探讨声触诊组织成像定量（VTIQ）技术鉴别诊断乳腺良恶性肿瘤的价值。

选择2015年9至12月于福建医科大学附属漳州市医院就诊的100例乳腺肿瘤患者共115个肿瘤。其中75例患者经手术病理证实，25例患者经穿刺活检病理证实。所有患者先行乳腺二维超声检查，进行乳腺影像报告与数据系统（BI-RADS）分类。然后在VTIQ模式下测量肿瘤剪切波速度（SWV）最大值、最小值及平均值。采用t检验比较乳腺良恶性肿瘤SWV值。绘制VTIQ技术诊断乳腺良恶性肿瘤的受试者工作特征（ROC）曲线。

115个乳腺肿瘤中，恶性38个，良性77个。VTIQ技术测量的乳腺恶性肿瘤SWV最大值、最小值及平均值分别为（7.22±0.94）、（4.33±1.31）、（5.73±1.11）m/s，均高于乳腺良性肿瘤的（5.11±1.61）、（2.90±0.86）、（3.73±1.02）m/s，且差异均有统计学意义（t=-7.442、-7.047、-9.356，P均<0.001）。ROC曲线显示，SWV最大值、最小值及平均值诊断乳腺良恶性肿瘤曲线下面积（AUC）分别为0.87、0.82、0.90，SWV平均值诊断乳腺良恶性肿瘤的效能最佳。二维超声检查诊断乳腺良恶性肿瘤的敏感度、特异度、准确性、阳性预测值、阴性预测值分别为68.4%、80.5%、76.5%、0.63和0.84。ROC曲线显示，以SWV平均值4.34 m/s作为阈值，VTIQ技术诊断乳腺良恶性肿瘤的敏感度、特异度、准确性、阳性预测值和阴性预测值达89.5%、85.7%、87.0%、0.76和0.95，均优于二维超声检查。

采用VTIQ技术测量的SWV平均值鉴别诊断乳腺良恶性肿瘤具有良好的临床应用价值。

To evaluate the diagnostic value of virtual touch imaging quantification (VTIQ) technique in the differential diagnosis between benign and malignant breast lesions.

From September to December 2015, the imaging data of 115 breast lesions in 100 patients confirmed by pathology on conventional ultrasound (2DUS) and VTIQ were retrospectively analyzed. The breast nodules were examined by 2DUS firstly and then the lesions were classified by breast imaging reporting and data system (BI-RADS). The maximum, minimum and average of shear wave velocity (SWV) values were obtained from multiple SWV measurement under the VTIQ speed mode. According to the pathology results, receiver operating characteristic (ROC) curve were plotted to determine the most accurate SWV value and the cut-off value for differential diagnosis. And the diagnosis efficiency was compared between 2DUS and VTIQ.

There were 38 malignant nodules and 77 benign nodules in 115 breast nodules. BI-RADS grading≥4b level was set as the malignant nodules and grading≤ 4a level as the benign nodules. The SWVmax, SWVmin, and SWVmean on VTIQ of benign and malignant breast nodules were (5.11±1.61) m/s, (2.90±0.86) m/s, (3.73±1.02) m/s, and (7.22±0.94) m/s, (4.33±1.31) m/s, (5.73±1.11) m/s. There were significant differences between malignant and benign breast nodules in SWVmax, SWVmin, and SWVmean on VTIQ (t=-7.442, -7.047, -9.356, all P<0.001). Based on the area under curve of ROC, the SWVmean value in the nodule was the best value in comparison with other SWV values. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of diagnose malignant lesion conducted by 2DUS were 89.5%, 85.7%, 87.0%, 0.63 and 0.84, respectively. The cut-off value of VTIQ mean was 4.34 m/s. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for the diagnosis of malignant lesion conducted by VTIQ were 89.5%, 85.7%, 87.0%, 0.76 and 0.95, respectively. The diagnosis efficiency of VTIQ was better than 2DUS.

The study proved that the VTIQ SWVmean is the best parameter for differential diagnosis and VTIQ plays an important role in differential diagnosis of breast nodules.