instruction
stringclasses 1
value | input
stringlengths 6
8.98k
| output
stringlengths 5
3.11k
|
|---|---|---|
Generate impression based on findings. | 86 year-old female with aortic stenosis See CARDIAC CT for cardiac vessel measurements.VESSELS: There are mild atherosclerotic vascular calcifications.SUPRARENAL ABDOMINAL AORTA: 1.9 X 1.8 cmINFRARENAL ABDOMINAL AORTA: 1.4 X 1.4 cmRIGHT COMMON ILIAC ARTERY: 10 X 10 mmRIGHT EXTERNAL ILIAC ARTERY: 11 X 10 mmRIGHT COMMON FEMORAL ARTERY: 7 X 7 mmLEFT COMMON ILIAC ARTERY: 10 X 10 mmLEFT EXTERNAL ILIAC ARTERY: 10 X 9 mmLEFT COMMON FEMORAL ARTERY: 7 X 8 mmCHEST: See the same day report of the cardiac CTA with Chest addendum. 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: Left collecting system non-obstructive calculus. Otherwise, unremarkable kidneys.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta without aneurysmal dilatation. See measurements above.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative disk disease.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right indirect inguinal hernia containing small bowel without evidence of obstruction or other complication.BONES, SOFT TISSUES: Degenerative disk disease. Injection granulomata are noted in the gluteal soft tissues, right greater than left. Small loculated fluid collection adjacent in the subcutaneous fat abutting the right gluteus maximus at the level of the greater trochanter (series 5/417) measuring 2.8 x 2.2 cm may represent a post-surgical seroma. OTHER: No significant abnormality noted. | 1.Trace effusions and interstitial edema. See chest addendum to cardiac CTA report for further details.2.Non-obstructive left renal calculus.3.Non-complicated right small bowel containing inguinal hernia. |
Generate impression based on findings. | Enlarged thyroid possible extension into pyramidal lobe with submental swelling. The thyroid is diffusely enlarged and contains a nodule with punctate calcifications in the right lobe that measures up to 15 mm. The left lobe of the thyroid extends inferiorly to the level of the manubrium. There is no significant narrowing of the trachea or discernible pyramidal lobe. There are globular hyperattenuating areas in the posterior root of the tongue that measure up to 15 mm with diffuse surrounding swelling of the oral tongue and tongue base. There is no evidence of significant cervical lymphadenopathy based on size criteria. The salivary glands are unremarkable. The major cervical vessels are patent. There are carious left maxillary molars and apparent linear defect in tooth # 4. The imaged orbits and intracranial structures are unremarkable. There is a retention cyst in the left maxillary sinus. There is a subcentimeter right apical lung cystic focus. | 1. Enlarged thyroid gland with a partially calcified nodule that measures up to 15 mm, but no significant narrowing of the trachea. A thyroid ultrasound may be useful for further characterization.2. Hyperattenuating areas in the posterior root of the tongue that measure up to 15 mm with diffuse surrounding swelling of the oral tongue and tongue base. Differential considerations include hemorrhage, undescended thyroid with inflammation, vascular malformation, neoplasm, or an infectious process. An MRI or ultrasound may be useful for further evaluation.3. Carious left maxillary molars and apparent fracture of tooth # 4. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two maternal cousins with breast cancer. Prior mammogram at Trinity in 2013. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. Benign calcifications are noted bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is most sensitive when assessing for interval change. If outside studies are submitted, comparison can be made. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The mastoid air cells are clear. | Negative noncontrast brain MRI. Specifically, there are no MRI findings to explain the patient's symptoms. |
Generate impression based on findings. | Reason: 50 yr old patient with fallopian tube cancer s/p 3 cycles of Taxol IV/CDDP IP/ Taxol IP/ Avastin and oral agent. eval disease process compare to baseline scan i History: none CHEST:LUNGS AND PLEURA: 3-mm right lower lobe pleural-based nodule unchanged (series 4 image 59). No new nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No adenopathy. Severe coronary calcification. Trace pericardial fluid.CHEST WALL: Right IJ chest port in place with tip at the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypoattenuating foci unchanged too small to characterize but unchanged and most likely small cysts. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: Fatty atrophy of the pancreas without focal lesion or ductal dilation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal lesion with fat attenuation consistent with an angiomyolipoma is unchanged. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No lymphadenopathyBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: A surgical drain enters the left abdomen with its tip in the pelvis. No abdominal or pelvic fluid collections. OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy and salpingo-oophorectomy. BLADDER: Collapsed bladder.LYMPH NODES: Scattered small inguinal lymph nodes. No pelvic lymphadenopathy by size criteria.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. No specific evidence of recurrent or metastatic disease. 2. Small right renal angiomyolipoma unchanged. |
Generate impression based on findings. | PHARYNX/LARYNX: The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable.GLANDS: The left parotid gland is heterogeneous and enlarged relative to the right, slightly decreased in size from the MRI of 2008 There are multiple hyperattenuating nodules within the lesion as seen previously as well as a small calcification. The left submandibular gland is atrophic with a large stone within left submandibular duct. The thyroid gland is unremarkable.ORAL CAVITY: The oral tongue and floor of mouth are unremarkable, within the limitations of this exam as there is artifact from dental amalgam.CERVICAL SOFT TISSUES: Multiple prominent lymph nodes adjacent to the left parotid are slightly decreased in size. Prominent level 2 lymph nodes on the left are again identified including a level 2 a node measuring 1.4 x 1.0 cm (7/30), unchanged. An prominent left level 3 node measures 1.3 x 0.9 cm (7/31), previously 1.4 x 0.9 cm.OTHER: Scattered upper lobe opacities are partially visualized. Mild mucosal thickening of the right sinuses. | 1.Enhancing heterogeneous left parotid gland is slightly decreased in size from the MRI of 2008.2.Left-sided cervical lymph nodes are slightly decreased in size.3.Large stone in the left submandibular duct with atrophy of the left submandibular gland.4.Patchy upper lobe pulmonary opacities are partially visualized. An inflammatory/infectious etiology is favored. A chest x-ray may be considered. |
Generate impression based on findings. | 75 year old man with mitral regurgitation referred for evaluation of cardiovascular anatomy prior to robotic mitral valve surgery.CPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with normal brachiocephalic branching pattern. No thoracic aortic dissection or aneurysm is noted; however, the ascending aorta is mildly dilated (41mm diameter). The thoracic aorta has no significant tortuosity. No protruding aortic atheroma or thrombus is noted in the thoracic aorta. There is mild calcification in the descending aorta. No aortic coarctation is noted. There is mild to moderate atherosclerosis the proximal brachiocephalic vessels. Aortic Valve: The aortic valve has no calcification.Mitral Valve: There is moderate posterior mitral annular calcification which extends onto the posterior leaflet. There is significant prolapse of the posterior mitral valve leaflet. Left Ventricle: The left ventricular end-diastolic dimension is mildly increased. There is no thrombus noted in the left ventricle. There appears to be a subtle perfusion defect in the LV apex (distal LAD territory), correlation with coronary angiogram suggested. The morphology of the interventricular septum is within normal limits. Right Ventricle: Visually the right ventricular end-diastolic size is within normal limits.Left Atrium: The left atrium is severely dilated. There are four distinct pulmonary veins which drain normally into the left atrium. There is no evidence of left atrial appendage thrombus.Right atrium, vena cavae, and coronary sinus: The right atrium is normal in size. The superior and inferior vena cavae are grossly normal. The coronary sinus is normal in size. Pulmonary Artery: Mildly dilated (33mm).Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary arteries: Because heart rate management was not attempted and nitroglycerine was not administered, this exam was not performed to optimally visualize the coronary arteries. However within the limitations of the study the following observations are made:LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There is mild calcification of the left main coronary artery. LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There is dense calcification in the mid LAD. LCx: The left circumflex coronary artery courses normally in the the left AV groove. It gives rise to the obtuse marginal branches and a small AV circumflex branch. There is no calcification of the LCx.RCA: The right coronary artery arises normally from the right sinus of Valsalva. It is the dominant coronary artery supplying a posterior descending artery and a posterolateral branch. There is moderate calcification of the RCA. Coronary Bypass Grafts:None present. | 1. Thoracic aortic anatomy as above. 2. There is moderate posterior mitral annular calcification which extends onto the posterior leaflet. There is significant prolapse of the posterior mitral valve leaflet. 3. Mild LV dilation with evidence of a subtle perfusion defect involving the LV apex, correlation with recent coronary angiography suggested. 4. Mild coronary artery calcification. 5. Severe left atrial dilation. 6. Mild dilation of the main pulmonary artery. This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report. The abdominal/ pelvis CTA will be reported separated by radiology. |
Generate impression based on findings. | Male; 80 years old. Reason: prostate cancer History: prostate cancer LUNGS AND PLEURA: Stable upper lobe emphysema, biapical scarring, and mild chronic interstitial changes at the lung bases. Stable mild chronic Stable index right middle lobe nodule measures 7 x 4 mm (image 39, series 5), previously 7 x 4 mm. No new or suspicious pulmonary nodules.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Severe atherosclerotic calcifications of the coronary arteries.CHEST WALL: Stable extensive bone metastases.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No significant interval change since 10/13/14. No new or suspicious pulmonary nodules. Stable extensive bone metastases. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of NHL in remission. Maternal uncle with breast cancer. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Reason: hx of urothelial carcinoma in left ureter and bladder, evaluate for metastatic disease with delayed imaging History: see above ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is bilateral renal scarring with increased left cortical atrophy since the prior study. A large exophytic right upper pole renal cyst is unchanged. There is no hydronephrosis.Delayed phase images demonstrate symmetric opacification of both proximal-mid ureters. The distal 25% of both ureters are incompletely opacified distal to the iliac vessels however there is no evidence of mass or filling defect to suggest recurrent/metastatic disease.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic disease affects the aorta and its branches.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. Mildly limited study due to incomplete opacification of both distal ureters but no specific evidence of recurrent/metastatic disease.2. Bilateral renal scarring with increased cortical atrophy of the left kidney since the prior study. |
Generate impression based on findings. | Reason: 26M w/ h/o AML s/p ASCT now neutropenic with purulent sinus drainage History: as above LUNGS AND PLEURA: 1- 2-cm poorly defined predominately groundglass nodular opacity at the right lung base (image 88/114) which is likely due to infection or aspirate. Calcified granuloma on the right.MEDIASTINUM AND HILA: Venous catheter at RA/SVC junction. Calcified right hilar nodes.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Small predominately groundglass nodular opacity at the right lung base is nonspecific but likely due to infection (possibly fungal) or aspirate. |
Generate impression based on findings. | Male; 58 years old. Reason: h/o base of tongue ca and CRT, compare to previous, measurements pls History: none LUNGS AND PLEURA: Minimal bibasilar dependent subsegmental atelectasis. Minimal paraseptal emphysema. No suspicious pulmonary nodules. Small amount of debris is again seen in the distal trachea.MEDIASTINUM AND HILA: Normal heart size. No pericardial effusion. Mild atherosclerotic calcifications of the coronary arteries. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of metastatic disease in the chest. |
Generate impression based on findings. | Reason: r/o fluid collection in LVAD pt History: abd wound, elevated WBC CHEST:LUNGS AND PLEURA: Calcified granulomas. Lungs hypoinflated. No pleural effusion.MEDIASTINUM AND HILA: Punctate foci of mediastinal air adjacent to the aortic limb of the LVAD which is nonspecific but could be seen with infection. However, there is no evidence of fluid collection or abscess. Exam is limited by streak artifact.CHEST WALL: Left chest wall ICD.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: CholelithiasisSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Cortical scarring on the left.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: LVAD drive line in expected location with no evidence of fluid collection. Minimal skin thickening around the drive line, correlate for cellulitis. Soft tissue thickening in the midline anterior abdomen is unchanged. | Punctate foci of mediastinal air adjacent to the aortic limb of the LVAD which is nonspecific but could be seen with infection. However, there is no evidence of fluid collection or abscess. |
Generate impression based on findings. | 61-year-old male status post lumbar spine fusion Posterior stabilization rods with transpedicular screws entering the vertebral bodies at L4, L5 (unilateral right screw) and S1. Status post L4-L5 and L5-S1 diskectomy with placement of bone graft. A drain is noted in the soft tissues. | Orthopedic fusion of lower lumbar spine as described above. |
Generate impression based on findings. | Metastatic head and neck cancer. New baseline; beginning clinical trial.RADIOPHARMACEUTICAL: 14.9 mCi F-18 NaF Today's CT portion grossly demonstrates numerous bilateral pulmonary nodules. Right hilar mass is also noted. Extensive atherosclerotic including coronary arterial calcifications are seen. Trace pericardial effusion or thickening is also present. A lytic lesion is seen in the superomedial right iliac wing. Extensive degenerative osteophytes are seen throughout the spine.Today's PET examination demonstrates multiple foci of increased osseous activity, consistent with metastases. The most avid are seen in the right mid iliac wing (SUV max = 20.1), posterior cortex of the left proximal femur (SUV max = 28.9), and the left aspect of T12 centered in the posterior elements (SUV max = 27.2). These lesions are also FDG avid on the comparison PET study. Some of these lesions including the left hip, right central iliac wing, and left T12 are visible on comparison conventional bone scan.At the more superior medial aspect of the right iliac wing, a focus of more subtly increased NaF activity is present (SUV max = 11.7). This corresponds with a lytic lesion on CT portion and is markedly FDG avid on comparison study. This indicates an additional osseous metastasis of a more lytic nature.At the inferior posterior occiput, a subtle punctate focus of activity could represent an additional osseous metastasis or indicate a benign focus. Numerous benign foci of activity are seen elsewhere throughout the skeleton, most notably the thoracic and lumbar spine with corresponding degenerative changes on CT portion. | Several osseous metastases as detailed above. |
Generate impression based on findings. | 61-year-old male with carpometacarpal joint pain Mild to moderate osteoarthritis affects the basilar joint and scattered interphalangeal joints, appearing similar to the prior exam. The bones are demineralized. | Osteoarthritis, as described above. |
Generate impression based on findings. | 9-year-old male with possible battery ingestion.VIEW: Abdomen AP (one view) 1/12/2015 No radiopaque foreign body is identified. The bowel gas pattern is nonobstructive. No pneumatosis intestinalis or free intraperitoneal air is evident. A moderate stool burden is distributed throughout the left hemicolon. | No radiopaque foreign body identified. |
Generate impression based on findings. | Chronic nasal congestion; possible nasal polyps. There is mild mucosal thickening in the left maxillary sinus. The other paranasal sinuses are clear. The nasal cavity is clear. There is no significant nasal septal deviation. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The mastoid air cells and middle ear cavities are clear. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. | Mild mucosal thickening in the left maxillary sinus. The other paranasal sinuses and nasal cavity are otherwise clear. |
Generate impression based on findings. | Reason: Assess location of possible enterocutaneous fistula thru fistula sight History: enterocutaneous fistula, possibly gastro-cutaneous Surgical clips, drains, spinal fusion device are noted on the scout image.There is dominant flow of the contrast into the jejunum with early filling of a sinus track. Brisk injection show sinus tract extending from the clips and sutures and tracking ventrally. Dominant tract extends to the skin with several blind ending short sinus tracts in between.TOTAL FLUOROSCOPY TIME: 2:41 minutes | Sinus tract to the skin. |
Generate impression based on findings. | Headache and blurry vision. There is no evidence of intracranial hemorrhage or mass. There is unchanged extensive cerebral white matter hypoattenuation, which may represent chronic small vessel disease. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There is partial opacification of the maxillary and ethmoid sinuses, as well as an air-fluid level in the left maxillary sinus. The mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | 1. Unchanged extensive nonspecific cerebral white matter hypoattenuation, but no evidence of intracranial hemorrhage or abscess. 2. Acute sinusitis. |
Generate impression based on findings. | 58-year-old female with chronic pain in bilateral hips Pelvis: The osseous structures of the pelvis appear within normal limits. An aortic-biiliac stent graft is noted.Right hip: Alignment is within normal limits. No specific findings to account for the patient's symptoms.Left hip: Alignment is within normal limits. There are no specific findings to account for the patient's symptoms. A small accessory ossicle along the superior acetabulum is noted. | No specific radiographic findings to account for the patient's symptoms. |
Generate impression based on findings. | Right parietal approach ventriculostomy catheter with tip near the right foramen of Monro is unchanged in position from the CT of 12/24/2014. Mild ventricular asymmetry is unchanged. Ventricles are overall similar in size to the prior CT exam. Enhancement along the course of the catheter is decreased, as is a nodular region of enhancement seen previously at the catheter tip. There are no new areas of abnormal enhancement. There is decreased edema along the course of the catheter. Ependymal enhancement seen previously has resolved.The basal cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. No extra-axial fluid collection is identified. Prominent pituitary gland is likely normal for age. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. | 1.Abscess adjacent to the ventriculostomy catheter is significantly decreased in size with only a small focus of residual enhancement. There is a small amount of residual enhancement and edema along the course of the catheter as well, however this is also significantly improved from the prior exam.2.Stable position of the ventriculostomy catheter and ventricular size. |
Generate impression based on findings. | Ms. Glass is a 50 year old female presenting for routine mammography. Personal history of lupus. Three standard views of both breasts and a right spot compression view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Asymmetry in the right lateral breast disperses on spot compression view. Circumscribed mass in the left upper outer breast is smaller than on prior exams, compatible with an involuting cyst. There has been a benign progression of calcifications in both breasts, the majority of which are arterial in nature. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Bilateral benign calcifications and decrease in size of left breast cyst. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 64-year-old female with history of ovarian cancer with retroperitoneal adenopathy. Evaluate pre-chemotherapy.Per chart review, patient with history of supracervical hysterectomy, BSO and appendectomy, all of which were positive for ER+PR-HER2+ grade 1 serous adenocarcinoma of the ovary. Now with recurrence. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: In the cleft of the liver capsule between segment 2 and 4, there is hypoattenuation (series 4, image 21) slightly greater than fluid attenuation, worrisome for disease. Additionally, there is a punctate calcification at the surface of the liver posteriorly (series 4, image 15) which may represent calcified disease versus old inflammatory changes. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Incompletely characterized left adrenal nodule measuring approximately 1.6 x 1.2 cm (series 4, image 35).KIDNEYS, URETERS: No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Mildly to moderately prominent retroperitoneal lymph nodes with reference left periaortic lymph node measuring 1.3 x 1.2 cm (series 4, image 51).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Postoperative changes of hysterectomy and bilateral salpingo-oophorectomy. There is a hypoattenuating bilobed mass in the pelvis measuring approximately 10 x 6.2 cm (series 4, image 113) consistent with history of recurrent ovarian carcinoma. This mass abuts and has mass effect upon the rectum posteriorly without evidence of bowel obstruction. Additionally, it abuts the bladder anteriorly with mild mass-effect.BLADDER: No significant abnormality notedLYMPH NODES: Prominent pelvic and inguinal lymph nodes bilaterally with reference right external iliac lymph node measuring 1.4 x 1.0 cm (series 4, image 112) and reference left common iliac lymph node measuring 2.0 x 1.5 cm (series 4, image 97).BOWEL, MESENTERY: No findings to suggest bowel obstruction or colitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Hypoattenuating bilobed pelvic mass consistent with history of recurrent ovarian carcinoma. 2.Retroperitoneal and inguinal lymphadenopathy with reference measurement as above.3.Incompletely characterized left adrenal nodule.4.Slightly greater than fluid attenuation in the cleft of the liver capsule between segment 2 and 4, worrisome for metastatic disease. |
Generate impression based on findings. | 15 year old female with shortness of breath and intermittent chest pain.VIEWS: Chest PA/lateral (two views) 1/12/2015 The cardiomediastinal silhouette is normal. The aortic arch, cardiac apex and stomach are left-sided. No focal airspace opacity, pneumothorax or displaced rib fracture is evident. | Normal examination. |
Generate impression based on findings. | 33 years, Female. Reason: s/p roux en y gastric bypass evaluate jejunojejunal anastomosis through g tube in gastric remnant with upper GI exam. History: abdominal pain s/p gastric bypass. The scout radiograph demonstrates a large amount of residual contrast material in the colon, presumably from recent upper GI examination. Nonobstructive bowel gas pattern. Cholecystectomy clips. | Large amount of residual colonic contrast material from recent upper GI exam, which precludes follow-up exam today. Serial radiographs can be obtained to document clearance of contrast, at which time the patient can return for the follow-up exam. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Per patient, she reports having a lumpectomy sometime in the past. Patient is uncertain of any additional medical history. Three standard digital views of both breasts (total of 9 images) were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. A linear marker is placed overlying a scar in the left upper outer breast. Underlying this scar marker, are two focal areas of architectural distortion. Surgical clips are also identified in the left axilla. In addition, in the left medial breast, there is an ovoid circumscribed mass present. There is no suspicious mass, microcalcifications or areas of architectural distortion present in the right breast. | Architectural distortion in the left upper outer breast with surgical clips in the left axilla. These findings may all be postsurgical in etiology, however, this is not certain given the lack of prior mammograms. Additional mass in the left inner breast. A release form has been faxed to Stroger Hospital to obtain the prior mammograms. Once these mammograms have been obtained, an addendum with further recommendations will be issued. If any of the patient's providers are able to supply additional history or could provide information regarding any prior mammograms, that would be greatly appreciated. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: O - Old Study For Comparison. |
Generate impression based on findings. | Two month old male, former 29 week gestational age with increased work of breathing.VIEW: Chest AP (one view) 1/12/2015, 14:52 Apparent right upper lobe opacity reflects normal thymic tissue and patient rotation. Persistent and unchanged left upper and right lower lobe subsegmental atelectasis. The cardiothymic silhouette is normal and no pleural effusion or pneumothorax is evident. | Subsegmental atelectasis of the left upper and right lower lobes persist. |
Generate impression based on findings. | 61-year-old female with history of intra-medullary rod stabilization of left humerus fracture. Evaluate for healing. An intramedullary rod and screw device affixes a healing pathologic fracture of the left proximal humerus in anatomic alignment. There is no evidence of hardware complication. The callus has matured slightly indicating continued healing. A poorly defined lytic lesion in the underlying bone represents the previously described metastatic lesion. There are surgical clips present within the left chest wall. | Orthopedic fixation of healing pathologic humerus fracture as above. |
Generate impression based on findings. | 15-year-old female with right knee injury after playing basketball. Pain on ambulation.VIEWS: Right knee AP, oblique and lateral (3 views) 1/12/2015 A moderate joint effusion is evident, but no underlying fracture or malalignment is seen. | Moderate joint effusion without underlying fracture or malalignment. |
Generate impression based on findings. | Male 71 years old; Reason: Pleural mesothelioma No abnormal osseous foci are identified to indicate metastatic disease.Scattered uptake likely degenerative in nature, such as in the cervical spine, shoulder and sternum. | No suspicious focal uptake to suggest metastatic disease. |
Generate impression based on findings. | New diagnosis of squamous cell lung cancer. Evaluate extent of disease. There is no evidence of abnormal intracranial enhancement or mass. There is no midline shift or herniation. There are postoperative findings related to anterior circulation cerebral aneurysm clipping with encephalomalacia in the inferior right frontal lobe. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter. There is also encephalomalacia in the inferior right cerebellum. There is mild diffuse cerebral volume loss. The paranasal sinuses and mastoid air cells are clear. | 1. No evidence of intracranial metastases. 2. Chronic right PICA territory infarct and nonspecific scattered hypoattenuation in the subcortical white matter likely represents small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.3. Postoperative findings related to cerebral aneurysm clipping.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 12-year-old female, evaluate new Dobbhoff position.VIEW: Abdomen AP (one view) 1/12/2015 Dobbhoff tube and nasogastric tube are in place, with their tips in the distal body of the stomach. Right femoral venous catheter with tip projecting over the region of the right external iliac vein. Previously administered contrast is present within the colon. A paucity of bowel gas is noted. Reticulation of the subcutaneous fat is consistent with body wall edema. Bibasilar interstitial opacities, left lower lobe consolidation and cardiac enlargement are again seen, but partially imaged. | Dobbhoff tube and nasogastric tube with tips in the distal body of the stomach. |
Generate impression based on findings. | 51-year-old male with history of right ankle soreness and instability. Right ankle: No acute fracture. Mild soft tissue swelling about the lateral aspect of the ankle.Right foot: There is a mild pes-planovalgus deformity. No acute fracture. | Mild soft tissue swelling about the lateral aspect of the ankle and mild pes-planovalgus deformity. |
Generate impression based on findings. | Reason: s/p stoma takedown >1 month prior now w chronic mildline and right lateral wound drainage, ?fistula v abscess History: above ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Normal hepatic morphology without focal lesion. Cholelithiasis without specific secondary signs of inflammation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postoperative changes of total colectomy and right lower quadrant ileostomy. Along the area of prior ileostomy along the subcutaneous soft tissues to the right of the current ileostomy, there is a tract of inflammatory changes, which may reflect a combination of postoperative and infectious/phlegmonous changes but there is no discrete abscess or drainable collection at this time. There are no gas foci to specifically indicate a fistula. Incomplete distention of bowel loops with enteric contrast. There is a focally dilated loop of small bowel in left abdomen but no evidence of acute obstruction.BONES, SOFT TISSUES: An open midline abdominal wound is present with small foci of gas tracking along the subcutaneous soft tissues and irregular midline soft tissue which may represent the sequela of prior laparotomy. No evidence of recurrent herniation of abdominal contents. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Right adnexal cystic lesion measuring 3.8 x 3.6 cm grossly unchanged. Pelvic ultrasound may be considered for further evaluation as warranted clinically. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As above. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Postoperative changes of total colectomy and right lower quadrant ileostomy revision. At the area of prior ileostomy along the subcutaneous soft tissues lateral to the current ileostomy, there is a tract of inflammatory changes which may reflect a combination of postoperative changes and infection/phlegmon, but no discrete abscess or drainable collection is present. 2. Midline open abdominal wound as described above likely represents the sequela of prior surgery. |
Generate impression based on findings. | 16-year-old male with neurofibromatosis type I and known plexiform neurofibroma of the pelvis with extension into the left leg, now with pain. Evaluate extent of tumor. Innumerable neural fibromas are again identified within the pelvis, extending along the lumbosacral nerve roots, appearing similar in size and morphology to the prior examination. The dominant neurofibroma in the left inguinal region now measures 5.0 x 7.0 cm in axial dimension (series 601, image 20), previously 5.5 x 7.6 cm and greater than 42 cm in craniocaudal dimension, also similar to the prior examination. Encasement of the femoral artery and vein is again present, without evidence of obstruction. Increased stir signal within the skin of the superomedial left thigh suggests skin thickening, perhaps related to lymphatic obstruction.Additional neurofibromas are noted in within the bilateral popliteal fossa and leg musculature. Similarly, these lesion show no significant interval change in size or morphology. | Extensive plexiform neurofibromas of the pelvis bilateral legs, without significant interval change. |
Generate impression based on findings. | Rule out tracheal compression. Dyspnea. There is a heterogeneous diffusely enlarged thyroid with mild narrowing of the trachea, which measures a minimum of 9 mm in width. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The major salivary glands are unremarkable. The osseous structures are unremarkable. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | A heterogeneous diffusely enlarged thyroid with mild narrowing of the trachea is compatible with multinodular goiter. |
Generate impression based on findings. | 61-year-old female with history of pain. Evaluate for fracture. Bandage material overlies to the 2nd finger. Soft tissue irregularity along the mid aspect of the 2nd finger may represent a laceration. There are degenerative arthritic changes at the 2nd MCP with slight volar subluxation of the 2nd finger. Additional mild degenerative changes affect the hand and wrist. We see no acute fractures. | Degenerative arthritic changes with slight volar subluxation of the index finger, but we see no acute fracture. |
Generate impression based on findings. | 75 year old man with mitral regurgitation referred for evaluation of cardiovascular anatomy prior to robotic mitral valve surgery.CPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with normal brachiocephalic branching pattern. No thoracic aortic dissection or aneurysm is noted; however, the ascending aorta is mildly dilated (41mm diameter). The thoracic aorta has no significant tortuosity. No protruding aortic atheroma or thrombus is noted in the thoracic aorta. There is mild calcification in the descending aorta. No aortic coarctation is noted. There is mild to moderate atherosclerosis the proximal brachiocephalic vessels. Aortic Valve: The aortic valve has no calcification.Mitral Valve: There is moderate posterior mitral annular calcification which extends onto the posterior leaflet. There is significant prolapse of the posterior mitral valve leaflet. Left Ventricle: The left ventricular end-diastolic dimension is mildly increased. There is no thrombus noted in the left ventricle. There appears to be a subtle perfusion defect in the LV apex (distal LAD territory), correlation with coronary angiogram suggested. The morphology of the interventricular septum is within normal limits. Right Ventricle: Visually the right ventricular end-diastolic size is within normal limits.Left Atrium: The left atrium is severely dilated. There are four distinct pulmonary veins which drain normally into the left atrium. There is no evidence of left atrial appendage thrombus.Right atrium, vena cavae, and coronary sinus: The right atrium is normal in size. The superior and inferior vena cavae are grossly normal. The coronary sinus is normal in size. Pulmonary Artery: Mildly dilated (33mm).Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary arteries: Because heart rate management was not attempted and nitroglycerine was not administered, this exam was not performed to optimally visualize the coronary arteries. However within the limitations of the study the following observations are made:LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There is mild calcification of the left main coronary artery. LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There is dense calcification in the mid LAD. LCx: The left circumflex coronary artery courses normally in the the left AV groove. It gives rise to the obtuse marginal branches and a small AV circumflex branch. There is no calcification of the LCx.RCA: The right coronary artery arises normally from the right sinus of Valsalva. It is the dominant coronary artery supplying a posterior descending artery and a posterolateral branch. There is moderate calcification of the RCA. Coronary Bypass Grafts:None present. | 1. Thoracic aortic anatomy as above. 2. There is moderate posterior mitral annular calcification which extends onto the posterior leaflet. There is significant prolapse of the posterior mitral valve leaflet. 3. Mild LV dilation with evidence of a subtle perfusion defect involving the LV apex, correlation with recent coronary angiography suggested. 4. Mild coronary artery calcification. 5. Severe left atrial dilation. 6. Mild dilation of the main pulmonary artery. This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report. The abdominal/ pelvis CTA will be reported separated by radiology. |
Generate impression based on findings. | 26-year-old male with neutropenic fever and foul-smelling nasal discharge. There is new complete opacification of the right maxillary sinus obstructing the right ostiomeatal unit also involving several adjacent ethmoid air cells as well as a rudimentary right frontal sinus, obstructing the right frontoethmoidal recess. Mild scattered paranasal sinus mucosal thickening is again noted elsewhere. The left ostiomeatal unit, bilateral sphenoethmoidal recesses, and left frontoethmoidal recess are clear.There is mild scattered paranasal sinus mucosal thickening. There is mild nasal septal deviation to the right with associated spur that contacts the right inferior turbinate. The mastoid air cells are clear. The imaged intracranial structures and orbits are unremarkable. Redemonstrated are extensive dental caries. | There is new complete opacification of the right maxillary sinus obstructing the right ostiomeatal unit also involving several adjacent ethmoid air cells as well as a rudimentary right frontal sinus, obstructing the right frontoethmoidal recess. |
Generate impression based on findings. | 63-year-old male with history of liver cancer? CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Calcified right hilar lymph nodes presumably from prior granulomatous disease. Lobular mildly enlarged anterior mediastinal lymph node (series 12, image 36) measures 1.5 x 1.3 cm -- in light of other evidence of calcified granulomatous lymph nodes, this lymph node is of uncertain significance. No other enlarged lymph nodes..CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Cirrhotic morphology to liver is seen with contracted atrophy of the liver, nodular contours, widening of the intrahepatic fissures. Evidence of portal hypertension is seen with extensive portosystemic collaterals. Portal venous and hepatic venous structures are normal.Three vascular enhancing lesions in the right lobe of liver meet AASLD/UNOS noninvasive imaging criteria for HCC with enhancement and washout on delayed features. These lesions measure 3.3 x 3.2 cm (series 9, image 31 and 4.5 x 3.7 cm (series 9, image 34) smaller lesions subcentimeter in size (series 9, image 28) enhances and washes out but does not meet the 1 cm criteria for definitive diagnosis. Smaller enhancing lesion in inferior right lobe (series 9, image 50) does not demonstrate washout it also remains nonspecific. In addition, multiple lesions are only visualized as hypoattenuating on the washout series (series 13, image 25, 28 and 40). Largest of these latter hypovascular lesions measures 3.0 x 2.9 cm (series 13, image 28).Gallbladder and biliary tract appear normal.SPLEEN: Splenomegaly without focal lesion seen.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nonobstructing pinpoint calyceal calculus in mid right kidney. Small cortical hypodensities subcentimeter size too small to characterize but most likely benign cysts.RETROPERITONEUM, LYMPH NODES: Clusters of enlarged lymph nodes is seen in the hepatoduodenal ligament up to rule largest size of 2.4 x 1.3 cm (series 12, image 100). Because lymph nodes to the size are commonly encountered in patients with chronic liver disease and cirrhosis, these lymph nodes remain nonspecific.BOWEL, MESENTERY: No abnormality seen in the stomach, small bowel or colon. No ascites seen in the upper abdomen, however small amount of free peritoneal fluid is seen in the dependent pelvis. 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: Small amount of free peritoneal fluid in the dependent pelvis without loculation. No other abnormalities.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Cirrhotic morphology to liver portal hypertension findings. 2. Multiple masses in the liver most consistent with multiple and diffuse hepatocellular carcinoma -- -- some hypervascular and meeting imaging criteria for HCC as measured and delineated above. Additional multiple hypovascular lesions seen only on delay phases which while not meeting AALSD/UNOS noninvasive imaging criteria, are almost certainly HCC has approximately 5% of HCC patients can demonstrate these types of findings. 3. Enlarged hepatoduodenal ligament lymph nodes -- these are nonspecific and can be seen normally in patients with cirrhosis, although metastatic disease cannot be excluded. 4. Nonobstructing small right kidney calyceal calculus. 5. Nonspecific mildly enlarged anterior mediastinal lymph node -- in light of the other calcified granulomatous disease lymph nodes, this lymph node is of uncertain significance. |
Generate impression based on findings. | Fall one week ago, on coumadin. There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. There are postoperative findings related to right mastoidectomy. There is opacification of the left mastoid air cells. There is moderate mucosal thickening in the maxillary sinuses and milder opacification elsewhere in the paranasal sinuses. There are also bubbly secretion and fluid in the maxillary sinuses. The skull and scalp soft tissues are unremarkable. | 1. No evidence of acute intracranial hemorrhage or skull fracture.2. Findings suggestive of acute sinusitis. |
Generate impression based on findings. | Reason: surveillance imaging for lung caner History: s/p radiation for LUL non small cell lung cancer CHEST:LUNGS AND PLEURA: Redemonstration of post treatment changes in scarlike opacities in the left upper lobe. There is however increasing nodular component to this region (sagittal image 90) and (coronal image 49) measuring 13 mm x 15 mm. This may represent ongoing fibrotic changes however neoplastic recurrence cannot be excluded. Moderate centrilobular emphysema unchanged.No pleural effusions.MEDIASTINUM AND HILA: Prominent left paratracheal lymph node (image 28 series 3) measuring 11 mm previously measuring 10 mm.Prominent right hilar lymph node (image 38 series 3) stable measuring 15 mm in short axis.Subcarinal lymphadenopathy stable.Cardiac size is normal with a stable small anterior pericardial effusion.Mild coronary calcifications.CHEST WALL: Degenerative changes in the thoracic spine.Stable axillary lymphadenopathy with index right axillary lymph node (image 22 series 3) measuring 12 mm previously measuring and.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable nonspecific hypodensity in the left lobe most likely representing a cyst.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Prominent index left periaortic lymph node (image 96 series 3) measures 16 mm by 6 mm previously measuring 17 mm x 10 mm.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Left upper lobe post treatment opacities are redemonstrated. Interval increase in nodular component raise the question of recurrent/residual neoplasm. Continued follow-up examination is recommended.2.Stable axillary, mediastinal, and retroperitoneal lymphadenopathy.3.Noted sites of disease identified. |
Generate impression based on findings. | Male 74 years old; Reason: PCa restaging History: asymptomatic Focal uptake along the anterior aspect of several left-sided ribs arranged in a linear pattern, suggestive of a posttraumatic process. Again seen is scattered uptake along the cervical spine and right elbow likely degenerative in etiology. In addition, there is a left knee prosthesis with expected adjacent increased radiotracer uptake unchanged. | 1. No suspicious scintigraphic evidence to suggest metastatic disease. 2. Additional findings as described above. |
Generate impression based on findings. | 56 year old male with dysphagia s/p OG tube placement. The pelvis is excluded from the field of view. Feeding tube tip in the gastric body, with the distal side-port just past the GE junction. Nonobstructive bowel gas pattern. Postsurgical changes in the right lung with persistent right pleural effusion; please see recent chest radiograph for additional details. | Feeding tube tip in the gastric body, with distal side-port just past the GE junction. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 32 years, Male. Reason: Evaluate NGT, r/o kinking to explain pt's vomiting/fullness History: leukocytosis, poor po/tolerance of tube feeds. NJ tube tip in the jejunum well past the ligament of Treitz. Nonobstructive bowel gas pattern with residual contrast material in the colon, presumably from recent CT scan. Pigtail catheters in the left upper quadrant are unchanged in position. | NJ tube tip in the jejunum, well past the ligament of Treitz. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 67 years old; Reason: Abscess, obstruction History: obstruction, decreased colostomy output ABDOMEN:LUNG BASES: New small bilateral pleural effusions, right greater than left. There is right basilar atelectasis.LIVER, BILIARY TRACT: Liver is normal in morphology. There is several hepatic lesions. Reference hepatic lesion near the IVC measures 1.2 x 1.0 cm (image 50/series 3) previously, 1.5 x 1.3 cm. Portal vein and hepatic veins remain patent.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: Multiple small retroperitoneal nodes. Calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: Postsurgical changes in the abdomen with a large ventral defect. A pocket of fluid deep to the rectus muscle in the pelvis measures 5.5 x 2.8 cm. There are smaller pocket of fluid extending into the left paracolic gutter it measures 4.0 x 3.0 cm..BONES, SOFT TISSUES: Large ventral abdominal wall defect. Left lower abdominal ostomy.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Post surgical changes in the rectum with a catheter. Infiltration of the fat planes within the pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Two fluid pockets within the pelvis one in midline anterior pelvis and second within the left paracolic gutter with wall enhancement and foci of gas suspicious for abscess. |
Generate impression based on findings. | 58 years, Female. Reason: s/p EVAR check graft location. Upper abdomen is excluded from the field of view. Infrarenal aortobi-iliac endograft is noted and in the expected position. Nonobstructive bowel gas pattern. Average stool burden. | Aortic endograft in the expected position but please correlate clinically. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Restaging head and neck supraglottic cancer status post chemoradiation, left 10/31/14. Attention stable 5-mm nodule left lower lobe on recent CT.RADIOPHARMACEUTICAL: 13.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 135 mg/dL. Today's CT portion grossly demonstrates extensive emphysematous changes bilaterally. An irregular approximately 1 cm pulmonary parenchymal opacity is again seen in the right upper lobe. On the current CT portion it has continued to decrease from previous and is most likely a resolving inflammatory focus. A punctate 3 to 4-mm pulmonary nodule at the left base is stable to slightly decreased. Post therapy changes are seen in the neck. Extensive atherosclerotic including coronary arterial calcifications are noted. A hypodense left renal lesion is likely a cyst. Today's PET examination demonstrates complete interval resolution of previous hypermetabolic supraglottic focus. There is currently no suspicious FDG avid lesion within the neck.In the right upper lobe, a small faintly FDG avid focus is identified (SUV max = 0 .9). While new from previous PET, it corresponds to the interval appeared and now decreasing parenchymal density on CTs and is most likely a residual inflammatory focus.No FDG avid lesion is otherwise identified in the neck, chest, abdomen or pelvis. The subcentimeter left lung base pulmonary nodule is not demonstrably FDG avid although too small to completely characterize. | Complete interval resolution of previous hypermetabolic supraglottic lesion without convincing FDG avid tumor currently in the neck, chest, abdomen or pelvis. Small faint parenchymal focus in the right upper lobe is most likely inflammatory as detailed above although further CT follow up can be performed to assure resolution/stability. |
Generate impression based on findings. | Male, 50 years old, with chronic sinusitis. Evidence of functional endoscopic sinus surgery is seen including resection of the uncinate processes, some of the ethmoid air cells and the middle nasal turbinates. Surgical findings have not significantly changed from prior.The frontal sinuses are clear. There is mild mucosal thickening along the left frontal ethmoidal recess. Dependent fluid and/or debris is evident in the bilateral maxillary sinuses which is new, though frothy debris along the floor of the right maxillary sinus seen previously is no longer evident. A small amount of mucosal thickening is evident in the right sphenoid sinus. The sphenoethmoidal recesses are clear. The mastoid air cells and middle ear cavities are clear.Evidence of a left pterional craniotomy/craniectomy is seen with encephalomalacia in the underlying inferior frontal and temporal lobes similar to prior. A left paraclinoid aneurysm clip is seen. | 1. Evidence of functional endoscopic sinus surgery appearing similar to the prior exam.2. Fluctuating areas of mucosal thickening and/or fluid/debris in the maxillary sinuses, improved in some areas and more pronounced in others.3. Chronic postoperative findings status post left paraclinoid aneurysm clipping. |
Generate impression based on findings. | 74-year-old male with prostate cancer -- staging (rise in PSA). ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Stable appearance to the right adrenal gland nodule (series 3, image 37) measuring 2.8 x 2 .6 cm, similar to the 1/10/14 CT examination when it measured 2.7 x 2.6. Left adrenal gland remains normal.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No lymphadenopathy or other abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Treatment seeds again seen in prostate. No other significant abnormalities noted.BLADDER: No significant abnormality notedLYMPH NODES: Prior reference left iliac lymph node is no longer visualized. No new foci of lymphadenopathy seen.BOWEL, MESENTERY: Sigmoid diverticulosis seen without complication and without change. No free mesenteric fluid.BONES, SOFT TISSUES: No significant abnormality noted, however nuclear medicine bone scintigraphy is more sensitive and accurate indicator of skeletal metastatic disease.OTHER: No significant abnormality noted | 1. No evidence for lymphadenopathy. Prior referenced left iliac lymph node continues to decrease in size and now is not visualized. 2. Stable appearance to nonspecific right adrenal gland mass/nodule. 3. No evidence for skeletal metastases, however nuclear medicine bone scintigraphy is more accurate insensitive indicator for skeletal metastatic disease. |
Generate impression based on findings. | Hypodensity is present throughout the white matter without associated mass effect. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. Note is made of vascular calcifications. | Advanced small vessel ischemic disease of indeterminate ages. If there is continued clinical concern for acute ischemia, MRI would be recommended. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Round marker was placed on a skin lesion overlying the left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: Pt w/ new diagnosis of squamous cell lung cancer, eval extent of disease. History: Pt w/ new diagnosis of squamous cell lung cancer, eval extent of disease. CHEST:LUNGS AND PLEURA: Right upper lobe mass measures 36 x 29 mm on image 41/101 (34 x 26 mm on prior). Small satellite nodule has increased from 7 to 8 mm (image 31/101). Emphysema.MEDIASTINUM AND HILA: Extensive right hilar lymphadenopathy compressing right pulmonary arterial branches, especially into the right upper lobe, however they appear to be patent. For continued reference a right hilar lymph node measures 41 x 30 mm on image 42/152.Moderate subcarinal and paratracheal lymphadenopathy on the right. Subcentimeter prevascular, left hilar, and paraesophageal nodes are noted.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Presumed renal cysts bilaterally.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative change involving the spine.OTHER: No significant abnormality noted. | Right upper lobe mass with an adjacent satellite nodule compatible with known lung cancer.Right hilar and paratracheal lymphadenopathy. Borderline subcarinal and contralateral intrathoracic nodes.No evidence of upper abdominal metastatic disease. |
Generate impression based on findings. | 67-year-old female with history of pain. Evaluate for degenerative joint disease. Right knee: No acute fracture or malalignment. Tiny osteophytes are essentially within normal limits given the patient's age. No joint effusion.Left knee: No acute fracture or malalignment. Tiny osteophytes are essentially within normal limits given the patient's age. No joint effusion.Right hip: There is severe osteoarthritis with near bone-on-bone apposition.Left: There is severe osteoarthritis with near bone-on-bone apposition. | Severe osteoarthritis at the hips and minimal osteoarthritis at the knees bilaterally . |
Generate impression based on findings. | Brain MRI:The right cerebellar tonsil lies 8 mm below the level of foramen magnum and demonstrates a slightly pointed configuration.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. Brain MRV:There is normal venous flow demonstrated within the internal cerebral veins, vein of Galen, straight sinus, superior sagittal sinus and within the bilateral transverse and sigmoid sinuses. No dural venous sinus thromboses or occlusions are identified. | 1.MRI evidence for Chiari malformation. Otherwise negative noncontrast brain MRI.2.Negative MR venogram of the brain with and without contrast. |
Generate impression based on findings. | Female, 56 years old, with headaches, and right MCA aneurysm on MRI, assess aneurysm for potential surgical planning. Patient has acoustic neuroma as well. Non-angiographic findings:A large right CP angle tumor is identified corresponding to an enhancing lesion noted on prior MRI and compatible with the stated history of acoustic neuroma. This lesion exerts mass effect on the pons and adjacent middle cerebellar peduncle.Ventricles are prominent but this is not significantly changed compared to the prior MRI study accounting for differences in technique. No intracranial hemorrhage or abnormal extra-axial fluid collections are seen. There is no clear evidence of parenchymal edema or loss of gray-white distinction.The osseous structures of the skull are intact. The paranasal sinuses and mastoid air cells are clear allowing for mild fatty debris in the left sphenoid sinus.Angiographic findings:A broad-based aneurysm arises from the right MCA bifurcation projecting laterally. This lesion incorporates the origins of both the superior and inferior divisions of the MCA. The aneurysm measures up to 6 mm in maximum width and 4 mm in length.There is an additional 2-mm outpouching arising from the left M1 segment of the MCA, proximal to the bifurcation, projecting superiorly. A small vessel does arise from the vicinity of this outpouching, but it does not seem to arise from the apex.No other definite aneurysms are seen. No areas of high-grade vascular stenosis or occlusion are suspected. The right A1 segment is congenitally hypoplastic. A moderately sized left PCOM artery is seen, and there may be a very small right PCOM artery. The ACOM artery is normal. | 1. A broad-based aneurysm arises from the right MCA bifurcation incorporating the origins of both the superior and inferior divisions. This lesion measures up to 6 mm in width and to 4 mm in length.2. A 2-mm superiorly projecting outpouching arising from the left M1 segment of the MCA is seen. Although a small vessel arises from the vicinity of this outpouching, the vessel does not clearly arise from its apex and therefore an additional aneurysm is suspected. |
Generate impression based on findings. | 64 year-old female with pancreas cancer -- compared to previous imaging and provide index lesion measurements. CHEST:LUNGS AND PLEURA: Stable appearance to small right upper lobe micronodules without significant other nodule or new nodules seen. MEDIASTINUM AND HILA: No significant abnormality noted. Atherosclerotic calcifications in the aorta. No adenopathy.CHEST WALL: Left chest wall Port-A-Cath with tip again seen terminating in the superior vena cava. No other abnormalities.ABDOMEN:LIVER, BILIARY TRACT: Increasing size and number of hypoattenuating metastatic lesions in the liver. Reference segment 2/3 lesion (series 3, image 84) measures 10.3 by 8.0 cm, previously 9.2 x 7.5 cm. this mass lesion now exerts posterior mass effect on the portal vein. Hepatic segment 4 a lesion (series 3, image 68) measures 5.1 x 5 .5 cm, previously 5.1 x 4.0 cm. Multiple new hypoattenuating lesions are seen now throughout the right lobe diffusely.Gallstone is again seen without other biliary tract complication.SPLEEN: Invasion of the splenic hilum by pancreatic tail mass again seen. Thrombosis of the splenic vein again noted.PANCREAS: Mass in the tail of the pancreas is slightly increased in size and measures 5.6 x 3.0 cm (series 3, image 79) compared with 4.9 x 2.7 cm previously. Multiple necrotic peripancreatic lymph node seen more medially and superior to the pancreas are similar in appearance.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: The conglomerate of lymph nodes in the gastrohepatic ligament (series 3, image 79) are unchanged in size measuring 2.4 x 3.2 cm compared with 2.4 x 3.1 cm previously. Small periaortic subcentimeter lymph nodes are again seen unchanged. BOWEL, MESENTERY: Prior noted duodenal dilatation is again seen just proximal to passing posterior to the SMA, however is less prominent than seen previously. No evidence of gastric distention is seen to suggest superior mesenteric artery syndrome at this time.Slight peritoneal thickening at the left subdiaphragmatic surface is again seen worrisome for peritoneal spread of disease (series 3, image 72). A small peritoneal nodule abutting the tip of the appendix (series 3, image 132) worrisome for peritoneal metastasis is also unchanged measuring 1.3 x 1 .0 cm, previously 1.2 x 1.0 cm. Small amount of free peritoneal fluid is seen in the pelvis cul-de-sac (series 3, image 158) not seen previously. No other peritoneal abnormalities are seen.BONES, SOFT TISSUES: Multiple compression deformities of the thoracic spine are seen unchanged with degenerative changes. No other focal abnormalities.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: A small peritoneal nodule abutting the tip of the appendix (series 3, image 132) worrisome for peritoneal metastasis is also unchanged measuring 1.3 x 1 .0 cm, previously 1.2 x 1.0 cm. Small amount of free peritoneal fluid is seen in the pelvis cul-de-sac (series 3, image 158) not seen previously. No other peritoneal abnormalities are seen.BONES, SOFT TISSUES: Multiple compression deformities of the upper lumbar vertebral bodies unchanged without other focal abnormality.OTHER: No significant abnormality noted. | 1. Slight increase in size of pancreatic tail mass, invading the splenic hilum. 2. Increasing size and number of hepatic metastases. 3. Stable appearance to two foci of suspected peritoneal metastatic disease. 4. Small amount of free peritoneal fluid in pelvis not seen previously may indicate peritoneal metastatic disease.. |
Generate impression based on findings. | Male 67 years old; Reason: pt with a history of prostate cancer, currently receiving chemotherapy, rising PSA. Please assess for disease progression History: prostate cancer CHEST:LUNGS AND PLEURA: Ground-glass nodule in the superior segment of the left lower lobe measures 8 mm (image 42 is series 5). The pleural spaces are clear.MEDIASTINUM AND HILA: Aberrant right subclavian artery.CHEST WALL: Extensive thoracic body wall metastases.OTHER: ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta. Aortic caval lymph node in the upper abdomen measures 2.1 x 1.7 cm (image 114/series 3). BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive bone disease.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Extensive osseous metastatic disease.OTHER: No significant abnormality noted | 1.Extensive osseous metastatic disease.2.8mm left lower lobe pulmonary nodule for which follow up is suggested.3.Aorta caval lymphadenopathy. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. A 1 cm lobulated mass is present near the 12 o'clock position of the right breast. No suspicious microcalcifications or areas of architectural distortion are present. | Right breast mass. Spot compression imaging and ultrasound are recommended. As well, if the patient can obtain outside mammograms, comparison will be made.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Increased desaturations. 31 day old former 24 to 26 week gestational age patient.VIEW: Chest AP (one view) 01/12/15, 1551 Endotracheal tube tip is at thoracic inlet. Right upper extremity PICC tip is in right brachiocephalic vein. Feeding tube tip is distal to GE junction and not included on the image.Cardiothymic silhouette is normal. Hazy lung opacities persist. No focal opacity is identified. | Continued hazy lung opacity. |
Generate impression based on findings. | Reason: history of prostate cancer History: prostate cancer Lack of IV contrast limits evaluation of solid organ pathology.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Probable left extrarenal pelvis without hydronephrosis/hydroureter.RETROPERITONEUM, LYMPH NODES: No lymphadenopathy by size criteria. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No evidence of osseous metastatic disease but nuclear medicine bone scintigraphy is a more sensitive indicator of disease. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Postoperative changes of prostatectomy. A bilobed fluid collection along the left pelvic sidewall is noted. The smaller superior component measures 2.8 x 2.5 cm and the larger component measures 8.9 x 5.4 cm (series 3 image 125). This collection measures simple fluid attenuation and exerts mass effect on the bladder which is displaced to the right.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No evidence of osseous metastatic disease but nuclear medicine bone scintigraphy is a more sensitive indicator of disease. OTHER: No significant abnormality noted | 1.Postoperative changes of prostatectomy with a bilobed fluid collection in the left pelvic sidewall likely representing a postoperative lymphocele or seroma.2.No evidence of metastatic disease. |
Generate impression based on findings. | 2-year-old male status post right pyelolithotomy, now with abdominal distention and emesis. Evaluate for urine leak. BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 3 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Mildly increased cortical echogenicity on the right. Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 2 Left: 3 Length*** Right: 6.3 cm Left: 8.0 cm Mean for age: 7.0 cm Range for age: 6.0 - 8.0 cmADDITIONAL OBSERVATIONS: The stone previously seen in the right renal collecting system is no longer evident, and there is now a small focus of air within the superior pole collecting system, presumably postoperative in etiology. Two shadowing stones are again seen in the left kidney. Multiple dilated loops of the bowel are present. | 1.Previously seen right renal stone no longer evident, with focus of gas in the right collecting system presumably postoperative in etiology.2.Resolution of the previously seen distal right hydroureter.3.New grade 3 left hydroureter, likely relating to vesicoureteral reflux.4.Two shadowing stones again present in the left pelvicaliceal system.5.Multiple dilated loops of bowel.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | 81-year-old female with history of left hip pain Moderate osteoarthritis affects the left hip, appearing similar to the prior exam. Multiple small densities projecting over the soft tissues of the hip are likely due to prior heavy-metal injection. Arthritic changes also affect the sacroiliac joint and visualized lower lumbar spine. No fracture or malalignment. | Moderate osteoarthritis appearing similar to the prior exam. |
Generate impression based on findings. | 21-year-old female status post femoral rod placement Interval placement of intramedullary rod and 2 screws affixing the comminuted right femoral fracture without evidence of hardware complication. The distal aspect of the rod extends beyond the field of view. Gas in the soft tissues reflect recent surgery. | Status post orthopedic fixation of proximal femur fracture as described above. The distal end of the intramedullary rod is not visualized. |
Generate impression based on findings. | 53-year-old female with history of subcutaneous gas on recent radiographs. Concern for necrotizing fasciitis versus tumor. There is a large air- and fluid-filled collection centered within the posterior compartment of the leg which measures 8.2 x 7.5 cm in the axial dimension and nearly 30 cm craniocaudally. There is an incomplete rim of enhancement along the majority of the collection. The posterior aspect of the lesion exerts mass effect on the gastrocnemius and may potentially involve the muscle. Laterally, the collection communicates with the skin surface of the lower leg and extends along the lateral aspect of the fibula replacing the peroneal musculature, with fluid noted along the common tendon sheath of the peroneal tendons distally. The lesion also extends anteriorly between the tibia and fibula involving the muscles of the anterior compartment. The lesion involves the deep posterior musculature, in particular the flexor hallucis longus. Distally, the collection extends medially in between the distal flexor hallucis longus and Achilles' tendon and wraps around the medial aspect of the distal tibial metaphysis. Diffuse soft tissue swelling extends into the foot particularly dorsally, but the plantar musculature also appears edematous. The majority of the deep facial planes are effaced. Proximally, the anterior tibialis vessels lie along the anterior aspect of the collection. The posterior tibials vessels lie along the medial aspect of the collection and the peroneal vessels are displaced medially and anteriorly as the lesion extends distally. As stated previously, this collection abuts the fibula. There is a pathologic fracture of the proximal fibular diaphysis with approximately 1 shaft width anterior displacement of the distal fracture fragment. There is extensive osteolysis at the site of fracture with aggressive-appearing periosteal reaction. We cannot ascertain whether this is secondary to a neoplastic process or infection.There are additional foci of gas density seen within the popliteal fossa adjacent to the distal biceps femoris muscle and popliteal vessels. These foci do not seem to communicate with the aforementioned lower leg collection.Redemonstrated is a destructive sacral lesion presumably representing the patient's known chordoma, but the proximal extent is not visualized on this dedicated lower extremity study. Decubitus ulceration extends into the sacrum with foci of gas within the bone compatible with osteomyelitis.Again seen is a lesion in the proximal femur with calcification along its rim. Additional soft tissue densities are appreciated within the medullary space of the femoral diaphysis which are new and likely represent additional metastatic foci. A focus of calcification with surrounding lucency is present in the distal femoral metaphysis which may represent a small area of infarction.A soft tissue mass within the subcutaneous tissues of the thigh adjacent to the tensor fascia lata measures 1.5 cm in greatest transverse dimension and 1.2 cm craniocaudally. This lesion presumably represents an additional site of metastatic disease. The previously seen soft tissue mass within the vastus intermedius and vastus medialis is no longer identified, perhaps due to prior surgical resection.A new soft tissue mass, slightly hypodense to muscle, is appreciated adjacent to the posterior aspect of the subtrochanteric femur along the lateral margin of the abductor musculature and immediately anterior to the sciatic nerve. This lesion measures 3 x 2.5 cm in maximal transverse dimensions and 4.5 cm craniocaudally.There is extensive subcutaneous reticulation in the lower leg and foot. | 1.Large collection containing fluid and gas involving the majority of the calf musculature and extending laterally to the skin surface with additional soft tissue edema extending into the foot. This constellation of findings most likely represents an abscess, perhaps arising in a necrotic metastatic focus. The extent of this lesion with foci of gas in the distal thigh suggests a necrotizing infection.2.Pathologic fracture of the fibula as above.3.Additional osseous and soft tissue metastatic lesions as above.4.Sacral decubitus ulcer with foci of air within the sacrum representing osteomyelitis. |
Generate impression based on findings. | 70 year-old male, evaluate osteoarthritis There is marked joint space narrowing, osteophyte formation and subchondral cysts involving the left hip consistent with severe osteoarthritis. Mild osteoarthritis affects the right hip. Relatively minimal osteoarthritis also affects the lower lumbar spine and SI joints. | Severe osteoarthritis affecting the left hip. |
Generate impression based on findings. | 60 year-old male with pain Small, rounded calcific bodies projecting over the inferior axillary recess are suggestive of loose bodies. Mild osteoarthritis affects the supraclavicular joint and glenohumeral joint. | Small calcified loose bodies may reside in the inferior axillary recess of the glenohumeral joint. |
Generate impression based on findings. | Female 30 years old; Reason: 30 y/o with breast cancer now completed 12 weeks of taxol, please re-stage History: see above CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions. The pleural spaces are clear.MEDIASTINUM AND HILA: Right chest wall port at the caval atrial junction. No mediastinal lymphadenopathy.CHEST WALL: Extensive body wall metastases to the osseous skeleton. Right axillary lymph node measures 1.3 x 0.9 cm (image 43/series 3) previously, 1.2 x 0.9 cm.ABDOMEN:LIVER, BILIARY TRACT: Noncontrast CT is suboptimal to evaluate for liver metastases. Within this limitation, no large liver lesions identified.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive osseous metastatic disease.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive osseous metastatic disease.OTHER: No significant abnormality noted. | 1.Extensive osseous metastatic disease. |
Generate impression based on findings. | Female 69 years old Reason: colon cancer with elevated bilirubin compare to last Ct \T\ measure 1) cardiophrenic node, 2) segment 4b liver met,; 3) peritoneal mass, 4) gastrohepatic node, 5) anterior gastrohepatic node, History: post chemo CHEST:LUNGS AND PLEURA: Again noted bilateral lung nodules. Previous index nodule is smaller measuring 4 by 3 mm on image number 19, series number 5. Other bilateral nodules have also decreased in size and number.Bilateral pleural effusions, more on the right compared to the left.MEDIASTINUM AND HILA: Small mediastinal lymph nodes.CHEST WALL: Index cardiothoracic node measures 2.6 x 1.8 cm on image number 56 on series number 3, slightly smaller compared to previous study.ABDOMEN:LIVER, BILIARY TRACT: Significant interval increase in the size and number of the liver lesion. Previously measured index lesion in the liver now measures 5.9 by 5.7 cm on image number 96, series number 3.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Interval placement of right double-J stent. Previously mentioned right hydronephrosis near completely resolved. Previously mentioned pelvic mass invading the uterus and right ureter now measures 4.7 x 3.4 cm on image number 150, series 3, slightly increased in size compared to previous study.RETROPERITONEUM, LYMPH NODES: Extensive enlarged retroperitoneal adenopathy. Index lymph node in the gastrohepatic region is now increased measuring 2.4 x 2.2 cm on image number 17, series number 3. The other retroperitoneal and peripancreatic adenopathy is also increased in size. The more superior index gastrohepatic node is also slightly increased in size measuring 1.7 by 1.6 cm in image number 74, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes secondary to right hemicolectomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Overall progression of disease with interval increase in the size and number of index lesions other than the bilateral lung nodules.Interval placement of right double J stent. |
Generate impression based on findings. | Sickle cell. Rule-out infiltrate. Pre-study evaluation.VIEWS: Chest PA/lateral (two views) 01/12/15 Cholecystectomy clips are present. Bone changes from sickle cell anemia are noted.Cardiac silhouette size is normal. The pulmonary artery branches are mildly dilated. Linear opacities are present in the lung bases. Focal opacities have resolved. No pleural effusion is seen. | Improvement in appearance of the lungs. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral breast reduction. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 67 year-old female with right rib pain Skin markers were placed over the right lower chest wall. No underlying fracture is evident. No rib fracture or other specific finding to account for the patient's pain. | No fracture or other findings to account for the patient's symptoms. |
Generate impression based on findings. | Male 63 years old Reason: evaluatio of bicusid arotic valve, aortic dilatation History: chest pain, palpitations LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Again noted dilated aortic root. Aorta measures 4.4 cm in its largest dimension at the level of the aortic root. Again noted bicuspid aortic valve and aortic calcifications. These have not significantly changed from previous study. Descending thoracic aorta is unremarkable.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No significant change from previous study with dilated ascending aorta and bicuspid aortic valve with calcifications. |
Generate impression based on findings. | Male 28 years old; Reason: 6 month colon cancer survellance History: surveillance CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable right subcentimeter hypodensity too small to characterize, but probably a cyst.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.No evidence of recurrence. |
Generate impression based on findings. | Male 63 years old Reason: 63 yo female with hx of ampullary cancer; s/p resection in 2013 patient having abdominal pain; please evaluate for recurrence and or abnormalities History: ampullary adenocarinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Again noted pneumobilia in the liver. Ill-defined, infiltrative soft tissue density encasing the celiac trunk and common hepatic artery as well SMA, main portal vein and SMV extending into the retroperitoneum anterior to the aorta, new from previous study. This infiltrative mass measures 2.8 x 2.7 cm on image number 98 on series number 4.SPLEEN: No significant abnormality notedPANCREAS: Status post Whipple surgery. Pancreatic tail is unremarkable.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | New infiltrative soft tissue density encasing the major retroperitoneal vessels and infiltrating into the hepatic hilum through the hepatic artery consistent with tumor recurrence. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsies. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Linear markers were placed on the scar overlying the right breast. Stable postsurgical architectural distortion is present. A benign intramammary lymph node is present in the left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable postsurgical scarring in the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 11-year-old male with abdominal pain.VIEW: Abdomen AP (one view) 1/12/2015 The bowel gas pattern is nonobstructive. No pneumoperitoneum or pneumatosis intestinalis is seen. An average stool burden is distributed throughout the colon. | Normal examination. |
Generate impression based on findings. | 20-year-old male with altered mental status, evaluate for bleed or mass. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in sister. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, with interval fatty involution. Two newly visualized masses are present in the right upper outer quadrant. A surgical clip is present in the posterior depth of the left breast, most likely from median sternotomy. Arterial calcifications are present.No suspicious microcalcifications or areas of architectural distortion are present. | Two right breast masses. Spot compression imaging and ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Left arm weakness, confusion, and slurred speech. There is no evidence of intracranial hemorrhage or mass. There is encephalomalacia in the left inferior frontal gyrus with mild ex vacuo dilatation of the left lateral ventricle. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | 1. No evidence of intracranial hemorrhage, mass, or cerebral edema.2. Chronic in the left inferior frontal gyrus. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | 14-year-old male with knee and shoulder pain.EXAMINATION: Right shoulder AP, Grashey and Y (3 views), right knee standing AP and notch , lateral, sunrise (4 views), left knee standing AP and notch (two views) 1/12/2015 KNEES: A small osteochondroma is again seen affecting the posteromedial left femoral metaphysis, without significant change in size or morphology from the prior examination. No acute fracture or malalignment is evident. The proximal tibial and distal femoral articular surfaces are smooth. No right joint effusion is evident. No loose body is seen.SHOULDER: No acute fracture is evident and the humeral head is well seated within the glenoid | Small osteochondroma of the posteromedial left femoral metaphysis without significant change in size or morphology. Normal right knee. Normal shoulder. |
Generate impression based on findings. | Distal swelling. Second and third phalanx fracture?VIEWS: Left hand PA/lateral/oblique (3 views) 01/12/15 Moderate soft tissue swelling surrounds the distal phalanx of the middle finger. Mild soft tissue swelling surrounds the distal phalanx of the index finger. The distal phalanx of the middle finger is abnormal. The physis is widened and a metaphyseal fragment is noted. Anterior angulation is seen of the distal fracture. No other fracture is identified. | Salter II fracture distal phalanx of middle finger. Soft tissue injury distal phalanx of index finger. |
Generate impression based on findings. | 84-year-old male with fall, nose pain No fracture or malalignment. The nasal bone, specifically, is intact. The frontal, ethmoidal, and mastoid air cells appear clear. | No facial fracture evident. |
Generate impression based on findings. | Swelling. Pain. Three views of the right shoulder are provided. There is a comminuted fracture of the proximal humerus involving the surgical neck and greater tuberosity, and resulting in slight varus angulation at the surgical neck. There is a double density along the superomedial aspect of the humeral head, raising the possibility of a vertically oriented intraarticular cleavage fracture. There is also a lipohemarthrosis with slight inferior subluxation of the humeral head with respect to the glenoid. Moderate osteoarthritis affects the acromioclavicular joint. Degenerative arthritic changes also affect the visualized spine.Two views of the right humerus reveal the aforementioned proximal humeral fracture. The distal humerus appears intact. The bones appear slightly demineralized suggesting osteopenia. | Proximal humerus fracture other findings as described above. |
Generate impression based on findings. | 80 year-old male with history of prostate cancer. Evaluate for progression. Motion artifact heavily degrades exam sensitivity. There is interval increase in mottled radiotracer activity in all the long bones as well as the skull, compatible with marked progression of metastatic disease. There is, however, relative improvement of uptake in the axial skeleton including the spine and ribs. Findings are compatible with mixed response to therapy. | Mixed response to therapy with evidence of disease progression specifically involving all 4 limbs and decreased activity within the axial skeletal components. See detail provided. |
Generate impression based on findings. | Status post left total knee replacement The previously seen total knee arthroplasty device has been removed and replaced with a cement spacer. There is a fracture/osteotomy of the anterior cortex of the proximal tibia affixed to the underlying bone via two cerclage wires. Alignment is near-anatomic. Skin staples and foci of gas density in the anterior soft tissues reflect recent surgery. Deformity of the inferior aspect of the patella represents a healing/healed fracture. | Postoperative changes of total knee arthroplasty removal as described above. |
Generate impression based on findings. | Two month history of left wrist pain. No history of trauma. History of right wrist sarcoma. Rule out bony pathology. There is swelling of the soft tissues along the radial aspect of the wrist which is nonspecific but could reflect DeQuervain tenosynovitis in the correct clinical context. Mild osteoarthritis affects the first carpometacarpal joint. | Nonspecific soft tissue swelling along the radial aspect of the wrist. This could represent DeQuervain tenosynovitis in the correct clinical context. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Pain with movement. Evaluate for pathology. There is diffuse soft tissue swelling about the wrist that extends into the hand. IV tubing overlies the radial aspect of the wrist. There is chondrocalcinosis of the triangular fibrocartilage as well as the articular cartilage of the ulnar aspect of the wrist. Small osteophytes indicate mild osteoarthritis. | Soft tissue swelling and arthritis as described above. Given the presence of chondrocalcinosis, the possibility of pseudogout is considered. |
Generate impression based on findings. | Fall with bruising and tenderness of left hip and coccyx. Large ecchymosis over left buttock. Three views of the sacrum/coccyx are provided. The bones appear demineralized, suggesting osteopenia/osteoporosis. I see no findings to suggest fracture of the sacrum or coccyx. Severe degenerative disk disease affects the visualized lower lumbar spine.Two views of the left hip are provided. I see no fracture. Mild osteoarthritis affects the left hip. | Degenerative disk disease of the lower lumbar spine and mild osteoarthritis of the left hip. I see no fracture. |
Generate impression based on findings. | Hip pain. Difficulty walking. Lower back pain. Two views of the left hip are provided. Mild osteoarthritis affects the left hip. I see no fracture or malalignment.Two views of the right hip are provided. Mild osteoarthritis affects the hip. I see no fracture or malalignment.Three views of the lumbar spine are provided. There is severe degenerative disk disease throughout the lumbar spine. There is also multilevel facet joint osteoarthritis particularly affecting the lower lumbar spine. There are grade 1 anterolistheses of L3 and L4. The bones appear slightly demineralized. There is slight anterior wedging of the T12 vertebral body, but this is of uncertain chronicity or clinical significance. Severe degenerative disk disease also affects the visualized lower thoracic spine. | Severe degenerative disk disease and mild hip joint osteoarthritis. Slight anterior wedging of the T12 vertebral body is of uncertain chronicity or clinical significance. |
Generate impression based on findings. | 44-year-old with history of idiopathic scoliosis and osteoporosis, status post fall on January 9, 2015, 12 metal stairs, complains of left shoulder, left elbow, low back and left hip pain. Swelling. Four views of the left elbow are provided. I see no fracture or malalignment.Three views of the left shoulder are provided. I see no fracture or malalignment.Two views of the left hip are provided. I see no fracture or malalignment. There is slight prominence of the anterolateral aspect of the femoral head neck junction indicating a CAM deformity that can be associated with femoroacetabular impingement in the correct clinical context. A small sclerotic focus in the intertrochanteric region likely represents a benign bone island.Five views of the lumbar spine are provided. There is a thoracolumbar scoliosis with severe degenerative disk disease at L4/5. I see no acute fracture. | Scoliosis and severe degenerative disk disease at L4/5. Cam deformity of the left femoral head/neck junction. I see no acute fracture. |
Generate impression based on findings. | A patient submitted the following outside studies for review. 1. Bilateral digital screening mammogram 9/16/20142. Left unilateral digital diagnostic mammogram 9/26/20143. Post procedure left unilateral digital diagnostic mammogram 10/2/20144. Left unilateral digital diagnostic mammogram 11/19/20145. Post procedure left unilateral digital diagnostic mammogram 11/26/20146. Bilateral digital screening mammogram 1/11/20117. Bilateral digital screening mammogram 8/26/2010 Submitted studies for review were performed at Northwestern Memorial Hospital in Chicago, Illinois. BILATERAL DIGITAL SCREENING MAMMOGRAM (9/16/2014): Two standard views of both breasts were obtained and compared to prior mammograms of 1/11/2011 and 8/26/2010. The breast parenchyma is heterogeneously dense, which could obscure the detection of small masses, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the left breast. In the posterior depth of the superior medial left breast, a new 4 cm linearly distributed group of pleomorphic calcifications is present. A stable group of coarse calcifications is present in the right upper outer quadrant. No discrete masses or areas of architectural distortion are present in either breast.LEFT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM (9/26/2014): Digital left LM and 2 spot magnification views were obtained. Additional imaging confirms a 4 cm linearly distributed group of pleomorphic calcifications in the posterior depth of the left superior medial breast. No associated mass is present.POST PROCEDURE LEFT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM (10/2/2014): According to the submitted outside report, patient underwent a stereotactic core needle biopsy of the calcifications in the left upper outer quadrant. Post procedure left LM and CC views reveal a hourglass clip in the central portion of the linearly distributed calcifications in the medial superior left breast. No complication from the procedure is present. PATHOLOGY: Per submitted outside report, pathology from the stereotactic core needle biopsy procedure of 10/2/2014 revealed DCIS. A surgical pathology final report from Northwestern Memorial Hospital dated 10/30/2014 was submitted. Patient underwent a left breast needle localization lumpectomy on 10/30/2014 with the final diagnosis of ductal carcinoma in situ.LEFT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM (11/19/2014): Three standard digital views, ML view, two laterally exaggerated CC views, medially exaggerated CC view and 6 spot magnification views of the left breast were submitted. Linear markers were placed on scars overlying the left breast. There has been interval removal of pleomorphic calcifications in the medial superior left breast with postsurgical architectural distortion and surgical clips in the lumpectomy bed. Newly visualized 2 cm group of calcifications is present in the inferior left breast, best seen on the ML views. No associated mass is present.POST PROCEDURE LEFT UNILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM (11/26/2014): By report, patient had stereotactic core needle biopsy of the calcifications in the left lower inner quadrant. Hourglass clip is present in the left lower inner quadrant without evidence for complication from the procedure. Surgical clips and architectural distortion are present in the superior medial left breast.PATHOLOGY: Per submitted outside report, final pathologic diagnosis from the stereotactic core needle biopsy of the left lower inner breast was DCIS. | Multicentric left DCIS. If definitive surgery has not been performed, a bilateral breast MRI may be helpful in assessing extent of disease and evaluating the right breast, given the parenchymal density. Pathology slides should be reviewed at University of Chicago. Surgical consultation is recommended.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | fall on the back of head, weakness No evidence of acute ischemic or hemorrhagic lesion on this scan.No change of mild ventricular enlargement and non specific small vessel disease since prior exam.There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion on this scan.No change of mild ventricular enlargement and non specific small vessel disease since prior exam. |
Generate impression based on findings. | No evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion on this scan. |
Generate impression based on findings. | altered mental status No evidence of acute ischemic or hemorrhagic lesion on this scan.Minimal patchy low attenuations on bilateral periventricular white matter indicate non specific small vessel disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion on this scan.No change of minimal non specific small vessel disease since 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. Minimal mucosal thickening of the right maxillary sinus, otherwise the paranasal sinuses and mastoid air cells are clear. | No acute intracranial abnormality. |
Generate impression based on findings. | altered mental status Multifocal low attenuation lesions involving right temporal lobe, left basal ganglia, and periventricular white matter indicating age indeterminate ischemic lesions.In addition, there are multiple scattered patchy low attenuations on bilateral periventricular white matter and centrum semiovale indicating non specific small vessel disease.Ventricle size appears to be appropriate considering ex vacuo change of right lateral ventricle. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | 1. Multifocal age indeterminate ischemic lesions as described above.2. Non specific small vessel ischemic disease.3. No evidence of acute hemorrhagic lesion.rec: if clinically indicated, brain MRI is recommended to evaluate associated acute ischemic lesion. |
Generate impression based on findings. | Cortical and sulcal prominence suggest a mild degree of volume loss. Unchanged tortuosity of the vertebro-basilar system. Extensive periventricular and subcortical hypoattenuation is nonspecific but unchanged, consistent with chronic small vessel ischemic disease. Right thalamic hypodensity is consistent with a small chronic lacunar infarct and is unchanged since the prior exam.There is no midline shift or mass effect. There is no intracranial hemorrhage. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. An NG tube is partially visualized. Calcifications with the cavernous carotid arteries are evident. There is an external electronic device overlying the right eyelid. | 1.No acute intracranial hemorrhage.2.Stable chronic small vessel ischemic disease. |
Generate impression based on findings. | Ventricular and sulcal prominence suggest a mild degree of volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. Periventricular and subcortical hypoattenuation is nonspecific but slightly worse than the prior exam and likely reflects moderate chronic small vessel ischemic disease. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | 1.No evidence of mass effect or edema to suggest metastatic disease. If there is strong clinical concern for metastases, an MRI would be more sensitive than nonenhanced CT.2.Nonspecific white matter changes, likely representing chronic small vessel ischemic disease, are slightly worse than the prior exam. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.