The diagnosis of larger liver lesions is relatively clear and easy, but for ≤25px liver lesions, the lesions are so small that they are easily missed or misdiagnosed during examination, especially hepatocellular carcinoma, which has a poor prognosis once missed or misdiagnosed. Common liver lesions include: liver cysts, hemangiomas, adenomas, primary liver cancer, secondary liver cancer, cirrhotic nodules, focal hyperplasia, foci of infection, foci of calcification, etc. The nature of hepatic occupying lesions is diverse, and there are basically no specific clinical manifestations. And different diseases can have cool CT and MRI images. Moreover, there are many factors that affect CT density and MRI signal, which makes the qualitative diagnosis of occupying liver lesions very difficult. Improving the diagnosis rate is the key: history of hepatitis B. The incidence of hepatocellular carcinoma (HCC) in patients with cirrhosis is 23.8-25.4%. In China, 90% of patients with hepatocellular carcinoma have a history of hepatitis B. Up to 84.6% of patients with HCC combined with cirrhosis are resected. The number of cirrhotic patients combined with hepatocellular carcinoma is also 49.9%. Therefore, in the differentiation of micro-occupying lesions in liver, detailed history taking into account the background of hepatitis B and cirrhosis is important for the diagnosis of micro-hepatocellular carcinoma. Analysis of medical history: Patients with hepatocellular carcinoma and focal hyperplasia usually have a history of hepatitis and cirrhosis. History of oral contraceptives in patients with hepatocellular adenoma. Inflammatory lesions showing abnormalities such as fever and abdominal pain. Tumor markers: methemoglobin, carcinoembryonic antigen, CA19-9, etc., whose values are higher than normal, the possibility of tumor development should be considered. Imaging examination: ultrasound, CT, MRI, hepatic arteriogram, etc. Microcysticercosis: It appears as a liquid dark area on ultrasound; CT shows a hypointense shadow with watery density, smooth border and always non-enhancing; MRI shows very low signal in T1W1 and high signal in T2W1, and the lesion is non-enhancing after enhancement. Microvascular hemangioma: Large hemangiomas typically appear as “fast-in, slow-out” on enhanced CT and “light bulb sign” on MRI. However, those ≤25px have a diverse presentation and are difficult to diagnose. Microinflammatory pseudotumor: A typical inflammatory pseudotumor is a well-defined lesion with no enhancement in the arterial phase, no enhancement or circumferential enhancement, core enhancement, peripheral stalactite-like enhancement, and no filling reduction in the portal and parenchymal phases on enhanced CT scan. The patient had no hepatitis, cirrhosis, or AFP negativity. Focal nodular hyperplasia: not a tumor. Enhanced CT suggests a homogeneously enhancing multivessel mass in the arterial phase and greater than or equal to the surrounding liver parenchyma in the portal and delayed phases as the most important feature. Microscopic hepatocellular carcinoma: the typical most important performance of enhanced CT is “fast in and fast out”; ultrasonography can show malignant perfusion characteristics; however, microscopic hepatocellular carcinoma has various manifestations and is not easy to diagnose. Micro metastatic carcinoma: enhanced CT enhancement is mostly heterogeneous and obvious in the marginal part, and it is usually multiple foci, which is generally not difficult to diagnose when combined with the history of primary malignant tumor. Gold standard: puncture biopsy. Follow-up strategy and management strategy: ? Hepatic occupying lesions, less than 50% of which may be malignant, especially single lesions, are more difficult to diagnose hepatocellular carcinoma. For patients with underlying disease of hepatitis and cirrhosis, close follow-up is required. EASL (European Society for the Study of the Liver) recommends: for patients with underlying disease of cirrhosis, ultrasound follow-up every 3 months and review of alpha-fetoprotein (AFP) every 6 months for ≤25px liver-occupying lesions. Patients without a history of hepatitis or cirrhosis, but with a family history of liver cancer or living in an area with a high incidence of liver cancer (village or community based is recommended) should also be followed up more closely, with the same follow-up protocol as for patients with combined cirrhosis. Patients without underlying diseases of hepatitis and cirrhosis, combined with multiple lesions, multiple liver cysts and hepatic hemangiomas are generally not difficult to diagnose, but mainly need to exclude the possibility of metastatic cancer. For patients with combined hepatitis and cirrhosis, for 2 or less lesions, ultrasonography, enhanced CT or MRI should be perfected, and for highly suspected malignant tumors, puncture biopsy and then microwave destruction therapy should be considered, and the needle tract should be destroyed to avoid metastasis of malignant tumors along the needle tract. For 3 or more lesions, enhanced CT and DSA of the hepatic artery should be completed to improve the whole liver examination. If malignancy is also highly suspected, puncture biopsy will be performed. In general, for those with a history of hepatitis, Prof. Du Xilin recommends active management, preferring ultrasound or ultrasonography-guided microwave needle percutaneous hepatic curettage, and there is no need to wait for lesions to increase in size or develop metastases before Charlie. If the location of the lesion is special, such as located next to the 1st or 2nd hepatic hilar, or next to the gallbladder, or the left lobe of the liver is close to the stomach, or the edge of the liver is near the intestinal canal, etc., then laparoscopic, or open treatment is required, and further ultrasound exploration of the liver is needed intraoperatively to understand the location, size, number, and distribution of the lesion in relation to important vasculature, etc., to clarify the pathological nature and treatment plan.