Echotexture

Echotexture is a descriptive term in ultrasound imaging that refers to the pattern of echo intensity within a region of interest. It characterizes how uniformly or variably tissue returns echoes, reflecting structural and compositional properties. Common descriptors include echotexture being homogeneous or heterogeneous, and echogenicity being hypo-, iso-, or hyperechoic relative to surrounding tissue. A homogeneous echotexture suggests uniform tissue, while a heterogeneous echotexture indicates mixed interfaces, fibrosis, calcifications, or other abnormalities. The term is used across organ systems but is especially common in thyroid, liver, breast, and musculoskeletal ultrasound.

Determination is typically qualitative, made by the radiologist during real-time or stored-image review. In addition to subjective assessment, quantitative texture analysis can be applied using image-processing techniques that measure gray-level variations, such as entropy, contrast, and homogeneity, sometimes via gray-level co-occurrence matrices or other radiomics features. These measurements depend on scanner parameters, region of interest size, and acoustic settings, so standardization is important.

Applications and limitations: Echotexture contributes to characterizing lesions, guiding the need for biopsy or further imaging. Certain patterns may associate with benign processes (e.g., homogeneous nodules) or malignant potential (e.g., marked heterogeneity), but overlap exists. Echotexture is one component of a broader imaging assessment and should be interpreted with context, including patient history and other imaging findings. The term has evolved with advances in quantitative imaging and radiomics, which seek to turn qualitative texture into reproducible biomarkers.