Objective:To explore the predictive value of contrast-enhanced ultrasound (CEUS) combined with conventional ultrasound for microvascular invasion (MVI) and early recurrence of liver cancer after interventional therapy. Methods:A total of 168 patients with primary liver cancer who were treated with interventional treatment in our hospital from January 2018 to January 2022 were selected. They were divided into MVI group (57 cases) and nMVI group (111 cases) based on the occurrence of MVI. They were divided into the early recurrence group (43 cases) and non recurrence group (125 cases) based on the recurrence within 12 months after surgery. All patients underwent routine ultrasound and CEUS examination. The imaging characteristics of routine ultrasound and CEUS were compared between the MVI group and the nMVI group, as well as between the early recurrence group and the non recurrence group. Multivariate logistic regression analysis was conducted to identify the risk factors for MVI and early recurrence after liver cancer intervention surgery. The predictive value of routine ultrasound, CEUS, and CEUS combined with routine ultrasound for MVI and early recurrence was analyzed. Results:There was a statistically significant difference in tumor size, tumor capsule integrity, microvascular grading, tumor edge smoothness, peritumoral enhancement rate, portal and delayed phase enhancement, and clearance time between the MVI group and the nMVI group (P<0.05). There was a statistically significant difference in the ultrasound imaging features between the early recurrence group and the non recurrence group(P<0.05). Multivariate logistic regression analysis showed that tumor size, incomplete tumor capsule, microvascular grade, peritumoral enhancement, low latency enhancement, and unsmooth tumor edge were independent influencing factors for the occurrence of MVI, while microvascular grade, peritumoral enhancement, and unsmooth tumor edge were independent risk factors for early recurrence in liver cancer patients after interventional therapy. The area under the curve (AUC) of conventional ultrasound combined with CEUS in predicting liver cancer MVI and early recurrence after interventional therapy was higher than that of the two alone (P<0.05). Conclusion:The combination of CEUS and conventional ultrasound has a high clinical value for MVI and early recurrence of liver cancer after interventional therapy.