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Generate impression based on findings.
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TachypneaVIEW: Chest AP and abdomen AP 1/20/15 Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. NG tube tip at the GE junction. Patchy atelectasis left lower lobe. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. Mild bowel dilation at the left lower quadrant. No pneumatosis or pneumoperitoneum.
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Minimal patchy atelectasis left lower lobe.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of benign excisional right breast biopsy in 2011 for fibroadenoma. Family history of breast cancer in mother. 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. Multiple surgical clips are identified in the right superior breast. 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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Feeding intoleranceVIEW: Abdomen AP 1/21/15 Feeding tube, suprapubic catheter and IVC stent are in place. Multiple surgical sutures at the right upper quadrant. There is a surgical drain at the right upper quadrant. Disorganized nonobstructive bowel gas pattern. No evidence of pneumoperitoneum.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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1-year-old for evaluation of pneumoniaVIEW: Chest AP (one view) 01/21/15 Cardiothymic silhouette is top normal. No pleural effusion or pneumothorax. Patchy left lower lung atelectasis. Mild peribronchial cuffing suggestive of reactive airway disease/bronchiolitis pattern.
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Bronchiolitis/reactive disease pattern with patchy left lower lung atelectasis.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history breast cancer in mother diagnosed at the age of 78. 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. Personal history of benign right breast biopsy in 1986. 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. Subcentimeter focal asymmetries and benign calcifications identified in both breasts are stable when compared to multiple prior exams. Benign lymph nodes project over both axillae.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Slurred speech and right fine motor skills deficits There is hypodensity involving the right superior cerebellar hemisphere most compatible with infarct. There is additional more well-defined hypoattenuation involving the genu and posterior limb of the left internal capsule which is favored to represent a chronic infarct. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus.Trace mucosal thickening in the paranasal sinuses. Mastoid air cells are clear. Calvarium is intact.
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1. Findings suspicious for acute to subacute right superior cerebellar artery territory infarct.2. Likely chronic left internal capsule infarct.3. No intracranial hemorrhage. No significant mass-effect or hydrocephalus
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Generate impression based on findings.
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53 year-old male with history of mesenteric ischemia status post SBR in November 2014 at outside hospital complicated by leak, status post washout and drain placement. Evaluate. ABDOMEN:LUNG BASES: Mild right basilar atelectasis.LIVER, BILIARY TRACT: No suspicious pulmonary nodules. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild nonspecific perinephric haziness. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Mildly prominent nonspecific retroperitoneal lymph nodes.BOWEL, MESENTERY: As below.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Bladder wall thickening is likely secondary to under distention.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postoperative changes of small bowel resection. Diffuse mesenteric haziness is likely edema.There is a loculated fluid collection in the pelvis anteriorly measuring 6.2 x 2.2 cm (series 3, image 105) with at least two drains that traverse through the collection.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Femoral-femoral bypass graft is present and patent.
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1.Postoperative changes of small bowel resection with a loculated pelvic fluid collection which is being drained by two pelvic drains. 2.Diffuse mesenteric haziness, likely edema.
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Generate impression based on findings.
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Two-year-old male for evaluation of pneumoniaVIEWS: Chest AP/lateral (two views) 01/21/15 Aortic arch, cardiac apex, and stomach are absent. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Moderate peribronchial cuffing is suggestive of reactive airway disease/bronchiolitis pattern. No focal pulmonary opacities.
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Reactive airway disease/bronchiolitis pattern.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of benign left breast biopsy. 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. Diffusely scattered calcifications, including benign ductal and vascular, are seen 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: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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76 year old male with weakness and confusion on warfarin, rule out intracranial hemorrhage. 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. The ventricles and sulci are prominent, consistent with mild age-related volume loss. 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. A more focal area of hypodensity and volume loss along the right central sulcus is compatible with chronic small vessel ischemia. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact.
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No evidence of intracranial hemorrhage.
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Generate impression based on findings.
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Abdominal distentionVIEW: Abdomen AP 1/21/15 NG tube tip in the stomach. The stomach is distended. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum.
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Relative paucity of bowel gas within the abdomen.
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Generate impression based on findings.
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IntubatedVIEW: Chest AP 1/21/15 ET tube tip below thoracic inlet and above the carina. NG tube tip not visualized. Right central line and left PICC again noted. Cardiothymic silhouette at the upper limits of normal. Minimal patchy atelectasis bilaterally improved from prior study. No pleural effusion or pneumothorax.
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Minimal patchy atelectasis improved in the interval.
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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 mother diagnosed at the age of 55. 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. Scattered benign calcifications 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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30 year-old female status post fall with foot pain Again seen is a mildly displaced fracture along the dorsal aspect of the navicular. The previously noted calcaneal fracture is not clearly evident. No additional fracture is noted.
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Navicular fracture without clear visualization of the calcaneal fracture.
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Generate impression based on findings.
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Intubated abdominal distentionVIEW: Abdomen AP 1/21/15 NG tube tip in the stomach. UVC tip at the cavoatrial junction. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. Diffuse lung haziness in the right lower lobe and left lower lobe.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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68-year-old male with history of lymphoma, recent syncope, nausea/vomiting. Evaluate for metastatic disease. 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. The ventricles and sulci are prominent, consistent with mild age-related volume loss. No extra-axial collections. Prominent vascular calcifications are noted of the distal right vertebral artery.The visualized portions of the paranasal sinuses are clear. Mildly under-pneumatized mastoid air cells. Calvarium is intact.
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No evidence of intracranial abnormality.
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Generate impression based on findings.
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TEF repair intubatedVIEW: Chest AP 1/21/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Right chest tube, left central line and gastrostomy tube again noted. The sidehole of the right chest tube is within the subcutaneous tissue. Cardiothymic silhouette normal. Patchy atelectasis in the right lung with a small right pneumothorax not significantly changed.
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Patchy atelectasis in the right lung with small right pneumothorax not significantly changed.
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Generate impression based on findings.
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Male; 48 years old. Reason: eval of RLQ fullness and pitting edema History: as above LUNGS AND PLEURA: Persistent right upper lobe atelectasis with occlusion of the right upper lobe bronchus. No discretely measurable tumor in the right upper lobe. Interval increased streaky subsegmental atelectasis in the remainder of the right lung. Moderate to large bilateral pleural effusions, increased since prior study. Mild adjacent compressive bibasilar subsegmental atelectasis.MEDIASTINUM AND HILA: Soft tissue in the right paratracheal area of the mediastinum encasing the superior vena cava, compatible with tumor and not significantly changed; the SVC is patent.Reference enlarged prevascular lymph node measures 14 mm, previously 14 mm (series 4/28).Reference enlarged subcarinal lymph node measures 16 mm, previously 16 mm (series 4/41).Moderate pericardial effusion is similar to prior study. No visible coronary artery calcifications.CHEST WALL: Reference enlarged right supraclavicular lymph node measures 15 mm, previously 15 mm (series 4/10). Mild body wall anasarca in the inferior chest.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. See report from dedicated CT abdomen and pelvis performed concomitantly.
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1. Moderate to large bilateral pleural effusions, increased since prior study. Otherwise, no significant interval change.2. Persistent atelectasis with no measurable tumor in the right upper lobe.3. Stable mediastinal lymphadenopathy.4. See report from dedicated CT abdomen and pelvis performed concomitantly.
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Generate impression based on findings.
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25-year-old female with pain in fourth and fifth digit post injury There is a 2-3 mm faint amorphus density in the soft tissues along the ulnar aspect of the PIP joint of the ring finger, which may represent a collateral ligament avulsion fracture fragment although no donor site is visualized. Alternatively, this may represent chronic injury. The remainder of the hand appears normal.
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Small density adjacent to the PIP joint of the ring finger which may represent a collateral ligament avulsion fragment or sequela of chronic injury.
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Generate impression based on findings.
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Fall with loose teeth. There is swelling and stranding in the left upper lip. There is periodontal lucency at tooth # 9 with an associated fine lucency medially in the maxillary alveolus that extends into the nasal spine. There are also carious teeth # 2 and 30 with associated periodontal lucency. There is a subcentimeter probable left posterior mandibular enostosis. The temporomandibular joints are intact. The orbits and salivary glands are unremarkable. There is moderate mucosal thickening in the right maxillary sinus. The mastoid air cells and middle ear cavities are clear. The imaged intracranial structures are unremarkable. There is degenerative spondylosis of the upper cervical spine.
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1. Left upper lip contusion and periodontal lucency at tooth # 9 with an associated fine lucency medially in the maxillary alveolus that extends into the nasal spine may represent a tooth loosening with what may represent an adjacent non-displaced fracture. Superimposed infection in the form of cellulitis cannot be excluded. However, assessment for abscess is limited without intravenous contrast.2. Carious teeth # 2 and 30 with associated periodontal disease.
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Generate impression based on findings.
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32-year-old female with pain after fall on ice Ankle: The ankle appears normal with no fracture or other findings to account for the patient's symptoms.Tibia and fibula: No fracture is evident. No specific findings to account for the patient's symptoms.
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No fracture or other specific findings to account for the patient's symptoms.
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Generate impression based on findings.
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18 year-old male with lumbar pain after fall playing basketball No fracture is evident. Alignment is within normal limits. No specific findings to account for the patient's symptoms.
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No fracture or other specific findings to account for the patient's symptoms.
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Generate impression based on findings.
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Neurofibromatosis type I. Needs IR embolization. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Gallstones.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: In the left flank, there is a 11.0 x 5.6 cm mixed density soft tissue mass abutting the left iliac bone (image 56; series 10). Multiple feeding arteries supplying the inferior portion of the mass have already been embolized by coils. Remaining vasculature appears to be predominating from intercostal and subcostal arteries on the left. Streak artifact from spine stabilization rods obscures visualization of some of these.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Presumed neurofibroma in the left flank status post partial embolization with residual feeding arteries emanating from the left intercostal and subcostal arteries. Gallstones.
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Generate impression based on findings.
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33-year-old female with back pain, lower extremity paresthesias after MVC Alignment is within normal limits. No fracture is evident. Vertebral body heights and disk spaces are preserved.
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No fracture or malalignment.
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Generate impression based on findings.
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12-year-old female with abdominal pain, amylase in 1000s. Rule out pancreatitis. ABDOMEN:LUNG BASES: No consolidation or pleural effusion.LIVER, BILIARY TRACT: Segment 4 apparent hypointensity is typical of a perfusion anomaly. Otherwise, the liver enhances homogeneously without focal lesion. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: Enhances normally without focal lesion.PANCREAS: The pancreas is enlarged with blurring of the peripancreatic fat planes, compatible with acute pancreatitis. There is decreased enhancement in the pancreatic distal body and tail which is suspicious for necrosis. Extensive complex free fluid is seen in the abdomen and pelvis, measuring between 25 and 50 Hounsfield units.ADRENAL GLANDS: No adrenal nodularity or thickening bilaterally.KIDNEYS, URETERS: The kidneys enhance symmetrically without focal lesion.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy is identified.BOWEL, MESENTERY: The bowel is normal in caliber without obstruction or ileus. A normal appendix is identified.BONES, SOFT TISSUES: No focal osseus lesion is identified. Minimal soft tissue edema in the posterior body wall.OTHER: The portal vein, splenic vein, and superior mesenteric veins are patent without evidence of thrombosis. The splenic artery is normal in caliber without evidence of pseudoaneurysm.PELVIS:UTERUS, ADNEXA: No significant abnormality is identified in the uterus or adnexa.BLADDER: Mildly distended.LYMPH NODES: No iliac chain, inguinal, or other pelvic lymphadenopathy.BOWEL, MESENTERY: Normal in caliber without evidence of obstruction or ileus.BONES, SOFT TISSUES: No focal osseous lesion is identified.OTHER: Free fluid in the pelvis, described above.
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Acute necrotizing pancreatitis with extensive complex fluid in the abdomen and pelvis.
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Generate impression based on findings.
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69-year-old female with pain. Evaluate for diverticulitis. ABDOMEN:LUNG BASES: Mild interval decrease in previously noted right lower lobe pulmonary micronodule (series 4, image 3). No suspicious pulmonary nodules. LIVER, BILIARY TRACT: No focal hepatic lesions. Cholelithiasis without associated inflammatory changes to suggest cholecystitis. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right kidney is asymmetrically atrophic, unchanged. The left kidney does not demonstrate nephrolithiasis or hydronephrosis. RETROPERITONEUM, LYMPH NODES: Surgical clips in the retroperitoneum noted.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis. No evidence of small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis. No evidence of small bowel obstruction. Surgical clips are present in the pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Diverticulosis without evidence of diverticulitis as clinically questioned.2.Stable right renal atrophy without evidence of hydronephrosis or renal calculi in the left kidney.3.Cholelithiasis.4.Interval decrease in size of right lower lobe micronodule.
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Generate impression based on findings.
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63-year-old male with back pain after MVC, evaluate for fracture Thoracic spine: Moderate to severe multilevel degenerative disk disease affects the thoracic spine. No fracture is evident. Degenerative arthritic changes also affect the visualized cervical spine.Lumbar spine: Severe degenerative disk disease is noted throughout the lumbar spine. There is loss of the normal lumbar lordosis and grade 1 retrolistheses of the L2 and L3 vertebral bodies.
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Severe degenerative disk disease without fracture evident.
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Generate impression based on findings.
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MVC, right temporal pain. Evaluate for intracranial hemorrhage and fracture. Brain:No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus.Minimal opacification of the visualized paranasal sinuses. Mastoid air cells are clear. Calvarium is intact.Cervical Spine:There is reversal of cervical lordosis with kyphosis at the C5-C6 level, which may be positional. There is minimal disk bulge at the C5-C6 level. No evidence of fracture or subluxation within the cervical spine. No significant spinal canal or neural foraminal stenosis is seen.Paraspinous soft tissues are unremarkable without evidence of prevertebral edema.
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1. No evidence of intracranial hemorrhage.2. No evidence of fracture or subluxation within the cervical spine. There is kyphotic angulation at the C5-C6 level which may be positional. If there is suspicion for ligamentous injury, consider MRI for further evaluation.
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Generate impression based on findings.
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55-year-old male with pain to left shoulder status post falling in CTA Mild osteoarthritis affects the glenohumeral joint. No fracture is evident. The acromioclavicular joint is slightly widened, which we suspect is chronic given that there is little soft tissue swelling, but this could conceivably represent a separation if the patient is tender at this site.
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No fracture evident. Mild widening of the acromioclavicular joint that we suspect is chronic, although if the patient is tender at this site this could conceivably represent a separation. Findings text paged to pager 5019 (Katheryne Amba).
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Generate impression based on findings.
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56-year-old female with history of recent resection of right vestibular schwannoma, now with altered mental status and right-sided weakness. Evaluate post operative hemorrhage. Postsurgical changes related to recent right parietooccipital craniotomy and gross total resection of the right cerebellopontine angle schwannoma, including extra-axial fluid, blood products, and multiple foci of intracranial air within the basal cisterns, the nondependent portions of the intracranial space and along the falx. An air-fluid cavity is present in the site of the previous mass. An extraaxial collection of hyperdense blood products is present in the right posterior lateral perimesencephalic cistern, extending into the right quadrigeminal plate cistern. There is no intraventricular extension of blood. There is continued mild mass effect on the right pons and cerebellum, including mild effacement of the fourth ventricle, and minimal midline shift to th left, which has mildly improved in the interim. There is now focal asymmetric prominence of the extra-axial space along the right anterolateral posterior fossa.Redemonstration of diffuse prominence of the ventricular system, which is not significantly changed when compared to prior exam. There is no specific evidence of focal obstruction.The known bilateral MCA aneurysms are not visualized on this noncontrast exam.There are air/fluid levels within the left maxillary, posterior ethmoids, and right sphenoid sinuses, as well as aerated secretions in the left sphenoid sinus.
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1. Postsurgical changes related to recent craniotomy and gross total resection of right cerebello-pontine angle mass including pneumocephalus and infratentorial blood products.2. Persistent mass effect upon right pons and cerebellum with mild effacement of the fourth ventricle, and minimal midline shift to the left.3. Communicating hydrocephalus, which is grossly stable when compared to prior exam.
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Generate impression based on findings.
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Pain over SI joint, rule out fracture Three views of the sacroiliac joints are provided. There is no fracture or malalignment. Degenerative disk disease affects L5-S1.
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Degenerative disk disease without evident fracture.
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Generate impression based on findings.
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Ms. Franczek is a 67 year old female with a personal history of left breast lumpectomy in 2013 for IDC/DCIS followed by radiation and Arimidex therapy. Family history of breast cancer in maternal cousin. No current breast related complaints. She is currently being followed up on a short term basis for high probability benign calcifications in the left lumpectomy bed. Three standard views of both breasts with two left spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the left breast. There are stable postsurgical changes including architectural distortion, increased density, and surgical clips present within the left lumpectomy site. Coarse dystrophic calcifications have developed in a benign fashion in the left lumpectomy bed. Additional scattered benign calcifications are present. Biopsy marker clip is identified in the right superior breast. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast.
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Stable postsurgical changes in the left breast with benign dystrophic calcifications in the lumpectomy bed. 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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Pain, swelling Two views of the right ankle show mild soft tissue swelling without acute fracture or dislocation. Mild osteoarthritis affects the ankle and midfoot. An ossicle distal to the medial malleolus may reflect old trauma.
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Soft tissue swelling and osteoarthritis without fracture.
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Generate impression based on findings.
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39-year-old female with abdominal pain with bleeding. Recent colonoscopy. Evaluate for colitis versus perforation. ABDOMEN:LUNG BASES: Mild bilateral basilar atelectasis.LIVER, BILIARY TRACT: No suspicious hepatic lesions. No intra-or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Nonspecific mildly prominent retroperitoneal lymph nodes.BOWEL, MESENTERY: Mild to moderate descending colonic wall thickening with mild associated inflammatory changes highly suspicious for colitis which may be infectious or inflammatory in etiology. No evidence of small bowel obstruction. No pneumoperitoneum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: Streak artifact from pelvic surgical hardware limits evaluation.UTERUS, ADNEXA: Bilateral adnexal hypoattenuating lesions likely physiologic cysts. Trace free pelvic fluid is likely physiologic in etiology.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As above.BONES, SOFT TISSUES: Surgical hardware about the left hemipelvis and pubis.OTHER: No significant abnormality noted
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1.Mild to moderate descending colonic wall thickening consistent with colitis which could be infectious or inflammatory in etiology. 2.No evidence of pneumoperitoneum as clinically questioned.
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Generate impression based on findings.
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Altered mental status. There is no evidence of intracranial hemorrhage or mass. There is mild patchy cerebral white matter hypoattenuation, which appears unchanged. The ventricles are unchanged in size and configuration, where there is perhaps disproportionate medial temporal volume loss. There is no midline shift or herniation. The imaged mastoid air cells are clear. There is mild scattered paranasal sinus opacification. The skull and scalp soft tissues are unremarkable. There are bilateral lens implants.
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1. No evidence of acute intracranial hemorrhage.2. Mild cerebral white matter hypoattenuation appears unchanged and may represent small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.3. Apparent disproportionate medial temporal volume loss, which may indicate Alzheimer's disease.
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Generate impression based on findings.
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3-year-old male with fracture.VIEWS: Left elbow AP/lateral/oblique (3 views) 1/21/2015, 036 No fracture or malalignment in the left elbow. A joint effusion is not present.
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Normal examination.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of uterine cancer in remission. Family history of breast cancer in sister at 66 years of age. 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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Evaluation is limited secondary to beam hardening artifact from the patient's shoulders along the lower cervical spine. Postoperative changes are seen from previous laminectomy from C3 through C6, with a widely patent central spinal canal at these levels. The scout lateral view and the sagittal reformatted images demonstrate normal alignment of the cervical spine, with a normal cervical lordosis. The vertebral body heights are well-maintained. There is mild disk space narrowing at C3-C4, and moderate space narrowing at C4-C5 and C5-C6. Scattered ventral osteophytes are noted along the mid to lower cervical spine.There is no acute fracture.At C1-C2, there is a normal relationship of the dens with the arch of C1.There are moderate multilevel spondylotic changes predominantly in the form of facet arthropathy and uncovertebral hypertrophy. There is severe foraminal narrowing bilaterally at C4-C5 and C5-C6.The visualized intracranial structures and lung apices appear normal.
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1. No acute fracture or subluxation.2. Postoperative changes from previous laminectomies C3 through C6 with decompressed central spinal canal.3. Moderate multilevel spondylotic changes with severe bilateral foraminal narrowing at C4-C5 and C5-C6.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of prior left breast benign surgical biopsy in 1984. 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 almost entirely fatty, unchanged in pattern and distribution. Linear scar marker overlies the left breast. Mild scarring in the left outer breast likely relates to prior benign biopsy. Benign calcifications are noted in the right breast. Intramammary lymph node in the right upper outer quadrant is unchanged.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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Ms. ParkerJones is a 67 years year old female with a personal history of left breast lumpectomy in 2013 for DCIS followed by radiation and hormonal therapy. Family history of breast cancer in mother (diagnosed at the age of 82), sister (diagnosed at the age of 62), and maternal aunt (diagnosed at the age of 76). No current breast related complaints. Three standard views of both breasts with three left spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the left breast. There are stable postsurgical changes including architectural distortion, increased density, and surgical clips present within the left lumpectomy site. A few 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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Stable postsurgical changes in the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Female; 21 years old. Reason: 21yo F with acute onset chest pain, hypoxia History: - PULMONARY ARTERIES: Nearly occlusive acute pulmonary embolus in the right lower lobar artery extending to the segmental level (series 6/112). Questionable nonocclusive pulmonary embolus in a left lower lobe segmental artery (series 6/115), but evaluation is limited by respiratory motion. Slightly enlarged main pulmonary artery measuring up to 3.1-cm, which may be due to pulmonary arterial hypertension. No evidence of right heart strain.LUNGS AND PLEURA: Moderate to marked right lower lobe consolidation with areas of groundglass, compatible with infarct and hemorrhage given the right lower lobe pulmonary embolus. Mild streaky subsegmental atelectasis and/or scarring in the right middle and upper lobes. Moderate nonspecific left basilar atelectasis/consolidation. Moderate right pleural effusion.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Acute right lower lobar pulmonary embolus. Questionable nonocclusive pulmonary embolus in a left lower lobe segmental artery.2. Slightly enlarged main pulmonary artery, which could be due to pulmonary arterial hypertension. No evidence of right heart strain.3. Moderate to marked consolidation in the right lower lobe, compatible with infarct and hemorrhage. Nonspecific left basilar atelectasis/consolidation.4. Moderate right pleural effusion.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Lobar.RV Strain: Negative.
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Generate impression based on findings.
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Left breast cancer.RADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 0.54 mCi Tc-99m filtered sulfur colloid was injected subcutaneously. Following injection, intraoperative probe localization was performed.
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Successful left breast injection for intraoperative identification of sentinel lymph node.
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Generate impression based on findings.
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Lumbar pain Two views of the lumbar spine show a slight leftward curvature of the lumbar spine. Mild degenerative disk disease affects L5-S1. Small anterior vertebral body osteophytes are present.
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Mild degenerative arthritic changes as described above.
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Generate impression based on findings.
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2-year-old female with vomiting after eating, rule out mass. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No evidence of intracranial hemorrhage or mass effect.
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Generate impression based on findings.
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Male 66 years old; Reason: s/p lung tx, pneumonectomy - r/o source of infection, free air, eval G/J tube History: ABD pain, sepsis CHEST:LUNGS AND PLEURA: Right hemithorax is completely fluid-filled after pneumonectomy. There is a small left pleural effusion with overlying atelectasis at the left lung base. MEDIASTINUM AND HILA: Midline tracheostomy tube. Right central venous catheter is unchanged in position. New left sided PICC and central venous catheter terminating in the lower SVC. Mildly prominent mediastinal lymph nodes again seen. CHEST WALL: Right sided shoulder intramuscular lipoma, unchanged. ABDOMEN:LIVER, BILIARY TRACT: Moderate layering sludge in nondistended gallbladder as noted previously. SPLEEN: No significant abnormalityPANCREAS: Previous described edema and fat stranding have nearly completely resolved.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral indeterminate renal nodules described in extensive detail previously (please refer to that report) appear stable. A benign etiology is favored.RETROPERITONEUM, LYMPH NODES: Aortobiiliac atherosclerotic calcifications. BOWEL, MESENTERY: Sigmoid colon diverticulosis without evidence of acute diverticulitis. GJ tube unchanged in position with its tip in the mid jejunum in the left lower quadrant.PELVIS:PROSTATE, SEMINAL VESICLES: Intraprostatic calcifications, stable.BLADDER: Collapsed bladder, making evaluation suboptimal.BONES, SOFT TISSUES: Visualized osseous structures without significant change. Multiple rib deformities again seen, unchanged. Multilevel loss of height of vertebral bodies, similar appearance to prior exam, including T6 compression deformity.OTHER: Small amount of ascites. Moderate anasarca. Subcentimeter fat containing umbilical hernia.
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No clear etiology to explain abdominal pain and sepsis. GJ tube in appropriate position, unchanged. Status post right pneumonectomy. Small amount of pelvic ascites. Regression of peripancreatic and pancreatic edema. Other findings stable compared to prior as above.
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Generate impression based on findings.
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30 year-old female with ventriculoperitoneal shunt. Pain at incision for shunt. Evaluate for pseudocyst. ABDOMEN:LUNG BASES: Mild bilateral basilar atelectasis. Interval resolution of left pleural effusion.LIVER, BILIARY TRACT: No focal hepatic lesions. No intra-or extrahepatic biliary ductal dilatation. Postoperative changes of cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Ventriculoperitoneal shunt with tip lateral to the liver with small amount of perihepatic ascites. Previously noted loculated fluid at the lateral aspect of the spleen has resolved.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Ventriculoperitoneal shunt catheter tip at the lateral aspect of the liver with small perihepatic ascites. 2.No loculated collections to suggest a CSF pseudocyst. 3.Interval resolution of perisplenic loculated collection. 4.Interval resolution of left pleural effusion.
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Generate impression based on findings.
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Decreased range-of-motion and left arm strength, evaluate for fracture or dislocation Three views of the left shoulder are provided. The bones appear demineralized. There is no acute fracture or malalignment. Mild osteoarthritis affects the acromioclavicular joint.
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Mild osteoarthritis without fracture.
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Generate impression based on findings.
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History of migraine headaches, left eye blurry vision No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus. Partially empty sella is noted.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact.
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1. No evidence of intracranial hemorrhage, hydrocephalus, or herniation.2. Partially empty sella, which can be a normal variant but is also associated with intracranial hypertension in the appropriate clinical setting.
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Generate impression based on findings.
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Parkinson's disease. Bilateral deep brain stimulator placement. A stereotactic frame is in position. There is interval insertion of deep brain electrodes into the bilateral globi pallidi region with introduction of small amounts of pneumocephalus. There is no evidence of gross intracranial hemorrhage, within the limits of metal streak artifact.
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Intraoperative CT demonstrates interval insertion of deep brain electrodes without apparent complications.
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Generate impression based on findings.
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10-week-old female for evaluation of pneumoniaVIEW: Chest AP (one view) 01/21/15 Aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is normal. There is focal upper lobe opacity with air bronchogram with scattered patchy atelectasis. No pleural effusion or pneumothorax.
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Left upper lobe pneumonia superimposed on bronchiolitis.
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Generate impression based on findings.
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Pain Two views left hip show components of a total hip arthroplasty situated in near anatomic alignment without radiographic evidence of hardware complications. There is chronic deformity of the left ilium, unchanged. There is partial sacralization of the L5 vertebral body. AP view the pelvis shows no acute fracture. There is perhaps a mild coxa valga deformity of the right hip, unchanged. A T-shaped contraceptive device is in the pelvis.
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Left total hip arthroplasty as described above.
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Generate impression based on findings.
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The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation or pathological enhancement. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.There is mild to moderate atherosclerotic calcification along the cavernous right internal carotid artery. The intracranial internal carotid arteries are normal in course and caliber. Incidental note is made of a small fenestration either involving the ACOM or a the left A1-A2 junction. The middle and anterior cerebral arteries are unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course and caliber. The left vertebral artery is dominant. There is no evidence of flow-limiting stenosis or aneurysm.
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Unremarkable CTA of the head.
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Generate impression based on findings.
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18-month-old with status epilepticus. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. Mild hypodensity along the superior-lateral aspect of the right tentorium likely relates to focal prominence of the extra-axial space. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No evidence of intracranial abnormality.
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Generate impression based on findings.
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61-year-old male with history of locally advanced esophageal cancer. Patient has been on chemotherapy for last two years. Evaluate. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Interval decrease in size of the left pleural effusion which is currently small in size. No pneumothorax.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion. Mild coronary artery calcifications. No significant interval change in the abnormal dilatation of the esophagus with associated esophageal wall stent extending into the gastric cardia. Stable abnormal circumferential wall thickening of the distal esophagus surrounding the wall stent.CHEST WALL: Left-sided chest port with catheter tip in the right atrium. ABDOMEN:LIVER, BILIARY TRACT: Two hepatic dome subcentimeter hypoattenuating foci are too small to characterize but stable and likely benign in etiology.SPLEEN: Splenic granulomata. Previously noted hypoattenuating focus within the posterior aspect of the spleen is not as conspicuous on the current examination.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral hypoattenuating renal lesions consistent with simple cysts. No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: Interval improvement in the previously noted gastrohepatic discrete nodular focus with no measurable soft tissue nodule on the current examination.BOWEL, MESENTERY: Interval removal of the gastrostomy tube.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.No significant interval change in distal esophageal wall stent with abnormal circumferential wall thickening of the distal esophagus, most likely corresponding to the known distal esophageal malignancy. 2.Interval resolution of the gastrohepatic node.3.Interval decrease in size of left pleural effusion, which is currently small.
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Generate impression based on findings.
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Male 75 years old; Reason: Evaluate vesicourethral anastomosis s/p prostatectomy Prompt filling of the bladder and right collecting system to the renal calyces with gross hydroureteronephrosis. No evidence of extraperitoneal or intraperitoneal leak. Left collecting system and transplanted kidney were not visualized. Postvoid imaging showed no evidence of urinary retention. Multiple bladder diverticula noted.
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1.No evidence of extraperitoneal or intraperitoneal leak. 2.No evidence of urinary retention.3.Reflux of contrast into extensive right hydroureteronephrosis. 4.Multiple bladder diverticula.
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Generate impression based on findings.
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CVA one month ago, evaluate for multiple lesions. Patient's symptoms have worsened. There is extensive encephalomalacia involving the left cerebellar hemisphere with ex vacuo dilatation of the fourth ventricle. Atrophy also involves the left middle cerebellar peduncle. There is mild volume loss involving the right cerebellar hemisphere. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. No hydrocephalus.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact.
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1. Chronic left cerebellar infarct.2. No evidence of acute intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.
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Generate impression based on findings.
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CHEST:LUNGS AND PLEURA: Small left pleural effusion, with only minimal fluid on the left.Small focus of groundglass opacity in the right upper lung (4/73), nonspecific but may be followed on subsequent exams to ensure resolution.MEDIASTINUM AND HILA: Heart size within normal limits, and there is no pericardial effusion. Severe coronary arteries calcifications.CHEST WALL: Diffuse axial and appendicular skeleton sclerosis, consistent with widespread metastases.ABDOMEN:LIVER, BILIARY TRACT: Approximately 2.7 x 3.5 x 5.1 cm heterogeneous hypoattenuating focus of liver parenchyma anteriorly on either side of the falciform ligament, consistent with given history of hepatic metastases (3/96). Additional adjacent hypoattenuating focus in the liver adjacent to the aforementioned metastases (3/89).SPLEEN: Multiple hypoattenuating foci within the spleen, consistent with given history of metastases. A reference splenic lesion (3/1) measures approximately 3 x 1.8 cm (3/101).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 small bowel obstruction, no free air. Appendix within normal limits.BONES, SOFT TISSUES: Diffuse axial and appendicular osseous metastases.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of pelvic ascites.
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1.Hepatic, splenic and osseous metastases as above.2.Small right pleural effusion.3.Right upper lung groundglass opacity, nonspecific and may be followed on subsequent exams.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of right breast cyst aspiration and scar underneath the left breast. History of ovarian cancer in maternal aunt diagnosed at the age of 84 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. Previous benign surgical biopsy of the right breast in 2003 and benign right breast FNA in 2005. 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. Linear scar marker overlies the upper outer right breast with associated architectural distortion. Stable focal asymmetry in the upper inner quadrant of the left breast. Scattered calcifications bilaterally have progressed in a benign fashion. 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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History of multiple myeloma, post-auto sctx evaluation SKULL: Two views of the skull show no discrete myelomatous lesions.CERVICAL SPINE: Two views of the cervical spine show multilevel degenerative disk disease without discrete myelomatous lesions.THORACIC SPINE: Two views of the thoracic spine are provided. The bones appear demineralized. Mild degenerative arthritic changes affect the thoracic spine. There are no discrete myelomatous lesions. LUMBAR SPINE: Two views of the lumbar spine show 5 lumbar vertebral bodies without discrete myelomatous lesions. Moderate facet osteoarthritis affects L5-S1.RIBS: Single view of the ribs shows no discrete myelomatous lesions.PELVIS: AP view the pelvis shows no discrete myelomatous lesions.UPPER EXTREMITY: Right humerus: Slightly mottled lucencies of the proximal humeral diaphysis could conceivably represent myelomatous deposits, but this is equivocal and unchanged from the prior exam.Left humerus: A couple small lucencies in the humeral diaphysis could conceivably represent myelomatous deposits, but this is equivocal and unchanged.Forearms: AP views of the left and right forearm show no discrete myelomatous lesions.LOWER EXTREMITY: Right femur: No discrete myelomatous lesions.Left femur: No discrete myelomatous lesions.Tibia/fibula: AP views of the left and right tibia/fibula show no discrete myelomatous lesions.
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Tiny nonspecific lucencies in the bilateral humeral diaphyses as described above could conceivably represent myelomatous deposits, but this is equivocal. There is no evidence of disease progression.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. 60lb weight gain since prior study. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Additional left MLO views and left cleavage view were performed (7 images total). Tomosynthesis was performed. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Again noted is a ribbon clip near the small benign mass in the 8 o'clock position of the right breast, unchanged from the prior study. 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: 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 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 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.BIRADS: 1 - Negative.RECOMMENDATION: NSD - Screening Mammogram.
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Generate impression based on findings.
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Nasal septal perforation; sinus pain/pressure; chronic rhinorrhea. There are postoperative findings related to septorhinoplasty. There is a defect in the cartilaginous nasal septum that measures up to 10 mm in length. There is otherwise no significant nasal septal deviation. There is linear opacification adjacent to the nasal septal defect in the right nasal cavity. The paranasal sinuses are clear. 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 are degenerative changes affecting the bilateral temporomandibular joints.
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1. Postoperative findings related to septorhinoplasty with a defect in the cartilaginous nasal septum that measures up to 10 mm in length and linear opacification adjacent to the nasal septal defect in the right nasal cavity that may represent crusting debris or adhesions.2. The paranasal sinuses are clear. 3. Bilateral temporomandibular joint degenerative disease.
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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 her mother at age 54. 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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Zero day old female with limb anomalyVIEW: Chest/Abdomen AP (two view) 01/21/15 Aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is normal. Minimal left lower lobe atelectasis. No pleural effusion or pneumothorax.Nonobstructive bowel gas pattern. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas.
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Minimal left lower lobe atelectasis.
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Generate impression based on findings.
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30 year-old female, rule out fracture A mildly displaced fracture along the dorsal aspect of the navicular is best seen on the lateral view. The fracture fragment measures just under 1 cm in AP dimension. There is also a mildly displaced fracture through the anterolateral corner of the calcaneus best seen on the AP view of the foot with the fracture fragment measuring just over 1 cm in medial/lateral dimension.
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Mildly displaced dorsal navicular and anterolateral calcaneal fractures.
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Generate impression based on findings.
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Female; 49 years old. Reason: pe? ILD flare? History: shortness of breath PULMONARY ARTERIES: No acute pulmonary embolus. Enlarged main pulmonary artery measuring up to 4.3-cm, compatible with pulmonary arterial hypertension. No evidence of right heart strain.LUNGS AND PLEURA: Chronic interstitial lung disease with bilateral reticular opacities with septal thickening, architectural distortion, and traction bronchiectasis is not significantly changed since prior study from outside institution on 2/10/14, accounting for differences in technique. However, the interstitial lung disease is mildly increased in the right upper lobe since study performed at this institution on 11/18/10. Moreover, there is increased ground glass opacity in the right upper lobe, which raises the question of acute interstitial pneumonia on a background of chronic interstitial lung disease. Mosaic attenuation may be due to airtrapping or small vessel disease. No evidence of honeycombing. No pleural effusions.MEDIASTINUM AND HILA: Moderate cardiomegaly without pericardial effusion. No visible coronary artery calcifications. Moderate mediastinal lymphadenopathy is grossly stable since 11/18/2010. Reference right paratracheal lymph node measures 26 mm (series 7/11), previously 26 mm.CHEST WALL: Old healed left-sided rib fractures.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Stable small left hepatic hypodensity is too small to characterize but likely represents a benign cyst.
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1. No acute pulmonary embolus.2. Chronic interstitial lung disease as described above with questionable superimposed acute interstitial pneumonia in the right upper lobe.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her sister at age 55. 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. Benign morphology mass in the left lower outer quadrant is again noted. Bilateral diffuse calcifications are also again seen, not significantly changed.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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40 year-old female with right upper and lower extremity weakness for two days, and right-sided paresthesias, evaluate for ischemia. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no mass effect or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No evidence of intracranial hemorrhage. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.
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Generate impression based on findings.
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The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.
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No acute intracranial abnormality.
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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 mother (diagnosed at age 50) and 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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There is redemonstration of a parenchymal hemorrhage centered in the right caudate tail along the lateral aspect of the posterior body and trigone of the right lateral ventricle. The hematoma is not significantly changed in size, measuring 1.4 x 3.9 cm in greatest axial dimensions on 80298/16. It has a slightly more homogeneous appearance than on the prior exam. There is again intraventricular extension with casting of the majority of the right lateral ventricle, with more confluent blood products in the right occipital horn. Other scattered hyperdense blood products are seen elsewhere within the ventricular system with similar distribution to the prior exam. Ventricular caliber is unchanged, with the right lateral ventricle slightly larger than the left.There is no midline shift or mass effect. There are no areas of abnormal attenuation or pathological enhancement. There is no extraaxial fluid collection. There is mild scattered mucosal thickening within the ethmoid air cells. Tiny mucosal retention cysts are noted in the maxillary sinuses. The visualized portions of the mastoids/middle ears are grossly clear.There is mild scattered atherosclerotic calcification along the cavernous carotid arteries bilaterally, with tortuosity of the right distal internal carotid artery. The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course and caliber. The right vertebral artery is dominant. There is no evidence of flow-limiting stenosis or aneurysm.CTA NECK
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1. Expected minimal interval evolution of right caudate hemorrhage with extensive intraventricular extension.2. Stable ventricular caliber, with right lateral ventricle slightly larger than left.3. No evidence of intracranial aneurysm. Essentially unremarkable CTA of the head and neck.4. Significant cervical spondylotic changes noted, including moderate-severe central spinal canal stenosis at least at C3-C4 with additional severe bilateral foraminal narrowing at this level as well multiple levels caudally. MRI of the cervical spine may be obtained as clinically indicated.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast carcinoma in her mother, aunt, and sister. History of a benign core biopsy of the right breast, performed in 2011. 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. A coarse benign calcification in the right retroareolar region is again noted, corresponding to the biopsied benign lesion (no marker clip was placed). Scattered benign-appearing calcifications in both breasts are unchanged. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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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 almost entirely fatty. Subcentimeter focal asymmetry is noted in the right breast at the 9:00 position. No suspicious microcalcifications or areas of architectural distortion are present.
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Focal asymmetry is noted in the right breast at the 9:00 position. Further evaluation with spot compression and possible ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EA - Additional Mammo/Ultrasound Workup Required.
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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 extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. Stable oval asymmetry in the inferior right breast seen only on right MLO view is stable dating back to 2009.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: NSD - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast carcinoma in half-sister. 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. Stable fibroadenomatous calcifications are present bilaterally. The benign-appearing subcentimeter mass in the medial right breast and focal asymmetry in left breast at 12 o'clock are stable. Arterial 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: NSB - Screening Mammogram.
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Generate impression based on findings.
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Fall, left hip internal rotation and knee pain, evaluate for fracture Right hip: Two views of the right hip show hardware components of a total hip arthroplasty situated in near anatomic alignment without radiographic evidence of hardware complications.Left hip: Two views of the left hip show hardware components of a total hip arthroplasty situated in near anatomic alignment without radiographic evidence of hardware complications.Pelvis: AP view the pelvis shows no evident fracture. Arterial calcifications are noted.Right knee: Mild osteoarthritis without evident fracture, malalignment, or joint effusion.Left knee: Left knee is normal for age without evident fracture.
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Total hip arthroplasties and mild right knee osteoarthritis without fracture.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of benign right stereotactic core biopsy for calcifications in 2004. History of breast carcinoma in paternal grandmother and 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. Round markers were placed on skin lesions bilaterally. Diffusely scattered calcifications bilaterally are stable. 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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Exertional headache. There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged mastoid air cells are clear. There is partial opacification of the left frontal sinus. The skull and scalp soft tissues are unremarkable.
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No evidence of intracranial hemorrhage, mass, or cerebral edema.
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Generate impression based on findings.
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66-year-old male with history of Burkitt's lymphoma, status post chemotherapy in remission. Compare to prior. CHEST:LUNGS AND PLEURA: Right apical scarring appears unchanged. Bilateral scattered micronodules, predominating at the right lung base, are stable.MEDIASTINUM AND HILA: Unchanged mediastinal lymph nodes. The reference right paratracheal lymph node measures 1.4 x 0.8 cm (series 3; image 36).CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Stable left adrenal nodule measuring 2.9 x 1.5 cm (series 3, image 101). Stable thickening of the right adrenal gland.KIDNEYS, URETERS: Reference soft tissue focus involving the posterior medial aspect of the right kidney which extends to and is inseparable from the right psoas muscle has decreased in size and currently measures 2.4 x 2.6 cm (image 1.3; surge 3).RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes about the visualized spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Slight regression of right retroperitoneal mass. Other findings are stable. Reference measurements are given above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast cancer in maternal cousin at age 60. Two standard digital views of both breasts were performed, with additional views in all projections including a cleavage view (9 total images), and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Intramammary lymph node in the right breast is stable. Few, scattered, benign-appearing calcifications are again noted.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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T4aN2b supraglottic laryngeal squamous cell carcinoma status post treatment. There are post-treatment findings in the neck, including persistent pharyngeal edema, but no discernible tumor. However, there is irregularity of the right greater cornu of the hyoid bone, which appears new. There is also continued increase in size of a left level 5B lymph node has increased in size, now measuring 11 mm in short axis, previously 9 mm, and there appears to be associated surrounding fat stranding. Otherwise, there is no significant cervical lymphadenopathy elsewhere in the neck. The thyroid and major salivary glands are unchanged. There is mild right and moderate left carotid bulb atherosclerotic plaque. The osseous structures are unchanged. The airways are grossly patent. The imaged intracranial structures and orbits are unremarkable. The imaged portions of the lungs are clear. There is a right maxillary sinus retention cyst.
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Persistent post-treatment findings in the supraglottic region without evidence of measurable locoregional tumor recurrence. However, a left level 5B lymph node has continued to slightly increase in size, but remains nonspecific. In addition, irregularity of the right greater cornu of the hyoid bone may represent osteoradionecrosis, although superimposed infection cannot be excluded.
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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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Cluster of punctate calcifications in the upper outer quadrant of the right breast compatible with milk of calcium seen on prior mammograms is stable.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: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Prior mammogram in Michigan over ten years ago. Two standard digital views of both breasts were performed with an additional left MLO view and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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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. 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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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. Stable benign intramammary lymph nodes are present bilaterally. Prominent axillary lymph nodes are present bilaterally, unchanged.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Reason: history of Crohn's disease, recent surgery for ileocolic History: RLQ abdominal pain with food. Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the colon was 15 minutes. Fluoroscopic evaluation showed normal mucosa throughout the small bowel, with no ulcers, sinus tracts, fistulae, or adhesions. The ileocolonic anastomosis was intact with no evidence of obstruction or leak. Contrast rapidly flowed passed neo-terminal ileum into remaining colon. No internal hernias or ventral hernias were evident. The ascending colon was grossly normal. TOTAL FLUOROSCOPY TIME: 1:46 minutes
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Normal examination of the small bowel and intact ileocolonic anastomosis. Contrast rapidly flowed passed neo-terminal ileum into remaining colon.
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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 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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Ms. Lamothe is a 87 year old female with known left breast cancer with locally advanced disease. She is status post neoadjuvant chemotherapy. She presents today for needle localization of the index tumor in the left inferior breast and needle localization of the biopsied left axillary lymph node. On review of the prior studies, a Hydromark clip is identified at the site of known index tumor in the left inferior breast, 6 o'clock position. In addition, a small left axillary lymph node in the inferior left axilla is identified with Hydromark clip in place.The procedure, risks including bleeding, mistargeting and infection, and benefits of needle-wire localization were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed to confirm patient identity and site of procedure. Ultrasound guided wire localization of left breast:The left breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially and at depth. Using aseptic technique, continuous ultrasound guidance and a lateromedial approach, a 5-cm Kopan's needle was placed through the lesion. Adequate positioning of the needle was confirmed after adjusting depth of the needle tip is approximately 2 cm deep to the center of the target. Targeting was judged very good.Two view orthogonal mammograms reveal the spring wire to be in excellent position. Ultrasound guided wire localization of left axillary lymph node:The left breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially and at depth. Using aseptic technique, continuous ultrasound guidance and a inferolateral to superomedial approach, a 7-cm Kopan's needle was placed through the lesion. Adequate positioning of the needle was confirmed after adjusting depth of the needle tip is approximately 2 cm deep to the center of the target. Targeting was judged very good.MLO mammograms reveal the reinforced portion of the spring wire to be approximately 3.5 cm posterior to the axillary lymph node and clip. The mammograms were annotated and reviewed with Dr. Chhablani prior to the patient's procedure. Patient tolerated the procedure well and was sent to the holding area in stable condition. Dr. Sheth performed the procedure under direct supervision of Dr. Schacht, who was present during the procedure at all times.Orthogonal digital specimen radiographs revealed the residual mass, Hydromark clip and spring wire to be within the specimen. Digital specimen radiograph of two excised left axillary lymph nodes reveal the Hydromark clip within one of the lymph nodes.
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Successful US-guided needle localization of the left breast malignancy and left axillary lymph node.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy. History of breast cancer in maternal grandmother. 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. Stable biopsy clip is present within the left breast. 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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Asymptomatic female presents for routine screening mammography. Family history of mother and maternal grandmother with breast cancer. 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. Scattered benign calcifications in the right breast are unchanged.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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80 year-old female with pain Right knee: Severe osteoarthritis affects the knee with uniform joint space narrowing and prominent osteophytes. Small joint effusion. Mild varus alignment of the knee with slight lateral translation of the tibia relative to the femur. Chondrocalcinosis affects the lateral meniscus.Left knee: Moderate to severe osteoarthritis affects particularly the medial tibiofemoral joint compartment. There is also slight varus deformity and chondrocalcinosis.
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Osteoarthritis, right greater than left.
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Generate impression based on findings.
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17-year-old male with femur allograft reconstruction for osteosarcoma A plate and screw device affixes the intercalary diaphyseal allograft to the proximal and distal native femur in near-anatomic alignment. No acute hardware complication is evident. Several screw fragments are again seen in the distal femur. The osteotomy margins appear indistinct, similar to the prior exam, indicating healing. Deformity of the distal femur appears similar to the prior exam. No evidence of tumor recurrence.
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Right femoral reconstruction without evidence of hardware complication or tumor recurrence.
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Generate impression based on findings.
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Female; 40 years old. Reason: r/o mediastinal air History: profuse vomiting, chest pain, lucency on CXR right heart border LUNGS AND PLEURA: Mild central bronchial wall thickening may be related to bronchitis. Minimal debris within the trachea. Single nonspecific pulmonary micronodule the right lower lobe, likely post infectious or inflammatory in etiology. No suspicious pulmonary or masses. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No mediastinal or hilar lymphadenopathy. No pneumomediastinum, as clinically questioned. Normal variant aberrant right subclavian artery which courses posterior to the superior esophagus.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Mild nonspecific left adrenal thickening.
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1. Mild central bronchial wall thickening may be related to bronchitis. Otherwise, no acute cardiopulmonary abnormality.2. Normal variant aberrant right subclavian artery which courses posterior to the superior esophagus. This could potentially be a source of the patient's symptoms.
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Generate impression based on findings.
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42-year-old male with right foot pain There is a medial plate with screws entering the talus, navicular, medial cuneiform and base of the first metatarsal affixing the bones in near-anatomic alignment. Mild lucency about the screws within the base of the first metatarsal and medial cuneiform is of questionable significance. There is a least partial fusion of the talus, navicular, and medial cuneiform.A lateral plate with screws entering the calcaneus, cuboid, and fourth metatarsal base affixes the bones in near-anatomic alignment without evidence of hardware complication. The calcaneus and cuboid appear at least partially fused. A screw affixes the subtalar joint in near anatomic alignment. The subtalar joint also appears at least partially fused. There is narrowing and/or fusion of additional midfoot articulations. We see no evidence of fracture.
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Postoperative changes of hindfoot and midfoot fusion without fracture.
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Generate impression based on findings.
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24 year-old female with pain Right hip: Deformity of the femoral head has progressed, with fragmentation and collapse of the femoral head and the superior margin of the femoral neck now abutting the superolateral rim of the acetabulum. Pelvis: Progression of AVN involving the right femoral head is again seen. Poor defined sclerosis within the left femoral head suggesting AVN is unchanged from the prior exam. Degenerative arthritic changes affect the visualized lower lumbar spine.
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Progression of avascular necrosis involving the right femoral head as described above.
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Generate impression based on findings.
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7-year-old female with constipation and stool incontinence, evaluate stool burdenVIEW: Abdomen AP (one view) 01/21/15 A large amount of amorphous stool is seen throughout the entirety of the colon. Nonobstructive bowel gas pattern.
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Above-average stool burden.
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Generate impression based on findings.
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40 year-old male with history of meniscal tear in 1997, now with pain Lucent tunnels within the distal femur and proximal tibia suggest prior ACL reconstruction. There is heterotopic ossification along the inferior patella and anterior to the tibial tubercle at the site of graft harvest. Additional lucencies within the proximal tibia and distal femur suggest additional orthopedic intervention. Tiny osteophytes indicate mild osteoarthritis. Alignment is within normal limits.
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Postoperative changes of ACL reconstruction and mild osteoarthritis without malalignment.
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Generate impression based on findings.
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Poor phonation, subglottic stenosis. There is an endotracheal tube. There is no evidence of subglottic stenosis. The left vocal cord displays a configuration that is suggestive of paralysis. There are secretions in the upper trachea. There is no evidence of mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are unremarkable. There is a left internal jugular venous catheter. The osseous structures are unremarkable. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. There are bubbly secretions within the sphenoid sinuses.
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1. An endotracheal tube is present, without evidence of subglottic stenosis. 2. The left vocal cord displays a configuration that is suggestive of paralysis. 3. Secretions in the upper trachea are suggestive of aspiration.4. Bubbly secretions within the sphenoid sinuses may indicate sinusitis.
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