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Generate impression based on findings.
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Female, 45 years old, status-post fall. Head:At most, there is minimal nonspecific periventricular hypoattenuation. No intracranial hemorrhage or abnormal extra-axial fluid is seen. There is no evidence of mass effect or parenchymal edema. The ventricular system is normal in size and morphology. The visualized paranasal sinuses and mastoid air cells are clear. The bones of the calvarium and skull base are intact. Right supraorbital soft tissue swelling is noted.C-spine:No evidence of fracture or dislocation is seen. Vertebral body height is within normal limits. The cervical lordosis is straightened which may be positional.There is a subcentimeter region of sclerosis within the left aspect of the posterior C7 vertebral body, as well as a similarly sized lucent lesion on the opposite side of the vertebral body with thinning of the overlying cortex. The thyroid is heterogeneous and the right lobe contains a hypoattenuating lesion with a coarse calcification.Multilevel cervical spondylosis is identified. This includes disk osteophyte complexes at C3-4, C4-5 and C5-6 which result in mild central canal effacement. At C6-7, disk osteophyte formation is evident along with a superiorly directed central extrusion which results in mild to moderate spinal canal narrowing and possibly some impingement of the cord itself.
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1. No acute intracranial abnormality.2. No traumatic cervical spine abnormality.3. Subcentimeter lesions are evident within the posterior aspect of the C7 vertebral body, one of which is sclerotic while the other is lucent with associated thinning of the adjacent cortex. These are nonspecific and may reflect a benign process. However, the possibility of metastatic disease needs to be considered and excluded. Review of risk factors and the results of screening exams should be made. Additional imaging to better characterize these lesions and detect any possible additional lesions would include MRI and/or nuclear medicine bone scanning.4. A hypoattenuating lesion is seen within the right thyroid lobe for which further evaluation via dedicated thyroid sonography should be considered as clinically warranted.
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Generate impression based on findings.
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Leg pain Interval moderate degenerative changes scattered throughout the lumbar spine with relative preservation of L2-3 and changes most pronounced involving L5-S1. Specifically minimal antero-listhesis of L3 on 4 is observed with otherwise unremarkable alignment above and below. No evidence of instability on flexion and extension. Preservation vertebral body heights
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Moderate degenerative changes with associated antero-listhesis. See detail provided
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Generate impression based on findings.
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T2N1 esophageal carcinoma status post chemotherapy and radiotherapy completed August 2013. There is no evidence of measurable esophageal mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. There is mild mucosal thickening in the maxillary sinuses. The left lateral neck cutaneous skin lesion has further decreased in size. There is radiation fibrosis in the medial lung apices. There are also patchy opacities in the periphery of the right lung.
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1. No evidence of measurable esophageal mass lesions or significant cervical lymphadenopathy. 2. Patchy opacities in the periphery of the right lung may be related to aspiration. Please refer to the separate chest CT report for additional details.
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Generate impression based on findings.
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63-year-old female with history of metastatic breast cancer on treatment. Compare to prior imaging evaluate for response and extent of disease. Again seen are foci of increased or tracer uptake within the body of the sternum and right lateral sixth rib, unchanged.Previously seen increased uptake in the right mandible likely related to periodontal disease is also unchanged. Increased activity in the area of the left breast is also unchanged.Degenerative changes involving the cervical spine, first CMC joints, and bilateral knees are again noted.No new foci of increased tracer uptake.
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Stable osseous metastases. No new sites of disease.
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Generate impression based on findings.
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Pancreatic protocol CT needed for assessment of cholangitis/abscess. ABDOMEN:LUNG BASES: Scarring and atelectasis at the right lung base without other abnormality notedLIVER, BILIARY TRACT: Interval placement of large-bore biliary stent traversing the head of the pancreas with expected pneumobilia proximally. Gallstones are seen in the gallbladder without other complication. Liver parenchyma is homogeneous without significant abnormal mass lesion (there is a small subcentimeter benign cyst in segment 4 superiorly (series 11, image 28) as seen on the prior MR). Hepatic vasculature appears normal. No evidence of any abnormal biliary duct wall thickening is seen to suggest cholangitis and no evidence for any peri-biliary abscesses in the liver are seen.SPLEEN: No significant abnormality notedPANCREAS: Large-bore stent traverses through the head of the pancreas as described above. Enlarged head of the pancreas is again seen (series 11, image 57) slightly increased measuring 4.6 x 2 .9 cm, where part of this increase is due to fluid collections both medially and laterally which may reflect a separate inflammatory process. Pancreatic head shows combination of solid and cystic components -- some of which reflect obstructed and pancreatic ducts. More proximal pancreatic duct through the body and tail again remains dilated. Pancreas itself more proximally also shows increased size with peri-pancreatic fat infiltration most likely representing changes of pancreatitis. More solid parenchyma is seen about the body and tail of the pancreas particularly posteriorly in the body (series 11, image 46) where a rounded increase in parenchymal density is seen measuring 2.0 x 2.6 cm. This is unlikely to represent tumor as it is occurred so rapidly since December 18, 2014 and most likely reflects some inflammatory changes.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Benign renal cysts are again seen without other abnormalityRETROPERITONEUM, LYMPH NODES: Enlarged anterior pancreaticoduodenal lymph node (series 11, image 41) measuring 1.8 by 1.5 cm, new since 12/18/14. Scattered other smaller subcentimeter lymph nodes are again seen unchanged.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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1. Insertion of large-bore biliary stent through the pancreatic head. 2. Pancreatic head mass again seen with dilatation of proximal pancreatic duct from obstruction. 3. Increasing densities of pancreatic tissue and increased peripancreatic fluid changes from pancreatitis -- no peri-pancreatic discrete fluid collections are seen. 4. Slight enlargement of anterior pancreaticoduodenal lymph node new since 12/18/14. 5. Gallstones without other gallbladder complication. 6. No evidence of peribiliary abscess or thickened bile duct walls to suggest cholangitis, however there absence does not preclude cholangitis.
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Generate impression based on findings.
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There post-treatment findings in the neck, including epiglottis resection, total thyroidectomy, and bilateral cervical lymph node dissection. There is persistent thickening of the supraglottic mucosal tissues without evidence of a measurable tumor. There is also no evidence of a mass in the thyroidectomy bed. There is no significant cervical lymphadenopathy. The parotid and submandibular glands are unremarkable. The cervical vasculature is patent. Moderate degenerative changes affect the cervical spine, predominantly at C5-6 and C6-7. The paranasal sinuses, mastoid air cells, and intracranial contents are unremarkable. There are mild ground glass opacities at the lung apices that are likely related to atelectasis.
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Post-treatment changes in the neck without discernible evidence of tumor recurrence or significant lymphadenopathy in the neck.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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55-year-old male with known Crohn's colitis with a long narrowing in the transverse and descending colon. Evaluate. ABDOMEN:LUNG BASES: Mild bilateral basilar atelectasis.LIVER, BILIARY TRACT: Segment 7 hypoattenuating lesion consistent with a cyst is stable. Two additional subcentimeter hypoattenuating lesions in the liver are too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: There is straightening and loss of haustral pattern of long segment of the transverse and descending colon which is not significantly changed compared to the prior MR examination. No circumferential mass lesions identified. No apparent enhancement or colonic wall thickening to suggest acute colitis. No evidence of small bowel obstruction.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: There is straightening and loss of haustral pattern of long segment of the transverse and descending colon which is not significantly changed compared to the prior MR examination. No circumferential mass lesions identified. No apparent enhancement or colonic wall thickening to suggest acute colitis. No evidence of small bowel obstruction.BONES, SOFT TISSUES: Left femoral head avascular necrosis is again noted.OTHER: No significant abnormality noted
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1.Chronic inflammatory changes involving the transverse and descending colon are unchanged in distribution, consistent with history of inflammatory bowel disease. 2.Left femoral head avascular necrosis.
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Generate impression based on findings.
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50 years, Female. Reason: Wegner's Granulomatosis on pred. with possible pill cam retention History: watery stools, hematemesis, melena Examination of the periphery is limited by patient body habitus. Diaphragm is out of field of view. Within this limitation, no camera pill is identified. Nonobstructive bowel gas pattern. Moderate stool burden. Surgical clips noted overlying L4 vertebral body and RLQ.
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Examination of the periphery and under the diaphragm is limited by patient body habitus. Within this limitation, no camera pill is identified. Nonobstructive bowel gas pattern. Moderate stool burden.
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Generate impression based on findings.
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34-year-old female, evaluate sagittal balance Moderate to severe degenerative disk disease affects L4/5. There is approximately 2 cm negative sagittal balance and approximately 3 cm negative coronal balance. No focal vertebral body anomalies are identified. There is minimal leftward cervicothoracic curvature and minimal rightward lumbar curvature with no measurable scoliosis.
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Negative sagittal and coronal balance and degenerative disk disease as described above.
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Generate impression based on findings.
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19 year-old male with swelling There is a comminuted, but predominately transverse fracture of the base of the fifth metacarpal with mild posterior displacement of the distal fragment. Overlying soft tissue swelling is noted.
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Base of the fifth metacarpal fracture as described above.
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Generate impression based on findings.
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Reason: 53 y/o woman with metastatic breast cancer receiving chemotherapy. Evaluate treatment response and extent of disease. History: Chronic abdominal pain in the RUQ and epigastrium. CHEST:LUNGS AND PLEURA: Subpleural fibrosis anteriorly on the right consistent with prior radiation therapy. Relatively hyperlucent left lower lobe with low-attenuation tubular branching structures most likely representing congenital bronchial atresia, unchanged. No suspicious pulmonary nodules. Lingular scarring and atelectasis unchanged.MEDIASTINUM AND HILA: Left jugular chest port tip at the SVC/RA junction. CHEST WALL: Sclerotic lesions and lower thoracic spine unchanged. Post op change right breast.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Biliary stents with pneumobilia. No suspicious hepatic lesions.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable presumed right renal cyst.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: Unchanged osseous sclerotic lesions in the left ilium and lumbar spine. OTHER: No significant abnormality noted.
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Stable skeletal lesions. No new sites of disease.
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Generate impression based on findings.
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69-year-old male with history of cholangiocarcinoma status post resection. Evaluate for new abnormalities or recurrence. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable postoperative findings of partial right hepatectomy, and cholecystectomy, without interval change. No new masses or findings of neoplastic recurrence. A wedge-shaped, subcapsular focus of arterial enhancement, of doubtful clinical significance, is likely vascular in etiology.SPLEEN: No significant abnormality notedPANCREAS: Hypoattenuating foci in the pancreatic head and body are unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis.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: Mild hydrocele, and unchanged right scrotolith.
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Stable postoperative findings of right hepatectomy without evidence of tumor recurrence.
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Generate impression based on findings.
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58 years, Male. Reason: R/O bowel obstruction History: bowel assessment for PEG placement No evidence of free air. Gaseous distention of bowel at right abdomen. Colon is filled with desiccated stool. No definite evidence of obstruction.
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No evidence of free air. No definite evidence of obstruction.
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Generate impression based on findings.
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76-year-old female with recent craniotomy and removal of right meningioma, currently with headache. Postsurgical findings related to recent bicoronal craniotomy and resection of large right frontal meningioma, including: air, blood products, and surgical packing material subadjacent to the craniotomy site. Heterogeneous hypodensity, predominantly in the right frontal lobe, compatible with edema, which was also present on recent MR exam. There has been interval expansion of the anterior horn of the right lateral ventricle, which was previously effaced by tumor. There is mild residual deformity of the right frontal lobe. A small amount of blood tracks along the falx. A small amount of subarachnoid blood is noted bilaterally. There is trace residual midline shift to the left. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminant small vessel ischemic changes.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarial screws/fixation hardware, subgaleal drain, a small subgaleal hematoma, and scalp staples are noted.
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Postsurgical changes related to recent craniotomy and resection of large right frontal meningioma, including: subadjacent pneumocephalus, blood products, and surgical packing material. Residual edema and mild deformity of the right frontal lobe. Mild subarachnoid hemorrhage and small amount of blood tracks along the falx. Trace residual midline shift, which has improved since the preoperative imaging.
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Generate impression based on findings.
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13-year-old male status trauma secondary to motor vehicle accident, evaluate for aortic injury. CHEST:ANGIOGRAM: The great vessels of the chest demonstrate normal caliber, and are without evidence of dissection or submural hematoma. There arch demonstrates conventional anatomy, as does the celiac axis. The peripheral vasculature is well opacified compatible with appropriate blood flow. No active hemorrhage is identified.LUNGS AND PLEURA: No focal air space opacity, pleural effusion or pneumothorax is evident.MEDIASTINUM AND HILA: A single enlarged right hilar node is identified measuring 1.2 x 1.4 cm (image 107, series 5), which is nonspecific. The trachea and mainstem bronchi are patent. No pneumomediastinum is seen.CHEST WALL: No significant abnormality notedABDOMEN:ANGIOGRAM: The great vessels of the chest demonstrate normal caliber, and are without evidence of dissection or submural hematoma. There arch demonstrates conventional anatomy, as does the celiac axis. The peripheral vasculature is well opacified compatible with appropriate blood flow. No active hemorrhage is identified.LIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral duplicated renal collecting systems are seen, without evidence of obstruction.RETROPERITONEUM, LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Single enlarged left upper quadrant mesenteric lymph node measures 1.0 x 1.4 cm (image 329, series 5), which demonstrates a normal fatty hilum. Cluster of adjacent mesenteric lymph nodes noted size criteria for lymphadenopathy.BONES, SOFT TISSUES: Screws are again seen affixing the bilateral sacroiliac joints with associated heterotopic ossification. Focal skin thickening and an infiltration of the subcutaneous fat along the right lateral lower abdominal wall likely reflects postsurgical scarring.
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1.No evidence of aortic injury as clinically questioned.2.Bilateral duplicated renal collecting systems, without evidence of obstruction.
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Generate impression based on findings.
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Male 11 years old; Reason: renal artery aneurysm History: left renal artery aneurysm The posterior abdominal radionuclide angiogram demonstrates prompt, symmetrical perfusion of the kidneys. Cortical phase images show the kidneys to be of normal size and morphology. There is prompt uptake of the radiopharmaceutical by both kidneys. Excretory phase images show mild delayed excretion of the radiotracer by the left kidney in comparison with the right. On postprocessing images, the estimated contribution of the right kidney to total renal function is 54.9% and that of the left kidney is 45.1%. There are no abnormalities of the ureters or bladder.
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Normal renal perfusion and morphology. There is mild relative delay in excretion of the left kidney, which may be related to patient's known left renal artery aneurysm.
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Generate impression based on findings.
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68-year-old male with shortness of breath. Evaluate for pulmonary embolism. PULMONARY ARTERIES: Large bilateral central pulmonary emboli with associated right ventricular strain.LUNGS AND PLEURA: Left upper lobe micronodule measuring up to 4 mm (series 12, image 71). No focal lung opacity or pleural effusion.MEDIASTINUM AND HILA: Moderate atherosclerotic changes of the aorta with moderate coronary artery calcifications. No hilar or mediastinal lymphadenopathy.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Large bilateral central pulmonary emboli with right ventricular strain.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Main.RV Strain: Positive.
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Generate impression based on findings.
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Three day old former 27 to 28 week gestational age patient with PICC placement.VIEW: Chest AP (one view) 01/19/15, 1322 Left upper extremity PICC has its tip superior to C4. Feeding tube tip is in stomach and side-port is at GE junction. Umbilical venous line tip is in right atrium.Coarse bilateral lung opacities are noted. Lung volumes are large. Cardiac silhouette size is normal.
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PICC tip is not located centrally. Coarse bilateral lung opacities.
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Generate impression based on findings.
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Ankle painVIEWS: Left ankle AP, oblique and lateral No acute fracture or dislocation. The ankle mortise joint is normal. No joint effusion noted.
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Normal examination.
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Generate impression based on findings.
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42 year-old with metastatic neuroendocrine cancer. Please evaluate for interval change. Conversation with the clinical service, patient with history of intraluminal tumor extending from it the ileocecal valve and proximally involving long segment of the terminal ileum. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Multiple hepatic lesions consistent with metastatic disease are again noted.Reference segment 3 arterially enhancing focus measures 0.6 x 0.6 cm (series 6, image 49), previously measuring 0.6 x 0.4 mm.Reference segment IVb arterially enhancing lesion measures 1.3 x 1.3 cm (series 6, image 48), previously measuring 1.4 x 1.4 cm.no new arterially enhancing lesions.Several predominantly hypoattenuating hepatic lesions are again noted, which are also consistent with metastatic disease.Reference segment IVb lesion measures 2.7 x 2.3 cm (series 6, image 58), previously measuring 2.7 x 2.6 cm.Reference segment 5/6 lesion measures 1.4 x 1.2 cm (series 6, image 55), previously measuring 1.2 x 1.0 cm.Reference segment two lesion measures 1.3 x 1.0 cm (series 6, image 22), previously measuring 1.4 x 1.2 cm. No significant interval change in multiple smaller ill-defined hypoattenuating lesions.Cholelithiasis. Mild intra-and extrahepatic biliary ductal dilatation is unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Unchanged subcentimeter retroperitoneal/left para-aortic lymph nodes.BOWEL, MESENTERY: There is marked thickening of a long segment of the terminal ileum which is unchanged in length with mildly increased in terminal ileal wall thickening. Additionally, there are multiple nodules/nodes in the right lower quadrant as best appreciated on coronal series with reference nodule measuring 2.5 x 1.5 cm (coronal series, image 61); there is mesenteric stranding associated with these nodules.The cecal wall is noted to be mildly thickened which may be secondary to lack of distention.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Fibroid uterus.BLADDER: No significant abnormality notedLYMPH NODES: Mild interval increase in the soft tissue nodularity in the pelvis (series 7, image 129) which cannot be accurately compared given the two nodularities are confluent on the current examination. BOWEL, MESENTERY: Right lower quadrant findings as detailed above. Small pelvic ascites is stable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Stable hepatic metastatic disease.2. Mild interval increase in the marked wall thickening of the terminal ileum without significant change in the extent of the length, which is patient's primary site of disease per clinical history. 3. Soft tissue nodularity in deep pelvis has mildly increased and suspicious for metastatic mesenteric lymph nodes.4. No significant interval change in right lower quadrant nodules with associated mesenteric stranding as detailed.5. Small stable ascites. 6. Cholelithiasis.
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Generate impression based on findings.
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Male 65 years old; Reason: prostate cancer History: prostate cancer No abnormal osseous foci are identified to indicate metastatic disease.Focal uptake at the left posterior aspect of the T10 vertebral body likely correlates with focal degenerative changes seen on comparison CT.
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1. No specific evidence of bone metastases.2. Focal uptake at T10 vertebral body likely correlates with degenerative changes given the absence of a suspicious lesion on comparison CT and presence of degenerative changes throughout the spine.
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Generate impression based on findings.
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Reason: s/p DAVF R transverse sigmoid embo History: h/a Brain CTA: There are number of dilated and tortuous vascular structures present surrounding the lower brainstem and upper spinal cord . There is a dilated vessel embedded within the lower brainstem measuring 5 x 9 mm in axial dimensions suspected to represent a venous aneurysm .There are number of dilated and tortuous vascular structures present surrounding the upper brainstem which are adjacent to the vena Galen.There are number of dilated and tortuous vascular structures present adjacent to the right gyrus rectus. Arterial supply is from the right anterior cerebral artery and possibly ethmoidal arteries.There is opacification of both transverse sinuses appear embolic material is present within the distal right transverse sinusThere is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The anterior communicating artery and the posterior communicating arteries are identified and are intact.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Periventricular and subcortical white matter hypodensities of a moderate degree are present.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1.The finding suggests persistent vascular malformations in the upper and lower brain stem. Conventional angiography would be more accurate in assessing these.2.Finding suggest arteriovenous malformation at the right gyrus rectus. This is better assessed using conventional angiography.3.There is redemonstration of a venous aneurysm noted in the lower brainstem.4.The patient is status-post embolization at the level of the right transverse sinus.
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Generate impression based on findings.
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Follow-up of recurrent oral tongue cancer status post resection with +LVI, +PNI and close/positive margins. Completed 6.5/6.5 cycles of FHx on 9/24/14. There are stable post-treatment findings in the neck. The oral cavity region is obscured by dental streak artifact. Consequently, assessment for oral tongue tumor is limited following resection. There is no evidence of significant cervical lymphadenopathy based on size criteria, status post bilateral neck dissection. The thyroid and major salivary glands are unchanged. The major cervical vessels are patent. There is a right internal jugular venous catheter. The osseous structures are unchanged. The airways are patent. There is opacification of the right mastoid air cells. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. There is an unchanged nonspecific cutaneous nodule in the right lateral neck.
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1. Stable post-treatment findings in the neck. The oral cavity region is obscured by dental streak artifact, which limits assessment for residual or recurrent oral tongue tumor is limited. 2. No evidence of significant cervical lymphadenopathy based on size criteria.
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Generate impression based on findings.
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CLINICAL DATA: Age: 41 years. Sex : Male. Indication: Reason: 41 yo M with fatty liver disease and splenomegaly. Pls eval liver for mass/lesions (significant fatty infiltration did not allow for eval on ultrasound). Eval for disseminated disease in chest/abd that may be causal to splenomegaly. History: transaminitis, splenomegaly of unknown origin, R pectoral fullness/mass. LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Diffuse hepatic steatosis. No masses or abnormal enhancement 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: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes affect the visualized spine, with posterior fixation rod and screw device at L5-S1. The right S1 transpediclar screw is fractured, unchanged.OTHER:No significant abnormality noted.PELVIS:PROSTATE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Hepatic steatosis, without appreciable liver mass lesions or biliary dilatation.2.Right S1 transpediclar screw fracture, unchanged.
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Generate impression based on findings.
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55-year-old male with history of pain. Left foot: Severe osteoarthritis affects the first MTP joint with prominent dorsal osteophytes. The soft tissues are unremarkable.Right foot: Severe osteoarthritis affects the first MTP joint with prominent dorsal osteophytes. The soft tissues are unremarkable.
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Osteoarthritis with osteophyte formation as above.
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Generate impression based on findings.
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69 year-old female with primary hyperparathyroidism. There is physiologic distribution of the radiopharmaceutical. No abnormal focus of activity consistent with an enlarged parathyroid gland is seen. The right thyroid lobe appears to measure 0.25 cm and the left lobe 0.25 cm in length.
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No scintigraphic evidence for parathyroid adenoma.
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Generate impression based on findings.
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19-year-old male with history of fracture. There is a 3-mm diamond-shaped fracture fragment along the ulnar aspect of the base of the middle phalanx likely representing an ununited avulsion fracture with intraarticular extension. There has been interval decrease in soft tissue swelling.
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Third middle phalanx fracture as above.
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Generate impression based on findings.
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Reason: re-staging lung cancer after three cycles of chemotherapy (after cycle 3) History: lung cancer staging CHEST:LUNGS AND PLEURA: Moderately severe centrilobular emphysema.Right apical nodule measuring 27 x 30 mm, decreased from 41 x 38 mm previously (series 4/26).The tumor is contiguous with the posterior pleural surface and may be invading the pleura. Adjacent interstitial and air space opacity may represent local tumor spread or hemorrhage.Left upper lobe non solid nodule with internal cysts (series 4/32) measuring 18 mm, slightly increased in total size due to increased size of the cysts which may reflect air trapping. This morphology is suspicious for a primary carcinoma but can occasionally be seen in metastases.Lobulated 18 mm solid nodule anteriorly in the left upper lobe (series 4/37) unchanged and suspicious for primary or metastatic disease.18 mm subpleural left lower lobe solid nodule, now with internal radiolucency which may represent cavitation, otherwise unchanged (series 4/72).MEDIASTINUM AND HILA: No significant mediastinal lymphadenopathy.Calcified lymph nodes compatible with previous granulomatous infection.Enlarged left hilar lymph node, now 6 mm in short axis, decreased from 15 mm previously.Severe coronary artery calcifications.No pericardial effusion.CHEST WALL: Subtle irregularity and sclerosis in the posterior right seventh rib is unchanged and indeterminant, but more likely benign than malignant.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Very small nonspecific hypodensities in the posterior right lobe, unchanged and most likely benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Slightly decreased size of the left adrenal nodule, and no 10 mm decreased from 13 mm, and now with a more homogeneous appearance, which may represent treatment response.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.Atherosclerotic calcifications of the aorta and its branches.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Decreased size of right upper lobe presumed a primary carcinoma, left hilar lymph nodes and left adrenal gland nodule, consistent with treatment response. 2. Several additional small left lung nodules, unchanged or slightly increased, compatible with metastases or synchronous primary tumors..
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Generate impression based on findings.
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Female 34 years old; Reason: metastatic breast cancer - baseline prior to starting new treatment regimen History: known adenopathy, bone and liver mets CHEST:LUNGS AND PLEURA: There are innumerable scattered pulmonary micronodules compatible with metastatic disease. Post radiation changes are present in the upper lobe of the left lung.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.Chest wall port terminates at the cavoatrial junction.CHEST WALL: Sclerotic metastases to the sternum. Postsurgical changes in the breasts.ABDOMEN:LIVER, BILIARY TRACT: Innumerable hepatic lesions compatible with metastatic disease. There are scattered areas of right hepatic lobe ductal dilatation due to mass effect from the lesions. A reference right hepatic lobe lesion measures 3.5 x 3.4 cm (image 101/series 3). SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus is absent or atrophic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Scattered sclerotic foci to the lumbar spine.OTHER: Trace pelvic ascites.
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1.Multiple subcentimeter pulmonary micronodules that are suspicious for metastatic disease2.Sclerotic bone metastases3.Multiple hepatic metastases
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Generate impression based on findings.
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Ms. Johnson is a 41 year old female presenting for short-term follow-up for calcifications in the right breast. Three standard views of both breasts, additional left CC view, and two right spot magnification views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Loose cluster of benign calcifications in the central right breast are unchanged when compared to prior examinations. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast.
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Benign calcifications in the right breast. 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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Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Patchy faint groundglass opacity in right upper lobe is not typical of metastatic disease. It is likely due to aspirate or infection. Continued follow-up is recommended. No new suspicious pulmonary nodules.MEDIASTINUM AND HILA: Scattered small subcentimeter lymph nodes are unchanged. Port catheter tip at RA/SVC junction.CHEST WALL: Right chest wall port.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.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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Faint ground glass opacity in right upper lobe likely due to aspirate or infection. Though it is not typical of metastatic disease, continued follow-up is recommended.
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Generate impression based on findings.
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Male; 44 years old. Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Interval resolution of mild subsegmental atelectasis in the right lower lobe.Very mild patchy ground glass opacity in the right lower lobe is most likely post inflammatory or infectious in etiology.Mild mucous plugging seen in the lower lobes.Stable subpleural fibrotic changes in both apices, which may be related to prior radiation treatment.Stable left apical 2-mm nodule (image 29, series 4).No new or suspicious palmar nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal. No pericardial effusion. Moderate to severe coronary artery calcification. Small hiatal hernia.CHEST WALL: Right chest wall port catheter terminates near the superior cavoatrial junction. No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly 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: Scattered small retroperitoneal lymph nodes are unchanged. Again seen is a somewhat linear low density within partially visualized right common iliac vein (e.g. image 155, series 3), which may be due to artifact versus nonocclusive chronic thrombus.BOWEL, MESENTERY: Absence of enteric contrast material markedly 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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No evidence of metastatic disease.
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Generate impression based on findings.
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4-year-old female with abdominal painVIEWS: Chest AP, abdomen AP supine/upright (3 views) 01/19/15 Aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities.Gas filled loops of small and large bowel in a nonobstructive bowel gas pattern. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas. Moderate amount amorphous stool is seen in the ascending colon. The bladder is distended.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Right-sided abdominal mass. Evaluate for mass, stool burden.EXAMINATION: Abdomen AP (one view) 01/19/15 A right thoracolumbar curve is noted. The femoral heads are superiorly and laterally positioned with respect to the acetabula. A gastrostomy tube is present.Only a small amount of bowel gas is present. Gas is seen in the stomach. There does not appear to be a significant stool burden.
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No evidence of mass or obstruction. Ultrasonography may be helpful if further evaluation is warranted.
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Generate impression based on findings.
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66-year-old female with history of pain. There is a fracture through the neck of the fifth proximal phalanx with mild dorsal angulation of the distal fracture fragment. The fracture line is relatively indistinct which may reflect some healing.
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Fifth toe fracture as above.
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Generate impression based on findings.
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56 year old male with metastatic prostate cancer, evaluation of disease after 22 cycles of investigational therapy. Again seen are foci of increased radiotracer activity in the right 7th costovertebral junction, L4 and L5 vertebral bodies and sacrum. Activity in the lumbosacral region has decreased in intensity on the anterior view compared to prior.Degenerative changes involving the thoracic spine and shoulders are again noted.No new foci of increased greater tracer activity.
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Decreased activity of lumbar/sacral metastases. No new sites of disease.
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Generate impression based on findings.
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Female 72 years old; Reason: parathyroid anatomy/location History: secondary hyperparathyroidism There is physiologic distribution of the radiopharmaceutical. There is increased activity in the region of the inferior pole of the left thyroid lobe.The right thyroid lobe appears to measure 4.8 cm and the left lobe 4.4 cm in length.
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Increased activity in the region of the inferior pole the left thyroid lobe consistent with parathyroid adenoma.
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Generate impression based on findings.
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75-year-old female with follow-up imaging based on CXR finding from 11/24/2014. Positive smoking history (2.5-pack-years) LUNGS AND PLEURA: Linear opacities in the right middle lobe and lingula which likely represent chronic discoid atelectasis/scarring. The right middle lobe opacity corresponds to the opacity seen on chest radiograph. Mild upper lobe predominant centrilobular emphysema. No suspicious nodules or masses. Scattered punctate micronodules, both calcified and noncalcified. No pleural effusion.MEDIASTINUM AND HILA: Normal heart size with small anteriorly located pericardial effusion/thickening. Mild atherosclerotic disease of the aorta and its branches with severe coronary calcifications. No mediastinal or hilar lymphadenopathy.CHEST WALL: Moderate degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Nonobstructing right renal calculus.
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No suspicious lung nodules or masses.Linear opacities in the right middle lobe and lingula likely represent chronic discoid atelectasis/scarring and correspond to the opacity seen on prior chest radiograph.
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Generate impression based on findings.
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Langerhans cell histiocytosis and resection.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, pelvis AP, right femur AP, left femur AP, right tibia fibula AP, left tibia fibula AP, right foot AP, left foot AP (22 views) 01/19/15 Postoperative changes are again seen in the occiput.Mineralization and modeling are normal. No bone destruction is seen.
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Unchanged examination. Postoperative changes in the occiput and no other abnormality.
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Generate impression based on findings.
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16-year-old male with asthma and fixed obstruction. Within the limits of a non IV contrast enhanced examination which limits ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: LUNGS AND PLEURA: A 1.1 x 1.3 cm (image 89, series 5) subpleural right upper lobe streaky groundglass opacity may reflect scarring or infection/inflammation. Diffuse mild bronchial wall thickening is seen. There is no bronchiectasis, pleural effusion or fibrosis identified. Multiple subcentimeter groundglass and solid nodules are identified in the lung bases, likely post infectious or post inflammatory in etiology. A subpleural cyst is seen in the superior segment of the right lower lobe.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedUPPER ABDOMEN: Evaluation of the upper abdomen is limited given the lack of intravenous and oral contrast administration. Given this limitation: no significant abnormality is noted.
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1.Mild diffuse bronchial wall thickening reflect reactive airways disease.2.Subcentimeter basilar groundglass and solid nodules are nonspecific, but may be post infectious or post inflammatory in etiology.3.Right upper lobe groundglass opacity likely reflects scarring or infection/inflammation.
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Generate impression based on findings.
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9-year-old male with Crohn's disease, evaluate extent of small bowel involvement.EXAMINATION: MR enterography without and with IV contrast 1/19/2015 ABDOMEN:LIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is no evidence of hydronephrosis or hydroureter. There is no evidence of nephrolithiasis or ureterolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is significant wall thickening of the terminal ileum with associated luminal narrowing and prestenotic dilatation as well as mild mucosal hyperenhancement. The affected bowel demonstrates abnormal peristalsis and measures approximately 6 cm long, extending retrograde from the level of the cecum. No additional foci of small bowel involvement are seen. No fibrofatty proliferation, sinus tracts or fistula are identified.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is significant wall thickening of the terminal ileum with associated luminal narrowing and prestenotic dilatation as well as mild mucosal hyperenhancement. The affected bowel demonstrates abnormal peristalsis and measures approximately 6 cm long, extending retrograde from the level of the cecum. No additional foci of small bowel involvement are seen. No fibrofatty proliferation, sinus tracts or fistula are identified.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Bowel wall thickening, luminal narrowing, prestenotic dilatation and mild mucosal hyperenhancement of the terminal ileum consistent with terminal ileitis, likely acute on chronic. No additional sites of small bowel inflammation identified.
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Generate impression based on findings.
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Hypertrophy of the left parotid gland, without discrete mass or pathologic enhancement. The right parotid gland is either not present or extremely atrophic. Mildly prominent regional lymph nodes which are non-enlarged by size criteria.The left submandibular gland is slightly enlarged when compared to the right. The thyroid gland is unremarkable. Small retention cyst in the right maxillary sinus. Poor dentition and partial edentulism. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. A calcified granuloma is noted in the left apex.
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Large, but otherwise unremarkable left parotid gland, which may be compensatorily enlarged secondary to absent/atrophic right parotid gland. No pathologic regional adenopathy.
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Generate impression based on findings.
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Reason: Metastatic prostate cancer needs re-evaluaiton and compare to prior scans. Measurement when applicable on IRB 09-267. History: Metastatic prostate cancer needs re-evaluaiton and compare to prior scans. Measurement when applicable on IRB 09-267. LUNGS AND PLEURA: Stable punctate calcified and noncalcified micronodules, presumably postinflammatory.No suspicious pulmonary nodules.MEDIASTINUM AND HILA: Scattered small subcentimeter nodes, unchanged.Mild coronary calcification.CHEST WALL: Degenerative changes throughout the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy.
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Stable CT with no evidence of pulmonary metastases.
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Generate impression based on findings.
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62 year old with history of left lumpectomy in 2005 for infiltrating ductal carcinoma, status post radiation and chemotherapy. History of benign right breast stereotactic biopsy in 2010. No new breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Left breast linear scar marker and round skin marker are noted. Stable architectural distortion with benign progressing dystrophic calcifications are present in the left lumpectomy bed. A serpiginous blood vessel is noted in the deep central left breast. An S-shaped clip is seen in within the right upper outer quadrant. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Benign post-surgical changes. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Male; 75 years old. Reason: Retromolar trigone cancer s/p RT, re-staging exam History: Retromolar trigone cancer s/p RT, re-staging exam CHEST:LUNGS AND PLEURA: Stable left lower lobe calcified granuloma. No suspicious pulmonary nodule or mass. No consolidation or pleural effusion. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion. Moderate coronary artery calcifications.CHEST WALL: Gynecomastia. Stable well-defined small lucent lesion in the T8 vertebral body, likely benign. Stable mild anterior wedging of L1 vertebral body.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy. Small subcentimeter hypodensity in right posterior segment (image 101/161) is too small to characterize.SPLEEN: Splenic calcification is unchangedADRENAL GLANDS: Stable left adrenal nodule measuring 14 mm (image 22, series 4).KIDNEYS, URETERS: Multiple bilateral nonobstructing renal stones. Stable renal cysts.PANCREAS: Multiple punctate pancreatic calcifications compatible with chronic pancreatitis. Small hypoattenuating lesion in the tail of the pancreas (image 103, series 4) is either new or better seen on today's examination; it is too small to characterize but continued follow-up is recommended.RETROPERITONEUM, LYMPH NODES: IVC filter is again seen in place with several struts projecting into the pericaval fat. Atherosclerotic calcifications are seen throughout the aorta.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Stable well-defined small lucent lesion in the T8 vertebral body, likely benign. Stable mild anterior wedging of L1 vertebral body.
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1. No definitive evidence of metastatic disease.2. Small hypoattenuating lesion in the tail of the pancreas is either new or better seen on today's examination; it is too small to characterize but continued follow-up is recommended to exclude malignancy. It most likely, however, represents a pseudocyst given findings of chronic pancreatitis.
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Generate impression based on findings.
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32-year-old female with a history of breast cancer. Patient with cellulitis around umbilicus. Evaluate for hernia versus urachal cyst. ABDOMEN:LUNG BASES: Bilateral breast prosthesis are noted.LIVER, BILIARY TRACT: Too small to characterize segment 7 hypoattenuating lesion (series 4, image 19).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy. Duplicated IVC is identified.BOWEL, MESENTERY: No findings to suggest small bowel obstruction or colitis. No evidence of anterior abdominal wall hernia.BONES, SOFT TISSUES: There is a fluid collection at the level of the umbilicus in the anterior abdominal soft tissues measuring 2.3 x 1.7 cm in size and with attenuation of 17 Hounsfield units. There is surrounding soft tissue inflammatory changes and induration as well is overlying skin thickening, suggesting an inflammatory process. Separate from this is an umbilical hernia (thin neck) containing only mesenteric fat, with the inflammatory process anterior and abutting to the hernia. No bowel is in the hernia, and the inflammatory process lies within the fat predominately of the subcutaneous tissue, but may involve the fat of the hernia as well.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No evidence of a urachal cyst as clinically questioned.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No findings to suggest small bowel obstruction or colitis.BONES, SOFT TISSUES: No osseous metastatic lesions are identified. There is a fluid collection at the level of the umbilicus in the anterior abdominal soft tissues measuring 2.3 x 1.7 cm in size and with attenuation of 17 Hounsfield units. There is surrounding soft tissue inflammatory changes and induration as well is overlying skin thickening, suggesting an inflammatory process.OTHER: No significant abnormality noted
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1.Fluid collection with surrounding inflammatory/phlegmonous changes as well as overlying skin thickening. Findings suggestive of inflammatory/infectious process. Additionally, clinically correlate with physical examination for cellulitis. 2.No evidence ofurachal cyst as clinically questioned. 3.Small umbilical hernia containing only mesenteric fat -- this is posterior to and abuts the inflammatory process delineated above.4.No evidence of metastatic disease.5.No osseous lesions identified; however, correlation with nuclear medicine examination may be considered as that is a more sensitive modality for evaluation of osseous structures.6.Duplicated IVC incidentally noted.
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Generate impression based on findings.
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19-year-old male with history of knee pain. Artifact overlies the lower thigh on the AP view. There may be a small joint effusion. The left knee is unremarkable as seen on the frontal views.
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Possible small joint effusion, but otherwise normal exam.
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Generate impression based on findings.
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18 year-old male with history of finger fracture. Redemonstrated is an oblique fracture through the base of the distal phalanx with intra-articular extension. Alignment is near-anatomic. The fracture line is less distinct indicating interval healing.
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Healing right ring finger fracture as above.
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Generate impression based on findings.
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66 year old female with history of left knee pain. The bones are demineralized suggesting osteopenia/osteoporosis. Minimal joint space narrowing and small osteophytes indicate mild osteoarthritis. Deformity of the patella compatible with healed fracture. Minimal osteoarthritis affects the right knee as seen on the frontal views.
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Minimal osteoarthritis.
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Generate impression based on findings.
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52 year-old female with rheumatoid arthritis, evaluate for interim erosion Left hand: Postoperative and arthritic changes of the wrist are similar to the prior exam with ankylosis of the second carpometacarpal joint and marked narrowing of the third, fourth, and fifth carpometacarpal joints. There is narrowing of the radial scaphoid joint as well. The metacarpophalangeal joints appear spared. There is marked narrowing of the PIP joint of the ring finger, likely representing a combination of rheumatoid arthritis and osteoarthritis. Narrowing of the remainder of the interphalangeal joints appears similar to the prior exams A small lucency at the base of the middle phalanx of the middle finger may represent a cyst or chronic erosion, and was not clearly evident on the prior study.Right hand: Narrowing of the second and fifth proximal interphalangeal joints, likely representing combined rheumatoid arthritis and osteoarthritis, appears unchanged along with relatively mild narrowing of the remainder of the interphalangeal joints. Third metacarpophalangeal joint narrowing is also unchanged.Left foot: The bones are demineralized. Mild osteoarthritis affects the first MTP joint, progressed slightly from the prior exam. No erosions are identified. Mild osteoarthritis also affects the midfoot, appearing similar to the prior exam.Right foot: Mild osteoarthritis affects the first metatarsophalangeal joint, slightly progressed from the prior exam. No definite erosions are identified. Mild osteoarthritis of the midfoot is also unchanged.
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1. Arthritic changes as described above, consistent with combined rheumatoid arthritis and osteoarthritis. A tiny new lucency in the middle phalanx of the left middle finger may represent a cyst or small erosion, but otherwise there is no evidence of RA progression. 2. Mild interval progression of osteoarthritis affecting the first metatarsophalangeal joints bilaterally.
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Generate impression based on findings.
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Chronic sinusitis. The paranasal sinuses are clear. The nasal cavity is also clear. There is no significant nasal septal deviation. 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.
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No evidence of sinusitis.
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Generate impression based on findings.
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54-year-old male with history of finger mass. Evaluate for bone deformity. There is a 5-mm crescentic ossific density adjacent to the dorsal aspect of the tuft of the fifth distal phalanx. This appears sightly smaller when compared to prior which may reflect partial interval resection/erosion. There is no soft tissue defect present.
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Focus of ossification adjacent to the tip of the fifth finger. This lesion may represent a peculiar exostosis, osteoma or possibly postraumatic heterotopic ossification.
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Generate impression based on findings.
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Chronic sinusitis. There is a subcentimeter right maxillary retention cyst and opacification of a right anterior ethmoid air cell and a right frontal bullar cell. The other paranasal sinuses are clear. The nasal cavity is also clear. There is mild nasal septal deviation 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. There is periodontal lucency associated with tooth #15.
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1. Subcentimeter right maxillary retention cyst and opacification of a right anterior ethmoid air cell and a right frontal bullar cell. The other paranasal sinuses are clear.2. Periodontal lucency associated with tooth #15.
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Generate impression based on findings.
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65 years, Male. Reason: ng tube placement History: 65M admit for cardiogenic vs septic shock. Now extubated requiring enteral feeds NG tube with tip in the proximal gastric body and sidehole in the gastric cardia near the gastroesophageal junction. Persistent gaseous distension of bowel loops suggesting ileus is incompletely imaged as the pelvis is not included in the field of view and limited by motion artifact. Nonspecific basilar pulmonary opacities.
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NG tube with tip in the proximal gastric body and sidehole in the gastric cardia.
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Generate impression based on findings.
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Multiple myeloma status post radiation therapy. Restaging exam.RADIOPHARMACEUTICAL: 13.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 102 mg/dL. Today's CT portion grossly demonstrates an ill-defined somewhat permeative lesion in the distal left tibia. Several sclerotic lesions are seen throughout the spine. Granulomatous calcifications involve bilateral hilar lymph nodes. Chronic appearing inflammatory changes surround both kidneys. Extensive atherosclerotic including coronary arterial calcifications are noted. The right knee prosthesis is identified.Today's PET examination demonstrates a medium size significantly hypermetabolic lesion at the distal left fibula (SUV max = 7.1), compatible with myeloma.Several additional much smaller but abnormal hypermetabolic osseous lesions are seen involving the proximal left fibula (SUV max = 1.8), the proximal right tibia (SUV max = 2.4), and in two discrete locations in the distal left femur (SUV max = 2.8). These indicate additional foci of multiple myeloma tumor activity.Another abnormal osseous focus is seen in the distal right humerus (SUV max = 2.5), consistent with additional tumor activity.Extensive increased largely soft tissue activity in surrounds the right knee prosthesis consistent with inflammation.Punctate hypermetabolic bilateral hilar and mediastinal lymph nodes are most consistent with granulomatous inflammation. Decreased osseous activity in the lower thoracic, upper lumbar, and cervical spine is consistent with radiation change.
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Multiple hypermetabolic osseous lesions consistent with multiple myeloma activity. These are present most notably at the distal left tibia but are also seen elsewhere in bilateral lower extremities as well as the distal right humerus.
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Generate impression based on findings.
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Ms. Jewell is a 52 year old female recalled from screening mammogram for a focal asymmetry in the right breast. An ML view and three spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Previously identified focal asymmetry in the central right breast disperses into normal breast parenchyma (almost identical in parenchymal pattern to mammogram from 2009) on spot compression views. 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, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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63 year old male with lung cancer. The comparison chest radiograph performed on 1/19/2015 demonstrates elevation of the right hemidiaphragm. Right basilar atelectasis. Known right hilar mass is not visualized.The ventilation images show decreased/no activity within the right lower lung likely related to elevation of the right hemidiaphragm and atelectasis. A Otherwise, there is uniform distribution of activity on single-breath and wash-in images. There is no abnormal pulmonary Xe-133 retention during the wash-out phase. Retention is visualized in the liver compatible with hepatic steatosis.The perfusion images show a physiologic distribution of pulmonary perfusion with exception of matched decreased/no activity within the right lower lung.Quantitation of relative single breath ventilation (using the posterior image):Left lung: 72.9% (upper lung 19.0.%; middle lung 36.8 %; lower lung 17.1 %)Right lung: 27.2% (upper lung 11.9%; middle lung 14.6 %; lower lung 0.7%)Quantitation of relative pulmonary arterial perfusion (using anterior and posterior geometric means):Left lung: 69% (upper lung 21.4%; middle lung 36.5%; lower lung 11.1%)Right lung: 31% (upper lung 12.7%; middle lung 17.5%; lower lung 0.9 %)
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Matched ventilation and perfusion defect in the right lower lung likely related to elevation of the right hemidiaphragm and atelectasis, which may be postobstructive due to known right hilar mass. Measurements as above.
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Generate impression based on findings.
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Male; 60 years old. Reason: h/o esophageal ca and CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Mild patchy nodular groundglass opacity in the posterior segment of the right upper lobe is similar to prior study with some areas showing slight increase and others decrease. New very mild patchy and tree-in-bud opacity in the left lower lobe. New nonspecific micronodule in the right middle lobe (image 54, series 4). There is debris in the right mainstem bronchus. Scarring in the right apex. Subpleural calcified nodularity on the right is unchanged and presumably benign. Apical medial symmetric fibrotic changes presumably secondary to prior XRT, unchanged Emphysema. MEDIASTINUM AND HILA: Scattered small mediastinal nodes are unchanged. Thickening of the upper esophagus is also unchanged. Coronary calcification.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly 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 markedly 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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Findings suggestive of mild aspiration bilaterally. New nonspecific micronodule in the right middle lobe may be post infectious or inflammatory in etiology. Though the appearance is not typical of metastatic disease continued follow up is recommended.
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Generate impression based on findings.
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61-year-old female with ocular melanoma. Evaluate for metastatic disease. CHEST:LUNGS AND PLEURA: Bilateral apical scarring is unchanged. Significant interval change in the right upper lobe nodule, which is nonspecific. Mild bilateral basilar atelectasis.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion.CHEST WALL: Bilateral breast prosthesis are unchanged in appearance.ABDOMEN:LIVER, BILIARY TRACT: Segment 6 hypoattenuating lesion is unchanged and most likely a cyst.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left nephrolithiasis and bilateral renal hypoattenuating lesions most likely cysts are unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis. No findings to suggest small bowel obstruction.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: Diverticulosis without evidence of diverticulitis. No findings to suggest small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No evidence of metastatic disease.2.Unchanged nonspecific right upper lobe nodule.
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Generate impression based on findings.
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Post-nasal drip, cough, and frontal headache. There is mild mucosal thickening in the left maxillary sinus and what likely represents a retention cyst or retrained secretion in the right sphenoid sinus. The other paranasal sinuses are clear. The nasal cavity is clear. However, there are bilateral conchae bullosa with partially paradoxical middle turbinates. There is minimal S-shaped nasal septal deviation. 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.
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Mild mucosal thickening in the left maxillary sinus and what likely represents a retention cyst or retrained secretion in the right sphenoid sinus. The other paranasal sinuses are clear.
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Generate impression based on findings.
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Reason: is the ett and CT in proper postion are the lungs clear History: brday desats, intubated, rds, pleural effusionVIEW: Chest AP (one view) 1/19/2015 ET tube tip is below thoracic inlet and above carina. Left upper extremity PICC is in the left subclavian vein. Chest tube is unchanged with side-port outside the chest wall within the subcutaneous tissue. NG tube courses below the field-of-view.Cardiothymic silhouette is unchanged. Increased bibasilar atelectasis with tenting of the left hemidiaphragm. Small bilateral pleural effusions. No pneumothorax. Soft tissue edema of the chest wall continues.
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ET tube is in proper position. Malpositioned left chest tube without pneumothorax. Worsening left basilar opacity.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed with additional right MLO and right CC views and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Benign intramammary lymph nodes are present in both upper outer quadrants. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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Female 34 years old; Reason: metastatic breast cancer - baseline prior to starting new regimen History: known bone mets There is markedly increased radiotracer uptake in the sternum. There is mottled appearance of the bilateral ribs diffusely as well as the bilateral clavicles. There is increased uptake in the proximal right humerus. There is uptake throughout the spine, more prominent in the lumbar spine. There is focal uptake in the is right iliac bone.
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Findings consistent with osseous metastatic disease to the right proximal humerus, bilateral ribs and clavicles, sternum, spine and right hemipelvis as described above.
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Generate impression based on findings.
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17-month-old female with dysphagia.EXAMINATION: Oropharyngeal motility study 1/19/2015 Julie Ecclestone, speech and language therapist, supervised the examination.31 seconds of fluoroscopy was used.PRESENTATION: The patient was presented with thin liquids via cut out cup, nectar thickened liquid via cut out cup, and stage I purées via spoon.RESULTS: The patient aversive to bottle presentation. The patient demonstrated immature oral skills including decreased bolus containment, propulsion and anterior loss. No penetration or aspiration is evident.
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No aspiration or penetration.Please see the speech and language therapist's report for feeding recommendations.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Prior mammogram at outside facility, per patient. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Tomosynthesis was performed. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is most sensitive when used to assess for interval change. If prior outside mammograms are submitted, comparison can be made.BIRADS: 1 - Negative.RECOMMENDATION: NSD - Screening Mammogram.
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Generate impression based on findings.
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Ocular melanoma. Head: There are stable postoperative findings related to right globe enucleation. There is no evidence of tumor in the right orbit. The left orbit is unremarkable. There is no evidence of intracranial mass or abnormal enhancement. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. There is a small retention cyst in the right maxillary sinus and a punctate right ethmoid sinus osteoma. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. Neck: There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.
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1. Stable postoperative findings related to right globe enucleation without evidence of measurable locoregional tumor recurrence. 2. No evidence of significant lymphadenopathy in the neck.
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Generate impression based on findings.
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Restaging recurrent non-Hodgkin's lymphomaRADIOPHARMACEUTICAL: 13.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 117 mg/dL. Today's CT portions will be reported separately.Today's PET examination demonstrates the following abnormalities:NECK: Very extensive markedly hypermetabolic bilateral jugular lymph nodes as well as intramuscular and intraparotid foci have significantly progressed in size, number, and (more modestly in) metabolic activity from previous and indicate tumor progression (SUV max = 24.5 previously, = 25.9 currently).THORAX: Very extensive markedly hypermetabolic bilateral axillary and mediastinal lymph nodes have significantly progressed in size, number, and metabolic activity (SUV max = 18.5 previously, = 21.5 currently), consistent with additional tumor progression.ABDOMEN: Multiple hypermetabolic mesenteric and retroperitoneal lymph nodes have progressed in size, number, and metabolic activity (SUV max = 7.2 previously, = 9.7 currently), consistent with additional tumor progression. There is also diffusely increased abnormal splenic activity (SUV max = 4.3 previously, = 6.6 currently), new from previous, and increase in splenic size, suggestive of new splenic tumor involvement.PELVIS: Multiple hypermetabolic mesenteric, iliac, and inguinal lymph nodes have significantly progressed in size, number, and metabolic activity from previous (SUV max = 12.4 previously, = 19.5 currently), consistent with additional tumor progression.
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1.Widespread markedly hypermetabolic tumor involving lymph nodes from the neck through pelvis, significantly progressed from previous. Also new diffuse splenic tumor involvement is likely.Diagnostic CTs of the head, neck, chest, abdomen, and pelvis also performed at today's visit will be reported separately.
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Generate impression based on findings.
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72-year-old female with change in behavior and personality for 3 months, with difficulty performing ADLs. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No mass, midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age, without evidence of hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminant small vessel ischemic changes.The visualized portions of the paranasal sinuses are clear. Small amount of fluid and trabecular thickening in the left mastoid air cells may relate to chronic inflammation. Small amount of debris is noted in the bilateral external auditory canals. Calvarium is intact.
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No evidence of intracranial hemorrhage or mass effect.
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Generate impression based on findings.
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Male 66 years old; Reason: 66 y/o M with NHL s/p BEAM/Auto SCT now with current disease, needs restaging please. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: New bilateral axillary (right greater than left), supraclavicular and paraspinal lymphadenopathy seen. Representative right axillary lymph node measures 6.3 by 2.4, image 38 series 7. Mediastinal lymphadenopathy, reference right paratracheal lymph node measuring 1.6 x 1 .2 cm, image 25 series 71, previously measured 0.5 x 0.3 cm.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Diffuse hepatic steatosis. SPLEEN: New from prior study is ill-defined soft tissue attenuation medial to spleen, image 101 series 701, component measuring approximately 2.2 x 2.2 cm, image 83 series 701. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Enlarging retroperitoneal lymphadenopathy. Reference preaortic lymph node measuring 1.9 x 1.2 cm on image 143 series 701, previously measured 1.3 x 1 cm. BOWEL, MESENTERY: Ovoid rectosigmoid colon soft tissue attenuation, compatible with neoplastic disease, may reflect intramural or subserosal disease (favored) versus mesenteric adenopathy exerting mass effect on adjacent colon, lesion measures 6.7 x 3.9 cm, image 193 series 7, in retrospect, focus of soft tissue attenuation seen at this level on prior study, measuring 2.6 x 1.6 cm. Associated luminal narrowing seen in region of mass, no significant proximal colonic dilatation seen. Increasing soft tissue attenuation seen adjacent to sigmoid colon, where sigmoid colon diverticulosis also present. Linear soft tissue attenuation seen along lateral aspect of sigmoid colon, intervening between colon and left iliopsoas muscle, measuring approximately 4.7 x 1.3 cm, image 184 series 701. Additional ill defined mesenteric stranding seen in left lower quadrant, suspicious for neoplastic involvement. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Subcentimeter external iliac and inguinal nodes. Reference left inguinal lymph node measuring 1.5 x 1 cm, image 227 series 701. BONES, SOFT TISSUES: Multilevel degenerative changes of spine, punctate sclerotic lesion in left symphysis pubis, not well seen on prior study, image 643 series 7. Heterogeneity in right aspect of T6 vertebral body, coronal image 80 series 702, similar appearance to prior study, nonspecific but given apparent of apparent hypermetabolic activity on PET imaging, benignity favored.
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1. Findings compatible with interval disease progression, with new and enlarging adenopathy, and mesenteric and bowel disease as above. 2. Ovoid rectosigmoid colon soft tissue attenuation, compatible with neoplastic disease, may reflect intramural or subserosal disease (favored given appearance) versus mesenteric adenopathy exerting mass effect on adjacent colon. Associated luminal narrowing seen in region of mass, no significant proximal colonic dilatation seen. Correlation with patient's clinical history recommended and further assessment with colonoscopy may be pursued.3. Increasing mesenteric nodularity and paracolonic ill defined soft tissue attenuation along sigmoid colon. While acute sigmoid diverticulitis another differential consideration for the latter findings, neoplastic spread favored. Correlation with patient's clinical history and laboratory values recommended.4. Please refer to concomitant PET/CT imaging from same day for additional findings.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Tomosynthesis was performed. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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78 years, Female. Reason: evaluate for R kidney stone History: R flank pain over the last few years Postsurgical sequelae of ventral hernia repair and cholecystectomy.Nonobstructive bowel gas pattern. No radiopaque renal stone is identified. There is dextroscoliosis with DJD of the thoracolumbar spine.
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No radiopaque renal stone is identified. Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of ovarian cancer in her mother in her 50s and breast cancer in a maternal aunt and a paternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Tomosynthesis was performed. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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63-year-old male with history of fall. Wrist: There is a cortical step-off along the dorsal and lateral aspects of the distal radius indicating a non-displaced fracture. Is difficult to assess whether this fracture extends into the articular surface, although we suspect that it does not. The scaphoid is intact.Hand: Again seen is the aforementioned distal radius fracture. The remainder of the hand is unremarkable.
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Distal radius fracture as above.These findings were discussed with Dr. Desai on 1/19/15 at 1520.
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Generate impression based on findings.
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51-year-old male with right ankle pain and fracture Knee: Orthopedic hardware is again seen affixing a comminuted fracture of the proximal tibia in near-anatomic alignment. No hardware complication is evident. The fracture line is indistinct, suggesting some interval healing. There is thickening of the distal patella tendon. Mild osteoarthritis affects the knee. A small joint effusion is noted. Mild osteoarthritis also affects the left knee as seen on the frontal view.Ankle: The bones are demineralized, but we see no fracture. Mild osteoarthritis affects the joint, appearing similar to the prior exam.
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Orthopedic fixation of healing proximal tibia fracture as described above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Tomosynthesis was performed. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Hypodensity is present throughout the white matter in both subcortical and periventricular locations with a suggestion of cortical involvement in the left occipital lobe. There is no significant associated mass effect. The ventricles and sulci are normal in size without evidence of obstruction or hydrocephalus. There are no masses, mass effect or midline shift. There is no evidence for acute intracranial hemorrhage. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear.
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1.Hypodensity is present throughout the white matter in both subcortical and periventricular locations with a suggestion of cortical involvement in the left occipital lobe. Given patient age 67 years this most likely represents ischemia of indeterminate ages, with perhaps cortical involvement in the left occipital lobe. This is new when compared to the study from 2004. If there is clinical concern for acute ischemia, MRI would be recommended to better define these abnormalities2.No CT manifestations of normal pressure hydrocephalus.
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Generate impression based on findings.
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34-year-old female with history of fifth metacarpal fracture An oblique fracture through the distal diaphysis of the fifth metacarpal with slight volar and radial angulation of the distal fragment appears similar to the prior study.
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Fifth metacarpal fracture appearing similar to the prior exam.
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Generate impression based on findings.
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12-year-old male, evaluate small finger Again seen is deformity of the proximal half of the middle phalanx of the fifth finger, perhaps representing sequela of prior infection. There is new bone formation along the radial aspect of the phalanx that may represent an attempt at healing. Mild radial deviation of the PIP joint also appears similar to the prior exam
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Deformity of the PIP joint of the fifth finger appearing similar to the prior exam as described above.
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Generate impression based on findings.
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18 year-old male status post multiple injuries with pain Several small foci of heterotopic mineralization within the soft tissues of the elbow are consistent with prior trauma. We see no acute fracture or malalignment. No joint effusion is noted.
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Multiple foci of heterotopic ossification suggesting prior injury without acute fracture or malalignment.
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Generate impression based on findings.
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70 year-old female with right-sided pain, evaluate DJD Although this exam is nonweightbearing there appears to be mild to moderate dextrorotoscoliosis of the lumbar spine. Severe multilevel degenerative disk disease affects the lumbar spine. Degenerative disk disease affects the visualized lower thoracic spine as well. Moderate multilevel facet joint osteoarthritis is noted. Mild osteoarthritis affects the SI joints and hips. The bones are slightly demineralized. Atherosclerotic calcifications affect the abdominal aorta and iliac arteries. Coils overlie the abdomen, likely representing prior hernia repair. Right upper quadrant surgical clips are noted.
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Scoliosis and severe degenerative arthritic changes as described above.
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Generate impression based on findings.
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60 year-old female with right thumb pain There is mild soft tissue swelling about the hand but we see no fracture. Mild osteoarthritis affects the hand.
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Osteoarthritis without fracture evident.
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Generate impression based on findings.
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Cognitive decline and judgment problems, suggestive of frontal lobe disorder. Evaluate for FTD versus Alzheimer's.RADIOPHARMACEUTICAL: 11.8 mCi F-18 fluorodeoxyglucose (FDG)BLOOD GLUCOSE (FASTING): 97 mg/dL Today's CT portion demonstrates no gross intracranial pathology.Today's PET exam demonstrates severely decreased activity throughout the mid and anterior right temporal lobe. Moderately decreased metabolic activity is seen throughout the similar distribution in the left temporal lobe.A small region of moderate hypermetabolic activity is seen in the right posterior parietal and to a lesser extent left posterior parietal regions.There is moderate hypometabolism involving the anterior portions of bilateral frontal lobes. There is also significant hypometabolism of the posterior cingulate, right greater than left. There is relative sparing of the anterior cingulate. No notable occipital involvement is present.
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Extensive intracranial hypometabolism characterized by severe involvement of the temporal lobes and moderate involvement of the anterior frontal and a smaller region of the parietal as well as posterior cingulate. There is relative sparing of the anterior cingulate and occipital regions. The distribution of these abnormalities is bilateral but right generally worse than left. Given this constellation of findings, Alzheimer's dementia (with frontal lobe involvement) is considered most likely.
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Generate impression based on findings.
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12-year-old female, evaluate for pathologic fracture Again seen is a pathologic fracture through a lucent lesion of the distal radial metadiaphysis with fracture fragments in near anatomic alignment. Early periosteal reaction along the distal radius seen best on the oblique view suggests an attempt at healing.
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Early healing of nondisplaced pathologic fracture through a lucent lesion of the distal radius we suspect is benign.
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Generate impression based on findings.
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17-month-old female with dysphagia and oral aversion.EXAMINATION: Oropharyngeal motility study 1/19/2015 Julie Ecclestone, speech and language therapist, supervised the examination.31 seconds of fluoroscopy was used.PRESENTATION: The patient was presented with the nectar thickened liquid via slow flow nipple and cut out cup as well as stage I purée via spoon.RESULTS: Oral aversion precludes excepted to bottle or spoon. The patient demonstrated immature oral skills including decreased bolus containment, propulsion and anterior loss. No penetration or aspiration was evident.
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No aspiration or penetration.Please see the speech and language therapist's report for feeding recommendations.
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Generate impression based on findings.
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50 year-old female with left proximal femur lesion, evaluate for interval change Again seen is a focus of sclerosis within the subtrochanteric region of the left femur extending across the medullary canal. The densest component of this lesion measures approximately 2.5 cm with an additional tail of sclerosis extending along the posteromedial aspect of the endosteum for an additional 3 cm. The lesion appears similar to the prior exam without evidence of progression or cortical destruction.
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Sclerotic lesion of the proximal femur as described above, which may represent a benign focus of intramedullary osteosclerosis, fibrous dysplasia or peculiar bone island, appearing similar to the prior exam.
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Generate impression based on findings.
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Female 49 years old; Reason: colon cancer follow up History: cough CHEST:LUNGS AND PLEURA: Post surgical changes in the left upper lobe with a wedge resection. The right lower lobe pulmonary lesion measures 5-mm (image 44/series 5) and is unchangedMEDIASTINUM AND HILA: New left hilar lymphadenopathy measures 2.6 x 1.6 cm (image 32/series 5). Chest wall port the cavoatrial junction.CHEST WALL: Left T8 pedicle destructive lesion with an extradural component that narrows the central canal approximately 20%. ABDOMEN:LIVER, BILIARY TRACT: No suspicious hepatic lesions. Probable calcification along the wall of the gallbladder.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes in the ascending colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable bilateral ileum sclerotic focus.OTHER: No significant abnormality noted.
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1.New left hilar lymphadenopathy in the region of the prior lung lesion.2.Left T8 destructive pedicle lesion with an extradural component that narrows the central canal approximately 20%. This can be evaluated by MRI if needed.
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Generate impression based on findings.
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11-year-old male with left renal artery aneurysm. HIstory of hypertension. ABDOMEN:LUNG BASES: No pleural effusions.LIVER, BILIARY TRACT: No focal hepatic lesions. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted. Note is made of a splenule.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Two left renal arteries are present. The superior, smaller renal artery supplies the upper pole and is without abnormalities. The inferior, larger renal artery demonstrates proximal narrowing with an area of dilation followed by another short segment of narrowing distally. No perfusion abnormality to the left kidney is seen. The dilated segment measures approximately 11 mm (series 80428, image 21). The right main renal artery is without abnormalities. The right kidney measures 10 cm and the left kidney measures 9.5 cm. No hydronephrosis. No perinephric fat stranding. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered, subcentimeter mesenteric lymph nodes not pathologically enlarged.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No additional aneurysmal or stenotic vessels are identified.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Scattered, subcentimeter mesenteric lymph nodes not pathologically enlarged.BOWEL, MESENTERY: The appendix is well-visualized and within normal limits. The bowel is within normal limits without evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Beaded appearance of the inferior of the two left renal arteries most likely due to fibromuscular dysplasia. Polyarteritis nodosa is also a consideration.
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Generate impression based on findings.
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Ms. Harvey is a 63 year old female with a personal history of benign right breast biopsy in 2000. She has no current breast related complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications are present in both breasts. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast.
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Scattered benign calcifications in both breasts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Bilateral ductal ectasia is stable.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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67 year old male with groin abscess. ABDOMEN:LUNG BASES: Minimal left pleural effusion, and small pericardial effusion. Small hiatal hernia.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Duplicated right renal collecting system. Bilateral moderate hydronephrosis, with a distended bladder and bladder wall thickening.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: In the medial posterior gastric fundus is an approximately 2 cm filling defect abutting the wall which may be adherent debris versus a masslike projection. Consider correlation with endoscopy.BONES, SOFT TISSUES: Diffuse body wall edema.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate hypertrophy, likely contributing to bladder outlet obstruction.BLADDER: Distended bladder, with wall thickening suggesting bladder outlet obstruction.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Approximately 5.5 x 3.7 x 5.7 cm low density collection in the left medial perineum at the base of the scrotum. Additional small loculations are seen in the surrounding inflammation, likely smaller abscesses. No soft tissue gas is seen.OTHER: No significant abnormality noted
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1. Perineal abscess at the base of the scrotum, with significant adjacent inflammatory stranding and small loculations/satellite abscess up to ~1cm.2. Bilateral hydronephrosis and bladder distention with wall thickening, likely related to prostate hypertrophy and bladder outlet obstruction.3. 2 cm filling defect abutting the posterior gastric fundus wall which may be adherent debris versus a masslike projection. Consider follow up with endoscopy.
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Generate impression based on findings.
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Reason: preop LV lead placement History: fatigue LUNGS AND PLEURA: Attenuation pattern partially accounted for by exam being obtained in less than optimal inspiration.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Residual thymic tissue within the anterior mediastinum.Moderate/marked cardiac enlargement without evidence of a pericardial effusion.Left-sided ICD with lead wires in the right atrial appendage and right ventricle.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.Mild mosaic attenuation pattern accentuated by less than optimal inspiration. This may represent small vessel disease. 2.Moderate/marked cardiac enlargement.3.Left-sided ICD with lead wires in the right atrial appendage and two wires within the right ventricle.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal cousin. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications and stable asymmetries are present in both breasts.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal cousin and maternal aunt. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Scattered benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Female 46 years old; reason: Rectal cancer competed therapy October 2013. Evaluate for interval disease recurrence history: Rectal cancer CHEST:LUNGS AND PLEURA: No dominant lung lesion. The pleural spaces are clear.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Well marginated hypodense focus in the left hepatic lobe is unchanged.No suspicious hepatic lesions. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small right renal cyst. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No mesenteric or retro-peritoneal lymphadenopathy.BOWEL, MESENTERY: Postsurgical changes in the descending colon in the pelvis.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: Postsurgical changes in the rectum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Postsurgical changes without evident metastatic disease.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Left breast moles. History of oophorectomy. Family history of breast cancer in paternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Scattered benign calcifications are present in both breasts. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Benign calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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Memory loss. Behavioral change. Normal head CT. Evaluate for Alzheimer's disease versus frontotemporal dementia.RADIOPHARMACEUTICAL: 10.6 mCi F-18 fluorodeoxyglucose (FDG)BLOOD GLUCOSE (FASTING): 100 mg/dL Today's CT portion demonstrates no gross intracranial pathology.Today's PET portion demonstrates severe hypometabolism involving the left posterior temporoparietal as well as left occipital regions. There is mild to moderate hypometabolism involving the right posterior temporoparietal and occipital regions. Significant involvement of the posterior cingulate and precuneal regions is also noted bilaterally, left greater than right.No significant frontal lobe or anterior cingulate involvement is present on either side.
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Extensive bilateral hypometabolism centered most notably at the left posterior temporoparietal region as detailed above. Given the constellation of findings, Alzheimer's disease is a likely etiology. However, given the prominent occipital involvement, Lewy body dementia is also a consideration. The appearance is not typical for frontotemporal dementia.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in daughter. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign morphology mass in the right central breast is unchanged when compared to prior exams. Scattered benign calcifications, including dermal and ductal calcifications, are present.
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Stable benign morphology mass in the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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