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Generate impression based on findings.
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48 year-old male with history of CVA. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial abnormality. 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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Swelling, erythema, bulla, evaluate for fasciitis Air is seen in the soft tissues inferior to the right tarsal bones. No bone erosion or periosteal reaction is seen.Nonspecific diffuse soft tissue swelling is seen throughout the right leg. Mild degenerative changes are seen at the right knee, right ankle, and right mid foot. Degenerative changes are also seen at the first MTP and sesamoids. No acute fracture or dislocation is seen. Vascular calcifications are present.
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Air inferior to the right tarsal bones is suspicious for fasciitis
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Generate impression based on findings.
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Hemophagocytic syndrome with leukopenia and anemia. Fevers and lower extremity edema 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: Stable within upper limits of normal for sizePANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable right renal cysts. Nonobstructing right renal calculus now absent.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence for acute, inflammatory, or neoplastic process. Subcentimeter right renal calculus now absent.
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Generate impression based on findings.
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22-year-old male with osteosarcoma with recurrent pulmonary metastasis x 4, assess for new pulmonary metastasis. LUNGS AND PLEURA: Bilateral surgical sutures compatible with previous resection. No nodules or micronodules are identified. No pneumothorax or pleural effusions.MEDIASTINUM AND HILA: No significant lymphadenopathy. Residual thymic tissue in the anterior mediastinum. Unchanged epicardial calcification. No pericardial effusions. Heart size is normal.CHEST WALL: Postoperative changes to the left anterior chest wall. Irregularity of the fourth segment sternum is unchanged.UPPER ABDOMEN: 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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69 year-old female with right hand/face weakness, slurred speech and hypertension. There is patchy hypoattenuation in the left frontal periventricular white matter extending into the left externa capsule . There is a focus of hypoattenuation the right putamen. The ventricles, sulci, and cisterns are symmetric and mildly prominent, representing 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. Intracranial arterial calcifications. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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1. No acute intracranial abnormality. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 2. Left frontal periventricular white matter and external capsule small vessel ischemic disease and right basal ganglia of indeterminate age.
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Generate impression based on findings.
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Reason: Evaluation for pulmonary embolism in patient with sudden onset of shortness of breath and leg swelling 6 days ago. History: dyspnea, hypoxemia (oxygen saturation decreased at 88%), leg swelling. PULMONARY ARTERIES: Technically adequate exam for evaluation of pulmonary embolism. No pulmonary embolus identified.LUNGS AND PLEURA: No significant abnormality noted. Calcified granuloma in the left upper lobe.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. Mild atherosclerotic calcification of the abdominal aorta.
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No evidence of pulmonary embolism, or other significant abnormality.
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Generate impression based on findings.
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Reason: 50 yo male with lung nodule on chest xray; please evaluate for abnormalities History: lung nodule LUNGS AND PLEURA: No pulmonary nodules identified. What was seen on the chest x-ray may have been an ossified costovertebral junction. MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Limited study, without contrast, grossly unremarkable.
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No significant thoracic abnormality. Specifically, no evidence of a nodule.
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Generate impression based on findings.
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21-year-old female with history of osteosarcoma and pulmonary metastases with hemoptysis LUNGS AND PLEURA: Postoperative changes in the left lower lobe and lingula.Irregular peripheral opacity in the right lower lobe is unchanged and likely postoperative. A 6-mm nodule along the right major fissure likely represents an intrapulmonary lymph node. Nodularity along the pleura of the left lower lobe (4/51) is unchanged. No new pulmonary nodules or masses. No consolidation or pleural effusions.MEDIASTINUM AND HILA: Heart size is normal. No mediastinal or hilar lymphadenopathy.CHEST WALL: Sclerotic foci along the posterior left sixth rib is unchanged.UPPER ABDOMEN: The visualized portions of the upper abdominal organs are normal.
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No significant change from the prior exam. No evidence of recurrent or metastatic disease.
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Generate impression based on findings.
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74-year-old male with history of lung cancer status post 6 cycles chemo, please re-eval. CHEST:LUNGS AND PLEURA: A cystic left upper lobe nodule now demonstrates an air-fluid level and is minimally decreased in size, now measuring 24 mm in maximal axial diameter (series #5, image 94), from previously 27 mm.A right upper lobe ground glass nodule with cystic components measures 28 x 17 mm (series number 10, 5, image 104), minimally decreased in size and solid components from previous when measured 27 x 21 mm.The additional previously noted right upper lobe non-solid nodule with cystic versus bronchiectatic components measures 11 mm, previously 12 mm, unchanged.Minimal scarring at the lung bases is noted. Patchy opacities in the dependent portion of the right lower lobe, consistent with aspiration.MEDIASTINUM AND HILA: Dense coronary artery and valvular calcifications. Scattered nonenlarged mediastinal lymph nodes are unchanged.CHEST WALL: T6 vertebral body lytic lesion is unchanged and is compatible with metastatic disease. No new bony metastases identified. Unchanged left posterior rib fracture. Pathological fracture cannot be ruled out.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Right hepatic lobe hypodensity measures 16 x 12 mm in greatest axial dimension (image 108, series #3), from previously 25 x 14 mm, though appears grossly unchanged in size and appearance from the prior study. Two left lobe hypodensities are also grossly unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Right adrenal gland has dramatically increased size, measuring 4.1 x 3.1 cm (image 108, series #3).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.Multiple simple cysts of the left kidney.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Continued slight decrease in size of left upper lobe now cavitary nodule. Two other nonsolid nodules in the right upper lobe are unchanged.Multiple hepatic metastases are grossly unchanged.Dramatic increase in right adrenal metastasis.No evidence of new metastases.
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Generate impression based on findings.
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36-year-old female with history of left thyroid lobectomy and enlarging right thyroid lobe. TECHNIQUE CT soft tissue neck after the administration of 65 mL Omnipaque 350 IV contrast. Diagnostic sensitivity is limited by patient body habitus.Postsurgical changes compatible with left thyroid lobectomy. There is continued heterogeneous attenuation within an enlarged right thyroid lobe, which measures approximately 5.3 x 3.0 cm and does not appear grossly changed (coronal series 80634, image 38), although the patient's body habitus significantly limits evaluation of this region. The lesion indents the right lateral tracheal wall slightly, but the airway is otherwise patent. No new masses or cervical lymphadenopathy are appreciated. The carotid arteries and jugular veins appear patent. The oral cavity, oro/nasopharynx, hypopharynx, larynx, and subglottic airways are unremarkable. The parotid and submandibular glands demonstrate normal size and appearance. There is bridging ossification of the PLL at C2/C3, but the osseous structures are otherwise within normal limits. The visualized intracranial structures and lung apices are unremarkable.
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1.Continued heterogenous attenuation within an enlarged right thyroid lobe s/p left thyroid lobectomy as described above. This lesion appears grossly unchanged, but assessment is limited considering image degradation in this region due to patient body habitus.2.No new masses or lymphadenopathy identified.
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Generate impression based on findings.
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49 year-old female. Metastatic lung cancer status post 7 cycles of Nivolumab. Compare to previous. CHEST:LUNGS AND PLEURA: Reference right apical spiculated nodule measures 9 x 14 mm, previously 10 x 14 mm (series 6, image 21). Scattered micronodules are stable. No new pulmonary nodules. Moderate upper lobe centrilobular emphysema.MEDIASTINUM AND HILA: Reference left paratracheal lymph node measures 7 mm in short axis (series 4, image 41), unchanged. Borderline enlarged right hilar lymph node is unchanged (series 4, image 49).CHEST WALL: Lucency in the right aspect of T5 is unchanged (series 4, image 36). Unchanged subcutaneous subcentimeter nodule on the left (series 4, image 62). aABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple subcentimeter hepatic hypodensities are too small to characterize but unchanged, likely benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Status post right adrenalectomy. Stable small subcentimeter left adrenal nodule.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No abdominal lymphadenopathy. Moderate atherosclerotic calcification abdominal aorta.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Previously seen 6 mm soft tissue metastases in the right flank has decreased in size with no measurable lesion remaining.OTHER: No significant abnormality noted.
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1. No significant change in right upper lung spiculated nodule.2. Interval decrease in size of small right flank soft tissue metastases.3. No new sites of disease.
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Generate impression based on findings.
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Female; 47 years old. Reason: neuroendocrine cancer compare to prior CT \T\ measure 1) Segment IVb liver lesion, 2) segment VII liver lesion \T\ 3) cecal mass History: post 2 cycles of therapy CHEST:LUNGS AND PLEURA: Multiple right-sided nodules are again identified. Reference right upper lobe lesion, best seen on image 39 of series 9, is stable in size measuring 5 mm, previously measuring 5 mm. No focal consolidation or pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: Nonpathologic sized axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: The reference segment 7 lesion, best seen on image 5 of series 7, is slightly larger measuring 6.3 x 5.7 cm, previously 5.8 x 5.2 cm. The reference segment IVb lesion, best seen on image 87 of series 7, is stable measuring 5.4 x 5.4 cm, previously 5.7 x 5.7 cm.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: Cecal mass, best seen on image 90 of series 6, has increased in size measuring 4.6 x 4.0 cm, previously 3.4 x 2.4 cm. Adjacent mesenteric soft tissue mass is unchanged in size and appearance and likely represents a lymph node.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Bilateral adnexal cysts are unchanged.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 pulmonary nodules.2.Multiple hepatic lesions are minimally changed with measurements as dictated above.3.Interval increase in size of cecal mass.
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Generate impression based on findings.
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75 or old male. Left parotid adenoid cystic carcinoma. Compare to last CT. CHEST:LUNGS AND PLEURA: Interval increased size of multiple pulmonary nodules in both lungs. This includes a right upper lobe nodule measuring 16 x 15 mm, previously 16 x 12 mm (series 5, image 51) and a right upper lobe nodule, now 11 mm previously 8 mm (series 5, image 20).MEDIASTINUM AND HILA: Ectatic ascending aorta and proximal arch; diameter of aortic root is 4.3 cm, unchanged (series 3, image 54). Right chest port tip is at the cavoatrial junction.Heavily calcified aortic valve. Severe coronary artery calcifications. Normal heart size. CHEST WALL: Surgical clips left upper chest wall. Right chest wall port. Mild degenerative arthritic changes of thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Marked interval increase in size and number of numerous hepatic metastases. Previously measured reference conglomerate liver mass is now confluent with a more superior lesion, making measurements inaccurate. An approximate measurement is 8.2 x 5.9 cm, previously 5.9 x 5.6 cm (series 80212, image 76). Cholelithiasis. Loculated ascites or subcapsular fluid, increased from prior exam.SPLEEN: No focal splenic lesion. Heavily calcified splenic artery.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left parapelvic cysts. Extrarenal pelvises bilaterally. Bilateral renal cysts. A few subcentimeter hypodensities in both kidneys, too small to characterize but not significantly changed and likely cysts. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe calcified atherosclerotic calcification of the abdominal aorta with mural thrombus and infrarenal aneurysm measuring 3.6 cm, unchanged.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Mild degenerative arthritic changes of lumbar spine.OTHER: No significant abnormality noted.
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Interval progression of lung and liver metastasis.
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Generate impression based on findings.
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Reason: Eval possible mets LT lower lobe nodule increased in size, HCC with new lesions - please do chest with and without contrast History: Left lower lobe pleural based nodule, 1.8 x 0.9 cm, recurrent HCC LUNGS AND PLEURA: Scattered benign appearing micronodules.Recently described left base subpleural nodule adjacent to scarring and prior wedge resection most likely is post inflammatory and not a metastasis. MEDIASTINUM AND HILA: Scattered mediastinal lymph nodes are upper normal in size, unchanged.CHEST WALL: Left sided thoracotomy defect.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Known liver abnormalities recently described by CT 12/19/2013.
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Scarlike abnormality left lung base periphery, probably not a metastasis.
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Generate impression based on findings.
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Male; 86 years old. Reason: Evaluation of Castleman's Dz, GIST and pelvic discomfort History: Castleman's and Hypothyroidism with growing thyroid mass (per symptoms) and pelvic discomfort with known retroperitoneal lymphadenopathy Lack of intravenous contrast enhancement limits the evaluation of solid organ parenchyma and vascular structures. Given these limitations, the following observations can be made:CHEST:LUNGS AND PLEURA: Reference nodule in the right lower lobe, best seen on image 73 of series 5, is stable in size measuring 0.9 cm, previously 0.9 cm.MEDIASTINUM AND HILA: Previously measured pretracheal lymph node, best seen on image 32 of series 80216, measures 1.5 x 1.1 cm. This measurement actually represents a conglomerate of lymph nodes and is stable in size and appearance.CHEST WALL: No significant abnormality notedOTHER: Enlarged and heterogeneous thyroid gland (well described on a prior dedicated soft tissue neck CT scan).ABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic cysts are unchanged dating back to 2008.SPLEEN: No significant abnormality notedPANCREAS: Partially calcified mass anterolateral to the pancreatic tail is unchanged.ADRENAL GLANDS: Small right adrenal nodule is unchanged in size and appearance.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Stable reference retroperitoneal lymph node, best seen on image 139 of series 80216, measures 1.8 x 0.9 cm, previously 1.8 x 0.9 cm.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: Diffuse patchy demineralization of the bones is unchanged.OTHER: Penile prosthesis noted.
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1.Stable examination without significant change.
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Generate impression based on findings.
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70-year-old male. Reason: pt with stage IV thymoma s/p neo-adjuvant chemo/rt and surgery. History: now needs disease evaluation compare to previous scans and comment. CHEST:LUNGS AND PLEURA: The reference posterior right upper lobe nodule is difficult to evaluate given obscuration by surrounding consolidation on the current and prior studies, however measures 12 x 8 mm on the current exam (series #3, image 34), and is decreased in size compared to the examination dated 8/21/2013, previously measuring 20 x 14 mm.Dense consolidation extending from the right mediastinum on the right with areas of groundglass are consistent with radiation pneumonitis, mildly decreased from the prior exam.Fibrotic changes and traction bronchiectasis are compatible with radiation fibrosis.Small right pleural effusion, minimally increased from prior.MEDIASTINUM AND HILA: Anterior mediastinal mass continues to decrease in size measuring 27 x 11 mm (series #3, image 33), from previously 32 x 11 mm.Mild calcification of the thoracic aorta, coronary arteries and aortic valve.No hilar or mediastinal lymphadenopathy.Right-sided chest wall port catheter tip in the SVC.Large hiatal hernia.CHEST WALL: Unchanged median sternotomy fixation.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple stable subcentimeter hepatic hypodensities, too small to further characterize.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 ossification of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Suggestion of bowel wall edema or fat involving the cecum and descending colon.BONES, SOFT TISSUES: Scaphoid abdomen. Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.
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1.Continued decrease in anterior mediastinal mass.2.Right upper lobe pulmonary nodule is decreased in size from exam dated 8/21/2013.3.Suggestion of bowel wall edema and/or fat involving the right hemicolon, which may be secondary to a previous colitis. Clinical correlation is advised.4.
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Generate impression based on findings.
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Reason: Recurrent head and neck cancer. Please evaluate for metastasis. History: As above LUNGS AND PLEURA: Paramediastinal fibrotic changes, most likely related to previous radiation therapy. Mild/moderate upper lobe predominant centrilobular and paraseptal emphysema.Calcified granuloma right middle lobe.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Mild cardiac enlargement with demonstration of a small pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense left renal lesion most likely representing a cyst.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Female; 42 years old. Reason: Please evaluate for appendicitis vs cholecystitis History: RUQ \T\ RLQ abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: The gallbladder is unremarkable. No evidence of pericholecystic fluid or gallbladder wall thickening. No intra or extrahepatic ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: The pancreas is unremarkable without evidence of inflammatory changes.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The appendix is well-visualized and unremarkable. No evidence of local inflammation to suggest appendicitis. The remainder of the bowel is normal in caliber.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Bilateral inguinal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Minimal free fluid in the pelvis.
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No radiographic evidence to account for the patient's pain. These results were discussed with Dr. Zeiger on 12/23/13 at 1630.
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Generate impression based on findings.
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86 old male with thyroid mass/goiter, apparently enlarging per patient Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. The thyroid gland is massively enlarged. Measuring at the same approximates as that utilized previously, the right lobe again measures 108 mm superior inferior x 46 mm AP whereas the left lobe measures 120 mm superior inferior dimension x 55 mm AP dimension. The overall width of the thyroid gland is 143 mm. As before. both lobes are heterogeneous in appearance and contain calcifications. Its inferior extent extends to the level of the manubrium, unchanged.The airway appears patent. The esophagus, appears to impress upon the posterior aspect of the trachea from the level of the thoracic inlet to the level of the cricoid, unchanged.The visualized intracranial structures are intact. The visualized portions of the orbits are intact. New opacification is present within a mid right ethmoid air cell. Mucosal thickening in bilateral maxillary sinuses is unchanged. The mastoid air cells are clear.The parotid and the submandibular glands appear intact. The visualized lung apices appear clear. Atherosclerotic calcifications are present at the carotid bifurcations. Cervical spondylitic changes are stable.
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1.Markedly enlarged and heterogenous thyroid gland without significant change in size or density characteristics.2.No clinically significant lymphadenopathy.
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Generate impression based on findings.
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74 year old female. Follow up of two nodules seen on CT chest 2/2013. LUNGS AND PLEURA: Severe centrilobular emphysema. Two nodules in the left lower lobe, each 5 mm in size (series 6, images 278 and 282).MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Calcified small right hilar nodes from healed granulomatous disease. Main pulmonary artery diameter of 3.2 cm suggestive of pulmonary artery hypertension.CHEST WALL: Median sternotomy. Kyphosis. Moderate degenerative arthritic changes of thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified atherosclerotic disease of abdominal aorta. Exophytic simple renal cyst arising from interpolar region of left kidney.
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1. Two 5 mm nodules in the left lower lobe. Retrieval of prior scans if available is requested.2. Severe centrilobular emphysema.
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Generate impression based on findings.
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60-year-old female. Bilateral pneumonia, intubated. LUNGS AND PLEURA: Diffuse ground-glass opacities with septal thickening consistent with edema or ARDS. Reticulation in the upper lobes may represent developing fibrosis. Small bilateral pleural effusions. Basilar dependent mild atelectasis. Centrilobular emphysema.MEDIASTINUM AND HILA: ETT 5 cm above carina. Mediastinal lymphadenopathy. Reference precarinal lymph node measures 18 mm in short axis (series 3, image 32).Cardiomegaly. Main pulmonary artery diameter is 4.6 cm consistent with pulmonary artery hypertension. Mild thoracic aorta calcification.CHEST WALL: Degenerative arthritic changes of thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. NG tube tip terminates in stomach. Right hepatic lobe cyst. Small amount of perihepatic and perisplenic ascites.
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1. Extensive diffuse ground-glass opacities with septal thickening, consistent with edema or ARDS. Small bilateral pleural effusions.2. Reticulation in the upper lobes may represent developing fibrosis.3. Findings consistent with pulmonary artery hypertension.
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Generate impression based on findings.
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Female 56 years old; Reason: r/o acute ICH/change History: N/V, HA w/vision changes x 2 days, s/p craniotomy per CVA. Redemonstration of postsurgical changes from a right pterional craniotomy is redemonstrated. The craniotomy flap is unchanged in morphology. It remains perforated by numerous linear lucencies. Also redemonstrated is a right parasellar surgical clip.Fluid surrounding both the extracranial and intracranial surfaces of the craniotomy flap is again seen and again there is interval reduction of fluid volume. For reference, the extracranial component measures 60 mm x 10 mm down from 83 mm x 16 mm. The intracranial component remains the same at 6 mm in maximal thickness. Sequelae of a large right MCA distribution stroke are redemonstrated including encephalomalacia of the frontal, parietal and temporal lobes as well as the basal ganglia and insula. There is ex vacuo dilatation of the right lateral ventricle and a shift of brain structures towards the right. This is unchanged The ventricular system is unchanged in size and morphology. No acute intracranial hemorrhage or other acute findings are demonstrated. There is diffuse mucosal thickening in the paranasal sinuses with opacification of the right mastoid, air cells which is nonspecific.
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1.Continued interval reduction in the extracranial volume of fluid located external to the bone flap.2.The remainder of the intracranial findings are stable compared to previous exam.
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Generate impression based on findings.
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Reason: afib, dilated aortic root on TEE History: afib, dilated aortic root on TEE LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.No evidence of pulmonary edema.No pleural effusions.MEDIASTINUM AND HILA: Mild ectasia of the aortic root and a 3 cm in 3.3 cm, previously measuring 3.2 cm and 3.5 cm..There is no evidence of either an aortic dissection or focal aneurysm.Cardiac size is normal without evidence of a pericardial effusion.There is no evidence of hilar or mediastinal lymphadenopathy.CHEST WALL: Degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Normal CT angiography of the thoracic aorta. Specifically, there is no evidence of aortic dissection or focal aortic aneurysm.
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Generate impression based on findings.
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17 year-old female with mediastinal mass and histoplasmosis infection for follow-up LUNGS AND PLEURA: Scarring of the apical segment right upper lobe is noted. Previously noted 7-mm noncalcified nodule in the apical posterior aspect of the right upper lobe is smaller appears less nodular but poorly defined margins, improved compared to prior exam (series 4, image 18). Stable left apical segment lower lobe micronodule or intrapulmonary lymph node (series 4, image 41). Right lower lobe micronodule or intrapulmonary lymph node appears smaller compared to prior exam (series 4, image 40).MEDIASTINUM AND HILA: Right superior mediastinal mass measures 2.1 x 2.0 cm AP/TR, compared to 2.5 x 2.2 cm AP/TR (series 2, image 21). Enlarged right hilar lymph node measures 1.8 cm in short axis, previously measuring 1.8 cm in short axis (series 3, image 33). Left vertebral artery originates independently of the aortic arch, normal variant. Heart size is normal. No pericardial effusions.CHEST WALL: Many prominent axillary lymph nodes bilaterally, increased in size compared to prior. For reference, a left axillary lymph node measures 1.7 mm in short axis (series 3, image 12). UPPER ABDOMEN: No significant abnormality.
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Minimal interval decrease in size of the right superior mediastinal mass. Minimal interval decrease in noncalcified right apical nodule. Unchanged right hilar lymphadenopathy. Increased axillary lymphadenopathy.
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Generate impression based on findings.
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Male; 79 years old. Reason: Rule out malignancy History: weakness, anorexia, weight loss ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Innumerable hypodensities with peripheral enhancement scattered throughout the liver parenchyma consistent with metastatic disease. Minimal intrahepatic ductal dilatation and perihepatic ascites. Cholelithiasis without signs of acute cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple bilateral punctate non-obstructing renal calculi. Simple cyst arising from the right midpole. No evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic calcifications of the aorta and its branches. Scattered pathologic-appearing periaortic lymphadenopathy with reference node best seen on image 68 of series 3, measuring 2.1 x 1.8 cm.BOWEL, MESENTERY: Abrupt abnormal focal thickening of the colonic wall measuring up to 1.5 cm near the rectosigmoid junction with near complete luminal obstruction likely represents a primary malignancy. Regional and distant mesenteric lymphadenopathy present.BONES, SOFT TISSUES: Sclerotic foci scattered about the bones especially at T9 vertebral body, left iliac wing, and left posterior acetabulum which likely represent metastatic disease, but this appearance is unusual for a primary GI malignancy. Other primaries, such as prostate, should be considered.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate is moderately enlarged.BLADDER: Foley catheter present within a collapsed bladder.LYMPH NODES: Scattered pathologic appearing lymphadenopathy with reference node is seen on image 86 of series 3 measuring 3.1 x 2.0 cm.mmBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Abrupt and abnormal focal thickening of the colon at the rectosigmoid junction, innumerable hepatic lesions and diffuse lymphadenopathy consistent with metastatic disease, likely secondary to colonic primary.2.Diffuse metastatic bony lesions may be secondary to the above malignancy, but given the patient's age and enlarged prostate, a primary prostate malignancy should be considered.
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Generate impression based on findings.
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2 year-old male with seizure. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The mastoid air cells are clear. There is mucosal thickening in the right maxillary and ethmoid sinuses.
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No acute intracranial abnormality.
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Generate impression based on findings.
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49 year-old male with headache. There appears some enhancement of the dural sinuses, which is likely from the abdominal CT earlier of the day. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear except for partial opacification of the right mastoid. There is mild deformity of the right nasal bone.
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No acute intracranial abnormality.
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Generate impression based on findings.
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Male 56 years old; Reason: eval for appendicitis History: R sided tenderness, n/v ABDOMEN: The absence of intravenous contrast limits evaluation of the solid organs and of the vasculature. Given these limitations, the following observations were made: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: Severe atherosclerotic disease of the aorta and branch vessels.BOWEL, MESENTERY: No obstruction, free air, or contrast extravasation. The appendix is clearly visualized comment morphologically normal.BONES, SOFT TISSUES: Moderate severe degenerative disease in the spine with changes compatible with DISH.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: Moderate severe degenerative disease in the spine with changes compatible with DISH.OTHER: No significant abnormality noted.
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1.No acute intra-abdominal pathology.2.Moderate to severe atherosclerotic disease of the aorta and branch vessels
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Generate impression based on findings.
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Male; 49 years old. Reason: nausea, bilious vomiting, LUQ pain History: nausea, bilious vomiting, LUQ pain ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis.LIVER, BILIARY TRACT: Hypodense segment 7 lesion measuring 2.9 x 1.5 cm is incompletely characterized. Consider dedicated liver imaging with CT or MRI. Non-cirrhotic liver morphology. Cholelithiasis without evidence of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Appendix is well visualized and unremarkable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No radiographic evidence to account for the patient's left upper quadrant pain.2.Hypodense segment 7 hepatic lesion is incompletely characterized. Consider dedicated liver MRI or CT for further evaluation.
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Generate impression based on findings.
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83-year-old male with a history of gastric outlet obstruction. Note is made of extensive streak artifact from residual barium within the ascending colon, limiting examination.ABDOMEN:LUNG BASES: There is a moderate-sized pleural effusions bilaterally with underlying atelectasis/consolidation. Left lower lobe calcifications suggestive of prior granulomatous disease.LIVER, BILIARY TRACT: No evidence of acute cholecystitis. There is a moderate amount of abdominopelvic ascites.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted. The patient is status post cystectomy. The ureters into exit the abdomen through the anterior abdominal wall in the right lower quadrant via an ileal conduit.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic disease affects the abdominal aorta and its branches. There is no abdominal aortic aneurysm. Note is made of prominent gastric lymph nodes.BOWEL, MESENTERY: Duodenal stent in place. No dilated loops of bowel suggest obstruction. There is no free intraperitoneal air, pneumatosis intestinalis, or portal venous gas.BONES, SOFT TISSUES: There is anasarca.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status-post prostatectomy.BLADDER: Status post cystectomy. Note is made of mild right-sided hydronephrosis. The distal right ureter is poorly visualized secondary to extensive artifact from residual barium. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. No evidence of obstruction, as clinically questioned2. Bilateral pleural effusions with underlying atelectasis/consolidation.3. Moderate amount of abdominopelvic ascites.4. Surgical changes from a prostatectomy, cystectomy and ileal conduit. 5. Mild right sided hydronephrosis.
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Generate impression based on findings.
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30 year-old male with leukocytosis of unknown origin. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There is minimal mucosal thickening in the right maxillary sinus. The frontal sinuses, frontal-ethmoid recesses, anterior/posterior ethmoids, sphenoid sinuses, and left maxillary sinus are well developed and clear. The osteomeatal complexes are normal with intact uncinate processes and patent infundibuli. The intersphenoid septum is normal. The nasal turbinates and nasal septum are normal. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable.
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Unremarkable CT paranasal sinuses apart from minimal mucosal thickening in the right maxillary sinus.
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Generate impression based on findings.
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Male 38 years old; Reason: 38yo male with EtOH pancreatitis and severe abdominal pain, known pseudocyst on OSH imaging, anemic and febrile concern for necrosis/hemorrhage. History: abd pain, anemia ABDOMEN:LUNGS BASES: Left pleural thickening and atelectasis noted. Nodule mass or pleural effusions identified.LIVER, BILIARY TRACT: Liver contour is normal. There is fatty infiltration of the liver. Trace perihepatic ascites noted No focal abnormality detected. The portal and hepatic veins are patent.SPLEEN: Pseudocyst erodes and to the spleen with likely an area of infarction near the hilum. Otherwise, no focal lesion detected.PANCREAS: Marked peripancreatic inflammation with a 6 x 6.8 cm pseudocyst noted in the pancreatic bed. A second pseudocyst is more cephalad measures 3.8 x 7 .5 cm, and invades the splenic hilum with resultant infarction of the spleen. The pseudocyst abuts the gastric wall with resultant inflammation of the mucosa, frank invasion cannot entirely be ruled out.Multiple calcifications are seen the pancreatic body with small amount of residual pancreatic enhancement. Areas of hypoenhancement are likely related to necrosis. Residual inflammatory change extends to the pararenal spaces and into the pelvis.The celiac trunk, splenic artery, common hepatic artery, and super mesenteric artery are all patent. No pseudoaneurysm detected.The SMV, and splenic vein are thrombosed with collaterals reconstituted by the gastroepiploic vessels.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Thickening of the wall of the ascending colon, and dilated small bowel are likely related to inflammation. Focal ileus is likely.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: Ascites noted in the pelvis.
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1.Complicated pancreatitis as described above with two discrete pseudocysts and minimal residual pancreas. Invasion into the spleen and stomach is likely although difficult to assess on CT. Thrombosis of the splenic vein and SMV as above.2.Dr. Steira notified of the findings at 9:00 am on 12/24/13
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Generate impression based on findings.
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21-year-old female. SOB status post MVA with pelvic fracture Friday. PULMONARY ARTERIES: Technically adequate examination. No acute pulmonary emboli identified. LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of acute pulmonary embolism or specific findings to account for symptoms.
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Generate impression based on findings.
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65-year-old female. Reason: pe History: shortness of breath, tachy. PULMONARY ARTERIES: Technically adequate exam for evaluation of pulmonary embolism though respiratory motion artifact is seen. No pulmonary embolus identified.LUNGS AND PLEURA: Diffuse interlobular septal thickening and groundglass opacities consistent with pulmonary edema, new from prior exam.Interval development of a small left and moderate right pleural effusion with overlying compressive atelectasis at the bases.Slight interval increase in size and number of bilateral pulmonary metastases.MEDIASTINUM AND HILA: New mild cardiomegaly.Mediastinal adenopathy is grossly stable to slightly increased.Stable left thyroid nodules.A replaced right subclavian artery is noted.A right-sided chest port catheter terminates at the cavoatrial junction.CHEST WALL: Unchanged skeletal mets.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Right adrenal nodule is unchanged in size from the previous exam, currently measuring 21 x 15 mm (series #5, image 249).
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1.No evidence of pulmonary embolism.2.New mild cardiomegaly, pulmonary edema, and bilateral pleural effusions are compatible with heart failure.3.Slight interval increase in size and number of bilateral lung metastases and adenopathy. 4.Stable right adrenal nodule.
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Generate impression based on findings.
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Male; 41 years old. Reason: eval for appendicitis History: RLQ abdominal pain, nausea, loose stool ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No suspicious lesions identified. The gallbladder is unremarkable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Scattered enlarged left periaortic lymph nodes with reference lesion best seen on image 72 series 3, measuring 2.2 x 1.7 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The bladder is moderately distended and unremarkable.LYMPH NODES: Pathologically enlarged left pelvic lymph node with reference node, best seen on image 124 of series 3, measuring 5.1 x 2.8 cm. Scattered mesenteric lymph nodes are also noted.BOWEL, MESENTERY: The appendix is well visualized and unremarkable. No inflammatory changes about the appendix.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Scattered retroperitoneal, mesenteric, and pelvic pathologic-appearing lymphadenopathy. While the etiology is unclear, neoplastic and inflammatory processes must be included in the differential diagnosis.
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Generate impression based on findings.
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59 year old female. History of IVC filter and past PE. Dyspnea, chest pain, hypoxia. PULMONARY ARTERIES: Suboptimal examination for evaluation of segmental and subsegmental pulmonary embolism. No large central pulmonary emboli identified.LUNGS AND PLEURA: Scattered micronodules. Mild dependent atelectasis.MEDIASTINUM AND HILA: Normal heart size without significant pericardial effusion.CHEST WALL: Mild degenerative arthritic changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatic steatosis.
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Suboptimal examination. No large central pulmonary emboli or other significant abnormality identified.
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Generate impression based on findings.
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71 year-old female with abdominal pain and emesis with decreased ostomy output. Lack of intravenous contrast limits evaluation of solid organs.ABDOMEN:LUNG BASES: Note is made of bibasilar scarring/atelectasis.LIVER, BILIARY TRACT: Hypodensity in the right lobe of the liver is incompletely characterized on the likely represents a simple cyst, unchanged. Cirrhotic liver morphology.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Note is made of vascular calcifications of the aorta and its branches. Note is made of an ectatic abdominal aorta.BOWEL, MESENTERY: There is a small hiatal hernia. Right lower quadrant ostomy in place. Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Multiple calcified fibroids within the uterus. Foci of gas density are identified within the vaginal cuff. 1BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis, without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. No evidence of obstruction, as clinically questioned. Diverticulosis without evidence of diverticulitis. 2. Ectatic abdominal aorta.3. Cirrhotic liver morphology.
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Generate impression based on findings.
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Female 27 years old; Reason: assess for sbo, ruptured viscus History: sudden abd pain, peritoneal signs ABDOMEN:The exam is not sensitive for detecting lesions in the solid organs due to lack of intravenous contrast. Given that limitation, the following observations are made.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes consistent with appendectomy. A small non-obstructing adhesions of the small bowel and cecum in the right lower quadrant. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. No evidence of acute inflammatory process detected. Findings consistent with prior appendectomy.
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Generate impression based on findings.
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15 year-old male with large swelling unilaterally and inability to open mouth. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear except for mild right ethmoid and maxillary sinus mucosal thickening. Limited view of the intracranial structure is unremarkable. Examination shows enlargement of the right palatine tonsil. In its lateral aspect, there is an area of hypoattenuation, measuring 16 x 15 mm. There is moderate narrowing of oro/nasopharynx. There is thickening of Waldeyer's ring. There are a few prominent nodes at levels I and II on the right, likely reactive. There is a 5 x 4-mm hyperdense focus anterior to the right submandibular gland. The oral cavity, 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. The osseous structures are unremarkable. Limited view of the chest is unremarkable.
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1. Right sided tonsillitis with a peritonsillar abscess with resultant moderate narrowing of oro/nasopharynx and reactive lymphadenopathy. 2. Proximal right submandibular duct sialolith.
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Generate impression based on findings.
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67 year old male with history of invasive squamous cell carcinoma of the left lower gum s/p composite resection and induction chemotherapy. Again seen are postoperative changes compatible with left marginal mandibulectomy, bilateral neck dissection, and flap reconstruction. Scarring and infiltration within and around the flap appear similar to the prior study and likely reflect treatment-related change. A cystic lesion has developed in the left buccal space that was not present before, situated just anterior to the masseter muscle and along the superior margin of the soft tissue flap. This lesion demonstrates peripheral enhancement and measures 2.3 x 2.0 cm (series 6, image 17). More inferiorly and deep to the flap, there is a new region of thickened and enhancing soft tissue which engulfs the surgical resection margin along the left hemimandible and which has partially eroded the remaining mandibular bone. This abnormal tissue extends inferiorly around the residual mandible into the floor of the mouth/submental space, and continues further as an infiltrative, partially rim-enhancing lesion along the left strap muscles to the level of the cricoid cartilage. Although certain features are present which can be seen with infection or inflammation, taken together, these findings are most compatible with progression of disease. There is no evidence of significant cervical lymphadenopathy. The airways are patent. The major cervical vessels are intact. The thyroid gland is unremarkable. The left submandibular gland has been resected, but the remaining major salivary glands are unremarkable. The visualized intracranial structures and lung apices are grossly unremarkable. The left mastoid air cells are partially opacified but the visualized paranasal sinuses are clear. There is multilevel ossification of the posterior longitudinal ligament (OPLL) with resultant severe canal stenosis, unchanged. Ossification along the anterior margins of the C5 and C6 vertebral bodies is also unchanged.
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Redemonstration of postsurgical changes s/p resection of invasive squamous cell carcinoma. New findings that are most compatible with progression of original tumor as detailed above.
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Generate impression based on findings.
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45-year-old female. Reason: pleural effusion History: pleural effusion, SOB.Additional history: Status post ventriculopleural shunt. LUNGS AND PLEURA: There is a moderate-sized, loculated right pleural effusion, presumably secondary to the patient's ventriculopleural shunt. The shunt catheter originates superiorly out of the field-of-view, courses in the soft tissues of the anterior right neck and chest wall and enters the pleural space above the anterior right second rib. It courses posteriolaterally in the pleural space, coiling and terminating at the low lateral costophrenic angle.Mild, scattered focal ground glass opacities in the left lung are nonspecific. Few micronodules in the left lung, some calcified, may represent granulomatous disease.MEDIASTINUM AND HILA: Heart size normal. No hilar or mediastinal lymphadenopathy is identified. No pericardial effusion. Mild atherosclerotic calcification of the coronary arteries.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy.
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Moderate, loculated right pleural effusion, likely secondary to ventriculopleural shunt.Nonspecific scattered focal groundglass opacities in the left lung may represent early infection.
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Generate impression based on findings.
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31 year old female with abdominal pain, nausea, and vomiting. Evaluate for internal hernia versus appendicitis. ABDOMEN:LUNG BASES: Note is made of bibasilar scarring/atelectasis.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: No significant abnormality noted.BOWEL, MESENTERY: Postoperative changes of a gastric bypass surgery without dilated loops of bowel to suggest obstruction. The efferent limb appears to be anterior to the transverse colon.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 visualized portion of the appendix is normal in size and appearance.BONES, SOFT TISSUES: Punctate sclerotic foci in the pelvis, likely representing a benign bone islands.OTHER: No significant abnormality noted
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Postoperative changes of a gastric bypass without evidence of obstruction or appendicitis as clinically questioned.
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Generate impression based on findings.
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49-year-old male. Shortness of breath. LUNGS AND PLEURA: Patchy ground-glass opacities in both upper lobes, right greater than left, possibly representing infection/aspiration.Mild upper lobe centrilobular emphysema. Right apical paraseptal emphysema. Mild lower lobe bronchial wall thickening.No pleural effusion. Calcified granulomas.MEDIASTINUM AND HILA: Cardiomegaly. LVAD. Left subclavian ICD leads terminate in the right atrial appendage and right ventricle.Enlarged mediastinal lymph nodes.CHEST WALL: Gynecomastia. Median sternotomy. Mild degenerative arthritic changes of thoracic spine.UPPER ABDOMEN: Absence of IV, enteric contrast material, and streak artifact from LVAD markedly limits sensitivity for abdominal pathology. No significant abnormality noted. Subcentimeter hypodensity in the interpolar region of the left kidney incompletely characterized.
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1. Patchy ground-glass in both upper lobes, right greater than left, possibly representing infection/aspiration.2. Mild centrilobular emphysema.
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Generate impression based on findings.
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Male; 34 years old. Reason: eval extent of obstruction History: abd tender -- air fluid levels on acute abd series ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Diffuse fatty infiltration of liver without evidence of cirrhosis. No intrahepatic ductal dilatation. The gallbladder is unremarkable.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: There is moderate dilatation of the cecum at the site of prior anastomosis with fluid fecal material. No signs of active inflammation or wall thickening. No evidence of obstruction.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: There is a thrombus extending from the right internal iliac vein to the confluence of the common iliac veins.
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1.Thrombus extending from the right internal iliac vein to the confluence of the common iliac veins.2.Cecal distention at the site of the prior anastomosis without evidence of acute inflammation. No evidence of obstruction.These results were discussed with Dr. Pasupneti by Dr. Masse on 12/24/13 at 0910.
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Generate impression based on findings.
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62 year-old male with altered mental status Trace air from previous shunt removal has resolved. The ventricular system remains stable in size, with persistent fourth ventricle and temporal horn dilatation. There are multifocal hypodensities in the periventricular white matter, left basal ganglia, left subinsular, and left external capsule, unchanged. Dense vascular calcifications are again noted. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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Stable ventricular size and multifocal parenchymal hypodensities.
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Generate impression based on findings.
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68 year old female with a history of type B aortic dissection. Evaluate extent of dissection. CHEST:VASCULATURE: Again seen is a type B aortic dissection originating distal to the origin of the left subclavian artery. The major arch vessels are not involved and are supplied by the true lumen. The dissection extends inferiorly and appears to terminate above the level of the origin of the renal arteries. The dissection extends into the celiac axis. The SMA is supplied by the true lumen.LUNGS AND PLEURA: There is interval development of a small bilateral pleural effusions with underlying atelectasis/consolidation.MEDIASTINUM AND HILA: Vascular calcifications of the aorta and its branches.CHEST WALL: No significant abnormality noted.ABDOMEN:VASCULATURE: Note is made of a type B aortic dissection originating distal to the origin of the left subclavian artery. The major arch vessels are not involved and are supplied by the true lumen. The dissection extends inferiorly and appears to terminate above the level of the origin of the renal arteries. The dissection extends into the celiac axis. The SMA is supplied by the true lumen.LIVER, BILIARY TRACT: Note is made of calcified granuloma in the liver and spleen. Hyperdensity within the gallbladder, likely represents vicarious excretion of contrast.SPLEEN: Note is made of calcified granuloma in the liver and spleen.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: There is nodular thickening of the left adrenal gland, appearing similar to the prior study.KIDNEYS, URETERS: Simple cysts in the interpolar region of the right kidney. Note is made of bilateral nonobstructing punctate renal calculi.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Note is made of diverticulosis, without evidence of diverticulitis.BONES, SOFT TISSUES: Note is made of a small fat containing umbilical hernia. There is a hemangioma within the vertebral body of L4.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. No significant interval change of previously described type B aortic dissection with extension into the celiac axis.2. Interval development of small bilateral pleural effusions with underlying atelectasis.
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Generate impression based on findings.
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80 year-old female with gross hematuria. ABDOMEN:LUNG BASES: There is bibasilar scarring/atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Subcentimeter nodule in the left adrenal gland with a density measuring less than 10 Hounsfield units. A benign lipid rich adrenal adenoma is favored.KIDNEYS, URETERS: Note is made of a round enhancing exophytic mass along the superior pole of the left kidney, measuring 2.3 x 2.1 cm in the transverse dimension and 1.9 cm in the craniocaudal dimension, suspicious for a primary renal carcinoma (46; series 9).There is a simple cyst along the inferior pole of the left kidney. There are multiple subcentimeter hypodensities within the kidneys, which are too small to characterize, but likely represent simple cysts.RETROPERITONEUM, LYMPH NODES: Note is made of vascular calcifications of the aorta and its branches.BOWEL, MESENTERY: Note is made of a small to moderate-sized hiatal hernia. Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: There is a small fat-containing ventral hernia.OTHER: Moderate coronary artery calcifications.PELVIS:Metal streak artifact from right total hip arthroplasty device limits evaluation of the lower pelvis.UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Right total hip arthroplasty device in place.OTHER: No significant abnormality noted
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2.3 cm mass along the superior pole of the left kidney is suspicious for a primary renal carcinoma. These findings were relayed to Dr. Cohen via phone call at 10:00 a.m. on 12/24/13.
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Generate impression based on findings.
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Male; 61 years old. Reason: h/o metastatic rectal ca, on chemo holiday, eval for progression History: rectal ca CHEST:LUNGS AND PLEURA: Right upper lobe reference nodule has increased in size, best seen on image 25 of series 5, measures 3.2 x 2.5 cm, previously 2.2 x 1.7 cm. Multiple micronodules are again identified, some new and some increased in size.MEDIASTINUM AND HILA: Precarinal lymph node, best seen on image 32 of series 3, measures 1.5 x 1.1 cm, previously 1.6 x 0.7 cm. Interval progression of right hilar lymphadenopathy.CHEST WALL: Right chest port with tip at cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: No evidence of suspicious hepatic lesions. The gallbladder is unremarkable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal hypodensities are too small to characterize, but unchanged. Stable bilateral pelvocaliectasis with normal cortical thickness. No evidence of nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large widemouthed ventral hernia containing small and large bowel without evidence of incarceration.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Brachytherapy seeds in the prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Surgical clips near the rectum.BONES, SOFT TISSUES: No evidence of suspicious bony lesions.OTHER: Bilateral fat containing inguinal hernias.
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1.Multiple new and enlarging lung nodules again noted with reference right upper lobe lesion increasing in size when compared to prior.2.Progression of right hilar lymphadenopathy.3.No evidence of intra-abdominal metastasis.
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Generate impression based on findings.
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48 year-old male with left sided weakness. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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No acute intracranial abnormality.
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Generate impression based on findings.
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67 year old female with known myeloma and hypercalcemia with atypical features raising the possibility of neoplastic origin. Evaluate for additional neoplasm, such as lung, renal, etc. Lack of intravenous contrast limits evaluation of solid organs and/or lymphadenopathy. Lack of enteric contrast limits evaluation of bowel.CHEST:LUNGS AND PLEURA: Note is made of biapical scarring/atelectasis. There is a 5-mm left upper lobe pleural-based nodule (23; series 6). There are scattered pulmonary micronodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Note is made of nodular breast parenchyma bilaterally with punctate calcification in the right breast. 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: Exophytic hypodensities in the interpolar region and inferior pole of the left kidney as well as the inferior pole of the right kidney are incompletely characterized on a noncontrast examination, but may represent simple cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small fat-containing ventral hernia. There are innumerable lytic lesions throughout the axial skeleton, consistent with the stated history of myeloma.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: There are innumerable lytic lesions throughout the axial skeleton, consistent with the stated history of myeloma. Note is made of a lipoma within the right iliopsoas muscle along the anterior aspect of the right femoral neck.OTHER: No significant abnormality noted.
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Numerous lytic lesions throughout the axial skeleton consistent with the stated history of myeloma.
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Generate impression based on findings.
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Male; 59 years old. Reason: r/o source of bleeding History: unknown source of bleeding Motion limits evaluation.CHEST:LUNGS AND PLEURA: Bilateral pleural effusions right greater left.Right lower lobe consolidations with air bronchograms consistent with pneumonia.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Central venous catheter tip at the cavoatrial junction. Endotracheal tube tip below the thoracic inlet and above the carina.OTHER: Total artificial heart noted with large amount of fluid in the mediastinum extending cranially.ABDOMEN:LIVER, BILIARY TRACT: Scattered subcentimeter hepatic hypodensities are too small to characterize. Large amount of perihepatic ascites. Hepatomegaly likely secondary to cardiac failure. The gallbladder is collapsed.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Poor enhancement of both kidneys likely secondary to poor cardiac output. No evidence of hydronephrosis or nephrolithiasis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The proximal and mid-small bowel walls are moderately thickened.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Large amount of ascites. While we cannot exclude active bleeding, there are no areas of increased density or layering to suggest hemoperitoneum. NG tube with tip terminating in the stomach.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Large amount of ascites.
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1.Bilateral pleural effusions and right lower lobe consolidation consistent with pneumonia.2.Diffuse ascites. While we cannot exclude active bleeding, there are no areas of increased density or layering to suggest hemoperitoneum.
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Generate impression based on findings.
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68-year-old female patient with cholangiocarcinoma. Please provide index lesion measurements for RECIST as required to follow per clinical trial. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Right cardiophrenic lymph node is stable compared to prior examination. Note is made of vascular calcifications of the aorta and its branches. There are minimal coronary artery calcifications. Trace pericardial effusion/thickening.CHEST WALL: Right chest port tip terminates in the SVC. Deformity of the posterior aspect of the right 9th rib may represent prior remote trauma, although a pathologic fracture cannot be excluded.ABDOMEN:LIVER, BILIARY TRACT: The gallbladder is filled with gallstones. There is associated gallbladder wall thickening with a reference mass surrounding the gallbladder which extends to involve segments 4 and 6. Maximal cross-sectional diameter of involvement measures 6.7 x 4 .2 cm, previously 8.6 X 5.8 cm (series 3 image 104). Redemonstration of extension to the common hepatic duct and encasement of vascular structures in the porta hepatis. There is also associated mesenteric fat stranding adjacent to the transverse colon which is suspicious for omental tumor involvement. Large-bore bile duct stent is in position extending to the ampulla. Air in the intrahepatic biliary system is consistent with patent stent.Nonspecific segment 7 reference lesion with peripheral enhancement measures 1.6 x 1 .4 cm, previously 1.7 x 1.3 cm (series 3 image 79). A second peripherally enhancing lesion in the inferior right lobe measures 1.4 x 1 .1 cm, previously 1.6 x 2.1 cm (series 3 image 114). The reference enhancing lesion in segment 3 measures 1.7 x 1 .5 cm, previously 1.9 x 1.3 cm (series 3 image 97).There is redemonstration of a hemangioma in segment 8.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate, nonobstructing left renal calculus.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There are two fat-containing ventral hernias.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Soft tissue density in the subcutaneous right lateral abdominal wall may be iatrogenic.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: Small bilateral fat containing inguinal hernias.OTHER: No significant abnormality noted.
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Numerous reference liver lesions, some of which appear decreased in size compared to the prior study whereas others are not significantly changed. However, there is interval development of fat stranding adjacent to the transverse colon which raises the question of tumor extension along the omentum.
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Generate impression based on findings.
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33-year-old female. Reason: evaluate pulmonary infiltrates History: immunocompromised, severely hypoxic, concerned for fungal infection. LUNGS AND PLEURA: Extensive dense consolidation and groundglass opacities in the right lung with significant though more mild involvement of the left lung. Peribronchiolar distribution with mild relative subpleural sparing. Small to moderate right pleural effusion. No cavitations or fungus ball.MEDIASTINUM AND HILA: Cardiomegaly and small pericardial effusion.Enlarged pulmonary artery compatible with pulmonary arterial hypertension.Enlarged mediastinal lymph nodes are noted. A right paratracheal lymph node measures 11 mm in its short axis (image 22, series #3).CHEST WALL: Bilateral breast implants are noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Residual contrast material is seen in the stomach.Stress post liver transplant with hepatomegaly. Postoperative changes including suture line posteriorly, and pneumobilia are noted.Round hypodensity in the left lobe, incompletely characterized.
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Extensive bilateral consolidation, right greater than left. Differential includes acute hemorrhage versus atypical infection, including PCP or viral pneumonia; atypical pulmonary edema is less likely.
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Generate impression based on findings.
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57-year-old male. History HNC status-post induction chemotherapy. Compared to last measurements. CHEST:LUNGS AND PLEURA: 6-mm subpleural nodule in the right lower lobe is unchanged dating back to 9/2013. Stable scattered micronodules. Calcified granulomas. No new pulmonary nodules.MEDIASTINUM AND HILA: No lymphadenopathy. Calcified lymph nodes consistent with healed granulomatous disease. Moderate coronary calcifications.CHEST WALL: Degenerative arthritic changes of the thoracic spine. Osteophyte in posterior longitudinal ligament in the upper thoracic spine causes spinal stenosis.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. Unchanged hypodensities in the right kidney, too small to characterize, but unchanged and likely 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: Degenerative changes of the lumber spine.OTHER: No significant abnormality noted.
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1. No evidence of metastatic disease in the chest or abdomen.2. Osteophyte in posterior longitudinal ligament in the upper thoracic spine causes spinal stenosis. Recommend neurologic correlation and consider MRI for further evaluation.
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Generate impression based on findings.
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73-year-old female. Prior CT with lung nodules and 6 month follow-up CT recommended. LUNGS AND PLEURA: 6-mm right apical pulmonary nodule on series 5, image 34 is unchanged. 9-mm posterior right upper lobe nodule on series 5, image 34; previously was 8 mm.Stable scattered micronodules. No new nodules identified.MEDIASTINUM AND HILA: No lymphadenopathy. Mild coronary artery calcifications.CHEST WALL: Mild degenerative arthritic changes of thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Mild hepatic steatosis. Unchanged splenic hypodensity, probably a cyst.
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Right upper lobe two pulmonary nodules are unchanged from 6/2013. Another follow-up exam in 12 to 18 months recommended.
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Generate impression based on findings.
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Aortic stenosis. Previous CABG. VESSELS:The distance from the sinotubular junction to the right brachiocephalic artery measures approximately 7 cm.SINUS OF VALSALVA: 3.5 X 3.6 X 3.4 cm SINOTUBULAR JUNCTION: 2.8 X 3.1 cmASCENDING THORACIC AORTA AT LEVEL OF MAIN PULMONARY ARTERY: 2.8 X 3.2 cmASCENDING THORACIC AORTA IMMEDIATELY PROXIMAL TO THE INNOMINATE ARTERY: 2.9 X 2.6 cmPROXIMAL DESCENDING THORACIC AORTA IMMEDIATELY DISTAL TO THE LEFT SUBCLAVIAN ARTERY: 2.4 X 2.3 cmDESCENDING THORACIC AORTA AT LEVEL OF HIATUS: 2.4 X 2.3 cmINFRARENAL ABDOMINAL AORTA: 2.4 X 2.4 cmRIGHT COMMON ILIAC ARTERY: 12 X 11 mmRIGHT EXTERNAL ILIAC ARTERY: 9 X 9 mmRIGHT COMMON FEMORAL ARTERY: 9 X 9 mmLEFT COMMON ILIAC ARTERY: 10 X 9 mmLEFT EXTERNAL ILIAC ARTERY: 9 X 9 mmLEFT COMMON FEMORAL ARTERY: 9 X 9 mmCHEST:LUNGS AND PLEURA: Small left pleural effusions and intralobular and interlobular septal thickening, compatible with interstitial edema. Mild bronchial/bronchiolar wall thickening. Overlying subsegmental atelectasis of the left lower lobe. Scattered calcified granulomas.MEDIASTINUM AND HILA: Prior CABG. Moderate to severe atherosclerosis of the coronary arteries and thoracic aorta, without stenosis or aneurysm. Left ventricular hypertrophy. No pericardial effusion. Calcified mediastinal lymph nodes. No mediastinal or hilar lymphadenopathy. Markedly calcified aortic valve and annulus.CHEST WALL: Healed sternotomy. No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis. Mildly dilated intrahepatic biliary tree. Dilated common bile duct, measuring up to 1.3 cm wide. No focal hepatic lesions evident. Note is made of a replaced right hepatic artery.SPLEEN: Calcified granulomata. No significant abnormality noted.PANCREAS: No significant abnormality noted. No distinct pancreatic mass evident. No pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Moderate to severe atherosclerotic disease of the abdominal aorta and its branches. No intra-abdominal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: 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: Diverticulosis of the distal descending and sigmoid colon. No significant abnormality noted otherwise.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate to severe atherosclerosis of the iliac arteries.
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1. Adequate access vasculature, with measurements above.2. Mild pulmonary edema and left greater than right pleural effusions.3. Non-specific dilated intra- and extra-hepatic biliary ducts, without specific etiology evident, although a previously passed gallstone is a possibility. Correlation with lab values may be helpful if clinically warranted.
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Generate impression based on findings.
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Female; 26 years old. Reason: Assess for recurrence of umbilical hernia or associated abscess History: Umbilical hernia repair 1 month ago, umbilical wall pain just left of umbilicus started 2 weeks ago, resolved, and then again starting yesterday 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: The bowel is normal in caliber. No evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Postoperative changes at the umbilicus without evidence of hernia recurrence. No abnormal fluid collections or other abnormalities noted in the vicinity of the surgical repair.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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Post-operative changes at the umbilicus without evidence of hernia recurrence, bowel obstruction, or any radiographic evidence to explain the patient's pain.
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Generate impression based on findings.
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59 year old female with a history of unresectable cholangiocarcinoma. Status post biliary drain placement. Presents with abdominal pain. Lack of intravenous contrast limits evaluation of solid organs and for lymphadenopathy.CHEST:LUNGS AND PLEURA: Reference left upper lobe nodule measures 5 mm, previously 5 mm (41; series 5). Note is made of scattered bilateral pulmonary micronodules. No new pulmonary nodules or masses are identified.MEDIASTINUM AND HILA: Again seen is an enlarged cardiophrenic lymph node measuring 8 mm in the short axis, previously 8 mm (71; series 3).CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Percutaneous internal/external biliary drain in place, unchanged. Multiple biliary stents in place. Expected pneumobilia. Large central liver mass is poorly evaluated secondary to lack of intravenous contrast but grossly appears unchanged. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The kidneys are small and atrophic.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small fat-containing umbilical hernia.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. No acute intra-abdominal process. No significant interval change compared to the prior studies.2. Findings consistent with stated history of cholangiocarcinoma.3. Persistent 5 mm left upper lobe nodule.
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Generate impression based on findings.
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Male, 48 years old, with left sided weakness. Evaluate for cervical cord lesion. Straightening of the cervical lordosis is likely positional. Alignment is otherwise unremarkable. Vertebral body heights and morphology are within normal limits. No fracture or focally destructive osseous lesion is seen.Please note that canal contents, and specifically the spinal cord, are not well assessed on CT. No obvious enhancing intracanalicular or paraspinal abnormality is demonstrated.Mild posterior disk-osteophyte complex formation is evident at several levels, most conspicuously C3-4 and C6-7. Even at these levels, however, there is no significant encroachment of the bony spinal canal. The bony neural foramina are mildly narrowed at C3-4 on the right and C6-7 on the left.
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1. Mild degenerative disk disease in the cervical spine.2. No evidence of fracture or focally destructive osseous lesion.3. The spinal canal contents, and in particular the spinal cord, are not well evaluated on CT. Given this caveat, no obvious intracanalicular abnormalities are seen. However, MRI would provide a more sensitive evaluation if concern for cord abnormality persists.
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Generate impression based on findings.
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65 year old female with recent fall, dizziness and chronic sinusitis. 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. There is a small right frontal subgaleal hematoma. The osseous structures are unremarkable without fracture. The orbits are unremarkable. The mastoids are clear. There is mild mucosal thickening in the maxillary and ethmoid sinuses. 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 and nasal septum are normal. Concha bullosa of the middle turbinates. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable.
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1. No acute intracranial abnormality. Small right frontal subgaleal hematoma. No calvarial fracture. 2. No evidence of acute sinusitis. Mild maxillary and ethmoid sinus inflammatory disease.
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Generate impression based on findings.
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67 year old man with chest pain and advanced liver failure. Patient had a non-diagnostic stress echo and is referred to rule out coronary artery disease prior to possible liver transplantation.CPT Code: 75574 Coronary arteries: LM: The left main coronary artery arises normally from the left sinus of valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There are no significant stenoses present in the left main.LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There is a calcified, non-obstructive plaque in the proximal LAD. The distal portion of the vessel is small in caliber. The first diagonal artery has a severe stenosis (>70%) in the proximal portion of the vessel.LCx: The left circumflex coronary artery is non-dominant. It courses normally in the left AV groove. It gives rise to the obtuse marginal branches. There are no significant stenoses in the LCx. The distal LCx is small.RCA: The right coronary artery is large and arises normally from the right sinus of valsalva. It is the dominant coronary artery supplying a posterior descending artery and a posterolateral branch. There are no significant stenoses in the right coronary artery.There is a non-obstructive, non-calcified plaque in the proximal and distal portions of the vessel. There is a non-obstructive calcified plaque in the mid portion of the vessel. The proximal portion of the PDA has a 25-50% stenosis in it. Left Ventricle: The left ventricle is normal in sizeRight Ventricle: Visually the right ventricular late diastolic volume is within normal limits.Left Atrium: Visually, the left atrial volume appears to be mildly dilated. There are four distinct pulmonary veins which drain normally into the left atrium. Right atrium, vena cavae, and coronary sinus: The right atrial volume appears to be mildly dilated. The superior and inferior vena cavae are grossly normal. The coronary sinus is normal in size. Valves: There is no calcification on the aortic or mitral valves.Great vessels: The visualized portions of the thoracic aorta demonstrate no evidence of dissection or aneurysm. The aortic arch is not seen. There is mild calcification of the aortic root. The main pulmonary artery is normal in size.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.
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1.There are several non-obstructive plaques (calcified and non-calcified) distributed throughout the coronary tree. 2.There is a severe stenosis (>70%) in the proximal portion of the first diagonal artery. 3.Mild calcification of the aortic root.This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report.
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Generate impression based on findings.
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Female; 34 years old. Reason: Assess for intra-abdominal pathology, also portal venous phase requested in addition to assess aorta History: Diffuse abd pain (b/l upper, epigastric \T\ b/l lower) radiating to back, N/V ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: The gallbladder is well visualized and unremarkable.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:UTERUS, ADNEXA: Questionable tubal dilatation of the right adnexa.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The appendix is well visualized and dilated measuring up to 14 mm at the tip. Air and contrast do not fill the lumen, but a frank appendicolith was not identified. Additionally, minimal to no inflammatory changes surround the appendix and the adjacent bowel appears normal. While there is no radiographic evidence of frank appendicitis, these findings are equivocal.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Dilated appendix without surrounding inflammatory changes raises the question of early appendicitis. Correlation with detailed clinical exam and history is recommended.
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Generate impression based on findings.
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Reason: pt with metastatic breast cancer on chemotherapy please assess response to treatment and compare to previous imaging History: MBC CHEST:LUNGS AND PLEURA: Right upper lobe anterior subpleural post radiation fibrotic changes are again identified.Redemonstration of a branching tubular opacity in left lower lobe, compatible with previously described bronchial atresia.No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.CHEST WALL: Right inferior and posterior chest wall. Focal thickening is not as readily apparent on the current exam and may represent treatment response.Sclerotic foci in the T11 and L2 vertebrae are unchanged.Status post right mastectomy and right axillary lymph node dissection.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Fatty infiltration of the liver.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small right renal cyst unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small peripancreatic lymph node (image 97, series 3) is unchanged.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Foci of sclerosis in the iliac wings, unchanged.OTHER: No significant abnormality noted.
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1.Interval decrease in the extrapleural soft tissue within the right inferior posterior chest wall corresponding to a decrease in FDG activity in the recent PET scan.2.No new sites of disease identified.
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Generate impression based on findings.
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30-year-old male. ARDS outside hospital, hypoxic. Evaluate for infection versus cardiogenic versus fibrosis in a patient with relapsed AML. LUNGS AND PLEURA: Diffuse ground glass nodular opacities in the mid to lower lung zones, increased from prior exam. Mild lower lobe bronchiectasis. No pleural effusion. Unchanged scattered micronodules. No evidence of pulmonary fibrosis.MEDIASTINUM AND HILA: No lymphadenopathy. Small pericardial effusion, new from prior exam. Interval removal of right internal jugular venous catheter.CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Diffuse ground glass opacities in the mid to lower lung zones are nonspecific, but may represent atypical infection, including viral etiologies, pulmonary hemorrhage, or drug reaction.
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Generate impression based on findings.
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75 year-old female. Questionable interstitial lung disease found on x-ray. Pulmonary nodule. LUNGS AND PLEURA: No evidence of interstitial lung disease. Scattered micronodules. No suspicious pulmonary nodules or masses. Areas of bronchiectasis are present in the lower lobes.MEDIASTINUM AND HILA: Nonspecific hypodensity in the left thyroid lobe, correlate with ultrasound as clinically warranted.Multiple small mediastinal and right hilar lymph nodes, not pathologically enlarged by CT size criteria.CHEST WALL: Mild degenerative arthritic changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Two subcentimeter hepatic hypodensity too small to characterize, but likely cysts. Left upper pole renal cyst.
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No evidence of interstitial lung disease or suspicious pulmonary nodules. Mild basilar bronchiectasis is present.
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Generate impression based on findings.
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45-year-old male. Adenoid cystic carcinoma. CHEST:LUNGS AND PLEURA: Marked interval increase in size and number of numerous bilateral lung and pleural metastases. Reference lesion in the right lung inseparable from the mediastinum measures 45 mm (series 4, image 55), previously 22 mm. Moderate right pleural effusion, new from prior exam.MEDIASTINUM AND HILA: No lymphadenopathy. Several now larger pleural metastases abut the mediastinum.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesion in the right hepatic lobe is too small to characterize, but unchanged and likely a benign cyst (series 3, image 110). No new hepatic lesions identified. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mildly complex right renal cystic lesion with a coarse calcification is unchanged. Multiple remaining hypodensities in both kidneys are too small to characterize, but unchanged and likely 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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Marled interval progression of lung and pleural metastases. New right moderate pleural effusion.
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Generate impression based on findings.
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62 year-old female with pelvic pain. Normal pelvic exam. 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: Postsurgical change involving the anterior abdominal wall.OTHER: Relatively diffuse vascular calcification.PELVIS:UTERUS, ADNEXA: Uterus normal in size. No adnexal masses. No fluid within the cul-de-sac.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Relatively diffuse vascular calcification.
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No findings to account for patient's pelvic pain.
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Generate impression based on findings.
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Male, 45 years old, history of salivary gland cancer, adenoid cystic, of the left submandibular gland. Findings are redemonstrated compatible with prior left submandibular gland resection. Evidence of a left neck dissection is also seen. Scarring within the surgical bed appears similar to the prior exam. No mass or pathologic enhancement is identified to suggest recurrent disease. Low density tissue within the left submandibular space along the pterygoid musculature, along with a punctate focus dense focus, is a stable finding and likely related to prior surgery or treatment. No pathologic adenopathy is detected in the neck by size criteria. The residual salivary glands are free of focal lesions as is the thyroid. Cervical vessels are not well seen secondary to poor bolus quality but appear grossly unremarkable. No concerning osseous lesions are seen.Limited views of the lungs show a new right pleural effusion and multiple new or larger parenchymal nodules.
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1. No evidence of progressive or recurrent disease in the neck.2. Findings in the lung apices concerning for progressive disease are better assessed on the separately dictated chest CT.
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Generate impression based on findings.
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75-year-old male. Reason: CXR shows widened mediastinum; evaluate for aortic aneurysm. History: see above. LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Tortuous ascending aorta with mild atherosclerotic calcification. Tortuous, enlarged ascending aorta without focal aneurysm or dissection.Calcified subcarinal and left hilar lymph nodes are consistent with prior granulomatous disease.CHEST WALL: Moderate-sized intramuscular lipoma of the right infraspinatus muscle.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Contracted gallbladder.Punctate calcifications in the spleen, consistent with prior granulomatous disease.Mild atherosclerotic calcification of the abdominal aorta.
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Tortuous ascending aorta without focal aneurysmal dilatation.
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Generate impression based on findings.
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82 year-old male, shortness of breath, history of lung adenocarcinoma with new lung mass on chest radiograph, evaluate for recurrence versus infection. LUNGS AND PLEURA: Status post right upper lobectomy. Moderate emphysematous changes and apical scarring are similar to prior. Reference nodule in the right anterior upper lung is slightly larger than prior measuring 7.4 mm with adjacent cysts laterally, however there is new large 2.7 x 2.0 cm nodule just lateral to this which borders both the anterolateral pleura as well as the posterior fissure, without identification of internal air bronchograms, with mildly spiculated margins, which is suspicious for malignancy. There are extensive new right pleural-based nodularity and irregular thickening which are nonspecific but also suspicious for malignancy. Subcentimeter nodule within the left lower lobe series 5 image 65 is similar to prior. Partially ovoid opacities are noted along the dependent portions of the carina which could represent secretions although difficult to entirely exclude endobronchial spread. No pneumothorax or frank pleural effusion is identified.MEDIASTINUM AND HILA: No significant adenopathy identified. Subcentimeter right thyroid hypodensity similar to prior. Right hilar surgical clips noted. Atherosclerotic calcifications noted, with large incompletely visualized abdominal aortic mural thrombus.CHEST WALL: Old rib fracture deformities are noted. Multiple rib sclerotic foci are again noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Nonenhancing left renal hypodensity noted. Right intrarenal nonobstructive calculus noted. Small left liver anterior peripheral hypodensity similar to prior. Incompletely visualized pancreatic ductal dilation similar to prior. Incompletely visualized G-tube noted.
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New large right lung nodule suspicious for recurrent malignancy, with new subpleural nodularity and thickening as above.
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Generate impression based on findings.
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Clinical question: Evaluate. Signs and symptoms: AMS. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits.Unremarkable all visualized paranasal sinuses and mastoid air cells. There is symmetrical bilateral prominence of mucosa of the nasal passage with resultant effacement of airway in the nasal passage.
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No acute intracranial process.
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Generate impression based on findings.
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Clinical question: Evaluate for hemorrhage. Signs and symptoms: Blood on MRI. Unenhanced head CT:Examination demonstrate expected postoperative changes of a left anterior temporal -- frontal craniotomy.Small expected residual epidural air and fluid under the craniotomy flap is noted.Surgical cavity in the left inferior frontal -- anterior temporal region containing a small amount of post operative hemorrhage.Postoperative changes at the site and including the residual edema results in subtle effacement of the left aspect of basal cistern and a slight bulge of the medial temporal lobe into the left perimesencephalic region not significantly different than prior exam. There is also trace rightward midline shift at the level of septum pellucidum which also appears very similar to prior exam.Mildly dilated right lateral ventricle remains similar to prior study.Expected postoperative changes in the soft tissues of the scalp in the left frontal temporal region.Unremarkable orbits, paranasal sinuses and mastoid air cells.
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1.Expected postoperative changes of left frontal and temporal craniotomy as detailed.2.Minimal residual blood and air in the surgical cavity in the left frontal -- temporal region with a postop change.3.Stable subtle mass effect of postoperative changes and possibly residual tumor and including trace midline shift to the right is similar to preoperative exam.4.Mildly prominent of right lateral ventricle similar to prior exam.
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Generate impression based on findings.
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Bilious vomiting abdominal pain and nausea history of sarcoid ptosis and head and neck carcinoma ABDOMEN:LUNG BASES: Patchy air space opacity left lung baseLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No change in pancreatic head/uncinate process low-attenuation focus best seen on image 55 series 3 measuring 2.7 x 1.7 cm.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable bilateral renal cystsRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Interval appearance of abnormal wall thickening involving the descending colon, sigmoid and rectum. Findings not associated with bowel obstruction, free air, or abscess.Stable gastrostomy tube within stomach.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Stable fibroid uterusBLADDER: 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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New abnormal wall thickening involving the distal colon, sigmoid, and rectum. Findings are suggestive for early acute infectious/inflammatory colitis. Given the history of antibiotic therapy, pseudomembranous colitis should be considered.Patchy air space opacity left lung base; cannot exclude early infectious/inflammatory focus.Dr. Volerman notified of findings 12/25/2013; 8:45am.
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Generate impression based on findings.
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History appendiceal carcinoma with fever and abdominal pain ABDOMEN:LUNG BASES: Stable left lower lung base micronodule as seen on image 24 series 4 measuring 0.5 cm in diameter.LIVER, BILIARY TRACT: No change in segment 7 right lobe complex low attenuation lesion best seen on image 26 of series 3 measuring 1.6 x 1.9 cm.Status post cholecystectomySPLEEN: Status post splenectomyPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild bilateral hydronephrosis and hydroureterRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Trace ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status-post resection of pelvic mass and uterusBLADDER: Moderately severe bladder distentionLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Focal bland appearing loculated fluid collection within the anterior pelvic subcutaneous tissues associated with the surgical scar; favor benign postoperative etiologyOTHER: No significant abnormality noted
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Status post resection of pelvic mass including TAH/BSO. Moderately severe distention of bladder with mild bilateral hydronephrosis and hydroureter. Otherwise no evidence for acute abnormality.
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Generate impression based on findings.
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Left lower quadrant abdominal pain; history of traumatic foreign body rectal insertion 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: Foci of free intra-abdominal airBONES, 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: Abnormal wall thickening involving the sigmoid colon and rectum associated with extensive pericolonic soft tissue infiltration. No obvious extraluminal contrast noted. 2 x 2.5-cm low-attenuation focus best seen on image 116 may represent a small intramural abscess. No bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Abnormal wall thickening involving the sigmoid colon and rectum associated with extensive pericolonic soft tissue infiltration consistent with acute infectious/inflammatory process, presumably secondary to traumatic foreign body rectal insertion. No obvious extraluminal extravasation noted. Possible small intramural abscess. No bowel obstruction. No drainable abscess. Small foci of free abdominal air noted suggests that the traumatic rectal foreign body insertion resulted in a small perforation.
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Generate impression based on findings.
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Clinical question: Change in vision, right-sided weakness. Signs and symptoms: Right-sided weakness. Unenhanced head CT:No detectable acute intracranial process. CT however is insensitive for detection of early nonhemorrhagic ischemic strokes.Stable shunted lateral ventricle since prior exam.Stable nearly collapsed left lateral ventricle and normal size of the right lateral ventricle. Stable right posterior temporal residual catheter fragment.Stable right frontal approach ventricular catheter with the tip in the left basal ganglia since prior exam.Unremarkable cerebral cortex, cortical sulci and CSF spaces and unchanged since prior study.Unremarkable calvarial, visualized paranasal sinuses and mastoid air cells.Unremarkable orbits.
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1.No acute intracranial process.2.Stable shunted lateral ventricles.
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Generate impression based on findings.
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11 month old male with left sided scalp lesion. There is left parietal scalp swelling without fluid collection or underlying osseous abnormality. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear except for opacification of the left maxillary sinus.
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1. Left parietal scalp swelling without fluid collection or underlying osseous abnormality. Etiology may include scalp inflammation/infection versus subgaleal hematoma. Clinical correlation. 2. No acute intracranial abnormality.
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Generate impression based on findings.
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19 year-old male with history of Burkitt's lymphoma with acute atrial fibrillation, evaluate for pulmonary embolus and mediastinal tumor PULMONARY ARTERIES: Technically adequate study. No evidence of a pulmonary embolus.LUNGS AND PLEURA: No consolidation. Small right pleural effusion with compressive atelectasis.MEDIASTINUM AND HILA: There is a subcarinal soft tissue mass measuring 4.7 x 3.0 x 8.0 cm (5/139 and (6/57) compatible with history of Burkitt's lymphoma. This lesion abuts the left atrium, bronchus intermedius and right inferior pulmonary vein which remain patent.No additional enlarged mediastinal lymph nodes. Heart is normal in size.Left upper extremity PICC with tip in SVC.CHEST WALL: No axillary lymphadenopathy. No osseous lesions identified.UPPER ABDOMEN: The liver appears heterogeneous with multiple round hypoattenuating lesions.
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1.No evidence of a pulmonary embolus.2.Subcarinal soft tissue mass compatible with history of Burkitt's lymphoma abuts the left atrium.3.Heterogeneous appearing liver with multiple hypoattenuating lesions is suspicious for lymphomatous involvement.4.Small right pleural effusion.
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Generate impression based on findings.
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70 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 unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. Frontal scalp lipoma. Small left parietal scalp sebaceous cyst.
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No acute intracranial abnormality. Minimal small vessel ischemic disease of indeterminate age. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists.
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Generate impression based on findings.
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Male; 18 years old. Reason: assess for appy, less likely stone History: acute onset periumbilical/LLQ pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The bowel caliber is normal. No evidence of obstruction. No inflammatory changes are identified in the right lower quadrant to suggest acute appendicitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate amount of free fluid in the pelvis which is nonspecific.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No evidence of acute appendicitis. Free fluid in the pelvis is nonspecific and has been previously described as physiologic.
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Generate impression based on findings.
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Female 55 years old; Reason: s/p loop ileostomy r/o abscess, fluid collection, leak, obstruction History: tachycardia, desaturation ABDOMEN:LUNG BASES: Interval development of bilateral moderate pleural effusions with overlying compressive basilar atelectasis. Dilation of the distal esophagus is again seen filled with contrast material, compatible with patient's known history of scleroderma.LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. Peripheral hypodensity in right lobe is incompletely characterized but not significantly changed (series 15, image 32). Peripheral nodular enhancement suggests this is a hemangioma.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: Multiple dilated loops of bowel are again seen with diameter measuring up to 4.1 Cm (series 15, image 114). The dilated loops of bowel extend to ostomy site in right lower quadrant; again suggesting chronic bowel pseudoobstruction rather than mechanical etiology. There has been interval removal of the enteric catheter. Some bowel wall thickening are noted in the loops of bowel in the left hemiabdomen.No loculated fluid collections to suggest abscess. Multiple mildly enlarged mesenteric lymph nodes are noted with thickening and mesenteric stranding along the ostomy site. The colon is decompressed.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: Multiple dilated loops of small bowel, as noted above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Stable multiple dilated loops of small bowel extending to ostomy. The small bowel dilation is most likely due to chronic pseudoobstruction/peristaltic abnormality associated with scleroderma rather than mechanical obstruction. Interval removal of the enteric catheter. Otherwise stable examination.
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Generate impression based on findings.
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Clinical question: Stroke. Signs and symptoms: Alteration of mental status. Unenhanced head CT:Examination demonstrate a patchy foci of low attenuation involving the cortex and subcortical white matter of left anterior and mid temporal lobe with resultant subtle effacement of the left sylvian fissure consistent with an acute nonhemorrhagic left MCA territory ischemic stroke. This finding also extends into the left basal ganglia. There is resultant subtle mass effect on the left lateral ventricle as well however without deviation of midline.Unremarkable cortical sulci and ventricular system is less disuse of the spaces otherwise.Unremarkable calvarium and soft tissues of the scalp.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells. Findings on this exam were discussed by phone with the neurology resident on-call pager number 9203 at the time of review exam.
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1.Acute left MCA territory temporal lobe and left basal ganglia acute nonhemorrhagic ischemic stroke.2.Unremarkable exam otherwise.
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Generate impression based on findings.
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58 year-old female with a history of nodular lymphoma presents with abdominal pain. Evaluate for colitis. ABDOMEN:LUNG BASES: There is bibasilar scarring/atelectasis. There is a small right fat containing Bochdalek hernia.LIVER, BILIARY TRACT: There is a small amount of abdominopelvic ascites.SPLEEN: Splenomegaly, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Note is made of bilateral nonobstructing renal calculi. There is no evidence of hydronephrosis or hydroureter. No perinephric fat stranding.RETROPERITONEUM, LYMPH NODES: Ill-defined reference retroperitoneal lymphadenopathy measures 1.7 x 1 .3 cm, previously 1.8 x 1.3 cm (74; series 3).BOWEL, MESENTERY: There is mild wall thickening of the rectosigmoid colon. There is no free intraperitoneal air, pneumatosis intestinalis or portal venous gas. No dilated loops of bowel suggest destruction.BONES, SOFT TISSUES: Again seen is sclerosis and partial collapse of the L2 vertebral body, appearing similar to the prior study.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Again seen are ovarian varices, which may represent pelvic venous congestion syndrome.BLADDER: No significant abnormality notedLYMPH NODES: Reference right common femoral lymph node measures 1.2 x 1 .0 cm, previously 1.0 x 1.2 cm (129; series 3).BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Mild wall thickening of the rectosigmoid colon suspicious for early colitis, including infectious and inflammatory etiologies, although neoplastic etiologies cannot be excluded. 2. Interval development of a small amount of ascites. 3. No significant interval change in reference retroperitoneal and pelvic lymph nodes.4. Chronic appearing L2 vertebral body compression fracture.
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Generate impression based on findings.
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5 year-old female with head injury. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The mastoid air cells are clear.
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1. No acute intracranial abnormality. 2. Evidence for paranasal sinus inflammatory disease and/or acute sinusitis.
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Generate impression based on findings.
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27-year-old male with neck and back pain, blurry vision, nausea, and papilledema. There are no extraaxial fluid collections or subdural hematomas. A right frontal approach shunt catheter tip terminates within the left frontal horn, unchanged. The size and shape of the ventricles has not significantly changed compared to 11/30/2013 study (the most recent study contained intraventricular contrast administration). There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute infarction. Suboccipital craniotomy changes are demonstrated with a clip and other surgical material causing streak artifact at the craniocervical junction, unchanged in appearance. The basilar artery appears mildly hyperdense, also a stable finding. The visualized portions of the paranasal sinuses and mastoid air cells are clear.
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No significant interval change in course of shunt catheter or ventricular sizes.
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Generate impression based on findings.
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Female; 45 years old. Reason: eval incarcerated hernia vs appendicitis History: abd pain Lack of intravenous contrast enhancement limits the evaluation of solid organ parenchyma and vascular structures. Given these limitations, the following observations can be made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: The hepatic parenchyma is slightly hypoattenuating compared to the spleen raising the question of hepatic steatosis/parenchymal dysfunction. Cholelithiasis without signs of acute cholecystitis. No intra-or extrahepatic ductal dilatation.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: The appendix is well-visualized and unremarkable. The bowel is normal in caliber. No evidence of obstruction, pneumoperitoneum, or pneumatosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.No radiographic evidence to account for the patient's pain.2.Minimal hepatic steatosis/parenchymal dysfunction.
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Generate impression based on findings.
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Female 59 years old; Reason: r/o SBO History: N/V, abd distension and tenderness, constipation ABDOMEN:LUNG BASES: Left lower lobe calcified pulmonary nodule. Right lower lobe pulmonary micronodule incompletely visualized. No pleural effusion.LIVER, BILIARY TRACT: Liver is normal in morphology without focal lesion. There is intrahepatic ductal dilation with suggestion of common biliary ductal dilation. No focal mass stricture or extrinsic compression is noted. Again seen are the numerous calcified hepatic granulomas. SPLEEN: Calcified splenic granulomas.PANCREAS: There is prominence of the main pancreatic duct with atrophy of the tail. No definite mass is seen.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left lower pole renal cyst. No renal or ureteral stone is identified. No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There are numerous dilated loops of small bowel measuring up to 3.3 cm (coronal series image 7) with prominence of small bowel noted distally measuring approximately 2.5 cm. No definite transition point is identified. Mesenteric edema and haziness in the left hemiabdomen is seen, nonspecific. A few mesenteric lymph nodes, none pathologically enlarged are noted. No free air or drainable abscess collections noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Bladder is distended.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There are numerous dilated loops of small bowel measuring up to 3.3 cm (coronal series image 7) with prominence of small bowel noted distally measuring approximately 2.5 cm. No definite transition point is identified. Mesenteric edema and haziness in the left hemiabdomen is seen, nonspecific. A few mesenteric lymph nodes, none pathologically enlarged are noted. No free air or drainable abscess collections noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Interval development of prominent loops of bowel and mesenteric edema/haziness in the left hemiabdomen. Differential considerations include infectious or inflammatory etiology, however partial or low grade obstruction cannot entirely be ruled out. No transition point identified to suggest a mechanical obstruction present.2. Intra-and extra hepatic ductal dilation with pancreatic ductal dilation. Full characterization with MRCP advised.
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Generate impression based on findings.
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33 year-old male stastus post MVA and midline neck tenderness. There is straightening of the cervical lordosis. The cervical spine alignment is anatomic. The vertebral bodies, dens, lateral masses, pedicles, lamina, facets, and posterior elements are intact with no evidence of fracture or subluxation. Within the limits of CT scanning, the thecal sac and spinal cord are preserved with no evidence of spinal canal stenosis. The neural foramen are patent. The intervertebral disk spaces are preserved. The paraspinal soft tissues are unremarkable.Calcification of the anterior longitudinal ligament at C4-C5 and C5-C6. Small left thyroid nodule.
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1. No evidence of cervical spine fracture or subluxation, if spinal cord or ligamentous injury is suspected MRI is recommended.2. Small left thyroid nodule.
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Generate impression based on findings.
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Clinical question: 66-year-old male with orthostatic hypotension, rule out vertebral basilar or carotid artery insufficiency. Signs and symptoms: As above. Nonenhanced head CT:There is no detectable acute intracranial process. CT is however insensitive for early detection of acute nonhemorrhagic ischemic stroke.Mild prominence of cerebral cortical sulci for patient's stated age. Unremarkable ventricular system, CSF spaces and preserve gray to white matter differentiation.Very minimal bilateral cavernous carotid vascular calcification is noted.Unremarkable calvarium, soft tissues of the scalp, orbits and visualized paranasal sinuses, mastoid air cells.Neck CTA:Very limited view of the aortic arch is unremarkable.The origins of major vessels are well visualized and unremarkable. There is a normal anatomical variation of bovine arch with the left common carotid artery arising from the brachiocephalic branch.Unremarkable dominant right vertebral artery.The nondominant left vertebral artery is very small in caliber however is well visualized from its origin through the entire cervical course and across the skull base. There is a left-sided pica branches which is well visualized and unremarkable.There is decreased caliber of distal left vertebral artery beyond the origin of left pica and is uniform fashion. New very distal segment of this hypoplastic left vertebral artery however is not well visualized and possibility of an occlusive process cannot be entirely ruled out. Considering a punctate focus of restricted diffusion in the left cerebellum on prior MRI the comment follow up with conventional angiogram for better assessment.Unremarkable right common carotid, right internal carotid and external carotid artery branches.Unremarkable left common carotid, left internal carotid and left external carotid artery branches.Head CTA: Unremarkable and patent bilateral internal carotid arteries in the distal cervical segment and through the skull base. Unremarkable bilateral supraclinoid internal carotids, bilateral anterior and middle cerebral arteries. Bilateral ophthalmic arteries are well visualized and unremarkable on source images. Unremarkable images of the anterior communicating artery. Unremarkable dominant right vertebral artery.Patent small nondominant left vertebral artery across the skull base and with normal visualization of the left pica. There is further decrease in the caliber of the left distal vertebral artery beyond the origin of left pica and a uniform pattern consistent with hyperplastic distal left vertebral artery. There is however very poor visualization of the very distal segment of intracranial left vertebral artery. Considering presence of a tiny focus of restricted diffusion in the left cerebellum consider follow up with conventional angiogram for better assessment.
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1.Unremarkable unenhanced head CT.2.CTA of the neck is unremarkable. There is a nondominant small left vertebral artery which remains patent through the neck and skull base as detailed. An unremarkable left pica is also identified. There is however further decreased caliber of distal left vertebral artery beyond the origin of left pica with very poor visualization of its very distal segment. Considering presence of a tiny focus of restricted diffusion in the left cerebellum on recent brain MRI, recommend follow up with conventional angiogram for better assessment of the distal left vertebral artery. Unremarkable neck CTA otherwise.3.Intracranial CTA demonstrate hypoplastic distal left vertebral artery as detailed above. Unremarkable head CTA otherwise.
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Generate impression based on findings.
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Female; 82 years old. Reason: Eval for retroperitoneal bleed History: Hb drop, abdominal pain Lack of intravenous contrast enhancement limits the evaluation of solid organ parenchyma and vascular structures. Given these limitations, the following observations can be made:ABDOMEN:LUNG BASES: Minimal bibasilar atelectasis.LIVER, BILIARY TRACT: No suspicious lesions. No evidence of intra-or extrahepatic ductal dilatation. The gallbladder show unremarkable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Interval removal of right renal cystic mass. Scattered calcifications in the right kidney likely postoperative in nature. No evidence of retroperitoneal hemorrhage.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic calcifications of the aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small fat-containing ventral abdominal wall defect superior to the umbilicus.PELVIS:UTERUS, ADNEXA: Right adnexal simple cyst.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Mild intrinsic hyperattenuating fluid collection in the pelvis represents small hemoperitoneum, likely postoperative in nature.
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Small hemoperitoneum, likely postoperative in nature, without evidence of retroperitoneal hemorrhage or hematoma.
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Generate impression based on findings.
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Clinical question: evaluate subdural. Signs and symptoms ground seen. Nonenhanced head CT:Examination demonstrate a small focus of subarachnoid hemorrhage and high convexity left anterior frontal region (axial images 25 through 28. No evidence of subdural as is questioned clinically.In addition there is a small focus of low-attenuation in the interhemispheric aspect of the left frontal lobe adjacent to small focus of subarachnoid hemorrhage. The finding could represent a subacute stroke. Recommend follow-up with MRI exam.Unremarkable cerebral cortex, cortical sulci and ventricular system otherwise. Gray -- white matter differentiation is otherwise also unremarkable.Mild to moderate bilateral cavernous carotid vascular calcification is noted.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits.Unremarkable paranasal sinuses and bilateral mastoid air cells and middle ear cavities.
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1.Small focus of subarachnoid hemorrhage and high convexity left anterior frontal.2.A small focus of cortical and subcortical low attenuation along the interhemispheric aspect of left anterior frontal lobe concerning for a small focus of stroke. Recommend follow-up with an MRI exam.
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Generate impression based on findings.
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Male 58 years old; Reason: assess for SBO History: Diffsue R-sided Abd pain since 5pm w/N \T\ no ostomy output x 24 hours; hx Crohn's w/ieostomy \T\ 20+ SBOs in past ABDOMEN:LUNG BASES: Coronary artery calcifications with cardiomegaly. Mild bibasilar atelectasis. No nodule or mass detected.LIVER, BILIARY TRACT: Cholelithiasis without CT evidence of complications. The liver is normal in morphology. No intrahepatic or extrahepatic biliary ductal dilation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of nephrolithiasis or ureterolithiasis. No obstructive morphology of the collecting systems or ureters.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Numerous dilated loops of bowel measuring up to 4.3 cm (coronal series image 14) extending up to the patient's ostomy are noted. There is desiccated stool present in the distal small bowel which suggests chronic obstruction.There is bowel wall thickening along the distal small bowel just proximal to ostomy site with extensive mesenteric edema and fluid. There is no intraperitoneal free air or drainable abscess collections. Status post total colectomy. Prominent lymph node adjacent to the ileostomy site measuring 7 mm in short axis.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: Numerous dilated loops of bowel measuring up to 4.3 cm (coronal series image 14) extending up to the patient's ostomy are noted. There is desiccated stool present in the distal small bowel which suggests chronic obstruction. There is bowel wall thickening along the distal small bowel just proximal to ostomy site with extensive mesenteric edema and fluid. There is no intraperitoneal free air, fistulas, or drainable abscess collections. Status post total colectomy. Prominent lymph node adjacent to the ileostomy site measuring 7 mm in short axis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Interval development of a small bowel obstruction, which has a chronic component given the desiccated feces in the small bowel, likely due to the inflamed loop of bowel entering the ostomy. Interloop mesenteric edema noted without free air or abscess collection seen.2. Cholelithiasis without complication
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Generate impression based on findings.
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67 year-old female with AML, baseline CT. The orbits are unremarkable apart from lens prostheses. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There is focal opacification in the left ethmoid, unchanged. The frontal sinuses, frontal-ethmoid recesses, anterior/posterior ethmoids, sphenoid sinuses, and maxillary sinuses are otherwise 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. There is mild leftward deviation of the nasal septum. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable.
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No evidence of sinusitis.
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Generate impression based on findings.
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55-year-old female. Reason: r/o pulmonary embolism History: desaturation, tachycardia. PULMONARY ARTERIES: Technically adequate exam for evaluation for pulmonary embolism. No pulmonary embolus identified.LUNGS AND PLEURA: New moderate bilateral pleural effusions with associated compressive atelectasis. Interval development of diffuse, bilateral bronchial wall thickening and patchy bilateral groundglass opacities as well as mild bronchiectasis. Stable subpleural reticulation.MEDIASTINUM AND HILA: Dilated, fluid-filled esophagus with oral contrast material proximally to the thoracic inlet, compatible with known history of scleroderma. Right-sided central venous catheter tip at the cavoatrial junction. Moderate cardiomegaly. Scattered, nonenlarged mediastinal lymph nodes.CHEST WALL: Degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.No evidence of pulmonary embolism.2.New bilateral moderate-sized pleural effusions, edema, and atelectasis, consistent with CHF.
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Generate impression based on findings.
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Male; 67 years old. Reason: eval constipation History: abd pain, constipation Lack of intravenous contrast enhancement limits the evaluation of solid organ parenchyma and vascular structures. Given these limitations, the following observations can be made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Scattered parenchymal calcifications likely secondary to granulomatous disease. Cholelithiasis without evidence of acute cholecystitis. No intra or extrahepatic ductal dilatation.SPLEEN: Scattered calcifications.PANCREAS: The pancreas is minimally enlarged with surrounding mesenteric fat stranding consistent with acute pancreatitis. No evidence of peripancreatic fluid collections, ductal dilatation or necrosis.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The bowel is normal in caliber. No evidence of obstruction, pneumatosis, or pneumoperitoneum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Acute uncomplicated pancreatitis.2.Cholelithiasis.
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Generate impression based on findings.
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72 year-old male with history of CVA. There is patchy hypoattenuation in the cerebral white matter. There are multiple well defined foci of hypoattenuation in the basal ganglia, thalami and cerebellum. The ventricles, sulci, and cisterns are symmetric and prominent, representing moderate 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. Intracranial internal carotid artery calcifications. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear except for sphenoid sinus mucosal thickening. Chronic blowout fracture of the right lamina papyracea.
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1. No acute intracranial hemorrhage. CT is insensitive to early detection of CVA. MRI should be considered if clinical suspicion for CVA persists. 2. Moderate small vessel ischemic disease of indeterminate age. Moderate brain volume loss. 3. Multiple, probably chronic infarcts in the basal ganglia, thalami and cerebellum.
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Generate impression based on findings.
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Clinical question: Rule-out abscess versus other infectious process. Signs and symptoms: Neutropenic fever. Unenhanced maxillofacial CT:Paranasal sinuses demonstrate minimal chronic sinus disease. There is noted left ostiomeatal unit and patent bilateral sphenoethmoidal recesses. No detectable abnormal enhancement.There is significant nasal septum deviation to the right without evidence of bony septal spur. Bilateral mastoid air cells and middle ear cavities are well pneumatized and unremarkable. Unremarkable images through the orbits and without detectable inflammatory/infectious process.Visualized soft tissues of the region of maxillofacial demonstrate no evidence of inflammatory/infectious process and without detectable abnormal in enhancement. No evidence of lymphadenopathy in this very limited view of upper neck.Unremarkable images through the partially visualized oral cavity, oropharynx and nasopharynx.Unremarkable bilateral inferotemporal fossa.
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Pre-and post enhanced CT of the maxillofacial region demonstrate mild chronic sinus disease and unremarkable otherwise. In particular no evidence of inflammatory/infectious process or abnormal enhancement as is questioned clinically.
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Generate impression based on findings.
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63-year-old male. Reason: c/f PE History: SOB, pleuritic CP. PULMONARY ARTERIES: Technically adequate for evaluation of pulmonary embolism. No pulmonary embolus identified.LUNGS AND PLEURA: A nodular opacity in the left lower lobe measuring 10 mm (image 95, series #8) is increased in size from the previous exam. Several other subpleural nodular opacities in the right lower lobe are new from the previous exam.Redemonstrated right lower lobe tree in bud opacities, with interval development of similar left-sided opacities as well as new groundglass opacities in the right lower lobe and left upper lobe. Relative resolution of other focal areas of groundglass. Debris is noted in the bronchial tree. Findings are consistent with chronic aspiration pneumonitis.Stable biapical and paramediastinal fibrosis consistent with postradiation changes.MEDIASTINUM AND HILA: Scattered prominent mediastinal lymph nodes.CHEST WALL: Degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Gastrostomy tube noted in the stomach.
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1.No evidence of pulmonary embolism.2.Findings consistent with chronic aspiration pneumonitis.3.Interval growth of a left lower lobe nodule, concerning for malignancy or metastatic disease.4.Interval development of several right lower lobe subpleural nodules, which may be sequela of aspiration, though warrant follow up imaging to ensure resolution.
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Generate impression based on findings.
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35-year-old male with history of shortness of breath. Evaluate for pulmonary embolus. PULMONARY ARTERIES: No pulmonary embolusLUNGS AND PLEURA: In the lateral right middle lobe is a smoothly marginated pleural based lesion (series 10 image 90) which measures approximately 2 x 1.8 cm. This well circumscribed solid nodule also has foci of low-attenuation internally, which may represent fat in a benign hamartoma.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Degenerative disease affects the visualized spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No pulmonary embolus. Well circumscribed nodule on the lateral right middle lobe pleural surface, favor hamartoma although this is too small to characterize. Comparison with prior chest imaging, or follow up for stability is suggested.
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Generate impression based on findings.
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60 year old female with new wound hematoma/seroma. New wound opened at bedside with foul-smelling drainage. Elevated WBC. Evaluate fascia and evaluate for fistula. ABDOMEN:LUNG BASES: Bibasilar scarring/atelectasis.LIVER, BILIARY TRACT: Subcentimeter hypodensities in the liver are too small to characterize, but may represent simple cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypodensities in the left kidney are too small to characterize, but may represent simple cysts, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Note is made of a 12.5 x 8.6 cm encapsulated fluid collection with foci of internal gas density within the soft tissues along the anterior aspect of the abdomen. There is no evidence of intra-abdominal extension. No free intraperitoneal air is identified. Note is made of a soft tissue defect along the midline of the inferior aspect of the fluid collection consistent with the stated history of incision and drainage.OTHER: There is a small amount of ascites.PELVIS:UTERUS, ADNEXA: Surgically absent.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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12.5-cm encapsulated fluid collection in the soft tissues along the anterior abdomen suspicious for abscess formation. There is no evidence of intra-abdominal extension or fistula formation, as clinically questioned.
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