Echogenic fluid: A pitfall in the ultrasonographic diagnosis of cystic lesions

Abstract

Although it is well known that biliary sludge can produce fine diffuse echoes within the gallbladder, it is less commonly appreciated that other cystic structures may contain echogenic fluid and therefore be mistaken sonographically for solid lesions. In this article three cases of splenic cysts and one case each of pyrometrocolpos, hydroureter, and pyonephrosis presented with diffuse fine echoes in the fluid. Three of these cases were misinterpreted as a result of this echogenic appearance. These cases serve to emphasize the need for awareness of the echogenicity of some types of fluid and the value of other signs of cystic lesions besides absence of internal echoes.

Diffuse echoes within a simple hydrocele: an imaging caveat.

“…A review of the literature reveals that the echogenic nature of such fluid can be attributed to both protein 3 and cholesterol crystals. 4 We have ascribed the echogenic nature of our fluid sample to the protein as large insoluble proteinaceous matter was abundant and cholesterol crystals were lacking.…”

Sonographic findings of intraabdominal foreign bodies due to retained gauze

“…However, the boundary echoes of the posterior wall were irregular and interrupted because of adhesion to adjacent organs. In case 1, the evenly and diffusely distributed fine echoes probably represented debris from chronic infection or inflammation [4]; Echo-free spaces caused by pus occupied most of the mass in case 2; The high internal irregular echoes of the gauze were clearly shown in both cases [5]. Abscess, hematoma, and pancreatic pseudocysts may have similar ultrasonic appearance [6], but high internal irregular echoes are highly specific for retained gauzes.…”

Asymptomatic Abdominal Hydatidosis Detected by Ultrasonography

“…The usefulness of ultrasonography in the diagnosis and follow-up of hydatid disease is well recognized (I, 11,13,15,16,19,21,24,26,27,31). The US findings reported here are similar to those found by others.…”