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Generate impression based on findings. | Ms. Kelly is a 24 year old female presenting with a physician detected area of "breast thickening" in the right breast. She denies any discrete mass, trauma, or fever/chills. Family history of breast cancer in mother, diagnosed at the age of 56. Upon physical exam at the palpable area of concern, no discrete mass is appreciated.A targeted right breast ultrasound was performed for the palpable area of concern. In the right breast 12 o'clock location, approximately 2 cm from the nipple, no suspicious cystic or solid mass is identified. | No sonographic evidence for malignancy. Patient should follow-up with her primary care physician as clinically warranted.BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Female 22 years old Reason: include liver and pancreas, ER visit 4/20/16, r/o pancreatitis, c/o abdominal pain, hx small bowel obstruction History: include liver and pancreas, ER visit 4/20/16, r/o pancreatitis, c/o abdominal pain, hx small bowel obstruction LIVER: Liver is normal in size and echogenicity. No focal liver lesions.GALLBLADDER, BILIARY TRACT: Gallbladder is mildly contracted but otherwise unremarkable. No evidence of biliary dilatation.PANCREAS: Not well visualized due to overlying bowel gas.RIGHT KIDNEY: No significant abnormalities noted. Right kidney measures 9 cm. Left kidney measures 9.2 cm.OTHER: No significant abnormalities noted. Spleen measures 8.3 cm. | Unremarkable ultrasound. |
Generate impression based on findings. | 39-year-old female with abdominal pain. Evaluate for cholelithiasis. LIVER: The liver measures 14.4 cm in length. Mild increased hepatic echogenicity without discrete focal lesion.GALLBLADDER, BILIARY TRACT: No cholelithiasis. No gallbladder wall thickening, pericholecystic fluid, or sonographic Murphy sign. No biliary ductal dilation.PANCREAS: No significant abnormalities noted.KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | 1. No cholelithiasis or evidence of cholecystitis.2. Increased hepatic echogenicity consistent with hepatic steatosis or parenchymal disease. |
Generate impression based on findings. | Worsening urine output and renal function RIGHT KIDNEY: Echogenic renal parenchyma without worrisome mass, stone, or hydronephrosis. Benign-appearing renal cyst. Right kidney 8.9 cm in length.LEFT KIDNEY: Echogenic renal parenchyma without worrisome mass, stone, or hydronephrosis. Benign appearing renal cyst. Left kidney 11.8 cm in length.OTHER: Bladder collapsed. Mild ascites. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or obstruction. Mild ascites. |
Generate impression based on findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 5.8 x 2.2 x 2.2 cmLEFT LOBE MEASUREMENTS: 5.9 x 1.6 x 1.6 cmISTHMUS MEASUREMENTS: 0.6 cmRIGHT LOBE: Stable predominant solid right thyroid nodule measuring 3.4 x 2.3 x 1.3 cmLEFT LOBE: Stable spongiform nodules. Mid pole nodule measures 0.5 x 0.5 x 0.3 cm. Inferior nodule measures 1 x 1 x 0.7 cm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable bilateral thyroid nodules. No regional adenopathy. |
Generate impression based on findings. | Male 67 years old Reason: r/o acalculous cholecystitis History: sepsis, abdominal discomfort, c/f gallbladder dilation on CT abdomen LIVER: Increased echogenicity of the liver compatible with fatty infiltration. Liver is enlarged. Liver measures 18.6 cm.BILIARY TRACT: Gallbladder is significantly distended. There is gallbladder wall thickening. Sludge is present within the gallbladder. These findings are compatible with acute cholecystitis. No evidence of intra or extrahepatic biliary dilatation.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: 2 x 2.4 cm hypoechoic lesion within the left kidney. This study is limited for optimal evaluation of this lesion. Right kidney is unremarkable measuring 11.9 cm. Left kidney measures 12.3 cm. OTHER: No significant abnormalities noted. | Sonographic findings compatible with acute cholecystitis. Diffuse fatty infiltration of the liver. Hepatomegaly. Left renal cyst.Dr. Wali was notified and acknowledged about the above findings at the time of dictation. |
Generate impression based on findings. | Hyperthyroidism RIGHT LOBE MEASUREMENTS: 1.4 x 4.6 x 1.7 cmLEFT LOBE MEASUREMENTS: 1 x 3.3 x 1.4 cmISTHMUS MEASUREMENTS: 0.2 cmRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Mildly atrophic thyroid gland without nodule or increased vascularity. No regional adenopathy. |
Generate impression based on findings. | Right-sided testicular pain RIGHT TESTIS: 4.0 x 2.1 x 3.0 cm. No significant abnormalities noted. Normal testicular vascularity.LEFT TESTIS: 4.2 x 2.3 x 2.7 cm. No significant abnormalities noted. Normal testicular vascularity.RIGHT EPIDIDYMIS: 9 x 11 x 9 mm. No significant abnormalities noted. Normal epididymal vascularity.LEFT EPIDIDYMIS: 10 x 10 x 10 mm. No significant abnormalities noted. Normal epididymal vascularity.OTHER: Small bilateral hydroceles. | No specific evidence of testicular torsion, orchitis, or epididymitis. Small non-specific bilateral hydroceles. |
Generate impression based on findings. | 51 year old with known multiple cysts in both breasts presents for annual mammogram. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Multiple masses in both breasts are again seen; some of them have increased in size. Diffuse benign calcifications are again noted in both breasts.Ultrasound study for both breasts is performed. There are multiple cysts in both breasts, right greater than left. No suspicious findings or solid masses are seen in either breast. | No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Acute renal insufficiency; chronic renal disease RIGHT KIDNEY: Echogenic parenchyma without worrisome mass or hydronephrosis. Nonobstructing subcentimeter right renal stone. Right kidney 9.8 cm in lengthLEFT KIDNEY: Echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Left kidney 10.2 cm in length.OTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass or obstruction. Nonobstructing subcentimeter right renal stone. |
Generate impression based on findings. | Male 53 years old; Reason: elevated PTH, hypercalcemia, assess for parathyroid adenoma History: as above RIGHT LOBE MEASUREMENTS: 5.5 x 2.3 x 2.1 cm.LEFT LOBE MEASUREMENTS: 5.6 x 2.1 x 1.8 cm.ISTHMUS MEASUREMENT: 0.4 cm.RIGHT LOBE: Normal and homogenous echogenicity of the right thyroid parenchyma. There is an approximately 1.3 x 1.3 x 1.0 cm round spongiform nodule on the right.LEFT LOBE: Normal and homogenous echogenicity of the left thyroid parenchyma without mass or nodule.ISTHMUS: Normal and homogenous echogenicity of the isthmus parenchyma without mass or nodule.LYMPH NODES: No suspicious adenopathy noted. OTHER: Posterior and inferior to the right thyroid, there is an approximately 1.3 x 0.8 x 0.9 cm mixed echogenicity lesion that may represent a parathyroid adenoma. | 1.Possible parathyroid adenoma of the right inferior gland. No adenopathy.2.Spongiform nodule in right thyroid as above; favor benign etiology. |
Generate impression based on findings. | 30-year-old female with a palpable lump/mass along the right lateral sternum/chest presents for ultrasound. Patient does not palpate the lump anymore. She felt it was a soft nodule that went away in 2 weeks. Family history of breast cancer in maternal aunt. A targeted right superior/infraclavicular ultrasound was performed for the patient’s area of concern. There is no solid or cystic mass identified. Normal glandular tissue noted. Ultrasound was performed in both supine and sitting position as patient thought the lesion was previously well appreciated in the sitting position. | No sonographic evidence for malignancy corresponding to patient's area of concern in the right infraclavicular/superior breastBIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Reason: R/o tendonitis History: 23-year-old female chronic (4-6 week) anterior knee pain in active adult The patellar tendon was visualized in its entirety and appears intact. The patellar tendon is of normal size and echogenicity. There is no increased vascularity on Doppler interrogation. There is no evidence of a prepatellar or deep infrapatellar bursitis. There are no sonographic findings to account for the patient's pain. | Normal appearing patellar tendon without findings to account for the patient's pain. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Elevated liver enzymes. Lower extremity edema. LIVER: Non-cirrhotic liver morphology. Increased parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction. Calcifications likely represent granulomata of prior infection.GALLBLADDER, BILIARY TRACT: No intrahepatic biliary ductal dilation. Prominent common bile duct within normal limits given cholecystectomy.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 8.3 cm in length. The left kidney is 10.2 cm in length. No suspicious renal lesion evident. No hydronephrosis is present.SPLEEN: 12.2 cm in length, without focal lesion evident.OTHER: No significant abnormalities noted. | Increased hepatic echogenicity, compatible with parenchymal dysfunction/steatosis. |
Generate impression based on findings. | HCV LIVER: Mildly heterogeneous and echogenic liver echotexture without mass. Liver length 14.7 cm.GALLBLADDER, BILIARY TRACT: Cholelithiasis without acute inflammation or ductal dilatation. Probable adenomyomatosisPANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 10.4 cm in lengthOTHER: Left kidney 9 cm in length. Spleen 8.4 cm in length. No ascites. | Mildly heterogeneous and echogenic liver parenchyma suggestive for chronic liver disease without mass or ductal dilatation. No ascites. Cholelithiasis without acute inflammation or ductal dilatation. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Non-cirrhotic liver morphology. 15.0 cm in length. Normal parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladderPANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 10.9 cm in length. The left kidney is 11.8 cm in length. No suspicious renal lesions are evident. No hydronephrosis is seen.SPLEEN: 9.2 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No abdominal free fluid identified. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 41-year-old male with history of thyroid cancer, status post surgery. 1.4 cm hypoechoic nodule seen on outside study, with biopsy-proven recurrence. RIGHT LOBE MEASUREMENTS: Status post thyroidectomyLEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not identified.LYMPH NODES: The 1.4 cm lymph node seen on the outside study is again identified at level 3 between the left carotid artery and left internal jugular vein. This node again measures 1.4 cm, however appears of normal morphology. An additional level 3 lobulated lymph node with internal hyperechoic area measures 9 x 5 x 5 mm. Multiple additional subcentimeter lymph nodes are noted throughout the left neck with suspicious internal echogenicity.OTHER: No significant abnormality noted. | 1. Multiple suspicious-appearing lymph nodes in the left neck, particularly at left level 3 . This level 3 lesion underwent fine-needle aspiration. Please see separate biopsy report for any additional details.2. Previously seen 1.4 cm lymph node identified in the left neck at level 3 between the carotid artery and internal jugular vein. |
Generate impression based on findings. | 57-year-old female with history of left breast mass status post trauma. Annual follow-up. Family history of breast cancer in maternal cousin. Mammogram: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. An 10:00 position of the left breast, the previously mentioned dense mass has significantly decreased in size now measuring 20 x 8 mm. There are stable subcentimeter benign type masses, likely benign intramammary lymph nodes, in the left upper outer quadrant.The right breast is unremarkable.Ultrasound: A targeted left breast ultrasound was performed in the area of mammographic abnormality at the 10:00 position. Approximately 8- 10 cm from the nipple at the 10:00 position, there is a mixed echogenicity oval lesion with a hyperechoic rim which has significantly decreased in size now measuring 16 x 7 x 5 mm (compared to 13 x 12 x 12 mm on prior). There was no internal vascularity. | Findings compatible with a resolving hematoma in the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (9/24/15), ultrasound images of both breasts (9/24/15), images from ultrasound guided biopsy of left breast with specimen radiograph and postprocedural left mammographic images, and images from ultrasound guided right breast aspiration (9/24/15) performed at Rush University Medical Center. For comparison, digital mammographic images (9/11/14, 9/11/13, 3/1/10), ultrasound images (9/11/14, 1/27/14, 9/11/13) are available. DIGITAL MAMMOGRAPHIC IMAGES (9/24/15):The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Multiple circumscribed masses are present in both breasts. Many of those masses are stable and benign. An oval mass at lower outer quadrant in the left breast shows interval increase in size. Multiple calcifications in both breast are unchanged. There are no suspicious findings in either breast on mammogram.ULTRASOUND IMAGES OF BOTH BREASTS (9/24/15):There are multiple simple cysts in the right breast. In the left breast, there is an irregularly shaped hypoechoic mass with angular margins at 6:30 position measuring 6 x 6 mm. A complicated cyst measuring 6 mm is seen at 4:00 position. In addition, there are multiple simple cysts in the left breast. A simple cyst at left 4:30 position likely corresponds to the developing circumscribed mass on left mammogram.IMAGES FROM ULTRASOUND GUIDED BIOPSY OF LEFT BREAST WITH SPECIMEN RADIOGRAPH AND POSTPROCEDURAL LEFT MAMMOGRAPHIC IMAGES, AND IMAGES FROM ULTRASOUND GUIDED RIGHT BREAST ASPIRATION (9/24/15):An aspiration for the complicated cyst at 4:00 position in the right breast was performed. Complete resolution of the cyst was achieved. Core needle biopsy for the hypoechoic mass at 6:30 in the left breast was performed with appropriate needle placement. Radiograph of the specimen shows several pieces of solid tissue without calcifications. Postprocedural mammographic images show a marker clip located at lower inner quadrant in the left breast.Per outside pathology report, the result of the core biopsy of left breast was DCIS grade 3. | Biopsy proven DCIS in the left breast. The lesion was occult on mammogram and was detected on ultrasound. Given complicated appearance of mammogram and dense breast tissue, breast MRI would be helpful to rule out any other occult disease.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Female 51 years old Reason: assess right upper quadrant for abnormality History: elevated alk phos LIVER: Liver measures 17.5 cm. The liver is coarse and nodular, concerning for cirrhosis. Main portal vein is patent with normal directional flow and a peak velocity of 26 cm/s.BILIARY TRACT: Patient is postcholecystectomy. Common bile duct measures 4 mm. No intra or extra hepatic biliary ductal dilatation.PANCREAS: Pancreas is not well-visualized. Spleen is normal in appearance measuring 11.8 cm.SPLEEN: No significant abnormalities noted.KIDNEYS: Right kidney is echogenic measuring 7.9 cm in length. Left kidney measures 7.5 cm. No hydronephrosis.OTHER: Large volume ascites. | 1.Coarse nodular liver, compatible with cirrhosis. No focal hepatic lesion or biliary abnormality.2.Large volume ascites. |
Generate impression based on findings. | 60-year-old female with flank pain, hematuria Limited examination due to body habitus. RIGHT KIDNEY: Measures 10.5 cm in length. No hydronephrosis, nephrolithiasis, or solid mass. LEFT KIDNEY: Measures 12.0 cm in length. No hydronephrosis, nephrolithiasis, or solid mass. URINARY BLADDER: Incompletely distended without focal abnormality. OTHER: No significant abnormalities noted. | No nephrolithiasis, hydronephrosis, or suspicious lesion. |
Generate impression based on findings. | Known history of myeloid circumflex, with palpable area of concern marked by the clinical service in the right axilla. A targeted ultrasound was performed for the right axillary palpable area of concern marked by the service. At this site, there is a superficially located predominantly hyperechoic area measuring 9 x 8 mm which is highly suggestive of a benign process like fat necrosis. There is no solid or cystic mass identified. | Hyperechoic area in the right axilla is highly suggestive of fat necrosis. Further management for this finding will be directed by Dr. Jaskowiak. If clinically desired, ultrasound-guided biopsy can be performed.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Abdominal pain and elevated lipase LIVER: No significant abnormalities noted.GALLBLADDER, BILIARY TRACT: Gallbladder collapsed. Diffuse gallbladder wall thickening with trace pericholecystic fluid. Negative Murphy's. No ductal dilatation.OTHER: No significant abnormalities noted. | Gallbladder collapsed. Diffuse gallbladder wall thickening with trace pericholecystic fluid with negative Murphy's. Favor benign etiology such as low-protein and right heart failure. No compelling evidence to suggest acute inflammation. No ductal dilatation. |
Generate impression based on findings. | 88-year-old male with history of cholecystitis. Evaluate for cholecystitis LIVER: The liver is normal in echotexture and measures 16.1 cm in length.GALLBLADDER, BILIARY TRACT: Layering gallbladder debris consistent with sludge. Gallbladder wall measures 0.3 cm without evidence of pericholecystic fluid. Negative sonographic Murphy's sign.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Kidneys are normal in echotexture with the right kidney measuring 10.6 and the left kidney measuring 9.1 cm in length.OTHER: No significant abnormalities noted. | Gallbladder sludge without sonographic evidence of cholecystitis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. There is a focal asymmetry in the right upper outer quadrant for which further evaluation with spot compression and possibly ultrasound is recommended. No suspicious microcalcifications are present. | Focal asymmetry in the right upper outer quadrant for which further evaluation with spot compression and possibly ultrasound is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | The patient submitted outside mammograms and ultrasound dated 6/17/14 and priors back to 10/9/12. Submitted outside study was compared to the current mammogram dated 8/26/15. The focal asymmetry in the right upper outer breast is stable compared to prior mammograms. At a similar location on the submitted ultrasound images, several adjacent cysts are seen. The left breast masses are not clearly visualized on prior studies (though the more posterior of the left breast masses is seen variably on some prior images--suggesting a waxing and wanning cyst). | Left breast masses should be further evaluated with spot compression and ultrasound. Right breast finding is stable and does not require additional work up at this time. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 74-year-old female with right upper quadrant and epigastric pain. LIVER: The liver is normal in morphology, echogenicity and size, measuring 16.6 cm in craniocaudal dimension. Note is made of a 1 x 1 x 0.7 cm right hepatic lobe echogenic lesion without posterior shadowing or enhanced through transmission. No additional hepatic lesions are identified and the liver capsule is smooth. No intrahepatic biliary ductal dilatation. There is normal hepatopetal portal venous blood flow at 20 cm/sec. The hepatic duct measures 3 mm at the porta hepatis, normal.BILIARY TRACT: There is a normally distended gallbladder without gallstones, wall thickening, pericholecystic fluid, or focal tenderness. The common bile duct at the level of the pancreatic head is normal in caliber measuring 3 mm.PANCREAS: The visualized portions of the pancreatic body and head are normal.SPLEEN: The poorly visualized spleen measures 5 cm in length.RIGHT KIDNEY: The right kidney measures 8.6 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: Limited evaluation of the left kidney, which measures 8.8 cm in length, shows no hydronephrosis, shadowing calculus or discrete lesion. Color Doppler demonstrates hilar blood flow. | 1. No specific findings to account for the patient's right upper quadrant and epigastric pain, accounting for the incomplete visualization of the pancreas. 2. Incidental 1 cm right hepatic lobe lesion likely represents a benign hemangioma in the absence of chronic liver disease. If there is a history of chronic liver disease further evaluation with a dedicated liver CT and/or MRI is recommended. |
Generate impression based on findings. | Right breast focal asymmetry seen on outside mammograms. A targeted right ultrasound was performed for the mammographic area of concern. An ill-defined 1.1 x 0.8 x 1.1 cm heterogeneously hypoechoic mass is seen in the 12:30 position of the right breast 6 cm from the nipple with posterior acoustic shadowing. Mild peripheral vascularity is noted. | Suspicious right breast lesion. Ultrasound guided biopsy is recommended for further evaluation. Findings were discussed with the patient. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | 40-year-old male with right upper quadrant pain LIVER: Echotexture likely mildly increased which is non--- specific. No gross mass on limited exam.GALLBLADDER, BILIARY TRACT: Gallbladder is poorly distended without wall thickening, definite stones or pericholecystic fluid. However, the exam is limited due to under distention and bowel gas.PANCREAS: Limited due to bowel gas.RIGHT KIDNEY: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Limited exam without gallbladder abnormality.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 49 years old; Reason: assess for cirrhosis, h/o ETOH use and congestive heart failure History: weight loss, elevated LFTS LIVER: The liver measures 15.3 cm in length. There is coarse echogenicity of the liver parenchyma. No focal hepatic lesions. No intrahepatic ductal dilation is seen. The main portal vein is patent with normal hepatopetal flow. GALLBLADDER/BILIARY TRACT: The gallbladder wall measures 3.1 mm. No stones are seen. No pericholecystic fluid. The common bile duct measures 4.3 mm in diameter. There are prominent vessels around the gallbladder which could be collaterals. This most likely does not represent cavernous transformation given the portal vein is patent.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 5.6 cm and no significant abnormalities are noted.RIGHT KIDNEY: The right kidney measures 10.5 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.LEFT KIDNEY: The left kidney measures 10.0 cm in length. The cortex has normal echogenicity. No hydronephrosis, stones, or worrisome masses are seen.OTHER: No significant abnormality noted. | 1. Increased and coarse echotexture of liver consistent with chronic liver disease/parenchymal dysfunction. No masses. |
Generate impression based on findings. | 60 years old, Female, Reason: abdominal abscess pocket History: cellulitis, pain, erythema In the right lower quadrant there is a complex area of subcutaneous heterogeneous echogenicity measuring approximately 3.4 x 2.6 x 3.3 cm. Curvilinear hypoechoic component of this complex likely represents fluid measuring up to 5 mm in greatest dimension (image time stamped 2:13:18). Skin thickening is present. Wound draining pus during ultrasound examination. | Complex subcutaneous area of heterogeneous echogenicity with scattered small loculated fluid may represent a severe focal cellulitis or developing abscess, only small amount of internal fluid seen. |
Generate impression based on findings. | Thyroid nodules RIGHT LOBE MEASUREMENTS: 5.8 x 1.6 x 1.9 cmLEFT LOBE MEASUREMENTS: 6.2 x 1.6 x 1.9 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: No significant change in multiple right thyroid nodules. Upper lobe nodule measures 1.1 x 0.8 x 1.1 cm. Mid pole nodule measures 1 x 10.6 x 0.9 cm. Lower pole nodule measures 0.6 x 0.3 x 0.6 cmLEFT LOBE: Stable left thyroid nodules. The largest again measures 1 x 0.6 x 1 cm.ISTHMUS: Stable solid isthmic nodule measuring 0.7 x 0.4 x 0.6 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable bilateral thyroid nodules. No regional adenopathy. |
Generate impression based on findings. | Hematuria RIGHT KIDNEY: Atrophic echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Renal cyst. Right kidney 7.4 cm in length.LEFT KIDNEY: Atrophic echogenic parenchyma without worrisome mass, stone, or hydronephrosis. Renal cyst. Left kidney 8 cm in lengthOTHER: Bladder nondistended | Atrophic echogenic parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or obstruction. |
Generate impression based on findings. | 64-year-old male with history of HCV, cirrhosis. Evaluate for HCC. LIVER: The liver measures 15.3 cm in length. No focal hepatic lesion is identified. There is coarsened echotexture of the liver with increased echogenicity consistent with chronic liver disease. The liver is mildly nodular in contour. Main portal vein flow is hepatopetal and measures 0.2 m/s.GALLBLADDER, BILIARY TRACT: There is no intra or extrahepatic biliary ductal dilatation. There is no pericholecystic fluid, gallbladder wall thickening, or gallstones. The common bile duct measures 4 mm in diameter. PANCREAS: The pancreas is largely obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 11 cm in diameter. The left kidney measures 11.7 cm in length. No evidence of hydronephrosis. OTHER: The spleen measures 10.3 cm in length. | Coarsened echotexture and increased echogenicity of the hepatic parenchyma consistent with chronic liver disease. No focal hepatic lesion is identified. |
Generate impression based on findings. | Renal stone RIGHT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. 11.7 cm in length.LEFT KIDNEY: Normal parenchymal echogenicity without mass, stone, or hydronephrosis. 10.8 cm in length.OTHER: Bladder collapsed | Normal renal ultrasound with normal parenchymal echogenicity without mass, stone, or hydronephrosis. |
Generate impression based on findings. | 47-year-old male patient with history of invasive greater than 3 cm papillary thyroid cancer. Evaluate for recurrence. RIGHT LOBE: Status post thyroidectomy without visible parenchymal tissue or recurrent mass.LEFT LOBE: Status post thyroidectomy without visible parenchymal tissue or recurrent mass.ISTHMUS: Status post thyroidectomy without visible parenchymal tissue or recurrent mass.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Bilateral mildly enlarged submandibular lymph nodes are noted.OTHER: No significant abnormality noted. | 1. No visible parenchymal tissue or recurrent mass in the thyroid bed.2. Mildly enlarged submandibular lymph nodes, which are possibly reactive in etiology. |
Generate impression based on findings. | 59-year-old male with hepatitis C. Evaluate for cirrhosis. LIVER: Course echotexture of the liver measuring 13.5 cm in length. No focal hepatic lesions. Portal vein is patient with appropriate directional flow; peak velocity measures 0.2 m/s. GALLBLADDER, BILIARY TRACT: 1.2 cm shadowing stone within the gallbladder. No pericholecystic fluid. No gallbladder wall thickening. Sonographic Murphy's sign is negative. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Not well-visualized due to overlying bowel gas.RIGHT KIDNEY: Normal echogenicity measuring 9.4 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Normal echogenicity of the left kidney measuring 11.7 cm in length. No hydronephrosis or shadowing calculi are noted.Normal echogenicity of the spleen measuring 12.1 cm in length. | 1. Coarse echotexture of the liver suggestive of parenchymal dysfunction/fatty infiltration. No focal hepatic lesions.2. Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | 70-year-old female with right lower abdominal/groin enlarging mass, possible hernia versus lipoma. In the region of right groin bulge/mass noted by the patient there is a hernial sac containing loops of bowel which increases with Valsalva maneuver and is reducible. | Right inguinal bowel containing reducible hernia. |
Generate impression based on findings. | 26 day old female neonate with apnea. History of ventriculomegaly. Please evaluate for ventriculomegaly/any mass effect. There is mild asymmetric enlargement of the left lateral ventricle on comparison to the right; however this finding is within normal limits and was seen on prior head ultrasound. There is no evidence of intracranial hemorrhage, mass or edema. No evidence of ventriculomegaly; the basal cisterns are normal in appearance.The calvaria and skull base are radiographically normal. The visualized paranasal sinuses are normally pneumatized; the mastoid air cells are partially opacified. | No evidence of ventriculomegaly or other acute abnormality. |
Generate impression based on findings. | Call back from screening mammogram for a mass in the left breast. An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. A lobulated mass is reidentified at lower inner quadrant in the left breast. The mass is circumscribed, isodensity mass.Focused ultrasound for the left breast is performed. There is an elongated anechoic lesion measuring 11 x 3 mm at 7:00 position, consistent with a cyst, corresponding to the mass on the mammogram. | No mammographic or sonographic evidence of malignancy. A cyst in the left breast. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 57 year-old female with goiter on Synthroid for suppression RIGHT LOBE MEASUREMENTS: 3.3 cm x 1.5 cm x 2.3 cmLEFT LOBE MEASUREMENTS: 4.3 cm x 1.5 cm x 1.5 cmISTHMUS MEASUREMENTS: 5 mm in thickness.RIGHT LOBE: Heterogeneous echotexture. Solid nodule again seen at the inferior pole measuring 1.7 cm x 1.3 cm x 1.1 cm, previously 0.9 cm x 1.1 cm x 1.2 cm.LEFT LOBE: Heterogeneous in echotexture with no discrete nodules identified.ISTHMUS: Nodule along the right side of the isthmus is again seen measuring 2.2 cm x 2.0 cm x 0.9 cm, previously measured 2.2 cm x 2.2 cm x 1.5 cm.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: In the right submandibular region corresponding to the patient's palpable lump is a lymph node with normal fatty hilum measuring 2.0 cm x 0.8 cm x 1.4-cm.OTHER: No significant abnormality noted. | Heterogeneous thyroid gland with solid nodules as described above unchanged. Benign appearing lymph node in the right mandibular region corresponding to the patient's palpable lump. |
Generate impression based on findings. | 62-year-old female with epigastric abdominal pain. Also, screening for pancreatic cancer due to strong family history. LIVER: NLiver is normal in size and normal in echogenicity in face study. No focal hepatic abnormality. Limited color and spectral Doppler demonstrates patency and appropriate flow direction in the main portal vein.BILIARY TRACT: Gallbladder is well-visualized. There may be a small amount of gallbladder sludge. Otherwise, the gallbladder appears normal without cholelithiasis, wall thickening or pericholecystic fluid. Visualized biliary tract is normal in caliber.PANCREAS: Normal in size, contour and echogenicity.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Minimal gallbladder sludge. Otherwise normal exam. Normal appearance of the pancreas. |
Generate impression based on findings. | Right upper quadrant pain LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Multiple subcentimeter gallstones identified. Very mild gallbladder wall thickening. Positive sonographic Murphy's sign elicited.PANCREAS: Obscured by bowel gas.KIDNEYS: The right kidney is 10.8 cm in length. The left kidney is 10.5 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 8.4 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No ascites. | Cholelithiasis with mild gallbladder wall thickening and positive sonographic Murphy's sign, likely representing mild cholecystitis. |
Generate impression based on findings. | 55-year-old female with fever of unknown origin. Evaluate for intra-abdominal fluid. Limited images demonstrate no evidence for intra-abdominal fluid. | No ascites. |
Generate impression based on findings. | Multinodular goiter. Gland appears to be enlarging, per patient. Prior biopsies demonstrated benign nodules at Loyola, per patient. RIGHT LOBE MEASUREMENTS: 4.7 x 1.9 x 2.0 cmLEFT LOBE MEASUREMENTS: 5.3 x 1.3 x 1.3 cmISTHMUS MEASUREMENTS: 2 mm in AP dimensionRIGHT LOBE: The right thyroid lobe is diffusely heterogeneous without discrete nodules. LEFT LOBE: The left thyroid lobe is multinodular. The largest of these measures 12 mm, with homogeneous echotexture, defined margins, and without suspicious features. Additional colloid nodules identified.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not identified.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Multinodular goiter, without suspicious features identified. |
Generate impression based on findings. | History of hepatitis B, screening for hepatocellular carcinoma. LIVER: The liver measures 12.2 cm in length. The liver parenchymal echotexture is mildly coarse. Redemonstration of focal lesion within segment 2 measuring 1.2 x 1.3 x 1.7 cm, unchanged in size, with imaging features on prior CT compatible with hemangioma. Stable right lobe hepatic cyst. 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 3 mm in diameter.PANCREAS: No significant abnormalities noted within the visualized portions of the pancreas.SPLEEN: No significant abnormalities noted. The spleen measures 7.4 cm in length. RIGHT KIDNEY: Kidney measures 10.7 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 10.8 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No significant abnormalities noted. | Stable left lobe hemangioma and right lobe hepatic cyst. No worrisome focal hepatic lesions identified. No ascites. |
Generate impression based on findings. | Multinodular goiter RIGHT LOBE MEASUREMENTS: 6.4 x 1.6 x 2.2 cmLEFT LOBE MEASUREMENTS: 5.9 x 1.6 x 1.5 cmISTHMUS MEASUREMENTS: 1 mm in AP dimension.RIGHT LOBE: Unchanged solid heterogeneous 1.9 cm nodule in the inferior pole.LEFT LOBE: Multiple subcentimeter cystic and heterogeneously solid nodules are unchanged. The largest of these measures 10 x 7 x 5 mm, previously 9 x 8 x 5 mm.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Benign-appearing lymph nodes identified.OTHER: No significant abnormality noted. | Unchanged multinodular goiter. |
Generate impression based on findings. | Ms. Battie is a 40 year old presenting with an enlarging palpable lesion in the right breast, previously found to be a cyst on prior diagnostic mammogram on 08/19/2016. A targeted right ultrasound was performed for the patient’s palpable area of concern. Multiple enlarging simple cysts are identified, the largest of which measures 3.9 x 2.5 x 3.3 cm. No suspicious solid masses identified. | Multiple benign simple cysts of the right breast. No sonographic evidence for malignancy. The patient should follow up with her primary care physician as clinically warranted, presuming these results are concordant with the physical exam findings. The patient can certainly get an ultrasound-guided cyst aspiration as a possible option for her enlarging cysts. Bilateral screening mammogram is recommended annually, due next in August 2017. All results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Female 58 years old Reason: Liver dysfunction History: ascites, hx of pancreatic and breast cancer LIVER: There are calcifications within the liver. Hepatic veins and IVC are dilated. Right-sided pleural effusion. Enlarged liver secondary to heart failure.BILIARY TRACT: Gallbladder is not visualized. No evidence of intra or extrahepatic biliary dilatation.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: Atrophic right kidney without evidence of hydronephrosis. Echogenic right kidney. Right kidney measures 8.6 cm. OTHER: No significant abnormalities noted. | Echogenic right kidney. Moderate amount ascites. Small right-sided pleural effusion. Enlarged liver secondary to heart failure. |
Generate impression based on findings. | 37-year-old male post thyroidectomy for papillary thyroid carcinoma with nodal metastases. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massesLEFT LOBE: No massesISTHMUS: No massesPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Morphologically normal lymph nodes bilaterally. A level 2 node on the right which is mildly abnormal in shape with poor visualization of fatty hilum is completely unchanged from prior exam, measuring 0.4 x 1 x 1.1 cm.OTHER: No significant abnormality noted. | No evidence for local recurrence or metastatic disease. |
Generate impression based on findings. | 56-year-old male with history of thyroid cancer post thyroidectomy. Follow-up nodules. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: There again noted to rounded, slightly hypoechoic nodules in the thyroidectomy bed. These are less well-visualized than on the prior exam. Nodule in the mid bed measures 0.4 x 0.4 x 0.5 cm without change and nodule in the inferior bed measures 0.5 x 0.5 x 0.5 cm without significant change.LEFT LOBE: No masses byISTHMUS: No massesPARATHYROID GLANDS: No massesLYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable nodules in the right thyroidectomy bed. |
Generate impression based on findings. | Acute kidney injury and hyperkalemia. RIGHT KIDNEY: Right kidney measures 11.4 cm. The cortex is increased in echogenicity. No renal calculus, hydronephrosis or suspicious mass identified.LEFT KIDNEY: Left kidney measures 9.1 cm. The cortex is increased in echogenicity. No renal calculus, hydronephrosis or suspicious mass identified.URINARY BLADDER: No significant abnormalities noted.OTHER: The liver appears nodular and increased in echogenicity. There is heterogeneity within the hepatic dome, probable mass. Large volume ascites present. | 1.Echogenic kidneys, probable medical renal disease. No renal calculus, hydronephrosis or suspicious mass.2.Nodular heterogeneous liver, compatible with cirrhosis. Hepatic mass present, but incompletely evaluated on this dedicated renal ultrasound.3.Large volume ascites. |
Generate impression based on findings. | Female 20 years old Reason: Needs US guided biopsy of transplant kidney History: Worsening of renal function Ultrasound guidance and technical assistance was provided for a renal allograft in the right iliac fossa. Dr. Chon attending. 2 passes made (one18-gauge 1.5 g and one 25 g).The procedure was successfully completed. | Successful ultrasound guided biopsy of the renal allograft in the right iliac fossa. |
Generate impression based on findings. | 79-year-old female patient with gallbladder wall thickening on CT. LIVER: The liver measures 15.4 cm in length. No focal hepatic lesion is identified Hepatic parenchyma echogenicity is mildly heterogeneous. Main portal vein flow is hepatopetal and measures 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder contains numerous shadowing gallstones. There is no pericholecystic fluid or gallbladder wall thickening. Sonographic Murphy's sign is negative. No intra- or extrahepatic biliary ductal dilatation is identified. The common duct measures 6 mm in diameter.PANCREAS: The head and body of the pancreas demonstrate normal echogenicity. The tail is obscured by overlying bowel gas.RIGHT KIDNEY: The right kidney measures 9.9 cm in length. No evidence of hydronephrosis. Renal cortical echogenicity is slightly increased.OTHER: The left kidney measures 9.9 cm in length. No evidence of hydronephrosis. Renal cortical echogenicity is slightly increased. There is a 4.1 x 4.3 x 4.3 cm left upper pole simple renal cyst.The spleen measures 8.5 cm in length. | 1. Cholelithiasis without sonographic evidence of acute cholecystitis.2. Medical renal disease and simple left upper pole renal cyst. |
Generate impression based on findings. | Right upper quadrant ultrasound, evaluate for cholecystitis LIVER: Liver measures 19.5 cm with diffuse coarse echotexture. Portal vein demonstrates normal flow directionality and patency. No focal lesions noted. Minimal fluid fluid noted in the abdomen. No intrahepatic biliary ductal dilatation.BILIARY TRACT: Gallbladder is distended with normal gallbladder wall thickness measuring up to 2.5 mm. No evidence of gallstones. Minimal sludge noted in the gallbladder. Cannot assess Murphy's sign on this patient as per the technologist. Common bile duct measures up to 4 mm within normal limits.PANCREAS: Head of the pancreas partially visualized appears unremarkable. Body and tail of pancreas could not be visualized due to overlying bowel gas.SPLEEN: Spleen measures 14.6 cm, mildly increased in size. Echogenic area in the spleen is not completely evaluated but could represent a small hemangioma.RIGHT KIDNEY: Right kidney measures 11.9 cm and left kidney measures 9 cm. Limited evaluation of the left kidney due to patient positioning. Mild increased echogenicity of the kidneys noted bilaterally. No hydronephrosis. OTHER: Minimal fluid in the abdomen | Coarse diffuse echotexture of the liver without any focal lesions. Distended gallbladder with minimal sludge within it without evidence of acute cholecystitis.Mild splenomegaly however spleen and left kidney could not be completely evaluated due to patient positioning.Bilateral echogenic kidneys consistent with chronic medical renal disease.Mild ascites |
Generate impression based on findings. | 21-year-old male with abnormal liver function. Short gut syndrome. LIVER: Liver is enlarged, measuring at least 20 cm in length. Echotexture is within normal limits. No focal hepatic abnormality.GALLBLADDER, BILIARY TRACT: Gallbladder contains dependent sludge without gallstones, wall thickening or pericholecystic fluid. The biliary tract is normal in caliber.PANCREAS: Not visualized due to access.RIGHT KIDNEY: Likely highly echogenic.OTHER: Left upper quadrant could not be evaluated. | Hepatomegaly.Gallbladder sludge. |
Generate impression based on findings. | 60-year-old female patient with biopsy-proven left breast IDC on chemotherapy. UNILATERAL LEFT DIAGNOSTIC MAMMOGRAM:Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty(BiRads Density Category A), unchanged in pattern and distribution. Again seen is in irregular mass with spiculated margins in the left lower outer breast that measures 1.4 x 1.7 cm on CC view, previously 1.8 x 2.1 cm when measured similarly. A percutaneous clip is noted along the posterior margin of the mass. Few benign calcifications are noted distant from the mass.In the left axilla there is a percutaneous clip immediately posterior to a lymph node that measures 0.7 x 1.0 cm, previously measuring 1.4 x 1.9 cm.LEFT BREAST AND AXILLARY ULTRASOUND:In the 4:00 position 5 cm from the nipple there is an irregular hypoechoic mass that measures 1.5 x 1.4 x 1.8 cm, previously 2.2 x 2.2 cm on ultrasound dated 09/18/2015.In the left axilla there are two abnormal appearing lymph nodes. One lymph node measures 0.8 x 0.7 x 0.8 cm. The previously biopsied lymph node with posterior clip measures 1.6 x 0.5 x 0.6 cm, previously measuring up to 1.6 cm on 10/08/2015. However, this lymph node node is decreased in volume compared to prior. | Interval decrease in size of known left breast cancer as well as interval decrease in size of left axillary lymph nodes. Findings were discussed with the patient.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 28-year-old female with a nontender palpable lump in the right breast for 2 weeks. A targeted right ultrasound was performed in the 2:00 position of the medial upper right breast approximately 3 cm from the nipple. On physical exam in this area, a non-tender mass was palpable. By ultrasound of this region, a oval circumscribed hypoechoic mass measuring 1.1 x 2.3 cm with internal vascular flow was identified. | 2.3 cm right breast mass could be a fibroadenoma. However, surgical consultation for consideration of palpably guided sampling is recommended to exclude malignancy. Results and recommendations were discussed with the patient who agreed with the plan.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Single thyroid nodule. Palpable. History of Hashimoto's thyroiditis, per patient. RIGHT LOBE MEASUREMENTS: 4.0 x 1.4 x 1.5 cm. Normal in size with normal background echotexture and vascularity.LEFT LOBE MEASUREMENTS: 3.9 and 1.1 x 1.2 cm. Normal in size with normal background echotexture and vascularity.ISTHMUS MEASUREMENTS: 1 mm in AP dimension.RIGHT LOBE: No significant abnormality noted.LEFT LOBE: No significant abnormality noted.ISTHMUS: 6 mm solid isoechoic nodule in the right aspect of the isthmus.PARATHYROID GLANDS: Not visualized.LYMPH NODES: Benign-appearing cervical lymph nodes identified.OTHER: No significant abnormality noted. | 6 mm solid nodule in the right aspect of the isthmus. This may be amenable to percutaneous biopsy. |
Generate impression based on findings. | History of fatty liver LIVER: Echogenic heterogeneous echotexture without mass. Liver length 19.4 cmGALLBLADDER, BILIARY TRACT: No significant abnormalities noted.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. 12.6 cm in lengthOTHER: Left kidney 12 cm in length. Spleen 11.7 cm in length. No ascites | Echogenic heterogeneous liver echotexture consistent with fatty infiltration without mass or ductal dilatation. No ascites. |
Generate impression based on findings. | Female 51 years old Reason: eval left labia/groin for fluid collection History: cellulitis and induration s/p bee sting The left labia is markedly edematous and swollen with hypo and anechoic indurated areas. No evidence of any loculated collection to suggest abscess. The largest focal measurable areas 0.7 x 0.7 cm. Labia are vascular on color Doppler imaging. | Swollen and indurated left labia with largest loculated collection measuring only 0.7 cm. No collections that would be amenable to percutaneous drainage. |
Generate impression based on findings. | Chronic indwelling Foley with retention of urine RIGHT KIDNEY: Echogenic renal parenchyma. Multiple minimally complex cysts. No stone or hydronephrosis. 11.5 cm in lengthLEFT KIDNEY: Echogenic renal parenchyma without worrisome mass, stone, or hydronephrosis. 1.2 cm hypoechoic focus in the region of the mid; favor normal renal parenchyma.OTHER: Diffuse bladder wall thickening. Indwelling Foley catheter noted. Trace ascites. Large right pleural effusion. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without worrisome mass, stone, or hydronephrosis. Diffuse bladder wall thickening suggestive for chronic inflammation; indwelling Foley catheter noted. Trace ascites. Large right pleural effusion. |
Generate impression based on findings. | Cirrhosis. Evaluate for hepatocellular carcinoma. LIVER: Non-cirrhotic liver morphology. Mildly coarsened parenchymal echogenicity. No focal hepatic lesions. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladderPANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 9.8 cm in length. The left kidney is 9.4 cm in length. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: 9.8 cm in length, without focal lesions evident.OTHER: No significant abnormalities noted. No ascites identified. | Mildly coarsened hepatic echogenicity compatible with parenchymal dysfunction, without suspicious hepatic lesion identified. |
Generate impression based on findings. | Cholelithiasis with history of cirrhosis LIVER: Cirrhotic morphology without mass. Liver length 13 cmGALLBLADDER, BILIARY TRACT: Stable cholelithiasis without acute inflammation or ductal dilatation.PANCREAS: Stable subcentimeter pancreatic cyst.RIGHT KIDNEY: No significant abnormalities noted. Stable renal cysts. Right kidney 11.2 cm in lengthOTHER: Stable left renal cyst. Left kidney 11.1 cm in length. Spleen 10.2 cm in length. No ascites. | Stable cirrhotic morphology without mass or ductal dilatation. No ascites. Stable subcentimeter pancreas cyst. Stable cholelithiasis without acute inflammation or ductal dilatation. |
Generate impression based on findings. | Acute renal failure RIGHT KIDNEY: Echogenic renal parenchyma without worrisome mass or stone. Minimal hydronephrosis. Right kidney 12.4 cm in lengthLEFT KIDNEY: Echogenic renal parenchyma without mass, stone, or hydronephrosis. Left kidney 12.7 cm in lengthOTHER: Bladder nondistended. Abdominal ascites. | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass or stone. Minimal right hydronephrosis. Abdominal ascites. |
Generate impression based on findings. | Right renal mass. RIGHT KIDNEY: 10.5 cm in length. The 2.9 x 2.2 x 2.8 cm solid mass at the superior pole is again noted, previously 2.8 x 2.2 x 2.7 cm. Additional multiple minimally complex cysts are identified. No hydronephrosis.LEFT KIDNEY: 10.5 cm in length. Multiple minimally complex cysts are identified. No suspicious lesions are evident. No hydronephrosis.BLADDER: Diffusely thickened bladder wall, similar to prior. OTHER: Prostatomegaly, measuring 6.4 x 6.2 x 5.1 cm and similar to prior. | Unchanged appearance of the right upper pole renal mass, which remains suspicious for renal cell carcinoma. |
Generate impression based on findings. | Liver failure. Known spontaneous left renal hemorrhage at outside hospital. LIVER: Cirrhotic liver morphology. Coarsened parenchymal echogenicity. No focal hepatic lesions. GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. The gallbladder is not well-visualized.PANCREAS: No sonographic abnormality evident in the visualized pancreatic head and neck. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney is 13.3 cm in length. The renal parenchyma is markedly echogenic. No suspicious renal lesions or hydronephrosis.The left kidney is 13.1 cm in length. No suspicious renal lesions. Mild hydronephrosis. A 12.5 x 8.3 x 5.4 cm hypoechoic collection extends from the inferior pole of the left kidney and is incompletely visualized.BLADDER: Collapsed with Foley catheter in place.SPLEEN: 12.6 cm in length, without focal lesions evident.ABDOMINAL AORTA: Patent. 2.2 cm in maximal diameter, without aneurysm. The distal most aorta is obscured by overlying bowel gas.INFERIOR VENA CAVA: Patent.OTHER: Moderate amount of ascites noted. Complex appearing right pleural effusion is partially imaged.DOPPLER | 1. Cirrhosis with minimal detectable portal venous flow.2. 12 cm retroperitoneal collection at the inferior pole of the left kidney, compatible with hemorrhage given the clinical history. This is incompletely visualized by ultrasound and CT is recommended if more complete evaluation is warranted.3. Echogenic kidneys compatible with medical renal disease. Mild left-sided hydronephrosis.4. Moderate amount of ascites. Right pleural effusion. |
Generate impression based on findings. | 73-year-old male patient with UTI, sepsis. Evaluate for hydronephrosis. RENAL TRANSPLANT: LOCATION: Right iliac fossa.PERITRANSPLANT TISSUES: No perinephric fluid collection is identified.KIDNEY: The transplant kidney measures 12.1 cm in length. Renal cortical echogenicity is within normal limits. A subcentimeter cyst is noted within the lower pole.COLLECTING SYSTEM/URETER: There is mild pelvicalyceal prominence, which decreases post-void. A catheter is noted within the renal pelvis.URINARY BLADDER: The bladder is distended with fluid with retention post-void. The distal end of a ureteral stent is visualized.OTHER: No significant abnormality noted | 1. Mild prominence of the collecting system which decreases post-void.2. Post-void urinary retention. |
Generate impression based on findings. | 57 years old, Female, Reason: 57 yo F with intermittent RLQ abdominal pain x weeks with CT showing concerns for cholecystitis. Pls aid in eval of acute vs. chronic cholecystitis. History: intermittent RLQ pain LIVER: The liver measures 14.1 cm in length. Mildly increased hepatic parenchymal echogenicity is consistent with fatty infiltration. 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: Multiple gallstones are present within the gallbladder. Gallbladder wall is hypovascular is mildly thickened measuring 5 mm. The sonographic Murphy's sign is negative. No intrahepatic biliary ductal dilatation is present. The common bile duct measures 8 mm in diameter. No evidence of pericholecystic fluid.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9.7 cm in length. RIGHT KIDNEY: Kidney measures 10.3 cm in length. Normal echotexture of the right kidney. Nohydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 9.7 cm in length. Normal echotexture. Nohydronephrosis, shadowing calculus or mass.OTHER: No significant abnormalities noted. | Cholelithiasis without definite evidence of acute cholecystitis. However findings may represent chronic cholecystitis. |
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. | 24-year-old female, pregnancy with right upper quadrant pain. Evaluate for subcapsular hematoma the liver. LIVER: Normal in size and echotexture. No associated fluid collections. Main portal vein is patent with appropriate flow direction.GALLBLADDER, BILIARY TRACT: No cholelithiasis, wall thickening or pericholecystic fluid. Visualized intra and extra hepatic biliary tract are normal in caliber.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Probable horseshoe kidney crossing the midline.OTHER: No significant abnormalities noted. | No evidence for subcapsular hematoma. No cause for patient's right upper quadrant pain identified. |
Generate impression based on findings. | 79-year-old male with history of CHF, VT ablation with rising LFTs, AMS. Evaluate patency of portal and hepatic vasculature. LIMITED ABDOMENLIVER: Increased echogenicity the liver measuring 15.4 cm in length. No focal hepatic lesions.BILIARY TRACT: The gallbladder is not visualized. No intra-or extrahepatic noted ductal dilatation.PANCREAS: Visualized portions of the pancreas are unremarkable.SPLEEN: Normal echogenicity of the spleen measuring 11.0 cm in length. RIGHT KIDNEY: Mildly echogenic right kidney measuring 10.0 cm in length. No hydronephrosis or shadowing calculi are noted.OTHER: Mildly echogenic left kidney measuring 9.3 cm in length. No hydronephrosis or shadowing calculi are noted. | 1. Increased echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. No hepatic mass. Patent inflow and outflow hepatic vasculature.2. Mildly echogenic kidneys suggestive of parenchymal dysfunction. |
Generate impression based on findings. | Acute renal failure RIGHT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. Right kidney 9 cm in lengthLEFT KIDNEY: Echogenic parenchyma without mass, stone, or hydronephrosis. Left kidney 10.4 cm in lengthOTHER: Bladder nondistended | Echogenic renal parenchyma consistent with medical renal disease/parenchymal dysfunction without mass, stone, or obstruction. |
Generate impression based on findings. | Right breast fibroadenoma, assess stability. Patient indicates palpable mass right breast 10:00 minimally increases in size during periods, mostly stable. A targeted right ultrasound was performed for the palpable area of concern. On physical examination, 2 cm mobile mass noted in the right breast 10 to 12:00 position. Ultrasound demonstrates a possible bilobed or 2 adjacent small masses at 10:00 position. The hypoechoic encapsulated mass measures 2.5 x 1.2 x 2.4 cm, previously measured 2.5 x 0.9 x 2 cm, mostly unchanged from prior study. Peripheral blood flow noted. There are no new masses noted. | Palpable abnormality right breast 10:00 position corresponds to stable benign fibroadenoma based on imaging. Findings conveyed to the patient and her mother.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Reason: Screening for hepatocellular carcinoma History: cirrhosis; hx of HCV LIVER: The liver measures 19.35 cm in length and is nodular in contour. The liver demonstrates increased parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions or masses are identified. The portal vein is patent demonstrating normal hepatopetal flow with a velocity of 0.19 m/s.BILIARY TRACT: Nonmobile, non-shadowing focus along the gallbladder wall likely representing a polyp measuring up to 4 mm, unchanged. No 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 12.3 cm in length. RIGHT KIDNEY: Kidney measures 13.4 cm in length. Normal cortical echotexture. No hydronephrosis.LEFT KIDNEY: Kidney measures 14.9 cm in length. Normal cortical echotexture. No hydronephrosis.OTHER: No ascites. | 1.Hepatomegaly and cirrhotic liver morphology without focal hepatic lesions. No ascites.2.4 mm gallbladder polyp is stable. |
Generate impression based on findings. | Reason: nodule on CT History: none RIGHT LOBE MEASUREMENTS: 5.9 x 1.7 x 1.7 cm.LEFT LOBE MEASUREMENTS: 4.9 x 1.9 x 1.5 cm.ISTHMUS MEASUREMENTS: 0.6 cm.RIGHT LOBE: In the inferior pole, there is a predominantly solid well-defined ovoid nodule measuring 0.9 x 0.5 x 0.9 cm, likely benign.LEFT LOBE: In the left lobe, there is a spongiform ovoid nodule measuring 1.2 x 0.8 x 1.0 cm.ISTHMUS: In the isthmus, there is a spongiform ovoid nodule measuring 1.2 x 0.8 x 1.0 cm, likely benign.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No lymphadenopathy.OTHER: No significant abnormality noted. | Three likely benign thyroid nodules. |
Generate impression based on findings. | Inflammatory bowel disease with abdominal pain and fatigue LIVER: No significant abnormalities noted. 15.4 cm in length BILIARY TRACT: Probable adenomyomatosis of gallbladder. No evidence for acute inflammation or ductal dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. 10.9 cm in lengthRIGHT KIDNEY: No significant abnormalities noted. 10 cm in lengthOTHER: Left kidney 11.2 cm in length. No ascites. | Probable adenomyomatosis of gallbladder without evidence for acute inflammation or ductal dilatation. No acute hepatobiliary abnormality. No ascites. |
Generate impression based on findings. | 22 years old, Male, Reason: Evaluate liver and biliary tract History: 22 yo M with hx of MCTD, tricuspid regurgitation, R knee infection, new transaminitis LIVER: The liver measures 16.6 cm in length. The parenchymal echogenicity of the liver is normal. No focal hepatic lesion identified. IVC and hepatic veins are distended, may be seen in the setting of rightsided heart failure. The portal vein is patent with pulsatile hepatopetal flow and 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 or extrahepatic biliary ductal dilatation is present. The common bile duct measures 5.5 mm in diameter.PANCREAS: No significant abnormalities noted in the visualized portions of the pancreas. SPLEEN: No significant abnormalities noted. The spleen measures 9 cm in length. RIGHT KIDNEY: Kidney measures 11.6 cm in length. No evidence of hydronephrosis.LEFT KIDNEY: Kidney measures 9.2 cm in length. No evidence of hydronephrosis. | 1.Normal gallbladder and biliary tract with no evidence of cholelithiasis or acute cholecystitis.2.The parenchymal echogenicity of the liver is normal. No focal hepatic lesion identified. 3.IVC and hepatic veins are distended, suggesting rightsided heart failure. |
Generate impression based on findings. | 51-year-old male with hepatitis C. Evaluate for HCC. LIVER: The liver parenchyma is mildly increased and coarsened in echogenicity. No discrete lesion is identified. It measures 17.8 cm in craniocaudal dimension. No intrahepatic biliary ductal dilatation. Normal hepatopetal portal venous blood flow at 20 cm/sec.BILIARY TRACT: The common duct measures 5 mm in caliber, within normal limits. The patient is status post cholecystectomy.PANCREAS: The visualized portions of the pancreatic body and head are normal.SPLEEN: The spleen is normal morphology, echogenicity and size, measuring 11.8 cm in length.RIGHT KIDNEY: The right kidney measures 10.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. OTHER: The left kidney measures 10.7 cm in length without hydronephrosis, shadowing calculus or discrete lesion evident. Color Doppler demonstrates hilar blood flow. | Mild hepatic parenchymal hyper-echogenicity suggesting underlying hepatic steatosis and/or parenchymal dysfunction. No discrete liver lesion. |
Generate impression based on findings. | There are 5 lumbar-appearing vertebrae. For the purposes of this exam, the last fully formed disc is at L5-S1 with the last rib-bearing vertebra designated as T12.The lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The distal spinal cord and conus are within normal limits with the conus terminating at the low normal L2-L3 level. On prone imaging, there is clear ventral motion of the distal cord and conus within the thecal sac. No abnormal fat signal intensity is seen along the distal thecal sac to suggest a fatty filum.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the lumbar spine. | Essentially unremarkable noncontrast MRI of the lumbar spine, without MR imaging findings of tethered cord. Conus termination is at the lower limits of normal at L2-L3. |
Generate impression based on findings. | Male 60 years old Reason: evaluate for hydronephrosis, medical renal disease in transplanted kidney History: patient with progressive creatinine worsening post transplant, course complicated by BK viremia and acute rejection RIGHT ILIAC FOSSA KIDNEY: No hydronephrosis or shadowing calculus. Renal cortex has increased echogenicity consistent with medical renal disease. Perinephric fluid collection is decreased in size compared to the prior exam measuring 2.8 x 1.2 x 2.0 cm.OTHER: No significant abnormalities noted. | 1.No hydronephrosis or shadowing calculus. Increased renal cortical echogenicity is nonspecific but can be seen in the setting of medical renal disease. 2.Perinephric fluid collection is decreased in size compared to the prior exam. |
Generate impression based on findings. | History of HCV, cirrhosis LIVER: Nodular contour of the liver with coarse echotexture compatible with cirrhotic morphology. No focal lesions noted.GALLBLADDER, BILIARY TRACT: Large stone noted within the distended gallbladder. The wall thickness within normal limits without evidence of pericholecystic fluid. No extra or intrahepatic ductal dilatation noted. Common bile duct measures up to 3 mm.PANCREAS: Partially visualized due to overlying bowel gas, unremarkableRIGHT KIDNEY: Right kidney measures 7.8 cm and left kidney measures 10.4 cm. Areas of cortical thinning noted in both kidneys. Normal echotexture without hydronephrosis. OTHER: The spleen measures 6.3 cm with normal echo texture. | Cirrhotic morphology of liver without any focal discrete lesion. No ascites. Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Evaluate for acute cholecystitis. Evaluate right iliac fossa renal allograft. LIVER: The liver is normal in morphology, echogenicity and size measuring 15.3 cm in craniocaudal dimension. No focal lesion or intrahepatic biliary ductal dilatation. Normal hepatopedal portal venous blood flow at 36 cm/s. Normally distended gallbladder without significant wall thickening pericholecystic fluid or focal tenderness (although non-specific in the setting of pain medication administration)2 4 mm non-dependent adherent non-shadowing gallstones and/or polyps.BILIARY TRACT: No intra or extrahepatic biliary ductal dilatation with the common duct measuring 2 mm.PANCREAS: The visualized portions of the pancreatic head are unremarkable. The body and tail is obscured by overlying bowel gas.SPLEEN: The spleen measures 10.9 cm in length.RIGHT ILIAC FOSSA TRANSPLANT: The right iliac fossa transplanted kidney measures 13.7 cm in length without hydronephrosis, shadowing nephrolithiasis or discrete lesion. It demonstrates normal corticomedullary differentiation. No peritransplant fluid collection. Color Doppler demonstrates hilar blood flow.OTHER: No significant abnormalities noted. | 1. Two 4 mm adherent non-shadowing gallstones versus gallbladder polyps. No evidence of acute cholecystitis.2. Unremarkable right iliac fossa renal allograft. Please note that detailed evaluation of the vasculature was not performed. |
Generate impression based on findings. | Unknown baseline creatinine, renal disease RIGHT KIDNEY: Measures 10.3 cm. Echogenic renal parenchyma. No hydronephrosis or mass.LEFT KIDNEY: Measures 9.1 cm. Echogenic renal parenchyma. No hydronephrosis or mass. Nonobstructive stone in the renal pelvis measures up to 0.9 cm.OTHER: Bladder is incompletely distended. | Medical renal disease and nonobstructive left renal pelvis stone. |
Generate impression based on findings. | 15-year-old female with history of right breast mass, presenting for short-term sonographic follow-up. No family history of breast cancer. On the physical exam there is a mobile oval mass at the right 11:00 position.Targeted ultrasound of the right upper outer breast, 11:00 position 3 cm from the nipple reveals an oval circumscribed parallel hypoechoic mass measuring 2.2 x 1.1 x 1.9 cm (largely stable in size using similar measuring techniques), with internal vascularity and posterior acoustic enhancement. | No enlargement of the high probability benign right 11:00 mass, with imaging characteristics suggestive of a fibroadenoma. As long as the mass remains clinically stable and will be followed, sonographic follow-up in 6-12 months is suggested. BIRADS: 3 - Probably benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | 57 year old female post thyroidectomy for thyroid cancer. Follow-up small focus left thyroid bed. RIGHT LOBE MEASUREMENTS: Post thyroidectomyLEFT LOBE MEASUREMENTS: Post thyroidectomyISTHMUS MEASUREMENTS: Post thyroidectomyRIGHT LOBE: No massesLEFT LOBE: No masses. There is identified small hypoechoic area no longer seen.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence for mass or abnormal lymph nodes. |
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 52 years old Reason: thyroid nodules History: thyroid nodules RIGHT LOBE MEASUREMENTS: 5.4 x 1.6 x 1.3 cmLEFT LOBE MEASUREMENTS: 5.2 x 1.5 x 1.1 cmISTHMUS MEASUREMENTS: 2 mm RIGHT LOBE: Again noted are multiple nodules in the right thyroid lobe. Index complex cystic solid and upper pole nodule is slightly smaller measuring 1.6 x 0.6 x 1 cm. Other nodules are also unchanged.LEFT LOBE: Again noted are multiple nodules in the left thyroid lobe. Index lower pole nodule is unchanged measuring 1.6 x 0.8 x 1 cm. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant change in the size and number of the nodules. |
Generate impression based on findings. | 81 years Female with pain over left renal fossa following trauma. RIGHT KIDNEY: Kidney measures 9.4 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: Kidney measures 10.0 cm in length. Normal echotexture. No hydronephrosis, shadowing calculus or mass.OTHER: The bladder appears grossly unremarkable. | Unremarkable examination without evidence of perinephric fluid collection. |
Generate impression based on findings. | Multiple lymph nodules. There is no evidence of significant cervical lymphadenopathy base on size criteria, including subcentimeter right level 5A lymph nodes. The major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | No discernible thyroid nodules or significant lymphadenopathy in the neck. |
Generate impression based on findings. | 61-year-old with known breast cancer and palpable left supraclavicular nodes. A targeted left ultrasound was performed for the area marked by the clinical service in the supraclavicular region. There are multiple adjacent small masses. Several of these are highly compatible with abnormal morphology lymph nodes. These measure up to 9 mm. The largest mass is a mixed echogenicity mass with increased vascularity measuring 2.0 x 1.9 cm. This could represent an additional lymph node replaced by tumor. | Multiple masses at the site of palpable concern most compatible with abnormal lymph nodes. The patient is followed by Dr. Jaskowiak.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Hematuria RIGHT KIDNEY: 9.4 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis. No perinephric fluid collections.LEFT KIDNEY: 9.2 cm in length. Unremarkable renal parenchymal echogenicity. No suspicious lesions are evident. No renal stones or hydronephrosis. No perinephric fluid collections.BLADDER: Collapsed.OTHER: No significant abnormality noted. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Successful hypodense lesion seen on prior chest CT. Weight loss. Normal TSH. RIGHT LOBE MEASUREMENTS: 5.1 x 2.6 x 2.3 cmLEFT LOBE MEASUREMENTS: 4.6 x 1.2 x 0.9 cmISTHMUS MEASUREMENTS: 0.2 cm in AP dimensionRIGHT LOBE: The heterogeneous predominantly-solid nodule in the midpole measures 3.2 x 1.8 x 2.8 cm, with some features suggestive of early spongiform changes. LEFT LOBE: Predominately cystic 0.4 x 0.3 x 0.4 cm nodule in the lower pole.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: Not visualized.LYMPH NODES: 1.5 x 0.7 x 0.3 cm left level 3 lymph node, without suspicious features. | Thyroid nodules, with the dominant right lobe nodule demonstrating early spongiform changes. |
Generate impression based on findings. | 36-year-old female with a multinodular thyroid. Evaluate nodules. RIGHT LOBE MEASUREMENTS: 5.3 x 1.6 x 1.8 cm.LEFT LOBE MEASUREMENTS: 4.5 x 1.8 x 1.8 cm.ISTHMUS MEASUREMENTS: 0.2 cm.RIGHT LOBE: The right parenchyma is heterogeneous and nodular. There are multiple hypoechoic areas throughout the thyroid. There are associated somewhat linear areas of increased echogenicity which may be seen in thyroiditis. No focal mass. The right thyroid appears less vascular in comparison to the prior study.LEFT LOBE: Left parenchyma is heterogenous and nodular. There are multiple hypoechoic areas throughout the thyroid. There are associated somewhat linear areas of increased echogenicity which may be seen in thyroiditis. No focal mass. The left thyroid appears less vascular in comparison to the prior study.ISTHMUS: The parenchyma of the isthmus is heterogenous and nodular. There are multiple hypoechoic areas throughout the isthmus. No focal mass. The isthmus appears less vascular comparison to prior study.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Parenchyma heterogenous and nodular without focal mass. The appearance is suggestive of thyroiditis. Interval decrease in vascularity in comparison to the prior study dated May 2016.Due to the lack of focal mass, biopsy was not performed. This was discussed with Dr. Peter Angelos. |
Generate impression based on findings. | 39-year-old female complains of right upper quadrant pain. LIVER:The liver measures 15.5 cm. There is normal echogenicity of the parenchyma. No masses, ascites, or intrahepatic ductal dilatation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: There is an approximately 1.7 x 0.6 cm hyperechoic, dependent, shadowing foci in the gallbladder that is consistent with a gallbladder stone. No sludge or debris is seen. The gallbladder wall measures approximately 0.1 cm. There is a negative sonographic Murphy's sign. No pericholecystic fluid. The common bile duct measures approximately 0.2 cm.PANCREAS: Evaluation appears limited due to overlying bowel gas, however the visualized portions appear normal.SPLEEN: The spleen measures approximately 10.5 cm. No abnormalities noted.KIDNEYS: The right kidney measures approximately 11.9 cm. The cortex has normal echogenicity. No shadowing calculi, concerning mass, or hydronephrosis. The left kidney measures approximately 10.4 cm. The cortex has normal echogenicity. No shadowing calculi, concerning mass, or hydronephrosis.OTHER: No significant abnormality noted. | 1. Cholelithiasis as described above without signs of acute inflammation or ductal dilatation. |
Generate impression based on findings. | Female; 31 years old. Reason: eval left neck salivary gland History: left neck tenderness 4 x 4 mm colloid cyst in the right thyroid gland.The patient indicated the area of tenderness on the left neck posterior to the ear. Images obtained in this location reveal no abnormal lymph nodes or fluid collection. The imaged portions of the left submandibular gland are unremarkable. | No ultrasound finding to explain the patient's left neck tenderness. |
Generate impression based on findings. | Oliguria, AKI RIGHT KIDNEY: Measures 9.7 cm. No hydronephrosis. No shadowing intrarenal echogenic focus seen to suggest underlying nephrolithiasis. No perinephric free fluid.LEFT KIDNEY: Measures approximately 9.7 cm, when large lower pole exophytic cyst included, measures up to 15 cm in longitudinal dimension. The cyst appears simple and measures 7.1 x 5.3 x 4.6 cm. No hydronephrosis. No shadowing intrarenal echogenic focus seen to suggest underlying nephrolithiasis. No perinephric free fluid.OTHER: Mild to moderate degree urinary bladder distention containing Foley catheter. | 1. No hydronephrosis.2. Distended during bladder despite presence of Foley catheter, suspicious for nonfunctioning or poorly functioning Foley catheter and correlation with patient's clinical history recommended and repositioning should be considered. |
Generate impression based on findings. | Term cell tumor status post right colectomy now with left testicular lesion RIGHT TESTIS: Status post orchiectomyLEFT TESTIS: 0.6 x 0.5 x 0.6 cm hypoechoic discrete mass within the left testicle. This lesion does not appear to be associated with the mediastinum.RIGHT EPIDIDYMIS: Status post orchiectomyLEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: Moderate left hydrocele | Subcentimeter hypoechoic discrete mass within the left testicle not associated with the mediastinum. This finding is worrisome for a neoplastic focus, including malignancy. |
Generate impression based on findings. | Female 29 years old Reason: biopsy of transplanted kidney History: elevated SCR Ultrasound guidance provided for a kidney biopsy performed by the nephrology service. | Ultrasound guidance provided for a kidney biopsy performed by the nephrology service. |
Generate impression based on findings. | Reason: Rule out obstruction, AKI on potential CKD RIGHT KIDNEY: The right kidney measures 10.57 m in length. There is increased renal parenchymal echogenicity. There is no hydronephrosis, focal mass, or stone.LEFT KIDNEY: The left kidney measures 10.47 m in length. There is increased renal parenchymal echogenicity. There is no hydronephrosis, focal mass, or stone.URINARY BLADDER: No significant abnormalities noted.OTHER: Mildly increased hepatic echogenicity and echotexture. | Increased renal parenchymal echogenicity, which can be seen in the setting of chronic medical renal disease. |
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