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目的：评估超声弹性成像定性和半定量鉴别乳腺良恶性病变的诊断价值。方法获得150例女性乳腺病变的实时超声弹性成像图像，由67例恶性和101例良性病变组成。传统的超声按照乳腺影像数据报告系统标准进行诊断分类；超声弹性成像是基于定性和半定量参数进行分析。结果常规超声结合弹性成像诊断乳腺恶性病变的敏感度和特异度比单独常规超声的明显增高。两种方法诊断恶性肿瘤的准确率差异有统计学意义(﹤0.001)。弹性应变比和宽度比的半定量评估是鉴别乳腺良恶性病变有用的参数。宽度比值超过1.1和应变率比值超过5.6表明恶性病变的特异度分别为84%和76%。结论常规超声和弹性成像结合的技术能有效的检查出乳腺癌，并可减少对不确定的或可疑的良性病变不必要的活检。“,”Objective This study was to evaluate the diagnostic value of qualitative and semi-quantitative assessment of ultrasound elastography in dif erentiating between benign and malignant breast lesions.Methods Real-time elastographic images were composed for 67 malignant and 101 benign breast lesions in 150 women.Three experienced Ultrasound doctors analyzed B-mode ultrasound alone and B-mode ultrasound combined with elastography independently.Conventional ultrasound findings were classified according to the American Col ege of Radiology Breast Imaging Reporting and Data System classification (BI-RADS).Elastographic was based on qualitative and semi-quantitative parameters (i.e.,strain pat ern,width ratio,strain ratio).Results The sensitivity and specificity of combined elastography and conventional ultrasound were significantly higher than that of conventional ultrasound alone ( ﹤0.001).The semi-quantitative assessment with strain ratio and width ratio in elastography were the most useful parameters in dif erentiating between benign and malignant breast lesions.Cut-of point values for width ratio of more than 1.1 and strain ratio of more than 5.6 showed a high predictive value of malignancy with specificities of 84%and 76%,respectively.Conclusion This combined technique also had the best results in detecting cancer and could reduce the need of unnecessary biopsy for benign lesions with indeterminate or equivocal features.