探讨自动乳腺全容积成像（ABVS）技术联合声触诊组织成像量化（VTIQ）技术在鉴别乳腺良恶性肿块中的价值。

选取2016年3月至2017年1月因乳腺疾病到杭州市第一人民医院行ABVS检查的患者507例，共675个肿块，采用ABVS与VTIQ技术对乳腺肿块进行检测，获得冠状面图像及肿块内剪切波速度（SWV）最大值、最小值及平均值（单位为m/s）；对照手术病理或穿刺组织学结果，判断冠状面有无"汇聚征"，比较良恶性肿块的SWV值，根据受试者工作特征（ROC）曲线确定准确性最高的一组SWV值，获得其诊断最佳截断值；评估冠状面"汇聚征"及VTIQ技术单独及联合使用后对诊断乳腺肿块良恶性的效能，采用独立样本t检验比较乳腺良恶性病变组间差异。

504个肿块病理组织学证实为良性，171个为恶性，冠状面"汇聚征"在乳腺恶性病灶内的出现率高于良性病灶，差异有统计学意义（χ²=279.89，P<0.001）；恶性病灶组的SWV值最大值、最小值、平均值均高于乳腺良性病灶组[（6.79±1.71）m/s vs（3.41±1.51）m/s、（5.03±1.24）m/s vs（2.46±0.87）m/s、（5.74±1.36）m/s vs（2.65±1.23）m/s]，差异均有统计学意义（t=32.43、33.85、26.77，P均<0.001），恶性病灶组SWV（最大值、最小值和平均值）ROC曲线下面积分别为0.922、0.934、0.937，其中，以肿块内SWV平均值的诊断效能为最佳，其截断值为4.045 m/s。ABVS冠状面"汇聚征"、VTIQ（SWV平均值）及两者联合诊断乳腺肿块良恶性的敏感度分别为39.65%、94.39%、95.78%；特异度97.50%、94.39%、95.53%；准确性82.84%、93.51%、94.25%；阳性预测值84.33%、82.64%、85.12%；阴性预测值82.64%、96.83%、97.68%。

ABVS冠状面"汇聚征"及VTIQ技术均有较高的诊断价值，两种方法联合使用能提高乳腺肿块良恶性鉴别的敏感度及准确性。

To investigate the value of the automated breast volume scanning (ABVS) combined with virtual touch tissue imaging quantification (VTIQ) in the differential diagnosis of benign and malignant breast lesion.

Five hundred and seven patients with a total of 675 breast nodules were detected using ABVS and VTIQ technique. Of them, coronal plane imaging, SWVmax, SWVmin, and SWVmean (in m/s) for each nodule was acquired three days before operation or core needle biopsy. According to pathological results, the receiver operating characteristic (ROC) curve analysis was performed to evaluate the utility of the ABVS alone (retraction phenomenon on coronal plane), VTIQ alone and their combination in the diagnosis of breast lesions.

Among all nodules, 504 lesions were benign, and 171 were malignant. The rate of retraction phenomenon on coronal plane in malignant lesions was significantly higher than that in benign lesions (χ²=279.89, P<0.001). The value of SWVmax, SWVmin, SWVmean (6.79±1.71 m/s, 5.03±1.24 m/s, 5.74±1.36 m/s) in malignant nodules were higher than that of benign nodules [(3.41±1.51) m/s, (2.46±0.87) m/s, (2.65±1.23) m/s], the differences were statistically significant (t=32.43, 33.85, 26.77, all P<0.001). The AUC of malignant nodules for SWV (maximum, minimum, and average) were 0.922, 0.934 and 0.937, respectively. With cut-off value of 4.045 m/s, SWVmean showed the best diagnostic performance. The sensitivity, specificity and accuracy of the retraction phenomenon on coronal plane, SWVmean and their combination in diagnosing malignant breast lesion were (39.65%, 94.39%, 95.78%), (97.50%, 94.39%, 95.53%) and (82.84%, 93.51%, 94.25%), respectively. And the SWVmean showed significant higher sensitivity than that of retraction phenomenon. The diagnostic capacity significantly improved when the two approaches were combined.

Both the retraction phenomenon on coronal plane and VTIQ had high diagnostic value, combining the two methods can improve the differential diagnosis ability for breast lesions.