The difference between a strongly echogenic and a hyperechoic liver is the presence or absence of a posterior acoustic shadow. Hypoechoic refers to an increased echo with a posterior acoustic shadow and is usually seen in places such as stones and bone surfaces. Hypoechoic echoes are those that are enhanced but not accompanied by an acoustic shadow and are usually seen in liver tumors. Strong echoes of the liver is an imaging manifestation of liver ultrasound. Strong echoes are often seen in liver stones, intrahepatic calcified foci, and in a few cases, liver tumors also have strong echoes of the liver. Therefore, this condition is usually used in the examination of moderate to severe fatty liver. On the other hand, hepatic hypoechoicity is mainly due to the lesions of hepatocytes, intrahepatic bile ducts and other parts of the liver caused by various physiological or pathological diseases, which is manifested in the imaging changes, and can be manifested in hemangiomas, primary tumors of the liver and so on. Therefore, hepatic strong echogenicity and hyperechogenicity are not the same, and the difference lies in whether the posterior is accompanied by acoustic shadows or not.