Acoustic enhancement refers to which phenomenon?

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Acoustic enhancement happens when a structure has low attenuation, such as a fluid-filled cyst, so ultrasound energy passes through it more easily. Because less energy is absorbed or scattered, more sound reaches the deeper tissues and the echoes from behind the structure are stronger, making the area posterior to the structure appear brighter. This is why the phenomenon is described in terms of more sound transmission through the structure. If a structure attenuates sound more, you’d expect posterior shadowing instead; Doppler shift is about moving blood flow, not tissue echogenicity.