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目的：探讨超声剪切波成像（SWE）与超声乳腺影像报告和数据系统（BI-RADS-US）对乳腺良恶性肿块的诊断价值。方法180例乳腺肿块患者术前1周行超声检查并按照 BI-RADS-US 标准分级，然后进行 SWE 并测定病灶弹性模量值。以术后病理结果为金标准，构建受试者工作特征曲线（ROC）获得良恶性病灶的临界弹性模量值并比较两种方法的诊断效率。结果乳腺良性肿块的最大、平均弹性模量值分别为（39．17±11．48）kPa、（21．56±9．68）kPa，均低于恶性肿块的（121．38±28．97）kPa、（62．92±18．49）kPa（t ＝23．668，P ＝0．000；t ＝18．194，P ＝0．000）。以43．79 kPa、65．15 kPa 为平均、最大弹性模量值临界值时，SWE诊断乳腺良恶性肿块的敏感度、特异度及准确率分别为92．59％、90．78％和94．84％；SWE 与 BI-RADS-US 的曲线下面积（AUC）分别为0．942、0．883（P ＝0．042）。结论SWE 量化参数能够提高超声诊断乳腺良恶性肿块的准确率，为临床治疗提供可靠依据。

Objective To evaluate the diagnostic value of shear wave elastography(SWE)and Breast Ima-ging Reporting and Data System -Ultrasonograpy(BI -RADS -US)in benign and malignant breast lesions.Methods 180 patients with pathological -confirmed benign and malignant breast lesions without any treatment were underwent ultrasonography scoring with BI -RADS and the quantitative elasticity parameters was measured by shear wave elastography 1week before operation.Pathological results were regarded as the gold standard,receiver operating characteristic curve(ROC)was used to determine cutoff values of quantitative parameters and diagnostic performance of two methods.Results Maximum elastic value(Emax)and mean elastic value(Emean)of benign breast lesions were (39.17 ±11.48)kPa and (21.56 ±9.68)kPa,which were significantly lower compared with the malignant breast lesions of (121.38 ±28.97)kPa and (62.92 ±18.49)kPa,respectively(t =23.668,P =0.000;t =18.194, P =0.000).Taking 43.79kPa and 65.15 kPa as the threshold of the Emean and Emax value,the sensitivity,specificity and accuracy of SWE were 92.59%,90.78% and 94.84%,respectively.The areas under the curve(AUC)of the SWE and BI -RADS -US were 0.942 and 0.883 (P =0.042).Conclusion SWE can improve the accuracy of ultrasonography in differentiation of benign from malignant breast lesions by quantitative elasticity parameters,which has important significance for clinical treatment.