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Echogenicity: Anechoic (US)
Regina J. Hooley, MD; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Synonyms

            • "Cystic" implies at least partially anechoic
          • Definitions

            • Devoid of internal echoes (US)
              • Artifactual internal echoes can be present
              • Anterior reverberation artifacts common
            • May be difficult to distinguish from markedly hypoechoic (suspicious)

          IMAGING

          • General Features

            • Mammographic Findings

              • Ultrasonographic Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              • Image Interpretation Pearls

                                Selected References

                                1. Ciurea AI et al: Breast cystic lesions: Not so simple after all? An ultrasonographic tactical approach. Med Ultrason. 1(1):95-9, 2018
                                2. Tayyab SJ et al: A pictorial review: multimodality imaging of benign and suspicious features of fat necrosis in the breast. Br J Radiol. 20180213, 2018
                                3. Evren S et al: Breast Implant-Associated Anaplastic Large Cell Lymphoma (ALCL): A Case Report. Am J Case Rep. 18:605-610, 2017
                                4. Kaartinen I et al: Breast implant-associated anaplastic large cell lymphoma - From diagnosis to treatment. Eur J Surg Oncol. 43(8):1385-1392, 2017
                                5. Berg WA et al: Quantitative maximum shear-wave stiffness of breast masses as a predictor of histopathologic severity. AJR Am J Roentgenol. 205(2):448-55, 2015
                                6. Mendelson EB et al: Breast Imaging Reporting and Data System: BI-RADS, Ultrasound. 2nd ed. Reston: American College of Radiology, 2013
                                7. Barr RG et al: The utility of the "bull's-eye" artifact on breast elasticity imaging in reducing breast lesion biopsy rate. Ultrasound Q. 27:151-5, 2011
                                8. Berg WA et al: Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am. 48(5):931-87, 2010
                                9. Lee HJ et al: Observer variability of Breast Imaging Reporting and Data System (BI-RADS) for breast ultrasound. Eur J Radiol. 65(2):293-8, 2008
                                10. Chang YW et al: Sonographic differentiation of benign and malignant cystic lesions of the breast. J Ultrasound Med. 26(1):47-53, 2007
                                11. Berg WA et al: Lesion detection and characterization in a breast US phantom: results of the ACRIN 6666 Investigators. Radiology. 239(3):693-702, 2006
                                12. Berg WA et al: Operator dependence of physician-performed whole-breast US: lesion detection and characterization. Radiology. 241(2):355-65, 2006
                                13. Lazarus E et al: BI-RADS lexicon for US and mammography: interobserver variability and positive predictive value. Radiology. 239(2):385-91, 2006
                                14. Hong AS et al: BI-RADS for sonography: positive and negative predictive values of sonographic features. AJR Am J Roentgenol. 184(4):1260-5, 2005
                                15. Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
                                16. Soo MS et al: Fat necrosis in the breast: sonographic features. Radiology. 206(1):261-9, 1998
                                17. Hilton SV et al: Real-time breast sonography: application in 300 consecutive patients. AJR Am J Roentgenol. 147(3):479-86, 1986
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Synonyms

                                          • "Cystic" implies at least partially anechoic
                                        • Definitions

                                          • Devoid of internal echoes (US)
                                            • Artifactual internal echoes can be present
                                            • Anterior reverberation artifacts common
                                          • May be difficult to distinguish from markedly hypoechoic (suspicious)

                                        IMAGING

                                        • General Features

                                          • Mammographic Findings

                                            • Ultrasonographic Findings

                                              • MR Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      CLINICAL ISSUES

                                                      • Presentation

                                                        • Demographics

                                                          DIAGNOSTIC CHECKLIST

                                                          • Consider

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. Ciurea AI et al: Breast cystic lesions: Not so simple after all? An ultrasonographic tactical approach. Med Ultrason. 1(1):95-9, 2018
                                                              2. Tayyab SJ et al: A pictorial review: multimodality imaging of benign and suspicious features of fat necrosis in the breast. Br J Radiol. 20180213, 2018
                                                              3. Evren S et al: Breast Implant-Associated Anaplastic Large Cell Lymphoma (ALCL): A Case Report. Am J Case Rep. 18:605-610, 2017
                                                              4. Kaartinen I et al: Breast implant-associated anaplastic large cell lymphoma - From diagnosis to treatment. Eur J Surg Oncol. 43(8):1385-1392, 2017
                                                              5. Berg WA et al: Quantitative maximum shear-wave stiffness of breast masses as a predictor of histopathologic severity. AJR Am J Roentgenol. 205(2):448-55, 2015
                                                              6. Mendelson EB et al: Breast Imaging Reporting and Data System: BI-RADS, Ultrasound. 2nd ed. Reston: American College of Radiology, 2013
                                                              7. Barr RG et al: The utility of the "bull's-eye" artifact on breast elasticity imaging in reducing breast lesion biopsy rate. Ultrasound Q. 27:151-5, 2011
                                                              8. Berg WA et al: Cystic breast masses and the ACRIN 6666 experience. Radiol Clin North Am. 48(5):931-87, 2010
                                                              9. Lee HJ et al: Observer variability of Breast Imaging Reporting and Data System (BI-RADS) for breast ultrasound. Eur J Radiol. 65(2):293-8, 2008
                                                              10. Chang YW et al: Sonographic differentiation of benign and malignant cystic lesions of the breast. J Ultrasound Med. 26(1):47-53, 2007
                                                              11. Berg WA et al: Lesion detection and characterization in a breast US phantom: results of the ACRIN 6666 Investigators. Radiology. 239(3):693-702, 2006
                                                              12. Berg WA et al: Operator dependence of physician-performed whole-breast US: lesion detection and characterization. Radiology. 241(2):355-65, 2006
                                                              13. Lazarus E et al: BI-RADS lexicon for US and mammography: interobserver variability and positive predictive value. Radiology. 239(2):385-91, 2006
                                                              14. Hong AS et al: BI-RADS for sonography: positive and negative predictive values of sonographic features. AJR Am J Roentgenol. 184(4):1260-5, 2005
                                                              15. Berg WA et al: Cystic lesions of the breast: sonographic-pathologic correlation. Radiology. 227(1):183-91, 2003
                                                              16. Soo MS et al: Fat necrosis in the breast: sonographic features. Radiology. 206(1):261-9, 1998
                                                              17. Hilton SV et al: Real-time breast sonography: application in 300 consecutive patients. AJR Am J Roentgenol. 147(3):479-86, 1986