the term used to describe the
brightness of an echo on the display.
● The echogenicity of an interface is
proportional to the strength of the echo that
is received by the transducer (stronger
echoes are displayed more brightly than
weaker echoes).

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● Evaluating the echogenicity of a structure is one
of the fundamental assessments that we can
make with ultrasound.
● For Example, in an abdominal scan the
echogenicity of the right renal cortex is always
compared to the echogenicity of the adjacent
liver at the same depth. If the renal cortex is
brighter (hyperechoic) than the adjacent liver
parenchyma, this suggests renal parenchymal
disease.
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● Echogenic: a region in an ultrasound image
which has echoes.
● Synonymous terms: reflective,
echoproducing, echoic.
● The echo pattern is analysed on the basis of
the number and strength of the echoes and
their distribution

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Anechoic:
● Means “without echoes”.
● An anechoic region in an ultrasound image contains no
echoes.
● Appears Black on Ultrasound.
● Synonymous terms:
○ Echo-free.
○ A term that is erroneously used is “echolucent”.
○ This term has come from Radiology where the term
radiolucent is used to describe dark appearing areas
on a radiograph representing tissues that permit
passage of x-rays. Use the term anechoic rather than
the term echolucent.
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Examples of Anechoic structures:
● Simple Cyst
● Full Urinary Bladder
● Gall Bladder etc.
● Only fluid in the strict physical sense is really
echo free.
● Other types of fluid (e.g. blood, abscesses or
exudates) contain small particles (e.g. blood
cells, fibrin) and cause weak echoes.

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Hyperechoic:
● The term used to describe bright echoes.
● Highly reflective when compared with the
neighboring structures, appears as varying
shades of lighter grey.
● You should also note that the term “echogenic”,
while not literally correct, is also used to
describe these echoes. Sonographers frequently
refer to structures as being “more echogenic”
(brighter) or “less echogenic” (darker).
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● Hypoechoic:
The term used to describe darker (weaker)
echoes.
Less reflective and low amount of echoes
when compared with neighboring
structures, appears as varying shades of
darker gray.
Synonyms: echo poor, echopenic.

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Isoechoic:
Having the same echogenicity (brightness) as
another structure.
As an example, the pancreas may be
iso-echoic to the liver.

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Echo Poor
● Same as Echopenic
● An echo pattern consisting of only a few
weak echoes

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Echo Rich
● Same as echogenic or echo dense.
● An echo pattern appears to be echo rich if
the tissue causes many weak echoes or a
few strong echoes.

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Terms Related to
Texture
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 Texture:
●Texture is the echo pattern (dot size, distribution
and brightness) generated by tissues.
●The displayed echo texture depends on several
technical factors including transducer frequency,
dynamic range, output power, gain, and pre- and
postprocessing (these will be discussed later).

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Homogeneous:
A homogeneous texture means that the structure
has a uniform appearance in terms of echogenicity,
dot size, and dot distribution on the display. For
example, the normal thyroid gland is very uniform
in texture and is said to be “homogeneous”.
Another good example of a homogeneous organ is
the spleen Note: do not use the term
“homogenous”.

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Heterogeneous:
Heterogeneous is the opposite of
homogeneous. A heterogeneous texture
would have significant variance in
echogenicity, dot size, and dot distribution.

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● A common example is a liver with diffuse
metastatic disease. The texture is much
more varied than the texture of a normal
liver. Heterogeneous is a better term than
“inhomogeneous”.

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Homogeneous Heterogeneous

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Thank you!