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Generate impression based on findings.
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Left upper quadrant abdominal pain ABDOMEN:LUNG BASES: Bibasilar dependent atelectasis, unchanged.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 2 cm simple appearing cyst in the upper pole of the left kidney is unchanged. Right nephrolithiasis, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Right nephrolithiasis. Left renal cyst. No CT findings to explain patient's left upper quadrant abdominal pain.
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Generate impression based on findings.
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The ventricles and sulci are prominent, suggesting very mild global volume loss slightly greater than expected for the patient's stated age. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is mild mucosal thickening in scattered paranasal sinuses.
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Very minimal global volume loss suggested, greater than expected for the patient's stated age. Otherwise, unremarkable contrast enhanced MRI of the brain. No MR evidence of intracranial demyelinating disease.
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Generate impression based on findings.
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Male 67 years old Reason: Assess vasculature prior to kidney transplant History: Pre-transplant evaluation ABDOMEN:LUNG BASES: Left lower lobe nodule measures 5 mm in diameter image number two, series number 3, not significantly changed from previous study.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Mild splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral small hypodense lesions in both kidneys which cannot be characterized in this noncontrast CT.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic calcifications involving the abdominal aorta and its major branches including bilateral common iliac arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Radiation seeds throughout the prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Extensive atherosclerotic changes.Stable left lower lobe nodule.Radiation seeds in the prostate.
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Generate impression based on findings.
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68 year-old female history of multiple myeloma and hip pain. The bones are demineralized. Right hip: There is no acute fracture or dislocation. Alignment is anatomic. There is no evidence of myelomatous lesions.Pelvis: Surgical tacks project over the lower pelvis. Lytic lesions related to myeloma are better evaluated on recent CT. No acute fracture.
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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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22-year-old male with history of unequal posture and medic right knee injury as a child. No acute fracture or dislocations. There is a subtle cam deformity along the left femoral neck. The right pubis, ischium, and obturator foramen are slightly smaller than the left. The soft tissues are unremarkable.
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Likely congenital abnormalities of the right pelvis and subtle cam deformity of the left femoral neck. No acute fractures.
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Generate impression based on findings.
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59-year-old female with history of RA. Right hand: There is significant joint space narrowing about the carpal bones with bone on bone apposition. There are secondary degenerative changes at the distal radial ulnar joint. There are moderate osteoarthritic changes at the DIP joints. Mild narrowing of the 4th MCP joint. No active osseous erosions are present.Left hand: There are severe degenerative changes at the 2nd PIP joint. No active osseous erosions are present.Right foot: There are chronic appearing erosions at the heads of the 1st, 4th and 5th metatarsals. Moderate degenerative disease affects the 1st IP joint.Left foot: There are chronic erosions at the heads of the 2nd-5th metatarsals. There is also mild dorsal subluxation of the MTP joints.
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Findings consistent with asymmetric rheumatoid arthritis worse in the right hand and left foot.
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Generate impression based on findings.
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Female, 61 years old, with chronic sinusitis and hearing loss. The frontal sinuses are clear and the fronto-ethmoidal recesses are unobstructed. The ethmoid air cells are clear. The sphenoid sinuses are clear and the sphenoethmoidal recesses are unobstructed. Maxillary sinuses are clear and the maxillary outflow pathways are unobstructed.The nasal cavity is clear. The nasal septum is intact. The turbinates are morphologically unremarkable.The mastoid air cells and middle ear cavities are well pneumatized.
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No evidence of active sinus inflammatory disease.
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Generate impression based on findings.
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27-year-old male with history of fifth PIP injury. The 5th distal phalanx is held in mild extension. No acute fracture or dislocation. Alignment is anatomic. Mild soft tissue swelling about the 5th PIP.
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Mild extension of the 5th distal phalanx which represent tendinous injury, however there are no fractures or avulsions appreciated.
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Generate impression based on findings.
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83-year-old male with history of knee pain. There is severe chondrocalcinosis of the menisci. Tricompartmental osteophytes indicate mild osteoarthritis. There are scattered arterial calcifications. There is perhaps some erosion along the lateral aspect of the lateral femoral condyle.
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Chondrocalcinosis of the menisci and subtle erosion of the lateral aspect of the lateral femoral condyle which can be seen in many conditions such as CPPD arthropathy and gout.
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Generate impression based on findings.
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Male 55 years old; Reason: right testicular swelling History: r/o torsion RIGHT TESTIS: Normal vascular flow and normal echogenicity. There is a small amount of fluid on the right.LEFT TESTIS: Normal vascular flow and normal echogenicity.RIGHT EPIDIDYMIS: The right epididymis is heterogeneously enlarged with increased echogenicity and increased vascular flow consistent with epididymitis.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: No significant abnormalities noted.
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1.Enlarged right epididymis with increased echogenicity and vascular flow consistent with epididymitis. 2.Vascular flow and echogenicity of the testicles are normal bilaterally. No evidence of torsion as clinically questioned.
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Generate impression based on findings.
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Male 66 years old Reason: establishing baseline for participation in a clinical trial, IRB 13-0936. Please provide bi-dimensional measurements per RECIST v1.1 History: neuroendocrine carcinoma of the lung LUNGS AND PLEURA: Post surgical scarring and volume loss on the right consistent with previous upper lobectomy.Triangular subpleural micro nodule in the right middle lobe consistent with an intrapulmonary lymph node, unchanged.No suspicious nodules.MEDIASTINUM AND HILA: No significant lymphadenopathy.Coronary artery stents and at least moderate coronary artery calcification.Calcification in the mitral annulus.No pericardial effusion.CHEST WALL: Demineralization and kyphosis in the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Very limited visualization with multiple abnormalities including a large left adrenal mass and partially visualized pancreatic mass which are described in detail on the abdominal CT report, dictated separately.
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Postsurgical abnormalities in the right hemithorax with no sign of recurrent or metastatic disease in the chest.
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Generate impression based on findings.
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64-year-old female with history of bladder cancer status post cystectomy and colon cancer status post subtotal colectomy now with loop ileostomy, known fistulas and leaks. Here with fever. Outside hospital CT notes fluid collection in the pelvis, evaluate for abscess/leak and is amenable to drainage. ABDOMEN:LUNG BASES: Minimal dependent atelectasis and mild groundglass opacities, nonspecific. No significant pleural effusion.LIVER, BILIARY TRACT: Cholelithiasis in a distended gallbladder, without findings of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: Mild dilation the pancreatic duct. No peripancreatic inflammation or fluid collections.ADRENAL GLANDS: Subtle nodularity of the left adrenal gland, nonspecific.KIDNEYS, URETERS: Bilateral percutaneous nephrostomies, and minimal bilateral perinephric stranding.RETROPERITONEUM, LYMPH NODES: Mildly enlarged retroperitoneal lymph nodes, similar to prior.BOWEL, MESENTERY: Left lower abdomen enterostomy site, with enteric contrast in the ostomy bag.BONES, SOFT TISSUES: Minimal degenerative changes affect the visualized spine, with L5/S1 posterior fixation hardware.OTHER: Surgical clips noted adjacent to the gastroesophageal junction, consistent with history of prior distal partial gastrectomy. Severe coronary artery calcifications.PELVIS:UTERUS, ADNEXA: Not visualized, likely surgically absent.BLADDER: Prior cystectomy.LYMPH NODES: Multiple mildly enlarged lymph nodes are again seen.BOWEL, MESENTERY: Postoperative changes of prior partial colectomy with ileal conduit/ileostomy. Mesenteric stranding in the lower abdomen and pelvis are consistent with previous radiation therapy and other postoperative findings. There is an approximately 9 x 2 cm fluid collection in the pelvis that has been intermittently filled with contrast and air since 2012. It is unclear the exact location of fistulous connection to this collection, however it is stable in size and location when compared to prior exams. No new fluid collections are identified.BONES, SOFT TISSUES: Sclerosis of the pelvic bones consistent with prior radiation therapy.OTHER: No significant abnormality noted
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1.Postoperative/post therapeutic changes in the pelvis, and an unchanged pelvic collection of contrast and air which is similar in appearance dating back to 2012 which presumably is filled via fistulous connection with small bowel.2.No new fluid collections are seen.3.No other evidence of infection.
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Generate impression based on findings.
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70 year-old female with history of pain. Mild osteoarthritis affects the hip. The left SI joint is not imaged. The soft tissues are unremarkable.
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Osteoarthritis as above. If there is clinical concern for SI joint pathology, dedicated SI joint radiographs may be obtained.
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Generate impression based on findings.
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Female 24 years old; Reason: abdominal pain, evaluate for acute appendicitis History: guarding + pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild to moderate circumferential wall thickening versus underdistention involving distal transverse colon and mid descending colon. Normal appendix containing radiopaque material, may reflect inspissated contrast versus appendicolith formation, image 79 series 3. Small locules of air in right lower quadrant, image 97 series 3, most likely in collapsed distal ileum, no evidence of definite pneumoperitoneum otherwise. PELVIS:UTERUS, ADNEXA: Intrauterine device present. Small pelvic free fluid, may be physiologic/related to recently ruptured ovarian follicle. 1.9 x 1.5 cm right ovarian rim enhancing cystic focus, likely an involuting corpus luteum. BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
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1. Normal appendix.2. Mild to moderate circumferential wall thickening versus underdistention (latter favored given patient's reported history of right-sided pain; however, correlation with patient's clinical history/physical exam recommended to exclude colitis) involving distal transverse colon and mid descending colon. 3. Small pelvic free fluid, may be physiologic/related to recently ruptured ovarian follicle. 1.9 x 1.5 cm right ovarian rim enhancing cystic focus, likely an involuting corpus luteum.
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Generate impression based on findings.
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Female 58 years old Reason: fall onto R hand Sept 2014 with persistent pain History: R hand 4th metacarpal pain Bone mineralization is normal. Alignment is anatomic. There is mild to moderate interphalangeal joint space loss compatible with osteoarthritis. No acute fracture or dislocation.
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Osteoarthritis without evidence of acute fracture.
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Generate impression based on findings.
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Male 71 years old Reason: R shoulder pain History: R shoulder pain Moderate to severe osteoarthritis affects the right shoulder with glenohumeral osteophytes. There is moderate to severe joint space loss. Enthesopathic changes are seen in the humeral head suggestive of underlying rotator cuff disease.No acute fracture or dislocation is evident.
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Moderate to severe right glenohumeral osteoarthritis
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Generate impression based on findings.
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Male 19 years old Reason: 19 yo male with chronic steroid use and shoulder pain, rule out avn History: pain Right shoulder: Bone mineralization is normal. Alignment is anatomic. No acute fracture or dislocation. Joint spaces are normal. No radiographic evidence of avascular necrosis.Left shoulder: Bone mineralization is normal. Alignment is anatomic. No acute fracture or dislocation. Joint spaces are normal. No radiographic evidence of avascular necrosis.
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No radiographic evidence of avascular necrosis.
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Generate impression based on findings.
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Female 56 years old Reason: outside diagnosis of RA and gout, evaluation for these History: pain Left hand: There is mild to moderate interphalangeal joint space loss most suggestive of osteoarthritis. Moderate osteoarthritis affects the basilar joint. No focal erosive change.Right hand: There is mild to moderate interphalangeal joint space loss compatible with osteoarthritis. No acute fracture or dislocation. No focal erosive change.Left foot: Bone mineralization is normal. Alignment is anatomic. No acute fracture or dislocation. No focal erosive change.Right foot: Bone mineralization is normal. Alignment is anatomic. No acute fracture or dislocation. No focal erosive change.Mild osteoarthritis affects the first metatarsophalangeal joint.
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Osteoarthritic changes as detailed above. No evident erosive change.
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Generate impression based on findings.
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Knee instability and pain Tiny osteophytes indicate minimal osteoarthritis, essentially within normal limits considering the patient's pain. There is also chondrocalcinosis of the menisci, as well as arterial calcification in the posterior soft tissues. I see no fracture or malalignment. I see no large joint effusion.
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Degenerative arthritic changes as described above.
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Generate impression based on findings.
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59-year-old female with sudden onset of sciatica two months ago. No improvement. Mild-moderate degenerative disk disease affects L5/S1. Mild degenerative disk disease affects L4/5. Small osteophytes project from the anterior aspects of the lumbar vertebra. Alignment is within normal limits. Vertebral body heights are preserved.
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Degenerative disk disease as described above appearing similar to the prior study accounting for slight positional and technical differences.
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Generate impression based on findings.
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Dislocation reduced. Axillary view needed to assess reduction. Glenohumeral joint alignment is within normal limits. I see no fracture.
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Glenohumeral joint alignment within normal limits.
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Generate impression based on findings.
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Cervical fusion. Screw placement? There is a posterior stabilization device with screws entering the C3 through C6 vertebrae. I see no hardware complications. A drain and foci of gas density in the posterior soft tissues reflect recent surgery. There is moderate multilevel degenerative disk disease. There is loss of the normal cervical lordosis.
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Postoperative changes of cervical spine fusion without radiographic evidence of hardware complication.
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Generate impression based on findings.
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Puncture wound, pain and swelling after stepping on needle. Foreign body? There is a 1.5-cm linear metallic density within the heel pad compatible with a broken needle tip. I see no fracture.
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Broken needle tip in the heel pad.
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Generate impression based on findings.
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Neck pain after MVA. Evaluate for fracture. I see no fracture or malalignment. Intervertebral disk spaces are within normal limits. The neural foramina appear patent.
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No fracture evident. I see no findings to account for the patient's pain.
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Generate impression based on findings.
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Hip pain The bones appear demineralized suggesting osteopenia/osteoporosis. I see no fracture or malalignment. Mild osteoarthritis affects the left hip joint. Degenerative arthritic changes also affect the left sacroiliac joint and visualized lower lumbar spine.
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Degenerative arthritic changes as described above.
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Generate impression based on findings.
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Status post fall down sewer, now with L3/L4 back pain. I see no fracture or malalignment. The lumbar spine appears normal. I see no findings to account for the patient's pain.
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No fracture or other findings to account for the patient's pain are evident.
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Generate impression based on findings.
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9 year old male with respiratory distress.VIEW: Abdomen AP (one view) 1/15/2015, 21:25 Interval advancement of the enteric feeding tube with the tip now in the second part of the duodenum. The nasogastric tube has been removed. Right central catheter projects in the distribution of the right common iliac vein. Disorganized nonobstructive bowel gas pattern. No portal venous gas, pneumoperitoneum or pneumatosis intestinalis. Partially imaged right basilar opacity.
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Enteric feeding tube with tip in the second part of the duodenum.
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Generate impression based on findings.
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9-year-old male with respiratory distress. Evaluate feeding tube position.VIEW: Abdomen AP (one view) 1/15/2015, 16:55 There has been placement of an enteric feeding tube, which is looped within the stomach with the tip in the distribution of the gastric body. Additionally, a nasogastric tube is in place with the tip in the region of the distal gastric body/antrum. Right central catheter projects in the distribution of the right common iliac vein. There is a paucity of bowel gas. No portal venous gas, pneumoperitoneum or pneumatosis intestinalis. Partially imaged right basilar opacity.
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Enteric feeding tube looped in the stomach and nasogastric tube with tip in the distal body/antrum of the stomach.
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Generate impression based on findings.
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Six month old male with tracheoesophageal fistula, status-post intubation.VIEW: Chest AP (one view) 1/16/2015, 05:00 Endotracheal tube tip just below the thoracic inlet. Right central venous catheter with tip possibly within a left-sided IVC. NG tube in place with tip in the fundus of the stomach and side-port at the level of the GE junction. Gastrostomy tube in place. Right chest tube in place, position unchanged.Decreased right sided lung volume with opacity in the right upper lobe likely reflecting atelectasis. Increased lingular opacity, also likely represents atelectasis. There is a moderate anterior apical pneumothorax, unchanged.
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Moderate anterior apical pneumothorax.
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Generate impression based on findings.
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47 year old male with history of endocarditis, assess for septic emboli. CHEST:LUNGS AND PLEURA: Minimal basilar atelectasis. No significant pleural effusion or consolidation.MEDIASTINUM AND HILA: Heart size upper normal, with no pericardial effusion. Mild coronary artery calcifications, and moderate calcifications of the mitral valve.CHEST WALL: Endplate defects with adjacent bone sclerosis at T12-L1, and L4-L5, consistent with given history of diskitis/osteomyelitis. Gynecomastia.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis.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: No small bowel obstruction or free air.BONES, SOFT TISSUES: T12-L1 and L4-L5 destructive/sclerotic findings as above.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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1.Findings of thoracolumbar diskitis/osteomyelitis.2.No findings of septic emboli or infection otherwise.
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Generate impression based on findings.
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56 year old male with abnormalities on chest x-ray. Fever of unknown origin. Evaluate. CHEST:LUNGS AND PLEURA: Interval progression of apical fibrosis, bronchiectasis and paraseptal emphysema. There are bilateral basilar groundglass opacities with mosaic attenuation. There is nonspecific left basilar nodule measuring 4 mm (series 5, image 77). Thin walled cyst in the left lower lobe (series 5, image 44) with an internal septation is nonspecific.MEDIASTINUM AND HILA: Mildly prominent nonspecific mediastinal lymph nodes with index subcarinal node measuring 1.2 cm (series 3, image 40). Mildly enlarged hilar lymphoid tissue. Left mainstem bronchus stent.CHEST WALL: Pectus excavatum again noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Non-obstructing right inferior pole nephrolithiasis. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postoperative changes of Nissen fundoplication. No findings to suggest bowel obstruction or colitis. No fluid collections to suggest abscess.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Findings raise suspicion for chronic findings of lung transplant rejection. Given basilar predominance of the groundglass opacities, infectious etiology is less likely; however, if the patient is immunocompromised, atypical infection is a consideration. Dedicated ILD protocol CT chest may be considered for further evaluation. 2.Left lower lobe thin-walled cyst and nodule as above. Attention on subsequent examination is recommended.3.Nonspecific mediastinal and hilar lymphadenopathy.4.No findings to suggest infection in the abdomen or pelvis.
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Generate impression based on findings.
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Status post right total hip revision The AP view of the right hip reveals components of a total hip arthroplasty device situated in near-anatomic alignment without radiographic evidence of hardware complication. A drain and foci of gas density within the adjacent soft tissues reflects recent surgery.The AP view of the pelvis reveals the aforementioned postoperative changes on the right. Moderate osteoarthritis affects the left hip. Mild degenerative arthritic changes affect the pubic symphysis and left sacroiliac joint.
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Right total hip arthroplasty revision as above
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Generate impression based on findings.
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6-month-old male status post tracheoesophageal fistula repair.VIEW: Chest AP (one view) 1/15/2015, 17:57 Endotracheal tube tip just below the thoracic inlet. Right central venous catheter with tip possibly within a left-sided IVC. NG tube in place with tip in the fundus of the stomach and side-port at the level of the GE junction. Gastrostomy tube in place. Right chest tube in place.Decreased right sided lung volume with opacity in the right upper lobe likely reflecting atelectasis. Increased lingular opacity, also likely represents atelectasis. There is a moderate anterior apical pneumothorax.
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Moderate anterior apical pneumothorax.
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Generate impression based on findings.
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40 years, Female. Reason: obstipation History: abdominal pain, nausea and vomiting Lung bases are unremarkable. Nonobstructive bowel gas pattern.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Ms. Woodson is a 32 year old female with a personal history of right breast mastectomy in June 2012 for IDC/DCIS followed by chemoradiation and tamoxifen therapy. Three standard views of the left breast (with an additional left MLO view) and three spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. A focal asymmetry in the left upper outer breast was identified. Spot compression views confirmed a fat-containing lesion, compatible with a benign oil cyst. There is no new suspicious mass, microcalcifications or areas of architectural distortion identified in the left breast.
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Benign oil cyst in the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral 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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Reason: new onset acute chest pain with elevated D-dimer, eval for PE History: chest pain, light-headedness PULMONARY ARTERIES: No evidence embolism. The pulmonary artery diameter is normal, and there is no specific evidence for right heart strain right atrial dilation and reflux of contrast into the liver. LUNGS AND PLEURA: Mild basilar predominant pulmonary edema is present with interlobular septal thickening, scattered ground glass opacities accompanied by subsegmental atelectasis.Marginated pulmonary nodules distributed throughout the lungs, the largest 13 mm and the right costophrenic angle; some of these were present in 2010 by chest radiography, but there is no comparison CT.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy, except for calcified subcarinal lymph nodes from prior granulomatous disease.ICD leads are present.Mild coronary artery calcifications are seen, and the heart is moderate to severely enlarged.CHEST WALL: Left chest wall ICD generator. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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. No evidence of pulmonary embolism, or level of its right heart strain of the right each enlargement in the setting of severe cardiomegaly, and reflux of contrast into the liver.2. Poorly marginated pulmonary nodules of unknown chronicity, at least some present as far back as 2010. The differential diagnosis includes metastases, synchronous primary lung cancers, or granulomatous disease such as sarcoidosis. Tissue diagnosis is suggested. PULMONARY EMBOLISM: PE: 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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80 years, Female. Reason: Dobbhoff placement Limited view of the abdomen with motion artifact. Pelvis is excluded from field of view. Dobbhoff tube tip in gastric body. Postsurgical changes are seen.
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Dobbhoff tube tip in gastric body.
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Generate impression based on findings.
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6 year old male with rib protrusion.VIEWS: Ribs name of views (number of views views) 1/15/2015 No focal airspace opacity is seen. The aortic arch, cardiac apex and stomach a left-sided. No displaced rib fracture is evident. The cardiothymic silhouette is normal.
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Normal examination.
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Generate impression based on findings.
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Two small foci of hypodensity bilaterally, inferior to the basal ganglia, demonstrate a location and appearance most consistent with perivascular space (less likely lacunar infarct). The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear.
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1.Two small foci of hypodensity bilaterally, inferior to the basal ganglia, demonstrate a location and appearance most consistent with perivascular space (less likely lacunar infarct). 2.No CT evidence of acute territorial, cortical infarct. If there is continued clinical concern for acute ischemia, MRI would be recommended.
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Generate impression based on findings.
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10-year-old female intubatedVIEW: Chest AP (one view) 01/16/15 Left upper extremity PICC with tip in the right atrium. ET tube tip is below thoracic inlet and above the carina. Enteric tube with tip below the field of view. Interval removal of right venous catheter.Cardiothymic silhouette is normal. No pneumothorax or pleural effusion. Interval improvement of left lower lobe patchy atelectasis.
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Mild patchy left lower lobe atelectasis, improved.
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Generate impression based on findings.
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61 years, Female. Reason: evaluate for cause of abdominal pain Patient is status post sternotomy and cholecystectomy.Nonobstructive bowel gas pattern. Degenerative disease of the spine.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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74 years, Female. Reason: enteric tube There is contrast in the jejunum with progression into the colon. Given recent earlier fluoroscopic contrast study, cannot definitively distinguish whether the contrast seen is from prior injection or current injection of contrast. No evidence of bowel obstruction. Evaluation for a leak suboptimal but grossly speaking visualized contrast appears to be intraluminal.
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Contrast seen in both small and large bowel as above. No evidence of bowel obstruction.
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Generate impression based on findings.
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7-month-old male intubated patientVIEW: Chest AP (one view) 01/16/15 Endotracheal tube tip is below thoracic inlet and above the carina. Nasogastric tube tip is in the body of the stomach.Persistent left upper lobe collapse. Right upper lobe atelectasis. Bibasilar patchy opacities likely represent atelectasis. The cardiothymic silhouette cannot be evaluated.
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Persistent left upper lobe collapse with right upper lobe and bibasilar atelectasis.
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Generate impression based on findings.
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34-year-old female with chest pain, elevated d-dimer PULMONARY ARTERIES: No pulmonary embolus. Enlargement of the main pulmonary artery measuring 4.0 cm may represent pulmonary arterial hypertension LUNGS AND PLEURA: Interval increase in basilar predominant ground glass opacities with fibrosis and areas of subpleural sparing. No pleural effusions.MEDIASTINUM AND HILA: Cardiomegaly with a moderate-sized pericardial effusion. Scattered mildly enlarged mediastinal lymph nodes. Patulous esophagus with an air-fluid level.CHEST WALL: Scattered enlarged axillary, supraclavicular, and subpectoral lymph nodes.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.No pulmonary embolus. Severe worsening pulmonary arterial hypertension. 2.Interval increase in basilar predominant ground glass opacities and fibrosis in an NSIP pattern, suggesting progressive scleroderma related interstitial lung disease given the patient's clinical history and associated findings as described above. 3.Moderate pericardial effusion and cardiomegaly. 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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Ms. Suskind is a 45 year old female recalled from screening mammogram for an asymmetry in the right breast. Family history of breast cancer in mother (diagnosed at the age of 50) and maternal second cousin (diagnosed at the age of 36). An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A mass in the right inferior breast persists on spot compression views and has typically benign features. There are no suspicious microcalcifications or areas of architectural distortion identified in the right breast. TARGETED RIGHT BREAST ULTRASOUND
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Simple cyst in the right breast. No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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6 year old male with left lower rib cyst, protrusion and pain.VIEWS: Chest AP/lateral (two views) 1/15/2015 No focal airspace opacity is seen. The aortic arch, cardiac apex and stomach a left-sided. No displaced rib fracture is evident. The cardiothymic silhouette is normal.
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Normal examination.
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Generate impression based on findings.
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6-day-old male on HFOVVIEW: Chest AP (one view) 01/16/15 ET tube tip is at the thoracic inlet. Umbilical artery catheter is at the level of T6. Umbilical vein catheter is in the right atrium. Three right-sided chest tubes are in place, unchanged in position.Interval improvement of pneumothorax. No pleural effusions. Left basilar atelectasis.
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Interval improvement of pneumothorax.
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Generate impression based on findings.
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17 year-old female status post fall evaluate for fracture.VIEWS: Mandible Panorex (one view), pelvis AP and frog leg (two views), and left knee AP oblique and lateral (3 views) 1/15/2015 MANDIBLE: No acute fracture or malalignment evident.PELVIS: Irregularity of the pubic symphysis suggests osteitis pubis. No acute fracture or malalignment is evident. Disorganized nonobstructive bowel gas pattern.KNEE: No acute fracture or malalignment evident. No significant joint effusion or soft tissue swelling seen.
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Normal examination.
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Generate impression based on findings.
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79-year-old female with history of pain. The bones are demineralized suggesting osteopenia/osteoporosis.Left hip: Moderate osteoarthritis affects the left hip. No acute fracture. Bandlike density overlying the lesser trochanter could represent artifact or subacute postraumatic heterotopic mineralization within the soft tissues which is of uncertain clinical significance.RIght hip: Mild osteoarthritis affects the right hip. No acute fracture.Pelvis: Orthopedic fixation of the lower lumbar spine as well as IVC filter are incompletely imaged. Severe degenerative disc disease affects L5-S1.
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Degenerative arthritic changes of the hips and lumbar spine and other findings as above without acute fracture evident.
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Generate impression based on findings.
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Leptomeningeal carcinomatosis with concern of elevated CSF pressures after intrathecal chemotherapy. There is a subdural hematoma along the right frontal lobe measuring up to 10 mm in thickness. There is small hyperdense component layering suggestive of acute blood products. Previously seen pneumocephalus has resolved. There is mild mass effect on the adjacent right frontal sulci. No midline shift or uncal herniation.Again seen is a right frontal approach Ommaya catheter with the tip in unchanged position at the septum pellucidum. There is mild edema/gliosis along the catheter tract. Ventricles remain unchanged in size without evidence of hydrocephalus. No findings to suggest global cerebral edema. Mild intraconal thickening of the left orbit is similar to prior.
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1. Evolution of previously seen immediate postsurgical changes of Ommaya catheter placement from 12/4/2014. There is a right frontal subdural hematoma with attenuation suggestion of acute on chronic blood products. Ommaya catheter tip is in unchanged position.2. Minimal local mass effect without midline shift.
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Generate impression based on findings.
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75-year-old female with history of abdominal pain, evaluate for hernia or traction. ABDOMEN:LUNG BASES: No significant pleural effusion or consolidation. Severe coronary artery calcifications.LIVER, BILIARY TRACT: Scattered calcified granulomas in the liver parenchyma, and a small right anterior cyst, unchanged. Postoperative findings of cholecystectomy, including biliary dilatation, correlate with labs to exclude biliary obstruction.SPLEEN: Scattered calcified granulomata.PANCREAS: Mild prominence of the pancreatic duct.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Several loops of dilated proximal small bowel in the left upper quadrant (up to 3.3 cm). The more distal small bowel is relatively collapsed, however gas and stool is noted in the colon. This is most consistent with incomplete/partial destruction. Transition point likely in the pelvis, however incompletely evaluated due to streak artifact. No free air, no pneumatosis, no appreciable bowel wall thickening and no free fluid.BONES, SOFT TISSUES: Posterior rod and screw device courses along the thoracolumbar spine, partially visualized in this exam. Bilateral hip prostheses.OTHER: No significant abnormality notedPELVIS: Limited evaluation of the pelvis due to metallic artifact.UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Gas and stool is seen within the distal bowel/colon and rectum.BONES, SOFT TISSUES: Bilateral hip prostheses as above.OTHER: No significant abnormality noted
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Mildly dilated proximal small bowel, with relatively collapsed distal small bowel and gas/stool in the colon. Most likely incomplete/partial obstruction.
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Generate impression based on findings.
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14-year-old male status post motor vehicle accident now with knee pain.VIEWS: Left knee AP oblique and lateral (3 views) 1/15/2015 No acute fracture or malalignment is evident. 2-cm lucent lesion in the posterior distal femoral metaphyseal cortex is nonspecific and may represent a nonossifying fibroma or early aneurysmal bone cyst.
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No acute fracture malalignment. Nonspecific lucent lesion in the cortex of the posterior distal femoral metaphysis may represent a nonossifying fibroma or aneurysmal bone cyst.
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Generate impression based on findings.
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Reason: Dermatomyositis-ILD History: Worsening dyspnea LUNGS AND PLEURA: Under to severe basal predominant interstitial lung disease has, if changed at all, slightly worsened in the bases; this change is subjective but there is decreased lung volume. Findings consist of reticular opacities with mild honeycombing, traction bronchiectasis and a significant ground glass disease; this is consistent with UIP pattern. Only mild airtrapping is seen on expiration series. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy noted.Mild coronary artery and aortic root calcifications are present.CHEST WALL: Degenerative abnormalities are present throughout the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Cholelithiasis without cholecystitis. Splenic artery calcifications. Nonobstructing renal calculi on the right.
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Equivocal progression of moderate to severe interstitial lung disease, consistent with a UIP pattern. No new abnormalities.
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Generate impression based on findings.
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30 year-old female status post fall. Left shoulder: There is a fracture of the proximal humerus involving the greater tuberosity and we suspect the surgical neck. There is minimal displacement of the greater tuberosity. The suspected surgical neck fracture is nondisplaced. There is evidence of a lipohemarthrosis as well as mild inferior displacement of the humeral head. Lumbar spine: The bones are demineralized. There is mild degenerative disc disease affecting L4-5. There is focal degeneration of the superior endplate of L5 with a Schmorl's node, a normal variant. There is no acute fracture or subluxation. Alignment is anatomic. Intervertebral disc spaces and vertebral body heights are well-maintained.
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1.Proximal humerus fracture as above.2.Mild degenerative disc disease of the lumbar spine.
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Generate impression based on findings.
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75-year-old female with chest pain PULMONARY ARTERIES: No pulmonary embolus.LUNGS AND PLEURA: Basilar scarring/atelectasis. No suspicious pulmonary nodules or masses. Punctate calcified nodules may represent prior granulomatous disease. No pleural effusions.MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes suggest prior granulomatous disease. Heart size upper limits of normal. Minimal coronary calcifications.CHEST WALL: Degenerative changes affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No pulmonary embolus or other acute findings to account for the patient's symptomsPULMONARY EMBOLISM: PE: NegativeChronicity: 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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78 years, Male. Reason: Dobbhoff Dobbhoff tube tip in region of the gastric body. Nonobstructive bowel gas pattern. Moderate stool burden. Pelvis is excluded from view. Lower lumbar spine laminectomy defects. Healing right lower rib fracture.
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Dobbhoff tube as above.
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Generate impression based on findings.
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sudden headache with hypertension. No evidence of acute ischemic or hemorrhagic lesion on this scan.Patchy low attenuations on bilateral periventricular white matter indicate non specific small vessel disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No evidence of acute ischemic or hemorrhagic lesion on this scan.Minimal to mild non specific small vessel disease.
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Generate impression based on findings.
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50 year-old female status post cholecystectomy. Evaluate perihepatic cyst. ABDOMEN:LUNG BASES: Bilateral small, right greater than left, pleural effusions with overlying mild compressive atelectasis.LIVER, BILIARY TRACT: Near complete resolution of previously noted perihepatic cyst on the MR examination which now measures 2.3 x 0.5 cm (series 3, image 55). Interval cholecystectomy. Fluid in the cholecystectomy bed measures 3.5 x 1.3 cm (coronal series, image 64) and is likely postoperative in etiology.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: No significant abnormality noted.BONES, SOFT TISSUES: Anterior abdominal wall and right flank gaseous foci as well as fatty infiltration most likely postsurgical in etiology.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No findings to suggest small bowel obstruction or colitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Postoperative changes of cholecystectomy with gallbladder fossa fluid collection as above. 2.Residual perihepatic cyst.3.Bilateral small pleural effusions, right greater than left.
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Generate impression based on findings.
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59 years, Male. Reason: evaluate for obstruction History: bilious vomit Nonobstructive bowel gas pattern.Scattered surgical clips noted. Bones appear demineralized. There is left lung base atelectasis/consolidation. Please refer to dedicated chest radiography for additional findings.
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Nonobstructive bowel gas pattern. Please refer to dedicated chest radiography for additional findings.
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Generate impression based on findings.
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Female 7 years old Reason: evaluate for knee abnormalities History: bilateral knee pain x 1 yearVIEWS: Pelvis AP and frog leg. Bilateral knees AP, lateral and oblique 1/15/15 (8 views) Pelvis: Both round, smooth and normally formed femoral heads are well directed to a normally developed acetabulum. No AVM or SCFE.Bilateral knees: There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. No OCD.
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Normal examination.
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Generate impression based on findings.
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Female 32 years old; Reason: evaluate for cause of generalized abdominal pain, concern for ovarian cyst vs appendicitis vs PID History: generalized LQ pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber and course. The appendix is normal in caliber. There are small right lower abdominal mesenteric lymph nodes.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Small cyst in the right adnexa. Uterus has heterogeneous enhancementBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Post surgical changes in the lower abdominal wall.OTHER: No drainable pelvic fluid collections. Trace pelvic ascites.
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1.Right ovarian cyst.2.No CT findings of acute appendicitis.3.The pain persists consider MRI of the pelvis for further evaluation for entities such as endometriosis and adenomyosis.
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Generate impression based on findings.
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42-year-old female with shortness of breath, DVT. PULMONARY ARTERIES: Limited examination due to suboptimal contrast bolus. Allowing for this limitation, no large central pulmonary emboli.LUNGS AND PLEURA: Interval progression of bilateral extensive linear and nodular opacities and patchy areas of basilar prominent consolidation since the prior study from 2013. No pleural effusions.MEDIASTINUM AND HILA: Normal variant double aortic arch. Increased size of mediastinal lymph nodes. Enlarged AP window lymph node measures 1.8 cm in short axis (series 8 image 90). Small hiatal herniaCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. No large central pulmonary emboli, allowing for limitation of suboptimal contrast bolus. 2. Progression of extensive linear and nodular bilateral pulmonary opacities with areas of basilar consolidation. These findings are suspicious for pulmonary Kaposi's sarcoma or other lymphoproliferative process, with atypical infections also in the differential. 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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34-year-old female with shortness of breath. Evaluate for pulmonary embolism and status of pleural effusion. PULMONARY ARTERIES: No evidence of pulmonary embolism. LUNGS AND PLEURA: Mild interval increase in the size of the fluid containing cavitary right lower lobe mass now measuring 4.7 x 3.7 cm (series 8, image 71) which previously measured 4.6 x 3.3 cm. The mass encases and significantly narrows the middle and right lower lobar pulmonary arteries. Branches to the right apex are patent.Stable appearance of peripheral mixed density opacity with surrounding groundless appearance in the posterior right upper lobe. New airspace opacity with similar appearance in the posterior aspect of the right upper lobe near the apex. These opacities may represent infection or tumor. Mild increase in size of the right pleural effusion.MEDIASTINUM AND HILA: New hypodense lesion in the anterior left ventricle extending through it the myocardium into the epicardial fat compatible with metastasis; hypoattenuation abutting the ventricular cavity is likely due to adherent thrombus. Small anterior pericardial effusion. Multiple enlarged mediastinal nodes and hilar relatively unchanged from previous, right greater than left. No evidence of right heart strain.CHEST WALL: Multiple osteolytic metastases without significant interval change. Again redemonstrated is a right posterior eighth rib lesion and sternal lesion.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Prominent right renal collecting system.
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1. No evidence of pulmonary embolism.2. Metastasis in the anterior left ventricle with probable adherent thrombus. MR or TEE may be helpful to further characterize extent of thrombus. 3. Interval increase in size of the cavitary right hilar mass. The mass encases and narrows the middle and right lower lobar pulmonary arteries with resultant hypoperfusion of the right lung.4.Two peripheral mixed density opacities in the right upper lobe may represent either infection or tumor, one of which is new.The findings were discussed by telephone with the primary service, Anita Kallepalli pager 2764 at 11:00 on 1/16/2015.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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4-year-old male status post stepping on glass. Rule out foreign body.VIEWS: Right foot AP lateral and oblique (3 views) 1/15/2015 Shallow soft tissue defect noted at the plantar surface of the midfoot, without radiopaque foreign body evident. No acute fracture or malalignment is seen.
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Soft tissue defect without associated radiopaque foreign body.
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Generate impression based on findings.
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Male 38 days old Reason: is the bowel gas pattern normal, is there pneumatosis History: bloody stool dilated loopsVIEW: Abdomen AP (one view) 1/16/15 at 449 hours. Misplaced NG tube again noted.Disorganized, less distended and nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas.
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Disorganized, less distended and nonspecific abdominal gas pattern.
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Generate impression based on findings.
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Status post fixation An intramedullary rod affixes a fracture of the mid clavicular diaphysis in near-anatomic alignment. There appears to be a small amount of callus adjacent to the fracture suggesting an attempt at healing. I see no hardware complications.
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Orthopedic fixation of clavicular fracture as above.
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Generate impression based on findings.
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68 years, Male. Reason: ileus Mild interval increase of predominantly colonic gaseous distention and rectal tube is displaced distally (compared to 1/11/2015). See same day chest radiography for additional findings.
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Mild interval increase of predominantly colonic gaseous distention, rectal tube migration distally (compared to 1/11/2015).
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Generate impression based on findings.
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Male 38 days old Reason: abdominal distension History: bloody stoolVIEW: Abdomen AP (one view) 1/15/15 at 2001 hrs NG tube tip is at the thoracic esophagus. Disorganized, persistently distended and nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas.
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Misplaced NG tube.Disorganized, persistently distended and nonspecific abdominal gas pattern.
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Generate impression based on findings.
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Left knee pain Four views of the left knee are provided. Mild medial compartment narrowing indicates mild osteoarthritis. There are also tiny osteophytes.A subcentimeter ovoid calcific density overlying the lateral tibial spine of the right knee on the frontal views could represent a loose body in a the joint. Amorphous density overlying the distal femoral diaphysis may represent a small focus of bone infarction or perhaps overlying dense arterial calcification.
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Mild osteoarthritis and other findings as above.
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Generate impression based on findings.
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94-year-old male with hematuria. Evaluate. ABDOMEN:LUNG BASES: Bilateral moderate-sized pleural effusions, right greater than left, with overlying mild compressive atelectasis. Cardiomegaly with mild to moderate pericardial effusion.LIVER, BILIARY TRACT: Few scattered subcentimeter hypoattenuating foci within the liver are too small to characterize but statistically likely cysts.SPLEEN: No significant abnormality notedPANCREAS: Mild nonspecific prominence of the pancreatic duct without evidence of a mass.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple renal hypoattenuating foci consistent with cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Thickening of the gastric wall and prominent folds may represent gastritis. No findings to suggest small bowel obstruction. Diffuse ascites.BONES, SOFT TISSUES: Severe degenerative changes affect the visualized spine. Diffuse anasarca.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Markedly enlarged and heterogeneous prostate gland measuring 6.5 x 6.0 x 6.5 cm (series 3, image 83).BLADDER: Moderate thickening of the bladder wall is nonspecific and may be related to under distention. Gaseous foci within the bladder likely secondary to Foley catheter.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Severe degenerative changes affect the visualized spine. Diffuse anasarca.OTHER: No significant abnormality noted
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1.Gastric wall thickening and prominent folds may be related to edema versus gastritis.2.Enlarged and heterogeneous prostate gland. Findings may to be related to benign prostatic hypertrophy versus prostate carcinoma. Evaluation for malignancy with MRI may be considered if clinically indicated.3.Nonspecific bladder wall thickening which may partly be related to under distention.4.Bilateral moderate pleural effusions, ascites, and diffuse body wall anasarca.5.Cardiomegaly with mild to moderate pericardial effusion.6.Severe degenerative changes.
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Generate impression based on findings.
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17 year old female with abdominal distention, rule out perforation.VIEWS: Abdomen AP and crosstable lateral (two views) 1/16/2015, 05:16 Right femoral venous catheter with tip in the distribution of the right external iliac vein. Disorganized nonobstructive bowel gas pattern. No evidence of pneumoperitoneum, portal venous gas or pneumatosis intestinalis.
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No evidence of pneumoperitoneum.
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Generate impression based on findings.
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44 year old female with history of left upper quadrant pain. Evaluate left retroperitoneum, with history of aortic tear from hardware. ABDOMEN:LUNG BASES: Left lower lobe thickening/scar at the site of prior sleeve gastrectomy. No significant pleural effusions.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No evidence of aortic tear, however this exam was not tailored for specific evaluation of the aorta.BOWEL, MESENTERY: Two adjacent anterior/ventral hernias containing fat and bowel, without nearby free fluid or bowel wall thickening. The appendix is within normal limits. Postoperative findings from sleeve gastrectomy.BONES, SOFT TISSUES: Postoperative findings in the thoracolumbar spine including stabilization rods for device, partially evaluated.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: No significant abnormality noted
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1.No evidence of aortic injury, however this exam was not tailored for specific evaluation of aorta.2.Postoperative findings as above.3.Ventral hernias, currently non-obstructive
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Generate impression based on findings.
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33 years, Female. Reason: 33F with chronic constipation and retained barium Percutaneous G tube noted. There is small residual contrast material noted in the right lower pelvis. Scattered postoperative changes. Nonobstructive bowel gas pattern.
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There is small residual contrast material noted in the right lower pelvis. Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Male 52 years old; Reason: driveline infection History: drainage at driveline ABDOMEN:LUNG BASES: Heart size is enlarged. There is a left ventricular assist device with a drive line coursing through the upper abdomen detailed below.LIVER, BILIARY TRACT: Liver is normal in morphology. Multiple small layering gallstones with gallbladder without gallbladder distention.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal lesion does not meet the criteria for a simple adenoma and measures 2.0 x 1.6 cm (image 60/series 3)KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Left central assist device - drive line courses through the upper abdomen and exits the right anterior abdominal wall. There is mild skin thickening and superficial soft tissue thickening surrounding the line. However, no discrete fluid pocket is identified.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Mild skin thickening surrounding the exiting driveline in the subcutaneous tissues but no discrete fluid pocket to suggest an abscess.2.Cholelithiasis3.left adrenal lesion
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Generate impression based on findings.
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Female 12 years old Reason: hx of SCT now presenting with fever History: cough, feverVIEWS: Chest AP/lateral (two views) 1/15/15 and 1950 hrs Central line terminates at the SVC. Cardiac silhouette size is normal. Left lower lobe streaky opacity, likely subsegmental atelectases.
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Left total lobe streaky opacity is described.
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Generate impression based on findings.
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19-month-old male evaluate renal stones. BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Left: 0 Length*** Right: 7.3 cm Left: 5.5 cm Mean for age: 7.0 cm Range for age: 6.0 - 8.0 cmADDITIONAL OBSERVATIONS: 4-mm hyperechoic focus in the region of the right renal collecting system may represent a residual stone or possibly renal sinus fat. Renal stone previously seen in the inferior pole of the right right kidney no longer evident. Probable splenule identified in left upper quadrant.
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1.Renal stone previously seen in the inferior pole of the right kidney no longer evident.2.4-mm hyperechoic focus in the region of the right renal collecting system may represent a residual stone or possibly renal sinus fat. 3.No evidence of hydronephrosis or additional nephrolithiasis.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469
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Generate impression based on findings.
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0-day-old male withplacementVIEW: Chest/Abdomen AP (two view) 01/16/15 Umbilical artery catheter tip is at the T10 level. Umbilical venous catheter is coiled with tip in the proximal umbilical vein. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Diffuse haziness may represent transient tachypnea of newborn.Nonobstructive bowel gas pattern.
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Umbilical venous catheter is coiled within the proximal umbilical vein.
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Generate impression based on findings.
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Status post DHS A dynamic hip screw device affixes a nondisplaced fracture of the proximal femur in near-anatomic alignment. The fracture line is indistinct suggesting healing, appearing similar to the prior study. I see no hardware complications. Moderate osteoarthritis affects the hip joint. The bones overall appear demineralized suggesting osteopenia. Severe degenerative disk disease affects the visualized lower lumbar spine. There are arterial calcification in the pelvis and upper thigh. Additional heterotopic mineralization in the soft tissues lateral to the right ilium is unchanged from the prior study.
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Orthopedic fixation of healing proximal femoral fracture.
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Generate impression based on findings.
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30 year old female status post proximal humerus fracture. Redemonstrated is a proximal humerus fracture. The glenohumeral joint is within normal limits.
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Proximal humerus fracture.
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Generate impression based on findings.
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55 years, Male. Reason: Evaluate position of DHT History: TENS/SJS pt, new DHT Study limited by motion artifact and limited field of view. DHT tip in gastric body. Mildly dilated small bowel loops measuring up to 3.1cm, incompletely seen.
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DHT tip in gastric body. Mildly dilated small bowel loops, suggestive of small bowel obstruction.
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Generate impression based on findings.
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Female 12 years old Reason: assess ETT History: intubated in PICUVIEW: Chest AP (one view) 1/16/15 at 312 hours ET tube tip is at the carina. Feeding tube is present. Right upper extremity central line terminates at the RA/SVC junction. Cardiac silhouette size is top normal. Persistent left lower lobe opacity, likely atelectasis. No effusions or pneumothorax.
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No change in left lower lobe opacity.
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Generate impression based on findings.
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Fracture A plate and screw device affixes a comminuted fracture of the distal fibular diaphysis in near-anatomic alignment, with slight anterior translation of the distal fracture fragment relative to the proximal fracture fragment. I see no hardware complications. Early immature bone formation is noted along the fibular fracture and within the distal tibiofibular syndesmosis, indicating an attempt at healing. Two trans-syndesmotic screws affix the distal tibiofibular articulation in near-anatomic alignment. Two additional screws affix a fracture of the medial malleolus in anatomic alignment.
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Orthopedic fixation of distal fibular and tibial fractures as above.
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Generate impression based on findings.
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Head CT:Incidental note is made of a cavum septum septum pellucidum et vergae; otherwise the ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. Maxillofacial CT:There is a nondisplaced fracture involving the angle of the left mandible medially, extending through the roots of ADA teeth 17 and 18. Bilateral TMJ remain well seated. There are no other fractures.The orbits are unremarkable. Other than sporadic scatter foci of mucosal thickening, the visualized portions of the paranasal sinuses and mastoid air cells are clear.
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1.Negative unenhanced brain CT.2.There is a nondisplaced fracture involving the angle of the left mandible medially, extending through the roots of ADA teeth 17 and 18.
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Generate impression based on findings.
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17 year-old female status post colonoscopy now with abdominal pain. Rule out perforation.VIEWS: Chest and abdomen AP, abdomen cross table lateral (3 views) 1/16/2015 01:44 Right femoral venous catheter with tip in the distribution of the right external iliac vein. Disorganized nonobstructive bowel gas pattern. No evidence of pneumoperitoneum, portal venous gas or pneumatosis intestinalis.
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No evidence of pneumoperitoneum.
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Generate impression based on findings.
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Female 7 months old Reason: f/u exam History: Status post liver transplant, intubatedVIEW: Chest AP (one view) 1/16/15 at 318 hours. Central line terminates at the right atrium. Feeding tube is noted. Reidentification of right upper abdominal quadrant surgical clips, IVC stent is again noted. ET tube terminates below thoracic inlet. Cardiac silhouette size is normal. Right upper lobe atelectasis developed.
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Interval right upper lobe atelectasis development.
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Generate impression based on findings.
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27-year-old female with fever, diarrhea, and leukocytosis. Evaluate for colitis. ABDOMEN:LUNG BASES: Mild bilateral basilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter left hypoattenuating renal lesion is incompletely characterized.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No findings to suggest colitis or small bowel obstruction.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 findings to suggest colitis or small bowel obstruction.BONES, SOFT TISSUES: Perineal soft tissue fluid collections with rim enhancement consistent with abscess draping along the medial buttock bilaterally. This measures 5.8 cm in the transverse dimension across the perineum (series 3, image 111), 6.9 cm in the right buttock (series 3, image 109), and 5.7 cm in the AP dimension in the left buttock. Associated edema extends to the level of the anus. Evaluation of fistulization to the bowel is limited by CT and fluoroscopic study with contrast or MRI is recommended if clinically indicated.OTHER: No significant abnormality noted
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1.Perineal abscess draping along the medial buttocks bilaterally as above. Associated edema extends to the level of the anus. Evaluation of fistulization to the bowel is limited by CT and fluoroscopic study with contrast or MRI is recommended if clinically indicated.2.No CT evidence of colitis as clinically questioned.
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Generate impression based on findings.
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Reason: hx of aneurysm, eval for enlargement/rupture History: HA, presyncope Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. There is a 5.4-mm by 5.4-mm axial dimension aneurysm present at the right middle cerebral artery bifurcation at the distal right M1 segment. Prior measurements from 2/13/12 are the same.The right A1 segment is larger than the left A1 segment. The posterior communicating arteries are small. The left vertebral artery is larger than the right vertebral artery. The right vertebral artery is distally hypoplastic.The anterior communicating artery and the posterior communicating arteries are identified and are intact.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Periventricular and subcortical white matter hypodensities of a moderate degree are present.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.The temporomandibular joints are narrow.
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1.Stable right middle cerebral artery aneurysm.2.No evidence for cerebral vascular occlusive disease.3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related.
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Generate impression based on findings.
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coiled basilar artery aneurysm which was recurred and ruptured. Recoiling of the aneurysm was performed on Dec 30 2014. Metallic artifacts due to basilar tip aneurysm coiling.Right frontal approach ventriculostomy catheter, the tip location is located on the right side foramen of Monroe.Remained IVH especially on bilateral lateral ventricle occipital horns.Multifocal low attenuation lesions demonstrate multi-age ischemic infarctions and associated encephalomalacia.All above findings do not show any significant interval change since prior exam.There is no evidence of new ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are stable. The mastoid air cells are clear.Opacification of the left maxillary sinus, no change since prior exam.
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No evidence of new ischemic or hemorrhagic lesion on this scan.Marked metallic artifacts due to basilar tip aneurysm coiling.Remained IVH with ventriculostomy tube insertion status, stable ventricular system.Multifocal various aged ischemic lesions as described above.
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Generate impression based on findings.
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17 year-old male with fifth toe painVIEWS: Left fifth toe AP, oblique, and lateral (3 views) 01/14/15 There is ankylosis of the distal and mid phalanx of the fifth digit. No acute fracture or malalignment is evident. No osseous erosions to suggest osteomyelitis.
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No acute fracture malalignment is evident.
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Generate impression based on findings.
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Status post TSA Components of a right total shoulder arthroplasty device are situated in near anatomic alignment without specific radiographic findings to suggest hardware complication. Mild osteoarthritis affects the acromioclavicular joint.
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Total shoulder arthroplasty as above.
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Generate impression based on findings.
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Ms. White is a 53 year old female presenting for a short-term follow-up for a cluster of cysts in the left breast. She has a personal history of right breast lumpectomy in 2006 for IDC/DCIS followed by chemoradiation therapy. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The circumscribed mass in the left upper outer breast is unchanged in size and appearance from prior exam. There are no new suspicious microcalcifications or areas of architectural distortion identified in the left breast. LEFT BREAST ULTRASOUND
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Probably benign cluster of cysts in the left breast. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Left shoulder pain. No trauma or previous history. Increased with abduction. Rule out osteoarthritis or other causes. I see no frank osteoarthritic changes. The acromion is slightly low-lying with respect to the distal clavicle, but the acromiohumeral interval is preserved. I see no specific findings to account for the patient's shoulder pain.
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No specific findings to account for the patient shoulder pain. If further imaging evaluation is clinically warranted, MRI may be considered.
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Generate impression based on findings.
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65-year-old female with chest pain, d-dimer PULMONARY ARTERIES: No significant abnormality noted.LUNGS AND PLEURA: There is a mosaic attenuation pattern. 4-mm right upper lobe micronodule (series 9 image 58) and focal linear scarlike opacity in the right upper lobe (series 9 image 66) have a benign appearance. Well marginated 6-mm opacity in an accessory left lower lobe fissure (series 9 image 117) is most consistent with a benign intrapulmonary lymph node, unchanged since 2011. Basilar scarring/atelectasis.MEDIASTINUM AND HILA: Mild coronary/atherosclerotic calcifications. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. No pulmonary embolism or other acute findings to account for the patient's symptoms. 2. Mosaic attenuation pattern which may be from chronic pulmonary embolism, hypersensitivity pneumonitis, or small airways disease. PULMONARY EMBOLISM: PE: NegativeChronicity: 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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13-year-old female with symptomatic juvenile hallux valgusVIEWS: Left foot AP, oblique, lateral weight-bearing (3 views) 01/14/15 No acute fracture is evident. Hallux valgus deformity is present.
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Hallux valgus deformity.
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Generate impression based on findings.
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Altered mental status, CVA 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.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. Bilateral proptosis is noted
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No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.
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Generate impression based on findings.
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Lumbago. Spondylosis? There is mild multilevel degenerative disk disease throughout the lumbar spine. Moderate to severe facet joint osteoarthritis affects the lower lumbar spine. There are minimal anterolistheses of L4 and L5. There is hypertrophy of the spinous processes with associated degenerative arthritic changes. I see no frank compression fracture. Osteophytes project from the anterior aspects of the vertebrae. There is atherosclerotic calcification of the distal abdominal aorta and common iliac arteries.
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Degenerative disk disease and facet joint osteoarthritis as above.
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Generate impression based on findings.
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4-year-old male with abdominal distention on physical examVIEWS: Abdomen AP (one views) 01/15/15 Surgical sutures are seen in the left upper quadrant. Gaseous distention of small and large bowel. No evidence of obstruction. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas.
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Nonspecific bowel gas pattern.
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Generate impression based on findings.
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44-year-old female status post left shoulder revision. Overlying splint material limits evaluation of fine osseous detail. Hardware components of a total shoulder arthroplasty are in gross anatomic alignment without radiographic evidence of hardware complication. There is a cortical step off along the proximal humerus which may reflect fracture or osteotomy. Catheter tubing overlying the upper chest likely represents an intrascalene nerve block.
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Postoperative changes of total shoulder arthroplasty as above.
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Generate impression based on findings.
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Altered mental status, rule out stroke, bleed, infection No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Extensive area of hypoattenuation in the periventricular and subcortical white matter is nonspecific but favored to represent chronic small vessel ischemic changes. Gray-white differentiation is maintained. Global parenchymal volume loss is seen, commensurate with age. No hydrocephalus. No extra-axial collections. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact.
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No acute intracranial findings; specifically no evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.
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Generate impression based on findings.
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78 years, Female. Reason: evaluate new NG tube placement History: NG tube Study limited by motion artifact and exclusion of pelvis. Enteric tube tip in the gastric body. Air containing loops of small and large bowel noted. IVC filter at L3/4 level.
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Enteric tube tip in the gastric body.
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