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Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in mother, maternal second cousins and maternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Tomosynthesis was performed. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Focal asymmetry in the left lower quadrant has been stable compared to the 8/18/2008 exam.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: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | ETT placement.VIEW: Chest AP (one view) 1/7/15 2007 ET tube tip is below the thoracic inlet and above the carina. The cardiothymic silhouette is normal.Peribronchial thickening is present, with increased bilateral subsegmental atelectasis. No focal lung opacities or pleural effusions are evident. | Bronchiolitis/reactive airway disease pattern with increased atelectasis. |
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. Tomosynthesis was performed. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Focal asymmetry in the left upper breast, seen only on MLO view, is stable compared to the 2/26/2009 exam.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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 22-year-old female with pain to right hand after MVC Alignment is anatomic. There is no fracture or other specific finding to account for the patient's pain. | Normal hand and wrist without specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 60 year-old male with pain, preoperative evaluation There is approximately 8 degrees valgus deformity about the knee and severe osteoarthritis affecting the knee joint with lateral greater than medial joint space narrowing. | Osteoarthritis and valgus deformity. |
Generate impression based on findings. | Cough and fever.VIEW: Chest AP (one view) 1/7/15 1817 The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal.Lingular opacity is suspicious for infection. Right upper lobe opacity likely represents atelectasis. No pleural effusions are evident. | Lingular pneumonia. |
Generate impression based on findings. | Reason: r/o atypical infection, change in lung lesion, HIV status (well-controlled) History: persistent cough, now blood streaked LUNGS AND PLEURA: Stable appearance of left lower lobe cavitary lesions, mild surrounding atelectasis. Mild dependent atelectasis on the right.Stable scarring in the left upper lobe.Mild bilateral pleural thickening.MEDIASTINUM AND HILA: Ill-defined soft tissue density in the anterior mediastinum likely represents residual thymic tissue.The heart size is within normal limits, no significant pericardial effusion. Main pulmonary is of normal caliber.No visible coronary artery calcifications.Scattered, nonenlarged mediastinal lymph nodes.CHEST WALL: No significant axillary lymphadenopathy.Degenerative disease in the spine including compression deformities in multiple thoracic levels including T8 and T11 vertebral bodies, not significantly changed when compared to prior.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Unchanged appearance of left lower lobe cavitary lesions, and no obvious source of hemorrhage.2 Multiple thoracic compression deformities, not significant change when compared prior. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in a sister. 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. Scattered 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: NSB - Screening Mammogram. |
Generate impression based on findings. | 54-year-old male with left basilar joint osteoarthritis There is moderate basilar joint and triscaphe joint narrowing. No fracture or dislocation. | Moderate osteoarthritis. |
Generate impression based on findings. | 52 year-old female with history of total right knee arthroplasty Hardware components of a total right knee arthroplasty are situated near anatomic alignment without evidence of complication. Osteoarthritis affects the left knee is seen on the frontal view. | TKA in near-anatomic alignment. |
Generate impression based on findings. | 49 years old, Female, Reason: LUQ abdominal pain, evaluate Stoma RLQ, hernia RLQ, L kidney History: as obove ABDOMEN:LUNG BASES: Bibasilar scarring and atelectasis. There is subpleural reticulation and honeycombing present. Mild traction bronchiectasis in the left. These findings are not significantly changed from chest CT dated 5/28/14 are consistent with known history of interstitial lung disease.LIVER, BILIARY TRACT: Subcentimeter hypodense hepatic segment 5 lesion is too small to characterize accurately, however is favored to be benign.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No perinephric stranding. No nephrolithiasis. Scarring within the lower pole of the right kidney.RETROPERITONEUM, LYMPH NODES: There is a right para-aortic retroperitoneal surgical clip which is unchanged from exam in 2012.BOWEL, MESENTERY: Evidence of surgical changes to the colon the right lower quadrant ostomy. Multiple loops are present within a parastomal hernia. No evidence of obstruction, bowel wall edema, pneumatosis, or free air. Surgical clips adjacent to the rectum.BONES, SOFT TISSUES: There are subcutaneous varices extending from the left femoral vein of uncertain clinical significance.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Evidence of surgical changes the colon the right lower quadrant ostomy. Multiple loops are present within a parastomal hernia. No evidence of obstruction, bowel wall edema, pneumatosis, or free air. Postsurgical changes of the rectum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Multiple loops of bowel are present within a parastomal hernia without evidence of obstruction, bowel wall edema, or other complication.2.Interstitial lung disease unchanged. |
Generate impression based on findings. | Crohn's disease recently started on Imuran, with subsequent development of fevers, head and neck pain, and joint pains. Neck: There is no evidence of measurable mass lesions or significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. There is a nonspecific subcentimeter nodule in the skin of the left lateral neck at the level of the larynx.Head: There is no evidence of intracranial mass or abnormal enhancement. 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. | 1. No evidence of head and neck abscess, sinusitis, or mastoiditis. However, CT is relatively insensitive for the detection of meningitis.2. Nonspecific subcentimeter nodule in the skin of the left lateral neck at the level of the larynx. |
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. Tomosynthesis was performed. 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. History of breast carcinoma in maternal great aunt. Two standard digital views of both breasts, including repeat right MLO view were performed and reviewed with the aid of R2 CAD 9.3. Tomosynthesis was performed. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable benign masses and benign calcifications are present in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable benign bilateral masses. 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. | 53-year-old female, evaluate hallux valgus deformity. There is marked hallux valgus deformity and mild osteoarthritis affecting the first MTP and interphalangeal joints. Mild osteoarthritis affect the midfoot. | Marked hallux valgus deformity and additional findings as described above. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (12/2/14, 12/4/14), ultrasound images of left breast (12/4/14), images from ultrasound guided biopsy of left breast and post procedural left mammographic images (12/10/14) performed at Hinsdale Imaging Center. DIGITAL MAMMOGRAPHIC IMAGES (12/2/14, 12/4/14):The breast parenchyma is heterogeneously dense, which limits the sensitivity of the mammogram. There is an ill-defined mass at lower outer quadrant in the left breast, measuring approximately 1 cm.Scattered benign calcifications and mild arterial calcifications are noted in both breasts.No dominant suspicious microcalcifications or areas of architectural distortion are noted in either breast. ULTRASOUND IMAGES OF LEFT BREAST (12/4/14):An irregularly-shaped hypoechoic mass, measuring 9 x 5 mm, is present at 5 o'clock position, 6 cm from nipple in the left breast, corresponding to the mass seen on the mammogram. Two sonographic images of the left axilla are also obtained, and there are no abnormal lymph nodes in these images.IMAGES FROM ULTRASOUND GUIDED BIOPSY OF LEFT BREAST AND POST PROCEDURAL LEFT MAMMOGRAPHIC IMAGES (12/10/14):Ultrasound guided biopsy of the left breast mass at 5 o'clock position was performed, with an appropriate needle placement. A marker clip (coil shaped) was placed within the target mass. Post procedural left mammographic images show a marker clip is at the expected location within the mass at lower outer quadrant.Pathology result is not available to us. | Status post biopsy of a suspicious mass in the left breast at 5 o'clock position.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother (age 76) and paternal grandmother. 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. Scattered benign calcifications in both breasts and two benign intramammary lymph nodes in the right upper outer quadrant are unchanged.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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | History of right lumpectomy in 2009 for DCIS. Patient received adjuvant radiation therapy. History of multiple percutaneous biopsies of the right breast. Short-term follow-up for high probability benign calcifications in the right lumpectomy bed. Three standard views of both breasts and two right spot magnification views 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 linear marker was placed on the scar overlying the right breast. Stable postsurgical architectural distortion and skin retraction are present in the lumpectomy bed. Stable calcifications are present in the immediate right retroareolar region. Two percutaneously placed clips in the right breast are unchanged in position. No new masses are present in either breast. Stable lymph nodes project over the axillae. | Stable postsurgical changes and calcifications in the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral 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. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Tomosynthesis was performed. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. Bilateral upper outer calcifications have progressed compared to the previous examinations.No suspicious masses, microcalcifications or areas of architectural distortion are present. | Progression of bilateral upper outer calcifications. Further evaluation with straight ML views and CC and ML spot magnification views to evaluate for milk of calcium is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: ED - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 19 year-old female with shoulder pain Glenohumeral alignment is normal limits. The osseous structures appear within normal limits. | Normal shoulder. |
Generate impression based on findings. | 29-year-old male with history of squamous cell carcinoma of the left lateral tongue status post glossectomy and left neck dissection 1/2014. Redemonstrated are postsurgical changes from left neck dissection and partial glossectomy. There is stable asymmetric appearance of the left lateral base of tongue. On axial images, there appears to be subtle asymmetric somewhat rounded enhancement of the left lateral oral tongue, although on coronal images this appears to be due to asymmetric positioning as well as volume loss. Correlation with visual inspection is recommended. There is no definitive mass-like enhancement to suggest local recurrence. There is no cervical lymphadenopathy by CT size criteria. The salivary and thyroid glands are unremarkable. The airway is patent. The carotid arteries and jugular veins are unremarkable. The visualized lung apices are normal. The visualized intracranial structures are unremarkable. | Subtle enhancement of the left lateral oral tongue seems to be related to asymmetric position and volume loss, although correlation with direct visual inspection is recommended. No evidence of cervical lymphadenopathy. |
Generate impression based on findings. | Female 58 years old Reason: history of vaginal cancer, evaluation for disease and for bowel status. CHEST:LUNGS AND PLEURA: Scattered bilateral lung nodules consistent with metastatic disease. Based on comparison to the lung bases on the prior abdominal CT it least some of these nodules are new. For example right middle lobe lesion series 6 image 47 as well as small nodules just above the diaphragm on the right images 54, 53 are new. A few upper lobe nodules demonstrate cavitation. Four baseline purposes, a (cavitating) index nodule in the superior segment of the left lower lobe measured on series #3 image 35/90, .7 x .7 cm.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Previously seen ureteral stents have been removed. There is mild bilateral hydronephrosis without significant hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Surgically absent.BLADDER: Status post cystectomy and Indiana pouch. Right lower quadrant ileostomy.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Expected postsurgical changes. Right lower quadrant ileostomy. Left lower quadrant colostomy. Mild soft tissue thickening in presacral space, decreased compared to prior exam. Series 5 image #115 the presacral soft tissue and/or fluid measures 3.9-cm transverse x 1.6 AP. Previously 4.6 x 2.4 cm.Nonobstructive ventral incisional hernia series 5 image 101. Distorted loops of bowel consistent with nonobstructive adhesions see pattern in the pelvis coronal image 49/86.No evidence of carcinomatosis or ascites.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall.OTHER: No significant abnormality noted. | Progression of disease in the chest. Postsurgical changes abdomen pelvis.Nonobstructive adhesions pelvic loops of small bowel. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of maternal breast cancer, diagnosed at age 65. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Tomosynthesis was performed. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Round skin marker has been placed over a right inner lower breast skin lesion. Benign appearing 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: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 66 years old Reason: S/p lap distal pancreatectomy s splenectomy 9/16/13 for a 2.4cm well diff neuroendocrine tumor, LN Neg. Had surveillance scan in 7/13/14 at OSH questionable recurrence in pancreas. IOE of the CT Scan, fluid coll, post -op bed, \T\ rt liver lesion. History: none ABDOMEN:LUNG BASES: Trace bibasilar atelectasis.LIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma. Cholelithiasis without cholecystitis. Hypodense lesions within the hepatic parenchyma are too small to characterize, and unchanged from the prior examination. No arterial enhancing lesions are identified.SPLEEN: No significant abnormality notedPANCREAS: Postoperative changes again noted in the pancreatic tail. The fluid collection within the surgical bed is not significantly changed in size, now measuring 4.1 x 7.2 cm (image 38, series 3), previously 4.2 x 7.2 cm. The remainder of the pancreatic parenchyma is unremarkable.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Numerous hypoattenuating lesions are evident within the left kidney consistent with renal cysts. Some of the cysts measure greater than simple fluid density suggesting minimal complexity. There are nonobstructing left renal stones. There is no evidence of hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Scattered retroperitoneal lymph nodes are not pathologically enlarged by size criteria.BOWEL, MESENTERY: There is colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: 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 | 1.Postsurgical changes related to distal pancreatectomy, with an unchanged fluid collection within the pancreatic bed, without significant interval change in size.2.No evidence of metastatic disease or locoregional recurrence. 3.Cholelithiasis without evidence of cholecystitis. |
Generate impression based on findings. | Cloacal repair constipationVIEW: Abdomen AP There is a suprapubic catheter in place. Again noted surgical sutures and sacrum malformation. Moderate amount of fecal burden without obstruction. | Moderate amount of fecal burden. |
Generate impression based on findings. | 26 year-old female with right hip pain after fall Alignment is anatomic. No hip or pelvic fracture is visualized. The osseous structures appear normal. | No fracture or dislocation. |
Generate impression based on findings. | 67-year-old man with history of pain in the shoulder and hand. Right shoulder: Mild degenerative change affects the glenohumeral joint. There is no acute fracture or malalignment.Right hand: There is narrowing of the second and third metacarpophalangeal joints with beaklike osteophyte involving the third metacarpal head. The PIP joints appear normal. There is no chondrocalcinosis noted. | Degenerative changes as described above with those of the hand most likely related to CPPD arthritis. |
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 coarse calcifications in both breasts, unchanged.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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 55-year-old man with history of tibial plateau fracture. A nondisplaced fracture through the proximal tibia extending to the lateral tibial plateau is again noted. Additionally, there is a nondisplaced fracture of the fibula which also appears unchanged. Osteophytes arising from the medial compartment and undersurface of the patella indicate moderate osteoarthritis. Alignment is near-anatomic. | Tibial plateau and proximal fibular fractures appearing similar to the prior examination. |
Generate impression based on findings. | Imperforate anus constipationVIEW: Abdomen AP Moderate amount of fecal burden without obstruction. No abnormal bowel dilation. No pneumatosis or pneumoperitoneum. | Moderate amount of fecal burden. |
Generate impression based on findings. | Evaluate for CVA. There is no evidence of acute intracranial hemorrhage. There is mild periventricular and subcortical white matter hypoattenuation compatible with age indeterminate ischemic small vessel disease. The superior cerebellar cistern is slightly prominent. The ventricles and sulci are age-appropriate. There is no midline shift or mass-effect. The visualized paranasal sinuses and mastoid air cells are clear. There are bilateral lens replacements. The calvarium and scalp soft tissues are unremarkable. | Mild age indeterminate ischemic small vessel disease. Please note that CT is insensitive for the detection of acute ischemic infarction. If there is strong clinical concern, an MRI should be considered.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 50 year-old female with shoulder pain, evaluate rotator cuff Intra-articular contrast is noted extending across a full-thickness defect through the distal supraspinatus tendon at its insertion on the greater tuberosity consistent with a full-thickness distal rotator cuff tear. Several additional contrast-filled linear tracts extending across the supraspinatus tendon slightly more proximally are consistent with additional tearing. Contrast fills the subacromial-subdeltoid bursa. There is mild adjacent tendinous retraction and significant atrophy of the rotator cuff muscles. | Full thickness distal supraspinatus tear as described above |
Generate impression based on findings. | 33 year-old woman with history of tibial plateau fracture. A side plate and screw device and an orthopedic pin are seen affixing a tibial plateau fracture in near anatomic alignment. The fracture lines are not visible and indicate healing. There is no evidence of hardware complication. | Orthopedic fixation of healing tibial plateau fracture. |
Generate impression based on findings. | 47-year-old female with left hip pain Left hip: Alignment is anatomic. The joint appears within normal limits. Pelvis: No pelvic fracture. Note is made of a right os acetabuli.Right knee: Mild osteophyte formation, consistent with mild degenerative changes. Left knee: There are small tibiofemoral osteophytes consistent with mild degenerative changes. | Mild osteoarthritis without specific findings to account for the patient's left hip pain. |
Generate impression based on findings. | Male 42 years old Reason: pain History: same Status post debridement, plate and screw fixation of a comminuted proximal fifth metacarpal fracture. The fracture fragments are in near anatomic alignment. No hardware complication is evident. | Surgical changes in the base of the fifth metacarpal as detailed above. |
Generate impression based on findings. | Female 35 years old Reason: 35 yo female s/p lap chole on 12/23; c/o abdominal pain; please evaluate for any abnormalities History: abdominal pain ABDOMEN:LUNG BASES: Punctate ossific density along the left lateral chest wall likely reflects heterotopic ossification, but is nonspecific.LIVER, BILIARY TRACT: Patient status post cholecystectomy. There is a trace amount of fluid within Morison's pouch, which is nonspecific, but presumably postoperative in etiology. Prominence of the common duct likely reflects sequelae of cholecystectomy. No retained stones are evident.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: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: There is a trace amount of heterogeneous fluid within the dependent portion of the pelvis, which is of uncertain significance.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Postoperative changes related to cholecystectomy, with a small amount of fluid within Morison's pouch, presumably postoperative in etiology. 2.No specific findings are seen to account for the patient's abdominal pain. |
Generate impression based on findings. | Female, 67 years old. Reason: please eval for ileus; free air likely 2/2 micro perf of diverticula. S/p OR washout History: see above Air filled loops of small and large bowel. Contrast within the colon from recent prior exam. Diffuse lucency over the right upper quadrant on supine imaging likely represents post-procedural free air.Nonobstructive bowel gas pattern.Interval placement of a right abdominal approach pelvic drain. Sternotomy wires and Swan-Ganz catheter partially visualized. Bilateral common iliac stents. | Nonobstructive bowel gas pattern. Findings on supine imaging suggestive of post-procedural free air. |
Generate impression based on findings. | 61-year-old man with history of left knee pain. Mild osteoarthritic affects the left knee with small tricompartmental osteophytes and mild medial joint space narrowing. Mild osteoarthritis also affects the right knee as seen on the frontal view. Alignment is within normal limits. | Mild osteoarthritis of the left knee. |
Generate impression based on findings. | Female 56 years old Reason: Hx of composite NHL History: Evaluate for continued remission CHEST:LUNGS AND PLEURA: Calcified and noncalcified pulmonary micronodules are nonspecific likely post infectious or post inflammatory in etiology. MEDIASTINUM AND HILA: The heart size is normal as is the caliber the great vessels. There is no evidence of pleural or pericardial effusion. The trachea and mainstem bronchi are patent. There is no evidence of mediastinal or hilar lymphadenopathy on the basis of size criteria. Postsurgical changes related to lymph node dissection in the neck are partially imaged.CHEST WALL: There is no evidence of axillary, subpectoral, cardiophrenic or retrocrural lymphadenopathy on the basis of size criteria.ABDOMEN:LIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is no evidence of hydronephrosis or hydroureter. There is no evidence of nephrolithiasis or ureterolithiasis.RETROPERITONEUM, LYMPH NODES: Postsurgical changes related to extensive retroperitoneal lymph node dissection. There is no evidence retroperitoneal lymphadenopathy on the basis of size criteria.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Postsurgical changes related to extensive pelvic lymph node dissection. There is no evidence of pelvic lymphadenopathy on the basis of size criteria.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | There is no evidence of lymphadenopathy in the chest, abdomen or pelvis to suggest disease recurrence. |
Generate impression based on findings. | Female, 21 years old. Reason: abdominal pain / assess for stool burden History: abdominal pain / gas / diarrhea Nonobstructive bowel gas pattern. Gas and stool filled loops of colon. Moderate colonic stool burden, predominantly in the ascending colon. | Moderate colonic stool burden. |
Generate impression based on findings. | Female, 35 years old. Reason: confirm NG tube placement History: N/V Interval placement of nasogastric tube with tip overlying the gastric fundus and distal sideport below the level of the GE junction.Multiple dilated loops of small bowel located centrally within the abdomen compatible with small bowel obstruction as seen on recent CT examination, not significantly changed in appearance.Pelvic drainage catheter in place. | Nasogastric tube with distal sideport below the level of the GE junction.Findings compatible with small bowel obstruction, similar in appearance to recent CT examination. |
Generate impression based on findings. | 15-year-old female status post MVA and significant back pain. Rule out fracture.VIEWS: Thoracic spine AP/lateral/swimmers view, lumbar spine AP/lateral/L5 view (6 views), 1/8/2015, 1111 hrs. Vertebral body heights, intervertebral disk spaces, and alignment are maintained in the thoracic and lumbar spine. No evidence of fracture or malalignment. | Normal examination. |
Generate impression based on findings. | Reason: 29F with Crohn's, multiple peristomal abscesses. please eval the small bowel History: peristomal abscesses. please eval small bowel Scout radiograph showed a nonobstructive bowel gas pattern. After administration of oral contrast, transit time to the ileostomy was one hour. Fluoroscopic evaluation showed normal mucosa throughout the small bowel, with no ulcers, sinus tracts, fistulae, or adhesions. No separation of bowel loops was present to suggest fibrofatty proliferation. The anastomosis to the ostomy was widely patent.On instillation of contrast and gas through the other barrel of the patient's double-barrel ostomy with a 6F catheter, the distal ileum, neo-terminal ileum, and proximal colon were normal in appearance. Transient apparent narrowing of the transverse colon (series 23) opened widely after air instillation. Contrast reached the splenic flexure before gaseous pressurization was lost. No strictures, ulcers, sinus tracts, or adhesions were seen. No obvious fistula was seen, but evaluation was somewhat limited as overlying loops of small bowel were opacified from the small bowel portion of the exam. No internal hernias or ventral hernias were evident.TOTAL FLUOROSCOPY TIME: 5:38 minutes | Normal examination of the small bowel, neo-terminal ileum and proximal colon. No specific evidence of stricture or obvious fistula in this patient with Crohn's disease. |
Generate impression based on findings. | Osteogenesis imperfecta and femur fracture.VIEWS: Left femur AP/lateral (two views) 01/08/15 The fracture has healed. Residual modeling abnormality is present with expansion of the medullary space and thinning of the cortex. Compression plate and screws are in place. | Healed proximal femoral fracture. |
Generate impression based on findings. | Ms. Isa is a 30-year-old female with known right breast cancer. Status post neoadjuvant chemotherapy. She presents today for ultrasound guided seed localization prior to surgery on 1/9/2015. Ultrasound examination of the biopsy-proven mass in the right breast 9 o'clock position (approximately 7 cm from the nipple), now measures 1.8 x 1.0 x 1.9 cm and contains a Y-shaped clip. PROCEDURE: The procedure, risks including bleeding, mistargeting and infection, and benefits of radioactive seed placement were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed to confirm patient identity and site of procedure. The right breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially. Using aseptic technique, continuous ultrasound guidance and an inferior to superior approach, an IsoAid preloaded breast localization needle was placed in the mass and adjacent to the clip. The I-125 seed was then deployed. The skin entry site was closed with a Band-Aid. A bracelet was placed on the right wrist labeled with the patient's name, MRN, number of seeds placed, right breast and surgical date (1/9/2015).Post-procedure digital right breast CC and ML views revealed the percutaneously placed seed to be in the expected location in the central aspect of the lesion and adjacent to the Y-shaped clip. No evidence of hematoma or other complication was present. The mammogram was annotated for the surgeon.Post seed placement instructions were given to the patient. Patient tolerated the procedure well and left the breast imaging center in stable condition. Drs. Sheth and Abe performed the procedure. | Successful radioactive seed localization of the right breast malignancy.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 20-year-old man with history of right knee pain, catching, and clicking. The right knee appears normal without acute fracture, malalignment, or significant degenerative changes. | Normal appearance of the right knee without finding to explain the patient's pain. |
Generate impression based on findings. | 57-year-old male for evaluation prior to lung transplant The comparison chest radiograph performed on 1/8/2015 demonstrates extensive chronic changes of cystic fibrosis.The ventilation images show large foci of decreased activity in the right upper and lower lung with slight gradual wash in on equilibrium images. There is abnormal Xe-133 retention in the left upper and right mid lung during the wash-out phase. The perfusion images show decreased perfusion to the majority of the right lung and small areas of the left lung.Quantitation of relative single breath ventilation (using the posterior image):Left lung: 76% (upper lung 13%; middle lung 35%; lower lung 28%)Right lung: 24% (upper lung 8%; middle lung 13%; lower lung 3%)Quantitation of relative pulmonary arterial perfusion (using anterior and posterior geometric means):Left lung: 87% (upper lung 20%; middle lung 50%; lower lung 17%)Right lung: 13% (upper lung 4%; middle lung 8%; lower lung 1%) | Markedly decreased ventilation and perfusion to the right lung. |
Generate impression based on findings. | History of excision of right nipple ducts in 2010 for an intraductal papilloma. History of benign right breast biopsy. Personal history of colon cancer. Family history of ovarian cancer in maternal grandmother and breast cancer in maternal cousin, paternal aunt and paternal cousin. No new breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the right breast. Stable postsurgical architectural distortion is present. Percutaneously placed clip is present in the right lower inner quadrant.No new masses or suspicious microcalcifications are present in either breast. Benign lymph nodes are projected over both axillae. | Stable postsurgical changes of the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 32 year-old woman with history of pain. Again seen is a minimally displaced fracture through the base of the fifth metatarsal with mild periosteal reaction suggesting interval healing. Dorsal soft tissue swelling persists. No additional fractures are identified and alignment is grossly anatomic. | Healing fracture of the base of the fifth metatarsal. |
Generate impression based on findings. | 30 year-old female. Morbid obesity, pre-op for bariatric surgery. Examination is somewhat limited by patient's body habitus. Single contrast visualization of the esophagus showed no morphologic abnormalities of the mucosal surfaces or mural contours. Limited upright fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave.Lap band device was seen in place, with appropriate orientation. Contrast flowed readily through the associated narrowed portion of the stomach (series 10). This channel measured approximately 8 - 10 mm in diameter. Otherwise, the stomach was normal in size, shape, and position. No abnormal stricture, stenosis, or fistula was seen. No hiatal hernia or obvious slippage of the lap band. Spontaneous emptying of contrast into the duodenal sweep was observed. TOTAL FLUOROSCOPY TIME: 1:51 minutes | Lap band device in appropriate position, without abnormal stricture, stenosis or fistula. No hiatal hernia or obvious slippage of the lap band. Otherwise normal limited examination of the esophagus and stomach. |
Generate impression based on findings. | 73-year-old male with dyspnea and history of stage III lung cancer status post radiation therapy ending November 9, 2014. Please evaluate disease progression prior to chemotherapy.RADIOPHARMACEUTICAL: 10.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 41 mg/dL. Today's CT portion grossly demonstrates a 4.5 cm posterior right hilar lung mass. There is also emphysema noted in the upper lobes bilaterally. Extensive atherosclerotic disease including coronary artery calcifications is noted. The left kidney is atrophic with a hypodense lesion most likely representing a benign cyst. In the lateral right kidney, there is a hypodense lesion containing high density components. This lesion is indeterminate for synchronous renal cell neoplasm despite negative FDG uptake.Today's PET examination demonstrates a markedly hypermetabolic posterior right hilar focus compatible with known lung cancer. For reference, the maximal SUV = 18.1 for the right perihilar lesion. There is also a small hypermetabolic right perihilar lymph node immediately adjacent to the lung lesion. This finding is consistent with ipsilateral lymph node metastasis. For reference, the maximal SUV = 13.1 for the right perihilar lymph node. No suspicious FDG-avid lesions are noted in the left thorax. In addition, no suspicious FDG-avid lesions are noted in the abdomen, pelvis, or bony skeleton.Incidentally noted is decreased bone marrow activity in the mid-thoracic spine likely secondary to prior radiation therapy. There is symmetric bilateral adrenal uptake which is likely benign. There is also hypermetabolic activity in the left hip which is likely benign and related to inflammatory changes. | 1.Markedly hypermetabolic right posterior perihilar focus compatible with the patient's known lung cancer.2.Hypermetabolic right perihilar lymph node consistent with ipsilateral lymph node metastasis.3.No contralateral thoracic or extrathoracic FDG-avid metastatic disease identified. 4.Cystic right renal lesion with high density component which is indeterminate for synchronous renal cell neoplasm despite lack of FDG uptake. Further evaluation with renal protocol CT is recommended as clinically warranted. Review of prior CT to assess for stability of the lesion may also be useful. |
Generate impression based on findings. | 86 year old woman with history of right total hip arthroplasty. There is been interval placement of a right total hip arthroplasty device in near anatomic alignment. There is no evidence of hardware complication. Foci of gas and a drain in the adjacent soft tissues reflect recent surgery. Moderate osteophyte is affects the left hip. Surgical suture is noted in the midpelvis. | Right total hip arthroplasty without evidence of complication. |
Generate impression based on findings. | History of left lumpectomy in 2013 for invasive ductal carcinoma, mucinous type. Patient received neoadjuvant chemotherapy and adjuvant radiation therapy. Currently on an aromatase inhibitor. No new breast complaints. History of breast cancer in mother diagnosed at age 59, sister diagnosed at age 62, maternal aunt, maternal grandmother and two maternal cousins. Three standard views of both breasts, an additional right CC view and two left spot magnification views 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. Linear markers were placed on scars overlying the left breast. Stable postsurgical architectural distortion, volume loss and surgical clips are present in the lumpectomy bed. There has been interval decrease in overlying skin thickening and trabecular edema. Scattered benign calcifications are present bilaterally.No new masses or suspicious microcalcifications are present in either breast. Benign lymph nodes are projected over the right axilla. | Expected post treatment changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 23 years old; Reason: hx of testicular cancer, evaluate for metastatic disease. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evidence of recurrent disease. |
Generate impression based on findings. | AML and severe abdominal pain.VIEW: Abdomen AP (one view) 01/08/15, 1134 Six coils are present in the right lower quadrant. No significantly dilated bowel loops are present. No abnormal calcifications are present. Focal opacities are present in both lower lobes. | No evidence of obstruction. Right lower quadrant coils may be related to ovarian pexy. |
Generate impression based on findings. | Scalp melanoma.RADIOPHARMACEUTICAL: The scalp at the right calvarial vertex was prepared in a sterile manner. A total of 0.5 mCi Tc-99m filtered sulfur colloid was injected in four intradermal injections surrounding the tumor excision site. Multiple foci of increased activity are identified in the right posterior neck, extending from the right posterior auricular to the right supraclavicular levels, compatible with lymphatic drainage in the right posterior jugular chain. These regions were marked and labeled with an indelible marker.No lymphatic drainage was noted in the left neck. No drainage was seen in either axillary region. | Sentinel nodes identified in the posterior right neck. |
Generate impression based on findings. | A counting sequence was not performed. Assuming 12 rib bearing vertebrae, there is redemonstration of a moderate compression deformity involving T10, with associated STIR hyperintensity indicating a component of acuity. There is trace vertebral fracture fragments super endplate which indents the ventral thecal sac although there is no significant stenosis. There is additional mild T1 hypointensity and STIR hyperintensity in the right anterior T9 vertebral body although there is no significant vertebral body height loss at this time.There is trace grade 1 retrolisthesis of L1 on L2 with right paracentral annular fissure. The thoracic spine is in normal alignment, with slight exaggeration of the normal thoracic kyphosis centered at T10. The vertebral body and disk heights are otherwise well-maintained. There are few foci of low T1 and T2 signal in the left T2 superior endplate and centrally in the T12 vertebral body, which are nonspecific. At C7-T1, there is a trace bulge without significant stenosis.At T5-T6, there is a focal central disk protrusion which indents the ventral thecal sac and flattens the ventral and right ventral cord. There is mild central spinal stenosis at this level.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the remainder of the thoracic spine. There is a partially visualized lobulated T2 hyperintensity of the interpolar left kidney measuring at least 4.7 x 4.0 cm. this cyst previously measured 3.5 cm on ultrasound from November 2013. | 1. Moderate recent compression deformity involving T10 is redemonstrated with trace retropulsion of fracture fragments, without significant stenosis. Likely also mild anterior T9 vertebral body compression although without significant height loss at this time. Evaluation by neurointerventional radiology at pager 9287 may be considered, for possible intervention. Please note that counting sequence was not obtained, and thoracic counting cannot be verified.2. Focal disk pathology at T5-T6 with flattens the ventral and right ventral cord.3. Partially visualized left renal T2 hyperintense dilated structure measuring up to 4.7 cm. This is consistent with previously seen cyst on ultrasound and appears to have enlarged. |
Generate impression based on findings. | Lung cancer initial staging.RADIOPHARMACEUTICAL: 12.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 130 mg/dL. Today's CT portion grossly demonstrates an approximately 4-cm left upper lobe mass with central cavitation and adjacent surrounding groundglass abnormalities. Multiple additional pleural-based soft tissue density nodular lesions are seen at the left mid and lower lung. Multiple enlarged lymph nodes are seen the left prevascular and right paratracheal locations. An approximately 4.5 cm left adrenal gland mass is noted, with stranding of the surrounding fat.Today's PET examination demonstrates the left upper lobe mass to be markedly hypermetabolic (SUV max = 11.8), compatible with the patient's diagnosis of lung cancer.Multiple pleural-based soft tissue density nodules at the left lung base are also markedly hypermetabolic (SUV max = 8.4), highly suspicious for metastatic disease.The enlarged left prevascular lymph nodes are moderately hypermetabolic (SUV max = 5.1). These are of some suspicion for mediastinal metastases although could also represent inflammatory lymph nodes. Smaller more mildly hypermetabolic bilateral hilar and right paratracheal lymph nodes are considered more likely inflammatory although mediastinal metastases in these locations cannot be entirely excluded.The large left adrenal mass is markedly hypermetabolic (SUV max = 13.0), compatible with an additional metastatic focus.No additional suspicious FDG of the lesion is identified elsewhere. No suspicious osseous lesion. A punctate focus of activity at the right seventh costovertebral junction corresponds with degenerative changes on CT. | 1.Markedly hypermetabolic left upper lobe mass, compatible with the patient's diagnosis of lung cancer.2.Several markedly hypermetabolic pleural based soft tissue density nodules at the left lung base, compatible with metastatic disease.3.Markedly hypermetabolic left adrenal gland mass, compatible with an additional metastasis.4.Mild to moderately hypermetabolic mediastinal lymph nodes, equivocal for additional metastases. Of these, the left prevascular lymph nodes are most suspicion. |
Generate impression based on findings. | Recall from screening mammogram for calcifications in the right retroareolar region. History of benign left breast biopsy. A ML view and 3 spot magnification views of the right breast 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. Magnification views confirm a 4 mm group of round calcifications that may layer on the ML view suggesting milk of calcium.No discrete masses or areas of architectural distortion are present. | High probability benign group of calcifications in the right breast. Right unilateral mammogram in 6 months is recommended. Results and recommendations were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear. Incidental note is again made of an oval exostosis projecting into the left frontal sinus medially which may relate to osteoma formation, although central lucency is present.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: There is minimal scattered trace mucosal thickening in the maxillary sinuses. The ostiomeatal units are clear.Posterior ethmoids: The posterior ethmoid air cells are clear.Sphenoid sinus: The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is mild leftward nasal septal deviation. The nasal turbinate morphology is within normal limits. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric.Mild degenerative changes are present in the visualized cervical spine. | No significant sinus inflammatory changes. |
Generate impression based on findings. | Moya Moya disease and multiple strokes. Central line placement.VIEW: Chest AP (one view) 01/08/15, 1107 Feeding tube tip is in body of stomach. Left upper extremity PICC tip is at junction of brachiocephalic veins. Right upper extremity PICC tip is lateral to costal border. Contrast material is seen in transverse colon.Cardiothymic silhouette is normal. No focal lung opacities present. | Left upper extremity PICC tip is located centrally. |
Generate impression based on findings. | Susceptibility artifact is present the right occipital region from a shunt. The cervical spine is in normal alignment, with trace reversal of the normal cervical lordosis centered at C4. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber. Ill-defined subtle T2 hyperintensity in the spinal cord at the level of C1-C2 is slightly less conspicuous on the current exam. The finding may be more apparent on STIR images as direct comparison demonstrates a similar appearance to prior exam.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the cervical spine. The fourth ventricle appears somewhat increased in size. Posterior arch of C1 is not well visualized. Cerebellar tonsils again extend abnormally below the level of the foramen magnum now at 10 mm, previously 8 mm. Tonsillar morphology does not appear significant change. | 1. Slight decreased conspicuity of subtle ill-defined T2 hyperintensity within the cord at the C1-C2 level.2. Redemonstration of abnormal cerebellar tonsillar caudal extension through the foramen magnum with crowding suggestive of a Chiari one malformation, which may be very minimally progressed. Slight interval increase in fourth ventricular size. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her mother at age 80. 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. Family history of breast cancer in her mother and a second cousin. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. There is a new mass in the right lower breast. Morphologically, it has features suggesting benignity. No suspicious microcalcifications or areas of architectural distortion are present. Benign calcifications are present bilaterally. Stable asymmetry in the left upper breast, most similar to the 2011 and 2012 comparison studies. | New mass in the right lower breast may represent a benign lesion such as a cyst. However, characterization with spot compression mammography and diagnostic ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Female 79 years old Reason: RCC History: none The exam is not sensitive detecting lesions in the solid organs or vasculature due to the lack of intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: A few small nonspecific hypodensities unchanged,1 likely cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Thickening left adrenal gland, unchanged.KIDNEYS, URETERS: Status post right nephrectomy. No evidence of recurrence in the right renal fossa.Left kidney is normal contour and texture. Perinephric fat is normal. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcification common no evidence of aneurysm. No pathologic size nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Normal appearing ovaries. Uterus appears surgically absent or atrophic.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Sigmoid diverticulosis. No evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes.OTHER: No significant abnormality noted | Given limitation of no intravenous contrast, no evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Bilateral parenchymal asymmetries are stable. | 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 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. Benign masses are present bilaterally, unchanged and likely intramammary lymph nodes. Normal-sized lymph nodes also project in each axilla, unchanged. A few benign calcifications are noted. | 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. | Asymptomatic female presents for routine screening mammography. Strong family history of breast cancer, BRCA 2 mutation carrier. 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. Previous benign left breast biopsy in 2001. 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. Bilateral benign calcifications are again noted. Biopsy clip in the left upper outer quadrant unchanged in position. | 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. | Male 26 years old; Reason: Evaluate for celiac artery compression, concern for median arcuate ligament syndrome ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: 2 cm splenule. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild extrinsic impression on proximal celiac artery near origin in expiration, sagittal image 58 series 80470, minimal to no poststenotic dilatation. Findings improve in inspiratory phase. No definite collateral flow via gastroduodenal artery seen as no significant dilatation of the vessel visualized. Incidentally seen replaced left gastric artery arising directly from abdominal aorta.BOWEL, MESENTERY: Small to moderate stool, no bowel obstruction. Normal appendix with small radiopaque density within, may reflect appendicolith formation.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Subcentimeter inguinal lymph nodes.BONES, SOFT TISSUES: No significant abnormality noted. | No significant celiac artery compression secondary to the median arcuate ligament seen. Mild extrinsic impression on proximal celiac artery in expiration, likely related to the median arcuate ligament, with minimal to no poststenotic dilatation; no definite collateral flow via gastroduodenal artery delineated. |
Generate impression based on findings. | Female 51 years old Reason: Weight bearing views of left knee. Evaluate degree of osteoarthritis. History: left knee pain Bone mineralization is normal. Alignment is anatomic. There is mild joint space loss .There are tiny osteophytes. No acute fracture.No joint effusion. | Minimal left knee osteoarthritis. |
Generate impression based on findings. | Female 54 years old Reason: right hip pain History: right hip pain Single view of the pelvis shows normal bone mineralization. Alignment is anatomic. Mild degenerative changes affect the pubic symphysis and sacroiliac joints.The right hip shows normal bone mineralization. Alignment is anatomic. Joint spaces are normal. No significant degenerative changes. Scattered soft tissue calcifications about the right ilium. | No significant right hip degenerative change. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild periventricular and subcortical white matter hypoattenuation which is nonspecific, likely representing chronic microvascular ischemic changes as noted on the prior exam. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. An endotracheal and orogastric tube are present with probable reactive air-fluid level in the right maxillary sinus and scattered right ethmoid sinus opacification, as well as debris within the nasopharynx with partial opacification of the left mastoid air cells. | No acute intracranial abnormality or other specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Recall from screening mammogram for increasing asymmetry in the left upper outer quadrant. History of breast cancer in sister and paternal grandmother. LEFT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: A ML view and two spot compression views of the left breast were performed digitally 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 discrete masses, suspicious microcalcifications or areas of architectural distortion are present in the left upper outer quadrant with spot compression imaging.LEFT BREAST ULTRASOUND: On physical examination, no palpable masses were present of the left breast. A targeted left breast ultrasound was performed for the area of mammographic concern. No suspicious cystic or solid masses were present in the left upper outer quadrant by ultrasound. | 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: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Right testicular swelling RIGHT TESTIS: Status post right orchiectomy.LEFT TESTIS: Testicle measures 4.3 x 2.7 x 2.2 cm. Testicular parenchyma heterogeneous, no focal parenchymal lesion delineated. Degree of parenchymal vascularity mildly improved when compared to prior exam. No evidence of testicular torsion or acute orchitis. Apparent interval improvement in minimal hydrocele.RIGHT EPIDIDYMIS: Status post right orchiectomy.LEFT EPIDIDYMIS: Ovoid 6 x 4 x 2 mm hypoechoic focus in left epididymis, no surrounding vascularity, may be an epididymal cyst or spermatocele, not as well seen on prior study.OTHER: Moderate scrotal edema and wall thickening, degree of heterogeneity and more focal sites of fluid improved/less pronounced, no drainable fluid collection seen. | Again seen moderate scrotal edema and wall thickening, degree of heterogeneity and more focal sites of fluid improved/less pronounced. Findings may reflect improving cellulitis and correlation with patient's clinical history and physical exam recommended. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her grandmother, an aunt and 3 cousins. Two standard digital views of both breasts and repeat left 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. 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. | There is a hyperdense 11 mm AP x 20 mm ML x 16 mm CC parenchymal hematoma in the left parietal lobe with surrounding vasogenic edema, causing local mass effect with sulcal effacement, and possibly mild mass effect on the left lateral ventricle. The ventricles and basal cisterns are otherwise normal in size and configuration. There is no midline shift or herniation. There is trace periventricular and subcortical white matter hypoattenuation which is nonspecific, likely representing age indeterminate small vessel ischemic changes. There are mucus retention cysts versus polyps in the bilateral maxillary sinuses. There is trace bilateral ethmoid and right frontal sinus mucosal thickening. There is scattered bilateral mastoid air cell opacification. The skull and extracranial soft tissues are unremarkable. | 1.Acute left posterior frontal/anterior left parietal lobe parenchymal hematoma with surrounding vasogenic edema and regional mass effect. No midline shift or herniation. 2.Age indeterminate small vessel ischemic changes.Findings were discussed with ED Dr. Christine Babcock at 1:33 PM today over the telephone. |
Generate impression based on findings. | Pubis fracture Three views of the pelvis reveal a fracture through the superior pubic ramus and the ischium on the right. No other fractures are identified. No significant change from the previous exam of December 18. | Fractures of the right superior pubic ramus and right ischium |
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. No suspicious masses, microcalcifications or areas of architectural distortion are present. Normal-sized lymph nodes project in each axilla. | 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. | Status post orthotopic liver transplant, elevated LFTs, evaluate vasculature and assess for fluid collection, status post exploratory laparotomy, portal vein thrombectomy and ligation a splenorenal shunt on January 3, 2015 PORTAL VENOUS: Main portal vein appears patent with normal hepatopetal flow and velocity 40 cm/sec. Patent left and right portal veins with normal directional flow, velocities measure 20 cm/sec and 23 cm/sec, respectively.HEPATIC ARTERIES: Patent common, left and right hepatic arteries and peak systolic velocities measure approximately 50 cm/sec, 30 cm/sec and 50 cm/sec, respectively. Resistive indices range from 0.53 to 0.59. HEPATIC VEINS: Patent hepatic veins.INFERIOR VENA CAVA: Visualized IVC patent.OTHER: Liver measures approximately 18.5 cm. Incompletely imaged right pleural effusion and at least moderate amount of ascites. Visualized splenic vein and splenic artery patent. | Patent hepatic vasculature and incompletely imaged pleural effusion and ascites. |
Generate impression based on findings. | Female 71 years old Reason: SLL with progression over one year.+ Right hip symptoms. Early restage to r/o development of bulky dz History: hip pain CHEST:LUNGS AND PLEURA: Right lower lobe nodule now measures 1.1 x 1.0 cm (image 82, series 5), previously 1.1 x 1.0 cm. Additional scattered calcified and noncalcified pleural micronodules are not significantly changed. There is biapical pleural parenchymal scarring.MEDIASTINUM AND HILA: Slight interval increase in size of the mediastinal lymphadenopathy. Reference high left paratracheal node now measures 1.7 cm in short axis (image 15, series 3), previously 1.5 cm.CHEST WALL: Increasing bilateral axillary lymphadenopathy. Reference right axillary lymph node now measures 2.4 x 3.4 cm (image 28, series 3), previously 2.3 x 3.0 cm.ABDOMEN:LIVER, BILIARY TRACT: Nonspecific subcentimeter hypoattenuating lesions are too small to characterize, but not significantly changed from the prior exam.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst unchanged. There is no evidence of hydronephrosis or hydroureter. There is no evidence of nephrolithiasis or ureterolithiasis.RETROPERITONEUM, LYMPH NODES: Overall stable retroperitoneal lymphadenopathy. Reference splenic hilar node now measures 1.6 x 2.7 cm (image 86, series 3), previously 1.5 x 3.2 cm. There is an IVC filter in place, position unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Reference right pelvic lymph nodes without significant interval change. Right common iliac node measures 1.5 x 2.4 cm (image 143, series 3), previously 1.5 x 2.1 cm. Right external iliac artery node now measures 3.1 x 5.5 cm (image 166, series 3), previously 3.0 x 5.7 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There are degenerative changes of the thoracolumbar spine.OTHER: There is a left iliac vein stent in place. | Interval increase in size of the axillary and mediastinal lymphadenopathy, with stable retroperitoneal and pelvic lymphadenopathy as detailed above. |
Generate impression based on findings. | Chest wall pain Three views of the ribs reveal no evidence of any fractures. | No evidence of rib fractures |
Generate impression based on findings. | 75-year-old male with history of prostate cancer Increased radiotracer uptake is again seen in the left medial clavicle, right posterior fifth rib, left posterior sixth rib, and bilateral iliac wings. The right posterior fifth rib focus and bilateral pelvic foci appear slightly bigger compared to the prior exam.Increased radiotracer uptake in the posterior soft tissues of the right thigh is unchanged and correlates with the known soft tissue mass seen on CT. | Slight progression in size of several osseous metastatic lesions. No new osseous lesions are identified. |
Generate impression based on findings. | 26-year-old female status post fall, unable to bear weight Glenohumeral alignment is within normal limits. No hip or pelvic fracture is visualized. The visualized soft tissue structures appear unremarkable. A 4.7-cm left cystic adnexal lesion is likely physiologic given the patient's age. | No fracture or other findings to explain the patient's symptoms. |
Generate impression based on findings. | 80 year-old female status post fall two days ago with left hip pain Hip: Small osteophytes consistent with osteoarthritis. No fracture or malalignment.Lumbar spine: Lumbar spinal alignment is within normal limits. Vertebral body heights are maintained. Small anterior osteophytes are noted.Thoracic spine: There is marked mid thoracic degenerative disk disease and small anterior vertebral body osteophytes without fracture or malalignment. | Degenerative arthritic changes without fracture or malalignment. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral benign needle aspirations. Two standard digital views of both breasts with tomosynthesis 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 skin marker identifies a cutaneous abnormality in the left lower inner breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign masses and a calcified oil cyst in the left upper outer breast are unchanged over multiple exams. Scattered benign-appearing calcifications bilaterally are also not significantly changed. | 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. | 58 showed female, evaluate for lytic bone disease SKULL: No discrete lytic lesion.CERVICAL SPINE: No discrete lytic lesion.THORACIC SPINE: No discrete lytic lesion. Mild degenerative arthritic changes.LUMBAR SPINE: No discrete lytic lesion. Small anterior vertebral body osteophytes.RIBS: No discrete lytic lesion.PELVIS: No discrete lytic lesion.UPPER EXTREMITY: No discrete lytic lesion.LOWER EXTREMITY: No discrete lytic lesion. | No evidence of lytic bone disease. |
Generate impression based on findings. | Reason: eval pleural effusion. (left) History: sob, fevers Motion somewhat limits sensitivity.LUNGS AND PLEURA: Patchy upper lobe predominant ground glass opacities, which may be secondary to atypical edema, aspiration, or infection.Interval development of small right pleural effusion, and enlargement of left pleural effusion with associated consolidation/atelectasis at the left lung base, concerning for infection. Increased pleural density raises the suspicion of empyema.Ventriculopleural catheter tip is seen in the inferior lateral left pleural space.MEDIASTINUM AND HILA: Heart size is within normal limits, trace pericardial effusion.New mediastinal and possible hilar lymphadenopathy, nonspecific, but likely reactive.Ill-defined anterior mediastinal soft tissue density likely represents residual thymic tissue.No visible coronary artery calcifications.CHEST WALL: No significant axillary lymphadenopathy.Mild degenerative disease of the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Bilateral pleural effusions, left greater than right with associated consolidation/atelectasis, more pronounced at the left lung base, which is suggestive of developing pulmonary/pleural infection. Recommend follow-up CT studies with IV contrast.2. New mediastinal/axillary lymphadenopathy is nonspecific, but likely reactive in nature.3. Soft tissue density in anterior mediastinum likely relates to residual/reactive thymic tissue.4. Ventriculopleural catheter terminates in the left inferior lateral pleural space.5. Persistent upper lobe predominant ground glass opacities are nonspecific, but may be related to atypical infection, aspiration, or edema. |
Generate impression based on findings. | 21-year-old male with history of fall. Evaluate for intracranial hemorrhage. No evidence of acute intracranial hemorrhage. The gray-white differentiation is preserved. The ventricles and cisterns are symmetric. There is no midline shift or mass effect. There is a minimal amount of fluid within the dependent aspect of the right maxillary and sphenoid sinuses. The mastoid air cells are clear. The visualized orbits are unremarkable. The calvarium and scalp soft tissues are normal. | No evidence of acute intracranial hemorrhage. |
Generate impression based on findings. | Fever and coughVIEWS: Chest AP/lateral (two views) 1/8/15, 1301 The cardiothymic silhouette is normal.Peribronchial thickening is present, without focal lung opacities or pleural effusions. Subsegmental atelectasis is noted in the lingula. The lung volumes are large. | Bronchiolitis/reactive airway disease pattern. |
Generate impression based on findings. | Female, 59 years old. Reason: r/o bowel obstruction/ischemic bowel History: nausea, post-op hernia repair. Hypoactive bowel sounds Multiple air-filled loops of small and large bowel, with moderate stool burden predominantly within the rectum and enteric contrast within the rectum from recent prior study. Gas seen within the rectum. Prominent loops of small bowel at upper limit of normal, not significantly dilated, similar in appearance to slightly improved from recent CT exam.Surgical changes in the mid abdomen. LVAD device. | Findings of partial small bowel obstruction unchanged to slightly improved from recent CT exam. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of left-sided benign biopsy. Two standard digital views of both breasts with tomosynthesis 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 biopsy clip is present in the left upper inner breast, unchanged in position. Focal asymmetry adjacent to the biopsy clip is not significant changed over multiple prior exams. Also in the region of the asymmetry there are multiple grouped calcifications, however these are unchanged over multiple exams. 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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 65-year-old female with history of hypoxemia, tachypnea and tachycardia. PULMONARY ARTERIES: No PE is seen to the segmental level.LUNGS AND PLEURA: Bibasilar dependent linear subsegmental atelectasis. Small focus of consolidation in the right lung base may also represent atelectasis, although cannot exclude superimposed infection or aspiration. Mild apical predominant emphysema. Scattered pulmonary micronodules, nonspecific and similar to prior.MEDIASTINUM AND HILA: Heart size within normal limits, and there is no pericardial effusion. Moderate coronary artery calcifications. No significant mediastinal or hilar lymphadenopathy. Atherosclerosis affects the aorta and its branches. Tracheostomy tube tip approximately 4 cm above the carina.CHEST WALL: L1 vertebral body superior endplate depression, likely Schmorl's node.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Atherosclerosis of the aorta and its branches. Cholecystectomy clips. | 1.Limited exam, however no pulmonary embolus to the segmental level.2.Mild dependent atelectasis and mild apical predominant emphysema.3.Contrast extravasation.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male, 68 years old. Reason: Ileus History: As above Significant gaseous distention of the colon is again seen, compatible with colonic ileus as seen on recent prior CT examination. Small bowel gas pattern is nonspecific. Enteric tube with tip overlying the gastric body and distal side-port just below the level of the GE junction. Emphysematous appearance of the lungs. Right femoral vascular catheter. | Findings compatible with colonic ileus as seen on recent prior CT examination. Enteric tube tip overlying the gastric body and distal side-port just below the level of the GE junction. Recommend to advance approximately 3-4 cm. |
Generate impression based on findings. | Anemia and weight loss. Bone pain at night.VIEWS: Right knee AP/oblique/lateral (3 views), left knee AP/oblique/lateral (3 views), right elbow AP/oblique/lateral (3 views), left elbow AP/oblique/lateral (3 views), 1/8/15 KNEES: The osseous mineralization is normal. No fracture or malalignment is present. No focal osseous lesion or periosteal reaction is evident. No suprapatellar joint effusion is seen.ELBOWS: The osseous mineralization is normal. No fracture or malalignment is present. No focal osseous lesion or periosteal reaction is evident. No elbow joint effusion is seen. | Normal examinations. |
Generate impression based on findings. | Reason: Mediastinal Adenopathy History: Metastic Papillary Thyroid Ca LUNGS AND PLEURA: Innumerable pulmonary micronodules and nodules, more prominent in the lower lobes, with the largest measuring 7 mm lateral with only metastases.No pleural effusions.MEDIASTINUM AND HILA: Status post thyroidectomy.Prevascular 11-mm lymph node (image 18 series 4).12-mm right hilar lymph node (image 30 series 4).10-mm subcarinal lymph node (image 31 series 4).Cardiac size is normal without evidence of a pericardial effusion.Marked coronary artery calcification.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Innumerable pulmonary micronodules and nodules compatible with metastatic disease.2.Mediastinal and hilar lymphadenopathy. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of skin cancer diagnosed at the age of 42 now in remission. Two standard digital views of both breasts with tomosynthesis 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. A benign calcification is noted in the left retroareolar region. | 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. | 41 year-old female with left flank pain. RIGHT KIDNEY: The right kidney measures 8.7 cm in length without hydronephrosis or shadowing calculus.LEFT KIDNEY: The left kidney measures 8.2 cm in length without hydronephrosis or shadowing calculus. There is an inferior pole markedly hypervascular nidus on color Doppler ultrasound which demonstrate some arterial flow on spectral Doppler evaluation. Similarly, the renal artery and vein demonstrate arterial spectral waveforms.URINARY BLADDER: The urinary bladder is partially distended with anechoic urine. There is apparent mild wall thickening which may be in part due to underdistention. | 1. No hydronephrosis or shadowing calculus.2. Findings suggestive of a left inferior pole arteriovenous fistula, which is likely iatrogenic given the reported history of prior renal biopsy. |
Generate impression based on findings. | Female 54 years old Reason: right knee pain History: right knee pain Bone mineralization is normal. Alignment is anatomic. There is minimal joint space loss with tiny osteophytes.Possible trace joint effusion. No acute fracture or dislocation.Comparison left knee shows minimal osteoarthritis. | Minimal right knee osteoarthritis. |
Generate impression based on findings. | History of breast cysts. Soft mobile palpable masses at the 12 o'clock position of both breasts. BILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: Three standard views and two spot compression views of both breasts were performed digitally 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. Previously demonstrated cyst at the 12 o'clock position of the right breast is smaller than on prior studies and now has a calcified wall. A wing clip at the 9 o'clock position of the right breast is unchanged in position. Benign lymph nodes project over both axillae.No new masses, suspicious microcalcifications or areas of architectural distortion are present in either breast. BILATERAL BREAST ULTRASOUND: On physical examination, no palpable masses were present in either breast. Bilateral breast ultrasound was performed for the areas of clinical concern. At the 12 o'clock position of the right breast, 3 cm from the nipple, an 8 mm cyst is present with a calcified wall. Smaller cysts are also present in the superior right breast. No suspicious cystic or solid lesions are present in the superior left breast. | Right breast cysts, one of which has a calcified wall. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
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