instruction
stringclasses 1
value | input
stringlengths 56
2.58k
| output
stringlengths 11
1.71k
|
|---|---|---|
Generate impression based on findings. | Patient with newly elevated LFTs and lactic acidosis, recent hyperthermia, assess for parenchymal disease, also do Doppler to look for thrombosis LIVER: Liver measures 12.3 cm with mild coarse echotexture without any focal lesions. No intrahepatic biliary ductal dilatation.Main portal vein demonstrates normal flow directionality and patency. The portal vein peak velocity measures 24.11 cm/s.BILIARY TRACT: Gallbladder appears unremarkable. No evidence of gallstones.PANCREAS: Head and body of pancreas visualized, tail of pancreas is not visualized due to overlying bowel gas. Pancreatic duct is mildly prominent measuring up to 3 mm.SPLEEN: No significant abnormalities noted. Spleen measures 5.2 cm, incompletely imaged spleen.RIGHT KIDNEY: Right kidney measures 8.9 cm and left kidney measures 8.4 cm. Mild increased echogenicity of both kidneys consistent with chronic medical renal disease. No hydronephrosisOTHER: Bilateral pleural effusions noted. | Bilateral pleural effusions.Main portal vein is patent.Mild coarse echotexture of the liver consistent with chronic liver disease/liver dysfunction.Incompletely imaged spleen due to patient positioning and overlying bowel gas. |
Generate impression based on findings. | Type 2 diabetes without complications, history of pain and fullness in the left abdomen. LIVER: Liver measures 12.7 cm, normal echotexture. Limited evaluation. No focal lesions. Gallbladder is visualized without gallbladder wall thickness.Main portal vein is patent with normal flow directionality and patency.BILIARY TRACT: No intrahepatic biliary ductal dilatation. Common hepatic duct measures up to 4 mm within normal limits.PANCREAS: Not visualized due to limited evaluation, position and overlying bowel gas.SPLEEN: Spleen could not be visualized due to patient positioning.RIGHT KIDNEY: Right kidney measures 9 cm and left kidney measures 10.1 cm. No hydronephrosis. Mild increased echogenicity noted consistent with chronic medical renal disease. OTHER: No ascites or significant abnormality in the right lower quadrant. | Limited evaluation due to patient positioning.Incomplete visualization of the spleen due to patient positioning.Mild increased echogenicity of the kidneys consistent with chronic medical renal disease.Normal echotexture of the liver. Gallbladder appears unremarkable. Main portal vein is patent. |
Generate impression based on findings. | Female 44 years old with right upper quadrant pain. LIVER: The liver has a smooth contour and is normal in echogenicity. It measures 13.2 cm in length. There is no focal liver lesion or ascites. The portal vein is patent with a velocity of 20.0 cm/s.BILIARY TRACT: The gallbladder has an anechoic lumen and a wall thickness of 2 mm. There is no pericholecystic fluid. Common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The head and proximal body of the pancreas are unremarkable. The distal body and tail are obscured by overlying bowel gas.SPLEEN: The spleen measures 8.3 cm in length. RIGHT KIDNEY: The right kidney measures 9.3 cm and has normal parenchymal echogenicity. There is no shadowing stone, suspicious mass or hydronephrosis. OTHER: The left kidney measures 9.0 cm in length with normal parenchymal echogenicity. There is no shadowing stone, suspicious mass or hydronephrosis | Unremarkable right upper quadrant ultrasound. |
Generate impression based on findings. | Newly elevated bilirubin and INR, evaluate for choledocholithiasis LIVER: Diffuse coarse echotexture of the liver is noted, which approximately measures 23.5 cm. Enlarged liver. No evidence of intrahepatic biliary ductal dilatation.BILIARY TRACT: Gallbladder wall thickened. Cannot assess Murphy's sign as patient is intubated. Common hepatic duct appears mildly dilated measuring up to 1 cm without definite evidence evidence of stones. No evidence of gallstones.OTHER: Mild ascites. | Coarse echotexture of the liver, enlarged liver, suspicious for parenchymal dysfunction.Thickened wall of the gallbladder secondary to adjacent ascites, CBD is mildly dilated without definite evidence of stones. If clinically warranted, MRCP can be performed for further evaluation. |
Generate impression based on findings. | Subclinical hypothyroidism RIGHT LOBE MEASUREMENTS: 1.2 x 2.7 x 2 cm. Right thyroid volume is 3 mLLEFT LOBE MEASUREMENTS: No significant abnormality noted.ISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: Multiple solid thyroid nodules identified within the mid and inferior pole, largest thyroid nodule measures 6.9 x 1.3 x 0.9 cm with multiple hyperechoic foci most likely colloid nodules.LEFT LOBE: Status post thyroidectomyISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple right thyroid nodules most likely colloid in nature. Follow-up ultrasound is recommended in 6 months to confirm stability. |
Generate impression based on findings. | Heart transplant status, rule out infection to bilateral groins In the right groin area there is a small linear hypoechoic band arising anteriorly from the femoral vessels which could represent a post procedural tract/fluid collection. No suspicious abnormality noted in the left groin area. | As aboveCLINICAL INFORMATION:Retained prior partial impella graft right subclavian, leukocytosisCOMPARISON: NoneTECHNIQUE: Grayscale and Doppler ultrasound of bilateral chest wall performedFINDINGS:Small fluid collection identified in the left upper chest wall measures 2.5 x 1.8 x 0.5 cm. No evidence of any fluid collection or abscess along the right upper chest wall. |
Generate impression based on findings. | Male 31 years old Reason: R posterior cervical lymph node enlargement, ultrasound to quantify size and shape History: see above There are a few benign-appearing cervical lymph nodes. Largest measures 1.6 x 0.4 cm. | Benign-appearing cervical lymph nodes at the site where the patient feels the lump. |
Generate impression based on findings. | Female 22 years old Reason: history of hypothyroidism, possible nodule on the right, please evaluate History: none RIGHT LOBE MEASUREMENTS: 5.1 x 1.4 x 1.6 cmLEFT LOBE MEASUREMENTS: 4.7 x 1.7 x 1.3 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: Coarse echotexture of the thyroid lobe without any focal nodules.LEFT LOBE: Coarse echotexture of the left lobe of the thyroid without any focal nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Coarse echotexture of the thyroid consistent with thyroiditis. |
Generate impression based on findings. | Female 55 years old s/p renal transplant 11/4/2016 now with fevers, leukocytosis, and elevated creatinine. RENAL TRANSPLANT: LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: Medial to the transplant kidney and lateral to the urinary bladder is a 12.4 x 10.8 x 7.2 cm heterogeneous collection without color Doppler flow. A small amount of simple appearing fluid is present lateral to the transplant kidney.KIDNEY: The transplant kidney measures 12.3 centimeters in length. The parenchyma is echogenic with increased cortical medullary differentiation. There is no hydronephrosis.COLLECTING SYSTEM/URETER: No hydronephrosis.URINARY BLADDER: The bladder is decompressed.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels Iliac artery peak systolic velocity 119 cm/s; resistive index 0.83Peak systolic velocity at the anastomosis is 104 cm/s; resistive index 0.93Proximal right renal artery peak systolic velocity 131 cm/s; no forward flow during diastole; resistive index 0.94Mid right renal artery peak systolic velocity 114 cm/s; reversal of diastolic flow; resistive index 1.13Distal right renal artery peak systolic velocity 111 cm/s; reversal of diastolic flow; resistive index 1.09Right renal artery at the hilum peak systolic velocity 117 cm/s; reversal of diastolic flow; resistive index 1.08The arcuate arteries have peak systolic velocities between 30.6 and 99.6 cm/s and resistive indices of 1.0-1.2. Diastolic flow is reversed throughout.The renal vein and renal vein anastomosis appear patent. In retrospect, there was a nonocclusive thrombus in the renal vein on the prior CT of the abdomen and pelvis.OTHER: No significant abnormality noted | 1.Echogenic renal transplant parenchyma compatible with acute rejection or ATN, see discussion below.2.Elevated resistive indices throughout the transplant kidney vessels and reversal of diastolic flow from the proximal right renal artery and more distally. The renal vein appears patent however, in retrospect, a small nonocclusive thrombus was present within the renal vein on the prior CT. The findings may be secondary to nonocclusive renal vein thrombus or mass effect from the perinephric collection.3.12.4 x 10.8 x 7.2 cm heterogeneous collection medial to the transplant kidney corresponds to the previously described hematoma, which may now be infected. |
Generate impression based on findings. | Female 32 years old Reason: r/o goiter. r/o nodules. r/o adenopathy History: Goiter. Had nodes on outside study RIGHT LOBE MEASUREMENTS: 4.7 x 1.6 x 1.5 cmLEFT LOBE MEASUREMENTS: 4.3 x 1.3 x 1.5 cmISTHMUS MEASUREMENTS: 6 mmRIGHT LOBE: Coarse echotexture of the thyroid suggestive of thyroiditis.LEFT LOBE: Coarse echotexture of the thyroid suggestive of thyroiditis.ISTHMUS: Thyroiditis.PARATHYROID GLANDS: There are multiple, well-defined, hypoechoic, bilateral lobar and round lesions inferior to the inferior aspect of the right lobe of the thyroid, suspicious for parathyroid adenomas/hyperplasia. Largest one is bilateral lobar and measures 1.4 x 0.6 cm.Similarly there are also well-defined, hypoechoic lesions inferior to the inferior aspect of the left thyroid lobe measuring 1.3 x 0.5 cm. These are also suspicious for parathyroid adenoma/hyperplasia.LYMPH NODES: Benign-appearing lymph nodes in the supraclavicular region on the left and in the neck bilaterally.OTHER: No significant abnormality noted. | Coarse echotexture of the thyroid suggestive of thyroiditis.Well-defined, round hypoechoic lesions inferior to the inferior aspect of the thyroid lobes. Etiology of these is uncertain but given the location and appearance-suspicious for parathyroid adenoma/hyperplasia. Clinical correlation and if necessary further evaluation with nuclear medicine scan is recommended. |
Generate impression based on findings. | Female 73 years old Reason: soft tissue superior aspect of the left kidney 1.4cm, R/o neoplasm History: renal mass RIGHT KIDNEY: Right kidney measures 8.7 cm. No focal lesions or hydronephrosis.LEFT KIDNEY: Left kidney measures 9 cm. No focal lesions or hydronephrosis.OTHER: No significant abnormalities noted.BLADDER: Unremarkable | Unremarkable ultrasound of the kidneys. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. Benign morphology mass in the right lower inner breast is compatible with the previously noted biopsy proven fibroadenoma. A few scattered subcentimeter cysts are present as well. There is no suspicious solid or cystic mass identified. Exam was double read by 2 attending breast radiologists. | No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Reason: pt with gastric submucosal nodule, biopsied History: LUQ abdominal pain, nausea LIVER: The liver measures 20.4 cm in length. Increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.18 m/s.BILIARY TRACT: There are several nonmobile, non-shadowing small, round structures along the gallbladder wall compatible with gallbladder polyps. The largest measures up to 6 mm. No intrahepatic or extrahepatic biliary ductal dilatation is seen.PANCREAS: The pancreas is largely obscured.SPLEEN: No significant abnormalities noted. The spleen measures 11.0 cm in length. RIGHT KIDNEY: Kidney measures 10.3 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 2.1 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massOTHER: No significant abnormalities noted. | 1.Mild hepatomegaly. Increased hepatic echogenicity suggestive of fatty infiltration/parenchymal dysfunction.2.Several gallbladder polyps measuring up to 6 mm. |
Generate impression based on findings. | Reason: LVAD work up, rule out cirrhosis or kidney disease LIVER: The liver measures 16.0 cm in length. Increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.33 m/s.BILIARY TRACT: Sludge is present within the gallbladder without associated gallbladder wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 12.7 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.3 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus or mass. Simple cyst. ABDOMINAL AORTA: The abdominal aorta measures 3.1 x 3.1 proximally. The mid and distal aorta are not well visualized.INFERIOR VENA CAVA: Not visualized.OTHER: Foley catheter. Moderate ascites. Right pleural effusion. | 1.Echogenic liver suggestive of fatty infiltration/parenchymal dysfunction without morphologic evidence of cirrhosis. 2.Ascites and right pleural effusion.3.Echogenic kidneys compatible with medical renal disease. |
Generate impression based on findings. | Reason: r/o pancreatitis, cholecystitis History: elevated lipase Examination limited due to constraints positioning patient as well as bandages.LIVER: The liver measures 20.6 cm in length. The liver is heterogeneous in echotexture which limits sensitivity for focal lesions. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.19 m/s.BILIARY TRACT: The gallbladder is contracted and contains stones and/or sludge. There is gallbladder wall thickening measuring up to 6 mm. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5.6 mm in diameter.PANCREAS: There is a linear echogenic structure in the pancreatic neck and body compatible with a stent.SPLEEN: No significant abnormalities noted. The spleen measures 11.0 cm in length. RIGHT KIDNEY: Kidney measures 10.8 cm in length. Normal echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 8.9 cm in length. Normal echotexture. No hydronephrosis.OTHER: Ascites. | 1.Limited exam.2.Heterogeneous appearance of the liver which is nonspecific. Underlying lesions cannot be excluded, and dedicated contrast-enhanced cross-sectional imaging is recommended for further evaluation when the patient is clinically able.3.Contracted gallbladder with cholelithiasis and gallbladder wall thickening. Chronic cholecystitis is not excluded and could be further evaluated with HIDA scan if clinically indicated. 4.Ascites. |
Generate impression based on findings. | Reason: Evaluate for cirrhosis History: autoimmune hepatitis Examination somewhat limited.LIVER: The liver measures 16.1 cm in length and is nodular in contour. The liver parenchymal echotexture is coarse. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.18 m/s.BILIARY TRACT: The gallbladder is contracted. No gallbladder wall thickening. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4.8 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.0 cm in length. RIGHT KIDNEY: Kidney measures 9.7 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 10.5 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massOTHER: Ascites. | Cirrhotic liver morphology without focal hepatic lesions identified. Ascites. |
Generate impression based on findings. | Reason: of liver hbv, screen for hepatocellular carcinoma LIVER: The liver measures 15.3 cm in length. The liver parenchymal echotexture is coarse. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.23 m/s.BILIARY TRACT: Several shadowing gallstones without associated gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: Oval hypoechoic structure adjacent to the pancreas measuring up to 1.2 cm most likely represents peripancreatic lymph node.SPLEEN: Not well visualized.RIGHT KIDNEY: Kidney measures 10.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 11.6 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Course hepatic echotexture compatible with chronic liver disease without focal mass. 2.Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Reason: s/p Renal transplant History: elevated Cr Ultrasound guidance was provided for a transplant kidney biopsy by the nephrology service. Two passes were performed. | Ultrasound guidance provided for transplant kidney biopsy. |
Generate impression based on findings. | Reason: R facial lump and cervical adenopathy History: painless swelling of discrete subcutaneous nodule X 2 months Within the right parotid gland, there is a well-circumscribed mass measuring 1.6 x 1.5 x 2.1 cm. The mass is predominantly hypoechoic, contains internal complexity, and demonstrates peripheral vascularity. | Nonspecific mass within the right parotid gland differential considerations for which include both benign and malignant etiologies. The mass would be amenable to fine-needle aspiration. |
Generate impression based on findings. | Reason: elevated liver enzymes History: rule out steatohepatitis -check liver and spleen and rule out cirrhosis or hepatitis LIVER: The liver measures 16.7 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.15 m/s.BILIARY TRACT: Cholelithiasis without associated gallbladder wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.5 cm in length. RIGHT KIDNEY: Kidney measures 9.5 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.4 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.Mildly increased hepatic echogenicity suggestive of fatty infiltration/parenchymal dysfunction.2.Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Reason: evidence of biliary dilation, stones; eval for liver echotexture History: rising bilirubin, possible cirrhosis LIVER: The liver measures 15.7 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 11.1 cm in length. RIGHT KIDNEY: Kidney measures 11.9 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 11.4 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus or massOTHER: Right pleural effusion. Ascites. | 1.No evidence of acute cholecystitis or biliary ductal dilatation.2.Increased hepatic echogenicity suggestive of chronic hepatic disease. 3.Increased renal echogenicity suggestive of medical renal disease.4.Right pleural effusion. Ascites. |
Generate impression based on findings. | Reason: rule out gallstones History: pancreatitis LIVER: The liver measures 17.1 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.24 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: Not well visualized.SPLEEN: No significant abnormalities noted. The spleen measures 10 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massLEFT KIDNEY: Kidney measures 11.4 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or massOTHER: No significant abnormalities noted. | No evidence of acute cholecystitis or biliary ductal dilatation. Pancreas not well visualized. |
Generate impression based on findings. | Reason: Right upper quadrant pain, please evaluate for cholecystitis or cholelithiasis. LIVER: The liver measures 15.9 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.26 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 8.8 cm in length. RIGHT KIDNEY: Kidney measures 11.7 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 13.6 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.No evidence of acute cholecystitis or biliary ductal dilatation.2.Mildly echogenic kidneys raising the possibility of medical renal disease. |
Generate impression based on findings. | Reason: RUQ History: r/o cholecystitis LIVER: The liver measures 14.8 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.23 m/s.BILIARY TRACT: Status post cholecystectomy. The common bile duct measures up to 9 mm in diameter.PANCREAS: Not well visualized.SPLEEN: No significant abnormalities noted. The spleen measures 8.6 cm in length. KIDNEY: Native kidneys not visualized. Transplant kidney in the left iliac fossa measuring 12.9 cm in length without hydronephrosis.OTHER: No significant abnormalities noted. | Status post cholecystectomy without evidence of acute cholecystitis. |
Generate impression based on findings. | Reason: Rule out abscess formation at the site of prior abdominal chest tube sites. Drainage and purulence at the sites. Sonographic images of the anterior superficial abdominal wall demonstrate tracts related to prior drains/tubes without associated discrete, drainable fluid collections identified. | No drainable fluid collections identified. |
Generate impression based on findings. | Rule out fatty liver LIVER: Liver measures 18.3 cm with moderate increased echogenicity consistent with hepatic steatosis. No focal lesions noted. No intrahepatic biliary ductal dilatation.BILIARY TRACT: Gallbladder is well-distended without any gallstones. Gallbladder wall thickness is within normal limits. Common bile duct measures up to 4 mm, within normal limits. No evidence of periprostatic fluid.PANCREAS: Head and body of pancreas appears mildly echogenic probably fatty involution. Tail of pancreas not visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 12 cmRIGHT KIDNEY: Right kidney measures 12.4 and left kidney measures 12.2 cm. No hydronephrosis. Normal echotexture. OTHER: No ascites | Increased echogenicity of the liver suggestive of hepatic steatosis. No focal lesions or ascites. |
Generate impression based on findings. | Assess for abnormalities including changes in nodules/progressive disease RIGHT LOBE MEASUREMENTS: 5.8 x 3.1 x 2.4 cmLEFT LOBE MEASUREMENTS: 5.3 x 2.1 x 2 cmISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: Multiple mixed cystic and solid nodules identified throughout the thyroid gland, largest nodule in the lower pole measures 2.8 x 2.4 x 2 cm, previously measured 3.4 x 2.8 x 3 cm, mostly unchanged in size and morphology.Inferior to the right thyroid gland that appears to be a hypoechoic solid nodule that measures 3.2 x 2.3 x 2.6 cm, previously measured 2.6 x 2 x 2.9 cm, mostly unchanged from prior study in morphology and size, this could represent a parathyroid nodule.LEFT LOBE: Multiple mixed cystic and solid nodules identified throughout the thyroid gland, representative upper pole nodule measures 1.3 x 1 x 1.3 cm, previously measured 3.8 x 0.5 x 0.6 cm, mostly unchanged.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: As aboveLYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multiple mixed cystic and solid nodules in both thyroid lobes are mostly unchanged. Along the inferior aspect of the right thyroid gland there appears to be a exophytic thyroid nodule versus parathyroid nodule which is unchanged in size and morphology from prior exam. |
Generate impression based on findings. | Left leg wound revealed the left many years Mild left leg skin thickening with edema noted. No underlying abscess or fluid collection noted. | Left leg focal cellulitis adjacent to the wound. No underlying abscess or fluid collection. |
Generate impression based on findings. | 43-year-old female with thyromegaly RIGHT LOBE MEASUREMENTS: 4.2 x 1.7 x 1.9 cm.LEFT LOBE MEASUREMENTS: 4.8 x 1.6 x 1.9 cm.ISTHMUS MEASUREMENTS: 5 mmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: Hypoechoic, cystic nodule in the inferior pole of the left thyroid lobe measures 5 x 3 x 4 mm, previously 4 x 4 x 2 mm. Hypoechoic nodule in the posterior mid/inferior pole of the left thyroid lobe measures 8 x 4 x 7 mm, previously 6 x 6 x 3 mm. There is a left upper lobe hypoechoic thyroid nodule measuring 4 x 2 x 5 mm, not present on the study.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: Incidentally noted is mildly echogenic material in the left internal jugular vein with turbulent flow. | 1.No significant change in reference left thyroid lobe nodules. New left upper lobe thyroid nodule.2.Incidentally noted is mild echogenic material in the left internal jugular vein with turbulent flow that may represent nonocclusive thrombus. Formal evaluation is recommended.The findings were discussed with Dr. Nicole Leong at 1012 on 11/30/2016. |
Generate impression based on findings. | Mass on the back with back pain Ultrasound shows an ill-defined hypoechoic area that measures 1.9 x 2.1 x 1.2 cm in the subcutaneous tissue involving the dermis without peripheral blood flow which could represent an infected sebaceous cyst or epidermal inclusion cyst. | Superficial hypoechoic subcutaneous lesion involving the dermis which could represent an infected sebaceous cyst or epidermal inclusion cyst. Clinical correlation is recommended. |
Generate impression based on findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 4.4 x 1.5 x 1.4 cmLEFT LOBE MEASUREMENTS: 4 x 1.5 x 1.4 cmISTHMUS MEASUREMENTS: 3 mmRIGHT LOBE: Multiple subcentimeter nodules identified in the right lobe, mostly partly cystic partly solid in nature especially in the midpole that measures 0.8 x 0.6 x 0.7 cm.LEFT LOBE: A large partly cystic partly solid nodule identified in the midpole that measures 2 x 1.2 x 1.3 cm with minimal peripheral blood flow.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal morphology level 3 right neck lymph nodes and level 2 left neck lymph nodes noted.OTHER: No significant abnormality noted. | Dominant left thyroid partly cystic partly solid nodule amenable to FNA. |
Generate impression based on findings. | Evaluate for right upper quadrant obstructive liver disease, new hyperbilirubinemia with coagulopathy LIVER: Diffuse coarse echotexture of the liver remains unchanged, mildly enlarged measuring 20 cm. Perihepatic fluid noted. No intrahepatic biliary ductal dilatation. No focal lesion.Main portal vein is patent with normal flow directionality.BILIARY TRACT: Gallbladder wall appears mildly thickened probably related to adjacent ascites. Sonographic Murphy sign cannot be assessed. No evidence of gallstones.Common bile duct measures up to 4 mm without any stones within it.PANCREAS: Not well visualized due to overlying bowel gas.OTHER: Mild ascites, minimally increased from prior examination and mild right pleural effusion. | Coarse echotexture of the liver, enlarged liver, suspicious for parenchymal dysfunction.Thickened wall of the gallbladder secondary to adjacent ascites which appears minimally increased.Mild right pleural effusion.CBD measurement within normal limits without evidence of any stones. |
Generate impression based on findings. | Recurrent hoarseness and difficulty swallowing for 6 months, nontoxic goiter RIGHT LOBE MEASUREMENTS: 4.9 x 1.8 x 1.9 cm, normal echotexture and sizeLEFT LOBE MEASUREMENTS: 4.9 x 2.1 x 2.2 cm, normal echotexture and sizeISTHMUS MEASUREMENTS: 4 mmRIGHT LOBE: Subcentimeter small mostly cystic nodule in the midpole of the right lobe measures 0.4 x 0.2 x 0.4 cm.LEFT LOBE: A large solid hypoechoic nodule with adjacent halo in the left mid pole measures 1.7 x 1.2 x 1.7 cm with minimal peripheral blood flow.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: left lateral level 2 neck lymph node measuring 0.7 x 0.8 cm with effaced hilum is noted.OTHER: No significant abnormality noted. | Dominant solid hypoechoic nodule with adjacent halo in the left thyroid gland is amenable to FNA.Subcentimeter left lateral level 2 neck lymph node with effaced hilum is indeterminate. |
Generate impression based on findings. | Low TSH, thyroid enlargement also cervical RIGHT LOBE MEASUREMENTS: 7.3 x 3.3 x 2.7 cm. Heterogenous echotexture, increased in size with increased vascularity.LEFT LOBE MEASUREMENTS: 6.6 x 2.9 x 2.3 cm, heterogenous echotexture, increased in size with increased vascularity.ISTHMUS MEASUREMENTS: 1 cmRIGHT LOBE: Large solid slightly hyperechoic mass with a hypoechoic halo identified in the inferior pole that measures 3.4 x 2.3 x 3.2 cm and needs further evaluation with fine-needle aspiration. LEFT LOBE: Heterogenous echotexture without any definite focal lesion.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Multiple enlarged reactive lymph nodes along the left level 5 chains, largest measuring 1.8 x 0.4 x 0.9 cm.OTHER: No significant abnormality noted. | Heterogenous echotexture of the thyroid gland suggestive of background thyroiditis.Dominant solid mass in the right lobe amenable to FNA.Level 5 left neck lymph nodes prominent, mostly reactive. |
Generate impression based on findings. | New right upper quadrant pain, evaluate for cholecystitis LIVER: Liver measures 17.1 cm with normal echotexture. No focal lesions noted. No intrahepatic biliary ductal dilatation. Portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: Gallbladder is distended with multiple gallstones within it. Gallbladder wall appears thickened, measures up to 8 mm. Minimal pericholecystic fluid noted. Sonographic Murphy sign is negative as per the technologist. Common bile duct measures up to 5 mm within normal limits. No stones or debris noted within the common bowel duct.PANCREAS: Normal echotexture of the pancreas without any focal lesions. Peripancreatic enlarged lymph node most likely reactive measures 1.6 x 1.2 cm.SPLEEN: No significant abnormalities noted. Spleen measures 10.2 cm.RIGHT KIDNEY: Right kidney measures 12.4 cm left kidney measures 11.4 cm. No hydronephrosis, normal architecture. OTHER: No significant abnormalities noted. | Distended gallbladder with multiple gallstones with gall bladder wall thickening and minimal pericholecystic fluid suspicious for acute cholecystitis. |
Generate impression based on findings. | Right upper quadrant pain, concern for cholecystitis versus appendicitis also with AKI, rule out hydronephrosis LIVER:Liver measures 12.9 cm demonstrates increased parenchymal echogenicity. Focal hypoechoic area adjacent to the gallbladder fossa is consistent with focal fatty sparing. Main portal vein demonstrates normal flow directionality and patency. No focal suspicious lesions noted. No intrahepatic biliary ductal dilatation.Minimal amount of ascites noted.GALLBLADDER, BILIARY TRACT: Gallbladder is well-distended with normal gallbladder wall thickness. No gallstones noted. Common bile duct measures within normal limits. No evidence of peri- cholecystic fluid.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormality noted. Spleen measures 8.2 cmKIDNEYS: Right kidney measures 10.4 cm and left kidney measures 11.4 cm. No hydronephrosis. Normal echotexture. Simple cyst in the mid to lower pole of the left kidney appears unchanged from prior examination. ABDOMINAL AORTA: Proximal abdominal aorta measures 2.3 x 2.3 cm. Mid aorta measures 2.3 x 11.9 cm and the distal abdominal aorta measures 2.5 x 2.4 cm, within normal limits. No evidence of aneurysmal dilatation.INFERIOR VENA CAVA: PatentOTHER: Partially distended bladder within normal limits. | Findings consistent with hepatic steatosis.Simple left renal cyst unchanged.No evidence of gallstones.Normal echotexture of the kidneys without hydronephrosis.Mild ascites. |
Generate impression based on findings. | 84-year-old female with left neck mass Redemonstrated is a vascular tumor deep and medial to the left internal jugular vein inserting mass effect and measuring 3.8 x 2.8 x 4.3 cm. The tumor is isoechoic to muscle and mildly heterogeneous in echogenicity. No significant lymphadenopathy is present. | Left neck mass compatible with paraganglioma as described above. |
Generate impression based on findings. | History of cirrhosis LIVER: 15.1 cm with diffuse coarse echotexture, cirrhotic morphology. No focal lesion noted. No intrahepatic biliary ductal dilatation. Portal vein demonstrates normal flow directionality and patency.BILIARY TRACT: Gallbladder is well-distended without any gallbladder wall thickening. No evidence of gallstonesPANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. Mildly increased size of the spleen measures 13.1 cm.RIGHT KIDNEY: Right kidney measures 13.1 cm and left kidney measures 14.7 cm. No hydronephrosis. Normal echotexture. OTHER: No ascites | Cirrhotic morphology of the liver without suspicious lesion.Mild splenomegaly. |
Generate impression based on findings. | Transaminitis and setting of workup for heart transplant LIVER:Liver measures 16.3 cm with mild coarse echotexture. No focal lesions noted.Portal vein demonstrates normal flow directionality and patency.GALLBLADDER, BILIARY TRACT: Wasn't distended gallbladder without any gallstones or pericholecystic fluid or gallbladder wall thickening.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted. Spleen measures 12.5 cm.KIDNEYS: Right kidney measures 10.7 cm and left measures 11.3 cm. No hydronephrosis or focal lesion within the kidneys. Normal echotexture of the kidneys noted. ABDOMINAL AORTA: Balloon pump noted in the proximal and mid aorta. Mid aorta measures 1.9 x 1.8 cm. Distal aorta measures 2 x 2 cm. No evidence of aneurysmal dilatation or atherosclerotic plaques.INFERIOR VENA CAVA: PatentOTHER: Partially distended bladder. | Mild coarse echotexture of the liver probably related to parenchymal dysfunction. |
Generate impression based on findings. | Volume overload, rule out cirrhosis or evidence of HCC, elevated alkaline phosphatase LIVER: Liver measures 16.9 cm, diffuse coarse heterogenous echotexture. No definite focal lesion noted. Portal vein is patent with normal flow directionality.Calcified granuloma noted in the right lobe of liver. Mild perihepatic fluid noted.BILIARY TRACT: Gallbladder is well-distended without any gallstones. No evidence of gallbladder wall thickening. Pericholecystic fluid is noted.Sonographic Murphy sign is negative.CBD measures 3 mm within normal limits.PANCREAS: Pancreas as visualized appears unremarkable. Tail of pancreas is not visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 11.1 cm.RIGHT KIDNEY: Right kidney measures 11.4 cm left kidney measures 10.7 cm. Normal echotexture of the kidneys. No hydronephrosis or focal lesionsOTHER: No ascites | Diffuse coarse echotexture of the liver consistent with chronic liver disease.Mild ascites. |
Generate impression based on findings. | Nontoxic multinodular goiter, rule out growth of nodules, adenopathy RIGHT LOBE MEASUREMENTS: 5.1 x 1.8 x 1.9 cm, mostly stableLEFT LOBE MEASUREMENTS: 7.5 x 3 x 2.7 cm, minimal increase in sizeISTHMUS MEASUREMENTS: 8 mmRIGHT LOBE: Multiple nodules identified mostly solid in appearance mostly unchanged from prior examination.Superior pole nodule: 2.1 x 1 x 1.8 cm, previously 1.8 x 1.3 x 1 cm.Midpole nodule: 1.1 x 0.8 x 0.6 cm, previously measured 1.1 x 0.9 x 0.6 cm.Lower pole nodule: Not well seen on today's imaging, previously measured 0.7 x 0.7 x 0.5 cm. No new suspicious nodules identified.LEFT LOBE: Multiple heterogenous nodules identified, mostly unchanged from prior examSuperior pole nodule: 1.5 x 0.9 x 1.4 cm, previously measured 1.2 x 0.7 x 0.7 cm. Mid pole nodule: 1.9 x 1.3 x 1.8 cm, previously measured 1.9 x 2 x 2.1 cm mostly unchanged.Inferior pole nodule: 3.8 x 3.1 x 2.8 cm, previously measured 3.6 x 2.5 x 2.9 cm, unchanged.No new suspicious nodules identified.ISTHMUS: Heterogenous thyroid nodule involving the isthmus measures 2 x 1.3 x 1.4 cm, previously measured 1.4 x 1.7 x 1.3 cm, mostly unchanged.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal morphology lymph nodes are notedOTHER: No significant abnormality noted. | Multinodular goiter mostly stable from prior examinations. |
Generate impression based on findings. | Right upper quadrant ultrasound post cholecystectomy pain LIVER: Liver measures 17 cm with increased echogenicity suggestive of hepatic steatosis. No focal lesions noted within the liver. Main portal vein is patent with normal flow directionality. No intrahepatic biliary ductal dilatation. BILIARY TRACT: Status post cholecystectomy. Common bile duct measures up to 6 mm within normal limits without any stones or sludge within it.PANCREAS: Head and body of pancreas appears unremarkable, tail of pancreas not visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 8.8 cmRIGHT KIDNEY: Right kidney measures 9.6 cm left kidney measures 8.2 cm. Mild increased echogenicity noted in both kidneys. No hydronephrosis or focal lesions. OTHER: No ascites | Mild increased echogenicity of the liver suggestive of hepatic steatosis.Status post cholecystectomy without intrahepatic or extra biliary ductal dilatation.Mild increased echogenicity of both kidneys suggestive of chronic medical renal disease. |
Generate impression based on findings. | 38-year-old female with right breast cancer. Evaluate right axilla. A targeted right ultrasound was performed of the right axilla. Few short axis subcentimeter lymph nodes are present, with normal morphology. No suspicious lymph node or mass identified. | No abnormal lymph node or mass identified within the right axilla. Known right breast cancer not evaluated. BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Look for iliac vein patency and iliac bifurcation, look for thrombus Limited examination due to overlying bowel gas. Left and right iliac veins are patent. No evidence of thrombus. | Patent iliac veins without thrombus. |
Generate impression based on findings. | Status post LVAD, transaminitis LIVER: Liver measures 17.5 cm with coarse echotexture suggestive of chronic liver disease or fatty infiltration. No intrahepatic biliary ductal dilatation noted. Portal vein demonstrates normal flow directionality and patency. GALLBLADDER, BILIARY TRACT: The common bile duct measures 4 mm in diameter. There is no cholelithiasis or findings to suggest acute cholecystitis.PANCREAS: The pancreas is entirely obscured by bowel gas.SPLEEN: The spleen measures 10. 8 cm in length.RIGHT KIDNEY: Right kidney measures 11 cm and left kidney measures 10.8 cm. No hydronephrosis. Normal echotexture noted. No focal lesion.OTHER: No ascites | Coarse hepatic echotexture suggestive of chronic medical renal disease or fatty liver. |
Generate impression based on findings. | History of ascites, right upper quadrant evaluation of the liver for echogenicity LIVER: Liver demonstrates diffuse coarse echotexture, measures 19.3 cm. Prominent hepatic veins are noted. Portal vein demonstrates normal flow directionality and patency. No hepatic focal lesions noted. Perihepatic fluid noted.BILIARY TRACT: No intra or extra hepatic delivery ductal dilatation noted. Status post cholecystectomy.PANCREAS: Visualized pancreas appears unremarkable. Tail and body of pancreas is not seen due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 13.8 cmRIGHT KIDNEY: Right kidney measures 8.4 cm and left measures 8.4 cm. No hydronephrosis or focal lesions. Normal echotexture noted. OTHER: Moderate amount of ascites | Diffuse coarse echotexture of the liver suggestive of chronic liver disease.Moderate ascites. |
Generate impression based on findings. | 70-year-old female with history of left breast cancer, with prior imaging performed at outside hospital. Bilateral Mammogram: Spot compression views of the right upper outer breast and spot magnification views of the left upper outer breast, as well as standard bilateral ML views, were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. Within the right upper outer breast there is a well circumscribed 8mm focal asymmetry, probably representing a normal lymph node. An additional focal asymmetry within the right upper outer breast did not persist on spot compression views. Benign calcifications, including arterial calcifications, are present.Within the left breast there is a group of amorphous calcifications spanning 3 mm. Additional scattered benign-appearing calcifications, including arterial calcifications, are present. A lock clip is identified within the left upper outer breast at site of biopsy-proven breast cancer.Left breast ultrasound: A targeted left ultrasound was performed at site of calcifications within the left breast 12:00 location, 5cm from the nipple. There is no solid or cystic mass identified. | Grouped calcifications within the left breast 12:00, approximately 5 cm from the nipple. Given known left breast cancer, further evaluation is recommended with stereotactic biopsy. Results were discussed with Dr. Bao.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Neck pain over thyroid RIGHT LOBE MEASUREMENTS: 5.4 x 1.6 x 1.7 cmLEFT LOBE MEASUREMENTS: 4.6 x 1.3 x 1.9 cmISTHMUS MEASUREMENTS: 2 mmRIGHT LOBE: Multiple nodules identified in the right lobe, measuring less than 1 cm.Nodule 1 appears complex measures 0.6 x 0.5 x 0.6 cm, previously measured 0.5 x 0.3 x 0.5 cm.Nodule 2 appears partly cystic partly solid, measures 0.6 x 0.3 0.5 cm, previously measured 0.7 x 0.4 x 0.5 cm.LEFT LOBE: Subcentimeter nodules identified. A new nodule is also identified in the inferior pole which appears partly cystic partly solid, measuring 0.6 x 0.3 x 0.5 cm.Nodule 1 in the liver lower pole predominantly cystic with ringdown artifact measures 0.4 x 0.3 x 0.4 cm, previously measured 0.4 x 0.2 x 0.4 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Normal morphology lymph nodes especially level 2 and on the right lateral neck and level 2 and level 3 in the left neck are unchanged.OTHER: No significant abnormality noted. | No increase in size of measured subcentimeter thyroid nodules. A new subcentimeter nodule identified in the left gland inferior pole. Continued surveillance is recommended. No dominant nodule noted. |
Generate impression based on findings. | History of thyroid nodule, assess for changes. RIGHT LOBE MEASUREMENTS: 4.8 x 1.4 x 1.2 cmLEFT LOBE MEASUREMENTS: 5.0 x 1.4 x 1.5 cmISTHMUS MEASUREMENTS: Up to 3 mm RIGHT LOBE: Normal echotexture.LEFT LOBE: Normal echotexture.ISTHMUS: There is a part cystic, part solid heterogeneous nodule in the thyroidal isthmus measuring approximately 1.5 x 0.9 x 1.2 cm, previously 1.8 x 1.0 x 1.8 cm. The cystic component has decreased in size.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mixed solid/cystic isthmus nodule, with interval decrease in size of the cystic component. |
Generate impression based on findings. | Reason: size of know cysts History: abdominal pain LIVER: The liver measures 19.1 cm in length and nodular in contour. The liver parenchymal echotexture is coarse. Right lobe dominant hepatic cyst measures 3.4 x 4.2 x 3.9, previously 2.6 x 3.9 x 4.1 cm. There is a less well-defined rounded, hypoechoic subcapsular structure in the right lobe measuring 1.9 x 2.1 x 2.1 cm, previously 1 x 1 x 1.2 cm which does have some cystic characteristics such as posterior acoustic enhancement. Additional hepatic cysts, some of which contain fine septations, appear not significantly changed.The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: A hyperechoic focus measuring up to 6 mm along the gallbladder fundus wall may reflect a calcification and appears unchanged. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10 cm in length. RIGHT KIDNEY: Kidney measures 10.4 cm in length. Normal echotexture. LEFT KIDNEY: Kidney measures 10 cm in length. Normal echotexture. OTHER: No significant abnormalities noted. | Cirrhotic liver with heterogeneous echotexture. Subcapsular structure in the right lobe which has some cystic characteristics has increased in size. Additional hepatic cysts not significantly changed. Echogenic focus along gallbladder wall which may reflect calcification, not significantly changed. |
Generate impression based on findings. | Reason: RUQ ultrasound to assess for gallstones or ductal dilation given elevated LFTs LIVER: The liver measures 18.9 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.27 m/s.BILIARY TRACT: Sludge is present within the contracted gallbladder without evidence of significant gallbladder wall thickening or pericholecystic fluid. No shadowing gallstones. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.9 cm in length. RIGHT KIDNEY: Kidney measures 11.2 cm in length. Increased parenchymal echogenicity. LEFT KIDNEY: Kidney measures 12.6 cm in length. Increased parenchymal echogenicity. OTHER: Pericardial effusion as seen on recent chest CT. | 1.Gallbladder sludge without specific evidence of acute cholecystitis or biliary ductal dilatation.2.Mild hepatomegaly. Echogenic liver raising the possible of parenchymal dysfunction/fatty infiltration.3.Echogenic kidneys suggesting medical renal disease.4.Pericardial effusion. |
Generate impression based on findings. | Reason: known cirrhosis, hx of stones, now with nausea and vomiting. LIVER: The liver measures 12.7 cm in length and is cirrhotic in morphology. The liver parenchymal echotexture is course. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: Cholelithiasis and layering sludge. Mild gallbladder distention and diffuse nonspecific wall thickening. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 6 mm in diameter.PANCREAS: Not visualized.SPLEEN: The spleen measures 13.5 cm in length. RIGHT KIDNEY: Kidney measures 10.0 cm in length. Normal echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 9.7 cm in length. Normal echotexture. No hydronephrosis.OTHER: Large ascites. | 1.Cirrhotic liver. Ascites.2.Cholelithiasis. Mild gallbladder wall thickening which is nonspecific in the setting of ascites. Clinical correlation is recommended for acute cholecystitis. HIDA scan could be considered for additional evaluation as clinically indicated. No biliary ductal dilatation. |
Generate impression based on findings. | Reason: concern for congestive hepatopathy, rule out portal vein thrombosis History: pulmonary hypertension of unclear cause LIVER: The liver measures 18.7 cm in length. The liver parenchymal echotexture is coarse. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating pulsatile hepatopetal flow with a velocity of 0.29 m/s. No filling defects are identified within the main portal vein or visualized branches. The hepatic veins appear somewhat prominent.BILIARY TRACT: No cholelithiasis. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 6 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: Not visualized.RIGHT KIDNEY: Kidney measures 14.9 cm in length. Normal echotexture. No hydronephrosis. Simple cyst.LEFT KIDNEY: Kidney measures 13.7 cm in length. Normal echotexture. No hydronephrosis.OTHER: Right pleural effusion. | 1.Portal vein appears patent without evidence of thrombus.2.Pulsatile portal vein and prominent hepatic veins raise question of right-sided heart failure. |
Generate impression based on findings. | Multinodular goiter, evaluate for change in nodules. RIGHT LOBE MEASUREMENTS: 5.9 x 2.2 x 1.9 cm.LEFT LOBE MEASUREMENTS: 6.3 x 3.3 x 4.3 cm.ISTHMUS MEASUREMENTS: Up to 8 millimeters.RIGHT LOBE: Multiple nodules. Dominant lower pole solid nodule with heterogeneous echotexture, no definite calcifications, and mild internal vascularity measures 2.9 x 1.8 x 2.1 cm, previously 2.7 x 1.5 x 1.7 cm and grossly stable since 2008.LEFT LOBE: Dominant nodule occupying nearly entire left lobe with heterogeneous echotexture, no definite calcifications, mild internal vascularity, and large complex cystic component overall measures 6.2 x 3.3 x 4.3 cm, previously 7.1 x 4.6 x 3.0 cm and grossly stable since 2008.ISTHMUS: No discrete nodules identified.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A few benign morphology cervical lymph nodes are noted.OTHER: No significant abnormality noted. | Multinodular goiter. Dominant nodules are stable in size. |
Generate impression based on findings. | Reason: evaluate right neck and right upper chest wall for retained line/object History: palpable object right neck. Corresponding to the superficial linear palpable structure in the right lateral neck, there is a corresponding tubular predominantly hypoechoic structure within the superficial subcutaneous soft tissues which measures approximately 2 mm in diameter and may reflect a retained catheter fragment. | Suspected retained catheter fragment within the superficial segment tissues of the right lateral neck. Soft tissue neck radiography recommended for confirmation (pager #1032 contacted, awaiting response; recommendation also entered into the follow-up tool). |
Generate impression based on findings. | 24-year-old female with history of palpable right periareolar lump for 2 1/2 months, with no significant change. Patient reporting history of mild trauma to the right breast. On the physical exam, there is a 1cm mobile area of induration in the right upper outer periareolar breast.A targeted right ultrasound was performed for the patient’s area of concern, revealing a 0.9 x 0.4 x 0.7 cm echogenic superficial avascular mass compatible with fat necrosis. A second adjacent similar smaller mass measuring 0.6 x 0.3 x 0.3 cm is also identified | Right periareolar palpable subcentimeter masses compatible with fat necrosis. No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Reason: s/p renal transplant admitted with UTI with bacteremia, eval for polynephritis or perinephric abscess History: fever, GNB bacteremia LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: Kidney measures 12.7 cm in length. Normal cortical echogenicity. No hydronephrosis. No perfusion defects are seen on the color Doppler images.COLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: The bladder is collapsed.OTHER: No significant abnormality noted | No evidence of hydronephrosis or perinephric collections. Please note that pyelonephritis is not excluded; if there is continued clinical concern, contrast-enhanced CT recommended for evaluation. |
Generate impression based on findings. | Reason: Question of multinodular goiter History: partial thyroidectomy of isthmus years ago on synthroid. RIGHT LOBE MEASUREMENTS: 2.9 x 1.8 x 1.4 cm.LEFT LOBE MEASUREMENTS: 5.6 x 2.4 x 2.8 cm.ISTHMUS MEASUREMENTS: 0.14 cm in thickness. RIGHT LOBE: Much of the right lobe is replaced by a dominant cystic and solid nodule measuring 2.4 x 1.6 x 1.5 cm which contains several echogenic foci which are nonspecific but may reflect inspissated colloid. No microcalcifications are detected.LEFT LOBE: Heterogeneous appearance of the left lobe of the thyroid. It is difficult to determine whether there is one large dominant mixed solid and cystic nodule or multiple individual nodules. No suspicious microcalcifications are delineated.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Few benign morphology cervical lymph nodes are noted.OTHER: No significant abnormality noted. | Multinodular goiter with multiple mixed cystic and solid nodules without specific evidence of malignancy. |
Generate impression based on findings. | History of thyroid nodules, assess for changes. RIGHT LOBE MEASUREMENTS: 4.5 x 1.4 x 1.7 cm.LEFT LOBE MEASUREMENTS: 3.5 x 1.3 x 1.4 cm.ISTHMUS MEASUREMENTS: 0.4 cm.RIGHT LOBE: Normal background parenchymal echotexture. Lower pole partially cystic partially solid nodule without internal vascularity or calcifications measures 1.9 x 1.5 x 1.6 cm, previously 2.1 x 1.7 x 1.7 cm and is of low suspicion for malignancy.LEFT LOBE: Normal background parenchymal echotexture. Upper pole partially cystic nodule without internal vascularity measures 0.6 x 0.3 x 0.4 cm, previously 0.4 x 0.4 x 0.2 cm and remains very low suspicion for malignancy.ISTHMUS: Benign cyst in the isthmus measures 0.9 x 0.8 x 0.9 cm, previously 0.6 x 0.9 x 0.4 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: A few benign morphology lymph nodes are noted.OTHER: No significant abnormality noted. | Right lower pole partially cystic partially solid nodule, low suspicion for malignancy based on ATA guidelines, slightly decreased in size. |
Generate impression based on findings. | History of Hashimoto's thyroiditis with right nodule, evaluate for change. RIGHT LOBE MEASUREMENTS: 4.2 x 2.2 x 1.7 cm.LEFT LOBE MEASUREMENTS: 4.1 x 1.6 x 1.7 cm.ISTHMUS MEASUREMENTS: 0.5 cm.RIGHT LOBE: Heterogeneous echotexture with increased vascularity. Previously described possible subcentimeter discrete nodule within the midpole not well seen on today's examination.LEFT LOBE: Heterogeneous echotexture with increased vascularity. No discrete nodules delineated.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: See discussion below. LYMPH NODES: A few benign morphology cervical lymph nodes are noted. In addition, there are 2 oval-shaped hypoechoic structures posterior to the inferior pole of the left lobe of the thyroid the larger of which measures 1.0 x 0.9 x 0.6 cm. There is a suggestion of hilar blood flow and fatty hila.OTHER: No significant abnormality noted. | 1.Diffusely heterogeneous thyroid gland with increased vascularity, appearance suggestive of underlying thyroiditis. Previously described subcentimeter right thyroid nodule is not well seen today.2.Subcentimeter hypoechoic structures posterior to the inferior pole of the left thyroid which are nonspecific but are favored to represent lymph nodes. However, if there is clinical suspicion for hyperparathyroidism, evaluation for parathyroid adenoma/hyperplasia with nuclear medicine scan can be considered as clinically warranted. |
Generate impression based on findings. | History of Hashimoto's thyroiditis with nodules. RIGHT LOBE MEASUREMENTS: 4.6 x 1.5 x 1.8 cm.LEFT LOBE MEASUREMENTS: 4.5 x 1.8 x 1.9 cm.ISTHMUS MEASUREMENTS: 0.4 cm.RIGHT LOBE: Diffusely heterogeneous parenchymal echotexture, appearance consistent with sequelae of Hashimoto's thyroiditis. Hyperechoic midpole nodule measuring 0.7 x 0.6 x 0.9 cm.LEFT LOBE: Diffusely heterogeneous parenchymal echotexture, appearance consistent with sequelae of Hashimoto's thyroiditis. Hyperechoic midpole nodule measuring 0.9 x 0.7 x 0.5 cm.ISTHMUS: Heterogeneous echotexture without discrete nodules.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Left level 2 cervical lymph node measuring 1.8 x 0.5 x 1.1 cm with indeterminate appearance in terms of shape and echogenicity.OTHER: No significant abnormality noted. | 1.Thyroid appearance compatible with Hashimoto's thyroiditis including hyperechoic nodules.2.Left level 2 cervical lymph node which may be reactive but has indeterminate imaging features. Continued follow-up is recommended. |
Generate impression based on findings. | 77-year-old male with cholangiocarcinoma and prior removal of cholecystostomy tube. Now with sepsis. Evaluate for biliary dilatation or fluid collection. LIVER: Liver is normal in size but highly echogenic due to parenchymal disease. There are scattered masses present within the liver which have a "target" appearance with an echogenic center and hypoechoic rim. Although not specific, findings should be worrisome for metastatic disease. Infection is considered unlikely. Main portal vein is taking by color and spectral Doppler with appropriate flow direction.BILIARY TRACT: No biliary dilatation. The gallbladder is significantly thick-walled with a small amount of pericholecystic fluid. This could be related to prior cholecystostomy tube but certainly cholecystitis cannot be excluded. No shadowing gallstones are identified, and the wall does not appear hypervascular.PANCREAS: Limited by bowel gas.SPLEEN: Limited but normal in size.RIGHT KIDNEY: 14.5 cm in length including a 4 cm cyst in the upper pole. Kidney is echogenic consistent with parenchymal disease. No hydronephrosis. OTHER: Left kidney measures approximately 12.3 cm in length. Kidney is echogenic consistent with parenchymal disease with at least one cyst in the midportion.Trace of perihepatic fluid. | 1. Trace of perihepatic fluid. Thick gallbladder wall. This could be related to prior drainage tube but cannot exclude acalculus cholecystitis.2. Presumed metastatic disease involving the liver.3. Echogenic kidneys with cysts.4. Echogenic liver |
Generate impression based on findings. | History of hepatomegaly on CT in 2011 now with right lower quadrant and flank pain. LIVER: The liver measures 15.1 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating pulsatile hepatopetal flow with a velocity of 0.31 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: The spleen is not visualized likely related to close approximation to the diaphragm as seen on 2011 CT.RIGHT KIDNEY: Kidney measures 10.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 12.8 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | 1.No evidence of acute cholecystitis, hydronephrosis, or other specific findings to account for patient's symptoms.2.Pulsatile blood flow in the portal vein raising the possibility of elevated right heart pressures. |
Generate impression based on findings. | 31-year-old female with renal transplant, acute kidney injury and urinary retention. RENAL TRANSPLANT: LOCATION: Left iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: COLLECTING SYSTEM/URETER: There is again noted moderate dilatation of the left renal collecting system without visualized dilated ureter. This is unchanged from the prior study.URINARY BLADDER: Mild distention. Gallbladder wall is very mildly thick-walled.OTHER: Post void imaging not obtained. | Stable dilatation left renal collecting system. Mild urinary bladder distention with associated wall thickening.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Bilateral call back for left breast mass and right breast calcifications. An ML view and two spot views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density(BiRads Density Category B), unchanged in pattern and distribution. Left upper outer quadrant mass persists with spot compression. Calcifications in the right lower outer breast appear to layer on the ML magnification view and appear smudgy on the CC magnification view, suggesting milk of calcium. Adjacent blood vessels are noted. ULTRASOUND | 1. Mass in the left upper outer quadrant for which ultrasound-guided biopsy is requested. Benign etiologies are favored, though malignancy is not entirely excluded.2. Probably benign calcifications in the right breast, suggestive of milk of calcium on mammography and clustered microcysts on ultrasound. Six-month follow-up right mammogram is recommended to ensure stability.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Male 48 years old with scrotal mass. Please evaluate. RIGHT TESTIS: The right testicle measures 4.0 x 3.0 x 3.3 cm, it is normal in echogenicity and without focal lesion. External to the right testicle in the area of palpable abnormality is a 0.3 x 0.1 x 0.3 cm anechoic lesion with no vascularity consistent with the tunica albuginea cyst.LEFT TESTIS: The left testicle measures 4.5 x 2.7 x 3.5 cm, it is normal in echogenicity and without focal lesion.RIGHT EPIDIDYMIS: The right epididymis measures 1.6 x 1.3 x 1.1 cm with a normal sonographic appearance.LEFT EPIDIDYMIS: The left epididymis measures 0.8 x 1.6 x 1.8 cm and contains a 0.3 x 1.2 x 0.3 cm anechoic structure consistent with an epididymal cyst.OTHER: Small right varicocele and small bilateral hydroceles. Normal, symmetric testicular vascularity. | 1.0.3 x 0.1 x 0.3 cm right tunica albuginea cyst corresponds to the patient's palpable abnormality.2.Small right varicocele. |
Generate impression based on findings. | 29-year-old female with biopsy proven fibroadenoma in the left breast presents for follow-up With focused ultrasound, there is a known hypoechoic mass, which is a biopsy proven fibroadenoma, with marker clip lateral to the mass at 12:00 position in the left breast. The lesion measures 0.9 x 0.5 x 1.1 cm (previously 0.9 x 0.5 x 1.2 cm). | No significant interval change in size of the biopsy-proven left fibroadenoma. No further imaging follow-up is needed.Results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 74-year-old male with prior left thyroidectomy for microfollicular adenomatous nodule. RIGHT LOBE MEASUREMENTS: 3.8 x 2.4 x 1.3 cmLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: 0.4 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No massISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No mass within the thyroidectomy bed or right lobe. No suspicious adenopathy. |
Generate impression based on findings. | 37-year-old male with acute on chronic congestive heart failure, preheart transplant and LVAD. LIVER:Normal in size and echotexture. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The visualized biliary tract is normal in caliber.PANCREAS: Poorly evaluated due to bowel gas.SPLEEN: No significant abnormality noted.KIDNEYS: The right kidney measures 10.6 cm in length and the left 9.9 cm. Echotexture is normal. No hydronephrosis, shadowing calculus or mass. ABDOMINAL AORTA: Only the proximal to mid aorta is adequately visualized and is normal in caliber. Remainder is obscured by bowel gas.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted. | Normal examination with inadequate visualization of the pancreas and mid to distal aorta. |
Generate impression based on findings. | 64-year-old female with abnormal liver function. Evaluate for NASH. LIVER: Liver is normal in size but is highly echogenic. Presumably this is due to severe fatty liver, but other causes of hepatic dysfunction cannot be excluded. No obvious hepatic mass although penetration to the depth of the liver is limited.BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliberPANCREAS: The head and body are normal. The tail is obscured by bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Highly echogenic liver, presumably fatty liver. |
Generate impression based on findings. | 37-year-old male with acute kidney failure. Evaluate for hydronephrosis. Abnormal liver function. LIVER:There is hepatomegaly with the liver measuring at least 20 cm in length. The hepatic parenchyma is echogenic which is nonspecific. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: The head is normal. The body and tail are less well seen due to bowel gas.SPLEEN: Splenomegaly with the spleen measuring at least 15 cm in length.KIDNEYS: Right kidney measures 15.7 cm in length and is likely mildly echogenic consistent with parenchymal disease. No hydronephrosis, shadowing calculus or mass. Left kidney measures approximately 15.2 cm in length and is likely mildly echogenic consistent with parenchymal disease. No hydronephrosis, shadowing calculus or mass.ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No ascites. | Hepatosplenomegaly with echogenic liver.No evidence for hydronephrosis. Kidneys may be mildly echogenic. |
Generate impression based on findings. | Reason: assess liver parenchyma for evidence of cirrhosis; assess for portal vein thrombosis History: liver failure Study mildly limited due to dilated bowel loops.LIVER: The liver measures 15.1 cm in length. Mildly increased parenchymal echogenicity. Left hepatic cyst as seen on prior CT examinations. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.32 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the head and body of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 6.6 cm in length. RIGHT KIDNEY: Kidney measures 7.9 cm in length. Increased parenchymal echogenicity. No hydronephrosis.LEFT KIDNEY: Kidney measures 8.0 cm in length. Increased parenchymal echogenicity. No hydronephrosis.OTHER: Right pleural effusion and ascites. | 1.Mildly increased hepatic echogenicity raising the possibility of fatty infiltration/parenchymal dysfunction without additional morphologic evidence of cirrhosis.2.Patent portal vein.3.Atrophic, echogenic kidneys suggestive of medical renal disease.4.Right pleural effusion and ascites. |
Generate impression based on findings. | History of hyperparathyroidism. RIGHT LOBE MEASUREMENTS: 6.5 x 2.2 x 2.5 cm.LEFT LOBE MEASUREMENTS: 6.0 x 2.2 x 2.6 cm.ISTHMUS MEASUREMENTS: 0.4 cm in thicknessRIGHT LOBE: Normal echotexture without discrete nodules.LEFT LOBE: Normal echotexture without discrete nodules.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: There is an oval-shaped hypoechoic structure posterior to the inferior pole of the right lobe of the thyroid measuring approximately 1.2 x 0.5 x 1.3 cm which is nonspecific but is a candidate for parathyroid adenoma.LYMPH NODES: Several benign morphology cervical lymph nodes are noted.OTHER: No significant abnormality noted. | Candidate for parathyroid adenoma posterior to the inferior pole of the right thyroid lobe. |
Generate impression based on findings. | History of thyroid cancer and ovarian cancer, rule out adenopathy or recurrence. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy. No abnormal soft tissue nodules identified within the thyroidectomy bed.LEFT LOBE: Status post thyroidectomy. No abnormal soft tissue nodules identified within the thyroidectomy bed.ISTHMUS: Status post thyroidectomy.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant lymphadenopathy noted.OTHER: No significant abnormality noted. | No evidence of local recurrence or suspicious lymphadenopathy. |
Generate impression based on findings. | Reason: Evaluate for fatty liver disease History: Heavy ETOH use, abnormal liver function tests. LIVER: The liver measures 22.7 cm in length. The liver parenchymal echotexture is coarse. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating hepatopetal flow with a velocity of 0.45 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 2 mm in diameter.PANCREAS: The visualized head and body of the pancreas are mildly hypoechoic.SPLEEN: No significant abnormalities noted. The spleen measures 9.3 cm in length. RIGHT KIDNEY: Kidney measures 13.1 cm in length. Increased parenchymal echogenicity. No hydronephrosis. Lower pole simple cyst.LEFT KIDNEY: Kidney measures 12.3 cm in length. Increased parenchymal echogenicity. No hydronephrosis. Lower pole simple cyst.OTHER: No significant abnormalities noted. | 1.Hepatomegaly. Echogenic liver suggestive of parenchymal dysfunction/fatty infiltration.2.Echogenic kidneys suggestive of medical renal disease.3.Diffusely decreased echogenicity of the pancreas which is nonspecific but can be seen with infiltrative processes such as edema. |
Generate impression based on findings. | Reason: thyroid nodule on ct scan RIGHT LOBE MEASUREMENTS: 4.6 x 2.5 x 2.6 cm.LEFT LOBE MEASUREMENTS: 4.8 x 2.0 x 2.1 cm.ISTHMUS MEASUREMENTS: 0.4 cm in thickness.RIGHT LOBE: Inferior pole nodule measures 2.3 x 1.5 x 2.2 cm, is spongiform in appearance, contains mild internal vascularity, lacks internal calcifications, and is of very low suspicion for low suspicion for malignancy.LEFT LOBE: Inferior pole nodule measures 1.1 x 0.9 x 1.0 cm, is predominantly isoechoic in appearance, contains mild peripheral vascularity, lacks internal calcifications, has an hypoechoic halo, and is of intermediate suspicion for neoplasm. Second more inferior inferior pole nodule measures 0.9 x 0.7 x 1.2 cm, is partially cystic and partially solid in appearance, contains mild internal vascularity, lacks internal calcifications, and is of very low suspicion for neoplasm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Single benign morphology left level 2 cervical lymph node noted.OTHER: No significant abnormality noted. | Multiple thyroid nodules as described above. 1.1 cm nodule in the inferior pole of the left lobe is of intermediate suspicion for neoplasm and would be amenable to FNA biopsy as clinically warranted. |
Generate impression based on findings. | Reason: evaluate liver parenchyma and vasculature, blockage seen on CT chest History: Abdominal pain and bloating LIVER: The liver measures 14.2 cm in length. Mildly increased hepatic echogenicity. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.26 m/s. BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.5 cm in length. RIGHT KIDNEY: Native kidney not visualized.LEFT KIDNEY: Native kidney not visualized.OTHER: No significant abnormalities noted. | Increased hepatic echogenicity suggesting fatty infiltration/dysfunction. Portal vein appears grossly patent. Additional dedicated cross-sectional imaging could be considered as clinically warranted. |
Generate impression based on findings. | History of gallbladder wall thickening seen on recent chest CT. LIVER: The liver measures 15.5 cm in length. The liver parenchymal echotexture is normal. Multiple small hepatic cystic lesions likely represent biliary hamartomas. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.18 m/s.BILIARY TRACT: The anterior gallbladder wall is thickened, diffusely echogenic, generates dense shadowing, and generates twinkle artifact. The gallbladder lumen and posterior wall are obscured. This appearance is most likely related to cholesterolosis of the gallbladder wall, however, cholelithiasis cannot be excluded. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 10.0 cm in length. RIGHT KIDNEY: Kidney measures 10.2 cm in length. Normal echotexture. No hydronephrosis. Small cyst.LEFT KIDNEY: Kidney measures 11.0 cm in length. Normal echotexture. Mild hydronephrosis, not clearly evident on recent chest CT (although kidney only partially visualized on chest CT). Multiple cysts, the largest of which demonstrates minimal internal complexity.OTHER: No significant abnormalities noted. | 1.Findings suggestive of gallbladder cholesterolosis. Gallbladder lumen and posterior wall obscured, and cholelithiasis not excluded.2.Mild left hydronephrosis, possibly new.Findings discussed with Dr. Schwartz at 3:50 PM on 12/2/2016. |
Generate impression based on findings. | Reason: Elevated LFTs, NASH? LIVER: The liver measures 13.3 cm in length. Mildly increased parenchymal echogenicity. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.16 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 11 cm in length. RIGHT KIDNEY: Kidney measures 11.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.7 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | Mildly echogenic liver suggestive of fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | Reason: 3.1 cm hypoattenuating nodule posterior to the right lobe of the thyroid noted on CT Chest 11/29. Please please evaluate further. RIGHT LOBE MEASUREMENTS: 5.2 x 3.0 x 2.1 cm.LEFT LOBE MEASUREMENTS: 4.8 x 2.6 x 2.1 cm.ISTHMUS MEASUREMENTS: Up to 0.7 cm in thickness.RIGHT LOBE: Normal background parenchymal echotexture. There is a subcentimeter nodule in the mid pole with imaging features suggestive of a benign colloid nodule.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: There is an oval-shaped, partially solid and partially cystic nodule posterior to the inferior pole of the right lobe of the thyroid which measures approximately 3.4 x 2.3 x 3.1 cm and demonstrates mild peripheral vascularity.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mixed solid and cystic nodule posterior to the right inferior pole of the thyroid. Differential considerations include degenerating parathyroid adenoma (favored) versus exophytic thyroid nodule. |
Generate impression based on findings. | Reason: assess for liver disease History: elevated AST and ALT LIVER: Mildly increased hepatic echogenicity. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.24 m/s.BILIARY TRACT: Layering gallbladder sludge without shadowing gallstones. No associated gallbladder wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 12.9 cm in length. RIGHT KIDNEY: Kidney measures 10.3 cm in length. Normal echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.9 cm in length. Normal echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | Mildly increased hepatic echogenicity suggestive of fatty infiltration/parenchymal dysfunction. |
Generate impression based on findings. | Reason: 79 yo male with CHF and new hyperbilirubinemia Examination somewhat limited by postsurgical changes in anterior abdominal wall.LIVER: The liver measures 14.2 cm in length. The liver parenchymal echotexture is coarse. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating biphasic hepatopetal flow with a velocity of 0.21 m/s. The hepatic veins appear prominent.BILIARY TRACT: The gallbladder is not visualized, and surgical clips in the right upper quadrant on prior chest radiograph suggests that the gallbladder is surgically absent. No intrahepatic biliary ductal dilatation is present. The common bile duct is mildly prominent measuring 8.9 mm in diameter which would not be unexpected status post cholecystectomy.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.7 cm in length. RIGHT KIDNEY: Kidney measures 9.8 cm in length. Increased parenchymal echogenicity and cortical thinning. No hydronephrosis.LEFT KIDNEY: Kidney measures 9.7 cm in length. Increased parenchymal echogenicity and cortical thinning. No hydronephrosis.OTHER: Large ascites. | 1.Findings suggestive of elevated right heart pressures.2.Increased hepatic echogenicity suggestive of parenchymal dysfunction which may be due to congestive hepatopathy.3.Large ascites.4.Increased renal echogenicity compatible with medical renal disease. |
Generate impression based on findings. | 52-year-old male with history of thyroid cancer. Evaluate for recurrence. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: Hyperechoic nodular focus in the left thyroid bed unchanged measuring 0.8 x 0.4 x 0.6 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right level 4 lymph node measuring 1.1 x 0.5 x 0.8 cm without significant interval change. Left level 3 lymph node with benign morphologic features also unchanged.OTHER: No significant abnormality noted. | No significant interval change since the prior study. |
Generate impression based on findings. | Reason: evaluate for mass in epigastric, upper abdomen History: palpable firmness, possible mass in epigastric/upper abdominal area appreciated on physical exam At the site of palpable concern in the anterior superficial abdominal wall, no abnormal focal masses are identified. | No focal mass identified on ultrasound. |
Generate impression based on findings. | 37-year-old male with acute kidney failure. Evaluate for hydronephrosis. Abnormal liver function. LIVER:There is hepatomegaly with the liver measuring at least 20 cm in length. The hepatic parenchyma is echogenic which is nonspecific. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.GALLBLADDER, BILIARY TRACT: Gallbladder is normal without cholelithiasis, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: The head is normal. The body and tail are less well seen due to bowel gas.SPLEEN: Splenomegaly with the spleen measuring at least 15 cm in length.KIDNEYS: Right kidney measures 15.7 cm in length and is likely mildly echogenic consistent with parenchymal disease. No hydronephrosis, shadowing calculus or mass. Left kidney measures approximately 15.2 cm in length and is likely mildly echogenic consistent with parenchymal disease. No hydronephrosis, shadowing calculus or mass.ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No ascites. | Hepatosplenomegaly with echogenic liver.No evidence for hydronephrosis. Kidneys may be mildly echogenic. |
Generate impression based on findings. | Reason: evaluate mass in left groin History: hard mass in left groin, possible lymph node At the site of palpable abnormality in the superficial tissues of the left inguinal region, there are 2 structures which are compatible with abnormal morphology enlarged lymph nodes. The larger measures 1.6 x 1.2 x 0.9 cm. An additional normal morphology lymph node is identified in the deeper soft tissues. | Abnormal morphology lymph nodes in the left inguinal region corresponding to the palpable abnormality. Continued follow-up is recommended. |
Generate impression based on findings. | Transaminitis LIVER: Normal parenchymal echogenicity and morphology without mass. Limited Doppler interrogation of the main portal vein demonstrates a patent main portal vein with normal directional flow. Liver length 16.7 cmBILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 7.9 cm in lengthRIGHT KIDNEY: Mildly echogenic renal parenchyma without mass, stone, or hydronephrosis. 10.2 cm in lengthOTHER: Mildly echogenic left renal parenchyma without mass, stone, or hydronephrosis. Left kidney 11.6 cm in length. Moderate ascites again noted. | Unremarkable liver morphology without mass or ductal dilatation. Moderate ascites again noted. Mildly echogenic renal parenchyma raises the possibility of medical renal disease/parenchymal dysfunction without mass, stone, or hydronephrosis. |
Generate impression based on findings. | Reason: concern for cholecystitis on CT scan History: epigastric abdominal pain BILIARY TRACT: The gallbladder is mildly distended and contains layering sludge. No shadowing gallstones are identified. No gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter. | Sludge in a mildly distended gallbladder without specific sonographic evidence of acute cholecystitis. If there is persistent clinical concern for acute cholecystitis, nuclear medicine HIDA scan may be considered as clinically warranted. |
Generate impression based on findings. | Reason: assess for cirrhosis and ascites History: jaundice LIVER: The liver measures 21.3 cm in length and is nodular in contour. The liver parenchymal echotexture is coarse with increased echogenicity. No focal hepatic lesions or masses are identified within the limitations of an echogenic liver. The portal vein is patent demonstrating hepatopetal flow with a velocity of 0.14 m/s.BILIARY TRACT: No cholelithiasis. Mild gallbladder wall thickening measuring up to 4 mm which is nonspecific in the setting of chronic liver disease and ascites. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: Not visualized due to overlying bowel gas.SPLEEN: The spleen is enlarged and measures 19.5 cm in length. RIGHT KIDNEY: Kidney measures 13.2 cm in length. Normal echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 13.3 cm in length. Normal echotexture. No hydronephrosis.OTHER: Mild ascites. Bilateral pleural effusions. | 1.Hepatomegaly and echogenic, nodular liver compatible with chronic liver disease/cirrhosis. Splenomegaly, ascites, and decreased flow velocity within the main portal vein compatible with sequelae of portal hypertension.2.Mild gallbladder wall thickening which is nonspecific but may be related to chronic liver disease without evidence of cholelithiasis.3.Bilateral pleural effusions. |
Generate impression based on findings. | Reason: 47-year-old female with Li Fraumeni syndrome. Evaluate for hepatic hemangioma, gallstones. LIVER: The liver measures 21.1 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. There is redemonstration of a predominantly hypoechoic mass within the right lobe of the liver measuring 5.6 x 4.6 x 5.5 cm, not significant changed from prior ultrasound allowing for differences in technique. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.21 m/s.BILIARY TRACT: Cholelithiasis. No gallbladder wall thickening or pericholecystic fluid is visualized. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 4 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: The spleen measures 10.4 cm in length. RIGHT KIDNEY: Kidney measures 13.7 cm in length. Normal cortical echotexture. No hydronephrosis, shadowing calculus, or mass. Renal cyst. LEFT KIDNEY: Kidney measures 12.5 cm in length. Normal cortical echotexture. No hydronephrosis, shadowing calculus, or mass.OTHER: No significant abnormalities noted. | 1.Cholelithiasis.2.Hepatomegaly and hepatic steatosis.3.Hepatic mass as characterized on prior MRI as compatible with a hemangioma, similar in size to 6/3/2016 ultrasound allowing for differences in technique. |
Generate impression based on findings. | Reason: Upper abdomen/epigastric pain, recent transplant day +5. History: Upper abdominal pain, epigastric pain, some nausea LIVER: The liver measures 15.9 cm in length. Mildly increased parenchymal echogenicity is suggestive of fatty infiltration/parenchymal dysfunction. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.3 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic biliary ductal dilatation is present. The common bile duct measures 8-9 mm in diameter and tapers distally. No choledocholithiasis is visualized.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 9.0 cm in length. RIGHT KIDNEY: Kidney measures 12.7 cm in length. Normal cortical echotexture. No hydronephrosis, shadowing calculus, or mass.LEFT KIDNEY: Kidney measures 12.1 cm in length. Normal cortical echotexture. No hydronephrosis, shadowing calculus, or mass.OTHER: Trace abdominal ascites. | 1.Mild prominence of the common bile duct which may simply reflect age-related ectasia but may be correlated with liver function tests. No evidence of intrahepatic biliary duct dilatation.2.Echogenic liver suggestive of parenchymal dysfunction/fatty infiltration.3.Trace abdominal ascites. |
Generate impression based on findings. | Reason: pancreatitis, rule out gallstones History: acute pancreatitis LIVER: The liver measures 15.7 cm in length. The liver parenchymal echotexture is normal. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.2 m/s.BILIARY TRACT: There is a single rounded, echogenic focus within the gallbladder fundus measuring up to 6 mm in diameter with associated probable twinkle artifact which is favored to represent a single gallstone over a solitary polyp. No gallbladder wall thickening or pericholecystic fluid. The sonographic Murphy's sign is negative. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3 mm in diameter.PANCREAS: The pancreatic parenchyma demonstrates mildly decreased echogenicity which is nonspecific but can be seen in pancreatitis. The visualized pancreatic duct is nondilated.SPLEEN: The spleen measures 9.1 cm in length. Scattered echogenic foci within the spleen may reflect calcifications related to prior granulomatous infection.RIGHT KIDNEY: Kidney measures 9.8 cm in length. Normal cortical echotexture. No hydronephrosis, shadowing calculus, or mass. Renal cyst.LEFT KIDNEY: Kidney measures 10.1 cm in length. Normal cortical echotexture. No hydronephrosis, shadowing calculus, or mass. Renal cyst.OTHER: No significant abnormalities noted. | Rounded structure within the gallbladder favored to reflect cholelithiasis rather than polyp. No sonographic evidence of acute cholecystitis or biliary ductal dilatation. |
Generate impression based on findings. | Reason: transaminitis History: abnormal LFTs Limited exam due to bandages overlying abdomen. LIVER: The liver measures 15.5 cm in length. The liver parenchymal echotexture is course and echogenic. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.26 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. Repeating linear reflectors at the gallbladder lumen are favored to artifactual, but also could be related to cholecystostomy catheter if one is present; correlate with procedural history. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 3.7 mm in diameter.PANCREAS: Not visualized. SPLEEN: Not visualized. RIGHT KIDNEY: Not visualized. LEFT KIDNEY: Not visualized. OTHER: No significant abnormalities noted. | 1.Limited exam. 2.Echogenic liver suggestive of parenchymal dysfunction/fatty infiltration. 3.No sonographic evidence of acute cholecystitis or biliary ductal dilatation. |
Generate impression based on findings. | Reported palpable abnormality in the anterior abdominal wall during menstruation, evaluate for hernia. At the site of the patient's reported palpable abnormality in the superficial soft tissues of the anterior abdominal wall, no abnormal masses or hernias are identified. Please note that the examination is somewhat limited by patient body habitus. | No sonographic evidence of mass or hernia in the anterior abdominal wall. Additional cross-sectional imaging can be considered for further evaluation as clinically warranted. |
Generate impression based on findings. | Reason: RUQ pain, epigastric pain. Examination mildly limited by constraints positioning patient. LIVER: The liver measures 12.0 cm in length. The liver parenchymal echotexture is normal. Several cystic structures within the liver some with mildly thickened internal septations. The largest cystic lesions is in the right lobe measuring up to 3.0 cm, slightly increased in size from 2010 CT. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.27 m/s.BILIARY TRACT: Single shadowing gallstone without associated gallbladder wall thickening or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common bile duct measures 6 mm in diameter.PANCREAS: Not well visualized. SPLEEN: No significant abnormalities noted. The spleen measures 6.8 cm in length. RIGHT KIDNEY: Kidney measures 9.8 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus, or mass. Cyst measuring up to 1.3 cm. LEFT KIDNEY: Kidney measures 9.2 cm in length. Increased parenchymal echogenicity. No hydronephrosis, shadowing calculus, or mass.OTHER: No significant abnormalities noted. | 1.Mildly limited exam. 2.Cholelithiasis without evidence of acute cholecystitis or biliary ductal dilation. 3.Echogenic kidneys suggestive of medical renal disease. |
Generate impression based on findings. | History of hepatitis C, evaluate for hepatocellular carcinoma. LIVER: The liver measures 18.4 cm in length. Mildly increased parenchymal echogenicity. Focal circumscribed mass within the right hepatic lobe measuring 5.6 x 4.4 x 4.4 cm which demonstrates heterogenous echotexture. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.29 m/s.BILIARY TRACT: There is no evidence of cholelithiasis, gallbladder wall thickening, or pericholecystic fluid. No intrahepatic or extrahepatic biliary ductal dilatation is present. The common hepatic duct measures 5 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 8.1 cm in length. RIGHT KIDNEY: Kidney measures 11.9 cm in length. Normal cortical echotexture. Focal solid mass in the lower pole measuring 4.2 x 3.9 x 3.9 cm. LEFT KIDNEY: Kidney measures 11.1 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | 1.Mass in the right lobe of the liver which is non-specific but suspicious for neoplasm. 2.Mass in the lower pole of the right kidney which is non-specific but suspicious for neoplasm. Dedicated cross-sectional imaging with contrast is recommended for further characterization of both masses. Ordering provider, PHO, MAI T (#9208) not pageable, so findings were e-mailed to her. Recommendation for follow-up also entered into the follow-up tool. |
Generate impression based on findings. | Reason: Evaluate for cholecystitis, biliary ductal dilation, also kidney injury History: concern for acute pancreatitis and acute renal failure LIVER: The liver measures 17.3 cm in length. The liver parenchymal echotexture is normal. There are several cystic structures within the liver, some of which contain mildly thickened internal septations. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.16 m/s.BILIARY TRACT: Contracted gallbladder. Cholelithiasis. Gallbladder wall thickening which is nonspecific in the setting of ascites. The sonographic Murphy's sign is negative. No intrahepatic biliary ductal dilatation is present. The common hepatic duct measures 7.6 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: Poorly visualized.RIGHT KIDNEY: Poorly visualized. Kidney measures 9.9 cm in length. No frank hydronephrosis.LEFT KIDNEY: Poorly visualized. Kidney measures 10.2 cm in length. No frank hydronephrosis.ABDOMINAL AORTA: Proximal aorta within normal limits. Middle and distal aorta obscured.INFERIOR VENA CAVA: No gross abnormality, though poorly visualized.OTHER: Mild abdominal ascites. Pleural effusions. Bladder collapsed with Foley. | 1.Contracted gallbladder with cholelithiasis and wall thickening which is nonspecific in the setting of ascites. Acute cholecystitis cannot be excluded on the basis of the study. Correlation with laboratory values and clinical history is recommended. Nuclear medicine HIDA scan can be considered for additional evaluation as warranted.2.Abdominal ascites and pleural effusions.3.No frank hydronephrosis. |
Generate impression based on findings. | Reason: Evaluate fistula for abscess History: fever Images demonstrate a tubular structure within the superficial soft tissues of the left anterior arm which presumably represents a dialysis AV fistula. Color Doppler flow is present within the structure with some aliasing suggestive of turbulent flow. No abnormal fluid collections are identified within the adjacent surrounding soft tissues to suggest abscess. | 1.No evidence of abscess associated with the left upper arm AV fistula. 2.Turbulent flow within the fistula. Dedicated vascular ultrasound can be considered as clinically warranted. |
Generate impression based on findings. | Ms. Bruce submitted outside mammograms dated 1/8/2015 and 3/8/2016, from Mercy Hospital. Submitted outside studies were compared to the current mammogram/ultrasound dated 11/4/2016. The breast parenchyma is composed of scattered fibroglandular density (BiRads Density Category B), unchanged in pattern and distribution. Previously identified mass in the right lateral breast (2:30 location) and left upper outer breast (1:00 location) are stable when compared to prior mammograms dating back to 2015.There is no significant change between these studies. | Bilateral stable benign morphology masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually, due next in November 2017.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Ms. Bruce submitted outside mammograms dated 1/8/2015 and 3/8/2016, from Mercy Hospital. Submitted outside studies were compared to the current mammogram/ultrasound dated 11/4/2016. The breast parenchyma is composed of scattered fibroglandular density (BiRads Density Category B), unchanged in pattern and distribution. Previously identified mass in the right lateral breast (2:30 location) and left upper outer breast (1:00 location) are stable when compared to prior mammograms dating back to 2015.There is no significant change between these studies. | Bilateral stable benign morphology masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually, due next in November 2017.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Subsets and Splits