If ultrasonography reveals rough parenchymal echogenicity in the liver, it can be seen in these cases: first, chronic viral hepatitis, especially recurrent hepatitis B, resulting in damage to liver cells, which may have fatty tissue deposits in the liver cell membrane, and imaging can reveal rough echogenicity. Should be systemic antiviral therapy, usually also to monitor the changes in liver function indicators. The second type, drug-related liver disease, is most commonly seen in patients with tuberculosis. During anti-tuberculosis treatment, because the commonly used drugs are rifampin and remifentan, which have some toxicity to the liver, can lead to drug-related hepatitis. Ultrasonography may also reveal coarse or dense echogenic changes, and in severe cases, significant increases in transaminases and bilirubin, which require prompt discontinuation of the drugs and symptomatic treatment with liver protection.