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Generate impression based on findings. | Female 55 years old Reason: hx B TKA, s/p MVC, with knee painanterior History: hx B TKA, s/p MVC, with knee pain anterior Right knee: Components of a total right knee arthroplasty device is situated innear-anatomic alignment. No joint effusion. No acute fracture.Left knee: Components of total left knee arthroplasty device is situated in near anatomicalignment. No joint effusion. No acute fracture. | No acute fracture or dislocation. |
Generate impression based on findings. | Female 48 years old Reason: pain finger History: pain Mineralization is normal. There is a mild flexion deformity at the DIP joint which may physiologic. No acute fracture or dislocation is evident. The joint spaces are normal.There is soft tissue swelling. | Soft tissue swelling and other findings as detailed above. |
Generate impression based on findings. | 87-year-old female with new diagnosis of vulvar cancer. Now with palpable inguinal lymph node. Evaluate for metastatic disease. RADIOPHARMACEUTICAL: 12.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 86 mg/dL. Today's CT portion grossly demonstrates a large hiatal hernia. There is also extensive atherosclerotic disease including coronary artery calcifications. Today's PET examination demonstrates focal vaginal hypermetabolic activity with a maximal SUV of 6.8. This finding could represent patient's known cancer versus artifact from urinary excretion.There is a punctate subcentimeter mild to moderately hypermetabolic right medial inguinal lymph node. The maximal SUV of the lymph node is 3.0. This finding may represent lymph node metastasis versus an inflammatory process (Series 605, Image 145).Otherwise, no focal FDG avid lesion is identified. | 1.Focal vaginal hypermetabolic activity which may represent patient's known cancer versus benign uptake.2.Single subcentimeter mild to moderately hypermetabolic right medial inguinal lymph node which is equivocal and may represent a lymph node metastasis versus an inflammatory lymph node.3.No other suspicious FDG avid lesion. |
Generate impression based on findings. | 50-year-old male with ultrasound inconclusive for acute cholecystitis. Angiographic images are unremarkable. Slightly delayed clearance of radiotracer from the blood pool and delayed, uniform accumulation of the tracer by the liver is present. There is normal excretion of tracer into the intrahepatic ducts, common bile duct, gallbladder and duodenum, indicating patent common bile and cystic ducts. | 1.Patent cystic and common bile ducts. No evidence of acute cholecystitis.2.Mildly delayed clearance of radiotracer suggest mild global hepatocyte dysfunction (likely medical hepatocellular disease). |
Generate impression based on findings. | Fall one week ago. Shoulder and clavicle pain. Assess for fracture. Osteoarthritis affects the shoulder but I see no fracture or malalignment. Degenerative arthritic changes also affect the visualized spine. | Osteoarthritis without fracture evident. |
Generate impression based on findings. | Status post MVC now with pain and bruising of left wrist. Fracture? There is perhaps mild swelling of the soft tissues along the radial aspect of the wrist, but I see no underlying fracture or malalignment. | No fracture evident. |
Generate impression based on findings. | Reason: progression of left MCA ischemic stroke History: right sided weakness and aphasia There is residual contrast present within the vasculature in this patient with chronic renal failure. There is enhancement of the cortical and leptomeningeal structures of the left MCA territory.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. The eyeball lenses are thin. | 1.Contrast enhancement within the left MCA territory cortex and leptomeninges likely represent infarcted tissue indicating large left MCA territory infarction. A follow-up CT after the contrast clears, would help assess for any hemorrhagic conversion and extent of reperfusion injury. |
Generate impression based on findings. | Hip pain Components of a right total hip arthroplasty device are situated in near anatomic alignment without radiographic evidence of complication. I see no fracture or dislocation. | Total hip arthroplasty without evidence of fracture. |
Generate impression based on findings. | Left foot gangrene. Assess infection. Since the prior study, there has been resection of the first ray through the tarsometatarsal joint, as well as the second and third rays through the second and third metatarsals, respectively. The medial cuneiform and remaining second and third metatarsals appear to protrude into the resultant surgical defect. The bony margins appear sharp, although I cannot exclude the possibility of osteomyelitis on the basis of this single study. Packing material overlies the wound. There is diffuse soft tissue swelling, but I see no soft tissue gas proximally. | Postoperative changes of first through third ray amputation as described above. |
Generate impression based on findings. | Status post left total knee replacement Components of a total knee revision are situated in near anatomic alignment without radiographic evidence of hardware complication. Skin staples, a drain, and foci of gas density within the soft tissues reflect recent surgery. | Total knee arthroplasty revision as described above. |
Generate impression based on findings. | Reason: r/o ICH History: hx ICH There is encephalomalacia involving the left inferior and middle frontal gyri as well as the left caudate nucleus. There is encephalomalacia involving the left cuneus and adjacent precuneus. These are associated with ex vacuo effect.The patient status post left craniotomy and aneurysm clip placement. Coils are present along the distal left internal carotid artery.There is opacification of the left sphenoid sinus and mucosal thickening present in the right sphenoid sinus. The patient is status post intubationThe visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Chronic stage infarctions in the left frontal lobe, left caudate nucleus and the left occipital lobe.2.Status post clipping of left carotid terminus aneurysm and coiling of left PCOMA aneurysm.3.No evidence for acute intracranial hemorrhage, mass effect or edema.4.CT is insensitive for the early detection of nonhemorrhagic CVA. |
Generate impression based on findings. | Pain in lateral wrist. Pain and swelling at MCP 3. No trauma. History two years ago of wrist sprain. Assess for fracture, arthritis, bony abnormality. Three views of the right wrist are provided. I see no fracture, frank arthritic changes, or other findings to account for the patient's pain.Three views of the right hand are provided. I see no fracture, frank arthritic changes, or other specific findings to account for the patient's pain. | Normal-appearing wrist and hand, without fracture, arthritis, or other findings to account for the patient's pain. |
Generate impression based on findings. | Fever. Osteomyelitis? Three views of the right foot are provided. The bones appear slightly demineralized. There is ulceration of the soft tissues along the posterior aspect of the calcaneus, but the underlying bone appears intact, I see no specific radiographic features of osteomyelitis. There is mild soft tissue swelling about the ankle and along the dorsum of the foot. Arterial calcifications are noted in the soft tissues. A small density dorsal to the head of the talus may represent old trauma and was present on the prior study. A lucency in the navicular probably represents a cyst or ganglion.Two views of the left heel are provided. I see no radiographic evidence of osteomyelitis. Arterial calcifications are noted within the soft tissues. | Ulceration of the right heel. I see no radiographic evidence of osteomyelitis. |
Generate impression based on findings. | Female, 34 years old. Reason: Asses for obstipation, ileus History: 34 y.o. woman with a history of gastroschisis, gastroparesis, constipation and weight loss Nonobstructive bowel gas pattern. Large colonic stool burden.IUD projecting over the pelvis. | Large colonic stool burden. |
Generate impression based on findings. | Reason: R/O intracranial mass/blood History: lethargy, vomiting. The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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. | No evidence for acute intracranial hemorrhage, mass effect or edema. |
Generate impression based on findings. | Male, 60 years old. Reason: bilious output per NG tube, signs of obstruction? History: as above Nonobstructive bowel gas pattern. Moderate stool burden.Enteric tube with tip overlying the gastric body, and distal side-port below the level of the GE junction. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male, 60 years old. Reason: og tube advanced History: as above Enteric tube with tip overlying the gastric body and distal side port below the level of the GE junction.The lower pelvis is excluded from the field of view. Nonobstructive bowel gas pattern. Moderate stool burden.Pulmonary opacities are better evaluated on same day chest radiograph. | Enteric tube with tip overlying the gastric body. |
Generate impression based on findings. | Female, 65 years old. Reason: ng placement History: altered mental status Nasogastric tube with tip overlying the gastric body.The pelvis is excluded from the field-of-view. Partially visualized nonobstructive bowel gas pattern. Enteric contrast within the colon from recent prior study. | Nasogastric tube with tip overlying the gastric body. |
Generate impression based on findings. | Male, 68 years old. Reason: assess NG placement History: NG advanced 3-4cm Nasogastric tube with tip overlying the proximal gastric body and distal side-port below the level of the GE junction.The lower abdomen and pelvis are excluded from the field of view. Significant gaseous distention of the colon is partially visualized, compatible clonic ileus as seen on recent prior examinations.Visualized lung bases showing emphysema and atelectasis. | Nasogastric tube with tip overlying the proximal gastric body. |
Generate impression based on findings. | Right shoulder pain Mild to moderate osteoarthritis affects or glenohumeral joint, with slight inferior positioning of the humeral head and narrowing of the glenohumeral joint that is new when compared with the prior study. Small foci of calcification along the greater tuberosity may represent calcification within the rotator cuff. | Progression of degenerative arthritic changes of the right shoulder as described above. |
Generate impression based on findings. | 9-year-old male. ALL, fever, neutropenia, abdominal pain, diarrhea, increased work of breathing. Evaluate for abscess, appendicitis, typhilitis, hepatitis, other pathology. CHEST:LUNGS AND PLEURA: Small right pleural effusion.Septal thickening suggestive of mild interstitial edema. Patchy atelectasis bilaterally.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: Left chest wall port tip terminates in the SVC.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesion. Hepatomegaly. Periportal edema. Distended gallbladder with diffuse wall thickening, nonspecific in the presence of ascites.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mildly enlarged kidneys with no focal lesion identified. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Nonspecific enlarged retroperitoneal lymph nodes. Peripancreatic lymph node is 1.3 x 1.8 cm in short axis (series 4, image 71) and right periaortic node is 1.3 x 2 cm.BOWEL, MESENTERY: Normal course and caliber of the small bowel. No evidence of colitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of abdominopelvic ascites. No abscess is identified.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal course and caliber of the small bowel. No evidence of colitis. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of abdominopelvic ascites. No abscess is identified. | 1. Small right pleural effusion and mild interstitial pulmonary edema. 2. Hepatomegaly and mild periportal edema, nonspecific, and can be seen in the setting of hepatitis.3. Diffuse wall thickening of a distended gallbladder, nonspecific in the presence of small amount of ascites. If there is clinical concern for acute cholecystitis, further evaluation with ultrasound is recommended.4. Nonspecific enlarged retroperitoneal lymph nodes. |
Generate impression based on findings. | 47-year-old male with back/flank pain Ribs: We see no fracture or other specific findings to account for the patient's pain. There is slight rightward curvature of the thoracic spine.Lumbar spine: A cortical step-off along the superior endplate of L5 was present on CT dated 2/26/14 and may represent old trauma or developmental variant. Heterotopic ossification adjacent to the L4 spinal process may reflect prior trauma. Mild multilevel degenerative disk disease is noted. Vertebral body heights are preserved.Hip: Small osteophytes indicate mild osteoarthritis. No fracture is evident. | Mild osteoarthritis, degenerative disk disease of the lumbar spine, and other findings as above. No acute fracture is evident. |
Generate impression based on findings. | 41 year old female with bone injury status post fall. Ankle: There are small plantar and calcaneal spurs. No fracture or other specific findings are identified to account for the patient's tenderness. The talar dome appears intact.Foot: No fracture is evident. We see no specific findings to account for the patient's tenderness.Knee: Small osteophytes indicate mild osteoarthritis, but we see no fracture or malalignment. | No fracture or other specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Female 58 years old Reason: r/o intra-abdominal abnormality History: AMS at baseline, PEG tube, w/upper abd TTP ABDOMEN:LUNG BASES: Dependent bibasilar atelectasis.LIVER, BILIARY TRACT: The patient is status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: IVC filter in place. There are moderate atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Gastrostomy tube in place, with hub in appropriate position. There is colonic diverticulosis without evidence of diverticulitis. Appendix identified in the right lower quadrant, normal in appearance.BONES, SOFT TISSUES: Mixed lucent sclerotic lesion along the right SI joint is a benign appearance.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Fluid in the vaginal fornix, is nonspecific and correlation with pelvic examination can be considered as clinically indicated.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Gastrostomy tube in place, with hub in appropriate position. There is colonic diverticulosis without evidence of diverticulitis. Appendix identified in the right lower quadrant, normal in appearance.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Fluid within the vaginal fornix is nonspecific, and correlation with pelvic examination can be considered as clinically indicated.2.Gastrostomy tube in place without evidence of complication. |
Generate impression based on findings. | 43-year-old male status post fall from 15 feet. Vertebral body heights are maintained. Lumbar spinal alignment is within normal limits. Moderate degenerative disk disease affects L5/S1. Small anterior osteophytes are present along the lower lumbar vertebral bodies. | Degenerative disk disease, but no compression fracture evident. |
Generate impression based on findings. | 78-year-old male with pain and swelling, rule out fracture No fracture is evident. There is a moderate joint effusion containing foci of gas density likely related to recent attempted aspiration. Moderate osteoarthritis affects the knee. Dense chondrocalcinosis is noted within the medial joint compartment. Scattered arterial calcifications are present in the soft tissues. | Osteoarthritis and joint effusion without fracture evident. |
Generate impression based on findings. | 19 year-old female with right lower quadrant pain, nausea. Evaluate for appendicitis. ABDOMEN:LUNG BASES: No consolidation or pleural effusion.LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion. No intra-or extrahepatic biliary ductal dilatation. Gallbladder is normal in appearance. Trace fluid in the gallbladder fossa.SPLEEN: Upper limits of normal in size.PANCREAS: Normal appearing pancreas without peripancreatic stranding.ADRENAL GLANDS: No adrenal nodularity or thickening bilaterally.KIDNEYS, URETERS: Kidneys enhance symmetrically. 10-mm left renal cyst.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Bowel is normal in caliber without evidence of obstruction or ileus. The appendix is not identified.BONES, SOFT TISSUES: Left thoracolumbar curve. No suspicious focal osseous lesion.OTHER: Moderate free fluid, see below.PELVIS:UTERUS, ADNEXA: Right ovary contains a 3.8 x 2.8 cm hypoattenuating structure, likely representing a corpus luteum as seen on ultrasound.BLADDER: No bladder wall thickening, stone or evidence of mass.LYMPH NODES: No significant pelvic, inguinal, or iliac chain lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No focal osseous lesion.OTHER: Moderate perihepatic, perisplenic, right paracolic gutter, and cul-de-sac free fluid of intermediate density approximating 20 HU. Higher-density fluid surrounds the right adnexa measuring approximately 70 HU and demonstrates fluid-fluid level, suggesting blood product layering dependently. | Findings suggestive of hemorrhagic right corpus luteum cyst with moderate abdominopelvic hemoperitoneum. No specific evidence of appendicitis.Findings relayed via telephone to Dr. Hendee at 10:12 a.m. on 1/9/2015. |
Generate impression based on findings. | Male, 62 years old. Reason: access stool burden History: significant stool burden on CT abd Nonobstructive bowel gas pattern. Enteric contrast within the colon from recent prior study. Moderate distal burden, predominantly in the rectum. | Moderate distal burden, predominantly in the rectum. |
Generate impression based on findings. | 93 year-old female with right hip pain after fall The bones are demineralized. Mild osteoarthritis affects the right hip. We see no fracture. | Mild osteoarthritis without fracture evident. |
Generate impression based on findings. | cerebrovascular accident No evidence of acute ischemic or hemorrhagic lesion.Chronic ischemic infarction with encephalomalacia on the left external capsule, caudate nucleus head, right external capsule, right caudate nucleus head.The ventricles, sulci, and cisterns are 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 chronic ischemic infarctions as described above. |
Generate impression based on findings. | 87 year-old female status post fall Hip: No fracture is evident. Mild osteoarthritis affects the hip.Pelvis: Mild osteoarthritis affects both hips. Mild chronic enthesopathic changes along the pelvis are likely of no current clinical significance. Vascular calcifications are noted in the soft tissue. Degenerative disk disease affects the lower lumbar spine. | Mild osteoarthritis without fracture evident. |
Generate impression based on findings. | 61-year-old female status post shoulder reduction Interval reduction of previously seen anterior shoulder dislocation. Glenohumeral alignment is near-anatomic. No fracture is evident. | Reduction of shoulder dislocation without fracture evident. |
Generate impression based on findings. | Female, 84 years old. Reason: r/o ileus History: distention Nonobstructive bowel gas pattern.Percutaneous gastrostomy tube in place over the mid abdomen, in the region of the gastric body.Ossified leiomyoma. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 61-year-old female with pain There is an anterior subcoracoid dislocation of the humeral head. No fracture is evident. | Anterior shoulder dislocation. |
Generate impression based on findings. | 43 rolled male status post fall with pain Note is made of an os acromiale. We see no fracture or malalignment. | Os acromiale without fracture or malalignment. |
Generate impression based on findings. | Female, 67 years old. Reason: assess for obstruction History: abdominal pain Multiple dilated loops of small bowel in left and mid abdomen, measuring up to 3.4 cm, with minimal colonic and rectal gas. Mild bowel wall thickening. Findings most suspicious for small bowel obstruction.Surgical clips, biliary stent, and enteric stent overlying the right upper quadrant. Midline sutures overlying the pelvis. | Findings most suspicious for small bowel obstruction. |
Generate impression based on findings. | Female 60 years old Reason: evaluate for colonic inflammation History: diarrhea ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse hepatic hypoattenuation consistent with hepatic steatosis. The degree of hepatic hypoattenuation limits evaluation for focal mass lesions within the liver.SPLEEN: The splenic vein is thrombosed and there are numerous perigastric varices.PANCREAS: The pancreatic tail parenchyma is atrophic and there is dilatation of the upstream pancreatic duct to the level of the mid body. There is ill-defined masslike enlargement of the pancreatic head; however, given the diffuse nature, precise measurements are not possible. The mass encases the celiac axis as well as the superior mesenteric artery, with marked attenuation of the superior mesenteric artery proximally 3 cm distal to its origin. The portal vein is also encased by the mass as is the distal SMV, with marked attenuation of the confluence and thrombosis of the splenic vein.There is a partially organized fluid collection arising along the greater curvature of the stomach and extending along the anterior pancreatic body and head, measuring approximate 4.6 x 7.0 cm, just inferior to the hepatic hilum (image 60, series 3). There is diffuse mesenteric fat stranding and distal peroneal nodularity suggestive of saponification, although carcinomatosis cannot be excluded. These findings are most consistent with a partially organized peripancreatic fluid collection, likely the result of acute or prior pancreatitis.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: There are scattered subcentimeter peripancreatic and retroperitoneal lymph nodes. Although not pathologically enlarged, these lymph nodes are worrisome for local metastases. For reference purposes an aortocaval node measures 2.7 x 0.9 cm.BOWEL, MESENTERY: There is diffuse mesenteric fat stranding, with the epicenter located above the pancreatic head, extending along the right paracolic gutter. There is a small amount of free fluid within the pelvis. There is no evidence of bowel obstruction. Apparent wall thickening of the sigmoid colon likely reflects underdistention rather than colitis. There is mild submucosal edema affecting the gastric antrum, likely inflammatory in etiology.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: There is diffuse mesenteric fat stranding, with the epicenter located above the pancreatic head, extending along the right paracolic gutter. There is a small amount of free fluid within the pelvis. There is no evidence of bowel obstruction. Apparent wall thickening of the sigmoid colon likely reflects underdistention rather than colitis. There is mild submucosal edema affecting the gastric antrum, likely inflammatory in etiology.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Pancreatic mass, which encases the SMA, celiac axis, the confluence of the portal vein and SMV, with associated thrombosis of the splenic vein..2.Partially organized peripancreatic fluid collection with associated mesenteric haziness, likely a result of acute or prior pancreatitis.3.Hepatic steatosis.4.Thickening of the gastric antral wall, likely inflammatory in etiology. Apparent wall thickening of the sigmoid colon, likely related to underdistention rather than colitis, although clinical correlation is recommended. |
Generate impression based on findings. | Female, 66 years old. Reason: bowel perf? History: hypotension Large area of lucency overlying the left upper abdomen likely represents severe gaseous distention of stomach. Rounded lucency overlying the right upper quadrant below the diaphragm is highly suspicious for free air. A few prominent air filled loops of small and large bowel are seen, with enteric contrast in the distal colon and rectum from recent prior procedure.Percutaneous cholecystostomy catheter in place within an amorphous collection in the right abdomen. | Findings suspicious for free air. See subsequent decubitus imaging for additional details.Severe gaseous distention of stomach. |
Generate impression based on findings. | Fall. No evidence of acute ischemic or hemorrhagic lesion.Multifocal 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.Nonspecific small vessel disease. |
Generate impression based on findings. | Reason: evaluate for bleed History: headache after MVC The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses demonstrate partial opacification of the left maxillary sinus and left ethmoid air cells.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage, mass effect or edema.2.Left maxillary and ethmoid air cell opacification is distributed in a pattern of obstruction located at the hiatus semilunaris. Please note this is not complete evaluation of the paranasal sinuses |
Generate impression based on findings. | Female, 66 years old. Reason: free air? History: septic shock Free air under the right hemidiaphragm on supine imaging and layering non-dependently on left lateral decubitus imaging.Gaseous distention of the stomach and a few mildly prominent air-filled loops of small and large bowel are again seen. Enteric contrast within the rectum from recent prior procedure.Percutaneous cholecystostomy catheter in place within an amorphous collection in the right abdomen. | Free intra-abdominal air. Recommend CT followup as clinically warranted. |
Generate impression based on findings. | fall. No evidence of acute ischemic or hemorrhagic lesion.Multiple vascular calcifications on bilateral distal vertebral arteries and cavernous sinus segments of ICAs indicate atherosclerotic chagnes, no change since prior exam.Patchy low attenuations on bilateral periventricular white matter indicate non specific small vessel disease. No change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. 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.No change of small vessel ischemic disease and multifocal vascular calcifications since prior exam. |
Generate impression based on findings. | 20 month old female. In C-collar. Evaluate for fracture.VIEWS: Cervical spine 2 views (AP/lateral) 1/8/2015. Straightening of the cervical spine due to placement in cervical collar. No acute fracture or post-traumatic subluxation. Vertebral body heights and intervertebral disk spaces are preserved. NG tube is noted. | No acute fracture or post-traumatic subluxation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in two sisters. Two standard digital views of both breasts with an additional cleavage view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally, including arterial calcifications and calcified oil cysts. 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: NSA - Screening Mammogram. |
Generate impression based on findings. | 31-year-old female with history of headache and dizziness. Evaluate for ischemic process. CT head without contrast: No evidence of acute intracranial hemorrhage. The gray-white differentiation is preserved. The ventricular configuration is unremarkable. The basal cisterns are intact. The orbits are unremarkable. The visualized paranasal sinuses and mastoid air cells are clear. The calvarium and scalp soft tissues are within normal limits.CT angiography head and neck: There is a normal 3 vessel arch. There is no evidence of aneurysm or stenosis in the neck. The vertebral arteries are patent. The intracranial vessels are intact with a patent ACOM and bilateral PCOMs. No evidence of aneurysmal dilatation or stenosis.9-mm left upper lobe pulmonary nodule appears similar to the cardiac CT from 2012 (image 42 series 8). Enlarged micronodular parotid glands with scattered microcalcifications. | 1.No acute intracranial abnormality.2.Unremarkable CT angiogram of the head and neck.3.Stable left upper lobe pulmonary nodule.4.Parotid findings which may be secondary to the patient's history of lupus. |
Generate impression based on findings. | 6-year-old male. Neck pain status post injury with history of posterior spinal fusion.VIEWS: Cervical spine two views (AP/lateral) 1/8/2015. Os odontoideum is noted. Status post posterior fusion and laminectomies at C1-C2. There is interval partial resorption of the bone graft between the posterior aspect of C1 and C2. There is widening of the predental space measuring 10 mm, new from prior exam. There is anterolisthesis of C2 on C3 measuring 3 mm. No prevertebral soft tissue swelling. | Predental space widening of 10 mm. Grade 1 anterolisthesis of C2 on C3. Recommend CT cervical spine for further evaluation. |
Generate impression based on findings. | 41 years old, Male, Reason: ascites fluid with +gram positive rods, eval for source History: sepsis, ARDS Evaluation of abdominal parenchyma is limited without intravenous contrast. Within these limitations the following observations are made:CHEST:LUNGS AND PLEURA: Respiratory motion degrades fine detail of the lungs. Moderate to large bilateral pleural effusions are present with underlying atelectasis and consolidation. There is diffuse upper lobe predominant ground glass patchy opacities compatible with ARDS, underlying infection cannot be ruled.MEDIASTINUM AND HILA: Endotracheal tube is present in the trachea with tip above the carina. Moderate-sized pericardial effusion is not significantly change from prior study. Cardiac leads present.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Partially calcified right hepatic lobe lesion is unchanged. Mild amount of perihepatic ascites not significant change from prior study. Sludge is present within the gallbladder.SPLEEN: Splenomegaly. Hypodensity extending from the capsule consistent with a splenic infarct is unchanged in size.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Scattered retroperitoneal lymph nodes not meeting size criteria for lymphadenopathy.BOWEL, MESENTERY: Enteric tube is present the level of the proximal duodenum. The appendix is normal in appearance and fills with contrast. Previously noted questionable ileitis is not appreciated on this study and is difficult to evaluate without IV contrast.BONES, SOFT TISSUES: Anasarca unchanged. Heterogeneity bones may related to known bone marrow disease.OTHER: Moderate volume of ascites not significantly changed from prior study.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: A there is a Foley within the bladder and a small amount of air, which is likely iatrogenic.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The appendix is normal in appearance and fills with contrast. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Moderate to large bilateral pleural effusions with associated underlying atelectasis or consolidation as well as upper lobe predominant ground glass opacities consistent with ARDS. Underlying infection cannot be excluded. 2.Moderate pericardial effusion not significantly changed.3.Moderate volume of ascites unchanged.4.Diffuse anasarca unchanged. |
Generate impression based on findings. | Female; 25 years old. Reason: fracture of clavicle History: clavicle pain Two views of the left clavicle again demonstrate a transverse fracture of the mid to distal clavicular diaphysis with approximately 1 shaft width inferior displacement of the distal fracture fragment, similar to prior study. Interval increased indistinctness and sclerosis along the point of contact of the proximal and distal fracture fragments, compatible with some interval healing. | Clavicular fracture with some interval healing. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of ovarian cancer, diagnosed at the age of 29. Three 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. Scattered benign calcifications including arterial calcifications and left retroareolar ductal 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: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Male, 18 years old, status post craniotomy for AVM resection, with headache. Postoperative findings are seen compatible with a right frontoparietal craniotomy. Pneumocephalus is an expected finding. There is a narrow resection tract extending through the right frontal lobe towards the lateral ventricle margin which contains a small amount of hyperdense blood product. The previously seen hyperattenuating lesion along the right caudate nucleus is no longer clearly seen.The remainder of the brain parenchyma is otherwise unremarkable. No evidence of significant generalized mass effect is seen. The ventricles are normal in size and morphology.Complete opacification of the right maxillary sinus persists with involvement of the right anterior ethmoids and right frontal sinus as well. | Expected postoperative findings related to right frontal lobe lesion resection. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal great aunt and two maternal second cousins. Two standard digital views (total of 8 images) 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. | 32 year old female with history of shortness of breath and non-small cell lung cancer. PULMONARY ARTERIES: No pulmonary embolus.LUNGS AND PLEURA: Large right pleural effusion, increased from prior, and small left pleural effusion. Underinflation of this exam affects the appearance of reference lesions. Left paramediastinal/perihilar consolidation (7/71) is again seen, nonspecific and similar to prior.Reference right apical lesion (7/31) measures 5 mm, unchanged.Reference right upper lobe lesion (7/40) measures 16 x 9 mm, unchanged.Mixed density groundglass lesion in the anterior right upper lobe a similar prior (7/26). Additional patchy groundglass opacities are not severely change.MEDIASTINUM AND HILA: Normal heart size, no pericardial effusion. Right chest Port-A-Cath tip at the superior cavoatrial junction. Mild coronary artery calcifications.CHEST WALL: Spinal fixation hardware and degenerative changes, similar to prior.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No pulmonary embolus.2.Increased large right pleural effusion, and other findings as above.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 2-year-old male. Rhonchi in right lung. Evaluate for pneumonia.VIEWS: Chest AP/lateral (two views) 1/8/2015. Mild peribronchial wall thickening consistent with bronchiolitis/reactive airway disease. No focal airspace opacity, pleural effusion, or pneumothorax. Normal cardiomediastinal silhouette. | Reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | Respiratory insufficiency requiring BiPAPVIEW: Chest AP Left upper extremity PICC with tip in the SVC. Cardiothymic silhouette normal. Improved atelectasis in the right lower lobe and left lower lobe. Probable small bilateral pleural effusions. Multiple surgical clips in the upper abdomen. | Bilateral atelectasis improved in the interval. |
Generate impression based on findings. | Male 73 years old Reason: Concern for intrabdominal process in LUQ. C/f absces vs bleed vs strained muscle. Need to avoid IV contrast due to renal failure History: LUQ pain 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: ABDOMEN:LUNG BASES: There is an LVAD in place. Assessment of the inflow and outflow tract is limited without intravenous administration of contrast. There is bibasilar atelectasis and trace bilateral pleural effusions.LIVER, BILIARY TRACT: Cirrhotic morphology of the liver. The patient is status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The kidneys are atrophic and there is symmetric perinephric fat stranding.RETROPERITONEUM, LYMPH NODES: There are severe atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: There is colonic diverticulosis without evidence of diverticulitis. Trace fluid is seen along the left paracolic gutter. Right inguinal hernia containing a single loop of small bowel, without evidence of obstruction.BONES, SOFT TISSUES: There are moderate/severe degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate is enlarged.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is colonic diverticulosis without evidence of diverticulitis. Trace fluid is seen along the left paracolic gutter. Right inguinal hernia containing a single loop of small bowel, without evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No specific findings seen to account for the patient's pain.2.Cirrhotic hepatic morphology.3.Small bowel containing right inguinal hernia without evidence of obstruction. |
Generate impression based on findings. | 21-month-old male. Coughing and fever. Evaluate for pneumonia.VIEWS: Chest AP/lateral (two views) 1/8/2015. Mild peribronchial thickening consistent with bronchiolitis/reactive airway disease. No focal airspace opacity, pleural effusion, or pneumothorax. Normal cardiomediastinal silhouette. Left-sided aortic arch, cardiac apex, and stomach. | Reactive airway disease/bronchiolitis pattern. |
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. 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.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Chest tube placementVIEW: Chest AP and abdomen AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Left upper extremity PICC with tip in the left brachycephalic vein. There is a urinary catheter in place. Removal of one of the chest tubes and there are now two chest tubes on the right. The moderate size right pneumothorax is unchanged. Cardiothymic silhouette normal. Minimal atelectasis left upper lobe. Absent bowel gas without pneumoperitoneum. | Moderate right pneumothorax with mild mediastinal shift from right to left unchanged. |
Generate impression based on findings. | 15-year-old male. Hemoptysis. Evaluate for AVM, bronchiectasis, mass. LUNGS AND PLEURA: Mild bronchial wall thickening suggestive of bronchitis or asthma. No focal airspace consolidation, pleural effusion, or pneumothorax. No suspicious pulmonary nodules or masses are identified. No evidence of a pulmonary AVM or bronchiectasis.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal cardiomediastinal silhouette.CHEST WALL: Small Schmorl's node in the superior plate of T11 with small focus of nitrogen gas in the adjacent disc.UPPER ABDOMEN: No significant abnormality. | No specific findings to explain the patient's hemoptysis. Mild bronchial wall thickening suggestive of bronchitis or asthma. |
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. Focal asymmetry present in the right lower inner breast, mid depth. There is no suspicious mass, microcalcifications, or areas of architectural distortion in the left breast. | Focal asymmetry in the right lower inner breast. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Male; 72 years old. Reason: 72 yo male with history of MM; post-auto SCT evaluation History: evaluate SKULL: Multiple bilateral calvarial lytic lesions, similar to prior study and compatible with myelomatous lesions. The largest in the left parietal region measures approximately 2.2 cm, unchanged.CERVICAL SPINE: Severe multilevel degenerative disk disease and facet joint arthritic changes. Poorly defined lucencies in the vertebral bodies are slightly more prominent than prior study, and we suspect this finding is secondary to positioning and technique rather than myelomatous lesions. THORACIC SPINE: Moderate multilevel degenerative arthritic changes, similar to prior study. Stable slight loss of height of T11 vertebral body. No discrete myelomatous lesions.LUMBAR SPINE: Moderate to severe multilevel degenerative arthritic changes, similar to prior study. No discrete myelomatous lesions.RIBS: Slightly mottled appearance of both clavicles appears similar to prior study and is equivocally secondary to myelomatous involvement. Old healed fractures of the right 10th and left 9th ribs. No discrete myelomatous lesions of the ribs.PELVIS: No significant abnormality noted.UPPER EXTREMITY: Scattered small lytic lesions in both humeri, similar to prior study and compatible with myelomatous lesions. Mild osteoarthritis affects the right knee.LOWER EXTREMITY: Scattered small lytic lesions in the right femur, similar to prior study and compatible with myelomatous lesions. Chronic-appearing calcification at the left greater trochanter. | No significant interval change in myelomatous involvement of both the axial and appendicular skeleton as detailed above. |
Generate impression based on findings. | 86 year old woman with severe aortic stenosis presents for CT for evaluation prior to possible TAVRCPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with normal brachiocephalic branching pattern. There is mild calcification of the proximal brachiocephalic vessels. No thoracic aortic dissection or aneurysm is noted. The thoracic aorta has minimal tortuosity. No protruding aortic atheroma or thrombus is noted in the thoracic aorta. There is mild calcification of the aortic root. There is moderate calcification of the aortic arch. There is mild calcification of the descending aorta. No aortic coarctation is noted. Aortic Annulus: Dimension: 26 mm x 19 mm Circumference: 7.3 cm Area: 3.7 cm2Sinus of Valsalva: Width: 30 mm x 28mm x 30 mm Height: 18mmSinotubular Junction: 25 x24 mmAscending Aorta (4cm from annulus): 31 mm x 31mmMid Aortic Arch: 26 x27 mmDescending Aorta: 21 mm x 22 mmAnnulus to LM Height: 16 mmAnnulus to RCA Height: 13 mmAortic Leaflet Length: 15 mmOptimal Fluoroscopic Angle: LAO24CAU0Aortic Valve: The aortic valve is trileaflet. There is severe aortic valve calcification, which involves all three coronary cusps. Mitral Valve: Mild mitral annular calcification is noted. No significant leaflet thickening or calcificationLeft Ventricle: The left ventricular diastolic volume is normal. There is no thrombus noted in the left ventricle. There is a mild sigmoid septum noted. Right Ventricle: Visually the right ventricular volume is within normal limits.Left Atrium: The left atrium is severely dilated. There are four distinct pulmonary veins which drain normally into the left atrium. There is a filling defect in the left atrial appendage, which could represent either a thrombus or poor flow/ filling.Right atrium, vena cavae, and coronary sinus: The right atrium is severely dilated in size. The inferior vena cavae is dilated. The coronary sinus is dilated. Pulmonary Artery: Normal in size.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary arteries: Because heart rate management was not attempted and nitroglycerine was not administered, this exam was not performed to optimally visualize the coronary arteries. However within the limitations of the study the following observations are made:LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There is no significant calcification of the left main coronary artery. LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There is mild calcification of the LAD. LCx: The left circumflex coronary artery courses normally in the the left AV groove. It gives rise to the obtuse marginal branches and a small AV circumflex branch. There is no significant calcification of the LCx.RCA: The right coronary artery arises normally from the right sinus of Valsalva. It is the dominant coronary artery supplying a posterior descending artery and a posterolateral branch. There is no significant calcification of the RCA. Coronary Bypass Grafts:None present. | 1. Severe aortic valve calcification2. Thoracic aorta anatomy and measurements as above3. Mild calcification of the coronary arteries4. Mild mitral annular calcification5. Severe left atrial dilation with evidence of a left atrial appendage filling defect, which could represent either a thrombus or "poor flow." This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report. The abdominal/ pelvis CTA will be reported separately by radiology. |
Generate impression based on findings. | FractureVIEWS: Left wrist AP, oblique and lateral There are healing fractures involving the metaphyses of the distal radius and ulna in near anatomic alignment. There is periosteal reaction reflecting interval healing. The overlying cast obscures fine bony detail. | Healing distal forearm fractures as described above. |
Generate impression based on findings. | Female 59 years old Reason: For abd/pelvis: please re-evaluate retroperitoneal LAD and omental nodularity with Contrast... For Chest: please eval Nodularity in the Distal Third of esophagus seen on recent EGD History: h/o node-positive Colon Cancer (stage 3) in 2012 s/p sigmoidectomy but no chemo/rad, now with abdominal pain, weight loss, CT findings of omental nodularity and LAD CHEST:LUNGS AND PLEURA: 5-mm right middle lobe nodule is nonspecific, but attention at follow-up is recommended.MEDIASTINUM AND HILA: There is no evidence of mediastinal or hilar lymphadenopathy on the basis of size criteria. The main pulmonary artery is slightly enlarged measuring 3.0 cm in maximal diameter, which is nonspecific but can be seen in the setting of pulmonary arterial hypertension. There is no evidence of pleural or pericardial effusion. The trachea and mainstem bronchi are patent. CHEST WALL: Increased cardiophrenic lymphadenopathy, reference lymph node measures 1.0 x 1.5 cm (image 68, series 3).ABDOMEN:LIVER, BILIARY TRACT: New/increased nodularity of the dome of the liver consistent with peritoneal carcinomatosis, with possible capsular invasion. Hypoattenuating lesion in hepatic segment 8 is too small to characterize.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple hypoattenuating lesions identified within the renal parenchyma, consistent with both simple and hyperdense cysts.RETROPERITONEUM, LYMPH NODES: Increasing bulky retroperitoneal lymphadenopathy. Index left para-aortic node now measures 1.6 x 3.2 cm (image 114, series 3), previously 1.9 x 2.4 cm. Additional non-index nodes have also increased in size. There is compression of the bilateral renal veins and arteries, without complete occlusion, by the conglomerate of retroperitoneal lymph nodes.BOWEL, MESENTERY: Increased omental nodularity compatible with peritoneal carcinomatosis. For reference purposes an omental implant measures 1.1 x 1.2 cm (image 127, series 3), previously 0.5 x 0.3 cm. Postsurgical changes related to sigmoidectomy and mesenteric lymph node dissection.There is significant asymmetric wall thickening of the distal esophagus to the level of the GE junction, which is nonspecific and correlation with endoscopy is recommended.BONES, SOFT TISSUES: There are moderate degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: See aboveBONES, SOFT TISSUES: There are moderate degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted. | 1.Disease progression: Increased lymphadenopathy and peritoneal carcinomatosis.2.Asymmetric wall thickening of the distal esophagus, is nonspecific and correlation with endoscopy is recommended. |
Generate impression based on findings. | 10-month-old male with head trauma, intubated.VIEW: Chest AP (one view) 1/9/2015, 0525 hours. Endotracheal tube tip at the carina. Left subclavian line terminates at the confluence of the brachiocephalic veins. Enteric tube tip in the antropyloric region of the stomach.Moderate bilateral pleural effusions with basilar atelectasis, not significantly changed. Normal cardiothymic silhouette. | ET tube tip at the carina. Persistent bilateral effusions and basilar atelectasis. |
Generate impression based on findings. | FractureVIEWS: Left elbow AP, oblique and lateral The supracondylar fracture with three K wires is in near anatomic alignment. No definite periosteal reaction noted. The overlying splint is in place. | Fixation of supracondylar fracture as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of benign right breast biopsy in December 2011. Family history of breast cancer in mother, two sisters, maternal cousin, and four paternal cousins. 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. Questionable area of architectural distortion seen in the right lateral breast (best seen on CC view). Biopsy marker clip identified within the right retroareolar region. Scattered benign calcifications are identified in the right breast. No suspicious masses, microcalcifications or areas of architectural distortion are seen in the left breast. | Questionable area of architectural distortion seen in the right lateral breast. Additional imaging, including repeat right CC view, spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 10-year-old female with hypoxia.VIEW: Chest AP (one view) 1/9/2015, 0508 hrs. ET tube tip between the thoracic inlet and carina. Right IJ catheter at the RA/SVC junction. Enteric tube tip in the antropyloric region of the stomach.Dense retrocardiac opacity not significantly changed, favor atelectasis over consolidation. Improving right basilar atelectasis. Persistent left pleural effusion. | Left pleural effusion unchanged. Improving right basilar atelectasis. |
Generate impression based on findings. | Evaluate pleural effusionVIEW: Chest AP and abdomen AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Left upper extremity PICC with tip in the left brachiocephalic vein. Left chest tube in place. Cardiothymic silhouette normal. Diffuse atelectasis bilaterally minimally improved. Bilateral small pleural effusions left greater than right. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. Marked body wall edema. | Bilateral small pleural effusions left greater than right minimally increased in the interval. |
Generate impression based on findings. | 15-year-old male. One episode of hemoptysis, 1 cup. Evaluate for hemorrhage or infiltrate.VIEWS: Chest AP/lateral (two views) 1/8/2015. Large lung volumes and mild peribronchial wall thickening suggestive of bronchiolitis/reactive airway disease. No focal airspace opacity, pleural effusion, or pneumothorax. Normal cardiomediastinal silhouette. | Mild reactive airway disease/bronchiolitis. |
Generate impression based on findings. | There are postoperative findings related to C1-C2 fusion with cables and bone graft material. Compared to the prior exam, there is decreased interval displacement with a decreased atlantodental interval on the neutral view measuring 2 mm as compared to 5 mm previously. However, there is 3 mm wide atlantodental interval on the extension view, and up to 5 mm on flexion view. As described on the prior exam, the posterior arch of C1 appears disrupted with the cables no longer engaging C1 in place. There is at least moderate spinal canal stenosis suspected at this level, similar to the prior exam. However, evaluation of the cervical canal and spinal cord is very limited on CT. Atlantooccipital alignment, and the alignment of the cervical spine below C2 appears anatomic, although there is straightening of the cervical spine as was present on prior exam on the neutral view which is likely positional. There is no acute fracture, or discrete fluid collection. | 1.Atlantooccipital alignment appears intact, however there is dynamic widening of the atlantodental interval on the flexion and extension views as compared to the neutral position suggesting persistent instability. Compared to the prior study, the atlantodental interval on the neutral view has decreased from 5 mm to 2 mm today.2.Very limited assessment of cervical canal on CT. If indicated, MRI would be recommended for further evaluation of the spinal cord and thecal sac. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of uterine cancer, diagnosed at the age of 42. 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. | 7 year-old female with 5 day history of abdominal pain, no fevers, no diarrhea. Stool burden palpated on exam. Rule out obstruction, anatomic abnormality, heavy stool burden.VIEW: Abdomen AP (one view) 1/9/2015, 0623 hours. Moderate colonic stool burden. Nonobstructive bowel gas pattern. | Moderate colonic stool burden. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Benign intramammary lymph node identified in the right upper outer 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. | 70 year-old female with history of left breast invasive poorly differentiated carcinoma who presents for needle localization prior to surgery. On review of the prior studies, there is left breast 8 o'clock asymmetry with associated clip which is the target for today's procedure. The procedure, risks including bleeding, mistargeting and infection, and benefits of needle-wire localization 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 left breast was placed in an alphanumeric grid using a medial to lateral approach. When the target was positioned in the aperture of the grid, the skin was cleansed with chlorhexidine. Local anesthesia was obtained using 2% Lidocaine. Using coordinates from the grid, a 5 cm Kopans needle was placed through the lesion. On orthogonal mammography, adequate positioning of the needle was confirmed after adjusting depth so the needle tip was approximately 2cm deep to the center of the target. A spring wire was then deployed. Repeat two view orthogonal mammograms reveal the spring wire to be in excellent position. The mammogram was annotated and reviewed with Dr. Chhablani prior to the patient's procedure. Patient tolerated the procedure well and was sent to the holding area in stable condition. Dr. Singh performed the procedure under direct supervision of Dr. Sennett, who was present during the procedure at all times.Orthogonal digital specimen radiographs revealed the mass and clip to be within the specimen. | Successful needle localization of the left breast malignancy.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 8-year-old female. Will not bear weight. Evaluate for fracture.VIEWS: Left foot AP/oblique/lateral views (3 views). Left ankle AP/oblique/lateral (3 views). Left foot: No fracture or malalignment is identified. Left ankle: Mild soft tissue swelling. Small ankle joint effusion. No fracture is identified. | Mild soft tissue swelling at the ankle and small ankle joint effusion. No fracture is identified. MRI is recommended if there is clinical concern for ligamentous injury. |
Generate impression based on findings. | 83 years old, Female, Reason: abd pain History: abd pain ABDOMEN:LUNG BASES: Respiratory motion limits evaluation of lung parenchyma. Moderate bibasilar reticulonodular opacities consistent with atelectasis. Scattered calcified hilar and mediastinal lymph nodes. Fluid is noted within the distal esophagus compatible with esophageal reflux. There is a small hiatal hernia present.LIVER, BILIARY TRACT: Diffuse hepatic steatosis.SPLEEN: Small peripheral hypodensity in the spleen may reflect a cyst and is unchanged from prior study.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal hypodensities some of which probably represent simple cysts, all of which are too small to characterize but are favored to be cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Bilateral inguinal hernias. Left inguinal hernia contains loops of sigmoid and and descending colon without evidence of bowel wall edema or obstruction. The right inguinal hernia contains loop of descending colon which are narrowed as they enter the hernia, dilated within the hernia, with local distal collapse as it exits the hernia. There is distention of the cecum measuring up to 12 cm in diameter. There is gas and stool in the distal loops of colon. These findings are consistent with a partial or early complete obstruction. There is no evidence of pneumatosis or free air. No definite evidence of ischemia. There is no drainable fluid collection. Trace pelvic free fluid is nonspecific but may be related to obstructive process.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: Bilateral inguinal hernias. Left inguinal hernia contains loops of sigmoid and and descending colon without evidence of bowel wall edema or structure. The right inguinal hernia contains loop of descending colon with local distal collapse and distention of the cecum measuring up to 12 cm in diameter. There is gas and stool in the distal loops of colon. These findings are consistent with a partial or early complete obstruction. There is no evidence of pneumatosis or free air. No definite evidence of ischemia. There is no drainable fluid collection. Trace pelvic free fluid is nonspecific but may be related to obstructive process.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Right inguinal hernia causing likely partial versus early complete obstruction of the right colon with dilated cecum.1.Hiatal hernia is present.2.Left inguinal hernia containing loops of colon without evidence of obstruction.3.Diffuse hepatic steatosis. |
Generate impression based on findings. | Female; 68 years old. Reason: shoulder pain History: same Four views of the right shoulder demonstrate mild osteoarthritis affecting the glenohumeral and acromioclavicular joints. Mild spurring is noted along the greater tuberosity. Glenohumeral joint alignment is within normal limits. No acute fracture is evident. | Mild osteoarthritis as described above. |
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 heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Focal asymmetry is identified in the left inferior breast, posterior depth. Previously characterized cyst in the left breast near 3:00 is not significantly changed. There is no suspicious masses, microcalcifications or areas of architectural distortion present in the right breast. | New focal asymmetry in the left inferior breast. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Male, 18 years old, status post craniotomy with headache. Again seen is evidence of lesion resection from the deep right frontal lobe. Pneumocephalus remains within expected limits. A surgical tract extends through the frontal lobe to the right periventricular region. A hypodense lesion seen on the preoperative examination along the caudate is no longer evident. There remains a small amount of hyperdense blood product within the surgical tract similar to prior. No significant interval changes are seen. The right maxillary sinus, anterior ethmoids and right frontal sinus remain opacified. | No significant change in expected postoperative findings. |
Generate impression based on findings. | Female 44 years old; Reason: diverticulitis History: epigastric, LLQ pain ABDOMEN:LUNG 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:UTERUS, ADNEXA: Indeterminate 1.8cm lesion seen best on axial image 117 appears separate from the urinary bladder and may represent an exophytic fibroid but is incompletely characterized.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No obstruction. Appendix is normal. No diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No acute abdominal or pelvic pathology. 1.8-cm lesion posterior to the bladder described above likely represents an exophytic fibroid, but may be more definitively characterized by pelvic ultrasound. |
Generate impression based on findings. | Male; 67 years old. Reason: shoulder pain History: same Three views of the right shoulder demonstrate a metallic surgical anchor within the humeral head, related to prior rotator cuff surgical repair. Mild osteoarthritis affects the glenohumeral and acromioclavicular joints. Alignment is within normal limits. Posterior spinal fusion of the thoracic spine is incompletely imaged. | Right shoulder postoperative and degenerative arthritic changes as described above. |
Generate impression based on findings. | 2-year-old female. Rales, SOB. Evaluate for pneumonia.VIEWS: Chest AP/lateral (two views) 1/8/2015. Peribronchial thickening consistent with bronchiolitis/reactive airway disease. Normal cardiothymic silhouette. No focal airspace opacity, pleural effusion or pneumothorax. There is a left-sided aortic arch, cardiac apex, and stomach. | Bronchiolitis/reactive airway disease pattern. |
Generate impression based on findings. | 18 year old female with severe right hip pain over past 72 hours. History of Crohn's disease and psoriatic arthritis. Evaluate for arthritis, AVM, or other bony changes. BONE AND MARROW: No significant bone marrow or cortical abnormality is identifiedSYNOVIUM: There is a moderate right hip joint effusion with mild enhancement of the synovium. No evidence of internal debris.MUSCULATURE: Edema and enhancement of the musculature adjacent to the right hip, including the obturator internus and externus as well as gluteus muscles.ADDITIONAL | Moderate right hip joint effusion with synovial enhancement suggestive of synovitis. No evidence of internal debris or underlying osseous changes. |
Generate impression based on findings. | 29-year-old male with history of chest pain. Evaluate for PE. Sickle cell patient. PULMONARY ARTERIES: No pulmonary embolus.LUNGS AND PLEURA: Minimal dependent atelectasis. No consolidation, no pleural effusion and pneumothorax.MEDIASTINUM AND HILA: Mild cardiomegaly, unchanged. No pericardial effusion. No significant mediastinal or hilar lymphadenopathy. No appreciable coronary artery calcifications.CHEST WALL: Osseous stigmata of sickle cell disease, unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Mildly prominent intrahepatic biliary ducts, not uncommon in patients post cholecystectomy. | No pulmonary embolus. Stable findings of sickle cell disease.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Nasal congestion and obstructive sleep apnea. There is moderate mucosal thickening in the left maxillary sinus with suggestion of an air fluid level. There is also opacification of the majority of the left ethmoid sinuses and frontoethmoid recess. There is mild mucosal thickening in the right maxillary sinus and left sphenoid sinuses. The frontal and right ethmoid and sphenoid sinuses are clear. There is opacification of the left nasal cavity. There are also secretions in the nasopharynx. There is no significant 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 ears are clear. There is mild diffuse prominence of the adenoids. The facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. | 1. Findings suggestive of acute rhinosinusitis.2. Mild diffuse prominence of the adenoids are nonspecific and may be reactive. |
Generate impression based on findings. | 8-month-old female. Vomiting. Evaluate for obstruction.VIEWS: Abdomen AP/left lateral decubitus (two views) 1/8/2015. Nonobstructive bowel gas pattern. No pneumoperitoneum, portal venous gas, or pneumatosis. Average stool burden. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female 46 years old Reason: 46 yo female with ERCP pancreatitis and bile duct leak. History: abdominal pain ABDOMEN:LUNG BASES: Unchanged right lower lobe nodule.LIVER, BILIARY TRACT: The patient is status post cholecystectomy. There is unchanged mild intrahepatic biliary ductal dilatation, presumably postprocedural in etiology.SPLEEN: The splenic artery appears to be occluded.PANCREAS: There has been interval removal of the percutaneous cystostomy tube, and the previously seen gas and fluid collection within the tail the pancreas now contains only gas, measuring approximately 1.5 x 4.6 cm, previously 1.5 x 4.7 cm. No new fluid collections are evident. There is unchanged atrophy of the pancreatic tail, consistent with pancreatic necrosis, which is unchanged. There is improved surrounding inflammatory change within the mesentery.ADRENAL GLANDS: Stable nonspecific nodularity of the left adrenal gland.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, 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: Fluid within the endometrial cavity is presumably physiologic in etiology. There is trace free fluid within the pelvis.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.Interval removal of the cystostomy tube from the previously seen fluid and gas containing collection in the region of the pancreatic tail, which now contains only gas.2.Improved inflammatory changes in the mesentery surrounding the pancreatic tail, but otherwise unchanged findings consistent with sequelae of necrotizing pancreatitis. |
Generate impression based on findings. | 18-month-old female. Fever, cough.VIEWS: Chest AP/lateral (two views) 1/8/2015. Peribronchial wall thickening consistent with bronchiolitis/reactive airway disease. No focal airspace opacity, pleural effusion, or pneumothorax. Normal cardiomediastinal silhouette. Left-sided aortic arch, cardiac apex, and stomach. | Reactive airways disease/bronchiolitis pattern. |
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 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. | Female; 71 years old. Reason: burning right leg pain History: burning right leg pain Three views of the lumbar spine demonstrate severe degenerative disk disease affecting L4-5, increased since prior study. Grade 2 anterolisthesis of L4, slightly increased since prior study. Moderate facet joint osteoarthritis affects the lower lumbar spine. Vertebral body heights are maintained. Hardware components of bilateral total hip arthroplasty devices are incompletely imaged on this study. | Progression of degenerative disk disease and anterolisthesis at L4-5 as described above. |
Generate impression based on findings. | There is severe dilatation of the ventricles diffusely. The posterior fossa does not appear significantly enlarged, although there is direct communication of the fourth ventricle with the posterior fossa CSF space. The brainstem is displaced ventrally with flattening posteriorly. Cerebellar tissue is identified and appears diminutive, especially the vermis, which is displaced superiorly/elevated. There is no midline shift. There is no intracranial hemorrhage. There is periventricular low density which may relate to transependymal edema although underlying unmyelinated white matter is also likely present. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is incidental mild disconjugate gaze. There is mild convexity of the anterior fontanelle. | Severe communicating hydrocephalus, with probable Dandy-Walker variant. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal great 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. 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. | 27 weeks pregnant. Concern for stone versus pyelonephritis. Low-back pain, nausea and vomiting. RIGHT KIDNEY: The right kidney measures 11 cm in length. There is mild hydronephrosis. No stones are identified.LEFT KIDNEY: The left kidney measures 10.2 cm in length. Minimal pelvocaliectasis. No stones are identified.URINARY BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Right hydronephrosis and minimal left pelvocaliectasis. These findings were communicated to the clinical service (pager 3551) at the time of dictation. |
Generate impression based on findings. | Female, 84 years old, history of lung cancer, assess for thrombus. Intraluminal thrombus is seen within the SVC (partially visualized), brachiocephalic and internal jugular veins on the right. Thrombus extends superiorly in the internal jugular vein to the level of the hyoid bone, at which point normal venous opacification reconstitutes. There is probably extension of thrombus into the external jugular vein as well. A fairly similar pattern of venous thrombus is evident on the examination of 12/20/14.Ill-defined infiltration of the fascial planes surrounding the right neck vessels is unchanged. No pathologic adenopathy is detected in the upper neck enlarged lymph nodes are seen, however, in the right supraclavicular fossa and upper mediastinum. The node in the supraclavicular fossa measures 20 x 11 mm (image 165 series 4) and has not significantly changed. A nodule is present within the left upper lobe similar to prior. The salivary glands are unremarkable. A calcification is present within the right thyroid lobe. No lesions appear to just mucosa are suspect.On limited intracranial views, a 4-mm enhancing lesion is seen within the right cerebellum (image 16 series 4).Advanced cervical spondylosis is present with suspected spinal canal stenosis at C5-6 and C6-7. No destructive osseous lesions are seen. However, the left C7-T1 neural foramen appears to be chronically widened (image 49 series 7). | Persistent thrombosis of the right SVC, brachiocephalic vein, and internal jugular vein with extension superiorly to the level of the hyoid. The distribution of thrombus is similar to that seen on the prior study.4-mm enhancing lesion in the right cerebellar hemisphere suspicious for a metastatic lesion. Further evaluation with contrast-enhanced MRI is suggestedNo destructive osseous lesions are seen. However, the left C7-T1 neural foramen is chronically widened. This may be a developmental anomaly, related to degenerative disease, or the presence of an indolent mass or space-occupying process. If clinically warranted, this could be assessed with contrast-enhanced MRI. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal grandfather and mother. BRCA positive. 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. 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. Breast MRI given her risk status is also appropriate. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Male; 77 years old. Reason: PREOP History: PREOP Severe arthritic changes affect the left shoulder. Narrowing of the glenohumeral joint with osteophyte formation, indicative of osteoarthritis. Chronic remodeling of the glenoid articular surface, which appears shallow with compensatory bone formation at the anterior aspect glenoid. Large cysts or chronic erosions within the anterior humeral head. Moderate glenohumeral joint effusion with distention of the subacromial/subdeltoid bursa with heterogeneous material, suggestive of fluid with synovitis and debris. Multiple bone fragments within the joint space and bursa. Arthritic changes of the acromioclavicular joint with chronic erosion of the distal end of the clavicle, perhaps degenerative, are also noted. There is slight anterior subluxation of the humeral head with narrowing of the coracohumeral interval.No discrete rotator cuff tendons are visualized, aside from the teres minor. There is severe fatty atrophy of the rotator cuff musculature, again aside from the teres minor. Overall, the findings are suggestive of chronic rotator cuff tearing. Multilevel degenerative arthritic changes of the incompletely visualized spine. Mitral valve annular calcifications are partially visualized. | Severe arthritic changes of the left shoulder as described above, which likely reflect long-standing changes related to rotator cuff arthropathy. However, an underlying inflammatory or neuropathic arthropathy cannot entirely be excluded. |
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. Two focal asymmetries are identified in the right central breast, mid depth (best seen on the CC view). No suspicious masses, microcalcifications or areas of architectural distortion are identified in the left breast. Additional bilateral circumscribed masses are stable in morphology and distribution. | Two focal asymmetries in the right central breast. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 3-day-old male with imperforate anus status post ostomy and fistula.VIEWS: Pelvis AP and frog leg (two views) 1/8/2015, 1843 hrs. No fracture or malalignment. No sacral anomalies identified. Previously noted dilated bowel loops are superior to the field of view. No significant abnormality is seen in the pelvis. | No significant abnormality in the pelvis. |
Generate impression based on findings. | 8-month-old male with UTI, possible ileus. Evaluate bowel gas pattern.VIEW: Abdomen AP (one view) 1/9/2015, 0841 hours. Enteric tube tip in the stomach. Persistent absence of bowel gas. No evidence of pneumatosis, portal venous gas, or intraperitoneal free air. Atelectasis/effusions noted in the lung bases. | Persistent absence of bowel gas. |
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