Objective To study the value of dynamic contrast-enhanced MRI in evaluating the curative effect of high intensity focused ultrasound (HIFU) for hepatocellular carcinoma (HCC) and the prognosis.  Methods〖WTBZ〗Fifty-one lesions in twenty-eight patients with surgically or pathologically confirmed HCC underwent dynamic contrastenhanced MRI scanning before and after HIFU treatment. The enhancement features of the lesions and the surrounding tissues were analyzed.  Results Forty-eight lesions underwent one HIFU treatment

among which 39 lesions (76.47％) showed no enhancement in the central necrotic regions or peripheral annular enhancement in 1-2 weeks after HIFU and no viable lesions were detected in the follow-up MRI;  4 lesions (7.84％) demonstrated no enhancement in the central necrotic regions

but peripheral annular enhancement in 1-2 weeks after HIFU and peripheral enhanced nodules in 2-3 months by the follow-up MRI; 3 lesions (5.88％) showed dot-like

nodal or patchy enhancement in the necrotic regions and (or) the surrounding tissues in 1-2 weeks after HIFU

and further

in the following 2-3 months

the enhanced survived lesions increased in size and number; 2 lesions (3.92％) complicated with portal vein thrombosis demonstrated new lesions after HIFU by the follow-up MRI. Due to their big size

3 lesions (5.88％) underwent more than one HIFU treatment (2-3 times). Lamellar necrosis without enhancement was shown in 1-2 weeks after the last HIFU treatment compared with prior HIFU treatment.  Conclusion Dynamic contrast-enhanced MRI can sensitively reflect the enhancement features of necrosis and the surrounding tissues after HIFU.