BackgroundTo investigate the viscoelastic signatures of proliferative hepatocellular carcinoma (HCC) using three-dimensional (3D) magnetic resonance elastography (MRE).MethodsThis prospective study included 121 patients with 124 HCCs as training cohort, and validation cohort included 33 HCCs. They all underwent preoperative conventional magnetic resonance imaging (MRI) and tomoelastography based on 3D multifrequency MRE. Viscoelastic parameters of the tumor and liver were quantified as shear wave speed (c, m/s) and loss angle (φ, rad), representing stiffness and fluidity, respectively. Five MRI features were evaluated. Multivariate logistic regression analyses were used to determine predictors of proliferative HCC to construct corresponding nomograms.ResultsIn training cohort, model 1 (Combining cirrhosis, hepatitis virus, rim APHE, peritumoral enhancement, and tumor margin) yielded an area under the curve (AUC), sensitivity, specificity, accuracy of 0.72, 58.73%,78.69%, 67.74%, respectively. When adding MRE properties (tumorcand tumorφ), established model 2, the AUC increased to 0.81 (95% CI 0.72–0.87), with sensitivity, specificity, accuracy of 71.43%, 81.97%, 75%, respectively. The C-index of nomogram of model 2 was 0.81, showing good performance for proliferative HCC. Therefore, integrating tumorcand tumorφcan significantly improve the performance of preoperative diagnosis of proliferative HCC (AUC increased from 0.72 to 0.81,p= 0.012). The same finding was observed in the validation cohort, with AUC increasing from 0.62 to 0.77 (p= 0.021).ConclusionsProliferative HCC exhibits low stiffness and high fluidity. Adding MRE properties (tumorcand tumorφ) can improve performance of conventional MRI for preoperative diagnosis of proliferative HCC.Critical relevance statementWe investigated the viscoelastic signatures of proliferative hepatocellular carcinoma (HCC) using three-dimensional (3D) magnetic resonance elastography (MRE), and find that adding MRE properties (tumorcand tumorφ) can improve performance of conventional MRI for preoperative diagnosis of proliferative HCC.Graphical AbstractSupplementary InformationThe online version contains supplementary material available at 10.1186/s13244-023-01427-4.