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Generate impression based on findings. | 49 year old female status post left lumpectomy for invasive ductal carcinoma grade 2 with lymphovascular invasion and associated DCIS, presents today for routine follow up. Patient received radiation, chemotherapy, and hormonal therapy with Femara. History of benign right breast biopsy. No current breast complaints. Family history of breast carcinoma in her sister. Three standard views and 2 spot magnification views of both breasts, as well as a laterally exaggerated left craniocaudal view 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. Linear markers were placed on scars overlying the left breast. Postsurgical changes including increased density, architectural distortion and surgical clips are present in the central outer left breast compatible with the history of lumpectomy. A biopsy marking clip is noted in the lower slightly outer right breast, with a stable group of calcifications present anterior to the clip. No new suspicious findings are present in either breast.Postsurgical changes are also present in the left axilla. | Postsurgical changes of the left breast. Stable right breast calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.Additionally, the patient was encouraged to obtain a follow-up breast MRI to document stability of a high probability benign right breast mass seen on prior MRI examination of 2/21/2014.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 48 years old; Reason: 48F h/o cervical cancer, hematuria, lung nodule History: h/o cervical cancer ABDOMEN:LUNGS BASES: Left lower lobe pulmonary nodularity, reference nodule is the largest and measures 7 x 5 mm. Additional left sided nodules stable to mildly more pronounced, another 3-mm lung nodule seen more superiorly in left lower lobe, image 6 series 4, this area may not have been included on the prior exam, pleural-based nodularity also noted. Incompletely imaged interlobular septal thickening, particularly on the left, worrisome for lymphangitic carcinomatosis.LIVER, BILIARY TRACT: No secondary signs of acute cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small atrophic left kidney. Moderate degree, stable to mildly increased, right-sided hydronephrosis with mild interval increase in soft tissue thickening and stranding at level of the ureteropelvic junction. Proximal portions of right-sided stents located in lower pole of kidney and in region of renal pelvis, proximal portions of left-sided stents located in area of renal pelvis, these are unchanged from earlier exam. Distal portions of nephroureteral stents seen extending into bladder, stable in appearance. Areas of right renocortical scarring. RETROPERITONEUM, LYMPH NODES: Retroperitoneal and gastrohepatic adenopathy seen. Reference left paraaortic lymph node unchanged accounting for differences in technique, measuring 2 x 1.1 cm, image 50 series 3. BOWEL, MESENTERY: Small pelvic free fluid, new from earlier exam. Stable circumferential perirectal fat prominence and mild rectal wall thickening. Unchanged presacral soft tissue attenuation. Findings likely related to prior radiation. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Bladder somewhat underdistended with circumferential wall prominence noted. Correlation with patient's clinical history and urinalysis recommended to exclude cystitis.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance. | 1. Moderate degree, stable to mildly increased, right-sided hydronephrosis with mild interval increase in soft tissue thickening and stranding at level of the ureteropelvic junction. Findings may again reflect stent dysfunction or chronic obstruction. 2. Small pelvic free fluid, new from earlier exam. Stable circumferential perirectal fat prominence and mild rectal wall thickening. Unchanged presacral soft tissue attenuation. Findings likely related to prior radiation. 3. Pulmonary nodularity and gastrohepatic/retroperitoneal lymphadenopathy, suspicious for metastatic disease. |
Generate impression based on findings. | Male; 61 years old. Reason: eval for infectious, new AML History: eval for infectious, new AML LUNGS AND PLEURA: No focal airspace consolidation. Scarlike subpleural opacity of the right middle lobe (coronal image 59).MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion. No visible coronary artery atherosclerotic calcifications. Ectasia of the ascending aorta measuring up to 4.7-cm.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Few subcentimeter hypoattenuating lesions in the right lobe of the liver are most likely due to benign cysts. Partially visualized hypoattenuating lesion in the right kidney mid pole may be due to a cyst but is incompletely evaluated. | No evidence of pneumonia or other acute cardiopulmonary abnormality. |
Generate impression based on findings. | 51 year old male with history of sigmoid diverticulitis complicated by colovesical fistula and abscess, s/p sigmoidectomy with diverting loop ileostomy in September 2014. Please assess bowel prior to ileostomy takedown. The scout film showed a nonspecific bowel gas pattern without any evidence of obstruction or ileus. Using an 18 French Foley catheter, the right lower quadrant ostomy site was accessed first with dilute Omnipaque 350. Contrast flowed proximally from the ostomy site, opacifying pelvic ileal bowel loops without evidence of obstruction or gross caliber change. Approximately 50 cm of ileum was opacified proximally from the ostomy site. Contrast and air were then injected into the rectum to opacify the colon. Contrast flowed freely from the rectum to the cecum, without evidence of contrast extravasation or abnormal communication with the bladder. There was no evidence of obstruction, stricture, or annular lesion. Scattered colonic diverticula were noted. Contrast refluxed across the cecum into the terminal ileum, and appeared to communicate with the more proximal ileal loops that were opacified earlier. No significant tortuosity or redundancy of the colon was identified.FLUOROSCOPY TIME: 7:32 mm:ss | 1.Expected postoperative changes with normal opacification of the rectum, colon, and postsurgical distal ileum as described above.2.No evidence of colovesical fistula as clinically questioned. |
Generate impression based on findings. | 41 year old female with history of ulcerative colitis s/p colectomy with J pouch creation. Now presents with new gradual periumbilical discomfort and cramping. Scout radiograph showed a nonobstructive bowel gas pattern. Transit time through the small bowel was 35 minutes. Fluoroscopic evaluation demonstrated postsurgical changes status post colectomy and some subtle nonobstructive adhesions involving left lower quadrant small bowel loops, given their triangular morphology and lack of movement after compression. Otherwise, normal mucosa was seen throughout the small bowel, without ulcers, sinus tracts, or fistulae. No separation of bowel loops was present to suggest fibrofatty proliferation. No internal hernias or ventral hernias were evident.TOTAL FLUOROSCOPY TIME: 4:30 mm:ss | Subtle nonobstructive adhesions involving left lower quadrant bowel loops as described above, but otherwise unremarkable exam. |
Generate impression based on findings. | 62 year-old female with knee osteoarthritis and limp Right knee: The bones are demineralized suggesting osteopenia. Poorly defined sclerosis within the lateral femoral condyle could conceivably represent osteonecrosis, but this is equivocal. There is no fracture or subchondral collapse.Left knee: The bones are demineralized suggesting osteopenia. The knee otherwise appears normal.Right hip: Severe osteoarthritis affects the right hip with flattening and depression of the superior articular surface, which may represent underlying osteonecrosis. There may be an intra-articular loose body as well.Left hip: Mild osteoarthritis affects the left hip. | Severe osteoarthritis of the right hip and other findings as described above. |
Generate impression based on findings. | 58-year-old male with history of bladder cancer, status post cystectomy and neobladder formation. Evaluate. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver without evidence of focal hepatic lesions.SPLEEN: Splenule is noted.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted in the right kidney. Mild dilation and mural thickening of the left collecting system is unchanged. Previously noted areas of decreased enhancement within the left renal cortex has resolved; there is mild to moderate cortical thinning in that region. The mid to distal ureters are not well opacified; however, no definite ureteral lesion noted.RETROPERITONEUM, LYMPH NODES: Nonspecific mildly prominent retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Postoperative changes of radical cystoprostatectomy.BLADDER: Postoperative changes of radical cystoprostatectomy and formation of orthotopic neobladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Postoperative changes of cystoprostatectomy and formation of neobladder without evidence of disease recurrence.2.Diffuse fatty liver. |
Generate impression based on findings. | 16-year-old male, evaluate for compression fracture, history of T4, T5 compression fractures There is a compression fracture of the T5 vertebral body with approximately 50% loss of vertebral body height. There is also relatively mild anterior wedging of the T4 vertebral body, indicating an additional compression fracture. The T5 vertebral body appears sclerotic, which may represent increased density of the underlying trabecula due to fracture. Associated kyphosis of the upper thoracic spine measures approximately 60 degrees from the superior endplate of T1 to the inferior endplate of T12. There is perhaps slight leftward curvature of the thoracolumbar spine, which we suspect is at least in part artifact of patient rotation. The coronal balance measures approximately +3 cm, which may be likewise exaggerated by patient rotation. The sagittal balance measures +3.5 cm. | Compression fractures and other findings as described above. |
Generate impression based on findings. | 59-year-old female status post left THA Hardware components of a left total hip arthroplasty are situated in near-anatomic alignment without evidence of complication. Foci of gas and drains in the soft tissues reflect recent surgery. Moderate to severe osteoarthritis affects the right hip as seen on the AP view. | Postoperative changes of total hip arthroplasty as described above. |
Generate impression based on findings. | 12-year-old male with swelling of dorsum of the right hand, ulnar aspectVIEWS: Right hand AP, oblique, lateral (3 views) 01/13/15 Predominantly transverse fracture through the neck of the fifth metacarpal with apex dorsal angulation. Overlying soft tissue swelling is noted. | Boxer's fracture of the fifth metacarpal. |
Generate impression based on findings. | Colon is well distended and well cleansed. There is a moderate amount of retained fluid is extremely well and oral contrast.No significant size polyps masses are seen anywhere in the colon. No evidence of diverticulosis.Note: CT colonography is not intended for the detection of diminutive colonic polyps (i.e., tiny polyps < 5 mm), the presence or absence of which will not change management of the patient.EXTRACOLONIC | Normal exam. Extracolonic findings as above.*OPTIONAL C-RADS CLASSIFICATION:C-1E-2*(see full definitions in: Zalis et al. CT Colonography reporting and data system: a consensus proposal. Radiology 2005;236:3-9)C1: Normal or benign lesions (no polyps > 6mm). Continue routine screening.C2: Intermediate polyp (less than three 6-9mm polyps or can't exclude >6mm in technically adequate study. Surveillance CTC or colonoscopy recommended.C3: Polyp, possibly advanced adenoma. (polyp >10mm or >three 6-9mm). Colonoscopy recommended.C4: Colonic mass, likely malignant. |
Generate impression based on findings. | 62-year-old female with history of metastatic breast cancer, pathologic fracture now with right proximal femur endoprosthesis. Femur: The previously seen hemi-hip arthroplasty and proximal femur have been removed and reconstructed with a long stem endoprosthesis. We see no evidence of hardware complication. There is osteolysis of the medial cortex of the proximal 3 to 4 cm of remaining femur representing underlying neoplasm. Hardware components of a total knee arthroplasty are present. Surgical skin staples are present along the lateral aspect of the thigh. Surgical drain and foci of gas within the subcutaneous soft tissues are present indicating recent surgery.Pelvis: Only the proximal portion of the aforementioned endoprosthesis is visualized. There is incompletely imaged cement noted within the proximal aspect of the left femur. Evaluation of the sacrum and right iliac bone is limited secondary to overlying bowel contents. There is a PD catheter coiled within the lower pelvis. | Reconstruction of right proximal femur with endoprosthesis and other findings as above. |
Generate impression based on findings. | 23 years, Female. Reason: assess for obstructive gas pattern and stool burden History: n/v/abdominal pain, constipation Non obstructive gas pattern. Above average stool burden. No evidence of free air. Lung bases are clear. | Non obstructive gas pattern. Above average stool burden. No evidence of free air. Lung bases are clear. |
Generate impression based on findings. | 44-year-old male with history of fracture Four views of the right foot again show diffuse demineralization as well as multiple fractures which have been previously described. There is deformity of the mid third metatarsal consistent with healed/healing fracture. Healing/healed fractures of the bases of the third, fourth, and fifth metatarsals appear similar to the prior exam. Healing/healed fractures of the navicular and cuboid bones appear similar to the prior exam. Fracture fragments along the lateral aspect of the midfoot are again noted. Deformity of the calcaneus, consistent with healed/healing fracture appears similar to the prior exam. | Multiple healed/healing fractures as described above. |
Generate impression based on findings. | 60 year-old female with history of colon cancer. Patient is on chemotherapy. Evaluate disease burden. CHEST:LUNGS AND PLEURA: Index left lower lobe nodule measures 0.2 cm (series 5, image 82), previously measuring 0.3 cm. No new lung nodules noted. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Heart is normal in size without pericardial effusion. No visible coronary artery calcifications. Reference retrocrural lymph node measures 0.6 x 0.4 cm (series 4, image 60), previously measuring 0.8 x 0.5 cm.CHEST WALL: Right-sided chest port with catheter tip in the distal SVC.ABDOMEN:LIVER, BILIARY TRACT: Again noted are numerous metastatic lesions in the liver with overall interval increase in size and number. Reference right hepatic lobe lesion measures 2.2 x 0.9 cm (series 4, image 94), previously measuring 1.1 x 0.9 cm.There is associated narrowing of the hepatic veins distally near confluence with IVC; however, the hepatic veins and IVC remain patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Persistent mild right hydroureteronephrosis. The right ureter traverses alongside the below referenced lymph node and the right lower quadrant inflammation as detailed. Right renal hypoattenuating lesion most likely a cyst is unchanged.Atrophic left kidney with multiple hypoattenuating lesions, some of which are compatible with simple cysts and some of which are incompletely characterized. RETROPERITONEUM, LYMPH NODES: No significant abnormality. BOWEL, MESENTERY: Extensive right lower quadrant inflammatory and other changes as described below.BONES, SOFT TISSUES: Sclerotic bone lesions in L1 and T10 vertebral bodies again noted.PELVIS:UTERUS, ADNEXA: Linear density in the region of the endometrial stripe is unchanged.BLADDER: No significant abnormality noted.LYMPH NODES: Index common iliac lymph node measures 1.3 x 1.0 cm (series 4, image 145), previously measuring 1.3 x 1.1 cm.BOWEL, MESENTERY:There has been interval worsening of the thickening of the cecum. Adjacent ileal loops are also thickened and tethered in appearance. An additional small bowel loop is seen in close proximity to the posterior aspect of the cecum (series 4, image 154); an abnormal fistulous connection cannot be excluded. There has been interval decrease in size of the previously mentioned small fluid collection adjacent to the terminal ileum; this fluid collection measures 0.4 centimeters on the current exam (series 4, image 164), previously measuring 1.4 x 1.3 cm. However, extending from this very small fluid collection there is a linear soft tissue tract to the anterior abdominal wall. Heterogeneity in the region of the right rectus muscle is also noted.Interval increase in the pelvic ascites.BONES, SOFT TISSUES: Sclerotic bone lesions in L1 and T10 vertebral bodies again seen. | 1.Interval worsening of metastatic disease, specifically hepatic.2.Interval worsening of thickening of the cecum and the inflammatory changes affecting the adjacent terminal ileum and small bowel and underlying fistulous formation not entirely excluded as above. Interval decrease in size of the right lower quadrant fluid collection with new soft tissue tract extending to the anterior abdominal wall.3.Persistent mild right hydroureteronephrosis with ureter traversing near reference lymph node and right lower quadrant inflammation as detailed. |
Generate impression based on findings. | 40-year old male with history of bilateral foot pain. Evaluate for bunion formation. Left foot: There is a moderate hallux valgus deformity. Mild osteoarthritis affects the first MTP joint and midfoot. No acute fractures or dislocations.Right foot: There is a moderate hallux valgus deformity. Mild osteoarthritis affects the first MTP joint and midfoot. No acute fractures or dislocations. | Bilateral hallux valgus deformities and osteoarthritis as described above. |
Generate impression based on findings. | 33 years, Female. Reason: see if contrast still in colon History: see if contrast still in colon There is persistent large amount of residual contrast material in the colon, presumably from recent upper GI examination. Nonobstructive bowel gas pattern. Cholecystectomy clips. | Persistent large amount of residual contrast material in the colon. |
Generate impression based on findings. | 74-year-old female with history of fall approximately 8 weeks ago. Evaluate for occult fracture. No evidence of acute fracture or dislocation. Moderate to severe osteoarthritis affects the AC joint. Mild to moderate osteoarthritis affects the glenohumeral joint. | Osteoarthritis as above without evidence of acute fracture. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with tomosynthesis 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. An asymmetry in the right upper breast disperses on tomosynthesis and has no correlate on the CC view, compatible with overlapping parenchymal tissue. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 12 year old male status-post cochlear implant.VIEW: Skull AP (one view) 1/13/2015 Interval placement of a right cochlear implant, with the implant evident along the lateral aspect of the skull, and with the cochlear lead making the curl of the cochlea in this single plane. Endotracheal tube in place with the distal tip out of the field of view. | Right cochlear implant. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of heart failure. 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. Focal asymmetry present in the left inferior breast, mid depth. No suspicious masses, microcalcifications or areas of architectural distortion are present in the right breast. | Focal asymmetry in the left inferior breast. Additional imaging, including spot compression views and possible ultrasound, is recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 64-year-old female with history of right knee pain. No acute fracture or malalignment. There is a moderate to large joint effusion. Moderate osteoarthritis affects the knee. Mild osteoarthritis affects the left knee as seen on the frontal view. | Osteoarthritis as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of left breast benign biopsy. 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. New superficially located right retroareolar mass. No suspicious masses, microcalcifications or areas of architectural distortion are present elsewhere. Right breast upper outer quadrant mass in the posterior depth has been stable, and likely represents a benign intramammary lymph node. | New superficially located right retroareolar mass for which spot compression and possible ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 78 year old woman with history of right breast lumpectomy for IDC in Jan 2014. Patient received radiation and is on Femara. Left breast reduction in Dec 2014 incidentally revealed ALH. No new breast complaints. History of breast cancer in maternal aunt and sister. Three standard views of both breasts, 2 right spot magnification views and 3 left spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A round marker was placed on a skin lesion overlying the left breast. A linear marker was placed on the scar overlying the right breast. Postsurgical architectural distortion with surgical clips are present in the right retroareolar region and right axilla. Postsurgical changes with surgical clips from reduction surgery are present in the left breast. Focal asymmetry in the medial left breast disperses into normal breast parenchyma with spot compression imaging.No new masses or suspicious microcalcifications are present in either breast. Benign lymph nodes project over the left axilla. | Expected postsurgical changes of both breasts. 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. | Reason: eval for bleed, other intracranial process History: ams, recent mca stroke, now on apixaban The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a hypodense focus measuring 40 x 24 mm axial dimensions located in the right middle frontal gyrus which contains a mildly hyperdense component centrally. This was also present but less conspicuous on the prior exam. Small hypodense foci are present in right medial frontal lobe.There is redemonstration of a hypodense focus in the left thalamusThe visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.There is magna cisterna magna redemonstrated.There is a 13 x 7 mm coronal dimension extra-axial lesion adjacent to the medial high convexity of the left frontal lobe. | 1.Findings are compatible with subacute infarctions involving the right middle frontal gyrus and small foci in the right medial frontal lobe. Some of somewhat hyperdense components in the right middle frontal gyrus may represent petechial blood products.2.Lacunar infarct in the left thalamus.3.Findings suggest a small meningioma adjacent to the left frontal lobe . |
Generate impression based on findings. | Reason: h/o HNC, CRT, compare to previous, measurements pls History: none LUNGS AND PLEURA: Mild basilar scarring.No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: Status post neck dissection with a phonation device.There is no mediastinal or hilar lymphadenopathy.Severe coronary calcifications, or a stent in the LAD, are present. CHEST WALL: Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of metastases. Severe coronary calcifications are present. |
Generate impression based on findings. | 64-year-old female with history of first MTP joint fusion. There is a plate and screw device affixing the first metatarsophalangeal joint in anatomic alignment. There is no evidence of hardware complication. Parts of the joint are indistinct suggesting early fusion. Mild osteoarthritis affects the interphalangeal joints. | Orthopedic fixation of the first MTP joint as above. |
Generate impression based on findings. | Metastatic melanoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Stable right breast skin thickening.ABDOMEN:LIVER, BILIARY TRACT: Stable cholelithiasis without acute inflammation or ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable negative examination. No evidence for acute, inflammatory, or metastatic process. |
Generate impression based on findings. | Reason: Hx tonsil CA, pls compare to previous and measure History: none LUNGS AND PLEURA: No sign of pulmonary or pleural metastases, or other significant abnormality.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Mild coronary artery calcifications are present, the heart and pericardium otherwise unremarkable.Right jugular catheter, tip in SVC.CHEST WALL: Moderate degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Septated gallbladder with a large calcified stone. | 1. No evidence of metastatic disease or change.2. Cholelithiasis. |
Generate impression based on findings. | 12-year-old male with worsening genu varumVIEWS: Standing lower extremities/mechanical axis 01/13/15 14 degrees of varus alignment of the right knee is present with respect in neutral mechanical axis. 16 degrees of varus alignment of the left knee is noted with respect to neutral mechanical axis. | Bilateral genu varus as described above. |
Generate impression based on findings. | 72 year old woman with history of left lumpectomy in 2006 for IDC. Status post radiation and hormone therapy. No new breast complaints. History of breast cancer in maternal 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. A round marker denotes a skin lesion and a linear marker denotes the scar overlying the left breast. Stable postsurgical volume loss, architectural distortion and surgical clips are present in the lumpectomy bed. The focal asymmetry in the right breast is unchanged dating back to 2010. No new masses or suspicious microcalcifications are present in either breast. | Stable right breast focal asymmetry and post-surgical left breast changes, 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. | Female 63 years old; Reason: Colon cancer with hx of PET positive mesenteric nodule. Following since '12. Evaluate for interval change CHEST:LUNGS AND PLEURA: Stable 4 mm right lower lobe lung nodule, image 150 series 5. MEDIASTINUM, HILA AND AXILLA: Incompletely imaged right humeral prosthesis with associated beam hardening artifact, making evaluation of axilla suboptimal. Reference right axillary lymph node, mildly smaller in size, measuring 1.1 x 0.9 cm, image 25 series 4, previously measured 1.4 x 0.9 cm.CHEST WALL: Stable punctate right breast calcification, nonspecific, image 54 series 4.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: Kidneys unchanged in appearance. Multiple renal hypoattenuating subcentimeter lesions, too small to characterize. Stable nonobstructing left intrarenal nephrolithiasis.RETROPERITONEUM, LYMPH NODES: Aortobiiliac atherosclerotic disease. BOWEL, MESENTERY: Sigmoid colon diverticulosis without evidence of acute diverticulitis. Multiple small mesenteric lymph nodes again visualized. Interval decrease in size of reference mesenteric lymph node, measuring 1 x 0.6 cm, image 125 series 4, previously measured 1.2 x 0.8 cm.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Some diastases of rectus abdominis muscles seen. | 1. Interval decrease in size of reference lymph nodes as described. 2. Unchanged 4 mm right lower lobe lung nodule, of uncertain etiology. |
Generate impression based on findings. | Reason: s/p left orbital / nasal recon History: postop The patient is status post repair for left orbital floor fracture. A mesh is present along the left orbital floor. The posterior aspect of the mesh droops approximately 5 mm below the osseous margins of the left orbital floor along with some intraorbital contents. Anteriorly the mesh is held in place by screws. There is left periorbital soft tissue swelling present.There are bilateral nasal bone fractures present with mild deviation of the nasal bones towards the rightThe skull base foramina are intact.The visualized eyeballs are intact lacrimal glands are unremarkable. Extraocular muscles are intact. The suprasellar cistern is unremarkable.Visualized portions of the mastoid air cells and middle ears are clear. The visualized portions of the paranasal sinuses demonstrate partial heterogenous density opacification of the maxillary sinuses left more than right with a fluid fluid level in the left maxillary sinus and some air bubbles. | 1.Status post left orbital floor a mesh placement as described above. Please correlate with clinical exam findings.2.Bilateral nasal bone fractures as described above.3.Partial opacification the maxillary sinuses may be related to blood products in this clinical context. |
Generate impression based on findings. | 17 year old male with cerebral palsy and question of aspiration pneumonia. Coughing with thin liquids.EXAMINATION: Oropharyngeal motility study 1/13/2015 Julie Ecclestone, speech and language therapist, supervised the examination.PRESENTATION: The patient was presented thin liquids via a spoon and an open cup, nectar thickened liquids via an open cup, honey thickened liquids via an open cup and table purée via a spoon. RESULTS: The patient demonstrated fair labial closure around the cup and spoon. There was positive tongue pumping and premature spillage. Decreased strength of the pharyngeal constrictors was noted with multiple attempts to clear. There was delayed swallowing as well as pharyngeal stasis. Positive penetration was seen with thin liquids via a spoon, without cough. Aspiration was noted with thin liquids via cup, nectar thickened liquid via cup, honey thickened liquids via cup and table purée via spoon, also without cough.50 seconds of fluoroscopy was used. | Aspiration without cough with all consistencies tested.Please see the speech and language therapist's report for feeding recommendations. |
Generate impression based on findings. | Postoperative changes are again seen from previous posterior cervical fusion of L5 and S1, with bilateral pedicle screws at these levels and bilateral connecting rods. There is associated extensive streak artifact, limiting evaluation of surrounding structures. There is no evidence of acute fracture or instrumentation complication. No lucency is identified along the screws. Decompressive laminectomies are again present at these levels. The degree of bone graft incorporation along the posterior elements of L5 and S1 appears slightly progressed bilaterally on axial images.The lumbar spine is in stable alignment, with a normal lumbar lordosis. There is redemonstration of grade 3 anterolisthesis of L5 on S1 due to chronic bilateral L5 pars interarticularis defects. The posterior L5 vertebral body again has a wedged appearance with prominent sclerosis along the lower L5 and upper S1 endplates, as well as slightly worsened severe space narrowing. The vertebral body and disk heights are otherwise well-maintained.There is a similar degree of central spinal canal effacement at the L5-S1 level due to alignment abnormality, although it is decompressed posteriorly. There is continued moderate-severe bilateral foraminal narrowing. There is no evidence of significant central spinal canal or foraminal stenosis at any other level.Subtle midline osseous defects are present in the T11 and T12 posterior elements without evidence of discrete spinous processes. Additional spina bifida occulta is present at L1 and L2 as well as along the upper sacrum. Postoperative changes in the posterior soft tissue at the lumbosacral junction have resolved. | 1. Essentially stable postoperative changes following previous decompressive laminectomy and posterior surgical fusion of L5 and S1. No acute fracture or instrumentation complication. Degree of posterior element fusion appears slightly progressed.2. Stable degree of grade 3 anterolisthesis with slightly progressed L5-S1 severe disk space narrowing. |
Generate impression based on findings. | 84-year-old male with history of parotid mucoepidermoid carcinoma, status post chemoradiation. Per chart, pT4aN0 high grade carcinoma ex pleomorphic adenoma of the R parotid with R auditory canal recurrence in 6/2014. Radiation to R parotid bed in 9/2013, R auditory canal/pinna in 12/2014 Again seen are postoperative changes of radical right parotid resection as well as lateral temporal bone resection extending to the level of the stylomastoid foramen. Compared to 10/12/2014, there is mild increase in soft tissue thickening in the deep aspect of the pinna as well deep aspect of the surgical bed extending into the right masticator space (axial series 7, images 20-29 of 79) which may be related to post treatment change. No discrete mass is appreciated. Evidence of reconstruction including right facial sling noted. Surgical changes extend into the right supraclavicular region. Unchanged appearance of the right mandibular condyle likely related to treatment. No discrete mass lesions are appreciated. No cervical lymphadenopathy. Remainder of the salivary glands and thyroid are unremarkable.Evaluation of the brain parenchyma demonstrates no evidence of intracranial mass or mass effect. No abnormal parenchymal or meningeal enhancement. Prominent extra-axial spaces are compatible with volume loss. Ventricles are within normal limits without hydrocephalus.Mild atherosclerotic changes are seen without significant stenosis. Minor degenerative changes are seen in the cervical spine without suspicious osseous lesions. Moderate neural foraminal narrowing noted at bilateral C5-6, C6-7, and right C4-5. Emphysematous changes are seen in the lung apices. Secretions in the trachea. Residual contrast noted in the esophagus. Right chest wall port partially visualized. Please refer to separate report for detailed findings in the chest. | 1. Posttreatment changes in the right head and neck including radical parotidectomy and lateral temporal bone reconstruction. Mild diffuse interval increase in soft tissue thickening is seen in the deep aspect of the surgical bed extending to the masticator space which likely represents evolving treatment changes. No new mass is seen.2. No cervical lymphadenopathy. |
Generate impression based on findings. | Female; 66 years old. Reason: small cell lung CA, s/p resection, chemo and RT. Followup History: none LUNGS AND PLEURA: Stable posttreatment changes of the right hemithorax with volume loss and apical/paramediastinal consolidation, fibrosis, and traction bronchiectasis. Surgical clips in the right hilum. No new pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No visible coronary artery atherosclerotic calcifications. No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy. Stable subcentimeter right breast nodule (image 44, series 4).UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Stable prominent portal caval lymph node measuring 8 mm (image 92, series 4). Stable subcentimeter hypoattenuating lesion in the left lobe of the liver (image 80). | No evidence of recurrent or metastatic disease in the chest. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of prior right breast benign biopsy in 1995. 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. Stable asymmetries bilaterally, including post-surgical asymmetry in the right inner breast. Stable benign calcifications. | 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. | Bladder carcinoma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty infiltration of the liver and cholelithiasis again noted.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic right kidney again noted with possible nonobstructing subcentimeter calculusRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterus absentBLADDER: Status post cystectomy. Unremarkable neobladderLYMPH NODES: Stable reference right external iliac lymph node best seen on image 126 of series 11 measuring 1.2 x 0.9 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination. |
Generate impression based on findings. | Reason: Abscess vs. fistula History: draining subcutaneous nodule LUNGS AND PLEURA: Mild upper lung centrilobular and paraseptal emphysema.No suspicious nodules and no sign of infection.MEDIASTINUM AND HILA: No significant lymphadenopathy.Mild coronary arterial calcification.No pericardial effusion.CHEST WALL: Abnormal subcutaneous soft tissue opacity slightly to the left of the midline at the level of T2 -- T3 with small gas and fluid collections, consistent with an abscess, extending about 2.5 cm deep to the skin, but not extending to the thoracic musculature.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Limited evaluation with no gross abnormalities. | Abscess confined to the soft tissues of the upper back, extending into the subcutaneous fat to a depth of 2.5 cm. |
Generate impression based on findings. | Reason: dysphagia History: dysphagia Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Penetration and trace aspiration was noted during exam. Prominent cricopharyngeal muscles were noted during terminal swallowing, of questionable clinical significance. There was possible small anterior web at the cervical esophagus (series 10). There was sharp angulation at the GE junction, with transient holdup of barium pill. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. TOTAL FLUOROSCOPY TIME: 5:44 minutes | 1.Possible anterior web at the cervical esophagus.2.Sharp angulation of the GE junction with transient holdup of the barium pill. This may have implication on swallowing solid food.3.Prominent cricopharyngeal muscle noted at terminal swallowing, of questionable clinical significance.4.No evidence of reflux. |
Generate impression based on findings. | 64 years, Male. Reason: evaluate NGT position History: see above NGT tip projects over distal third duodenum. Decreased gas in the bowel loops. | NGT tip projects over distal third duodenum. Decreased gas in the bowel loops. |
Generate impression based on findings. | 84 years, Female. Reason: Assess stool burden History: Abdominal pain, constipation, abdominal distension Non obstructive gas pattern. Average stool burden.Mild scoliosis and degenerative disc disease of spine and hips. | Non obstructive gas pattern. Average stool burden. |
Generate impression based on findings. | 17-month-old female with history of gastroschisis and short gut on total parenteral nutrition, with elevated LFTs, evaluate for biliary sludge. LIVER: No significant abnormality noted. The liver measures 10 cm.GALLBLADDER, BILIARY TRACT: No significant abnormality noted.PANCREAS: No significant abnormality noted.SPLEEN: Splenule is noted. The spleen is enlarged measuring 9 cm.KIDNEYS: No significant abnormality noted. The right kidney measures 6 cm. The left kidney measures 6.2 cm.ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Scattered lymph nodes are noted in the right lower quadrant. | No evidence of biliary sludge. Splenomegaly. |
Generate impression based on findings. | Male 39 years old; Reason: right testicle pain and swelling, eval for torsion vs orchitis History: pain and swelling to testicle RIGHT TESTIS: 4.1 x 2.8 x 2.2 cm. No focal lesions.LEFT TESTIS: 4.4 by 3.1 x 1.8 cm. No focal lesions.RIGHT EPIDIDYMIS: Right epididymis is enlarged with slightly increased vascularity.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: Bilateral small varicoceles. | Mildly thickened right epididymis with mildly increased vasculature suggestive of acute right epididymitis. Bilateral small varicoceles. |
Generate impression based on findings. | Male 67 years old; Reason: GIST - restaging CHEST:LUNGS AND PLEURA: Biapical pleural nodularity/scarring. MEDIASTINUM AND HILA: Mildly prominent mediastinal lymph nodes, for example, prevascular lymph node measuring 9 x 8 mm, image 29 series 7. Asymmetric dilatation of left jugular vein.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic metastases again seen, decreased in size. Reference inferiorly located right hepatic lesion demonstrates interval decrease in size from prior MRI, measuring 2.1 x 1.9 cm, previously measured approximately 3.4 x 3.4 cm.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Symmetric renal parenchymal enhancement.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia. Diffuse circumferential thickening of stomach, particularly gastric body. Left-sided colon diverticulosis without evidence of acute diverticulitis. Interval decrease in size of right lower quadrant mass, suspicious for adenopathy, measuring approximately 3.6 x 2.8 x 3.4 cm in craniocaudal dimension, located posterior to ascending colon/cecum and inseparable from adjacent small bowel, image 163 series 7. No bowel obstruction.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: Underdistended bladder, making evaluation suboptimal.LYMPH NODES: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative disease of spine. | 1. Diffuse circumferential thickening of stomach, particularly gastric body, appearance may be exacerbated by underdistention. Improving hepatic metastatic disease. Interval decrease in size of right lower quadrant mass as described, suspicious for metastatic adenopathy. 2. Mildly prominent mediastinal lymph nodes, nonspecific. |
Generate impression based on findings. | Male 49 years old Reason: pt with a history of met renal cell cancer, pelase assess for disease progression History: met RCC CHEST:LUNGS AND PLEURA: Bilateral pleural effusions, more on the right side compared to the left. Bilateral dependent atelectasis. Stable left lower lobe nodule on image number 76 on series number 5 measuring 5-mm in diameter. Nodular density in the left lower lobe is also unchanged, best seen on image number 62, series number 5.MEDIASTINUM AND HILA: Index left supraclavicular node measures 1.3 by 1.1-cm measures two by 1.4-cm image number one, series number 3, unchanged. Calcified left hilar lymph node, stable.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis, unchanged. Periportal edema is slightly worse.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Right adrenal gland is not well seen.KIDNEYS, URETERS: Left renal interpolar defect is unchanged. Stable, small hypodense lesions in the left kidney.RETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal adenopathy. Index portacaval lymph node measures 5 by 2.9 cm on image number 105, series number 3, not significantly changed from previous study. Index left para-aortic node measures 5.2 by 4.6 cm on image number 124, series number 3, minimally enlarged compared to previous study. Retroperitoneal adenopathy encases the left renal vein IVC and main portal vein.BOWEL, MESENTERY: Small amount of ascites. This is new from pre-study.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 | Mostly stable metastatic disease other than minimal interval increase in one of the left paraortic lymph nodes.New small amount of ascites. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her cousin. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Tortuous blood vessel noted in the posterior right upper breast. | 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. Prior benign right breast surgical biopsy. 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. Stable left upper breast focal asymmetry and stable benign calcifications 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. | Asymptomatic female presents for routine screening mammography. Personal history of cervical cancer diagnosed at age of 49 treated by hysterectomy, chemotherapy, radiation. Family history breast cancer in mother with age in the 80s. 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. | 32 year old male who has a complaint of bilateral breast enlargement and tenderness. Palpable areas in the upper/outer periareolar region on the left and left retroareolar breast. BILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: Three standard views of both breasts and two left spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. Triangular markers were placed on the skin of the left breast at the sites of clinical concern. There is flame-shaped asymmetry within both retroareolar regions, left significantly greater than right, compatible with asymmetric gynecomastia. No discrete masses, suspicious microcalcifications or areas of architectural distortion are present in either breast. LEFT BREAST ULTRASOUND: On physical examination there is a firm, mobile 1.0 cm nodular area within the left retroareolar region. Additionally at the 1:00 position, at the areolar border, there is a firm, ridge-like palpable area. A targeted left ultrasound was performed for the mammographic and palpable areas of concern. Within the left retroareolar region, there is an ill-defined hypoechoic area compatible with gynecomastia, corresponding to the retroareolar palpable site, and the mammographic findings. At the 1:00 position of the left breast, along the areolar border, at the second site of palpable abnormality, there is no solid or cystic mass identified. | Bilateral gynecomastia, left greater than right. The patient should consult his physician for management. Results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Previous left breast aspiration. 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. Bilateral benign calcifications and stable normal sized lymph nodes in each axilla are noted. No change in left upper breast asymmetry. | 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. | Male 59 years old Reason: GE junction carcinoma please compare to most recent imaging and provide index lesions for RECIST as required per study History: As study CHEST:LUNGS AND PLEURA: Interval decrease in the amount of bilateral pleural effusions.MEDIASTINUM AND HILA: As a fascial stent is in place. Wall thickening of the distal esophagus compatible with patient known history of a esophageal cancer is most is stable.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Scattered subcentimeter hypodense lesions in the liver are stable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral nephrolithiasis and small cysts.RETROPERITONEUM, LYMPH NODES: Index left para-aortic measures 7 x 5 mm on image number 116, series number 604. Indexed paraesophageal node measures 1.3 by 0.9 cm on image number 92, series number 604. These nodes are not significantly changed compared to previous study.BOWEL, MESENTERY: Again noted diffuse gastric wall thickening . Small amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Index left external iliac lymph node is unchanged measuring 7 mm short axis on image number 180, series number 604.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval decrease in the amount of bilateral pleural effusions, otherwise no significant change from previous study. |
Generate impression based on findings. | The frontal sinus and frontoethmoidal recesses are clear. The anterior ethmoid air cells are clear. The posterior ethmoid air cells are clear. There is trace mucosal thickening involving the bilateral maxillary sinuses inferiorly. Maxillary molar roots are noted projecting into the maxillary antrum. The maxillary sinuses are otherwise clear. The ostiomeatal units are clear. The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is rightward nasal septal deviation with small right septal spur. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. Brain parenchyma is unremarkable. | No significant paranasal sinus disease. |
Generate impression based on findings. | 51 year old female status post right lumpectomy 1/2013 for invasive ductal carcinoma grade 1 with tubular features, presents today for routine follow up. Patient received breast radiation and is currently on tamoxifen. No current breast complaints. Family history of breast carcinoma in her maternal grandmother. Three standard views of both breasts and two right spot magnification views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A round marker was placed on a skin lesion overlying the left breast. A linear marker has been placed on a scar overlying the central upper right breast, with expected underlying architectural distortion, increased density and surgical clips. Postsurgical clips are also present in the upper outer, far posterior right breast. Mild skin thickening is appreciated involving the right breast, likely a result of radiation therapy. There is stable focal asymmetry in the upper outer left breast. No new masses or suspicious microcalcifications are present in either breast. Benign lymph nodes are projected over both axillae. | Stable postsurgical changes of the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female, 67 years old, status-post orbital and maxillary reconstruction with a free fibular flap on 1/5. Evidence of prior extensive left maxillectomy is seen with resection of the entire left maxillary sinus, the inferior orbital wall, the left heart palate and alveolar ridge and the left sided nasal structures.The current examination shows findings compatible with maxillofacial reconstruction including placement of two pieces of fibular bone graft. One of these is oriented horizontally and is positioned analagous to the anterior maxillary wall, while the other is positioned obliquely running inferomedially from the infratemporal fossa down to the hard palate. The bone graft is surrounded by soft tissue grafting which bridges the previously seen large left facial defects. Also noted is the placement of a mesh plate along the left orbital floor. Edema and stranding through the soft tissue components of the flap are expected findings. A nasal trumpet has been placed through the left nasal cavity through which passes an NG tube.Limited visualization of the intracranial contents show no gross abnormalities. Visualized soft tissue structures of the neck are likewise unremarkable. Cervical spondylosis is seen particularly at C5-6 where there is likely some degree of spinal canal stenosis. No destructive osseous lesions are seen. | Findings are seen related to recent extensive left maxillofacial reconstruction with placement of bone and soft tissue graft across the previously seen left maxillary defects, as as well as a mesh plate along the left orbital floor. |
Generate impression based on findings. | There is redemonstration of extensive post operative changes of right frontal and anterior temporal craniotomy for resection of a meningioma. Right greater than left anterior/inferior frontal encephalomalacia and bilateral trace right greater than left subfrontal extra-axial CSF collections remain unchanged. There is redemonstration of plaque-like enhancement along the dorsal planum sphenoidale, with similar configuration and size compared back to 10/16/2013. Enhancement again extends posteriorly along the diaphragmatic sella and is inseparable from the adjacent slightly elevated optic chiasm on the left side and proximal post chiasmatic left optic nerve. The distal A1 and proximal A2 segments abut the mass and are likely partially encased especially on the left.The ventricles and sulci are stable. The cisterns remain patent. There is no midline shift. There is no diffusion abnormality.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. | 1. No significant interval change in appearance of residual enhancing meningioma along the dorsal planum sphenoidale extending along the diaphragmatic sella, comparing back to 10/16/2013. Redemonstration of intimate relationship with slightly elevated optic chiasm and proximal left optic nerve as well as the proximal anterior cerebral arteries.2. Stable chronic postoperative changes as well as bilateral inferior frontal encephalomalacia and bilateral subfrontal extra-axial likely postoperative collections. |
Generate impression based on findings. | Male 87 years old Reason: colon cancer restaging History: colon cancer restaging CHEST:LUNGS AND PLEURA: Right lower lobe dependent atelectasis, some of which are new from previous CT.MEDIASTINUM AND HILA: Index precarinal lymph node measures 10 x 7 mm on image number 33, series number 3.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts are unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Fat-containing anterior abdominal hernias.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No significant change from previous study. |
Generate impression based on findings. | The frontal sinuses are clear. There is mild opacification of the anterior ethmoid air cells with minimal extension into the right frontal recess. There is right medial orbital wall defect with herniation of fat medially. The posterior ethmoid air cells are clear. There is trace mucosal thickening involving the bilateral maxillary sinuses. The maxillary sinuses are otherwise clear. The ostiomeatal units are clear. The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. Nasal septum is midline. Small right nasal septal spur. The nasal cavity is clear. The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. There is moderate opacification of the left mastoid air cells and middle ear cavity including the epitympanum. Findings can be better assessed with temporal bone CT if clinically indicated. | 1. Minimal mucosal thickening in the paranasal sinuses.2. Right medial orbital wall defect with herniation of fat medially. Finding may be related to prior trauma.3. Opacification of the left mastoid air cells and middle ear cavity including the epitympanum. |
Generate impression based on findings. | Male 75 years old Reason: s/p 4 cycles of treatment for prostate cancer History: s/s associated with metastatic prostate cancer CHEST:LUNGS AND PLEURA: Left upper lobe nodule measures 8-mm in diameter image number 27, series number 5, not significantly changed from previous study. Elevation of the left hemidiaphragm is unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse bone metastases, grossly stable.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: Diffuse bone metastases, grossly stable.OTHER: No significant abnormality noted | Diffuse bone metastases. No significant change from previous study. |
Generate impression based on findings. | Male 45 years old Reason: Pt is a 44 y/o male with RCC, s/p nephrectomy, evaluate for recurrence, attention to lung nodules History: RCC CHEST:LUNGS AND PLEURA: Scattered subcentimeter nodules, unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodense lesions in the liver are unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post left nephrectomy.RETROPERITONEUM, LYMPH NODES: Index left common iliac lymph node is unchanged measuring 7 mm in diameter image number 156, series number 4.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 | No significant change from prior study. |
Generate impression based on findings. | 12-year-old male status post reduction of right fifth digit boxer's fracture.VIEWS: Right hand PA and lateral (two views) 1/13/2015, 12:02 Overlying splint material obscures fine bone detail. Interval reduction of the transverse fracture of the neck of the fifth metacarpal, with residual anterior angulation. | Reduction and splinting of the fifth metacarpal boxer's fracture with residual anterior angulation. |
Generate impression based on findings. | 50 year-old male with history of pancreatic cancer who presents for surveillance after 3 cycles. ABDOMEN:LUNG BASES: Mild to moderate bibasilar atelectasis. No suspicious pulmonary nodule or mass. No pleural effusion or pneumothorax.LIVER, BILIARY TRACT: Few scattered subcentimeter hypoattenuating hepatic lesions too small to characterize but statistically most likely cysts.SPLEEN: No significant abnormality notedPANCREAS: Heterogeneously enhancing mass in the expected location of the pancreatic head measures 3.4 x 2.8 cm (series 10, image 50), previously measuring 4.0 x 2.8 cm. This mass abuts and causes attenuation of the main portal vein without occlusion. This mass also abuts the superior mesenteric vein and artery as well as the common hepatic artery without occlusion. Persistent pancreatic ductal dilatation measuring up to 8 mm and diffuse atrophy of the distal pancreas, unchanged. Soft tissue attenuation to the right of the SMA is presumed to be the uncinate process of the pancreas.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Interval decrease in size of the peripancreatic lymph nodes with the reference lymph node measuring 0.8 x 0.7 cm (series 10, image 45), previously measuring 1.6 x 1.2 cmModerate atherosclerotic calcifications affect the abdominal aorta.BOWEL, MESENTERY: There is mild mesenteric haziness encasing the celiac axis and SMA at its origins, not significantly changed. Interval increase in diffuse abdominal and pelvic ascites.Postoperative related to gastrojejunostomy. Thickening at the hepatic flexure is nonspecific in the setting of ascites.BONES, SOFT TISSUES: Moderate to severe degenerative changes affect the lower lumbar spine.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedBOWEL, MESENTERY: As above.BONES, SOFT TISSUES: Moderate to severe degenerative changes affect the lower lumbar spine. | 1.Interval decrease in size of the pancreatic head mass with persistent pancreatic ductal dilatation and distal atrophy.2.Interval decreased size of peripancreatic lymphadenopathy. |
Generate impression based on findings. | 61-year-old female with history of pancreatic cancer. Surveillance study, evaluate for liver lesions. CHEST:LUNGS AND PLEURA: Scattered pleura micronodules, and calcified left lung base granuloma, unchanged. No pleural effusion or consolidation, and no suspicious nodule or masses.MEDIASTINUM AND HILA: Heart size within normal limits, no significant pericardial effusion. Reference superior mediastinal/level 2 pretracheal lymph node (3/24) is unchanged at 6 mm in the short axis. Additional scattered small mediastinal and hilar lymph nodes are again seen, unchanged. Heterogeneous enlarged thyroid, with coarse calcifications similar to prior.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Focus of hypoattenuation in the anterior liver parenchyma (3/74) is unchanged in size at 1 cm, stable since 2013.Patent hepatic vasculature, and postoperative findings of Whipple. No biliary dilation.SPLEEN: No significant abnormality noted.PANCREAS: Postoperative findings of Whipple procedure, with the remaining pancreas tissue appearing intact.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: 10 x 3 mm soft tissue thickening posterior to the SMV, unchanged and likely postsurgical in nature. No significant retroperitoneal lymphadenopathy.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Small focus of hypoattenuation in the anterior left hepatic lobe, unchanged from prior. Nonspecific, and may be followed on subsequent imaging.2.Postoperative findings of Whipple procedure, without findings of disease recurrence, unchanged. |
Generate impression based on findings. | 78 year-old male with metastatic prostate cancer after 6 cycles of investigational therapy. Stable foci of increased radiotracer uptake are again seen, including L5 vertebral body/left transverse process, left sacrum, left iliac wing, and left hip, compatible with metastatic disease. Increased activity in the cervical spine, shoulders, hips, and knees likely represent degenerative changes. | Stable osseus metastatic disease without evidence of progression. |
Generate impression based on findings. | 68 years, Male. Reason: OG tube placement History: OG tube placement NGT tip projected over the gastric antrum. Gaseous distention of the colon similar to prior studies. Rectal tube in place. | NGT tip projected over the gastric antrum. Gaseous distention of the colon similar to prior studies. |
Generate impression based on findings. | 74 years, Male. Reason: Rule out obstruction. Mild diffuse bowel loop dilatation with some air fluid levels on upright views, suggestive of ileus. No free air. Surgical and skin staples project over the pelvis. Right hip arthroplasty hardware. Surgical drain in the pelvis. Cardiomegaly. | Findings compatible with ileus as described above. No free air. |
Generate impression based on findings. | CT HEAD:No intracranial mass or mass effect. The ventricles and sulci are within normal limits. There is no midline. There is no intracranial hemorrhage. Minimal periventricular white matter hypoattenuation is nonspecific but unchanged from the prior exam and likely represents age indeterminate small vessel ischemic disease. There is no extraaxial fluid collection. Small left maxillary mucous retention cyst/polyp is unchanged. The remaining paranasal sinuses are clear. Lenses are thin bilaterally.CT NECK:Postoperative changes related to total thyroidectomy. There is focal area of thickening along the upper esophagus adjacent to the surgical bed. No discrete enhancing mass to suggest tumor progression/recurrence. No cervical lymphadenopathy identified. Submandibular glands are normal. Accessory parotid tissue on the left with fatty atrophy of the parotid glands bilaterally. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. Mild atherosclerotic calcifications along the aortic arch and the right vertebral origin. For findings in the chest, please see dedicated chest CT performed on the same day. | 1.Postoperative findings related to total thyroidectomy. No evidence of tumor progression in the neck or lymphadenopathy.2.Mild focal area of esophageal thickening at the level of the surgical bed is unchanged. Endoscopy may be considered if clinically indicated.3.For findings in the chest, please see dedicated chest CT performed on the same day. |
Generate impression based on findings. | 46 years old female with a history of cervical adenocarcinoma s/p surgery and chemoRT. This is a post-treatment scan for restaging and evaluating of therapeutic response. RADIOPHARMACEUTICAL: 12.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 103 mg/dL. Today's CT portion grossly demonstrates a soft tissue density with surgical clips in the right breast. There is diffuse skin thickening of the right breast. Soft tissue densities are seen in the subcutaneous tissue of the anterior abdominal wall. An IVC filter is again noted. The uterus is surgically absent.Today's PET examination demonstrates a focal mild FDG uptake in the soft tissue density in the right breast with SUVmax of 2.6. Diffuse FDG uptake is seen in the skin thickening of the right breast.There are several new foci of increased FDG uptake in the left axilla corresponding to normal-sized lymph nodes seen on CT portion of the study. Mild FDG uptake is seen in the several normal sized lymph nodes in the inguinal regions. There is interval decreased activity in the multiple soft tissue densities in the anterior abdominal wall.Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Soft tissue density with mild FDG uptake and surgical clips in the right breast, which is nonspecific. However tumor cannot be excluded. Suggest clinical correlation.2.Stable normal sized lymph nodes in the bilateral inguinal regions, which are most likely due to inflammatory change.3.Multiple new normal-sized lymph nodes with increased activity in the left axilla, which are most likely due to extravasation of the tracer due in the FDG tracer injection. However, inflammatory change or tumor activity cannot be excluded.4. Subcutaneous soft tissue densities with increased metabolic activity are most likely due to injection granuloma. |
Generate impression based on findings. | 78-year-old male with history of bilateral knee pain. Right knee: There is medial compartment joint space narrowing and tricompartmental osteophytes compatible with moderate osteoarthritis which has progressed when compared to prior. There is a slight varus deformity of the knee. Scattered arterial calcifications are present.Left knee: There is medial compartment joint space narrowing and tricompartmental osteophytes compatible with moderate osteoarthritis. There is a slight varus deformity of the knee. Tiny ossicle in the posterior aspect of the knee joint may represent a loose body. A focus of heterotopic bone is present within the posterior soft tissues of the thigh, likely posttraumatic in etiology. Scattered arterial calcifications are present. | Osteoarthritis and other findings as above. |
Generate impression based on findings. | Male 85 years old; Reason: 85 yo M with HCC, please evaluate extent of disease prior to planned radioembolization procedure. CHEST:LUNGS AND PLEURA: Mild biapical nodularity/scarring. Nonspecific mild asymmetric airspace disease in left upper lobe, image 15 series 3. Emphysematous changes seen. Biapical pleural nodularity/scarring. Left basilar atelectasis. MEDIASTINUM AND HILA: Evaluation for hilar adenopathy suboptimal without IV contrast. Small calcified hilar lymph nodes. Atherosclerotic calcifications of the aorta. Moderate to marked calcified coronary artery disease. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple bilobar hepatic lesions, imaging characteristics compatible with multifocal hepatocellular carcinoma. In arterial phase of imaging, heterogeneous enhancement seen. On subsequent venous phase of imaging, largest lesion demonstrates some washout, other lesions minimally hypoattenuating to isodense in comparison to liver in the later phase. Dominant mass present in hepatic segment 7/6, measuring 13.9 cm in AP dimension by 12.9 cm in transverse dimension by approximately 13 cm in craniocaudal dimension. Mild intrahepatic biliary duct dilatation, primarily in right hepatic lobe. Visualized proximal hepatic arteries patent. Marked luminal narrowing of right hepatic vein. Posterior right portal venous segments not well visualized, likely occluded due to patient's dominant liver mass. SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic fatty atrophy.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Renal cysts, largest measuring 2 cm on the left.RETROPERITONEUM, LYMPH NODES: Aortobiiliac atherosclerotic disease. Status post endovascular aortic repair with infrarenal abdominal aortic aneurysm seen measuring 5.2 cm in transverse dimension by 5.1 cm in AP dimension. On postcontrast imaging, a contrast blush is evident within the aneurysm sac, the leak appears to be supplied by the inferior mesenterica artery (image 72 series 12), appearance compatible with a type II endoleak. Aneurysmal right common iliac artery, measuring up to 2 cm and ectatic left common iliac artery, measuring up to 1.7 cm, ectatic external iliac arteries, measuring up to 1.5 cm. Findings discussed with ordering physician Dr. Sharma at 2:15 p.m. on 1/13/15 and discussed with IR team.BOWEL, MESENTERY: Extensive left-sided colon diverticulosis without evidence of acute diverticulitis. Subcentimeter radiodensity seen in left anterior abdomen.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate gland, measuring up to 5.9 cm in transverse dimension, and containing coarse calcification. Contour deformity in region of prostate base, may reflect prior TURP defect and correlation with patient's clinical history recommended. BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes of spine, most pronounced at L2/3 level, and scoliosis seen, age indeterminant loss of height of multiple midthoracic vertebral bodies noted. Right inguinal surgical clips. Nonspecific focus of skin thickening measuring 1.2 cm seen in left mid abdomen, image 73 series 13, correlation with patient's clinical history and physical exam recommended. | 1. Multifocal hepatocellular carcinoma with dominant right hepatic lesion as described.2. Endovascular aortic repair with type II endoleak seen.3. Nonspecific mild asymmetric airspace disease in left upper lobe, of uncertain clinical significance, correlation with patient's clinical history recommended, may be re-assessed on followup imaging. |
Generate impression based on findings. | 56-year-old female with history of right knee pain. There is narrowing of the lateral compartment particularly on the skiers view compatible with moderate osteoarthritis. Minimal osteoarthritis affects the left knee as seen on the frontal view. | Osteoarthritis as above. |
Generate impression based on findings. | 60 year-old female with shoulder pain, joint pain, evaluate for RA Left hand: There is marked soft tissue swelling about the dorsum of the wrist. There is a questionable erosion of the ulnar styloid. No additional erosions or significant arthritic changes are identified.Right hand: A small ossicle adjacent to the ulnar styloid is likely of no clinical significance. There are no significant arthritic changes involving the hand or wrist.Left shoulder: Glenohumeral alignment is within normal limits. Mild osteoarthritis affects the acromioclavicular joint.Left elbow: There is a questionable small joint effusion. The osseous structures appear unremarkable. | Marked soft tissue swelling about the left wrist and questionable ulnar styloid erosion without other findings to suggest inflammatory arthritis. |
Generate impression based on findings. | Findings compatible with recent Le Fort I surgical maxillary osteotomy and biparietal halo placement, including a band-like fixation device along the anterior maxilla, and screws within the paramedian and bilateral anterior rami of the mandible. ADA number 7 and 10 are absent. The distractor has not yet been deployed. Extensive streak artifact secondary to metallic hardware is somewhat limiting. Hypoplasia of the maxilla, including a 10-mm under-jet. There is a large defect in the bony palate, measuring 18 mm in the transverse diameter. Heterogeneous soft tissue and fat density along the expected location of the undersurface of the hard palate may be postsurgical in nature.Postsurgical changes including diffuse swelling of the soft tissues of the anterior face, right greater than left. There is near-complete opacification of the bilateral maxillary sinuses, with layering hyperdense fluid, compatible with blood products. Blood products are also present in the posterior nasal cavity, right greater than left. Scattered, linear hyperdensities, which appear isodense to bone, are present in the bilateral maxillary sinuses, and may represent post-osteotomy bone fragments versus packing material. There is also more mild opacity of the remainder of the paranasal sinuses. There is significant under-pneumatization of the right mastoid air cells, and moderate under-pneumatization of the left mastoid air cells. Fluid is present in the right aditus ad antrum.An enlarged left submandibular lymph node measures 18 mm, but retains a fatty hilum and a normal reniform morphology, likely reactive.An extra-axial fluid density structure in the anterior/inferior left middle cranial fossa causes mass effect on the adjacent left temporal lobe, measuring 4.0 x 2.4 x 2.3 cm, likely an arachnoid cyst. | 1. Postsurgical changes related to recent Le Fort I osteotomy and halo placement, without definitive distractor device deployed. Extensive soft tissue swelling in the anterior facial soft tissues, right greater than left.2. Blood products are present within the posterior nasal cavity as well as the maxillary sinuses. 3. Extra-axial fluid density structure in the anterior/inferior left middle cranial fossa statistically most likely represents an arachnoid cyst.4. Bilateral under-pneumatization of the mastoid air cells, right greater than left, and fluid within the right aditus ad antrum. |
Generate impression based on findings. | 84 female with history of lumbar diskitis, osteomyelitis There is loss of the L1/2 intervertebral disk space with destruction of the adjacent vertebral body endplates consistent with the history of diskitis osteomyelitis. There is minimal kyphosis at this level. The remaining lumbar spine appears unremarkable. | Findings consistent with L1/2 diskitis osteomyelitis as described above. |
Generate impression based on findings. | 27-day-old male with desaturationVIEW: Chest AP (one view) 01/13/15, 1126 ET tube tip is below thoracic inlet and just above carina. Nasogastric tube tip is in the stomach, unchanged. There are now 3 chest tubes on the right. The left upper extremity PICC with tip in the superior vena cava is unchanged.Interval decrease in size of large right pneumothorax. Background interstitial emphysematous changes to the right lung is present. Leftward mediastinal shift with atelectatic left lung. Heart size cannot be evaluated. | Interval decrease in size of large right pneumothorax with leftward mediastinal shift. Atelectatic left lung. |
Generate impression based on findings. | 69-year-old female with heel ulcers, bacteremia. Evaluate for osteomyelitis. There remains increased blood flow to the right foot and ankle, particularly at the right heel, which does not appear significantly changed. Mildly increased flow in the left heel is new from the prior exam. Blood pool images show persistent increased uptake in the posterior right foot soft tissues/right heel, and to a lesser degree, in the left heel.Delayed imaging shows diffusely increased activity in the proximal right foot and more focal activity in the heel. There is also mild persistent increased activity in the left heel. | Cellulitis and inflammatory soft tissue changes. Stable uptake in the right heel and new uptake in the left heel on delayed phase imaging may involve the cortex, and therefore osteomyelitis of both/either calcanei remains a differential consideration. |
Generate impression based on findings. | Female 51 years old; Reason: History of metastatic breast cancer on treatment. Compare to previous scans and evaluate for response and extent of disease. Abnormal uptake in the L4 vertebral body consistent with metastatic disease is unchanged.Scattered uptake in the shoulders, hips and knees consistent with degenerative changes. | L4 vertebral body metastasis not significantly changed. |
Generate impression based on findings. | 75-year-old male status post fusion. Posterior stabilization rods with transpedicular screws entering the vertebral bodies of L5, L4, L2 and L1 in near-anatomic alignment without evidence of hardware complication. There is disk space narrowing and endplate destruction at L2-L3, appearing similar to the prior exam, consistent with the history of diskitis osteomyelitis and associated vertebral body compression fracture. Mild degenerative disk disease affects L5-S1. | Orthopedic fixation and other findings as described above without evidence of hardware complication. |
Generate impression based on findings. | 84-year-old male, evaluate hardware and fusion Posterior stabilization rods with transpedicular screws enter T5, T4, T3 and C4, C5 and C6 without evidence of hardware complication. Sclerosis of the T1 vertebral body is consistent with prostate metastasis. Multilevel degenerative disk disease affects the lower cervical spine. | Orthopedic fixation of the cervical and thoracic spine as well as other findings as described above. |
Generate impression based on findings. | Colon and cervical carcinoma CHEST:LUNGS AND PLEURA: Stable biapical bullae and emphysematous findings.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Status post wedge resection of previously noted segment 6 metastatic focus. No new worrisome mass lesion. Stable bilobar subcentimeter low-attenuation foci. No ductal dilatation. Hepatic vessels patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable nodular thickening adrenal glands bilaterallyKIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fibroid uterusBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postop findings stableBONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Status post wedge resection of segment 6 metastatic hepatic lesion. No new mass lesion or metastatic focus appreciated. |
Generate impression based on findings. | 84-year-old male, preoperative evaluation There is 8 degrees valgus deformity of the knee relative to the neutral mechanical axis. Severe osteoarthritis affects the knee with lateral greater than medial joint space narrowing. Hardware components of a right total hip arthroplasty are situated in near-anatomic alignment. | Valgus deformity and severe osteoarthritis of the knee as described above. |
Generate impression based on findings. | 40 year-old male with metastatic thymic cancer. Evaluate for metastatic disease. CHEST:LUNGS AND PLEURA: Right paramediastinal ground glass and fibrotic changes have increased compared to previous examination and may be related to previous treatment. Interval resolution of the previously noted opacity at the left lung base. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Heterogeneous anterior mediastinal mass containing areas of necrosis and calcification has decreased in size. At the level of the main pulmonary artery, the mass measures 7.9 x 2.2 cm (series 3, image 32), previously measuring 8.5 x 2.4 cm. The mass compresses the superior vena cava and remains adherent to the aorta, unchanged. Right peritracheal and right hilar lymphadenopathy is similar.CHEST WALL: Osseous erosion and sclerotic metastases in the sternum, unchanged.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: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant change in the heterogeneous appearance of and mild compression deformity of L1 vertebral body.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 change in the heterogeneous appearance of and mild compression deformity of L1 vertebral bodyOTHER: No significant abnormality noted | 1.Interval decrease in size of anterior mediastinal mass. 2.Interval increase in right paramediastinal ground glass opacity/fibrotic changes which may be related to treatment.3.Stable osseous metastases. 4.Interval resolution of tree in bud opacity at the left lung base. |
Generate impression based on findings. | 52-year-old female status post ACDF 3 months prior. Evaluate for bony fusion. An anterior plate with screws affixes C4 and C5 with interposed bone graft material. We see no frank intervertebral fusion. No evidence of instability. Moderate degenerative disk disease affects C5-6 and C6-7. The prevertebral soft tissue swelling has decreased. | Postoperative changes of ACDF and degenerative disc disease as described above. |
Generate impression based on findings. | Female; 58 years old. Reason: Pt w/ extensive stage small cell lung cancer. Not on therapy. Eval for progression. History: Pt w/ extensive stage small cell lung cancer. Not on therapy. Eval for progression. CHEST:LUNGS AND PLEURA: Large left hydropneumothorax has slightly improved since prior study with mildly increased aeration of the underlying residual left lung, which again demonstrates marked bronchiectasis. Multiple surgical clips in the left hilar region. In situ thrombus is again seen in the left pulmonary artery stump. Stable right upper lobe paramediastinal fibrosis and traction bronchiectasis, likely related to radiation treatment. Moderate paraseptal and centrilobular emphysema of the right lung. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. Normal heart size without pericardial effusion. No visible coronary artery atherosclerotic calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Tiny hypoattenuating focus in the inferior right lobe of the liver is too small to characterize and may be due to cyst (image 83, series 3).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: Moderate atherosclerosis of the abdominal aorta and proximal common iliac arteries.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. Large left hydropneumothorax has slightly improved. Again, this may be related to a bronchopleural fistula.2. Marked bronchiectasis of the residual left lung and moderate emphysema of the right lung, similar to prior study. No suspicious pulmonary nodules or masses.3. No evidence of metastatic disease in the abdomen. |
Generate impression based on findings. | Ms. Gill is a 45 year old female with screen-detected asymmetry in the left lower inner breast. US showed possible cluster of cysts vs solid mass. She presents today for US-guided aspiration of cyst vs biopsy. Left ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a cluster of two hypoechoic lesions. The superior lesion measured 0.7 cm and the inferior lesion measured 0.8 cm. Both were located at the 7 o’clock position with questionable increased adjacent/peripheral vascularity of the superior lesion is noted, but there is no vascularity associated with or near the inferior (less suspicious) lesion. The lesions were readily visible.PROCEDURE: The procedure and its risks, including bleeding, infection, and failure to diagnose, and expected benefits of ultrasound-guided cyst aspiration with possible core biopsy with percutaneous placement of a marking clip and post-procedure unilateral mammogram were discussed with the patient. Prior to the prepping for the procedure, the options of aspiration versus core biopsy were discussed and the patient declined the option for core biopsy. Questions were answered. Consent was obtained both verbally and in writing. The time-out form was completed to confirm patient identity and side/type of procedure.The left breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially. Using aseptic technique, continuous ultrasound guidance and a lateromedial approach, fine needle aspiration was performed for the superior lesion. Two cc of greenish liquid was aspirated with complete imaging resolution of the superior lesion, confirming a cyst (please note that this was the more suspicious component of the cluster of cysts).Then fine needle aspiration was performed for the inferior lesion. Two cc of blood-tinged clear liquid was aspirated with near-complete imaging resolution, confirming a complicated cyst with viscous liquid. Targeting was judged excellent. No fluid was sent to cytology.No clip was placed. Pressure was held over the biopsy site until all bleeding subsided. The skin incision was closed with a Steri-Strip. Post-procedure digital left CC and ML views revealed interval near complete resolution of previously identified focal asymmetry in the left lower inner breast, compatible with successful aspiration of cysts. No evidence of hematoma or other complication.A Band Aid was positioned over the aspiration site. Post-procedure instructions were reviewed with the patient both verbally and in writing. She tolerated the procedure well with no evident complications and left the Breast Imaging Department in stable condition.The procedure was performed by Dr. Sheth. Dr. Schacht was present during the procedure at all times. | Successful aspiration of two cysts in the left lower inner breast. No fluid was sent for cytology based on the typically benign appearance. A short term follow-up ultrasound of the left breast is recommended in 6 months to confirm stability of these findings.BIRADS: 3 - Probably benign findingRECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 65-year-old female with history of osteoarthritis and worsening right knee pain. The bones are demineralized suggesting osteopenia/osteoporosis. There is severe osteoarthritis affecting the right knee with bone on bone apposition medially which has progressed slightly when compared to prior. There are small tricompartmental osteophytes. There is chondrocalcinosis of the lateral meniscus. Calcifications anterior to the distal femur may lie within the suprapatellar recess or fibers of the distal quadriceps tendon. The left knee appears normal as seen on the frontal view. | Severe osteoarthritis as above. |
Generate impression based on findings. | There is been a left frontotemporal craniectomy and cranioplasty with small fixation plates and microscrews. Multiple patchy areas of bone graft appears similar to the with large areas of uncovered dura. There is irregularity and mild overlap along the inferior cranioplasty margin. The dura in this region as thickened with an underlying left hemispheric extra-axial fluid collection measuring 10 mm in thickness, unchanged. Mild bulging of the left frontal lobe through the craniectomy defect is unchanged. No mass-effect or midline shift.The ventricles and sulci are within normal limits. There is no intracranial hemorrhage. Posterior defect in the right frontal sinus which is partially opacified and unchanged. There is mild mucosal thickening of the posterior right ethmoid air cells and right sphenoid sinus. | 1.Left frontotemporal cranioplasty is unchanged in appearance. Small underlying extra-axial CSF fluid collection is unchanged. 2.Mild stable irregularity along the cranioplasty margins as described above, possibly corresponding to palpable abnormality. |
Generate impression based on findings. | 55-year-old female with left lower quadrant pain. Evaluate for diverticulitis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Unchanged peripherally calcified hypoattenuating subcentimeter lesion in the lateral right hepatic lobe; apparent macroscopic fat in lesion. SPLEEN: Splenule noted.PANCREAS: Minimally increased prominence of the main pancreatic duct without a focal pancreatic lesion is of uncertain significance.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal hypoattenuating lesion measuring approximately 1 x 0.8 cm (series 3, image 47) with Hounsfield units of 30, is incompletely characterized. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Nonspecific mildly prominent retroperitoneal nodes.BOWEL, MESENTERY: Moderate thickening of the descending colonic wall, appearance compatible with colitis. No evidence of small bowel obstruction.PELVIS:UTERUS, ADNEXA: Fibroid uterus.BLADDER: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality noted | 1.Findings consistent with descending colitis.2.Indeterminate right hepatic lobe lesion is unchanged, favor benign lesion.3.Incompletely characterized right renal lesion. |
Generate impression based on findings. | 45-year-old female with history of head and neck cancer and chemoradiation therapy.RADIOPHARMACEUTICAL: 14.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 80 mg/dL. Today's CT portion grossly demonstrates right chest wall port catheter tip common terminating in the right atrium, cholelithiasis without evidence of cholecystitis, and questionable soft tissue nodule in the transverse colon near the splenic flexure.Today's PET examination demonstrates abnormal pituitary uptake, compatible with known microadenoma; symmetric multifocal paraspinal bilateral multilevel mild activity in the upper thorax/lower cervical spine typical of brown fat. No evidence of FDG avid tumor in the head and neck is present.There is intense focal FDG uptake in the left upper quadrant, correlating with a questionable nodular soft tissue abnormality in the transverse colon proximal to the splenic flexure (maximum SUV 13). Mild diffuse activity extending to the bilateral adnexa is also noted. | 1.No evidence of FDG avid tumor in the head and neck.2.Focal intense FDG avidity in the left upper quadrant may represent colonic adenoma or carcinoma versus less likely metastasis. Correlation with endoscopic findings is recommended.3.Endometrial/adnexal increased activity may be physiologic, and correlation with last menstrual period is recommended. Ultrasound may be considered for further evaluation if clinically indicated.4.Pituitary uptake compatible with known microadenoma. |
Generate impression based on findings. | Male 42 years old; Reason: right hydronephrosis History: hydronephrosis The posterior abdominal radionuclide angiogram demonstrates decreased perfusion in the left kidney at the level of the renal sinus likely due to mild hydronephrosis. Sequential images of the left kidney is significant for an area of indentation along the superolateral aspect; otherwise the left kidney is normal in size. There is normal uptake and excretion of the radiopharmaceutical by the left kidney from the renal cortex to the pelvicalyceal system, with delayed washout to the ureter and bladder. Images of the right kidney demonstrate diffuse decreased perfusion likely due to hydronephrosis which is greater in extent compared to the left. The right kidney is enlarged relative to the left kidney. There is normal excretion of the radiopharmaceutical by the right kidney from the renal cortex to the pelvicalyceal system, with delayed washout to the ureter and bladder.The estimated contribution of the right kidney to total renal function is 46.08% and that of the left kidney is 53.92%. There are no abnormalities of the ureters or bladder.Following administration of the diuretic, there was normal washout of radiotracer from the left kidney into the bladder without evidence of current obstruction. There was delayed washout of radiotracer from the right kidney into the bladder. The T1/2 washout from the right collecting system was 22.12 minutes. The T1/2 washout from the left collection was 13.02 minutes. | 1. Bilateral hydronephrosis, right greater than left. 2. Delayed washout of radiotracer after administration of diuretic from the right kidney may represent obstruction. Suggest follow-up in one month to determine change in renal function if clinically indicated. 3. Indentation along the superolateral aspect of the left kidney may be due to focal infarct, neoplasm, or other process. Correlate with anatomical imaging such as ultrasound. |
Generate impression based on findings. | 66 years, Male. Reason: Dobbhoff tube placement History: Dobbhoff tube placement Dobbhoff tube tip projecting over gastric fundus. Decreased bowel gas compared to prior study. | Dobbhoff tube tip projecting over gastric fundus. Decreased bowel gas compared to prior study. |
Generate impression based on findings. | 53-year-old female status post right wrist fusion. There has been prior resection of the proximal carpal row with the exception of the distal pole of the scaphoid. There is now a plate and screw device affixing the radius and third metacarpal. The articulation between the distal radius and capitate is indistinct which may represent partial fusion. There is no evidence of hardware complication. | Postoperative changes of wrist fusion as described above. |
Generate impression based on findings. | 67-year-old woman with a history of a right breast lumpectomy in 2002 for IDC, status post chemoradiation. Recent history of left breast lumpectomy in Jan 2014 for IDC, status post chemoradiation. Today complains of medial left breast "thickness." Three standard views of both breasts were performed digitally with additional left breast compression views and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the right breast. Stable post-surgical changes are noted, with architectural distortion and skin retraction. A benign-appearing mass with coarse calcifications is unchanged in the right lower inner quadrant, likely representing a hyalinizing fibroadenoma. A skin marker was placed in the medial left breast over the patient's stated soft tissue thickening. Skin thickening is noted in the medial left breast, without associated underlying abnormality. Post-surgical changes are noted in the left breast with architectural distortion. Benign calcifications are present bilaterally. No dominant mass, suspicious microcalcifications, or areas of suspicious architectural distortion are evident in either breast. LEFT BREAST ULTRASOUND | Post-surgical changes with medial left breast skin thickening and edema, likely secondary to radiation. 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; 64 years old. Reason: h/o sarcoma History: sarcoma LUNGS AND PLEURA: 5-mm left apical ground glass nodule (image 14, series 5). Additional smaller ground glass nodule in the right lower lobe (image 61). Very small nodular opacities along both major fissures, most compatible with intrapulmonary lymph nodes.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion. No visible coronary artery atherosclerotic calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Ground glass nodules which could represent atypical adenomatous hyperplasia (AAH) or adenocarcinoma in situ (ACIS) and for which annual follow-up is recommended. No specific evidence of sarcoma metastasis. |
Generate impression based on findings. | 44-year-old male with history of known aortic aneurysm, proximally 4 cm at the level of the sinus of Valsalva and outside MRI, evaluate current size. VASCULAR: Proximal ascending aorta measures approximately 3 cm in diameter just superior to the sinus of Valsalva. Descending aorta measures approximately 2.2 cm at the level of the left superior pulmonary vein. No dissection, no pulmonary embolus and no additional significant abnormality.LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules.MEDIASTINUM AND HILA: Heart size within normal limits, and no pericardial effusion. 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. | Mild dilation of the ascending thoracic aorta to approximately 3 cm, without additional abnormality. |
Generate impression based on findings. | BRAIN:There is redemonstration of tonsillar herniation below the foramen magnum approximately 14 mm, unchanged. Evaluation of CSF flow at the foramen magnum shows near complete absence of flow dorsally and mild attenuation of biphasic flow ventrally, similar to the prior exam. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The remainder of the midline structures are within normal limits. COMPLETE SPINE:Redemonstration of tonsillar herniation as previously described. Vertebral body marrow signal is within normal limits. Vertebral body heights are intact. Alignment is anatomic. No significant central canal or neuroforaminal stenosis. Trace prominence central canal at the C6 level is unchanged (2801/20). No evidence of syrinx. Conus terminates normally at L2. The posterior fusion defects or other soft tissue abnormalities. No masses along the filum or cauda equina. There is appropriate anterior motion of the conus and cauda equina on prone images. | 1.Chiari 1 malformation is not significantly changed.2.No evidence of syrinx or tethered cord. Trace prominence of the central canal at the C6 level is unchanged |
Generate impression based on findings. | Male; 78 years old. Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Interval resolution of patchy groundglass and nodular opacities in the posterior right upper lobe, most compatible with prior infection or aspiration. Stable scattered micronodules, some of which are calcified. No suspicious pulmonary nodules or mass.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion. Mild coronary artery calcifications. Small hiatal hernia.CHEST WALL: No axillary lymphadenopathy. Mild degenerative changes of the thoracic spine. Gynecomastia again noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Splenic granulomata.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable right renal cyst. No significant change in multiloculated cystic lesion in the inferior pole of the left kidney with entrapped macroscopic fat from prior rupture.PANCREAS: Atrophic.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic changes affect the abdominal aorta and its branches. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No significant abnormality noted.BONES, SOFT TISSUES: Moderate multilevel degenerative changes affect the lumbar spine.OTHER: No significant abnormality noted. | Interval resolution of patchy opacities in the posterior right upper lobe, most compatible with prior infection or aspiration. No evidence of metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal grandmother and paternal first cousin. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Circumscribed benign mass in the left superior breast is stable when compared to prior exams. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
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