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Generate impression based on findings.
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There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. Dense periventricular and subcortical white matter hypoattenuation is nonspecific but likely related to the sequela of small vessel ischemic disease. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. Dense calcifications are noted of the vertebral arteries and proximal basilar artery.
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1.No evidence of acute intracranial hemorrhage or other acute intracranial abnormalities.2.Marked small vessel ischemic disease.
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Generate impression based on findings.
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57-year-old female with history of pain. Evaluate for shoulder dislocation. The bones are demineralized suggesting osteopenia/osteoporosis. There is no evidence of fracture or dislocation. The glenohumeral joint is grossly anatomic. There is widening of the AC joint. There is a chronic appearing deformity of the posterior lateral humeral head which may represent a Hill-Sachs deformity. Deformity of the mid humeral diaphysis may be the sequela of prior trauma. Partially imaged right central venous catheter. Right pleural effusion.
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No evidence of shoulder dislocation. Other findings as above.
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Generate impression based on findings.
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Female 23 years old Reason: rule out post op complications, perc chole drain History: abdominal pain RUQ. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Percutaneous cholecystostomy tube in place. No fluid collections in the pericholecystic or perihepatic areas.Hepatic parenchyma is normal with no focal lesions, biliary dilatation or venous thrombus.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Irregular, somewhat striated nephrogram in the right kidney with least 3 ill-defined hypoattenuating areas in the upper and lower poles. Differential diagnostic considerations favor vascular cause such as infarct or infection such as pyelonephritis. The appearance is unchanged. There is no evidence of peri-renal fluid collections or hydronephrosis.The left kidney appears normal.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Small functional cysts.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality noted. Small amount of physiologic fluid in the dependent portion of the pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No findings to explain right upper quadrant pain other than the expected percutaneous cholecystostomy tube.No change in multifocal hypoattenuating areas in the right kidney as described, favor infection or infarction.
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Generate impression based on findings.
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Chronic sinusitis after tooth extraction with tooth pain. There has been interval extraction of tooth # 13 with a residual fragment of metallic implant in the extraction cavity. There has also been interval extraction of tooth # 4 with a residual fragment of metallic implant in the extraction cavity. There is new complete opacification of the left maxillary sinus with extension into the middle meatus and anterior left ethmoid air cells, as well as complete opacification of the left frontal sinus. There is sclerosis of the paranasal sinus walls. The other paranasal sinuses are clear. There mild nasal septal deviation with spur directed to the right. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. There appears to be a partially-empty sella. The nasopharynx, facial soft tissues, and orbits appear to be unremarkable.
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1. Interval extraction of tooth # 13 with a residual fragment of metallic implant in the extraction cavity and development of left ostiomeatal unit opacification.2. Apparent partially-empty sella, which is nonspecific.
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Generate impression based on findings.
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26-year-old male with history gunshot wound. No acute fracture or malalignment. Lucency projecting over the left proximal humeral metaphysis may represents subcutaneous gas or a soft tissue defect, although a lytic bone lesion cannot be excluded. There is no evidence of retained radiopaque foreign objects.
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1.No acute fracture or retained radiopaque foreign object.2.Lucency projecting over the left proximal humeral metaphysis may represents subcutaneous gas or a soft tissue defect, although a lytic bone lesion cannot be excluded. Follow radiographs may be obtained in 2 to 4 weeks.
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Generate impression based on findings.
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66 years, Male. Reason: 66M w/ ureteral stent placement for ureteral obstruction, now with decreased UOP and back pain; please assess stent placement History: assess stent placement Interval removal of enteric tube and placement of bilateral nephrostomy tubes. Nephrostomy pigtails project over the expected location of the bilateral kidneys and bladder. Nonobstructive bowel gas pattern.Patient is status post sternotomy with surgical clips. Left iliac stents are noted. Surgical clips overlying bilateral proximal lower extremities are noted. Skin staples are noted compatible with recent surgery. Vascular calcifications and moderate stool burden noted.
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Nephrostomy pigtails appear to overlie expected location of bilateral kidneys and bladder. Postoperative changes. Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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4-year-old female with altered mental status, leukocytosis. Rule-out abscess, appendicitis, pancreatitis, etc. Within the limits of non-IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made:ABDOMEN:LUNG BASES: Bibasilar atelectasis without other significant abnormality notedLIVER, BILIARY TRACT: Atrophy of the right lobe of the liver. No specific mass lesions are seen the liver although lack of IV contrast and artifact obscures detail. Probable gallstones are seen in the gallbladder without other biliary tract complication.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Anterior abdominal wall ventral hernia containing colon without complication. No other abnormality seen in this limited examination of the intestinal tract. No free mesenteric fluid.BONES, SOFT TISSUES: Degenerative changes seen throughout the skeletal system without other abnormality seen.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Foley catheter in a collapsed bladder. No other abnormalities.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality noted. No free mesenteric fluid.BONES, SOFT TISSUES: Diffuse osteopenia and degenerative changes seen without other abnormality identified.OTHER: No significant abnormality noted
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1. Bibasilar pulmonary atelectasis. 2. Probable gallstones. 3. Ventral hernia containing colon without evident complication. 4. No other significant abnormality seen and no abnormality seen to account for patient's symptomatology.
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Generate impression based on findings.
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65-year-old female status post right TKA Hardware components of a total right knee arthroplasty device are situated in near-anatomic alignment without evidence of complication. Foci of gas, surgical staples and drain in the soft tissues reflect recent surgery.
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Status post right TKA in near anatomic alignment.
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Generate impression based on findings.
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21-year-old male with history of pain. Evaluate for fracture. Right wrist: There is mild soft tissue swelling about the dorsal aspect of the wrist. There is no acute fracture or dislocation. Alignment is anatomic.Right forearm: No acute fracture or dislocation. Alignment is anatomic.
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Soft tissue swelling about the dorsal aspect of the wrist without underlying fracture.
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Generate impression based on findings.
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Reason: SBO History: abd distension and pain Evaluation of solid organ pathology is limited without intravenous contrast.ABDOMEN:LUNG BASES: Groundglass opacity in the inferior right lung incompletely imaged, likely representing basilar scarring/atelectasis but nonspecific. No pleural effusions. Coronary calcifications partially imaged.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: Splenic artery calcifications.PANCREAS: Surgical clips in the midabdomen presumably denote the location of the transplant pancreas but is incompletely evaluated without intravenous contrast. Mild nonspecific mesenteric haziness is nonspecific, and correlation with lipase is recommended as clinically warranted. No peripancreatic fluid collections or ductal dilation.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic native kidneys with calcified renal arteries. Transplant kidney in the left iliac fossa without hydronephrosis or perinephric collection.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications of the abdominal aorta and branches.BOWEL, MESENTERY: Postoperative changes of subtotal gastrectomy. There is a nonobstructive small bowel-small bowel intussusception in the left upper quadrant adjacent to the area of prior surgery. There is a focally dilated loop of small bowel more inferiorly in the midabdomen at the level of surgical clips (series 3 image 80) which is nonspecific and may represent a focal enteritis.BONES, SOFT TISSUES: Thin density along the anterior abdominal wall presumably represents graft material from prior surgery.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Scattered pelvic calcifications most consistent with phleboliths.
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1.Status post kidney/pancreas transplant, evaluation of which is limited without intravenous contrast. A focally dilated small bowel loop in the midabdomen and subtle mesenteric haziness is nonspecific, and could possibly represent either a focal enteritis or pancreatitis.2.Status post subtotal gastrectomy. Nonobstructive small bowel-small bowel intussusception in the left upper quadrant adjacent to the area of prior surgery is likely transient.
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Generate impression based on findings.
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No evidence of acute intracranial hemorrhage. There is moderate periventricular and subcortical white matter hypoattenuation which is nonspecific but may be the sequela of small vessel ischemic disease. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. No depressed calvarial fractures.
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1.No evidence of acute intracranial hemorrhage or other acute intracranial abnormalities.2.Moderate small vessel ischemic disease.
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Generate impression based on findings.
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Female; 32 years old. Reason: r/o PE History: tachycardia, SOB, increased D-dimer PULMONARY ARTERIES: Evaluation of the pulmonary arteries is adequate except beyond the proximal bilateral upper lobar arteries, given limitation described above. Acute pulmonary embolus in a left lower lobe subsegmental branch (image 68, series 7). Normal caliber of main pulmonary artery. No evidence of right heart strain.LUNGS AND PLEURA: Moderate bibasilar streaky subsegmental atelectasis. Trace pleural effusions.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No visible coronary calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips. Ventral midline abdominal wall surgical sutures. Mild nonspecific subcutaneous fatty stranding right anterior abdomen, partially visualized.
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Limited evaluation with superior thorax off the field-of-view demonstrating acute left lower lobe subsegmental pulmonary embolus. PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Single.Most Proximal: Subsegmental.RV Strain: Negative.
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Generate impression based on findings.
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61 year-old female with right shoulder pain, rule out fracture or dislocation Right shoulder: There is marked joint space narrowing and osteophyte formation compatible with severe osteoarthritis appearing similar to the prior exam. Relatively mild osteoarthritis affects the acromioclavicular joint.Humerus: The humerus appears intact. Mild osteoarthritis affects the elbow joint.
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Severe osteoarthritis appearing similar to the prior exam.
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Generate impression based on findings.
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12 year old female status post fight, now with edematous nose.VIEWS: Nasal bones lateral and Waters (two views) 1/14/2015 A nondisplaced nasal bone fracture is evident, best seen on the lateral view. The imaged paranasal sinuses are unopacified.
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Non-displaced nasal bone fracture.
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Generate impression based on findings.
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60 year-old female, evaluate for psoriatic arthritis Vacuum phenomena in bilateral SI joints indicates degenerative changes without sacroiliitis. Degenerative changes also affect the lower lumbar spine.
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Degenerative changes at the SI joints without sacroiliitis.
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Generate impression based on findings.
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Seven month old female, assess PICC placement.VIEW: Chest AP (one view) 1/14/2015, 18:45 Right upper extremity PICC terminates in the right atrium near the ostium of the tricuspid valve. Gastrostomy tube in place. Amplatzer occlusion devices project over the heart. PDA clip in place, position unchanged.Bibasilar opacities suggestive of atelectasis. Vascular engorgement is evident. The cardiothymic silhouette is normal. Multiple spinal segmentation and fusion anomalies are seen in the thoracic spine. 10 right and 11 left ribs are evident.
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Right upper extremity PICC with the tip terminating in the right atrium near the ostium of the tricuspid valve.
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Generate impression based on findings.
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37 years, Female. Reason: 37yo F severe c. diff colitis, now with increased pain History: eval for ileus, perforation Redemonstration of severe rotoscoliosis. G-tube and VP shunt catheter are again noted. Right hip dysplasia and gracile pelvis are again noted.Interval decrease in pleural effusions.There is interval excretion of the contrast material from the bowels. There is mild gaseous distention of the bowel loops diffusely, compatible with generalized ileus but developing obstruction cannot be excluded. Ileus is favored given thickening of rectosigmoid colon seen on recent CT. Evaluation of free air is limited on this supine image, please obtain erect or decubitus views.
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Generalized ileus but developing obstruction cannot be excluded. Evaluation of free air is limited on this supine image, please obtain erect or decubitus views if indicated. No gross pneumoperitoneum.
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Generate impression based on findings.
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64-year-old male with abdominal pain. Rule-out infection, status post new nephrostomy tubes. ABDOMEN:LUNG BASES: No significant change left basilar atelectasis and pleural effusion. Resolution of the prior noted right pleural effusion and atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted in the liver parenchyma. Vascular structures appear normal. Gallbladder is again moderately distended with cholelithiasis but without other evidence biliary complication.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral percutaneous nephrostomy tubes are again seen bilaterally without hydronephrosis. Renal parenchyma shows bilateral simple cysts unchanged. Area of cortical scarring in the right kidney midpole laterally is unchanged. No other significant parenchymal renal abnormalities are seen with good cortical enhancement without evidence of pyelonephritis. No pericardial fluid collections are seen. No abnormal calcifications.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Orally administered contrast rapidly progresses through normal appearing stomach and small bowel and through the colon without evidence of intrinsic abnormality or obstruction. No free mesenteric fluid is seen.BONES, SOFT TISSUES: Diffuse subcutaneous edema again seen without other significant focal abnormality.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Mild thickening of the bladder wall which may relate to lack of distention. Air is seen in the bladder, presumably representing recent instrumentation.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Patient is status post prior penectomy with less edema in the surgical bed. No loculated fluid collections are seen to suggest abscess at surgical site. Posteriorly the post surgical debridement changes appear very similar with exposure of the right iliac and resection of the distal sacrum with residual more inferiorly phlegmonous tissues extending along the posterior margins to bilateral acetabular regions and involving the ischii bilaterally with destructive changes consistent with chronic osteomyelitis appearing similar to prior examinations.. Increased soft tissue phlegmonous changes are seen adjacent to the left inferior ischium (series 3, image 128) with several foci of punctate air. This reflects increased inflammatory and probably infectious phlegmon with necrosis but without liquefaction. Diffuse subcutaneous edema is seen. OTHER: No significant abnormality noted
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1. Chronic posterior sacro- and ischio osteomyelitis with decubiti ulcer -- while much of this is unchanged in appearance comment increased soft tissue phlegmon changes about the inferior left ischio are seen with punctate foci of air suggesting necrosis but without liquefaction. 2. Diffuse subcutaneous edema. 3. Distended gallbladder with gallstones unchanged. 4. Bilateral nephrostomy tubes without complication or significant changes from prior exam seen. 5. Left pleural effusion persists. 6. No other sites of potential infection identified.
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Generate impression based on findings.
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34-year-old female with headache and bradycardia, history of sickle cell crisis. Motion somewhat degrades sensitivity, as does difficulty in patient positioning.High-density is present within the suprasellar, interpeduncular, perimesencephalic, ambient, and quadrigeminal plate cisterns, compatible with subarachnoid hemorrhage. There is suggestion of a small rounded filling defect within the hemorrhage in the interpeduncular cistern, which appears more as an area of heterogeneity on the current exam, but appears better defined on the precontrast images of the subsequent CTA head. A small amount of blood versus underlying calcified choroid is within the fourth ventricle. No intraparenchymal blood is identified.The sulci are not well visualized but this may be related to patient positioning. There is prominence of the temporal horns for the patient's age, concerning for early/developing communicating hydrocephalus.There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. There is moderate to severe dental disease with multiple dental caries, as well as torus palatini.
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1. Subarachnoid hemorrhage is identified within multiple basal cisterns and likely the fourth ventricle. No intraparenchymal blood is identified. Questioned rounded filling defect in the interpeduncular cistern which appears to correspond to a basilar tip aneurysm on subsequent CTA head.2. Mild temporal horn dilatation, concerning for early communicating hydrocephalus.3. Moderate to severe dental disease is noted. Please correlate with dental exam.Findings were conveyed to the ordering provider by the resident radiologist on call at 4:40 a.m. on 1/15/15.
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Generate impression based on findings.
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There is slight straightening (loss of normal cervical lordosis) of the cervical spine which may be related to position or cervical collar. There are no fractures or subluxations. No abnormalities are noted of the spinous process alignment and interspinous process distance appear to be within normal range. The visualized intracranial and paraspinal contents are unremarkable.Normal atlantodental interval. There is marked degeneration of the atlanto-occipital joint with osteophyte formation and subchondral sclerosis.C2/3: Tiny posterior disc-osteophyte complex. No significant spinal canal stenosis or neuroforaminal stenosis.C3/4: No significant spinal canal stenosis or neuroforaminal stenosis.C4/5: No significant spinal canal stenosis or neuroforaminal stenosis.C5/6: Tiny posterior disk osteophyte complex which does not cause significant spinal canal stenosis. Minimal left bony neural foraminal narrowing.C6/7: Notable disk height loss and posterior disk osteophyte complex which does not cause significant spinal canal stenosis. Minimal left bony neural foraminal narrowing.C7/T1: No significant spinal canal stenosis or neuroforaminal narrowing.A few nonspecific nodules are noted in the left apex of the lung which are more likely related to the chronic lung changes are described on a previous chest CT.
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1.No evidence of an acute fracture or subluxation.2.Degenerative changes about the cervical spine most severe at the atlantoaxial joint and C6-7 levels as described above.
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Generate impression based on findings.
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12-year-old male with thumb pain.VIEWS: Left thumb PA and lateral (two views) 1/14/2015 Cortical irregularity seen at the level of the physis proximal first phalanges on the lateral view, likely represents a physeal projection artifact. There is moderate soft tissue swelling about the thumb.
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Soft tissue swelling about the thumb without definite fracture identified.
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Generate impression based on findings.
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66 years, Female. Reason: NGT pulled back - previously kinked History: NGT Very limited view of the abdomen with exclusion of the pelvis from field of view.Enteric tube tip appears to overlie the GE junction with side-port in the esophagus. There are right upper quadrant catheters.
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Enteric tube tip overlying the GE junction with side-port in the esophagus. Advancing the tube is recommended.
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Generate impression based on findings.
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9-year-old male with chest trauma.VIEWS: Chest AP/lateral (two views) 1/15/2015 No pleural effusion or pneumothorax is seen. No displaced rib fractures are evident. The aortic arch, cardiac apex and stomach left-sided. The cardiothymic silhouette is normal.
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No radiographic evidence of chest trauma, specifically no evidence of pneumothorax or displaced rib fracture.
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Generate impression based on findings.
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5-year-old female with wheezing, cough and fever. Rule out pneumonia.VIEWS: Chest AP/lateral (two views) 1/15/2015 Peribronchial thickening and large lung volumes as well as right middle lobe segmental atelectasis is evident. The aortic arch, cardiac apex and stomach are left-sided. The cardiothymic silhouette is normal.
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Bronchiolitis/reactive airways disease pattern.
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Generate impression based on findings.
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56 day old female status post chest tube placement, with respiratory distress.VIEW: Chest AP (one view) 1/15/2015, 05:10 Endotracheal tube tip is above the carina and below the thoracic inlet. Enteric feeding tube tip projects out of the field of view. Left upper extremity PICC tip is in left brachiocephalic vein. Left chest tube position unchanged.Persistent soft tissue edema, with interval improvement of the subcutaneous gas collection. Improved bibasilar opacities likely reflecting pleural effusions. Cardiac silhouette size is mildly enlarged. No pneumothorax seen.
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Improved bibasilar opacities suggestive of pleural effusions.
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Generate impression based on findings.
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3 year old male with blunt head trauma followed by seizures. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No evidence of intracranial hemorrhage or skull fracture.
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Generate impression based on findings.
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5-year-old male with right-sided pleuritic chest pain.VIEWS: Chest AP/lateral (two views) 1/15/2015 Increased lung volumes and mild peribronchial thickening. No focal air space opacity is seen. The aortic arch, cardiac apex and stomach a left-sided. The cardiothymic silhouette is normal. No pneumothorax or displaced rib fracture is evident.
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Reactive airways disease versus bronchiolitis pattern.
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Generate impression based on findings.
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Female; 69 years old. Reason: r/o PE History: SOB PULMONARY ARTERIES: No acute pulmonary embolus. Stable mild dilation of the main pulmonary artery measuring up to 3.3-cm, which again is suggestive of pulmonary arterial hypertension. No evidence of right heart strain.LUNGS AND PLEURA: Stable scattered nonspecific micronodules. No suspicious pulmonary nodules or masses. Mild streaky left basilar subsegmental atelectasis and/or scarring is similar to prior study. Mild nonspecific mosaic attenuation. No pleural effusions.MEDIASTINUM AND HILA: Stable mildly prominent mediastinal lymph nodes without definite lymphadenopathy. Stable ectatic ascending aorta measuring up to 4.2-cm. Mild cardiac enlargement without pericardial effusion. Moderate coronary artery calcifications. Dense mitral valve annular calcifications. CHEST WALL: Stable mild degenerative arthritic changes of the midthoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. No acute pulmonary embolus.2. Stable dilated ascending aorta and main pulmonary artery, the latter of which is again suggestive of pulmonary arterial hypertension.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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3-year-old female status post foreign body ingestion.VIEW: Abdomen AP (one view) 1/15/2015 A 2.2 x 2.1 cm metallic foreign body is seen just above the diaphragm, presumably residing within the distal thoracic esophagus. The bowel gas pattern is nonobstructive. A moderate stool burden is distributed throughout the left colon.
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Metallic foreign body presumably residing within the distal thoracic esophagus.
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Generate impression based on findings.
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There is no evidence of acute intracranial hemorrhage. No intracranial mass or mass effect. The grey-white matter differentiation appears to be intact. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The imaged mastoid air cells are clear. Chronic left maxillary sinusitis with diffuse opacification of the left maxillary sinus. The skull and scalp soft tissues are unremarkable.
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No evidence for acute intracranial hemorrhage.
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Generate impression based on findings.
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54-year-old female with history of pain. Right ankle: There is a 3-mm linear ossific density adjacent to the superior aspect of the talus which likely represents an avulsion fracture off the anterior process of the calcaneus. Mild degenerative disease affects the midfoot. There is mild soft tissue swelling about the medial aspect of the ankle.Right knee: No acute fracture or dislocation. Alignment is anatomic. There is no joint effusion.
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Fracture fragment superior to the talus likely represents an avulsion fracture off the anterior process of the calcaneus.
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Generate impression based on findings.
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58 year old female with a personal history of right excisional biopsy in 09/2013 for bloody nipple discharge with histology demonstrating intraductal papilloma. She then had a left breast terminal duct excision in 03/2014 for bloody nipple discharge with histology demonstrating intraductal papilloma, which was complicated by a hematoma that was aspirated on 03/28/2014. Three standard views of both breasts with two additional left breast spot magnifications 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 right chest port is noted. A linear left breast skin marker denotes the surgical scar. Scattered benign calcifications are present in the left breast No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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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.
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Generate impression based on findings.
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Female 39 years old Reason: r/o aortic dissection History: r/o aortic dissection. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No evidence of an aortic aneurysm or dissection. The lung no evidence of adenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: 21. x 15 cm lesion in the right adrenal glands which measures higher than fluid density, and has incomplete rim-like calcification. Although there is no portal phase scan, in the arterial phase it does not show enhancement. Differential diagnostic considerations include trauma or hemorrhage, or adenoma. Other neoplasms extremely unlikely.The left adrenal gland is normal.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, ADNEXAE: Suggestion of 3-cm non-calcified uterine lesion series 9 image 251, it is nonspecific given the lack of calcification, but statistically most likely fibroid.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.
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No evidence of findings to explain chest pain. No evidence of aneurysm or dissection in the aorta. Small nonspecific uterine mass.Small calcified right adrenal lesion. Differential diagnostic considerations as above.
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Generate impression based on findings.
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2-year-old male with germline APC mutation, high risk for hepatoblastoma. LIVER: The liver measures 9.3 cm in length and demonstrates appropriate parenchymal echogenicity, without evidence of focal mass lesion. The main portal vein is patent demonstrating hepatopetal flow with a velocity of 0.3 m/sec.GALLBLADDER, BILIARY TRACT: There is no evidence of gallbladder wall thickening or pericholecystic fluid. The common duct measures 0.2 cm in diameter.PANCREAS: No significant abnormality noted.SPLEEN: The spleen measures 7.8 cm in length.KIDNEYS: The left kidney measures 5.9 cm in length and the right kidney measures 6.5 cm in length, both demonstrating appropriate corticomedullary differentiation. There is no evidence of hydronephrosis or hydroureter.ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted.
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Normal examination.
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Generate impression based on findings.
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8-year-old male with left wrist fractureVIEWS: Left wrist AP/lateral (two views) 01/15/15 Interval removal of cast material. Mild sclerosis at the site of prior fracture. No fracture is identified. No malalignment is evident.
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Healing radial torus fracture.
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Generate impression based on findings.
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71 year old female with multifocal right breast invasive ductal carcinoma status post neoadjuvant chemotherapy with excellent imaging response, presents for presurgical needle wire localization. On review of the prior studies, a wing clip is noted within the far posterior medial slightly inferior right breast. Additionally, a Hydromark clip is noted more anteriorly within the inferomedial right breast. No residual mammographic evidence of previous identified breast masses, compatible with complete imaging response. Target Hydromark clip is located in the right breast in the lower inner quadrant region located in mid-breast 5 o’clock. Dr. Kulkarni planned to excise back to the chest wall from the location of our wire. The procedure, risks including bleeding, mistargeting and infection, and benefits of needle-wire localization were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed to confirm patient identity and site of procedure. The right breast was placed in an alphanumeric grid using medial to lateral approach. When the target was positioned in the aperture of the grid, the skin was cleansed with chlorhexidine. Local anesthesia was obtained using 2% Lidocaine. Using coordinates from the grid, a 5 cm Kopans needle was placed slightly anterior to the Hydromark clip. On orthogonal mammography, adequate positioning of the needle was confirmed after adjusting depth so the needle tip was approximately 2cm deep to the center of the target. A spring wire was then deployed. Repeat two view orthogonal mammograms reveal the spring wire to be in excellent position. The mammogram was annotated. Patient tolerated the procedure well and was sent to the holding area in stable condition. Dr. Happ performed the procedure under direct supervision of Dr. Schacht, who was present during the procedure at all times.Orthogonal digital specimen radiographs revealed the clips and spring wire to be within the specimen.
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Successful needle localization of the right breast Hydromark clip.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.
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Generate impression based on findings.
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45 year old female with history of fall and left rib pain. No evidence of displaced rib fracture. No significant pneumothorax.
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No displaced rib fracture.
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Generate impression based on findings.
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38-year-old male with history of left shoulder pain. No acute fracture or dislocation. Alignment is anatomic. The soft tissues are unremarkable.
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No radiographic findings to account for the patient's pain.
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Generate impression based on findings.
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75-year-old female with history of left knee pain. There are tricompartmental osteophytes and joint space narrowing, worse in the medial compartment where there is near bone-on-bone apposition. There are scattered arterial calcifications. No acute fracture or dislocation. Small joint knee joint effusion.
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Moderate to severe osteoarthritis without acute fracture.
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Generate impression based on findings.
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Female; 78 years old. Reason: rule out PE History: chest pain and SOB PULMONARY ARTERIES: No evidence of acute pulmonary embolus. Normal caliber of the main pulmonary artery. No evidence of right heart strain.LUNGS AND PLEURA: Severe diffuse emphysema and a lower zone bronchiectasis, not significantly changed. Mild right lower lobe subsegmental atelectasis. Stable scattered micronodules. No new or suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion. Moderate coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Mildly enlarged retrocrural lymph node versus possible lymphocele, unchanged. Stable hepatic cysts in the partially visualized liver.
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1. No acute pulmonary embolus.2. Severe diffuse emphysema and basilar predominant bronchiectasis, similar to prior study.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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37-year-old male with history of fall and pain. Evaluate for fracture. No acute fracture or dislocation. Alignment is anatomic. No joint effusion. There is an incompletely imaged intra-medullary nail with distal stabilization screws without radiographic evidence of hardware complication.
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No evidence of acute fracture.
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Generate impression based on findings.
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50 year-old female with history of multiple myeloma, status post stem cell transplant SKULL: Numerous lytic lesions involving the calvarium appear similar to the prior exam.CERVICAL SPINE: Mild degenerative disk disease affects C5/6. No discrete lytic lesions.THORACIC SPINE: Compression fractures of T6 and to a lesser extent T5 appear similar to the prior exam. Mild to moderate multilevel degenerative disk disease is again noted. LUMBAR SPINE: Lucencies involving multiple vertebral bodies and posterior elements, particularly at L2 appear similar to the prior exam. Vertebral body heights are maintained.RIBS: Scattered, subtle lucencies likely represent myelomatous involvement and appear similar to the prior exam.PELVIS: Multiple lucencies consistent with myomatous involvement appears similar to the prior exam.UPPER EXTREMITY: Lucent lesions involving the left greater than right proximal humeri to the prior exam. No discrete lesions within the for arms.LOWER EXTREMITY: Multiple lucent lesions involving the proximal femurs and left fibula appears similar to the prior exam
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Findings consistent with multiple myeloma appearing similar to the prior exam.
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Generate impression based on findings.
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57 years Female with history of subarachnoid hemorrhage. Evaluate for edema or fluid collection along the external ventricular drain tract. Please note, extensive streak artifact from coils limits the exam.Redemonstration of endovascular coil embolization of large basilar tip aneurysm and right frontal approach ventriculostomy catheter, which terminates near the foramen of Monro. There is persistent intraventricular and subarachnoid blood products, which may be minimally decreased when compared to prior exam. No definitively new areas of hemorrhage. Layering blood is still present within the occipital horns of the lateral ventricles. No midline shift or herniation is present.There is hypoattenuation surrounding the EVD tract, which has slightly decreased when compared to prior exam, and may represent resolving edema around the catheter. There is no focal discontinuation in the visualized catheter tubing.Interval increase in the size of the lateral ventricles. The frontal horns currently measure 30 mm in transverse diameter, previously 25 mm.Stable appearance of hypoattenuation in the supratentorial white matter, including more focal hypoattenuation in the bilateral periventricular white matter, along the corona radiata and basal ganglia, while nonspecific, is likely ischemic in nature. Larger geographic areas of low-attenuation in the cerebellar hemispheres, compatible with age indeterminate infarcts are unchanged. Stable appearance of atherosclerotic calcification of the distal vertebral and internal carotid arteries. Patient's gaze is deviated down and to the left.Mild interval worsening of mucosal thickening of the paranasal sinuses; persistent near-complete opacification of the left maxillary sinus, with high-density fluid, which may represent blood versus proteinaceous debris; an air-fluid level has developed in the sphenoid sinus. Under-pneumatization and fluid within the bilateral mastoid air cells as well as fluid within the middle ears.
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1. Hypodensity surrounding the external ventricular drain tract has mildly improved when compared to prior exam, and may represent resolving edema along the catheter. No focal fluid collection along the catheter is identified.2. Interval increase in the size of the lateral ventricles is concerning for developing/worsening hydrocephalus.3. Persistent intraventricular hemorrhage, which is mildly decreased when compared to prior.Findings were conveyed by Dr. Alix Purakal To covering provider, Dr. Kak, on 1/15/15 at 11:35 am.
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Generate impression based on findings.
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Male 86 years old Reason: cholelithiasis History: RUQ pain LIVER: Diffuse fatty infiltration. This is also confirmed on the CT scan.19.4 cm in length as measured today but on the CT scan which is more accurate for measuring size, the liver does not appear enlarged. No focal lesions.Flow in the portal vein is normal hepatopedal in direction, velocity.3 m/sec.GALLBLADDER, BILIARY TRACT: Punctate echogenic focus along the wall represent a small cholesterol crystal or stone. It is not diffuse.Gallbladder is not hydropic. There is no tenderness to compression. No pericholecystic fluid.No intrahepatic or extrahepatic biliary dilatation. Common hepatic duct measures .4 cm in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Numerous bilateral renal cysts some large unchanged from CT scan and from prior ultrasound. No hydronephrosis hydroureter.OTHER: No significant abnormalities noted.
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Diffuse fatty infiltration of the liver. Single punctate focus in the gallbladder may represent cholesterol stone, less likely focal adenomyosis.Bilateral renal cysts, unchanged some large.
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Generate impression based on findings.
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T1N0 squamous cell carcinoma of the left oral tongue status post wide local excision with positive margin at the main specimen and perineural invasion. Post-procedure CT with enlargement of left level 2 node. Now status post panendoscopy, re-excision of left oral tongue lesion, and left selective neck dissection on September 10, 2014 with surgical pathology demonstrating no evidence of tumor, with negative margins and no perineural invasion. Selective neck dissection showed evidence of metastatic disease in 2 of 10 lymph nodes. This is a pT1N2bM0 left oral tongue squamous cell carcinoma. There are post-treatment findings in the neck. There is no evidence of mass lesions or significant cervical lymphadenopathy. The thyroid and major salivary glands are unchanged. The major cervical vessels are patent. There are small skin excrescences arising from the left eyelid and left nasal ala. There is irregularity and sclerosis of the right clavicular head, compatible with degenerative change. There is also multilevel degenerative spondylosis of the cervical spine. The airways are patent. The skull base and orbits are grossly unremarkable. There is mild nonspecific patchy cerebral white matter T2 hypoattenuation. The imaged portions of the lungs are clear.
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Post-treatment findings in the neck without convincing evidence of measurable locoregional tumor recurrence or residual significant cervical lymphadenopathy.
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Generate impression based on findings.
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65-year-old male with pain Postoperative changes of triple arthrodesis with orthopedic screws affixing the talocalcaneal, subtalar, and calcaneocuboid joints appears similar to the prior exam. There is osseous bridging at all 3 articulations. No evidence of hardware complications. Severe osteoarthritic changes affect the midfoot and ankle joints.
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Postoperative and arthritic changes as described above, without evidence of complication.
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Generate impression based on findings.
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Female 74 years old Reason: evaluate for OA History: pain. discomfort Right knee: Bone mineralization is decreased. Alignment is near anatomic. There is moderate medial compartment joint space loss with subchondral cystic change in the femoral condyle and tricompartmental osteophytes. No joint effusion.Left knee: Bone mineralization is decreased. Alignment is near anatomic. There is mild to moderate medial compartment joint space loss with small tricompartmental osteophytes. No joint effusion. No acute fracture or malalignment.
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Moderate right knee and mild to moderate left knee osteoarthritis.
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Generate impression based on findings.
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55-year-old female with pain Alignment is within normal limits. The osseous and soft tissue structures appear unremarkable.
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No specific findings to account for the patient's symptoms.
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Generate impression based on findings.
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63-year-old male with right knee pain Mild to moderate joint space narrowing and small osteophytes consistent with osteoarthritis. Mild deformity of the distal lateral femur may reflect old trauma. Ossification along the medial femoral condyle likely represents old injury to the MCL.
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Mild to moderate osteoarthritis.
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Generate impression based on findings.
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54-year-old female status post IM rod placement A cast obscures underlying osseous detail. A sideplate with screws affixes the distal fibula fracture. The distal aspect of the sideplate and fibula have been resected. An intramedullary nail with screws affixes the tibia and tibiotalar joint with distal fixation screws within the calcaneus. No evidence of hardware complication.
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Orthopedic fixation as described above without evidence of hardware complication.
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Generate impression based on findings.
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31 year old female, evaluate healing of second and third metatarsals Marked callus formation about the second metatarsal diaphysis is consistent with a healing fracture. No new fractures are identified.
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Healing second metatarsal fracture.
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Generate impression based on findings.
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23-year-old male status post ORIF Sideplates and screws affix distal radius and ulna fractures in near-anatomic alignment without evidence of hardware complication. A small amount of callus formation about the fractures indicates an attempt at healing. An ossicle adjacent to the ulnar styloid likely represents old trauma.
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Orthopedic fixation of distal radius and ulnar fractures without evidence of complication.
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Generate impression based on findings.
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Reason: eval for progression History: metastatic RCC CHEST:LUNGS AND PLEURA: Calcified nodules consistent with granulomatous disease are unchanged. No new nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Scattered small mediastinal lymph nodes unchanged with calcified mediastinal and hilar nodes consistent with granulomatous disease. Mild coronary calcification.CHEST WALL: Left supraclavicular adenopathy with reference lesion measuring 3.7 x 2.6 cm (series 3 image 13), allowing for changes in orientation not significantly changed compared with prior examinations dating back to June 2014.ABDOMEN:LIVER, BILIARY TRACT: Scattered granulomatous calcifications. No new focal lesions identified.SPLEEN: Scattered granulomatous calcifications.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable postoperative changes in the left kidney. RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy appears unchanged compared with prior examinations dating back to June 2014 allowing for differences in orientation. Reference retroaortic lymph node measures 2.6 x 1.6 cm (series 3 image 143).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Subtle lucency/sclerosis in the right ninth rib (sagittal series image 18-19) unchanged compared with prior exams and most likely benign. Severe degenerative changes affect L5-S1.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Markedly enlarged prostate.BLADDER: Nonspecific bladder wall thickening.LYMPH NODES: As aboveBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: As aboveOTHER: No significant abnormality noted
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1.No significant change in left supraclavicular and retroperitoneal lymphadenopathy allowing for differences in orientation since June 2014.2.No new areas of disease allowing for limitations of a non-contrast enhanced examination. 3.Other chronic findings as described above.
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Generate impression based on findings.
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42 year old female with biopsy proven fibroadenoma presents for 6-month follow-up examination. No family history of breast cancer. Left Breast Diagnostic Mammogram: Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. There is redemonstration of a circumscribed mass within the central outer left breast, which contains a ribbon clip, compatible patients known biopsy proven fibroadenoma. No new dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over the left axilla.Left Breast Ultrasound: On physical examination, a 2 cm firm, mobile palpable mass is identified along the 3:00 radian. No additional palpable areas are appreciated in the left breast. A targeted ultrasound was performed to assess stability of a previously sonographically identified hypoechoic lesion at the 2:00 radian of the left breast. At the 2:00 position of the left breast, 4 cm from the nipple, there is redemonstration of a circumscribed hypoechoic mass measuring 0.4 x 0.3 x 0 .4 cm, not significantly changed in size or appearance from prior examination. No internal vascularity is present. At the 3 o'clock position of the left breast, 3 cm from the nipple, there is redemonstration of a circumscribed, gently lobulated hypoechoic mass which contains a clip, compatible patients known biopsy proven fibroadenoma. On today's examination this measures 1.8 x 0.9 x 1.6 cm, not significantly changed in size or appearance. Peripheral vascularity is identified.
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Stable biopsy proven fibroadenoma at the 3 o'clock position of the left breast. Stable hypoechoic lesion at the two o'clock position of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in April 2015. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Headache, fall, evaluate for subdural hematoma No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent chronic small vessel ischemic changes. Small foci of hypoattenuation at the right frontal corona radiata and anterior right caudate compatible with chronic lacunar infarct. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. Changes of right intraocular lens replacement.
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1. No evidence of intracranial hemorrhage or mass effect. 2. Mild chronic small vessel ischemic changes.
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Generate impression based on findings.
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Clinical Male 91 years old Reason: eval for progression History: papillary RCC on bevacizumab. The exam is not sensitive detecting lesions in the solid organs or vasculature due to the lack of intravenous contrast. Given that limitation, observations are made:CHEST:LUNGS AND PLEURA: Stable micronodules some which are calcified. No new nodules. Scarring right upper lobeMEDIASTINUM AND HILA: Mild coronary artery calcifications.Index lymph node in the right cardiophrenic space measures 1.3 x 0.8 cm on series 4 image 91. Previously 1.5 x 0.8 cm.No new nodes. Atherosclerotic calcifications unchanged. Minimal and heterogeneous left thyroid gland, unchangedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Granulomata.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post right partial nephrectomy. Given limitations of no IV contrast no evidence of recurrent tumor.Contour and texture of the left kidney and normal in limitation of no intravenous contrast.RETROPERITONEUM, LYMPH NODES: Heavily calcified lymph node abutting IVC near the gastrohepatic ligament region. This is unchanged. No new nodes.BOWEL, MESENTERY: Scattered colonic diverticulosis. No bowel wall thickening or dilatation. No free or loculated intraperitoneal fluid.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: Scattered colonic diverticulosis. No evidence of ascites or carcinomatosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Stable exam. Postsurgical changes right kidney. Small stable node in chest and lung micronodules.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal great aunt diagnosed at the age of 55. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Tomosynthesis was performed. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Small subcentimeter benign-morphology masses are noted in the left breast, mostly unchanged. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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11-year-old male with hip painVIEWS: Pelvis AP/frog leg (two views) 01/15/15 Bilateral coxa valga deformities. No evidence of slipped capital femoral epiphysis. Osseous structures within normal limits.
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Bilateral coxa valga deformities.
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Generate impression based on findings.
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There is a left frontal parenchymal hematoma measuring 3.7 x 2.6 x 3.3 cm (oblique AP x TR x CC) with increasing edema and local mass effect compared to 1/13/2015. There is 5 mm of rightward subfalcine herniation measured at the level of the foramen of Monro. Within this hematoma there is a round low attenuation focus measuring 9 x 9 mm (series 4, image 18); underlying malignancy is not excluded. There are no other sites of intraparenchymal hemorrhage. Posterior wire fixation is noted at C1-2.
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1.Left frontal hematoma as described above with increasing mass effect and edema compared to 1/13/2015. 2.Round low-attenuation nodule within left frontal hematoma; malignancy is not excluded. Correlate with outside MRI.
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Generate impression based on findings.
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Female presents for routine screening mammography. History of left breast cyst surgical removal. States left breast pain. 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. Scattered, benign-appearing calcifications are again seen and unchanged, including arterial calcifications. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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.
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Generate impression based on findings.
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35 years old, Female, Reason: Left flank pain with sxs extending anteriorly. Pt has bilirubin uria also - Please vs liver and biliary heel, as well as kidneys. History: Left Flank Pain. LIVER: Increased echogenicity of the liver suggests fatty infiltration. No focal mass lesions. The liver measures 16.5 cm in length. The velocity the main portal vein measures .2 m/sec.GALLBLADDER, BILIARY TRACT: No evidence of cholelithiasis or cholecystitis. No biliary ductal dilatation. PANCREAS: No significant abnormality noted. No significant pancreatic ductal dilatation.SPLEEN: No significant abnormality noted. The spleen measures 7.6 cm in length.KIDNEYS: No significant abnormality noted. The right kidney measures 11.7 cm in length. The left kidney measures 11.2 cm in length. No evidence of hydronephrosis or nephrolithiasis.ABDOMINAL AORTA: No significant abnormality noted. The maximum diameter of the aorta measures 2.4 cm. No evidence of abdominal aortic aneurysm.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Increased echogenicity of the liver suggest fatty infiltration.2.No evidence of biliary ductal dilatation, cholelithiasis or cholecystitis. No specific findings to account for the patient's symptoms.
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Generate impression based on findings.
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4-year-old female with history of cloaca repair and constipation, evaluate degree of stool burden/colonic distentionVIEW: Abdomen AP (one view) 01/15/15 Surgical clips are noted the mid left hemiabdomen.Moderate to large amount of stool within the rectum, descending colon, and transverse colon. Nonobstructive bowel gas pattern. No evidence of obstruction.
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Moderate to large stool burden.
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Generate impression based on findings.
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2-year-old female with stage IV neuroblastoma, 12 months off therapy, surveillance evaluation CHEST:LUNGS AND PLEURA: No significant abnormality noted. No pleural effusion.MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary, retrocrural, or cardiophrenic lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Multiple hypoattenuating lesions throughout the liver are unchanged. Reference right hepatic lobe lesion measuring 6 mm (series 3, image 21) is unchanged. No new hepatic lesions are identified.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Surgical clips are noted in the right adrenal bed. Calcifications in soft tissue are unchanged.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia. The bowel is within normal limits without evidence of obstruction. The appendix is well-visualized and within normal limits.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic lesion in the right iliac bone is likely a bone islandOTHER: No significant abnormality noted
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Unchanged hepatic metastatic lesions. No evidence of new metastatic disease.
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Generate impression based on findings.
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67-year-old female with chest pain, evaluate for pulmonary embolism. The lateral left and right chest wall are excluded from the field-of-view.PULMONARY ARTERIES: No evidence of pulmonary embolism. The pulmonary artery measures up to 39 mm suggestive of pulmonary arterial hypertension without right heart strain.LUNGS AND PLEURA: Diffuse mosaic attenuation pattern which can be seen in the setting of chronic pulmonary embolism or other pulmonary perfusion abnormality of other causes. Pleural thickening and/or small pleural effusions. No focal lung opacity or suspicious lung nodule.MEDIASTINUM AND HILA: Cardiomegaly. ICD with tip in the right ventricle. Upper normal sized hilar and mediastinal nodes are probably not significant without a history of cancer.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.No evidence of acute pulmonary embolus. 2.Diffuse mosaic attenuation pattern which can be seen in the setting of chronic pulmonary embolism or other pulmonary perfusion abnormality of other causes. These findings can also be seen in hypersensitivity pneumonitis in the correct clinical setting.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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67 year old female status post left lumpectomy for carcinoma in 2002, presents today for routine follow up. History of additional benign left breast biopsy. Patient received radiation and chemotherapy. No current breast complaints. Family history of breast carcinoma in her maternal aunt and sister. 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. Linear markers have been placed on scars overlying the upper central left breast, and far posterior central right breast with expected underlying postsurgical architectural distortion. Dystrophic calcifications at the 12 o'clock position of the right breast, subjacent to the scar, are unchanged. No new dominant mass, suspicious microcalcifications or areas of nonsurgical architectural distortion in either breast. Benign appearing lymph nodes are projected over both axillae.
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Stable postsurgical changes of the left 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.
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Generate impression based on findings.
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67 years, Female. Reason: NGT location and checking for air fluid levels History: abdominal pain Enteric tube tip is noted at in the gastric antrum. Common bile duct stent and percutaneous biliary stent are seen.There is dilated loops of small bowel measuring up to 3.5 cm, which appears new from recent prior CT, which may be compatible with generalized ileus. There is outlining of small bowel loops, which is thought to represent pseduo-rigler's sign or contrast coating from recent CT. Contrast material is noted in the pelvic bowel loop. If there is high clinical suspicion of perforation, please obtain decubitus view.
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1. Enteric tube tip is noted at in the gastric antrum. 2. Developing generalized ileus. 3. No definite evidence of free air on erect view. If there is high clinical suspicion of perforation, please obtain decubitus view.
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Generate impression based on findings.
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78-year-old female with history of meningioma, status post recent resection/craniotomy. Redemonstration of findings related to recent left parietal craniotomy and partial resection of the parietal calvarium. Interval decrease in the amount of pneumocephalus, as well as the degree of hypoattenuation within the adjacent white matter, consistent with improving vasogenic edema. There is persistent effacement of the posterior body and atrium of the left lateral ventricle, without midline shift. Trace extra-axial fluid and fluid within the bony surgical defect is not significantly changed. No evidence of intracranial hemorrhage. Stable appearance of mild diffuse cerebellar volume loss. The imaged paranasal sinuses and mastoid air cells are clear. Interval removal of scalp drain catheter, surgical hardware and skin staples remain. There has been placement of an NG tube, with tip terminating out of field-of-view.
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1. Postoperative findings related to recent left parietal craniotomy and partial resection of the parietal calvarium.2. Mild improvement of left cerebral hemisphere vasogenic edema; persistent partial effacement of the left lateral ventricle, without significant midline shift.3. No evidence of acute intracranial hemorrhage.
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Generate impression based on findings.
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57 year old female with history of renal cell carcinoma with metastases. CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules consistent with history of metastases. Left upper lobe referenced nodule (4/17) measures 2 x 1.9 centimeters, not significantly changed from previous measurement of 1.9 x 1.7 cm.Ill-defined right hilar mass partially encasing the right pulmonary artery is again seen, with grossly unchanged associated atelectasis. No pericardial effusion.MEDIASTINUM AND HILA: Heart size within normal limits, no significant pericardial effusion. Small mediastinal and hilar lymph nodes are seen. Right hilar mass is grossly unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Small inferior right hepatic lobe hypoattenuating focus, too small to characterize and likely a cyst.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Postoperative findings of left nephrectomy, with surgical clips in the nephrectomy bed. Right kidney is normal in appearance, with small hypoattenuating foci consistent with benign cysts.RETROPERITONEUM, LYMPH NODES: Mildly enlarged subdiaphragmatic periaortic lymph nodes are not significantly changed, measuring 2.1 x 1.6 cm (3/93).BOWEL, MESENTERY: Left buttock injection granulomas, unchanged.BONES, SOFT TISSUES: Left posterior sixth rib expansile lytic lesion at the costovertebral junction, new from prior. Best seen on coronal images (80216/9).OTHER: Small amount of low attenuation material in the left nephrectomy bed is likely postoperative in nature, and is unchanged from prior, however it may be followed to ensure stability.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.
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1.Multiple bilateral pulmonary nodules, and a right parahilar soft tissue mass, consistent with metastases are not significantly changed.2.Mildly enlarged left retroperitoneal, para-aortic lymph nodes, and soft tissue within the left nephrectomy bed are unchanged.3.Left posterior T6 lytic rib lesion most likely metastatic.
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Generate impression based on findings.
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TFXH for T1N2c floor of mouth squamous cell carcinoma. There are stable post-treatment findings in the neck. There is no evidence of mass lesions or significant cervical lymphadenopathy. For example, a left level 1A lymph node measures 4 mm in short axis and a left level 1B lymph node also measures 4 mm in short axis. The thyroid and remaining salivary glands are unchanged. There is at least moderate right and mild left carotid bifurcation stenosis secondary to atherosclerotic plaque. The osseous structures are unchanged. The airways are patent. The imaged intracranial structures are unremarkable. There are multiple subcentimeter pulmonary nodules, which appear to be unchanged.
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1. Post-treatment findings in the neck without evidence of measurable locoregional tumor recurrence or significant cervical lymphadenopathy.2. At least moderate right and mild left carotid bifurcation stenosis secondary to atherosclerotic plaque.
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Generate impression based on findings.
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Male 20 years old; Reason: r/o testicular torsion and evaluation of tender R testicular mass History: R testicular mass RIGHT TESTIS: Normal echogenicity and normal vascular flow within the right testicle. No discrete mass or evidence of torsion. The right testicle measures 4 x 3.2 x 2 cm.LEFT TESTIS: Normal echogenicity and normal vascular flow the left testicle. No discrete mass or evidence of torsion. The left testicle measures 3.9 x 3.3 x 1.6 cm.RIGHT EPIDIDYMIS: Right epididymis is increased in echogenicity and enlarged and has mildly increased vascular flow suggesting epididymitis. The right epididymis measures 5.6 x 3.6 x 1.5 cm.LEFT EPIDIDYMIS: No significant abnormalities noted. The left epididymis measures 2.3 x 1.6 x 0.7 cm.OTHER: No significant abnormalities noted.
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1.Complex changes of right epididymis suggesting epididymitis. 2.Normal vascular flow in bilateral testes. No evidence of torsion.
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Generate impression based on findings.
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79 years, Female. Reason: evaluate for cause of lower abdominal pain in Pt with multiple abd surgeries, concern for stricture History: RLQ pain Vertebroplasty of L1, 3, and 5 lumbar vertebral bodies are again noted. Multiple surgical clips are noted scattered overlying the abdomen and pelvis. Scoliosis and degenerative disease of spine and hips are noted.Nonobstructive bowel gas pattern. Moderate stool burden is noted.
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Nonobstructive bowel gas pattern. Moderate stool burden.
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Generate impression based on findings.
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Female; 62 years old. Reason: restaging for NSCLC s/p chemo radiation History: evidence of local regional or distant recurrence LUNGS AND PLEURA: Postsurgical changes from right upper lobe wedge resection. Septal thickening with architectural distortion in the remaining right upper lobe and superior segment of the right lower lobe, most likely due to postradiation and postsurgical changes. Patchy nonspecific atelectasis/consolidation in the right upper lobe and superior segment of the right lower lobe. Nonspecific 5-mm pulmonary nodule in the right lower lobe is new since prior study (image 42, series 4). Additional scattered nonspecific micronodules are stable. Moderate emphysema. Small right hydropneumothorax.MEDIASTINUM AND HILA: Left chest Port-A-Cath tip near the superior cavoatrial junction. Normal heart size without pericardial effusion. No visible coronary artery calcifications. No mediastinal or hilar lymphadenopathy.CHEST WALL: Stable degenerative arthritic changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Post treatment changes of the right superior lung with small right hydropneumothorax. Patchy nonspecific atelectasis/consolidation is also seen in the right upper lobe and superior segment of the right lower lobe.2. New 5-mm nodule in the right lower lobe. Additional micronodules are stable.
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Generate impression based on findings.
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78-year-old male with renal cell carcinoma status post resection. Rule-out recurrence. CHEST:LUNGS AND PLEURA: No significant abnormality noted-- punctate calcified micronodules unchanged.MEDIASTINUM AND HILA: No lymphadenopathy. Mild coronary artery calcification again seen. No change in the right pericardial benign cyst.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted in the liver. Gallbladder and biliary tract appear normal. Slight haziness about the hepatoduodenal ligament anterior and posterior to the portal vein is seen -- this is of uncertain significance but is unchanged dating back to 2012 examination presumably is benign scarring or post inflammatory.SPLEEN: No significant abnormality notedPANCREAS: Fatty replacement seen in the pancreas. The nonspecific small cystic lesions in the head of the pancreas (series 3, image 123 ), uncinate process (series 3, image 118) and body the pancreas (series 3, image 104) are unchanged and presumably represents small branch type IPMNs. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post left nephrectomy without evidence of residual or recurrent tumor seen in the surgery bed. Right kidney again shows benign cortical cysts without other significant abnormality.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Markedly enlarged prostate unchanged.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Bilateral inguinal hernias containing only mesenteric fat. The low density well-circumscribed abnormality and there right psoas muscle insertion anterior to right hip (series 3, image 200) has decreased in size and now measures 1.9 cm in maximal length compared to 2.5 cm previously. This has been present dating to the 2012 examination and most likely represents postinflammatory or synovial cyst. Diffuse skeletal degenerative changes without focal abnormalities to suggest metastatic disease.OTHER: No significant abnormality noted
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1. Status post left nephrectomy without evidence of recurrent or metastatic disease. 2. Stable small unilocular cyst in pancreas. 3. Stable appearance to cystic abnormality near right psoas muscle insertion -- most likely inflammatory.
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Generate impression based on findings.
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20 year old male with history of osteosarcoma, evaluate for metastases. LUNGS AND PLEURA: Unchanged punctate calcified micronodule in the anterior left lower lobe (image 24, series 3), unchanged from the prior examinations consistent with a granuloma.MEDIASTINUM AND HILA: The heart size is normal as is the caliber the great vessels. There is no evidence of pleural or pericardial effusion. The trachea and mainstem bronchi are patent. There is no evidence of mediastinal or hilar lymphadenopathy on the basis of size criteria.CHEST WALL: Right chest wall Port-A-Cath with tip in the cavoatrial junction. There is no evidence of axillary, subpectoral, cardiophrenic or retrocrural lymphadenopathy on the basis of size criteria.UPPER ABDOMEN: No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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68 years, Male. Reason: ileus History: as above Enteric tube tip is noted in the gastric antrum. Rectal tube is again noted coiled in the sigmoid colon. Right hip arthroplasty and prostatic calcifications are again noted. Stable to slightly more prominent gaseous dilatation of the bowel loops, favoring ileus.
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Stable to slightly more prominent gaseous dilatation of the bowel loops, favoring ileus. Stable appearing tubes.
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Generate impression based on findings.
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39 day old male with neck mass. Follow-up examination. A 3.0 x 1.0 x 2.5 cm lobulated vascular soft tissue mass is again seen in the left mid neck, previously measuring 3.2 x 1.2 x 2.6. The mass demonstrates mildly heterogeneous echogenicity, without cystic changes, appearing slightly less edematous compared to the prior examination. No drainable fluid collection is evident to suggest abscess formation.
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1.Minimal interval decrease in size of the lobulated vascular soft tissue mass, now appearing slightly less edematous. While nonspecific, this may represent an edematous/infected lymph node/conglomerate of lymph nodes. 2.No drainable fluid collection is evident to suggest abscess formation.
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Generate impression based on findings.
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33 years, Female. Reason: 33F with chronic constipation and retained barium History: retained barium There is interval decrease but persistent contrast material in the colon. Nonobstructive bowel gas pattern. Scattered postsurgical sequelae.
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Interval decrease but persistent contrast material in the colon.
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Generate impression based on findings.
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67-year-old female with recent MCA stroke, status post tPA, 24 hour follow-up exam. Minimally increased appearance of hypodensity involving the right frontal lobe pre-central gyrus, consistent with known evolving acute infarct. No intracranial hemorrhage or hemorrhagic transformation is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained in the remainder of the brain. Sulci and ventricles are within normal limits for age, without evidence of hydrocephalus. No extra-axial collections. Scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, consistent with previously described chronic small vessel ischemic changes. Persistent opacification of the left posterior ethmoid sinus; otherwise, the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. Persistent rightward gaze deviation.
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Evolving acute right frontal infarct involving the precentral gyrus. No evidence of hemorrhagic transformation.
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Generate impression based on findings.
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There are 5 lumbar-type vertebrae for numbering purposes. Minimal L5-S1 retrolisthesis. Alignment is otherwise anatomic. There are no fractures. The marrow signal is benign. Disk desiccation is noted at the L5-S1 level. Small focal T1 hyperintense lesions are noted in the mid L3 and posterior L5 vertebral bodies likely representing benign hemangiomas. The conus is normal in signal and morphology and terminates at the lower L2 level. T12/L1: No significant spinal canal stenosis or neuroforaminal narrowing.L1/2: No significant spinal canal stenosis or neuroforaminal narrowing.L2/3: No significant spinal canal stenosis or neuroforaminal narrowing.L3/4: No significant spinal canal stenosis or neuroforaminal narrowing.L4/5: Mild facet hypertrophy and ligamentum thickening without significant spinal canal stenosis or neuroforaminal narrowing.L5/S1: Minimal retrolisthesis. A small right central disk protrusion is noted which causes very mild effacement of the lateral recess. No central canal stenosis. Minimal neuroforaminal stenosis bilaterally. Mild facet arthropathy and ligamentum flavum thickening. Small 2.6 cm cystic structure partially seen in the left adnexa which may represent an ovarian cyst.
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Mild degenerative changes in the lower lumbar spine without significant spinal canal or neural foraminal stenosis.
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Generate impression based on findings.
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Female; 78 years old. Reason: Oral tongue cancer s/p RT. Eval for disease. History: Oral tongue cancer s/p RT. Eval for disease. CHEST:LUNGS AND PLEURA: Stable right upper lobe intrapulmonary lymph node measures 4 x 9 mm (image 50/series 5). No suspicious pulmonary nodules or masses. Minimal basilar dependent atelectasis. Mild basilar bronchial wall thickening is similar to prior exam. No focal airspace opacities, pleural effusions, or pneumothorax.MEDIASTINUM AND HILA: Cardiomegaly with severe coronary artery disease. No mediastinal or hilar lymphadenopathy. Small hiatal hernia.CHEST WALL: Stable vertebral body end plate sclerotic lesions, likely degenerative. ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative arthritic changes of the lumbar spine.OTHER: No significant abnormality noted.
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No evidence of metastatic disease in the chest and abdomen.
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Generate impression based on findings.
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Ms. Spencer submitted outside mammogram dated 04/19/2007, from Roseland Community Hospital. Submitted outside study was compared to the current mammogram dated 11/26/2014. The breast parenchyma is composed of scattered fibroglandular elements. Prominent bilateral axillary lymph nodes are unchanged. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is no significant change between these two studies.
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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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Generate impression based on findings.
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Ms. Faulkner submitted outside mammograms dated 10/01/2012 and 10/22/2010, from Mercy Hospital. Submitted outside studies were compared to the current mammogram dated 12/29/2014. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is no significant change between these studies.
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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.
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Generate impression based on findings.
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87-year-old female with back pain, INR 2.0. Rule-out retroperitoneal bleed. ABDOMEN:LUNG BASES: New small bilateral pleural effusions since 5/7/13 CT examinations. Marked coronary artery calcifications and ICD wires.LIVER, BILIARY TRACT: No significant abnormality noted in the liver parenchyma. Patient is status post cholecystectomy with slightly prominent intrahepatic and extrahepatic bile duct dilatation. This slightly more prominent than seen in the past. No evidence of biliary tract stone disease is seen and no definite mass is seen in the head of the pancreas although it does appear prominent but unchanged dating back to 2012. SPLEEN: No significant abnormality notedPANCREAS: Pancreatic duct is slightly more prominent than on 5/7/13 examination, but still within normal limitsand seen throughout the entire length to the ampulla. The size of the pancreatic head has slightly increased but pancreatic parenchyma enhances normally throughout. This remains of uncertain significance and if concern exists over biliary obstruction, MR examination would be recommended. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No change in appearance of benign right renal cyst without other renal abnormalities seen. No perirenal fluid collections or abnormalities are seen.RETROPERITONEUM, LYMPH NODES: No evidence for retroperitoneal bleed or other retroperitoneal masses are seen. Atherosclerotic calcifications throughout an otherwise normal-appearing aorta seen with normal bifurcation into atherosclerotic iliac arteries.BOWEL, MESENTERY: No significant abnormality noted in the stomach, small bowel mesenteries. Anterior umbilical ventral hernia is again seen, and obtaining transverse colon without complication. No free mesenteric fluid is seen..BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Right inguinal hernia containing mesenteric fat.OTHER: No significant abnormality noted
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1. No evidence for retroperitoneal bleed. 2. Slightly more prominent intra-and extra hepatic bile ducts with slightly more prominent size to the head of the pancreas dating back to 2012. No definite mass is seen, but if concern exists for biliary/pancreatic obstruction exists, MR examination be recommended, or alternatively, in light of slight increase in pancreatic duct size as well, ERCP examination.
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Generate impression based on findings.
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2-year-old male with suspicion of abuse, history of fibular fracture. Evaluate for old fractures.EXAMINATION: Skull AP/lateral, cervical spine AP/lateral, thoracolumbar spine AP/lateral, right humerus AP, left humerus AP, right forearm AP, left forearm AP, right hand PA, left hand PA, chest AP, ribs right oblique/left oblique, pelvis AP, right femur AP, left femur AP, right tibia fibula AP, left tibia fibula AP, right foot AP, left foot AP (24 views) 1/15/2015 The cardiothymic silhouette is normal. The cardiac arch, cardiac apex and stomach are left-sided. The bowel gas pattern is disorganized. There is a moderate stool burden distributed throughout the colon.Bandages are place, covering the bilateral distal forearms and hands, with multiple associated clips. Soft tissue swelling is seen about both wrists.There is a nonspecific subcentimeter round sclerotic lesion in the mid left femoral diaphysis with a lucent center. No fractures or malalignments are evident.
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1.No acute or healing fractures evident. 2.Mild soft tissue swelling about both wrists with bandages in place. 3.Subcentimeter lucent lesion with a round sclerotic margin may represent an osteoid osteoma.
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Generate impression based on findings.
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80 year old female with known high probability benign, loose the calcifications in the right upper outer breast presents for routine annual follow-up. No family history of breast cancer. 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. There is reconstruction loosely grouped cluster of calcifications within the upper outer right breast, which have minimally progressed a benign fashion. Additionally, a similar appearing loosely grouped cluster of calcifications is present within the upper outer left breast, minimally progressed in a benign fashion. No new dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Bilateral calcifications progressing in a benign fashion. 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.
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Generate impression based on findings.
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Ms. Faulkner submitted outside mammograms dated 10/01/2012 and 10/18/2012, from Mercy Hospital. Submitted outside studies were compared to the current mammogram dated 12/29/2014. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is no significant change between these studies.
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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.
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Generate impression based on findings.
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Ms. Hearon submitted outside mammograms dated 10/15/2013 and 08/15/2012, from Metrosouth Medical Center. Submitted outside studies were compared to the current mammogram dated 11/04/2014. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is no significant change between these studies.
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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.
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Generate impression based on findings.
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Ms. Hearon submitted outside mammograms dated 10/15/2013 and 08/15/2012, from Metrosouth Medical Center. Submitted outside studies were compared to the current mammogram dated 11/04/2014. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is no significant change between these studies.
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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.
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Generate impression based on findings.
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No restricted diffusion to suggest recent infarct. There are scattered T2/flair hyperintense foci in the periventricular and subcortical white matter which likely represent the sequela of small vessel ischemic disease. No susceptibility abnormalities to indicate hemorrhage. Brain parenchymal volume appears within normal limits. No evidence of disproportional atrophy involving the hippocampi or particular lobe.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear.
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1.No evidence of acute infarct or intracranial mass. No significant volume loss is seen for age.2.Scattered T2/flair hyperintense foci in the periventricular and subcortical white matter which are nonspecific but compatible with mild chronic small vessel ischemic disease.
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Generate impression based on findings.
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Reason: hx of bladder cancer s/p radical cystectomy with neobladder urinary diversion, recent renal scan reveals right mechanical obstruction, evaluate with delayed imaging History: right hydronphrosis Evaluation of solid organ pathology is limited without intravenous contrast.ABDOMEN:LUNG BASES: Basilar atelectasis/scarring.LIVER, BILIARY TRACT: Hepatic steatosis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Moderate right hydronephrosis/hydroureter with a transition point and irregularity/narrowing in the right distal ureter 2 cm from the neobladder (series 3 image 150). New since 2010 examination. This may represent an area of stricture but is incompletely evaluated without intravenous contrast. Right renal cyst not significantly changed.Increased marked atrophy of the left kidney with mild nonspecific perinephric stranding but no hydronephrosis.RETROPERITONEUM, LYMPH NODES: No lymphadenopathy by size criteria. Scattered atherosclerotic calcifications.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Status post cystectomy. Neobladder is partially collapsed.LYMPH NODES: No lymphadenopathy by size criteria.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Marked degenerative lumbar spondylosis with grade I anterolisthesis of L4 on L5 and central canal stenosis. OTHER: No significant abnormality noted
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1. Moderate right hydronephrosis/hydroureter with narrowing and irregularity of the distal 2 cm of the right ureter likely represents a stricture but incompletely evaluated without IV contrast. Correlation with direct visualization may be helpful. 2. Increased left renal atrophy following resolution of left hydronephrosis since 2010. 3. No evidence for metastatic or recurrent tumor disease.
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Generate impression based on findings.
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Ms. Sanders submitted outside mammogram dated 05/16/2011, from Mercy Hospital. Submitted outside study was compared to the current mammogram dated 12/12/2014. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is no significant change between these two studies.
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No mammographic evidence of malignancy. Physical examination is of increased importance for a patient with dense breast. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Ms. Sanders submitted outside mammogram dated 05/16/2011, from Mercy Hospital. Submitted outside study was compared to the current mammogram dated 12/12/2014. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is no significant change between these two studies.
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No mammographic evidence of malignancy. Physical examination is of increased importance for a patient with dense breast. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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29-day-old male with pneumothorax.VIEWS: Chest AP/lateral (two views) 1/15/2015, 09:43 Interval placement of a nasogastric tube with the tip terminating in the body of the stomach. Left upper extremity PICC with tip in the superior vena cava. Endotracheal tube tip below the thoracic inlet and above the carina. Interval placement of a new right-sided chest tube, with the remaining two right-sided chest tubes in place, position positions unchanged.Persistent large right anterior pneumothorax, perhaps slightly smaller. Background interstitial emphysematous changes in the right lung again seen. Leftward mediastinal shift with atelectatic left lung.
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Large right anterior pneumothorax, perhaps slightly smaller. New nasogastric tube with tip in the body of the stomach. Interval placement of a new right-sided chest tube, with the remaining two chest tubes unchanged in position.
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Generate impression based on findings.
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56-year-old male with metastatic renal cell carcinoma, on Sunitinib CHEST:LUNGS AND PLEURA: Prior referenced right upper lobe nodule (series 5, image 31) is unchanged measuring 5 mm. No new nodules or air space disease is seen. No pleural disease.MEDIASTINUM AND HILA: Mediastinum and hila shows no evidence of measurable lymphadenopathy. The prior noted right paratracheal and precarinal lymph nodes all measure less than 5 mm and cannot accurately be measured. No new foci of enlarged lymph nodes are seen. Coronary artery calcification unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple hypoattenuating lesions with peripheral enhancement are again seen in multiple locations in the liver unchanged in size or appearance with no new lesions identified. Prior referenced segment IVb lesion (series 3, image 100) is not significantly changed measuring 2.9 x 2 .0 cm, previously 2.9 x 1.7 cm.Postsurgical changes about the liver seen with small evolving hematoma along the periphery of the inferior right lobe.SPLEEN: Prior splenectomy.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Prior left nephrectomy without evidence of tumor recurrence in surgical bed.RETROPERITONEUM, LYMPH NODES: Small para-aortic benign appearing lymph nodes unchanged over series of prior examinations. No significant abnormality noted.BOWEL, MESENTERY: Postoperative changes without other significant abnormality noted.BONES, SOFT TISSUES: Anterior wedge compression deformity of the T12 vertebral body unchanged in appearance. No new abnormalities are identified to suggest metastatic disease.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Stable examination with unchanged 1) hepatic presumed metastatic lesions, 2) unchanged 5-mm right apical lung nodule, 3. No enlarged lymph nodes identified or other sites of potential metastatic disease..
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts (with an additional left MLO view) 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.
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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.
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Generate impression based on findings.
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Male; 57 years old. Reason: s/p 21 mo after RUL for T1aN0 Stage IA Adenocarcinoma History: 6 mo f/u LUNGS AND PLEURA: Postsurgical changes status post right upper lobectomy. Moderate centrilobular emphysema.Previously seen micronodule in the right lower lobe adjacent to a stable area of focal atelectasis/scarring has resolved. A few additional scattered micronodules are stable.Small nodular opacity in the right middle lobe is unchanged. No new suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: Stable moderately enlarged superior mediastinal lymph nodes. Normal heart size without pericardial effusion. Mild coronary artery calcifications.CHEST WALL: Degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Fatty infiltration of the liver.
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1. No evidence of recurrent or metastatic disease. 2. Stable enlargement of superior mediastinal lymph nodes.
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Generate impression based on findings.
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12-year-old male with left humerus fracture.VIEWS: Left humerus AP/lateral (two views) 01/15/15 Predominantly transverse fracture through the proximal humeral metaphysis with mild apex lateral angulation is again seen. There is sclerosis of the fracture line and mild periosteal reaction suggestive of attempted healing.
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Healing proximal humeral fracture.
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Generate impression based on findings.
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58 years, Female. Reason: Evaluate for obstruction History: Constipation There are mild gaseous distention of colon with mildly prominent air filled loops of small bowel, which may represent developing ileus. There is ovoid stool density in the RLQ, likely representing stool within the large bowel. No pleural effusions noted.
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Dilated loops of colon with mildly prominent small bowel, may represent developing ileus.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in sister. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Multiple benign lymph nodes project over both axillae.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Male 68 years old Reason: assess for mets History: new brain lesion CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Precarinal node measures 1.8 x 1.1 cm, series 3 image 45. Previously 1.8 by 1 cm.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: A few small hypodensities are unchanged and nonspecific.SPLEEN: No significant abnormality noted. Surgical clip noted dorsal to the spleen along the diaphragm.PANCREAS: No significant abnormality notedADRENAL GLANDS: Status post left adrenalectomy.KIDNEYS, URETERS: Status post left nephrectomy. Stable soft tissue focus 1.7 by .9 cm. series 3 image #105 left renal fossa.There is some blurring from respiratory motion several small hypoattenuating lesions are seen in the right kidney likely unchanged and cysts.RETROPERITONEUM, LYMPH NODES: Scattered surgical clips consistent with nephrectomy and possible lymph node dissection.BOWEL, MESENTERY: Previously seen marked generalized ascites is no longer present. Trace ascites and haziness in some areas of omentum for example in the left paracolic gutter, series image 128.No evidence of bowel wall thickening or dilatation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Air and Foley catheter in the seen in the urinary bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No evidence of ascites or carcinomatosis. No measurable nodules.BONES, SOFT TISSUES: Stable mixed sclerotic lytic focus L2.OTHER: No significant abnormality noted
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Ascites is resolved. Very subtle area of haziness in the omentum in the left paracolic gutter. No measurable solid carcinomatosis.Stable appearance of the left nephrectomy bed and stable right renal lesions likely cysts.Stable precarinal node and bone
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