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Generate impression based on findings. | Right knee pain Four views of the right knee are provided. Mild medial compartment narrowing and small tricompartmental osteophytes indicate mild to moderate osteoarthritis. There is perhaps a small joint effusion.Minimal osteoarthritic changes affect the left knee as seen on the frontal view. | Osteoarthritis as described above. |
Generate impression based on findings. | Chronic sinusitis. Dental disease. There are multiple dental fillings. There is a large cavity of the left third mandibular molar, and possibly of the right third mandibular molar as well. The maxillary teeth are not well visualized due to blurring artifact inherent to Panorex technique, but I suspect that there are cavities of the remaining maxillary molars as well. I see no abnormal lucent lesions of bone on this study. | Findings of poor dentition as described above. If further imaging evaluation is clinically warranted, dedicated dental radiographs are recommended. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bilateral breast reduction. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of tongue cancer. Two standard digital views with additional left MLO view of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Linear markers are placed overlying scars and bilateral lower axillary regions. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications, including dermal calcifications, are present bilaterally. | 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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. 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. | Traumatic fall on outstretched hand with tenderness to palpation at base of thumb and thenar prominence. Fracture of carpals, metacarpals? I see no fracture. Moderate osteoarthritis affects the first carpometacarpal joint. Mild osteoarthritic changes affect scattered interphalangeal joints. A small lucency in the ulnar styloid may represent a cyst or chronic erosion. | Osteoarthritic changes as described above without fracture evident. |
Generate impression based on findings. | Sepsis. Evaluate for fluid collection. Two views of the right femur show an intradurally rod and screw/nail device affixing an oblique fracture of the proximal femur with extension to the lesser trochanter in gross anatomic alignment. Mineralization along the anterolateral aspect of the fracture may represent an attempt at healing. I see no hardware complications. There is reticulation of the subcutaneous fat of the thigh indicating edema, but I see no focal opacity. Mild osteoarthritis affects the hip joint. There is chondrocalcinosis in the knee. There is calcification of the femoral artery.The AP view the pelvis reveals the aforementioned postoperative changes on the right. The bones are demineralized suggesting osteopenia/osteoporosis. Mild osteoarthritis affects both hip joints. Degenerative arthritic changes affect the visualized lower lumbar spine. Arterial calcifications are noted within the pelvis and upper thighs. There is a surgical clip in the pelvis and suture material in the right lower quadrant. | Orthopedic fixation of proximal femoral fracture as described above. There is soft tissue edema, but I see no focal soft tissue opacity. Please note that radiographs are limited in their ability to assess for fluid collections. |
Generate impression based on findings. | Reason: Evaluate for steno-occlusive disease or other etiology of stroke History: posterior circulation stroke, R field cut, cognitive and short-term memory deficits Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.There are degenerative changes present in the cervical spine with endplate and uncal vertebral osteophytes at C4-5, C5-6 and C6-7 resulting in narrowing of the neural foramina at these levels.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.There is occlusion of the left posterior cerebral artery at the left parimesencephalic cistern suggesting a branch occlusion.The left internal artery is ectatic. There is a wide neck aneurysm present along the medial aspect of the horizontal segment of the left cavernous segment of the left internal carotid artery. This aneurysm measures 4 x 3 mm.The anterior communicating artery is identified and is small. The posterior communicating arteries are identified and are tiny.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is hypodensity involving the left parahippocampal gyrus and hippocampus.Periventricular and subcortical white matter hypodensities of a moderate degree are present. Punctate hypodense foci are present in the basal ganglia, internal capsules as well as the left thalamusA small focus of encephalomalacia is present along the left fusiform gyrus.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. The right eyeball lens is thin. | 1.Left posterior cerebral artery occlusion at the distal p2 segment.2.There is a left cavernous segment aneurysm along the left internal carotid artery.3.Findings are compatible with a subacute infarction involving the posterior aspect of the left parahippocampal gyrus and hippocampus extending towards the splenium of the corpus callosum4.lacunar infarcts are present in the basal ganglia and thalami which are age indeterminate based on CT. Please refer to the MRI from 1/7/15 for further comments.5.Multilevel degenerative changes are present in the cervical spine. |
Generate impression based on findings. | Status post slip/fall. Evaluate for acute process. Three views of the right ankle are provided. I see no fracture or malalignment. I see no joint effusion. Mild osteoarthritis affects the tibiotalar joint.Two views of the right tibia/fibula are provided. I see no fracture. | Mild ankle joint osteoarthritis. No fracture evident. |
Generate impression based on findings. | Reason: h/o HNC/CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Stable small micronodules and calcified pleural plaques.Unchanged basilar scarring.No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: Severe vascular calcifications including the coronary arteries.Stable small saccular aneurysm of the aortic arch.Enlargement of the main pulmonary artery is suggestive of PA hypertension although this also be seen in advanced age.No lymphadenopathy is present. CHEST WALL: Mild degenerative abnormalities affect the thoracic spine.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Large right renal cyst, stable.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive vascular calcifications are present.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. No evidence of metastases.2. Extensive vascular disease including the coronary arteries. |
Generate impression based on findings. | Female 59 years old; Reason: Decreasing hemoglobin, ascites, concern for intrabdominal bleed; also re-evaluate pneumonia seen on CT one month ago History: Re-eval pneumonia, decreasing hemoglobin CHEST:LUNGS AND PLEURA: Interval reduction in size of a now small right pleural effusion. Stable left pleural effusion with adjacent compressive atelectasis. Previously seen patchy consolidation and tree in the opacities of the right lower lobe have improved compared to the prior study. Persistent bronchial wall thickening is still noted. Calcified pulmonary micronodules. Biapical scarring. New 4-mm pulmonary nodule with surrounding ground glass is felt to be infectious (3:56), and likely related to above-described process. However, further follow-up to document resolution is suggested.MEDIASTINUM AND HILA: Left and right-sided central line tips in the superior vena cava.CHEST WALL: No significant abnormality noted.ABDOMEN:Limited evaluation secondary to lack of intravenous contrast and diffuse ascites.LIVER, BILIARY TRACT: Layering high density seen within the gallbladder. Although no recent contrast-enhanced study is visible on a PACS workstation, this could represent a case excretion of contrast due to recent procedure. Correlate with history. Nodular liver contour. No biliary dilatation. Cholelithiasis. Increased attenuation of the noncontrast liver is again seen, which may related to iron overload, or drug toxicity.SPLEEN: Status post splenectomy.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate, nonobstructing renal stones bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Significant interval increase in ascites compared to most recent CT chest, but slightly increased compared to most recent CT abdomen. No obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Foley catheter with air seen in the urinary bladder.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Ascites. No Obstruction.BONES, SOFT TISSUES: Anasarca. Redemonstrated compressive changes of L2 vertebral body.OTHER: No significant abnormality noted. | No evidence of hematoma.1.Cirrhotic hepatic morphology. Increased attenuation of the liver on this noncontrast scan can be seen with drug toxicity or overload.2.Significant interval increase in large volume ascites, worsened from most recent chest CT, but grossly stable to slightly increased from most recent abdominal CT.3.Redemonstrated compression deformity of the L2 vertebral body.4.Interval improvement in the still existing right bronchopulmonary pneumonia. A new pulmonary nodule described above is likely related to this infectious process, but follow-up until resolution is recommended. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is scattered periventricular and subcortical white matter hypoattenuation are without significant change from prior exam, likely representing chronic microvascular ischemic changes. The ventricles and basal cisterns are unchanged. There is no midline shift or herniation. There is moderate to severe mucosal thickening in the right maxillary sinus with high attenuation material suggesting inspissated secretions. There is mild bilateral cavernous carotid and V4 vertebral artery segment atherosclerotic calcification. The imaged mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | 1.No acute intracranial hemorrhage, mass effect or skull fracture. CT is insensitive for detection of early nonhemorrhagic stroke.2.Chronic microvascular ischemic changes are again seen. |
Generate impression based on findings. | There are bubbly secretions in the right maxillary, and right sphenoid sinuses. There is opacification of a posterior left ethmoid air cell. There is trace mucosal thickening of the left maxillary sinus, and scattered ethmoid air cells. There is mild partial opacification of bilateral mastoid air cells. There is leftward bowing of nasal septum superiorly and focal right sided deviation of the nasal septum anteriorly. The orbits and imaged intracranial structures are unremarkable. | Finding suggesting acute right sphenoid and maxillary sinusitis. |
Generate impression based on findings. | Male 65 years old Reason: lung cancer surviellance, follow up imaging of right psoas lesion History: history of lung cancer s/p XRT, right psoas lesion ABDOMEN:LUNG BASES: Chest section of the report will be dictated separately.LIVER, BILIARY TRACT: Previously measured heterogeneous area within the left lobe now measures 3.2 x 2.2 cm on image number 24, series number 9, not significantly changed from previous study. The etiology of this lesion is unknown.SPLEEN: No significant abnormality notedPANCREAS: Peripancreatic hypodense index lesion measures 1.4 x 0.7 cm on image number 50, series number 9, slightly smaller compared to previous study.ADRENAL GLANDS: Left adrenal nodule is unchanged measuring 1.9 x 1.6 cm in image number 42, series number 9.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: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 | Slight interval decrease in the size of the peripancreatic low-density lesion. Otherwise no significant change from previous study. |
Generate impression based on findings. | Pain, stiffness. Evaluate for inflammatory or erosive changes. Evaluate for severity of osteoarthritis. Evaluate for chondrocalcinosis. Three views of the right hand are provided. Mild osteoarthritis affects the interphalangeal joints of the fingers and thumb. Small periarticular calcifications at the PIP joint of the ring finger may reflect old trauma. I see no erosions. I see no definite chondrocalcinosis.Three views of the left hand are provided. Mild osteoarthritis affects the interphalangeal joints of the fingers and thumb. I see no erosions. I see no chondrocalcinosis.Four views of the right knee are provided. Small tricompartmental osteophytes indicate mild to moderate osteoarthritis. I see no erosions. I see no chondrocalcinosis. I see no joint effusion.Four views of the left knee are provided. Tricompartmental osteophytes and mild medial compartment narrowing indicate moderate osteoarthritis. I see no erosions. I see no chondrocalcinosis. I see no joint effusion. | Osteoarthritic changes affecting the hands and knees as described above. |
Generate impression based on findings. | History sarcoid valued for crying LV. Dyspnea on exertion. LUNGS AND PLEURA: Low normal lung volumes.Mosaic attenuation of the lung parenchyma with evidence of air trapping on the expiration sequence, most pronounced in the right lower lobe.Mild, nodular thickening of the fissures and interlobular septa.Peribronchovascular groundglass opacity, most pronounced in the superior aspect of the right lower lobe, seen to a lesser extent the perihilar regions elsewhere.No bronchiectasis, honeycombing, masses or pleural fluid.MEDIASTINUM AND HILA: Moderate atherosclerotic calcification of the thoracic aorta. Upper normal heart size with mild prominence of the left ventricle. Physiologic volume of pericardial fluid. Small right cardiophrenic lymph nodes. No visible coronary artery calcifications on this non-cardiac gated study. Mildly prominent high right paratracheal, hilar and subcarinal lymph nodes measuring up to 12-mm (3/40), but no significant lymphadenopathy.Main pulmonary artery is at least upper normal in caliber.CHEST WALL: Small axillary and subpectoral lymph nodes.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Splenomegaly, 15-cm. Widening of the fissure between the hepatic lobes and caudate lobe hypertrophy is suggestive of cirrhosis. Apparent splenorenal varices. | Diffuse interstitial lung disease consistent provided history of sarcoidosis. Air trapping is consistent with small airways involvement. Groundglass component consistent with alveolar involvement. No significantly enlarged mediastinal or hilar lymph nodes. Splenomegaly is not significantly changed. |
Generate impression based on findings. | Reason: Evaluate for steno-occlusive disease or other etiology of stroke History: posterior circulation stroke, R field cut, cognitive and short-term memory deficits Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.There are degenerative changes present in the cervical spine with endplate and uncal vertebral osteophytes at C4-5, C5-6 and C6-7 resulting in narrowing of the neural foramina at these levels.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.There is occlusion of the left posterior cerebral artery at the left parimesencephalic cistern suggesting a branch occlusion.The left internal artery is ectatic. There is a wide neck aneurysm present along the medial aspect of the horizontal segment of the left cavernous segment of the left internal carotid artery. This aneurysm measures 4 x 3 mm.The anterior communicating artery is identified and is small. The posterior communicating arteries are identified and are tiny.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is hypodensity involving the left parahippocampal gyrus and hippocampus.Periventricular and subcortical white matter hypodensities of a moderate degree are present. Punctate hypodense foci are present in the basal ganglia, internal capsules as well as the left thalamusA small focus of encephalomalacia is present along the left fusiform gyrus.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. The right eyeball lens is thin. | 1.Left posterior cerebral artery occlusion at the distal p2 segment.2.There is a left cavernous segment aneurysm along the left internal carotid artery.3.Findings are compatible with a subacute infarction involving the posterior aspect of the left parahippocampal gyrus and hippocampus extending towards the splenium of the corpus callosum4.lacunar infarcts are present in the basal ganglia and thalami which are age indeterminate based on CT. Please refer to the MRI from 1/7/15 for further comments.5.Multilevel degenerative changes are present in the cervical spine. |
Generate impression based on findings. | History of lung cancer with destruction of left fifth and sixth ribs now with worsening with rib pain. Evaluate for fracture. There is an expansile lytic lesion of the left fifth rib with poor visualization of a segment of the posterolateral segment of the adjacent sixth rib compatible with the stated history of neoplasm. I see no fracture. There is adjacent pleural thickening and fibrosis. I see no additional rib lesions. Scarring and emphysematous changes are noted in the right upper lung. Calcified left hilar lymph node appears similar to that seen on prior studies. | Lytic lesions of the left fifth and sixth ribs; and other findings as above. I see no fracture. |
Generate impression based on findings. | Reason: Delirium, thrombocytopenia, concern for bleed History: Thrombocytopenia, delerium. 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 demonstrates opacification of the left frontal sinus and left ethmoid air cells with some minor opacities in the left maxillary sinus. There is heterogeneous appearance to the opacification of the ethmoid sinus and frontal sinus. Since the previous exam opacification of the left frontal sinus and ethmoid air cells has progressed compared to some of the bony septations of the left ethmoid air cells are not appreciated as readily as on the prior exam. Since the prior exam left maxillary sinus opacification has regressed. Since the prior exam the left inferior turbinate has been removed. 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.s/p recent paranasal sinus surgery.3.Progression of heterogeneous appearance in the left frontal sinus and left ethmoid air cells raises the question infiltrative lesion such as fungal sinusitis. Please refer to operative findings from recent endoscopic sinus surgery. |
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. | T1b N0 squamous cell carcinoma of the lung. 18 months after neoadjuvant chemotherapy followed by left upper lobe sleeve resection. Six month follow-up. LUNGS AND PLEURA: Postsurgical and post-therapeutic volume loss on the left consistent with provided clinical history. Remaining left lung is mildly emphysematous but no suspicious nodules or masses are appreciated. Loculated fluid collection at the left apex containing internal septations similar to prior study.Moderate centrilobular and paraseptal emphysema the right lung, no suspicious nodules or masses.Well-circumscribed 6-mm lipid containing nodule right upper lobe, most consistent with a hamartoma.MEDIASTINUM AND HILA: Leftward mediastinal shift. No lymphadenopathy. Atherosclerotic calcification of the aorta and its branches, severe in the coronary arteries. No pericardial fluid. Small hiatal hernia..CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Limited scanning range. Cholelithiasis. The extrahepatic common bile duct is prominent within normal limits for age. | No signs of localized recurrence or metastatic disease. |
Generate impression based on findings. | Ms. Franklin submitted outside mammograms dated 1/6/2012 and 11/29/2012, from Stroger Hospital. Personal history of right lumpectomy for cancer in 1999 followed by chemoradiation therapy. Family history of breast cancer in maternal aunt. Submitted outside studies were compared to the current mammogram dated 11/26/2014. The breast parenchyma is composed of scattered fibroglandular density. There are postsurgical changes including architectural distortion, increased density, and skin retraction present within the right lumpectomy site. There is no significant change when compared to the current exam.Focal asymmetries in the left central and lateral breast are also unchanged when compared to the current exam. No new suspicious microcalcifications or areas of architectural distortion in either breast. There is no significant change between these two studies. | Stable postsurgical changes in the right breast. 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. | Neck pain. Evaluate for cervical stenosis. Shoulder pain. Evaluate for osteoarthritis or impingement. Three views of the left shoulder are provided. There are tiny glenohumeral joint osteophytes, essentially within normal limits considering the patient's age. The acromioclavicular joint appears normal, and the acromiohumeral interval is preserved. There appears to be a mild thoracic scoliosis.Six views of the cervical spine are provided. There is anterior osteophyte formation along the inferior aspect of C4, but the intervertebral disk spaces are preserved, as are vertebral body heights. The neuroforamina appear patent. | Minimal degenerative arthritic changes of the shoulder and cervical spine as described above, without findings to suggest a mechanism for impingement. |
Generate impression based on findings. | Reason: hx of head trauma with plate over R skull History: LUE/facial numbness and lburry vision now resolved The CSF spaces are appropriate for the patient's stated age with no midline shift. The patient is status post right-sided craniotomy. There is a focus of encephalomalacia present along the right temporal lobe laterally involving the right superior and middle temporal gyri and measuring approximately 30 by 16 mm axial dimensions.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Encephalomalacia along the right temporal lobe.3.Status post right-sided craniotomy. |
Generate impression based on findings. | 60 year-old female with history of follicular thyroid cancer, status post thyroidectomy. Evaluate for recurrence. RIGHT LOBE MEASUREMENTS: Status-post thyroidectomyLEFT LOBE MEASUREMENTS: Status-post thyroidectomyISTHMUS MEASUREMENTS: Status-post thyroidectomyRIGHT LOBE: Status-post thyroidectomyLEFT LOBE: Status-post thyroidectomy. Subcentimeter homogeneous hyperechoic focus in the left thyroid bed does not appear substantially changed compared to prior. ISTHMUS: Status-post thyroidectomyPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Subcentimeter lymph nodes.OTHER: No other significant abnormality noted. | Status post thyroidectomy. Hyperechoic focus remains stable most consistent with residual thyroid tissue. |
Generate impression based on findings. | Pain Four views of the left shoulder are provided. Severe osteoarthritis affects the glenohumeral joint, with prominent osteophyte formation arising from the inferomedial aspect of the humeral head/neck. An additional osteophyte projects from the superior aspect of the humeral head. Relatively mild osteoarthritis affects the acromioclavicular joint. The bones appear demineralized, suggesting osteopenia. Calcified foci within the left lung presumably represent granulomas.Four views of the right shoulder are provided. Mild osteoarthritis affects the glenohumeral and acromioclavicular joints. There is also spurring along the anterior aspect of the acromion process and mild spurring along the greater tuberosity. The acromiohumeral interval is narrowed to approximately 5 mm and I cannot exclude the possibility of a rotator cuff tear. Calcified foci in the lung presumably represent granulomas. | Osteoarthritis and other findings as described above. |
Generate impression based on findings. | Ms. Hardin submitted outside mammograms dated 5/16/2000 and 03/26/2009, from Northwestern Memorial Hospital. Submitted outside studies were compared to the current mammogram dated 12/17/2014. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is no significant change between these two studies. | 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. | 61 years old, Male, Reason: pt with HCC needs surveillance CT scans for staging History: left sacral pain CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Patient status post liver transplant with multiple surgical clips. Mild prominence of intrahepatic biliary ductal system, decreased from prior study. No definite evidence of common bile duct obstruction or radiopaque choledochal lithiasis. The common bile duct measures 15 mm, previously measuring up to 2 cm. Liver calcifications may represent granuloma.No abnormal enhancing lesion in the liver to suggest recurrent disease.SPLEEN: Spleen size is unchanged measuring 13 cm in craniocaudal dimension.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Redemonstration of cortical thinning and parenchymal loss of the left lower pole. Renal lesions are too small to characterize and unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Atrophy of the abdominal rectus muscles. There appears to be surgical clips in the anterior abdomen, unchanged from prior study.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Atrophy of the abdominal rectus muscles.OTHER: No significant abnormality noted | 1.Stable exam without evidence to suggest HCC recurrence or metastatic disease.2.Mild interval decrease in biliary duct dilatation without evidence of obstruction or choledocholithiasis. |
Generate impression based on findings. | Female 54 years old Reason: esgophagogastric cancer restaging after diagnostic ex-lap revealed occult carcinomatosis - restaging History: dysphagia s/p stent, pain CHEST:LUNGS AND PLEURA: Calcified and noncalcified micronodules, unchanged.MEDIASTINUM AND HILA: There is asymmetric thickening of the distal esophagus, and there has been interval placement of an esophageal stent, which traverses the gastroesophageal junction. Oral contrast progresses past the stent, without evidence of obstruction. The esophagus is moderately patulous. 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. CHEST WALL: Left chest wall Port-A-Cath with tip terminating in the cavoatrial junction. There is a cluster of gastrohepatic ligament nodes, which do not meet the size criteria for lymphadenopathy, but are worrisome for metastatic disease (image 68, series 401).ABDOMEN:LIVER, BILIARY TRACT: Hypoattenuating hepatic lesions are most consistent with simple hepatic cysts, which were not metabolically active on the most recent PET examination.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: Scattered subcentimeter retroperitoneal lymph nodes do not meet the criteria of a lymphadenopathy.BOWEL, MESENTERY: Postsurgical changes related to apparent lymph node biopsy with extensive postsurgical changes seen along the midline abdominal wall. New subcentimeter pericecal lymph node.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate degenerative changes of thoracolumbar spine.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Scattered pelvic lymph nodes noted in size criteria a lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval stenting of the esophageal mass. However, a cluster of stable gastrohepatic ligament nodes are still worrisome, although not pathologically enlarged by size criteria. |
Generate impression based on findings. | Malignant neoplasm of the colon with metastases to the liver evaluate for lung metastases prior to chemotherapy. LUNGS AND PLEURA: No pneumothorax or pleural fluid. Mild scarring or atelectasis at the lung bases. Sub-solid micronodule measuring right upper lobe (5/50) could reflect a small subpleural lymph node. 2-3 mm micronodule right apex, too small to characterize. Subcentimeter nodular density left lower lobe posteromedially (5/73). Thin-walled cyst right middle lobe.MEDIASTINUM AND HILA: Nonspecific 14-mm hypoattenuating nodule in the right thyroid lobe. The thyroid gland is mildly enlarged and heterogeneous suggestive of goiter. Normal heart size. No pericardial fluid. No visible lymphadenopathy in this unenhanced study.CHEST WALL: Multilevel endplate sclerosis in the mid and lower thoracic spine, most consistent with degenerative change.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Limited scanning range. Heterogeneously hypoattenuating hepatic mass. | No conclusive evidence of pulmonary metastases; pulmonary micronodules are too small to accurately characterize but based on their size and location statistically most likely benign. Nonspecific thyroid gland nodule. |
Generate impression based on findings. | 73 year old female with history of left upper sublobar resection for squamous cell carcinoma 1.5 years ago. LUNGS AND PLEURA: Stable postoperative findings of left upper lobe sublobar resection. Left lower lobe sub-solid nodule is unchanged in size (5/52), currently measuring 6 x 3 mm. Left lung base subpleural consolidation is unchanged, and likely postoperative. No pleural effusion, and no suspicious pulmonary nodules or masses. Moderate to severe upper lobe predominant emphysema.MEDIASTINUM AND HILA: Stable small mediastinal lymph nodes, with reference low left paratracheal/4L lymph node (3/39) measuring 7 mm, unchanged. No hilar lymphadenopathy. Mild coronary artery calcifications. Heart size normal, without pericardial effusion. Atherosclerosis affects the aorta and its branches.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Bilateral adrenal nodules, unchanged. | 1.Postoperative findings in the left upper lung are stable, without evidence of recurrent tumor.2.Emphysema and other findings as above, without interval change. |
Generate impression based on findings. | Follow-up of T3N0 squamous cell carcinoma of the right vocal cord treated via FHX completed on 7/15/2011. The lack of intravenous contrast administration limits sensitivity for the detection of tumor. Nevertheless, there is mild residual supraglottic edema, but no definite discrete mass lesions. There is no significant cervical lymphadenopathy. The salivary glands and thyroid appear unchanged. There is fusiform dilation of the supraclinoid internal carotid arteries, right larger than left. The osseous structures and partially imaged lungs appear unchanged. | 1. No definite evidence of locoregional tumor recurrence or significant cervical lymphadenopathy, although the assessment is limited by the lack of intravenous contrast.2. Fusiform dilation of the supraclinoid internal carotid arteries, right larger than left. Dedicated vascular imaging may be useful for further characterization, if clinically warranted. |
Generate impression based on findings. | 82-year-old female. Reason: Evaluate for evidence of aspiration History: History of stroke, coughing with food and wheezing Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Exam was somewhat limited by patient immobility. Limited single contrast evaluation of the esophagus and gastric cardia/fundus revealed a slightly patulous esophagus. Otherwise no morphologic abnormalities of the mucosal surfaces or mural contours. Fluoroscopic evaluation of esophageal peristalsis demonstrated esophageal dysmotility with proximal escape and tertiary contractions involving the distal third of the esophagus. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. During the exam, a single episode of coughing was observed, but no fluoroscopic evidence of aspiration was seen.TOTAL FLUOROSCOPY TIME: 3:06 minutes | 1. During the exam, a single episode of coughing was observed, but no fluoroscopic evidence of aspiration was seen. If there is continued concern for aspiration, recommend OPM.2. Esophageal dysmotility with proximal escape and tertiary contractions involving the distal third of the esophagus. |
Generate impression based on findings. | Female 53 years old Reason: s/p gastric lap band in 2008 History: same Scout image shows moderate amount of fecal matter. Gastric band has a phi angle of 33 degrees.Single contrast esophagram shows the lumen to the gastric band at approximately 8 millimeters. The proximal esophagus is mildly dilated. There is altered use esophageal motility with moderate proximal escape, moderate tertiary contractions in the mid to distal esophagus. Passage of the contrast bolus through the region of the gastric band was slow due to altered esophageal motility.No reflux is elicited.TOTAL FLUOROSCOPY TIME: 3:07 minutes. | Altered esophageal motility with moderate amount of proximal escape and moderate amount of tertiary contractions.The gastric band is in appropriate position. |
Generate impression based on findings. | Shortness of breath and pleuritic chest pain on left. PULMONARY ARTERIES: Excellent infusion quality. No evidence of acute pulmonary embolus. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Small linear area of subsegmental atelectasis or scarring in the posterior aspect of the right upper lobe near the level of the aortic arch (series 8 image 61).No pleural fluid or pneumothorax.MEDIASTINUM AND HILA: Normal heart size. Physiologic volume of pericardial fluid. Anterior wall the right ventricle appears to be hypoattenuating. There is calcification seen at the origin of the right coronary artery, poorly assessed on this non-gated study.Atherosclerotic calcification of the great vessels. No lymphadenopathy.CHEST WALL: Solid nodule in the right thyroid lobe approximately 1 0.8-cm in size, nonspecific by CT.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Localized nodule-like thickening of the posteromedial gastric wall near the fundus measuring 13-mm of unclear etiology and incompletely characterized due to under distention and lack of oral contrast. | 1. No evidence of acute pulmonary embolus.2. Calcification at the origin of the right coronary artery with hypoattenuation involving the anterior wall of the right ventricle, of unclear chronicity but may indicate infarction or ischemia. Clinical service in the ED notified.3. Incompletely assessed solid nodule in the right thyroid lobe and a nodular area of thickening in the proximal stomach, of indeterminate etiology or clinical significance.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 1 year old female with respiratory distress, hypoxia, increased ventilator settings. Status post NJ placement.VIEW: Chest and abdomen AP (two views) 1/9/2015, 1322 hrs. ET tube tip between the thoracic inlet and carina. Right IJ catheter tip and left upper extremity PICC tip at the cavoatrial junction. Enteric tube is coiled in the stomach with tip in the gastric fundus. Gastrostomy tube additionally noted.Patchy bilateral air space opacities mildly increased on the right. Persistent small right pleural effusion. Stable mild enlargement of the cardiac silhouette.Nonspecific disorganized dilated bowel loops, not significantly changed from the prior exam. No evidence of pneumatosis, portal venous gas, or intraperitoneal free air. | 1.Enteric tube coiled in the stomach, with tip in the gastric fundus.2.Increasing right pulmonary opacities. |
Generate impression based on findings. | Micrognathia. Pierre Robin sequence. There is micrognathia with approximately 10 mm of overjet and 8 mm of underbite as well as glossoptosis with narrowing of the oropharyngeal airway. A nasoenteric tube is present. The imaged paranasal sinuses and mastoid air cells are clear. The internal auditory canals are borderline narrow bilaterally. The imaged intracranial structures are grossly unremarkable. There is a large right Wormian bone. The skull and scalp soft tissues are otherwise unremarkable. | 1. Stigmata of Pierre Robin sequence with micrognathia with approximately 10 mm of overjet and 8 mm of underbite as well as glossoptosis with narrowing of the oropharyngeal airway. 2. The internal auditory canals are borderline narrow bilaterally. A temporal bone MRI may be useful for further evaluation, if clinically warranted. |
Generate impression based on findings. | Male 65 years old; Reason: post op vad, abdominal distension, ileus History: post op vad, abdominal distension, ileus LVAD device projected over the chest and upper abdomen. Multiple lines and tubes project over the chest. Status post median sternotomy.Hyperdense appearance of both kidneys likely due to retention of intravenous contrast suggesting renal dysfunction.Enteric tube terminates in the region of the first portion of the duodenum.There is a moderate amount of colonic fecal matter. The bowel gas pattern is nonobstructive. | 1.Enteric tube terminates in the region of the first portion of the duodenum |
Generate impression based on findings. | 64 year old female with history of non-small lung cancer status post radiation therapy. CHEST:LUNGS AND PLEURA: Severe centrilobular emphysema. Left lower lobe post radiation changes appear stable (5/47). Left upper lobe scarring is also unchanged (5/26). Focal nodular thickening in the right upper lobe (5/27) measures 3 mm, previously 4 mm. No pleural effusion, or new suspicious nodule/masses.MEDIASTINUM AND HILA: Heart size within normal limits, no pericardial effusion. No mediastinal lymphadenopathy, and small left hilar lymph nodes are stable in size. Ascending aorta measures approximately 3.5 cm in diameter, similar to prior. Moderate hiatal hernia. Mild coronary calcifications.CHEST WALL: Minimal degenerative changes affect the spine, including lumbar and cervical fixation hardware partially visualized on this exam.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis. Small hepatic cyst, unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Colonic diverticulosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable post therapeutic changes, without evidence of recurrent tumor. |
Generate impression based on findings. | Male, 81 years old. Reason: prostate cancer s/p prostatectomy Scout film demonstrated no abnormal calcification.300mL Cystografin was administered by gravity via the Foley catheter.The urinary bladder was suboptimally distended. No mucosal abnormality was evident. No evidence of vesicoureteral reflux or extravasation of contrast.Postsurgical changes were seen at the level of the bladder-urethral anastomosis. On void, a small amount of contrast flowed through the ureter around the catheter, without evidence of extraluminal contrast leak or specific evidence of abnormal stricture.Post void examination demonstrated no significant residual contrast within the urinary bladder. | Cystogram showing post-surgical changes without evidence of contrast leak from the urinary bladder or urethra. |
Generate impression based on findings. | ORBITS: No acute orbital bone fracture is identified. The globes are intact. There is no evidence of intraorbital hematoma or stranding. No significant soft tissue swelling is identified. The temporomandibular joints are intact. There are postoperative sinonasal findings from bilateral maxillary antrostomies and ethmoidectomies. The nasal septum is deviated to the right. There is mild to moderate bilateral maxillary sinus mucosal thickening with scattered bilateral residual ethmoid and left frontal sinus mucosal thickening. There is bilateral maxillary sinus wall thickening likely reflecting changes related to chronic sinusitis. There are bilateral infraorbital Haller cells present, which are normal variants. The visualized mastoid air cells are clear. BRAIN: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is advanced periventricular and subcortical white matter hypoattenuation which is nonspecific. 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. | 1.No acute orbital wall fracture, acute intracranial hemorrhage or skull fracture.2.Advanced periventricular and subcortical white matter hypoattenuation which is nonspecific, and may represent age indeterminate small vessel ischemia, although given the extensive degree of involvement for patient's age, differential diagnosis also includes demyelination, infectious/inflammatory etiologies, and posttreatment changes. Please correlate with underlying patient risk factors and clinical history. Further evaluation with MRI can be obtained if clinically indicated. |
Generate impression based on findings. | Ms. Hardin submitted outside mammograms dated 5/16/2000 and 03/26/2009, from Northwestern Memorial Hospital. Submitted outside studies were compared to the current mammogram dated 12/17/2014. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is no significant change between these two studies. | 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. | Female 43 years old Reason: Assess for malignancy, other abdominal pathology History: Lower abdominal pain, weight loss Within the limits of a non IV contrast enhanced examination which limits ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: The patient is status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypoattenuating lesion in left kidney lesion consistent with a simple renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Previously seen loculated phlegmon in the right anterior abdominal wall no longer evident.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of malignancy as clinically questioned. No specific finding seen to account for patient's abdominal pain and weight loss. However, examination suboptimal for the detection of malignancy without intravenous contrast. |
Generate impression based on findings. | 76 years old female with metastatic breast cancer to bone and adrenal. Followup scan, on therapy. Restaging and evaluating response to therapy. RADIOPHARMACEUTICAL: 13.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 96 mg/dL. Today's CT portion grossly demonstrates stable small nodular densities in the right middle lobe and left lingula. Left mastectomy with axillary lymph node dissection. Vague multiple hypodense lesions in the liver are noted. The numerous predominantly lytic metastasis throughout the skeleton are again noted.Today's PET examination again demonstrates innumerable mild to moderately hypermetabolic osseous metastases in the sternum; T-, L- and S-spine; scapulae; left humerus; ribs; and pelvis. These bony lesions are stable to minimally increased in metabolic activity. SUVmax of T4 vertebral body lesion slightly increased from 3.9 to 4.6 And SUVmax of right iliac wing lesion is stable( from 2.6 to 2.7). No new hypermetabolic lesions are identified. The metabolic activity of several mild hypermetabolic right middle lobe and lingular nodular densities are slightly decreased. The SUVmax in the right middle lobe nodular densities is 1.63 (it was 2.01 on the prior study). These lesions may represent resolving inflammation or decreasing tumor.There is no evidence of metastatic tumor in the adrenal glands.Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Stable osseous metastasis as described above.2.Resolving nodular densities in the right middle lobe and left lingular lobe, which may represent inflammatory change or decreasing tumor. |
Generate impression based on findings. | 77-year-old male with restaging for widely metastatic prostate cancer and renal cell carcinoma. Numerous foci of tracer uptake at the skull, spine, bilateral ribs, pelvis, bilateral proximal humeri, clavicle, scapula and proximal femurs are relatively stable, consistent with diffuse metastatic disease. There is increased intensity of tracer uptake in the thoracic and lumbar spine most notably the T9 and L1 level. There is no apparent new bone lesion. | Stable diffuse metastatic bone disease. |
Generate impression based on findings. | 72 years old, Female, Reason: restaging CT after maintenance chemotherapy (known peritoneal metastasis found intraoperatively) History: none CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged. Appearance of the right lower lobe subsegmental atelectasis unchanged.MEDIASTINUM AND HILA: Tracheobronchial calcifications likely related to age. Indeterminate right thyroid nodule.CHEST WALL: Right chest wall port with tip in the SVC.ABDOMEN:LIVER, BILIARY TRACT: Evidence of prior cholecystectomy. No focal liver lesions noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 7-mm nodule adjacent to the left kidney is unchanged in size (series 3, image 97). There is mild hydronephrosis and proximal dilatation of the ureter which is presumably secondary to narrowing or obstruction by peritoneal implant or scarring.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Patient is status post partial gastrectomy. Persistent peritoneal nodularity consistent with carcinomatosis with minimal free fluid. No evidence of obstruction.BONES, SOFT TISSUES: Small bone islands are present in the appendicular skeleton.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: Persistent peritoneal nodularity consistent with carcinomatosis with minimal free fluid. No evidence of obstruction, pneumatosis or free air.BONES, SOFT TISSUES: Degenerative disease of the spine.OTHER: No significant abnormality noted. | 1.Persistent evidence of peritoneal carcinomatosis with a small amount of free fluid.2. New right hydronephrosis and hydroureter proximal dilatation of the ureter which is presumably secondary to narrowing by peritoneal implant or scarring.Discussed findings with Dr. Catenacci at time of dictation. |
Generate impression based on findings. | 4-year-old female with remote history of anoxic encephalopathy, admitted for severe failure to thrive. Patient has disorganized feeding, poor PO intake.EXAMINATION: Oropharyngeal motility study 1/9/2015, 1015 hrs. Julie Ecclestone, speech and language therapist, supervised the examination.65 seconds of fluoroscopy was used.Thin liquids and nectar liquid were each administered via slow flow and fast flow nipples. Table puree consistency was also administered.Oral deficits included immature oral skills, poor latch and expression of all consistencies and flow rates. Decreased anteroposterior propulsion of bolus.Pharyngeal deficits included trace penetration with thin fluids via fast flow nipple without cough, delayed swallow onset, premature spillage into hypopharynx. No aspiration seen, though exam was limited by reduced ability to take PO. There was decreased pharyngeal constriction and multiple swallows were required to clear each bolus. Nasopharyngeal reflux was observed. | Oral and pharyngeal deficits, as above.Please see the speech and language therapist's report for feeding recommendations. |
Generate impression based on findings. | History of esophageal cancer status post resection assess for recurrence or metastatic disease. CHEST:LUNGS AND PLEURA: Granuloma in the left lower lobe unchanged. Very mild subpleural reticulation is in the lung periphery, not significantly changed. No evidence of honeycombing. No suspicious nodules or masses.MEDIASTINUM AND HILA: Debris level in the esophagus extends to just above the level of the great vessels. Anastomoses are unremarkable in appearance. Neoesophagus filled with large volume of fluid and debris.Normal heart size. No lymphadenopathy. Mild atherosclerotic calcification of the coronary arteries.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral cystsPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Dissection clips. Atherosclerotic calcifications of the aorta and its branches. Circumaortic left renal vein, normal variant anatomy.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Postsurgical changes.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Male; 76 years old. Reason: lumbar disc bulge History: lumbar disc bulge Three standing views of the lumbar spine demonstrate interval postsurgical changes from posterior spinal fusion with rods and screws, as well as intravertebral spacer device, at L5-S1. Hardware appears intact without evidence of loosening.Moderate degenerative disk disease at L1-2 and L2-3 with small osteophytes projecting at the anterior aspects of the vertebral bodies. Mild chronic compression deformities of the T11 through L1 vertebral bodies, similar to prior study. There is grade 1 anterolisthesis of L5 and slight retrolisthesis of L2, similar to prior study. | Postsurgical and degenerative arthritic changes as described above. |
Generate impression based on findings. | 7-month-old male with DORV with PS s/p central shunt. History of respiratory infections.VIEWS: Chest AP/lateral (two views) 1/9/2015, 1221 hrs. Improved retrocardiac atelectasis.No focal pulmonary opacity or pneumothorax.Engorged central vasculature and pulmonary edema suggestive of left to right shunt.Minimal blunting of the costophrenic angles again seen bilaterally may represent trace effusions.Cardiac silhouette size remains enlarged. | No evidence of pneumonia. |
Generate impression based on findings. | Ms. Franklin submitted outside mammograms dated 1/6/2012 and 11/29/2012, from Stroger Hospital. Personal history of right lumpectomy for cancer in 1999 followed by chemoradiation therapy. Family history of breast cancer in maternal aunt. Submitted outside studies were compared to the current mammogram dated 11/26/2014. The breast parenchyma is composed of scattered fibroglandular density. There are postsurgical changes including architectural distortion, increased density, and skin retraction present within the right lumpectomy site. There is no significant change when compared to the current exam.Focal asymmetries in the left central and lateral breast are also unchanged when compared to the current exam. No new suspicious microcalcifications or areas of architectural distortion in either breast. There is no significant change between these two studies. | Stable postsurgical changes in the right breast. 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. | DVT. History of pulmonary nodules, follow up. LUNGS AND PLEURA: Right lower lobe nodule in the costophrenic angle continues to decrease in size, now 9-mm (6/251).Additional nodular densities in the periphery of the right lower lobe are not significantly changed.Subpleural scarlike opacity in the lingula (6158) is unchanged compared to the most recent previous study. However, it has a slightly more cranial level within the lingula there is a new peripheral lesion, similar in appearance, measuring approximately 10 mm.MEDIASTINUM AND HILA: Focal calcification in noted in the left anterior descending coronary artery (4/53).Upper normal heart size. No lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. IVC filter. | 1. Continued decrease in size of the right lower lobe nodule, favoring a post infectious or postinflammatory lesion.2. New peripheral scarlike lesion in the lingula, similar in appearance to abnormalities elsewhere in the lingula and right lower lobe which have not significantly changed from the prior study. This may represent sequela of prior PE/vasculitis or organizing pneumonia.3. Unless the etiology of these regions has been determined, continued conservative CT monitoring is suggested in the next 6 to 9 months. |
Generate impression based on findings. | Female; 40 years old. Reason: eval for fx History: fall, multiple myeloma Five views of the lumbar spine demonstrate normal vertebral body height and alignment. No evidence of acute fracture or malalignment. Minimal degenerative disk disease L5-S1. Mild facet joint arthritic changes in the lower lumbar spine.Single AP view of the pelvis demonstrates mild osteoarthritis of both hips. Scattered, small lucencies in both of the partially visualized proximal femurs with mild cortical endosteal scalloping, suspicious for myelomatous lesions given the provided clinical history of multiple myeloma. There is also slightly mottled appearance of both ischii, which may be due to myelomatous lesions. No acute fracture or malalignment is evident. | 1. Small lucencies in both partially visualized proximal femurs suspicious for multiple myeloma.2. No acute fracture or malalignment of the pelvis and hips. |
Generate impression based on findings. | 50 year old female. Reason: 50 yr old female with dysphagia, gerd Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Double contrast evaluation of the esophagus and gastric cardia/fundus revealed no morphologic abnormalities of the mucosal surfaces or mural contours. Fluoroscopic evaluation of the oropharynx and proximal esophagus showed no evidence of aspiration. Fluoroscopic evaluation of esophageal peristalsis demonstrated moderate esophageal dysmotility with breakup of the primary peristaltic wave and tertiary contractions predominantly involving the distal esophagus. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. A swallowed barium tablet rapidly passed to the stomachTOTAL FLUOROSCOPY TIME: 4:15 minutes | 1. Moderate esophageal dysmotility with breakup of the primary peristaltic wave and tertiary contractions predominantly involving the distal esophagus. 2. No gastroesophageal reflux was observed during the exam. |
Generate impression based on findings. | Ms. Allen submitted outside mammogram dated 12/08/2011, from Cook County Hospital. Submitted outside study was compared to the current mammogram dated 12/01/2014. The breast parenchyma is composed of scattered fibroglandular density. The previously identified circumscribed mass in the right upper outer breast, 11:00 position, and the focal asymmetry in the right upper inner breast, 2:00 position, are unchanged from the prior exam. Though no ultrasound images are submitted, the US measurements on the included paperwork are in fact slightly larger than the current measurements. Based on the 3 year lack of growth, the finding is considered benign (though it would still be best to confirm this with correlation with biopsy pathology). In addition, the focal asymmetry in the left upper outer breast, 2:00 position, is also unchanged from the prior exam. No suspicious microcalcifications or areas of architectural distortion are seen in either breast. There is no significant change between these two studies. | Stable benign masses bilaterally. 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. | 72-year-old female with elevated calcium and hyperparathyroidism. Evaluate for parathyroid adenoma. On early images, there is a small focus of increased radiotracer activity immediately inferior to the lower pole of the left thyroid which exhibits delayed washout. These findings are suspicious for parathyroid adenoma. There is physiologic distribution of the radiopharmaceutical with normal early physiologic uptake within the thyroid gland and slightly atypical mild retention of uptake. The right thyroid lobe appears to measure 4.0 cm and the left lobe 3.8 cm in length.Today's CT portion grossly demonstrates nonspecific asymmetric soft tissue thickening within the right hypopharynx region. | 1. Findings highly suspicious for parathyroid adenoma inferior to lower pole of the left thyroid.2. Nonspecific asymmetric soft tissue thickening within the right hypopharynx region. Clinical correlation is suggested. |
Generate impression based on findings. | Male; 57 years old. Reason: pain History: same Four views of the right humerus demonstrates tiny glenohumeral joint osteophytes, indicating minimal osteoarthritis. Mild spurring of the greater tuberosity is also seen. The acromioclavicular joint is within normal limits. No acute fracture or malalignment is evident. | Degenerative arthritic changes as described above. |
Generate impression based on findings. | 35-year-old female. Reason: Mild gastroparesis. Evaluate for possible small bowel inflammation History: abdominal pain, nausea Scout radiograph showed a nonobstructive bowel gas pattern.Double contrast visualization of the esophagus showed no morphologic abnormalities of the mucosal surfaces or mural contours. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. The stomach was normal in size, shape, and position. Spontaneous emptying of contrast into the duodenal sweep was observed. The gastric mucosal surface was normal.Transit time to the colon was 15 minutes. 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 terminal ileum and ileocecal valve were normal in appearance. No internal hernias or ventral hernias were evident. The ascending colon was grossly normal. TOTAL FLUOROSCOPY TIME: 4:47 minutes | Normal fluoroscopic examination of the esophagus, stomach, small bowel, and proximal colon. |
Generate impression based on findings. | 43-year-old female who is recalled from screening for right upper breast asymmetry seen only on MLO view. Right breast MLO, ML, and spot compression views 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 identified asymmetry in the right breast at upper aspect on the MLO view is not present on today's examination and was likely overlapping breast parenchyma. Numerous bilateral parenchymal calcifications and vascular calcifications are again noted.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, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 68-year-old male with history of lung cancer status post chemo radiation and surgery. CHEST:LUNGS AND PLEURA: Moderate upper lobe predominant emphysema.Right upper lobe posttherapeutic changes and volume loss, similar to prior. Right upper lobe masslike region in the medial aspect of the apex (coronal image number 39 and 40) measures 31 mm in its thickest diameter, previously 35 mm. This may represent a combination of fibrosis and atelectasis, although nonspecific.Right upper paramediastinal nodularity (3/35) with adjacent atelectasis is unchanged in size, measuring 16 mm.Reference right lower lobe nonspecific subpleural nodule (5/62) measures 4 mm, previously 5 mm.MEDIASTINUM AND HILA: Low right paraesophageal reference lymph node (3 slice 61) measures 7 mm, previously 9 mm. Additional non-reference mediastinal lymph nodes are similar or decreased in size. Severe coronary artery calcifications. Heart size within normal limits, and there is no pericardial effusion.CHEST WALL: Postoperative findings in the left axilla, and degenerative findings of the lower spine, similar to prior.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hypoattenuating liver foci, unchanged and most likely cysts.SPLEEN: Previously noted hypoattenuating focus projecting from the surface of the spleen is no longer visualized.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts, unchanged. Unchanged stranding.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disease of the lower spine.OTHER: No significant abnormality noted. | 1.Right upper lung posttherapeutic changes and right apical masslike opacity are not significant changed.2.Mediastinal lymph nodes are slightly smaller than prior.3.No new evidence of metastatic disease. |
Generate impression based on findings. | 49-year-old female with palpable left breast lump for approximately 3 years at the 8 o'clock position who presents for evaluation. BILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present in either breast. LEFT BREAST ULTRASOUND: On physical examination, the patient has a prominent palpable rib near the 8 o'clock position of the left breast. Targeted left breast ultrasound between the 6 o'clock and 9 o'clock position demonstrates no suspicious solid or cystic mass. Patient's palpable region of concern is most consistent with underlying ribs. | Patient's palpable region of concern is most consistent with underlying ribs. No mammographic or sonographic 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; 29 years old. Reason: left knee pain History: left knee pain Four views of the left knee including weight-bearing views demonstrate a notched appearance of the lateral femoral condyle on the lateral view, suspicious for hyperextension and impaction injury in this location and which can be associated with ACL injury. Probable small knee joint effusion. | Notched appearance of the lateral femoral condyle, suspicious for an impaction injury and possible ACL injury. |
Generate impression based on findings. | pT4aN1 left buccal mucosa squamous cell carcinoma status post treatment. There are interval post-treatment findings, including left mandibulectomy, flap reconstruction, neck dissection, tracheostomy, and radiation therapy effects. There is no definite evidence of residual tumor or significant lymphadenopathy in the neck. There is mild diffuse dilatation of the left parotid ducts, which may be due to surrounding regional edema. The thyroid gland appears unremarkable. There is a right internal jugular venous catheter. The major cervical vessels are patent. The airways inferior to the tracheostomy tube are patent. The imaged intracranial structures and orbits are unremarkable. There is opacification of the bilateral mastoid air cells. There is a retention cyst in the left sphenoid sinus. The imaged portions of the lungs are clear. There are partially-imaged postoperative findings in the left anterior chest. | Interval post-treatment findings without definite evidence of residual tumor or significant lymphadenopathy in the neck. |
Generate impression based on findings. | Heart transplant rule-out pneumonia, evaluate right pleural effusion. Motion artifact degrades image quality.LUNGS AND PLEURA: A right chest tube terminates at the lung apex, no pneumothorax or pleural fluid.New consolidation in the right lower lobe.Moderate left pleural effusion with associated compressive atelectasis has increased in volume since the previous examination.MEDIASTINUM AND HILA: Duplication of the SVC and aberrant right subclavian artery are normal anatomic variants. The native ascending aorta and proximal arch appear mildly ectatic, the descending thoracic aorta is of normal caliber but has extensive atherosclerotic calcification. Graft at the aortic root in expected position; the juncture between the native and donor ascending aorta is slightly kinked but is unchanged in position compared to last study and within the expected appearance. No new fluid collections.Mild cardiomegaly, similar to the prior examination. Small volume of high density pericardial fluid consistent post operative blood products. Pericardial pacing wires in place. CHEST WALL: Sternotomy closure is intact and fracture fragments are well approximated. Right anterior chest wall pre-pectoral fluid collection slightly smaller, measuring 2 x 3.2 x 7.2 cm in greatest dimensions, previously 2 x 3.9 x 8 cm. The location and proximity to orphaned AICD wires suggests that this is a pacemaker pocket. Small axillary lymph nodes on the right are slightly larger and less well defined compared to previous examination, measuring up to 11 mm short axis. Interval increase in soft tissue stranding in the right chest wall.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Limited scanning range. Trace air within the fascial planes of the upper abdomen presumably postoperative. Epicardial wires enter through the ventral body wall. New area of hypoattenuation along the anterior aspect of the spleen incompletely included with the scanning range but most likely the result of volume averaging with the diaphragm due to motion. The possibility of a small infarct cannot be entirely excluded.Perihepatic fluid collection has increased in volume in the interim. Small volume of perisplenic fluid. | 1. No right pleural effusion, but there is a new area of right lower lobe consolidation which may represent pneumonia.2. Left pleural fluid collection and intra-abdominal fluid have increased in volume.3. Slight decrease in size of right prepectoral loculated fluid collection. Development of adjacent soft tissue stranding and of mild axillary lymphadenopathy raises suspicion for infection. 4. The appearance of the anterior splenic hypoattenuation may be caused by volume averaging with the diaphragm due to motion; the possibility of an infarct cannot be entirely excluded however. |
Generate impression based on findings. | Ms. Allen submitted outside mammogram dated 12/08/2011, from Cook County Hospital. Submitted outside study was compared to the current mammogram dated 12/01/2014. The breast parenchyma is composed of scattered fibroglandular density. The previously identified circumscribed mass in the right upper outer breast, 11:00 position, and the focal asymmetry in the right upper inner breast, 2:00 position, are unchanged from the prior exam. Though no ultrasound images are submitted, the US measurements on the included paperwork are in fact slightly larger than the current measurements. Based on the 3 year lack of growth, the finding is considered benign (though it would still be best to confirm this with correlation with biopsy pathology). In addition, the focal asymmetry in the left upper outer breast, 2:00 position, is also unchanged from the prior exam. No suspicious microcalcifications or areas of architectural distortion are seen in either breast. There is no significant change between these two studies. | Stable benign masses bilaterally. 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. | 62 years old, Female, Reason: Assess vasculature prior to kidney transplant History: Serial monitoring of known aortoiliac calcifications ABDOMEN:LUNG BASES: Reticular nodularity of the left lung base may represent a focus of atelectasis. Coronary artery calcifications are present.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Multiple calcifications in the tail of the pancreas unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The kidneys appear atrophic bilaterally. Multiple hypodensities in the kidneys bilaterally which are favored to represent cysts. Some of these cysts may be complex however the internal complexity is not evaluated without contrast.RETROPERITONEUM, LYMPH NODES: Severe calcified atherosclerotic disease of the abdominal aorta with circumferential dense calcific plaque throughout the abdominal aorta extending to the common iliac vessels. The common iliac vessels bilaterally greater than 180 degrees of dense calcification. The internal iliac arteries bilaterally have scattered chunky calcifications. The left external iliac artery has punctate scattered calcifications in the posterior portion along its course and dense calcifications of the level of the inguinal canal. The right external iliac artery has minimal calcifications along its course until the level of approximately the inguinal canal where it has dense calcifications.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomy. Cyst in the right adnexa unchanged.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: See abdomen section for description of vessels. | 1.Severe dense calcific atherosclerotic disease of the aorta and its branches as detailed above not significantly change from prior study.2.Bilateral renal hypodensities are unchanged. Some of these may represent complex cysts although their complexity is not fully evaluated without IV contrast. |
Generate impression based on findings. | 72-year-old female with left upper lobe lung nodule. Previous history of carcinosarcoma of the uterus.RADIOPHARMACEUTICAL: 12.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 91 mg/dL. Today's CT portion of the neck grossly demonstrates no significant abnormality. Today's CT portion of the pelvis grossly demonstrates post-surgical changes consistent with prior hysterectomy. There are surgical clips noted in the bilateral pelvis. No soft tissue mass is noted. Ileal conduit is visualized. Today's PET examination demonstrates a moderately hypermetabolic focus in the left upper lobe of the lung corresponding with spiculated nodule seen on CT. The maximal SUV of the nodule is 6.9. There is increased activity surrounding the ileal conduit consistent with benign post-surgical changes. No other suspicious FDG-avid lesion is seen in the chest, abdomen, or pelvis. Physiologic uptake is seen in the liver, spleen, kidneys, bowel, and bladder. | 1.Moderately hypermetabolic focus in the left upper lobe consistent with patient's known history of lung cancer. 2.No other suspicious FDG-avid lesion in the chest, abdomen, or pelvis.Diagnostic CTs of the chest and abdomen also performed at today's visit will be reported separately. |
Generate impression based on findings. | Reason: recurrent infarction? History: transient facial droop and spinning dizziness The CSF spaces are appropriate for the patient's stated age with no midline shift. Is a 20 x 34 mm axial dimension a hypodense focus present in the interest of the left insular cortex and adjacent left frontal lobe which was also present on 10/11/14 exam and has regressed and is associated with less mass effect. Involves gray and white matterThe visualized portions of the paranasal sinuses demonstrates scattered opacities in right sinus and left anterior 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.Are compatible with a focus of infarction now in a more chronic stage involving insular cortex and frontal lobe as indicated above. |
Generate impression based on findings. | 29-year-old female with left lower extremity swellingRADIOPHARMACEUTICAL: A total of 0.49 mCi Tc-99m filtered sulfur colloid was divided into two injections over the dorsum of the left foot. A total of 0.50 mCi of Tc-99m filtered sulfur colloid was divided into two injections over the dorsum of the right foot. Asymmetrically decreased radiotracer activity is seen in the left inguinal region at one hour suggestive of decreased transit in the left lower extremity. | Slight delay in transit of radiotracer in the left lower extremity relative to the right. |
Generate impression based on findings. | Male; 27 years old. Reason: r/o fx, disloc History: hip pain after bumping countertop 16 x 8 mm calcific density projecting just lateral to the femoral head with sharp and somewhat indistinct borders, suspicious for small avulsion fracture fragment with the donor site potentially being the anterior-inferior iliac spine. Otherwise, no additional acute fracture or malalignment is evident. | Findings suspicious for avulsion fracture from the anterior inferior iliac spine. |
Generate impression based on findings. | Female 26 years old; Reason: r/o renal injury History: left flank pain s/p fall directly to flank ABDOMEN:LUNG BASES: No significant abnormality noted. No rib fractures.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted. No laceration.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted. No laceration.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. No free fluid.BONES, SOFT TISSUES: No significant abnormality noted. No fractures.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted. No fractures. Parts of the patient's subcutaneous fat are outside of the field of view.OTHER: No significant abnormality noted. | 1.No acute abdominal or pelvic pathology. |
Generate impression based on findings. | Reason: acute onset of neurologic deficit r/o stroke History: acute onset of neurologic deficit r/o stroke The CSF spaces are appropriate for the patient's stated age with no midline shift. Small hypodense foci are present along the right frontal lobe involving gray and white matter. One is located along the postcentral gyrus measures 10 mm in diameter and another one right precentral gyrus and middle frontal gyrus measures 11 x 25 mm. There is no evidence for acute intracranial hemorrhage appreciated.Incidental note is made of partial empty sella.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Small lesions are present in the right frontal lobe and parietal lobe which are suspicious for subacute infarction though could represent alternative entity such as infection or neoplasm. If clinically appropriate MRI may be helpful.2.No evidence for acute intracranial hemorrhage. |
Generate impression based on findings. | 37-year-old male with history of UPJ obstruction status post pyeloplasty The posterior abdominal radionuclide angiogram demonstrates prompt, symmetrical perfusion of the kidneys. Sequential renal images show the right kidney to be of normal size and morphology while the left kidney is enlarged and dilated. There is prompt uptake and excretion of the radiopharmaceutical by both kidneys. The estimated contribution of the right kidney to total renal function is 47% and that of the left kidney is 53%. The T1/2 washout from the dilated left collecting system was 12 minutes. There are no abnormalities of the ureters or bladder.Following administration of the diuretic, there was prompt washout of collecting system radiotracer into the bladder without evidence of current obstruction. | Dilated left kidney without evidence for obstruction. |
Generate impression based on findings. | 1 year old female with suspected magnet ingestion.EXAMINATION: Chest and abdomen AP (two views), 1/9/2015, 1314 hrs. No radiopaque foreign body is identified.Aortic arch, cardiac apex, and stomach are left-sided. No focal pulmonary opacity, pleural effusion, or pneumothorax.Nonobstructive bowel gas pattern. No pneumatosis, portal venous gas, or intraperitoneal free air. Average stool burden. | No radiopaque foreign body. |
Generate impression based on findings. | 73-year-old female with back pain, hip pain, and knee pain. Three standing views of the lumbar spine demonstrate moderate degenerative disk disease L3-4, L4-5, and L5-S1. Moderate facet joint arthritic changes of the lower lumbar spine. Vertebral body heights are preserved. There is grade 1 anterolisthesis of L4, likely secondary to degenerative arthritic changes at this level. Otherwise, alignment is within normal limits. Mild to moderate bilateral SI joint osteoarthritis. Multiple air-fluid levels are seen in the incompletely imaged abdomen, which may be due to ileus or obstruction.Two views of the right hip demonstrate moderate osteoarthritis. No acute fracture or malalignment is evident.Three views of the right knee demonstrate components of a total knee arthroplasty situated in anatomic alignment without evidence of hardware complication.Three views of the left knee demonstrate components of a total knee arthroplasty situated in anatomic alignment. Interval removal of surgical drain. Overlying skin staples remain. There has been interval increased soft tissue swelling about the knee, particularly anteriorly, with mild scattered soft tissue emphysema. | 1. Degenerative and postsurgical changes as described above. Increased soft tissue swelling about the left knee with soft tissue emphysema, which may be postsurgical in etiology. However, clinical correlation is recommended for the possibility of infection, which is of moderate concern given the interval change.2. Multiple air-fluid levels in the incompletely imaged abdomen, which may be due to ileus or obstruction. Clinical correlation is recommended with consideration to dedicated abdominal imaging. |
Generate impression based on findings. | Female 41 years old Reason: Abdominal pain s/p liver biopsy History: Abdominal pain ABDOMEN:LUNG BASES: Diffuse bibasilar ground glass opacities present on the prior examination. There is mild right basilar bronchiectasis. Subcentimeter cardiophrenic nodes are unchanged from the prior examination.LIVER, BILIARY TRACT: There is portal venous gas seen within the left hepatic lobe and contrast present within the right hepatic lobe compatible with recent biopsy. The liver has a cirrhotic morphology. Cavernous transformation of the portal vein is again demonstrated. There is no evidence of hepatic capsular hematoma.SPLEEN: The spleen is enlarged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The left kidney is displaced inferiorly by the enlarged spleen. The left kidney is enlarged.RETROPERITONEUM, LYMPH NODES: Scattered retroperitoneal lymph nodes are nonspecific in the setting of chronic liver disease.BOWEL, MESENTERY: There is no evidence of pneumoperitoneum, intraperitoneal hemorrhage or ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: There is an intrauterine device place.BLADDER: Excreted contrast is present within the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Trace free fluid in the pelvis is likely physiologic. | 1.Postprocedural changes related to transjugular liver biopsy including portal venous gas and contrast within liver, without evidence of complication.2.Cirrhosis with associated sequelae of portal hypertension.3.Cavernous transformation of the portal vein.4.Groundglass opacities appearing similar to the prior CT examination. Please see chest CT report from the same day for full evaluation of the thorax. |
Generate impression based on findings. | There are post-treatment findings including left base of tongue and floor of mouth resection with myocutaneous flap reconstruction and denervation left hemitongue atrophy and mandibulotomy with hardware. There is increased size of ill-defined mass centered within the left parapharyngeal space adjacent to the surgical bed, as well as the left parotid gland and masticator space tumors. There is also increase in size of cervical adenopathy. For example, a left level 2B lymph node measures 12 x 16 mm, previously 10 x 13 mm and a level 6 lymph nodes measure up to 18 mm versus14 mm previously. There are multiple bilateral posterior lower neck subcutaneous and intramuscular intermuscular soft tissue nodules, which have also increased in size. For example, a nodule in the left lower neck paraspinal muscles measures 17 x 11 mm, previously 13 x 10 mm. There are multiple unchanged hypoattenuating lesions in the thyroid gland. There is a right internal jugular venous catheter. The left internal jugular vein remains occluded. The remaining major vessels in the neck are patent. There is a partially imaged large right pleural fluid that exerts mass effect upon the mediastinum. There is a subcentimeter sclerotic focus in the C5 vertebral body, which appears to be unchanged and may represent an enostosis. | 1.Overall slight interval tumor progression of extensive tumor in the neck, including along the surgical margins in the left parapharyngeal space, bilateral cervical lymph nodes, subcutaneous tissues in lower neck dermis and right parietal scalp, as well as intramuscular metastases within the neck and left lateral rectus muscle.2.Partially imaged persistent large right pleural effusion. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | ALL requiring intrathecal chemotherapy. The procedure, indications, benefits, risks/complications and alternatives were described to the patient and informed consent was obtained. The patient was placed in the prone position and the inferior back was prepped with Betadine, draped and anesthetized with 1% lidocaine subcutaneously and into the deeper soft tissues.Using fluoroscopic guidance, a 22 gauge x 3.5 inch spinal needle was localized into the thecal sac at the L2/L3 level. There was immediate return of approximately 4 mL of clear cerebrospinal fluid which was collected into 3 tubes. Subsequently the primary service injected intrathecal chemotherapy over 3 minutes. The stylet was replaced and needle was removed and hemostasis was achieved with manual compression by Dr. Brewer. The patient tolerated the procedure well with no immediate complications. Post procedure instructions were given. Fluoroscopy time: 0.2 minutes. | Successful fluoroscopically-guided lumbar puncture and intrathecal chemotherapy injection without complication. |
Generate impression based on findings. | 91 year-old female status post fall, evaluate for fracture No fracture is identified. Mild degenerative arthritic changes affect the right and left hip as well as the pubic symphysis. Moderate degenerative changes affect the lower lumbar spine. The sacrum is obscured by bowel gas. | No fracture or dislocation. |
Generate impression based on findings. | 75 year old female with history of base of tongue cancer. CHEST:LUNGS AND PLEURA: Right upper lobe pleural-based density (5/46) is unchanged in size, at 13 x 6 mm, and may represent scarring. No pleural effusion or suspicious nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size within normal limits, and there is no pericardial effusion. Moderate coronary artery calcifications. Small hiatal hernia.CHEST WALL: Minimal degenerative changes affect the spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis. No biliary dilatation.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts, unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerosis affects the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative changes affect the visualized spine, unchanged.OTHER: No significant abnormality noted. | Right upper lobe subpleural nodule is stable in size. No interval change or evidence of metastatic disease. |
Generate impression based on findings. | Two masses on the left nipple. History of benign left breast biopsy in 2002 with histology of fibroadenoma. BILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: Three standard views of both breasts and 5 left spot compression 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 stable benign lobulated mass with punctate calcifications in the left upper outer quadrant corresponds to the biopsy proven fibroadenoma. A new lobulated mass projects over the left nipple. No new masses, suspicious microcalcifications or areas of architectural distortion are present in the right breast. Benign lymph nodes project over both axillae. LEFT BREAST ULTRASOUND: On physical examination, the patient has two masses protruding from either side of the left nipple. A left breast ultrasound was performed for the area of clinical and mammographic concern. Just lateral to the left nipple, an 8 x 5 x 8 mm round hypoechoic mass is present. Just medial to the left nipple, a 7 x 4 x 9 mm oval hypoechoic mass is present. At the two o'clock position of the left breast, 4 cm from the nipple, a stable 1.9 x 0.9 x 1.7 cm circumscribed mass is present with internal calcifications, corresponding to the biopsy proven fibroadenoma. | Two circumscribed solid masses on either side of the left nipple. Surgical consultation is recommended. Stable left breast fibroadenoma. Results and recommendations were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 41-year-old male with left knee pain Left knee: Mild sharpening of the tibial spines especially within normal limits for the patient's age. Small joint effusion.Right ankle: Alignment is anatomic. No fracture or other specific findings to account for the patient's symptoms. There is mild pes planus deformity.Left ankle: Alignment is anatomic. No fracture or other specific findings to account for the patient's symptoms. | 1. Minimal arthritic changes and small left knee joint effusion..2. Mild right pes planus deformity. |
Generate impression based on findings. | 68 year old male with history of Crohn's disease, enterovesical fistula, and small bowel obstruction. Abdomen:LIVER, BILIARY TRACT: Scattered nonenhancing foci in the liver are too small to characterize. No biliary ductal dilatation. SPLEEN: No significant abnormality noted.PANCREAS: Scattered punctate cystic lesions in the pancreas. No pancreatic ductal dilatation. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral renal cysts, some of which are exophytic. No hydronephrosis. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes compatible with prior bowel resection. Short segment wall thickening and hyperenhancement involve the neo-terminal ileum (series 20, image 86). No definite evidence of fistula or abscess formation. 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: Postsurgical changes compatible with prior bowel resection. Short segment wall thickening and hyperenhancement involve the neo-terminal ileum (series 20, image 86). No definite evidence of fistula or abscess formation. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Findings compatible with acute-on-chronic inflammation in the neo-terminal ileum as described above, presumably due to active Crohn's disease at this site. |
Generate impression based on findings. | Female 35 years old Reason: pancreatic cancer with lung mets. Please measure all measurable lesions using recist criteria History: pre chemo CHEST:LUNGS AND PLEURA: Stable to slightly improved cluster of predominantly left-sided pulmonary nodules, suggestive of aspiration or infection.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. CHEST WALL: Right chest wall Port-A-Cath with tip terminating in the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesion in hepatic segment 5/6 is too small to characterize (image 133, series 3), and is unchanged from the prior examination.SPLEEN: The splenic vein is occluded.PANCREAS: Again visualized a large mass in the region of the head/body of the pancreas extending into the uncinate process. This lesion measures approximately 3.5 x 5.2 cm (image 120, series 3), previously 3.4 x 5.2 cm. There is encasement of the celiac, hepatic, splenic and superior mesenteric arteries. The portal vein is occluded, with cavernous transformation of portal vein evident. There is attenuation of the SMV near the confluence. The splenic vein is occluded, with numerous perigastric varices evident.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered subcentimeter retroperitoneal lymph nodes are not pathologically enlarged by size criteria.BOWEL, MESENTERY: Loss of the fat plane between the pancreas and antrum of the stomach suggests possible invasion. There is mild diffuse mesenteric fat induration again seen.BONES, SOFT TISSUES: Unchanged sclerotic focus in the L4 vertebral body.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: There is trace free fluid in the pelvis.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Unchanged sclerotic focus in the L4 vertebral body.OTHER: No significant abnormality noted. | 1.Pancreatic head/body mass as detailed above, with extensive vascular encasement.2.Stable to slightly improved pulmonary nodules most likely affecting aspiration/infection/pneumonitis.3.Unchanged nonspecific sclerotic focus in the L4 vertebral body. |
Generate impression based on findings. | 64-year-old female with shoulder pain Glenohumeral alignment is anatomic. No fracture is evident. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 59 years old, Female, Reason: Pt with h/o relapsed CLL History: Evaluation of disease status prior to treatment regimen CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Significant interval increase in size of innumerable mediastinal lymph nodes. Significant interval increase in size of hilar lymphadenopathy. Reference right paratracheal lymph node measures 1.7 x 2.3 cm (series 401, image 21). Cardiophrenic lymph nodes also appear enlarged. There is supraclavicular and submental lymph nodes that are enlarged.CHEST WALL: Numerous bilateral axillary enlarged lymph nodes which appear to have increased since prior exam. A reference right axillary lymph node measures 3.8 x 4.2 cm (series 401, image 30).ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. No focal lesions of the liver. Evidence of diffuse fatty infiltration of the liver. Portal veins appear patent.SPLEEN: Unchanged atrophic appearing spleen.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypodensity in the midpole the right kidney is unchanged from priors exams.RETROPERITONEUM, LYMPH NODES: Significantly enlarged retroperitoneal lymph nodes compared to prior exam dated 10/8/14. Abdominal aorta and its branches appear patent.BOWEL, MESENTERY: Very large conglomerate of lymph nodes within the mesentery, significantly increased from prior exam, measuring 19 x 9.3 cm (series 401 image 128). No evidence of obstruction. There is a small amount of free fluid likely related toBONES, 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: Hundred and numerous bilateral enlarged pelvic lymph nodes with reference to measuring 4.4 x 2.3 cm (series 401, image 167).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Marked increase in widespread lymphadenopathy including supraclavicular, mediastinal, hilar, axillary, retroperitoneal, mesenteric, and pelvic lymphadenopathy. |
Generate impression based on findings. | Lung cancer. LUNGS AND PLEURA: Postsurgical volume loss consistent with right upper lobectomy. Asymmetric vascularity in the upper lung zones with decreased appearance on the right appearing similar to previous. Moderate to severe underlying emphysema. Right lower lobe linear area of spiculation with internal bronchiectasis surrounding a fiducial marker unchanged in appearance and no new areas of soft tissue or contour abnormality are appreciated to suggest recurrence.MEDIASTINUM AND HILA: Calcified small mediastinal and hilar lymph nodes, but no suspicious lymphadenopathy. Normal heart size. No pericardial fluid. Moderate coronary artery calcifications in all vessels.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Nodule arising from the caudal aspect of the left adrenal gland, mass in left hepatic lobe, nonspecific focal fat stranding in the region of the gastrohepatic ligament; please refer to separately reported abdominal CT. | 1. Stable appearance of the right lower lobe with no signs of localized recurrence.2. No lymphadenopathy. |
Generate impression based on findings. | Complex regional pain syndrome on her left side and subsequent hearing loss. Right: The external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The inner ear structures are unremarkable. The facial nerve describes a normal course. The jugular bulb and carotid canal are intact. Left: The external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The inner ear structures are unremarkable. The facial nerve describes a normal course. The jugular bulb and carotid canal are intact. Miscellaneous: There is mild mucosal thickening within the right sphenoid sinus. | Unremarkable temporal bones. |
Generate impression based on findings. | 49-year-old male, closed car on right elbow 4 months ago, with continued pain Alignment is anatomic. No fracture is identified. There is no significant joint effusion. | No fracture or dislocation. |
Generate impression based on findings. | Short-term follow-up for high probability benign calcifications in the right upper outer quadrant. History of breast cancer in two paternal cousins. 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. Loosely grouped calcifications in the superior lateral and superior medial right breast are stable.No new masses, suspicious microcalcifications or areas of architectural distortion are present in either breast. Benign lymph nodes are projected over both axillae. | Stable right breast calcifications. 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. | 52 year old female with breast cancerRADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 0.49 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. A focus of increased activity is noted in the left axilla, representing the sentinel nodes. This region was marked with an indelible marker. | Sentinel node identified in the left axilla. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views (total of 8 images) and tomosynthesis (in MLO projections) of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. 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: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: dyspnea, eval for LVRS, valve placement, enrollment in the study History: dyspnea LUNGS AND PLEURA: Severe paraseptal and centrilobular emphysema, with a marked upper lobe predominance.Nodular regions of pleural thickening, calcified on the left, of little clinical significance.Mild right base linear scarring.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.At least moderate coronary calcifications are present, the heart and pericardium otherwise unremarkable.Mild to moderate aortic calcifications are present.CHEST WALL: Mild degenerative abnormalities thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Mild nodularity left adrenal gland, likely benign in the absence of known cancer. Hepatic cyst image 98 series 3, likely benign.Vascular calcifications are present in the upper abdomen. | Severe centrilobular and paraseptal emphysema with a marked upper lobe predominance. |
Generate impression based on findings. | Recall from screening for asymmetry in the left lower outer quadrant. 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. Additional imaging confirms a 1.5 cm circumscribed oval mass near the 3 o'clock position of the left breast, mid depth.No suspicious microcalcifications or areas of architectural distortion are present. 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. At the 3 o'clock position of the left breast, 4 cm from the nipple, a 9 x 6 x 10 mm cluster of cysts is present. No suspicious solid lesions are present. | Cluster of the left breast cysts. 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. 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 cousin. 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 two maternal great aunts. 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. Scattered benign calcifications are seen in both breasts. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 59-year-old female with CLL currently on clinical trialRADIOPHARMACEUTICAL: 10.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 142 mg/dL. Today's PET examination demonstrates diffuse, extensive lymphadenopathy in bilateral neck, supraclavicular, axillary, and chest wall chains. There is also prominent mediastinal and hilar lymphadenopathy. There is extensive lymphadenopathy in the retroperitoneum, mesentery, and pelvis. The majority of the enlarged lymph nodes are mild to moderately hypermetabolic with SUV max 5.0. There is a lymph node in the left subpectoral space with more intense activity, SUV max 8.0, that may represent tumor activity or may be due to potential extravasation from the injection site. | 1.Moderate new hypermetabolic activity in the neck, chest, abdomen, and pelvis may be consistent with CLL but is suspicious for FDG avid lymphoma.2.Worsening of mesenteric lymphadenopathy with increase in size, number, and activity suspicious for transformation to FDG avid lymphoma.Diagnostic CTs of the neck, chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | Reason: h/o parotid cancer s/p chemorads and surg ck response History: facial droop CHEST:LUNGS AND PLEURA: Right middle lobe subpleural nodule unchanged as far back as 7/2/2013 and likely is benign.However, there is a new 15 x 9 mm left lower lobe subpleural nodule image 72/91, barely visible in hindsight on the prior study.Areas of scarring are present in both lower lung zones.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Aortic root calcifications are present, as well as very mild coronary calcifications; the heart and pericardium are otherwise unremarkable.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted, except for the gallbladder is not identified even though there are no surgical clips. SPLEEN: Small stable splenic cyst.ADRENAL GLANDS: 28 x 34 mm heterogeneous left adrenal nodule, grossly stable, previously 26 x 34 mm. KIDNEYS, URETERS: New severe right hydronephrosis as well as small renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Vascular calcifications are present. The right ureter remains dilated to the lower margin of the image, at the pelvic brim. Mild thrombosis is seen in the proximal left iliac artery. BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. New left lower lobe nodule suspicious for metastasis.2. New severe right hydronephrosis, with obstruction below the lower margin of the image/pelvic brim.3. Stable left adrenal nodule possibly still benign. |
Generate impression based on findings. | 70 year-old male with history of right upper lobe squamous cell carcinoma, status post chemoradiation CHEST:LUNGS AND PLEURA: Right apex and right major fissure radiation fibrosis are similar to prior. Right lung base/costophrenic angle nodule (5/37) measures 4 mm, previously 6 mm. Left lower lung linear opacities, with mild associated bronchial wall thickening, likely related to aspiration. No pleural effusion.MEDIASTINUM AND HILA: Heart size within normal limits, and no pericardial effusion. Severe coronary artery calcifications. No mediastinal or hilar lymphadenopathy. Right chest dual lumen Port-A-Cath with tip in the SVC.CHEST WALL: Old rib fractures in the right posterior lateral upper ribs. Left shoulder subcutaneous soft tissue nodule, partially visualized but grossly similar to prior. May represent a sebaceous cyst, nonspecific.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Right quadrant cholecystectomy clips.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The kidneys are atrophic, with unchanged bilateral cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Diverticulosis affects the colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Posttherapeutic findings, without interval change. No evidence of metastatic disease or malignancy recurrence.2.Left lower lung linear opacities, with mild associated bronchial wall thickening, likely related to aspiration. |
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