What does hypoechoic mean?

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Echogenicity describes how much ultrasound sound is reflected by tissue. Hypoechoic means the tissue produces fewer echoes than the surrounding tissue, so it appears darker on the image. This relative reduction in echogenicity helps distinguish it from areas that reflect more sound. For context, anechoic areas produce no echoes and look completely black (often fluid-filled cavities like cysts), while hyperechoic areas produce more echoes and appear brighter. If the area reflected echoes about the same as surrounding tissue, it would be isoechoic, not hypoechoic.