What causes increased echogenicity distal to an anechoic structure?

Comprehensive and Detailed Explanation From Exact Extract:

An anechoic structure (such as a cyst or fluid-filled space) allows ultrasound waves to pass through with minimal attenuation. As a result, more sound energy reaches tissues distal to the structure, producing a bright area known as posterior acoustic enhancement or increased echogenicity.

The sonography Principles and Instrumentation documents state:

"Posterior acoustic enhancement occurs distal to fluid-filled structures due to reduced attenuation through the anechoic medium, allowing increased beam intensity to reach deeper tissues."

Reduced penetration (A) and increased attenuation (B or C) would not produce enhancement.

Reduced attenuation (D) is the correct mechanism.

Therefore, the correct answer is D: Reduced attenuation through the structure.

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