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Generate impression based on findings. | 33 year old female s/p C-section. RFO trigger is pregnant woman with BMI over 50. Suspected RFO location: Abdomen. Attending physician: Dr. Nicole Leong. Entire abdomen not viewed due to patient body habitus. No unexpected radiopaque foreign body seen. Midline skin staples and epidural catheter noted. Distended loops of bowel likely represent ileus. | Limited exam without unexpected radiopaque foreign body seen. Findings were discussed with the attending physician, Dr. Leong, via telephone on 1/13/2015 at 09:48. |
Generate impression based on findings. | known lung cancer patient There are significant edema with mass effects on the left hemisphere.Relatively thick walled intra axial mass lesion measured about 20mm on the left superior temporal gyrus and left fronto-parietal operculum area indicating possible metastatic lesion.About 9mm midline shift toward right side was seen and the left lateral ventricle appears to be obliterated.The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | About 20mm sized mass on the left superior temporal gyrus and left fronto-parietal operculum with significant surrounding edema and mass effects indicating metastatic lesion as described above.Rec: Brain MRI with and without contrast enhancement is recommended for further evaluation. |
Generate impression based on findings. | 79 year old female, Dobbhoff tube repositioned. Pelvis excluded from the field of view. Dobbhoff tube tip in gastric fundus. Nonobstructive bowel gas pattern. Calcified lesion in right upper quadrant compatible with gallstone. Left basilar opacity and probable small bilateral pleural effusions. | Dobbhoff tube tip in gastric fundus, unchanged. |
Generate impression based on findings. | 79 years, Male. Reason: Evaluate for SBO, constipation History: 9/10 acute abdominal pain, N/V, met prostate CA. Above average stool burden. Nonobstructive bowel gas pattern. IVC filter in place. Scoliosis with degenerative arthritic changes. Vascular calcifications. Left basilar opacification and bilateral pleural effusions. | Above average stool burden. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 59 years, Male. Reason: abdominal fullness- evaluate for constipation vs ascites, he has history of ascites in past History: fullness Non-obstructive bowel gas pattern. No radiographic evidence of ascites. Average stool volume.Vacular calcifications and embolization coils are noted. | Non-obstructive bowel gas pattern. No radiographic evidence of ascites. |
Generate impression based on findings. | 77 years, Female. Reason: Evaluate for SBO, free air History: dysphagia, N/V, abdominal pain, H pylori + Nonobstructive bowel gas pattern. No free air on upright view. Moderate fecal burden extending into the proximal colon. At least 5 undissolved pills are noted within bowel loops. Left upper quadrant surgical clips. Elevation of the right hemidiaphragm; please see same day chest radiograph report for further details. | 1.Nonobstructive bowel gas pattern. No free air. 2.At least 5 undissolved pills noted within bowel loops; please correlate clinically. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | No acute intracranial abnormality. |
Generate impression based on findings. | Seven month old male status post intubation. History of pulmonary insufficiency.VIEW: Chest AP (one view) 1/13/2015, 05:34 The endotracheal tube tip is below thoracic inlet and above carina. Enteric tube tip is in the body of the stomach.Right upper, right lower and left lower lobe segmental atelectasis unchanged. Persistent subsegmental atelectasis in the left upper lobe. The cardiothymic silhouette is normal. Minimal opacity in the lateral costophrenic sulci may reflect atelectasis or very tiny pleural effusions. | Multifocal atelectasis without significant interval change. |
Generate impression based on findings. | 4-month-old female with cough, congestion, feverVIEWS: Chest AP/lateral (two views) 01/12/15 Cardiothymic silhouette is normal. No pleural effusions or pneumothorax. Large lung volumes. Mild peribronchial cuffing suggestive of bronchiolitis/reactive airway disease. Right upper lobe and left lower lobe streaky opacities represent atelectasis. Double manubrial ossification center is noted, normal variant. | Bronchiolitis/reactive airway disease with foci of atelectasis. |
Generate impression based on findings. | Blunt head trauma, loss of consciousness No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus. Prominence of the retrocerebellar subarachnoid space may represent a mega cisterna magna versus a small arachnoid cyst.Mild mucosal thickening in the paranasal sinuses. Mastoid air cells are clear. Calvarium is intact. | No evidence of acute intracranial hemorrhage or mass effect. |
Generate impression based on findings. | 7-month-old male with history of bronchiolitis and intubation.VIEW: Chest and abdomen AP (two views) 1/13/2015, 17:00 The endotracheal tube tip is below thoracic inlet and above carina. Enteric feeding tube tip is in the body of the stomach. Right femoral venous catheter with tip at the confluence of the common iliac veins.Right upper, right lower and left lower lobe segmental atelectasis unchanged. Persistent subsegmental atelectasis in the left upper lobe. The cardiothymic silhouette is normal.Gas is only present in the stomach and one loop of bowel in the right lower quadrant, but no pneumatosis intestinalis, pneumoperitoneum or portal venous gas is seen. There is subcutaneous edema affecting the proximal aspects of both thighs, right greater than left. | Multifocal atelectasis without significant interval change. Paucity of bowel gas. |
Generate impression based on findings. | 65 year old male s/p Dobbhoff placement. Pelvis is excluded from the field of view. Dobbhoff tube tip in gastric antrum. LVAD and median sternotomy hardware unchanged. Persistent nephrogram appearance of kidneys from retained contrast is suggestive of renal dysfunction. Nonobstructive bowel gas pattern. Cardiomegaly. | Dobbhoff tube tip in gastric antrum. |
Generate impression based on findings. | 58 year-old female with left lower quadrant pain. Evaluate for diverticulitis. ABDOMEN:LUNG BASES: Mild left basilar atelectasis.LIVER, BILIARY TRACT: No focal hepatic lesion. No intra or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Mildly enlarged nonspecific retroperitoneal lymph nodes.BOWEL, MESENTERY: No specific findings to suggest colitis or bowel obstruction.PELVIS:UTERUS, ADNEXA: There is a heterogeneous 8.6 x 5.6-cm mass in the expected location of the left adnexa raising concern for malignancy. Heterogeneous appearance of the uterus with foci of calcifications consistent with a fibroid uterus.BLADDER: No significant abnormality notedLYMPH NODES: Mildly enlarged enhancing bilateral inguinal lymph nodes are nonspecific. BOWEL, MESENTERY: Underdistention of left colon makes evaluation suboptimal. No colitis or small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Large left adnexal mass is nonspecific but suspicious for malignancy. Further evaluation and characterization with pelvic sonography versus MRI is recommended. |
Generate impression based on findings. | Swelling There is an oblique fracture of the distal fibula extending to the level of the tibiotalar joint with slight posterolateral displacement of the distal fracture fragment. There is also a transverse fracture through the medial malleolus with minimal displacement. There is diffuse soft tissue swelling. Scattered arterial calcifications are noted in the soft tissues. | Distal fibular and medial malleolar fractures as above. |
Generate impression based on findings. | Fall, possible seizure. Evaluate for intracranial hemorrhage, mass. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus. There is mild to moderate mucosal thickening throughout the paranasal sinuses. Mastoid air cells are clear. Calvarium is intact. | No evidence of acute intracranial hemorrhage or mass effect. If there is continued suspicion for intracranial pathology, consider MRI for further evaluation. |
Generate impression based on findings. | 21 month old male born prematurely, now with crackles and wheezes.VIEWS: Chest AP/lateral (two views) 1/12/2015 Multifocal subsegmental atelectasis. Large lung volumes, flattening of the diaphragms and peribronchial thickening is evident. PDA clip position unchanged. The cardiothymic silhouette is normal. Healed posterior rib fractures of the right 9th and 10th ribs. | 1.Bronchiolitis/reactive airways disease pattern without superimposed infection.2.Healed posterior rib fractures of the right 9th and 10th ribs. |
Generate impression based on findings. | 90 year-old male status post fall in bed on right side Ribs: Multiple markers were placed along the right lower chest wall. There is a nondisplaced fracture of the lateral right 10th rib and posterolateral 11th rib.Elbow: Mild degenerative changes affecting the elbow. A small olecranon spur is noted. No significant joint effusion or fracture evident. | Nondisplaced rib fractures. |
Generate impression based on findings. | 48-year-old male with history of epigastric bruising. Evaluate for abdominal injury. CHEST:LUNGS AND PLEURA: Small probable intra/perifissural lymph node seen on the left, unchanged from prior. No pleural effusion, consolidation or pneumothorax.MEDIASTINUM AND HILA: Small amount of residual thymic tissue. No pericardial effusion. Heart size within normal limits.CHEST WALL: Gynecomastia.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy, with minimal dilation of the intrahepatic bile ducts that is commonly seen in patients with this procedure.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable left renal complex cyst, nonspecific on this nondedicated study. Stable right renal hypoattenuating foci, too small to characterize. No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative changes affect the spine, with bridging anterior osteophytes.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: No significant abnormality notedOTHER: Small bilateral fat containing inguinal hernias. | 1.No significant acute abnormality, specifically no findings of acute traumatic injury.2.Status post cholecystectomy, other findings as above. |
Generate impression based on findings. | 22-day-old male with desaturations and blood from noseVIEW: Chest AP (one view) 01/12/15 Tracheostomy tube tip is at the thoracic inlet. Left upper extremity PICC with tip in the SVC. Nasogastric tube with side-port within the proximal stomach with tip below the field-of-view.Cardiothymic silhouette is unchanged. No pleural effusion or pneumothorax. Persistent bilateral diffuse lung haziness. No focal pulmonary opacities to suggest infection. Interval decrease in soft tissue edema. | Persistent bilateral, diffuse lung haziness. |
Generate impression based on findings. | 79-year-old female with humeral head fracture A comminuted proximal humerus fracture involving the surgical neck and greater trochanter with intra-articular extension is again visualized. | Comminuted proximal humerus fracture. |
Generate impression based on findings. | 38 years Male. Reason: eval for ventriculomegaly. Multiple ventriculostomies, status post Torkildson shunt. Redemonstration of bilateral parietal-approach ventriculostomy catheters, and remnant of a left frontal approach ventriculostomy catheter. The left parietal-approach catheter continues to drain into the cervical subarachnoid space.The ventricular system is stable in size. The frontal horns continue to measure 43 mm in transverse dimension, and the third ventricle measures 10 mm in transverse dimension. The fourth ventricle remains nondilated.Stable appearance of colpocephaly and a thin corpus callosum. A subependymal calcification is again noted at the trigone of left lateral ventricle.No evidence of acute intracranial hemorrhage or edema. The paranasal sinuses are clear. There is trace fluid within the mastoid air cells. The orbits appear intact. | 1. Stable appearance of the lateral ventricles and third ventricle.2. Status post multiple ventriculostomies.3. No evidence of acute intracranial hemorrhage, mass-effect, or edema. |
Generate impression based on findings. | 60 year-old female with nausea and abdominal pain. Evaluate for obstruction versus colitis. ABDOMEN:LUNG BASES: Persistent moderate left pleural effusion with overlying atelectasis. Partially visualized micronodules in the right lung base, with at least one of them new, consistent with known history of metastatic disease. Right breast mass again noted measuring 1.8 x 0.8 cm (series 4, image 19), previously measuring 1.9 x 1.8 cm.LIVER, BILIARY TRACT: No focal hepatic mass. Gallbladder surgically absent. No significant interval change in the prominent common bile duct and minimal central biliary prominence, possibly related to cholecystectomy. The common bile duct tapers distally but no radiopaque stone is identified.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Unchanged mild thickening of the adrenal glands bilaterally.KIDNEYS, URETERS: Right renal hypoattenuating lesion is unchanged in size and measures approximately 25 Hounsfield units and may be a complex cyst. Other bilateral subcentimeter hypoattenuating lesions are too small to characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Moderately dilated stomach with debris/ingested material and small bowel loops measuring up to 4 cm in diameter with collapsed ileal loops and transition point in the right lower quadrant; findings consistent with a small bowel obstruction. Diverticulosis without specific findings to suggest diverticulitis or colitis.BONES, SOFT TISSUES: Mild interval increase in several punctate sclerotic foci in the pelvis, lumbar spine, and femora concerning for progressed metastatic disease versus treated disease. Reference T8 vertebral body sclerotic lesion measures 2.7 x 2.3 (sagittal series, image 72), previously measuring 1.7 x 1.5 cm.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Mild interval increase in several punctate sclerotic foci in the pelvis, lumbar spine, and femora concerning for progressed metastatic disease versus treated disease. Reference T8 vertebral body sclerotic lesion measures 2.7 x 2.3 (sagittal series, image 72), previously measuring 1.7 x 1.5 cm. | 1.Findings consistent with small bowel obstruction with transition point in the right lower quadrant.2.Interval decrease in size of right breast mass.3.Partially visualized lung metastases. 4.Osseous metastases as above. Nuclear medicine bone scan may be considered for further evaluation of osseous disease burden. |
Generate impression based on findings. | 6-year-old male with low back pain, rule out mass.VIEWS: Lumbar spine AP and lateral (two views) 1/12/2015 Left hemisacralization of L5, a normal anatomic variant. No fracture, malalignment or osseous destruction is seen. A moderate stool burden is present within the rectosigmoid colon. | No soft tissue mass seen, but this could be this could be better evaluated with MRI or ultrasound. |
Generate impression based on findings. | 24 years, Male. Reason: Nausea and vomiting s/p NGT placement History: nausea and vomiting; ex-lap, extensive lysis of adhesions, Hartmann-type takedown with ileorectal anastomosis 1/9/15 NGT tip is in the gastric body with side port in the EG junction. Mildly dilated loops of bowels consistent with SBO pattern, likely generalized ileus given recent surgery. Skin staples in place. | SBO pattern, likely generalized ileus. Side port of the NGT is in the EG junction. |
Generate impression based on findings. | 3-year-old female with cough, tachypnea, and feverVIEWS: Chest AP/lateral (two views) 01/12/15 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Bronchial wall thickening suggestive of bronchitis/reactive airway disease. No focal pulmonary opacities. | Bronchiolitis/reactive airway disease. |
Generate impression based on findings. | 55-year-old female with pain Glenohumeral alignment is within normal limits. No fracture is evident. Deformity of the AC joint likely relates to old trauma. | No acute fracture or dislocation. |
Generate impression based on findings. | Female; 53 years old. Reason: sob, hx of PE History: sob, hx of PE PULMONARY ARTERIES: No acute pulmonary embolus. Redemonstration of linear filling defects in the left main pulmonary artery, compatible with arterial web and chronic emboli. Main pulmonary artery again measures 3.1-cm, suggestive of pulmonary hypertension. No evidence of right heart strain.LUNGS AND PLEURA: No significant interval change in the appearance of the lungs with multifocal areas of consolidation, interlobular septal thickening, and architectural distortion. Large basilar bullae are again seen.MEDIASTINUM AND HILA: No significant interval change in mediastinal lymphadenopathy. Normal heart size without pericardial effusion. No significant coronary artery atherosclerotic calcifications are evident.CHEST WALL: Stable mild anterior wedging of T6 vertebral body.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Stable prominent gastrohepatic lymph nodes. | 1. No evidence of acute pulmonary embolus. Findings chronic pulmonary emboli/web with suggestion of chronic pulmonary hypertension, similar to prior study.2. Persistence of severe interstitial lung disease and multifocal consolidation.PULMONARY EMBOLISM: PE: Positive.Chronicity: Chronic.Multiplicity: Multiple.Most Proximal: Lobar.RV Strain: Negative. |
Generate impression based on findings. | 86-year-old female status post fall Hardware components of a total knee arthroplasty are situated in near-anatomic on without evidence of hardware complication. No fracture is evident. | Status post TKA without fracture or dislocation. |
Generate impression based on findings. | 16-year-old female with pain, evaluate for fractureVIEWS: Pelvis AP/frog leg (two views), lumbar spine AP/lateral (two views) 01/13/15 Lumbar spine: There are 5 non-rib bearing lumbar vertebra. Vertebral body heights and alignment are preserved. There is mild leftward curvature of the lumbar spine. Coccyx has been removed.Pelvis: No acute fracture or malalignment is evident. The osseous structures are within normal limits. Moderate amount of stool and bowel gas obscures evaluation of the sacrum. | No acute fracture or malalignment is evident. |
Generate impression based on findings. | 84 years, Female. Reason: r/o ileus History: emesis \T\ distension G-tube is noted projecting over the gastric antrum. Slightly decreased small bowel gas. Calcified uterine fibroid again noted. | Slightly decreased small bowel gas. |
Generate impression based on findings. | 13 year old female with pain along the plantar aspect of the left foot.VIEWS: Left foot AP lateral and oblique (3 views) 1/12/2015 No acute fracture or malalignment is evident. No foreign body or soft tissue swelling seen. | Normal examination |
Generate impression based on findings. | Three day old former 24 week gestational age patient with pneumothorax. Desaturations.VIEWS: Chest and abdomen AP (two views) 01/13/15, 0134 Endotracheal tube tip is between carina and thoracic inlet. Umbilical venous line tip is in right atrium. Umbilical arterial line has its tip at T6. Three right chest tubes continue in place.Soft tissue edema is developing.Right anterior and subpulmonic pneumothorax herniates across the midline and the mediastinum is displaced to the left. Hazy lung opacities persist and atelectasis of the left lower lobe continues. Cardiac silhouette size cannot be evaluated.No bowel gas is present. | Persistent pneumothorax. |
Generate impression based on findings. | There are 5 lumbar type vertebral bodies. Again seen are postsurgical changes of laminectomies for decompression from L3 to L5. Partial resection of the spinous process seen at the L3 level inferiorly. There is mild loss of height involving the L4 and L5 vertebral bodies including prominent erosion of the anterior/superior aspect of the L5 vertebral body. There is minimal retrolisthesis of L5 on S1. Alignment is otherwise maintained. Advanced degenerative changes are seen at the L4-L5 and L5-S1 levels. Extensive vacuum disk phenomena is noted at the L4-L5 level, and to a lesser degree at the L5-S1 level. Epidural soft tissue seen in the spinal canal, compatible with scar tissue.Multilevel degenerative changes are seen, as seen on recent MRI with individual levels as below:At L1-2 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L3-4 there is disk bulge and facet arthropathy. Spinal canal is decompressed. Minimal bilateral foraminal stenosis..At L4-5 there is disk bulge with endplate osteophytes, relatively large on the left, extending into the neural foramen. Spinal canal is decompressed with epidural soft tissue compatible with scar. There is bilateral moderate to severe neural foraminal stenosis. Advanced bilateral facet arthropathy with diastasis on the right is noted.At L5-S1 there is disk bulge with prominent endplate osteophytes extending into the foramen. Spinal canal is decompressed. There is mild to moderate bilateral foraminal stenosis. | 1. Postsurgical changes of posterior spinal decompression from L3 to L5. 2. Advanced degenerative changes at the L4-L5 and L5-S1 levels again seen. Prominent endplate erosive changes are seen which are favored to be on a degenerative basis. There is also prominent vacuum disk phenomena at these level. Although not completely excluded, infection is very unlikely.3. Bilateral neural foraminal stenosis at L4-L5 and L5-S1 and facet arthropathy at L4-5 and L5-S1 as detailed above. |
Generate impression based on findings. | Evaluate pleural effusionsVIEW: Chest AP 1/13/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Left chest tube in place. Left upper extremity PICC unchanged. Cardiothymic silhouette normal. Bilateral small pleural effusions left greater than right not significantly changed. Diffuse atelectasis bilaterally unchanged. Marked body wall edema. | Bilateral small pleural effusions left greater than right not significantly changed. |
Generate impression based on findings. | 63 year old female with history of ampullary cancer and liver metastases. Staging. CHEST:LUNGS AND PLEURA: Mild apical predominant emphysema. Patchy groundglass opacities, particularly in the left upper lobe (4/97), nonspecific and may be infectious/inflammatory in etiology, however, consider low dose CT chest follow up if clinically desired. Linear opacities in the bilateral lower lobes, consistent with subsegmental atelectasis. Minimal right pleural effusion.MEDIASTINUM AND HILA: Heart size within normal limits comment a pericardial effusion. Scattered small nonspecific mediastinal lymph nodes. Small hila hernia.CHEST WALL: Minimal degenerative changes affect the spine, including mild/stage one retrolisthesis of L5 on S1.ABDOMEN:LIVER, BILIARY TRACT: Nodular liver contour, consistent with hepatic fibrosis. Pneumobilia and dilated intra/extrahepatic biliary ducts upstream from a new common bile duct stent in the expected location, degree of biliary duct dilatation improved from earlier MRI. Right peripheral hepatic lobe (3/82) hypoattenuating focus measures approximately 1.3 x 1 cm, unchanged in size from the previous MRI measurements. The gallbladder is enlarged with air fluid level. Portal vasculature is patent. Moderate ascites, stigmata of portal hypertension.SPLEEN: Small splenule in the splenic hilum.PANCREAS: Pancreatic duct dilation up to 1.1 cm, unchanged. There is an approximately measuring 4.1 x 3.3 cm low attenuation mass near the junction of the head of the pancreas and duodenal ampulla, not significantly changed.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts, nonobstructing right renal calculus measuring 5 mm.RETROPERITONEUM, LYMPH NODES: Enlarged peripancreatic, portacaval and retroperitoneal lymphadenopathy. For example, portacaval lymph node measuring 1.6 x 1 cm, image 111 series 3.BOWEL, MESENTERY: Diffuse bowel thickening of the colon, with relative sparing of the rectosigmoid junction, most consistent with nonspecific colitis.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate pelvic ascites. | 1. Hypoattenuating mass near the junction of the pancreas head/duodenal ampulla. Interval placement of biliary stent with improved biliary duct dilatation. Persistent pancreatic duct dilatation.2. Hepatic fibrosis, with stigmata of portal hypertension and moderate ascites, right hepatic hypoattenuating lesion, metastatic focus not entirely excluded. 3. Enlarged adenopathy, suspicious for metastatic disease.4. Diffuse bowel wall thickening of the colon, consistent with nonspecific colitis.5. Patchy groundglass opacities, particularly in the left upper lobe (4/97), nonspecific and may be infectious/inflammatory in etiology, however, consider low dose CT chest follow up if clinically desired. Correlation with patient's clinical history/symptoms recommended. |
Generate impression based on findings. | 21 month old female with aplastic anemia and hypoxemia. Evaluate endotracheal tube placement.VIEW: Chest AP (one view) 1/12/2015, 18:27 Endotracheal tube tip below thoracic inlet and above carina. Right internal jugular central venous catheter tip in the SVC and left upper extremity PICC with tip at the level of the cavoatrial junction. Right upper and left lower lobe air space opacities are unchanged. The cardiothymic silhouette is upper limits of normal. Lung volumes are large. | Increased lung volumes with persistent multifocal airspace opacities. |
Generate impression based on findings. | 38 year-old male with left flank pain. Evaluate. ABDOMEN: Lack of IV contrast limits evaluation of solid organs and bowel.LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No focal hepatic lesions. No intra or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No nephrolithiasis or ureteral calculus. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mildly dilated loops of small bowel measuring up to 2.5 cm in diameter and mild bowel wall thickening in the left upper quadrant with normal sized ileum.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Mildly dilated loops of small bowel measuring up to 2.5 cm in diameter and mild bowel wall thickening in the left upper quadrant with normal sized ileum. No specific findings to suggest colitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Mildly dilated and thickened loops of proximal small bowel in the left upper quadrant. Findings may be secondary to enteritis versus a focal ileus, partial small bowel obstruction is considered less likely at this time. |
Generate impression based on findings. | 68 years, Male. Reason: eval ileus History: ileus s/p rectal tube Redemonstration of diffusely distended colon. Enteric tube with tip in the region of the gastric body, unchanged. Right hip prosthesis, right femoral line and rectal tube are again noted. Dystrophic calcifications in pelvis, most reflect coarse calcifications in prostate as seen on the CT of 1/5/15. | Redemonstration of diffusely distended colon. Enteric tube and rectal tube, unchanged. |
Generate impression based on findings. | ET placementVIEW: Chest AP 1/13/15 ET tube tip below thoracic inlet and above the carina. Feeding tube extends below the hemidiaphragm and the tip is not visualized. Right central line with tip in the SVC. Cardiothymic silhouette normal. Patchy atelectasis left lower lobe. Interval improvement in the atelectasis in the right middle lobe. No pleural effusion or pneumothorax. | Right middle lobe atelectasis improved with patchy atelectasis left lower lobe. |
Generate impression based on findings. | Female; 47 years old. Reason: r/o PE History: chest pain + LLE calf pain PULMONARY ARTERIES: No acute pulmonary embolus. Normal caliber of the main pulmonary artery.LUNGS AND PLEURA: Minimal bibasilar subsegmental atelectasis.MEDIASTINUM AND HILA: No significant abnormality noted. No coronary artery atherosclerotic calcifications evident.CHEST WALL: No significant abnormality.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No acute pulmonary embolus.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | IntubatedVIEW: Chest AP 1/13/15 ET tube tip below thoracic inlet and above the carina. Feeding tube and left central line in place. Again note IVC stent in place. Cardiothymic silhouette at the upper limits of normal. Patchy atelectasis right lower lobe and left lower lobe. No pleural effusion or pneumothorax. | Patchy atelectasis right lower lobe and left lower lobe not significantly changed. |
Generate impression based on findings. | The ventricles and sulci are more prominent than on the prior exam, consistent with expected mild age-related volume loss. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal diffusion or enhancement. There are a few scattered oval foci of minimally confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, progressed since the previous exam. There is also now more conspicuous ill-defined T2/FLAIR hyperintensity within the pons, most prominent on the right, without enhancement or diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. | 1.Progression of scattered periventricular and subcortical white matter T2/FLAIR hyperintensity are nonspecific but most likely related to mild chronic small vessel ischemic disease. Superimposed findings relating to migraines may also be present.2.Increased conspicuity of ill-defined T2 signal within the pons, most prominent on the right, without enhancement is most likely related to patchy chronic small vessel ischemic disease as well, given supratentorial findings. |
Generate impression based on findings. | IntubatedVIEW: Chest AP 1/13/15 ET tube tip below thoracic inlet and above the carina. NG tube and left central line in place. Cardiothymic silhouette normal. Patchy atelectasis right upper lobe and left lower lobe. No pleural effusion or pneumothorax. | Minimal patchy atelectasis right upper lobe and left lower lobe. |
Generate impression based on findings. | 78 years, Female. Reason: NG placement History: NG placement Incomplete visualization of pelvis and abdomen.Non-obstructive bowel gas pattern. IVC filter projecting over L3/4. NGT tip projecting over proximal gastric body. | Non-obstructive bowel gas pattern. NGT tip projecting over proximal gastric body. Limited field of view. |
Generate impression based on findings. | HypoxiaVIEW: Chest AP 1/13/15 Cardiothymic silhouette normal. Bilateral moderate size pleural effusions right greater than left increased in the interval. Patchy dependent atelectasis in the right lower lobe and left lower lobe. | Bilateral moderate size pleural effusions right greater than left increased in the interval. |
Generate impression based on findings. | Abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty infiltration of the liver without mass.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts. An intermediate attenuation lesion within the midportion of the left kidney best seen on image 59 of series 4 corresponds to a minimally complex cyst on the prior ultrasound exam.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: Diffuse mild bladder wall thickening.LYMPH NODES: Mildly enlarged right external iliac lymph node best seen on image 129 of series 4 measuring 2 x 1.2 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Fatty infiltration of the liver without mass or ductal dilatation.Mild diffuse bladder wall thickening; favor inflammatory/infectious etiology over neoplastic. Associated with mildly enlarged right external iliac lymph node.No evidence to suggest obstruction or inflammatory process involving the bowel |
Generate impression based on findings. | Increasing oxygen requirementVIEW: Chest AP and abdomen AP Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Minimal atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Minimal patchy atelectasis in the right lower lobe and left lower lobe. |
Generate impression based on findings. | 8-year-old female with tenderness, rule out fracture.VIEWS: Left forearm AP and lateral (two views) and left hand PA, oblique and lateral (3 views) 1/12/2015 LEFT FOREARM: No acute fracture or malalignment is evident. No significant soft tissue swelling seen.LEFT HAND: No acute fracture or malalignment is evident. No significant soft tissue swelling seen. | Normal examinations. |
Generate impression based on findings. | Reason: evaluate for infections, new AML There are no fractures identified involving the maxillofacial bones.The skull base foramina are intact.The orbits are intact with no abnormal mass lesions in either orbit. There is no abnormal enhancement of the optic nerves. The visualized eyeballs are intact lacrimal glands are unremarkable. Extraocular muscles are intact. The suprasellar cistern is unremarkable.The ostiomeatal complex units are patent bilaterally. Within the nasal cavity no obstructive lesions are appreciated. The nasal septum is deviated towards the right.The frontal sinuses demonstrate only minor mucosal thickening Maxillary sinuses demonstrate mucus retention cysts in the maxillary sinuses Ethmoid air cells demonstrate only minor mucosal thickening Sphenoid sinuses are clear. Visualized portions of the mastoid air cells and middle ears are clear. Visualized orbits are intact and the visualized intracranial structures are within normal limits.The patient status post removal of right-sided maxillary molar tooth. | 1.There are minor inflammatory changes in the paranasal sinuses but no convincing evidence for acute sinusitis |
Generate impression based on findings. | Female; 84 years old. Reason: eval for PE History: hypoxia PULMONARY ARTERIES: No acute pulmonary embolus. Main pulmonary artery is enlarged and measures 3.3-cm, suggestive of pulmonary arterial hypertension. No evidence of right heart strain.LUNGS AND PLEURA: Mild diffuse interlobular septal thickening, most likely due to pulmonary edema. Mosaic attenuation pattern, which can be seen in hypersensitivity pneumonitis, chronic pulmonary embolism, and small airways disease. No pleural effusions.MEDIASTINUM AND HILA: Mild cardiomegaly. No pericardial effusion. Severe atherosclerotic calcifications coronary arteries. Moderate mitral valve annular calcifications. Mild aortic valve annular calcifications. Large sliding hiatal hernia with the majority of the stomach intrathoracic in location. Apparent mild diffuse thickening of the esophagus, most likely related to reflux.CHEST WALL: Left chest wall pacemaker with leads in the right atrium and right ventricle. Apparent low attenuation lesion in the inferior right thyroid lobe adjacent to a small calcification is indeterminate and poorly visualized due to streak artifact from pacemaker; this would be better characterized by ultrasound as clinically indicated. Diffuse subcutaneous reticulation, suggestive of anasarca. Degenerative arthritic changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Single large gallstone, partially visualized. | 1. No acute pulmonary embolus.2. Findings suggestive of mild CHF with cardiomegaly, mild pulmonary edema, and body wall anasarca.3. Enlarged pulmonary artery, suggestive of pulmonary arterial hypertension.4. Mosaic attenuation pattern, which can be seen in hypersensitivity pneumonitis, chronic pulmonary embolism, and small airways disease. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | ET tube placementVIEW: Chest AP 1/13/15 ET tube tip below thoracic inlet and above the carina. There are two NG tubes in the stomach and the tips are not identified. Right upper extremity PICC with tip at the cavoatrial junction. Cardiothymic silhouette at the upper limits of normal. Patchy opacities in the right lower lobe and left lower lobe minimally improved. Probable small bilateral pleural effusions. | Bilateral patchy opacities in the right lower lobe and left lower lobe minimally improved. |
Generate impression based on findings. | ET placementVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Right central line and left PICC again noted. Cardiothymic silhouette at the upper limits of normal. Patchy atelectasis in the left lower lobe, right lower lobe and left upper lobe. No pleural effusion or pneumothorax. | Patchy atelectasis bilaterally not significantly changed. |
Generate impression based on findings. | Reason: 41 yo hx of asthma pw exacerbation to eval for sinusitis/polyps History: resp fail req bipap The frontal sinuses are hypoplastic. There is opacification of all the paranasal sinuses with heterogeneous density opacities. There is also opacification of the superior middle and chonchae.There is a 25 x 18 mm axial and nodule in the left submandibular spaceVisualized portions of the mastoid air cells and middle ears are clear. Visualized orbits are intact and the visualized intracranial structures are within normal limits. | 1.Opacities in the paranasal sinuses and nasal cavity suggests sinonasal polyposis in the given clinical context. Hyperdense opacities most likely represent inspissated secretions but may also represent fungal infection.2.Finding suggests lymphadenopathy left submandibular space.3.Findings were discussed with Dr Jenniffer Thai (pager 4100) at 9 am. |
Generate impression based on findings. | Asthma exacerbationVIEW: Chest AP 1/13/14 Cardiothymic silhouette normal. Patchy opacities at the right lower lobe and left lower lobe likely to represent atelectasis with no evidence of pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Respiratory insufficiencyVIEW: Chest AP 1/13/15 Cardiothymic silhouette normal. Patchy atelectasis in the right lower lobe and left lower lobe not significantly changed. No pleural effusion or pneumothorax. G-tube in place. | Patchy atelectasis bilaterally not significantly changed. |
Generate impression based on findings. | 15 years Male with history of gunshot wound to the head. Evaluate right occipital contusion. There is redemonstration of a depressed right occipital skull fracture, associated with a 4-5 mm depression of the fracture fragment. Mild interval worsening of edema within the adjacent brain parenchyma. The resultant hematoma measures 20 x 10 mm (series 2, image 33), previously 16 x 11 mm.Mild increase in the degree of soft tissue swelling in the adjacent scalp. Interval placement of multiple scalp staples. Redemonstration of multiple punctate metallic-density foreign bodies, compatible with bullet fragments.There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | Redemonstration of a depressed right occipital fracture and associated extra-axial hematoma, which has mildly enlarged since the previous exam. Mild interval worsening of edema within the adjacent brain parenchyma. Increased soft tissue swelling in the overlying scalp. |
Generate impression based on findings. | 45-year-old male with history of pancreatic surgery/Frey procedure. Evaluate for obstruction. ABDOMEN:LUNG BASES: Mild bilateral basilar atelectasis.LIVER, BILIARY TRACT: No focal hepatic lesion. Status post cholecystectomy with minimal prominence of the intrahepatic biliary ductal system, possibly secondary to the cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: Postoperative changes of Frey procedure with resection of the pancreatic head. There is mild peripancreatic edema and mesenteric fat stranding in the surgical bed/region of pancreatic head. No drainable fluid collections. There is mild diffuse peripancreatic edema; while this may be partially postoperative in etiology, underlying pancreatitis is suspected.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal hypoattenuating lesion is too small to characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild mesenteric haziness adjacent to the sigmoid colon is nonspecific.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Mild mesenteric haziness adjacent to the sigmoid is nonspecific.BONES, SOFT TISSUES: Mild degenerative disk disease. | Postoperative changes related to prior Frey procedure with mild peripancreatic edema as above. While this may be secondary in part to the patient's recent surgery, superimposed acute pancreatitis is a consideration. Correlation with patient's history and laboratory values is recommended. |
Generate impression based on findings. | PainVIEWS: Right elbow AP, oblique and lateral No acute fracture or dislocation. No elbow joint effusion. | Normal examination. |
Generate impression based on findings. | 54 year old female status post left lumpectomy and sentinel lymph node biopsy 11/2010 for IDC. Status post radiation and hormone therapy. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A linear scar marker denotes the left breast scar. Postsurgical changes are present and unchanged, with architectural distortion and surgical clips in the medial left breast. No new masses or suspicious microcalcifications are present in either breast. | Stable postsurgical changes in the left breast without mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 44 year old female with history of acute onset abdominal pain. Evaluate for diverticulitis/nephrolithiasis. ABDOMEN:LUNG BASES: Calcified left lung base granuloma.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydronephrosis or hydroureter. No nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No small bowel obstruction. No mesenteric lymphadenopathy.PELVIS:UTERUS, ADNEXA: Approximately 5.6 x 6.5 centimeter complex ovoid structure in the left/mid pelvis, and a second right pelvic 4.1 x 3 cm complex cystic lesion, suspicious for bilateral adnexal masses. Soft tissue at the posterior-inferior base of the more midline mass may reflect residual uterine tissue.BLADDER: The bladder is slightly displaced anteriorly by these suspected adnexal lesions.LYMPH NODES: No appreciable lymphadenopathy.BOWEL, MESENTERY: No secondary findings of appendicitis or diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted | Heterogeneous cystic lesions in the suspected location of the bilateral adnexa, nonspecific and may be large hemorrhagic cysts but should be further evaluated with ultrasound or pelvic MRI to exclude underlying neoplastic process. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bilateral benign breast biopsies. (right breast - 1959, left breast - 1969). 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. There are several benign circumscribed masses seen in both breasts, which are stable when compared to prior exams. Scattered benign calcifications, including arterial calcifications are seen. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | PainVIEWS: Right hand AP, oblique and lateral No acute fracture or dislocation. There is a soft tissue prominence immediately adjacent to the middle phalanx of the index finger. | No acute fracture or dislocation. Moderate size soft tissue prominence immediately adjacent to the middle phalanx of the index finger and clinical correlation recommended. |
Generate impression based on findings. | 66 year old female with history of stent cell transplant. Patient with fever, abdominal pain, and weight loss. Evaluate. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules without suspicious nodules or masses. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Scattered mediastinal and hilar lymph nodes not significantly changed compared to previous examination. Right juxtaphrenic lymph node measures 9 x 4 mm (series 3, image 70), previously measuring 7 x 3 cm. Heart is normal in size without pericardial effusion. CHEST WALL: Right chest port with tip in the SVC/right atrial junction.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly without focal hepatic lesions. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: Splenomegaly, unchanged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal hypoattenuating lesions compatible with simple cysts, unchanged.RETROPERITONEUM, LYMPH NODES: No significant change in the subcentimeter gastrohepatic lymph node.BOWEL, MESENTERY: Persistent thickening of the distal esophagus and gastroesophageal junction.No evidence of thickening of the gastric antrum. The previously referenced lymph node anterior to the antrum is no longer present. No findings to suggest small bowel obstruction. Diverticulosis without evidence of diverticulitis.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Moderate degenerative disk disease affects the lower lumbar spine. Subcutaneous emphysema in the abdominal wall, likely injection sites.OTHER: No significant abnormality noted. | 1.Hepatosplenomegaly without specific findings to suggest metastatic disease. 2.Persistent thickening of the distal esophagus and gastroesophageal junction.3.Interval resolution of nonspecific thickening of gastric antrum and the adjacent lymph node seen on prior exam. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of right cyst aspiration in 2003. Two standard digital views (including an additional right MLO view) and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. Scattered benign calcifications are seen. 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. The sensitivity of mammography for detecting breast cancer is decreased in patients with dense breasts such as this patient. Physical exam assumes a more important role.BIRADS: 1 - Negative.RECOMMENDATION: NSD - Screening Mammogram. |
Generate impression based on findings. | 17 year-old male status post T5 to pelvis spinal effusion.VIEW: Lumbar spine AP (one view) 1/12/2015, 18:50 Rods and hooks are again seen extending from just superior to T6 to the inferior margin of L5 on the right. The left rod has been extended, now extending out of the field of view superiorly, to L5 inferiorly. Bilateral iliac screws are in place, position unchanged. A skin staple line courses along the posterior aspect of the spine. A left thoracolumbar curve is again seen. There is a large stool burden present in the colon. The enteric feeding tube has been removed. Baclofen pump an intraspinal catheter are present. | Postoperative changes as above. |
Generate impression based on findings. | 73 year old woman with history of left breast ALH status post left stereotactic core biopsy. History of breast cancer in maternal great aunt diagnosed in her 50s. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The biopsy clip at the site of ALH is noted in the left breast at the 12 o'clock position. Scattered benign calcifications are present in both breast. No new masses, suspicious microcalcifications or areas of architectural distortion are present in either breast. Stable lymph nodes project over the axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign intramammary lymph nodes are seen bilaterally. | 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. | 65 years Male with history of head and neck cancer, chemotherapy follow-up. Please compare to previous with measurements. Large right tonsillar mass is no longer appreciably measurable. Diffuse thickening and hyperenhancement of the pharyngeal, tonsillar, and tongue-base tissues, likely related to treatment. No new focal mass is identified.Previously described right level IIa nodal mass currently measures 8 x 6 x 6 mm, previously 12 x 9 x 10 mm. Currently, no significant cervical lymphadenopathy.The previously described attenuation of the right internal jugular vein has resolved. The major cervical vessels are patent. Unchanged appearance of degenerative disease in the spine, including moderate right C5-C6 neural foraminal narrowing. No suspicious osseous lesion. Small left maxillary sinus retention cyst is stable. Poor dentition, including multiple missing teeth, is again noted. The thyroid and major salivary glands are unremarkable. The airways are patent. Mild opacification of bilateral mastoid air cells. The imaged intracranial structures are unremarkable. | Diffuse thickening and hyperemia of the pharyngeal, tonsillar, and tongue-base tissues, likely post-treatment related. Large right tonsillar mass is no longer appreciably measurable. Interval decrease in size of right level II nodal mass, consistent with treatment response. No significant residual/new cervical adenopathy. |
Generate impression based on findings. | 69-year-old female with adenoid cystic cancer who presents for evaluation of disease status. CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules and masses are again seen, some of which have increased in size compared to previous exam and some of which are new. For example, there are new nodules/masses in the left lower lobe (series 5, image 73) and left upper lobe (series 5, image 27).Reference left lower lobe mass measures 8.3 x 4.5 cm (series 5, image 70), previously measuring 4.3 x 7.7 cm.Reference right lower lobe mass measures 8.3 x 7.3 cm (series 3, image 70), previously measuring 7.8 x 7.0 cm (series 3, image 71) as remeasured.Small right pleural effusion with a small loculated component. Although, this is stable in appearance and size, superimposed infection cannot be excluded.MEDIASTINUM AND HILA: Reference superior paratracheal lymph node measures 1.4 cm (series 3, image 35) in short axis, unchanged.The right anterior subpleural mass measures 2.7 cm (series 3, image 41) in long axis, previously measuring 2.4 cm in long axis.Other mildly enlarged mediastinal lymph nodes are not significantly changed.CHEST WALL: Status post right mastectomy and right axillary lymph node dissection. Unchanged compressive fracture T8 vertebral body.Left-sided chest port with catheter tip in distal SVC. Stable nonspecific heterogeneity in the right humeral head.ABDOMEN:LIVER, BILIARY TRACT: Reference anterior left hepatic lobe hypodense lesion measures 1.6 x 1.6 cm (series 3, image 83), unchanged. Interval increase in size of the caudate lobe lesion which measures 2.1 x 1.5 cm (series 3, image 83), previously measuring 1.8 x 1.5 cm. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left lower pole renal mass measures 3.0 x 2.6 cm (series 3, image 112), previously measuring 2.9 x 2.7 cm as remeasured on series 3, image 114.RETROPERITONEUM, LYMPH NODES: Reference gastrohepatic lymph node measures 1.1 cm (series 3, image 84) in short axis, unchanged.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Right hip orthopedic hardware is again seen. Unchanged compressive fracture T8 vertebral body. | 1.Worsening metastatic disease, specifically involving the lungs and liver as above.2.Small right pleural effusion with a small loculated/walled off component. Although, this is stable in appearance and size, superimposed infection cannot be excluded. |
Generate impression based on findings. | 53-year-old male status post distal radius ORIF A sideplate and screws affix the comminuted distal radius fracture in near-anatomic alignment without evidence of hardware complication. An ununited ulnar styloid fracture is again noted. The bones are demineralized. | Orthopedic fixation of distal radius fracture without evidence of complication. |
Generate impression based on findings. | 77-year-old male with frozen shoulder, pain Glenohumeral alignment is within normal limits. No fracture identified. Mild degenerative changes affect the glenohumeral joint and moderate osteoarthritis affects the acromioclavicular joint. | Degenerative changes as described above. |
Generate impression based on findings. | 21-year-old male with history of acute lymphoid leukemia on chemotherapy, hepatomegaly diagnosed July 2013, now with persistent thrombocytopenia. ABDOMEN:LUNG BASES: Central venous catheter with tip terminating at the cavoatrial junction.LIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma. The hepatic venous vasculature is patent. The hepatic arteries are not well seen secondary to phase of contrast enhancement. The liver measures 20 cm in craniocaudal dimension, which is upper normal in size.SPLEEN: Subcentimeter hypoattenuating focus in the periphery of the superior pole of the spleen, which is nonspecific. The spleen is normal in size.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is no evidence of hydronephrosis or hydroureter. There is no evidence of nephrolithiasis or ureterolithiasis.RETROPERITONEUM, LYMPH NODES: There is no evidence of retroperitoneal lymphadenopathy on the basis of size criteria.BOWEL, MESENTERY: There is a cluster of subcentimeter left upper quadrant mesenteric lymph nodes, with one enlarged node measuring 1.0 cm in short axis (image 73, series 4). BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Borderline hepatomegaly.2.Normal sized spleen. |
Generate impression based on findings. | Male 78 years old; Reason: metastatic prostate cancer, evaluation of disease after 6 cycles of investigational therapy CHEST:LUNGS AND PLEURA: Visualized lung fields without significant change. Stable 2 mm nodular focus in right upper lobe anteriorly, image 58 series 5, unchanged, possibly calcified and may reflect postinfectious/inflammatory sequela. Unchanged 1 to 2 mm right lower lobe nodule, image 93 series 5.MEDIASTINUM AND HILA: Severe calcified coronary artery disease. Aortic atherosclerotic calcification.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable subcentimeter hypodensity in hepatic segment 6, image 130 series 3, may be a cyst but nonspecific.SPLEEN: No significant abnormality noted.PANCREAS: Stable cystic foci in distal pancreatic body, for instance, images 113 and 115 of series 3, largest lobulated, partially exophytic and measuring up to 1.3 x 1.2 cm, lesions may represent intraductal papillary mucinous neoplasms.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Kidneys stable in appearance. Stable 7-mm exophytic right upper pole renal lesion, image 118 series 3, associated Hounsfield units of 19 seen, nonspecific and unchanged. Additional left midpole subcentimeter hypoattenuating lesion too small to characterize, coronal image 45. Incidentally seen circumaortic left renal vein.RETROPERITONEUM, LYMPH NODES: Aortobiiliac atherosclerotic disease. BOWEL, MESENTERY: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy. No definite soft tissue attenuation seen at level of surgical bed to suggest local tumor recurrence. BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures similar to prior study, including left iliac sclerotic focus (image 190 series 3), lucent focus in anterior right iliac area (image 173 series 3) and involving L5 vertebral body (image 155 series 3) , with additional smaller sclerotic foci scattered also seen. Please refer to nuclear medicine bone scan for better delineation of extent and activity of metastatic disease. | 1. Osseous metastatic disease similar in appearance to prior CT imaging. Please refer to nuclear medicine bone scan for additional findings.2. Cystic foci in distal pancreatic body, present on earlier October 7, 2014 exam but not well seen on imaging performed prior to that date. Lesions may represent intraductal papillary mucinous neoplasms. |
Generate impression based on findings. | 16-year-old male with bilateral knee pain Right knee: Alignment is within normal limits. There is no fracture or other specific finding to account for the patient's symptoms.Left knee: Three views of the left knee appear normal for the patient's age.Ankle: Three views of the ankle appear within normal limits. | Normal exam without specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 33 year-old female with right knee pain Right knee: Abnormal trabecular pattern within the proximal tibia diaphysis is consistent with the patient's known bone infarction. Alignment is anatomic.Left knee: Medullary calcifications within the proximal tibia diaphysis are consistent with the patient's known bone infarction. Alignment is within normal limits. | Findings compatible with the patient's known bone infarctions without specific findings to account for patient's pain. |
Generate impression based on findings. | 43-year-old woman presents with right breast foci of ADH, stereotactic biopsy performed on 1/14/2014. History of breast cancer in paternal grandmother diagnosed in her 50s and maternal great aunt. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The S-shaped clip is noted in the posterior right breast upper outer quadrant, at the site of the biopsy proven ADH. No suspicious calcifications are present adjacent to the clip. Multiple loosely scattered punctate calcifications in the right retroareolar region are unchanged dating back to 2007.No new masses, suspicious microcalcifications or areas of architectural distortion are present in either breast. Benign lymph nodes project over the axillae. | Stable punctate calcifications in the right retroareolar region. No suspicious calcifications around the prior biopsy site. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female; 73 years old. Reason: Pt with lung cancer on tarceva, ck response History: none CHEST:LUNGS AND PLEURA: Numerous pulmonary nodules are overall slightly increased in size as detailed below.Left lower lobe nodule measures 8 x 7 mm, previously 7 x 6 mm (image 59, series 4).Reference left upper lobe nodule measures 11 x 10 mm, previously 10 mm x 7 mm (image 43).Additional left upper lobe nodule on the same image measures 7 x 8 mm, previously 6 mm x 6 mm (image 43).No new pulmonary nodules are identified.No pleural effusions.Centrilobular emphysema.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion. Mild atherosclerotic calcification coronary arteries.CHEST WALL: New sclerosis of the T1 vertebral body, suspicious for metastasis.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: Stable left adrenal nodule.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Sclerotic L5 vertebral body is again only partially visualized.OTHER: No significant abnormality noted. | 1. Numerous pulmonary nodules are overall slightly increased in size. No new nodules.2. New sclerosis of the T1 vertebral body, suspicious for metastasis.3. Stable left adrenal nodule and partially visualized sclerotic L5 vertebral body. |
Generate impression based on findings. | Female 87 years old; Reason: Location of active uptake History: Toxic multinodular goiter The thyroid images demonstrate uniform activity throughout the gland. The left thyroid lobe is enlarged, the right thyroid lobe is normal. The 24-hour uptake is 6.9 % (normal range 10-30% at 24-hours).Please note the 4-hour radioactive iodine uptake and scan was not performed as the patient was not able to stay or come back to obtain that portion of the study. Dr. Sarne was notified of this prior to initiation of the study and only the 24 hour portion of the study was obtained. | Enlargement of the left thyroid lobe with slight decreased thyroid uptake throughout the gland. |
Generate impression based on findings. | 79 year old female s/p Dobbhoff tube placement. Pelvis not fully included in the field of view. Dobbhoff tube tip in gastric fundus. Nonobstructive bowel gas pattern. Calcified lesion in right upper quadrant compatible with gallstone. Left basilar opacity and probable small bilateral pleural effusions. | Dobbhoff tube tip in gastric fundus. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of right cyst aspiration in 2000. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | There are scattered periventricular and subcortical T2 hyperintensities which are nonspecific. In particular, the internal capsules demonstrate normal signal bilaterally. No intracranial mass or mass effect. The ventricles and sulci are within normal limits. No evidence of recent ischemia or hemorrhage. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. | Scattered T2/FLAIR hyperintense foci within the periventricular and subcortical white matter are nonspecific. Differentials include prior inflammation, infection, or less likely demyelination. These can also be seen with migraines. Examination is otherwise unremarkable. No abnormal signal is seen within the internal capsules as questioned. |
Generate impression based on findings. | There are unchanged post-treatment findings related to laryngectomy, flap reconstruction, voice prosthesis insertion, tracheostomy, and nodal dissection. No evidence of residual or recurrent disease. There is no evidence of enlarged lymph nodes by CT criteria. The partially imaged intracranial structures are grossly unremarkable. There is a chronic fracture of the left lamina papyracea. Minimal maxillary mucosal thickening bilaterally, right greater than left. Aerated secretions are noted in the left sphenoid sinus. There is unchanged fatty replacement of the parotid and submandibular glands. There is unchanged multilevel degenerative spondylosis. Secretions are again noted within the dependent upper airway, but slightly decreased. The imaged portions of the lungs are clear. | No evidence tumor recurrence or significant lymphadenopathy. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views (with an additional right MLO view) and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. 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. | 92-year-old female with history of back pain and bilateral foot pain and swelling. The bones are diffusely demineralized suggesting osteoporosis/osteopenia.Right foot: Mild osteoarthritis affects the midfoot and 1st MTP joint.Left foot: Small midfoot osteophytes indicate mild OA. Mineralization along the 3rd and 4th metatarsal may be secondary to old stress injuries.Lumbar spine: Moderate to severe degenerative disc disease affects the lumbar spine. Vertebral body heights are preserved. There are scattered atherosclerotic calcifications of the distal abdominal aorta and its branches. Cholecystectomy clips are present. | Mild osteoarthritis of the feet and degenerative disc disease of the lumbar spine and other findings as above. |
Generate impression based on findings. | Reason: 61F w/ HIV, ESRD p/w SOB History: SOB/Dyspnea on exertion PULMONARY ARTERIES: No evidence of a pulmonary embolus.LUNGS AND PLEURA: Severe centrilobular and paraseptal emphysema redemonstrated.Diffuse interstitial opacities and multifocal nodular opacities with areas of consolidation in the right middle and upper lobes may represent atypical infection.Pleural thickening and small pleural effusions noted at both lung bases. MEDIASTINUM AND HILA: Enlarged mediastinal and hilar lymph nodes similar to the prior exam.Cardiac enlargement without evidence of a pericardial effusion.Marked coronary artery calcifications.CHEST WALL: Markedly thickened trabecula within the vertebral bodies compatible metabolic bone disease.Focal radiolucencies within multiple vertebrae are unchanged and presumably are sequelae of metabolic bone disease.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Redemonstration of focal nonspecific hypodensity within the spleen. | 1.No evidence of a pulmonary embolus.2.Severe centrilobular and paraseptal emphysema. 3.Diffuse increased interstitial opacities , predominately in the right upper and middle lobes , with progressive increase in multiple focal nodular and consolidative opacities suggestive of atypical infection and edema.4.Evidence of metabolic bone disease.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Ms. Constantino is a 45 year-old female with known left breast cancer She had a recent MRI that demonstrated a 4-mm focus in the right superior breast with washout kinetics. This will be the target for today's biopsy. On subtraction images, the previously identified 4-mm focus was again seen in the right superior breast, 12 o'clock position. This was chosen as the target.PROCEDURE:Coordinates of the central portion of the biopsy target were determined on the monitor. The approach was from lateral to medial direction. Overlying skin was cleansed with chlorhexidine and superficial and deep anesthesia were obtained with lidocaine. A 9-gauge introducer with stylet was advanced to the target lesion. Subsequent MR images demonstrated that the tip of the introducer was slightly inferior to the target lesion. However, the depth of the introducer was satisfactory. A 9-gauge petite needle was then advanced to the target lesion. The trough of the needle was targeted superiorly and the biopsy was performed using a Suros vacuum assisted device. A total of 6 cores were obtained with sampling performed preferentially towards the location of the lesion and they were sent to Pathology with an accompanying history sheet.Post procedural MR images show a moderate-sized hematoma at the biopsy site. An ATEC clip was placed into the center of the target.Following the removal of the grid, pressure was held at the biopsy site until bleeding subsided. The skin wound was closed with a Steri-Strip and pressure bandage and ice pack were applied to the biopsy site.Specimen radiograph was obtained for documentation. No calcifications were seen in the specimen radiograph.The patient tolerated this procedure well and underwent a right unilateral mammogram CC and ML views to locate the percutaneously placed clip. The clip is placed at 12 o'clock position with no evidence of any complications due to the procedure. The patient tolerated this procedure well and left the radiology suite in stable condition. The MR procedure was performed by Dr. Sheth under direct supervision of Dr. Schacht who was present throughout the procedure. | Successful MR guided core needle biopsy of the right breast 12 o'clock enhancing lesion. Successful clip placement. Pathology is pending.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Male; 64 years old. Reason: 64 M with pulmonary opacities, now on Ancef, worsening leukocytosis, eval for worsening History: leukocytosis LUNGS AND PLEURA: Mild patchy bibasilar nodular opacities, lingular atelectasis/consolidation with adjacent cystic focus, and right lobe groundglass opacities have all decreased since prior study. Mild bibasilar streaky subsegmental atelectasis, similar to prior study. No new pulmonary opacities.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Moderate atherosclerotic calcification of the coronary arteries. Right jugular central venous catheter tip near the superior cavoatrial junction.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Cirrhotic liver morphology, trace ascites, and partially visualized cholelithiasis. | Improved pulmonary opacities, suggestive of resolving infection. No new pulmonary opacities. |
Generate impression based on findings. | Exam is somewhat limited due to beam hardening artifact from the patient's shoulders along the lower cervical spine. The scout lateral view and the sagittal reformatted images demonstrate normal alignment of the cervical spine, with mild reversal of the normal cervical lordosis centered at C4-C5. There is moderate disk space narrowing at C5-C6 and mild disk space narrowing at C6-C7. The vertebral body and disk space heights are otherwise well-maintained.There is no acute fracture.At C1-C2, there is a normal relationship of the dens with the arch of C1.At C2-C3, there is no significant disk pathology or stenosis.At C3-C4, there is minimal right paracentral posterior osteophyte disk complex without stenosis.At C4-C5, there is a trace diffuse posterior osteophyte disk complex with mild bilateral foraminal stenosis.At C5-C6, there is a mild diffuse posterior osteophyte disk complex as well as minimal bilateral uncovertebral hypertrophy. There is also mild-moderate left and mild right foraminal narrowing. There is indentation of the left ventral thecal sac. At C6-C7, there is a diffuse posterior osteophyte disk complex with significant right-sided uncovertebral hypertrophy. This results in moderate right foraminal narrowing.At C7-T1, there is no significant disk pathology or stenosis.The visualized intracranial structures and lung apices appear normal. There is slight asymmetric appearance of the visualized oropharynx and right glossotonsillar sulcus although this is felt to be related to coaptation of mucosal surfaces. | 1. No acute fracture or subluxation. Mild reversal of the normal cervical lordosis which may be positional in etiology.2. Mild scattered spondylotic changes with only mild focal findings on the left at C5-C6 resulting in mild to moderate foraminal stenosis. Further evaluation with MRI of the cervical spine may be obtained as clinically indicated.3. More significant findings on the right at C6-C7 in the form of a posterior osteophyte disk complex diffusely with right-sided uncal vertebral hypertrophy resulting in moderate right foraminal narrowing. |
Generate impression based on findings. | A large extra axial collection along the right frontal and parietal lobes is unchanged in size and configuration measuring 8.9 x 5.6 x 4.8 cm (1101/6 and 601/18), previously 8.7 x 5.6 x 4.8 cm. There are small septations within the lesion, which extends slightly beyond the midline, however no diffusion restriction, abnormal enhancement or susceptibility is evident. The superior margin of the cysts is lobulated and has remodeled the calvarium. There is moderate local mass effect without midline shift which remains unchanged.The ventricles and sulci are otherwise within normal limits. The cisterns remain patent. There is no diffusion abnormality or areas of abnormal enhancement. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. | Large arachnoid cyst is unchanged in size and configuration. |
Generate impression based on findings. | Redemonstrated are bilateral subdural fluid collections overlying the left frontoparietal lobes. The right side subdural fluid collection again measures 8mm in thickness, appears similar in size and is less dense compared to the prior exam. The left sided subdural fluid collection is slightly smaller measuring 8 mm compared to 9 mm in greatest thickness previously, with other areas of more striking decreased size, and has also overall decreased in density while increasing in heterogeneity. There are linear areas of internal hyperdensity remaining. Very mild residual mass effect is exerted on the cerebral convexities bilaterally.There is partial effacement of the cisterns which may be from intracranial hypotension suggested previously. The ventricles are symmetric and unremarkable.Post-surgical changes are partially visualized of a posterior fossa decompression. The paranasal sinuses and mastoid air cells are clear. | Evolving bilateral frontoparietal hematomas appearing overall similar to slightly decreased in size and less dense compared to the previous exam. Linear areas of hyperdensity remain in both subdural collections, more likely representing evolving blood products and possible membrane formation on the left, although minimal superimposed acute blood products cannot be excluded. |
Generate impression based on findings. | 51-year-old male with history of low back pain. Moderate to severe degenerative disc disease affects L5-S1. There is moderate degenerative facet arthropathy of L5-S1. Vertebral body heights are maintained. Cholecystectomy clips are present. | Degenerative disc disease and other findings as above. |
Generate impression based on findings. | 77-year-old female with history of lumbar spinal stenosis. Severe degenerative disc disease affects L3-4 with grade 1 retrolisthesis of L3. Mild to moderate degenerative disc disease affects the remaining lumbar spine. Facet joint arthritis is appreciated most severely affecting the lower lumbar spine. Degenerative arthritic disease also affects the lower thoracic spine. Atherosclerotic calcifications of the aorta and common iliac arteries. | Degenerative disc disease and other findings as above. |
Generate impression based on findings. | Female 91 years old; Reason: evaluate for hyperthyroidism ? graves dx. History: low tsh and elevated T3T4 The thyroid images demonstrate uniform activity in a gland of normal size and configuration. There is slight decreased uptake diffusely. The 4-hour radioactive iodine uptake is 2.4 % and the 24-hour uptake is 3.7% (normal range 10-30% at 24-hours). No hot or cold nodules are identified. | Slight decreased uptake in the thyroid gland. In the setting of clinical evidence of hyperthyroidism, findings are consistent with thyroiditis. |
Generate impression based on findings. | 41-year-old female with history of left knee pain. Tricompartmental osteophytes and joint space narrowing worse in the medial compartment indicates mild to moderate osteoarthritis. Similar osteoarthritic changes affect the right knee as seen on the frontal view. | Osteoarthritis as above. |
Generate impression based on findings. | 56-year-old male with history of right knee pain. Tricompartmental osteophytes and joint space narrowing especially in the lateral compartment indicate moderate osteoarthritis. There is a small joint effusion. Ossific densities within the posterior aspect of the knee may represent loose bodies within the joint and/or within a Baker's cyst.Severe osteoarthritis affects the left knee with bone on bone apposition as seen on the skiers view. | Osteoarthritis as above. |
Generate impression based on findings. | Male; 68 years old. Reason: evaluate apical cavitary lesions. Determining if they have resolved or are still present since hospitalization and last CT chest History: cough, sputum production LUNGS AND PLEURA: Decreased wall thickness of cavity in the left upper lobe with focal calcifications at its inferior aspect. Stable mild associated left upper lobe bronchiectasis.Decreased atelectasis abutting the left major fissure. Decreased nodular airspace opacities in the left upper lobe.Stable right apical fibrocavitary disease, consistent with post-inflammatory scarring.Stable mild diffuse bronchial thickening, consistent with bronchitis.Severe emphysema.Calcified nodules, consistent with healed granulomatous disease.No new pulmonary opacities.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. No visible coronary calcifications. Normal heart size without pericardial effusion.Mildly patulous upper thoracic esophagus.CHEST WALL: Mild degenerative changes of the thoracolumbar spine. Stable mild T8 vertebral body compression deformity.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Right upper pole renal cyst. | Decreased wall thickness of the left upper lobe cavitary lesion, as well as decreased nodular airspace opacities, suggestive of resolving infection. No new pulmonary opacities. |
Generate impression based on findings. | 5-year-old male with cough and fever.VIEWS: Chest PA/lateral (two views) 1/13/2015, 09:38 Streaky left lower lobe opacity consistent with atelectasis. Peribronchial thickening is seen. The aortic arch, cardiac apex and stomach left-sided. The cardiothymic silhouette is normal. | Peribronchial thickening and atelectasis consistent with bronchiolitis/reactive airways disease without superimposed pneumonia evident. |
Generate impression based on findings. | Redemonstrated are two masses in the left superior parietal lobule with residual adjacent mass effect and sulcal effacement. The larger lesion measures 1.7 x 2.0 cm compared to 2.8 x 2.8 cm on the previous MRI when taking into account differences in technique. There is no abnormal enhancement in this region. The previously noted hypodense left parietal vasogenic edema has significantly improved.There is no significant midline shift. There are no new lesions or new foci of intracranial hemorrhage. The ventricles and basal cisterns are unchanged. The imaged paranasal sinuses and mastoid air cells are clear. The skull is unremarkable. Incidental note is made of benign appearing skin thickening of the left lateral frontoparietal region. | Two non-enhancing metastatic lesions in left superior parietal lobule which are more cystic in appearance, and are decreased in size with less adjacent vasogenic edema compared to the prior exam. No new lesions are identified elsewhere. |
Generate impression based on findings. | Reason: 57 year old male with lung cancer admitte for septic shock History: fevers, septic shock LUNGS AND PLEURA: Right upper lobe nodule (image 25 series 4) has increased in size now measuring 2.2 cm x 2.9 cm previously measuring 1.9 cm by .83 cm.New right upper lobe 6-mm nodule (image 38 series 4).No pleural effusions.MEDIASTINUM AND HILA: Markedly enlarged right hilar lymph node. At great measurement cannot be made without the use of intravenous contrast however appears to be significant increase in comparison to prior exam.Enlarged right paratracheal lymph node (image 31 series 3) measuring 10 mm in short axis.Enlargement of the pulmonary artery compatible of pulmonary arterial hypertension.Cardiac size is normal without evidence of a pericardial effusion.Moderate coronary artery calcification.Lipomatous infiltration (lipoma) of the interatrial septum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Interval increase in size of the right upper lobe nodule.2.Increasing right hilar and mediastinal lymphadenopathy.3.New right upper lobe nodule most likely representing metastatic focus. |
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