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Generate impression based on findings.
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15-year-old male with seizure evaluate for intracranial hemorrhage. 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 acute intracranial abnormalities.
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Generate impression based on findings.
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13-year-old male with history of motor vehicle accident Scalp injury along the left frontal high convexity with bifrontal metallic fragments in the subcutaneous soft tissues which likely represent foreign bodies, correlate clinically. The underlying calvarium is intact.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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Left frontal high convexity soft tissue scalp injury with probable subcutaneous metallic foreign bodies in the scalp. No skull fractures or acute intracranial abnormalities.
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Generate impression based on findings.
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88-year-old male with fatigue and malaise, evaluate for CVA Similar to the prior, there is extensive small vessel ischemic disease of indeterminate age as well as prominent ventricular volumes and cortical sulci compatible with cerebral volume loss. No abnormal extra-axial fluid collections or intracranial hemorrhage is present. Heavy intracranial atherosclerotic vascular calcifications. No midline shift, edema or mass effect.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1. No acute intracranial abnormalities. Please note CT is insensitive for the detection of acute ischemia.2. Redemonstration of extensive small vessel ischemic disease of indeterminate age and brain parenchymal volume loss.
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Generate impression based on findings.
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65-year-old male with history of fall one month ago, headache, neck pain, left upper extremity and left lower extremity paresthesias since fall, evaluate for bleed Brain: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.Mild right maxillary mucosal thickening, otherwise the visualized portions of paranasal sinuses and mastoid air cells are clear. The visualized portions of the orbits are intact.Cervical spine:Exaggerated cervical lordosis. The vertebral body heights are relatively well maintained without evidence of fracture. No prevertebral soft tissue swelling. Multilevel severe loss of disk space height, vacuum disk phenomenon, uncovertebral hypertrophy, posterior disk osteophyte complexes and sclerotic endplate changes most pronounced at C4 through C7. These changes result in multilevel neuroforaminal narrowing and at least mild central canal stenosis. The visualized paraspinal contents are unremarkable. Visualized lung apices demonstrate bilateral apical scarring.
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1. No acute intracranial abnormalities.2. No evidence of cervical spine fractures with significant multilevel degenerative disk disease which may be further characterized with MRI if clinically warranted.
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Generate impression based on findings.
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63-year-old male with jaundice. ABDOMEN:LUNG BASES: Bilateral pleural effusions, moderate on the right and small on the left, with overlying basilar consolidation/atelectasis. Several nodules are seen in partially visualized lungs.LIVER, BILIARY TRACT: Although lack of IV contrast limits evaluation of parenchyma, there are multiple hypoattenuating, ill-defined lesions throughout the liver, consistent with metastases. Hepatomegaly and cirrhotic liver morphology. Small amount of ascites fluid around the liver.No extrahepatic or intrahepatic biliary ductal dilation. High density material is seen in the gallbladder, consistent with vicarious excretion of contrast/renal failure.SPLEEN: Multiple splenic granulomas.PANCREAS: Subtle hypoattenuating lesion in pancreatic head/uncinate process measures approximately 4.5 x 2.8 cm (series 3, image 70). No significant pancreatic ductal dilation is visualized.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Multiple prominent upper retroperitoneal lymph nodes. Atherosclerotic calcifications affect the aorta and its branches.BOWEL, MESENTERY: Moderate amount of ascites in abdomen and pelvis. Multiple collateral vessels are seen in the upper abdomen. Nodularity of mesentery, best appreciated in lower quadrants, suspicious for peritoneal carcinomatosis.BONES, SOFT TISSUES: Kyphosis centered at the thoracolumbar junction, with anterior wedging of T12 through L3 vertebral bodies.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Moderate ascites fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Pancreatic head lesion consistent with known pancreatic adenocarcinoma.2.Extensive hepatic metastatic disease.3.Moderate ascites fluid and mesenteric nodularity suspicious for peritoneal carcinomatosis.4.Bilateral pleural effusions, right more than left.5.Multiple nodules in partially visualized lungs.
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Generate impression based on findings.
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31-year-old female with bilateral flank pain after urination. Right renal cysts found incidentally 8/2013. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 1.6-cm hypoattenuating, nonenhancing lesion in right kidney is consistent with cyst (series 7, image 52). Additional subcentimeter hypodense focus in inferior pole of right kidney is too small to characterize but most likely represents additional cyst.No suspicious renal lesions are identified. No obstructing stones or hydronephrosis. No perinephric fat stranding.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No evidence of stones, obstruction, or other abnormality account for symptoms.2.Simple renal cyst in right kidney; no suspicious renal lesions identified.
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Generate impression based on findings.
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28 year-old male with right lower quadrant pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Extensive stranding around the appendix, consistent with appendicitis (series 3, image 82). A small fluid collection is seen along the course of the appendix, measuring 0.9 x 1.1 cm, consistent with small intramural abscess (sagittal series image 66). No evidence of free air or gross perforation. No extramural abscess. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Severe appendicitis with small intramural abscess.
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Generate impression based on findings.
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60 year-old female with ovarian cancer on chemotherapy. Evaluate for small bowel obstruction and assess cancer burden. CHEST:LUNGS AND PLEURA: Dependent atelectasis and trace bilateral pleural effusions. No suspicious lung nodulesMEDIASTINUM AND HILA: Right chest wall port catheter tip in upper right atrium. No lymphadenopathy. Ectasia of the ascending aorta unchanged. Heart size normal.CHEST WALL: Reference right axillary node not significantly changed, measuring 1.6 x 2.0 cm, previously measured 1.7 x 1.9 cm (series 3, image 35).ABDOMEN:LIVER, BILIARY TRACT: Loculated hypoattenuating material is seen around the liver.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple punctate hypodensities are seen in both kidneys, most compatible with cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple dilated loops of small bowel, with maximal diameter measuring 4.9 cm, consistent with high-grade distal obstruction. The transition point is likely located in the most inferiorly located ventral hernia (series 3, image 144). Several other more superiorly located ventral hernias are seen containing small and large bowel. No evidence of significant wall thickening or free fluid to suggest ischemia.Multiple loculated collections of hypoattenuating material, but measuring above water density, are seen throughout the abdomen and pelvis, suspicious for pseudomyxoma peritonei.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: As described above, there is high grade distal small bowel obstruction with transition point likely in most inferiorly located ventral hernia. Multiple loculated collections of hypoattenuating material are seen throughout the abdomen and pelvis, suspected to represent pseudomyxoma peritoneum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.High-grade distal small bowel obstruction, with transition point likely in most inferiorly located ventral hernia. Several other hernias identified, containing small and large bowel loops. 2.Multiple loculated collections of hypoattenuating material in the abdomen and pelvis, highly suspicious for pseudomyxoma peritonei.
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Generate impression based on findings.
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77-year-old male patient with right pleuritic chest pain and elevated d-dimer. Evaluate for pulmonary embolism. PULMONARY ARTERIES: Technically adequate study. No pulmonary embolus.LUNGS AND PLEURA: Mild paraseptal emphysema with bullae in the apices bilaterally. There is a scarlike nodule in the right upper lobe (series 10 image 37), not included in the field of view on prior examinations. Scattered micronodules, some of which are calcified.MEDIASTINUM AND HILA: Heart is within normal limits without pericardial effusion. Severe coronary artery calcifications. Mild atherosclerotic changes of the thoracic aorta.Scattered small mediastinal and hilar lymph nodes.CHEST WALL: Diffuse idiopathic skeletal hyperostosis and moderate multilevel degenerative changes of the thoracic spine. No sclerotic osseous lesions.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy.Bilateral sub-centimeter hypoattenuating lesions in the renal parenchyma are too small to characterize and likely represent cysts.
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1.No pulmonary embolus.2.Paraseptal emphysema.
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Generate impression based on findings.
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83-year-old female with abdominal pain. History of CLL and colon cancer. ABDOMEN:LUNG BASES: Bilateral pleural effusions, moderate right and small left, with overlying basilar consolidation/atelectasis. Multiple nodules noted in partially visualized lung bases.Severe cardiomegaly.LIVER, BILIARY TRACT: Hepatomegaly with heterogeneous attenuation of the liver parenchyma likely passive congestion. Periportal edema. Cholelithiasis.SPLEEN: Splenomegaly. Hypoattenuating nonspecific lesion in spleen parenchyma measures 2.8 cm.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Wedge shaped area of hypoattenuation in the right kidney most compatible with infarction (series 3, image 58). Stone located in the inferior calix of left kidney measures 4 mm. Hypoattenuating, subcentimeter lesions in both kidneys are too small to characterize.RETROPERITONEUM, LYMPH NODES: Extensive bulky retroperitoneal lymphadenopathy, most consistent with known lymphoma. For reference, left periaortic node measures 3.5 x 2.8 cm (series 3, image 74).BOWEL, MESENTERY: No bowel obstruction. Multiple prominent mesenteric lymph nodes.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Multiple enlarged pelvic lymph nodes. For reference, right iliac node measures 1.6 x 2.0 cm (series 3, image 119).BOWEL, MESENTERY: Small amount of free fluid in the pelvis. Postsurgical changes around the cecum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Bulky retroperitoneal and pelvic lymphadenopathy, most consistent with lymphoma.2.Hepatomegaly, periportal edema, splenomegaly, and bilateral pleural effusions, most compatible with CHF/volume overload given severe cardiomegaly.3.Nonspecific hypoattenuating lesion in the spleen.
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Generate impression based on findings.
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Male; 53 days old. Reason: Questionable extrinsic lesion affecting a short segment of the upper thoracic esophagus on OPM, ct recommended for further eval History: 7wo with Pierre Robin and Stickler syndrome here with reflux LUNGS AND PLEURA: Minimal bibasilar dependent subsegmental atelectasis. No suspicious pulmonary nodule or masses. No pleural effusions.MEDIASTINUM AND HILA: Normal heart size. No pericardial effusion. No mediastinal or hilar lymphadenopathy. No lesions are evident along the course of the esophagus. No aberrant course of the subclavian arteries or vascular slings.CHEST WALL: No axillary lymphadenopathy. No suspicious osseous lesions.UPPER ABDOMEN: Residual oral contrast material is noted within the stomach. Otherwise, the partially visualized upper abdomen is unremarkable.
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No lesions are evident along the course of the esophagus. No aberrant course of the subclavian arteries or vascular slings.
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Generate impression based on findings.
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82-year-old female patient with lung cancer. Please reevaluate. CHEST:LUNGS AND PLEURA: Marked interval increase in reference right lower lobe mass, measuring 10.1 cm by 5.5 cm (series 5 image 81), previously 3.5 x 4.8 cm.Right middle lobe nodule measures 12 x 9 mm (series 5 image 51), previously 11 x 8 mm.Interval resolution of bilateral diffuse ground glass opacities. Mild centrilobular emphysema.Small right pleural effusion with associated trace atelectasis.MEDIASTINUM AND HILA: Heart size within normal limits without pericardial effusion. Mild coronary artery calcifications. Mild atherosclerotic changes in the thoracic aorta.Scattered small mediastinal lymph nodes, some of which are calcified, are smaller compared to prior examination.There is interval decrease in the confluent subcarinal/paraesophageal mass that currently measures 4.4 x 2.9 cm (series 3 image 50), previously 4.7 x 3.1 cm, and is subjectively smaller.Reference right infrahilar lymph node measures 2.2 x 1.7 cm (series 3 image 58), previously 2.6 x 1.8 cm.Slight interval decrease in diffuse esophageal thickening that is likely secondary to radiation esophagitis.CHEST WALL: Surgical clips in the right axilla and postsurgical changes in the right breast. No axillary lymphadenopathy.Mild multilevel degenerative changes in the thoracic spine. ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hypoattenuating lesions in the liver parenchyma. The left hepatic lobe hypoattenuating lesion is subjectively smaller compared to examination on 8/20/2013. Other lesions are stable.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Nodule on the lateral limb of the left adrenal gland measures 1.9 x 1.4 cm (series 3 image 103), stable. Right adrenal gland within normal limits.KIDNEYS, URETERS: Multiple hypoattenuating lesions within the kidneys likely represent cysts. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic changes in the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Clonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Moderate multilevel degenerative changes in the lumbar spine with degenerative disk disease. No focal sclerotic osseous lesions identified.OTHER: No significant abnormality noted.
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1.Marked interval increase in right lower lobe mass, measuring 10.1 x 5.5 cm. Minimal interval increase in right middle lobe nodule.2.Interval decrease in hilar and mediastinal lymphadenopathy.3.Interval decrease in subcarinal/periesophageal mass with slight interval decrease in diffuse esophageal thickening.4.Interval resolution of diffuse bilateral groundglass opacities.
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Generate impression based on findings.
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Female; 6 years old. Reason: 6 yo F with 3 days of abd pain, started RUQ now suprapubic. Elevated WBC to 14 and CRP to 120. R/o appendicitis History: Abdominal pain, n/v, fever ABDOMEN:LUNG BASES: Scattered patchy air space opacities in the bilateral lung bases are most suspicious for multifocal pneumonia. No pleural effusions. The visualized heart is normal in size without pericardial effusion.LIVER, BILIARY TRACT: No focal hepatic lesions. No intra-or extrahepatic biliary dilation. Normal CT appearance of the gallbladder.SPLEEN: No focal splenic lesions.PANCREAS: No focal pancreatic lesions. No pancreatic ductal dilation. Patulous esophagus the stripping in that space of theADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No focal renal lesions. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Scattered, slightly enlarged right lower quadrant mesenteric lymph nodes are identified. For reference, the largest measures 1.5 x 1 cm (image 58, series 3). These are nonspecific and may be due to infectious lymphadenitis.BOWEL, MESENTERY: There is normal transit of contrast into the colon. No evidence of bowel obstruction. No evidence of appendicitis.BONES, SOFT TISSUES: No suspicious osseous lesions.PELVIS:UTERUS, ADNEXA: Normal CT appearance of the uterus. No adnexal lesions are evident.BLADDER: Bladder is mildly distended.LYMPH NODES: No pelvic or inguinal lymphadenopathy.BOWEL, MESENTERY: No evidence of bowel obstruction.BONES, SOFT TISSUES: No suspicious os incisions.OTHER: No significant abnormality noted.
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1. Bilateral airspace opacities most suspicious for multifocal pneumonia. Recommend dedicated chest radiography for further evaluation.2. Slighlty enlarged right lower quadrant mesenteric lymph nodes, which may be due to infectious lymphadenitis in the appropriate clinical setting.3. No evidence of appendicitis.
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Generate impression based on findings.
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52-year-old male with abdominal pain and vomiting. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Nonspecific left adrenal nodule measures 1 cm, incompletely characterized on this study.KIDNEYS, URETERS: Subcentimeter hypoattenuating focus in right kidney too small to characterize but most likely represents benign cyst.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcifications in aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No specific abnormality to account for patient's symptoms.2.Nonspecific 1.1-cm left adrenal nodule, incompletely characterized on current exam.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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Trauma on Coumadin. Frontal hematoma. Rule out intracranial hemorrhage. There is no intracranial mass, hemorrhage, edema or hydrocephalus. Gray-white matter differentiation is maintained bilaterally and the midline is intact. There is periorbital and perioral/buccal soft tissue stranding most likely representing hematoma given the history of trauma and ecchymosis. There is no visualized fracture. There is minimal secretions dependently within the maxillary sinuses. Remaining sinuses are clear. There is asymmetry including diminutive/atrophic right and prominent left submandibular gland. Left-sided mastoids are opacified, right are clear.
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Soft tissue stranding most prominent in the buccal soft tissues likely representing hematoma in this patient with recent trauma. No intracranial hemorrhage.
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Generate impression based on findings.
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66 year-old female with abdominal pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hypoattenuating lesion in dome of liver compatible with benign cyst. Status post cholecystectomy.SPLEEN: Multiple calcified granulomas consistent with prior granulomatous infection.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Multiple surgical clips in upper abdomen.BOWEL, MESENTERY: Postsurgical changes in upper abdomen, consistent with the history of gastric bypass surgery. No obstruction or other acute abnormality.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No specific abnormality to account for patient's abdominal pain.2.Postsurgical changes consistent with history of gastric bypass surgery.
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Generate impression based on findings.
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50 year-old female with persistent fevers. Assess for abscess/infection. CHEST:LUNGS AND PLEURA: Punctate calcified and noncalcified micronodules, all measuring less than 4 mm and likely benign in nature. Mild basilar scarring. No consolidation or pleural effusions.MEDIASTINUM AND HILA: Soft tissue in anterior mediastinum consistent with minimal residual thymus gland. No mediastinal lymphadenopathy.Hypoattenuating oval lesion in right posterior mediastinum measures 2.9 x 2.2 cm, likely congenital lesion such as bronchogenic/foregut cyst (series 3, image 47).Heart is normal in size without pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly. No intra-or extrahepatic delayed ductal dilation. No suspicious liver lesions. No CT evidence of cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No bowel obstruction. Moderate amount of stool in colon. No bowel wall thickening or fluid collections to suggest abscess.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No specific signs of infection in the chest, abdomen, and pelvis.2.Calcified and noncalcified lung micronodules, likely benign in nature.
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Generate impression based on findings.
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85-year-old male with Crohn's disease presents with persistent weight loss, fever, and fatigue. Evaluate for Crohn's disease activity and malignancy. ABDOMEN:LUNG BASES: Bilateral basilar scarring.LIVER, BILIARY TRACT: Intra and extrahepatic biliary ductal dilation appears similar to 2006 exam. No suspicious liver lesions identified. Status post cholecystectomy.SPLEEN: Splenomegaly and multiple tortuous collateral vessels near splenic hilum not significantly changed. Nonspecific oval-shaped hypoattenuating focus along the splenic capsule measures 1.6 cm, likely benign in nature (series 3, image 21).PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple hypoattenuating lesions are seen in both kidneys, many of which are too small to characterize but most compatible with cysts. Several of these cysts contain mural calcifications which are mildly increased in thickness since 2006 (series 3, image 44). No solid components are identified.Interval increased atrophy of left kidney. No hydronephrosis bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of bowel obstruction or bowel wall thickening.BONES, SOFT TISSUES: Multiple small collateral vessels as well as postsurgical changes are seen in abdominal wall.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Mildly enlarged left pelvic node (series 3, image 112).BOWEL, MESENTERY: Postsurgical changes including multiple surgical clips are seen around the rectum. There is a fluid collection adjacent to the anastomosis site, which is increased since 2006 and measures 4.2 x 2.6 cm, previously measured 3.6 x 1.8 cm (series 3, image 104); this is likely post-surgical in nature, such as lymphocele or seroma. Lack of peripheral enhancement makes abscess unlikely.Mild rectal wall thickening is not associated with significant surrounding inflammatory change and not significantly changed since 2006, likely postsurgical in nature.BONES, SOFT TISSUES: Degenerative changes in the lower lumbar spine.OTHER: No significant abnormality noted
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1.No evidence of active Crohn's disease or malignancy.2.Interval increase in size of small fluid collection along rectal anastomosis, which is likely post-surgical in nature, possibly lymphocele or seroma. Lack of peripheral enhancement and surrounding inflammation makes abscess unlikely.
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Generate impression based on findings.
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Midline neck pain. Rule out fracture or misalignment. There is straightening of the cervical lordosis which is likely on the basis of a combination of muscle spasm and progressed degenerative change. There is no visualized fracture. Vertebral body height is maintained. There is loss of intervertebral disk heights at each visualized level from C2-3 through T1-2. No prevertebral soft tissue swelling.C2-3: There is a disk osteophyte complex and bilateral facet fusion without canal or neural foraminal stenosis.C3-4: There is a disk bulge in addition to bilateral uncovertebral and facet degeneration resulting in mild bilateral neural foraminal stenosis and mild canal stenosis.C4-5: There is a disk bulge in addition to bilateral uncovertebral and facet degeneration (right worse than left) resulting in mild-moderate right neural foraminal stenosis and moderate canal stenosis.C5-6: There is a disk osteophyte complex, partial fusion of the C5-6 bodies and bilateral facet degeneration. Neural foramina are patent. There is moderate canal stenosis.C6-7: There is a disk osteophyte complex, partial fusion of the C6-7 vertebral bodies and bilateral facet degeneration. There is mild canal stenosis without significant foraminal stenosis.C7-T1: There is a disk osteophyte complex, and bilateral facet degeneration resulting in mild-moderate canal stenosis and moderate bilateral neural foraminal stenosis.
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Significant multilevel spondylosis resulting in multilevel neural foraminal and spinal canal stenosis without acute sequela of or trauma including fracture.
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Generate impression based on findings.
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62 year-old female with diarrhea. Evaluate for colonic inflammation. CHEST:LUNGS AND PLEURA: Several calcified and noncalcified micronodules, most likely of benign etiology (series 4, image 43). Bilateral basilar scarring/atelectasis. No consolidation or pleural effusions.MEDIASTINUM AND HILA: Moderate coronary artery calcifications. Moderate cardiomegaly. No pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Minimal intrahepatic and extrahepatic biliary ductal dilation, with common bile duct measuring approximately 11 mm in diameter. No evidence of obstructing lesion or stones. No evidence of cholecystitis. No suspicious liver lesions identified.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications in aorta and its branches. Minimal ectasia of the aorta just proximal to bifurcation not significantly changed (series 3, image 134).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Peripherally calcified lesion in proximal medial left thigh is partially visualized but likely not significantly changed, consistent with myositis ossificans (series 3, image 28).OTHER: No significant abnormality noted.
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No evidence of bowel thickening or other specific abnormality to account for patient's diarrhea.
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Generate impression based on findings.
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right hemipareses, altered mental status, and dysconjugate gaze in a patient with known left ventricular cardiac thrombus. Patient has left subclavian balloon counterpulsation device. Neck CTA: There is opacification of the vessels from the aortic arch and carotid arteries and vertebral arteries. The aortic arch and origins of the great vessels were not included on this scan. 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 a large right pleural effusion present. There is a small left pleural effusion present.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. The anterior communicating artery and the posterior communicating arteries are identified and are intact. The ACOMA is small. The right PCOMA is medium size. The left PCOMA is tiny.
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1.No evidence for aneurysm.2.No evidence for cervicocerebral occlusive disease3.Pleural effusions right more than left.4.Findings were discussed with the clinical service at the time the images were acquired . It was decided not to proceed with embolectomy.
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Generate impression based on findings.
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High speed MVC. There is straightening of cervical lordosis. Vertebral body height is normal. Intervertebral disk is normal. There is irregularity of the anterior/superior corner of the C6 vertebral body including a 1 mm calcific fragment anterosuperior to the body. There is additional fragment with rounded edges associated with the left transverse process of T1. There are no other findings suggestive of fracture. No significant prevertebral soft tissue swelling. There are no disk bulges and no spinal/neural foraminal stenosis.Incidental note is made of incomplete fusion of the anterior and posterior arches of C1.
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1.Irregularity at the anterior/superior aspect of the C6 vertebral body without obvious associated soft tissue swelling. This could represent mineralization of the anterior longitudinal ligament or a degenerative/congenital variant, however given the patient's history of trauma, fracture is a possibility. MRI could be considered.2.Bony fragment associated with the left transverse process of T1 which appears corticated most likely represents a congenital variant or chronic fracture.A verbal report was issued to the emergency room physician caring for the patient at the time of reporting (Dr Howse on 11/23/2013)
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Generate impression based on findings.
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63 year-old female with seizure, now postictal, rule out bleed The patient is intubated.The CSF spaces are appropriate for the patient's stated age with no midline shift. Atherosclerotic vascular intracranial calcifications.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Secretions are present in the sphenoid sinuses, otherwise 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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Limited portable examination without gross acute intracranial abnormalities.
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Generate impression based on findings.
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67 year old female with bilateral hydronephrosis after Foley catheter placement. Metastatic bladder cancer. ABDOMEN:LUNG BASES: Increase in innumerable nodules and masses in partially visualized lungs, consistent with metastases. New small bilateral pleural effusions with overlying basilar consolidation/atelectasis.LIVER, BILIARY TRACT: Evaluation of liver parenchyma is difficult given lack of IV contrast; given limitation, multiple hypoattenuating lesions are again identified consistent with metastatic disease. No significant change in extrahepatic biliary ductal dilation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: New severe right hydronephrosis with surrounding fat stranding, likely due to compression by increased retroperitoneal lymphadenopathy.Moderate left hydronephrosis not significantly changed.RETROPERITONEUM, LYMPH NODES: Confluent retroperitoneal lymphadenopathy is difficult to accurately evaluate given lack of IV contrast, but appears increased.BOWEL, MESENTERY: No evidence of bowel obstruction. Several enlarged mesenteric lymph nodes are identified the lower abdomen.BONES, SOFT TISSUES: Diffuse anasarca.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Foley catheter is present in decompressed bladder.LYMPH NODES: Multiple enlarged inguinal lymph nodes; reference right inguinal node measures 2.3 x 1.5 cm, previously measured 2.4 x 1.5 cm (series 3, image 136).BOWEL, MESENTERY: Small amount of free fluid in the pelvis.BONES, SOFT TISSUES: Fat-containing right inguinal hernia. Diffuse anasarca.OTHER: No significant abnormality noted
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1.Interval increase in severe right hydronephrosis and persistent moderate left hydronephrosis; etiology is most likely due to increased confluent retroperitoneal lymphadenopathy.2.New bilateral pleural effusions and diffuse anasarca, consistent with volume overload.3.Increased innumerable metastases in partially visualized lungs.
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Generate impression based on findings.
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Blunt head trauma with forehead laceration. Syncope and collapse. There is no intracranial mass, hemorrhage, edema or hydrocephalus. There is no mass-effect or midline shift. There is soft tissue stranding and a defect in the right frontal area corresponding with hematoma and laceration. Sinuses and mastoids are clear. There is no visualized bony abnormality and the orbits are unremarkable.Incidental note is made of a cavum septum pellucidum.
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Right frontal hematoma/laceration without intracranial abnormality or fracture.
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Generate impression based on findings.
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88 year old female patient with shortness of breath and weight loss. Examination is significantly limited by patient motion.LUNGS AND PLEURA: Bilateral small pleural effusions, right greater than left, with associated atelectasis. Bibasilar groundglass opacities and septal thickening consistent with pulmonary edema. Linear opacities in the left upper lung base may be atelectasis versus scarring.Scattered bilateral micronodules, largest of which is in the right middle lobe and measures 3 mm (series 5 image 50).MEDIASTINUM AND HILA: Moderate cardiomegaly. Mitral valve annuloplasty. Severe coronary artery calcifications and severe atherosclerotic changes in the thoracic aorta.Homogenously enlarged left thyroid lobe with associated rightward deviation of the trachea, consistent with a goiter.Prominent mediastinal lymph nodes with reference precarinal lymph node measuring 1.9 x 1.8 cm (series 3 image 37). Calcified left perihilar lymph nodes consistent with prior granulomatous disease.CHEST WALL: Sternotomy wires in place without abnormalities. Moderate multilevel degenerative changes with degenerative disk disease in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Hypoattenuating lesion in the left hepatic lobe is too small to characterize.
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1.Bilateral pleural effusions with moderate cardiomegaly, suggestive of CHF with edema.2.Scattered pulmonary micronodules are nonspecific.
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Generate impression based on findings.
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Seizure. Rule out acute hemorrhage. There is diffuse prominence of CSF spaces in keeping with the patient's age. In addition to patchy periventricular hypoattenuation most likely represent sequela of chronic small vessel ischemic disease, there are multiple more prominent areas of hypoattenuation within the right parietal and occipital lobes correlating with findings on the recent MRI representing encephalomalacia related to more focal infarcts.There is no intracranial hemorrhage, mass, hydrocephalus or midline shift. There is no fracture or aggressive bony lesion.
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Sequela of chronic small vessel ischemic disease in addition to multiple foci of encephalomalacia likely representing sequela of prior infarcts which correlates with the recent MRI exam. CT is suboptimal for assessment of acute ischemia and it is persisting concern, MRI could be considered.
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Generate impression based on findings.
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60 year-old male status post liver transplant and right flank incisional hernia, nausea and vomiting. Evaluate for SBO ABDOMEN:LUNG BASES: Mild basilar scarring. Moderate coronary calcifications.LIVER, BILIARY TRACT: Status post liver transplant. Portal veins, hepatic veins and hepatic artery appear patent.Biliary stent is in place, without evidence of biliary dilation; mild associated pneumobilia. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypodensities in both kidneys too small to characterize but most likely represent benign cysts. Nonobstructing 2-mm stone is present in the inferior calix of left kidney.RETROPERITONEUM, LYMPH NODES: Multiple prominent retroperitoneal lymph nodes. Atherosclerotic calcifications in aorta and its branches.BOWEL, MESENTERY: No evidence of bowel obstruction, bowel wall thickening, or other significant abnormality.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes in lower lumbar spine.OTHER: No significant abnormality noted
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1.No evidence of bowel obstruction or other specific abnormality to account for patient's symptoms.2.Status post liver transplant with biliary stent in place.3.2 mm non-obstructing stone in inferior calix of left kidney.
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Generate impression based on findings.
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Known C1 mass (plasmacytoma). For assessment of stenosis. Findings are consistent with those on the recent MR. There is a lytic lesion with a large soft tissue component centered within the right lateral aspect of the anterior arch of C1. The soft tissue component extends primarily anterolaterally into the soft tissues the retropharynx, while the spinal canal remains widely patent at this level. The lytic lesion has ill-defined margins within the bone and has completely eroded the anterior and lateral aspects of the body, including the articular surface, transverse process and the insertion site of the transverse ligament. The exiting right C1 and 2 nerve roots are not visualized and are likely involved by the mass described on the MR.In there is hypoattenuation within the anterior aspect of the odontoid base as well as a focal lytic lesions within the right lateral mass and body of C3 which also most likely represent myelomatous lesions. Marrow is heterogeneity elsewhere in keeping with diffuse myelomatous involvement of the cervical spine.The cervical spine is normal. There is no intervertebral disk height loss or fracture. Incidental note is made of incomplete fusion of the posterior arch of C2.
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Aggressive appearing lytic lesion involving the anterior/right aspect of the C1 vertebral body as described on MRI in keeping with the patient's known plasmacytoma at this level. Multiple other bony lucencies most likely representing multiple myeloma.
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Generate impression based on findings.
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History of prostate cancer with new right inguinal mass ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomyBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Small fat-containing bilateral inguinal hernias, right greater than left without bowel involvement.OTHER: No significant abnormality noted
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Small fat-containing bilateral inguinal hernias, right greater than left without bowel involvement. Otherwise negative examination. Specifically, no evidence for acute, inflammatory, or neoplastic process.
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Generate impression based on findings.
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59-year-old male patient with fever and abnormal chest x-ray. Evaluate for pneumonia. LUNGS AND PLEURA: Diffuse bilateral ground glass opacities with peripheral sparing. Small left pleural effusion with associated atelectasis.MEDIASTINUM AND HILA: Right internal jugular venous catheter with tip in the right atrium. Heart size within normal limits without pericardial effusion. Mild coronary artery calcifications. Mild atherosclerotic changes in the thoracic aorta. No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy. Moderate multilevel degenerative changes in the thoracic spine. Diffuse sclerotic osseous changes, consistent with patient's known myelofibrosis.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Small amount of abdominal ascites.Cholelithiasis.Splenomegaly.
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1.Diffuse bilateral ground glass airspace opacities consistent with pneumocystis pneumonia or other atypical infection.2.Small left pleural effusion.
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Generate impression based on findings.
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Cellulitis and abdominal abscess status post drain removal ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomySPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable left renal cystRETROPERITONEUM, LYMPH NODES: Stable mildly enlarged retroperitoneal lymph nodes. Reference left aortic lymph node best seen on image 53 of series 3 measures 1.1 x 0.6 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No evidence for loculated fluid collection or abscess within the anterior subcutaneous abdominal wall. Granulating anterior abdominal wound.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomyBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Interval resolution of previously noted right pelvic abscess. No bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence for loculated fluid collection or abscess within the anterior subcutaneous abdominal wall. Granulating anterior abdominal wound. Interval resolution of previously noted right pelvic abscess. No bowel obstruction.
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Generate impression based on findings.
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59-year-old male with history of small bowel obstruction, right lower quadrant pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes in the upper abdomen, likely due to gastric bypass surgery. Multiple surgical clips in the left lower quadrant. No other significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes in abdominal wall.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Large prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Multiple surgical clips in the pelvis.OTHER: No significant abnormality noted
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Postsurgical changes without evidence of small bowel obstruction or other specific abnormality to account for symptoms.
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Generate impression based on findings.
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45-year-old female patient with diffuse pulmonary infiltrates. ARDS. LUNGS AND PLEURA: Diffuse bilateral patchy consolidative airspace opacities and groundglass opacities.Small left pleural effusion.Small pneumothorax with chest tube entering the right anterior chest wall between the sixth and seventh ribs and terminating in the posterior right upper lobe.Endotracheal tube terminating 3 cm above the carina.MEDIASTINUM AND HILA: Pneumomediastinum. Heart size within normal limits without pericardial effusion. LAD stent. Right subclavian central line with tip at the cavoatrial junction. No mediastinal lymphadenopathy.CHEST WALL: Diffuse, significant subcutaneous emphysema involving the thorax circumferentially.There is a well-circumscribed hypoattenuated lesion in the T6 vertebral body is suggestive of a benign bone lesion.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Enteric tube within the stomach. Tip not visualized in the field of view.
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1.Diffuse airspace opacities consistent with ARDS.2.Extensive circumferential subcutaneous emphysema, pneumomediastinum and small pneumothorax.
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Generate impression based on findings.
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22 day old male, trauma, evaluate for acute intracranial bleeding Subarachnoid blood along the anterior aspect of the right sylvian fissure. No evidence of subdural hematoma or skull fractures.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No edema is identified within the brain parenchyma.The visualized portions of the orbits are intact.
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Small amount of subarachnoid hemorrhage along the anterior aspect of the right sylvian fissure. No evidence of subdural hematoma or skull fractures.These findings were discussed with the PICU resident on call at 10:00 a.m. on 11/23/2013.
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Generate impression based on findings.
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69-year-old male with unclear past medical history, found down at home, now in rhabdomyolysis and acute renal failure, altered mental status. The CSF spaces are appropriate for the patient's stated age with no midline shift. Mild patchy hypoattenuation in the periventricular white matter most likely represents small vessel ischemic disease of indeterminate age.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 acute intracranial abnormalities.
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Generate impression based on findings.
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40 year-old female with obstructive hydrocephalus, evaluate status post brain surgery. Expected postoperative changes of a right frontal ventriculostomy catheter placement, including pneumocephalus and small amount of subarachnoid blood along the high right frontal convexity. No postprocedural intraparenchymal hematomas are present. The catheter tip terminates near the foramen of Monro. Slight interval decrease in the size of the lateral ventricular system compared to the postoperative study.Redemonstration of a well demarcated low-attenuation lesion/arachnoid cyst in the right thalamus with extension into the interpeduncular cistern and third ventricle, unchanged. Calvarial and skull changes compatible with multiple prior shunt catheter placement. The visualized paranasal sinuses and mastoid air cells are clear.
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Expected postoperative changes of a right frontal ventriculostomy catheter placement with slight interval decrease in size of the lateral ventricular system.
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Generate impression based on findings.
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Back pain status post kyphoplasty. 71-year-old with history of metastatic adenocarcinoma of the lung. Findings related to previous kyphoplasty including L4 hemilaminectomy and radiopaque cement within the L4 vertebral body are demonstrated. The physiologic lumbar lordosis is minimized. There is loss of vertebral body height at L4 owing to the previously described pathologic fracture. Intervertebral disk heights are minimized at multiple levels though are stable from previous. There is multilevel facet degeneration and disk bulges which result in bilateral neural foraminal stenosis at L2-3 through L5-S1. There is spinal canal stenosis at L2-3(moderate-severe), L3-4 (severe), and L4-5 (moderate-severe). There is 9 mm of extension of the posterior cortex of the L4 body into the spinal canal.Lucencies within multiple vertebral bodies, most prominently T12, L1, L5 and S1 are consistent with MRI findings most likely representing metastatic lesions at these levels as well. Incidental note is made of calcified atherosclerosis of the aorta and iliac arteries.
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1.Postoperative findings related to hemilaminectomy and L4 kyphoplasty.2.Sequela of previous pathologic fracture and L4 including extension of posterior cortex into the canal resulting in severe spinal stenosis at this level.3.Other bony lesions likely representing multifocal metastatic disease as described.4.Multilevel degenerative changes resulting in spinal and neural foraminal stenosis as described.
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Generate impression based on findings.
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55 year-old male with right-sided weakness, intracerebral hemorrhage, evaluate No significant interval change in the size of the hematoma within the left thalamus, cerebral peduncle, midbrain, pons and inferior cerebellar peduncle as well as a punctate focus of hemorrhage in the left parietal lobe. There is persistent hemorrhage layering within the lateral ventricles. Interval decrease in amount of hemorrhage within the third ventricle. Interval increase in layering blood within the fourth ventricle. No new sites of hemorrhage are present. Right trans-frontal ventricular shunt catheter terminating in the right lateral ventricle, unchanged. The size of the ventricular system is not significantly changed.Persistent hypoattenuation within the right basal ganglia, thalamus and corona radiata. Patchy hypoattenuation in the cerebral white matter is unchanged. No midline shift or herniation. Persistent opacification of the paranasal sinuses likely secondary to intubation. The visualized mastoid air cells are clear.
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1. No significant change in size or extent of intracranial hemorrhage.2. Persistent intraventricular hemorrhage with interval decrease in layering blood within the third ventricle and interval increase in layering blood within the fourth ventricle.3. No significant interval change in the size of the ventricular system.
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Generate impression based on findings.
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History of hemophagocytic lymphohistiocytosis and fungal sinusitis. Postoperative changes include bilateral maxillary antrectomy with mid/inferior turbinectomy and partial ethmoidectomy. There has been interval progression in the degree of sinus opacification in this patient with previous documented fungal sinusitis. The frontal sinuses were previously clear, and are now partially opacified bilaterally. Ethmoids were largely clear previously though are partially opacified bilaterally today. There has been interval increase in the amount of soft tissue density within the maxillary sinuses bilaterally. The sphenoid sinuses had previously been clear, though are largely opacified bilaterally today. Orbits are unremarkable. There is no intracranial abnormality within the visualized portion of the anterior cranial fossa. There are no lytic bony lesions.
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Interval progression in the degree of soft tissue attenuation demonstrated throughout all sinuses bilaterally in this patient with prior maxillary antrectomy/ethmoidectomy and fungal sinusitis. No CT evidence of invasiveness at this time.
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Generate impression based on findings.
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84-year-old female with history of malignant neoplasm of larynx, status post CRT completed in 5/2012, reevaluate Limited intracranial and orbital views are unremarkable. Opacification of the left mastoid air cells. The left mastoid air cells and visualized paranasal sinuses are clear. The clivus is hypoplastic.Interval decrease in mucosal edema within the supraglottic and glottic regions. No focal cervical soft tissue mass or suspicious enhancement is present. No lymphadenopathy by CT size criteria. The thyroid, parotid and submandibular glands are free of focal lesions. The major cervical vasculature is patent. Bilateral atherosclerotic calcifications at the carotid bifurcations. Atherosclerotic calcifications of the aortic arch.Mild right apical scarring, otherwise the visualized lung apices are clear. Pleural calcification along the posterior left lung apex. Please see dedicated chest CT from today's date.The bones are diffusely demineralized. Loss of vertebral body height of T4 and T5 appears similar to the prior examination. No new compression fractures are identified in the visualized cervicothoracic spine. No frankly destructive osseous lesions are identified.
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1. Post treatment changes in the neck without definite evidence of progressive primary disease or cervical lymphadenopathy.2. Redemonstration of T4 and T5 compression fractures appearing similar to the previous study.
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Generate impression based on findings.
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63 year-old female with recurrent endometrial cancer, neck mass, evaluate Limited intracranial and orbital views are unremarkable. Visualized mastoid air cells and paranasal sinuses are clear.No soft tissue density neck mass is present. In the right supraclavicular region, there is prominence of fat which is compatible in appearance with a lipoma. No exophytic mass or focal effacement of the aerodigestive tract. Prominent nonspecific oropharyngeal lymphoid tissue. The thyroid gland, submandibular and parotid glands are free of focal lesions. No lymphadenopathy by CT size criteria. The major cervical vasculature is patent with mild atherosclerotic vascular calcifications at the carotid bifurcations. No suspicious osseous lesions are present. Multilevel degenerative changes of the visualized cervicothoracic spine including loss of disk height, uncovertebral hypertrophy and posterior disk osteophyte formation and endplate degenerative changes most pronounced at C5-C6, C6-C7 and C7-T1, resulting in multilevel neuroforaminal narrowing.The visualized lung apices are clear. Please see dedicated chest CT from today's date for further details.
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1. No evidence of primary malignancy or metastatic disease in the neck.2. Prominence of fat in the right supraclavicular region compatible with a lipoma.
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Generate impression based on findings.
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50 year old female with stage IV ovarian cancer status post chemotherapy in 2012, and cervical/infraclavicular lymphadenopathy at time of diagnosis, reevaluate. Limited orbital and intracranial views are unremarkable. The visualized paranasal sinuses and mastoid air cells are clear.No lymphadenopathy by CT size criteria. No soft tissue masses are present in the neck. No exophytic mass or focal effacement of the aerodigestive tract. The submandibular and parotid glands are free of focal lesions. The thyroid gland is enlarged with a hypodense right thyroid nodule similar to the prior.The major cervical vasculature is patent. Multilevel degenerative changes similar to the prior examination without suspicious osseous lesions.The visualized lung apices are clear. Please see dedicated chest CT from today's date for further details.
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1. No evidence of a soft tissue mass in the neck.2. No evidence of cervical lymphadenopathy.
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Generate impression based on findings.
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64 year-old female evaluate for recurrence of subdural hematoma or other structural lesion, headache, history of recent subdural evacuation. No evidence of any new intracranial hemorrhage. No significant interval change in size of right anterior frontal subdural hematoma. No hyperdense components to suggest acute bleed. Similar to the prior, there is subtle mass effect associated with this finding without midline shift.No abnormal mass lesions are appreciated intracranially. No edema is identified within the brain parenchyma. Prior parietal burr holes again demonstrated.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1. No evidence of new intracranial hemorrhage.2. No significant interval change in the size of a chronic appearing right hemispheric subdural hematoma.
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Generate impression based on findings.
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68 year-old female with head contusion, status post fall, history of aneurysm Subgaleal hematoma along the left frontal bone.The CSF spaces are appropriate for the patient's stated age with no midline shift. Heavy intracranial atherosclerotic vascular calcifications.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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Left frontal scalp lesion without calvarial fracture or acute intracranial abnormalities.
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Generate impression based on findings.
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Recurrent head and neck cancer, on therapy. Evaluate for disease and compare with previous including measurements. Head: There is no intracranial mass, hydrocephalus, hemorrhage or pathologic enhancement. The midline is intact. There is lobulated soft tissue thickening in addition to secretions within the maxillary sinuses bilaterally. Remaining sinuses are unremarkable. Mastoids are clear. Bones are unremarkable.Neck: Assessment of the oral cavity and oropharynx is limited by significant streak artifact from dental hardware. The right sided Port-A-Cath has its tip within the SVC. Post treatment changes include septal thickening within the lung apices and postoperative neck changes including absence of the left sternocleidomastoid and jugular vein.There is stranding of piriform sinus fat with effacement of the left piriform fossa and mucosal thickening. There is asymmetry of the oropharynx the region of the uvula related to prior treatment. There is no focal mass within the nasopharynx or oropharynx. There is no measurable lymphadenopathy. Epiglottis and superior trachea are normal. There is heterogeneous calcification of the cricoid and thyroid cartilages. The parotids and submandibular glands are unremarkable. There is atherosclerotic calcification at the origin of the subclavian carotid and brachiocephalic cephalic arteries.There are degenerative changes within the cervical spine including intravertebral disk height loss and vacuum phenomena at C5-6 and C6-7. There is a disk osteophyte complex at the C3-4 level most prominent on the left which results in moderate left neural foraminal stenosis without canal or right neural foraminal stenosis. There are no aggressive bony lesions. Incidental note is made of a bilateral pulmonary nodules within the limited visualized field. Refer to the designated CT chest report for further detail.
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1.Post-therapeutic changes in the neck without focal mass or lymphadenopathy demonstrated.2.No intracranial abnormality demonstrated.3.Nodules on limited assessment of the lung apices, refer to be designated CT chest report for further detail.4.Maxillary sinus disease.
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Generate impression based on findings.
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57 year old patient with history of prostate cancer. Nonspecific finding on recent bone scan to rule out bone metastasis. There is preservation of the overall lumbar lordosis with multilevel degenerative change resulting in of L1 on 2 (2.2 mm), L2 on 3 (2.2 mm), and L3 on 4 (2.6 mm). There is intervertebral disk height loss at each level from L2-3 through L5-S1 with vacuum phenomena at L3-4 through L5-S1. There are sclerotic endplate changes most prominent at L2-3 and L5-S1.L1-2: In addition to the retrolisthesis and disk height loss there is a left paracentral disk bulge which results in mild left neural foraminal stenosis without significant right neural frontal stenosis.L2-3: There is a broad-based disk bulge with osteophyte formation. This results in mild left neural foraminal stenosis without significant right neural frontal stenosis. There is mild spinal stenosis.L3-4: There is a broad-based disk bulge with osteophyte formation which results in bilateral mild neural foraminal stenosis. There is mild spinal stenosis.L4-5: There is a small left paracentral extrusion with inferior migration resulting in mild canal stenosis. There is mild right neural foraminal stenosis without left neural foraminal stenosis. L5-S1: There is a broad-based disk bulge and osteophyte formation in addition to bilateral facet arthropathy resulting in bilateral moderate neural foraminal stenosis and mild canal stenosis.
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Multilevel significant degenerative changes including multilevel neural foraminal stenosis and spinal canal stenosis as described. These findings are felt to be the cause of the uptake on prior bone scan.
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Generate impression based on findings.
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57 year old female with newly diagnosed lymphoma. Status post mediastinoscopy with biopsy, now with left lobe opacity. LUNGS AND PLEURA: There is extrinsic compression of the airways from the patient's mediastinal tumor. This is most pronounced on the left. Measurements of the airway as follows:Level of the manubrium transverse dimension of the trachea is 11 mm, previously 12-mm (30; series 7). Approximately 1 cm above the level of the carina the trachea measures 7-mm in AP dimension.Level of the carina the proximal main bronchi each measure 7-mm in AP dimension.Distal right main bronchus 4 mm, previously 5-mm in AP dimension (7/44).Right upper lobe segmental airways are patent. Bronchus intermedius is mildly compressed at its origin but is patent distal to that level as are the right middle and right lower lobe airways. Again seen is a tiny focal right upper lobe ground glass opacity, appearing similar to the prior study (31/7).The distal left main stem bronchus is completely compressed/occluded with associated near complete atelectasis of the entire left lung with minimal apical aeration.Note is made of a large left pleural effusion with underlying atelectasis/consolidation, appearing increased when compared to the prior study. There is a moderate-sized right pleural effusion, appearing increased compared to the prior study.In the left apex paramediastinal groundglass opacity and septal thickening are consistent with passive congestion. Mild thickening of the fissures on the right. Mild septal thickening right lung base.MEDIASTINUM AND HILA: Large mediastinal mass consistent with patient's known lymphoma encases the aorta, pulmonary artery, esophagus and central airways. The esophagus is collapsed by the tumor. Distal to that level, the esophageal wall is severely thickened and the lumen is narrowed, indistinguishable from tumor. The esophagus returns to a normal size near the GE junction. Left subclavian ICD leads are in expected position. Trace pericardial effusion/thickening, unchanged. Small superior and anterior mediastinal lymph nodes are noted separate from the mass. Note is made of several foci of subcutaneous gas density is anterior to the thyroid, likely from recent mediastinoscopy. The SVC appears mildly narrowed, but is grossly patent.CHEST WALL: Left chest wall generator. Mild internal mammary chain lymphadenopathy bilaterally.. Equivocal sclerosis and minimal height loss of the T3 vertebral body, possibly related to lymphoma but equivocal.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Nonspecific hypoattenuating hepatic lesion (6/121), too small to characterize. Several small lymph nodes in the upper abdomen noted..
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Severe compression of the airways and thoracic esophagus by the patient's known mediastinal lymphoma with interval development of complete occlusion of the left mainstem bronchus and complete to near complete atelectasis of the left lung. Interval increase in large left pleural fluid collection.
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Generate impression based on findings.
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42 year old patient with headache, vertigo, acute vestibular syndrome. Rule out vertebral artery dissection. Unenhanced head: There is focal hyperattenuation within the medial globus pallidi bilaterally most likely representing mineralization. There is no intracranial mass, edema, hydrocephalus or hemorrhage. With the exception of benign hyperostosis frontalis, bones are normal. Paranasal sinuses and mastoids are aerated. Orbits are unremarkable.CT angiogram: There is a 4 vessel arch wherein the left vertebral artery arises directly from the aorta between the left subclavian and left common carotid. Carotid arteries demonstrate normal course within the neck. There is no significant stenosis according to NASCET criteria, including at the carotid bifurcation. There is an infundibular origin at the cavernous portion of the left internal carotid artery, with no aneurysm or steno-occlusive lesion demonstrated intracranially. Bilateral MCA and ACAs are normal.There is a right dominant posterior circulation with no extracranial stenosis or aneurysm. Intracranial branches including PICA, AICA, SCA and PCAs are normal. There is no aneurysm or steno-occlusive lesion.
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No acute intracranial abnormality and no significant vascular abnormality including aneurysm, stenosis or dissection.
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Generate impression based on findings.
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Female 43 years old Reason: sacral abscess History: sacral swelling and pain UTERUS, ADNEXAE: High density structure is without calcification, likely fibroids. Series 4 image 16 one lesion measures 2.1 x 3.1 cm.BLADDER: No significant abnormality notedLYMPH NODES: Bilateral enlarged inguinal lymph nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: 3.4 x 5 by 3 x 10.5 cm subcutaneous fluid collection consistent with an abscess with moderately mature enhancing lateral, located in the subcutaneous fat dorsal to the distal sacrum and coccyx. The lesion does extend to abut the coccyx. This appears to be recurrent in a similar location as seen on the CT scan 5/07.No lytic or blastic changes. No definite evidence of osteomyelitis.OTHER: No significant abnormality noted
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Probable abscess subcutaneous tissues of the back.
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Generate impression based on findings.
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57 year-old female with chest pain and difficulty breathing. Rule out PE. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. There is no evidence of right heart strain.LUNGS AND PLEURA: There is bilateral dependent atelectasis without evidence of focal consolidation, pleural effusion, or pneumothorax. There are scattered, nonspecific bilateral pulmonary micronodules.MEDIASTINUM AND HILA: No significant abnormality noted.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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No evidence of pulmonary embolus.
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Generate impression based on findings.
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Female 89 years old Reason: evaluate for active bleeding, free air, or fluid History: hypotension s/p trauma, abd pain Exam is not sensitive for detecting lesions in the bowel, solid organs of vasculature due to the lack of oral or intravenous contrast. Active bleeding cannot be evaluated without intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: Basilar atelectasis. Postsurgical changes mediastinum and heart.Some irregularities are seen at one or two ribs in the left lung lower chest possibly representing dramatic fracture. There seems been associated soft tissue density possibly representing pleural based hematoma; series 4 image 23. Recommend correlation with plain films when patient is able.LIVER, BILIARY TRACT: Probable gallstone. No obvious biliary dilatation or focal liver lesions.SPLEEN: Markedly heterogeneous concerning for splenic hematoma and possible splenic rupture.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nephrolithiasis right upper pole and scattered calcifications elsewhere. Hypoattenuating foci likely cysts or complex cyst. No obvious hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Minor atherosclerotic changes aorta no obvious aneurysm or retroperitoneal hematoma evident.BOWEL, MESENTERY: Although limited by back lack of opacification of the small bowel there is a moderate amount of free intraperitoneal fluid. Some areas suggesting layering of high density concerning for hemoperitoneum.Small sliding hernia.BONES, SOFT TISSUES: Osteoporosis. Loss of height of vertebral bodies the lower chest and upper abdomen (T12, L1). No lytic or blastic disease.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Atrophic.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: A small amount of free intraperitoneal fluid. In the dependent portion of the pelvis suggestion of layering effect consistent with hemoperitoneumBONES, SOFT TISSUES: Surgical appliance right hip. Surgical clips right thigh.OTHER: No significant abnormality noted
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Exam is markedly limited by lack of intravenous or oral contrast. Heterogeneity in the spleen, possible rib fractures and suggestion of layering effect and some of the intraperitoneal fluid and strongly suspicious for splenic laceration and hemoperitoneum. Suggest correlation with plain films if possible for the rib fractures and ultrasound of the spleen when the patient is able.Other findings as above.
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Generate impression based on findings.
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58-year-old male with a history of non-small cell lung carcinoma. Status post left lower lobectomy with new onset atrial fibrillation and RVR with hypoxia. PULMONARY ARTERIES: Note is made of filling defects in the segmental branches of the right upper, middle, and right lower lobes consistent with pulmonary emboli. The main pulmonary artery measures 3.6 cm in diameter which can be seen with pulmonary artery hypertension.LUNGS AND PLEURA: Postsurgical changes in the left lung with associated pleural thickening and volume loss are again seen.Again seen is scattered foci consolidation in the left upper lobe, appearing similar to the prior study. There is consolidation and scattered nodular opacities affect the left lung base and right lower lobe. Again seen are loculated pleural fluid collections in the left base and along the left aspect of the upper mediastinum, slightly increased when compared to the prior study.MEDIASTINUM AND HILA: No significant change in mediastinal adenopathy. AP window lymph node measures 13 mm in the short axis, previously 13 mm (series 9/116). Left cardiophrenic node measures 10 mm, previously 10 mm (series 9/275).Stable heterogeneous left thyroid nodule.CHEST WALL: Multiple mixed lytic and sclerotic lesions in vertebral bodies, manubrium and left ribs, compatible with metastases.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Again seen are multiple hypodensities in the liver, consistent with the known history of liver metastases. These are for recent abdominal CT report for further details. Accurate measurement is limited secondary to contrast phase, however, lesions appear grossly stable.Interval increase in the size of the left adrenal metastatic lesion. The lesion measures 2.2 x 1.6 cm, previously 2.2 x 1.6 cm on image number 92, series number 9. Right adrenal gland is unremarkable.
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1. Filling defects in the segmental branches of the right upper, middle, and lower lobe pulmonary arteries consistent with pulmonary emboli.2. Slight interval increase in bilateral multifocal nodular opacities and consolidation with associated mediastinal lymphadenopathy. 3. Slight interval increase in size of loculated left pleural effusion.4. Persistent hepatic, left adrenal, and lytic lesions affecting the axial skeleton, suspicious for metastatic disease.These findings were relayed to the clinical service by the radiology resident on call on 11/23/13.
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Generate impression based on findings.
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History of abdominal mass. Concerns for lung abscess. Fever for 9 days, cough and coarse relation on x-ray from outside institution. LUNGS AND PLEURA: Right upper lobe and superior segment of the lower lobe consolidation, subsegmental atelectasis of the right middle lobe and underlying pleural effusion. No evidence of lung abscess. Normal left lung.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedUPPER ABDOMEN: Upper abdomen
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Multifocal right lung consolidation with underlying pleural effusion. No evidence of lung abscess.
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Generate impression based on findings.
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Female 25 years old Reason: Pt w/ abdominal pain , renal transplant, diarrhea, eval for colitis History: abdominal pain, diarrhea Exam is not sensitive at detecting lesions in the solid organs of vasculature due to lack of intravenous contrast. Oral contrast was given patient apparently ingested only a very small amount limiting evaluation of the bowel.ABDOMEN:LUNG BASES: Small bilateral pleural effusions. Groundglass opacities suggestive of edema. Also several small micronodules bilaterally which are not seen on the 2/11 CT.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic native kidneys consistent with history of medical renal disease.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Evaluation of the bowel is markedly limited due to lack of oral contrast. There is mesenteric fat stranding both around the transverse colon and also throughout the mesentery and somewhat in the right paracolic gutter. Etiology is uncertain. Colitis cannot be excluded but is not definitely present.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Atrophic allograft right iliac fossa.Renal allograft left iliac fossa. In the coronal plane the allograft is estimated at 12.1 cm in length coronal image 51/92.PELVIS:UTERUS, ADNEXAE: 3.1 x 2.2 cm right adnexal fluid collection likely ovarian cyst.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No definite free or loculated fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Suspicious but not diagnostic for focal colitis. Lung micronodules which are new and ground glass appearance with small effusions. Other findings as above. Probable ovarian cyst.
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Generate impression based on findings.
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35-year-old male with 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. A hypodense focus is present in the right basal ganglia, unchanged. The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1.No acute intracranial hemorrhage mass effect or edema. 2.A hypodense focus in the right basal ganglia is unchanged and could represent a lacunar infarct age indeterminant versus dilated perivascular space.
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Generate impression based on findings.
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New seizure like activity status post cardiac arrest. Assess for intracranial bleed. Within the limitation of portable technique including suboptimal positioning, there is no intracranial mass, hemorrhage, or hydrocephalus. There is a 3-mm focus of air at the torcular heterophili posteriorly likely on the basis of IV access and resuscitation. The midline is intact. Orbits, paranasal sinuses and mastoids are unremarkable.
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No acute hemorrhage. An intravascular focus of air likely relates to IV access during resuscitation.
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Generate impression based on findings.
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Female 31 years old Reason: rule out kidney stone History: flank pain, hematuria The exam is not sensitive for detecting lesions in the bowel, solid organs or vasculature to to lack of oral or intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of nephrolithiasis, perinephric fat stranding, hydronephrosis or hydroureter. Slight hyperdensity of the papilla may be associated with dehydration, correlate clinically.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Small to moderate sized bilateral groin nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No findings to explain the patient's symptoms. If hematuria persists follow-up evaluation should be done to rule out neoplasm.
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Generate impression based on findings.
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27-year-old female with 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.Previously demonstrated mildly hyperintense intracranial vasculature has resolved, consistent with the prior head CT demonstrating residual contrast from an abdomen CT performed earlier that day.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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Negative noncontrast head CT.
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Generate impression based on findings.
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55 year-old male with intracranial hemorrhage A small amount of new hemorrhage is present within the peripheral frontal lobe parenchyma at the site of EVD insertion.No significant interval change in the size of the hematoma within the left thalamus, cerebral peduncle, midbrain, pons and inferior cerebellar peduncle as well as a punctate focus of hemorrhage in the left parietal lobe. Although there has been slight decrease in density of the left thalamic, peduncle, midbrain component consistent with evolution. There is persistent hemorrhage layering within the lateral ventricles as well as hemorrhage within the third and fourth ventricles. No new sites of hemorrhage are present. Right trans-frontal ventricular shunt catheter terminating in the right lateral ventricle, unchanged in position. The size of the ventricular system is unchanged.Persistent hypoattenuation within the right basal ganglia, thalamus and corona radiata. Patchy hypoattenuation in the cerebral white matter is unchanged. No midline shift or herniation. Persistent opacification of the paranasal sinuses likely secondary to intubation. New fluid is present within a few bilateral deep and mastoid air cells.
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1.No significant change in size and extent of intracranial hemorrhage although some components demonstrate decreased density consistent with evolution.2.No significant interval change in the size of the ventricular system.
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Generate impression based on findings.
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Female 75 years old Reason: evaluate g-j tube placement for possible leak - place water soluble contrast via g-tube port to evaluate History: evaluate g-j tube placement for possible leak - place water soluble contrast via g-tube port to evaluate The exam is not sensitive for detecting lesions in the solid organs of vasculature due to lack of intravenous contrast. No oral contrast is also markedly limited.ABDOMEN:LUNG BASES: Bilateral pleural effusions decreased in size. Bibasilar atelectasis or consolidation.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right kidney is surgically absent. Atrophic left kidney with probable cysts incompletely characterized due to lack of intravenous contrast.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications aorta and branch vessels. No definite evidence of aneurysm.BOWEL, MESENTERY: Gastrostomy balloon now lies within the stomach. Air fluid collection seen along the greater curvature of the stomach is not significantly changed.The jejunal portion of the tube coils in the gastric fundus with its tip in the gastric antrum region.Free intraperitoneal air is seen but is decreased compared to the prior exam.Colon is surgically absent. Hartmann's pouch.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall. Anasarca.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY:Colon surgically absent, Hartmann pouch, right lower quadrant ostomy. Generalized ileus likely. No evidence of mechanical obstruction. No intramural air. Fat stranding and small amount of fluid. No evidence of loculated fluid to suggest abscess.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall. Lower abdominal anterior wound. No evidence of loculated fluid collections in the subcutaneous fat or adjacent peritoneum. Anasarca.OTHER: Large and small vessel atherosclerotic calcifications.
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Tube positions as described above. Decrease in amount of free intraperitoneal air. No evidence of abscess or obstruction. Other findings as above.
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Generate impression based on findings.
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Fall. Rule out intracranial hemorrhage. Head: Postoperative changes include a bony defects related to left parietal craniotomy. There is underlying left parietal encephalomalacia with ex vacuo dilatation of the adjacent lateral ventricle. There is no acute intracranial abnormality including mass, hemorrhage or edema. The midline is intact.Facial bones: There is soft tissue density and enlargement of the upper lip which was demonstrated on the prior exam 11/4/2013. Correlation with findings on physical exam could elicit nature of this lesion as possibilities would include hematoma, abscess or soft tissue mass. The maxillary and frontal sinuses are normal. There is minimal soft tissue density within posterior ethmoids. Sphenoid sinuses demonstrate aerated secretions bilaterally with dystrophic ossification peripherally in keeping with chronic sinusitis. Orbits are unremarkable. There are bilateral periapical lucencies associated with mandibular molars.Cervical spine: There is preservation of the physiologic lordosis. There is preservation of vertebral body height with intervertebral disk height loss at C4-5 and C5-6. There are degenerative changes without visualized fracture. The paravertebral including prevertebral soft tissues are unremarkable.C2-3: No significant degenerative change or disk bulge. Spinal canal and neural foramen are patent bilaterally.C3-4: There are bilateral uncovertebral osteophytes which do not result in significant canal or neural foraminal stenosis.C4-5: There are bilateral uncovertebral joint osteophytes, larger on the right than left. This does not result in significant canal or neural foraminal stenosis.C5-6: There is a disk osteophyte complex associated with loss of intervertebral disk height. There is facet arthropathy as well which results in bilateral moderate neural foraminal stenosis.C6-7: There is no significant degenerative change or disk bulge. Spinal canal and neural foramina are patent.C7-T1: There is no significant disk bulge or degenerative change. Spinal canal and neural foramina are patent.
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1.Postoperative findings on head examination without acute intracranial pathology.2.Significant soft tissue density associated with the right upper lip. Correlation with clinical examination recommended as this could potentially represent hematoma, abscess or soft tissue mass.3.Periapical lucencies consistent with dental disease associated with mandibular molars bilaterally.4.Soft tissue density and peripheral dystrophic calcification in keeping with chronic sphenoid sinusitis.5.Degenerative changes resulting in bilateral neural foraminal stenosis at C5-6 without acute pathology including fracture.
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Generate impression based on findings.
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Female 58 years old Reason: r/o stone History: flank pain ABDOMEN:LUNG BASES: Probable centrilobular emphysema is seen in lung bases. No effusion.LIVER, BILIARY TRACT: Cholelithiasis. No obvious biliary dilatation. No evidence of fatty liver. Smooth contour to the liver.SPLEEN: No significant abnormality notedPANCREAS: Pancreatic calcifications consistent with chronic pancreatitis. Pancreatic stent in place with one end in the pancreatic tail and the other end in the inferior genital of the duodenum. Peripancreatic fluid collections incompletely characterized due to the lack of intravenous contrast regretting the mature in the probably chronic consistent with probable pseudocyst. This collection is in the or dorsal to the distal pancreatic body measured on series 3 image 30 is 2.1 x 2 cm. fluid collection in the uncinate process described on the MRI of 2011 is not seen.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate nephrolithiasis left mid kidney. No hydronephrosis hydroureter. No perinephric fat stranding.RETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications aorta no evidence of aneurysm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Calcifications likely representing uterine fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Limited by lack of IV contrast. Findings consistent with chronic pancreatitis. Cholelithiasis without obvious biliary dilatation.Other findings as above including nonobstructive left nephrolithiasis probable emphysema lung base.
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Generate impression based on findings.
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Male 80 years old; Reason: llq pain History: pain ABDOMEN:LUNG BASES: Surgical changes chest painLIVER, BILIARY TRACT: Cholelithiasis. No evidence of biliary dilatation. Punctate calcifications consistent with granulomas. Punctate hypodensity likely benign cyst. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypoattenuating foci likely cysts. Possible scarring right kidney. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications. No evidence of aneurysm.BOWEL, MESENTERY: Ventral hernia containing transverse colon without evidence of obstruction or ascites. No fluid in the hernia sac. TheBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate gland.BLADDER: Diverticulum right lateral wall.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Corkscrewed tacks consistent laparoscopic ventral hernia repair without evidence of recurrent hernia in the anterior abdominal wall low abdomen and pelvic inlet. Intraperitoneal bowel is not obstructed. The some angulation just deep to the abdominal wall probably representing nonobstructive adhesions distorting the bowel. The minimal fat stranding just underneath the left rectus muscle and 665 is unchanged from the 8/24/13 exam and therefore not likely the cause of the patient's symptoms.BONES, SOFT TISSUES: Anterior osteophytes. No lytic or blastic disease.OTHER: Vascular calcifications.
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Cholelithiasis without biliary dilatation. Nonobstructive small ventral hernia. Nonobstructive adhesions small bowel in the region of the laparoscopic hernia repair. No acute findings to explain left lower quadrant pain.
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Generate impression based on findings.
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Atypical migraines. JC virus carrier. There is no intracranial mass, edema, hemorrhage or hydrocephalus. The midline is intact. Visualized portions of the paranasal sinuses are unremarkable. Bony structures, mastoids and the orbits are unremarkable.
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No acute intracranial pathology demonstrated.
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Generate impression based on findings.
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Fall. Rule intracranial hemorrhage. There is no intracranial mass, hemorrhage, edema or hydrocephalus. There is a chronic wedge shaped region of encephalomalacia within the left posterior MCA territory with underlying ex vacuo dilatation of the left trigone likely related to prior infarct. There is a small amount of secretions demonstrated within the dependent aspect of the left maxillary sinus. Sinuses and mastoid cells are otherwise unremarkable. Orbits are normal.
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Sequela of prior left posterior MCA infarct. No acute intracranial abnormality including hemorrhage.
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Generate impression based on findings.
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Female 60 years old Reason: evaluate bowel obstruction History: see above Exam is not sensitive for detecting lesions in the bowel solid organs of vasculature due to lack of oral or intravenous contrast. Given the limitations, the following observations are made:ABDOMEN:LUNG BASES: Persistent small bilateral pleural effusions and bibasilar atelectasis.LIVER, BILIARY TRACT: A density material in the gallbladder consistent with vicarious excretion of previously administered intravenous contrast. Distortion of liver contour by the ascites unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Probable renal cysts unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Ascites with loculation redemonstrated. Residual oral contrast is seen in the colon. Bowel is distorted nonobstructive in the upper abdomen. The fluid is loculated in the mid and left abdomen in a pattern similar to the prior exam.Small nonobstructive periumbilical hernias. NG tube in stomach.BONES, SOFT TISSUES: Subcutaneous injection sites. Postsurgical changes anterior abdominal wall.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Surgically absent.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Dilated small bowel redemonstrated. Degree of dilatation is less marked than on the prior exam. Abdomen the transition zone is seen probably due to adhesion in the anterior abdominal (this is seen on annotated sagittal image 76/146. Note that small bowel in the hernia sac is less dilated and there is no fluid in the hernia sac. Nevertheless, I suspect multifocal sites of adhesions. No intramural air or free air. Lack of intravenous contrast makes the exam insensitive for bowel ischemia.BONES, SOFT TISSUES: Post surgical changes anterior abdominal wall. Redemonstration hernia sac.OTHER: No significant abnormality noted
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Multifocal adhesions as the dominant of one of which is outside of the hernia sac along the anterior abdominal wall. Persistent but decreased small bowel dilatation in the pelvis. Persistent ascites with loculation. Case reviewed in person with Dr. Tenney
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Generate impression based on findings.
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Headache post fall with frontal scalp laceration. No intracranial mass, edema, hemorrhage or hydrocephalus. The midline is intact. There is a minimally displaced left nasal bone fracture with associated with soft tissue swelling over the left aspect of the nose. There is partial opacification of left the sphenoid sinus while the remaining sinuses and mastoid air cells are clear. Orbits are unremarkable.
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No acute intracranial abnormality. Minimally displaced left nasal bone fracture and associated soft tissue swelling.
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Generate impression based on findings.
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Female 40 years old Reason: assess for kidney stone History: R flank pain, hx kidney stones The exam is not sensitive for detecting lesions in the bowel, solid organs of vasculature due to lack of oral or intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholecystectomy clips. No evidence of fatty liver. No definite focal lesions given the limitation of no intravenous contrast.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Scattered punctate foci of nephrolithiasis is seen bilaterally without evidence of hydronephrosis or hydroureter or perinephric fat stranding. No calcifications are seen along the course of the ureters.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No evidence of nephrolithiasis and urinary bladder or distal ureters. Calcification in the right pelvis is consistent with a phlebolithLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Nonobstructive nephrolithiasis bilaterally.
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Generate impression based on findings.
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Midline neck pain. Rule out fracture or misalignment. There is reversal of the physiologic lordosis. There is loss of vertebral body height with sclerotic change and C6 and C7 as well as the partially imaged T4 vertebral body. There is loss of intervertebral disk heights and C5-6, C6-7 and C7-T1. There is no prevertebral soft tissue swelling or fracture demonstrated.C2-3: There is left facet degeneration without spinal or neural foraminal stenosis.C3-4: Disk osteophyte complex with bilateral facet arthropathy not resulting in any significant canal or neural foraminal stenosis. C3-4: Uncovertebral osteophytes and bilateral facet degeneration without significant canal or neural foraminal stenosis.C4-5: Uncovertebral osteophytes with bilateral facet arthropathy resulting in mild left neural foraminal stenosis without right neural foramina or canal stenosis.C5-6: Uncovertebral osteophytes without significant facet arthropathy. No significant canal or neural foraminal stenosis.C6-7: Uncovertebral osteophytes without significant degenerative facet change. No significant canal or neural foraminal stenosis.C7-T1: Left facet degeneration without canal or neural foraminal stenosis.
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Severe multilevel degenerative change which does not result in central canal stenosis. There is mild left neural foraminal stenosis at C4-5. No acute anomalies including fracture.
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Generate impression based on findings.
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Female 47 years old Reason: r/o stone History: hematuria The exam is not sensitive detecting lesions in the bowel, solid organs of vasculature due to lack of oral or intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: Postsurgical changes right middle lobe. Groundglass opacities, fibrosis and honeycombing unchanged.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of nephrolithiasis, hydronephrosis hydroureter or perinephric fat stranding.RETROPERITONEUM, LYMPH NODES: IVC filter in place with narrowing of the IVC inferior to the filter probably chronic in nature.Small retroperitoneal lymph nodes unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Vascular collaterals subcutaneous tissues. No lytic or blastic disease.OTHER: Vessels likely representing venous collaterals in the right abdomen and pelvis.PELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: Foley catheter in place.LYMPH NODES: Stable right inguinal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative cystic changes in the left acetabulum. No lytic or blastic disease. Vascular collaterals subcutaneous fat.OTHER: No significant abnormality noted
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Multiple findings chronic in nature as described above. No evidence of nephrolithiasis or perinephric fat stranding. If unexplained hematuria persists, further evaluation with contrast-enhanced CT or MRI may be obtained.
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Generate impression based on findings.
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Male 54 years old; Reason: evaluate hepatic vasculature and echotexture, Cirrhosis protocol History: NASH Cirrhosis, pre liver transplant evaluation ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Elevated location due to elevation of the right hemidiaphragm. Normal size 14 cm cephalocaudad at coronal image 42/79. No evidence of fatty liver. Pre-IV contrast average density 55 Hounsfield units series 3 image 24. Heavy density linear calcification right lobe of liver unchanged from 2009.No focal intrahepatic lesions on any phase. Hepatic vasculature enhances normally without evidence of intrahepatic thrombus. Patent hepatic arterial anatomy with a replaced right hepatic artery. There is partial thrombus however in the extrahepatic portal vein and confluence. Scattered portal venous wall calcifications (some are annotated). Maximal thickness of the thrombus is seen in the portal vein just cephalad to the confluence on venous coronal series number 80756, and 21/79 with a thrombus measures 1.1 cm in thickness. Some distortion and impression on the anterior contour of the liver due to the subhepatic or perihepatic fluid, unchanged.Cholecystectomy clips. No biliary dilatation..SPLEEN: Splenomegaly 16.4 cm cephalocaudad venous coronal image 41. Large splenic vein and venous collaterals.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Accessory right renal artery. No evidence of nephrolithiasis. No focal lesions.RETROPERITONEUM, LYMPH NODES: Retroperitoneal varices. Atherosclerotic calcifications of small caliber aorta and iliac arteries. No evidence of aneurysm.BOWEL, MESENTERY: Varices seen in the EG junction. Extensive mesenteric venous collaterals particularly in the right abdomen. There is marked haziness and flank soft tissue density encasing the mesenteric vasculature. This is consistent with mesenteric panniculitis. No evidence of bowel wall thickening or dilatation. No free or loculated intraperitoneal fluid.Scattered small mesenteric nodes. These are unchanged.BONES, SOFT TISSUES: Metallic fragment in the subcutaneous tissues of the back abutting the posterior elements of the spine with associated streak artifact. The series 11 image 67. This has the appearance of a bullet.OTHER: No significant abnormality noted.
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Chronic dens liver calcifications. No focal liver lesions. No evidence of fatty infiltration of the liver.Thrombus in the extrahepatic portal vein but not completely occlusive. Mesenteric venous wall calcifications, correlated for implications for liver transplantation venous anastamosis. Variant hepatic arterial anatomy; replaced right hepatic artery. Small caliber aorta.Extensive mesenteric venous collaterals. Esophageal varices. Splenomegaly. Mesenteric panniculitis. Chronic perihepatic fluid distorting the hepatic contour.
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Generate impression based on findings.
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Fall. Rule out intracranial hemorrhage or C-spine injury. CT head: The diffuse sulcal and ventricular prominence which is likely age related. There is patchy paraventricular/subcortical white matter hypoattenuation most likely in keeping with sequela of chronic small vessel ischemic disease. There is calcification along the course of the vertebral and para/supraclinoid ICAs. There is no focal intracranial mass, hemorrhage or edema. The midline is intact. There is soft tissue swelling over the left posterior parietal region without underlying fracture. Minimal secretions within the right maxillary sinus. Remaining sinuses and mastoid cells are clear. Orbits are unremarkable.CT cervical spine: Alignment is abnormal and including accentuation of the physiologic lordosis inferiorly and reversal superiorly. There is 3 mm anterolisthesis of C2 on 3 and 3 mm retrolisthesis of C5 on 6. This preservation of vertebral body height with loss of intravertebral disk height at each level from C2-3 through C7-T1. There is diffuse osteopenia without a discrete visualized fracture. Prevertebral soft tissues are unremarkable.C2-3: In addition to disk height loss and anterolisthesis of C2 on 3 there is calcification of a central disk protrusion and left facet arthropathy which does not result in significant canal or neural foraminal stenosis.C3-4: There is disk osteophyte complex and facet degeneration without canal or neural foraminal stenosis.C4-5: There is disk osteophyte complex and facet degeneration without canal or neural foraminal stenosis.C5-6: Disk osteophyte complex and bilateral facet arthropathy results in moderate left and severe right-sided neural foraminal stenosis.C6-7: Disk osteophyte complex and bilateral facet arthropathy results in moderate left and severe right-sided neural foraminal stenosis.C7-T1: Minimal degenerative change without canal or neural foraminal stenosis.
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1.No acute intracranial findings including volume loss and sequela chronic small vessel ischemic disease without hemorrhage or fracture.2.Significant multilevel spondylosis resulting in multilevel moderate-severe neural foraminal stenosis.3.Osteopenia without visualized fracture.
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Generate impression based on findings.
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Female 63 years old Reason: 63yo female recurrent endometrial CA, lung nodule. assess for dx progression History: as above CHEST:LUNGS AND PLEURA: Index left upper lobe nodule series 4 image 18, 4 x 4 mm. Previously 9 mm.Cluster of small nodules of scar abutting the medial pleural surface at the level of aortic arch series 4 image 27, unchanged. No new nodules. No effusions. Persistent fibrotic changes and groundglass opacities in the right base.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Perihepatic soft tissue density is ill-defined and estimated on series 2 image 68 is 1.3 x 1 cm. Previously 2.4 x 1.4 cm.Liver 19 cm cephalocaudad unchanged coronal image 70.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Probable scarring left kidney unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Surgical clips right rectus muscle. Surgical clips anterior abdominal wall. Midline scar low abdomen and pelvis.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Surgically absent.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall.OTHER: No significant abnormality noted.
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Decrease in size of index lesions. No new sites of disease.
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Generate impression based on findings.
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Fell and struck head. INR 4.4. Rule out intracranial hemorrhage and cervical spine injury. CT head: There is minimal soft tissue swelling over the right frontal area. There is chronic encephalomalacia within the right temporoparietal lobe with associated ex vacuo dilatation of the underlying lateral ventricle in keeping with sequela of an old infarct. No acute intracranial pathology including hemorrhage, edema or hydrocephalus. The midline is intact.Cervical spine: There is preservation of physiologic lordosis. There is preservation of vertebral body height. Intervertebral disk height is minimized at C3-4 and C6-7. There are no fractures and prevertebral soft tissues are normal. The odontoid peg is intact.C2-3: No significant disk bulge or degenerative change. There is no canal or foraminal stenosis.C3-4: There is a disk-osteophyte complex and facet degeneration which does not result in significant canal or neural foraminal stenosis.C4-5: Uncovertebral osteophytes and facet degeneration without significant canal or neural foraminal stenosis.C5-6: Bilateral facet arthropathy without significant canal or neural foraminal stenosis.C6-7: Disk osteophyte complex with facet degenerative changes resulting in moderate left and severe right neural foraminal stenosis without significant canal stenosis.C7-T1: Disk osteophyte complex without significant neural foraminal or canal stenosis.The right thyroid lobe is multinodular which could be assessed by ultrasound as clinically indicated. Incidental note is made of a torus palatini.
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No acute intracranial abnormality including hemorrhage. Chronic findings including sequela of an old infarct. Multilevel degenerative change within the cervical spine resulting in bilateral neural foraminal stenosis at C6-7. Incidental note of a multinodular right thyroid lobe which could be assessed by ultrasound as clinically indicated.
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Generate impression based on findings.
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Reason: 50 yo female with stage IV ovarian CA s/p surgery/chemo completed in Nov 2012. Assess for disease progression History: as above CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: 4mm right thyroid nodule unchanged. No pathologic size lymph nodes.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Subtle implants on the surface of the liver is redemonstrated on coronal image 46 measuring about 6 mm in thickness compared to the prior exam image 35 where it measured 8 mm in thickness.SPLEEN: Irregular hypoattenuating focus along the medial perihilar aspect of the spleen measures 1.3 x 1.1 cm. Previously 1.6 x 1.6 cm.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Surgical clips from lymph node dissection. No pathologic size lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Surgically absentBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Decrease in size of index lesions. No new sites of disease.
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Generate impression based on findings.
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Male 53 years old Reason: 51M s/p RYGB in 1999, now s/p 2 episodes of severe GI bleeding. S/p upper and lower endoscopy with no source of bleeding. History: S/p lower GI bleeds ABDOMEN:LUNG BASES: Coronary artery calcifications. Persistent relative elevation right diaphragm.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: Postsurgical changes consistent with Roux-en-Y gastric bypass. No definite focal lesions seen in the bowel. No active bleeding is seen (although the exam is not protocoled to be optimized for active bleeding due to administration of oral VoLumen). There is some hypo-it attenuating blood within the distal superior mesenteric vein and jejunal branches likely due to vascular flow of unopacified blood rather than thrombus.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Expected postsurgical changes. No bowel lesions identified. Small bowel is well distended with negative oral contrast in the wall enhances normally. No free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: Postsurgical changes anterior abdominal wall.OTHER: No significant abnormality noted
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No lesion that might contribute to GI bleeding is seen. Expected postsurgical changes.
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Generate impression based on findings.
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Male 53 years old; Reason: 53 yo with HCV. wt loss. cirrhosis. please screen for HCC. prior adenopathy noted History: wt loss 13# ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Prominent lateral segment left lobe. No evidence of liver surface nodularity. No focal liver lesions. No evidence of fatty liver. Portal veins, hepatic veins and hepatic arteries enhance normally. Extrahepatic portal vein diameter 1.9 cm delayed coronal image 42/87. Post cholecystectomy. No biliary dilatation. Extrahepatic portal vein and mesenteric veins enhance normally without evidence of thrombusSPLEEN: Splenomegaly 15.6 cm cephalocaudad delayed coronal image 56/87.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Accessory right renal artery. A small nonspecific hypoattenuating foci in the left kidney too small to characterize likely cyst.RETROPERITONEUM, LYMPH NODES: Small shotty retroperitoneal nodes. Minimal atherosclerotic calcifications. Normal caliber arteries.BOWEL, MESENTERY: No evidence of ascites or varices. No bowel wall thickening or dilatation. No free or loculated intraperitoneal fluid. Surgical clip in the pelvis.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: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Splenomegaly. Prominent lateral segment left lobe and prominence of the portal vein without evidence of liver surface nodularity. No focal liver lesions. Other findings as above.
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Generate impression based on findings.
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Female, 30 years old, with surgery in July for recurrent epidermoid cancer of the parotid, evaluate for disease recurrence An area of soft tissue prominence along the medial aspect of the large soft tissue flap now appears more conspicuous, masslike, with enhancement, measuring 16 x 16 mm (series 5, image 85).There is also an area of increasing prominence with peripheral enhancement along the posterior margin of the large soft tissue flap measuring 15 x 12 mm (series 5, image 69).New suspicious enhancement without well-defined borders is present just lateral to the left lateral pterygoid plate (series 5, image 70).A subcutaneous lymph node along the left paramedian neck has increased in size and demonstrates no peripheral enhancement, now measuring 12 x 9 mm (previously 12 x 6 mm) (series 5, image 93).There is a new solidly enhancing mass along the inferoposterolateral aspect of the large soft tissue flap measuring 11 x 11 mm (series 5, image 136).A solidly enhancing mass is seen just anterolateral to what may be an atrophied submandibular gland, measuring 18 x 19 mm (series 5, image 136). The left submandibular gland has been resected, a second mass lesion is present.A new solidly enhancing mass with spiculated margins measuring 23 x 25 mm is present within the left supraclavicular fossa.Postoperative changes in thinning of the squamous temporal bone which is again noted. Infiltration of the subcutaneous fat and reticulation reflects posttreatment change.The right parotid and submandibular glands are within normal limits. The thyroid is free of focal lesions.The cervical arterial structures are within normal limits. The left internal jugular vein has been resected.The bones of the cervical spine are unremarkable.
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Multiple new enhancing lesions as described in detail above worrisome for recurrent disease.
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Generate impression based on findings.
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43-year-old female with history of subarachnoid hemorrhage, evaluate for new hemorrhage There has been near complete interval resolution of previously demonstrated subarachnoid hemorrhage, with only a small portion remaining in the rightward basilar cisterns. There is no evidence of any mass effect, midline shift or hydrocephalus. The CSF spaces remain within normal for patient stated age. The gray/white matter differentiation is preserved. Calvarium and soft tissues of the scalp are unremarkable. Paranasal sinuses and mastoid air cells remain well pneumatized.
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There has been near complete interval resolution of previously demonstrated subarachnoid hemorrhage, with only a small portion remaining in the rightward basilar cisterns.
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Generate impression based on findings.
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72-year-old patient for further assessment of a small carotid aneurysm demonstrated on MRA. Unenhanced head: There is no intracranial mass, hemorrhage, edema or hydrocephalus. The midline is intact. There are secretions within the left frontal sinus. Remaining sinuses and mastoid cells are clear. Orbits are unremarkable.CT angiogram: There is a two-vessel arch wherein the left common carotid is the first branch from the right brachiocephalic. There is no ostial stenosis of the aortic branches or carotid/vertebral arteries bilaterally. Extracranial portions of the vertebral arteries demonstrate normal caliber and course. At the left carotid bifurcation there is a calcified plaque which results in 50% stenosis by NASCET criteria. The right carotid is normal including at its bifurcation where no stenosis is identified. There are no other extracranial steno-occlusive lesions.Intracranially, the examination confirms the presence of a 3.9 x 3.7 mm aneurysm (3.9 mm at neck) extending medially from the post-orbital portion of the cavernous carotid. There is a diminutive left A1 segment. Anterior cerebral and MCAs are otherwise normal bilaterally. There is no aneurysm or steno-occlusive lesion of the right ICA. Vertebral, basilar and PCAs demonstrate normal course and morphology. There is no steno-occlusive lesion or aneurysm. Following administration of contrast, the patient experienced hives. She was assessed by the resident physician on call (Dr. Lo) and discharged without requiring treatment. Instructions were given to seek care of a physician should symptoms worsen.
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1.3.9 x 3.7 mm aneurysm extending medially from the postorbital portion of the cavernous carotid. 2.Calcified plaque at the bifurcation of the left carotid with 50% stenosis of the internal carotid by NASCET criteria.3.The patient experienced hives following the examination which did not require intervention.
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Generate impression based on findings.
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50 year-old female with history of meningioma experiencing headache No detectable activity intracranial hemorrhage, edema, mass-effect, midline shift or hydrocephalus. Redemonstrated are changes from prior right frontal craniotomy with small foci of underlying parenchymal encephalomalacia in the right frontal cortex identical to prior study. The cortical sulci, ventricular system, CSF cisterns and gray/white matter differentiation is otherwise within normal limits. Limited images of the orbits, paranasal sinuses and mastoid air cells are unremarkable with the exception of a small mucous retention cyst again noted in the left maxillary sinus.
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1.No acute intracranial abnormality.2.Stable cortical encephalomalacia of right frontal lobe.
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Generate impression based on findings.
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43-year-old patient with headache. Rule out posterior bleed. No acute abnormality including intracranial hemorrhage, mass, edema or hydrocephalus. Paranasal sinuses and mastoids are aerated. There is no visualized fracture and orbits are unremarkable.CT angiogram: There is normal course and morphology and the intracranial portions of the carotid and vertebral arteries. Anterior and middle cerebral arteries demonstrate a normal pattern of branching. There is no aneurysm or steno-occlusive lesion demonstrated. Vertebral, basilar and posterior cerebral arteries demonstrate normal course and morphology. There is no aneurysm or stenotic lesion. Incidental note is made that posterior communicating arteries are not visualised bilaterally.
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No acute intracranial abnormality including hemorrhage. No vascular abnormality on CT including aneurysm or steno-occlusive lesion.
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Generate impression based on findings.
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51 year old female status post proctocolectomy with end ileostomy, now with upper abdominal pain and decreased stoma output, leukocytosis. ABDOMEN:LUNG BASES: Left basilar scarring/atelectasis.LIVER, BILIARY TRACT: Subcentimeter hypodensity in the right lobe incompletely characterized but likely benign cyst (series 4, image 31). Diffuse low-attenuation of liver parenchyma suggestive of hepatic steatosis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophy of left kidney. Hypoattenuating lesions in both kidneys, most likely benign cysts. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large hiatal hernia.Loculated fluid collection in anterior peritoneal cavity with associated small foci of internal gas and thickened wall, most consistent with abscess given history of leukocytosis. This collection measures approximately 2 cm in AP dimension and 10 cm in craniocaudal extent. Mild wall thickening of adjacent bowel loops is likely reactive in nature or spread of infection (series 4, image 93). No evidence of obstruction.Left lower quadrant ostomy in place. Status post proctocolectomy. BONES, SOFT TISSUES: Post surgical changes in the anterior abdominal wall.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Small amount of gas in the bladder may be due to recent instrumentation.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Status post proctocolectomy. Percutaneous pelvic surgical drain is in place. There is stranding as well as several foci of gas in the perirectal fat, presumably postsurgical in nature.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Loculated fluid collection in anterior peritoneal cavity with associated small foci of internal gas and thickened wall, most consistent with abscess given history of leukocytosis.2.No evidence of obstruction.
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Generate impression based on findings.
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40 year old female with left flank pain. ABDOMEN:LUNG BASES: Minimal basilar atelectasis and pleural thickening.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No renal stones or other specific abnormality to account for symptoms.
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Generate impression based on findings.
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56-year-old male with history of urothelial cancer status post cystectomy/neobladder in 5/2013. Evaluate for recurrence or metastatic disease. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy. Diffusely decreased attenuation of parenchyma consistent with hepatic steatosis. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right pelvic kidney again noted.Previously seen areas of mild perinephric fat stranding around left kidney are not significantly changed, and likely infectious in etiology. Given lack of IV contrast, enhancement pattern of renal parenchyma and collecting system cannot be evaluated.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Foley catheter present in decompressed neobladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Residual oral contrast is present throughout the colon. Apparent wall thickening of sigmoid colon is likely due to collapsed lumen.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Due to presence of oral contrast throughout the colon, IV contrast was not administered. Patient will return after clearance of oral contrast to complete CT urogram study.2.Mild perinephric fat stranding around left kidney is not significantly changed from recent CT on 11/22/2013, suspected to be infectious in etiology.
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Generate impression based on findings.
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66-year-old female status post laparoscopic cholecystectomy converted to open on 11/18, now with open surgical wound, fevers, tachycardia, concern for surgical site infection. ABDOMEN:LUNG BASES: Bilateral small pleural effusions, right more than left, with overlying basilar consolidation/atelectasis.LIVER, BILIARY TRACT: Status post cholecystectomy, further described below.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild to moderate atrophy of kidneys bilaterally. Hypoattenuating lesions in both kidneys, most likely benign cysts. Multiple calcifications in renal hilum likely vascular in nature.RETROPERITONEUM, LYMPH NODES: Right calcifications in aorta and its branches. IVC filter noted. No significant adenopathy.BOWEL, MESENTERY: Moderate hiatal hernia.Extensive mottled foci of free intraperitoneal air with associated mesenteric fat stranding in the upper abdomen underlying the open abdominal wound, most consistent with infection. While no drainable fluid collection is identified, a relative large focus of free air with associated air-fluid level measures 3.5 x 1.7 cm, most consistent with infected fat necrosis and early abscess formation (series 3, image 43). Small amount of free fluid is seen around the liver. Gastrostomy tube is in place. No evidence of bowel obstruction.BONES, SOFT TISSUES: Diffuse anasarca. Severe degenerative changes in lower lumbar spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Left hip prosthesis. Diffuse anasarca.OTHER: No significant abnormality noted
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Mottled free air and mesenteric fat stranding in upper abdomen underlying open abdominal wound, most consistent with infection. While no drainable fluid collection is identified, a relative large focus of free air with associated air-fluid is most consistent with infected fat necrosis and early abscess formation.
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Generate impression based on findings.
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68 year-old female with altered mental status and subdural hemorrhage. There is a small hyperdense extra-axial collection overlying the right hemisphere measuring up to 7 mm in maximal depth, without significant underlying mass-effect. This was not present on the comparison study.Redemonstrated is patchy hypodensity in the periventricular white matter. The ventricles, sulci, and cisterns are prominent, representing volume loss, unchanged in extent. The gray-white matter differentiation is maintained. There is no mass effect, edema, or midline shift. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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There is a small subdural hemorrhage overlying the right hemisphere measuring up to 7 mm in maximal depth, without significant underlying mass-effect.
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Generate impression based on findings.
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63 year old female with AML, neutropenia, and right lower quadrant tenderness. ABDOMEN:LUNG BASES: Interval improvement in basilar ground glass and nodular opacities, most likely representing resolving aspiration/infection.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Multiple calcified granulomas.PANCREAS: No significant abnormality notedADRENAL GLANDS: Bilateral adrenal nodules, measuring 4.7 cm on the right and 1.1 cm on the left; these are nonspecific but not typical of adenomas given heterogeneity, large size, and attenuation measuring above 20 Hounsfield units.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is wall thickening and stranding affecting 9-cm segment of sigmoid colon, consistent with diverticulitis. No evidence of free peritoneal air, abscess, or obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Sigmoid diverticulitis, as described above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Sigmoid diverticulitis without evidence of complications.2.Bilateral adrenal nodules, largest on the right measuring 4.7 cm; these are nonspecific and incompletely evaluated on current exam, but not typical of benign adenomas. Given large size of right nodule, malignancy is suspected. 3.Improved basilar opacities compatible with resolving aspiration or infection. Findings were communicated to Dr. Darren King at 8:24 a.m., 11/25/2013
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Generate impression based on findings.
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55 year-old male with intracranial hemorrhage No significant interval change in the size of the hematoma within the left thalamus, cerebral peduncle, midbrain, pons and inferior cerebellar peduncle as well as at the ventriculostomy insertion site. There has been decrease in hemorrhage layering within the occipital horns. No new sites of hemorrhage are present. Right trans-frontal ventricular shunt catheter terminating in the right lateral ventricle, unchanged in position. The size of the ventricular system is unchanged.Persistent hypoattenuation within the right basal ganglia, thalamus and corona radiata. Patchy hypoattenuation in the cerebral white matter is unchanged. No midline shift or herniation. Persistent opacification of the paranasal sinuses likely secondary to intubation. New fluid is present within a few bilateral deep and mastoid air cells.
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1.No significant change in size and extent of intracranial hemorrhage.2.Decrease in hemorrhage layering within the occipital horns. 3.No significant interval change in the size of the ventricular system.
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Generate impression based on findings.
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42-year-old male patient with sinus tachycardia in history chest pain postop day two. Evaluate for a pulmonary embolus. PULMONARY ARTERIES: Technically limited study. No evidence of a pulmonary embolus to the segmental level. Main pulmonary artery size within normal limits.LUNGS AND PLEURA: Small left sided pleural effusion with associated atelectasis. Moderate-sized right pleural effusion with atelectasis.MEDIASTINUM AND HILA: Heart size within normal limits. No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy. Multilevel degeneration changes in the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Enteric tube coiled within the stomach, tip is not visualized. Status post Whipple with abdominal ascites and surgical drain in the upper abdomen.
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1.No evidence of a pulmonary embolus to the segmental level.2.Bilateral pleural effusions with associated atelectasis.3.Expected postsurgical changes in the upper abdomen.
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Generate impression based on findings.
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40 year-old female status post third ventriculostomy Postoperative changes of a right frontal approach ventriculostomy catheter with its tip located between the suprasellar cistern and intrapeduncular cistern, unchanged in position. Postoperative pneumocephalus and a small amount of subarachnoid hemorrhage in the right frontal lobe along the course of the catheter is not significantly changed. A small amount of intraventricular hemorrhage is unchanged. Enlargement of the lateral and third ventricles is similar to the prior exam.Well demarcated low attenuation cystic lesion in the midbrain and right thalamus with extension into the interpeduncular cistern and third ventricle is unchanged. Calvarial and skull changes compatible with prior shunt catheter placements. The visualized paranasal sinuses and mastoid air cells are clear.
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1.Right frontal ventriculostomy catheter unchanged in position with stable ventriculomegaly.2.Cystic lesion in right thalamus and midbrain is not significantly changed.3.Small amount of postoperative pneumocephalus, subarachnoid hemorrhage and intraventricular hemorrhage is unchanged.
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Generate impression based on findings.
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Female 46 years old; Reason: evaluate post surgical changes in pelvis History: lower abdominal pain s/p THA/BSO and recent intercourse ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Cholelithiasis without cholecystitis. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Nonspecific general haziness in the mesentery without frank blood or extravasation noted. No obstruction, free air, or abscess collection.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy and bilateral salpingo oophorectomy. BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace free fluid noted in the cul-de-sac.
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1.No acute intraabdominal pathology detected.
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Generate impression based on findings.
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Neoplasm of unspecified nature of brain,bleed, seizure The CSF spaces are appropriate for the patient's stated age with no midline shift. There is redemonstration of a 16 x 12 mm axial dimension hyperdense mass located in the left postcentral gyrus associated with vasogenic edema measuring approximately 60 by 55 mm axial dimensions it is unchanged since prior examThere is redemonstration of a small hypodense focus in the left superior frontal gyrus .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. Atherosclerotic calcifications are present along the distal internal carotid arteries.
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1.Redemonstration and no change in size of a left parietal lobe mass associated with vasogenic edema.2.There is a small left frontal lobe lesion which is also stable compared to prior exams
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Generate impression based on findings.
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Reason: hip pain History: hip pain Subchondral cysts at the sacroiliac joint and the femoral head at the level of the greater trochanter compatible with osteoarthritis. No evidence of fracture or malalignment. No soft tissue abnormalities.Note is made of vascular calcifications. Calcifications in the trochanteric bursa.
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No evidence of acute fracture or dislocation.
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Generate impression based on findings.
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69 year-old female with weakness The ventricles, sulci, and cisterns are symmetric and unremarkable. The cortical gray-white matter differentiation is maintained. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. Lens prostheses.
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No acute intracranial abnormality.
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Generate impression based on findings.
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Neoplasm of unspecified nature of brain,bleed, seizure The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a 16 x 12 mm axial dimension hyperdense mass located in the left postcentral gyrus associated with vasogenic edema measuring approximately 60 by 55 mm axial dimensions it is unchanged since prior MRI . It has changed character since the prior CT from 7/7/13 the extent of vasogenic edema is similar to 9/4/13. The hyperdense component is new but was probably present on the MRI of 11/20/13There is redemonstration of a small hypodense focus in the left superior frontal gyrus .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. Atherosclerotic calcifications are present along the distal internal carotid arteries.
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1.Redemonstration and no significant change in size of a left parietal lobe mass associated with vasogenic edema when compared to the recent MRI. On the prior CT from September this was hypodense whereas on the current CT this hyperdense indicating that this contains blood products which developed in the interim, however it is very similar to its MRI appearance from 11/20/13 given differences in modality.2.There is a small left frontal lobe lesion which is also stable compared to prior exams
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Generate impression based on findings.
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61-year-old female with left lower quadrant abdominal pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: IVC filter with expected position and appearance. No adenopathy, masses or retroperitoneal abnormal collections.BOWEL, MESENTERY: Orally administered contrast rapidly progresses to normal-appearing stomach, small bowel, and, to the colon without obstruction or intrinsic abnormality. No free mesenteric fluid. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Multiple calcified masses consistent with fibroid tumors. Intrauterine high density coiled structure seen. BLADDER: No significant abnormality noteddLYMPH NODES: No significant abnormality noteddBOWEL, MESENTERY: No significant abnormality notedd -- normal appendix seen without inflammatory changes are associated inflammatory changes in the right lower quadrant. No significant diverticular changes and no evidence of diverticulitis in the colon. No free mesenteric fluid seen.BONES, SOFT TISSUES: Degenerative changes seen about the hips bilaterally. Diffuse disk disease and degenerative posterior element changes about the lumbar spine.OTHER: No significant abnormality notedd
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1. No findings seen to account for patient's symptomatology.
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Generate impression based on findings.
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Reason: 60 female with AML, r/o baseline infiltrate History: AML LUNGS AND PLEURA: Mild paraseptal emphysema.MEDIASTINUM AND HILA: Coronary calcification.CHEST WALL: Postop change right axilla and right breast. Soft tissue thickening surrounding right breast clips. Please dedicate with dedicated breast imaging.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense left adrenal nodule consistent with an adrenal adenoma. Nonspecific wall thickening involving the gallbladder seen only on last images (image 98/98) incompletely evaluated.
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1. No acute cardiopulmonary abnormality.2. Soft tissue thickening surrounding clips at right lumpectomy site. Correlation with dedicated breast imaging is recommended.
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Generate impression based on findings.
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66 year old female, abdominal pain, epigastric. Evaluate for obstruction. ABDOMEN: Lack of intravenous contrast limits the evaluation of abdominal organs.LUNG BASES: Bibasilar atelectasis. Small amount of pericardial fluid, similar to prior exam. LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal hyperattenuating focus appears similar to prior exam. Hypoattenuating lesion left inferior renal pole is unchanged, most likely representing a cyst.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Once again seen is diffuse small bowel dilatation with distally collapsed small bowel, with transition in the right lower quadrant (image 83, series 3) with similar appearance and distribution compared to prior exam. No mesenteric fluid is seen. Left lower quadrant colostomy is again seen. There is a ventral hernia containing a loop of small bowel without evidence of complication.BONES, SOFT TISSUES: Spinal fixation hardware involving L4 and L5 appearing similar to prior exam.OTHER: Mild body wall anasarca.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Once again seen is diffuse small bowel dilatation with distally collapsed small bowel, with transition in the right lower quadrant (image 83, series 3) with similar appearance and distribution compared to prior exam. No mesenteric fluid is seen. Left lower quadrant colostomy is again seen. There is a ventral hernia containing a loop of small bowel without evidence of complication.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Mild body wall anasarca.
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Findings consistent with chronic small bowel obstruction which is not significantly changed compared to 11/9/13 examination. Obstruction most likely due to adhesions given the presence of surgical sutures in the right lower quadrant.
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