Objective To dynamically observe the developing process and characteristics of the chronic intra-hepatic hyperplastic nodule to small hepatoma with ultrasound,and to evaluate the value of ultrasound in the diagnosis of small hepatoma.Methods One hundred twenty-two chrome hepatitis cases with HBsAg(+),HBcAb(+)and HBeAg(+)were prospectively examined by two-dimensional ultrasound and three-dimensional reconstruction.Characteristics and diagnostic accuracy of two-dimensional ultrasound and three-dimensional reconstruction were compared with the results of hepatic biopsy.Results Thirty-four of 122 patients developed small hepatoma.The duration between hepatic fibrosis and liver cirrhosis was (6.30±2.31)years,and time of hepatoma changed from liver cirrhosis was (8.01±2.10) years.The intrahepatic hyperplastic nodule,shape of small hepatoma and relationship between tumor and ambient tissue were displayed clearly with three-dimensional ultrasound,and the number of detection with threedimensional ultrasound was much higher than that of two-dimensional ultrasound significantly.Conclusions Dynamic ultrasound examination of the echogenicity change of chronic hepatic lesion caused by HBV is useful for early detection of small intra-hepatic nodule,three-dimensional ultrasound reconstruction may enhance the accuracy in diagnosing small hepatoma.