hyperechogenicity

Hyperechogenicity, or increased echogenicity, is a term used in ultrasound imaging to describe tissue that appears brighter on the scan than surrounding reference tissue. It indicates greater reflection of the emitted sound waves and can be described as focal (localized) or diffuse (involving a larger region or an entire organ).

Cause and interpretation: Echogenicity depends on tissue composition, density, interfaces, and the presence of interfaces such as calcifications, fibrous tissue, fat, or air. Diffuse hyperechogenicity may point to systemic or widespread tissue changes, while focal hyperechogenicity suggests a localized abnormality. However, echogenicity is influenced by technical factors such as transducer frequency, gain settings, and patient habitus, so findings must be interpreted in the clinical context and, when needed, correlated with additional imaging or laboratory data.

Common contexts where hyperechogenicity is observed include: the liver, where diffuse increased echogenicity can indicate fatty infiltration or fibrosis; the breast, where bright foci or dense parenchyma may reflect calcifications or fibrous tissue; and musculoskeletal structures, such as tendons or ligaments, which can appear hyperechoic due to their dense collagen content or degenerative changes. Hyperechogenicity may also be reported in various focal lesions as part of their imaging phenotype.

Limitations: Ultrasound is operator-dependent and susceptible to artifacts. A cautious, integrated interpretation is essential, taking into account clinical history and, if necessary, follow-up imaging with alternative modalities.