In this study, we constructed VX2 tumors in normal liver and NAFLD background, respectively, compared the CEUS TIC parameters, explored the correlation between TIC parameters and MVD, VEGF, Ki-67, and PCNA, with the aim of addressing the following scientific questions:(1) whether the NAFLD background influences the microperfusion characteristics of VX2 hepatomas; (2) whether the fatty liver background on VX2 tumor microperfusion whether it further affects tumor angiogenesis and proliferative activity. This evidence concerns the gene MKI67 and metabolic dysfunction-associated steatotic liver disease.