Objective To explore the application values of multi-slice spiral CT and magnetic resonance imaging (MRI) in the lesion residues and recurrence of primary hepatic carcinoma (PHC) intervention. Methods 60 cases of PHC patients treated in our hospital from June 2015 to June 2017 were selected for the study with a total of 84 lesions, and all the patients were given the review at 2-6 months after the transarterial chemoembolization (TACE). The multi-slice spiral CT, MRI and digital subtraction angiography (DSA) were performed. The accuracy, sensitivity, specificity of the lesion residues and recurrence and the detection rate of the lesion tumor capsule were analyzed by the multi-slice spiral CT and MRI examination taking the DSA as the gold standard. Results The accuracy, sensitivity and specificity of lesion residues and recurrence were 79.76%, 72.58% and 100.00% respectively by the multi-slice spiral CT and were 94.05%, 91.94% 100.00% by MRI, and the accuracy and sensitivity of MRI diagnosis were significantly higher than those by multi-slice spiral CT (P<0.05). The detection rate of the lesion tumor capsule by multi-slice spiral CT was significantly lower than that by MRI (3.57% vs 10.71%) (P<0.05). Conclusion MRI has the high accuracy of efficacy diagnosis for PHC patients after TACE, which is significantly better than the multi-slice spiral CT diagnosis.