In our study, the Clinic-CEUS model integrates serum AFP, intratumoral necrosis and peritumoral nutrient vessel for MTM-HCC prediction and age, serum AFP-L3% and AP branched enhancement for high Ki-67 pattern identification, achieving an undesirable AUC of 0.720 and 0.673, respectively. Here, AFP is linked to hepatocellular carcinoma.