B-type ultrasound examination (B ultrasound for short) is the most common method of modern medical imaging diagnosis, and has an important position in the diagnosis of liver disease and some other diseases. However, many patients, because of the lack of relevant knowledge, understand some specialized terms of ultrasound literally and unilaterally, which will add a lot of troubles to themselves. Ultrasound terms such as “thickened liver parenchyma”, “diffuse liver parenchymal lesions”, “early cirrhosis”, etc. can make many patients feel anxious. The B ultrasound has brought great convenience to the diagnosis of liver disease, but it has also added unnecessary burden to some unknown patients. psychological baggage. Ultrasound reports of the liver usually contain various data on which doctors base their judgments of normalcy or the presence of disease. However, because of the great variation in individuals and the fact that the location of each ultrasound measurement cannot be exactly the same, there is always some variation in the results of each measurement. If the ultrasound report is slightly over the standard or slightly more than the last measurement, it does not necessarily mean that it is abnormal or that the lesion is aggravated. Experiments have been done where different doctors examined the thickness of the spleen of the same patient and the results varied by 5 to 15 mm. The normal liver parenchyma echogenicity is low with small dots, evenly distributed, and the intrahepatic portal vein, hepatic veins, hepatic ducts and their primary branches can be displayed. The main manifestation of acute hepatitis is an increase in liver volume, fullness of form, and gradual thickening and densening of echogenicity. In chronic hepatitis, the liver is enlarged or normal in size, the liver parenchyma is thickened and enhanced, the intrahepatic veins and bile duct system are mildly disturbed, and the gallbladder wall is thickened and gross and the spleen is mildly enlarged. Generally speaking, the presence of “thickened and denser liver parenchymal dots” on the ultrasound report indicates inflammation of the liver; however, there is no absolutely reliable objective standard for the number and thickness of the so-called dots, which is mainly empirical and related to the performance of the instrument. The ultrasound results of the same patient may not be identical when examined in different hospitals within a short period of time, with some saying that the liver is normal and others saying that the parenchymal dots are thickened, and such examples are very common in clinical practice. The so-called “diffuse lesion” means that the lesion has spread to the whole tissue or organ, and the lesion is more evenly distributed. Diffuse lesions are not related to the severity of the disease and can be mild or severe. The opposite of a diffuse lesion is a focal lesion or an occupying lesion, which is a lesion that affects only a portion of the tissue or organ. The description of “diffuse lesions” is very common on ultrasound reports, so don’t have trouble sleeping because you see “diffuse lesions”. The ultrasound findings of typical cirrhosis are reduced liver size, irregular shape, unsmooth surface, thickened envelope, increased parenchymal echogenicity, uneven distribution, sometimes hypoechoic nodules, dilated and distorted portal vein system and enlarged collateral circulation, moderate or severe enlargement of the spleen, etc. It should be said that ultrasound has an important diagnostic value for mid- to late-stage cirrhosis. Experienced examiners may find sonographic changes in early cirrhosis, but the diagnosis of “early cirrhosis” by ultrasound is based on ultrasound characteristics and may not be fully compatible with the clinical diagnosis of cirrhosis, so patients do not need to add to the burden of thought. Each examination method has a certain scope of application, and ultrasound examination has its advantages and limitations, as the so-called “one key opens one lock”. So, what lesions can be accurately diagnosed by ultrasound? What chronic liver diseases are diagnosed with the greatest value by ultrasound? Ultrasound can confirm the diagnosis of cysts, and ultrasound can also confirm the diagnosis of hemangioma in general patients, but in patients with cirrhosis it is sometimes difficult to distinguish from liver cancer, and some cautiously need to do magnetic resonance imaging again. If there is shrinkage of liver, disproportion of each lobe, uneven surface, uneven parenchyma, nodules of different sizes, widening of portal vein, widening of splenic vein and splenomegaly, the preliminary diagnosis of cirrhosis can be made by combining with clinical data. A small amount of ascites is found in cirrhotic patients, for which ultrasound examination is much more sensitive than physical examination. Patients with cirrhosis must have ultrasound and methemoglobin checked every 6 months, which is the international medical routine, and CT or MRI is needed to confirm the diagnosis if any findings. Ultrasound findings of fatty liver, gallbladder polyps, gallbladder or bile duct stones can establish the initial diagnosis, and these are not always followed by further tests. Ultrasound in jaundiced patients reveals dilated bile ducts, and cholangiography must be performed to clarify the diagnosis for proper medical and surgical treatment. Can ultrasound determine the severity of inflammation and fibrosis in chronic hepatitis? In fact, not only ultrasound, but also CT and MRI imaging examinations have no definite significance for hepatitis diagnosis or disease assessment. Imaging examinations for hepatitis patients are mainly useful for detecting their comorbidities, such as combined cirrhosis, ascites, and especially for early detection of liver cancer, which is the most important screening method. However, it is not sensitive enough for the diagnosis of cirrhosis, and more than half of the cases will be missed. Early detection of cirrhosis is mainly based on the diagnosis of liver histology pathology by puncture. In conclusion, ultrasound has important diagnostic value for hepatocellular carcinoma, liver abscess, liver ascites, extrahepatic obstructive jaundice and mid- to late-stage cirrhosis, but it cannot determine the severity and cause of liver inflammation based on ultrasound results. ultrasound is only an auxiliary examination after all, and its results must be combined with clinical symptoms and other examination results by experienced doctors to make a correct diagnosis.