Hepatic parenchyma as tiny punctate to moderate-intensity echoes is a descriptive term used in ultrasonography for a normal liver or a nonhomogeneous fatty liver. Ultrasound sonograms of normal liver parenchyma often show moderate tiny punctate echoes that are evenly distributed. Alternatively, a non-homogeneous fatty liver can also present with tiny dots of moderate intrahepatic echoes. The intensity of ultrasound echoes in human tissues is classified as strong, high, moderate, low, or no echoes. Moderate echoes are common in parenchymal tissues such as the liver and spleen. Normal liver parenchyma is usually characterized by small dots to moderate echoes with uniformity. If the liver is diseased, on ultrasound, the surface of the liver is not smooth and the parenchymal echoes are enhanced, diminished, or heterogeneous. In fatty liver, liver fat is not evenly distributed and ultrasound will show fine punctate to moderate intensity echoes in the liver. If you have upper abdominal discomfort, anorexia of greasy food and other discomforts, you can combine the symptoms, or do further examination, and analyze the cause under the guidance of the doctor.