Many patients often take the ultrasound report and ask, “Doctor, what does lipid deposition in the liver area mean?” We often reply, “It means that there is a tendency of fatty liver or mild fatty liver, which will disappear naturally with less food and more movement, and no treatment is needed.” I don’t know which ultrasound expert invented and coined this diagnostic term “hepatic lipid deposition”, which gives the ultrasonographer a very beautiful conclusion in diagnosing the disease and a wonderful explanation around this conclusion, which is easy to understand. Let’s start by understanding the diagnostic criteria for fatty liver. The primary criterion for the diagnosis of fatty liver by ultrasound is “increased echogenicity of the liver parenchyma” (Figures 2 and 3), which in layman’s terms means that the entire background of a fatty liver is brighter than that of a normal liver, which (as in Figure 1) has a homogeneous echogenicity and very clear echogenicity of the internal ducts. The criteria for fatty liver diagnosis also include: increased posterior echogenic attenuation (the deeper part of the liver becomes darker due to energy attenuation during ultrasound travel, making that part of the liver poorly visible, (Figure 2 and Figure 3) and poorly visible or indistinct intrahepatic ducts (Figure 3, the intrahepatic ducts are completely indistinct). The diagnosis of fatty liver is confirmed when the criteria of “increased parenchymal echogenicity” are combined with either of the other two criteria. However, there are often many patients whose liver ultrasound examination only shows “elevated parenchymal echogenicity” (Figure 4), and then the definitive diagnosis of fatty liver is lost and the fatty liver is considered suspicious. So the clever ultrasound predecessors invented the beautiful diagnostic term “hepatic lipid deposition”, thus providing a once-and-for-all solution to this simple ultrasound phenomenon. “Lipid deposition in the liver area” indicates a change in the body’s fat metabolism and therefore gives us a rather gentle warning to act before it is too late. If the blood lipids are normal, the “lipid deposits in the liver” can usually disappear by strengthening the body, limiting the weight and eating a low-fat, light diet. Figure 1: Normal liver Figure 2: Mild fatty liver Figure 3: Severe fatty liver Figure 4: Lipid deposition in the liver area