Liver hemangiomas display a variety of appearances on ultrasound, including hyper-echoic, hypo-echoic, and mixed echoes. Typically, hemangiomas appear on ultrasound as round or oval hyper-echoic masses, with internal echoes that may show a sieve-like change. In contrast, liver cancer primarily appears as hypo-echoic on ultrasound, and liver cancer symptoms are more varied because most liver cancers develop on the basis of cirrhosis. In addition to hypo-echoic masses, there are other manifestations, such as an incomplete liver capsule, widened liver fissures, spleen enlargement, and dilated portal veins, which are used to differentiate from hemangiomas.