BSTRACT Objective To investigate the value of Virtual touch tissue Quantification (VTQ) imaging in differentiating diagnosis of small-hepatocellular carcinoma(sHCC) and dysplastic nodule(DN) associated with HBV infection. Methods Fifty-four sHCCs and 30 DNs，confirmed by Surgery or biopsy pathology were included in our study. All were examined by convention ultrasound and VTQ，the shear wave velocity(SWV) of the nodules and tissue surounding nodule were required. Receiver-operating characteristic curve(ROC) ,area under ROC curve(AUROC),sensitivity，specificity，positive predictive value，negative predictive value， Likelihood ratio，-Likelihood ratio were performed to assess the diagnostic value. Results The SWV value of sHCC was higher than dysplastic nodule(DN), Of the 54 sHCCs, the mean SWV was [(3.45±1.44)m/s，95%CI：( 3.06，3.85)m/s], and the 30 DNs, the mean SWV was [(1.87±0.40)m/s，95%CI：(1.72，2.02)m/s]. Kappa value was 0.82, P＜0.05, The Kappa test results showed better consistency. The AUROC was 0.96，With a cut-off value of 2.455 m/s，the sensitivity，specificity，positive predictive value，negative predictive value， Likelihood ratio，-Likelihood ratio for differentiating between the benign and the malignancy nodules were 90.74%，93.33%，96.08%，84.85%，13.61，0.10，respectively. Conclusion VTQ provides the stiffness of benign and malignant nodules by SWV，which could play an important value in differentiating diagnosis of sHCC and dysplastic nodule associated with HBV infection.