Objective: To explore the differential diagnosis value of virtual touch tissue imaging quantification(VTIQ) combined with sonoway contrast-enhanced ultrasound for breast BI-RADS type 4 nodules. Methods: 90 female patients with breast nodules who were treated in outpatient and inpatient treatment in our hospital from June 2018 to December 2019 were selected as study subjects.VTIQ ultrasonic elastic imaging technology was used to obtain the maximum shear wave velocity(SWVmax), minimum shear wave velocity(SWVmin) and average shear wave velocity(SWVmean) parameters. Sonoway contrast-enhanced ultrasound was used to evaluate the echogenicity of lesions, morphology and vascular filling. The pathological results of surgical pathology or ultrasound-guided puncture biopsy were taken as the gold standard, the differential diagnostic value of VTIQ ultrasonic elastic imaging technology combined sonoway contrast-enhanced ultrasoun for breast BI-RADS type 4 nodules were analyzed. Results: Among the 90 patients(90 breast nodules), 62 cases underwent surgical pathological examination, and 28 cases underwent ultrasound-guided puncture biopsy, including48 cases of benign nodules and 42 cases of malignant nodules. The SWVmax, SWVmin and SWVmean of breast BI-RADS type 4 benign and malignant nodules were statistically different(P<0.05). With SWVmax ≥3.83 m/s as the cut-off point, the area under the curve(AUC), sensitivity, specificity of differentiating and diagnosing benign and malignant nodules of breast BI-RADS type 4 nodules were0.875, 83.33%, 91.67% respectively, which were all higher than SWVmin and SWVmean. There was no statistically significant difference among the accuracy of SWVmax, sonoway contrast-enhanced ultrasound and combined diagnosis(P>0.05). The AUC, sensitivity,specificity of SWVmax combined sonoway contrast-enhanced ultrasound in differentiating and diagnosing benign and malignant nodules of breast BI-RADS type 4 nodules were 0.914, 95.24%, 87.50% respectively, the diagnosis efficiency was best. Conclusion: Sonoway contrast-enhanced ultrasound and VTIQ ultrasonic elastic imaging technology are of certain value in the differential diagnosis of breast BI-RADS type 4 nodules. The diagnostic efficiency of SWVmax parameter of VTIQ ultrasonic elastic imaging technology is superior to SWVmin and SWVmean. VTIQ ultrasonic elastic imaging technology combined with sonoway contrast-enhanced ultrasound can improve the differential diagnosis efficiency of breast BI-RADS type 4 nodules. [ABSTRACT FROM AUTHOR]