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Echogenicity: Hyperechoic (US)
Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS

  • Terminology

    • Top Differential Diagnoses

      • Pathology

        TERMINOLOGY

        • Synonyms

          • Hyperechoic, echogenic
        • Definitions

          • Defined by US appearance: ↑ echogenicity (brighter) relative to subcutaneous fat
          • Distinguish homogeneously hyperechoic from mixed hyper- and hypoechoic lesions
          • Echogenic rim: Indistinct, echogenic transition zone between lesion and surrounding tissue, suspicious
            • Distinguish from thin pseudocapsule due to compressed normal tissue (benign)
          • Echogenic foci due to Ca⁺⁺, clips, air
          • Edema: Diffuse hyperechogenicity in tissue

        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. Journo G et al: Hyperechoic breast images: all that glitters is not gold! Insights Imaging. 9(2):199-209, 2018
                              2. Nassar L et al: Predictors of malignancy in hyperechoic breast lesions. J Ultrasound Med. 35(4):783-90, 2016
                              3. Tiang S et al: Malignant hyperechoic breast lesions at ultrasound: A pictorial essay. J Med Imaging Radiat Oncol. 60(4):506-13, 2016
                              4. Nam SY et al: Ultrasonographic hyperechoic lesions of the breast: are they always benign? Acta Radiol. 56(1):18-24, 2015
                              5. Adrada B et al: Hyperechoic lesions of the breast: radiologic-histopathologic correlation. AJR Am J Roentgenol. 200(5):W518-30, 2013
                              6. Gao Y et al: Echogenic breast masses at US: to biopsy or not to biopsy? Radiographics. 33(2):419-34, 2013
                              7. Mendelson EB et al: Breast Imaging Reporting and Data System: BI-RADS: Ultrasound. 2nd ed. Reston: American College of Radiology, 2013
                              8. Linda A et al: Hyperechoic lesions of the breast: not always benign. AJR Am J Roentgenol. 196(5):1219-24, 2011
                              9. Linda A et al: The wide spectrum of hyperechoic lesions of the breast. Clin Radiol. 66(6):559-65, 2011
                              10. Okazaki H et al: Radiologic-pathological correlation of punctate hyperechoic foci by ultrasound in stereotactic vacuum-assisted breast biopsy samples. Jpn J Radiol. 27(10):438-43, 2009
                              11. Cawson JN: Can sonography be used to help differentiate between radial scars and breast cancers? Breast. 14(5):352-9, 2005
                              12. Paulinelli RR et al: Risk of malignancy in solid breast nodules according to their sonographic features. J Ultrasound Med. 24(5):635-41, 2005
                              13. Soo MS et al: Fat necrosis in the breast: sonographic features. Radiology. 206(1):261-9, 1998
                              14. Stavros AT et al: Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology. 196(1):123-34, 1995
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Top Differential Diagnoses

                                  • Pathology

                                    TERMINOLOGY

                                    • Synonyms

                                      • Hyperechoic, echogenic
                                    • Definitions

                                      • Defined by US appearance: ↑ echogenicity (brighter) relative to subcutaneous fat
                                      • Distinguish homogeneously hyperechoic from mixed hyper- and hypoechoic lesions
                                      • Echogenic rim: Indistinct, echogenic transition zone between lesion and surrounding tissue, suspicious
                                        • Distinguish from thin pseudocapsule due to compressed normal tissue (benign)
                                      • Echogenic foci due to Ca⁺⁺, clips, air
                                      • Edema: Diffuse hyperechogenicity in tissue

                                    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. Journo G et al: Hyperechoic breast images: all that glitters is not gold! Insights Imaging. 9(2):199-209, 2018
                                                          2. Nassar L et al: Predictors of malignancy in hyperechoic breast lesions. J Ultrasound Med. 35(4):783-90, 2016
                                                          3. Tiang S et al: Malignant hyperechoic breast lesions at ultrasound: A pictorial essay. J Med Imaging Radiat Oncol. 60(4):506-13, 2016
                                                          4. Nam SY et al: Ultrasonographic hyperechoic lesions of the breast: are they always benign? Acta Radiol. 56(1):18-24, 2015
                                                          5. Adrada B et al: Hyperechoic lesions of the breast: radiologic-histopathologic correlation. AJR Am J Roentgenol. 200(5):W518-30, 2013
                                                          6. Gao Y et al: Echogenic breast masses at US: to biopsy or not to biopsy? Radiographics. 33(2):419-34, 2013
                                                          7. Mendelson EB et al: Breast Imaging Reporting and Data System: BI-RADS: Ultrasound. 2nd ed. Reston: American College of Radiology, 2013
                                                          8. Linda A et al: Hyperechoic lesions of the breast: not always benign. AJR Am J Roentgenol. 196(5):1219-24, 2011
                                                          9. Linda A et al: The wide spectrum of hyperechoic lesions of the breast. Clin Radiol. 66(6):559-65, 2011
                                                          10. Okazaki H et al: Radiologic-pathological correlation of punctate hyperechoic foci by ultrasound in stereotactic vacuum-assisted breast biopsy samples. Jpn J Radiol. 27(10):438-43, 2009
                                                          11. Cawson JN: Can sonography be used to help differentiate between radial scars and breast cancers? Breast. 14(5):352-9, 2005
                                                          12. Paulinelli RR et al: Risk of malignancy in solid breast nodules according to their sonographic features. J Ultrasound Med. 24(5):635-41, 2005
                                                          13. Soo MS et al: Fat necrosis in the breast: sonographic features. Radiology. 206(1):261-9, 1998
                                                          14. Stavros AT et al: Solid breast nodules: use of sonography to distinguish between benign and malignant lesions. Radiology. 196(1):123-34, 1995