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Generate impression based on findings. | Reason: patient with metastatic squamous cell lung cancer, evaluate liver for accessible lesions to biopsy for further molecular characterization History: vertebral metastases s/p radiation treatment to control pain and maintain function CHEST:LUNGS AND PLEURA: Heterogeneous soft tissue density mass containing areas of calcification posterior to the right main bronchus (right upper lobe), with epicenter abutting the right hilum in the superior portion of the right lower lobe. The mass circumferentially narrows the bronchus intermedius and attenuates the right lower lobe bronchus and its branches with associated segmental atelectasis distal to the mass due to occlusion of some of the segments. Greatest transaxial dimensions of the mass measure 5.3-cm transversely x 4.9-cm AP (series 3 image 48) and the mass is 5-cm in craniocaudal length.No pleural fluid or pneumothorax. Mild emphysema.MEDIASTINUM AND HILA: Mediastinal and right hilar lymphadenopathy, with a reference right lower paratracheal lymph node (3/34) measuring 15 mm in short axis. Right subcarinal and hilar lymphadenopathy inseparable from the mass. Mildly enlarged ipsilateral superior and inferior interlobar lymph nodes. Nonenlarged contralateral hilar lymph nodes are isoattenuating to the mass.Heart size is normal. No pericardial effusion.Moderate coronary artery calcifications.CHEST WALL: No significant abnormality.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Right hepatic lobe (segment VII/VIII) metastasis measuring approximately 10 x 7 cm. (3/81). Areas of hypoattenuation in this lesion are likely due to necrosis. Mild localized biliary ductal dilatation both superior and inferior to the mass in the right hepatic lobe.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic calcification of the abdominal aorta and its branches.IVC filter in expected location.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: L3 vertebral body has been replaced by packing material. The inferior endplate of L2 is incomplete, with an erosive, lytic process which is similarly fracture of the superior endplate of L4. Stabilization hardware in this area causes streak artifact. Subtle mixed lytic/sclerotic process in the right iliac bone, L5 and sacrum, may represent metastatic disease.OTHER: No significant abnormality noted. | 1.Right lower lobe mass with local extension to the right upper lobe posterior to the right main bronchus produces segmental atelectasis due to bronchial occlusion, consistent with patient's given history of primary squamous cell carcinoma.2.Hepatic metastasis.3.Mild to moderate ipsilateral mediastinal and hilar lymphadenopathy.4.Subtle mixed lytic/sclerotic process in the right iliac bone, lumbar spine and sacrum, suspicious for metastatic disease. |
Generate impression based on findings. | Reason: 65 yo F with worsening lung function History: evaluate for underlying lung disease in setting of decreasing lung function LUNGS AND PLEURA: Surgical staples are seen in the right upper lobe. Compression atelectasis is present adjacent to a very large hiatal hernia. MEDIASTINUM AND HILA: Mild aortic root calcifications, but no evidence of coronary artery calcifications. The heart and pericardium appear normal.No mediastinal or hilar lymphadenopathy noted.Massive hiatal hernia containing stomach and a large amount of omental fat as well as a loop of large bowel.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Large hiatal hernia described above. Hepatic cystlike hypodensities are unchanged. | No specific pulmonary abnormality. However, a very large hiatal hernia, larger than on prior studies, significantly decreases the left hemithorax volume. |
Generate impression based on findings. | Male, 73 years old, history of right neck squamous cell carcinoma, unknown primary. Head:A small region of hypoattenuation is seen within the left lateral cerebellar hemisphere corresponding to the location of a known lesion. No discretely measurable mass is identified which may be due at least in part to limitations of CT technique.Elsewhere, no new intracranial lesions are demonstrated. No evidence of significant parenchymal edema or mass effect is detected. The ventricles are normal in size and morphology. The osseous structures of the skull are intact.Neck:Evidence of right neck dissection is redemonstrated with volume loss and severe extensive subcutaneous and fascial plane infiltration. Superimposed upon this are scattered areas of irregular tumor like enhancement along the carotid space. For example, ill-defined enhancing tissue surrounds the carotid bifurcation with near encasement of the vessel. This tissue measures 23 x 14 mm on the present study (image 37 series 8), previously 19 x 8 mm. A nodule of ill-defined enhancement may also be present just below the jugular foramen on the right (image 14 series 8) at which point the jugular vein ceases to opacify. This finding was not clearly evident on the prior exam. There may be additional areas of very subtle ill-defined enhancement scattered along the carotid space and in the paravertebral musculature of the lower neck.Ill-defined enhancement which infiltrates the right trapezius muscle is redemonstrated measuring about 31 mm in diameter on sagittal images (image 34 series 80451), previously up to 23 mm.A right supraclavicular nodule has decreased in size measuring up to 27 mm in diameter (image 50 series 8), previously up to 31 mm. A conglomerate of nodes is also partially visualized in the right axilla. Accurate assessment is difficult due to field of view limitations, but some of these seem to have decreased in size while one may have increased.No pathologic adenopathy is clearly identified in the left neck. Sequelae of surgery and therapy are redemonstrated including fatty atrophy of the right hemitongue, diffuse supraglottic mucosal edema, and a retropharyngeal effusion. The remaining salivary glands and thyroid are unremarkable. The remaining cervical vessels demonstrate normal opacification. There is a new right-sided pleural effusion. Scattered lung nodules are better assessed on dedicated chest imaging.The proximal right first rib demonstrates a new mottled appearance suspicious for metastatic involvement. Elsewhere, no definite destructive osseous lesions are seen. | 1. Progression of infiltrative tumor at several locations in the right neck, for example at the carotid bifurcation where the vessel is nearly completely encased, and perhaps just below the jugular foramen. Infiltrative tumor has also progressed within the right trapezius muscle, and there is new lysis and mottling of the right first rib compatible with metastatic involvement.2. A tumor deposit in the right supraclavicular fossa has decreased in size. In the right axilla, which is partially visualized, some tumor nodules may have decreased in size but one appears to have increased. This region is better assessed on chest imaging.3. Scattered pulmonary nodules are better assessed on chest imaging. A right pleural effusion is new.4. The previously seen left lateral cerebellar lesion is not well appreciated on the present study which may in part be due to limitations of the CT technique. If assessment of this lesion is needed, MRI with contrast should be performed. |
Generate impression based on findings. | 81 years old, Male, Reason: Hx NHL History: upper abdominal pain CHEST:LUNGS AND PLEURA: Scattered micronodules. Small subcentimeter nodule in the right lower lobe. Mild emphysematous changes in the lung apices.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Scattered subcentimeter axillary lymph nodes not meeting size criteria for lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Unchanged hypodense lesion in the left lobe of the liver. There are other small hypodensities which are too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: Heterogeneity of the uncinate process is unchanged from prior study and may represent element of fatty infiltration. No evidence of pancreatic mass. No pancreatic ductal dilatation. No adjacent mesenteric stranding or fluid collections.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy. Aortic atherosclerotic calcifications without evidence of aneurysmal dilatation.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate is enlarged.BLADDER: Thick walled bladder that is underdistended. While bladder is underdistended, the wall appears thickened, possibly representing sequela of chronic outlet obstruction.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No evidence of enlarged adenopathy in the chest, abdomen, or pelvis. 2.New subcentimeter pulmonary nodule in the right lower lobe.3.No evidence of pancreatic mass as clinically questioned.4.Enlarged prostate, bladder wall thickening suggested, may reflect sequela of chronic bladder outlet obstruction. |
Generate impression based on findings. | 22 years old, Female, Reason: Rule out intra-abdominal/pelvic infection s/p nephrectomy/ureteretomy History: Abd pain, fever ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Postsurgical changes of left heminephrectomy. Mild hydronephrosis of the left with a dilated distal left ureter, likely chronic in etiology. The right kidney is normal in appearance.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Thickened descending and transverse colon which has a chronic appearance, however patient and may have an acute on chronic presentation. No evidence of obstruction. No evidence of pneumatosis, fistula, or free air.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Trace the fluid within the pelvis which can be normal in a premenopausal female. No free fluid or drainable fluid collection.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: See abdomen sectionBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Expected postsurgical changes of a left heminephrectomy without evidence of pyelonephritis. Left hydroureter which is likely chronic in etiology.2.Bowel wall thickening of the descending and transverse colon concerning for colitis, age indeterminate. |
Generate impression based on findings. | Female; 56 years old. Reason: fx? History: fall Two views of the right hip demonstrate severe osteoarthritis. No evidence of acute fracture or malalignment. | Severe osteoarthritis without evidence of fracture. |
Generate impression based on findings. | Pain in range of motion of rotator cuff, weakness in internal and external rotation, weakness in active arc, intact distal strength. Evaluate for bony pathology. Mild osteoarthritis affects the glenohumeral joint. There is slight inferior translation of the humeral head relative to the glenoid which may not be of any clinical significance, although could conceivably reflect a joint effusion. | Mild osteoarthritis and other findings as described above. If further imaging evaluation of the shoulder is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Pain after injury Four views of the left knee are provided. There is a moderate-sized joint effusion which appears to have decreased slightly in size compared with the prior study. There is also reticulation of the subcutaneous fat anteriorly suggesting edema. I see no fracture or malalignment.The right knee appears normal on the frontal views. | Joint effusion. |
Generate impression based on findings. | Status post right total knee arthroplasty Components of a right total knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. Skin staples, a drain, and foci of gas density in the anterior soft tissues reflect recent surgery. | Postoperative changes of total knee arthroplasty as above. |
Generate impression based on findings. | Metastatic adenoid cystic carcinoma status post cis/navelbine and palliative radiotherapy. There is interval decrease in size of the hyperattenuating left tongue base mass that crosses the midline and extends into the left oral tongue and into the left tonsillar fossa, now measuring up to approximately 35 mm, previously 45 mm. Furthermore, the mass appears to be more hypoattenuating centrally, which suggests necrosis. There has also been interval decrease in size of the cervical lymphadenopathy. For example, a right level 2A lymph node measures 7 mm in short axis, previously 11 mm, a right level 3 lymph node measures 6 mm, previously 12 mm, and a left level 2A lymph node measures 4 mm in short axis, previously 13 mm. Likewise, the partially imaged upper mediastinal lymphadenopathy has decreased in size. A lesion within the right manubrium also appears to less conspicuous. The thyroid and major salivary glands are unchanged. There is a right internal jugular venous catheter. The imaged intracranial structures are unremarkable. The majority of the nodules in the partially-images lungs appear to have decreased in size. However, there is a new area of ground glass opacification in the right lung and the right pleural effusion has increased in size. | 1. Interval decrease in size of the mass centered within the left tongue base with extension into the left lateral floor of mouth and right tongue base and left tonsillar fossa.2. Interval decrease in size of the bilateral neck and partially imaged upper mediastinal lymphadenopathy. Please refer to the separate chest CT report for additional details.3. The majority of the metastases in the partially-images lungs appear to have decreased in size. However, there is a new area of ground glass opacification in the right lung and the right pleural effusion has increased in size. Please refer to the separate chest CT report for additional details.4. The metastasis within the right manubrium appears less conspicuous. |
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. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. History of ovarian cancer in maternal aunt diagnosed in her 30s. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the right breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of kidney cancer diagnosed at the age of the age of 55. Four standard digital views of both breasts and a cleavage view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable circumscribed masses are present in the anterior depths of both breasts. A new group of coarse calcifications is present in the anterior depth of the left upper outer quadrant. No suspicious masses or areas of architectural distortion are present. | New group of calcifications in the left breast. Spot magnification imaging is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | lethargic, altered mental status Motion artifacts degraded image quality.No evidence of acute ischemic or hemorrhagic lesion.Minimal patchy low attenuation on bilateral periventricular white matter indicate non specific small vessel disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The mastoid air cells are clear. The right maxillary sinus shows fluid level with internal high attenuation indicate possibility of calcification, hemorrhage but could also related to motion artifacts. If indicated, clinical correlation is recommended. | No evidence of acute ischemic or hemorrhagic lesion.Motion artifacts degraded image quality.Minimal non specific small vessel disease.Right maxillary sinus fluid collection. |
Generate impression based on findings. | gait instability, short term memory loss, confusion No evidence of acute ischemic or hemorrhagic lesion.There are multifocal low attenuation lesions on the left posterior aspect of inferior temporal gyrus, left cerebellar hemisphere and right basal ganglia (putamen) indicating age indeterminate likely represent chronic ischemic infarctions.Mild patchy low attenuations on bilateral periventricular white matter indicate non specific small vessel disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion.Multifocal age indeterminate ischemic infarctions (likely chronic) as described above.Non specific small vessel ischemic disease. |
Generate impression based on findings. | Male, 54 years old. Reason: Dobbhoff placement History: Dobbhoff placement Interval adjustment of Dobbhoff tube, now with an atypical trajectory overlying the left hemithorax, raising concern for intrabronchial placement. This tube has been removed on subsequent imaging. Dual lumen central venous catheter, with tip overlying the right atrium.Nonobstructive bowel gas pattern. The lower pelvis is excluded from the field of view. | Findings suggestive of malpositioned Dobbhoff tube, with intrabronchial placement. Dr. Pabla, covering pager 2836 was paged with the findings at 9:25 am. This tube has been removed on subsequent imaging. |
Generate impression based on findings. | headache Focal tissue loss on the left basal ganglia (globus pallidus) indicating possibilities of lacune or large perivascular space. Otherwise no evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion on this scan. |
Generate impression based on findings. | Female, 75 years old. Reason: Evaluate for obstruction History: h/o cervical ca, s/p many surgeries long ago, rectovaginal fistula, now with nausea, dry heaves, abdominal pain. Indeterminate prominent bowel loop overlying the right hemisacrum could represent distal ileum, and is nonspecific. No free air seen on upright imaging. Surgical clips and sutures throughout the abdomen and pelvis. Rounded artifact overlying left abdomen could represent an ostomy, and adjacent lobulated lucencies could be related to herniated bowel, such as due to a parastomal hernia.Degenerative disease of the spine and bilateral hips. Vascular calcifications. | Indeterminate bowel loop overlying the right hemisacrum could represent prominent distal ileum, but is nonspecific. Rounded artifact overlying left abdomen may be an ostomy, and adjacent lobulated lucencies may represent a hernia. If there is continued clinical concern, further evaluation with dedicated CT imaging recommended. |
Generate impression based on findings. | 65-year-old male with abdominal pain. Evaluate bowel gas pattern. Post-surgical changes, support devices, and tubes are again seen and appear similar to the same day chest radiograph (please refer to chest study for additional findings). Nonobstructive bowel gas pattern. Above average amount of stool in the colon. Surgical clips are noted throughout the abdomen and pelvis. Small oval density projecting over the midline pelvis could reflect ballistic material. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male, 41 years old. Reason: OG tube placement Enteric feeding tube with tip overlying the region of pylorus, with distal sideport overlying the antrum.The lower pelvis is excluded from the field of view. Partially visualized mildly prominent loops of small bowel with relative paucity of gas within the distal colon, suggestive of developing/partial small bowel obstruction.Partially visualized bilateral perihilar opacities. See concomitant chest radiography for additional intrathoracic details. | Enteric tube with distal sideport overlying the gastric antrum. Additional findings suggestive of developing/partial small bowel obstruction. |
Generate impression based on findings. | 49-year-old male with history of renal cell carcinoma. On clinical trial. CHEST:LUNGS AND PLEURA: Stable right upper lobe nonspecific nodule adjacent to the pleura measuring 6 x 6 mm (series 4/19). Calcified left lower lobe micronodule compatible prior granulomatous disease. No focal consolidation or pleural effusions.MEDIASTINUM AND HILA: Normal cardiac size without pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Status post right adrenalectomy.KIDNEYS, URETERS: Status post right nephrectomy with no evidence of residual or recurrent disease in the nephrectomy bed.Stable left renal cyst. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Fat-containing umbilical hernia. Multilevel degenerative disk disease, worst at the L1-2 level with minimal anterior wedging of L1, unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination with no evidence of local recurrent or metastatic disease. |
Generate impression based on findings. | Female, 68 years old. Reason: evaluate for dilatation of bowel loops; hx of ileus Multiple mildly prominent loops of small bowel in the left abdomen. Colonic gas and moderate stool burden, with air seen within the rectum. Findings most compatible with ileus.Swan-Ganz catheter and IABP in place. Left femoral vascular sheath. Scoliosis and degenerative disease of the spine. | Findings most compatible with ileus. |
Generate impression based on findings. | altered mental status. Focal linear encephalomalacia on the right external capsule indicating chronic focal hemorrhagic lesion. Otherwise, no evidence of acute ischemic or hemorrhagic lesion.Minimal patchy low attenuations on bilateral periventricular white matter indicate non specific small vessel disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | 1. No evidence of acute ischemic or hemorrhagic lesion on this scan.2. Focal lenticular shaped encephalomalacia on the right external capsule.3. Minimal non specific small vessel ischemic disease. |
Generate impression based on findings. | Male 72 years old Reason: eval for bowel obstructions History: abd pain, no flatus, multiple abd surgeries and prior SBOs ABDOMEN:LUNG BASES: Bibasilar atelectasis/scarring.LIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma. The patient is status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple hypoattenuating lesions in the bilateral renal parenchymal, the largest of which are compatible simple renal cysts, and the smallest of which, are too small to characterize.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Small hiatal hernia. There is a moderate stool burden, predominantly affecting the rectum. Contrast progressed to the right colon and there is no evidence of bowel obstruction.BONES, SOFT TISSUES: Sclerotic focus in the right iliac bone unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: There are dense prostatic calcifications.BLADDER: There are bilateral bladder diverticula.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic focus in the right iliac bone unchanged.OTHER: No significant abnormality noted | No specific finding seen to account for the patient's pain, specifically no evidence of small bowel obstruction as clinically questioned. |
Generate impression based on findings. | There are postoperative findings related to a right parietal craniectomy and cranioplasty with mesh placement. There is extensive encephalomalacia of the right parietal lobe with ex vacuo dilatation of the adjacent right lateral ventricle. The ventricles and sulci are unchanged. There is no midline shift or mass effect. There is no intracranial hemorrhage. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | No significant interval change. No acute findings. |
Generate impression based on findings. | fall, acute mental status change No evidence of acute ischemic or hemorrhagic lesion on this scan.Minimal brain atrophy which is age appropriate.Minimal patchy low attenuations on bilateral periventricular white matter indicate non specific small vessel ischemic disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | 1. No evidence of acute ischemic or hemorrhagic lesion on this scan.2. Minimal brain atrophy as well as minimal non specific small vessel ischemic disease as described above. |
Generate impression based on findings. | 53-year-old female with bilateral hip pain Left hip: Hardware components of a total hip arthroplasty are situated in near-anatomic alignment without evidence of complication. There is an ossific fragment projecting lateral to the prosthetic femoral head appearing similar to the prior study that we suspect is chronic. We see no definite acute fracture. There is also a sideplate, screw and tension wire device affixing the distal diaphysis of the femur in near anatomic alignment.Right hip: Hardware components of a total hip arthroplasty are situated in near-anatomic alignment without evidence of complication.Pelvis: The aforementioned total hip arthroplasties are again visualized as well as orthopedic fixation of the lumbosacral spine. The remainder of the pelvis is unremarkable. | Postoperative changes of bilateral total hip arthroplasties and other findings as described above. We see no definite acute fracture. |
Generate impression based on findings. | There is no evidence of acute intracranial hemorrhage. There is an unchanged subcentimeter calcified extra-axial mass along the right parietal convexity may represent a meningioma. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The scalp soft tissues are unremarkable. There is no evidence of depressed calvarial fracture. | 1. No evidence of acute intracranial hemorrhage.2. Unchanged subcentimeter calcified extra-axial mass along the right parietal convexity may represent a meningioma. A brain MRI may also be useful for further characterization.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | fell out of bed and hit head 2 days ago. No evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion on this scan. |
Generate impression based on findings. | 26-year-old man with history of pain and swelling. Right ankle: There is soft tissue swelling about the ankle. Deformity of the medial malleolus may reflect old trauma, but there is no acute fracture or malalignment.Right foot: There is no acute fracture or malalignment. | Soft tissue swelling about the ankle without acute fracture or malalignment. |
Generate impression based on findings. | Male 79 years old Reason: eval for metastatic disease History: prostate cancer, weight loss Within the limits of a non IV contrast enhanced examination which limits ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: CHEST:LUNGS AND PLEURA: There is moderate centrilobular emphysema. Calcified nodule in the right major fissure likely reflects a calcified intrapulmonary lymph node. There are small bilateral pleural effusions, left greater than right with associated compressive atelectasis. The left pleural effusion is partially loculated.MEDIASTINUM AND HILA: There postsurgical changes related to gastric pull-up. There moderate/severe atherosclerotic calcifications of the coronary arteries.CHEST WALL: Left chest wall Port-A-Cath with tip terminating at the confluence of the proximal SVC.ABDOMEN:LIVER, BILIARY TRACT: Hypoattenuating lesions in the right hepatic lobe are consistent with simple hepatic cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is mild/moderate bilateral hydronephrosis and hydroureter extending to level of the mid ureters bilaterally, likely a result of compression secondary to the bulky retroperitoneal and pelvic lymphadenopathy. High-density fluid within the left renal collecting system and bladder likely reflects excretion of contrast from prior administration of contrast. Asymmetry in excretion suggests obstructive uropathy of the right kidney.RETROPERITONEUM, LYMPH NODES: There is bulky retroperitoneal lymphadenopathy. Four reference purposes a left para-aortic lymph node measures 3.0 x 3.0 cm (image 80, series 80280). The aorta is displaced anteriorly secondary to the lymphadenopathy. There is an IVC filter in place. There are severe atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Diffuse small volume ascites.BONES, SOFT TISSUES: Sclerotic lesions are seen scattered throughout the axial skeleton, which are consistent with sclerotic metastases. Nuclear medicine bone scan is more sensitive for the evaluation of osseous metastatic disease. There is a compression fracture of the T10 vertebral body with approximately 90% loss of height.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate gland is enlarged.BLADDER: High-density fluid in the bladder consistent with excreted contrast from a prior examination. Left-sided bladder diverticulum.LYMPH NODES: There is bulky bilateral pelvic lymphadenopathy. For reference purposes, a left pelvic sidewall node measures 1.8 x 2.7 cm (image 151, series 80280).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic lesions are seen scattered throughout the axial skeleton, which are consistent with sclerotic metastases. Nuclear medicine bone scan is more sensitive for the evaluation of osseous metastatic disease. There is a compression fracture of the T10 vertebral body with approximately 90% loss of height.OTHER: Asymmetry of the bilateral femoral and external iliac venous density and caliber is consistent with a deep venous thrombosis. | 1.Bulky mediastinal of pelvic lymphadenopathy compatible metastatic disease.2.Sclerotic lesions scattered throughout the axial skeleton consistent with sclerotic metastases. Nuclear medicine bone scan is a more sensitive test for evaluation of osseous metastatic disease.3.Compression fracture of the T10 vertebral body.4.Bilateral mild/moderate hydroureter/hydronephrosis with hydroureters extending into the lower abdomen, likely result of compression secondary to the bulky intraperitoneal lymphadenopathy.5.Lack of contrast excretion from the prior interventional radiology examination from the right kidney suggests obstructive uropathy.6.Deep venous thrombosis as detailed above, with IVC filter in place. |
Generate impression based on findings. | There is physiologic activity in the liver, spleen, blood pool, and external genital organ. The angiographic phase images are unremarkable. There is no abnormal activity to indicate gastrointestinal bleeding. | No evidence for gastrointestinal bleeding. |
Generate impression based on findings. | 8-year-old male with abdominal pain. Evaluate for constipation.VIEW: Abdomen AP (one view) 1/6/2014, 1732 Mild colonic stool burden. Nonobstructive bowel gas pattern. | Mild colonic stool burden. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy demonstrating fibroadenomatous change with associated calcifications. Personal history of thyroid cancer diagnosed at the age of 42. History of breast cancer in maternal aunt, maternal cousin and paternal aunt. Two standard digital views and tomosynthesis of both breasts 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. A percutaneously placed clip is present in the left lower inner quadrant with surrounding residual calcifications. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable left breast calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 37-year-old female with AIH s/p OLT with E.coli sepsis, pancreatitis, ileus. Paucity of small bowel gas but no discrete evidence of obstruction or ileus. Right upper quadrant coil embolization material suggested. A right upper quadrant drain is also noted. An additional catheter projects over the left paramedian abdomen, correlate with patient's history/physical exam. Intrauterine device projects over the pelvis. | No definitive evidence of bowel obstruction. |
Generate impression based on findings. | 27-year-old with headache for two days. Evaluate for obstructive hydrocephalus. The patient is status post right frontoparietal craniotomy and right hemispherectomy. Dystrophic appearing calcifications are again seen along the dura. Again seen is ventriculostomy tube coursing through the left parietal lobe into the left lateral ventricle with the tip at the lateral aspect of the trigone. The lateral ventricles are stable in size when compared to the prior exam. The fourth ventricle is stable compared to the prior exam.There are periventricular hypodensities present which are stable compared to the prior exam. No evidence of acute intracranial hemorrhage, new mass or mass-effect.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Unchanged size of the ventricular system without evidence of hydrocephalus. 2.Status post right hemispherectomy.3.Findings suggest some periventricular leukomalacia along the left hemisphere which is stable since prior exams. |
Generate impression based on findings. | Leukemic crisis, leukostasis, wbc 155K, headache. There is mild mucosal thickening in the alveolar recess of the right maxillary sinus and minimal scattered mucosal thickening in the ethmoid sinuses. The paranasal sinuses are otherwise clear. The nasal cavity is clear. There are bilateral conchae bullosa. There is mild S-shaped nasal septal deviation. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The mastoid air cells and middle ear cavities are clear. There is an area of subcutaneous stranding in the left cheek. The nasopharynx, orbits, and imaged intracranial structures appear to be unremarkable. However, there are partially-imaged mildly prominent upper cervical lymph nodes. | 1. Mild mucosal thickening in the alveolar recess of the right maxillary sinus and minimal scattered mucosal thickening in the ethmoid sinuses. The paranasal sinuses are otherwise clear. 2. Partially-imaged mildly prominent upper cervical lymph nodes are likely related to leukemia.3. Nonspecific area of subcutaneous stranding in the left cheek may represent cellulitis or other inflammatory process versus scar tissue. |
Generate impression based on findings. | 64-year-old female status post hip fracture repair, evaluate for osteomyelitis An intramedullary rod and screw device affixes an intertrochanteric fracture in near anatomic alignment. We see no hardware complication or specific radiographic evidence of infection. | Orthopedic fixation of proximal femoral fracture without a specific radiographic evidence of infection. |
Generate impression based on findings. | 39 years old, Female, Reason: appendicitis History: rlq pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypodensity in the midpole of the right kidneyRETROPERITONEUM, LYMPH NODES: Again seen is a mildly prominent right gonadal vein with peripheral calcified phlebolith.BOWEL, MESENTERY: The appendix is normal in appearance. No evidence of obstruction, pneumatosis, or free air. Small fat-containing ventral hernia is present without evidence of bowel involvement. Mildly enlarged lymph node in the right lower quadrant is nonspecific.BONES, SOFT TISSUES: There is moderate degenerative changes at the level of L5-S1 with vacuum disk phenomena.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No specific findings to account for the patients pain. If clinically warranted, gynecologic ultrasound may be helpful for further evaluation of the uterus and adnexa in the absence of CT findings. |
Generate impression based on findings. | Altered mental status and history of GBM. Evaluate for edema/mass effect. There are postsurgical changes of a right frontal craniotomy. Underlying the craniotomy site, there is an approximately 2.3 x 3.4 cm area of hypoattenuation with peripheral calcification. There are additional smaller areas of hypoattenuation with peripheral calcification inferior to this. Another area of ill-defined hypoattenuation is seen within the left frontal lobe, measuring 2.7 x 2.4 cm, with a more cystic area immediately superior to this. There is no clear evidence to suggest prior surgery in the left frontal region. There is diffuse white matter hypoattenuation of the bilateral frontal lobes which is non-specific. There is no acute intracranial hemorrhage. There is no significant mass effect or midline shift. The left parieto-occipital sulcus is widened which may represent asymmetric volume loss or an old ischemic lesion. Periventricular white matter hypoattenuation, beyond the frontal lobe hypoattenuation is non-specific but may represent small vessel ischemic disease. There is prominence of the ventricles and cortical sulci compatible with mild parenchymal volume loss. There is mucosal thickening of the paranasal sinuses with partial opacification of the right maxillary sinus with a round focus of high density. The right mastoid air cells are completely opacified. | 1. Right frontal craniotomy and bilateral frontal lobe hypoattenuating areas without significant mass effect or acute intracranial hemorrhage. No definite evidence of surgical intervention of the left frontal cranium. Diffuse white matter hypoattenuation is non-specific but may be related to edema and/or radiation effect. MRI of the brain with contrast and comparison to prior scans, if available, is recommended. 2. Age-indeterminate small vessel ischemic disease and questionable left parietal chronic infarct. CT is insensitive for the detection of non-hemorrhagic, acute ischemic infarcts. If there is concern for ischemia, MRI may be obtained. 3. High density material within the right maxillary sinus may represent inspissated secretions or fungal elements. |
Generate impression based on findings. | Male 1 day old. Evaluate bowel gas pattern and NG placement. Increasing respiratory distressVIEWS: Chest and abdomen AP (2 views) 1/6/14 1705 Enteric tube tip in the gastric body. The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. Mild diffuse lung haziness is present, without focal opacities, pleural effusions, or pneumothorax.Distended bowel loops throughout the abdomen compatible with distal bowel obstruction. No pneumatosis, portal venous gas, or pneumoperitoneum. | 1. Distal bowel obstruction.2. Mild diffuse lung haziness. |
Generate impression based on findings. | 33-year-old man with history of fifth toe ulcer, foot pain, and swelling. The patient is status post second digit amputation with expected postoperative changes. There is gross destruction of the fifth proximal and middle phalanges with associated soft tissue swelling indicating osteomyelitis. Additionally, there is destruction and irregularity of the third metatarsal head which may represent an additional focus of infection. There is hallux valgus deformity and degenerative change of the first interphalangeal joint. The remainder of the foot appears unremarkable. | 1.Osseous destruction of the fifth phalanx compatible with osteomyelitis. 2.Additional, questionable focus of osseous destruction of the third metatarsal head. |
Generate impression based on findings. | 55 year old presenting with increasing prominence of the right nipple the last 3 to 4 months. Patient has history of benign right breast biopsy and hematoma. Family history in the patient's maternal grandmother and cousin. Three standard views of both breasts and additional right CC spot compression view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Skin markers overlie the right upper inner breast. A biopsy clip in the right retroareolar region is unchanged in position. Right lower inner breast focal asymmetry is not significantly changed from prior. Oil cysts, some which are calcified, in the right lower inner quadrant are also unchanged. An additional focal assymetry in the right upper outer breast has also not significantly changed.Benign appearing lymph nodes are projected over the right axilla. | Stable benign findings as described. Mammographically, the right nipple and retroareolar region is unremarkable, however clinical correlation is suggested. 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: C - Clinical Correlation Needed. |
Generate impression based on findings. | 66 year-old female with fall and knee pain. A splint obscures underlying osseous detail. Moderate osteoarthritis affects the knee. A 1.5-cm ossicle within the intracondylar notch likely represents a chronic loose body. A smaller ossicle lateral to the lateral tibial plateau is also likely chronic. There is no evidence of acute fracture. | Osteoarthritis and chronic appearing ossicles, one of which appears to be intra-articular. No acute fracture evident. |
Generate impression based on findings. | 4-month-old male with fever, evaluate for interval changes in lung fields.VIEWS: Chest and abdomen AP (two views) 1/7/2015, 0547 hours. Tracheostomy tube tip between the thoracic inlet and carina. Enteric tube tip within the stomach, which is likely within the giant omphalocele.No focal pulmonary opacity. Normal cardiac silhouette size.Interval decrease in bowel distention within the omphalocele. A single dilated loop remains in the right upper aspect. No pneumatosis, portal venous gas, or intraperitoneal free air is identified.Thoracic length is increased and thoracic width is decreased, as expected. | Decreased bowel distention. |
Generate impression based on findings. | 29 year-old female with right elbow pain No evidence of fracture, malalignment, or joint effusion. | No fracture or other specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 67-year-old female with RA and OA Left foot: The bones are demineralized. There are no specific radiographic features of rheumatoid arthritis. Mild osteoarthritis affects the first MTP joint. There is soft tissue swelling about the ankle. A prominent enthesophyte is noted at the Achilles insertion on the calcaneus.Right foot: There are no specific radiographic features of rheumatoid arthritis. Mild osteoarthritis affects the first MTP joint. Soft tissue swelling is present particularly about the ankle. A prominent enthesophyte is noted at the Achilles insertion on the calcaneus.Shoulder: Mild osteoarthritis affects the glenohumeral and acromioclavicular joints. There are no specific radiographic features of rheumatoid arthritis. | Osteoarthritis and other findings as described above without specific radiographic features of rheumatoid arthritis. |
Generate impression based on findings. | 60 year-old male with joint pain, gout, +ANA Right hand and wrist: There is mild ulnar translation of the carpus as well as slight narrowing of the radiocarpal and ulnocarpal articulations. Focal soft tissue swelling is present along the ulnar aspect of the wrist with erosion of the underlying ulnar styloid and distal ulnar surface. The metacarpophalangeal and interphalangeal joints appear normal for the patient's age.Left hand and wrist: We see no erosions. Osteoarthritis affects the DIP joint of the fifth finger, likely reflecting old trauma. The remainder of the hand and wrist are unremarkable.Right foot: Mild osteoarthritis affects the first metatarsophalangeal joint. Small defects within the first metatarsal head may represent small chronic erosions. There are small midfoot osteophytes, indicating mild osteoarthritis. Arterial calcifications are noted in the soft tissues. Left foot: There is slight hallux valgus deformity. A small ossicle dorsal to the talonavicular joint may represent old trauma. Arterial calcifications are noted in the soft tissues. | Soft tissue swelling along the ulnar aspect of the right wrist, which may represent a gouty tophus with underlying erosion of the ulna. There is also ulnar translocation of the carpus, which is of uncertain etiology, and while this may be seen with rheumatoid arthritis, the lack of additional inflammatory changes are argues against this diagnosis. There may also be small erosions of the right first metatarsal head, which may also be due to gout. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in sister and maternal cousin. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Round markers were placed on skin lesions overlying both breasts. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 75 year-old woman with history of shoulder and elbow pain after fall. Right shoulder: There is a transverse fracture through the surgical neck of the humerus and vertically oriented fracture through the greater tuberosity. Additionally, the humeral head appears inferiorly displaced, compatible with a pseudosubluxation due to hemarthrosis.Right elbow: There is no acute fracture or malalignment. | Fractures through the surgical neck and greater tuberosity of the right humerus. |
Generate impression based on findings. | 55-year-old male with history of bone spurs and arthritis in neck radiating down left arm Cervical spine: Moderate degenerative disk disease affects C4/5 and C6/7. Mild degenerative disk disease affects C3/4 and C5/6. There are prominent multilevel anterior vertebral body osteophytes as well as posterior vertebral body osteophytes at C4/5. Moderate C4/5 neuroforaminal narrowing on the right and mild C6/7 neuroforaminal narrowing of the left. There is slight straightening of the cervical spine.Lumbar spine: There is mild degenerative disk disease affecting L1/2 with a prominent left sided osteophyte at this level. Vertebral body heights are preserved. The lumbar spinal alignment is within normal limits. | Degenerative disk disease and other findings as described above. |
Generate impression based on findings. | Stomach pain for two days. Constipation.VIEW: Abdomen AP (one view) 1/6/15 1756 Large amount of rectal stool is present, with a moderate to large amount of stool throughout the rest of the colon. The rectum measures at least 10 cm in width. No pneumatosis, portal venous gas, or pneumoperitoneum is evident. | Large amount of rectal stool. |
Generate impression based on findings. | 59-year-old female with metastatic colon cancer and known left scapular metastases all with right upper rib and shoulder pain Right shoulder: The right shoulder appears normal for the patient's age. No focal osseous lesions are identified to suggest metastases to the bones of the shoulder.Ribs: There is lytic destruction of the posteromedial aspect of the right third rib. Again seen is a destructive lesion of the left scapular spine and acromion previous described on CT dated 12/26/14. Multiple pulmonary metastases are again noted. There is a right chest wall port with catheter tip projecting over the cavoatrial junction. | Metastatic disease as described above, including lytic destruction of the posteromedial right third rib. |
Generate impression based on findings. | Trauma There is an acute subdural hematoma along the left parietal convexity, measuring up to 6 mm in the coronal plane. Subdural hematoma extends along the falx as well as along the tentorium. Small subdural component is also seen along the left frontal convexity. There is small amount of subarachnoid hemorrhage which is also noted in the right frontal lobe. No hydrocephalus.Extensive streak artifact makes evaluation of the underlying parenchyma difficult. There is however some evidence of diffuse sulcal effacement and loss of gray-white differentiation. No significant midline shift or uncal herniation.There are fractures involving the left parietal bone with posterior displacement and without depression. Fracture involving the squamosal left temporal bone is also noted. There is also a nondisplaced fracture of the right parietal bone. Subgaleal hematoma is present in the left temporal parietal region. Mastoid air cells are clear. Minimal opacification of ethmoid air cells. | 1. Acute subdural hematoma along the left frontoparietal convexity measuring up to 6 mm, with extension along the falx and tentorium. Small subarachnoid hemorrhage is also seen in the right frontal lobe.2. Multiple calvarial fractures involving the left parietal bone, left temporal bone, and right parietal bone as described above. No depressed calvarial fractures.3. Streak artifact in technique limit evaluation of the parenchyma. However, there is evidence of diffuse sulcal effacement and loss of gray-white differentiation consistent with cerebral edema with suggestion of global ischemic injury. |
Generate impression based on findings. | 59-year-old female status post left hip hemiarthroplasty Hardware components of a left hip hemiarthroplasty are situated in near anatomic alignment without evidence of complication. Surgical staples, drain and gas in the soft tissues reflects recent surgery. | Status post left hip hemiarthroplasty in near anatomic alignment. |
Generate impression based on findings. | 82 years old, Female, Reason: kidney stone History: History of stones with hematuria and right cvat Lack of IV contrast limits evaluation of abdominal parenchyma. Within these limitations following observations are made:ABDOMEN:LUNG BASES: Micronodule in the left lung base.LIVER, BILIARY TRACT: Multiple hypodensities within the liver which are too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right mid ureter obstructing stone measuring approximately 3 mm in diameter (series 4, image 58). Perinephric fat stranding and hydroureter on the right, likely secondary to obstructing stone. No specific evidence for pyelonephritis. Nonobstructing nephrolithiasis on the left. Right parenchymal renal hypodensities are too small to characterize. Two left renal cysts are present. Interval removal of left nephroureteral stent.RETROPERITONEUM, LYMPH NODES: Calcifications of the abdominal aorta.BOWEL, MESENTERY: Colonic diverticulosis without evidence diverticulitis. No evidence of obstruction, pneumatosis, or free air. BONES, SOFT TISSUES: Degenerative changes of the spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: See abdomen sectionBONES, SOFT TISSUES: See abdomen sectionOTHER: No significant abnormality noted | Right mid ureter calculus with resultant right hydronephrosis and perinephric fat stranding. |
Generate impression based on findings. | 37 year-old female with pain and swelling after car crash There is mild soft tissue swelling along the dorsum of the hand. Slight irregularity of the medial margin of the head the second metacarpal seen on the PA view with underlying curvilinear lucency seen on the oblique view could represent a minimally displaced fracture if there is pain at this site. | Findings suggestive of a minimally displaced fracture of the head of the second metacarpal, discussed with the clinical service at the time of dictation (pager 1223). |
Generate impression based on findings. | 16-month-old male with desaturations.VIEW: Chest AP (one view) 1/7/2015, 0102 hrs. Endotracheal tube tip at the ostium of the right mainstem bronchus. Enteric tube tip beyond the field of view.Continued worsening of right-sided pulmonary opacities. Left-sided/retrocardiac opacities stable. New right pleural effusion. Normal cardiac silhouette size.Right sixth rib fracture again noted. | 1.Worsening right-sided opacities.2.New right pleural effusion.3.Endotracheal tube tip at the ostium of the right mainstem bronchus. This finding was relayed via telephone to Dr. Chong at 9:39 a.m. on 1/7/2015. |
Generate impression based on findings. | 58 showed female status post hardware removal Hardware components of a total left hip arthroplasty are situated in near-anatomic alignment. A greater trochanter claw and cerclage wire device has been removed with residual wires noted in the soft tissues. The head of the prosthesis is slightly eccentrically positioned, suggesting liner wear. The distal femoral component extends beyond the field of view.Hardware components of a right total hip arthroplasty are situated in near-anatomic alignment with the distal aspect of the femoral stem extending beyond the field-of-view. | Postoperative changes of bilateral total hip arthroplasties with removal of greater trochanteric claw and cerclage wires as described above. |
Generate impression based on findings. | 82-year-old male with trauma, left foot pain, evaluate for infection There is soft tissue swelling along the dorsum of the foot with confluent soft tissue opacity suggesting hematoma. There are no specific findings to suggest abscess. The bones are diffusely demineralized, but there are no specific features to indicate osteomyelitis. No fracture or dislocation is evident. Scattered arterial calcifications are noted in the soft tissues. | Dorsal soft tissue swelling and possible subacute hematoma without fracture or specific features of infection. |
Generate impression based on findings. | 16-month-old male presents after blunt trauma.VIEW: Chest AP (one view) 1/6/2014, 2123 hrs. ET tube tip at the ostium of the right mainstem bronchus. Enteric tube tip beyond the field of view.The aortic arch, cardiac apex, and stomach are left-sided. Hazy left-sided and more patchy right-sided pulmonary opacities are present, better evaluated on subsequent CT. No definite pneumothorax or pleural effusion. Normal cardiac silhouette size.Right sixth rib fracture. | Pulmonary opacities suggestive of hemorrhage/contusion.ET tube tip at ostium of the right mainstem bronchus. This finding was relayed to Dr. Chong at 9:39 a.m. on 1/7/2015. |
Generate impression based on findings. | 16-month-old male presents after blunt trauma.VIEWS: Pelvis AP (one views) 1/6/2014, 2118 hrs. No fracture or malalignment in the pelvis. Femoral heads are well seated within normally formed acetabula. | No fracture or malalignment. |
Generate impression based on findings. | 40 year-old female with bony tenderness, evaluate for metastasis or fracture Mild to moderate osteoarthritis affects the right hip. No fracture or focal osseous lesion is identified to suggest metastatic disease. | Osteoarthritis without fracture or bone metastasis evident. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Benign calcifications are present. Stable focal asymmetry is present in the right upper outer quadrant. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable right focal asymmetry. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | left upper extremity weakness, history of metastatic lung cancer. No evidence of acute ischemic or hemorrhagic lesion on this scan.Right parietal encephalomalacia with overlying craniotomy do not show any significant interval change since prior exam.Patchy low attenuations on bilateral periventricular white matter indicating non specific small vessel ischemic disease do not show any significant interval change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The paranasal sinuses and mastoid air cells are clear. | 1. No evidence of acute ischemic or hemorrhagic lesion on this scan.2. No interval change of right parietal encephalomalacia, overlying craniotomy and non specific small vessel ischemic disease since prior exam. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of skin cancer. History of ovarian cancer in paternal grandmother and paternal first cousin. Two standard digital views of both breasts 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts and an additional right CC view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Benign calcifications are present, including arterial calcifications. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 16-month-old male presents after blunt trauma. CHEST:LUNGS AND PLEURA: Dense patchy and confluent opacities are present bilaterally, which may represent contusion/hemorrhage. More confluent left-sided opacities may be partially accounted for by atelectasis secondary to right mainstem intubation. No significant pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Endotracheal tube tip at the ostium of the right mainstem bronchus. Normal heart size without pericardial effusion. The left common carotid and right innominate arteries branch from a common trunk from the aorta, normal variant anatomy.CHEST WALL: Right lateral sixth rib fracture.ABDOMEN:LIVER, BILIARY TRACT: A2 .5 cm, irregular linear hypoattenuation near the hepatic dome extends to the periphery and likely represents a liver laceration. The liver enhances in a mottled pattern. There is significant periportal edema.SPLEEN: No splenic laceration is identified.PANCREAS: Normal-appearing pancreas.ADRENAL GLANDS: 3.2 x 2.4 cm right adrenal high density fluid collection of approximately 50 Hounsfield units is concerning for adrenal hemorrhage.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy is present.BOWEL, MESENTERY: Enteric tube tip at the duodenal bulb. Diffuse mucosal hyperenhancement in the small bowel may represent shock bowel. No pneumatosis or free air is identified.BONES, SOFT TISSUES: No fracture or malalignment is evident.OTHER: There is a large amount of intraperitoneal free fluid, including in Morison's pouch, the gallbladder fossa, and the paracolic gutters, and also in the inguinal canals bilaterally. Fluid measures between 10 and 20 Hounsfield units, and a component of hemoperitoneum is not excluded.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Moderately distended without evidence of bladder wall thickening or mass lesion.LYMPH NODES: No pelvic, inguinal, or iliac chain lymphadenopathy.BOWEL, MESENTERY: Small bowel mucosal hyperenhancement, as above.BONES, SOFT TISSUES: No fracture or malalignment is evident.OTHER: No significant abnormality noted | 1.Liver laceration. 2.Findings concerning for shock bowel and shock liver.3.Large amount of intraperitoneal intermediate density free fluid. Hemorrhage not excluded.4.Right adrenal hemorrhage.5.Right 6th rib fracture.Findings relayed via telephone to Dr. Oddiri at 10:45 a.m. on 1/7/2015. |
Generate impression based on findings. | Altered mental status, visual hallucination. There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. There is no evidence of abnormal intracranial enhancement. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is partially-imaged opacification of the left maxillary sinus. The imaged middle ear cavities and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | No evidence of intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in sister and ovarian cancer in maternal aunt. Two standard digital views and tomosynthesis of both breasts and an additional right MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Vocal cord paralysis, vagal nerve involvement? History: hoarseness. Head: There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. Neck: There is mild asymmetry of the laryngeal vestibules, left larger than right. The larynx otherwise appears grossly unremarkable. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria, although the assessment is limited by the lack of intravenous contrast. The thyroid and major salivary glands are unremarkable. The osseous structures are unremarkable. There is a right internal jugular venous catheter. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | 1. Mild asymmetry of the laryngeal vestibules, left larger than right, may be related to vocal cord paralysis.2. No evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria, although the assessment is limited by the lack of intravenous contrast.3. No evidence of intracranial hemorrhage or mass. |
Generate impression based on findings. | 16-month-old male with respiratory distress after sustaining blunt trauma. Evaluate for pneumothorax or hemothorax.VIEW: Chest AP (one view) 1/6/2014, 2243 hrs. Endotracheal tube at the ostium of the right mainstem bronchus. Enteric tube tip in the pyloric/duodenal bulb region.Worsening right-sided patchy pulmonary opacities. Retrocardiac and left upper lobe opacities appear similar to the previous exam. Normal cardiac silhouette size. No evidence of pneumothorax or significant pleural effusion.Right sixth rib fracture again noted. | 1.Worsening right-sided opacities.2.Endotracheal tube tip at the ostium of the right mainstem bronchus. This finding was relayed via telephone to Dr. Chong at 9:39 a.m. on 1/7/2015. |
Generate impression based on findings. | Head trauma.VIEW: Chest AP (one view) 1/7/15 0552 ET tube tip is at the carina. Left subclavian venous catheter tip is at the confluence of the brachiocephalic veins. NG tube tip is in the antropyloric region. The cardiothymic silhouette is normal.Increased bibasilar lung opacities likely represent subsegmental atelectasis. | Bibasilar subsegmental atelectasis. |
Generate impression based on findings. | 32 year old female with a given history of Graves' disease. Need uptake for dosing of RAI. The thyroid images demonstrate decreased activity in the right lower pole consistent with a cold nodule. Otherwise there is uniform activity in both lobes in a gland of normal size and configuration. The 4-hour radioactive iodine uptake is 5.5% and the 22-hour uptake is 11.9% (normal range 10-30% at 24-hours). | 1. Scintigraphic findings of normal radioactive iodine uptake are inconsistent with Graves' disease.2. Decreased activity in the lower pole of the right thyroid lobe is compatible with a cold nodule. Correlate with ultrasonography. |
Generate impression based on findings. | 4 year old female with HIE. Evaluate for atelectasis or pneumonia. VIEW: Chest AP (one view) 1/7/15 0557 Left PICC tip is at the superior cavoatrial junction. Upper abdominal surgical clips are noted. The cardiothymic silhouette is normal. Bibasilar pulmonary opacities persist, unchanged. | Persistent bibasilar opacities. |
Generate impression based on findings. | 79-year-old woman with history of swelling and tenderness over the wrist, elbow, and shoulder. Right forearm: There is no acute fracture or malalignment. Mild degenerative changes are noted at the elbow joint.Right humerus: There is no acute fracture or malalignment. Severe degenerative changes affect the acromioclavicular joint and moderate degenerative changes affect the glenohumeral joint. There is an approximately 7 x 7 mm radiopaque density in the soft tissues of the right breast, which may be due to an overlying structure but this can be correlated with physical exam. | No acute fracture or malalignment. Degenerative changes as described above. |
Generate impression based on findings. | Right eye pain, worsening frontal headaches, right eye chemosis. Evaluate for worsening lymphoma infiltration. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact.Previously seen soft tissue thickening involving the nasopharynx appears to have resolved. Nodule involving the left parieto-occipital scalp seen on prior study from 10/14/2014 is resolved. Dedicated temporal bone study was not performed however there appears to be resolution of the previously seen nodularity involving the right external auditory canal. There also appears to be some improvement thickening involving the suboccipital soft tissues.There is soft tissue thickening involving the right orbital preseptal soft tissues slightly worse compared to 10/14/2014. No retrobulbar mass is seen. No obvious proptosis or enlargement of the superior ophthalmic veins. Small right maxillary mucous attention cyst. | 1. No evidence of intracranial hemorrhage or intracranial mass effect.2. Preseptal soft tissue thickening involving the right orbit appears slightly worse than prior. Based on prior PET from 10/14/2014, finding may be related to lymphomatous infiltration although infection should also be considered. No CT findings to suggest cavernous sinus thrombosis. No retrobulbar lesions. 3. Previously seen soft tissue nodule in the left parieto-occipital scalp, prominence of the nasopharyngeal soft tissues, and nodularity in the right external auditory canal have resolved, findings suggestive of treatment response. Consider MRI brain for more sensitive evaluation of intracranial neoplasm if clinically indicated. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 41-year-old with right breast ALH and papilloma. Additional calcifications noted on prior mammogram requiring short interval follow-up. No family history of breast cancer. Three standard views of right were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A biopsy clip is present in the right upper inner breast, unchanged in position. There are regionally distributed calcifications in the anterior right breast. Some these are grouped, however they do not have suspicious morphology and appear similar to prior. No dominant mass or suspicious microcalcifications. Benign appearing lymph nodes are projected over the right axilla. | Stable calcifications in the anterior right breast as described. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 56 year-old woman with history of pain status post fall. There is an acute fracture of the right greater trochanter with no significant displacement of the fracture fragment. The fracture line does not extend into the femoral neck or to the lesser trochanter. Associated soft tissue edema is noted. Extensive degenerative changes affect the right hip joint with superior joint space narrowing, subchondral sclerosis, and subchondral cysts. The musculature of the right hip appears normal. | Nondisplaced fracture of the right greater trochanter. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in 4 maternal cousins. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable bilateral calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Pneumothorax.VIEW: Chest AP (one view) 1/7/15 0419 ET tube tip is at the thoracic inlet. Left upper extremity PICC tip is in the SVC. NG tube tip is in the stomach. Three right-sided chest tubes are again noted. The superior-most projecting right chest tube side port is likely extra-pleural.The cardiothymic silhouette is normal. The lung volumes are large with PIE pattern. The large right-sided pneumothorax is unchanged. | Unchanged large right pneumothorax. |
Generate impression based on findings. | 19 year-old woman with history of puncture wound with broken glass. There is a punctate radiopaque density along the anterolateral aspect of the first phalanx nail bed which may represent a foreign body or may be artifactual. No additional unexpected radiopaque foreign bodies are identified. There is no acute fracture or malalignment. | Punctate radiopaque density in the first phalangeal nailbed which may represent a foreign body or may be artifactual. Correlation with physical exam is recommended. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Round markers were placed on skin lesions overlying both breasts. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 58 years old, Female, Reason: appy History: rlq pain ABDOMEN:LUNG BASES: Mild bibasilar dependent atelectasis.LIVER, BILIARY TRACT: Cholelithiasis without evidence cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right lower pole renal hypodensity which is too small to characterize. No left kidney is in appearance. No evidence of pyelonephritis, hydroureter or hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix measures approximately 14 mm in diameter with associated periappendiceal fat stranding consistent with acute appendicitis. No drainable fluid collections are noted. No evidence of obstruction or free air.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Leiomyomatous uterus.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: See abdomen section.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Findings consistent with acute appendicitis. No drainable fluid collection, obstruction, or free air. |
Generate impression based on findings. | Female 57 years old Reason: r/o obstruction History: abdominal pain, constipation 6 days ABDOMEN:LUNG BASES: Resolution of the previously seen right-sided pleural effusion with associated atelectasis.LIVER, BILIARY TRACT: Hypoattenuating lesion in the right hepatic lobe slightly smaller, now measuring 1.7 x 6.2 cm (image 30, series 3), previously 2.5 x 6.0 cm.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There has been marked interval decrease in size of the exophytic infiltrative right renal mass, now measuring approximately 5.0 x 7.2 cm (image 69, series 3), previously 11.7 x 14.1 cm. The mass again appears to infiltrate the right psoas muscle, right hemidiaphragm, and right abdominal wall as well as encasing the proximal right ureter. There is no evidence of associated hydronephrosis.RETROPERITONEUM, LYMPH NODES: There has been marked interval decrease in size of the conglomerate of aortocaval nodes with the reference conglomerate of nodes now measuring approximately 2.2 x 3.3 cm (image 61, series 3), previously 5.5 x 6.0 cm.BOWEL, MESENTERY: There is marked bowel wall thickening of the terminal ileum with associated mesenteric fat stranding and adjacent lymphadenopathy consistent with terminal ileitis.BONES, SOFT TISSUES: Again seen are lesions the transverse processes of the right L1, L2 and L3 vertebral bodies, reflecting local invasion from the renal mass.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Again seen are erosions of the right transverse processes of the L1, L2 and L3 vertebrae, reflecting local invasion from the renal mass. The mass again appears to extend through the neural foramina of the lower thoracic and upper lumbar spine, although this could be better evaluated with MR as clinically indicated.BOWEL, MESENTERY: See aboveBONES, SOFT TISSUES: Again seen are erosions of the right transverse processes of the L1, L2 and L3 vertebrae, reflecting local invasion from the renal mass. The mass again appears to extend through the neural foramina of the lower thoracic and upper lumbar spine, although this could be better evaluated with MR as clinically indicated.OTHER: No significant abnormality noted | 1.Findings consistent with terminal ileitis as detailed above.2.Marked interval decrease in size of the right renal mass and associated lymphadenopathy, compatible with treatment response, as detailed above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast cyst aspiration. Two standard digital views and tomosynthesis of both breasts 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. Stable benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 29-year-old man with history of left tibial plateau fracture. Again seen is a comminuted fracture of the tibial plateau with fracture lines extending to the lateral articular surface. Fracture fragments are in near anatomic alignment. The cast has been removed and there is mild periosteal reaction suggesting interval healing. A small to moderate joint effusion persists. | Healing comminuted tibial plateau fracture with fracture fragments in near anatomic alignment. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. History of breast cancer in mother diagnosed at age 55 and paternal grandmother. Two standard digital views of both breasts and an additional left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the right breast. Stable calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 44 year old female with a history of thyroid cancer. Status post thyroidectomy and radioiodine therapy. THYROID: The patient is status post thyroidectomy. RIGHT THYROIDECTOMY BED: Status post thyroidectomy with no evidence of residual or recurrent disease. LEFT THYROIDECTOMY BED: Status post thyroidectomy with no evidence of residual or recurrent disease. ISTHMUS BED: Status post thyroidectomy with no evidence of residual or recurrent disease. LYMPH NODES: Bilateral morphologically unremarkable and normal-sized lymph nodes are identified.PARATHYROID GLANDS: No significant abnormality noted.OTHER: No significant abnormality noted. | No specific findings of residual or recurrent disease. No regional lymphadenopathy. |
Generate impression based on findings. | 26 years old, Female, Reason: r/o IBD History: diffuse abd pain, worse in suprapubic area, 3 months of diarrhea ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mildly enlarged lymph nodes within the mesentery. No evidence of appendicitis or diverticulitis. No evidence of obstruction or bowel wall thickening.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: See abdomen sectionBONES, SOFT TISSUES: No significant abnormality notedOTHER: Trace amount of free fluid within the pelvis is likely physiologic in a premenopausal female. | No specific CT findings to account for patient's symptoms. |
Generate impression based on findings. | 54-year-old male with increased thickening in the left retroareolar region. The patient is on numerous medications, including prednisone. History of right mastectomy for breast cancer. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Biopsy clip again noted in the left retroareolar region. There has been the interval increase in flame-shaped focal asymmetry in the left retroareolar region compatible with increasing gynecomastia. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. ULTRASOUND | Findings compatible with increasing gynecomastia. Surgical consultation is planned for today. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in maternal cousin diagnosed at the age of 51. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Abdominal distension.VIEW: Abdomen AP (one view) 1/7/15 0436 Enteric tube tip is in the stomach. The bowel gas pattern is disorganized and nonobstructive, with decreased bowel distension. No pneumatosis, portal venous gas, or pneumoperitoneum is present. | Decreased bowel distension. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. History of breast cancer in maternal aunt diagnosed at the age of 30. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A round marker was placed on a skin lesion and a linear marker was placed on a scar overlying the right breast. Stable benign intramammary lymph node is present in the left upper outer quadrant. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 30 years old Reason: r/o appendicitis vs ruptured cyst History: RLQ pain ABDOMEN:LUNG BASES: Trace bibasilar dependent atelectasis. Punctate calcifications seen in both breasts.LIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma. Borderline hepatomegaly.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is no evidence of hydronephrosis or hydroureter. There is no evidence of nephrolithiasis or ureterolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Post surgical changes related to L5-S1 fusion.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Left adnexal cyst, presumably physiologic in etiology. There is trace free fluid in the pelvis.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Post surgical changes related to L5-S1 fusion.OTHER: No significant abnormality noted | No specific findings seen to account for the patient's pain, specifically no evidence of appendicitis or ruptured adnexal cyst. |
Generate impression based on findings. | Tachypnea and retractions. VIEW: Chest AP and abdomen AP (two views) 1/7/15 0832 The ET tube has been removed. The left jugular central venous catheter tip is in the right atrium. The enteric tube tip is in the third portion of the duodenum. An IVC stent and upper abdominal surgical clips/suture are noted. The right chest tube has been removed. A new drain projects over the right hemiabdomen.The cardiothymic silhouette size is slightly enlarged, unchanged. The lung volumes remain small with bibasilar and right upper lobe opacities. The bowel gas pattern remains disorganized and nonobstructive, with minimal bowel gas evident. No pneumatosis, portal venous gas, or pneumoperitoneum is present. | Low lung volumes with bilateral opacities possibly representing subsegmental atelectasis. |
Generate impression based on findings. | 52 years old, Female, Reason: r/o right inguinal hernia, R hip abnormality, infection, mass History: right inguinal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mild calcifications of the abdominal aorta and common iliacs.BOWEL, MESENTERY: No evidence of inguinal hernia as clinically questioned. No evidence of any type of hernia. No evidence of obstruction, pneumatosis, or free air.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: See abdomen sectionBONES, SOFT TISSUES: Small lipoma in the right gluteal area.OTHER: No significant abnormality noted | No evidence of inguinal hernia, infection, or mass as clinically questioned. No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A round marker was placed on a skin lesion overlying the left breast. Stable circumscribed mass is present in the anterior depth of the right breast. Benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable right breast mass. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
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