Most patients with hepatocellular carcinoma present as hypoechoic nodules on color ultrasound exploration, and most of the hyperechoic nodules are hemangiomas of the liver. For patients with hepatocellular carcinoma who produce hypoechoic nodules, there are distinctive features such as irregular morphology, uneven internal echogenicity, rich blood flow and satellite foci in the periphery, even including enlarged lymph nodes with abnormal echogenicity in the hilar region, which are all specific manifestations of color ultrasound imaging in patients with hepatocellular carcinoma. Sometimes the patient has a cancerous thrombus in the portal vein, which can also be clearly shown by ultrasound. When ultrasound examination is performed on liver patients and hypoechoic nodules are found, further examination measures must be taken, including enhanced CT and, if necessary, MRI, all of which can help diagnose and finalize the diagnosis of liver cancer.