Hypoechoic zone on liver ultrasound usually refers to an area where fatty liver is strongly echogenic and mixed with hypoechoic on the background of fatty liver, which generally refers to the uneven fat deposition caused by fat. Hypoechoic zone generally refers to less fat deposition. Diffuse liver cancer can form hypoechoic zone, which can appear as hypoechoic zone on ultrasound due to smaller cancer nodules without stereoscopic sensation, often diffuse liver cancer is mostly accompanied by portal vein carcinoma thrombus, which can appear as widened portal vein with parenchymal-like material filling. For hypoechoic zone of diffuse liver cancer, it is more likely to be considered as malignant, and when it is difficult to identify hypoechoic zone in liver enhanced imaging examinations, such as enhanced CT, enhanced MRI and other examinations are needed.