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Generate impression based on findings.
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69-year-old male patient with history of anaplastic thyroid cancer. Please evaluate for progressive disease. CHEST:LUNGS AND PLEURA: Stable bibasilar subsegmental atelectasis and scarring and mild centrilobular emphysema. Marked interval increase in 6-mm nodule in the right lower lobe (series 6 image 55).MEDIASTINUM AND HILA: Cardiac size within normal limits without pericardial effusion. Mild coronary artery calcifications. Mild atherosclerotic changes of the thoracic aorta.Stable mildly enlarged mediastinal lymph nodes with right upper paratracheal node measuring 10 mm (series 4 image 21), unchanged.Left-sided PICC with catheter tip in the superior vena cava near the confluence of the left and right brachiocephalic veins.There is interval increase in size of the soft tissue and fluid dense lesion in the subcutaneous fat of the lower neck and right chest wall, consistent with a seroma or hematoma. Please refer to dedicated CT neck for complete evaluation.CHEST WALL: No axillary lymphadenopathy.Moderate multilevel degenerative changes in the thoracic and lumbar spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesion at the dome of the liver is too small to characterize and likely resents a cyst.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy. Left kidney with multiple subcentimeter hypoattenuating lesions consistent with cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic changes of the abdominal aorta and its branches. No significant retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Surgical clips in the right lower quadrant.
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1.Marked interval increase in size of right lower lobe nodule. Given rate of growth, nodule may be an intrapulmonary lymph node or inflammatory in etiology. The rate of growth is unusually rapid for a metastatic lesion. Recommend further follow-up.2.Stable mildly enlarged mediastinal lymph node.
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Generate impression based on findings.
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52-year-old male patient with head and neck cancer status post CRT in 2011. Please evaluate for recurrent disease and compare to previous scans. CHEST:LUNGS AND PLEURA: Stable nonspecific scattered micronodules, some of which are calcified. Bilateral dependent atelectasis and scarring. No suspicious pulmonary nodules.MEDIASTINUM AND HILA: Heart size within normal limits without pericardial effusion. Mild coronary artery calcifications.No mediastinal or hilar lymphadenopathy.CHEST WALL: Mild multilevel degenerative changes in the thoracic spine. No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic changes in the abdomen aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Mild distal colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Mild multilevel degenerative changes in the thoracic spine.OTHER: No significant abnormality noted.
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No specific evidence of metastatic disease.
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Generate impression based on findings.
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75 year-old male with new inability to cross gaze midline. The previously seen left basal ganglia hematoma has largely resolved. There is large hypodensity in the area. The intraventricular and subarachnoid hemorrhages have also significantly decreased, with residual in the occipital horns and parietal and occipital subarachnoid space. There is no new hemorrhage. There is no mass effect or midline shift. The ventricles, sulci, and cisterns are mildly prominent, representing volume loss. There is scattered hypodensity in the periventricular white matter, likely small vessel ischemic disease. The osseous structures are unremarkable. The paranasal sinuses are clear except for sphenoid sinus mucosal thickening. There is opacification of the mastoid air cells. The orbits are unremarkable.
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Significant interval decrease of intracranial hemorrhages as above. No new hemorrhage or mass effect.
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Generate impression based on findings.
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52 years old male with metastatic thyroid cancer, on therapy. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Limited view of the intracranial structure is unremarkable. The aerodigestive tract is unremarkable.The right parotid gland has been partially resected, a stable finding. The left parotid gland and submandibular glands are unremarkable.The thyroid gland has been resected and the appearance of the surgical bed is unchanged. No concerning findings for recurrent disease are seen.No pathologic adenopathy is detected in the neck by size criteria.Pulmonary nodes are seen in the upper lobes. No bony lesions are seen.
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Stable exam with no evidence of recurrent disease or adenopathy in the neck.
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Generate impression based on findings.
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46 year-old male with altered mental status. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. 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 except for opacification of the left sphenoid sinus.
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No acute intracranial abnormality. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists.
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Generate impression based on findings.
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66 year-old male status post fall. There is patchy hypoattenuation in the cerebral white matter. There are foci of hypodensity in the right internal capsule genu and left cerebellum. The ventricles, sulci, and cisterns are symmetric and moderately prominent. The gray-white matter differentiation is normal. 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.
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1. No acute intracranial abnormality. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 2. Moderate small vessel ischemic disease of indeterminate age. Age indeterminate lacunar infarcts in the right internal capsule genus and left cerebellum. Moderate brain volume loss.
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Generate impression based on findings.
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48 year-old female with altered mental status. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. 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 except for right maxillary sinus retention cyst.
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No acute intracranial abnormality.
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Generate impression based on findings.
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48 year old female. Reason: r/o perforation vs abscess History: acute abdominal pain ABDOMEN:LUNG BASES: Mild bibasilar dependent atelectatic changes.LIVER, BILIARY TRACT: Subcentimeter hepatic hypodensities are compatible with small cysts or hemangiomas.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted. No nephrolithiasis, hydronephrosis or hydroureter.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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No specific abnormality to explain acute abdominal pain.
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Generate impression based on findings.
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39-year-old male with pancreatic cancer, restaging exam. Reason: Determine extent of pancreatic cancer and whether it can explain recent clinical suggestion of obstruction. History: constipation, abdominal pain, intractable nausea. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse hepatic steatosis. Segment 4 hypoattenuating lesion measures 1.5 x 1.0 cm (image 25, series 3), stable. Cholelithiasis. The gallbladder is collapsed.SPLEEN: No significant abnormality notedPANCREAS: Pancreatic mass measures 3.3 x 4.4 cm (image 51, series 3), stable. Infiltration of the surrounding mesentery suggests local invasion. There is encasement of the SMA, SMV and proximal splenic artery. The splenic vein is occluded.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple retroperitoneal sub-centimeter lymph nodes are noted.BOWEL, MESENTERY:Mild diffuse mesenteric fat infiltration. No bowel obstruction. No pneumatosis, portal venous gas or pneumoperitoneum.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: Small amount of pelvic free fluid. No loculated fluid collections..
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Stable findings. No bowel obstruction.
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Generate impression based on findings.
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19 year old male. Reason: appy? History: abd pn 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. No bowel obstruction. The appendix is not well visualized due to overlying bowel loops. No focal inflammatory changes in the right lower quadrant.Mild diffuse mesenteric fat stranding with a small amount of ascites. This finding is nonspecific, but may represent developing colitis/enteritis or less likely pancreatitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: There is a small amount of ascites.PELVIS: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: Pelvic free fluid. Minimal ascites.
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Small amount of ascites. Small amount of mesenteric fat stranding. Findings may represent enteritis or pancreatitis. No bowel obstruction. No definite signs of appendicitis.
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Generate impression based on findings.
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77-year-old male. Reason: UC s/p colectomy with ostomy, prostate cancer s/p prostatectomy, c/o emesis of ? fecal matter, abdominal pain, eval for obstruction ABDOMEN:LUNG BASES: Ovoid 2.4 cm diameter low attenuation area at the right lung base adjacent to the right atrium (image 6, series 4) is unchanged from studies dating back to March of 2013 and may represent loculated fluid.LIVER, BILIARY TRACT: Left hepatic lobe cyst is unchanged. Numerous subcentimeter hepatic hypodensities most likely represent simple cysts.SPLEEN: No significant abnormality notedPANCREAS: Atrophic pancreas with fatty infiltration.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post total colectomy. Right lower quadrant ileostomy. There is concentric wall thickening involving small bowel loops in the left upper quadrant. This appearance is not specific and could be inflammatory or less likely ischemic in origin. There is no bowel obstruction. There are multiple mildly dilated small bowel loops, some with angulation suggesting low-grade effusions similar to prior examinations. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Post prostatectomy.BLADDER: Foley catheter in a decompressed urinary bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No bowel obstruction. Right lower quadrant ostomy. Status post total colectomy and proctectomy.BONES, SOFT TISSUES: Penile prosthesis noted with reservoir within the pelvis. Degenerative changes in the lumbosacral spine and pelvis.OTHER: Status post left inguinal hernia repair.
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Low-grade adhesions of small bowel without acute obstruction.Stable abnormality at the right lung base medially.
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Generate impression based on findings.
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55 year old female. Reason: Please perform with cirrhosis protocol; patient with OLT and rising LFTs; liver biopsy with improving rejection but LFTs still rising. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Normal OLT hepatic morphology. No hepatic steatosis or a focal parenchymal lesions are identified. No intrahepatic or extrahepatic biliary duct dilatation. Pneumobilia. Patent main portal vein and hepatic artery. Status post cholecystectomy.SPLEEN: Mild splenomegaly. The spleen measures 13.5 cm in length. Splenic artery aneurysm measures 12 mm in diameter.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nonobstructing punctate left renal calculus. Asymmetric kidneys with left kidney moderately atrophic.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. No mesenteric fat stranding.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No free or loculated fluid collections. Fat-containing ventral hernia neck is 5 cm in diameter on sagittal image 35.PELVIS: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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Splenic artery aneurysm. Normal OLT hepatic morphology. Mild splenomegaly. Mildly atrophic left kidney. Fat-containing ventral hernia.
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Generate impression based on findings.
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79 year old male with chest AVM s/p resection and chest wall recon, s/p washout of surgical site with known residual extrapleural air/fluid level. Please assess for infectious source. History: hypothermia, hyperglycemia, abdominal pain. LUNGS AND PLEURA: Status post right lung wedge resection and partial resection of the posterior chest wall on the right. Stable right posterior paramediastinal air collection adjacent to the suture line. Although no bronchopleural fistula is identified, the air leak most likely arises from the suture line.Surgical changes in the right hemithorax after right lung wedge resection and resection of the posterior chest wall. Interval decrease and partial resolution of the previously described fluid collection with multiple air foci in the right upper pleural space and subcutaneous tissue around the scapula. Most of the right upper lobe in the right apex remains consolidated. Heterogeneous fluid collection persists, located posteriorly within the thorax and extending inferiorly. Small loculated right pleural effusion. The remainder of the right lung appears stable.Reexpansion of the left lower lobe with minimal pleural effusion with fluid tracking along the fissures. The small pulmonary nodule in the left upper lobe is stable.MEDIASTINUM AND HILA: Tracheostomy tube in the expected position. Heart size is normal. Mild atherosclerotic calcifications of the coronary arteries and aorta. CHEST WALL: Anasarca. Soft tissue stranding and layering of fluid in the right posterior chest wall decreased from prior exam. Postsurgical changes to the right ribs are unchanged. Multiple chest wall venous collaterals. Right axillary lymphadenopathy is again noted and likely reactive. Two percutaneous drain tubes are seen coursing from the right axilla superomedially, the more cranial tube appears situated in the posterior soft tissues near the apex. The tip does not appear to be in communication with the right thoracic fluid collection. ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. A increased perfusion hepatic segment IVb which is possibly artifactual due to technique. The chest CT PE examination performed on 11/10/2013 does not show this abnormality. Small amount of perihepatic and pelvic ascites. Hepatomegaly. The liver measures more than 21 cm craniocaudally.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Enlarged mesenteric and retroperitoneal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted. No bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No loculated fluid collections to suggest abscess formation. Anasarca. Small amount of ascites.PELVIS:PROSTATE, SEMINAL VESICLES: The prostate is enlarged.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of pelvic ascites.
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1.Stable right subcutaneous and extrapleural fluid collection.2.Unchanged chest drain tubes on the right. Hepatomegaly.3.No acute abnormality to explain infectious source.
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Generate impression based on findings.
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60 year old male. Reason: s/p stem cell transplant with persistent candidemia and abd distension, please evaluate for source of fungal infection. Some scrotal pain as well, please evaluate to level of scrotum. History: candidemia Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. ABDOMEN:LUNG BASES: Small right pleural effusion. Scattered punctate micronodules, some of which are calcified, are stable and presumably benign postinflammatory nodules. No new pulmonary nodules. LIVER, BILIARY TRACT: Small amount of perihepatic ascites.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Small amount of diffuse nonspecific mesenteric stranding without fluid collections.BOWEL, MESENTERY: No significant abnormality noted. No bowel obstruction. Normal appendix.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Anasarca. PELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Ovoid calcification in the left hemiscrotum measures 1 cm in greatest dimension. This are may be further evaluated with ultrasound examination, if indicated.
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Small right pleural effusion. No specific abnormality to explain persistent candidemia. The scrotolith on the left may be further evaluated with ultrasound.
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Generate impression based on findings.
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86 year old male. Reason: metastatic prostate CA, local recurrence, please eval inferior bladder/prostate mass and extent of metastasis. Also eval for pelvic/RP bleed CHEST:LUNGS AND PLEURA: Small right pleural effusion. Minimal left pleural effusion with associated compressive atelectasis.MEDIASTINUM AND HILA: Coronary artery calcifications. Atherosclerotic calcifications of the aorta. Calcified lymph nodes compatible with old granulomatous disease.CHEST WALL: Degenerative changes in the thoracolumbar spine. Sclerosis of T3 vertebral body is suspicious for metastasis, correlates with outside bone scan. ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. Punctate calcifications from old granulomatous disease.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild bilateral hydronephrosis.RETROPERITONEUM, LYMPH NODES: Left periaortic lymphadenopathy. Measures 2.5 x 2.7 cm at axial image 120 of series 3. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: An IVC filter is in expected position. Degenerative changes in the thoracolumbar spine. Numerous midline surgical skin staples and surgical clips in the abdominal wall.OTHER: There is diffuse thickening of the body wall in the left flank posterolaterally extending into the pelvis. This is best seen on coronal image 32. This most likely represents a hematoma.PELVIS:PROSTATE, SEMINAL VESICLES: A Foley catheter is present within the prostate extending to the urinary bladder.BLADDER: The urinary bladder is decompressed with both a Foley catheter and a suprapubic tube. Adjacent to the Foley catheter balloon there is a collection which measures 2 x 5 cm at image 173 of series 3. On noncontrast CT this radiodense collection is indicative of acute hemorrhage.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: There are degenerative changes in the lumbosacral spine and pelvis. Diffuse sclerosis of S1 vertebral segment (sagittal image 56) correlates with the positive outside bone scan of 11/7/2013. There is supra-acetabular sclerosis on coronal image 30 that correlates with the positive outside bone scan of 11/7/2013. OTHER: There is gas and loculated fluid in the pelvic midline at axial image 181 of series 3 extending into the left flank and superiorly. Some of this gas is may be from recent surgical procedure while the loculated fluid collection containing gas is suggestive of a midline abscess which measures 2.5 x 11.3 cm. Multiple surgical skin staples are present. A second collection containing numerous gas bubbles is present in the left anterior pelvic wall at image 25 of series 3 and measures 2.6 x 7.6 cm.
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Acute bladder hemorrhage. Midline and left sided pelvic wall phlegmon and abscess. Left lateral abdominal wall hematoma extends superiorly. Left periaortic lymphadenopathy. Multiple areas of bony sclerosis are positive on outside bone scan (11/7/2013), compatible with metastases.
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Generate impression based on findings.
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55 year old female. Reason: eval for pancreatitis History: epigastric pain ABDOMEN:LUNGS BASES: Calcific granuloma in the lingula. No basilar pleural effusions.LIVER, BILIARY TRACT: Status post cholecystectomy. No biliary ductal dilatation. Subcentimeter hypodense segment 7 lesion is too small to characterize. Hepatic vasculature are patentSPLEEN: Splenic granulomataPANCREAS: No significant abnormality noted. No peripancreatic inflammatory fat stranding or fluid collections. No pancreatic parenchymal findings to suggest necrosis.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Appendix is normal in caliber. No surrounding inflammatory changes.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.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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No evidence of acute appendicitis. No evidence of acute pancreatitis. No specific abnormality to explain epigastric pain.
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Generate impression based on findings.
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59 year old female. Reason: evaluate RUQ, obstruction History: RUQ/epigastric abdominal pain, nausea, vomiting ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No cholelithiasis or cholecystitis. No evidence of hepatic steatosis. Subtle hypoattenuating subcentimeter hepatic lesions are incompletely characterized on this noncontrast study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. No evidence of bowel obstruction. No mesenteric fat stranding.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No abdominal free fluid or loculated collections.PELVIS: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 specific acute abnormality to explain right upper quadrant and epigastric abdominal pain.
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Generate impression based on findings.
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23 year old male. Reason: eval for dissection, pulm contusion History: trauma CHEST:LUNGS AND PLEURA: Scattered small focal ground glass and patchy lung opacities, predominately at the lingula medially and right lower lobe medially may represent contused lung or small amount of aspiration in a patient with altered mental status. Pulmonary contusion is most likely possible etiology.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Linear lucency in the left sixth rib may represent an acute fracture. Seen best on axial image 71 of series 3. Clinical tweedy correlate for point tenderness.UPPER ABDOMEN: No significant abnormality was found. The thoracic aorta and major vessels are widely patent. No evidence of aneurysm or dissection.
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A small amount of diffuse lung opacity in the lingula and RLL of uncertain significance. Possible left sixth rib fracture. No pneumothorax. No aortic or vascular abnormality.
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Generate impression based on findings.
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72 year old male. Reason: please evaluate etiology of hematuria by performing a CT urogram. History: hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Small right adrenal mass measures 1.4 cm in diameter at the axial image 48 of series 9. Most likely a benign adenoma.KIDNEYS, URETERS: 3.3-cm diameter cystic mass at the left renal hilum enhances with IV contrast compatible with a primary neoplasm. This most likely represents a cystic renal cell carcinoma.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: Enlarged prostate.BLADDER: Marked prostate enlargement. The prostate measures 7.4 x 8.7 cm axial image 132 of series 9. Urinary bladder is otherwise unremarkable.LYMPH NODES: Several enlarged and borderline enlarged left-sided lymph nodes are present including 1.3 cm diameter it coronal image 76, left obturator node measuring 1.9 cm in greatest dimension at coronal image 77 and common iliac lymph node measuring 1.6 cm in greatest dimension it coronal image 68. Left external iliac lymph node measures 1.5 cm in longitudinal dimension at axial image 117 of series 9.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes in the lumbosacral spine and pelvis.OTHER: No significant abnormality noted
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Cystic left renal neoplasm suspicious for renal cell carcinoma. Enlarged prostate. Cholelithiasis.
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Generate impression based on findings.
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Female 54 years old; Reason: GIST follow up, neurofibromatosis. CHEST:LUNGS AND PLEURA: Multiple scattered pulmonary nodules. No dominant lung lesion. Pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy. Main pulmonary artery is dilated.CHEST WALL: Multiple body wall cutaneous nodules. Multiple bilateral thyroid nodules.ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. No suspicious hepatic lesions. Hepatic and portal veins are patent. No biliary ductal dilatation.SPLEEN: No significant abnormality noted. The 6 mm splenule in the herniated omental fat is unchanged. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right kidney enhances homogeneously. Small fatty lesion along its posterior aspect is unchanged and likely represents a small angiomyolipoma.Cortical scarring of the left kidney with areas of atrophy. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Post operative changes in the jejunum with stable patulous distention at the anastomosis. No focal mass is evident. BONES, SOFT TISSUES: Elevation of the left hemidiaphragm with herniation of the stomach and liver into the left chest postoperative defect. There is a left anterolateral body wall hernia containing nonobstructed bowel, seen best on coronal image 57.Multiple body wall superficial cutaneous nodules compatible with history of neurofibromatosis.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Centrally calcified mass anterior to the right iliopsoas muscle measures 2.1 x 1.8 cm on image 154/series 3, unchanged.BONES, SOFT TISSUES: Expansile lesion involving the right sacral neuroforamen is unchanged and likely represents a dilated nerve sheath. Numerous cutaneous nodules.OTHER: No significant abnormality noted.
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Stable exam without measurable metastatic disease.
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Generate impression based on findings.
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Female 54 years old; Reason: Stage II carcinosarcoma of the uterus, S/P 6 cycles Taxol/Carbo on GOG 261. Please assess current disease status and compare with previous scans. CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. No suspicious nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion.CHEST WALL: Right-sided port with tip at the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodensity is unchanged and too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Status post lymph node dissection retroperitoneum without recurrent lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes in the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS: UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Punctate sclerotic foci in the right iliac wing is unchanged. Moderate degenerative changes of the lumbar spine.OTHER: No significant abnormality noted.
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Stable exam without evidence of residual or metastatic disease.
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Generate impression based on findings.
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68 year-old male. Patient with history of penile cancer, currently being treated with Carbo/Taxol chemotherapy. Assess for disease progression. CHEST:LUNGS AND PLEURA: Calcified lung granulomas. No suspicious pulmonary nodules or masses are identified. Right apical bulla.MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes, unchanged. Severe coronary artery calcifications.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Calcified splenic granulomata. PANCREAS: 2.2 x 2.5 cm hypodense lesion in the pancreatic head is not significantly changed. This mass is nonspecific but may represent a primary pancreatic cystic neoplasm such as an IPMN. No pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left lower pole cyst. No hydronephrosis. RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta. No retroperitoneal lymphadenopathy .BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate with a prominent median lobe. BLADDER: Bladder is displaced by new left pelvic sidewall cystic nodule.LYMPH NODES: Reference right inguinal necrotic lymph node measures 3.8 x 2.5 cm (series 3, image 185) has increased in size. All of the right groin cystic nodes have increased in size (coronal image 54) BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Geographic lucency in the right ilium adjacent to the SI joint without cortical breakthrough, is unchanged (series 3, image 146). OTHER: New cystic mass at the left pelvic sidewall adjacent to the bladder has developed, measuring 6.5 x 3.5 x 4.4 cm (axial image 169, series 3 and coronal image 43).
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1. Increased size of reference right inguinal necrotic lymph nodes. New left pelvic sidewall cystic lesion.2. Unchanged hypodense pancreatic head lesion, nonspecific, but may represent a primary pancreatic cystic neoplasm. Recommend MRCP for further evaluation, if indicated.
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Generate impression based on findings.
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41 year old male. Reason: renal cell cancer s/p nephrectomy, evaluate for recurrence. CHEST:LUNGS AND PLEURA: Bilateral micronodules are too small to characterize. None larger than 3 - 4 mm. MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post right nephrectomy. 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: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Transitional L5 with left sided sacralization. OTHER: No significant abnormality noted
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No measurable metastatic disease. No local recurrence.Status post right nephrectomy.
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Generate impression based on findings.
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73 year old female. Reason: evaluate for source of presumed primary malignancy History: diffuse back pain, MRI findings of lytic lesions and fractures. Multiple sacral decubitus ulcers, rising white count. Subtrochanteric fracture of the left femur, presumably pathologic with innumerable lesions highly suspicious for diffuse metastatic disease. CHEST:LUNGS AND PLEURA: Diffuse pleural thickening, loculated effusion and left lung volume loss in the left hemithorax with associated mediastinal shift.MEDIASTINUM AND HILA: Aortic root calcification.CHEST WALL: Innumerable predominantly lytic skeletal lesions of varying size compatible with diffuse metastases. 4 x 4 cm solid lesion in the right posterior chest wall and rib at axial image 50 series 3.ABDOMEN:LIVER, BILIARY TRACT: Layering density within the gallbladder is suggestive of sludge.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Benign-appearing simple renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: Foley catheter in a decompressed urinary bladder.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Nonobstructed bowel in a large right inguinal hernia. BONES, SOFT TISSUES: There is an associated 5 x 6 cm mass at image 195 of series 3 adjacent to the subtrochanteric fracture of the left femur. A lytic metastasis is present in the right femoral neck and axial image 192 of immanent orthopedic significance.OTHER: No significant abnormality noted.
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Diffuse predominantly lytic skeletal metastases. 4-cm diameter mass in right chest wall. Loculated left pleural effusion, pleural thickening and volume loss. Subtrochanteric fracture of left femur with associated mass.
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Generate impression based on findings.
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76 year-old female with headache. There is patchy hypoattenuation in the cerebral white matter. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. Basal ganglia calcification. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. Arterial calcification. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial abnormality. Small vessel ischemic disease of indeterminate age. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists.
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Generate impression based on findings.
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18 year-old female with headache. There appears subtle hypoattenuation in the bilateral occipital lobes (images 14-16 of series 5). The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The mastoid air cells are clear. The paranasal sinuses are small, with opacification of the left maxillary sinus.
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1. No acute intracranial hemorrhage. 2. Subtle hypoattenuation in the bilateral occipital lobes. MRI is recommend for further evaluation.
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Generate impression based on findings.
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44 year-old male with midline tenderness after MVC. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. 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. There is straightening of the cervical lordosis. The cervical spine alignment is anatomic. The vertebral bodies, dens, lateral masses, pedicles, lamina, facets, and posterior elements are intact with no evidence of fracture or subluxation. Within the limits of CT scanning, the thecal sac and spinal cord are preserved with no evidence of spinal canal stenosis. The intervertebral disk spaces are preserved. The paraspinal soft tissues are unremarkable.There are prominent osteophytes along the ventral vertebral bodies of C4-C7. The prevertebral soft tissues are unremarkable. Degenerative changes are specified by the intervertebral level as follows: C2-C3: minimal disc bulge; no neuroforaminal narrowing or spinal stenosis. C3-C4: shallow central disc protrusion; no neuroforaminal narrowing or spinal stenosis. C4-C5: central disc protrusion; partial loss of disc height; osteophytes; moderate right and mild left neuroforaminal narrowing; no spinal stenosis. C5-C6: disc osteophyte complex; partial loss of disc height; moderate right and mild left neuroforaminal narrowing; minimal spinal stenosis. C6-C7: mild disc bulge; no neuroforaminal narrowing or spinal stenosis. C7-T1: no neuroforaminal narrowing or spinal stenosis.
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1. No acute intracranial abnormality. 2. No evidence of cervical spine fracture or subluxation, if spinal cord or ligamentous injury is suspected MRI is recommended.3. Mild degenerative disc disease.
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Generate impression based on findings.
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23 year-old male with trauma. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. 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. Chronic blowout fracture of the right lamina papyracea. There is normal cervical lordosis. The cervical spine alignment is anatomic. The vertebral bodies, dens, lateral masses, pedicles, lamina, facets, and posterior elements are intact with no evidence of fracture or subluxation. Within the limits of CT scanning, the thecal sac and spinal cord are preserved with no evidence of spinal canal stenosis. The neural foramen are patent. The intervertebral disk spaces are preserved. The paraspinal soft tissues are unremarkable.Right apical emphysema.
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1. No acute intracranial abnormality. 2. No evidence of cervical spine fracture or subluxation, if spinal cord or ligamentous injury is suspected MRI is recommended.3. Chronic blowout fracture of the right lamina papyracea.
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Generate impression based on findings.
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77 year-old male with altered mental status. Since prior exam, there has been development of multifocal hypodensity in the right frontal and parietal cortices and subcortical white matter,specifically the precentral, superior frontal, middle frontal, angular, superior parietal and minimal postcentral gyri. There are loss of gray white differentiation and sulcal effacement. There is no CT evidence of hemorrhage or midline shift. There is patchy hypoattenuation in the cerebral white matter. The ventricles and cisterns are symmetric and unremarkable. The osseous structures are unremarkable. The mastoid air cells are clear. Extensive post surgical changes in the paranasal sinuses are compatible with prior endoscopic sinus surgery.
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1. Findings are consistent with acute infarct in the right MCA territory. There is no CT evidence of hemorrhage or midline shift. 2. Mild small vessel ischemic disease.
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Generate impression based on findings.
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89 year-old male status post fall. There is right periorbital and preseptal soft tissue swelling and emphysema, suggesting laceration. There is patchy hypoattenuation in the cerebral white matter. There is focus of hypoattenuation in the right thalamus. The ventricles, sulci, and cisterns are symmetric and prominent. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. Arterial calcification. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. There is a lipoma in the left temporal scalp.
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1. No acute intracranial abnormality. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 2. Moderate small vessel ischemic disease of indeterminate age. Moderate brain volume loss. Age indeterminate lacunar infarct in the right thalamus. 3. Right periorbital and preseptal soft tissue swelling and emphysema, suggesting laceration.
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Generate impression based on findings.
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8 day female with body stiffness. There is small amount of subdural hemorrhage along tentorium. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. 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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Small amount of subdural hemorrhage along tentorium.
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Generate impression based on findings.
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59-year-old female status post laparoscopic partial gastrectomy June 2008. The patient had a gastrointestinal stromal tumor. Reason: r/o appendicitis History: abdominal pain ABDOMEN:LUNG BASES: Bilateral dependent atelectasis. No pulmonary masses or suspicious pulmonary nodules. No pleural or pericardial effusions.LIVER, BILIARY TRACT: Normal hepatic morphology without biliary ductal dilatation. Scattered subcentimeter hypodensities are too small to characterize; unchanged. Larger hypoattenuating lesion adjacent to the IVC in segment VI seen on the prior exam is difficult to separate in a noncontrast study. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Faint radiodensity in both renal collecting systems and ureters are due to recent contrast enhanced CT scan examination at outside hospital.RETROPERITONEUM, LYMPH NODES: No large retroperitoneal lymphadenopathy. Minimal atherosclerotic calcification of the abdominal aorta without aneurysmal dilatation.BOWEL, MESENTERY: Postsurgical changes from a prior gastric resection with surgical clips/sutures noted. There is a duodenal diverticulum.Since the 6/27/2012 exam, there is wall thickening and cranial displacement of the terminal ileum with non-filling of the appendix in the right lower quadrant. The appendix was seen on the prior exam (coronal image 33, axial image 108 of series 4). Adjacent to the appendix on the present exam is a large blind ended cavity filled with enteric contrast that communicates with the colon (axial image 121, series 3, coronal image 49) suggestive of a contained perforation and associated inflammatory changes, new since 2012. The adjacent appendix and terminal ileum wall are thickened. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Enlarged uterus containing a uterine fibroid is grossly unchanged. Bilateral adnexal cystic lesions are similar in appearance to the prior examination and are likely physiologic.BLADDER: Residual iodinated contrast in the urinary bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: New extensive inflammatory changes with wall thickening and displacement of bowel loops at the cecum and terminal ileum in the right lower quadrant. Findings suggest appendicitis and contained perforation. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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New RLQ inflammatory changes compatible with acute appendicitis and probable contained perforation. Otherwise stable examination without specific findings suggestive of metastatic or recurrent disease.
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Generate impression based on findings.
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55 year-old male with clamped EVD. There has been removal of the right frontal approached EVD. The hemorrhage extends through the left thalamus, extending through the left cerebral peduncle, midbrain and cerebellar peduncle has been attenuated. A second focus at the insertion site of the EVD with in the right frontal lobe has been less. Intraventricular hemorrhage layers bilaterally has been unchanged. No new hemorrhage. There has been no interval change in dimension of the ventricular system and there is no mass effect including midline shift or herniation.There is unchanged patchy hypoattenuation within the cerebral white matter bilaterally as well as the basal ganglia and thalami. Secretions layering within the ethmoid, sphenoid, and right maxillary sinus are unchanged. There is scattered opacification of mastoid air cells. Orbits are unremarkable.
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Interval removal of the right frontal EVD. Stable residual intracranial hemorrhages as described above. No new hemorrhage. Stable ventricular size. Stable thalamic, basal ganglial and cerebral white matter hypodensities.
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Generate impression based on findings.
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74 year-old male with confusion. Periventricular hypoattenuation is a non-specific finding which most commonly represents age-indeterminate small vessel ischemic disease. Extensive intracranial arterial atherosclerotic calcification is noted affecting both the anterior and posterior circulations.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. 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. Small vessel ischemic disease of indeterminate age. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists.
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Generate impression based on findings.
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23 year-old female with facial trauma. The mastoids are clear. Limited view of the intracranial structure is unremarkable. The globes, lenses, extraocular muscles, optic nerves, and retroglobal spaces are symmetric and normal. No radiopaque foreign body is identified. The orbital soft tissues are normal. The osseous structures are unremarkable with no evidence of fracture. The maxilla, mandible, sphenoid boned, nasal bones, zygoma, hard palates, pterygoid plates, visualized cervical spine and TMJs are intact, without fracture. There is mild left cheek and periorbital soft tissue swelling. There is minimal mucosal thickening in the left maxillary sinus and right frontal sinus. The frontal sinuses, frontal-ethmoid recesses, anterior/posterior ethmoids, sphenoid sinuses, and maxillary sinuses are well developed and clear. The osteomeatal complexes are normal with intact uncinate processes and patent infundibuli. The intersphenoid septum is normal. The nasal turbinates and nasal septum are normal. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable.
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Mild left cheek and periorbital soft tissue swelling. No evidence of orbital or maxillofacial bone fracture.
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Generate impression based on findings.
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73 year-old female with hypertension. There is mild patchy hypoattenuation in the periventricular white matter. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. 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.
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No acute intracranial abnormality. Mild small vessel ischemic disease of indeterminate age. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists.
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Generate impression based on findings.
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86 year-old female status post fall and left sided headache. There is patchy hypoattenuation in the cerebral white matter. The ventricles, sulci, and cisterns are symmetric and prominent. The gray-white matter differentiation is normal. 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. There is normal cervical lordosis. The cervical spine alignment is anatomic. The vertebral bodies, dens, lateral masses, pedicles, lamina, facets, and posterior elements are intact with no evidence of fracture or subluxation. Within the limits of CT scanning, the thecal sac and spinal cord are preserved with no evidence of spinal canal stenosis. The paraspinal soft tissues are unremarkable.There are multilevel disc osteophyte complexes from C4 to C7 with neuroforaminal narrowing. There is loss of disc space and fusion of C5 and C6. Apical emphysema.
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1. No acute intracranial abnormality. 2. No evidence of cervical spine fracture or subluxation, if spinal cord or ligamentous injury is suspected MRI is recommended.3. Moderate small vessel ischemic disease of indeterminate age. Moderate brain volume loss. 4. Degenerative changes of the cervical spine.
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Generate impression based on findings.
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19 year old female. Reason: eval for appy, pyelo History: rlq 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 noted. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. The appendix is not well visualized. Small amount of free fluid in the right lower quadrant and pelvis without loculation, rim enhancement or internal air may be physiologic in a 19 year old female. No small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No free air.PELVIS: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: Small amount of physiologic free fluid in the pelvis.
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Negative examination. No definite evidence of acute appendicitis. Moderate stool load suggests constipation. No acute abnormality to explain abdominal pain.
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Generate impression based on findings.
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60 year-old male with PDA status post altelase GGT per cards PULMONARY ARTERIES: There is a large pulmonary embolus within the right main pulmonary artery and extending into all 3 lobes, which is similar to prior exam, with apparent slightly decreased burden as seen extending into the right lower lobe pulmonary arteries. Pulmonary embolus in the left lower lobe pulmonary artery is again noted, perhaps slightly decreased in size. No definite left upper lobe pulmonary emboli are identified.LUNGS AND PLEURA: Left upper lobe is clear. Left lower lobe posterior inferior base air space opacity may represent atelectasis versus small infarct versus less likely pneumonia. Small peripheral wedge-shaped opacity in both the right upper lobe and right lower lobe appears to traverse the adjacent major fissure, suspicious for small infarct. Additional slightly larger consolidation with air bronchograms within the posterior right lower lobe base could represent infarct versus consolidation.No significant pleural effusion is identified.3-mm nodular density associated with the right minor fissure is too small to characterize, likely within the right middle lobe. The right middle lobe is otherwise clear.MEDIASTINUM AND HILA: There is a small radiopaque catheter seen in the IVC entering the right atrium and likely courses through the main pulmonary artery and appears to terminate in a right lower lobe pulmonary artery.CHEST WALL: 4.3 x 2.3 cm left subcutaneous circumscribed nodule in the lateral chest wall inferior to the axillary region is noted which is nonspecific. Thoracic vertebral degenerative changes are noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.Right greater than left pulmonary emboli as above with possible infarcts.2.Left lateral chest wall subcutaneous nodule as above.
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Generate impression based on findings.
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Fever, status post transplant. LUNGS AND PLEURA: Basilar reticular opacities are noted similar to prior. Minimal bronchiectasis is noted in the lung bases. Benign appearing micronodules are similar prior, some of which are calcified. Minimal right pleural effusion is suggested.MEDIASTINUM AND HILA: Chronic calcific granulomatous changes are noted.CHEST WALL: Thoracic vertebral degenerative changes are noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Small hepatic focal hypodensities and cholelithiasis are similar to prior. Nodular left adrenal gland is again noted.
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No evidence of new infection.
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Generate impression based on findings.
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Acute respiratory decompensation. 63-year-old female. PULMONARY ARTERIES: No significant abnormality noted. Trace iatrogenic gas is noted within the innominate vein.LUNGS AND PLEURA: There is small/moderate sized bilateral pleural effusions with associated collapse/atelectasis of portions of both lower lobes, slightly improved since prior. Minor emphysematous changes are noted. Calcified nodules are noted. Previously noted scattered ground glass opacities are markedly improved, with minor persistence in the anterior right lung.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. Chronic calcific granulomatous disease is noted. Enteric tube is noted. Calcification is noted in the expected position of the splenic flexure. Trace abdominal ascites is noted.
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1.No pulmonary embolus.2.Improved pulmonary opacities since 11/26/13, as above.
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Generate impression based on findings.
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92 year-old female, hemoptysis, and treated for TB. LUNGS AND PLEURA: Debris is noted within numerous bilateral bronchi similar to prior, raising suspicion for chronic aspiration. Bibasilar air space opacities suggesting chronic aspiration versus consolidation are similar or slightly improved since prior exam. Small right pleural effusion is similar to prior. Minor biapical scarring is similar to prior. Small nodules are similar to prior.MEDIASTINUM AND HILA: Slight cardiomegaly without pericardial effusion. Tortuous aorta is noted. Atherosclerotic calcifications are noted.CHEST WALL: There is displaced fracture deformity of the sternal body as seen on the sagittal images which is new since September 2013. Diffuse demineralization is noted. Thoracic vertebral degenerative changes and compression deformities are noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Calcific granulomas are noted with small focal hepatic hypodensities and pancreatic tail hypodensity, similar to prior.
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Pulmonary opacity similar or slightly improved since 9/11/13.1.New displaced fracture deformity of the sternum. Please correlate clinically.
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Generate impression based on findings.
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Clinical question: Intracranial hemorrhage. Signs and symptoms : left arm weakness. Nonenhanced head CT:Focus of low-attenuation in involving the cortex and subcortical white matter of right posterior temporal, occipital and parietal lobes consistent with late acute to early subacute nonhemorrhagic ischemic stroke. There is regional mass effect evident by effacement of adjacent cortical sulci and without mass effect on the lateral ventricle or midline shift.Findings of age indeterminate small vessel ischemic stroke is also evident by periventricular and subcortical low attenuation white matter.Heavy bilateral cavernous carotid scar calcification and punctate distal right MCA territory vascular calcification is noted.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits paranasal sinuses and mastoid air cells.
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1.Late acute to early subacute right MCA territory posterior temporal -- parietal -- occipital stroke without evidence of hemorrhage and with only regional mass-effect.2.Mild age indeterminate small vessel ischemic strokes.3.Unremarkable exam otherwise.
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Generate impression based on findings.
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Clinical question; intracranial hemorrhage. Signs and symptoms: Facial droop since yesterday. Nonenhanced head CT: No detectable acute intracranial hemorrhage or CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Interval significant decrease in vasogenic edema left hemisphere. Small residual focus of low attenuation at the site of patient's known previously resected tumor.Stable normal size of ventricular system and no evidence of midline shift.Unremarkable calvarial with the exception of a small burr hole in the left temporal region. Unremarkable paranasal sinuses, orbits and mastoid air cells.
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1.No acute intracranial process.2.Significant interval decrease in left hemispheric vasogenic edema since prior exam.3.Small focus of low attenuation in the left posterior frontoparietal region at the site of previous resected lesion.
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Generate impression based on findings.
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Clinical question : Herniation are there signs and symptoms :biopsy proven CNS lymphoma. Nonenhanced head CT:There are no prior exams for comparison.There is a focus of increased density likely hemorrhagic mass in the right inferior frontal lobe measuring at 19 x 21 mm sized and with surrounding vasogenic edema. Additional smaller focus of high density in the right basal ganglia measuring at 15 times 8-mm. Both of these lesions demonstrate subtle surrounding vasogenic edema and subtle mass effect on the right frontal horn. High density of lesions are highly suggestive of post biopsy hemorrhage. There is evidence of a small right frontal burr hole. In addition a larger focus of slightly high density mass is noted in the left basal ganglia measuring at 22.5 x 22.5 mm size with surrounding edema and no appreciable mass effect. Finding is consistent with an additional foci of non-hemorrhagic lymphoma.Normal size of supratentorial ventricular system and without midline shift.Unremarkable orbits, paranasal sinuses and mastoid air cells.
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1.Focus of hemorrhage in right frontal lobe at the site of previously biopsied lymphoma as detailed.2.Well demarcated round mass measuring at 22.5 x 22.5 mm sized in the left basal ganglia are consistent with additional focus of lymphoma.
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Generate impression based on findings.
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Clinical question: Evaluate for hemorrhage. Signs and symptoms: Fall two weeks ago on warfarin, history of recurrent meningioma. Nonenhanced head CT:Examination demonstrates a large loculated nearly isodense mass in the left frontal region consistent with patient's known recurrent meningioma. There are extensive surrounding low attenuation white matter consistent with vasogenic edema. There is resultant significant mass effect and deviation of midline to the right of approximately 9-mm. Compared to prior brain MRI exams from 4 -- 2 -- 13 there is significant interval increase mass effect due to increased tumor size. There regarding tumor is very irregular in size and difficult to precisely measure however it is at the least 38 x 58 mm in size. There is no evidence of hydrocephalus. No convincing evidence of hemorrhage. Mild crowding of left perimesencephalic cistern suspicious for early transtentorial herniation.Large left frontal -- temporal craniotomy/craniectomy changes.
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1.Significant tumor growth/meningioma in the left frontal region since prior brain MRI exam from 4 -- 2 -- 2013. Significant associated mass effect and midline shift to the right of approximately 9 mm is also new since prior exam.2.Stable extensive postoperative changes left frontal -- temporal craniotomy/craniectomy.3.Recommend follow-up with an MRI exam.
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Generate impression based on findings.
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Clinical question: Stroke versus hemorrhage. Signs and symptoms: Alteration of mental status. Nonenhanced head CT:No detectable acute intracranial process CT however is insensitive for early detection of acute nonhemorrhagic ischemic stroke. Examination demonstrates similar to prior exam multiple large chronic cortical strokes in bilateral cerebral hemispheres with resultant underlying parenchymal volume loss. Mild ex vacuo no dictation of lateral ventricles secondary to chronic strokes is noted and unchanged since prior study. Recommend MRI if clinical concern for new acute ischemic strokes is high. Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells.
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1.No convincing evidence of any acute intracranial process.2.Stable multiple large bilateral hemispheric chronic cortical strokes since prior study.3.Recommend MRI if clinical concern for new stroke is high.
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Generate impression based on findings.
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Clinical question: Intracranial hemorrhage. Signs and symptoms: Headache. Nonenhanced head CT:No detectable acute intracranial process. CT however he is insensitive for early detection of acute nonhemorrhagic ischemic stroke.There is slight prominence of cerebellar and vermian area of the patient's stated age. Correlate with history and risk factors.Unremarkable exam otherwise.Calvarium, orbits, paranasal sinuses and mastoid air cells are unremarkable.
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No acute intracranial process.
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Generate impression based on findings.
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Clinical question: Evaluate for stroke. Signs and symptoms: Small, right-sided weakness. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic strokes.Subtle periventricular and subcortical low attenuation of white matter is concerning for age indeterminate small vessel ischemic strokes.Unremarkable cortical sulci, ventricular system, CSF spaces otherwise.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells.
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Mild age indeterminate small vessel ischemic strokes.
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Generate impression based on findings.
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36-year-old male with recurrent acute pancreatitis and dropping hemoglobin. Concern for abscess versus hemorrhage versus necrosis. ABDOMEN:LUNGS BASES: Small left pleural effusion with associated atelectasis. Right lower lobe subsegmental atelectasis.LIVER, BILIARY TRACT: Moderate hepatomegaly, liver measuring 25 cm. Hypoattenuating liver parenchyma consistent with hepatic steatosis.SPLEEN: Mild splenomegaly, measuring 15 cm.PANCREAS: The pancreas is markedly thickened and edematous, increased since the previous study, without evidence of pancreatic necrosis. Extensive peripancreatic fluid and fat stranding is redemonstrated. Interval increase in amount of peripancreatic fluid, which now extends in an ascitic fashion around the liver and spleen in the upper abdomen with caudal extension down the right flank to the pelvic brim and to the left paracolic gutter. The splenic vein is attenuated, though no evidence of thrombosis. No evidence of pseudocyst formation, loculated fluid collection/abscess, or hemorrhage.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple stable bilateral hypoattenuating lesions in the kidneys bilaterally are too small to characterize, though likely represent benign cysts.RETROPERITONEUM, LYMPH NODES: Peripancreatic fat stranding and fluid as above.BOWEL, MESENTERY: Peripancreatic inflammation extends to the splenic flexure, involving the distal transverse and proximal descending colon. 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: Sigmoid colonic without CT evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Interval increase in peripancreatic inflammation and fluid .2.No CT evidence of hemorrhage, necrosis, venous thrombosis, pseudocyst formation, or abscess.3.Hepatosplenomegaly.
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Generate impression based on findings.
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Male 55 years old Reason: perforated appendicitis? History: rigors, RLQ abd pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is a hypodense lesion in segment IVa and likely represents a simple hepatic cyst, appearing similar to the prior study. The hepatic vasculature appears patent and there is no intrahepatic biliary ductal dilatation. SPLEEN: No significant abnormality notedPANCREAS: There is fullness of the pancreatic tail, which appears unchanged since the prior examination.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Multiple small retroperitoneal lymph nodes are present.BOWEL, MESENTERY: No focal fluid collection to suggest abscess formation. Innumerable slightly prominent mesenteric lymph nodes are again seen. There is fat stranding adjacent to the distal sigmoid colon and rectum likely related to active inflammatory bowel disease. No evidence of acute appendicitis. There is no focal fluid collection to suggest abscess formation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Innumerable prominent mesenteric lymph nodes are again seen.BOWEL, MESENTERY: No focal fluid collection to suggest abscess formation. Innumerable slightly prominent mesenteric lymph nodes are again seen. There is fat stranding adjacent to the distal sigmoid colon and rectum likely related to active inflammatory bowel disease. There is a tubular structure adjacent to the sigmoid colon within the aforementioned fat stranding and may represent a loop of small bowel. No evidence of acute appendicitis. There is no focal fluid collection to suggest abscess formation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Findings consistent with distal colitis, possibly related to the patient's history of inflammatory bowel disease.
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Generate impression based on findings.
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54-year-old male with hypoxia and tachycardia, history of cancer PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus.LUNGS AND PLEURA: Small amount of debris within the trachea, right upper lobe ground glass nodules and right lower lobe atelectasis as well as consolidation and mild left basilar atelectasis.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy, possibly reactive in etiology. The heart size is normal. Center venous catheter extends to the cavoatrial junction. Upper esophageal wall thickening which may represent esophagitis.CHEST WALL: Lytic osseous lesions consistent with the history of multiple myeloma.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. Partially visualized hypoattenuating left renal lesion likely represents a cyst.
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1. Technically adequate study without evidence of pulmonary embolus.2. Basilar atelectasis and consolidation, worse on the right, with a small amount of associated tracheal debris suspicious for aspiration.
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Generate impression based on findings.
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71-year-old male status post ascending and descending aortic aneurysm replacement and lung wedge resection, assess whether effusion is intra-or extra parenchymal LUNGS AND PLEURA: The left lung is collapsed. Small left pleural effusion containing a pigtail drain. Small right pleural effusion. Groundglass opacities on the right suggestive of aspiration.MEDIASTINUM AND HILA: Central venous catheter tip extends to the cavoatrial junction. Esophageal stent containing debris. Tracheostomy tube tip at the thoracic inlet.Pneumomediastinum likely reflects recent surgery. High density material adjacent to the ascending and descending aorta suggestive of blood product. Status post aneurysm repair incompletely evaluated due to the lack of IV contrast. The descending aorta appears indistinct.CHEST WALL: Status post median sternotomy. Degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Marked abdominal ascites. G-tube catheter extends to the small bowel.
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1. Complete collapse of the left lung. Small pleural effusions contain a pigtail drain in the left. Groundglass opacities on the right suggestive of aspiration.2. Status post aortic aneurysm repair, incompletely evaluated due to the lack of IV contrast. High density material adjacent to the ascending and descending aorta suggestive of hematoma, discussed with the clinical service by the resident on-call at 1:11 p.m.
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Generate impression based on findings.
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63-year-old female with chest pain and shortness of breath PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus. Enlargement of the main pulmonary artery and right ventricle indicates pulmonary arterial hypertension..LUNGS AND PLEURA: Extensive pulmonary fibrosis with traction bronchiectasis and honeycombing diffusely involving both lungs. Interspersed parenchyma demonstrates evidence of emphysema and groundglass opacities. Apical bullae.MEDIASTINUM AND HILA: The right thyroid lobe is absent. Extensive mediastinal lymphadenopathy is again noted. Reference pretracheal lymph node measures 1.3 cm and previously measured 1.5 cm (image 85, series 10).CHEST WALL: Right lower thoracic wall fat containing mass measures 7.5 cm in greatest dimension (image 319, series 10).UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Technically adequate exam without evidence of pulmonary embolus.2. Extensive pulmonary fibrosis with underlying emphysema appears similar to the prior exam, with features of both NSIP and UIP.3. Evidence of pulmonary arterial hypertension.4. Right posterolateral chest wall mass containing fat, most likely a lipoma.
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Generate impression based on findings.
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Syncope and collapse There is a left-sided tripod fracture with fractures through the anterior and posterior walls of the left maxillary sinus, the posterior wall of the left maxillary sinus has a comminuted fracture. The fracture through the anterior wall of the left maxillary sinus goes through the infraorbital foramen. There is also a fracture through the left zygomatic arch which is angulated inwards . There is comminuted left orbital blow out fracture presents with depression of the floor of the left orbit. There is an air-fluid level present in the left maxillary sinus part of which is hyperdense suggestive of blood productsThere are air bubbles surrounding the left maxillary sinus and left zygomatic arch. There is left periorbital soft tissue swelling present.The left mandible is deformed at the neck and head of the left mandible with a poor articulation at the left temporomandibular joint. Much of the dentition is absent. There is a periapical lucency along with single mandibular tooth with periapical lucency is also present along the remnant of a left canine tooth at the maxilla.The visualized eyeballs are intact lacrimal glands are unremarkable. Extraocular muscles are intact without evidence for entrapment. The suprasellar cistern is unremarkable.Visualized portions of the mastoid air cells are underdeveloped. The visualized intracranial structures are within normal limits. An opacity is present in the right external auditory canal and representing most likely cerumen. There is opacification of the right middle ear appearedA small focus of encephalomalacia is present at the left orbital gyrus
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1.There is a left-sided tripod fracture present associated with left orbital blowout fracture without evidence for extraocular muscle entrapment. There is associated left periorbital soft tissue swelling and soft tissue emphysema at the fracture sites.2.Opacification of the right middle ear. please correlate with clinical symptoms. No obvious obstruction is appreciated3.deformity of the left mandible involving the temporomandibular joint is likely related to prior injury. Please correlate with clinical history4.a small focus of encephalomalacia is present along the left orbital gyrus also identified on prior exam from 2004 but is better appreciated on the coronal reconstruction.5.Periapical lucencies along the patient's dentition. This is nonspecific but can be seen with periapical infection or may be chronic. Please correlate with clinical findings.
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Generate impression based on findings.
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73-year-old male with buttock lesions, sepsis. Evaluate for gangrene, abscess (perirectal vs perianal). ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Atrophic pancreas with large globular calcifications.ADRENAL GLANDS: The right adrenal gland contains calcifications, likely from old infection or hemorrhage. Left adrenal nodule is incompletely characterized in this single phase study.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: Foley catheter in place. Bladder is decompressed.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Two packed right buttock wounds. One perianal, close to the midline, and extending proximally 5.3 cm superiorly from the level of the anorectal verge. The second is lateral in the right posterior perineum. Surrounding the wounds is extensive soft tissue fat stranding, consistent with inflammation versus infection. Scaphoid abdomen with diffuse anasarca and dystrophic soft tissue calcifications.OTHER: No significant abnormality noted.
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1.Two packed right buttock wounds with surrounding inflammatory changes.2.Incompletely characterized left adrenal nodule.
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Generate impression based on findings.
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21 year old female with left flank pain. Rule out stone. Lack of intravenous contrast limits evaluation of solid organs. Lack of enteric contrast limits evaluation of bowel.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 renal or ureteral calculus are identified. There is no evidence of hydronephrosis, hydroureter, or 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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No findings to account for the patient's pain.
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Generate impression based on findings.
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Clinical question: Evaluate for hemorrhage or fracture. Signs and symptoms: Increased sleepiness after having an unwitnessed fall yesterday. Nonenhanced head CT:No detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.There is prominence of cortical sulci for patient's stated age of 13 concerning for underlying parenchymal volume loss.Ventricular system also appears mildly prominent as well suspicious for volume loss. Gray -- white matter differentiation is preserved. Unremarkable images through posterior fossa.Partially visualized paranasal sinuses demonstrate opacification of the left maxillary sinus with evidence of associate bony thickening or consistent with chronic long-standing sinus disease. Minimal left ethmoid sinus disease is also noted and unremarkable other visualized paranasal sinuses.Unremarkable limited images through the orbits. Well pneumatized bilateral mastoid air cells and middle ear cavities.
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1.No detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.2.Mild prominence of cortical sulci and the ventricular system for patient's stated age as detailed.3.Chronic sinusitis of the left maxillary and minimally of the left ethmoids.
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Generate impression based on findings.
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Reason: h/o sinus cancer History: r/o chest mets LUNGS AND PLEURA: Micronodules, some calcified, stable as far back as at least 5/7/2011 and benign in appearance.Minimal lower lung zone bronchial wall thickening.MEDIASTINUM AND HILA: No significantly enlarged mediastinal or hilar lymph nodes.At least mild to moderate calcification affects the LAD.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 metastases, or other significant abnormality.
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Generate impression based on findings.
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Female, 64 years old, persistent MSSA bacteremia with unclear etiology, complicated by altered mental status. Evaluate for bacteremic disease to the brain and evaluate for mass effect in the event LP is pursued in the near future. Evaluation is somewhat compromised by motion and nonstandard positioning. Within these limitations, no definite evidence of focal parenchymal edema or significant mass-effect is seen. No abnormal intracranial collections are detected. There is no evidence of acute intracranial hemorrhage. There may be scattered subcortical hypoattenuation as well as a more focal lucency within the right caudate which are likely reflective of age indeterminate small vessel ischemic disease. The ventricular system is patent and normal in size. The bony structures of the calvarium and skull base are intact. The paranasal sinuses and mastoid air cells are clear.
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No definite acute abnormalities including no evidence of abnormal intracranial collections or significant mass effect. If clinical concern for intracranial infection persists, MRI would provide a more sensitive evaluation.
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Generate impression based on findings.
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Clinical question: Neutropenic fever clinical fungal sinusitis. Signs and symptoms: Neutropenic fever. Nonenhanced maxillofacial CT:Maxillary sinuses demonstrate mild mucosal thickening in the dependent portion and unremarkable otherwise. Patent bilateral ostiomeatal units.Minute bilateral mucosal thickening of the ethmoid sinuses.Minute mucosal thickening in bilateral frontal sinuses (left greater than right).Unremarkable sphenoid sinus and with patent bilateral sphenoethmoidal recess.Nasal cavity demonstrate mild rightward deviation of nasal septum and unremarkable otherwise.When pneumatized bilateral mastoid air cells and middle ear cavities.Unremarkable images through the orbits.
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1.No evidence of acute sinus disease.2.Minimal chronic sinus disease of paranasal sinuses (more noticeably in the dependent portion of maxillary sinuses) as detailed.3.Mild rightward nasal septum deviation.4.Unremarkable mastoid air cells and middle ear cavities bilaterally.5.Unremarkable orbits.
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Generate impression based on findings.
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36-year-old female with chest pain and shortness of breath PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus.LUNGS AND PLEURA: Mild bronchial wall thickening suggests reactive airway disease or bronchiolitis. No evidence of pneumonia or pulmonary edema.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. The heart size is normal.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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Technically adequate exam without evidence of pulmonary embolus. Mild bronchial wall thickening suggests reactive airway disease or bronchiolitis. No evidence of pulmonary edema or pneumonia.
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Generate impression based on findings.
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Hematoma on left side of nose extending below orbit and pain when moving left eye, assess for orbital fracture. There is a comminuted fracture of the left nasal bone with minimal depression, associated soft tissue swelling, and collapse/edema of the underlying nasal mucosa (image 116, series 4).The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. The maxilla, mandible, sphenoid boned, nasal bones, zygoma, hard palates, pterygoid plates, visualized cervical spine and TMJs are intact, without fracture. The frontal sinuses and frontal-ethmoid recesses are well developed and clear. Scattered mucosal thickening is present in the sphenoid, maxillary, and ethmoid sinuses. A mucus retention cyst is present in the dependent portion of the left maxillary sinus measuring approximately 2.3 cm. The left ostiomeatal complex is occluded; the right ostiomeatal unit is patent. The intersphenoid septum is normal. The nasal turbinates and nasal septum are normal. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable.
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1.Minimally depressed, comminuted nasal bone fracture with associated soft tissue swelling.2.No orbital fractures. 3.Chronic sinus disease.
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Generate impression based on findings.
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61-year-old male with multiple myeloma. Neutropenic fever, diarrhea. Evaluate for infiltrate, abscess. The absence of intravenous contrast limits evaluation of the solid organs. Given this limitation, the following observations were made:CHEST:LUNGS AND PLEURA: Minimal bibasilar atelectasis.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedOTHER: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Diffuse hypoattenuation of the liver parenchyma, consistent with hepatic cytosis. Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: A 1.6-cm hypoattenuating lesion of the right kidney is not well characterized due to lack of IV contrast.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Massively dilated small bowel loops as well as colonic dilatation to the splenic flexure. Spared normal-caliber short-segment loops of small bowel in the right lower quadrant raises the question of possible mechanical obstruction, however diffusely dilated colon and provided history of diarrhea strongly favor nonmechanical etiology. No evidence of free air or pneumatosis.BONES, SOFT TISSUES: Anasarca. Degenerative changes of the spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the spine. Anasarca.OTHER: No significant abnormality noted
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Massively dilated small bowel loops and colonic dilatation to the splenic flexure with sparing of few small bowel loops in right lower quadrant favors generalized ileus over obstruction.
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Generate impression based on findings.
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67-year-old male with CVA on anti-coagulation, rule out acute hemorrhage There is extensive confluent hypodensity within the periventricular and subcortical white matter with more focal hypodensities within the basal ganglia which likely represents small vessel ischemic disease, age indeterminant. No large territorial infarct is identified. No evidence of acute hemorrhage or extra-axial fluid collection.The ventricles and sulci fall within normal limits for age. There are no intracranial masses, midline shift, or basal cistern effacement. The mastoid air cells are clear. There is partial opacification of the left sphenoid sinus. The orbital contents are unremarkable. There is no retrobulbar hematoma. The osseous structures are unremarkable.
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1.No acute intracranial hemorrhage.2.Extensive periventricular and subcortical hypodensity is stable from the prior study and likely represents small vessel ischemic disease, age indeterminate. No large territorial infarct is identified, however further evaluation with MRI may be considered.
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Generate impression based on findings.
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71-year-old female with cardiac arrest, evaluate for PE PULMONARY ARTERIES: Technically adequate exam without evidence of acute pulmonary embolus. Right perihilar filling defects suggest the residua of previously noted embolus with possible adjacent lymphoid material.LUNGS AND PLEURA: Diffuse patchy ground glass opacities and areas of consolidation and atelectasis suspicious for edema and aspiration. Moderate pleural effusion.MEDIASTINUM AND HILA: Cardiomegaly. Tracheostomy tube extends 3 to 4 cm above the carina. An enteric tube is noted. Left central venous catheter extends to the SVC. Enlarged mediastinal and hilar lymph nodes are again noted.CHEST WALL: Marked degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Mild abdominal ascites. Reflux of contrast into the IVC suggests right heart dysfunction.
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1. Technically adequate exam without evidence of acute pulmonary embolus. Right perihilar filling defects suggest the residua of previously noted embolus.2. Diffuse bilateral ground glass opacities and small right pleural effusions small areas of consolidation, suggestive of edema and aspiration.
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Generate impression based on findings.
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Male, 62 years old, history of larynx cancer status post CRT, now with metastases to the chest. Evaluate for progression with measurements, patient on 13-0311. No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. Again seen is extensive infiltrating tumor centered predominantly within the supraglottic larynx but with extension and to the level of the glottis which is obliterated and mildly into the subglottic spaceon the right. The geographic extent of tumor involvement has not changed substantially. The tumor itself appears less centrally enhancing which may be technical or related to treatment effect.Both aryepiglottic folds are infiltrated by tumor and there is effacement of the piriform sinuses, left more than right, similar to prior. Both sides of the thyroid cartilage are permeated, similar to prior and likely reflecting tumor invasion. When compared with the prior exam, there is more distinct extension of hypoattenuating tissue over the superior margin of the right thyroid cartilage and extending deep to the strap muscles. The arytenoid cartilages remain engulfed and the right aspect of the cricoid cartilage is infiltrative and partially obliterated, slightly progressed from prior. A tracheostomy remains in place with soft tissue thickening along the ostomy margin on the left similar to prior.The hypopharynx remains thickened and infiltrated. Thickening along the tracheoesophageal groove also persists within the upper mediastinum. At its point of maximum size, this thickening measures 3.1 x 2.3 cm (image 60 of series 7), previously 3.9 x 3.5 cm. Infiltrative thickening is also redemonstrated deep to the right clavicular head (image 65 series 7) with evidence of osseous erosion. The size of the soft tissue lesion is not significantly changed though there is less centrally enhancement. A soft tissue mass in the left supra-clavicular fossa is redemonstrated measuring 2.4 x 1.7 m (image 37 series 7), previously 2.4 x 2.0 cm.The salivary glands and surgically divided thyroid are unremarkable. The cervical vessels remain patent. No significant abnormalities are detected in the lung apices.In addition to erosive change of the right clavicular head, lucency within the anterior aspect of the T2 vertebral body is again seen similar to the immediate prior examination and with more evidence of sclerosis when compared to the examination of 10/6/13. No new destructive osseous lesions are seen in the cervical region.
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1. Diffuse infiltrative tumor centered in the supraglottic larynx with extension to the level of the glottis and slightly below, not significantly changed in terms of gross geographic extent. The tumor tissue is less enhancing than on the prior exam which may be technical or which may reflect a treatment effect.2. At most there may be very slight interval extension of hypodense tumor around the superior edge of the right thyroid cartilage. There is also progressive erosion of the right cricoid cartilage.3. Bulky tumor along the right tracheoesophageal groove in the upper mediastinum has decreased slightly in size. A soft tissue nodule in the left supraclavicular fossa is also slightly smaller than on the prior exam.4. Osseous erosions involving the right clavicular head and the anterior T2 vertebral body are unchanged.
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Generate impression based on findings.
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Female 30 years old; Reason: eval for pyelo, crohn's flare History: left flank pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Note is made of the punctate focus of high attenuation in the gallbladder fundus, which may represent a polyp or noncalcified gallbladder stone. There is no evidence of acute cholecystitis. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No nephrolithiasis or hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Post operative changes at the cecal base consistent with an ileocecectomy. No bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Note is made of a heterogeneous uterus, which may be related to the recent MRI findings of adenomyosis. There is a left adnexal cystic lesion measuring 3.7 x 2.6 cm, likely physiologic. BLADDER: No distal ureteral or bladder calculi. The bladder is distended.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 acute intra-abdominal process to account for the patient's pain.2. Left adnexal cystic lesion, likely physiologic.3. Probable gallbladder polyp versus noncalcified stone, without evidence of acute cholecystitis.
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Generate impression based on findings.
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62 year-old female with rectal bleeding. Evaluate for diverticulitis. ABDOMEN:LUNG BASES: There is extensive bibasilar fibrotic changes. Please refer to the accompanying CT chest examination report for further details.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Note is made of contrast within the collecting systems bilaterally, likely related to prior PE chest examination.RETROPERITONEUM, LYMPH NODES: IVC filter in place.BOWEL, MESENTERY: The NG tube tip terminates at the level of the GE junction and needs to be advanced. Incidental note is made of multiple duodenal diverticula. There is diverticulosis of the ascending and descending colon without evidence of acute diverticulitis. There is no focal fluid collection to suggest abscess formation. There is no evidence of free intraperitoneal air or portal venous gas.BONES, SOFT TISSUES: Note is made of multiple lipomas in the soft tissues along the lateral and posterior right hemiabdomen. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Note is made of multiple probable calcified uterine fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The NG tube tip terminates at the level of the GE junction and needs to be advanced. Incidental note is made of multiple duodenal diverticula. There is diverticulosis of the ascending and descending colon without evidence of acute diverticulitis. There is no focal fluid collection to suggest abscess formation. There is no evidence of free intraperitoneal air or portal venous gas.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Diverticulosis without evidence of diverticulitis.2. NG tube tip terminates at the level of the GE junction and needs to be advanced.3. Extensive bibasilar fibrotic changes. Please refer to the CT chest examination report for further details.
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Generate impression based on findings.
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63-year-old female past history of left triple negative breast cancer, now with recurrence CHEST:LUNGS AND PLEURA: bibasilar atelectasis. Few calcified subpleural nodules in the right lower lobe.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Left skin thickening with multiple surgical clips in the central breastABDOMEN:LIVER, BILIARY TRACT: Hepatic contour nodularity with fissural prominence suggestive of cirrhotic morphology. Hepatic vessels are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable left adrenal nodule previously documented to be an adenoma, measuring 1.2 x 1.7 cm.KIDNEYS, URETERS: Small bilateral subcentimeter renal cysts are unchanged from prior study.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Surgically absent or atrophic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Few diverticula in the sigmoid colon without evidence of diverticulitis.BONES, SOFT TISSUES: Few degenerative changes in the lumbosacral spine.OTHER: No ascites
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Stable left adrenal nodule. Cirrhotic morphology of the liver.No evidence of metastatic disease.
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Generate impression based on findings.
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32 year old male, evaluate for foreign body in left arm seen on Doppler. There is possible peripheral rim of increased attenuation involving multiple muscles in the forearm, and may represent early mineralization / heterotopic bone formation. Otherwise no discrete foreign body is evident. There is a venous catheter noted in the soft tissue of the forearm. Reticulation of the subcutaneous fat is noted diffusely, indicating edema. No fracture or dislocation is seen. Visualized tendons are within normal limits.
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1. Possible early heterotopic bone formation. Follow up CT is recommended in one month to evaluate for progression. 2. Widespread edema throughout the forearm.
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Generate impression based on findings.
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71-year-old female with altered mental status and bleeding diathesis, evaluate for hemorrhage Although the study was performed without contrast administration, the patient received a bolus of contrast at 19:30 for a PE study and there is significant residual enhancement within the intracranial vessels.There is hyperdense material diffusely and bilaterally throughout most of the cerebral sulci most compatible with diffuse subarachnoid hemorrhage. There is persistent IV contrast and as such, the possibility of some superimposed gyral enhancement cannot be excluded. No hemorrhage is seen within the ventricles or basal cisterns. The sulci are not effaced and gray white differentiation is preserved.The ventricles and sulci fall within normal limits for age. There are no intracranial masses, midline shift, or basal cistern effacement. The mastoid air cells are clear. Mild mucosal thickening is seen in the bilateral axillary and ethmoid sinuses. The orbital contents are unremarkable. The osseous structures are unremarkable.
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Diffuse and bilateral hyperdense material within the cerebral sulci is most compatible with diffuse subarachnoid hemorrhage. There is persistence IV contrast from a prior PE study and as such, the possibility of superimposed enhancement cannot be excluded.
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Generate impression based on findings.
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48 year old female with deviated left pupil. Severely limited study due to motion artifact and portable technique, however there is no large hyperdense hemorrhagic collections. The study is otherwise mostly nondiagnostic for small foci of hemorrhage, masses or edema.
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Severely limited study, however no large hemorrhagic collection is identified.
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Generate impression based on findings.
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56M with cholesteatoma of right attic evaluate extent The prior exam was obtained with thicker slices. This could potentially over or under estimate any changes.There is opacification of the right epitympanum associated with erosion of the right scutum. This scutum erosion was also present on the 2003 exam and does not appear to have changed substantially. There is a redemonstration of opacification of the right epitympanum. The tegmen tympani appears to be intact. The patient appears to be status post right meatoplasty.The right tympanic membrane remains retracted medially and to the right maleus is somewhat eroded - but not measurably more than the prior exam. The patient is status post a right-sided surgery involving epitympanum and middle ear. The extent of the opacification in the right epitympanum appears to have increased since 2003 with more bony erosion along the lateral aspect of the epitympanum. The tegmen appears similar to the prior exam. The horizontal semicircular canal appears to be slightly dehiscent. It is not clear whether this finding was previously present but does not appear to have beenThe patient is status post left temporal bone surgery consistent with meatoplasty and mastoidectomy as well as middle ear surgery. A stapedial implant has been placed on the left side. The medial aspect of the implant adheres inferior to the oval window at the level of the basal turn of the cochlea . The left tympanic membrane is retracted medially and irregular in thickness with hicker and thinner portions and possibly a perforation. The The surgical site appears to be relatively stable with no evidence for recurrence.The internal auditory canals are symmetric in diameter and intact. The middle ear structures are intact. The courses of the facial nerves were followed and appear intact. The mastoid air cells are hypoplastic and opacified bilaterally. The vestibular aqueduct is identified and is within normal limits. The course of the eustachian tube is intact. The jugular foramen is intact; the left jugular foramen is asymmetrically smaller than the right. The carotid canal is intact . Foramen spinosum is identified and is intact.
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1.The patient is status post bilateral temporal bone surgery. Within the right epitympanum there appears to be some accumulation of soft tissue compared to the prior exam with slightly more bony erosion at the epitympanum. There is erosion of the bony wall adjacent to the right horizontal semicircular canal. This erosion has progressed since the prior exam. Please correlate with clinical findings and exam. A horizontal canal fistula cannot be excluded. 2.The prior exam was obtained with thicker slices. This could potentially over- or under- estimate any changes.3.A stapedial implant left middle ear attaches inferior to the left oval window. Please correlate with physical findings on clinical exam.
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Generate impression based on findings.
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Male 55 years old; Reason: History metastatic papillary renal cancer, assess for progression. CHEST:LUNGS AND PLEURA: Multifocal bilateral lung nodules consistent with metastases. No new lesions. Postsurgical changes right lower lobe. No effusions.Reference left lower lobe lesion measures 0.9 x 0.9 cm series 5 image 65. Previously 0.8 x 0.7 cm.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Fatty lesion in the dome of the liver of uncertain significance is unchanged measuring 1 x 0.9 cm series 3 image 81.SPLEEN: No significant abnormality notedPANCREAS: Hypoattenuating foci in the pancreas one in the medial aspect of the head abutting the superior mesenteric vein (S3 Im 123) and another elongated focus in the distal body of the pancreas (less likely focal ductal dilatation with distal tail atrophy) are both unchanged from the prior. The lesion in the medial aspect of the head is unchanged from 2008. These are nonspecific and could represent IPMN.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Native kidneys surgically absent.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: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Demonstration of degenerative changes and subchondral cysts in the acetabuli. Sclerotic foci in the pelvis are unchanged since 2008.OTHER: Renal allograft right iliac fossa normal size and enhancement.
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1.Stable findings including lung metastasis, hypoattenuating foci as described in the pancreas, fatty focus in the liver and osseous findings.
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Generate impression based on findings.
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54-year-old female with shortness of breath, evaluate for air space filling lesion or infiltrate LUNGS AND PLEURA: Right apical bulla. Nodular right upper lobe subpleural opacity measures 20 x 18 mm (image 44, series 5). Multiple additional bilateral pulmonary nodules are highly suspicious for malignancy. Diffuse interstitial opacity may represent lymphangitic spread. Scattered cysts.There is complete collapse of the left upper lobe suggesting a proximal obstructive lesion.Small left pleural effusion.MEDIASTINUM AND HILA: Marked mediastinal lymphadenopathy, many nodes which appear necrotic. Necrotic paratracheal lymphadenopathy measures 4.6 centimeters (image 34, series 3). The heart size is normal.CHEST WALL: Bilateral supraclavicular lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Heterogeneously hypoattenuating left hepatic lesion measures 2.4 x 3.6 cm (image 93, series 3) bulging of the capsule highly suspicious for metastasis.
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1. Multiple bilateral pulmonary nodules and marked mediastinal and supraclavicular lymphadenopathy highly suspicious for malignancy. Interstitial pulmonary opacities suggest possible lymphangitic spread.2. Collapsed left upper lobe with probable proximal obstructing lesion. 3. Left hepatic metastasis.
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Generate impression based on findings.
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Female 55 years old Reason: History of metastatic renal cancer, on pazopanib, assess for progression History: none CHEST:LUNGS AND PLEURA: Stable nodular pleural thickening diffusely lung the right lung. No discrete lung nodules or effusions. Atelectasis right base unchanged.MEDIASTINUM AND HILA: Diffuse mediastinal adenopathy redemonstrated with index lesions measured as follows:Thoracic inlet on the right, series 3 image 8/234, 0.7 x 0.6 cm. Previously 0.9 x 0.7 cm.Right paratracheal node series 2 image 21, 1.4 x 1.4 cm. Previously 1.3 x 1.3 cm.Right pericardial mass measured approximately to location, series 2 image 42, 4 0.3 x 2.9 cm. Previously 4.4 x 2.7 cm.CHEST WALL: Mixed sclerotic foci with lytic centers seen in the thoracic spine are stable in size and number.ABDOMEN:LIVER, BILIARY TRACT: Demonstration of multifocal ill-defined hepatic mets with confluent metastases filling most of the right lobe representing the index measurement. Series 3 image 79, 13.7 x 10.2 cm. Previously 13 x 8.5 cm.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right kidney is surgically absent. Redemonstration of lobular soft tissue in the surgical bed series 3 image 106, unchanged.RETROPERITONEUM, LYMPH NODES: Pericaval lymph node enlarged, unchanged see coronal image 81.BOWEL, MESENTERY: Large right-sided incisional hernia containing bowel, nonobstructive.BONES, SOFT TISSUES: Mixed sclerotic and lytic foci change consistent with osseous metastasis.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Right adnexal mass 6.3 x 5.3 cm, series 3 image 167. Previously 6.1 x 5 cm.BLADDER: Asymmetric bladder wall thickening described previously is questionably present.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Lytic metastasis unchanged involving pelvic bones and sacrum. No new sites of disease.OTHER: No significant abnormality noted.
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No new sites of disease. Index lesion measurements as above with limitations related to their irregular shape.
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Generate impression based on findings.
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60 year-old female with right paratracheal mass LUNGS AND PLEURA: Multiple right pulmonary and subpleural nodules the largest measuring 2.0 x 2.6 cm in the right upper lobe (image 18, series 5). Apical predominant underlying centrilobular emphysema.MEDIASTINUM AND HILA: Right paratracheal mass measures 6.5 x 5.6 cm (image 28, series 3). Multiple enlarged mediastinal lymph nodes including contralateral lymph nodes are identified. Biventricular ICD leads in appropriate position. Cardiomegaly.CHEST WALL: Right supraclavicular mass and extensive axillary and subpectoral lymphadenopathy. Degenerative changes of the thoracolumbar spine.Healing right lateral thoracic rib fracture with adjacent subpleural nodule which may be pathologic (image 64, series 3). Mild sclerosis of the posterior aspect of a right thoracic rib with adjacent subpleural nodule, which may represent early tumor involvement (image 44, series 3).UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Bilateral large adrenal masses highly suspicious for metastases measuring up to 3.5 x 4.3 cm (image 90, series 3) in the left adrenal gland. Multiple hypoattenuating hepatic lesions, incompletely characterized due to lack of IV contrast
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1. Right paratracheal mass and multiple right pulmonary and subpleural nodules highly suspicious for malignancy, most likely lung primary. The severity of mediastinal lymphadenopathy raises the question of small cell lung cancer. 2. Axillary, supraclavicular and subpectoral lymphadenopathy as well as bilateral adrenal metastases.
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Generate impression based on findings.
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Reason: eval miliary process tomorrow will be getting a bronch History: eval miliary process tomorrow will be getting a bronch LUNGS AND PLEURA: Diffuse miliary nodules have improved, slightly smaller and less dense.Confluent air space opacities have significantly improved in the upper lung zones, although a focus persists primarily in the right upper lobe.No pleural effusions are present.Calcified granulomata are unchanged.MEDIASTINUM AND HILA: Numerous calcified mediastinal and hilar lymph nodes are unchanged.Otherwise, there are no significant lymphadenopathy.Severe coronary artery calcifications are stable. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Retained contrast material is seen in large bowel, the upper abdomen otherwise unremarkable.
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Interval improvement in miliary interstitial opacities comment and in areas of confluent consolidation.
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Generate impression based on findings.
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60 year-old female with lung cancer status post 8 cycles of treatment CHEST:LUNGS AND PLEURA: Reference right lower lobe mass is slightly decreased in size and now measures 4.4 x 3.0 cm and previously measured 4.4 x 3.5 cm (image 63, series 5). Reference left upper lobe nodule measures 7 x 5 mm (image 29, series 5) and previously measured 2 x 3 mm. Multiple additional small pulmonary nodules are not significantly changed in size. Moderate centrilobular emphysema.MEDIASTINUM AND HILA: Multiple subcentimeter mediastinal lymph nodes with reference subcarinal lymph node measuring 6 mm and previously measuring 7 mm (image 43 series 3). Heart size is normal. No pericardial effusion. Mild atherosclerotic calcifications of the coronary arteries and aortic arch.CHEST WALL: No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Marked atherosclerotic calcification and noncalcified plaque of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Sclerotic lower lumbar vertebral body lesion is likely a benign bone island. Chronic compressive deformity of L1 vertebral body.OTHER: No significant abnormality noted.
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Reference right lower lobe mass slightly decreased in size. One reference left upper lobe lesion is increased in size. Multiple additional small pulmonary nodules are unchanged.
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Generate impression based on findings.
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Male 52 years old Reason: pancreatic cancer restaging History: pancreatic cancer chemo restaging CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Port-A-Cath right chest wall. Catheter tip terminates in the SVC RA junction.ABDOMEN:LIVER, BILIARY TRACT: Pectus pneumobilia due to biliary stent in place. No evidence of liver metastasis or venous thrombosis. Periportal edema. Mild to moderate biliary dilatation process.SPLEEN: Mild to moderate splenomegaly 15.6-cm length coronal image 50.PANCREAS: Hypoattenuating lesion in the medial aspect of the pancreatic head abutting the SMV and first jejunal branch, as measured on series 2 image 122, 1.6 x 1.2 cm. Previously measured as 1.9 x 1.8 cm. somewhat more cephalad it abuts the superior mesenteric artery sector of about 100 degrees on series 2 image 120 Atrophic body and tail with ductal dilatation redemonstrated.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multifocal bilateral nephrolithiasis redemonstrated. Marked left-sided hydronephrosis with obstructing proximal ureteral stone is redemonstrated unchanged. Correlate clinically as to the need for stenting.RETROPERITONEUM, LYMPH NODES: Extensive heterogeneous portacaval nodes redemonstrated. 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: Small amount of ascites which is a new finding. No evidence of carcinomatosis. Moderate stool burden. No evidence of mechanical obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No new sites of disease. Index pancreatic mass with vascular abutment as described. Persistent marked left-sided hydronephrosis due to obstructing renal calculus. Bilateral nephrolithiasis. Small amount of ascites which is new. Splenomegaly.
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Generate impression based on findings.
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Reason: 69 y/o M w/ SCC of the lung s/p resection needs restaging please. History: none LUNGS AND PLEURA: Postsurgical volume loss in the right hemithorax with a moderately large residual pleural effusion.No sign of tumor recurrence.MEDIASTINUM AND HILA: No significant lymphadenopathy.Extensive severe coronary artery calcification involving all branches.CHEST WALL: Degenerative disease in the spine.Fracture deformities of the right fifth and sixth ribs laterally, likely related to surgery.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Bilateral renal cysts.
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Postsurgical abnormalities with residual pleural effusion but no sign of tumor recurrence.
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Generate impression based on findings.
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Reason: changes in pulmonary nodules and evaluation of lung parenchyma History: dyspnea with exertion LUNGS AND PLEURA: Focal consolidation is present inferiorly in both posterior costophrenic angles, with a very small left pleural effusion.Elsewhere, the lungs are unremarkable in appearance and no nodules are identified as questioned in the clinical history provided. MEDIASTINUM AND HILA: Severe cardiomegaly and small to moderate pericardial effusion are present.Severe coronary artery and aortic root calcifications are present.There is no significant mediastinal or hilar lymphadenopathy. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Right nephrectomy clips and a very atrophic left kidney.Extensive vascular calcifications are seen.
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1. Severe cardiomegaly with a pericardial effusion.2. Consolidation deep and the costophrenic angles, or atelectasis.
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Generate impression based on findings.
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25-year-old male with history of portal vein thrombosis presents with GI bleed. History of extensive ABDOMEN:LUNGS BASES: Bilateral basilar consolidation. Bilateral small pleural effusions.LIVER, BILIARY TRACT: Diffuse hypoattenuation of the liver parenchyma, consistent with hepatic steatosis. Cholelithiasis in the gallbladder neck. High-density of the gallbladder lumen likely represents vicarious excretion of contrast material from recent angiogram.SPLEEN: Moderate splenomegaly.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Two punctate calcifications in the interpolar region of the right kidney likely represent tiny nonobstructing renal calculi.RETROPERITONEUM, LYMPH NODES: Soft tissue nodularity with diffuse punctate calcifications are seen diffusely in the the low pelvis, tracking superiorly along the distribution of the left gonadal vein in the retroperitoneum, with cranial extension to the level of the left renal artery.BOWEL, MESENTERY: The bowel is normal in caliber throughout without CT evidence of active bleed. High-density structures in the rectum and splenic flexure likely represent embolization coils.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: The extrahepatic portal vein does not fill, consistent with thrombosis, which extends proximally to the splenic and superior mesenteric vein. Distally the intrahepatic right and left portal vein branches are reconstituted. Extensive varices in the porta hepatis, as well as gastroepiploic and peri-pancreatic varices, are identified. Minimal ascites.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: Nodularity with numerous calcifications in the pelvis extending from the abdomen as detailed.OTHER: No significant abnormality noted.
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1.Extensive venous thrombosis involving the portal, splenic, and superior mesenteric veins with marked chronic collateral formation, moderate splenomegaly, and minimal ascites.2.Extensive soft tissue nodularity extending from the level of the left renal vein to the low pelvis with punctate calcifications raises question of hemangiomatosis, which may cause a consumptive coagulopathy. Alternatively could represent phleboliths in numerous varices or collateral vessels.3.No CT evidence of active GI bleed.4.Cholelithiasis.
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Generate impression based on findings.
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Reason: assess for underlying lung disease and neoplasm History: respiratory failure LUNGS AND PLEURA: Extensive patchy bilateral air space and ground glass opacity involving all lobes.Calcified granuloma in the left upper lobe compatible with previous infection.No pleural effusion.MEDIASTINUM AND HILA: Lower paratracheal and subcarinal lymphadenopathy with subcarinal nodes measuring 26 mm in short axis dimension.Mild pericardial thickening.Moderately dilated main pulmonary artery measuring 36 mm in diameter which raises the question of pulmonary hypertension.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. Mildly enlarged gastrohepatic lymph nodes.
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1.Extensive patchy bilateral mainly air space opacity, nonspecific but compatible with infection in the appropriate clinical setting.2. Marked mediastinal lymphadenopathy, which raises the question of atypical infection.
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Generate impression based on findings.
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Reason: hx of presumed fungal infection; now off azole x 5 weeks with recurrent cough and chest pain History: cough and chest pain LUNGS AND PLEURA: Right upper lobe peripheral wedge-shaped consolidation unchanged at 14 x 14 mm, consistent with resolving infection or infarction.Otherwise, the lungs are unremarkable in appearance with scattered punctate benign-appearing micronodules. MEDIASTINUM AND HILA: Previously measured AP window node 9 x 6 mm image 42 series 3, unchanged.Right paratracheal lymph node image 44 series 3 10 x 9 mm, previously 11 x 8 mm and little changed. Minimal coronary calcifications are present.CHEST WALL: Right axillary lymph node image 30 series 3 9 x 5 mm, previously 11 x 6 mm.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Previously measured retroperitoneal nodes are not included on this chest CT.
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Right upper lobe peripheral wedge-shaped nodule unchanged from either resolving infarct or infection. Previously measured lymph nodes unchanged or smaller in size.
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Generate impression based on findings.
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52-year-old male with metastatic thyroid cancer CHEST:LUNGS AND PLEURA: Innumerable pulmonary nodules of varying size are not significantly changed in size.Reference left upper lobe nodule measures 12 x 11 mm and previously measured 10 x 11 mm (image 47, series 5). Reference right lower lobe nodule measures 12 x 9 mm and previously measured 12 x 10 mm (image 76, series 5). No new pulmonary nodules. No pleural effusions.MEDIASTINUM AND HILA: Reference right peri-hilar lesion measures approximately 1.6 cm and previously measured 1.2 cm (image 51, series 3), most likely representing a pulmonary nodule, as there is no additional mediastinal lymphadenopathy. Multiple subcentimeter mediastinal lymph nodes are unchanged. Mild coronary arterial calcification.CHEST WALL: Status post thyroidectomy. No axillary lymphadenopathy.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Multiple bilateral pulmonary nodules, not significantly changed in size.
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Generate impression based on findings.
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Male 69 years old Reason: 69 year old man with DLBCL (primary bone) s/p chemotherapy in remission. Compare to prior scans. CHEST:LUNGS AND PLEURA: In addition to basilar scarring unchanged there is an irregular-shaped nodule in the left lower lobe measuring up to 1.7-cm series 5 image 66. No effusions.MEDIASTINUM AND HILA: Small nonpathologic size nodes unchanged. Minimal coronary artery calcifications unchanged.CHEST WALL: Osteoporosis and compression fractures unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Moderately atrophic.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications with focal lateral aneurysmal bulge along the left wall of the mid abdominal aorta over a length of about 2.3-cm although the maximal caliber of the ureters only 1.7-cm. See coronal image 62/140. These findings are unchanged from the previous scan but compressed from the baseline scan of 5/20/10. No pathologic size nodes.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: Postsurgical changes left hip.OTHER: No significant abnormality noted
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No pathologic size nodes. Note is made of a focal bulge along the left wall of the abdominal aorta consistent with a focal aneurysm based on shape with progression from the baseline CT of 5/20/10. Other findings stable as described.
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Generate impression based on findings.
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Clinical question: Assess ventricles with dye. Signs and symptoms: Status-post shunt. Unenhanced head CT:Examination is performed at two stages. Staff of neurosurgery administered 5 cc of Omnipaque 180 through a right frontal approach ventricular catheter. The CT exams were performed10 minutes and 15 minutes after administration of contrast into the ventricular system.Initial head CT: The initial exam was performed 10 minute post contrast administration and demonstrates a right frontal approach ventricular catheter which traverses the right frontal lobe and the midline and with the tip in the left frontal horn of left lateral ventricle. There is no convincing evidence that this catheter traverses the right frontal horn. The position of the catheter remains identical to prior head CT from 11 -- 30 -- 13.No evidence of ventriculomegaly and stable size of ventricular system since prior study.There is complete opacification of all supratentorial ventricular system (left greater than right), aqueduct, fourth ventricle and extensively in the subarachnoid space. The contrast also noted in the basal cistern and extensively in the subarachnoid spaces off the posterior fossa and in including subarachnoid space at the level of foramen magnum.Follow-up CT:Follow up exam was performed 15 minutes after administration of contrast into the ventricular system.Examination re-demonstrate presence of contrast through all the ventricular system similar to prior study. There is slight interval increased contrast in the subarachnoid space and the supra-tentorial subarachnoid space. Extensive contrast within the subarachnoid space in the posterior fossa remains similar to prior exam.
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1.Initial 10 minute delayed post intraventricular contrast injection CT demonstrate complete opacification of all ventricular system with contrast. Subarachnoid contrast in the basal cistern and extensive subarachnoid contrast in the posterior fossa was noted.2.15 minute post intraventricular contrast injection CT examination redemonstrates complete opacification of ventricular system with contrast. Slight interval increased subarachnoid contrast in the supratentorial space and stable extensive subarachnoid contrast in the posterior fossa.
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Generate impression based on findings.
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Reason: hx of larynx ca, s/p CRT and sx, now with mets to chest, eval for dz progression with measurements, pt on 13-0311 History: as above CHEST:LUNGS AND PLEURA: Left lower lobe micro-nodule decreased, likely post infectious (series 5/36).No suspicious pulmonary nodules.MEDIASTINUM AND HILA: Retrotracheal mass (series 3/20) measures 30 mm, unchanged from previous. Poorly defined abnormal soft tissue extends further cephalad and does not appear changed.Interval decrease in the AP window and subcarinal lymph nodes. For instance, subcarinal nodes have decreased from 14 to 9 mm in short axis.CHEST WALL: Marked interval increase in a destructive left 10th rib lesion (series 3/59).Lytic and sclerotic metastasis in the T2 vertebral body with partial collapse, unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Diagnostic detail is limited by motion artifact.LIVER, BILIARY TRACT: Hypodense hepatic lesion (series 3/108) measuring 21 x 16 mm, not significantly changed. This is indeterminate and may represent a hemangioma or metastasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Gastrostomy tube in place..BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Progression of left posterior chest wall metastasis.2.Stable reference lesions. 3.Marked decrease in mediastinal lymphadenopathy.
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Generate impression based on findings.
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Male, 72 years old, status post cervical spine corpectomy and fusion with cage and plate for severe myelopathy. Partial corpectomy has been performed from the inferior aspect of the C3 vertebral body down to the midpoint of the C5 vertebral body. A cage device has been placed with a surgical defect and filled with amorphous bone graft. Anterior spinal fusion hardware is in place with plate and screw fixation spanning from C3 through C5. No hardware complications are suspected.As a result, the previously seen spinal canal stenoses have been relieved, particularly at C4-5 which was the worst level on the prior exam. The prevertebral soft tissues through the operative bed are edematous but this is within expected postsurgical limits. No definite evidence of any loculated fluid collection is seen though there may be some tracking of fluid within the prevertebral space.The cervical spine remains mildly scoliotic with a slight rotational component. Outside of surgically induced change, no fracture or new loss of vertebral body height is demonstrated.C2-3: Left worse than right facet hypertrophy. Uncovertebral hypertrophy and mild canal narrowing. Moderate bilateral foraminal narrowing. No changes. C3-4: Corpectomy change. Relief of prior canal stenosis. Left facet hypertrophy. Mild bilateral foraminal narrowing.C4-5: Corpectomy change. Relief of prior canal stenosis with some mild residual canal narrowing. Moderate right and mild left foraminal narrowing. C5-6: Corpectomy change. Relief of prior canal stenosis. Mild bilateral foraminal narrowing. C6-7: Posterior disk-osteophyte complex resulting in mild to moderate canal stenosis. Facet hypertrophy. Moderate right foraminal narrowing. C7-T1: No significant canal or foraminal stenosis.
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Expected postoperative findings consistent with partial corpectomy from C3 through C5 with anterior plate and screw fusion. There has been interval relief of spinal stenoses seen through this region on the prior examination. Additional degenerative findings have not substantially changed.
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Generate impression based on findings.
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Female 73 years old Reason: evaluate renal mass, r/o metastasis History: hx of bilat renal mass CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Thyroid nodules seen in the right lobe isthmus and left lobe. Atherosclerotic calcifications aorta and coronary arteries. Calcified hilar granulomata. Triple lumen catheter tip in right atrium.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Few punctate nonspecific hypoattenuating foci too small to characterize and unchanged several scans.SPLEEN: Normal size. Granuloma.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: At least 6 hypervascular renal masses are seen in the left kidney and one large lesion in the right kidney. Previously measured lesions are remeasured as follows:Large right-sided renal mass measures 4.1 x 3.4 cm series 8 image 108. Remeasured on the prior exam, series 7 image 104 as 4.1 x 4.1 cmSmall enhancing mass off the lower pole of the right kidney measures about 9 mm in diameter series 8 image 115. Previously measured 5 mm is probably unchanged.Previously measured left upper pole renal lesion along the lateral aspect somewhat exophytic, measures 1.5 x 1.3 cm on series 8 image 82. Previously 1.5-cm.Interpolar mass previously measured on series 7 image 97 is seen on the current study series 8 image 101 to measure 3.8 x 3.2 cm. Previously 3.2-cm in longest dimension.RETROPERITONEUM, LYMPH NODES: Atherosclerotic disease. Heavy calcification at the origin of the celiac and superior mesenteric arteries. No evidence of aneurysm. No pathologic size nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right-sided colonic thickening is less marked on today's exam. There is a small amount of ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Atherosclerotic calcifications diffuse, no aneurysm.
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Multifocal hypervascular renal masses consistent with multifocal renal cell carcinoma. Some lesions are stable and some are increased in size. No new sites of disease. No definite evidence of metastatic disease.Right sided colonic thickening less marked. Small amount of ascites. Other findings as above.
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Generate impression based on findings.
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71-year-old female with history of bladder cancer status post cystectomy. Evaluate for disease. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Gallstones in the gallbladder fundus. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral subcentimeter hypodensities are too small to further characterize but likely represent benign cysts. Patchy enhancement pattern with striated appearance of the renal parenchyma bilaterally, left greater than right.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Neobladder decompressed in the low pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Multiple left pulmonary micronodules. Follow up is advised.2.Abnormal, patchy enhancement with striated appearance of the kidneys bilaterally. May represent infection versus new or chronic vascular abnormality. Clinical correlation is recommended.
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Generate impression based on findings.
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chronic sinusitis, follow up CT scan The left ostiomeatal complex unit is patent. The right ostiomeatal complex unit is opacified but unchanged. Within the nasal cavity no obstructive lesions are appreciated. The nasal septum is deviated towards the right.The frontal sinuses are hypoplastic and clearMaxillary sinuses demonstrate opacification of the right maxillary sinus similar to the prior exam and interval regression of mucosal thickening in the left maxillary sinus. The walls of the maxillary sinus areEthmoid air cells are clear . Sphenoid sinuses are clear. Visualized portions of the mastoid air cells and middle ears are clear. Visualized orbits are intact and the visualized intracranial structures are within normal limits.
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1.Persistent opacification of the right maxillary sinus and ostiomeatal complex unit.2.Since the prior exam in March, mucosal thickening in the left maxillary sinus and of the right sphenoid sinus has regressed3.nasal septal deviation
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Generate impression based on findings.
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13-year-old male with history of recurrent rhabdomyosarcoma, status post resection and chemotherapy Head:There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Neck:There are postoperative changes of a right parotidectomy and neck dissection. A peripherally enhancing soft tissue mass in the right parotid and masticator spaces is not significantly changed in size measuring 2.2 x 2.0 x 1 .6 cm, previously 1.9 x 1.9 x 1.6 cm. Retraction of the mucosal surface into the parapharyngeal space appears similar to the prior exam. This lesion partially encases the right internal carotid artery which remains patent. The right internal jugular vein is compressed but remains patent. No new enhancing masses or lymphadenopathy is identified throughout the neck. The orbits are unremarkable. The mastoid air cells are clear. There are bilateral mucous retention cysts/polyps. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are patent. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. The right submandibular gland is atrophic. The left submandibular, left parotid and thyroid glands are unremarkable. The osseous structures are unremarkable.
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1.Enhancing soft tissue mass within the surgical bed in the right masticator and parotid spaces likely represents recurrent tumor and is overall stable in size. This mass abuts the right internal carotid artery2.No evidence for brain metastasis
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Generate impression based on findings.
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Male; 13 years old. Reason: alveolar rhabdomyosarcoma receiving chemotherapy; assess response to therapy History: rhabdomyosarcoma LUNGS AND PLEURA: Scattered, faint reticulonodular opacities in the right upper lobe (series 80256, image 33) and left posterior costophrenic angle (image 94). New 4-mm right upper lobe nodule along the major fissure (image 46) and 2-mm left lower lobe micronodule (image 49). No pleural effusions.MEDIASTINUM AND HILA: Chest port catheter tip in the SVC. No significant mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion.CHEST WALL: Left chest port. No suspicious osseous lesions.UPPER ABDOMEN: No significant abnormality.
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1. Scattered mild reticulonodular opacities in the right upper and left lower lobes.2. New pulmonary micronodules as described above.3. The above findings are nonspecific and may be post infectious or inflammatory in etiology.
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Generate impression based on findings.
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56-year-old with history of fallopian tube cancer CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Previous reference right precarinal nonenlarged lymph node is no longer identifiable. CHEST WALL: Tip of Port-A-Cath at the junction of right atrium and SVC.ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis.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: At least two focal areas of stricture are identified within the distal jejunal and proximal ileal loops (image 54, 52 coronal plane.). The proximal small bowel loops are dilated measuring up to 3 cm without wall thickening (image 48, 3, coronal plane. This finding is new from prior study. Oral contrast does not reach the distal ileal loops or the large bowel. Centrally, the small bowel loops appear to have matted together. Differential includes metastatic disease or adhesions from prior surgery causing stricturing.no evidence of interloop fluid.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Surgically absentBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: At least two focal areas of stricture are identified within the distal jejunal and proximal ileal loops (image 54, 52 coronal plane.). The proximal small bowel loops are dilated measuring up to 3 cm without wall thickening (image 48, 3, coronal plane). This finding is new from prior study. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. At least two focal areas of stricturing within the distal jejunal and proximal ileal loops in mid abdomen causing proximal focal areas of small bowel dilatation without wall thickening or interloop fluid. This finding is new from prior study. Differential includes metastatic disease or adhesions from prior surgery causing stricturing.Findings conveyed to pager 3323, Dr. LADANYI, ANDRAS at 1:20 pm on 12/2/13
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Generate impression based on findings.
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Clinical question: Chronic nasal congestion despite medical therapy, with history of septal spur. Signs and symptoms: As above. Medtronic fusion sinus CT:There is no evidence of acute sinusitis.Minute mucosal thickening in the dependent portion of bilateral maxillary sinuses and patent bilateral ostiomeatal units.Well pneumatized sphenoid sinus and with patent bilateral sphenoethmoidal recess.Well pneumatized bilateral ethmoid air cells and bilateral frontal sinuses.Images through nasal passage demonstrate mild soft tissue prominence along the right lateral wall of the nasal passage with resultant collapse of the right anterior nasal valve (best appreciated on axial images 36 through 49). No convincing evidence of any nasal bony abnormalities. There is also no convincing evidence of any nasal septum abnormalities.Well pneumatized bilateral mastoid air cells and middle ear cavities.Unremarkable images through the orbits.
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1.No evidence of acute sinusitis.2.Minimal a coastal thickening in the dependent portion of bilateral maxillary sinuses and unremarkable sinuses otherwise. Patent bilateral ostiomeatal units and bilateral sphenoethmoidal recess.3.Soft tissue prominence along the right lateral wall of the anterior nasal passage with resultant collapse of right anterior nasal valve as detailed. This appearance is similar to visualized paranasal sinuses and nasal cavity on prior CT of soft tissues of neck from 2 -- 27 -- 12.4.No convincing evidence of nasal septum or nasal bone abnormalities.5.When pneumatized bilateral mastoid air cells and middle ear cavities.6.Unremarkable images through the orbits.
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Generate impression based on findings.
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Female 50 years old Reason: stage Iv ovarian ca History: voice changes CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: The catheter tip in distal SVC above RA junction. No pathologic size nodes.CHEST WALL: Port-A-Cath right chest wall.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No pathologic size nodes. Small node abutting and medial to the left adrenal gland, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered small mesenteric lymph nodes are unchanged. No evidence of ascites.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No interval change. No evidence of metastatic disease.
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Generate impression based on findings.
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Female 71 years old Reason: assess for metastatic disease History: none CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Heavy atherosclerotic calcifications with multifocal ulcerated plaques. Port-A-Cath tip in SVC just above RA junction. Heavy atherosclerotic calcifications coronary arteries.CHEST WALL: Port-A-Cath right chest wall.ABDOMEN:LIVER, BILIARY TRACT: Probable fatty liver. No focal liver lesions. Nephrolithiasis redemonstrated. No biliary dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Marked fatty replacement in the head and neck.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Scattered small hypoattenuating foci too small to characterize likely benign.RETROPERITONEUM, LYMPH NODES: Heavy atherosclerotic calcification aorta and branch vessels. Several ulcerated plaques are seen. No evidence of aneurysm.Surgical clips consistent with node dissection in the iliac distribution.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Surgically absent.BLADDER: No significant abnormality noted.LYMPH NODES: Calcified right inguinal lymph node redemonstrated measured on series 2 image 166, 2.1 x 1.7 cm. Previously 2 x 1.6 cm. Other small lymph nodes in iliac and obturator chains, right greater than left, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Heavy atherosclerotic calcifications. Evidence of aneurysm
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Minimal change in measurement of partially calcified right inguinal lymph node. Other lymph nodes stable. Other findings unchanged including cholelithiasis, fatty replacement pancreatic head. Small nonspecific hypoattenuating foci liver and kidneys. Heavy atherosclerotic disease with ulcerated plaque seen.
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