What is echotexture on ultrasound?

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Last updated: June 28, 2025View editorial policy

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From the Guidelines

Echotexture on ultrasound refers to the pattern of echoes within a tissue or organ that creates its characteristic appearance on an ultrasound image, describing how sound waves interact with the internal structure of tissues, resulting in varying degrees of brightness and texture patterns. This concept is crucial in diagnostic imaging as it helps radiologists evaluate the health and pathology of tissues by comparing their appearance to surrounding structures or to what is considered normal for that organ 1.

Key Aspects of Echotexture

  • Echotexture is based on the physical properties of tissues, with different cellular compositions and arrangements reflecting ultrasound waves differently.
  • Dense tissues like bone strongly reflect sound waves, appearing bright or hyperechoic, while fluid-filled structures allow sound to pass through, appearing dark or hypoechoic.
  • Soft tissues show intermediate patterns, and changes in echotexture often provide valuable diagnostic information about tissue health and pathology.

Clinical Application

In clinical practice, understanding echotexture is vital for diagnosing various conditions. For instance, liver tissue normally has a homogeneous, medium-level echotexture, but conditions like fatty liver disease, fibrosis, or tumors can cause heterogeneous or abnormal echotexture patterns 1. Similarly, biliary hamartomas may appear as hypoechoic, hyperechoic, or mixed heterogenic echoic structures on ultrasound, with their echogenicity dependent on the presence of dilated bile ducts and fibrocollagenous stroma 1.

Diagnostic Utility

The assessment of echotexture is operator-dependent and requires advanced imaging or tissue diagnosis to improve accuracy 1. However, it serves as a critical tool in characterizing lesions, evaluating the layer of origin, size, echogenicity, and presence of blood vessels, all of which have diagnostic and prognostic implications 1.

Recent Advances

Recent studies have highlighted the importance of echotexture in various medical specialties, including cardiology, where intravascular ultrasound (IVUS) is used to characterize intracoronary pathology, plaque morphology, and vessel wall architecture 1. The interpretation of IVUS images, including echotexture, is crucial for predicting malignant potential and guiding therapeutic decisions.

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From the Research

Definition of Echotexture on Ultrasound

Echotexture on ultrasound refers to the pattern of echoes that appear on an ultrasound image, which can provide information about the texture and composition of the tissue being imaged. This can include the brightness, darkness, and homogeneity or heterogeneity of the echoes.

Characteristics of Echotexture

  • Echotexture can be classified as homogeneous or heterogeneous, with homogeneous echotexture appearing as a uniform pattern of echoes and heterogeneous echotexture appearing as a non-uniform pattern of echoes 2.
  • Echotexture can also be described as hypoechoic, hyperechoic, or anechoic, depending on the brightness of the echoes, with hypoechoic areas appearing darker and hyperechoic areas appearing brighter 3.
  • The echotexture of a tissue can be influenced by its composition, with different types of tissue having distinct echotexture patterns 4.

Clinical Applications of Echotexture Analysis

  • Echotexture analysis can be used to evaluate breast tissue composition and assess the risk of breast cancer, with heterogeneous echotexture patterns being associated with a higher risk of breast cancer 2, 5.
  • Echotexture analysis can also be used to detect and characterize prostate cancer, with computer-aided classification systems being developed to automatically classify echotexture patterns in ultrasound images 6.
  • Echotexture analysis can provide valuable information for the diagnosis and treatment of various diseases, including cancer, and can be used in conjunction with other imaging modalities to provide a more comprehensive understanding of tissue composition and disease characteristics 3.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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