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Generate impression based on findings.
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Age: 41 years. Sex : Male. Indication: Reason: patient with abdominal pain, no source identified History: as above. The following observations are made given the limitations of an unenhanced study.LUNG BASES: Severe diffuse air space disease again seen, with small, left greater than right, pleural effusions, nonspecific but most likely due to ARDS. Moderate sized pericardial effusion muscle or prior.LIVER, BILIARY TRACT: Stable perihepatic ascites, and right hepatic lobe calcified lesion. Vicarious excreted contrast in the gallbladder, versus small amount of sludge.SPLEEN: Splenomegaly, but approximately 14.6 cm, unchanged.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: Nasogastric tube tip seen in the distal stomach. No small bowel obstruction or free air. Appendix within normal limits. Interval development of bowel wall thickening in the mid and distal small bowel, some of which may be related to abdominal ascites however bowel injury due to infection, inflammation or vascular etiology is on the differential.BONES, SOFT TISSUES: No significant abnormality noted.OTHER:No significant abnormality noted.PELVIS:PROSTATE: No significant abnormality noted.BLADDER: A Foley catheter is in the expected location.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mid/distal small bowel loops demonstrate bowel wall thickening, nonspecific.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Limited unenhanced CT.1.Partially visualized pulmonary findings are suggestive of ARDS.2.Small amount of abdominal/pelvic ascites3.Non-specific small bowel wall thickening without evidence of obstruction.
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Generate impression based on findings.
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85 year-old female with severe acute back pain, history of bladder cancer The bones are demineralized. No focal osseous lesion is evident. Again seen is a T6 vertebral body compression fracture, now with greater than 50% loss of vertebral body height. Since the prior exam there is new compression deformity of the T12 vertebral body with approximately 30% loss of vertebral body height anteriorly. There is mild anterior wedging of the T7 vertebral body, which appears similar to the prior exam. There may also be a mild compression fracture of the T5 vertebral body, but this is equivocal. Moderate to severe degenerative disk disease affects the visualized lower cervical spine and upper lumbar spine.Multiple bilateral calcified pulmonary nodules likely represent granulomas. Streaky retrocardiac opacity is suggestive of scarring.
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Vertebral body compression fractures as described above. The T12 vertebral body compression fracture is new from the prior exam. If further evaluation is clinically warranted, MRI may be considered.
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Generate impression based on findings.
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There is redemonstration of a large 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. There is expected evolution of the diffuse intraventricular blood products, with again the right lateral ventricle slightly greater than the left. There is perhaps subtle periventricular hypoattenuation along the right atrium and occipital horn which may represent transependymal edema.There is no significant mass effect. There is stable trace midline shift to the left. 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
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No significant interval change in appearance of right caudate parenchymal and diffuse intraventricular hemorrhage except for expected evolution. Stable asymmetric prominence of the right lateral ventricle as compared to the left, with a suggestive of possible mild transependymal edema along the right atrium/occipital horn.
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Generate impression based on findings.
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Female; 94 years old. Reason: r/o PE History: dizziness, elevated dimer PULMONARY ARTERIES: No acute pulmonary embolus. Normal caliber of the main pulmonary artery. No evidence of right heart strain.LUNGS AND PLEURA: Moderate upper lobe predominant centrilobular emphysema, mildly progressed since prior study. Stable small nodular opacities along the left major fissure, most likely due to intrapulmonary lymph nodes. Minimal scarring in the lingula. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No visible coronary artery calcifications. No mediastinal or hilar lymphadenopathy.CHEST WALL: Nodular enlargement of the thyroid gland, nonspecific.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. No acute pulmonary embolus.2. Moderate emphysema, mildly progressive since prior study.3. Findings suggestive of multi-nodular thyroid goiter. Further evaluation with ultrasound can be performed as clinically indicated.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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Female; 30 years old. Reason: r/o PE History: sudden onset pleuritic CP, SOB, surgery 1 mo ago PULMONARY ARTERIES: No acute pulmonary embolus. Normal caliber of the main pulmonary artery. No evidence of right heart strain.LUNGS AND PLEURA: Minimal tree-in-bud like opacity in the left upper lobe in a subpleural location, which may be related to aspiration less likely infection. Otherwise, no significant abnormality noted.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. No acute pulmonary embolus.2. Possible aspiration, less likely infection, in the left upper lobe as described above.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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70-year-old with history of prior benign biopsy approximately 1 year ago. Three standard views of both breasts with additional bilateral MLO 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. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Scattered bilateral benign calcifications are noted, a few progressed in a benign fashion. Left breast clip from prior benign stereotactic biopsy noted. Stable right retroareolar mass. Benign appearing lymph nodes are projected over both axillae.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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CLINICAL DATA: Age: 44 years. Sex : Male. Indication: Reason: eval nephrolithiasis, less likely appy History: R-sided abd pain radiating to flank. Please note lack of IV and oral contrast limits evaluation of solid organ pathology, and also of the GI tract.LUNG BASES: Mild bibasilar dependent atelectasis, and exam is in expiratory phase.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild right hydronephrosis/hydroureter with small amount of right perinephric stranding proximal to a 3 mm distal ureteral calculus at the ureterovesical junction. Left kidney is within normal limits. No hydronephrosis or hydroureter on the left. No additional collecting system stone is seen.RETROPERITONEUM/LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No small bowel obstruction or free air, appendix within normal limits. Evaluation is limited due to lack of oral contrast.BONES, SOFT TISSUES: No significant abnormality noted.OTHER:No significant abnormality noted.PELVIS:PROSTATE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Small right ureterovesical junction obstructing calculus, and other findings as above. Otherwise exam within normal limits.
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Generate impression based on findings.
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72-year-old male with history of prostate cancer, now with gross hematuria. Evaluate. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There are two punctate non-obstructing right nephrolithiasis (series 3, image 77). Bilateral renal hypoattenuating lesions are consistent with cysts. The kidneys enhance and excrete contrast symmetrically without hydronephrosis. The left ureter is opacified throughout its length without evidence of filling defects. The right proximal and mid ureter is not opacified but no evidence of a mass.RETROPERITONEUM, LYMPH NODES: Minimally prominent retroperitoneal lymph nodes are nonspecific. Mild atherosclerotic calcifications affect the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes affect the visualized spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: Mild bladder wall thickening. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes affect the visualized spine.OTHER: No significant abnormality noted
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1.Two punctate non-obstructing right renal stones. 2.No suspicious renal masses. 3.Mild bladder wall thickening is nonspecific and may partially be secondary to underdistention. Correlation with cystoscopy recommended.4.Diffuse fatty liver.
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Generate impression based on findings.
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57 year old female with right knee pain, inability to bear weight There is mild joint space narrowing and small osteophytes consistent with mild osteoarthritis, progressed slightly from the prior exam. No large joint effusion is seen. Moderate osteoarthritis affects the left knee as seen on the frontal view.
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Osteoarthritis, as described above.
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Generate impression based on findings.
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79-year-old female, assess reason for pain The bones are demineralized. Moderate to severe osteoarthritis affects the glenohumeral joint and moderate osteoarthritis affects the acromioclavicular joint, appearing similar to the prior exam. Glenohumeral alignment is within normal limits as seen on the axillary view.
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Osteoarthritis, as described above.
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Generate impression based on findings.
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Postoperative prosthetic assessment Three views of the right knee show hardware components of a total knee arthroplasty situated in near anatomic alignment without radiographic evidence of hardware complications. Anterior soft tissue swelling limits evaluation of the patellar tendon. Moderate to severe osteoarthritis affects the left knee as seen on the frontal view.
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Total knee arthroplasty as described above.
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Generate impression based on findings.
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85 year-old male with abdominal aortic aneurysm repair. Patient with distended abdomen. Evaluate. Per chart review, patient with history of metastatic lung cancer. CT angiogram: Post-operative changes of EVAR of a fusiform abdominal aortic aneurysm measuring up to 4.8 cm (coronal series, image 58) without evidence of complications. No evidence of contrast extravasation from the aorta to suggest new leak.There is bilateral retroperitoneal hemorrhage as detailed below and high attenuation within the thrombosed native aneurysm consistent with the known recent history of AAA rupture. There is a gas focus within the excluded aneurysmal sac (series 9, image 80), most likely postoperative in etiology. Mild to moderate calcifications affect the abdominal aorta. The celiac axis, SMA, renal arteries, common iliac arteries, and external arteries are patent without evidence of thrombus or dissection.ABDOMEN:LUNG BASES: Partially visualized right upper lobe nodule (series 4, image one). Bilateral moderate-sized pleural effusions with associated atelectasis.LIVER, BILIARY TRACT: Diffuse fatty liver. There are multiple hepatic lesions with central hypoattenuation and peripheral rim enhancement with index segment 5/8 lesion measuring 5.1 x 4.3 cm (series 9, image 39). Findings highly suspicious for metastatic disease.SPLEEN: Splenic granulomata. Wedge-shaped peripheral hypoattenuation within the spleen measuring up to 1.6 cm highly suspicious for splenic infarct.PANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal gland nodule measures 2.6 x 2.5 cm, suspicious for metastatic disease.KIDNEYS, URETERS: Bilateral hypoattenuating lesions in both kidneys, some of which are consistent with simple cysts and some of which are too small to characterize. Bilateral retroperitoneal hemorrhage consistent with stated history of recent abdominal aortic aneurysm rupture. The right sided hemorrhage extends to the level of the pelvis to the level of the inferior iliac wing (series 9, image 124). The left sided hemorrhage extends inferiorly to the level of the left superior iliac wing.RETROPERITONEUM, LYMPH NODES: See above for details regarding CT angiogram and aorta.BOWEL, MESENTERY: No significant abnormality.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.Postoperative changes of EVAR of a fusiform abdominal aortic aneurysm without evidence of complication. 2.Bilateral retroperitoneal hemorrhage and high attenuation within the thrombosed native aneurysmal sac consistent with prior known AAA rupture.3.Multiple hepatic rim enhancing lesions suspicious for metastatic disease on a background of diffuse fatty liver. 4.Left adrenal nodule suspicious for metastatic disease.5.Moderate sized bilateral pleural effusions.6.Findings consistent with a small sized splenic infarct.
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Generate impression based on findings.
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Fatty liver disease. Evaluate for mass lesion. LIVER: The liver measures 19 cm in length. Markedly echogenic compatible fatty infiltration. There is a limited ability to visualize intraparenchymal abnormalities with this condition. Relatively hypoechoic region adjacent to the gallbladder fossa probably represents focal fatty sparing. The portal vein is patent with flow towards the liver on color Doppler imaging.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. The common bile duct measures 0.6 cm which is at the upper limits of normal.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No hydronephrosis of either kidney. The right kidney measures 11.5 cm in length and the left kidney measures 12.6 cm in length.OTHER: The spleen measures 10.4 cm in length.
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Echogenic liver probably representing fatty infiltration. Less echogenic region adjacent to the gallbladder probably represents focal fatty sparing.
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Generate impression based on findings.
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52-year-old male with history of lung cancer. Restaging examination. ABDOMEN:LUNG BASES: See concurrent CT chest report for details regarding the thoracic disease. Bilateral small to moderate-sized pleural effusions, left greater than right.LIVER, BILIARY TRACT: There is a vague segment 7 hypoattenuating lesion measuring 3.3 x 2.2 cm (series 3, image 33), unchanged. Left hepatic lobe hypoattenuating focus compatible with a cyst, unchanged.SPLEEN: Splenule.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a new omental nodularity anteriorly which is new compared to the 11/5/2014 examination and highly suspicious for carcinomatosis. Index omental nodularity measures approximately 2.8 cm in thickness (series 3, image 75) and is adjacent to the inferior margin of the liver.BONES, SOFT TISSUES: Multiple sclerotic lesions throughout the spine and the pelvis are again noted.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is a new omental nodularity anteriorly which is new compared to the 11/5/2014 examination and highly suspicious for carcinomatosis. Interval increase in free pelvic fluid.BONES, SOFT TISSUES: Multiple sclerotic lesions throughout the spine and the pelvis are again noted.OTHER: No significant abnormality noted
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1.Extensive new omental nodularity highly suspicious for carcinomatosis. 2.Interval increase in free pelvic fluid.3.Vague segment 7 hepatic hypoattenuating lesion highly suspicious for metastatic disease4.Please refer to concurrent CT chest report for details regarding the thoracic disease5.Multiple sclerotic lesions throughout the spine and the pelvis are again noted. Further evaluation with nuclear medicine bone scan may be considered for more sensitive evaluation for osseous metastatic disease.
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Generate impression based on findings.
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56 show female with left breast multicentric breast cancer 3 sites -- need lymph for SLBX surgery.RADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 0.51 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. A focus of increased activity is noted in the left axilla, representing the sentinel node(s). This region was marked with an indelible marker.
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Sentinel node identified in the left axilla.
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Generate impression based on findings.
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Ms. Stevens is a 65 year old female with a personal history of left breast lumpectomy in 2011 for IDC with locally advanced disease followed by chemoradiation therapy. No current breast related complaints. Three standard views of both breasts, additional right MLO view, and additional right CC view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Linear markers were placed on scars overlying the left breast. There are stable postsurgical changes including architectural distortion, increased density, minimal skin thickening and surgical clips present within the left lumpectomy site. Coarse dystrophic calcifications have developed in a benign fashion within the left breast. Benign hyalinized fibroadenoma and central focal asymmetry are stable in the right breast. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast.
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Stable postsurgical changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Metastatic lung cancer, follow-up CHEST:LUNGS AND PLEURA: Unchanged postsurgical findings in the right lower lobe following lobectomy with associated pleural thickening and minimal residual scarring along the pleura. No suspicious new abnormalities to suggest recurrence. No effusions.The reference pulmonary nodules also appear stable when measured in a similar fashion. The right upper lobe lesion with small stippled calcifications (image 34 series 5) remains 11 x 9 mm. The left lower lobe nodule again remains 8 mm (image 54 series 5) when measuring the central solid component. Underlying diffuse fibrotic changes also unchangedMEDIASTINUM AND HILA: No lymphadenopathy.Mild cardiomegaly with coronary calcifications unchanged. Pericardium unremarkableSmall to moderate hiatal hernia.CHEST WALL: Right chest port unchangedABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholecystectomy without additional hepatic abnormality. Focal fat is again observed adjacent to the falciform ligamentSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged renal cystsPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted. BONES, SOFT TISSUES: Extensive diffuse scattered degenerative changes throughout the thoracic and visualized lumbar spine. No suspicious news lytic or blastic lesionsOTHER: No significant abnormality noted.
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Stable pulmonary nodules with reference measurements and underlying pulmonary fibrotic appearance
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Generate impression based on findings.
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Dizziness with position change, ataxia No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. There is unchanged ventriculomegaly without acute hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent chronic small vessel ischemic changes. There is mild mucosal thickening involving the right posterior ethmoid and maxillary sinus. Mastoid air cells are clear. Calvarium is intact.
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1. 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.2. Global parenchymal volume loss. 3. Stable ventriculomegaly which is slightly prominent compared to the degree of volume loss raising question of communicating hydrocephalus/NPH in the appropriate clinical setting.
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Generate impression based on findings.
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Unspecified viral hepatitis C. LIVER: Coarse, heterogeneous liver echotexture without focal lesion as noted previously. Liver normal in size and contour, measuring 15.1 cm, unchanged. GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. No intra-or extrahepatic biliary ductal dilatation. The common hepatic duct measures 4 mm which is within normal limits or.PANCREAS: Visualized portions are normal. Pancreatic head and tail obscured by bowel gas.RIGHT KIDNEY: Measures 9 cm in length. Visualized portions are normal in echotexture.OTHER: The left kidney measures 10.4 cm in length. Visualized portions are normal in echotexture. Spleen normal in size and contour, measuring 9.6 cm.
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Nonspecific coarse liver echotexture without focal lesion, unchanged. Status post cholecystectomy.
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Generate impression based on findings.
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Lower extremity edema, pain Two views of the right leg show musculature enlargement and reticulation of the subcutaneous fat, which may represent edema. There is no acute fracture. Again seen is chronic periosteal reaction along the tibial and fibular diaphyses. Skin staples project over the leg.Three views of the right ankle show soft tissue swelling without fracture.
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Soft tissue abnormalities as described above without acute fracture.
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Generate impression based on findings.
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Congestion, fever, and neutropenia. There is mild right and moderate left maxillary sinus mucosal thickening. There is also minimal mucosal thickening in the ethmoid sinuses. The other paranasal sinuses are clear. There are nonspecific linear opacities in the nasal cavity. There is mild nasal septal deviation and spur directed to the left. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. The mastoid air cells and middle ears are clear.
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Mild right and moderate left maxillary sinus mucosal thickening, as well as minimal mucosal thickening in the ethmoid sinuses.
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Generate impression based on findings.
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Osteoarthritis Three views of the left shoulder are provided. Mild/moderate osteoarthritis affects the glenohumeral joint. There is spurring along the anterior aspect of the acromion process. Enthesophytes are present along the greater tuberosity at the expected insertion of the rotator cuff. The bones are demineralized.
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Osteoarthritis as described above appearing similar to prior.
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Generate impression based on findings.
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Postoperative prosthetic assessment The bones are demineralized. The proximal femur has been resected and reconstructed with a long stem total hip endoprosthesis. There are no hardware complications. Heterotopic bone formation along the prosthesis appears similar to prior. Osteoarthritis and chondrocalcinosis about the knee appear similar to prior
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Femoral prosthesis appears similar to prior.
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Generate impression based on findings.
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Pain Four views of the left shoulder are provided. Osteoarthritis affects the glenohumeral and acromioclavicular joints. The glenohumeral joint alignment is within normal limits.
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Mild osteoarthritis.
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Generate impression based on findings.
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History of follicular lymphoma in remission. comes in with neutropenia, aphthous ulcers and swelling of neck. Concern for abscess versus recurrence. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are unremarkable. There is a right internal jugular venous catheter. The major cervical vessels are patent. There is multilevel degenerative spondylosis of the cervical spine, which is most pronounced at C5-6 and C6-7. The airways are patent. The imaged intracranial structures are unremarkable. There are bilateral lens implants. The imaged portions of the lungs are clear.
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No evidence of abscess or recurrent lymphoma in the neck.
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Generate impression based on findings.
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Right distal radius osteosarcoma resection and reconstruction, evaluate for healing A side plate and screw device affixes allograft bone between the native radial diaphysis and the carpus. Additional screws are noted within the third metacarpal. The distal allograft appears fused to the lunate. The proximal osteotomy margin is visible but slightly less distinct than the prior exam suggesting some interval healing. There are no hardware complications or evidence of tumor recurrence.
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Postoperative changes of distal radius resection without evidence of tumor recurrence.
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Generate impression based on findings.
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Male, 74 years old. Elevated BMI and longer than 8 hour surgery; counts correct No RFO identified. NGT side port in the gastric cardia, tip in gastric body. Prominent non-dilated loops of bowel which may represent developing ileus.Skin staples noted. Scattered pelvic and thigh surgical clips noted.
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No RFO identified. Prominent non-dilated loops of bowel which may represent developing ileus.Findings discussed with Dr. Steppacher by on call radiologist on 1/20/2015 at 20:00.
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Generate impression based on findings.
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Shortness of breath and right upper lobe nodule LUNGS AND PLEURA: Multiple pulmonary findings including a 3.7 x 3.0 cm focal mass (image 63 series 5) in the right lower lobe adjacent to the major fissure with an associated moderate to large pleural effusion and underlying basilar compression atelectasis is observed. This finding correlates with the plain film abnormality. A small oval densities also observed along the major fissure, likely a pleural lymph node (image 44 series 5).In addition, a small focal density in the right apex in the right upper lobe is also observed, most suggestive of scarring, however observation will be needed. Additionally two small nonspecific fissural and pleural subcentimeter focal densities are observed on the left, the largest adjacent to the major fissure (image 40 series 5) also warranting close follow-up yet likely post inflammatory given their polygonal shape.Mild to moderate emphysematous changes largely in a centrilobular pattern.MEDIASTINUM AND HILA: Associated lymph adenopathy, including a right paratracheal reference node (image 33 series 3) measuring 1.2 cm and a subcarinal lymph node are conglomerate nodal mass measuring 1.2 cm (image 42 series 3). A small subcentimeter right hilar lymph nodes also observedMild to moderate coronary calcifications largely involving the left descending coronary.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No gross upper abdominal abnormalities observed however exam is limited due to extensive streak artifact from cholecystectomy clips, specifically on the right
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Right lower lobe mass extending to the pleural surface and major fissure with associated large pleural effusion. No definite associated intrapulmonary focal nodular disease to suggest satellite nodules, however lymphadenopathy is observed centrally. See reference measurements provided.
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Generate impression based on findings.
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The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. SPINE
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Unremarkable contrast enhanced MRI brain and entire spine.
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Generate impression based on findings.
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63 years, Male. Reason: Evaluate NGT position after advancement History: as above NGT side port and tip in gastric fundus. Nonobstructive bowel gas pattern. Pelvis is excluded from view. Surgical drains and clips in the abdomen.
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NGT side port and tip in gastric fundus.
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Generate impression based on findings.
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There is no diffusion abnormality to suggest acute infarct. There is extensive encephalomalacia with T2/FLAIR hyperintensity and volume loss involving the left cerebellum extending into the left middle cerebellar peduncle consistent . There is also T2 hyperintensity involving the ventral pons as well as T2 hyperintensity along the transverse pontine fibers. Mild volume loss is also noted throughout the right cerebellar hemisphere. There is focal T2 hyperintensity involving the right ventral medulla which likely represents hypertrophic olivary degeneration related to left cerebellar injury. There is evidence of prior craniotomy involving the left lateral occipital region. Tiny focus of chronic microhemorrhage along the surgical tract.No intracranial mass or mass effect. The ventricles and sulci are within normal limits for age. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.MRA HEAD
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1. No acute infarct. Extensive encephalomalacia involving the left cerebellum and middle cerebellar peduncle which may be related to chronic infarct, prior infection, or other injury. There is evidence of prior left occipital craniotomy.2. T2 hyperintensity in the right ventral medulla compatible with hypertrophic olivary degeneration related to left cerebellar injury.3. Extensive T2 hyperintensity in the ventral pons including along the transverse pontine fibers with volume loss as well as mild volume loss in the right cerebellar hemisphere. Unclear if all of these findings can be explained by transneuronal degeneration alone. Would be helpful to compare with prior MRI to assess the extent of initial injury/infarct.4. No significant stenosis is seen within the intracranial or extracranial circulation in the neck. Specifically, no evidence of vertebrobasilar stenosis or dissection.
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Generate impression based on findings.
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Reason: assess for pleural effusions, pericardial effusion/changes, location of pleurx catheter History: h/o constrictive cardiomyopathy, recurrent pleural effusions s/p pleurx, significant XRT LUNGS AND PLEURA: Pleural catheter located posteriorly with its tip located medially in the mid right hemithorax.Interval decrease in the loculated right pleural effusion.Decrease in septal thickening and nodular opacities in the right upper lobe.Interval decrease in left upper lobe consolidation with minimal residual scarring/atelectasis.Left perifissural lower lobe nodule (image 53 series 5) has decreased in size now measuring 6 mm previously measuring 12 mm.MEDIASTINUM AND HILA: Stable subcarinal lymph node (image 40 series 4) measuring 10 mm.Other mildly prominent mediastinal lymph nodes unchanged.Cardiac size is normal with interval decrease of pericardial fluid.Right-sided pacemaker identified is in the right atrial appendage and right ventricle.Marked coronary artery calcifications.CHEST WALL: Bilateral breast implants. Postsurgical changes in the thyroid bed. Surgical clips in left axilla.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Stable left adrenal nodule.
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Interval improvement in the loculated right pleural effusion,, pericardial effusion, septal thickening, and pulmonary nodular/consolidative opacities.
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Generate impression based on findings.
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Relapsed FCL; completed 6 cycles of BR in May 2014. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. For example, a right level 2A lymph node measures 5 x 8 mm. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. There is mild mucosal thickening in the maxillary sinuses. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.
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No evidence of recurrent lymphoma in the neck.
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Generate impression based on findings.
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Dyspnea LUNGS AND PLEURA: Mild centrilobular emphysematous changes without superimposed discrete focal abnormality, specifically no discrete nodular disease. There is however a mixed groundglass and mild solid component subcentimeter focus observed in the right upper lobe (image 48 series 5) specifically the solid component measures 7 mm.Both lung bases demonstrate mild tree in bud like abnormality with streaky densities suggesting atelectasis and bronchial wall thickening. Mild bronchiectasis. No effusions.MEDIASTINUM AND HILA: Small well-defined focal hypodensities observed in the right thyroid lobe, presumably small cysts.Borderline nonspecific precarinal lymph node measuring 1.0 cm (image 33 series 3) additionally a right hilar lymph node is also observed measuring 1.3 cm in short axis (image 51 series 3)Moderate coronary and annular calcifications. The cardiac and paracardiac are otherwise significant for minimal thickening of the pericardium and/or small pericardial effusion.Small hiatal hernia CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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Bilateral basilar pulmonary changes suggesting chronic aspiration. Otherwise a nonspecific constellation of thoracic changes including mild borderline lymphadenopathy and nonspecific sub-centimeter mixed groundglass nodule with solid components observed in the right upper lobe. Correlation with prior outside imaging if available would be helpful
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Generate impression based on findings.
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Male; 61 years old. Reason: Pleural mesothelioma. Please compare to prior exam per recist criteria. History: Pleural mesothelioma. CHEST:LUNGS AND PLEURA: Diffuse nodular right pleural thickening consistent with mesothelioma, overall slightly decreased. Reference measurements are as follows:1. At the level of the aortic arch (series 3/27): 10 o'clock position, 4 mm, unchanged; 2 o'clock position, 7 mm (previously 9 mm).2. At the level of the right atrial appendage (series 3/49): 2 o'clock position, 5 mm (previously 6 mm); 4 o'clock position, 8 mm (previously 12 mm).3. At the level of the aortic valve (series 3/52): 10 o'clock position, 7 mm (previously 13 mm); 8 o'clock position, 3 mm (previously 4 mm). Suture material along the right upper lobe, unchanged. Scattered calcified granulomas. No tumor involvement of the left hemithorax.MEDIASTINUM AND HILA: Reference subcarinal lymph node measures 16 mm (previously 16 mm) (series 3/42). Additional mediastinal and right hilar enlarged lymph nodes or not significantly changed. Normal heart size. No pericardial effusion. No visible coronary artery calcifications. Right chest port tip at the cavoatrial junction.CHEST WALL: Right chest port. Mild degenerative changes of the thoracolumbar spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable left renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable small gastrohepatic ligament lymph nodes.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Mild degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.
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Slightly decreased right nodular pleural thickening with slight interval decrease in the reference measurements as above. Stable mediastinal lymphadenopathy. No new sites of disease.
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Generate impression based on findings.
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Postoperative prosthetic assessment Three views of the right knee show hardware components of a total knee arthroplasty in near anatomic alignment appearing similar to the prior. Arterial calcifications are present in the posterior soft tissues. Moderate osteoarthritis affects the left knee as seen on the frontal view with mild varus deformity.
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Total knee arthroplasty appearing similar to prior.
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Generate impression based on findings.
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Fracture. Foot pain.VIEWS: Right foot AP/lateral/oblique (3 views) 01/21/15 A cast obscures bone detail. Callus formation is noted along the lateral aspect of the distal fourth metatarsal. There may be some sclerosis/callus formation in the distal fifth metatarsal.
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Healing fracture of fourth metatarsal. Probable healing fracture of fifth metatarsal.
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Generate impression based on findings.
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Head and neck cancer, follow-up CHEST:LUNGS AND PLEURA: Stable unchanged nonspecific pleural calcifications on the right. Specifically the more focal 5-mm nodule observed along the medial posterior margin is currently not appreciated and likely representing old post inflammatory change. Scattered bilateral basilar groundglass and streaky densities suggesting aspiration and/or atelectasis, probable aspiration given patient history. No effusionsMEDIASTINUM AND HILA: No lymphadenopathy.The cardiac and paracardiac are well within limits other than moderate to severe coronary calcifications, unchanged.Moderate hiatal herniaCHEST WALL: Small unchanged fat-containing ventral hernia (image 136 series 3), unchangedABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Stable appearing right adrenal nodule measuring 2.1 x 2.0 cm (image 101 series 3), unchanged. Left adrenal unremarkableKIDNEYS, URETERS: Scattered small suspected subcentimeter renal cysts, all unchangedPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Moderate scattered degenerative changes largely represented by disk degeneration in the lower lumbar spine and osteophytes. No suspicious lytic or blastic lesions observedOTHER: No significant abnormality noted.
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Interval resolution of the nonspecific subcentimeter pleural right lower lobe nodule, presumably post inflammatory. Changes of aspiration without additional new abnormalities to suggest metastatic disease
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Generate impression based on findings.
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CLL with erythema and tenderness over lateral and medial malleoli for 3 days, evaluate for fracture Soft tissue swelling is present without acute fracture. Tiny calcifications distal to the fibula may represent old trauma. Arterial calcifications are present in the soft tissues. Evaluation of the Achilles tendon is limited by overlying soft tissue swelling.
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Soft tissue swelling without fracture.
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Generate impression based on findings.
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60 year-old male with history of CLL. Compare to prior. CHEST:LUNGS AND PLEURA: Biapical fibrosis. Bilateral scattered pulmonary nodules, not substantially changed. Index lesion in the lingula again measures 7 mm in diameter (image 47; series 5).MEDIASTINUM AND HILA: Mediastinal and hilar adenopathy is stable. Unchanged left hilar lymph node measures 1.9 x 1.4 cm (image 49; series 3). Mild coronary artery calcifications.CHEST WALL: Bilateral axillary adenopathy is unchanged. Unchanged left axillary lymph node measures 2.3 x 1.8 cm (image 32; series 3). Old left rib fracture unchanged.ABDOMEN:LIVER, BILIARY TRACT: Mild splenomegaly. Stable small, nonspecific hypodense lesions in the liver. SPLEEN: Mild splenomegaly as noted previously.PANCREAS: No significant abnormality notedADRENAL GLANDS: 1.9-cm right adrenal nodule, stable. Unchanged 1.5 x 1.4 cm left adrenal nodule.KIDNEYS, URETERS: Retroperitoneal adenopathy.RETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal adenopathy. The index left para-aortic node measures 1.8 x 1.8 cm (image 131; series 3), unchanged. Other retroperitoneal soft tissue nodules remain in the posterior pararenal space.BOWEL, MESENTERY: Borderline enlarged mesenteric lymph nodes.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Vascular calcifications.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Bilateral pelvic adenopathy. Index right external iliac node measures 5.3 x 2.3 cm (image 189; series 3), stable to equivocally enlarged.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Bilateral axillary, mediastinal, hilar, retroperitoneal and pelvic adenopathy stable or equivocally enlarged. Bilateral adrenal nodules, unchanged.
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Generate impression based on findings.
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57-year-old female with left blown pupil, bradycardia, wide pulse pressure and altered mental status. Evaluate for uncal herniation. 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. There is calcification of the distal portion of the right vertebral artery. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Changes of right intraocular lens replacement.
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No evidence of intracranial hemorrhage or mass effect. No evidence of herniation as clinically queried. Please note non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct, and MRI should be considered if there is significant clinical suspicion.
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Generate impression based on findings.
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4 month old female (ex-34 week gestational age) with disorganized swallowing and cough with feeds.EXAMINATION: Oropharyngeal motility study 1/21/2015, 1025 hrs. Beth Harrison, speech and language therapist, supervised the examination.31 seconds of fluoroscopy was used.Thin liquid was administered via slow-flow nipple from home. Half-strength nectar as administered via a medium-flow nipple.No oral deficits were observed. Mild pharyngeal deficits included decreased oropharyngeal coordination over time with slight pharyngeal swallow lag. There was mild penetration with half-strength nectar. No cough was observed but there was audible wheezing. The patient tolerated thin liquids.
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Penetration with half-strength nectar via medium-flow nipple.Please see the speech and language therapist's report for feeding recommendations.
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Generate impression based on findings.
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0 day old female, infant of diabetic mother, hypoplastic tibia. Evaluate for any deformity.VIEWS: Pelvis AP/frog leg (two views), left femur AP/lateral (two views), 1/21/2015, 1027 hrs. Proximal femoral metaphyses are normally positioned with respect to the acetabula. No significant abnormality in the pelvis.The left femur appears normally formed without bowing or hypoplasia.
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Normal pelvis and left femur.
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Generate impression based on findings.
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53 year old female with cold right foot, absent pulses. ANGIOGRAM:Moderate calcification affects the abdominal aorta and iliac arteries. The abdominal aorta is normal in size. Conventional celiac axis anatomy. The origins of the celiac, superior mesenteric, and inferior mesenteric arteries are widely patent. The iliac arteries are normal in size. Focal, partially occlusive soft plaque or thrombus in the distal right superficial femoral artery (series 10 image 187). Distal flow is reconstituted, but remains decreased compared to the left. The right anterior tibial peroneal arteries attenuate at the level of the ankle mortise while the posterior tibial artery attenuates at the level of the plantar arch. Normal left side three vessel runoff. ABDOMEN:LIVER, BILIARY TRACT: Focal fatty infiltration surrounding the ligamentum teres. Lobulated hypodense subcapsular lesion in the right lobe with patchy enhancement on the arterial phase compatible with a hemangioma. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Submucosal fatty proliferation in the cecum suggestive of chronic colitis. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Partially calcified uterine fibroidsBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Focal partially occlusive soft plaque or thrombus in the distal right superficial femoral artery resulting in decreased distal flow as described.2. Normal left side three vessel runoff.3. Moderate atherosclerotic disease affects a normally sized abdominal aorta. The aortic branch vessels are widely patent.
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Generate impression based on findings.
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Reason: Recurrence of rectal abscess, any other signs of active Crohn's disease History: 8 year old with Crohn's disease and history of rectal abscess, on Remicade, with markedly elevated inflammatory markers PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The rectal wall is thickened and edematous with minimal enhancement. No rectal wall abscess is evident. No fistulas is identified.BONES, SOFT TISSUES: The skin at the inferior aspect of the left vulva is thickened but nonenhancing, decreased from prior exam.OTHER: No significant abnormality noted
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Rectal wall thickening and inflammation without evidence of fistula or abscess.
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Generate impression based on findings.
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40 year-old female with right proximal tibia myeloma, evaluate for other lesions SKULL: There is a 4 cm lucent lesion involving the right parietal bone with prominence of the overlying soft tissues suggesting a potential soft tissue component (assuming that this is not artifactual on the patient's scalp).CERVICAL SPINE: The cervical spine is slightly kyphotic. No myelomatous lesions.THORACIC SPINE: Posterior stabilization rods with screws entering the vertebral bodies of T1, T2, T4 and T5. There has been at least partial resection of the T3 vertebral body with placement of a spacer device between the T2 and T4 vertebral bodies. No abnormalities of the lower thoracic spine are seen.LUMBAR SPINE: No discrete myelomatous lesion. Moderate degenerative disk disease affects L5/S1.RIBS: No discrete myelomatous lesion.PELVIS: No discrete myelomatous lesion. Mild bilateral protrusio deformity.UPPER EXTREMITY: Right humerus: No discrete myelomatous lesion.Left humerus: No discrete myelomatous lesion.Right forearm: No discrete myelomatous lesion.Left forearm: No discrete myelomatous lesion.LOWER EXTREMITY: Right femur: Mild osteoarthritis affects the hip. No discrete myelomatous lesion.Left femur: No discrete myelomatous lesion. Mild osteoarthritis affects the hip. Moderate osteoarthritis affects the left knee. A lucency along the anterior tibial metaphysis seen only on the lateral view of the distal femur is probably artifactual rather than representing a discrete myelomatous lesion as it is not seen on the AP view of the tibia and fibula.Right tibia and fibula: A plate and screw device affixes cement within the proximal tibia, presumably representing curettage of a myelomatous lesion. No hardware complications are evident. Adjacent soft tissue swelling and gas reflects recent surgery. The distal tibia and fibula are unremarkable.Left tibia and fibula: A geographic, expansile lytic lesion of the left distal fibula measures approximately 3 cm in longitudinal dimension and presumably represents a myelomatous lesion.
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Multiple myeloma as described above with additional lucent lesions in the skull and distal left fibula.
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Generate impression based on findings.
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Female; 65 years old. Reason: evaluate effusions History: sob LUNGS AND PLEURA: Interval removal of a right chest tube with new trace right pleural effusion.Large left pleural effusion, mildly increased since prior study. No pneumothorax.Mild bibasilar dependent atelectasis/consolidation, similar to prior study.MEDIASTINUM AND HILA: New left jugular venous catheter with tip in left-sided IVC. Otherwise, no significant interval change in the appearance of the mediastinum.Right jugular central venous catheter tip in right-sided IVC.Stable appearance of graft at the aortic root.Mild cardiomegaly. Small volume of high density pericardial fluid consistent post operative blood products. Pericardial pacing wires in place. Normal variant aberrant right subclavian artery.CHEST WALL: Right anterior chest wall pre-pectoral fluid collection measures 2 x 3.2 x 6.4 cm, as well as overlying skin thickening and subcutaneous fatty stranding, not significantly changed. Prominent right axillary lymph nodes are grossly stable. Intact median sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Mild upper abdominal ascites is partially visualized and appear slightly increased since prior study.
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Large left and trace right pleural effusions as described above.
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Generate impression based on findings.
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64-year-old male with altered mental status and intubated. Evaluate for changes in ICH. Redemonstrated is a intraparenchymal hematoma centered at the left thalamus measuring 2.6 x 4.0 and approximately 3.7 cm in the craniocaudal dimension. There is surrounding low density vasogenic edema. Again seen is intraventricular extension with hemorrhage including the lateral, third, and fourth ventricles. There is stable rightward midline shift measuring up to 6 mm at the level of the third ventricle, which re-measured at 6 mm on the prior exam. There has been slight interval decrease in the right sided ventricular dilatation and stable left temporal horn dilatation. There is unchanged position of right transfrontal ventriculostomy with its tip in the right inferior frontal horn near the foramen of Monro. There is periventricular low density which matches the previous FLAIR abnormality on the recent MRI and is consistent with transependymal edema. There remains diffuse sulcal effacement. There is right maxillary and ethmoid sinus opacification. Mastoid air cells are clear. Calvarium is intact. Interval intubation.
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1.Stable evolution of the left thalamic intraparenchymal hematoma centered at the left thalamus with intraventricular extension. 2.Overall slight decrease in size of the right lateral ventricle and stable left ventricular dilatation.3.Unchanged rightward midline shift.
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Generate impression based on findings.
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Reason: high resolution, ILD protocol CT History: home oxygen, shortness of breath LUNGS AND PLEURA: Consolidation/atelectasis involving the right lower lobe medially compatible with infection or aspiration.Atelectasis in the right middle lobe and left lung base again compatible with aspiration/infection.No pleural effusions.No suspicious nodules or masses. Mild bronchiolar wall thickening.No evidence of interstitial lung disease. No significant airtrapping on the expiratory images.MEDIASTINUM AND HILA: Cardiomegaly without evidence of a pericardial effusion.Calcified hilar and mediastinal lymph nodes compatible with a prior granulomatous disease.No definite hilar or mediastinal lymphadenopathy.Mildly enlarged pulmonary artery compatible with pulmonary arterial hypertension.CHEST WALL: Extensive degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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Focal areas consolidation/atelectasis involving the right middle, right lower, and left lower lobes compatible with aspiration and/or infection. No evidence of interstitial lung disease. Stable cardiac enlargement.
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Generate impression based on findings.
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history of PML and DIC on ATRA/arsenic therapy. Multiple known intracranial hemorrhages. Please assess for changes. There has been interval resolution of multifocal hemorrhages in the brain and cerebellum. No new foci of hyperattenuation are identified. There is mild diffuse prominence of the ventricular system, which is new when compared to prior exam, and may represent resolving edema or possible superimposed pseudo-atrophy. There is no mass effect or herniation. Gas within the right globe likely relates to recent vitrectomy. There is mild mucosal thickening of the right maxillary and left sphenoid sinuses. The mastoid air cells are clear.
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1. Interval involution of multifocal intracranial hemorrhages. 2. Interval increase in size of the sulci and ventricular system may relate to resolving edema or superimposed pseudo-atrophy secondary to treatment effects. 3. Gas within the right globe may relate to recent vitrectomy. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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MDS, neutropenic fevers, and pneumonia. There is a retention cyst in the right maxillary sinus and mild mucosal thickening in the left maxillary sinus. There is scattered opacification of the ethmoid sinuses. There is mild mucosal thickening in the right frontal sinus and opacification of the right frontoethmoid recess. The sphenoid sinuses are clear. The nasal cavity is clear. However, there is mild nasal septal deviation and spur directed to the right, which contacts the right inferior turbinate. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. The mastoid air cells and middle ear cavities are clear.
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1. Scattered paranasal sinus opacification in a sporadic pattern.2. Mild nasal septal deviation and spur directed to the right, which contacts the right inferior turbinate.
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Generate impression based on findings.
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63-year-old male with history of colorectal carcinoma stage IV, and chemotherapy. CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules are again seen, with reference lesions as follows:Left lower lobe posterior nodule (5/73) measures 2 x 1.2 cm, similar to prior 2.1 x 1.4 cm. Additional pulmonary nodules are grossly stable in size. Minimal left pleural fluid, unchanged.MEDIASTINUM AND HILA: Cardiac size is within normal limits. No evidence of pleural effusion. Stable coronary artery stent. CHEST WALL: Right chest Port-A-Cath tip in the SVC.ABDOMEN:LIVER, BILIARY TRACT: Unchanged hepatic cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No small bowel obstruction or free air. Reference mesenteric lymph node (3/120) is unchanged, measuring 7 x 4 mm.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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Stable pulmonary nodules and lymph nodes as above, without new findings of metastatic disease.
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Generate impression based on findings.
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Pleural mesothelioma. CHEST:LUNGS AND PLEURA: Postoperative changes of left pleurectomy/decortication. A single small focus of residual pleural thickening has increased from 3 to 5-mm the left apex at the 11 o'clock position (3/19).Multiple pulmonary nodules have developed within the left lung in the interim, consistent with pulmonary metastases. These measure up to 7-mm in size (left lower lobe series 5 image 88). No pleural fluid. MEDIASTINUM AND HILA: Left mediastinal shift. Mild to moderate cardiomegaly. No pericardial fluid. Small lymph nodes in the anterior mediastinum are similar to previous.CHEST WALL: New left axillary lymph node measuring 12-mm (3/28). New small left internal mammary chain lymph nodes (3/42).ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: 18-mm gastrohepatic ligament lymph node (3/86) increased from 8mm previously. Several subcentimeter retroperitoneal and mesenteric lymph nodes are noted, some of which appear slightly marked larger.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Small mesenteric lymph nodes under 1 cm in size, some of which appear larger. Mesenteric fat stranding nonspecific, present previously.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Left lateral margin of diaphragmatic graft does not appear to be anchored to the chest wall, unchanged.
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1. Interval development of multiple pulmonary nodules in the left lung, most compatible with metastases.2. Interval development of left axillary and internal mammary chain lymphadenopathy.3. Interval development of gastrohepatic lymphadenopathy with persistent small mesenteric and retroperitoneal lymph nodes appearing more prominent, suspicious for intra-abdominal nodal disease.
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Generate impression based on findings.
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Nine-year-old female with history of trauma, pain, swellingVIEWS: Right fourth digit AP/lateral, foot AP (3 views) 01/21/15 No acute fracture or malalignment is evident.
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No acute fracture or malalignment is evident.
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Generate impression based on findings.
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Parotid gland tumor, dyspnea CHEST:LUNGS AND PLEURA: Redemonstrated are two small pulmonary nodules in the right middle lobe (see image 40 and image 51 series 5). The more solid inferior nodule has increased in size, currently measuring 8 mm from a prior measurement of 6 mm, yet the more cranial faint groundglass nodule appears grossly unchanged yet is associated with additional faint and poorly defined peripheral groundglass abnormality. Scattered punctate micronodules without additional suspicious focal lesions or effusions.MEDIASTINUM AND HILA: Scattered mediastinal lymph nodes, of which the subcarinal and paraesophageal lymph node (image 43 series 3) has increased in size currently measuring 1.4 cm in short axis from a prior measurement of 8 mm.The cardiac and paracardial are within normal limitsSmall hiatal herniaCHEST WALL: Scattered mild degenerative changes of the thoracic spine without suspicious new lytic or blastic lesions. Left chest portABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Incompletely visualized lower lumbar spine fixation and disk fusion. Again no suspicious new lesionsOTHER: No significant abnormality noted.
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Mild interval increasing lymph nodes and associated enlargement of the more focal solid nodule in the right middle lobe, seen reference measurements provided. Overall appearance is suspicious for metastatic disease given patient's history of a known malignancy
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Generate impression based on findings.
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Joint pain, evaluate for erosive disease/progression Left hand: There is slight narrowing of the fourth MCP joint, which may represent rheumatoid arthritis, but there are no erosions. Mild osteoarthritis affects the DIP joints of the fingers. There may be volar rotary subluxation of the scaphoid.Right hand: There is narrowing and erosion of the fifth DIP joint. There is also mild narrowing of the second through fourth DIP joints and possibly the fourth and fifth MCP joints. Narrowing of the radiolunate and capitolunate articulations is noted. There may be volar rotary subluxation of the scaphoid.Left foot: There are chronic erosions of the first, second, fourth, and fifth MTP joints as well as the fifth PIP joint. Erosion of the fourth metatarsal head has progressed.Right foot: Chronic erosions of all MTP joints appears similar to prior.
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Erosive arthropathy as described above most severely affecting the MTP joints with progression of left fourth metatarsal head erosion.
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Generate impression based on findings.
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51-year-old male with lower extremity edema and pain Right tibia and fibula: An intramedullary rod and screw device affixes a healing/healed fracture of the distal tibial diaphysis in near-anatomic alignment without evidence of hardware complication. There is also a healing/healed fracture of the distal fibular diaphysis in near anatomic alignment. There is diffuse soft tissue swelling without radiographic evidence of osteomyelitis. The distal aspect of an intramedullary rod within the femur is noted.Left tibia and fibula: Soft tissue swelling without radiographic evidence of osteomyelitis. No fracture is evident. Mild osteoarthritis affects the knee and midfoot.
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Soft tissue swelling and postoperative/post traumatic changes as described above without radiographic evidence of osteomyelitis.
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Generate impression based on findings.
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NSCLC LUNGS AND PLEURA: Redemonstration of a right upper lobe perifissural cavitating mass (image 36 series 5) now measuring 23 mm x 29 mm previously measuring 26 mm x 33 mm. The solid component (sagittal image 27) has decreased in size now measuring 10 mm x 6 mm previously measuring 12 mm x 8 mm.Persistent thickening of the adjacent fissure and irregular nodular right basilar pleural thickening.Right middle lobe atelectasis and right pleural nodular thickening similar to the prior exam.New small left pleural effusion.Calcified granuloma in the lingula.No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Left thyroid hypodense nodule unchanged.No hilar or mediastinal lymphadenopathy.Calcified hilar and mediastinal lymph nodes compatible with a prior granulomatous disease.Cardiac size normal without evidence of a pericardial effusion.Moderate coronary artery calcification.CHEST WALL: New sclerotic foci in the T11 and T8 vertebrae compatible with metastatic disease.Sclerotic right eighth rib was present on the prior exam .UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. Stable hepatic hypodensity most likely representing a cyst.
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1.Mild interval decrease in size of the right upper lobe cavitating nodule.2.New sclerotic foci within the thoracic vertebrae and stable sclerotic focus within the eighth rib compatible with osseous metastases.3.New left-sided pleural effusion
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Generate impression based on findings.
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76-year-old old male with pain with movement for 5 weeks Mild to moderate osteoarthritis affects the glenohumeral joint. Glenohumeral alignment and the acromiohumeral interval are within normal limits.
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Glenohumeral joint osteoarthritis.
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Generate impression based on findings.
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51-year-old male with enchondroma Two views of the left humerus again show a cluster of calcifications within the proximal humeral diaphysis consistent with the suspected diagnosis of enchondroma. A small focus of endosteal scalloping along the posterior margin of the lesion appears similar to the exam dated 5/21/14. There is no frank cortical penetration or other specific feature to indicate malignancy.
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Findings compatible with enchondroma appearing similar to the prior exam.
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Generate impression based on findings.
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Male; 63 years old. Reason: please assess for leakage of contrast given via OG tube out of esophagus past esophageal stent History: chest pain CHEST:LUNGS AND PLEURA: Small right pleural effusion, decreased since prior study status post right chest tube placement. Small right pneumothorax.Moderate to large left pleural effusion, increased since prior study. Left chest tube tip is slightly retracted since prior study and may have tip within the lung parenchyma rather than pleural space. No left pneumothorax.Mild scattered groundglass and nodular opacities in the left upper lobe are most likely post infectious or inflammatory in etiology. Mild to moderate bibasilar compressive subsegmental atelectasis.MEDIASTINUM AND HILA: Stable metallic distal esophageal wall stent in place with a clip near the GE junction. Small amount of pneumomediastinum to the right of the distal esophagus has decreased. No contrast extravasation. Normal heart size without pericardial effusion. No visible coronary artery calcifications. Endotracheal tube in place.CHEST WALL: Minimal bilateral chest wall subcutaneous emphysema related to chest tube placement. Stable benign-appearing left axillary lipoma.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval placement of Dobbhoff tube with tip in the proximal jejunum. New diffuse mild circumferential wall thickening of the partially visualized descending colon, compatible with nonspecific colitis. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Stable distal esophageal clip and stent. Interval decreased adjacent pneumomediastinum. No contrast extravasation.2. Large left pleural effusion, increased since prior study. Left chest tube tip is slightly retracted since prior study and may have tip within the lung parenchyma rather than pleural space. Consider adjusting the left chest tube.3. New nonspecific mild colitis of the partially visualized descending colon.
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Generate impression based on findings.
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Female 87 years old Reason: Patient enrolled in clinical trial History: Please compare to prior scan CHEST:LUNGS AND PLEURA: No substantial interval change in reference right middle lobe nodular opacity which measures 1.6 x 1.2 cm (image 71, series 4. Second nodular opacity in the the right middle lobe (image 63, series 4), which is presumably infectious or inflammatory in etiology has decreased in size compared to prior. The groundglass opacity in the left upper lobe (image 47) is unchanged.MEDIASTINUM AND HILA: There are mild coronary arterial calcifications. There are dense atherosclerotic calcifications of the abdominal aorta. There is no evidence of mediastinal or hilar lymphadenopathy on the basis of size criteria. Thyroid nodules.CHEST WALL: Index left axillary lymph node measures 0.6 x 1.0 cm (image 20, series 3), stable. Partly visualized right axillary lipoma, which is unchanged. ABDOMEN:LIVER, BILIARY TRACT: Hypodensity in hepatic segment 4b is too small to characterize and stable. There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: Index hypodense splenic lesion measures 1.2 cm in diameter (image 87, series 3), stable.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: The index confluent aortocaval adenopathy measures 2.6 x 1.3 cm (image 112, series 3), stable. Abdominal aortic aneurysm measures approximately 3.2 cm in diameter (image 119; series 3), grossly unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is unchanged anterior wedging of the L1 vertebral body, and grade 1 retrolisthesis of L3 on L4, both unchanged.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Index right internal iliac chain node measures 0.4 x 1.0 cm (image 162, series 3), stable.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is unchanged anterior wedging of the L1 vertebral body, and grade 1 retrolisthesis of L3 on L4 as noted above.OTHER: No significant abnormality noted.
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Stable examination with reference measurements given above.
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Generate impression based on findings.
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The ventricles and sulci are prominent, consistent with mild global volume loss greater than expected for the patient's stated age. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is trace mucosal thickening in the maxillary sinuses.MRA HEAD
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1. No acute infarct. Mild global volume loss greater than expected for the patient's stated age.2. Unremarkable MRA of the head and neck.
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Generate impression based on findings.
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50-year-old female with cardiac arrest. Evaluate for intracranial hemorrhage. The supratentorial ventricles appear small and the gray-white differentiation is less distinct than expected which is suspicious for early diffuse cerebral edema. Basal cisterns remain patent. There is no evidence for intracranial hemorrhage. There are no extraaxial fluid collections. There are no masses or midline shift. There are multiple small air-fluid levels within the paranasal sinuses as well as debris in the nasal cavity.
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Findings suggestive of early diffuse cerebral edema.These findings were discussed with Dr. Deshmukh (3201), the Neuro-ICU physician taking care of the patient by Dr. Veronesi at the time of this dictation at 1200 on 1/21/15.
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Generate impression based on findings.
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82 year-old female with lymphoma (DLBCL vs. Burkitt's). Needs staging.RADIOPHARMACEUTICAL: 13.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 117 mg/dL. Today's CT portion grossly demonstrates right maxillary sinus mucosal thickening. Thyromegaly. Right lower neck/upper chest mass with destruction of the right first and second ribs. Bibasilar atelectasis. Bilateral small pleural effusions. Mildly enlarged right precarinal lymph node. Moderate hiatal hernia. Gallstones. Bilateral, right greater than left, pelvic masses.Today's PET examination demonstrates extensive hypermetabolic tumor involving the head, neck, chest, abdomen, and pelvis.Extensive hypermetabolic tumor involves the musculoskeletal system including several foci involving the bilateral humeri, extensive involvement of the left rotator cuff muscles and left scapula, extensive involvement of the left maxillary bone, small foci involving the bilateral mandibular bones, foci involving the bilateral masticator muscles, extensive involvement of the right lower neck and upper chest wall including the right first and second ribs, focus involving the left fifth rib, extensive involvement of the left midthoracic paraspinal muscles, vertebral bodies, and probable spinal cord, additional foci involving T4, L3, L4, and sacral vertebral bodies, and foci involving both femora.Extensive hypermetabolic tumor involving the bilateral thyroid lobes, right lower neck and superior mediastinal lymph node, heart in the region of the interatrial septum, multiple periesophageal lymph nodes, gastric wall, bilateral kidneys, right greater than left, and multiple pelvic masses, right greater than left.For reference, right lower neck/upper chest wall mass measures a maximum SUV of 14.2.
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Extensive markedly hypermetabolic tumor involving the head, neck, chest, abdomen, and pelvis as described above.
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Generate impression based on findings.
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Pleural mesothelioma. CHEST:LUNGS AND PLEURA: Mild left pleural thickening appears overall improved. The volume of pleural fluid on the left has significantly decreased, now small. No evidence of contralateral pleural spread. Reference measurements on the left as follows:1. Level of the great vessels (3/20) 9 o'clock position 4 mm, previously 7-mm. 6 o'clock position 0 mm.2. Level of the left ventricular apex (3/70). Due to contrast opacification of chest wall vasculature, anatomy of the previously measured areas are now defined. At the previously measured 1 o'clock position pleural thickening now measures 1 mm, previously 9-mm however at the 8 o'clock position on the prior measurement an unopacified dilated intercostal vein was inadvertently measured. At this level the pleural measurement is 1 mm and on the prior study when remeasured was 3-mm. A better defined site of pleural thickening at the 2 o'clock position measures 7 mm, previously 6-mm. 3. Left costophrenic angle (3/86) 12 o'clock position 18-mm previously 13 mm, 6 o'clock position 4-mm previously 9-mm. The apparent increase in the 12 o'clock position lesion that may be secondary to anatomic changes related to decreased pleural fluid.MEDIASTINUM AND HILA: Mild pericardial thickening and enhancement appears improved. Normal heart size. Minimal pericardial fluid. No significant coronary artery calcifications.Left interlobar lymphatic tissue measures 7-mm (3/54), unchanged. Decreased size of left inferior pulmonary ligament lymph node 4 mm, previously 6-mm (3/65).CHEST WALL: No lymphadenopathy. Lower thoracic intercostal veins remain are engorged.Enhancing soft tissue in the left eighth/ninth lateral intercostal space appears minimally improved (3/89), favoring biopsy site scar but should continue to be monitored to exclude seeding of the biopsy tract.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Nonspecific hypoattenuating subcentimeter lesion, no suspicious nodules.SPLEEN: Previously seen fluid has resolved.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Left renal vein appears compressed as it passes between the aorta and superior mesenteric artery, correlate for symptoms.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Overall improvement in left hemithorax pleural thickening and loculated fluid. Two view improved contrast opacification of chest wall vasculature, index level measurements were adjusted at, an addendum to be previous report will be provided. A residual focus of tumor noted in the left anterolateral costophrenic angle was measured as a new area of reference.2. Improved size of small lymph nodes3. Resolved perisplenic fluid, and no conclusive evidence of intra-abdominal or contralateral pleural extension.4. Improved left chest wall biopsy site appearance, favoring post operative scarring.
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Generate impression based on findings.
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50 years old male with history of head and neck cancer, status-post chemoradiation. This study was performed for restaging.RADIOPHARMACEUTICAL: 12.6 MCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 104 mg/dL. Today's CT portion grossly demonstrates 4 small nodules in the right upper lobe, right middle lobe and right lower lobe. There are two nodules in the left lower lobe. Diffuse decreased attenuation of the liver is seen. Postsurgical changes seen in the lower lumbar spine.Today's PET examination demonstrates increased activity in the two nodules in the right middle lobe and right lower lobe, and in two left lower lobe nodules. The maximal SUV in the dominant nodule in the right middle lobe is 6.9. The maximal SUV in the left lower lobe lung nodules is 5.3.There is a increased activity in the base of the tongue/epiglottis.There is increased activity in the subcarinal lymph node with maximal SUV of 6.4.Mildly increased activity in the bilateral inguinal lymph nodes.
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1.Several hypermetabolic pulmonary nodules, consistent with tumor. They are most likely due to metastases.2.Increased metabolic activity in the tongue base/epiglottis, which can be due to inflammatory change or tumor.3.Increased activity in the subcarinal lymph node, which can be due to metastasis.
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Generate impression based on findings.
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46-year-old female with a focal asymmetry in the right breast found on the screening mammogram presents for ultrasound guided biopsy of the right breast. Right ultrasound identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 10 x 5 mm at 6:30 position without increased vascularity, 4 cm from the nipple. The lesion was somewhat subtle.PROCEDURE: The procedure and its risks, including bleeding, infection, and failure to diagnose, and expected benefits of ultrasound-guided core biopsy with percutaneous placement of a marking clip and post-procedure unilateral mammogram 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 side/type of procedure.The right breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially, with 1% lidocaine with 1:100,000 epinephrine at depth. A 3 mm incision was made in the skin with a #11 scalpel blade. Using aseptic technique, continuous ultrasound guidance and a inferolateral to superomedial approach, three 14-gauge core needle (Inrad) specimens were obtained of the lesion. Targeting was judged very good. All specimens partially sank in the prefilled container of 10% formalin. Specimen quality was judged very good.Specimens were sent to Pathology with an accompanying history sheet. Using continuous ultrasound-guidance a Bard ribbon clip was placed into the lesion in the usual manner. Pressure was held over the biopsy site until all bleeding subsided. The skin incision was closed with a Steri-Strip. Post-procedure digital right CC and ML views revealed the percutaneously placed clip to be in the expected location in the peripheral anterior lateral aspect of the lesion. No evidence of hematoma or other complication.A pressure dressing was positioned over the biopsy site and an ice pack positioned over the pressure dressing. Post-procedure instructions were reviewed with the patient both verbally and in writing. She tolerated the procedure well with no evident complications and left the Breast Imaging Department in stable condition.The procedure was performed by Dr. Abe.
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Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.
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Generate impression based on findings.
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49 year old female with history of liver transplant completed by PTLD. CHEST:LUNGS AND PLEURA: Unchanged right apical foci of ossification and fibrosis (4/15).Left upper lung groundglass opacity (4/20) is unchanged. Minimal right pleural effusion.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Postoperative findings are noted about the liver, similar to prior. Mild intrahepatic biliary dilatation, unchanged.SPLEEN: Mild splenomegaly, stable.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts, similar to prior.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right iliac bone deformity and sclerosis, likely postoperative in nature and unchanged.OTHER: No significant abnormality noted.
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1. Stable mildly dilated intrahepatic biliary ducts, unchanged, and other findings as above.2. Left upper lung ground glass opacity, not significantly changed, may be followed on subsequent imaging studies.
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Generate impression based on findings.
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Postoperative changes are seen from previous anterior fusion of T12 through L2, with a probable strut graft spanning L1. Susceptibility artifact limits evaluation of surrounding structures.The spine is in normal alignment. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and grossly of normal signal. The distal spinal cord and conus are grossly within normal limits with the conus terminating at the approximate L1-L2 level.There is no definite evidence of significant disk pathology or stenosis within the spine, within limitations of sagittal images only.
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November evidence of acute cord compression. Postoperative changes at the thoracolumbar junction.
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Generate impression based on findings.
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Male 73 years old; Reason: Relapsed FCL History: Most recently, he completed 6 cycles of BR in May 2014 CHEST:LUNGS AND PLEURA: Stable mild bibasilar scarring. Mild interval decrease in size of nodular lesion in lingular area, measuring 2 x 1.2 cm, image 78 series 6, previously measured 2.4 x 1.4 cm. At site of previously seen 1.3 cm right upper lobe groundglass nodule is a cluster of subcentimeter groundglass nodularity, may reflect improving disease. No pleural effusion. Incidentally seen azygous lobe. MEDIASTINUM AND HILA: Scattered subcentimeter mediastinal lymph nodes, nonenlarged by CT criteria. CHEST WALL: Right chest wall port with tip in mid to distal SVC. Bilateral gynecomastia. ABDOMEN:LIVER, BILIARY TRACT: Unchanged hepatic dome cyst. Additional scattered smaller hypoattenuating foci, too small to characterize but unchanged. Cholelithiasis. No evidence of acute cholecystitis. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Subcentimeter retroperitoneal/left para-aortic lymph nodes. BOWEL, MESENTERY: Small hiatal hernia. Small bowel containing right groin hernia, measuring 5.7 x 3.8 cm. Descending and sigmoid colon diverticulosis.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate gland with relative hypertrophy of median lobe, gland measures up to 6.3 cm in transverse dimension.BLADDER: No significant abnormality noted.LYMPH NODES: Reference right inguinal lymph node mildly smaller, measuring 0.9 x 0.9 cm, previously measured 1.5 x 1 cm.BONES, SOFT TISSUES: Multilevel degenerative changes of spine.
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Mild interval decrease in size of reference lesions as described. At site of previously seen 1.3 cm right upper lobe groundglass nodule is a cluster of subcentimeter groundglass nodularity, may reflect improving disease. New new site of disease identified.
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Generate impression based on findings.
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The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is left maxillary sinus mucosal retention cyst.
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Unremarkable noncontrast MRI brain.
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Generate impression based on findings.
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Hip pain Two views of the left hip are provided. Again seen is mixed lucency and sclerosis in the femoral head indicating avascular necrosis. There is a slight step off along the superomedial aspect of the femoral head that was not clearly evident on the prior study and may represent focal subchondral fracture. Small osteophytes indicate mild osteoarthritis.The AP view of the pelvis reveals the aforementioned left femoral head osteonecrosis. Mild osteoarthritis affects the right femoral head. The remainder of the pelvis is unremarkable.
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Left femoral head osteonecrosis as described above.
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Generate impression based on findings.
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Left distal radius aneurysmal bone cyst status post curettage/cementation. Evaluate for local recurrence. Again seen is cement within the site of curettage of a distal radial aneurysmal bone cyst. There is lucency within the bone along the distal and radial margins of the cement, but the overlying cortical bone appears intact and I therefore suspect that this is of no clinical significance. There is questionable subluxation at the first carpometacarpal joint, although this may simply be an artifact of patient positioning for the examination.
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Postoperative changes of aneurysmal bone cyst curettage and packing with findings as described above.
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Generate impression based on findings.
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Dyspnea on exertion. Lung cancer, follow-up CHEST:LUNGS AND PLEURA: Multiple bilateral irregularly marginated modules are again observed with interval increase in both size and solid components. Multiple lesions are associate with pleural surface thickening and extension as well architectural distortion and retraction.The reference right upper lobe nodule when measured similarly (image 52 series 4) is mildly larger measuring 2.5 x 1.5 cm from a prior measurement of 2.0 x 1.4 cm. The reference left lower lobe nodule along the major fissure demonstrates increased fullness and thickening, it is difficult however to confirm that this is not fluid and contents tract along the fissure. For reference the lesion currently measures 3.6 x 3.0 cm (image 55 series 4) from a prior measurement of 3.4 by 1.9 cmTo improve potential accuracy, and additional reference nodule in the apical segment of the right lower lobe (image 35 series 4) currently measures 1.3 cm from a prior measurement of 0.8. cm. Additionally scattered bilateral focal opacities are all similarly increased in sizeIncreased bilateral pleural effusions currently moderate on the right and large on the left with underlying compressionMEDIASTINUM AND HILA: Interval mild enlargement of the precarinal reference node, previously 9 mm and currently 11 mm (image 39 series 3).Moderate valve and coronary artery calcifications without additional mediastinal findings.CHEST WALL: Multiple sclerotic osseous lesions are observed scattered throughout the thoracic and lumbar spine without evidence of interval change. Specifically no new blastic or lytic lesions observed.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Mild nodularity of the left adrenal gland unchangedKIDNEYS, URETERS: Stable left parenchymal atrophy with hydroureter and pelvic prominence similar to prior. Right kidney unremarkablePANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: IVC stentBOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Sclerotic foci unchanged, see description aboveOTHER: Small umbilical hernia
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Continued interval increasing size of both reference and multiple scattered pulmonary lesions despite differences in patient positioning and technique. Interval increasing size of bilateral pleural effusions create an image and appearance concerning for continued progression of known metastatic and primary lung malignancies
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Generate impression based on findings.
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77-year-old with history of right breast cancer status post mastectomy. Three standard views of the left breast 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. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the left breast. Intramammary lymph nodes and benign calcifications are again noted.Benign appearing lymph nodes are projected over the left axilla.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Reason: ? extrinsic compression History: nodular goiter, occ dysphagia Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions. Double contrast evaluation of the esophagus and gastric cardia/fundus revealed no abnormalities of the mucosal surfaces or mural contours.Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave. There was no functional obstruction to liquid contrast or barium pill. During the exam, one episode of trace provoked gastroesophageal reflux was observed.TOTAL FLUOROSCOPY TIME: 3:46 minutes
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One episode of trace provoked gastroesophageal reflux. Otherwise normal exam.
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Generate impression based on findings.
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Reason: patient s/p liver transplant, HIV+, skin cancer, now with organizing pneumonia (LLL). please f/u nodules for resolution History: lung nodules LUNGS AND PLEURA: Decrease in size of the left lower lobe subpleural opacity (image 73 series 4) now measuring 15 mm x 8 mm mm previously measuring 31 mm x 17 mm.Interval decrease in the subpleural atelectasis/consolidation at the left costophrenic angle.Interval increase in right pleural effusion with new subpleural area of consolidation at the right costophrenic angle . Areas of discoid atelectasis at both lung bases.MEDIASTINUM AND HILA: Stable minimally enlarged right hilar lymph node although this cannot be accurately measured due to lack of intravenous contrast.No evidence of mediastinal lymphadenopathy.Cardiac size is normal with evidence of a small stable anteriorly located pericardial effusionCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Postsurgical changes related to a prior liver transplant.
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1.Subpleural areas of consolidation /atelectasis may represent sites of organizing pneumonia.2.Interval decrease in the prior left lower lobe subpleural area consolidation (organizing pneumonia).3.Increasing right pleural effusion.4.No new suspicious pulmonary nodules or masses.
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Generate impression based on findings.
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63 years old male with a history of PTLD Lymphoma, s/p liver transplant and 6 cycles of R CHOP in need of end of treatment restaging. RADIOPHARMACEUTICAL: 14.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 179 mg/dL. Today's CT portion grossly demonstrates stable soft tissue densities in the bilateral maxillary sinuses. There is an interval near complete resolution of the patchy opacity in the left upper lobe. Extensive atherosclerotic coronary arterial calcifications are again noted. The biliary internal stent is noted.Today's PET examination demonstrates a new focus of increased activity in the right side of mandible without definite CT correlation. This finding is most likely due to periodontal disease.There is interval near complete resolution of mild FDG uptake in the patchy opacity in the left upper lobe. Stable linear of increased activity in the biliary stent, which is consistent with post procedural change.FDG uptake in the remaining portion of the body is physiological. Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder.
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1.No definite evidence of FDG avid tumor on the current study.2.Focal increased metabolic activity in the right side of mandible, which is most likely due to periodontal disease.3.Resolving inflammatory change in the left upper lobe.
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Generate impression based on findings.
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Breast cancer, follow-up CHEST:LUNGS AND PLEURA: Mild basilar atelectasis and mildly decreased lung volumes without suspicious superimposed air space abnormality. Specifically no nodules or masses. No effusions.MEDIASTINUM AND HILA: No lymphadenopathyThe cardiac and pericardium are within limitsSmall hiatal herniaCHEST WALL: Large left breast mass with spiculation and extension skin surface, incomplete visualization due to field of view. Associated enlarged left axillary lymphadenopathy are conglomerate lymph nodes, measuring 2.9 cm for reference (image 29 series 3).ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Questionable minimal gallbladder sludge or cholelithiasisSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Large left breast mass and changes incompletely visualized and with axillary lymphadenopathy correlating with the patient's known breast cancer, however no intrapulmonary or central abnormalities.
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Generate impression based on findings.
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Liver transplant and Hodgkin's lymphoma (PTLD-type), stage IVA, status post chemotherapy. The previously described multiple small lymph nodes distributed throughout the neck appear to have decreased in size when compared to the previous exam. For example, the right level 2A lymph node now measures 8 x 12 mm, previously 7 x 9 mm. Additionally the right level 2B lymph node now measures 8 x 5 mm, previously also 8 x 5 mm; and the left level 2A lymph node now measures 6 x 7 mm, previously 4 x 13 mm. No other pathologically enlarged lymph nodes based on size criteria are identified. The thyroid gland, submandibular glands, and parotid glands are unremarkable. The left sternocleidomastoid muscle is atrophic, appearing similar to the previous examination. The imaged sinuses and mastoid air cells are clear. The imaged skull base is unremarkable. There is a partially imaged scoliosis rod. The groundglass nodule in the left apex is not significantly changed in size. Likewise, the partial calcified nodules in the right apex are also unchanged.
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1. Although the right level 2A lymph node is slightly larger than previously, it and other cervical lymph nodes are not significantly enlarged by size criteria. 2. Refer to the separate chest CT report for additional details regarding the lung lesions.
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Generate impression based on findings.
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Adenocarcinoma LUNGS AND PLEURA: Postsurgical changes from right upper lobectomy unchanged. No suspicious new nodules or masses identified. Scattered bilateral nonspecific micronodules. No effusions. Mild diffuse emphysematous changesSpecifically stable linear scarring both in the lingular region and right middle lobe.MEDIASTINUM AND HILA: No lymphadenopathyModerate coronary calcifications without additional pericardial or cardiac abnormalitySuspected small hiatal herniaCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Diffuse fatty liver again observed without evidence of focal abnormality. No definite evidence to support cirrhosis. Difficult discernment of previously identified small soft tissue nodule adjacent to left lobe of the liver, grossly unchanged in possibly a splenule however currently this abnormality is interposed between the filled expanded stomach and left lobe of the liver (see arrow (image 94 series 10307).
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No evidence of recurrent or metastatic disease
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Generate impression based on findings.
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The scout lateral view and the sagittal reformatted images demonstrate the lumbar spine to be in normal alignment, with a normal lumbar lordosis. There is mild disk space narrowing at L5-S1 especially posteriorly. The vertebral body and disk space heights are otherwise well-maintained. There is no evidence of a pars defect. Schmorl's nodes are forming at L1-L2 and L3-L4.There is no acute fracture.The axial images do not demonstrate any significant bony spinal canal or foraminal stenosis. There are trace disk bulges along the lumbar spine, most conspicuous at L3-L4 and to a lesser degree at L1-L2.Limited views through the retroperitoneum demonstrate no gross abnormalities.
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No evidence of spondylolysis. Trace disk bulges along the lumbar spine without significant stenosis.
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Generate impression based on findings.
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Small lymphocytic lymphoma. Evaluate for lymphadenopathy. There is diffuse cervical lymphadenopathy involving the bilateral jugular chains, occipital nodes, and parotid nodes, as well as the imaged portions of the superior mediastinal nodes. Index nodes include:Left parotid node: 12 x 14 mm, previously 12 x 13 mmLeft level 1a node: 15 x 12 mm, previously 14 x 12 mmLeft level 1b node: 27 x 18 mm, previously 27 x 16 mm Right level IIb node: 12 x 15 mm, previously 11 x 16 mmThere is mild enlargement of the palatine tonsils bilaterally mild narrow the oropharyngeal airways. The thyroid gland is unremarkable. There is degenerative cervical spondylosis. The partially imaged intracranial structures are unremarkable. There is partially imaged pulmonary emphysema. A 9 mm diameter left cheek subcutaneous nodule may represent an inclusion cyst.
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No significant interval change in the diffuse bilateral cervical lymphadenopathy and partially-imaged superior mediastinum related to lymphoma.
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Generate impression based on findings.
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Right hand. Determine if catheter or sheath or thrombophlebitis. At the site of the abnormality, there is a mildly dilated and thrombosed vein. No foreign body was visualized.
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Thrombophlebitis. No sonographic evidence of foreign body.
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Generate impression based on findings.
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TachypneaVIEW: Chest AP 1/21/15 Cardiothymic silhouette normal. Minimal peribronchial wall thickening with subsegmental atelectasis in the right lower lobe. No pleural effusion or pneumothorax.
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Bronchiolitis or reactive airway disease.
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Generate impression based on findings.
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PainVIEWS: Left ankle AP, oblique and lateral No acute fracture or dislocation. The ankle mortise joint is normal. No joint effusion noted. There is a small radiopaque density immediately adjacent to the base of the fifth metatarsal bone.
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No acute fracture or dislocation. Radiopaque density immediately adjacent to the base of the fifth metatarsal bone and if clinically warranted dedicated radiographs of the left foot could be obtained.
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Generate impression based on findings.
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Neutropenia and worsening frontal headaches. There is a small left maxillary sinus retention cyst and mild mucosal thickening in the right anterior ethmoid sinus and left frontal sinus. The other paranasal sinuses are clear. There are bilateral conchae bullosa, with opacification on the right. There is mild nasal septal deviation and spur. 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 in the right temporomandibular joint.
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1. Small left maxillary sinus retention cyst and mild mucosal thickening in the right anterior ethmoid and left frontal sinuses. The other paranasal sinuses are clear. 2. Degenerative changes in the right temporomandibular joint.
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Generate impression based on findings.
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74 year old female with ankle pain at lateral and medial malleolus and difficulty with weight-bearing. Concern for arthritis versus trauma. Fell at home, swelling. There is soft tissue swelling about the ankle. I see no fracture. There is streaky calcification and possibly ossification of the distal Achilles' tendon indicating chronic tendinosis. Mineralization is also noted beneath the calcaneus at the expected site of attachment of the plantar fascia and distal to the medial malleolus in the expected location of the deltoid ligament; this is not necessarily of any current clinical significance. Mild osteoarthritis affects the midfoot. Alignment is within normal limits.
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Soft tissue swelling and calcifications as well as mild osteoarthritis as described above. I see no fracture.
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Generate impression based on findings.
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Left knee pain. Rule out osteoarthritis changes. Four views of the left knee are provided. There is mild medial compartment narrowing and small tricompartmental osteophytes indicating mild osteoarthritis. Mild osteoarthritis also affects the right knee as seen on the frontal view.
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Mild osteoarthritis.
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Generate impression based on findings.
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Status post right total knee arthroplasty Components of a total knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. Skin staples, a drain, and foci of gas density in the anterior soft tissues reflect recent surgery.
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Postoperative changes of total knee arthroplasty as above.
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Generate impression based on findings.
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Pain. Loose tooth. Dental root fracture? There is a cavity of the distal root of the first right mandibular molar. Additionally, there is resorption of the bone about the roots that may represent an abscess. I see no fracture. There is mild impaction of the adjacent molar, as well as the third right maxillary molar.
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Right first mandibular molar cavity and periapical bone resorption in the adjacent mandible which could represent abscess formation. I see no fracture.
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Generate impression based on findings.
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37 year old female with IDC grade 3 breast cancer. No abnormal osseous foci are identified to indicate metastatic disease.Faint radiotracer uptake diffusely within the left breast related to the patient's known breast cancer or post therapy changes.Focus of radiotracer activity within the right anterior 10th rib likely posttraumatic in etiology.Scattered degenerative changes in the shoulders, knees, and ankles.Physiologic radiotracer uptake in the kidneys and bladder.
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1.No definite evidence of bone metastases. 2.Focus of activity within the right anterior 10th rib likely posttraumatic in etiology.3.Diffuse left breast activity related to known breast cancer or post therapy changes.
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Generate impression based on findings.
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66-year-old female with shoulder pain, evaluate for osteoarthritis Right knee: Severe tricompartmental osteoarthritis affects the knee, appearing similar to the prior exam. Mild varus deformity.Left knee: Severe osteoarthritis has progressed slightly from the prior exam. Mild varus deformity.
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Severe osteoarthritis bilaterally.
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Generate impression based on findings.
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5-year-old male with high risk neuroblastoma status-post consolidation therapy, here for pre-antibody workup CHEST:LUNGS AND PLEURA: Bibasilar focal consolidations likely represent atelectasis. No pleural effusions. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: No significant mediastinal or hilar lymphadenopathy. Heart size is normal. No pericardial effusion.CHEST WALL: No axillary, cardiophrenic, or retrocrural lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. No intrahepatic or extrahepatic biliary ductal dilatation. The gallbladder is within normal limits.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Surgical clips in the right adrenal region with absent right adrenal gland. Unchanged small amount of soft tissue adjacent to the surgical clips. Left adrenal gland is within normal limits. KIDNEYS, URETERS: No evidence of hydronephrosis or perinephric fat stranding.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The bladder is significantly distended.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Focal opacities in bilateral lung bases likely represent atelectasis. Unchanged small amount of residual soft tissue in the surgical bed. No evidence of metastatic disease.
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Generate impression based on findings.
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66-year-old female with pain Right hip: The bones are demineralized. No osteoarthritis or fracture evident.Pelvis: The bones are diffusely demineralized. There is slight widening of the pubic symphysis and the margins of the greater trochanters are indistinct, possibly reflecting chronic hyperparathyroidism, appearing similar to the prior exam. Minimal osteoarthritis affects the left hip. Calcifications projecting over the pelvis likely represent calcified uterine fibroids.
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Demineralization of the bones and other findings as described above, which may reflect chronic hyperparathyroidism.
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Generate impression based on findings.
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21 year-old female with right lower quadrant abdominal pain. Evaluate for appendicitis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydroureteronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Bilateral hypoattenuating lesions in the expected location of the adnexa measuring up to 55 Hounsfield units may be hemorrhagic cysts.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Appendix measures 9 mm in diameter with hyperemic wall and periappendiceal inflammatory changes. Findings consistent with acute appendicitis. No drainable fluid collections. No evidence of small bowel obstruction. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Findings consistent with acute appendicitis.2.Bilateral adnexal lesions with high attenuation raising possibility of hemorrhagic adnexal cysts. Findings relayed to Dr. Ankit Bhatia over the phone at approximately 1:35 p.m.
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Generate impression based on findings.
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Status post motor vehicle accident, right shoulder pain extending to neck, rule out fracture There is no acute fracture or malalignment. Minimal osteoarthritis affects the acromioclavicular joint. Mild sclerosis along the greater tuberosity is likely degenerative in etiology.
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Minimal osteoarthritis without fracture.
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Generate impression based on findings.
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68-year-old female, assess prosthesis Hip: Hardware components of a total hip arthroplasty device are situated in near-anatomic alignment without evidence of complication.Pelvis: The aforementioned right total hip arthroplasty device is again noted. The bones are demineralized. Moderate osteoarthritis affects the left hip. There are extensive arterial calcifications in the soft tissues.
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Total hip arthroplasty as described above.
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Generate impression based on findings.
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HIV and low CD4 with new unilateral headache and visual floaters. 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. There is a retention cyst in the left maxillary sinus. There is mild mucosal thickening in the right maxillary sinus. The imaged mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. There is anterior subluxation of the mandibular condyles. There are partially-imaged carious teeth # 5, 13, and 16.
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1. No evidence of intracranial hemorrhage, mass, or abscess.2. Partially-imaged carious teeth # 5, 13, and 16. 3. Anterior subluxation of the mandibular condyles.
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