Uneven echoes are indicative of localized tissue pathology. Uneven echoes in different areas represent different clinical significance. Uneven echoes is a term used in ultrasound to describe normal tissue echoes that are generally homogeneous and may be hypoechoic, hyperechoic, or anechoic, but may be heterogeneous in the presence of localized lesions. For example, hepatic cysts in the liver can be seen as unevenly enhancing echoes in the liver parenchyma; non-uniform fatty liver can be seen as focal hypoechoic areas in the liver parenchyma. Graves’ disease of the thyroid gland can be characterized by diffuse, symmetric enlargement of the thyroid gland with internal heterogeneous coarse echogenicity; Hashimoto’s thyroiditis can also be characterized by glandular echogenicity that is attenuated and heterogeneous, and so on. Therefore, if you find uneven echoes, you should consult a doctor immediately and combine with other tests to clarify the disease.