Thickening and enhancement of the liver parenchyma is mainly indicative of previous or current hepatocellular damage and may suggest fatty liver, liver fibrosis, cirrhosis, etc. 1. Fatty liver. Fatty liver is characterized by the presence of fat deposits in some of the hepatocytes, which can lead to thickening and enhancement of the liver parenchyma on imaging. Fatty liver can be diagnosed or excluded based on the patient’s body type, lipid levels, and relevant past medical history. 2. Liver fibrosis and cirrhosis. When liver fibrosis or cirrhosis occurs, the fibrous tissue in the liver proliferates to replace the necrotic tissue, which also causes thickening and enhancement of liver parenchyma echogenicity. If the patient has a history of alcoholism, hepatitis virus infection, and other related medical conditions, the disease may progress to liver fibrosis or even cirrhosis. It is important to seek medical attention to clarify or rule out any associated medical conditions in order to determine the next course of treatment.