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Generate impression based on findings.
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54 year old female with lung cancer and new pleural fluid, evaluate prior to starting Tarceva CHEST:LUNGS AND PLEURA: Diffuse nodular pleural thickening on the left with scattered pulmonary and pleural nodules/masses. Interval decrease in left pleural effusion. For reference a left subpleural nodule along the mediastinum measures 9 mm (image 41, series 3) Multiple masses are adherent to the pericardium (image 64, series 3).MEDIASTINUM AND HILA: Right central venous catheter extends to the cavoatrial junction. Multiple mildly enlarged mediastinal, and thoracic inlet lymph nodes. For reference a prevascular lymph node measures 9 mm (image 32 series 3). The heart size is normal.Multiple pericardial and cardiophrenic lymph nodes and masses. For reference one lesion measures 11 mm (image 64, series 3).CHEST WALL:Degenerative changes of the thoracolumbar spine. Sclerotic focus in the mid thoracic spine may represent a bone island. No evidence of chest wall invasion.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Small splenule.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.No gross abnormalities noted.BONES, SOFT TISSUES: Small ventral hernia.OTHER: No significant abnormality noted.
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1. Extensive left pleural and pulmonary disease with associated lymphadenopathy and reference measurements as above. 2. Decreased left pleural effusion.
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Generate impression based on findings.
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Colorectal carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM 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: No change in moderate left hydronephrosis and hydroureterRETROPERITONEUM, 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: Stable presacral postoperative findings.OTHER: No significant abnormality noted
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Stable examination without evidence for metastatic focus. No change in moderately severe left hydronephrosis and hydroureter.
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Generate impression based on findings.
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Clinical question: Rule out infarct. Signs and symptoms: AMS. Unenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Stable mildly prominent third ventricle and normal size of the lateral ventricles.Right frontal porencephalic cavity with free communication with the right frontal horn of lateral ventricle remains identical to prior study.Stable bilateral frontal approach ventricular catheter is since prior exam. Similar to prior exam the left paramedian frontal approach ventricular catheter with the tip in the body of left lateral ventricle.Stable right frontal approach ventricular catheter which traverses the right frontal porencephalic cavity, right lateral ventricle, midline and with the tip terminating in the left posterior parietal lobe. In addition note is made of a very tiny caliber catheter which is visualized only in its intracranial component and without detectable extracranial component. The catheter traverses the right frontal porencephalic cavity, enters the right lateral ventricle, enters the third ventricle and the tip of the catheter projecting in the left perimesencephalic cistern similar to prior exam. Mild prominence of the left hemispheric cortical sulci remain similar to prior exam.Unremarkable images through the orbits.Unremarkable paranasal sinuses.Extensive opacification of left mastoid air cells and the middle ear cavity consistent with otitis. This is interval worsening of this finding since prior exam.
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1. No evidence of acute new finding since prior exam CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.2.Stable mildly dilated supratentorial ventricular system, large right frontal porencephalic cavity and multiple ventricle catheters as detailed.3.Interval worsening of opacification of left mastoid air cells and middle ear cavity since prior exam.
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Generate impression based on findings.
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68-year-old male with abdominal pain. Evaluate for SBO. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Mild diffuse gallbladder wall thickening. There is a large gallstone in the gallbladder with air identified in the gallbladder lumen. The second portion of the duodenum descends in close proximity to and abuts the gallbladder.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: Multiple dilated loops of small bowel with air-fluid levels proximal to a transition point in the distal terminal ileum where a 2.5-cm circumferentially calcified high density structure resembling a large gallstone is lodged. The terminal ileum distal to the gallstone is collapsed. Though a fistulous connection with the gallbladder is not confidently visualized, this calcified focus in the distal ileum with air in the gallbladder are consistent with gallstone ileus with presumed fistulization between the gallbladder lumen and second portion of the duodenum. No pneumatosis, intraperitoneal free air, or loculated fluid collection.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Small bowel obstruction with ectopic gallstone in the distal ileum, consistent with gallstone ileus with presumed fistulization between the inflamed gallbladder and descending duodenum.
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Generate impression based on findings.
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76-year-old female with lung cancer, status post resection as well as resection of second primary. CHEST:LUNGS AND PLEURA: Postoperative changes of right upper lobectomy and lower lobe wedge resection. Unchanged 7-mm left lower lobe ground glass nodule most compatible with AAH or adenocarcinoma in situ. No nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. The heart size is normal. Atherosclerotic calcifications of the aorta and its branches.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Unchanged subcentimeter hepatic hypodensities.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged bilateral renal lesions including a solid right mass measuring 2.1 x 2.3 cm and previously measuring 2.2 x 2.2 cm (image 117, series 3), found to be a hemorrhagic cyst on prior MR.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic calcification 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: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.
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1. Postoperative changes without evidence of recurrent or metastatic disease. 2. Unchanged left lower lobe ground glass nodule.
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Generate impression based on findings.
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Reason: now over a year status post palate resection followed by. Please re-eval History: as above CHEST:LUNGS AND PLEURA: Moderate bronchial compatible with bronchitis and mild dependent atelectasis.Azygos lobe incidentally noted.No suspicious nodules.MEDIASTINUM AND HILA: No lymphadenopathy.CHEST WALL: No significant abnormality noted.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: Bilateral cysts.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.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of metastases.
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Generate impression based on findings.
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Reason: asymptomatic lung nodule History: serial CT's to eval LUNGS AND PLEURA: 8mm solid left upper lobe nodule unchanged since 1/23/2013 and probably unchanged since an earlier low resolution outside scan of 10/24/2012.Right upper lobe 4 mm solid nodule also unchanged.No new nodules.MEDIASTINUM AND HILA: Calcified left hilar lymph nodes compatible with previous infection.Mild coronary artery calcification.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Bilateral small solid nodules unchanged for at least one year, which makes malignancy extremely unlikely. No further follow-up is strictly necessary, but an additional low dose scan could be obtained in 12 months time for additional reassurance.
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Generate impression based on findings.
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54-year-old male with shortness of breath, evaluate for fungal infection CHEST:LUNGS AND PLEURA: Multiple peripheral, subpleural nodules have decreased in size, compatible with resolving necrotizing infection. Right lower lobe round opacity may represent round atelectasis or organizing pneumonia. Interval decrease in left basilar consolidation. Interval decrease in pleural effusions. Peri-fissural cysts in the right lung compatible with areas of previous necrotizing infection. Underlying centrilobular and paraseptal emphysema. MEDIASTINUM AND HILA: Central catheters extend to the SVC. Tracheostomy tube tip at the thoracic inlet. Atherosclerotic calcifications of the aorta.CHEST WALL: No significant abnormality noted.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: Diffuse coarse pancreatic calcifications consistent with chronic pancreatitis.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic calcification 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: Multiple open anterior abdominal wounds.OTHER: Moderate abdominal ascites. Foci of free intraperitoneal air. Diffuse cachexia.
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1. Interval decrease in bilateral peripheral nodular opacities, compatible with resolving necrotizing infection. Right lower lobe round opacity may represent rounded atelectasis or organizing pneumonia. Decreased pleural effusions and left lower lobe consolidation.2. Small foci of free intraperitoneal air, correlate for recent procedure or instrumentation.3. Findings of chronic pancreatitis and abdominal ascites.4. Multiple open anterior abdominal wounds.
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Generate impression based on findings.
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Uterine sarcoma. Abdominal pain and bloating. Evaluate for obstruction or infection. ABDOMEN:LUNG BASES: Moderate left and small right pleural effusions with compressive atelectasis of the lower lobes, slightly increased on the right and slightly decreased on the left compared to 12/2/13. Unchanged 0.8 x 0.6 cm right middle lobe lung nodule (series 5, image 12). Scattered calcified micronodules.Enlarged cardiophrenic lymph nodes compared to 11/8/13.LIVER, BILIARY TRACT: Hepatomegaly without focal hepatic lesions.SPLEEN: Calcified granulomata.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left nephrectomy. No significant abnormality noted in the right kidney.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Enlargement and development of multiple intra-abdominal soft tissue masses. The necrotic left upper quadrant posterior masses are now confluent. The larger mass measures approximately 7.9 x 6.6 cm (series 4, image 38), previously 7.5 x 5.0 cm. The extensive disease in the retrocolonic fat appears worse than prior. Increased lymphadenopathy at the porta hepatis and upper abdomen, encasing the extrahepatic main portal vein and compressing the left renal vein.Persistent retroperitoneal lymphadenopathy. The reference necrotic appearing left periaortic lymph node measures 1.6 x 1.2 cm (series 4, image 72), previously 2.2 x 2.0 cm.BOWEL, MESENTERY: No gross abnormalities noted. No evidence of obstruction.BONES, SOFT TISSUES: Multiple focal sclerotic foci in the lumbar spine, unchanged.PELVIS:UTERUS, ADNEXA: Status post hysterectomy. Ovaries not visualized.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality noted. No evidence of obstruction.BONES, SOFT TISSUES: Enlarged left pelvic soft tissue nodules. Stable sclerotic lesions in the pelvis and lumbosacral spine. OTHER: New small amount of ascites. No loculated fluid collections to suggest abscess formation.
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Marked increase in metastatic disease, particularly in the upper abdomen and left renal bed.
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Generate impression based on findings.
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73-year-old male with history of head and neck cancer status post chemotherapy and radiation. Evaluate for interval change. HEAD:The ventricles, sulci, and cisterns are symmetric and prominent, consistent with parenchymal volume loss. The gray-white matter differentiation is normal. There is no mass effect, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement. Patchy hypoattenuation in the periventricular white matter is consistent with chronic small vessels disease.NECK:Mucosal thickening and edema of the aryepiglottic folds and epiglottis are similar to the previous exam. The vocal cords and laryngeal ventricle are also stable in morphology and attenuation. Asymmetric tissue in the right piriform sinus does not enhance and is unchanged in appearance since the previous exam. These findings are most consistent with post-treatment change.No significant lymphadenopathy is noted. The parotid, submandibular, and thyroid glands are unremarkable.The tracheostomy tube has been removed.A scleral band is noted around the right globe. Right lens prosthesis. The orbits are otherwise unremarkable. Status post right uncinectomy. Mild mucosal thickening is noted in both maxillary sinuses. The paranasal sinuses and mastoid air cells are otherwise clear. Atherosclerotic calcifications are noted in the bilateral carotid bifurcations. The carotid and vertebral arteries and jugular veins are patent.Multilevel degenerative disk disease is again noted, most severe at C5-C6 and C6-C7.Mild apical fibrosis.
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1. Stable post treatment findings without evidence of recurrence or metastatic disease.2. No evidence of brain metastases.
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Generate impression based on findings.
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Clinical question: Infarction. Signs and symptoms: Left hemipelvis and magnetic status post right CEA. Nonenhanced head CT:Examination demonstrates a new large focus of low-attenuation involving the cortex and subcortical white matter of right posterior temporal, occipital and posterior frontal -- parietal region consistent with acute nonhemorrhagic ischemic stroke. There is resultant effacement of adjacent cortical sulci and subtle mass effect on the right lateral ventricle with resultant trace midline shift to the left.Revisualization of mild age indeterminate small was ischemic strokes.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses, mastoid air cells and middle ear cavities.
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Acute nonhemorrhagic right hemispheric stroke involving the right posterior temporal, occipital, parietal and frontal lobes with resultant effacement of cortical sulci, subtle mass effect on the right lateral ventricle and trace midline shift to the left.
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Generate impression based on findings.
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43 year-old female with history of right parotid cancer and status post CRT. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass, mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage, or abnormal contrast enhancement. There are punctate calcifications in the pons. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. There is a subcutaneous lesion in the suboccipital region, which has been stable since prior exam. This may represent a sebaceous cyst. Examination again shows posttreatment change of right-sided parotidectomy. There is no abnormal enhancement with in the parotid bed to suggest tumor recurrence. Stable appearance of right hemitongue and right submandibular gland as well as right SCM muscle atrophy. No lymphadenopathy is noted. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable/patent. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. The left parotid, left submandibular, and thyroid glands are unremarkable. The carotid arteries and jugular veins are patent. The osseous structures are unremarkable. Limited view of the chest shows apical scarring.
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1. Stable posttreatment changes with no evidence of tumor recurrence in the neck.2. No evidence of intracranial metastasis.
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Generate impression based on findings.
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46 year old female with history of neck cancer. Please reevaluate. CHEST:LUNGS AND PLEURA: Postsurgical scarring in the left lower lobe are again noted. Nodular thickening along the suture is unchanged in appearance. Biapical scarring is again noted.MEDIASTINUM AND HILA: Cardiac size is normal without pericardial effusion. No mediastinal or hilar lymphadenopathy. Aortic arch, origin of the left vertebral artery is again seen.CHEST WALL: No significant abnormality noted.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: Left renal cyst is unchanged.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.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Postsurgical scarring in the left lower lobe with stable nodular opacities.2.No evidence of metastatic disease in the chest or abdomen.
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Generate impression based on findings.
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History of bladder cancer. Evaluate for metastatic disease ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Stable left adrenal adenomas.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Stable mild aneurysmal dilatation of the distal abdominal aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Status post cystectomy. Unremarkable neobladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence of metastatic or recurrent disease. No significant change from previous study.
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Generate impression based on findings.
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Reason: h/o head and neck cancer History: cough and mucous production. CHEST:LUNGS AND PLEURA: Mild apical fibrosis.No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: Tracheostomy tube.No mediastinal or hilar lymphadenopathy.Severe coronary calcifications are present.CHEST WALL: Degenerative abnormalities affect the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis is present.SPLEEN: Small accessory splenule.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Large left renal cyst unchanged.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.Sutures associated with the anterior gastric wall are unchanged.BONES, SOFT TISSUES: Degenerative abnormalities affect the lumbar spine.OTHER: No significant abnormality noted.
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No sign of metastases, or other significant abnormality.
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Generate impression based on findings.
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History bladder cancer. ABDOMEN:LUNG BASES: Subcentimeter left lower lobe nodule is unchanged.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small left para-aortic lymph nodes are stable.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: Status post cystectomy. Right lower quadrant ileostomy.LYMPH NODES: Small right inguinal lymph nodes are stable.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Small sclerotic bone lesions in the pelvic bones are stable.OTHER: No significant abnormality noted
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No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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55-year-old male, history of renal cell carcinoma. Restaging scan per IRB 13-0696. Please evaluate per RECIST 1.1 LUNGS AND PLEURA: Right upper lobe pulmonary nodule measures 5 mm (image 24, series 6), previously 4 mm. Additional scattered pulmonary micronodules measuring less than 4 mm are unchanged.MEDIASTINUM AND HILA: Tracheal diverticulum is again noted. No pathologically enlarged mediastinal or hilar lymph nodes. Mild coronary artery calcification.CHEST WALL: Mild wedge deformity of T12 vertebral body is unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Hypoattenuating hepatic lesions, compatible with liver metastases. Please refer to MR of the abdomen for better characterization. Status post splenectomy and left nephrectomy.
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Slightly increased size of right upper lobe pulmonary nodule. Additional scattered pulmonary micronodules are unchanged.
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Generate impression based on findings.
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55-year-old male with history of bladder cancer 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: Left lower pole renal stones are again noted. No evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: Status post cystectomy. Neobladder is unremarkable.LYMPH NODES: Index right external iliac lymph nodes is unchanged measuring 1.8 by 0.9-cm image number 124, series number 9. Other borderline enlarged pelvic lymph nodes are also stable.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Left renal stones and pelvic lymph nodes are stable.
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Generate impression based on findings.
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Reason: h/o larynx and thyroid cancer History: eval for lung mets LUNGS AND PLEURA: Emphysema and scarring in the middle lobe and lingula unchanged.No sign of pulmonary or pleural metastases.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Moderate coronary calcifications are present.CHEST WALL: Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No sign of metastases, or other significant abnormality. No change.
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Generate impression based on findings.
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Colon carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant change in bilobar metastatic lesions. Reference segment IVb lesion best seen on image 102 of series 3 measures 2.2 x 2.9 cm. No ductal dilatation. Hepatic vessels patent.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Stable examination
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Generate impression based on findings.
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12 year-old male with purulent nasal drainage and refractory asthma. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There is minimal mucosal thickening in the posterior ethmoids. There is small amount of bubbly fluids in the left sphenoid sinus. The frontal sinuses, frontal-ethmoid recesses, anterior ethmoids, right sphenoid sinus, 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. There is anterior translation of the bilateral TMJs.
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1. Small amount of bubbly fluids in the left sphenoid sinus is suggestive of acute sinusitis.2. Minimal mucosal thickening in the posterior ethmoids.
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Generate impression based on findings.
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Bladder cancer, evaluate for metastatic disease ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Simple appearing right renal cyst.RETROPERITONEUM, LYMPH NODES: Index aortocaval lymph node is stable measuring 7 x 7 mm on image number 15, series number 7. Other small retroperitoneal lymph nodes are also stable.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Not visualized.BLADDER: Status post cystectomy.LYMPH NODES: Previously mentioned index lymph node is no longer visualized.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Interval cystectomy. No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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29-year-old male with right-sided renal colic and hematuria. Rule out nephrolithiasis. ABDOMEN:LUNGS BASES: No significant abnormality noted.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: A, mid right ureteral stone is identified (image 52, series #3; coronal image 59) at the approximate level of L3-L4 with minimal pelvocaliceal prominence. No surrounding inflammatory changes or fluid collections identified.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: 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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4 mm right mid ureteral stone with minimal pelvo-calyceal prominence.
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Generate impression based on findings.
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83-year-old male status post status post retroperitoneal mass resection with rectal injury and repair on 12/04/13, then developed abscess in the pelvis concerning for leak from rectal repair. Placed drain in the pelvic collection on 12/9/2013. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The bladder is surgically absent. There is bilateral incompletely visualized ureteral stents and a Foley catheter in the neobladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There has been interval placement of percutaneous drain in the midline and slightly to the left of the rectum pelvic collection containing debris, fluid and gas. The drain pigtail catheter is in the caudal portion of the aforementioned pelvic collection. The collection measures 9.7 x 5 .4 cm in axial dimension (series 2 image 47) and 8.9 cm in craniocaudal dimension 8.9 cm (series 8020 image 36).. Rectal contrast is noted in the rectum and distal sigmoid colon. No definitive contrast extravasation or communication with the other collection is evident. There is thickening of the rectal wall.Multiple surgical clips are seen in the pelvis.BONES, SOFT TISSUES: Bilateral inguinal hernias contain mesenteric fat.OTHER: No significant abnormality noted
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1.No evidence of fistulous tract or contrast extravasation after rectal contrast administration. If there is a high clinical suspicion for rectal leak a dedicated fluoroscopic exam can be performed by GI radiology.2.Interval drain placement in the pelvic collection.3.Findings discussed with Dr. Posner at the time of the dictation.
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Generate impression based on findings.
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Reason: following cyst in right middle lobe and nodule in right lung History: none LUNGS AND PLEURA: Cyst in the right middle lobe with mild thickening of the cyst wall, unchanged.Almost complete resolution of a small left pleural effusion with residual pleural thickening and a minimal amount of loculated or organizing fluid at the left base. Scarring and volume loss of the left base is still present with partial resolution of atelectasis.Calcified nodule at the right base consistent with previous infection.MEDIASTINUM AND HILA: Vascular calcifications of the aorta and its branches. Mild coronary artery calcifications. No pericardial effusion. Calcified mediastinal lymph nodes suggestive of prior granulomatous disease.Mildly dilated right main pulmonary artery, unchanged.CHEST WALL: Several small nodular opacities in the right axilla and breast, not significantly changed, better evaluated by mammography.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Mildly enlarged gastrohepatic lymph nodes, unchanged.
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1. Stable right middle lobe cyst with mild thickening of the wall, most likely benign. If the patient is at high risk, annual low dose CT follow-up may be considered.2. Interval decrease in left effusion with residual scarring and atelectasis..
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Generate impression based on findings.
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Reason: Hx H\T\N ca, s/p CRT, evaluate dx and compare to previous measurements History: as above CHEST:LUNGS AND PLEURA: Scattered benign appearing micronodules are present, but there is no sign of pulmonary pleural metastases.MEDIASTINUM AND HILA: Median sternotomy for ascending aorta and valve repair since the prior study.There is no mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Numerous hepatic cystlike hypodensities are unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst.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.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. No sign of metastases or other significant abnormality.2. Ascending aorta and valve repair since the prior study.
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Generate impression based on findings.
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83-year-old male with history of prostate cancer CHEST:LUNGS AND PLEURA: Biapical scarring, unchanged.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: Unchanged right adrenal nodule in left adrenal nodularity.KIDNEYS, URETERS: Bilateral renal cysts, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Unchanged large ventral hernia containing fat and bowel loops.BONES, SOFT TISSUES: Extensive bone metastases, unchanged.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: Extensive bone metastases, unchanged.OTHER: No significant abnormality noted
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Extensive bone metastases without any significant change from previous study.
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Generate impression based on findings.
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History of renal cell cancer CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM 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 left nephrectomy. No evidence of recurrence.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: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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47-year-old female status post op total proctocolectomy and colostomy on 11/25. Evaluate for obstruction. ABDOMEN:LUNG BASES: Minimal left-sided pleural thickening.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Numerous small hypodense lesions in the spleen of uncertain etiology and significance. Largest one measures 1.4-cm in diameter image number 42, series number 3.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The tip of the surgical drains in the pelvis in the presacral region. Anterior to the drain. There is a 4 x 2.1 cm collection on image number 138, series number 3. Postsurgical changes are noted within the pelvis. No evidence of bowel obstruction. Left lower quadrant ostomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence of bowel obstruction. Postsurgical changes in the pelvis. Small collection in the pelvis anterior to the surgical drain.Indeterminant small hypodense lesions in the spleen.
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Generate impression based on findings.
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Reason: New masses? History: medullary thyroid cancer LUNGS AND PLEURA: Multiple calcified micronodules, unchanged, compatible with previous infection.No suspicious nodules.MEDIASTINUM AND HILA: Status post thyroidectomy.No significant lymphadenopathy.Mild coronary artery calcification.CHEST WALL: Stable sclerotic focus in the right inferior scapula.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Large hemangioma in the dome of the liver, unchanged and a newly visible hyperdense focus (series 3/82) also compatible with an hemangioma.Status post cholecystectomy with mild biliary ductal dilatation, unchanged.Small left adrenal nodule also unchanged and presumably benign.Large right renal cyst.
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Multiple incidental findings as described, but no evidence of metastatic disease.
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Generate impression based on findings.
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Metastatic pancreatic neuroendocrine tumor CHEST:LUNGS AND PLEURA: New, patchy air space opacities in the left lower lobe may represent atelectasis versus resolving pneumonia.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Numerous hypodense lesions in the liver are not significantly changed compared to previous study.SPLEEN: No significant abnormality noted.PANCREAS: Postsurgical changes in the pancreas.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small, hypodense lesions in the kidneys are unchanged.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Dilated endometrial cavity is unchanged. Further evaluation with pelvic ultrasound is recommended to exclude endometrial carcinoma.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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New, patchy air space opacity in the left lower lobe of the lung. This may represent focal atelectasis versus resolving pneumonia. No other significant change from previous study.
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Generate impression based on findings.
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Hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Significantly enlarged prostate gland.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Enlarged prostate gland. No evidence of renal stones, focal, kidney or ureteral lesions to explain patient's hematuria.
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Generate impression based on findings.
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Study prostate cancer CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Thoracic spinal metastases are unchanged.ABDOMEN:LIVER, BILIARY TRACT: Hypodense lesions in the liver are unchanged.SPLEEN: High density lesion in the kidney on the right side is unchanged and measures 1.8 cm in diameter image number 104, series number 3.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive bone metastases, unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Percutaneous cystostomy tube, again noted.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Extensive bone metastases, unchanged.OTHER: No significant abnormality noted
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Extensive bone metastases, unchanged. No significant change from previous study.
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Generate impression based on findings.
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History of bladder cancer 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: Persistent significant left hydronephrosis and hydroureter.RETROPERITONEUM, LYMPH NODES: Mild infrarenal aneurysmal dilatation of the abdominal aorta is unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Left hydronephrosis, unchanged. No significant change from previous study.
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Generate impression based on findings.
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64-year-old male with history of chest CHEST:LUNGS AND PLEURA: 6-mm nodule in the lingula on image number 50, series number 8, not significantly changed from previous study. Left lower lobe atelectasis and pleural thickening, unchanged. Small left pleural effusion, unchanged.MEDIASTINUM AND HILA: Small mediastinal lymph nodes are unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Stable hepatic cysts. Stable slightly hypervascular foci in the liver. An index, subcentimeter lesion is on image number 51, series number 6. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Stable exam.
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Generate impression based on findings.
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64-year-old female with neuroendocrine tumor of small bowel. Status post resection. Follow-up examination. CHEST:LUNGS AND PLEURA: Unchanged. Right lung micronodules, one of which is densely calcified. No new nodules. No air space consolidation or air space disease seen. No pleural disease.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.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: Right renal benign cysts, unchanged. No other abnormality seen.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted in retroperitoneum. Prior noted. Reference mesenteric lymph node (series 3. Image 138) is unchanged in size, measuring 1.4 x 1.2 cm. Scattered small peritoneal lymph nodes subcentimeter in size are unchanged..BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Post hysterectomy. No other abnormalities.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Stable micronodules and chest without other thoracic abnormality seen. 2. Stable referenced mesenteric lymph node. No changes since prior examination.
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Generate impression based on findings.
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Alcoholic hepatitis with amenia despite transfusions ABDOMEN:LUNG BASES: Small bilateral pleural effusions and bibasilar atelectasisLIVER, BILIARY TRACT: Regions of geographic low attenuation throughout the liver. The noncontrast nature of this examination precludes the ability to detect a true discrete mass lesion. Cholelithiasis without obvious acute inflammation.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: Mild ascites.BONES, SOFT TISSUES: Diffuse anasarcaOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Mild ascitesBONES, SOFT TISSUES: Diffuse anasarcaOTHER: No significant abnormality noted
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No evidence for acute hematoma or bleed.Bilobar multifocal geographic regions of low attenuation involving the liver consistent with fatty infiltration. However, the noncontrast nature of the study precludes the ability to identify a discrete hepatic mass lesion amongst the background of fatty infiltration. Mild ascites
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Generate impression based on findings.
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67-year-old male with renal cell lymphoma now status post 6 cycles of chemotherapy and need of restaging. CHEST:LUNGS AND PLEURA: No significant abnormality noted in the lung parenchyma without nodules, masses or airspace disease. No pleural abnormality seen.MEDIASTINUM AND HILA: No adenopathy or mass is seen.CHEST WALL: Right anterior chest the Port-A-Cath system with tip of catheter in the proximal superior vena cava. Mixed sclerotic/lucent lesion in the T6 vertebral body is unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Large retroperitoneal mass which encases the inferior vena cava and extends into the aorta caval space and invades. There right renal hilus and, probably parenchyma is again seen. Mass measures 9.5 x 4.6 cm (series 69, image 118) compared with 8.6 x 4.4 cm previously. IVC is patent, but slightly attenuated through this mass and the right renal artery progresses through this mass as well.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Extensive mesenteric stranding is again seen diffusely with prominent mesenteric lymph nodes. The reference mesenteric lymph node reported previously now seen on series 609, image 135 is minimally changed measuring 1.2 x 1.0 cm, minimally changed in size, measuring 1.3 x 0.8 cm previously. More inferiorly, bulky, lymph nodes are more prominent than when seen before in density, but relatively unchanged in size compared with 10/9/13, but markedly increased when compared with 8/27/13 (see image 149). Oral administered contrast rapidly progresses through normal appearing stomach, small bowel, and colon without intrinsic abnormality. A small amount of free mesenteric fluid is seen predominantly in the dependent pelvis.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: Oral administered contrast rapidly progresses through normal appearing stomach, small bowel, and colon without intrinsic abnormality. A small amount of free mesenteric fluid is seen predominantly in the dependent pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Minimal change slightly increased right retroperitoneal mass invading right kidney. 2. Mesenteric infiltrative changes and lymph nodes minimally changed since 10/9/13 but significantly increased when compared with 8/27/13. 3. Minimal change mixed lucent/sclerotic lesion T6 vertebral body.
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Generate impression based on findings.
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Male, 32 years old, status post fall. No definite abnormalities of parenchymal attenuation or morphology are detected. At most, there may be some minimal periventricular hypodensity which is nonspecific. No intracranial hemorrhage or abnormal extra-axial fluid collection is seen. There is no evidence of mass effect or midline shift. The ventricles and basal cisterns are patent and normal in size. The paranasal sinuses are clear. The right mastoid air cells are partially fluid opacified.The bones of the calvarium and skull base are intact.
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No acute intracranial abnormalities.
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Generate impression based on findings.
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Clinical question: Electrode placement. Signs and symptoms: Electrode placement. Unenhanced head CT:Examination performed with a surgical assist device in place.Examination redemonstrates a focus of encephalomalacia in the right anterior temporal lobe and evidence of a prior surgical small partial right anterior anterior temporal lobectomy. Generalized prominence of cortical sulci and cerebellar -- vermian folia for patient's stated age of 27 similar to prior exam and concerning for underlying parenchymal volume loss. Evidence of prior extensive surgical changes of calvarium in bilateral frontal and temporal regions.
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1.Focus of right anterior temporal encephalomalacia/gliosis and postoperative changes remain stable since prior MRI exam.2.Generalized prominence of cortical sulci and cerebellar -- vermian folia similar to prior study.
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Generate impression based on findings.
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Clinical question: Rule out chronic sinusitis. Signs and symptoms: History of asthma with with multiple ED visits, concern for other etiologies.. Unenhanced maxillofacial CT:All paranasal sinuses are well pneumatized. There is minute mucosal thickening of the dependent portion of right maxillary sinus and along the superior -- medial aspect of bilateral maxillary sinuses and unremarkable all other paranasal sinuses.Patent bilateral ostiomeatal units of maxillary sinuses and minimally compromised bilateral sphenoid portal recesses.Unremarkable images through the nasal passage.Almost a vessels and bilateral middle ear cavities remain well pneumatized.Unremarkable images through the orbits.
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Negative CT of paranasal sinuses.
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Generate impression based on findings.
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Clinical question: Rule out CVA, TIA. Signs and symptoms: left-sided facial droop. Nonenhanced head CT:No evidence of acute intracranial process, CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There is interval complete resolution of previously noted acute hematoma in the left cerebellum. There is resultant left cerebellar parenchymal volume loss and ex vacuo dilatation of the fourth ventricle.Moderate to advanced age indeterminate small muscle ischemic strokes and including bilateral thalamic lacunar infarcts remain grossly identical to prior exam.Slight prominence of cortical sulci and ventricular system remains similar to prior study. Midline is maintained.Evidence of prior right temporal craniotomy with stable postop changes since prior exam and unremarkable calvarium otherwise.Paranasal sinuses demonstrate extensive opacification of left maxillary sinus with significant bony thickening and sclerotic changes similar to prior study. New since prior exam is increased opacification of left mastoid air cells and increased soft tissues in the left nasal passage and partially visualized region.
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1.No evidence of acute intracranial process, CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.2.Moderate to advanced age indeterminate small muscle ischemic strokes as detailed above.3.Revisualization of extensive left maxillary sinusitis with bony sclerotic/thickening changes. Interval opacification of the left ethmoid air cells and increased soft tissue density in the left nasal passage as detailed.
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Generate impression based on findings.
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Status post craniofacial reconstruction following infected cranioplasty after basal cell resection. Evaluate bony reconstruction. Stable findings related to extensive cranioplasty surgery including biparietal craniotomy defect and graft placement over the frontal area. The bifrontal grafted bone is in a roughly similar configuration to previous, though the left has demonstrated some interval healing at the posterolateral aspect. There is an unchanged somewhat mottled appearance of native frontal and parietal bones. The large flap extending through the epidural space and occupying the surgical defect related to left orbital exenteration and left ethmoid/sphenoidectomy is stable. The left maxillary sinus has undergone antrectomy with superior and middle turbinectomy and demonstrates a stable pattern of mucosal thickening. The posteromedial margin of the left maxillary sinus is absent and immediately adjacent to this defect, there is stable nonspecific soft tissue density within the slightly asymmetrically widened left pterygopalatine fossa which is nonspecific, though stable since the prior exam. There are no new soft tissue lesions or pathological enhancement. The right orbit is unremarkable. Limited assessment of intracranial structures is unremarkable. Within the limitation of significant metallic artifact, the oral cavity and oropharynx are unremarkable. The left internal jugular vein is diminutive (stable) and there are bilateral atherosclerotic/calcified lesions at the carotid bifurcations.
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1.Stable findings related to extensive cranioplasty, left orbital exenteration and left sinus surgery. Note is made of nonspecific soft tissue density within the widened left pterygopalatine fossa which is not changed since the prior examination. This may be postoperative in etiology.2.Some interval healing of the left frontal bone graft with respect to the adjacent frontal bone with an unchanged mottled appearance of native frontal and parietal bones.
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Generate impression based on findings.
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65-year-old female with history of sarcoid, pulmonary nodules, evaluate interval change LUNGS AND PLEURA: Multiple bilateral perihilar and upper lobe predominant pulmonary nodules have increased in size and number, some becoming confluent. Interval decrease in lung volumes. Reference right upper lobe spiculated nodule measures 2.0 x 1.5 cm and previously measured 1.1 x 1.0 cm (image 32 series 4). Confluent nodules in the left upper lobe with focal bronchiectasis. No cavitation. Perihilar and upper lobe architectural distortion and bronchiectasis. MEDIASTINUM AND HILA: Mediastinal and hilar lymphadenopathy is decreased from the prior exam. Hiatal hernia. Diffuse thyroid gland enlargement.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips.
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Progression of perihilar and upper lobe predominant nodular air space disease consistent with sarcoidosis. Interval decrease in mediastinal and hilar lymphadenopathy.
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Generate impression based on findings.
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57-year-old male with metastatic hemangioendothelioma, evaluate for extent of disease. CHEST:LUNGS AND PLEURA: Numerous bilateral pulmonary nodules, many of which are calcified are not significantly changed in size. No new pulmonary nodules are identified.Reference anterior right upper lobe nodule measures 6 x 6 mm (image 29, series 6), previously 6 x 6 mm. Reference left lower lobe nodule measures 8 x 11 mm (image 44 series 6), previously 8 x 11 mm.MEDIASTINUM AND HILA: Cardiac size is normal, without pericardial effusion. No mediastinal or hilar lymphadenopathy. Mild/moderate coronary artery calcifications.CHEST WALL: Multiple sclerotic foci are again noted in the ribs some of which appear similar to prior exam. Expansile lesion within the left inferior scapula is stable.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypoattenuating right inferior hepatic lesion measures 15 x 16 mm (image 119, series 4), is unchanged in size, but remain suspicious for metastasis. Hyperattenuating focus in the right hepatic lobe is stable, likely a flash filling hemangioma. Status post cholecystectomy.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 calcification of the abdominal aorta. No 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: Stable metallic density posterior to the inferior right hepatic lobe, likely a surgical clip.
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1.Stable size and number of pulmonary metastases, many of which are calcified.2.Stable size of non-specific ill-defined hypoattenuating focus in the right inferior liver which remains suspicious for metastasis.3.Stable appearance of sclerotic foci throughout the ribs.
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Generate impression based on findings.
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Status post resection of dermatofibrosarcoma. Asymptomatic. CHEST:LUNGS AND PLEURA: Few non-specific scattered micronodules, similar to 9/18/12. Mild apical predominant centrilobular emphysema.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal sized heart without pericardial effusion. Moderate atherosclerotic calcification of the thoracic aorta. Surgical clips at the distal esophagus.CHEST WALL: Subcentimeter axillary and supraclavicular lymph nodes.ABDOMEN: LIVER, BILIARY TRACT: No significant abnormality noted in the liver. Cholelithiasis, without CT evidence of cholecystitis.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: Moderate atherosclerotic calcification of the abdominal aorta.BOWEL, MESENTERY: No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Soft tissue thickening at the left buttock (series 3, image 175), without loculated fluid collection, likely representing postsurgical changes of the patient's prior dermatofibrosarcoma resection.OTHER: Bilateral scrotal hydroceles.
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1. No specific evidence of metastatic disease in the chest, abdomen, or pelvis.2. Cholelithiasis.
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Generate impression based on findings.
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65-year-old female with history of sarcoidosis The partially visualized brain is grossly unremarkable.The mastoid air cells are clear. There is mild mucosal thickening of the bilateral maxillary sinuses appearing similar to the prior exam. The orbital contents are unremarkable. There is redemonstration of medialization of the left true vocal cord with mild paraglottic hyperattenuation at this level which appears similar to the prior exam and may be due to prior Teflon injection as previously suggested. Otherwise, remaining aerodigestive tract is patent. The epiglottis, vallecula, piriform sinuses, and vocal cords are unremarkable. The parotid and submandibular glands are unremarkable. The thyroid is mildly enlarged without focal lesions evident. Bilateral tonsilliths are evident. There are scattered small cervical lymph nodes, however there is no lymphadenopathy identified by CT criteria. The carotid arteries and jugular veins are patent. Mild multilevel degenerative changes of the cervical spine appear similar to the prior exam. For findings in the thorax, please see dedicated chest CT performed on the same day.
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1.No CT findings of sarcoidosis in the neck.2.Mildly enlarged thyroid without focal lesions evident.3.For findings in the thorax, please see dedicated chest CT performed on the same day.
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Generate impression based on findings.
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Female 43 years old; Reason: Rectal cancer evaluate for progression History: Rectal cancer. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: A right-sided central venous catheter of the chest port terminates in the right atrium.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Hypodense splenic lesion is nonspecific though unchanged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Interval removal of bilateral nephroureterostomy tubes. Residual moderate right and mild left hydronephrosis is seen. No evidence of nephroureterolithiasis. RETROPERITONEUM, LYMPH NODES: Multiple scattered subcentimeter retroperitoneal lymph nodes.BOWEL, MESENTERY: Postsurgical changes of a Hartmann's pouch and left descending colostomy are redemonstrated. Orally administered contrast passes rapidly throughout the bowel to the colostomy without evidence of obstruction or ileus. BONES, SOFT TISSUES: Minimal residual soft tissue density in areas of the two previously identified complex fluid collections in the anterior abdominal wall is consistent with scarring.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Scarring with multiple surgical clips along the right pelvic sidewall and trace presacral edema is unchanged and may represent postsurgical and/or postradiation changes. No evidence of recurrence.OTHER: No significant abnormality noted.
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1.Moderate right and mild left residual hydronephrosis.2.Near resolved anterior abdominal wall fluid collections with scarring.3.Postsurgical changes are redemonstrated.4.No evidence of recurrence or adenopathy.
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Generate impression based on findings.
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61 year-old male with pleomorphic adenoma of the palate. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear except for minimal left maxillary sinus mucosal thickening. Limited view of the intracranial structure is unremarkable. Empty sella. The previously seen mass lesion underneath the left hard palate is not readily seen on the present exam. There is thinning of the left hard palate. There appears small amount of soft tissue in the surgical bed, for instance, image 26 of series 8045, which is nonspecific. No lymphadenopathy is noted. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are unremarkable/patent. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. The parotid, submandibular, and thyroid glands are unremarkable. The carotid arteries and jugular veins are patent. There is retropharyngeal course of the left internal carotid artery. The osseous structures are unremarkable. There are disc osteophytes with neuroforaminal narrowing at C5-C6 and C6-C7. Limited view of the chest is unremarkable.
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Interval resection of a left hard palate mass. Small amount of soft tissue in the surgical bed, which is nonspecific and could represent granulation tissue. Residual or recurrent tumor cannot be ruled out entirely. Continued follow-up is recommended. No cervical lymphadenopathy.
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Generate impression based on findings.
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35-year-old female with breast cancer -- response to therapy. CHEST:LUNGS AND PLEURA: No significant abnormality noted without nodules, masses or airspace disease. No pleural abnormalities..MEDIASTINUM AND HILA: No significant abnormality noted. No adenopathy.CHEST WALL: Left anterior chest wall Port-A-Cath with tip of catheter in the proximal right atrium. Status post right mastectomy. No adenopathy in the axilla. Extensive sclerotic lesions throughout. The bony skeleton unchanged in their distribution.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: Right renal hypodensity, 1 cm probable cyst, unchanged. No other abnormalities.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse osseous changes consistent with metastatic disease. Grossly unchanged in distribution and appearance. Compression deformity of the L4 vertebral body, unchanged.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Heterogeneous uterus, similar to to prior examinations, most likely due to fibroid changes.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse osseous changes consistent with metastatic disease. Grossly unchanged in appearance and extent.OTHER: No significant abnormality noted.
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1. Extensive osseous metastases with distribution appearance unchanged on CT. 2. No other abnormalities to suggest metastatic disease.
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Generate impression based on findings.
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73-year-old male with pleural mesothelioma status post two cycles of chemotherapy. Evaluate disease and compare to previous scan. CHEST:LUNGS AND PLEURA: Pleural thickening right hemithorax is redemonstrated with associated volume loss.Reference pleural measurements appear similar to prior study:1.Adjacent to T4 vertebral body at the 4 clock position measures 13 mm, previously measured 17 mm (series 3, image 29).2.Pleural nodule at the level of right main pulmonary artery at 7 o'clock position measures 5 mm, previously measured 7 mm (series 3, image 45).3.The para-aortic thickening at 4 clock position measures 6 mm, previously measured 6 mm (series 3, image 65). Pleural thickening along the right major fissure is not significant changed. Non specific pleural calcification in the left lung base is unchanged. Ill-defined left lower lobe opacity is not significant changed (image 66, series 4). Scattered pulmonary micronodules are unchanged. Surgical changes are again noted in the right lung base.MEDIASTINUM AND HILA: No pathologically enlarged mediastinal or hilar lymph nodes. Moderate to severe coronary artery calcifications. Stable mildly enlarged cardiophrenic lymph nodes. CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable subcentimeter hypoattenuating liver lesions, too small to characterize, unchanged and most likely representing cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Renal cysts, unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Mesenteric haziness and stranding adjacent to the left abdominal wall, most likely due to inflammation (images 128 and 108)BONES, SOFT TISSUES: Degenerative changes in the spine.OTHER: No significant abnormality noted.
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1.No significant interval change in thoracic mesothelioma.2.Mesenteric haziness and stranding, most likely due to inflammation. 3.Stable appearance of irregular left lower lobe pulmonary nodule.
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Generate impression based on findings.
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Ampullary cancer complicated by post ERCP pancreatitis and pancreatic necrosis. Has IR drain in place. ABDOMEN:LUNG BASES: Mild bibasilar scarring. No focal air space opacities or pleural effusions.LIVER, BILIARY TRACT: Metallic stent within the common bile duct with associated pneumobilia, similar to the prior exam. No significant abnormality noted within the liver. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged subcentimeter bilateral hypodense lesions, which are too small to fully characterize. Nonobstructing small bilateral renal calculi.PANCREAS: Prominent pancreatic head, compatible with the patient's known history of ampullary carcinoma. A mass is not distinctly visualized for measurement. Unchanged mildly dilated pancreatic duct. Drain adjacent to the pancreatic tail, without distinct fluid collection evident. Decreased minimal peripancreatic inflammatory stranding. Improved visualization of the splenic vein, likely secondary to reconstitution via collaterals.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal appearing bowel loops. Subcentimeter mesenteric lymph nodes, without definite evidence of carcinomatosis.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal appearing bowel loops. Subcentimeter mesenteric lymph nodes, without definite evidence of carcinomatosis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No ascites.
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Stable examination. No significant interval change in the appearance of the pancreas.
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Generate impression based on findings.
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72-year-old male with history of prostate cancer and renal mass. Evaluate renal mass. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Left hepatic lobe simple cyst, unchanged in size. Multiple subcentimeter right hepatic lobe hypodensities are too small to further characterize. Cholelithiasis with no evidence of acute inflammation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: A cystic lesion of the left kidney approximates water density and likely represents a benign simple cyst. Multiple other bilateral subcentimeter hypodensities are too small to characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis of the descending and sigmoid colon, without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Simple cyst of the left kidney.2.Cholelithiasis.
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Generate impression based on findings.
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Reason: lung cancer with adenopathy and adrenal mets. PLease compare to outside CT 9/2013 that is uploaded in EPIC. Please measure using recist criteria History: post cycles of therapy CHEST:LUNGS AND PLEURA: Dense scarlike opacity in left perihilar and paramediastinal area with bronchiectasis and architectural distortion, consistent with radiation reaction.No suspicious nodules.No pleural effusion.MEDIASTINUM AND HILA: Mildly enlarged right hilar lymph nodes unchanged.Very mild pericardial thickening or minimal effusion.CHEST WALL: Markedly enlarged bilateral axillary lymph nodes, measuring 19 mm in short axis on the left, increased from 14 mm previously.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple sharply defined hypodensities most consistent with cysts, unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Moderate thickening of the right adrenal gland, measuring 16 mm in diameter, slightly increased since the previous scan.More marked enlargement of the left adrenal gland, measuring 19 x 21 mm, increased from 13 x 18 mm previously.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.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Radiation reaction in the thorax with no measurable tumor.2. Markedly enlarged bilateral axillary lymph nodes suspicious for metastases.3.Enlarged bilateral adrenal glands, greater on the left, suspicious for metastases.
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Generate impression based on findings.
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Reason: persistent cough with decreased DLCO on PFTs History: persistent cough with decreased DLCO on PFTs LUNGS AND PLEURA: There is no evidence of interstitial lung disease.Mild lower lung zone bronchiectasis is present.Only minimal air trapping is seen on expiration series.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is present.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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Mild lower lung zone bronchiectasis. No other significant abnormality.
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Generate impression based on findings.
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66-year-old male with pancreatic cancer -- assess disease response. CHEST:LUNGS AND PLEURA: Scattered lung parenchymal micronodules unchanged. No new nodules, masses, or foci of airspace consolidation. No pleural disease.MEDIASTINUM AND HILA: Coronary calcification. No adenopathy or other masses or abnormalities.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Hypoattenuating lesion in the right lobe of the liver referencedpreviously, now measures 2.0 x 2.3 cm (series 4, image 96), increased from 0.6 cm previously. Several ill-defined hypodensities subcentimeter in size are now seen in segment 8 (series 4, image 77) and segment 6 (series 4, image 101) -- these are suspicious, but not definitive, and, if concern over worsening liver metastases exists, MRI would be recommended to confirm or characterize.SPLEEN: No significant abnormality notedPANCREAS: The dilated pancreatic duct in the tail is again easily seen -- the tumor itself causing obstruction is more difficult to differentiate from adjacent pancreas. As noted on prior examinations tumor measurement is not possible on these images, and if concern over exact size of pancreatic tumor exists, MRI is recommended.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Orally administered contrast rapidly progresses to normal-appearing stomach, small bowel, and, to the colon. The colon shows normal appearance in ascending, transverse, and descending portions. Loss of haustral folds and submucosal fat deposition throughout. The sigmoid colon and into the rectum suggests old, quiescent colitis. No free mesenteric fluid. BONES, SOFT TISSUES: No significant abnormality noteddOTHER: No significant abnormality noteddPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noteddBLADDER: No significant abnormality noteddLYMPH NODES: No significant abnormality noteddBOWEL, MESENTERY: Orally administered contrast rapidly progresses to normal-appearing stomach, small bowel, and, to the colon. The colon shows normal appearance in ascending, transverse, and descending portions. Loss of haustral folds and submucosal fat deposition throughout. The sigmoid colon and into the rectum suggests old, quiescent colitis. No free mesenteric fluid.BONES, SOFT TISSUES: Lucent lesions are again seen in the right iliac bones, of uncertain significance, but unchanged dating back to April, 2013. Some of these above the acetabula appear degenerative in nature.OTHER: No significant abnormality notedd
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1. No evidence of metastatic disease in the chest with stable micronodules. 2. Increasing size of liver reference lesion worrisome for progressive metastasis. In addition, two subcentimeter new hypodensities are seen that while several and difficult to delineate, are worrisome for additional metastases. MRI could characterize further if clinically indicated. 3. Stable lucent lesions of uncertain significance and right iliac bone. 4. Dilated pancreatic duct in tail persists, but delineation of pancreatic tumor to document size is difficult.
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Generate impression based on findings.
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GI bleed. Evaluate for extrinsic compression of the pylorus. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Nonspecific approximately 2 cm hypodense splenic lesion, possibly representing a lymphangioma or hemangioma.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Few bilateral subcentimeter hypodense lesions, which are too small to fully characterize, possibly representing cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted at the stomach. No extrinsic compression of the stomach is seen. Nondistended loops of bowel without associated soft tissue lesions or mesenteric stranding.BONES, SOFT TISSUES: Levoscoliosis with moderate to severe degenerative changes of the lumbar spine.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Nondistended loops of bowel without associated soft tissue lesions or mesenteric stranding.BONES, SOFT TISSUES: Osseous changes at the right superior pubic ramus likely represents prior trauma. Moderate degenerative changes at the sacroiliac and hip joints.OTHER: No ascites.
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No specific findings to account for the patient's symptoms.
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Generate impression based on findings.
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96 year old female with abdominal pain, status post cholecystostomy. Assess for pus, fluid collection. ABDOMEN:LUNGS BASES: Interval development of a small right pleural effusion with associated compressive atelectasis.Moderate-sized hiatal hernia.LIVER, BILIARY TRACT: A percutaneous cholecystostomy tube enters beneath the eighth rib and coils in the gallbladder fossa. While an intraluminal position is favored, collapse of the gallbladder limits exact localization of the tip. No fluid collection is identified.SPLEEN: Small spleen. Correlate for clinical hyposplenism.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Simple exophytic left superior pole simple cyst.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches.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: Foley catheter within a decompressed bladder.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Descending colon and extensive sigmoid diverticulosis.BONES, SOFT TISSUES: Redemonstrated left quadriceps lipoma. Partially imaged. Nonspecific perineal subcutaneous soft tissue mass measures 4.2 x 2.6 cm and is unchanged from the prior exam.OTHER: No significant abnormality noted.
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1.Interval development of small right pleural effusion.2.Percutaneous cholecystostomy tube likely within lumen of a collapsed gallbladder.3.No free fluid in the abdomen identified, as clinically questioned.4.Perineal subcutaneous soft tissue mass is partially imaged and nonspecific.5.Extensive diverticulosis.
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Generate impression based on findings.
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History of chromophobe T2 renal cell carcinoma, resected in 2008. Evaluate for recurrence. CHEST:LUNGS AND PLEURA: Unchanged left lower lobe micronodule. No new suspicious nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal sized heart without pericardial effusion.CHEST WALL: No significant abnormality noted. No axillary lymphadenopathyABDOMEN: LIVER, BILIARY TRACT: there is a new 0.8 x 0.6 cm hypodense lesion at the inferior tip of the right hepatic lobe (series 3, image 115) nonspecific in appearance, but as not demonstrated on any prior exams is worrisome for metastasis. No other liver lesions seen or other abnormalities. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left nephrectomy. No residual soft tissue noted in the left renal bed. No significant abnormality noted in the right kidney.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No retroperitoneal or mesenteric lymphadenopathy.BOWEL, MESENTERY: No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality noted. No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality noted
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New 0.8 cm hypodense lesion in the right hepatic lobe. Though this is non-specific in appearance, attention to this region on close interval follow up is recommended. If further characterization of this lesion is desired, MR may be helpful. No other abnormalities.
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Generate impression based on findings.
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Clinical question: Rule out chronic sinusitis; assess extent of nasal polyps. Signs and symptoms: Left sided nasal polyp; left-sided sinus pressure. Medtronic fusion sinus CT:Frontal sinuses are well pneumatized and unremarkable.Ethmoid sinuses are well pneumatized and unremarkable.Sphenoid sinus is well pneumatized and unremarkable with patent bilateral sphenoethmoidal recess.Right maxillary sinus demonstrate a small retention cyst in its dependent portion near the 9 times 9-mm and unremarkable otherwise and with patent ostiomeatal unit.Left maxillary sinus demonstrates a retention cyst measuring at 22 x 16 x 26-mm in size, unremarkable otherwise and with patent ostiomeatal unit.Nasal cavity demonstrate mild rightward nasal septum deviation. No bony septal spur. There is increased soft tissue density on the left projecting along the superior aspect of left inferior turbinate and in contact with the left middle turbinate and abuts the left lateral wall of the nasal passage. The finding measures at 9 x 7 millimeter on coronal images and. Finding is nonspecific although could represent clinically indicated nasal polyp. 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.Bilateral maxillary sinus retention cyst (left larger than right and measuring at 22 x 16 x 26-mm). Patent bilateral ostiomeatal limits.3.Well pneumatized all other paranasal sinuses, bilateral mastoid air cells and middle ear cavities.4.Soft tissue density measuring at 9 times 7-mm on coronal images abutting the left lateral nasal wall and projecting between the left middle and inferior turbinates which is a nonspecific finding however could represent patient's reported nasal polyp. There is also mild rightward deviation of the nasal septum without a bony septal spur.
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Generate impression based on findings.
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Male, 61 years old, history of tongue cancer status post CRT. 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. The oral tongue and floor of mouth are free of mass lesions and suspicious enhancement. The remainder of the aerodigestive mucosa is also within normal limits.No pathologic adenopathy is detected by size criteria. A reference left level 2 node continues to measure 4 mm short axis (image 35 series 6), unchanged.Thickening of the platysma and infiltration of the fascial planes of the left neck are redemonstrated compatible with prior therapy. The salivary glands and thyroid are free of focal lesions. The cervical vessels are patent. No worrisome osseous lesions are seen.
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1. No evidence of recurrent disease or pathologic adenopathy in the neck.2. No intracranial metastatic disease.
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Generate impression based on findings.
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43 yer-old male with chronic nasal congestion, facial pain/pressure. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There appears mild polypoid mucosal thickening/small retention cysts in the maxillary sinuses and minimal mucosal thickening in the ethmoid sinuses. There is rightward nasal septal deviation with a spur. The frontal sinuses, frontal-ethmoid recesses, and sphenoid 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 are normal. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable.
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1. Minimal maxillary and ethmoid sinus inflammatory disease. 2. Rightward nasal septal deviation with a spur.
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Generate impression based on findings.
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51 year old female with atypical chest pain, positive d-dimer. Evaluate for PE. PULMONARY ARTERIES: Technically adequate exam without evidence of pulmonary embolus.LUNGS AND PLEURA: 6-mm noncalcified right middle lobe pulmonary nodule (image 95, series 11). No pleural effusion or focal air space opacity.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.No CT evidence of PE.2.6 mm pulmonary nodule. Guidelines by the Fleischner society (Radiology 2005: 237:395-400) suggest that patients with a low risk for lung cancer who have nodules 6-8 mm in diameter require 6-12 month follow up. In patients with a higher risk, such as smokers, initial follow-up is recommended in 3-6 months.
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Generate impression based on findings.
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39-year-old female with history of stage IV metastatic melanoma. IRB 10-666 re-evaluate disease status after add'l systemic therapy, please compare to prev and provide bi-dimensional measurements. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Redemonstrated scattered subcentimeter mediastinal lymph nodes, with reference pretracheal node, measuring 0.8 x 0.5 cm (image 40, series #3), unchanged. No new mediastinal adenopathy.CHEST WALL: Postoperative changes in the right axilla are redemonstrated. Reference soft tissue focus in the right axilla measures 0.9 x 0.4 cm, unchanged to slightly decreased from prior study.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Mild nodularity of left adrenal gland is unchanged from 6/18/2012 and likely of benign etiology.KIDNEYS, URETERS: Hypoattenuating left renal lesion is unchangedRETROPERITONEUM, 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: Left adnexal cystic lesion measures 4.3 x 3.8 cm.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Stable reference adenopathy and soft tissue postoperative changes in the right axilla. No evidence of disease progression.2.Left adnexal cystic lesion may be physiologic, though correlation with ultrasound is recommended given its size.
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Generate impression based on findings.
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63 year-old female with history of prolonged hypoxia at OSH. The exam is limited due to motion and streak artifact. Images through the mid to distal brainstem are not diagnostic. The ventricles, sulci, and cisterns are symmetric and appropriate for the patient's age. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses are clear. There is partial opacification of the mastoid air cells. Right suboccipital scalp swelling. There is partial visualization of endotracheal tube and nasogastric tube.
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No gross acute intracranial abnormality with limitation of artifacts. 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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50 year old female with acute myeloid leukemia, polymicrobial pulmonary infections, history of graft versus host, concern for pulmonary graft versus host. Increased oxygen requirement. LUNGS AND PLEURA: Dense areas of consolidation and the right middle lobe, in the left lower lobe are present. There is also extensive bronchial wall thickening, as well as tree in bud opacities involving the right upper and right lower and right middle lobes.MEDIASTINUM AND HILA: Cardiac size is normal. Small amount of pericardial fluid. No mediastinal or hilar lymphadenopathy.CHEST WALL: Degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Previously identified left adrenal nodule is incompletely visualized on this exam. High-density material is again noted within the stomach.
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Dense areas of consolidation, as well as bronchial wall thickening and tree in bud opacities compatible with bronchiolitis and pneumonia.
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Generate impression based on findings.
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Metastatic urothelial cancer. Baseline study prior to clinical trial CHEST:LUNGS AND PLEURA: Unchanged scattered micronodules. Mild subpleural apical scarring.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Marked coronary artery calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN: LIVER, BILIARY TRACT: Hepatic steatosis, without focal lesions. Cholelithiasis.SPLEEN: Splenule noted. Unchanged calcified splenic lesion.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy. Hypoattenuating left renal lesions are unchanged, possibly representing cysts.PANCREAS: Atrophic pancreas.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted. No lymphadenopathy.BOWEL, MESENTERY: Normal appearing bowel loops. Left lower quadrant ileostomy.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality noted. No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: The fluid collection arising from the bed of the prostate and extending into the base of the penis measures 5.4 x 2.5 cm (series 4, image 224), previously 5.8 x 2.5 cm, likely representing post-surgical changes of prior urethrectomy. Left pelvic sidewall soft tissue lesion measures 1.9 x 1.0 cm (series 4, image 189), previously 2.2 x 1.3 cm.
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1. Interval decrease in size of the reference left pelvic sidewall mass. No new sites of disease.2. Stable appearance of the fluid collection extending to the base of the penis.
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Generate impression based on findings.
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Follow up of subdural hemorrhage status post craniotomy. Postoperative findings including the right parietal craniotomy and associated hardware are stable. There is a stable pattern of bilateral hypoattenuation extending from the right superior temporal gyrus to the right cuneus as well as encephalomalacia within the left lingual gyrus. No acute intracranial abnormalities including hemorrhage, mass, edema or midline shift. Orbits, paranasal sinuses and mastoids are unremarkable.
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No acute intracranial pathology. Stable post-craniotomy findings as described.
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Generate impression based on findings.
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65 year-old male with altered mental status. There is mild patchy hypoattenuation in the periventricular white matter. The ventricles, sulci, and cisterns are symmetric and prominent, representing age related volume loss. 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. Intracranial arterial calcification. The paranasal sinuses and mastoid air cells are clear. There appears some soft tissue density in the left external auditory canal.
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No acute intracranial abnormality. Mild small vessel ischemic disease of indeterminate age. Mild brain volume loss. 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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Male, 80 years old, history of glottic larynx cancer. 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. Tumor seen previously at the level of the glottis is substantially decreased in size. The glottis remains deformed and irregular with some hyperenhancement relative to surrounding tissues. The aryepiglottic folds remain thickened, right side more than left. However, the components of tumor which previously extended through the bilateral thyroid cartilage are no longer clearly identified. Where the thyroid cartilage was previously eroded, sclerotic bony material has developed to fill the defects. Given the significant interval changes in this area, an accurate measurement of tumor cannot be made.There is infiltration of the fascial planes bilaterally. The base of tongue tonsils and submandibular glands are hyperemic, also likely related to therapy. No new mucosal lesions are suspected.No pathologic adenopathy is detected in the neck by size criteria. The salivary glands and thyroid are free of focal lesions. The cervical vessels remain patent. A tracheostomy is in place. Emphysema is demonstrated in the lung apices. Extensive degenerative disease is redemonstrated in the cervical spine, but there are no worrisome osseous lesions.
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1. Substantial interval decrease in the size of the previously demonstrated glottic tumor. Irregularity and hyperenhancement of the glottic mucosa could represent some residual tumor or treatment related effects. Previous erosive destruction of the thyroid cartilage has healed in with sclerotic bone. Given these extensive interval changes, the tumor is no longer reliably measurable.2. No evidence of pathologic adenopathy in the neck.3. No evidence of intracranial metastatic disease.
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Generate impression based on findings.
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75 year old female with history of mesothelioma. Status post two cycles of chemotherapy, evaluate disease and compare with previous. CHEST:LUNGS AND PLEURA: Diffuse pleural nodular thickening in the left hemithorax compatible with mesothelioma. Reference lesions have not significantly changed in size.Reference lesion measurements:At the level of the aortic arch at the 5 o'clock position, 6 mm (axial image 25 series 10301), previously 5 mm.At the level of the carina, focal pleural thickening adjacent to the descending aorta, 9 mm (image 36 series 10301), previously 10 mm. At the level of the inferior left atrium at the 3 o'clock in the left major fissure, 18 mm (image 62, series 10301), previously 18 mm.MEDIASTINUM AND HILA: Heterogeneous thyroid is unchanged. No mediastinal or hilar lymphadenopathy. Cardiac size is normal without pericardial effusion. Moderate coronary artery calcifications.CHEST WALL: Large left anterior chest wall mass with skin thickening and extensive chest wall invasion extends to the left flank area, now measures 63 mm in short axis (image 76 axial series) previously 61 mm. No definite intra-abdominal extension.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: Atrophic right kidney, with mild hydronephrosis and right nephroureteral stent, unchanged. Bilateral renal cysts are again noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of abdominal aorta.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative changes of the thoracic and lumbar spine.OTHER: No significant abnormality noted.
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1.Large mass with extensive left chest wall invasion, but no significant interval change.
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Generate impression based on findings.
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90 year-old male, with glottic larynx squamous cell carcinoma, post chemoradiotherapy, compare to prior LUNGS AND PLEURA: New right upper and lower lobar pulmonary arterial filling defects consistent with pulmonary emboli. Debris is noted in the trachea. Right lower lobe consolidation and atelectasis favors resolving aspiration pneumonia over tumor. Diffuse centrilobular emphysema. Resolution of right upper lobe airspace opacity.MEDIASTINUM AND HILA: Dependent filling defect in the SVC may represent thrombus versus mixing. Tracheostomy tube tip at the thoracic inlet. Mildly enlarged mediastinal lymph nodes appear similar to the prior exam. Moderate coronary arterial calcification. The heart size is normal. CHEST WALL: Mild degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Coarse pancreatic calcifications and dilated pancreatic duct consistent with chronic pancreatitis. Nonspecific hypoattenuating hepatic lesions are unchanged.
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1. New right upper and lower lobar pulmonary emboli. A small filling defect in the SVC may represent thrombus versus mixing.2. Right lower lobe consolidation and atelectasis with associated tracheal debris favors resolving aspiration pneumonia over underlying malignancy, however, follow-up imaging is recommended to confirm resolution. Findings discussed with Dr. De Souza (pager 3686) at the time of dictation.
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Generate impression based on findings.
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64 year-old female status post fall. 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 except for nonunion of the posterior arch of C1. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial abnormality.
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Generate impression based on findings.
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Reason: Lung cancer - please re-eval. Thanks. History: Lung cancer CHEST:LUNGS AND PLEURA: Detail is degraded by respiratory motion artifact.Left upper lobe irregular mass with adjacent atelectasis measures 43 x 20 4 mm, slightly increased in one dimension probably due to adjacent atelectasis.Additional small discrete nodules in the left lung have not significantly changed allowing for motion artifact.A partially cystic and ground glass right lower lobe lesion suggestive of a primary adenocarcinoma is also unchanged (series 5/60).Nodular concentric opacities in the anterior segment of the right upper lobe, suggestive of local tumor spread, also unchanged.Large bilateral pleural effusions, increased compared to previous with adjacent compressive atelectasis.MEDIASTINUM AND HILA: Enlarged lower right paratracheal lymph node measuring 12 mm in short axis, unchanged.Interval decrease in the pericardial effusion with moderate residual pericardial thickening.CHEST WALL: Port catheter with its tip in the SVC.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Very small cysts and no sign of metastases.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: Markedly enlarged retroperitoneal lymph nodes (series 401/101) measuring up to 19 mm in short axis diameter.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Left upper lobe mass and pulmonary metastases, unchanged.2. Mildly enlarged mediastinal and hilar lymph nodes and nodular thickening of the pericardium, consistent with metastases. 3. Increasing bilateral pleural effusions.4. Markedly enlarged retroperitoneal lymph nodes, not imaged on the scan from one month ago, consist with metastatic disease.
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Generate impression based on findings.
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46 year old female, history of 5-mm pulmonary nodule in high-risk patient. Shortness of breath with exertion. Suboptimal examination due to body habitus and mild motion artifact.LUNGS AND PLEURA: Left upper lobe pulmonary nodule measures 5 mm (image 31, series 5), unchanged in size compared to low resolution outside examination. No pleural effusion or focal lung consolidation.MEDIASTINUM AND HILA: Cardiac size is normal without pericardial effusion. No mediastinal or hilar lymphadenopathy. Calcified right thyroid nodule.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Stable left upper lobe pulmonary nodule, measuring 5 mm. Lack of change and small size of the nodule strongly favor a benign etiology, but recommend 12 month follow-up to confirm stability.
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Generate impression based on findings.
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76-year-old female with metastatic lung cancer status post chemo and RT, compare with prior CHEST:LUNGS AND PLEURA: Reference right upper lobe nodule measures 1.8 x 1.3 cm (image 24, series 4) and previously measured 2.3 x 1 .5 cm, decreased in size. No new nodules or masses.MEDIASTINUM AND HILA: Moderate atherosclerotic calcification of the coronary arteries. The heart size is normal. Small calcified nodes consistent with prior granulomatous disease. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.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: Extensive atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Interval decrease in size of right upper lobe nodule. No evidence of metastatic disease.
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Generate impression based on findings.
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39-year-old male status post bronchoscopy with negative cultures. Please evaluate lung lesions on right for interval change. Lung mass. LUNGS AND PLEURA: Focal areas of consolidation and groundglass opacities have decreased in size, now with traction bronchiectasis and architectural distortion compatible with resolving inflammatory/infectious process.MEDIASTINUM AND HILA: Cardiac size is normal without pericardial effusion. No mediastinal or hilar lymphadenopathy. Mildly enlarged left low cervical lymph node is unchanged. Thymic aplasia is again noted.CHEST WALL: Right gynecomastia is unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Findings compatible with resolving infectious process.
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Generate impression based on findings.
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66-year-old female with metastatic renal cell cancer -- assess for disease progression. CHEST:LUNGS AND PLEURA: Scattered micronodules and some calcified nodules are unchanged. The reference right middle lobe nodule (series 4, image 47) measures 4 mm and is unchanged. No new nodules or air space disease is seen. No pleural abnormalities. MEDIASTINUM AND HILA: Calcified lymph nodes typical of prior granulomatous disease. No other lymphadenopathy. Coronary artery calcification. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Diffuse hepatic steatosis again seen to a degree that hepatic lesions cannot be well discriminated. Foci of residual soft tissue density adjacent to the, gallbladder fossa and more peripherally up in segment 8 are again seen, but cannot be delineated nor measured for possible metastatic disease -- as mentioned previously these could be areas of focal sparing or scarring. If concern over liver lesions exists, or would be important for determining therapy, MR examination would be recommended.SPLEEN: Calcified granulomata without other abnormalityPANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Prior left nephrectomy without evidence of tumor in bed. Right kidney appears normal and unchanged.RETROPERITONEUM, LYMPH NODES: No adenopathy or other significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Prior hysterectomy without other abnormality.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. Stable micronodules in lung parenchyma. 2. Diffuse fatty liver without change and unable to measure prior noted index lesions -- presence of fat can obscure lesions and if concern over liver lesions exists, MR would be recommended.
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Generate impression based on findings.
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29-year-old male with 3 episodes of nausea/vomiting/diarrhea over two weeks, with periumbilical pain. Rule out appendicitis or other colitis. ABDOMEN:LUNGS BASES: No significant abnormality noted.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 significant abnormality noted.BOWEL, MESENTERY: Nonspecific scattered , diffuse, mildly prominent mesenteric lymph nodes, largest of which measures 1.3 x 1.4 cm (image 83, series #3). BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Scattered, diffuse mildly enlarged mesenteric lymph nodes, nonspecific in appearance, without any other associated abnormality.
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Generate impression based on findings.
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Status post partial hepatectomy now with abdominal pain nausea and vomiting ABDOMEN:LUNG BASES: Right basilar atelectasis and small pleural effusion likely postoperativeLIVER, BILIARY TRACT: Status post resection of segment 6/7 mass lesion with expected postoperative changes including fluid and gas foci noted. No obvious loculated collection to suggest abscess at this time. No ductal dilatation or biloma. Gallbladder absent. Hepatic vessels patent.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Soft tissue infiltration and gas foci within the right abdominal subcutaneous tissues anteriorly consistent with expected postoperative findingsOTHER: Distal end of surgical drain anterior to superior liverPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Trace ascites likely postoperativeBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Status post resection of right hepatic lobe mass lesion with expected postoperative findings. No evidence for abscess, hematoma, biloma, or bowel obstruction.
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Generate impression based on findings.
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History bladder cancer. ABDOMEN:LUNG BASES: Subcentimeter left lower lobe nodule is unchanged.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small left para-aortic lymph nodes are stable.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: Status post cystectomy. Right lower quadrant ileostomy.LYMPH NODES: Small right inguinal lymph nodes are stable.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Small sclerotic bone lesions in the pelvic bones are stable.OTHER: No significant abnormality noted
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No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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Abnormal LFTs. History of HHS. ABDOMEN:LUNG BASES: Bibasilar scarring/atelectasis. Non-specific left lower lobe micronodule (series 5, image 13). LIVER, BILIARY TRACT: Bilobar intrahepatic biliary ductal dilation, with soft tissue fullness at the porta hepatis, possibly secondary to adenopathy or mass; however, this is poorly characterized on this non-contrast examination. Common bile duct stent visualized. Non-cirrhotic liver morphology. Prominent portacaval lymph nodes.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Fatty atrophy of the pancreas.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No gross abnormalities noted.BONES, SOFT TISSUES: Moderately severe degenerative changes of lumbar spine.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Distended bladder with Foley catheter in place. Air within the bladder is likely secondary to instrumentation.LYMPH NODES: No pelvic lymphadenopathyBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No ascites.
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1. Soft tissue fullness at the porta hepatis, suspicious for adenopathy or mass. Bilobar intrahepatic biliary ductal dilation with common bile duct stent in place, raising the question of stent malfunction. If patency of the portal venous system is of clinical concern, Doppler evaluation may be helpful. 2. Non-specific left lower lobe micronodule. Comparison to prior outside exams or attention to this on subsequent exams is recommended.2. Distended bladder with catheter in place. If catheter not currently clamped, replacement may be helpful.
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Generate impression based on findings.
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Burkitt lymphoma CHEST:LUNGS AND PLEURA: New multifocal air space opacity involving the left upper lobe; cannot exclude early infectious/inflammatory process. Previously noted right lower lobe micronodules and right upper lobe scarring and nodularity have remained stable.MEDIASTINUM AND HILA: Slight interval increase in size of mediastinal lymph nodes. The referenced right paratracheal lymph node best seen on image 37 series 3 now measures 1.2 x 1.5 cm; this is comparison to 1 cm on 7/5/2013.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Slight interval increase in size of referenced left adrenal module best seen on image 103 of series 3 now measuring 2.9 x 1.5 cm; this is in comparison to 2.6 x 1.3 cm on 7/5/2013KIDNEYS, URETERS: No change in soft tissue focus involving the posterior medial aspect of the right kidney extending and inseparable from the right psoas as seen on image 132 of series 3 measuring 2.8 x 3.2 cm.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: No significant abnormality notedOTHER: No significant abnormality noted
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Slight interval increase in size of mediastinal lymph nodes and left adrenal referenced nodule.New multifocal airspace opacity upper lobe left lung; cannot exclude early infectious or inflammatory process.
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Generate impression based on findings.
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Neuroendocrine tumor CHEST:LUNGS AND PLEURA: Left lower lobe bronchiectasis filled with mucous plugs, new from previous study.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Numerous liver metastases, again noted. Index lesion in the right lobe now measures 4 by 3.0-cm image number 89, series number 3, increased in size compared to previous study. Other metastatic lesions are also minimally increased in size.SPLEEN: No significant abnormality noted.PANCREAS: Large heterogeneous, enhancing hypervascular mass posterior to the pancreatic tail now measures 9.7 x 8.5 cm on image number 97, series number 3, slightly increased compared to previous study.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Index retroperitoneal lymph node measures 1.1-cm in diameter image number 122, series, number 3, stable compared to previous study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Cortical irregularity involving the right iliac bone with lytic lesions in both iliac bones, unchanged. Metastatic disease cannot be excluded. Sclerotic lesions involving the L2 and L4 vertebral bodies, unchanged.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Interval increase in the size of the hepatic metastases, pancreatic tail mass. Index retroperitoneal lymph nodes and bone lesions are stable.Interval development of mucous plugging involving the left lower lobe bronchiectasis.
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Generate impression based on findings.
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71-year-old male with carcinoid tumor of unknown primary site. Surveillance images. CHEST:LUNGS AND PLEURA: No significant abnormality notedin the lung parenchyma. Bilateral pleural effusions.MEDIASTINUM AND HILA: Calcified lymph nodes from prior granulomatous disease. Coronary artery calcifications seen. No adenopathy is seen and no significant mediastinal or hilar masses noted. Small pericardial effusion seen, unchangedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted in the liver parenchyma. There is scalloping of the right liver from extrinsic fluid -- the scalloped margin and in a detention raises question of subcapsular collection, but this may be loculated ascites.Patient is status post cholecystectomy. No intrahepatic or extrahepatic biliary duct dilatation is seen to suggest, biliary tract abnormality.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: A snapped periaortic lymph nodes are again seen, unchanged and no enlarged nodes to suggest adenopathy.BOWEL, MESENTERY: The bowel reflects multiple prior surgeries and anastomoses with marked distension of small bowel loops. There is a dilatation of small bowel loops in a pattern unchanged from 8/21/13. The colon and distal ileum does appear collapsed and as described in prior report, concern over partial obstruction remains. This appearance is unchanged from 8/21/13, but compared back to 2/19/13 there is increasing distention noted in multiple foci of small bowel loops. The prior noted ascites has markedly increased and is now largely distributed throughout much of the abdomen without loculation.The prior described enterocutaneous fistula is again demonstrated (series 4 , image 145) although not as well visualized as on prior examination.The right lower quadrant spiculated and calcified mass (series 4, image 158) is unchanged and measures 3.8 x 3.7 cm.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: Bilateral hip prostheses, which create a schemes streak artifact, obscuring visualization of the distal pelvis. Diffuse subcutaneous fat and soft tissue anasarca, new since prior examination.OTHER: No significant abnormality noted
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1. No change - calcified mesenteric mass. 2. No significant change in the distorted appearance of small bowel, with probable chronic obstructions. 3. Marked increase in diffuse ascites. 4. Enterocutaneous fistula again visualized. 5. No significant thoracic abnormalities noted. 6. No other change is noted from 8/21/13.
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Generate impression based on findings.
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Pre-kidney transplant evaluation. Patient with previous pancreas transplant, need images deceive transplanted pancreas common-law post aorto iliac. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Heterogeneous enhancement of the liver may be secondary to congestion.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic kidneys. Large left renal stone measuring 1.1-cm in diameter. There are bilateral other smaller stones. No evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy. An index left para-aortic node measures 1.3 cm in diameter image number 49, series number 11.Arterial anastomosis to the transplant pancreas common-law from abdominal aorta immediately above the level of aortic bifurcation. There are atherosclerotic calcifications in celiac trunk, SMA, and its branches, and internal iliac vessels, however, no atherosclerotic calcifications are visualized in the abdominal aorta and proximal common iliac vessels.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Transplanted pancreas is unremarkable.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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Normal transplant pancreas.Bilateral nephrolithiasis. Bilateral atrophic kidneys.
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Generate impression based on findings.
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71year-old male with history of bladder cancer CHEST:LUNGS AND PLEURA: Subcentimeter bronchopulmonary lymph nodes adjacent to the fissure image number 56 on series number 5.MEDIASTINUM AND HILA: Small mediastinal lymph nodes and right hilar lymph nodes. An index pretracheal lymph node measures 9 mm on image number 36 of series number 7.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Subcentimeter cystic lesion in the pancreas like representing a branch type by PMN.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate Gland Is Enlarged.BLADDER: Diffuse wall thickening of the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Bilateral inguinal hernias. Right-sided inguinal hernia contains fat. Left-sided inguinal hernia contains fat and nonobstructed sigmoid colon segment.
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Diffuse wall thickening of the bladder. Bilateral inguinal hernias.
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Generate impression based on findings.
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Clinical question:intracranial hemorrhage versus mass. Signs and symptoms: History of HIV, headache x 6 days, left eye blurred peripheral vision. Nonenhanced head CT:No detectable acute intracranial process. CT however these insensitive for the detection of acute nonhemorrhagic ischemic strokes.Mild prominence of cortical sulci and lateral ventricles. Unremarkable nonenhanced head CT otherwise.Calvarium and soft tissues of the scalp are unremarkable.Visualized paranasal sinuses and bilateral mastoid air cells and middle ear cavities remain well pneumatized.
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No acute intracranial process.
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Generate impression based on findings.
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Clinical question : Rule out toxo. Signs and symptoms: Altered mental status. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes.Prominence of cortical sulci and cerebellar -- vermian consultation stated age of 35 is noted. Unremarkable intracranial contents otherwise.No significant interval change since prior head CT exam from 6 -- 17 -- 11.Unremarkable calvarium and soft tissues of the scalp, orbits, paranasal sinuses and mastoid air cells.
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No acute intracranial process.
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Generate impression based on findings.
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Clinical question : No acute infarct or bleed. Signs and symptoms: Worsening mental status coma starting. Nonenhanced head CT:No detectable acute intracranial process CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Very minimal periventricular /subcortical low attenuation of white matter considering patient's stated age of 79 likely representing age indeterminate moderate small vessel ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system and in the CSF spaces otherwise for patient's stated age of 79.Unremarkable calvarium, paranasal sinuses, mastoid air cells and orbits.
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No acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.
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Generate impression based on findings.
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Clinical question: Evaluate for 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 strokes.Examination demonstrates interval postoperative changes of transphenoidal hypophysectomy and including high density fluid (possibly blood product and packing) within the sphenoid sinus, well demarcated high density content within the sella measuring at 8 times 8-mm which is surrounded with fatty tissue density and likely representing postoperative changes and packing. Images through the basal cisterns are unremarkable. No evidence of pneumocephalus or hemorrhage in the subarachnoid space or the parenchyma is detected. Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces otherwise.Calvarium and soft tissues of the scalp are unremarkable.Bilateral mastoid air cells and middle ear cavities are well pneumatized and unremarkable.Images through the orbits are unremarkable.
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1.Postoperative changes of transphenoidal hypophysectomy and including high density fluid within the sphenoid sinus, bony defect along the floor of the sella, high density material within the sella surrounded in fatty tissue as detailed above.2.Unremarkable nonenhanced head CT otherwise.
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Generate impression based on findings.
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Clinical question: Postop bleeding, shunt placement there signs and symptoms: Shunt placement. Unenhanced head CT:There is a right frontal paramedian burr hole and a catheter extends from the burr hole through the right frontal lobe and with the tip in the frontal horn of right lateral ventricle. There is no evidence of hemorrhage along the course of the catheter or in the ventricular system.Compared to prior exam there is a slight interval increased size of lateral ventricles. A previously noted left posterior parietal approach ventricular catheter/drain has been removed minimal attenuation of brain parenchyma at the site remains similar to prior exam and may represent edema. Stable exam otherwise.
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1.Slight interval increased size of supratentorial ventricular system since prior study.2.Interval placement of ventricular drain from right frontal paramedian burr hole approach without evidence of postprocedural hemorrhage.3.Interval removal of left posterior parietal approach ventricular drain.4.No convincing evidence of any acute new finding since prior exam other than above-described interval enlargement of lateral ventricles.
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Generate impression based on findings.
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22-year-old female with abdominal pain, nausea, vomiting. 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: Several fluid filled, mildly distended small bowel loops, possibly focal ileus or gastroenteritis. No wall thickening or obstruction. No free fluid. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Diffuse bladder wall thickening is likely due to under distention.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Several fluid filled, mildly distended small bowel loops, possibly due to gastroenteritis. 2.Diffuse mild bladder wall thickening may be due to underdistention, however, correlate with any UTI/cystitis symptoms.
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Generate impression based on findings.
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Clinical question: Non-small cell lung cancer with known metastases to brain. Presenting with lower extremity weakness, please evaluate for brain metastases. Signs and symptoms: As above. Pre-and post-enhanced head CT:Examination demonstrates subtle focal increased density in the left anterior frontal lobe with evidence of surrounding vasogenic edema the site of previously removed tumor. The post enhanced images there is suspected subtle enhancement of this finding which in combination with increased surrounding vasogenic edema (compare to prior MRI exam from 10 -- 7 -- 13) raises the possibility of a metastatic lesion.Examination also demonstrates a focus of subtle increased density in the immediate events or white matter of left frontal lobe with surrounding vasogenic edema and without convincing evidence of enhancement. This focus is also suspected of a small hemorrhagic metastatic lesion.Additional smaller subcortical focus of increased density without convincing evidence of enhancement is also noted in the left high convexity anterior frontal lobe measuring at 4.4 mm size as well suspect that of a small hemorrhagic metastatic lesion. Examination demonstrate also very subtle edema in the right posterior temporal lobe containing a 4.9-mm focus of increased density and subtle suspected enhancement.Normal size of ventricular system and with maintained midline. Unremarkable images through posterior fossa.Calvarium demonstrates expected postoperative changes of a left anterior frontal paramedian craniotomy and unremarkable otherwise.Unremarkable soft tissues of the scalp.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells.
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1.Multiple small hemorrhagic metastatic lesions of bilateral cerebral hemispheres as detailed. The surrounding vasogenic edema and subtle lesion or mass effect however without detectable mass effect on the ventricular system or midline shift. There is no detectable leptomeningeal enhancement.2.Calvarium demonstrates a left frontal craniotomy and unremarkable otherwise.
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Generate impression based on findings.
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76 year old female with elevated white blood cell count and open abdominal wound. ABDOMEN:LUNG BASES: Small bilateral pleural effusions with overlying consolidation/atelectasis in both bases.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications affect the aorta and its branches.BOWEL, MESENTERY: Postsurgical changes including extensive mesenteric haziness/inflammatory change in the right lower quadrant with associated adhesion and thickening of adjacent bowel loops. Percutaneous drain with tip in right upper quadrant. No evidence of bowel obstruction. No loculated fluid collection to suggest abscess. No extraluminal oral contrast identified to suggest leak or fistula.BONES, SOFT TISSUES: Open anterior abdominal wound. High density round focus measuring 1.9 x 2.2 cm located in inferior rectus muscle adjacent to the open abdominal wound does not show definite communication with the bowel and may represent small hematoma (series 3, image 118).Bilateral pars defects at L5-S1 resulting in grade 2 anterolisthesis of L5 on S1.Multiple round soft tissue attenuation foci in anterior bowel wall, likely injection granulomas.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Foley catheter in bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Extensive postsurgical changes including open abdominal wound and mesenteric inflammation, without evidence of drainable fluid collection.
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Generate impression based on findings.
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61-year-old male with history of prostate cancer. Evaluate for fluid collection. PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Significant decrease in fluid collection located along right pelvic sidewall which measures 3.0 x 7.0 cm (series 3, image 36); a percutaneous pigtail catheter is present in this collection. No other fluid collections are identified.OTHER: No significant abnormality noted
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Significant interval decrease in right hemipelvis fluid collection.
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Generate impression based on findings.
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49-year-old female with left lower quadrant pain. ? tics. ABDOMEN:LUNGS BASES: Mild bilateral basilar atelectasis. No effusions. Normal heart size. Small hiatal hernia.LIVER, BILIARY TRACT: The liver enhances homogeneously without focal lesion. Probable hepatic steatosis. Interval removal of the gallbladder is noted with cholecystectomy clips in the gallbladder fossa. Residual common duct is prominent in size measuring 11 mm in maximal diameter without evidence of choledochal lithiasis.SPLEEN: Small subcentimeter nonspecific splenic hypodensity. 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: Colonic polyps versus adherent stool in the transverse colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:Streak artifact from bilateral orthopedic procedures significantly limits evaluation of the pelvis.UTERUS, ADNEXA: Small right adnexal cystic lesion is likely physiologic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild, scattered diverticulosis of the descending and sigmoid colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of diverticulitis as clinically questioned, though early or mild diverticulitis may be radiographically occult.
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Generate impression based on findings.
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84-year-old female with dyspnea PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus.LUNGS AND PLEURA: Basilar atelectasis.MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes compatible with prior granulomatous disease. Atherosclerotic calcification of the thoracic aorta. Severe coronary arterial calcification.CHEST WALL:Degenerative changes of the thoracolumbar spine. Anterior chest wall collaterals are noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Splenic and hepatic granulomata. Right renal cyst. Left renal scarring.
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No pulmonary embolus, or other significant abnormality.
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Generate impression based on findings.
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Female 67 years old; Reason: cirrhosis and RLQ pain, evaluate for HCC and cause of pain. BMP ordered today History: above ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver contour: The liver contour is nodular..Marked cholelithiasis without cholecystitis. There is no intrahepatic or extrahepatic biliary ductal dilation.Portal vein: Patent although apparent filling defects are noted at the take off of the right and left main veins with Klatskin's point may be mixing of contrast.Hepatic veins: Apparent filling defect in the IVC just proximal to the hepatic veins. Hepatic veins are not well visualized on this examinationHepatic artery: Patent with conventional anatomyLesions: No definite lesion is seen, although this is a single phase contrast, which limits evaluation. Small hypoattenuating focus is noted in left lateral segment (series 3 image 32) incompletely characterized given lack of arterial phase imaging.Marked collaterals with varices and a recannulized umbilical vein noted.Marked ascites.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: Moderate to severe echo hernia with stomach herniated into the thoracic cavity.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Marked soft tissue nodularity in the omentum and measuring 5.3 x 12 cm (series 3 image 35) compatible with omental carcinomatosis. Extensive caking and nodularity is seen along the anterior omentum as well as into the pelvis, compatible with worsening carcinomatosis. This is new since previous examinations.PELVIS:UTERUS, ADNEXA: 7.3 x 5.9 cm heterogeneous mass arising from the right adnexa, worrisome for ovarian carcinoma. Soft tissue nodularity and cystic components are noted within the lesion.Small amount of fluid is noted in endometrial cavity. The left adnexa is also cystic, and may contain some nodular components measuring approximately 5 0.5 x 3.5 cm (series 3 image 79).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: Ascites and nodularity compatible with peritoneal carcinomatosis.
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1.Large bilateral heterogeneous masses arising from the adnexa, worrisome for an ovarian carcinoma. Pelvic MRI or ultrasound advised for full characterization.2. Interval development of moderate to severe peritoneal carcinomatosis and ascites3.Cirrhotic morphology with no definite HCC although nonspecific hypoattenuating lesion in left lateral segment.4.Questionable filling defect in the IVC and portal veins, which could be artifactual versus clot.5.Moderate to severe hiatal hernia6.Dr. Reddy notified of the findings at 9:12 on 12/11/13
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Generate impression based on findings.
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71 year-old female with history of PE, pulmonary nodules. Evaluate for primary malignancy. ABDOMEN:LUNGS BASES: Large filling defect in the right main pulmonary artery is redemonstrated, with right pulmonary artery enlargement and straightening of the interventricular septum. The mass/thrombus in the right pulmonary artery is only partially included, and a more detailed report is available for the chest CT scan on 12/9/2013. Multiple bilateral pulmonary nodules are suspicious for metastatic disease.LIVER, BILIARY TRACT: Liver enhances homogeneously without focal lesion. Cholelithiasis and/or sludge in the gallbladder is noted without acute inflammation. The gallbladder is hydropic.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: An IVC filter is noted at the level of the right renal vein.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Myomatous uterus with calcified fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.IVC filter is positioned at the inflow of the right renal vein.2.Unchanged large filling defect in the right pulmonary artery with evidence of right heart strain.3.Bilateral pulmonary nodules, suspicious for metastatic disease.4.No specific evidence for primary malignancy in the abdomen is identified.5.Cholelithiasis/sludge in the gallbladder.
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