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Generate impression based on findings.
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Female 49 years old; Reason: assess for micro thromboembolism not seen on CT PE, has h/o ILD, part of pulmonary hypertension work-up History: SOB The comparison CT chest performed on 1/20/2015 demonstrates extensive bilateral pulmonary opacities.The ventilation images show decreased ventilation which is patchy in appearance throughout the entire left lung and right lung base on single-breath images. There is eventual equilibrium, with retention of Xe-133 in the left apex and right lung base during the washout phase. The perfusion images show numerous perfusion defects in the bilateral lower lobes and left apex which appear generally matched to the ventilation images. Quantitation of relative single breath ventilation (using the posterior image):Left lung: 40 % (upper lung 12%; middle lung 18%; lower lung 10%)Right lung: 60% (upper lung 20%; middle lung 29%; lower lung 11%)Quantitation of relative pulmonary arterial perfusion (using anterior and posterior geometric means):Left lung: 33% (upper lung 10%; middle lung 18%; lower lung 4%)Right lung: 67% (upper lung 20%; middle lung 38%; lower lung 10%)
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1. Numerous matched ventilation perfusion defects. Given the extensive nature of the abnormalities, the exam is considered intermediate/indeterminate probability for pulmonary embolism. However there are no definite significant ventilation-perfusion mismatch defects to conclusively suggest pulmonary embolism.2. Multiple bilateral decreased ventilation-perfusion defects, left worse than right as quantified above.
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Generate impression based on findings.
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57 year old female with head trauma. HEAD: There are postoperative findings related to left pterional craniotomy for clipping of a distal left internal carotid artery aneurysm. There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are otherwise unremarkable. FACIAL BONES: There are bilateral depressed fractures of the frontal processes of the maxillary bone and nasal bones with swelling and emphysema within the adjacent soft tissues, including the cartilaginous septum, which is angulated to the right. There is no orbital fracture. The globes are intact without evidence of intraorbital hematoma or stranding. The temporomandibular joints are intact. The imaged paranasal sinuses and mastoid air cells are clear. There is no significant soft tissue swelling. There are tonsilloliths.
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1.Bilateral depressed nasal skeleton fractures with nasal septal disruption. 2.Unchanged postoperative findings related to left pterional craniotomy for clipping of a distal left internal carotid artery aneurysm. 3.No evidence of acute intracranial hemorrhage or skull fracture. 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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Acute respiratory failure, assess ETT placement.VIEW: Chest AP (one view) 1/23/2015, 02:48 Endotracheal tube tip is below the thoracic inlet and above the carina. Right PICC and left central line again noted, positions unchanged. Enteric feeding tube tip projects out of the field of view. Bilateral multifocal lung opacities are not significantly changed. No pleural effusion or pneumothorax. The cardiothymic silhouette is upper limits of normal to mildly enlarged in size.
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Bilateral multifocal atelectasis, unchanged.
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Generate impression based on findings.
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Acute respiratory distress.VIEW: Chest AP (one view) 1/22/2015, 17:02 Endotracheal tube tip is below the thoracic inlet and above the carina. Right PICC and left central line again noted, positions unchanged. Enteric feeding tube tip projects out of the field of view. Bilateral multifocal lung opacities are not significantly changed. No pleural effusion or pneumothorax. The cardiothymic silhouette is upper limits of normal to mildly enlarged in size.
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Bilateral multifocal atelectasis, unchanged.
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Generate impression based on findings.
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Patient with hematochezia, evaluate stool burden.VIEW: Abdomen AP (one view) 1/22/2015 A moderate stool burden is distributed throughout the colon, perhaps slightly improved from the prior examination. The bowel gas pattern is nonobstructive, and no portal venous gas, pneumatosis intestinalis or pneumoperitoneum is present.
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Moderate stool burden, perhaps slightly improved.
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Generate impression based on findings.
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2-year-old male with pneumonia and history of chronic constipation presents with questionable metallic foreign body that was noted in the right lower quadrant at outside hospital VIEWS: Abdomen AP/left lateral decubitus (two views) 01/22/15 Amorphous stool within the rectum. Nonobstructive bowel gas pattern. No radiopaque foreign body is identified. No pneumatosis intestinalis, pneumoperitoneum, or portal venous gas.
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No radiopaque foreign body is identified as clinically questioned. Moderate feces in the rectosigmoid.
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Generate impression based on findings.
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No evidence of acute intracranial hemorrhage. No mass, midline shift or herniation. There is a region of hypoattenuation within the right greater than left centrum semiovale which is age indeterminate in the absence of prior exams. Additional periventricular and subcortical white matter hypoattenuation is nonspecific but compatible with small vessel ischemic disease. Focal lacunar lesions are noted in the thalami. Ventricular size is within normal limits. On some slices, there appears to be widening of the extra-axial space along the right frontal lobe. There is left maxillary, ethmoid, frontal and sphenoid sinus opacification. Debris is noted in the nasal cavity.There is extensive subcutaneous emphysema within the soft tissues of the face and scalp, particularly involving the maxillary and temporal regions as well as superficial to the right convexity. There is also emphysema deeper in the soft tissues within the parapharyngeal spaces and extending into the right orbit within the preseptal extraconal space, greater superiorly and medially.
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1.No evidence of acute intracranial hemorrhage or mass.2.Hypoattenuation in the right more than left centrum semiovale is age-indeterminate in the absence of prior exams and would be better evaluated by MRI if there is clinical concern an ischemic infarct.3.Asymmetric widening of the extra-axial space along the right frontal lobe. This could be normal variation, asymmetric volume loss or increased extra-axial fluid. MRI would provide further information if clinically warranted.4.Extensive soft tissue emphysema involving the subcutaneous tissues of the face and scalp, extraconal preseptal space of the right orbit and in deeper spaces of the neck such as in the parapharyngeal spaces.
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Generate impression based on findings.
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One day old full-term infant with desaturationsVIEW: Chest AP (one view) 01/23/15, 0108 Cardiac apex and stomach are left-sided. Cardiothymic silhouette is normal. Diffuse lung haziness and left upper and lower lobe atelectasis. No pleural effusion or pneumothorax.
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Diffuse lung haziness may represent transient tachypnea of newborn.
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Generate impression based on findings.
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Reason: altered mental status History: altered mental status The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses demonstrate partial opacification of the sphenoid sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Atherosclerotic calcifications are present along the distal internal carotid arteries.
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1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of hemorrhagic CVA.
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Generate impression based on findings.
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Pain in middle finger after basketball injury.VIEWS: Right third finger PA, oblique and lateral (3 views) 1/22/2015 Soft tissue swelling is present about the proximal interphalangeal joint. Curvilinear lucency at the base of the middle phalanx may be artifactual as it is seen on only one view, although it may represent a nondisplaced fracture.
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Equivocal intra-articular nondisplaced fracture of the base of the middle phalanx with associated soft tissue swelling. Correlation with point tenderness is recommended.These findings were discussed with Dr. Louissaint via telephone at 09:03 11/23/2015
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Generate impression based on findings.
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The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. Scattered periventricular and subcortical T2 hyperintensities without diffusion restriction or enhancement are nonspecific but may suggest chronic small vessel ischemic disease. Subcentimeter T1 hyperintense right calvarial lesion is likely benign, possibly a hemangioma. No abnormal intraparenchymal enhancement to suggest metastases. There is no diffusion abnormality. No extra-axial fluid collection is identified. A peripheral oval area of susceptibility along the dura of the anterior left frontal lobe without enhancement, edema or diffusion restriction may represent a dural calcification, although a small meningioma cannot be excluded. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.Bone marrow within the posterior calvarium is of low signal intensity diffusely and there is also heterogeneous signal intensity within the cervical spine, which are nonspecific findings. There is a small nonspecific T1 hypointense likely sclerotic focus within the left L3 vertebral body.
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1.No evidence of intracranial metastases.2.Mild chronic small vessel ischemic disease.3.A peripheral oval area of susceptibility along the dura along the anterior left frontal lobe may represent a dural calcification, although a small meningioma cannot be excluded.
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Generate impression based on findings.
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Reason: r/o SAH History: sudden onset occipital HA within 1 hr, now much improved The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is redemonstration of a small hypodense focus located in the left basal ganglia probably representing a perivascular spaceThe visualized portions of the paranasal sinuses demonstrate partial opacification of the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1.No evidence for acute intracranial hemorrhage mass effect or edema.
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Generate impression based on findings.
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Female, 44 years old.RFO Bilateral nephroureteral stents extending into the region of the ileal conduit in the right lower quadrant. Surgical clips overlie the pelvis. Pelvic surgical drains are noted. There is esophageal temperature probe. Gas filled loops of large bowel. No unexpected radiopaque foreign body.
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No unexpected radiopaque foreign body.Findings discussed with Dr. Yamada, attending physician, by phone at 6:58 PM 1/22/2015.
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Generate impression based on findings.
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There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. There is a focus of hyperattenuation along the lateral margin of the left retina.
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1. No acute intracranial hemorrhage.2. A focus of hyperattenuation along the lateral margin of the left retina is likely related to history of retinal hemorrhage.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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Reason: r/o space occupying lesion History: new hallucinations The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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No evidence for acute intracranial hemorrhage mass effect or edema.
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Generate impression based on findings.
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70 year-old female with left acetabular fracture. A nondisplaced left acetabular/pelvic fracture is redemonstrated. No other pelvic fracture is evident. Mild degenerative changes of the hips, sacroiliac joints, and pubic symphysis are noted.
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Redemonstrated left acetabular/pelvic fracture.
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Generate impression based on findings.
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93 year-old male with right hemiarthroplasty Hardware components of a total right hip arthroplasty device are situated in near-anatomic alignment without evidence of complication. Foci of gas, drain and staples in the soft tissues reflect recent surgery. Moderate osteoarthritis affects the left hip. Degenerative arthritic changes affect the lower lumbar spine.
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THA in near-anatomic alignment.
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Generate impression based on findings.
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Male, 29 years old.RFO There is radiopaque catheter traversing mid abdomen which is outside the patient her care team. Overlying skin staples are noted. Enteric tube tip is coiled in the fundus. Mildly prominent gas-filled bowel loops.No unexpected radiopaque foreign body.
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No unexpected radiopaque foreign body.Findings discussed with Dr. Hurst, attending physician, at 7:22 PM 1/22/2015.
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Generate impression based on findings.
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Tachycardia, evaluate for PE PULMONARY ARTERIES: Multiple filling defects involving the bilateral descending pulmonary arteries and multiple segmental and subsegmental pulmonary arteries consistent with acute pulmonary emboli.LUNGS AND PLEURA: Multifocal nodular ground glass opacities involving all lobes compatible with pulmonary hemorrhage in the setting of acute pulmonary emboli. Small right lower lobe infarct. No pleural effusions.MEDIASTINUM AND HILA: The heart is top normal in size and without signs of right heart strain. There is no pericardial effusion. 13 mm high right tracheoesophageal lymph node.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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Multiple acute pulmonary emboli bilaterally with findings consistent with multifocal hemorrhage and a small right lower lobe pulmonary infarct.PULMONARY EMBOLISM: PE: Yes.Chronicity: Acute.Multiplicity: Yes.Most Proximal: Lobar - bilateral descending pulmonary arteries.RV Strain: No.
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Generate impression based on findings.
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19 year-old female status post chest tube placementVIEW: Chest AP (one view) 01/23/15, 0307 Right chest tube, surgical sutures, and right perihilar clips are present.Cardiothymic silhouette is normal. No pleural effusion. Small right apical pneumothorax is unchanged. New airspace opacities in the right lung. Subcutaneous emphysema in the right chest wall. The anterior fifth and sixth ribs have been resected.
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Persistent right apical pneumothorax.
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Generate impression based on findings.
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72-year-old male status post left total hip arthroplasty Hardware components of the left total hip arthroplasty revision are situated near anatomic alignment without evidence of fracture. Mild residual lucency about the superior margin of the acetabular component appears improved from the prior exam.
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Left THA revision without evidence of complication.
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Generate impression based on findings.
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93 year-old female with mechanical fall, evaluate for intracranial hemorrhage. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci are prominent, consistent with moderate age-related volume loss. No extra-axial collections. There are patchy areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminant small vessel ischemic changes. Trace residual fluid in the left sphenoid sinus. Otherwise, the paranasal sinuses and mastoid air cells are clear. New soft tissue swelling overlying the right lateral frontal bone and the left parietal bone, each measuring up to 5 mm. There is no associated calvarial fracture or intracranial process identified. Heterogeneous, nonspecific calvarial lucencies are unchanged.
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1. New soft tissue swelling overlying the right lateral frontal bone and the left parietal bone, without underlying calvarial or acute intracranial abnormality.2. No evidence of acute intracranial hemorrhage or mass effect. Please note CT is insensitive for the early detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.
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Generate impression based on findings.
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Reason: CDiff infection, worsening abdominal pain concern for worsening colitis; no IV contrast, po OK History: Abdominal pain Evaluation of solid organ pathology is limited without IV contrast. ABDOMEN:LUNG BASES: New small pleural effusions. Small hiatal hernia. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Evaluation of the colon is limited as oral contrast opacifies only the small bowel and portions of the colon are fluid filled and collapsed. The distal transverse colon is gas distended and appears normal. There is no discrete wall thickening or specific evidence of colitis. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of abdominal and pelvic free fluid appearing similar to the recent prior study without loculation. PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As above. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of abdominal and pelvic free fluid appearing similar to the recent prior study without loculation.
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1. Limited study without IV contrast and with oral contrast only partially opacifying the small bowel. Small amount of abdominal and pelvic free fluid appearing similar to the recent prior study without loculation. No obvious colitis.2. New small pleural effusions.
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Generate impression based on findings.
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78-year-old female with left acetabular fracture. A fracture is seen in the roof of the acetabulum extending to the anterior column and minimally to the left superior pubic ramus. Alignment is anatomic. No significant displacement of the fracture fragments is present. No additional associated pelvic or proximal femoral fracture is identified.
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Acetabular fracture, as above.
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Generate impression based on findings.
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Five month old male with respiratory distress, evaluate for pneumonia.VIEW: Chest AP (one view) 1/22/2015 Right upper lobe focal opacity most consistent with infection. The aortic arch, cardiac apex and stomach are left-sided. The cardiothymic silhouette is normal. No pleural effusion or pneumothorax is evident.
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Right upper lobe opacity most consistent with infection.
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Generate impression based on findings.
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Male, 63 years old.RFO Foley catheter noted. There is right iliac fossa nephroureteral stent. Nonobstructive bowel gas pattern. No unexpected radiopaque foreign body.
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No unexpected radiopaque foreign body.Findings discussed with Dr. Becker, attending physician, over the phone 9:41 PM 1/22/2015.
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Generate impression based on findings.
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3-year-old male with constipation status post bowel regimen, evaluate stool burdenVIEW: Abdomen AP (one view) 01/23/15, 0539 Gastrostomy tube, cecostomy tube, and left upper quadrant surgical sutures and clips are unchanged.Interval decrease in the amount of stool within the colon. Gaseous distention of bowel in a nonobstructive bowel gas pattern. No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas. Sacrum malformation is again seen. The bladder is distended.
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Very small stool burden, decreased in the interval.
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Generate impression based on findings.
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8 year-old male with periumbilical pain.VIEW: Abdomen AP (one view) 1/22/2015 An above average stool burden is distributed throughout the colon, with desiccated stool present within the rectum. Rightward curvature of the thoracolumbar spine is evident. No pneumoperitoneum, pneumatosis intestinalis or portal venous gas is seen.
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Above average stool burden.
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Generate impression based on findings.
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Exam somewhat limited by motion and streak artifact, especially in the skull base and pharyngeal region. No evidence of acute intracranial hemorrhage. No focal mass effect, midline shift or herniation. The ventricles and sulci are normal in size. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear.
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Allowing for artifact, no evidence of acute intracranial hemorrhage or mass. Note that the suboptimal quality of the exam would make it difficult to detect subtle findings.
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Generate impression based on findings.
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85 year-old female with slurred speech, seizures, left-sided weakness. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci are prominent, consistent with moderate age-related volume loss. No extra-axial collections. Atherosclerotic calcifications are present along the distal internal carotid arteries.There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminant small vessel ischemic changes.The paranasal sinuses and mastoid air cells are clear. Calvarium is intact.
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No evidence of acute intracranial hemorrhage or mass effect. Please note CT is insensitive for the early detection of acute non-hemorrhagic infarcts.
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Generate impression based on findings.
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67 years, Female. Reason: ogt reposition History: ogt reposition Limited view of the abdomen with motion artifact. The pelvis is excluded from view. Enteric tube tip overlies the gastric fundus. Central venous catheter tip overlies the cavoatrial junction. Rotoscoliosis noted. Please see recent CT report for additional findings.
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Enteric tube tip overlies the gastric fundus.
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Generate impression based on findings.
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66-year-old male with history of lymphoma and steroid use with persistent hip and shoulder pain, evaluate for fracture or AVN Hip: Alignment is anatomic. No fracture or other specific findings to account for the patient's pain. There is no radiographic evidence of avascular necrosis.Left shoulder: Glenohumeral alignment is anatomic. There is no fracture or other specific finding to account for the patient's pain.
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No fracture or other specific finding to account for the patient's symptoms.
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Generate impression based on findings.
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49-year-old female with knee pain. Rule out osteomyelitis. Below-the-knee amputation is present. There is severe tricompartmental osteoarthritis and vascular calcifications again noted. No evidence of acute fracture or malalignment. No osteolysis to suggest osteomyelitis.
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No evidence of osteomyelitis.
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Generate impression based on findings.
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Status post washout for foreign body.VIEWS: Left tibia/fibula AP and lateral (two views) 1/23/2015, 01:45 The previously seen radiopaque foreign bodies, which were present in the soft tissues along the posteromedial aspect of the mid to distal tibial diaphysis are no longer evident. Reticulation of the subcutaneous fat along the posteromedial lower leg is consistent with edema. No acute fracture or malalignment is seen.
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Removal of the radiopaque foreign bodies in the soft tissues along the mid to distal lower leg.
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Generate impression based on findings.
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Male, 52 years old, history of p16+ right neck TxN2b SCCa of unknown primary, also with history of papillary thyroid carcinoma. Posttreatment and postsurgical findings are again seen including evidence of right neck dissection, infiltration of the fascial planes, as well as evidence of thyroidectomy.No evidence of local tumor recurrence is seen within the thyroidectomy bed. No evidence of pathologic adenopathy is detected on either side of the neck. The salivary glands are free of focal lesions. The cervical vessels enhance normally. No concerning osseous lesions are detected.
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Redemonstration of treatment-related findings in the neck with no evidence of locally recurrent tumor or pathologic adenopathy.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal grandmother. Two standard digital views of both breasts with additional bilateral MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable calcified oil cyst in the right breast. Scattered benign calcifications are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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25 years, Female. Reason: LP shunt History: LP shunt Radiopaque portions of the LP shunt appear intact. Interval change of the valve pressure setting, now pointing between 7 and 8 o'clock position. Exam otherwise unchanged.
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Interval change of the valve pressure setting, now pointing between 7 and 8 o'clock position. Exam otherwise unchanged.
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Generate impression based on findings.
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Concern for foreign body, laceration with glass.VIEWS: Left tibia/fibula AP and lateral (two views) 1/22/2015 Multiple radiopaque foreign bodies with geometric borders are seen in the soft tissues of the posteromedial lower leg, the largest measuring up to 6 mm, consistent with foreign bodies, presumably glass given the reported history. No acute fracture or malalignment is evident.
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Multiple radiopaque foreign bodies, presumably representing glass, in the soft tissues of the posteromedial lower leg.
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Generate impression based on findings.
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There is extensive subcutaneous soft tissue swelling and stranding within scattered hyperattenuating areas in the right mandibular and maxillary soft tissues. No evidence of an acute fracture in the maxillofacial region. A fracture diagnosed on mandible radiographs back in May of 2014 is no longer visualized. The right sigmoid sinus projects into the mastoid portion of the temporal bone, which may represent a normal variant sigmoid diverticulum. Otherwise, the partially visualized intracranial contents are unremarkable. There is no acute facial bone or orbital fracture. The globes are intact without evidence of intraorbital hematoma or stranding. The temporomandibular joints are intact. The imaged paranasal sinuses and mastoid air cells are clear. There is partial ingrowth of the wisdom teeth some of which are angled obliquely.
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1.Extensive soft tissue swelling and hematoma formation of the superficial right mandibular and maxillary soft tissues.2.No evidence of an acute fracture or dislocation.3.The right sigmoid sinus projects into the mastoid portion of the temporal bone, which may represent a normal variant sigmoid diverticulum.
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Generate impression based on findings.
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42-day-old, ex-28 week twin gestationVIEWS: Chest and abdomen AP (two views) 01/23/15, 0602 NG tube side-port is at the GE junction with tip in the stomach. Left lower extremity PICC tip is in the right atrium.Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Bilateral subsegmental atelectasis.No pneumoperitoneum or portal venous gas. Disorganized bowel gas pattern. Lack of bowel distention limits evaluation of pneumatosis intestinalis.
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1.Disorganized bowel gas pattern. 2.NG tube side-port is at the GE junction.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable benign morphology masses in the left upper outer breast. Scattered benign calcifications are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Evaluate for pneumonia, desaturations.VIEWS: Chest PA/lateral (two views) 1/22/2015, 23:40 Moderate bilateral pleural effusions are present, without significant interval change when accounting for differences in technique. Associated compressive basilar atelectasis also unchanged. The cardiothymic silhouette is upper limits of normal in size, suggesting possible associated pericardial effusion. A paucity of bowel gas is seen.
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Unchanged moderate bilateral pleural effusions with associated atelectasis. Possible pericardial effusion.
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Generate impression based on findings.
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25 years, Female. Reason: LP shunt History: LP shunt Radiopaque portion of the LP shunt is intact with tip overlying the left lower quadrant. Valve pressure setting approximately at two o'clock position. Average stool burden. Nonobstructive bowel gas pattern.
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Radiopaque portion of the LP shunt is intact. Valve pressure setting approximately at two o'clock position. Average stool burden. Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt and paternal aunt. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present in both breasts. Stable asymmetries are present in the right breast (best seen on the CC view).
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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76 years, Male. Reason: constipation History: AMS, abdomen distention Mild to moderate stool burden. Nonobstructive bowel gas pattern. Possible small left pleural effusion.
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Mild to moderate stool burden. Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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26 years, Female. Reason: abdominal pain Mildly prominent small bowel loops measure up to 3 cm, with relative paucity of colonic gas and presence of air-fluid levels. Findings are suspicious for small bowel obstruction. No pneumoperitoneum. Intrauterine device in expected position.
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Findings suspicious for small bowel obstruction. No free air.
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Generate impression based on findings.
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Evaluate for pneumonia, desaturations.VIEW: Chest AP (one view) 1/22/2015 Moderate bilateral pleural effusions are seen, with associated airspace opacities likely reflecting compressive atelectasis. The aortic arch, cardiac apex and stomach are left sided. The cardiothymic silhouette is upper limits of normal in size suggesting a pericardial effusion. A paucity of bowel gas is noted.
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Moderate bilateral pleural effusions with associated compressive atelectasis. Possible pericardial effusion.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Asymmetry with questionable distortion in the right outer breast is present. No suspicious masses, microcalcifications or areas of architectural distortion are present in the left breast.
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Asymmetry with questionable distortion in the right outer breast. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are otherwise clear. The skull and extracranial soft tissues are unremarkable.
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No evidence of intracranial hemorrhage, mass, or cerebral edema.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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Asymptomatic female presents for routine screening mammography. Two standard digital views, additional left MLO view and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Fever and questionable history of aspiration.VIEW: Chest AP (one view) 1/23/2015, 03:14 The left chest wall neurostimulator position is unchanged. Slightly decreased retrocardiac opacity suggests improving atelectasis. No additional focal airspace opacity is evident. No pneumothorax or pleural effusion is seen. The cardiothymic silhouette is normal.
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Slightly decreased retrocardiac opacity suggests improving atelectasis.
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Generate impression based on findings.
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45-year-old female, evaluate PICC line A PICC is seen extending medially along the humerus, superior chest wall and then crossing right of the midline and extending beyond the field-of-view. There is no kink or discontinuity visualized. The PICC is not present within the forearm. The osseous structures appear intact.
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Partially visualized PICC as described above without kinking or discontinuity.
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Generate impression based on findings.
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51-year-old female with back pain and sciatica bilaterally. Rule out fracture versus mass effect. Lumbar spine: Five lumbar vertebral bodies are identified. Disk space narrowing is noted at T12-L1. Degenerative osteophyte formation is seen anteriorly, most prominent at L1-2. Mild superior endplate depression of L1 is mostly chronic in nature. Alignment is anatomic. No specific evidence of acute fracture or malalignment in the lumbar spine.Sacrum/coccyx: No evidence of fracture or malalignment. Injection granuloma is noted in the posterior soft tissues.
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No evidence of acute fracture or malalignment.
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Generate impression based on findings.
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Tachypnea and respiratory failure.VIEW: Chest AP (one view) 1/23/2015, 05:28 The endotracheal tube has been removed. The left upper extremity PICC tip is in the right atrium, and the left internal jugular central venous catheter tip is in the distal SVC. The nasogastric tube tip is in the prepyloric antrum.Bibasilar atelectasis persists, without significant change. The cardiothymic silhouette is upper limits normal in size and mild vascular engorgement is present.
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Bibasilar atelectasis without significant change.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Bilateral partially obscured ovoid masses are present. No suspicious microcalcifications or areas of architectural distortion are present.
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Bilateral partially obscured ovoid masses. An attempt to obtain patient's prior mammogram should be made to confirm stability of these findings.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: O - Old Study For Comparison.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in sister diagnosed at the age of 49. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Evaluate for fracture, patient favoring left arm.VIEWS: Left humerus AP and lateral (two views) left elbow AP oblique and lateral (3 views) forearm AP and lateral (two views) 1/23/2015 No acute fracture or malalignment is seen. No elevation of the humeral fat pads is seen to suggest a joint effusion.
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Normal examination.
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Generate impression based on findings.
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70 year old female who was recalled from screening mammogram for left breast calcifications and right breast asymmetry. History breast carcinoma in a maternal cousin in her late 20s. Bilateral Diagnostic Mammogram: An ML view of each breast, multiple spot compression views of the right breast, and multiple spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The asymmetry within the upper outer right breast partially disperses on spot compression imaging. A 4-mm focal asymmetry within the right upper outer breast persists on spot compression imaging.On magnification views, the question calcifications within the left breast are present along a vascular distribution, and are deemed benign.Benign appearing lymph nodes are projected over both axillae. Right Breast Ultrasound: On physical examination, no palpable abnormality is identified. The targeted right ultrasound is performed for the mammographic area of concern. At the 10 o'clock position of the right breast, 8 cm from the nipple, there is a circumscribed 0.4-cm normal morphology intramammary lymph node, corresponding to the 0.4-cm asymmetry on mammogram. A rest of dense breast tissue is present at the 10 o'clock radian of the right breast, 6 cm from the nipple, corresponding to the larger area of asymmetry within the upper outer right breast
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1. Left breast calcifications, vascular in origin.2. Normal morphology right intramammary lymph node, and a rest of dense breast tissue within the upper outer right breast, corresponding to the asymmetry seen on prior mammogram. 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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Asymptomatic female presents for routine screening mammography. Personal history of ovarian cancer, diagnosed at the age of 64. Family history of breast cancer in sister, diagnosed at the age of 74. Two standard digital views of both breasts (total of 13 images) were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Multiple subcentimeter, circumscribed masses and scattered benign calcifications are present bilaterally.
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Stable bilateral calcifications and masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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51-year-old male with left shoulder pain There is marked separation of the acromioclavicular joint measuring approximately 4.3 cm. No fracture is visualized. Glenohumeral alignment is within normal limits.
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Marked acromioclavicular separation as described above.
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Generate impression based on findings.
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Ms. Beard is a 44 year old female presenting with a self palpated mass in the right upper outer breast for the past few weeks along with a physician palpated mass in the left lateral breast. Three standard views of both breasts with two spot compression views in both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography.A triangular marker is placed in the palpable area of abnormality in the right upper outer breast and left lateral breast. No discrete mass or area of architectural distortion is identified underneath the marker. There are no suspicious microcalcifications in either breast. BILATERAL BREAST ULTRASOUND
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(1) No mammographic or sonographic evidence of malignancy in the right breast, at site of patient's area of concern. This area can be followed by her primary care physician as clinically warranted. If physical exam findings remain concerning, surgical consultation may be warranted. (2) 0.8 cm solid mass with benign sonographic features in the left superior breast. We advocated for short term imaging follow-up, however, patient strongly desired histologic sampling for pathologic confirmation. She will be scheduled for an US-guided biopsy. She is not on any blood thinning medications. All results and recommendations were discussed with the patient. BIRADS: 3 - Probably benign finding.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.
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Generate impression based on findings.
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50 year-old male, evaluate elbow fracture A cast obscures underlying osseous detail. Alignment is grossly anatomic. A poorly visualized fracture within the proximal ulna is noted.
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Casted elbow fracture in near-anatomic alignment.
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Generate impression based on findings.
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67-year-old woman with a history of a right breast lumpectomy in 2002 for IDC, status post chemoradiation. Recent history of left breast lumpectomy in Jan 2014 for IDC, status post chemoradiation. Today complains of medial left breast "thickness." Three standard views of both breasts were performed digitally with additional left breast compression views and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the right breast. Stable post-surgical changes are noted, with architectural distortion and skin retraction. A benign-appearing mass with coarse calcifications is unchanged in the right lower inner quadrant, likely representing a hyalinizing fibroadenoma. A skin marker was placed in the medial left breast over the patient's stated soft tissue thickening. Skin thickening is noted in the medial left breast, without associated underlying abnormality. Post-surgical changes are noted in the left breast with architectural distortion. Benign calcifications are present bilaterally. No dominant mass, suspicious microcalcifications, or areas of suspicious architectural distortion are evident in either breast. LEFT BREAST ULTRASOUND
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Post-surgical changes with medial left breast skin thickening and edema, likely secondary to radiation. 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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13-year-old male status post fracture fixation An intramedullary rod/screw device affixes the distal clavicular diaphyseal fracture in near-anatomic alignment without evidence of complication. Interval callus formation about the fracture line consistent with healing.
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Orthopedic fixation of healing clavicular diaphyseal fracture.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of bilateral breast reduction in 1999. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Extensive post-operative distortion and scattered benign calcifications with lucent centers are compatible with stated history of reduction surgery and are unchanged. Benign morphology mass in the medial left breast is stable.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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34-year-old female with pelvic pain A small spur along the inferior aspect of the right femoral head appears unchanged from prior exams, possibly an osteophyte. No additional abnormality is identified.
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No acute abnormality to explain the patient's pain or significant interval change.
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Generate impression based on findings.
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T1N2c tonsillar squamous cell carcinoma, completed CRT on 12/14/12. There is no evidence of mass lesions or significant cervical lymphadenopathy. For example, a right level 2 lymph node measures 4 mm in short axis, previously 4 mm and a right level 3 lymph node measures 5 mm in short axis, previously also 6 mm. The thyroid and major salivary glands are unchanged. The major cervical vessels are grossly patent. The osseous structures are unchanged. The airways are patent. The imaged intracranial structures are unremarkable. There is an unchanged 5 mm calcified nodule in the right lung.
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No evidence of locoregional tumor recurrence or significant lymphadenopathy.
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Generate impression based on findings.
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52-year-old female with known right breast cysts presents for routine follow-up examination. No family history of breast cancer. Bilateral Diagnostic Mammogram: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. There is redemonstration of a circumscribed round mass within the upper outer right breast, increased in size from prior examination, today measuring approximately 2.5 cm. Numerous loosely clustered benign appearing calcifications are noted throughout both breasts, and have minimally progressed in a benign fashion. No new dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over both axillae.Right Breast Ultrasound: On physical examination, no palpable mass is identified. A targeted right ultrasound was performed for the mammographic area of concern. At the 12 o'clock position of the right breast, 3 cm from the nipple, there is a well-circumscribed anechoic cyst the posterior acoustic enhancement measuring 2.5 x 1.4 x 2.8 cm, corresponding to the mammographic finding. Additionally, the the right breast 10:00, 3 cm from the nipple, there is a well-circumscribed, anechoic cyst with posterior acoustic enhancement measuring 0.5 x 0.3 x 0.5 cm.
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Right simple breast cysts. 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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Down syndrome and choanal atresia. The images are degraded by patient motion artifact. There is near complete bony stenosis of the right posterior choana with an approximately 1 mm soft tissue gap. There is opacification of the right nasal cavity as well as the right maxillary and ethmoid sinuses. The orbits and imaged intracranial structures are grossly unremarkable. There is opacification of the bilateral middle ears and mastoid air cells. The inner ear structures otherwise appear grossly unremarkable. There appears to be mild midface hypoplasia with approximately 4 mm of underjet.
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1. Right choana atresia with a predominantly osseous component and an approximately 1 mm wide membraneous component, as well as associated retained sinonasal secretions.2. Nonspecific bilateral tympanomastoid opacification, which may represent otomastoiditis. 3. Apparent midface hypoplasia may be related to Down syndrome.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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63-year-old male with right wrist pain, history of fracture A cast obscures underlying osseous detail. The distal radius fracture is again noted in near anatomic alignment.
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Casted distal radius fracture in near-anatomic alignment.
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Generate impression based on findings.
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37 year old female who has a complaint of painful left breast mass x 5 months. No family history of breast cancer. Bilateral Diagnostic Mammogram: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density.Within the upper outer quadrant of the left breast, there is a 9.4 x 7.2 x 9.0 cm mass, corresponding to the area of palpable abnormality. Approximately 3 cm posterior lateral to the index lesion, there is a 2.2 x 2.8 x 2.0 cm asymmetry. Multiple enlarged left axillary lymph nodes are identified, with the largest measuring 4.8 cm in greatest dimension.No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast. Benign appearing right axillary lymph nodes are identified.Left Breast Ultrasound: On physical examination, there is a large, approximately 10 cm firm palpable mass at the approximate one o'clock position of the left breast, 10 cm from the nipple. Additionally, enlarged left axillary lymph nodes are noted on physical examination, with the largest measuring approximately 3 cm. A targeted left ultrasound was performed for the palpable and mammographic areas of concern. At the one o'clock position of the left breast, 10 cm from the nipple, is a large, ill-defined, hypoechoic mass which spans a distance greater than the footplate of the ultrasound probe, with largest maximal dimension by ultrasound measuring 3.7 cm. Increased vascularity is noted within this mass. At the one o'clock position of the left breast, 12 cm from the nipple, there is a 1.7 x 1.5 x 1.8 cm ill-defined hypoechoic mass with hyperechoic rim corresponding to the asymmetry visualized on mammogram. Within the low left axilla, there are several abnormal morphology, enlarged lymph nodes with no visualized fatty hilum. The largest identified node measures approximately 3.8 cm in greatest dimension, and demonstrates non-hilar flow.
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1.Large, ill-defined, hypoechoic mass measuring approximately 9 cm by mammogram, at the one o'clock position of the left breast, 10 cm from the nipple, corresponding to the patient's palpable abnormality. This finding is highly suspicious for malignancy, and core needle biopsy of this mass is recommended.2. Ill-defined hypoechoic mass at the one o'clock position of the left breast, 12 cm from the nipple, concerning for satellite lesion.3. Enlarged, abnormal morphology left axillary lymph nodes, with the largest identified measuring 4.8 cm in greatest dimension by mammogram. Tissue sampling of this lesion may be performed as indicated.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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42 year old female with biopsy proven fibroadenoma presents for 6-month follow-up examination. No family history of breast cancer. Left Breast Diagnostic Mammogram: Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. There is redemonstration of a circumscribed mass within the central outer left breast, which contains a ribbon clip, compatible patients known biopsy proven fibroadenoma. No new dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over the left axilla.Left Breast Ultrasound: On physical examination, a 2 cm firm, mobile palpable mass is identified along the 3:00 radian. No additional palpable areas are appreciated in the left breast. A targeted ultrasound was performed to assess stability of a previously sonographically identified hypoechoic lesion at the 2:00 radian of the left breast. At the 2:00 position of the left breast, 4 cm from the nipple, there is redemonstration of a circumscribed hypoechoic mass measuring 0.4 x 0.3 x 0 .4 cm, not significantly changed in size or appearance from prior examination. No internal vascularity is present. At the 3 o'clock position of the left breast, 3 cm from the nipple, there is redemonstration of a circumscribed, gently lobulated hypoechoic mass which contains a clip, compatible patients known biopsy proven fibroadenoma. On today's examination this measures 1.8 x 0.9 x 1.6 cm, not significantly changed in size or appearance. Peripheral vascularity is identified.
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Stable biopsy proven fibroadenoma at the 3 o'clock position of the left breast. Stable hypoechoic lesion at the two o'clock position of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in April 2015. 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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70 year-old male status post gastric ESD this evening now with persistent fevers. Please evaluate for intra-abdominal etiology of fevers. Lack of intravenous contrast limits evaluation of solid organs.ABDOMEN:LUNG BASES: Bibasilar scarring/atelectasisLIVER, BILIARY TRACT: Calcifications in the right posterior liver may reflect prior infection or hemorrhage. Multiple hypodensities in the liver are incompletely characterized due to lack of intravenous contrast.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: Thickening of the antrum of the stomach is nonspecific and may be postoperative change versus neoplastic, given the patient's history of gastric adenocarcinoma. No evidence of free intraperitoneal air, pneumatosis intestinalis or portal venous gas.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Vascular calcifications of the aorta and its branches. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Bilateral fat containing inguinal hernias. There is fluid within the right inguinal hernia sac. Note is made of a pars defect of the right pars interarticularis at the level of L5/S1. OTHER: Vascular calcifications of the aorta and its branches. Surgical clips in the pelvis.
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1. Nonspecific thickening of the antrum of the stomach. No CT evidence of post-procedural complication, as clinical questioned. 2. Right sided pars defect at the level of L5/S1.
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Generate impression based on findings.
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HIV, cough, cavitary lesion on chest radiograph LUNGS AND PLEURA: Cavitary mass in the right upper lobe measuring 5.9 x 9.1 cm (series 3 image 37) with multiple adjacent peribronchial satellite nodules and endobronchial opacities. Additional cavitary mass in the right lower lobe measures 7.9 x 5.5 cm (series 4, image 71, which crosses the minor fissure anteriorly (series 4, image 66). Single lesion in left costophrenic angle, otherwise the left lung is clear.MEDIASTINUM AND HILA: There are multiple mildly enlarged right hilar and mediastinal lymph nodes measuring up to 2.3 cm in short axis (series 3, image 50). The heart size is normal.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. The adrenal glands are normal in appearance.
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Large cavitary masses within the right upper and lower lobes with adjacent satellite nodules and associated ipsilateral hilar and mediastinal lymphadenopathy. Necrotizing infection is favored over neoplasm. Mycobacterial infection, either MTB or other atypical mycobacteria are favored.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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31 year old woman with palpable periareolar abnormality for past 4-6 months. History of NF1. Three standard views of both breasts were performed digitally with 2 additional left spot compression views and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. A triangular marker is noted near the left nipple, without underlying abnormality evident. No discrete masses, suspicious microcalcifications or areas of architectural distortion are present in either breast. Benign intramammary and axillary lymph nodes are present bilaterally.LEFT BREAST ULTRASOUND
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No mammographic or sonographic abnormality to correspond with the palpable area of concern which should be managed clinically. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral annual screening mammogram is recommended once the patient is 40 years of age. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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79 year-old female with hip pain. Rule out fracture. Pelvis: No evidence of acute fracture or malalignment in the pelvis. Bilateral mild hip osteoarthritis and moderate to severe degenerative disk disease in the lower lumbar spine are noted.Right hip: Mild osteoarthritis without evidence of acute fracture or malalignment.
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No evidence of acute fracture or malalignment.
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Generate impression based on findings.
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54 years, Male. Reason: Nausea and vomiting. Dobbhoff tube tip in gastric body. Foley catheter in the bladder. Average stool burden. Nonobstructive bowel gas pattern.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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69-year-old female with right knee swelling, pain. Evaluate for fracture or dislocation. Moderate joint effusion is present. Mild osteoarthritis affects the knee, particularly the medial and patellofemoral compartments. No evidence of fracture or malalignment. Waviness of the patellar ligament is likely related to positioning.
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Moderate joint effusion without evidence of fracture or malalignment.
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Generate impression based on findings.
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Jaw swelling status post break x 2 in motor vehicle collision. Evaluate for abscess versus osteomyelitis. There is a rim-enhancing fluid collection in the left masticator space centered in the masseter muscle that measures approximately up to 25 mm, which is consistent with abscess. There is overlying enlargement and inflammatory changes of the masseter muscle and thickening of the platysma. There is an underlying minimally displaced fracture of the left mandibular angle. There is screw fixation of the right mandibular body and ramus fracture. The hardware appears to be intact. There is left suprahyoid cervical lymphadenopathy, which is likely reactive. The thyroid and major salivary glands are unremarkable. There is apparent paucity of opacification of a left external jugular vein branch in the region of the left parotid gland, which may be attributable to phase of the contrast distribution versus perhaps thrombosis. The major cervical vessels are otherwise patent. The airways are patent. The imaged intracranial structures are unremarkable. There is minimal mucosal thickening of the right maxillary sinus. The imaged portions of the lungs are clear.
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1. Left masticator space abscess that measures up to 25 mm with associated cellulitis and myositis overlying a minimally displaced fracture of the left mandibular angle. 2. Intact screw fixation of the right mandibular body and ramus fracture. 3. Apparent paucity of opacification of a left external jugular vein branch in the region of the left parotid gland, which may be attributable to phase of the contrast distribution versus perhaps thrombosis. A Doppler ultrasound exam of this region may be useful if this is clinically relevant.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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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable benign morphology mass in the right lower outer breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in paternal grandmother. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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52 year woman with left breast calcifications seen on screening mammogram. Three views of the left breast, including spot compression views, were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Segmentally distributed calcifications are again seen in the left upper outer quadrant. No dominant mass or areas of architectural distortion are present in the left breast. LEFT BREAST ULTRASOUND
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Segmentally distributed calcifications and vague hypoechoic soft tissue in the left breast upper outer quadrant, without distinct mass identified. Stereotactic biopsy is recommended for further evaluation. Finding and recommendation were discussed with the patient. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration.
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Generate impression based on findings.
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76-year-old female with recent craniotomy and meningioma resection, now with altered mental status. Redemonstration of postsurgical findings related to recent bicoronal craniotomy and resection of large right frontal meningioma, including air, blood products, dural flap, and surgical packing material subjacent to the craniotomy site. There has been no significant change in degree of pneumocephalus and multiple frontoparietal hyperdense foci, consistent with evolving subarachnoid and intraparenchymal blood products. There is persistent hypoattenuation in the bilateral anterior cerebral artery territories which is concerning for evolving ischemia with associated edema. There is increased downward mass effect and the right lateral ventricle is more effaced when compared to most recent prior, which suggests an increase in the degree of edema, right greater than left. The trace midline shift to the left and small subdural along the falx are unchanged. Interval removal of subgaleal drain. Interval increase in the amount of subgaleal fluid, most prominent overlying the right frontoparietal region, with air-fluid levels, measuring up to 12 mm, (previously 8 mm). Fluid is also noted within the craniotomy sites. Calvarial screws/fixation hardware and scalp staples are unchanged. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Partial edentulism is unchanged. NG tube is noted.
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1. Evolving postsurgical changes related to recent craniotomy and resection of right frontal meningioma, including hypoattenuation in the bilateral anterior cerebral artery territories, suspicious for evolving ischemia. There has been mild interval worsening of bilateral frontoparietal edema, more extensive on the right, with mildly increased downward mass effect. There is no significant effacement of the suprasellar cistern or uncal herniation. 2. No significant change in density of frontoparietal subarachnoid and intraparenchymal blood products, right greater the left.3. Interval removal of subgaleal drain, with increase in subgaleal fluid, now with air-fluid levels.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of benign left breast biopsy in 2008 and 1989. Family history of breast cancer in two maternal great aunts. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications in the left breast have progressed in a benign fashion. Biopsy marker clip is identified in the left central breast, at site of prior benign biopsy.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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43-year-old male with hip pain. Exam is suboptimal secondary to portable technique and patient's BMI. Mild to moderate osteoarthritis affects the right hip. No evidence of fracture or malalignment.
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No evidence of fracture or malalignment.
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Generate impression based on findings.
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Reason: r/o esophageal path History: dysphagia Scout radiograph of the chest showed at least three nodular pulmonary opacities. Double contrast evaluation of the esophagus and gastric cardia/fundus revealed no morphologic abnormalities of the mucosal surfaces or mural contours. Aortic knob impression was noted without functional obstruction. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. No hernia was identified. TOTAL FLUOROSCOPY TIME: 4:37 minutes
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1.Normal motility.2.No reflux or hernia.3.No mucosal abnormality or structural lesion.4.Scout radiograph of the chest showed at least three nodular pulmonary opacities. Follow up with chest CT suggested.Findings discussed with Dr. Hong at 9:37 AM 1/23/2015.
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Generate impression based on findings.
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32 year old male who has a complaint of bilateral breast enlargement and tenderness. Palpable areas in the upper/outer periareolar region on the left and left retroareolar breast. BILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM: Three standard views of both breasts and two left spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. Triangular markers were placed on the skin of the left breast at the sites of clinical concern. There is flame-shaped asymmetry within both retroareolar regions, left significantly greater than right, compatible with asymmetric gynecomastia. No discrete masses, suspicious microcalcifications or areas of architectural distortion are present in either breast. LEFT BREAST ULTRASOUND: On physical examination there is a firm, mobile 1.0 cm nodular area within the left retroareolar region. Additionally at the 1:00 position, at the areolar border, there is a firm, ridge-like palpable area. A targeted left ultrasound was performed for the mammographic and palpable areas of concern. Within the left retroareolar region, there is an ill-defined hypoechoic area compatible with gynecomastia, corresponding to the retroareolar palpable site, and the mammographic findings. At the 1:00 position of the left breast, along the areolar border, at the second site of palpable abnormality, there is no solid or cystic mass identified.
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Bilateral gynecomastia, left greater than right. The patient should consult his physician for management. Results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed.
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Generate impression based on findings.
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Reason: r/o stroke History: AMS, left weakness Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.There is medial deviation of the right internal carotid are intact retropharyngeal space at the C2 and C3 vertebral body levels.Some air bubbles are present in the left neck adjacent to the left jugular vein compared there is some associated thickening of the left sternocleidomastoid muscle.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.There is a fetal origin of the left posterior cerebral artery. The right posterior communicating artery is similar in diameter to the right P1 segment.The anterior communicating artery and the posterior communicating arteries are identified and are intact.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Atherosclerotic calcifications are present along the distal internal carotid arteries.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The patient is status post intubation. There some retained secretions within the nasal cavity and nasopharynx.
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1.No evidence for aneurysm.2.No evidence for cervicocerebral occlusive disease3.there is some thickening of the left sternocleidomastoid muscle and some air bubbles adjacent to left jugular vein. Please correlate with patient's clinical history and clinical exam evaluation .
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Generate impression based on findings.
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No breast symptoms. History of breast cancer in mother diagnosed at the age of 36 and paternal grandmother. Cyst previously seen at the 6 o'clock position of the right breast. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. Additional CC and MLO views were performed bilaterally (9 total images). The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Stable benign masses are present in both breasts. Unchanged bilobed intramammary lymph node in the right upper outer quadrant. Scattered benign calcifications are present bilaterally. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Stable benign masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of benign left breast biopsy and cyst aspiration. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable benign intramammary node in the right upper outer breast. Scattered benign calcifications are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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48 year old female who has a complaint of left axillary discomfort x 3 months. History of benign right breast excisional biopsy. History of known multiple fibroadenomata. No family history of breast cancer. Bilateral Diagnostic Mammogram: Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Multiple benign morphology masses are present bilaterally, and are unchanged from prior examination. A linear marker has been placed on a scar overlying the upper outer right breast with underlying postsurgical architectural distortion, unchanged. No new dominant mass, suspicious microcalcifications or areas of nonsurgical architectural distortion in either breast. Benign appearing lymph nodes are projected over both axillae.Left Breast Ultrasound: On physical examination, no palpable abnormality is identified within the left axilla. A targeted left ultrasound is performed for the patient's area of concern. Within the low left axilla, at the patient's area of focal pain, there are multiple benign morphology lymph nodes which demonstrate normal hilar blood flow.
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Benign morphology left axillary lymph nodes at the site of the patient's focal pain. Stable bilateral benign breast masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Family history of breast cancer in four maternal nieces. Two standard digital views, additional right CC view, and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable benign intramammary lymph node in the right breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Personal history of benign excisional biopsy of the left breast. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present. Stable benign morphology mass in the left lower outer breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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57-year-old female with right ankle pain. Assess for fracture. There has been interval removal of the lateral distal fibular plate and screws device. A fractured tension wire remains in the distal fibular diaphysis. Distal fibular screw and two medial malleolar screws in the distal tibia are again noted. No evidence of complication of the present hardware is identified.Soft tissue irregularity and mild swelling about the distal leg and ankle is present. No evidence of fracture or malalignment.
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No evidence of fracture or malalignment in the right ankle.
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Generate impression based on findings.
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Male 44 years old; Reason: h/o diverticulitis with recurrent RLQ abdominal pain not improved with oral antibiotic treatment for diverticulitis, please assess for diverticular inflammation and complications, or other cause of RLQ abdominal pain History: RLQ pain ABDOMEN:LUNG BASES: No significant abnormality identifiedLIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter hypoattenuating lesion within the mid of the left kidney is too small to characterize and unchanged.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:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Subcentimeter reactive mesenteric lymph nodes.BOWEL, MESENTERY: Previously described diverticulitis appears to have nearly completely resolved. Numerous diverticula persist. There is no evidence of peridiverticular abscess or other fluid collection.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Unchanged fat-containing umbilical hernia.
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Near complete resolution of diverticulitis.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable benign intramammary lymph nodes are present bilaterally.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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