instruction
stringclasses 1
value | input
stringlengths 6
8.98k
| output
stringlengths 5
3.11k
|
|---|---|---|
Generate impression based on findings. | Fall. Concern for altered mental status.VIEWS: Cervical spine AP/lateral (two views) 01/11/15, 0131100127 Normal examination. Adenoid hypertrophy. | Normal examination. |
Generate impression based on findings. | 25 day old former 25 week gestational age patient with pneumothorax and chest tube placement.VIEWS: Chest AP/lateral (two views) 01/11/15, 0200 and 0202 Endotracheal tube tip is above the carina. Two right chest tubes are in place with their tips located anteriorly. Left upper extremity PICC tip is in superior vena cava. Feeding tube tip is in stomach and side-port is at GE junction.Soft tissue edema and changes from metabolic bone disease of prematurity continue.Pneumothorax is much smaller with residual subpulmonic component. Right interstitial emphysema and pneumatoceles are again seen. Right lung volume is increased and herniates anteriorly across the midline. Mediastinum is shifted to the left and left hemithorax is completely opacified. Cardiac silhouette size cannot be evaluated. | Small subpulmonic pneumothorax after chest tube placement. |
Generate impression based on findings. | Female 49 years old; Reason: 49 yo with pancreatic abnormality, weight loss, constant n/v. Needs pancreas protocol CT Scan History: abdominal pain, nausea and vomiting ABDOMEN:LUNGS BASES: Incompletely imaged patchy left lower lobe air space disease, not well seen on prior MRI and suspicious for pneumonia.LIVER, BILIARY TRACT: Multiple hepatic hypoattenuating lesions, several too small to characterize, for example, subcentimeter hepatic segment 2 and hepatic segment 8/7 hypoattenuating foci, image 27 series 9 and image 20 series 3, too small to characterize. Lobulated 2.7 x 1.6 cm lesion near hepatic dome, located in segment 8, suggestive of a hemangioma given discontinuous peripheral nodular enhancement apparent on image 21 series 11. Additional nonspecific right inferior lesion seen, image 45 series 11, may be additional hemangioma or complex cyst but nonspecific. No intrahepatic or extrahepatic biliary duct dilatation. SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic duct stent placement noted, extending into duodenum. Mild prominence of pancreatic duct, measuring up to 3 mm, to level of placement of stent. Visualized pancreatic parenchyma relatively homogeneous. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia. Relative underdistention of colon beginning at level of mid transverse colon,, may be related to normal peristalsis and makes assessment suboptimal. Relative underdistention duodenum near junction of second and third portions of duodenum. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes of spine. Deformity of lumbosacral region/pelvis, may be congenital or iatrogenic in etiology, correlation with patient's clinical history recommended. Lumbosacral ankylosis noted. | 1. Pancreatic duct stent placement noted, extending into duodenum. Mild prominence of pancreatic duct, measuring up to 3 mm, to level of placement of stent. Visualized pancreatic parenchyma relatively homogeneous. Please refer to outside MRI report for additional findings.2. Incompletely imaged patchy left lower lobe air space disease, suspicious for infectious etiology/pneumonia and correlation with patient's clinical history and laboratory values recommended.3. Hepatic lesions as described. |
Generate impression based on findings. | Emesis. Colectomy and multiple bowel resections.VIEW: Abdomen AP upright (one view) 01/11/15, 0216 Several dilated bowel loops are present with air-fluid levels. Other very small air-fluid levels are seen, a string of pearls sign, indicating dilated fluid-filled bowel with small amount of air trapped in the valvulae conniventes. No free peritoneal air is identified. Right lower quadrant stoma is present. | Bowel obstruction. |
Generate impression based on findings. | Acute bronchiolitis. Respiratory failure. History of prematurity.VIEW: Chest AP (one view) 01/11/15, 0304 Endotracheal tube tip is above carina. Feeding tube has been placed and its tip is in gastric body.Segmental atelectasis is present in right upper and lower lobes. Subsegmental atelectasis is noted in left lung. Lung volumes are large. Cardiothymic silhouette is normal. | Bronchiolitis with multiple opacities. |
Generate impression based on findings. | Liver transplant and acute kidney failure. Endotracheal tube placement.VIEW: Chest AP (one view) 01/11/15, 0534 Endotracheal tube tip is between thoracic inlet and carina. Left-sided central line has its tip at junction of superior vena cava and right atrium. Feeding tube tip is distal to mid body of stomach and not included on image. IVC stent remains in place. Postoperative changes are noted in right upper quadrant.Cardiothymic silhouette is top normal to mildly enlarged. Hazy lung opacities have decreased but persist. | Decrease in lung opacities. |
Generate impression based on findings. | 63 year old male with syncope. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage or mass effect.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | One day old 24 week gestational age patient with respiratory distress.VIEW: Chest AP (one view) 01/11/15, 0503 A large right pneumothorax has developed in the interval. Mediastinum is shifted to the left. Right lung is incompletely collapsed due to surfactant deficiency. Hazy opacities are seen on the left. Cardiac silhouette size is normal.Endotracheal tube tip is between thoracic inlet and carina. Umbilical venous line tip is in right atrium. Umbilical arterial line has its tip at T6. | Large right pneumothorax. |
Generate impression based on findings. | Endotracheal tube placement. Neutropenic sepsis. Stem cell transplant for neuroblastoma.VIEW: Chest AP (one view) 01/11/15, 0236 Endotracheal tube tip is below thoracic inlet. A feeding tube has been placed and its tip is in the gastric antrum. Right jugular line tip is in superior vena cava. Left upper extremity PICC tip is at level of tricuspid valve.Cardiothymic silhouette is normal. Airspace disease is noted in left lower lobe. Subsegmental atelectasis is seen bilaterally. | Left lower lobe airspace disease. |
Generate impression based on findings. | Intubated and head trauma.VIEW: Chest AP (one view) 01/11/15, 0542 Endotracheal tube tip is between thoracic inlet and carina. Left-sided central line tip is at junction of brachiocephalic veins. Feeding tube tip is distal to proximal gastric body and not included on image.Cardiothymic silhouette is normal. Multifocal opacities continue. Left lower lobe opacity is decreased. | Decrease in left lower lobe opacities. |
Generate impression based on findings. | One day old 24 week gestational age patient with pneumothorax and chest tube placement.VIEWS: Chest AP/lateral (two views) 01/11/15, 0610 and 0615 Endotracheal tube tip is below thoracic inlet. A right chest tube has been placed and its tip is located anteriorly. Umbilical venous line tip is in right atrium. Umbilical arterial line has its tip at T6.Large right pneumothorax persists. Mediastinum remain shifted to left. Right lung is only partially collapsed due to surfactant deficiency. Opacity in left lung has worsened. Cardiac silhouette size cannot be evaluated. | Continued large right pneumothorax. |
Generate impression based on findings. | 59-year-old female with chest pain and history of pulmonary embolism PULMONARY ARTERIES: Technically adequate examination. No evidence of pulmonary embolism. The pulmonary artery is borderline enlarged measuring 2.8 cm suggestive of pulmonary artery hypertension.LUNGS AND PLEURA: Minimal bibasilar atelectasis at the lung bases, left greater than right. Multiple 1-2 mm micronodules the left lung for example, there is a micronodule in the left upper lobe (series 80522, image 8).MEDIASTINUM AND HILA: No significant mediastinal or hilar lymphadenopathy. The heart size is normal. No pericardial effusion.CHEST WALL: No axillary, retrocrural, or cardiophrenic lymphadenopathy. The osseous structures are within normal limits.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small hiatal hernia. Otherwise the visualized intra-abdominal contents are within normal limits. | 1.No pulmonary embolism.2.Borderline enlarged pulmonary artery suggestive of pulmonary artery hypertension.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Imperforate anus. Adjustment of PICC.VIEW: Chest AP (one view) 01/11/15, 0507 Left upper extremity PICC tip is at junction of brachiocephalic veins.Cardiothymic silhouette is normal. No focal lung opacity is present. | PICC tip at junction of brachiocephalic veins. |
Generate impression based on findings. | Female 62 years old; Reason: R femur lesion. Evaluate for primary/mets CHEST:LUNGS AND PLEURA: 2 mm lingula lung nodule, image 50 series 6, nonspecific. Small bibasilar linear atelectasis versus scarring. MEDIASTINUM AND HILA: Mildly heterogeneous thyroid gland with bilateral relatively hypoattenuating nodules measuring up to 1.3 cm. Mild left axillary and subpectoral lymphadenopathy. Left axillary lymph node submitted for reference measuring 2.1 x 1 cm, image 31 series 5. Mild calcified coronary artery disease. CHEST WALL: Located in the superior/medial left breast is lobulated soft tissue mass, measuring 3.4 x 2.7 cm on image 41 series 5. Coarsely calcified soft tissue lesion measuring 1.6 x 1.5 cm located in the superior/lateral right breast, image 48 series 5. Additional right breast soft tissue foci seen, for example, more inferiorly located 1.6 x 1 cm foci, image 56 series 5.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES, OTHER: Small perihepatic ascites extending to level of gallbladder fossa and small peri-splenic ascites. Pelvic drain is present. Small air and fluid seen in right lateralmost/inferior abdominopelvic subcutaneous tissues may reflect sequela from prior injection or other intervention and correlation with patient's history recommended. Extensive beam hardening artifact from right hip postsurgical hardware, making evaluation of pelvic structures suboptimal. Subcentimeter sclerotic focus in right third rib, near costochondral junction, image 35 series 5, indeterminate. Mild deformity of ribs, for example, with associated small adjacent callus formation involving posterior right ninth rib, image 66 series 5. Mild asymmetric sclerosis involving left first rib, images 12 to 19 series 5. Heterogeneous marrow attenuation in portions of incompletely imaged left proximal femur. Multilevel degenerative changes of spine. | 1. Breast lesions as described, suspicious for primary breast malignancy (particularly lesion alluded to in left breast) and correlation with patient's clinical history/physical exam and mammography recommended. Mildly enlarged left-sided axillary and subpectoral lymph nodes, suspicious for metastatic adenopathy.2. Sites of osseous sclerosis and heterogeneity as above, nonspecific and some findings may be posttraumatic in etiology; however, metastatic disease a consideration and nuclear medicine bone scintigraphy should be considered for further evaluation. Please refer to same day CT imaging of right lower extremity for additional findings.3. Lingula lung nodule measuring 2 mm, nonspecific and may be postinfectious/inflammatory in etiology but follow-up recommended to exclude underlying metastatic disease.4. Mildly heterogeneous thyroid gland with bilateral relatively hypoattenuating nodules measuring up to 1.3 cm. |
Generate impression based on findings. | 89 year old male with altered mental status prior to intubation. This exam is mildly degraded by motion artifact. There is no evidence of acute intracranial hemorrhage. There is prominence of the extra-axial CSF spaces along the bilateral convexities which is favored to be related to volume loss and less likely small chronic subdural collection. There is mild atherosclerotic calcification of the distal internal carotid and vertebral arteries, moderate global volume loss, and patchy foci of low-attenuation within the supratentorial white matter which are most compatible with age indeterminant small vessel ischemic disease. The ventricles and basal cisterns are normal in size and configuration given the degree of volume loss. There is no midline shift or herniation. The imaged paranasal sinuses are clear. There is apparent fluid within the bilateral mastoid air cells and possibly within the right middle ear cavity. The skull and extracranial soft tissues are unremarkable. There are bilateral lens implants. | 1.No evidence of acute intracranial hemorrhage.2.Moderate global volume loss and mild age indeterminate small vessel ischemic disease. There is prominence of the extra-axial CSF spaces along the bilateral convexities which is favored to be related to volume loss and less likely small chronic subdural collections. No associated mass effect. 3.While this is a motion degraded exam, there is apparent nonspecific fluid within the bilateral mastoid air cells and possibly within the right middle ear cavity. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 43 years old; Reason: Evaluate for acute appendicitis, colitis, free fluid History: periumbilical abdominal pain, +rebound tenderness ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal hypoattenuating lesion, too small to characterize, coronal image 30. Punctate nonobstructing right renal calculus, image 44 series 4.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Dilated small bowel with area of relative collapse or transition seen in mid to lower pelvis on left side, i.e., collapsed segment of bowel in region of lateral lower left rectus musculature, images 83 to 95 series 4, with somewhat tethered appearance and underlying adhesive disease as an etiology for the described small bowel obstruction a consideration. Left groin surgical clips seen. Although not definitively seen, possible defect in region of left linea semilunaris, as in setting of a spigelian type hernia, not entirely excluded. No definite pneumatosis. Distended stomach containing large amount of ingested contrast. Moderate stool burden. No secondary signs of acute appendicitis.PELVIS:UTERUS, ADNEXA: Small air and fluid seen in vagina. Small pelvic free fluid. Rounded soft tissue attenuation seen laterally in left lower quadrant, image 85 series 4, nonspecific and may reflect ovary. BLADDER: Mildly distended bladder. BONES, SOFT TISSUES: No significant abnormality noted. | 1. Findings consistent with small bowel obstruction. Area of transition seen in region of lateral lower left rectus musculature with somewhat tethered appearance of bowel noted, suspicious for underlying adhesive disease as an etiology for the described small bowel obstruction; left groin surgical clips seen. Although not definitely seen, possible small underlying defect in region of left linea semilunaris, as in setting of a spigelian type hernia, another consideration and not entirely excluded. |
Generate impression based on findings. | 30 year-old female with chest pain, dyspnea on exertion, shortness of breath and tachycardia PULMONARY ARTERIES: Limited study due to patient motion and body habitus. Within these limitations, there is no evidence of pulmonary embolism.LUNGS AND PLEURA: There is a right middle lobe air space opacity/consolidation consistent with pneumonia.MEDIASTINUM AND HILA: Mildly prominent mediastinal lymph nodes. No significant hilar lymphadenopathy. The heart size is normal. No pericardial effusion.CHEST WALL: No significant axillary, retrocrural, or cardiophrenic lymphadenopathy. Chest structures are within normal limits.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. Splenosis is noted. | 1.Limited examination without evidence of pulmonary embolism.2.Right middle lobe pneumonia. PULMONARY EMBOLISM: PE: None.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 58 year-old female with HIV/AIDS for evaluation of scarring/atelectasis seen on radiograph LUNGS AND PLEURA: Left lower lobe scarring and/or atelectasis. No focal pulmonary opacities or findings to suggest infection. No pleural effusions.MEDIASTINUM AND HILA: No significant hilar or mediastinal lymphadenopathy. The heart size is borderline enlarged. No pericardial effusion.CHEST WALL: No significant cardiophrenic, axillary, or retrocrural lymphadenopathy. The osseous structures are within normal limits.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Calcification near the porta hepatis may be in the gallbladder or represent vascular calcification. Partially visualized spleen appears enlarged. Small hiatal hernia. | Left lower lobe scarring and/or atelectasis. No focal pulmonary opacities to suggest infection. |
Generate impression based on findings. | 61-year-old female with chest pain PULMONARY ARTERIES: Technically adequate examination. No evidence of pulmonary embolism. LUNGS AND PLEURA: Bilateral nodules measuring up to 7 mm (series 10, images 25, 51). Bibasilar subsegmental atelectasis/scarring, right greater than left. Bronchial wall thickening in the lung bases appear chronic. Debris within the right mainstem bronchus. No pleural effusions.MEDIASTINUM AND HILA: Severe coronary artery calcifications are noted. Atherosclerotic calcifications of the aorta is and its branch vessels are noted. The heart size is normal. No pericardial effusion.CHEST WALL: No significant axillary, retrocrural, or cardiophrenic adenopathy. The osseous structures are unremarkable.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. Status post cholecystectomy with expected dilatation of the common bile duct. Splenic granuloma. | 1.No pulmonary embolism.2.Bilateral pulmonary nodules measuring up to 7 mm. Recent guidelines by the Fleischner society (Radiology 2005: 237:395-400) suggest that patients with a low risk for lung cancer who have nodules greater than 6 mm and less than or equal to 8 mm in diameter should have follow up in approximately 6 to 12 months. In patients with a higher risk, such as smokers, follow-up is recommended in 3 to 6 months. Patients with a known malignancy are at increased risk for metastasis and should receive a three month follow-up.PULMONARY EMBOLISM: PE: None.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male 46 years old; Reason: 46yoM new AML on standard induction, neutropenic, persistent fevers, known fungal PNA and sinusitis CHEST:LUNGS AND PLEURA: Interval resolution of previously seen left pleural effusion. Persistent left greater than right patchy ill-defined airspace disease in lungs bilaterally with improved aeration noted, particularly in right upper lobe and left lower lobe. Again seen subcentimeter mediastinal lymph nodes. Evaluation for hilar lymphadenopathy suboptimal without IV contrast.MEDIASTINUM AND HILA: Right central venous catheter with tip near cavoatrial junction. CHEST WALL: Mild bilateral gynecomastia.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis and layering sludge suggested. No secondary signs of acute cholecystitis otherwise.SPLEEN: 2 cm splenule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic aortic calcifications. Small retroperitoneal and pelvic lymph nodes, including inguinal lymph nodes with fatty hila, may be reactive in etiology.BOWEL, MESENTERY: Interval improvement in previously visualized segmental distal transverse colonic wall thickening. Liquefied stool seen throughout colon. No secondary signs of acute appendicitis. Small presacral edema. New small ascites. Small hiatal hernia with small amount of contrast seen in distal esophagus, may reflect reflux.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance. | 1. Interval improvement in previously visualized segmental distal transverse colonic wall thickening, liquefied stool seen throughout colon. New small ascites.2. Improved aeration with respect to multifocal airspace disease however with persistent findings noted, as above, likely reflecting patient's reported history of atypical/fungal pneumonia. Interval resolution of previously seen left pleural effusion. 3. Cholelithiasis.4. Small hiatal hernia with small amount of contrast seen in distal esophagus, may reflect reflux. |
Generate impression based on findings. | Female 23 years old; Reason: Evaluate for acute appendicitis. Comment on gallbladder History: RLQ pain ABDOMEN:LUNGS BASES: Evaluation of incompletely imaged lung fields suboptimal secondary to extensive respiratory motion artifact.LIVER, BILIARY TRACT: Pericholecystic fluid/thick walled gallbladder seen. No radiopaque cholelithiasis. Mild periportal edema. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Similar to prior exam is asymmetrically heterogeneous right-sided nephrogram, may reflect sequela of pyelonephritis/infectious process or infarcts. No hydronephrosis. Mild right perinephric fat induration seen, also present on earlier exam.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Air and fluid containing appendix normal in size and extends into right upper abdomen, image 62 series 4. Small adjacent induration noted, mild right perinephric fat induration also seen.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES, OTHER: Visualized osseous structures stable in appearance. Small right lower quadrant and pelvic free fluid, may be partly physiologic. | 1. Findings suspicious for acute cholecystitis with marked gallbladder wall thickening seen. Correlation with patient's clinical history/physical exam recommended and please refer to subsequent abdominal sonography performed on January 11, 2015 for additional findings.2. Normal sized appendix.3. Similar to prior exam is asymmetrically heterogeneous right-sided nephrogram, may reflect sequela of pyelonephritis/infectious process or infarcts. Correlation with patient's clinical history and urinalysis suggested. |
Generate impression based on findings. | Female 29 years old Reason: Evaluate for VP shunt-related fluid collection History: pain Survey views of the quadrants of the abdomen unremarkable. No significant ascites or discrete fluid collection delineated. Incidentally visualized portions of gallbladder unremarkable, no intraluminal mobile echogenic foci seen to suggest underlying gallstones. Visualized portions of liver, kidneys, spleen and underdistended bladder unremarkable. | Unremarkable exam. No sonographic evidence of loculated fluid/discrete fluid collection to suggest CSFoma formation. |
Generate impression based on findings. | Per chart, T2N2b left tonsil SCCA, p16+, s/p CRT finished 8/17/12. Again seen are post-treatment findings in the neck without evidence of mass lesions or significant cervical lymphadenopathy. Unchanged asymmetry of the oropharynx. The thyroid and salivary glands are unchanged including small hypodense bilateral thyroid nodules and atrophy of the submandibular glands. The major cervical vessels are patent. The osseous structures are unchanged. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | No evidence of locoregional tumor recurrence or significant lymphadenopathy. |
Generate impression based on findings. | Nausea, vomiting, assess for bowel obstruction Nonobstructive bowel gas pattern, small to moderate stool burden. Radiodensities in abdomen, more pronounced on right than on left, may reflect ingested material in the bowel (largest focus seen in right upper quadrant may be intrarenal stone but no stone was present on the prior CT exam), correlate with patient's clinical history. Lower lumber spine hardware. Incompletely imaged cardiac leads in right atrium and right ventricle. | Nonobstructive gas pattern. |
Generate impression based on findings. | Abdominal pain, location of enteric tube Enteric tube seen with side-port just beyond gastroesophageal junction and further advancing by approximately 8 cm suggested. Right upper quadrant surgical clips related to prior cholecystectomy. Additional retroperitoneal/pelvic surgical clips present. Mild small bowel dilatation, measuring up to 3.1 cm in left lower quadrant, with air and contrast seen distally in colon, may be seen in setting of a partial small bowel obstruction. | Enteric tube as above. Partial small bowel obstruction suggested. |
Generate impression based on findings. | Abdominal distention, evaluate for ileus versus obstruction No significant change from prior study. Nonobstructive bowel gas pattern. Percutaneous gastrostomy overlying mid abdomen, in expected region of gastric body. Calcified fibroid uterus. Decreased osseous mineralization and degenerative changes of spine. Deformity of right inferior pubic ramus suggested, may reflect sequela of prior trauma. | Stable study as described, nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female, 46 years old, counts were reportedly correct, history of kidney transplant. Right-sided nephroureteral stent. Right pelvic drain and additional catheter overlying lateral aspect of right hemiabdomen, tip kinked or bent, catheter may be overlying patient, correlate with patient's clinical history. No unexpected radiopaque foreign body. Findings discussed with attending surgeon Dr. Witkowski over phone by oncall radiology resident at 1640 on 1/10/15. | No unexpected radiopaque foreign body. |
Generate impression based on findings. | Male, 48 years old. Renal transplant, evaluate for radiopaque foreign body Right-sided nephroureteral stent. Right pelvic drain. Multiple surgical clips overlying left femur/in left inguinal area. No unexpected radiopaque foreign body. Please refer to concomitant chest radiography from same day for additional findings. Findings discussed with attending surgeon Dr. Witkowski by oncall radiology resident at 0515 on 1/11/15. | No unexpected radiopaque foreign body. |
Generate impression based on findings. | Nausea, vomiting, metastatic SCLC, evaluate for ileus, obstruction or large stool burden Residual contrast and moderate stool seen in right colon. No definitive evidence of bowel obstruction. Degenerative disease of spine. | Residual contrast and moderate stool seen in right colon. |
Generate impression based on findings. | Dobbhoff tube placement Dobbhoff tube with tip beyond gastroesophageal junction in region of gastric fundus. Incompletely imaged abdomen (lower abdomen and lateralmost left abdomen excluded) demonstrates nonobstructive bowel gas pattern. Amorphous radiodensity in region of or just above left iliac crest incompletely imaged, may reflect external artifact but nonspecific and not well assessed on current exam. Degenerative disease of spine.Please refer to concomitant chest radiography from same day for additional findings. | Dobbhoff tube as above. |
Generate impression based on findings. | Evaluate ileus and rectal tube position Some redistribution of bowel gas in colon with no significant gross interval change. Rectal tube unchanged in position, coiled in region of descending/sigmoid colon. Enteric tube seen with side-port below level of hemidiaphragms. Dystrophic calcifications in pelvis, may reflect coarse calcifications in prostate versus fecal material in rectum, unchanged. Right total hip arthroplasty and right-sided femoral line. Please refer to concomitant chest radiography from same day for additional findings. | Essentially unchanged as described, with persistent colonic ileus. |
Generate impression based on findings. | Reportedly no bowel movements, evaluate for obstruction Relative paucity of bowel gas, may be seen in setting of fluid containing bowel. No definitive evidence of bowel obstruction seen otherwise. Please refer to concomitant chest radiography from same day for additional findings. Mild hip, spine and symphysis pubis degenerative disease. | Paucity of bowel gas, no definitive evidence of bowel obstruction. |
Generate impression based on findings. | Female 40 years old; Reason: right back pain, concern for possible kidney stone, also please evaluate stability of left adrenal nodule Evaluation of organs of abdomen and pelvis suboptimal without IV contrast, evaluation of bowel suboptimal without ingested contrast.ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Splenules seen.PANCREAS: Previously seen mild prominence of pancreatic duct as well visualized.ADRENAL GLANDS: Accounting for differences in technique, unchanged left adrenal nodule, measuring 11 x 10 mm, image 32 series 3. Associated Hounsfield units of 40 seen on this noncontrast exam, which is not consistent with a lipid rich benign. On prior November 16, 2013 CT imaging, nodule was suggested to be a lipid poor adenoma.KIDNEYS, URETERS: Multiple nonobstructing intrarenal calculi, measuring up to 3 mm in left kidney. No hydronephrosis. Subcentimeter calcification located to the right of midline, image 94 series 3, may be vascular in origin.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small fluid in underdistended stomach.PELVIS:UTERUS, ADNEXA: Status post left-sided salpingo-oophorectomy. Incompletely imaged right adnexal cystic focus, image 124 series 3, measuring approximately 2.5 cm in AP dimension, similar in appearance to prior imaging. BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures without significant change. Mild spinal degenerative disease. | Nonobstructing intrarenal nephrolithiasis as described.Left adrenal nodule stable in size. |
Generate impression based on findings. | Female 54 years old; Reason: abdominal pain/hx pancreatitis/hx gallstone CHEST:LUNGS AND PLEURA: Nonspecific micronodules seen bilaterally. For example, 3-mm left perifissural nodule, image 48 series 6. Nonspecific 5-mm pleural-based nodule in right upper lobe, image 29 series 6.MEDIASTINUM AND HILA: Incompletely imaged heterogeneous thyroid gland, left sided nodule seen measuring 1.5 x 1.2 cm. Mildly prominent mediastinal lymph nodes. Representative paratracheal lymph node, measuring 1.2 x 1.1 cm, image 18 series 4.CHEST WALL: Indeterminant 8 mm soft tissue focus seen in right upper/outer breast, image 19 series 4.ABDOMEN:LIVER, BILIARY TRACT: Stable vague hypoattenuation along the ligamentum teres, may reflect artifact or small fatty infiltration. Gallbladder unremarkable, no radiopaque cholelithiasis. No biliary duct dilatation.SPLEEN: Subcentimeter hypoattenuating focus in spleen, unchanged.PANCREAS: Improvement in previously seen indistinctness in region of anterior pancreatic head/neck and improved fat stranding in area also visualized. Satisfactory enhancement of pancreatic parenchyma.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Kidneys stable in appearance with hypoattenuating focus in right kidney unchanged, too small to characterize but most likely a cyst, image 117 series 4. Additional too small to characterize lesion seen in left kidney unchanged, image 95 series 4.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal appendix. Nonspecific subcentimeter foci of mesenteric nodularity or mesenteric nodes, for example, 6 x 5 mm focus seen in right lower/lateral abdomen, image 149 series 4, previously measured 4 x 3 mm. Colonic diverticula without evidence of acute diverticulitis. Moderate to large stool in colon.PELVIS:UTERUS, ADNEXA: Interval decrease in size of left adnexal cystic focus, measuring 3.2 x 2 cm on image 167 series 4, previously measured 7.2 x 4.3 cm.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures without significant change, including multilevel degenerative changes of spine. | 1. Improvement in previously seen indistinctness in region of anterior pancreatic head/neck and improved adjacent fat stranding also visualized. 2. Decreased size of left adnexal cystic lesion, may be physiologic, may be further characterized with dedicated pelvic sonography.3. Indeterminant 8 mm soft tissue focus seen in right upper/outer breast, mammographic correlation recommended.4. Left sided thyroid nodule. |
Generate impression based on findings. | Female 49 years old; Crohn's disease ABDOMEN:LUNGS BASES: Small left base linear atelectasis or scarring.LIVER, BILIARY TRACT: Mild intrahepatic biliary duct prominence.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Although underdistended, extensive moderate degree circumferential colonic wall thickening suggested from approximately level of splenic flexure distally, to region of rectum. Region of terminal ileum not well assessed but grossly unremarkable, see images 45 through 57 coronal plane. Small pelvic ascites.PELVIS:UTERUS, ADNEXA: Heterogeneous uterus, particularly in region of cervix, may be within normal limits or be related to underlying leiomyomatous disease but correlation with patient's clinical history and further evaluation with dedicated pelvic sonography recommended. BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted. | 1. Suboptimal evaluation due to paucity of intraabdominal fat and patient motion artifact. 2. Although somewhat underdistended, extensive moderate degree circumferential colonic wall thickening suggested from approximately level of splenic flexure distally, to region of rectum, suspicious for long segment of inflammatory disease involvement. Correlation with patient's clinical history and physical exam recommended. Small pelvic ascites.3. Heterogeneous uterus, particularly in region of cervix, may be within normal limits or be related to underlying leiomyomatous disease but correlation with patient's clinical history and further evaluation with dedicated pelvic sonography recommended. |
Generate impression based on findings. | Female 66 years old; Reason: unexplained bilateral lower quadrant abdominal pain History: 2-3 weeks of persistent abdominal pain ABDOMEN:LUNGS BASES: Incompletely imaged micronodules, nonspecific but majority of which are calcified, may reflect sequela of prior granulomatous disease.LIVER, BILIARY TRACT: Hepatic steatosis suggested.SPLEEN: Subcentimeter splenule, image 43 series 3.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small extrarenal pelvises, more pronounced on right side, no definite obstructing ureteral stone, phleboliths noted. Symmetric renal parenchymal enhancement. Subcentimeter renal hypoattenuating foci, too small to characterize.RETROPERITONEUM, LYMPH NODES: Aortobiiliac atherosclerotic disease.BOWEL, MESENTERY: Moderate to large stool burden. No bowel obstruction. Small hiatal hernia. Normal appendix. PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: Small subcentimeter inguinal lymph nodes.BONES, SOFT TISSUES: Mild subcutaneous fat induration seen in bilateral lower quadrants with possible mild overlying skin thickening, correlation with patient's clinical history and physical exam recommended to exclude cellulitis or sequela of prior intervention/trauma. Degenerative disease of spine. | 1. Mild subcutaneous fat induration seen in bilateral lower quadrants with possible mild overlying skin thickening, correlation with patient's clinical history and physical exam recommended to exclude cellulitis or sequela of prior intervention/trauma.2. Moderate to large stool burden. No bowel obstruction. |
Generate impression based on findings. | Female 51 years old; Reason: 50yo female with history of sigmoid colon resection for diverticulitis in 5/13 with recurrent LLQ and RLQ abdominal pain. History: abdominal pain ABDOMEN:LUNGS BASES: Triangular shaped 4-mm nodular focus along minor fissure, nonspecific but may be a lymph node.LIVER, BILIARY TRACT: Scattered subcentimeter hypoattenuating hepatic foci, too small to characterize but without significant change accounting for differences in technique. SPLEEN: No significant abnormality noted.PANCREAS: Probable normal lobulation at level of pancreatic tail, image 38 series 3, appearance unchanged from earlier study.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Symmetric renal parenchymal enhancement. Small extrarenal pelvises.RETROPERITONEUM, LYMPH NODES: Subcentimeter retroperitoneal lymph nodes, for example, 5 x 4 mm infrarenal pericaval lymph node, image 63 series 3, measured approximately 9 x 7 mm previously.BOWEL, MESENTERY: Sequela of prior sigmoid colon resection with associated postsurgical anastomotic suture material seen. Scattered colonic diverticula, primarily involving left colon and transverse colon, no evidence of acute diverticulitis. Intraluminal ovoid hypoattenuating focus in region of pylorus, image 47 series 3, presumably ingested material. No secondary signs of acute appendicitis.PELVIS:UTERUS, ADNEXA: Small air in vagina, nonspecific. BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: New from prior exam are supraumbilical and left periumbilical fat-containing hernias. Former measures 4.1 x 1.4 cm on transaxial imaging, image 64 series 3, with defect measuring 0.9 cm. Hernia sac related to latter measures 3 x 2.1 cm on transaxial imaging, image 74 series 3, with defect measuring 1.5 cm. Multilevel degenerative changes of spine. | 1. New from prior exam are supraumbilical and left periumbilical fat-containing hernias as described.2. Scattered colonic diverticulosis. No evidence of acute diverticulitis. |
Generate impression based on findings. | Reason: Evaluate for steno-occlusive disease as etiology of possible stroke History: R sided weakness, expressive aphasia 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 is some mild degenerative changes present in the cervical spine worse at C5-6 and C6-7 where there are mainly anterior osteophytes present.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.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The left A1 segment is larger than the right A1 segment. The right posterior communicating artery is medium-sized more left is small. The vertebral arteries appear slightly asymmetric left slightly larger than right there there is extracranial origin of the left posterior inferior cerebellar artery. There is extracranial origin of the right posterior inferior cerebral artery. It is prominent right posterior meningeal artery.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a small hypodense focus present along the posterior limb of the left internal capsule which is rather subtle. It extends to the left centrum seminale.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 intracranial aneurysm.2.No evidence for cervicocerebral occlusive disease3.A small lesion in posterior limb of the left internal capsule may represent lacunar infarct of indeterminant age or a focus of demyelination from other cause. Please correlate with clinical symptoms. If clinically appropriate follow-up exam or MRI of the brain may help further evaluate this. |
Generate impression based on findings. | 35-year-old female with history of mixed epithelial and stromal tumor status post right partial nephrectomy and history of multiple ectopic pregnancies who presents with right flank pain and diffuse abdominal pain. Evaluate for abscess or renal stone. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No focal hepatic lesions. Status post cholecystectomy. Mild intra and extrahepatic biliary ductal dilatation is unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Postoperative changes of right partial nephrectomy with interval resection of previously noted right renal mass. No hydroureteronephrosis or perinephric fluid collections to suggest perinephric abscess. The kidneys enhance symmetrically.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis or small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: In the expected location of the right adnexa, there are a few hypoattenuating foci measuring slightly less than 1 cm diameter, but with a somewhat tubular character, creating larger foci measuring approximately 2 cm which is best appreciated on the coronal images (coronal series 80256, image 48, 49 and 50). this was present on old examinations although may appear mildly more prominent compared to previous exam (series 3, image 124). If there is clinical concern for developing hydro-or pyosalpinx, further evaluation with pelvic sonography may be considered.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Appendix is normal and unchanged in appearance compared to the 10/18/2013 exam. No evidence of colitis or small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Postoperative changes of partial right nephrectomy without evidence of obstruction or perinephric abscess.2.Mildly changed tubular configuration to the right adnexa which most likely relates to prior ectopic pregnancies --. However, if there is clinical concern for developing hydro-or pyosalpinx, further evaluation with pelvic sonography may be considered. |
Generate impression based on findings. | Reason: CVA History: CVA The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a small hypodense focus present along the posterior limb of the left internal capsule which is rather subtle. It extends to the left centrum seminale.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. | 1.A small lesion in posterior limb of the left internal capsule may represent lacunar infarct of indeterminant age or a focus of demyelination from other cause. Please correlate with clinical symptoms. If clinically appropriate follow-up exam or MRI of the brain may help further evaluate this.2.No evidence for acute intracranial hemorrhage or mass effect. |
Generate impression based on findings. | Reason: headache History: headache The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits demonstrates a depression of the right orbital floor. This is associated with mild enophthalmus. There is no associated periorbital soft tissue swelling appreciated. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Right-sided orbital floor fracture. This appears chronic. Please correlate with clinical history and clinical exam findings. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. Moderate mucosal thickening of the left sphenoid and posterior ethmoid sinuses. The remaining sinuses are clear. | No acute intracranial abnormality. Please note that non-enhanced CT is not sensitive for the early detection of acute ischemic stroke and if there is strong clinical concern, an MRI may be considered. |
Generate impression based on findings. | 53-year-old female with pancreatic cyst and cyst gastrostomy in place. Patient with nausea and abdominal pain. Evaluate. ABDOMEN:LUNG BASES: New small left pleural effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Patient is status post splenectomy and distal pancreatectomy. Again seen are two peripherally hyperattenuating fluid collections within the surgical bed, along the greater curvature of the stomach. There has been interval placement of a cyst gastrostomy tube. The more posterior fluid collection is decreased in size measuring 2.3 x 1.1 cm, previously measuring 5.1 x 2.7 cm. The more anterior fluid collection which is more organized is not appreciably changed and measures 4.8 x 3.3 cm, previously measuring 4.6 x 3.5 cm. PANCREAS: Post operative changes of distal pancreatectomy.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydroureteronephrosis. The kidneys enhance symmetrically.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant change in the wall thickening of the greater curvature of the stomach, presumably inflammatory in etiology.BONES, SOFT TISSUES: Nodules in the subcutaneous fat of the anterior abdominal and pelvic wall, likely injection site granulomas.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical changes about the colon and J-pouch.BONES, SOFT TISSUES: Postsurgical changes at the anterior abdominal wall with a broad-based ventralhernia. Nodules in the subcutaneous fat of the anterior abdominal and pelvic wall likely reflect injection site granulomas.OTHER: No significant abnormality noted | 1.Interval placement of a cyst gastrostomy tube with interval decrease in size of the posterior fluid collection and stable anterior fluid collection as above.2.Unchanged wall thickening along greater curvature of the stomach, presumably inflammatory in etiology.3.Small new left pleural effusion. |
Generate impression based on findings. | Reason: r/o bleed History: s/p slip and fall, LOC. states hx of brain tumor The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | Fall. No evidence of acute ischemic or hemorrhagic lesion on this scan.Calcified extra axial lesion on the left sylvian fissure likely represent calcified aneurysm, no change since prior exam.Expansile right frontal skull lesion also does not show any interval change since prior exam.Patchy scattered low attenuations on bilateral periventricular white matter indicating non specific small vessel disease, no change since prior exam.Subtle low attenuation lesion on the right basal ganglia indicating chronic ischemic lesion does not show any interval change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. The paranasal sinuses and mastoid air cells are clear. | 1. No evidence of acute ischemic or hemorrhagic lesion.2. No interval change of left sylvian fissure calcified lesion likely represent calcified aneurysm, chronic ischemic lesion on the right basal ganglia and right frontal skull lesion since prior exam. |
Generate impression based on findings. | Reason: evaluate for cva, ich History: ams post surgical The CSF spaces are appropriate for the patient's stated age with no midline shift. Small subtle hypodense foci are present in the brain stem.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. There are scleral calcifications present adjacent to the insertion sites of the ciliary bodies most likely representing scleral plaque. Atherosclerotic calcifications are present along the distal internal carotid arteries. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Subtle hypodensities in the brainstem are present which could be vascular or related. |
Generate impression based on findings. | Reason: free air History: AMS, abd tenderness. Pelvis excluded from field of view.No evidence of free air given limitations of a single supine view. If there is strong clinical concern, upright or decubitus views may be obtained.Enteric tube tip projects over the gastric body.Non-obstructive bowel gas.Breast calcifications noted as on the CT. | No evidence of gross free air. Enteric tube tip in distribution of gastric body. |
Generate impression based on findings. | Reason: follow up contusion/GSW History: s/p GSW There is right occipital depressed skull fracture associated with 4mm depression of the fracture fragment into the calvarium. There is adjacent punctate hyperdensity along the occipital lobe and a 3mm small extra-axial collection associated with some punctate extra-axial fat. There is adjacent scalp soft tissue swelling associated with punctate metallic density foreign objects. Since the prior exam the edema within the adjacent brain parenchyma and is mildly increased. The hematoma itself currently measures 11 x 16 mm and previously measured approximately the same.The CSF spaces are appropriate for the patient's stated age with no midline shift. 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.Right occipital depressed skull fracture associated with adjacent contusion and thin extra-axial hematoma. Since the prior exam the adjacent edema has mildly increased. |
Generate impression based on findings. | History of left mastectomy in 2006 for Paget's disease and DCIS. History of benign right core needle biopsy. No new breast complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Round markers were placed on skin lesions overlying the right breast. An S-shaped clip is present in a coarse cluster of calcifications near the 12 o'clock position of the right breast. Arterial calcifications are present.No new masses, suspicious microcalcifications or areas of architectural distortion are present. Benign lymph nodes are projected over the right axilla. | Stable right breast calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 64-year-old male with painless hematuria. Evaluate for bladder cancer. ABDOMEN:LUNG BASES: Mild bilateral basilar atelectasis.LIVER, BILIARY TRACT: No focal hepatic lesion. No intra-or extrahepatic biliary ductal dilatation. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is a heterogeneously enhancing renal mass with associated calcifications in the right upper pole measuring approximately 5.1 x 4.6 cm (series 9, image 48). The mass abuts the renal vein and the artery but both are patent without definite involvement by tumor. There are two hypoattenuating foci in the left kidney compatible with simple cysts. No hydroureteronephrosis. The kidneys enhance and excrete contrast symmetrically from the pelvocalyceal system with opacification of the ureters throughout their length without evidence of filling defect.RETROPERITONEUM, LYMPH NODES: Scattered nonspecific normal sized retroperitoneal lymph nodes.BOWEL, MESENTERY: No findings to suggest colitis or bowel obstruction.BONES, SOFT TISSUES: Mild to moderate degenerative changes affect the visualized spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No specific evidence of bladder mass within the limitation of an incompletely distended bladder.LYMPH NODES: Nonspecific but enlarged and enhancing inguinal lymph nodes of uncertain clinical significance. Reference left inguinal lymph node measures1.4 cm (series 7, image 161).BOWEL, MESENTERY: No evidence of colitis or bowel obstruction.BONES, SOFT TISSUES: Mild to moderate degenerative changes affect the visualized spine.OTHER: No significant abnormality noted | 1.Heterogeneously enhancing right renal mass as above highly suspicious for renal cell carcinoma.2.Nonspecific scattered normal sized retroperitoneal and enlarged, enhancing inguinal lymph nodes of uncertain significance. |
Generate impression based on findings. | 10 year old female, intubated.VIEW: Chest AP (one view) 1/12/2015, 05:33 The endotracheal tube tip is between the thoracic inlet and carina. The right internal jugular line tip is at the level of the cavoatrial junction.The cardiothymic silhouette is upper limits of normal in size, unchanged. The bibasilar opacities are unchanged. | Unchanged bibasilar opacities most likely representing atelectasis. |
Generate impression based on findings. | Stable postoperative appearance of right parietal craniotomy with underlying encephalomalacia. There is mild ex vacuo dilatation of the right occipital horn. The ventricles are overall unchanged in size from the prior exam. No significant midline shift or evidence of mass effect. No acute intracranial hemorrhage or extra-axial fluid collection. Small basal ganglia calcifications are unchanged. There is patchy periventricular and subcortical hypoattenuation which is nonspecific but unchanged from the prior exam and likely treatment related. Lenses are thin bilaterally, likely representing cataracts. The mastoid air cells and paranasal sinuses are clear. | No significant change in right parietal craniotomy with underlying encephalomalacia. |
Generate impression based on findings. | 46-year-old male status post fall, rule out fracture Tibia and fibula: Proximal fibula fracture without significant displacement. There is adjacent soft tissue swelling.Ankle: No ankle fracture or significant soft tissue swelling is evident. | Nondisplaced proximal fibular fracture. |
Generate impression based on findings. | Reason: assess ventricular size History: enlarging ventricles on previous CT Head There are bilateral ventriculostomy tubes coursing through the frontal lobes into the lateral ventricles with tips near the region of the foramen of Monro. The left frontal ventriculostomy tube does not continue extracranially. Additionally, there is a right parietal entry ventriculostomy tube coursing into the trigone of the left right lateral ventricle with tip in the body of the right lateral ventricle. A newer left parietal ventriculostomy tube is also present with tip in the body of the left lateral ventricle. These are in stable position when compared to the previous exam.The biventricular diameter at the level of foramina of Monro and at the tip of the right frontal ventriculostomy catheter is currently 43 mm and previously was 43 mm on 1/10/14. Third ventricular diameter was previously 10 mm and is currently 10 mm .There is redemonstration of colpocephaly. The corpus callosum is thin.Small fluid fluid levels are present in the occipital horns of the lateral ventricles. A subependymal calcification is present at the trigone of the left lateral ventricle.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.Since the previous exam the lateral ventricles and third ventricle are stable.2.Hyperdense fluid within the lateral ventricles is suspected to represent a small amount of blood which has been previously present and unchanged.3.Status post multiple ventriculostomies.4.A small calcification is present in the left lateral ventricle which is likely dystrophic or related residua from old congenital infection.5.No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | 87 year-old female with abdominal pain. Evaluate for obstruction. ABDOMEN:LUNG BASES: Right lower lobe pulmonary nodule measures 1.4 x 1.0 cm (series 4, image 27), previously measuring 1.3 x 0.9 cm. Left basilar atelectasis/scarring is unchanged.LIVER, BILIARY TRACT: No focal hepatic lesions. Status post cholecystectomy with mild intra-and extrahepatic biliary ductal dilatation, unchanged.SPLEEN: Status post splenectomy.PANCREAS: There are surgical clips about the tail of the pancreas.ADRENAL GLANDS: Stable incompletely characterized right adrenal gland nodule.KIDNEYS, URETERS: Status post left nephrectomy with surgical clips within the nephrectomy bed without evidence of an enhancing soft tissue to suggest local tumor recurrence.Right renal mass measures 3.5 x 2.9 cm (series 3, image 34), previously measuring 3.6 x 3.0 cm.RETROPERITONEUM, LYMPH NODES: Again identified are multiple prominent retroperitoneal lymph nodes with the reference right retrocaval lymph node measuring 2.3 x 1.1 cm (series 3, image 33), previously measuring 2.6 x 1.2 cm.BOWEL, MESENTERY: Fat and bowel-containing ventral hernia without evidence of bowel obstruction. There is a nonspecific mildly dilated loop of small bowel in the midabdomen measuring up to 2.6 cm without distinct zone of transition and may be related to peristalsis.BONES, SOFT TISSUES: Unchanged lytic lesion involving the L1 vertebral body and left posterior elements.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterus is not identified. Prominent cystic lesions in the expected location of the adnexa bilaterally measuring up to 3.1 cm on the right, as best appreciated on the coronal series, are stable since 2006.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis or colitis. No specific findings to suggest small bowel obstruction.BONES, SOFT TISSUES: Lytic lesion in L1 vertebral body and posterior elements, not significantly changed.OTHER: No significant abnormality noted | 1.No specific findings to suggest bowel obstruction.2.Stable right renal mass with mild interval decrease in associated retrocaval lymphadenopathy.3.Stable lytic lesion involving L1 vertebral body. |
Generate impression based on findings. | 2-year-old male, intubated. Evaluate support tubes and lines.VIEW: Chest AP (one view) 1/12/2015, 05:02 Endotracheal tube tip is below the thoracic inlet and above the carina. The feeding tube tip is in the gastric antrum. Right internal jugular line tip is in the superior vena cava. The left upper extremity PICC line tip is at the level of the tricuspid valve.The cardiothymic silhouette is normal. Slightly increased left lower lobe airspace opacity. Bibasilar subsegmental atelectasis unchanged. | Slightly increased left lower lobe airspace opacity, unchanged bibasilar subsegmental atelectasis. |
Generate impression based on findings. | 37-year-old female with history of pain. No acute fracture or malalignment. The soft tissues are unremarkable. | No radiographic findings to account for the patient's pain. |
Generate impression based on findings. | Reason: Patient with multiple episodes emesis s/p total abdominal colectomy POD4, now s/p NGT placement. Please evaluate for possible bowel obstruction and check for proper NGT placement History: nausea and vomiting Time stamp 2:48 hrs.There is marked dilatation of jejunum up to 3.5-cm with air filled distended stomach and a paucity of ilial gas compatible with small obstruction pattern, but likely ileus given recent surgery. Follow up as clinically indicated.Enteric tube with side-port in esophagus. No free air is identified. Skin staples are noted, consistent with history recent surgery. | Small bowel obstruction. Enteric tube with tip projecting in the esophagus. Dr. Martin Coronel p3163 was informed at the time of this dictation (1/12/2015 10:00AM). |
Generate impression based on findings. | 27-year-old female with history of pain. There is a small suprapatellar joint effusion. No acute fracture or malalignment. The soft tissues are unremarkable. | Small joint effusion without acute fracture. |
Generate impression based on findings. | 9-year-old male with ARDS.VIEW: Chest AP (one view) 1/12/2015, 05:16 Endotracheal tube tip below the thoracic inlet above the carina. Enteric feeding tube tip is in the antrum of the stomach. Left chest wall Port-A-Cath with tip in the superior vena cava.The cardiothymic silhouette is mildly enlarged. Improved right upper lobe airspace opacity likely reflecting improved atelectasis. There is persistent diffuse bilateral basilar predominant airspace disease, perhaps slightly increased on the right. The bilateral pleural effusions do not appear significantly changed. | Pulmonary edema pattern, perhaps slightly increased on the right, with associated unchanged bilateral pleural effusions. |
Generate impression based on findings. | 64 years Female with history of falls, rule out bleed. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage or mass effect. |
Generate impression based on findings. | 97-year-old female with history of pain. The bones are diffusely demineralized suggesting osteoporosis/osteopenia. Left hand: There is a partially imaged chronic deformity of the distal ulnar diaphysis. Mild osteoarthritis affects the DIP, basilar, and triscaphe joints.Left forearm: No acute fracture or malalignment. There is a chronic deformity of the distal ulnar diaphysis. IV tubing overlies the antecubital fossa.Right forearm: There is an acute oblique fracture of the distal ulnar diaphysis with approximately 4 cm of overlap and significant lateral angulation of the distal fracture fragment. The overlying skin appears to be intact. There is additional fracture of the proximal radial diaphysis with 4 cm of overlap and volar angulation of the distal fracture fragment. There is significant soft tissue swelling about the forearm. There are scattered arterial calcifications.Right elbow: Redemonstrated is the aforementioned fracture of the proximal radial diaphysis. The elbow is otherwise unremarkable.Right wrist: Again demonstrated is the aforementioned comminuted fracture of the distal ulnar diaphysis. There is mild osteoarthritis affecting the basilar and triscaphe joint. There is a chronic fracture of the first proximal phalanx. | 1.Acute right both bones forearm fracture.2.Degenerative disease and other findings as above. |
Generate impression based on findings. | The scout lateral view and the sagittal reformatted images demonstrate normal alignment of the cervical spine, with a normal cervical lordosis. The vertebral body and disk space heights are well-maintained.There is no acute fracture.At C1-C2, there is a normal relationship of the dens with the arch of C1.The axial images do not demonstrate any significant disk bulge, disk herniation, significant bony spinal canal or foraminal stenosis.The visualized intracranial structures and lung apices appear normal. Scattered small jugular chain lymph nodes, none of which are enlarged by CT criteria. | No evidence of fracture or malalignment. |
Generate impression based on findings. | Respiratory insufficiency.VIEW: Chest AP (one view) 1/11/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Right upper lobe opacity, either atelectasis or pneumonia. No effusions or pneumothorax. | Right upper lobe opacity as described. |
Generate impression based on findings. | 7-week-old former 27 week gestational age patient with chylothorax. Replacement of chest tube.VIEW: Chest AP (one view) 01/12/15, 0548 Endotracheal tube tip is above carina. A feeding tube has been placed and its tip is distal to the GE junction are not included on image. Left upper extremity PICC tip is in left brachiocephalic vein. Left chest tube is noted.Soft tissue edema persists. Opacities in the lung bases are slightly decreased. Hazy bilateral opacity is noted. Cardiac silhouette size is mildly enlarged. | Decrease in bilateral pleural effusion. |
Generate impression based on findings. | Male 11 years old Reason: possible fracture History: FOOSHVIEWS: Right forearm AP and lateral 1/11/15 (two views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Reason: fracture dislocation History: see other imaging studies The cervical vertebral bodies are appropriate in overall alignment and height. No fractures are identified in the cervical spine. The osseous structures appear osteopenic. No cervical spine fracture or subluxation is appreciated.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is bilateral facet hypertrophy present at this level with subchondral cysts.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is predominately right-sided facet hypertrophy and associated with fusion across the facet joint.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is facet hypertrophy present at this level right more than left with some partial fusion across the facet joints andAt C5-6 there is no significant compromise to the spinal canal or neural foramina. There are small uncovertebral osteophytes present at this level narrowing the neural foramina.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.There is opacification of the left mastoid air cells. There is a hearing aid present in the left external auditory canal | 1.There are multilevel degenerative changes present in the cervical spine with some narrowing of neural foramina at C5-6. |
Generate impression based on findings. | Reason: eval ileus History: ileus Redemonstration of diffusely distended colon. Stable appearing enteric tube with tip in the region of the gastric body. Right hip prosthesis, right femoral line and rectal tube are again noted. Dystrophic calcifications in pelvis, most reflect coarse calcifications in prostate as seen on the CT of 1/5/15. | Stable appearing gaseous distention of the colon. Enteric tube and rectal tube, unchanged. |
Generate impression based on findings. | 15-year-old male with gunshot wound to the right knee, going for washout with orthopedic surgery. As seen on the prior radiograph, an intact bullet is seen within the medial aspect of the proximal tibial metaphysis. There is cortical destruction of the central tibial plateau present just anterior to the tibial spines, with a tract of trabecular destruction extending to the bullet medially. A skin defect is seen just lateral to the superior pole of the patella with soft tissue gas extending to the level of the tibial plateau. High-density fluid within the suprapatellar bursa is consistent with lipohemarthrosis, with an associated small gas collection. Lack of intravenous contrast limits evaluation of the vascular structures. | Bullet tract extending from the anterior central tibial plateau to the medial tibial metaphysis, where the bullet now resides. Entrance wound seen just lateral to the superior pole of the patella with associated lipohemarthrosis. |
Generate impression based on findings. | 21 year old female status post reduction, history of skiing accident and femur fracture Comminuted spiral fracture of the proximal femur with mild dorsal displacement of the mid fracture fragment appears similar to the prior exam. | Comminuted proximal femur fracture appearing similar to the prior exam. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | No acute intracranial abnormality. Please note that CT is not sensitive for the early detection of acute ischemic stroke and if there is strong clinical concern, an MRI may be considered. |
Generate impression based on findings. | 21-year-old female status post traction pin placement A comminuted spiral fracture of the proximal femur is visualized with mild dorsal displacement of a mid fracture fragment. A traction device is noted on the crosstable lateral view. | Comminuted proximal femur fracture, as above. |
Generate impression based on findings. | 76-year-old female with abdominal pain. Evaluate for abdominal aortic aneurysm leak. CT ANGIOGRAM: Extensive atherosclerotic calcific disease affects the abdominal aorta with an infrarenal abdominal aortic fusiform aneurysm measuring approximately 4.4 x 4 .3 cm, not significantly changed compared to previous CT 10/4/2014 exam. The aneurysm extends into the right common iliac artery, unchanged. No evidence of contrast extravasation to suggest an abdominal aortic leak. No evidence of dissection or thrombus in the abdominal aorta.Moderate to severe atherosclerotic calcifications affect the origins of the celiac and SMA branches, which are patent without evidence of thrombus or dissection. Moderate calcifications at the origin of the renal arteries bilaterally with moderate narrowing of the right renal artery at the ostium. The common, external, and internal iliac arteries are patent without evidence of a thrombus or dissection.ABDOMEN:LUNG BASES: Unchanged left lower lobe micronodule.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Fatty atrophy of the pancreas is not significantly changed.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No nephrolithiasis or ureteral stones. The kidneys enhance symmetrically without evidence of hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Severe calcific atherosclerotic disease affects the abdominal aorta with an infrarenal abdominal aortic fusiform aneurysm as detailed above.CTA findings as above. BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis. No evidence of bowel obstruction or drainable fluid collections.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: The uterus is absent.BLADDER: Again identified is extension of the bladder into the pelvis suggesting pelvic laxity.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis. No evidence of small bowel obstruction. The appendix is not identified.BONES, SOFT TISSUES: Degenerative changes affect the lumbar spine.OTHER: No significant abnormality noted | 1.Stable infrarenal abdominal aortic aneurysm without evidence of a leak. 2.Extensive atherosclerotic disease affects the abdominal aorta and its branches as above.3.No specific acute findings to account for patient's abdominal pain. |
Generate impression based on findings. | 72-year-old female with history of breast cancer Hip: There are destructive lesions involving the medial anterior acetabulum, inferior pubic rami and pubic symphysis, consistent with pathologic fractures. The femoral head and neck appear within normal limits.Pelvis: Again seen are destructive lesions and pathologic fractures of the medial acetabulum, pubic symphysis and inferior pubic rami. | Pathologic pelvic fractures of the acetabulum, pubis and ischium as described above. |
Generate impression based on findings. | Fall, evaluate for acute intracranial abnormality Head: Again seen are postsurgical changes from a right frontoparietal craniotomy with underlying encephalomalacia of the frontal parietal lobes and not significantly changed from previous exam. There is associated ex vacuo dilatation of the right lateral ventricle. There is an extra-axial hyperdense mass measuring 15 x 11 mm in the coronal plane at the right posterior frontal convexity near the vertex which is unchanged and 7/16/2014 and compatible with a meningioma. Small foci of air again seen in the extra-axial space adjacent to the craniectomy and scalp defect.Adjacent to the left central sulcus is also extra axial dural-based hyperdense lesion measuring approximately 13 x 19 mm and also not significantly changed in size since the previous exam. There is again local sulcal effacement but this is unchanged. Finding also compatible with a meningioma. There is also a 6 mm hyperdense lesion along the posterior surface of the petrous temporal bone. Which was also present previously.There is no evidence of acute intracranial hemorrhage or new mass-effect. No midline shift or basal cistern effacement. There is prominent intracranial internal carotid artery vascular calcification. There is stable patchy hypoattenuation in the periventricular white matter, consistent with chronic small vessel ischemic changes.There is a left parietal subgaleal hematoma. Underlying calvarium is intact. Paranasal sinuses and mastoid air cells are clear. Cervical Spine:No acute fracture or subluxation is seen in the cervical spine. There are extensive degenerative changes throughout the cervical spine including loss of intravertebral disk space and facet arthropathy. There is osseous fusion involving the vertebral bodies at the C3-C4 level. There is also fusion involving the posterior elements from C2 to C4 on the left and C2 to C3 on the right. Multiple areas of lucencies are seen throughout the cervical spine which are nonspecific and may be related to osteopenia. Moderate right C5-C6 foramina stenosis. No prevertebral edema. There is heterogeneous and nodular appearance of the thyroid gland. | 1. No evidence of acute intracranial hemorrhage or new mass effect. Left parietal subgaleal hematoma without underlying calvarial fracture.2. No acute fracture or subluxation in the cervical spine.3. Extra-axial hyperdense masses along the bilateral convexities and posterior surface of the left petrous temporal bone are compatible with meningiomas and not significantly changed since prior. MRI can be considered for further assessment if clinically indicated.4. Right frontoparietal encephalomalacia and evidence of prior craniotomy.5. Degenerative changes in the cervical spine as detailed above.6. Heterogeneous nodular thyroid gland. Consider ultrasound for further evaluation as clinically indicated |
Generate impression based on findings. | Crackles on left lung.VIEWS: Chest AP/lateral (two views) 1/11/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Peribronchial thickening and ill-defined left lingular opacity likely atelectasis. . No effusions or pneumothorax. | Peribronchial thickening and left lingular opacity, likely atelectasis. |
Generate impression based on findings. | No abnormal DWI signal to suggest acute infarct. A few scattered periventricular T2 hyperintensities without corresponding DWI abnormality likely represent mild chronic small vessel ischemic disease. Increased T2 signal within the paramedian pons is also likely vascular related. Enlarged ventricles and prominent sulci are similar to the prior CT and likely reflect a mild degree of atrophy. Cavum septum pellucidum. Flow-voids are intact. Lens is a thin bilaterally, likely representing cataracts. Right maxillary atelectasis, otherwise the paranasal sinuses and mastoid air cells are clear. Midline structures are intact. | Mild atrophy and chronic small vessel ischemic disease. Please note that nonenhanced CT is not sensitive for the early detection of acute ischemic stroke and if there is strong clinical concern, an MRI may be obtained. |
Generate impression based on findings. | Reason: retroperitoneal bleed, pneumothorax, rib fracture History: 99yoM fall onto left side earlier today. now complaining of pain with deep inspiration. palpable crepitus on exam over lateral surface of rib 7,8,9. Hypotensive 70s-80s SBP, pall CHEST:LUNGS AND PLEURA: Left lower lobe airspace opacities consistent with aspiration and/or pneumonia. Coarse calcified left lobe nodule.Right pleural calcifications consistent with prior infection or prior asbestos exposure. 1.7 cm spiculated mass in the right apex, suspicious for malignancy.MEDIASTINUM AND HILA: Severe atherosclerotic calcifications. Mildly dilated esophagus containing enteric contrast.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Mild perihepatic ascites. SPLEEN: High grade splenic laceration (most consistent with grade IV) with associated large splenic hematoma but no active arterial extravasation identified. Splenic calcifications consistent with prior granulomatous disease.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic kidneys with bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications of the aorta and its branches.BOWEL, MESENTERY: Mild dilation of bowel loops without transition point most suggestive of a reactive ileus.BONES, SOFT TISSUES: Severe degenerative disease affecting the spine. Mildly displaced left eighth through 11th rib fractures.Paraspinal muscle atrophy with scattered calcifications.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.High grade splenic laceration with associated perisplenic hematoma.2.Mildly displaced left eighth through eleventh rib fractures.3.Left lower lobe aspiration/possible pneumonia.4.1.7-cm right apical lung mass suspicious for neoplasm. Continued follow-up recommended.5.Other findings as described above. |
Generate impression based on findings. | Reason: bleed, fracture History: 99yoM fall onto left side earlier today. now complaining of pain with deep inspiration. palpable crepitus on exam over lateral surface of rib 7,8,9 The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The right eyeball lens is thin. The hearing aid in the left external auditory canal. Atherosclerotic calcifications are present along the distal vertebral arteries. Atherosclerotic calcifications are present along the distal internal carotid arteries. | 1.No evidence for acute intracranial hemorrhage. mass effect or edema.2.CT is insensitive for early detection of nonhemorrhagic CVA. |
Generate impression based on findings. | Abdominal pain. Rule-out appendicitis. ABDOMEN:LUNG BASES: No focal opacity. No pleural effusion.LIVER, BILIARY TRACT: Normal in appearance. Normal opacification of the portal vein.SPLEEN: Normal in appearance.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Symmetric enhancement. No pelvicaliceal dilation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple right lower quadrant mesenteric lymph nodes.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderately dilated distal small bowel due to right lower quadrant phlegmonPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Distended and normal in appearance.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Cecum and proximal ascending colon wall is thickened. In the right lower quadrant an inflammatory process is identified measuring approximately 7 x 5 x 6 cm (trans x AP x long). The appendix may be part of this but cannot be identified discretely. The terminal ileum also cannot be identified.BONES, SOFT TISSUES: Minimal anterior wedging of L1.OTHER: Small amount of free fluid in the pelvis. No free air. | Right lower quadrant phlegmon with small bowel obstruction and thickening and cecum/proximal ascending colon. Differential considerations include perforated appendicitis, infectious/inflammatory ileitis and colitis. |
Generate impression based on findings. | 85-year-old female with tenderness to palpation and bilateral pain Right foot: There is marked soft tissue swelling about the foot and ankle as well as the distal Achilles tendon. Heterotopic ossification is noted dorsal to the calcaneus near the Achilles tendon insertion. Vascular calcifications are noted in the soft tissues. Degenerative arthritic changes affect the first MTP joint.Left foot: Marked soft tissue swelling about the foot and ankle as well as the distal Achilles tendon. Small foci of heterotopic ossification are noted projecting over the distal Achilles tendon. Degenerative arthritic changes affect the first MTP joint. | Marked soft tissue swelling about the foot and distal Achilles tendon as well as degenerative arthritic changes as described above. |
Generate impression based on findings. | 34-year-old female with history of left hip bleed, leukocytosis, assess for abscess or Large soft tissue mass surrounding the hip extending proximally along the ileum with heterogeneously increased signal consistent with subacute blood product. The mass extends extends beneath the gluteal musculature and measures approximately 12.9 x 7.4 cm in maximal AP and transverse dimensions. There is extensive edema within the overlying soft tissue. Pelvic ascites is noted. The underlying osseous structures appear unremarkable. | Large complex collection surrounding the left hip extending beneath the gluteal muscles consistent with a subacute hematoma and/or abscess. |
Generate impression based on findings. | Male 2 days old Reason: Is there evidence of atelaectasis History: Increased WOBVIEW: Chest AP (one view) 1/12/15 at 757 hours ET tube tip is at the thoracic inlet. Umbilical lines unchanged. Right-sided multiple chest tubes (3) are again noted. Cardiac silhouette is non sizable due to an almost complete atelectasis of the left lung and a residual right-sided pneumothorax. There is left sided mediastinal shift. No effusions. | No change in almost complete atelectasis of the left lung, mediastinal shift and residual right-sided pneumothorax. |
Generate impression based on findings. | 39-year-old with history of right mastectomy for IDC. Patient presents for left unilateral follow-up. Three standard views of the left breast 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 dominant mass, suspicious microcalcifications or areas of architectural distortion in the left breast. A few scattered benign calcifications are present.Benign appearing lymph nodes are projected over the left axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually (although the patient is considering prophylactic mastectomy). Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | History of pneumothorax. Worsening ABGsVIEW: Chest AP (one view) 1/11/15 at 2139 hrs ET tube tip is above the carina. UVC terminates at the right atrium. UAC tip is at T6. Three right-sided chest tubes are again noted. Cardiac silhouette is non-sizable due to a left-sided mediastinal shift, almost complete atelectasis of the left lung and small, residual right-sided pneumothorax. | Persistent almost complete atelectasis of the left flank and small, residual right-sided pneumothorax. |
Generate impression based on findings. | 7-month-old male in respiratory distress with acute hemoglobin drop and hypotensive. Evaluate for infiltrate or effusion.VIEW: Chest AP (one view) 1/12/2015, 05:09 Endotracheal tube tip below the thoracic inlet and above the carina. Feeding tube tip in the gastric antrum.Right upper, right lower and left lower lobe segmental atelectasis unchanged. Persistent subsegmental atelectasis in the left upper lobe. The cardiothymic silhouette is normal. | Multifocal atelectasis without significant interval change. |
Generate impression based on findings. | Male, 40 years old, with gait disturbance, visual disturbance, left-sided Babinski. Assess for mass. At least 3 parenchymal masses are identified, two in the right frontal lobe and one within the left frontal lobe. They range in size from approximately 1.8 cm in diameter (on the right) to 4.8 cm in diameter (on the left). The lesions appear to be partially cystic and partially solid, and they elicit fairly significant edema and mass effect in the surrounding parenchyma. This results in effacement of the lateral ventricles, left side more than right, perhaps some effacement of the suprasellar cistern, and a very mild 1- to 2-mm midline shift to the right.The osseous structures of the skull are intact. The paranasal sinuses and mastoid air cells are clear. | At least 3 parenchymal masses are identified, two in the right frontal lobe and one in the left frontal lobe, compatible with metastases. Further evaluation with contrast-enhanced MRI is recommended. |
Generate impression based on findings. | 76 years Female with Reason: fall, AMS, eval for bleed. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. There i moderate global parenchymal volume loss commensurate with age. There is prominence of the superior cerebellar cistern. No hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent chronic small vessel ischemic changes.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion. |
Generate impression based on findings. | Right hemispheric hypoattenuating extra-axial collection is decreased in size measuring 9 mm in thickness (80273/55), previously 15 mm. Dependent hyperdense blood seen on the prior exam is decreased. No evidence of acute interval hemorrhage. No midline shift. Mild mass effect on the adjacent right hemisphere is slightly decreased.Periventricular and subcortical hypoattenuation is unchanged from the prior exam likely reflecting moderate age indeterminate small vessel ischemic disease. Prominent ventricles and sulci unchanged suggestive of mild atrophy. Mucosal thickening of the ethmoid sinuses has resolved. The imaged mastoid air cells and paranasal sinuses are clear. | 1.Right hemispheric chronic subdural hematoma is decreased in size without evidence of acute hemorrhage.2.Periventricular and subcortical white matter changes are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | Male 20 months old Reason: 20 mo with neuroblastoma, new increased work of breathing, History: retractionsVIEWS: Chest AP/lateral (two views) 1/11/15 at1556 hours. Right IJ venous access terminates at the right atrium. Cardiac silhouette size is normal. Bibasilar atelectasis and right side of her effusion again noted. Right diaphragmatic invasion is also present. | Persistent right-sided pleural effusion and bibasilar opacities. Right diaphragmatic elevation noted. |
Generate impression based on findings. | 57-year-old male history of metal in eye as welder No radiopaque foreign bodies identified within the orbits. Dental fillings are noted. The osseous structures appear within normal limits. | No radiopaque foreign body. |
Generate impression based on findings. | 47-day-old male with persistent right respiratory support requirements.VIEW: Chest AP (one view) 1/12/2015, 05:57 Enteric feeding tube tip terminates in the fundus of the stomach, with the side port below the GE junction. The cardiothymic silhouette is the upper limits of normal in size. Persistent diffuse hazy pulmonary opacities, slightly improved on the right. No pleural effusion or pneumothorax is evident. | Persistent diffuse hazy pulmonary opacities, slightly improved on the right. |
Generate impression based on findings. | Reason: assess intraabdominal processes History: Hep C cirrhosis (on Harvoni) ABDOMEN:LUNG BASES: Small right pleural effusion and bibasilar pulmonary masses. Please see separately dictated chest CT for further description.LIVER, BILIARY TRACT: Cirrhotic liver morphology without discrete focal lesion. Esophageal/splenic varices.SPLEEN: Splenomegaly and splenic varices consistent with portal hypertensionPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate nonobstructive right renal calculus. No hydronephrosis.RETROPERITONEUM, 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 | 1.Right pleural effusion and bibasilar pulmonary masses. Please see separately dictated chest CT for further description of thoracic findings.2.No evidence of metastatic disease in the abdomen/pelvis.3.Cirrhotic liver morphology and findings consistent with portal hypertension. |
Generate impression based on findings. | Female; 66 years old. Reason: patient with chest tightness, SOB, diaphoresis History: chest tightness, SOB, diaphoresis PULMONARY ARTERIES: Technically adequate study. Redemonstration of multiple bilateral partially occlusive pulmonary emboli in the left upper and right middle lobes. Overall, the clot burden is slightly decreased since prior study. For example, there has been partial recanalization of the previously completely occlusive right middle lobar artery clot. No new pulmonary emboli. The main pulmonary artery again measures 2.7 cm in diameter. There is no evidence of right heart strain, though reflux of IV contrast into the hepatic veins is suggestive of elevated right heart pressures.LUNGS AND PLEURA: Mild patchy groundglass opacities diffusely with mild septal thickening is new since prior study and is most suggestive of mild pulmonary edema. Slight improvement in large bilateral pleural effusions with adjacent bibasilar compressive atelectasis. Stable 5-mm groundglass nodule in the right upper lobe (21; series 8). Stable 5-mm groundglass nodule in the left upper lobe (22; series 8). Stable 10 mm ground glass nodule in the left upper lobe (55; series 8). Right basilar suture material. Right basal pleural calcifications. Mild apical predominate centrilobular emphysema. MEDIASTINUM AND HILA: Interval removal of left subclavian central venous catheter. Severe coronary artery calcification.CHEST WALL: No significant abnormality.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small amount of abdominal ascites, partially visualized. | 1. Multiple pulmonary emboli with overall clot burden slightly decreased since prior study. No new pulmonary emboli.2. Mild diffuse groundglass opacity and septal thickening, suggestive of mild pulmonary edema.3. Large bilateral pleural effusions with underlying compressive atelectasis/consolidation, slightly improved. 4. Multiple ground glass nodules in the upper lobes are stable and again nonspecific. Again, follow up examination in 6-12 months to establish resolution is recommended to exclude the possibility of AAH or AIS. PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Lobar.RV Strain: Negative. |
Generate impression based on findings. | Reason: r/o malignancy History: weight loss, cough, abnormal ct june 2014 LUNGS AND PLEURA: Airspace opacity in the posterior aspect of the right upper lobe has significantly improved. There are residual small interstitial and groundglass opacities. Patchy right basilar opacities have also improved with scattered areas of punctate nodularity and interstitial thickening. Lingular scarring or atelectasis is noted. Calcified granulomas on the right.Previously referenced nodular opacity in the left lower lobe measures 6 mm (image 57/94) not significantly changed.MEDIASTINUM AND HILA: Borderline right hilar lymph node unchanged. Moderate coronary calcification.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy. Left adrenal nodule only partially visualized, this was characterized on prior dedicated bowel imaging.. | 1. Previously referenced nodular opacity in the left lower lobe measures 6 mm, not significantly changed. Though this is likely an area of scarring, nodules are typically followed to 2 years with CT to confirm stability and exclude the small chance of malignancy.2. Significant interval improvement in right sided opacities, likely resolving pneumonia. |
Generate impression based on findings. | 21-month-old female with respiratory failure and worsening hypoxemia.VIEW: Chest AP (one view) 1/12/2015, 07:00 Endotracheal tube tip is below the thoracic inlet and above the carina. Left upper extremity PICC line is at the level of the cavoatrial junction. Right-sided central line tip is in the distal superior vena cava.Right pleural effusion perhaps slightly decreased in size. Left pleural effusion persists, and is unchanged. Right upper and left lower lobe air space opacities are unchanged. The cardiothymic silhouette is upper limits of normal. Lung volumes are large. | Increased lung volumes with persistent multifocal airspace opacities and small bilateral pleural effusions. |
Generate impression based on findings. | 24 year-old female status post MVC. Evaluate for fracture. There is a nondisplaced fracture of the radial styloid. Alignment is anatomic. Mild soft tissue swelling about the wrist. | Radial styloid fracture as above. |
Generate impression based on findings. | Colectomy and bowel obstruction.VIEWS: Abdomen AP/left lateral decubitus (two views) 01/11/15, 1850, 1851, 1909 Feeding tube tip is at GE junction.Multiple air-fluid levels are again seen. Dilated bowel loops are present. There is no free peritoneal air. A right lower quadrant stoma is present. | Continued bowel obstruction. |
Generate impression based on findings. | 37 years Female with localized swelling on back of head on the right side, concern for lytic lesion History: localized head swelling The skull and extracranial soft tissues appear unremarkable. There is no intracranial mass effect or herniation. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration.The imaged paranasal sinuses and mastoid air cells are clear. | No intracranial abnormality. No suspicious lesions are seen in the calvarium or scalp. |
Generate impression based on findings. | No abnormal DWI signal to suggest acute infarct. 6-mm left temporal lobe lesion (1302/165) is unchanged in size. Punctate foci of enhancement in the left pons is also unchanged. Enhancing lesions in the frontal lobe along the left cingulate gyrus and anteriorly along the right falx are increased in size from the prior exam and new since the exam from 7/5/2014. A lesion along the left cingulate gyrus measures 6 mm (1301), previously 3 mm. These lesions are associated with increased T2 signal which is increased from the prior exam. There is also increased T2 signal within the white matter, not associated with enhancement, which is increased from the prior exam and may be treatment related.Normal vascular flow voids. Lenses are thin bilaterally. No abnormal susceptibility. Ventricles are normal. No mass effect or midline shift. Midline structures and craniocervical junction are within normal limits. | 1.Mixed appearance of progression and stability of brain metastases as described in detail above.2.Increased white matter T2 signal which may be treatment related. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.