Objective:To explore the value of magnetic resonance imaging (MRI) parameters combined with serum macrophage migration inhibitory factor (MIF) and microRNA-1203 (miR-1203) in the early diagnosis of hepatocellular carcinoma (HCC) and its relationship with efficacy.Methods:From October 2017 to October 2019, 100 patients with HCC in Hunan Provincial Hospital of Traditional Chinese Medicine were selected as the observation group. 92 patients with benign liver tumor and 102 healthy people were randomly selected as the control group and normal control group. The clinicopathological features, MRI parameters [hepatic artery perfusion index (HPI), volume transfer constant (K trans)], serum MIF and miR-1203 levels were compared among the three groups; the value of MRI parameters, serum MIF and miR-1203 in single and combined diagnosis of HCC was explored; the relationship between each index and curative effect of HCC patients was analyzed. Results:The levels of HPI, K trans, serum MIF and miR-1203 in observation group were higher than those in control group and normal control group ( P<0.05); There were significant differences in HPI, K trans, serum MIF and miR-1203 levels among patients with different tumor length, differentiation degree, Child Pugh grade and distant metastasis in the observation group ( P<0.05). Among HPI, K trans and serum MIF, miR-1203, the specificity of HPI and K trans for diagnosis of HCC were the largest (94.57%), and the sensitivity of K trans for diagnosis of HCC was the largest (75.00%); the area under the curve (AUC) of the combined diagnosis of HCC was 0.879, which was greater than the AUC of the single diagnosis of HPI, K trans and serum MIF, miR-1203 (0.753, 0.793, 0.792, 0.809); the optimal sensitivity and specificity of the combined diagnosis were 79.00% and 86.96%, respectively; the levels of HPI, K trans, serum MIF, and miR-1203 in effective patients in the observation group were lower than those in the ineffective patients after treatment ( P<0.05); the clinical efficacy of HCC patients were significantly correlated with the levels of HPI, K trans, serum MIF and miR-1203 ( P<0.05). Conclusions:The MRI parameters HPI, K trans and serum MIF, miR-1203 levels in patients with HCC increased significantly, which has high application value in assisting clinical diagnosis of HCC, and is closely related to the clinical efficacy of patients, and has great development potential in efficacy evaluation.