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Generate impression based on findings.
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Female 61 years old Reason: r/o renal stones (L CVA tenderness) History: L flank pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of renal stones. Calcification anterior to left psoas muscle on image number 110, series number 3 likely represents a phlebolith, however, ureteral stone, although much less likely, cannot be entirely excluded. No evidence of hydronephrosis bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Calcified uterine fibroid.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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No evidence of renal stones or hydronephrosis.
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Generate impression based on findings.
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40 years old, Female, Reason: fracture History: fell on tail bone with severe pain No evidence of fracture or malalignment. Severe degenerative changes affect L5-S1.
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Degenerative changes at the lower lumbar spine without evidence of fracture or malalignment.
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Generate impression based on findings.
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Evaluate for areas ischemia, hemorrhage, history of cerebral thrombosis with cerebral infarction. There is no evidence of intracranial hemorrhage or mass. There is mild cerebral white matter hypoattenuation. The ventricles are normal in size and configuration. There is no midline shift or herniation. There are vertebral and carotid artery calcifications. There is minimal opacification of the ethmoid sinuses. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable.
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Mild cerebral white matter hypoattenuation is nonspecific, but may represent age-indeterminate small vessel ischemic disease. No evidence of intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct and cerebral venous thrombosis. An MRI/MRV may be useful for further evaluation, if there are no contraindications for this modality.
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Generate impression based on findings.
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Male 52 years old Reason: abdominal pain ams History: abdominal pain Limited study due to lack of intravenous contrast.ABDOMEN:LUNG BASES: Bilateral dependent atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Paraumbilical hernia containing fat and nonobstructed bowel segments.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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Limited study due to lack of intravenous contrast. No CT findings to explain patient's acute abdominal pain.
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Generate impression based on findings.
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22 years old, Male, Reason: eval for syndesmotic injury History: ankle pain Along the posterior aspect of the tibial epiphysis there is a small ossific fragment compatible with an acute fracture of the posterior tibial plafond. There is significant soft tissue swelling posterior aspect of the ankle. No additional fracture lines are evident. The ankle mortise is maintained.
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Acute fracture of the posterior tibial plafond and associated soft tissue swelling.
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Generate impression based on findings.
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Female 41 years old Reason: abdominal pain, tranpslant pt History: abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Pancreas is mildly but diffusely enlarged. Its difficult to evaluate the pancreas on this noncontrast study, however, this may be compatible with mild acute pancreatitis. Correlation with serum markers is recommended.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: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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Limited study to lack of intravenous contrast. Mildly enlarged pancreas which may be compatible with acute pancreatitis. Correlation with serum markers is recommended.These findings were discussed with and acknowledged by Dr. Wood at the time of dictation.
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Generate impression based on findings.
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Male 44 years old Reason: r/o stone L side History: gross hematuria/pain L flank ABDOMEN:LUNG BASES: Centrilobular emphysema.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant 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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No evidence of urolithiasis or hydronephrosis.
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Generate impression based on findings.
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44 years old, Female, Reason: r/o frx History: pain No fracture or malalignment evident. There are small intra-articular ossific fragments in the anterior tibiotalar joint which may represent loose bodies, likely from prior trauma or degenerative changes. Degenerative changes affect the midfoot.
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No fracture or malalignment. Small intra-articular ossific fragments in the anterior tibiotalar joint may represent loose bodies.
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Generate impression based on findings.
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Male 55 years old Reason: rule out dissection History: chest pain, back pain CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Ascending aorta is ectatic measuring up to 4.5 cm on image number 54, series number 10. Descending thoracic aorta is normal in size. However there are multiple ulcerated plaques and eccentric mural thrombus involving the distal descending thoracic aorta. No evidence of dissection.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver. Mild hepatomegaly.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: 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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Ectatic ascending aorta. Ulcerating plaques and eccentric mural thrombus involving the distal descending thoracic aorta without evidence of dissection.
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Generate impression based on findings.
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Female 52 years old Reason: right-sided kidney stone, gallbladder pathology History: ruq pain, hx kidney stone ABDOMEN:LUNG BASES: Linear atelectasis in the right lung base.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 4-mm nonobstructing right renal stone. Mild right caliectasis. Prominent right ureter with minimal inflammatory changes around it. A punctate calcification best seen on image number 43, coronal series there are presented punctate right ureteral stone versus a phlebolith.Left kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes involving the stomach.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Right renal stone and mild right caliectasis.. Prominent right ureter with mild inflammatory changes which may be secondary to recently passed stone. A punctate calcification in the right distal ureter is seen on coronal images may represent a punctate stone versus a phlebolith.
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Generate impression based on findings.
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Female 65 years old Reason: r/o appy History: fever, RLQ pain The study is limited due to lack of intravenous contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, 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 significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Cholelithiasis. Limited study due to lack of intravenous contrast.
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Generate impression based on findings.
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Male 67 years old Reason: eval for anastomotic leak, abscess, bleed History: recent whipple, eval for bleed vs abscess. fever, vomiting, abd pain. ABDOMEN:LUNG BASES: Trace right-sided pleural effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Postsurgical changes secondary to Whipple surgery. Small amount of fluid around the pancreas.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right nephrolithiasis. Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes secondary to Whipple surgery. Mild wall thickening of the jejunal loop anastomosed to the pancreas, nonspecific and likely postsurgical.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: Mild nonspecific wall thickening of distal small bowel loops and cecum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Mild wall thickening of the jejunal loops anastomoses the pancreas, likely postsurgical. Small amount of fluid and on the pancreas, postsurgical.
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Generate impression based on findings.
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Female 29 years old Reason: Evaluate for causes of worsening abdominal pain History: Abdominal pain, nausea, vomiting in pt with h/o Noonan's syndrome, chronic constipation/obstipation, s/p colonic decompression yesterday ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild wall thickening of the rectosigmoid colon may be compatible with colitis.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: Mild wall thickening of the rectosigmoid colon and left colon may be compatible with colitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Mild wall thickening of the rectosigmoid and left colon may be compatible with colitis. Otherwise unremarkable study.
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Generate impression based on findings.
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39 years old, Female, Reason: Fell on hand. r/o fracture; hemarthrosis History: Pain thenar area and wrist No acute fracture or dislocation of the wrist and.
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No acute fracture or dislocation.
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Generate impression based on findings.
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Male 52 years old Reason: HO of fistulizing crohn's dz with perianal dz s/p diversion cb coccyx osteo s/p resection pw failure to thrive. Q: intra abd or pelivc abscess? recurrent osteo? History: above ABDOMEN:LUNG BASES: Bilateral moderate pleural effusions and dependent atelectasis, new from previous study.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Chronic scarring of the left kidney, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Moderately distended small bowel loops are matted together in the midline pelvis. Again noted is a small collection measuring 2.7 x 0.9 cm in image number 87, series number 4, in the midline pelvis. This collection is surrounded by the moderately distended small bowel loops and extends inferiorly to the pelvis and fistulized to the skin. This likely represents and enterocutaneous fistula. This collection also communicates with a presacral collection measuring 2-cm in diameter on image number 102, series number 4. Inflammation encases the sacrum. Osteomyelitis in the sacrum cannot be excluded.There is a separate left perianal collection on the left side of the pelvis is July the skin measuring 3 x 2 cm on image number 118, series number 4.Right lower quadrant ostomy. Slight increased enhancement of the wall of the jejunal loops may be secondary to active Crohn's disease.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Small amount of air in the bladder. This is likely secondary to Foley catheter. The balloon of the Foley catheter is distended in the urethra instead of the bladder.LYMPH NODES: Bilateral pelvic adenopathy, likely reactive.BOWEL, MESENTERY: Please see discussion aboveBONES, SOFT TISSUES: Please see discussion aboveOTHER: No significant abnormality noted
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Extensive decubitus ulcers and perianal abscesses. There is an enterocutaneous fistula extending from the midline pelvis to the perianal region.Osteomyelitis of the sacrum cannot be excluded.The balloon of the Foley catheter should be moved into the bladder. Currently the balloon is in the prostatic urethra.
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Generate impression based on findings.
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24 years old, Female, Reason: rule out fx History: pain, leg injury Comminuted fracture of the proximal diaphysis of the left fibula in near anatomic alignment. There is associated lateral soft tissue swelling. No additional fractures are evident. No evidence of knee joint effusion the extensor mechanism appears intact.
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Comminuted fracture of the proximal diaphysis of the left fibula with associated soft tissue swelling.
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Generate impression based on findings.
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27 years old, Female, Reason: MVC History: neck pain No acute fracture or subluxation. No significant soft tissue swelling. Mild straightening of the cervical spine is likely related to positioning. Vertebral heights and disk spaces are maintained. The neural foramina are normal in appearance. Granuloma in left lung apex.
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No acute fracture or subluxation.
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Generate impression based on findings.
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20 years old, Female, Reason: is there a fx or dislocation History: pain= trouble walking s/p fall No acute fracture or dislocation. Small knee joint effusion. Extensor mechanism appears intact.
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Small knee joint effusion without acute fracture or dislocation.
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Generate impression based on findings.
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45 years old, Female, Reason: r/ fx History: pain and swelling/bruising Fracture of the patella with a predominately transverse orientation. No significant distraction of the fracture fragments. There is a moderate-sized knee joint effusion.
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Transverse fracture of the patella with associated joint effusion.
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Generate impression based on findings.
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Chest painVIEW: Chest AP 1/18/15 Cardiothymic silhouette normal. Patchy atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax. Left PICC has been removed in the interval.
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Patchy atelectasis in the right lower lobe and left lower lobe.
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Generate impression based on findings.
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There is an unchanged left cerebral convexity mixed attenuation subdural hematoma that measures up to 15 mm in width with layering hyperattenuated blood products and associated unchanged 8 mm shift of the septum pellucidum to the right and unchanged subfalcine and uncal herniation. There is no evidence of new intracranial hemorrhage. There is unchanged right subinsular ovoid hypoattenuating focus. The ventricles and basal cisterns are unchanged. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No significant change in the heterogeneous left cerebral convexity subdural hematoma with 8mm midline shift.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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39 years old, Female, Reason: r/o cancerous growths or lytic lesions on spine, less likely fxr History: low back pain, sciatica No acute fracture or malalignment. Vertebral body heights and disk spaces are preserved. No evidence of lytic or blastic lesion as clinically questioned. One of the tubal ligation clips is now located in the right mid abdomen.
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No acute fracture or malalignment. No evidence of lytic or blastic lesion as clinically questioned.
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Generate impression based on findings.
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61 years old, Female, Reason: r/o fx History: pain No evidence of fracture or dislocation. Mild degenerative changes are present.
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No evidence of fracture or dislocation.
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Generate impression based on findings.
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29 years old, Female, Reason: r/o acute fxr History: knee pain s/p fall Left knee: No evidence of fracture or dislocation. No definite evidence of soft tissue swelling or joint effusion.Right knee: No evidence of fracture or dislocation. No definite evidence of soft tissue swelling or knee joint effusion.
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No evidence of fracture or dislocation.
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Generate impression based on findings.
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There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild asymmetry of the lateral ventricles which is likely an anatomical variant. There is a magna cisterna magna. The ventricles and basal cisterns are otherwise normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No acute intracranial hemorrhage or mass-effect.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Snoring, sinus congestion, and sinus surgery. There are postoperative findings related to bilateral uncinectomy, antrostomy versus prominent secondary ostea, and perhaps partial ethmoidectomy. There is opacification in the medial right maxillary sinus near the neo-infundibulum and residual portions of Haller cells. There is a tiny retention cyst in the right sphenoid sinus. The paranasal sinuses are otherwise clear. The nasal cavity is clear. There is mild nasal septal deviation directed to the left. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. The mastoid air cells and middle ear cavities are clear. There is opacification of the left external auditory canal, which may represent cerumen.
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Postoperative findings related to endoscopic sinus surgery with opacification in the medial maxillary sinuses near the neo-infundibulum and residual portions of Haller cells, as well as a tiny retention cyst in the right sphenoid sinus. The paranasal sinuses are otherwise clear.
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Generate impression based on findings.
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There are postoperative findings related to left parietal craniotomy and partial resection of the parietal calvarium. There is a small amount of residual pneumocephalus in the region of the surgical bed. There is persistent extensive confluent cerebral white matter hypoattenuation with regional sulcal effacement, but no significant midline shift. There is no evidence of intracranial hemorrhage or definite evidence of residual intracranial tumor. There is diffuse mild cerebellar volume loss. The imaged paranasal sinuses and mastoid air cells are clear. There are skin staples and a partially-imaged nasoenteric tube.
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1. Postoperative findings related to left parietal craniotomy and partial resection of the parietal calvarium for resection of a meningioma without evidence of acute intracranial hemorrhage.2. Persistent left cerebral hemisphere vasogenic edema surrounding the resection bed, but no significant midline shift.
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Generate impression based on findings.
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Assess pathology causing pain/effusion. The bones appear slightly demineralized. Tiny osteophytes indicate minimal osteoarthritis. There is a small joint effusion, but I see no erosions. I see no fracture or malalignment.
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Mild osteoarthritis and small joint effusion.
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Generate impression based on findings.
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Right hip pain after fall. Evaluate for fracture. I see no fracture or dislocation. There is perhaps slight narrowing of the hip joint which may reflect very mild osteoarthritis. The bones appear slightly demineralized, perhaps presenting osteopenia.
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No fracture evident.
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Generate impression based on findings.
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Patient with metastatic cancer with known spinal metastases and metastasis to right pinky finger now with wrist and forearm pain. Please evaluate for lesions. There is an aggressive-appearing lytic lesion of the distal ulnar diaphysis with poorly defined margins and destruction of the cortex, particularly along its radial aspect. The lesion is approximately 2.5 cm in longitudinal dimension and occupies the entire width of the bone, and I suspect there is also a soft tissue component laterally. I see no fracture at this time.
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Distal ulnar metastasis as described above.
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Generate impression based on findings.
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Status post fusion. Evaluate hardware. There are posterior rods with screws entering the L4, L5, and S1 vertebrae. I see no hardware complications. There is also a new spacer device between the L5 and S1 vertebral bodies. Mature bone graft material is noted along the lateral aspects of the lower lumbar spine. Severe degenerative disk disease affects the remainder of the lumbar spine. There is a grade 1 retrolisthesis of L2 relative to L3. Vertebral body heights are preserved. There is a slight rightward curvature of the lumbar spine. Phleboliths are noted in the pelvis.
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Postoperative changes of lumbosacral fusion and degenerative changes as described above.
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Generate impression based on findings.
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Back pain. Evaluate for signs of "osteo" or fracture. I see no radiographic features of osteomyelitis. I see no fracture. Mild degenerative disk disease affects L5/S1. Mild to moderate degenerative disk disease affects L1/2. Moderate to severe degenerative disk disease affects T12/L1. Moderate facet joint osteoarthritis affects the lower lumbar spine. Alignment is within normal limits. Note is made of multiple air-filled and perhaps mildly distended loops of bowel. Evaluation of the sacrum is limited by stool in the overlying rectum.
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Degenerative disk disease and other findings as described above without radiographic evidence of osteomyelitis or fracture.
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Generate impression based on findings.
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Pain and swelling. Rule out fracture. There is an oblique intra-articular fracture through the lateral condyle of the head of the proximal phalanx of the great toe. Fracture fragments are in near-anatomic alignment. There is an orthopedic screw in the first metatarsal head. Moderate osteoarthritis affects the first metatarsophalangeal joint.
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Fracture of the proximal phalanx as described above.
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Generate impression based on findings.
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Pain and swelling to left scapula from battery and fall down stairs. Fracture? I see no fracture or malalignment.
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No fracture evident.
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Generate impression based on findings.
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Mid foot tenderness.VIEWS: Left foot AP/lateral/oblique (3 views) 01/19/15 The bones are normal in appearance. A fracture is not identified. No soft tissue swelling is seen.
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Normal examination.
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Generate impression based on findings.
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68 years, Female. Reason: femoral trialysis in place? History: femoral trialysis in place Right femoral access catheter projects over the right common iliac stent. Surgical drain with tip in the pelvis. Foley catheter in place. Surgical staples. Nonspecific bowel gas pattern without specific evidence of acute obstruction. Pneumoperitoneum better seen on prior radiographs from the same day.
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1. Right femoral access catheter projects over the right common iliac stent. 2. Postoperative changes with pneumoperitoneum better seen on prior radiographs from the same day.
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Generate impression based on findings.
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2-year-old female with known left femur fracture.EXAMINATION: Skull AP/lateral, cervical spine AP/lateral, thoracolumbar spine AP/lateral, right humerus AP, left humerus AP, right forearm AP, left forearm AP, right hand PA, left hand PA, chest AP, ribs right oblique/left oblique, right femur AP, right tibia fibula AP, right foot AP (20 views) 01/18/15 Bone mineralization and modeling are normal. No additional fractures were noted. Gas distended stomach is seen. Interval placement of spica cast. Round, lucent lesion in medial aspect of the distal right femoral metaphysis represents a nonossifying fibroma.
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No additional fractures are noted.
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Generate impression based on findings.
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55 years, Male. Reason: NGT repositioned, pulled back 6cm since last KUB History: NGT pulled back 6cm Skin staples noted. Enteric tube tip overlies the gastric body. Bilateral double J stents. Right sided abdominal drain unchanged. The pelvis is out of the field-of-view. Stable mild to moderate gaseous distention of small bowel loops and colon. These findings likely represent ileus. No definite free air is identified.
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Stable gaseous distention of small bowel loops and colon, consistent with ileus.
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Generate impression based on findings.
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Swollen foot, erythema. Concern for gout. There is diffuse soft tissue swelling, particularly along the dorsum of the foot. There is at least partial fusion of the first tarsometatarsal joint via two orthopedic screws; the tip of one of the screws enters the distal aspect of the navicular. Two additional screws affix a healed osteotomy of the first metatarsal diaphysis in near anatomic alignment. Overall, the postoperative changes appear similar to those seen on the prior study. There is a mild hallux valgus deformity and moderate osteoarthritis of the first metatarsophalangeal joint. There is fusion of the PIP joint of the second toe, presumably postoperative. A small fragment of ossification along the medial aspect of the second metatarsophalangeal joint appears similar to that seen on the prior study. The Achilles' tendon silhouette is not visible on the lateral view which may simply be due to overlying soft tissue swelling, but I cannot exclude the possibility of a tear. I see no discrete tophi or erosions.
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Soft tissue swelling, postoperative changes, and other findings as described above; I see no specific radiographic features of gout.
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Generate impression based on findings.
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68 years, Female. Reason: h/o bowel perforation, recent bowel surgery - assess for obstruction History: emesis, decreased ostomy output Pneumoperitoneum again noted on both AP and decubitus views, in the setting of known bowel perforation and recent surgery may be expected. Correlate with surgical history. Surgical staples and pelvic drain visualized. Cardiomegaly with basilar opacities consistent with atelectasis and probable small right effusion and mild edema. Sternal fixation wires and orphaned ICD wire/lead. Left IJ central venous catheter with tip at the brachiocephalic/SVC junction.
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1. Pneumoperitoneum in the setting of known bowel perforation and recent surgery may be expected. Correlate with surgical history. No acute obstruction. 2. Cardiomegaly and basilar opacities consistent with atelectasis, small effusions and edema.
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Generate impression based on findings.
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56-year-old who is recalled from screening for focal asymmetries in the right breast. An ML view and spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Within the right central breast, the adjacent focal asymmetries at least partially disperse. A benign morphology mass in the right central 6 o'clock position does not appear significantly changed. No suspicious microcalcifications or areas of architectural distortion in the right breast. ULTRASOUND
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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67-year-old female with history of distal thoracic aortic intramural thrombus. Evaluate for thrombus. CT ANGIOGRAM: Multifocal regions of atherosclerotic disease and thrombus within the thoracic and abdominal aorta. Common origin of the innominate and left carotid arteries. There is a focal thrombus along the anterior wall of the ascending aorta (series 11, images 82 through 86). Additionally, there is extensive thrombus of the descending thoracic aorta immediately above the diaphragmatic hiatus with evidence of plaque that is protruding as best appreciated on sagittal series 80899, image 67. Diffuse extensive plaque throughout the abdominal aorta. There is a saccular abdominal aortic aneurysm immediately above the level of the iliac bifurcation measuring approximately 2.5 cm in transverse dimension (coronal series 80836, image 23), not significantly changed with the limited comparison to the previous limited nonenhanced examination. Additionally, there is evidence of focal exophytic plaque immediately above the saccular aneurysm as best appreciated coronal series 80836, image 22. As noted on the axial series, the aneurysmal sac has mildly increased in size measuring 3.3 cm in AP dimension (series 11, image 376), previously measuring 2.9 cm in AP dimension.There is high-grade stenosis of the celiac artery at its origin (sagittal series 80899, image 70 ) with evidence of post stenotic dilatation. The SMA, IMA, and common iliac arteries are patent. The left renal artery is patent. There is high-grade stenosis at the orifice of the right renal artery.CHEST:LUNGS AND PLEURA: Moderate upper lobe predominant centrilobular and paraseptal emphysema. No suspicious pulmonary nodules or masses. No pleural effusions or pneumothorax. MEDIASTINUM AND HILA: See above for CTA findings. Nonspecific mildly enlarged mediastinal lymph nodes. Heart size is normal without pericardial effusion. Severe coronary artery calcifications.CHEST WALL: Scoliosis with multilevel degenerative changes.ABDOMEN:LIVER, BILIARY TRACT: 1.7 x 1.4 cm (series 11, image 30 33) hypoattenuating focus in segment 3 of the liver is most compatible with a cyst.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Nonspecific thickening of both of the adrenal glands without focal mass.KIDNEYS, URETERS: Two right renal hypoattenuating foci, some of which are compatible with cysts and some of which are too small to characterize.RETROPERITONEUM, LYMPH NODES: See above for CTA findings.BOWEL, MESENTERY: No evidence of bowel obstruction or colitis.BONES, SOFT TISSUES: Scoliosis and multilevel degenerative changes.OTHER: No significant abnormality noted.
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1.Extensive multifocal thoracic and abdominal aortic thrombus which demonstrates an exophytic as well as a protruding component as detailed above. There is saccular aneurysmal dilatation of the abdominal aorta which is mildly increased compared to the prior exam. Thrombus at the level of the ascending aorta may be the source of patient's cerebral thrombus/embolus given clinical history of unspecified cerebral artery occlusion with cerebral infarction.2.High-grade stenosis at the celiac axis origin and the right renal artery orifice. 3.Extensive multilevel degenerative changes and scoliosis.
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Generate impression based on findings.
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Five day old male status post peripherally inserted central venous catheter placement.VIEW: Chest and abdomen AP (two view) 1/18/2015, 14:00 Interval placement of a left upper extremity PICC with the tip terminating in the left internal jugular vein. New nasogastric tube, with tip terminating in the fundus of the stomach with the side port below the GE junction. The UAC and UVC catheters have been removed.New mild multifocal bilateral pulmonary opacities may reflect atelectasis. The cardiothymic silhouette is normal. The bowel gas pattern is disorganized and nonobstructive. No pneumatosis intestinalis, portal venous gas or pneumoperitoneum is seen.
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Left upper extremity PICC with tip terminating in the internal jugular vein.
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Generate impression based on findings.
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2 year-old female with fall down stairs with refusal to bear weightVIEWS: Pelvis AP/frogleg, left femur AP/lateral, left tibia-fibula AP/lateral, left foot AP/lateral/oblique (9 views) 01/18/15 Pelvis: There is a fracture through the left femoral metadiaphysis with medial and posterior displacement of a butterfly fragment.Femur: Again seen is a fracture through the left proximal femoral metadiaphysis with medial and posterior displacement of a butterfly fragment.Tibia-fibula: No acute fracture or malalignment is evident.Foot: No acute fracture malalignment is evident.
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Acute fracture through the left femoral metadiaphysis with medial and posterior displacement of a butterfly fragment.
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Generate impression based on findings.
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55 years, Male. Reason: s/p NGT placement History: s/p NGT Skin staples noted. Enteric tube tip overlies the gastric body. Bilateral double J stents. Right sided abdominal drain unchanged. The pelvis is out of the field-of-view. Stable mild to moderate gaseous distention of the colon and jejunal loops with air fluid levels consistent with ileus. This is not significantly changed from prior study. No definite free air is identified.
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Enteric tube tip overlies the gastric body. Stable gaseous distention of small bowel loops and colon, consistent with ileus.
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Generate impression based on findings.
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Abdominal distentionVIEWS: Chest and abdomen AP, abdomen cross table lateral 1/18/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Cardiothymic silhouette normal. Bilateral atelectasis improved from prior study. No pleural effusion or pneumothorax. Multiple dilated loops of bowel not significantly changed. The stomach is decompressed. No pneumatosis or pneumoperitoneum.
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Multiple dilated loops of bowel not significantly changed.
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Generate impression based on findings.
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Female; 64 years old. Reason: interval change; PNA History: SOB; worsening pleural effusions LUNGS AND PLEURA: Moderate bilateral pleural effusions have mildly increased since prior study, particularly loculated fluid in both major fissures and the left apex. Bilateral pleural catheters are in place. Interval appearance of nodular septal thickening in the inferior left lung, suspicious for lymphangitic spread of tumor. New left bronchial wall thickening is suggestive of superimposed edema. Additional nonspecific patchy atelectasis/consolidation in the lung bases posteriorly is seen, left greater than right.MEDIASTINUM AND HILA: Right chest port catheter tip in SVC. Normal heart size without pericardial effusion. No visible coronary artery calcifications. Enlarged mediastinal lymph nodes have mildly increased, particularly in the subcarinal space.CHEST WALL: Enlarged left axillary lymph nodes have mildly increased. Body wall anasarca.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Previously seen enlarged retroperitoneal lymph nodes are not included in the field-of-view. Mild perihepatic ascites, partially visualized.
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1. New nodular septal thickening in the inferior left lung, suspicious for lymphangitic spread of tumor.2. Findings suggestive of superimposed edema with bronchial wall thickening, increased effusions, and body wall anasarca.3. Nonspecific basilar atelectasis/consolidation, left greater than right.4. Increased mediastinal and left axillary lymphadenopathy.
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Generate impression based on findings.
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Hypodensity is found within the white matter without associated mass effect, demonstrating some interval progression compared to 2008. 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. Fluid is present within left mastoid air cells. The visualized portions of the paranasal sinuses and right mastoid air cells are clear.
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Small vessel disease of indeterminate ages. 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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2-day-old female born prematurely, evaluate central line placement.VIEWS: Chest and abdomen AP (two views) 1/18/2015, 15:13 The UVC has been repositioned with the tip now in right portal vein. The UAC tip is at T6. The endotracheal tube tip is below thoracic inlet and above carina. Enteric tube tip is in stomach.Persistent hazy diffuse pulmonary opacity unchanged, with associated left apical and basilar atelectasis slightly improved. The cardiothymic silhouette is normal. The bowel gas pattern is disorganized and nonobstructive. No portal venous gas, pneumatosis intestinalis or pneumoperitoneum is identified.
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UVC tip now in the left portal vein. Persistent diffuse hazy pulmonary opacity.
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Generate impression based on findings.
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Increased oxygen requirementVIEW: Chest AP and abdomen AP 1/18/15 Tracheostomy tube, NG tube and left PICC again noted. Cardiothymic silhouette normal. Patchy atelectasis in the left lower lobe not significantly changed. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum.
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Patchy atelectasis left lower lobe not significantly changed.
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Generate impression based on findings.
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Pain. Second digit fracture? There is perhaps mild soft tissue swelling, but I see no fracture or malalignment.
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No fracture evident.
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Generate impression based on findings.
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Respiratory distressVIEW: Chest AP 1/19/15 Multiple embolization coils, vascular coils, pulmonary and SVC stents again noted. Cardiothymic silhouette normal. Minimal atelectasis in the right lower lobe. Minimal blunting right costophrenic angle representing small right pleural effusion.
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Minimal atelectasis right lower lobe.
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Generate impression based on findings.
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32-year-old female with history of pain and swelling. Hand: No acute fracture or malalignment. Mild soft tissue swelling about the base of the index finger.Wrist: There is mild soft tissue swelling without acute fracture. There is a negative ulnar variance.
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Soft tissue swelling without acute fracture.
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Generate impression based on findings.
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59 years, Male. Reason: abdominal distension, History: abdominal distension Nonobstructive bowel gas pattern. Average stool burden.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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83 year old female with history of hematuria Please note lack of IV and oral contrast limits evaluation of solid organ pathology, and also of the GI tract.ABDOMEN:LUNG BASES: Lung bases are clear with only minimal basilar scarring, and no significant pericardial effusion. Severe coronary artery calcifications.LIVER, BILIARY TRACT: 2.5 x 1.8 cm right hepatic lobe hypoattenuating area (3/38) is unchanged, consistent with benign hemangioma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: At the left ureteropelvic junction is an approximately 4 mm calculus (3/44) with only minimal periureteral stranding. No significant hydronephrosis or hydroureter. Bilateral renal cysts are unchanged in appearance.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower abdomen enterostomy site appears intact. Evaluation of the bowel is limited due to lack of oral contrast.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: Evaluation of the pelvis is limited by streak artifact from bilateral hip prosthetics.UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes affect the spine, with at least some narrowing of the spinal canal.OTHER: No significant abnormality noted
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Nonobstructive left UPJ 4-mm calculus with minimal adjacent stranding as above.
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Generate impression based on findings.
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65-year-old female with chest pain. Evaluate for pulmonary embolism. PULMONARY ARTERIES: No evidence of pulmonary embolism. Pulmonary artery size is within normal limits. No evidence of right heart strain.LUNGS AND PLEURA: Moderate bronchial thickening most prominent in the right lower lobe which may suggest bronchitis. Small diffuse subpleural linear scar like opacities which are likely post infectious in etiology. Mild dependent atelectasis. No pleural effusion. No suspicious mass or nodule. MEDIASTINUM AND HILA: Left ventricular wall hypertrophy. Mild coronary artery calcifications. No hilar or mediastinal adenopathy. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense lesion in the right kidney measuring up to 4 cm, likely represents a simple cyst. Patient is status post cholecystectomy.
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No evidence of pulmonary embolism. No acute abnormality.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative.
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Generate impression based on findings.
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2-year-old female with diarrhea. Please evaluate peri-stomal hernia for possible obstruction. Within the limits of a non-IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse low-attenuation to liver seen throughout consistent with hepatic steatosis. Lack of IV contrast limits further evaluation of liver parenchyma. Patient status post cholecystectomy without other biliary tract abnormality seen.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild cortical renal atrophy unchanged bilaterally. Bilateral renal cysts again seen unchanged. No hydronephrosis or other abnormalities. Lack of IV contrast limits ability to evaluate renal parenchyma.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Orally administered contrast rapidly exits a normal-appearing stomach into small bowel. No evidence of small bowel obstruction seen with rapid progression of orally administered contrast in normal-appearing jejunum and ileum. Right lower quadrant colostomy is seen with parastomal hernia of cecum and ascending colon and distal terminal ileum. No evidence of obstruction or intrinsic bowel abnormalities are associated with this. No free mesenteric fluid is seen. Second uncomplicated anterior ventral abdominal wall hernia containing transverse colon is also seen (series 3, image 44). Patient has a Hartmann's pouch with surgical sutures at the sigmoid colon. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Prior hysterectomy without other abnormality.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Orally administered contrast rapidly exits a normal-appearing stomach into small bowel. No evidence of small bowel obstruction seen with rapid progression of orally administered contrast in normal-appearing jejunum and ileum. Right lower quadrant colostomy is seen with parastomal hernia of cecum and ascending colon and distal terminal ileum. No evidence of obstruction or intrinsic bowel abnormalities are associated with this. No free mesenteric fluid is seen. Patient has a Hartmann's pouch with surgical sutures at the sigmoid colon. OTHER: No significant abnormality noted
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1. Right lower quadrant colostomy with parastomal hernia involving ileum, cecum and ascending colon. 2. Second anterior ventral wall uncomplicated hernia containing only transverse colon. 3. No evidence of bowel obstruction or other complication.
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Generate impression based on findings.
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2-day-old female born prematurely, status post central line placement.VIEWS: Chest and abdomen AP (two views) 1/18/2015, 13:52 The UVC has been repositioned, now looping back upon itself within the umbilical vein. The UAC tip position is unchanged, at the T6 level. The endotracheal tube tip is below thoracic inlet above carina. Interval placement of an enteric tube with the tip in the body of the stomach.Diffuse hazy pulmonary opacity is again seen, with associated left apical and basilar predominant atelectasis. The cardiothymic silhouette is normal. Disorganized nonobstructive bowel gas pattern evident. No portal venous gas, pneumatosis intestinalis or pneumoperitoneum.
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UVC now looping back upon itself with the tip terminating in the umbilical vein. Persistent diffuse hazy pulmonary opacity.
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Generate impression based on findings.
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Fall, dementia, abrasion to face No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. There is global parenchymal volume loss. 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.Prominent vascular calcifications. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact.
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No evidence of acute intracranial hemorrhage or calvarial fracture.
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Generate impression based on findings.
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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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Negative unenhanced brain CT. Specifically, there are no CT findings to explain the patient's symptoms.
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Generate impression based on findings.
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Fracture.VIEWS: Right foot AP/lateral/oblique (3 views) 01/19/15 No fracture is identified. Demineralization is noted. No soft tissue swelling is identified.
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Demineralization. No fracture identified.
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Generate impression based on findings.
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18 years Female with Reason: retropharyngeal abscess History: L neck swelling; s/p I\T\D peritonsillar abscess and tonsillectomy on 1/16 Postsurgical changes related to recent bilateral tonsillectomy.Interval development of prominent fluid collection with multiple internal foci of gas in the left parapharyngeal space, measuring 2.3 x 2.0 cm (series 3, image 117). Extensive asymmetric soft tissue inflammatory changes and fat stranding of the adjacent superficial soft tissues in the left neck.Multiple persistent small fluid collections in the left peritonsillar region, with internal high density fluid, and associated soft tissue stranding, which is suspicious for persistent/progressive infection. A reference left peritonsillar fluid collection measures 9 x 7 mm (series 3, image 122). There is mild, resultant mass effect in the left upper airway.Fluid and associated inflammatory changes track down to approximately the C5 vertebral level, and asymmetric soft tissue stranding extends to the inferior neck. There is persistent partial effacement of the left vallecula and piriform sinus. For reference, a measurable fluid collection in the left parapharyngeal space measures 1.8 x 2.3 cm (series 3, image 140). Reactive cervical lymphadenopathy is again noted. A previously described left level IIa nodal conglomerate is not significantly changed, measuring 12 mm in short axis (series 3, image 133). There has been mild interval improvement of the right level IIa nodal conglomerate, currently measuring 15 mm in short axis (series 3, image 119), previously 18 mm.Unchanged appearance of trace retropharyngeal effusion, measuring up to 3 mm in thickness, without loculated fluid to suggest retropharyngeal abscess. Persistent asymmetric enlargement of left submandibular gland, which is likely reactive.Stable appearance of lobulated retention cyst and mucosal thickening in the bilateral maxillary sinuses, reversal of the normal cervical lordosis.
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1. Postsurgical changes reflecting recent bilateral tonsillectomy.2. Extensive fluid collections, with internal foci of air, asymmetric soft tissue inflammatory changes and superficial fat stranding of the left neck, which is suspicious for persistent/progressive left peritonsillar and parapharyngeal infection.3. Prominent reactive cervical lymphadenopathy, with nodal conglomerates, are not significantly changed.4. Persistent asymmetric enlargement of the left submandibular gland, likely reactive secondary to surrounding inflammation.
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Generate impression based on findings.
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Female 72 years old. History of bilateral breast cancer. Right lumpectomy 2005 status post chemoradiation and left breast mastectomy 2012. No current symptoms. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Linear marker was placed on the scar overlying the right breast. The increased density, architectural distortion, and surgical clips in the lumpectomy bed are stable. Benign calcifications are present in the right breast. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast.
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Stable postsurgical changes of the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right 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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20 years, Female. Reason: toxic megacolon History: crohn's colitis, abd pain Nonobstructive bowel gas pattern with mild gaseous distension of bowel loops in the right lower quadrant, which could represent a focal ileus. Slight leftward scoliotic curvature of the lumbar spine.
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Nonobstructive bowel gas pattern with mild gaseous distension of bowel loops in the right lower quadrant which could represent a focal ileus. No specific evidence of toxic megacolon as clinically questioned.
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Generate impression based on findings.
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Reason: fall, hit head History: no new focal deficits The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present.The visualized portions of the paranasal sinuses demonstrate a mucus retention cyst in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1.No evidence for acute intracranial hemorrhage mass effect or edema.2.There are periventricular white matter hypodensities present which are known to the related to the patient's demyelinating disorder. Please refer to recent MRI for more comments.
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Generate impression based on findings.
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Abdominal distentionVIEW: Chest AP and abdomen AP 1/19/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Cardiothymic silhouette normal. Minimal atelectasis left lower lobe. No pleural effusion or pneumothorax. Multiple dilated loops of bowel within the abdomen. No pneumatosis or pneumoperitoneum.
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Abnormal multiple dilated loops of bowel within the abdomen.
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Generate impression based on findings.
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59-year-old female with HIV, alcoholic/HCV cirrhosis, cholelithiasis. Evaluate for ileus, colonic distention, and liver architecture. ABDOMEN:LUNG BASES: Mild bilateral basilar atelectasis.LIVER, BILIARY TRACT: The liver demonstrates a nodular surface contour with hypertrophy of the left lateral segment and widening of the fissures; findings compatible with hepatic cirrhosis. No focal hepatic masses identified on this limited examination. There is low density material in the posterior aspect of the portal vein extending from the splenic vein/confluence, which demonstrates peripheral calcifications and is most compatible with a chronic portal vein thrombus, unchanged. There is recanalization of the umbilical veins compatible with portal hypertension. There is small amount of peri-hepatic ascites.Hydropic gallbladder with cholelithiasis, small amount of pericholecystic fluid (series 4, image 83), and dilated common bile duct measuring up to 13 mm (series 4, image 42). SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter right upper lobe hypoattenuating lesion is too small to characterize. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: See below.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: Moderate dilatation of the cecum and ascending colon with the cecum measuring up to 8.9 cm (series 4, image 103) is nonspecific and may be physiologic. No cecal wall thickening or peri-cecal fluid to suggest inflammatory changes.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Findings compatible with cirrhosis and portal hypertension. Evaluation of HCC is limited on this single phase examination. If there is concern for HCC, dedicated triple phase examination is recommended. 2.Unchanged chronic nonocclusive thrombus of the portal vein and extending to the level of the confluence.3.Hydropic gallbladder with cholelithiasis, pericholecystic fluid, and dilated common bile duct. Findings concerning for cholecystitis.
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Generate impression based on findings.
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Altered mental status, BG ICH and IVH There is a intraparenchymal hematoma centered at the left thalamus measuring 2.4 x 3.5 cm in the axial plane and approximately 3.5 cm in the craniocaudal dimension. There is intraventricular extension with hemorrhage including the lateral, third, and fourth ventricles. There is rightward midline shift measuring up to 5 mm the level of the third ventricle.There is prominence of the ventricular system with placement of right transfrontal ventriculostomy seen with tip in the right inferior frontal horn near the foramen of Monroe. Small amount of pneumocephalus.There is diffuse sulcal effacement suggestive of elevated intracranial pressures. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. Secretions are seen filling the nasopharynx.
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1. Intraparenchymal hematoma centered at the left thalamus with intraventricular extension.2. Prominence of the ventricular system with recent placement of right frontal EVD.
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Generate impression based on findings.
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71-year-old male with history of flatulence and irritation. Evaluate for obstruction. Distended abdomen without tenderness to palpation. Please note lack of IV contrast limits evaluation of solid organ pathology.ABDOMEN:LUNG BASES: Large right greater than left pleural effusions and associated atelectasis/consolidation, appearing similar to prior. New patchy opacities more anteriorly in the lungs, nonspecific and may be related to aspiration, infection or edema. Marked cardiomegaly and cardiac assist device.LIVER, BILIARY TRACT: High density material in the gallbladder is most likely residual contrast from prior CT.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Limited evaluation of the kidneys due to streak artifact, however there is a small amount of hyperattenuating material in the bilateral renal calices which may be related to contrast excretion.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No small bowel obstruction or free air.BONES, SOFT TISSUES: Approximately 12 x 6 cm left lower quadrant/left upper pelvis heterogeneous, loculated fluid collection (4/140) which was seen on the prior exam. OTHER: Large amount of ascites, increased from prior.PELVIS:PROSTATE, SEMINAL VESICLES: Hyperattenuating brachytherapy seeds again seen.BLADDER: Layering densities within the bladder, likely excreted contrast.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Rectal tube in place.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Large right greater than left pleural effusions with associated atelectasis. New patchy opacities in the lungs may represent aspiration, infection or edema.2.Large amount of ascites, increased from prior.3.Left lower quadrant loculated fluid collection with heterogeneous contents suggesting hemorrhagic material.
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Generate impression based on findings.
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47-year-old female with facial swelling, difficulty breathing, difficulty speaking Poor dentition is noted with periapical lucency surrounding many of the remaining teeth, more prominently noted about left maxillary molars. Adjacent to these left maxillary molars is a hypoattenuating rim enhancing lesion measuring 12 x 12 mm which is partially obscured by artifact from dental hardware, suspicious for extension of a possible periapical abscess. This is contiguous with adjacent masslike soft tissue thickening measuring up to 2.1 x 3.6 cm in transaxial dimension (series 5, image 32) which displaces the left parapharyngeal space posteromedially and resultant effacement/stranding of adjacent deep space fatty planes. This also extends to, and is associated with, a more focal yet non-discrete hypodensity in the left peritonsillar region with rim enhancement measuring 8 x 13 mm (series 5, image 35). An additional hypoattenuating focus is noted just inferiorly which measures 10 x 14 mm (series 5, image 39). The also extends superficially causing a stranding of the fat planes around the muscles of mastication and extending into the subcutaneous tissues (most prominently seen series 5, image 32). The process results in rightward shift of the adjacent airway which remains patent. There two enlarged, enhancing, non-centrally necrotic lymph nodes in left level IIb stations.The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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1.Extensive process involving the deep tissues of the left neck with an appearance most suggestive of multifocal phlegmon and cellulitis which may have arisen from left maxillary molar caries/periapical abscesses. This process does extend superficially to involve the subcutaneous tissues. Although the airway is displaced rightward, it remains patent.2.Given patient age of 47 years, repeat imaging is recommended to ensure resolution and to exclude any potential underlying neoplastic process.
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Generate impression based on findings.
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Female, 82 years old, with stridor at outside hospital, mild respiratory distress at UCMC, assess mass compressing trachea. The left lobe of the thyroid is replaced by a large, heterogeneous mass containing perhaps a few calcifications which measures at least 66 x 51 mm transaxial and 110 mm craniocaudal. This lesion extends substernally into the superior mediastinum where it splays and/or displaces the great vessels. It exerts significant mass effect upon the adjacent trachea which is deviated towards the right and narrowed to a minimum diameter of 5 mm. Although not as abnormal as the left, the right thyroid lobe is also prominent and slightly heterogeneous as well.Anterior to the trachea, a nodule of tissue is present with attenuation similar to that of adjacent thyroid measuring 19 x 16 mm (image 47 series 5). It is difficult to tell if this lesion is contiguous with or separate from the thyroid and associated thyroid mass.Elsewhere, no definite pathologic adenopathy is detected in the neck by size criteria. The salivary glands are free of focal lesions. Although displaced by the thyroid process significantly, the vessels of the neck remain patent and enhance normally. Retropharyngeal course of the ICAs is noted incidentally. Lung apices are clear. No concerning osseous lesions are detected. Multilevel cervical spondylosis is noted with a grade 1 anterolisthesis of C4 relative to C5.
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A large, heterogeneous masslike process replaces the left thyroid lobe with substernal extension into the mediastinum. Although not as significantly abnormal as the left, the right lobe of the thyroid is also enlarged and slightly heterogeneous.A nodule of tissue anterior to the trachea and similar in appearance to thyroid may represent contiguous enlargement of the gland or a discrete nodule. Elsewhere in the neck no definite pathologic adenopathy is seen.The differential diagnosis includes thyroid neoplasm as well as benign thyroid goiter.
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Generate impression based on findings.
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Reason: fall, hit head History: no new focal deficits The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present.The visualized portions of the paranasal sinuses demonstrate a mucus retention cyst in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1.No evidence for acute intracranial hemorrhage mass effect or edema. There is no interval change since the prior exam from yesterday.2.There are periventricular white matter hypodensities present which are known to the related to the patient's demyelinating disorder. Please refer to recent MRI for more comments.
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Generate impression based on findings.
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63-year-old female with concern for pulmonary edema versus pneumothorax versus aspiration in patient with known interstitial lung disease and pulmonary hypertension, also concern for small bowel obstruction. Within the limits of a non-IV contrast enhanced examination which limits the ability to evaluate vascular structures and solid parenchymal organs, the following observations can be made:CHEST:LUNGS AND PLEURA: Diffuse changes of emphysema with chronic basilar interstitial lung disease. Focal wedge-shaped airspace consolidation is seen in the lateral aspect of the right middle lobe (series 4, image 60) and differential diagnosis would include infection, embolic disease or aspiration. No other foci of airspace disease seen. Trace small pleural effusion seen in the right base with bibasilar atelectasis /scarring. No pleural effusions or pleural disease noted.MEDIASTINUM AND HILA: No adenopathy or masses seen. Central venous catheter line with tip of the catheter in the right atrium. Enlarged right atrium and right ventricle. Small pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted in liver parenchyma, the lack of IV contrast markedly limits evaluation. Patient status post cholecystectomy with no other biliary tract complication or abnormality seen..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: Diffuse atherosclerotic calcifications in the aorta without other abnormality in the vascular tree limited by lack of non-IV contrast. No no adenopathy, masses or other significant abnormality noted.BOWEL, MESENTERY: Lack of oral contrast limits ability to evaluate intestinal tract. No dilatation seen to suggest obstruction. Small amount of free peritoneal fluid is seen about the liver and in the dependent pelvis without loculation, and is of uncertain etiology.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Lack of oral contrast limits ability to evaluate intestinal tract. No dilatation seen to suggest obstruction. Small amount of free peritoneal fluid is seen about the liver and in the dependent pelvis without loculation, and is of uncertain etiology.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Emphysematous changes along with chronic interstitial changes at lung bases. 2. Focal wedge-shaped consolidation in lateral aspect of right middle lobe, nonspecific with differential of infection, aspiration or vascular embolic disease. 3. Trace pleural effusion and right lung base. Number 4. Small pericardial effusion. 5. Small amount of free peritoneal fluid of uncertain significance.
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Generate impression based on findings.
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16-year-old male with fifth metacarpal painVIEWS: Left hand PA/oblique/lateral (3 views) 01/18/15 No acute fracture or malalignment is evident. Soft tissue welling over the 5th metacarpal head. Normal exaggeration of the pitlike depression in the head of the 5th metacarpal.
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Soft tissue swelling over the 5th metacarpal head without evidence of acute fracture or malalignment.
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Generate impression based on findings.
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Male; 89 years old. Reason: rule out pe History: sob PULMONARY ARTERIES: No acute pulmonary embolus. Normal caliber of the main pulmonary artery. No evidence of right heart strain.LUNGS AND PLEURA: Severe emphysema. Patchy and nodular opacities in a centrilobular distribution in both lower lobes with moderate atelectasis/consolidation of the left lower lobe, suspicious for infection. There is also atelectasis of the right middle lobe. Small pleural effusions.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Mild coronary artery calcifications. Single nonspecific enlarged right hilar lymph node measures 10 mm (image 169, series 7).CHEST WALL: Right PICC tip in the right subclavian vein.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. No acute pulmonary embolus.2. Bibasilar nodular opacities and multifocal atelectasis suspicious for infection or aspirate. These should be followed to resolution to exclude malignancy as an underlying mass could be obscured.3. Severe emphysema.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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44-year-old male with right upper quadrant pain. Evaluate. ABDOMEN:LUNG BASES: Interval resolution of bilateral pleural effusions. Mild right basilar atelectasis.LIVER, BILIARY TRACT: Interval placement of percutaneous cholecystostomy tube with metallic marker within the region of the gallbladder. The gallbladder is collapsed without evidence of pericholecystic fluid collections. 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 findings to suggest small bowel obstruction or colitis. Trace pelvic fluid again identified.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 findings to suggest small bowel obstruction or colitis. Trace pelvic fluid again identified.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Interval placement of percutaneous cholecystostomy tube with a collapsed gallbladder. No loculated fluid collections. 2.No specific findings to account for patient's pain.
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Generate impression based on findings.
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23-year-old female with left-sided abdominal pain, cervical motion tenderness. Evaluate for appendicitis, diverticulitis, signs of PID. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Normal right kidney. Bifid left kidney with two separate collecting systems, with superior pole with normal orientation and lower pole with rotation and external oriented pelvis. Lack of delayed imaging does not afford opacification of the ureters to evaluate anatomy of the ureteral system. No abnormal masses are seen in either kidney and no hydronephrosis or calcifications are seen as a potential cause of pain. No perinephric fluid collections are seen.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted in the stomach, small bowel or colon. The appendix is not definitely visualized, however no abnormal mesenteric changes, fluid collections or wall thickening of bowel is seen in the right lower quadrant to suggest inflammation..BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Small amount of lower density presumed fluid in the endometrial cavity, which while nonspecific, are most often seen with physiologic changes in female patient's of this age. No abnormal mural changes are seen uterus and no adnexal abnormal fluid collections are seen. No free peritoneal fluid.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality noted in the small bowel or colon. The appendix is not definitely visualized, however no abnormal mesenteric changes, fluid collections or wall thickening of bowel is seen in the right lower quadrant to suggest inflammation..BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Benign congenital abnormality in the left kidney, incompletely evaluated. 2. Small amount of low-density fluid in the endometrial cavity, most often this represents physiologic changes in a female patient of this age. 3. No other abnormality seen.
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Generate impression based on findings.
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56 year old male with history of pancreatitis, pseudocyst and rapid rise in white blood cell count Please note lack of IV contrast limits evaluation of solid organ pathology.ABDOMEN:LUNG BASES: Small left pleural effusion and bibasilar subsegmental atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Diffusely enlarged pancreas with extensive peripancreatic/upper abdomen mesenteric edema and free fluid consistent with given history of acute pancreatitis. No definite loculated fluid. Unable to assess extent of pancreatic necrosis given lack of intravenous contrast, however no frank liquefaction is seen. No gas foci are visualized.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate bilateral hyperattenuating foci in the renal parenchyma and pelvis, may represent nonobstructing nephrolithiasis. Mild bilateral perinephric stranding.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Few colonic diverticuli.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter in place, and the bladder is decompressed.LYMPH 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.Enlarged pancreas with marked retroperitoneal fluid consistent with acute pancreatitis.2.Small amount of intraperitoneal ascites.
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Generate impression based on findings.
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ConstipationVIEW: Abdomen AP 1/19/15 Disorganized nonobstructive bowel gas pattern. No abnormal dilated loops of bowel. No pneumatosis or pneumoperitoneum. Patchy atelectasis right lower lobe.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Four month old male with severe pulmonary hypertension, status post intubation.VIEW: Chest AP (one view) 1/19/2015, 14:59 The endotracheal tube tip is below the thoracic inlet above the carina. The nasogastric tube tip is within the body of the stomach with the side port below the GE junction.New right upper lobe atelectasis is present. Unchanged chronic lung disease. The cardiothymic silhouette is normal.
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New right upper lobe atelectasis.
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Generate impression based on findings.
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Intracerebral hemorrhage, assess ventricle size and bleed. There is a intraparenchymal hematoma centered at the left thalamus measuring 2.6 x 4.0 and approximately 3.7 cm in the craniocaudal dimension. There is surrounding edema. Again seen is intraventricular extension with hemorrhage including the lateral, third, and fourth ventricles. There is slight increase in rightward midline shift measuring up to 8 mm the level of the third ventricle.No significant change in ventricular dilatation with unchanged position of right transfrontal ventriculostomy with its tip in the right inferior frontal horn near the foramen of Monroe. There is diffuse sulcal effacement suggestive of elevated intracranial pressures. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. Secretions are seen filling the nasopharynx.
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1. Slight interval enlargement of intraparenchymal hematoma centered at the left thalamus with intraventricular extension. There is slight increase in rightward midline shift. Diffuse sulcal effacement again seen suggestive of elevated intracranial pressures.2. Unchanged dilatation of the ventricular system. Right frontal EVD remains in place.
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Generate impression based on findings.
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History of bowel obstructionVIEW: Abdomen AP 1/19/15 NG tube tip in the stomach. Multiple surgical sutures at the right lower quadrant. There are two radiopaque densities projected over the left midline of the abdomen likely to represent postoperative changes. The previously noted dilated loops of bowel have resolved. The upper abdomen is not included in this radiograph. Within this limitation no definite free intraperitoneal air.
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The upper abdomen is not included in the radiograph and within this limitation no definite free intraperitoneal air.
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Generate impression based on findings.
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60 year-old male with left upper quadrant abdominal pain. Obstruction versus colitis. Within the limits of a non-IV contrast enhanced examination, limiting the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made:ABDOMEN:LUNG BASES: Bibasilar atelectasis without other abnormality.LIVER, BILIARY TRACT: Patient is status post cholecystectomy without other biliary tract abnormality. Limited evaluation liver shows no other abnormalities.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral atrophic native kidneys with diffuse calcifications, most of which represent punctate calyceal nonobstructing stones seen on prior examinations. Right lower quadrant pelvis transplant kidney without abnormality seen, limited by lack of IV contrast.RETROPERITONEUM, LYMPH NODES: IVC filter again noted unchanged in position or appearance.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Two abdominal anterior ventral wall hernias containing only mesenteric fat. A third umbilical ventral hernia seen described in pelvic section below.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: Second more inferior anterior abdominal wall, umbilical ventral hernia containing only mesenteric fat, unchanged. Left inguinal hernia containing only mesenteric fat.OTHER: No significant abnormality noted
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1. Atrophic native kidneys with nonobstructing calyceal calculus unchanged since 3/15/14 CT examination. 2. Right iliac fossa transplant kidney unchanged in position or appearance without evident complication seen. 3. Three anterior abdominal wall ventral hernia is unchanged. 4. Left inguinal hernia containing only mesenteric fat unchanged. 5. No abnormalities otherwise seen.
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Generate impression based on findings.
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Four month old male born prematurely, status-post intubation.VIEW: Chest AP (one view) 1/18/2015, 16:51 Interval intubation with the endotracheal tube tip below the thoracic inlet and above the carina. Additionally, there has been interval placement of an enteric feeding tube with the tip terminating in the body of the stomach.Improved right basilar atelectasis, on a background of unchanged chronic lung disease The cardiothymic silhouette is normal.
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Interval intubation. Improved right basilar atelectasis.
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Generate impression based on findings.
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Reason: Dx Esophageal cancer History: Evalaute disease/ chck for progression/compare CHEST:LUNGS AND PLEURA: Interval increase in bilateral pulmonary nodules. Reference right middle lobe nodule (image 46/110) now measures 15 mm previously measuring 12 mm.Reference left lower lobe subpleural nodule (image 54/110) now measures 19 mm previously measuring 16 mm.MEDIASTINUM AND HILA: Right paraesophageal lymph node has increased in size (image 61/155) now measuring 4.8 x 2.7 cm, 3.5 cm x 2.2 cm on previous with continued further extension within the mediastinum of the paraesophageal tumor. Other intrathoracic nodes have also increased.Right chest Port-A-Cath with its tip in the SVC. Small amount of fibrin sheath or nonocclusive thrombus around the tip.Moderate coronary artery calcification.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: AtrophicRETROPERITONEUM, LYMPH NODES: Small abdominal nodes are unchanged.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Continued increase in pulmonary nodules and intrathoracic lymphadenopathy.
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Generate impression based on findings.
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ET placementVIEW: Chest AP 1/19/15 ET tube, NG tube, gastrostomy tube and right chest tube again noted. The sidehole of the right chest tube is within the subcutaneous tissue. Cardiothymic silhouette normal. Patchy atelectasis in the right lung and left lower lobe not significantly changed. There is bilateral small pleural effusions not significantly changed.
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Bilateral atelectasis and small pleural effusions not significantly changed.
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Generate impression based on findings.
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34-year-old female who is status post D&C. Evaluate for abscess. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No focal hepatic lesions. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Lobulated appearance of the kidneys with cortical thinning bilaterally is nonspecific but likely postinflammatory in etiology. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a small sized small bowel-containing ventral hernia without evidence of small bowel obstruction. No findings to suggest colitis.BONES, SOFT TISSUES: No significant abnormality.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Enlarged, heterogeneous, enhancing uterus is nonspecific and may be secondary to recent post procedural edema; however, differential considerations include fibroid uterus versus inflammatory disease. No loculated fluid collections to suggest an abscess. Small amount of free pelvic fluid which may be physiologic or postprocedural in etiology.BLADDER: Moderately distended bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is a small sized small bowel-containing ventral hernia without evidence of small bowel obstruction. No findings to suggest colitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Enlarged, heterogeneous, enhancing uterus is nonspecific and may be secondary to recent post procedural edema; however, differential considerations include fibroid uterus versus inflammatory disease. 2.No loculated fluid collections to suggest an abscess as clinically questioned. 3.Bilateral renal cortical thinning is nonspecific but most likely postinflammatory in etiology.
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Generate impression based on findings.
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Four month old male with respiratory distress syndrome and desaturations.VIEW: Chest AP (one view) 1/18/2015 14:44 The enteric feeding tube has been removed. There is persistent right basilar atelectasis, on a background of chronic lung disease. The cardiothymic silhouette is normal. No pleural effusion or pneumothorax is evident.
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Chronic lung disease with associated right basilar atelectasis.
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Generate impression based on findings.
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Respiratory distressVIEW: Chest AP 1/19/15 Cardiothymic silhouette normal. Minimal peribronchial wall thickening with subsegmental atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax.
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Bronchiolitis or reactive airway disease.
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Generate impression based on findings.
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37 years old. History of left lumpectomy in 2007 for invasive ductal carcinoma and DCIS. Patient has received radiation, chemotherapy and hormonal therapy. No new breast complaints. Three standard views of both breasts were performed digitally with an additional lateral exaggerated left CC view and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the left breast. The postsurgical architectural distortion in the lumpectomy bed is stable.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Stable postsurgical changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient. The patient had her annual MRI today, and that will be separately dictated. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Male; 63 years old. Reason: s/p stenting of esophageal perforation, please assess fluid/air in chest cavity History: SOB, back pain CHEST:LUNGS AND PLEURA: Moderate right and small left pleural effusions with adjacent bibasilar atelectasis/consolidation. Left chest tube in place with tip in the superior aspect of the major fissure; the tube likely courses through the parenchyma of the left upper lobe. Trace residual pneumothorax anteriorly at the base. A few scattered groundglass opacities in the left upper lobe are most likely post infectious or inflammatory in etiology.MEDIASTINUM AND HILA: Metallic distal esophageal wall stent in place with a clip near the GE junction. Small amount of pneumomediastinum to the right of the distal esophagus. Normal heart size without pericardial effusion. No visible coronary artery calcifications. Endotracheal tube in place.CHEST WALL: Minimal left chest wall subcutaneous emphysema related to chest tube placement. Benign-appearing left axillary lipoma measuring up to 6.5 x 5.3 cm (image 16, series 3).ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No focal liver lesions. High density within the gallbladder, likely due to vicarious excretion of IV contrast material from prior outside imaging.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small cysts in the right kidney. Additional bilateral renal hypoattenuating lesions are too small to characterize.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Status post distal esophageal clipping and stent placement. Mild pneumomediastinum.2. Moderate right and small left pleural effusions with adjacent bibasilar atelectasis/consolidation. Left chest tube in place with tip in the superior aspect of the major fissure; the tube likely courses through the parenchyma of the left upper lobe. Trace residual pneumothorax anteriorly at the base. A few scattered groundglass opacities in the left upper lobe are most likely post infectious or inflammatory in etiology..
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Generate impression based on findings.
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78 years, Male. Reason: s/p dobhoff History: as above Dobhoff tube tip in the gastric body. Nonobstructive bowel gas pattern. Average stool burden with stool predominantly located in the proximal colon and rectum. Left hip intramedullary nail partially imaged.
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Dobhoff tube tip in the gastric body.
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Generate impression based on findings.
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Redemonstrated is an unchanged left cerebral convexity mixed attenuation subdural hematoma that measures up to 15 mm in width with layering hyperattenuated blood products and associated unchanged 8 mm shift of the septum pellucidum to the right and unchanged subfalcine and uncal herniation. There is no evidence of new intracranial hemorrhage. There is unchanged right subinsular ovoid hypoattenuating focus. The ventricles and basal cisterns are unchanged. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No significant change in the heterogeneous left cerebral convexity subdural hematoma with 8 mm midline shift.
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Generate impression based on findings.
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Evaluate pleural effusionVIEW: Chest AP 1/18/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Left PICC and left chest tube again noted. Cardiothymic silhouette normal. Patchy atelectasis in the right upper lobe. No pleural effusion or pneumothorax.
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Minimal patchy atelectasis in the right upper lobe.
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Generate impression based on findings.
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80 years, Female. Reason: NGT placement History: Hematemesis NG tube exchanged for Dobhoff with tip in the gastric body. Nonobstructive bowel gas pattern. Surgical staples. Arterial calcifications.
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NG tube tip in the gastric body.
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Generate impression based on findings.
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Male, 39 years old, left submandibular abscess with fistula to the left lower dental abscess. A rim enhancing, centrally hypoattenuating collection is evident within the left submandibular space measuring 27 x 24 mm. This collection seems to connect via a cortical defect in the mandible to the alveoli of the left first and second mandibular molars which show evidence of erosion and periapical lucency.Numerous additional mandibular and maxillary teeth are affected by erosion and peri-apical lucency. No other destructive osseous lesions are seen. Mucosal thickening is evident within the right maxillary sinus and the sinus walls are themselves thickened and sclerotic.The right palatine tonsil is thickened relative to the left and contains a coarse calcification. No discrete masses are seen in the aerodigestive mucosa.No pathologically enlarged lymph nodes are evident in the neck. The salivary glands and the thyroid are free of focal lesions. Cervical vessels enhance normally. Paraseptal emphysema is evident in the visualized lungs.
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1. Left submandibular space abscess likely arising from dental infection within the adjacent mandibular alveoli.2. Asymmetric thickening of the right palatine tonsil may be inflammatory or even a normal variation. Correlation with direct visualization is suggested.3. Paraseptal emphysema.
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Generate impression based on findings.
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Reason: h/o lung ca, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Reference right upper lobe mass has not significantly changed measuring 38 x 20 mm on image 38/90 (28 x 21 mm on prior. The prior report indicates that this measured 28 x 21 mm please note that the actual measurement is 38 x 21 mm as shown on the annotated images.Interval increase in pulmonary nodule posterior to the bronchus in the superior segment of the right lower lobe measuring 14 mm on image 38/90 (10 mm in prior image 41/100).No significant change in right-sided pleural thickening and effusion with compressive atelectasis and peripheral scarlike opacities.MEDIASTINUM AND HILA: No pathologically enlarged nodes.CHEST WALL: Degenerative change involving the spine with punctate sclerotic focus in T12 unchanged. Small axillary lymph nodes are unchangedABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative change involving the spine with L1 partial collapse and punctate sclerotic focus in T12 unchanged.OTHER: No significant abnormality noted.
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1. Stable reference mass in right upper lobe and perihilar area. Interval increase in a non reference right lower lobe nodule.2. Stable right sided pleural thickening and effusion.
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Generate impression based on findings.
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Interval evacuation of the left cerebral convexity subdural hematoma via two Burr holes. There remains primarily hypodense extra-axial fluid as well as pneumocephalus. Mass effect has significantly decreased, with midline shift now measuring 3 mm (previously 8 mm) and improved medialization of the left uncus. Expected overlying soft tissue changes are noted including skin staples. There is no evidence of new intracranial hemorrhage. There is unchanged right subinsular ovoid hypoattenuating focus. The imaged paranasal sinuses and mastoid air cells are clear.
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Expected changes from interval evacuation of a left cerebral convexity subdural hematoma.
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Generate impression based on findings.
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TachypneaVIEW: Chest AP 1/18/15 Feeding tube, left central line and IVC stent again noted. Multiple surgical sutures project over the right upper quadrant. Cardiothymic silhouette normal. Patchy atelectasis in the left upper lobe and left lower lobe not significantly changed. No pleural effusion or pneumothorax.
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Patchy atelectasis left lung unchanged.
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Generate impression based on findings.
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Ms. Gounari is a 54 year old female with a personal history of left breast mastectomy in 2006 followed by chemotherapy and tamoxifen therapy. She has no current breast related complaints Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Few scattered benign calcifications are present. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in the right breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
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