Objective To investigate the risk factors associated with early postoperative recurrence of hepatocellular carcinoma( HCC) after surgical resection,and to discuss the predictive value of preoperative ultrasound examination for early recurrence of HCC after surgical resection. Methods The clinical data of 59 patients who underwent radical resection for HCC in Xiangya Hospital of Central South University from December 2010 to January 2014 were analyzed retrospectively. These patients were divided into early recurrence group( 27 patients)and no early recurrence group( 32 patients) based on whether recurrence occurred within 1 year after resection. The demographic data,laboratory examination data,and diagnostic data for conventional ultrasound and contrast- enhanced ultrasound( CEUS) in HCC patients with HBV who received CEUS before surgery were analyzed to determine their predictive values for early recurrence of HCC. The t- test or Mann-Whitney U test was applied for continuous data,chi- square test or Fisher's exact test was applied for categorical data,and the logistic regression model was applied for multivariate analysis. Results Univariate analysis showed that preoperative serum α- fetoprotein( AFP)level ≥400 ng / ml,maximum tumor diameter ≥5 cm,involvement of major blood vessels,a " fast wash- out" enhancement pattern on CEUS,and uneven distribution of contrast agent were risk factors for early postoperative recurrence( all P < 0. 05). Multivariate analysis showed that preoperative serum AFP level ≥400 ng / ml( OR = 14. 90,95% CI: 1. 44- 154. 39; P = 0. 02),maximum tumor diameter ≥5 cm( OR = 6. 75,95% CI: 1. 07- 42. 50; P = 0. 04),and a “fast wash- out”enhancement pattern on CEUS( OR = 9. 67,95% CI:1. 78- 52. 54; P = 0. 01) were independent risk factors for early postoperative recurrence. The evaluation of sensitivity of each independent risk factor and their combinations to predict early recurrence showed that the sensitivity of a“fast wash- out”enhancement pattern on CEUS did not differ significantly from that of maximum tumor diameter ≥5 cm( P > 0. 05),but it was significantly higher than that of the other indicators( all P < 0. 05). Conclusion The “fast wash- out”enhancement pattern on CEUS is highly sensitive in predicting early recurrence of HCC; therefore,it can be applied as one effective indicator for high- risk population screening,and provide guidance for the development and perfection of perioperative and postoperative long- term comprehensive therapeutic regimens for HCC.