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Generate impression based on findings.
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51 year old female with history of muscle weakness/Eaton-Lambert syndrome. Rule out lung mass. LUNGS AND PLEURA: Scattered pulmonary micronodules, one of which are calcified. Multiple scattered scar like opacities are again seen, with one area of scarring in the right middle lobe having increased from prior. No masses.MEDIASTINUM AND HILA: Very small pericardial effusion. Coronary artery calcifications are again seen. No mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Arterial calcifications of the aorta and its branches. Punctate calcification in the right kidney parenchyma is partially visualized.
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Given the lack of intravenous contrast, no lung or mediastinal masses were seen. Scattered pulmonary micronodules and multiple areas of scarring in the lungs as above which are for the most part unchanged from prior exam.
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Generate impression based on findings.
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60 year-old male status post esophagectomy/gastric pull up in 12/4 now with obstruction. Evaluate for possible diaphragmatic herniation, small bowel obstruction. CHEST:LUNGS AND PLEURA: There is biapical scarring/atelectasis. There is bibasilar scarring/atelectasis. MEDIASTINUM AND HILA: Note is made of postoperative changes consistent with the stated history of esophagectomy and gastric pull up. NG tube tip terminates in width in the gastric pull-up.CHEST WALL: Deformity of the lateral aspect of the right fifth rib may represent prior remote trauma.ABDOMEN:LIVER, BILIARY TRACT: Multiple subcentimeter hypodensities in the liver are too small to characterize, but likely represent simple cysts.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: Note is made of multiple dilated loops of small bowel in the left hemiabdomen, measuring up to 4.3 cm in diameter. There are multiple decompressed loops of small bowel. There is a probable transition point in the left hemiabdomen. No free intraperitoneal air, pneumatosis intestinalis, or portal venous gas. Percutaneous jejunostomy tube in place.BONES, SOFT TISSUES: Probable hemangioma in the T10 vertebral body.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Note is made of multiple dilated loops of small bowel in the left hemiabdomen, measuring up to 4.3 cm in diameter. There are multiple decompressed loops of small bowel. There is a probable transition point in the left hemiabdomen. No free intraperitoneal air, pneumatosis intestinalis, or portal venous gas. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Findings consistent with a small bowel obstruction, likely related to adhesions, with a probable transition point in the left upper quadrant.
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Generate impression based on findings.
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69-year-old male with history of neutropenic fever. Evaluate for pneumonia versus aspiration. CHEST:LUNGS AND PLEURA: Left apical opacity is similar to slightly decreased in size. Left lower lobe groundglass opacities are again seen, most consistent with prior aspiration. Inferior left upper lobe subsegmental atelectasis.MEDIASTINUM AND HILA: Mild coronary artery calcifications are noted.CHEST WALL: Degenerative disease affects the visualized spine. T4 and T6 compression fractures, with T6 appearing slightly increased from prior.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Aortic calcifications are again seen.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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Left apical and left lung base ground glass opacities appear similar to slightly decreased in size from prior. No new findings to suggest infection.
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Generate impression based on findings.
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Reason: history of AML, would like repeat baseline CT of chest and sinus for monitoring. History: none LUNGS AND PLEURA: No significant abnormality noted. Specifically, there is no evidence of infection.Minimal atelectasis or scarring affects the left lung base.MEDIASTINUM AND HILA: No significant mediastinal or hilar lymphadenopathy. A small pericardial effusion is stable.CHEST WALL: Several vertebral body hemangiomas are stable in appearance.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Scattered hepatic hypodensities still appear cystlike although could be slightly larger, which sometimes occurs with cysts.Upper abdominal surgical clips are present.
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Resolution of prior pulmonary opacities with no current evidence of infection.
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Generate impression based on findings.
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66 year old female with a history of stage IV ampullary cancer status post wedge resection of liver lesion. Please provide index lesion measurements. CHEST:LUNGS AND PLEURA: Scattered micronodules which are nonspecific but unchanged.There is bibasilar scarring/atelectasis.MEDIASTINUM AND HILA: Vascular calcifications in the aorta and its branches. There is minimal coronary artery calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: There is near complete interval resolution of the previously described fluid collection along the left lobe of the liver, consistent with the patient's known history of abscess. No drainable collections are identified. Pneumobilia secondary to metallic stent, unchanged. Status post cholecystectomy. Calcified granuloma in the liver.SPLEEN: Subcentimeter splenic lesion, unchanged. Calcified granuloma in the spleen.PANCREAS: Dilated pancreatic duct, unchanged. Reference ill-defined masslike enhancement of the pancreas is difficult to measure but is approximately 2.3 x 2.2 cm, previously 2.7 x 2.4 cm on image number 120, series number 3.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter hypodensity in the interpolar region of the left kidney is too small to characterize, but likely represents a simple cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia.BONES, SOFT TISSUES: Postsurgical changes in the midline.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. Near complete interval resolution of the previously described intrahepatic fluid collection. No drainable collections are identified. 2. The reference pancreatic mass like enhancement is difficult to measure, but appears slightly decreased in size when compared to the prior study dated 10/10/13.
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Generate impression based on findings.
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Male; 46 years old. Reason: EGJ Adenocarcinoma: Restaging History: none CHEST:LUNGS AND PLEURA: No suspicious lung lesion noted.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy is unchanged with reference lesion best seen on image 51 of series 3 measuring 2.0 x 0.8 cm, previously 1.9 x 1.0 cm.CHEST WALL: Right chest port with tip at the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Innumerable hypodense lesions in the liver are stable to somewhat increased in size consistent with metastasis. Reference right lobe lesion is best seen on image 102 of series 3 measures 6.0 x 4.8 cm, previously 6.3 x 5.0 cm. Segment 3 lesion, best seen on image 120 of series 3, measures 6.2 x 5.4 cm, previously 6.1 x 4.8 cm. Cirrhotic liver morphology.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Reference portocaval lymph node best seen on image 114 of series 3 measures 2.3 x 1.7 cm, previously 2.3 x 1.3 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Scattered prostatic calcifications.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Ill-defined and irregular thickening of the gastric wall along the greater curvature with hypoattenuating/necrotic areas, best seen on image 99 of series 3, likely represents the primary malignancy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Stable to slightly progressive metastatic disease with measurements as dictated above.
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Generate impression based on findings.
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61-year-old male with history of gastric adenocarcinoma. Restaging examination. CHEST:LUNGS AND PLEURA: Unchanged scattered nonspecific micronodules. No new pulmonary nodules or masses are identified.MEDIASTINUM AND HILA: Subcentimeter mediastinal lymph nodes, similar to prior exams. No hilar lymphadenopathy. Normal sized heart without pericardial effusion. Mild coronary artery calcifications.CHEST WALL: Right chest port with tip in the SVC.ABDOMEN: LIVER, BILIARY TRACT: Unchanged nonspecific subcentimeter hypodensity in the right hepatic lobe which may represent a simple cyst. No new lesions or biliary ductal dilatation. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Note is made of fatty pancreatic atrophy. RETROPERITONEUM, LYMPH NODES: The previously described mesenteric haziness adjacent to the celiac axis is not as prominent on today's examination. Scattered retroperitoneal lymph nodes are unchanged in appearance. BOWEL, MESENTERY: Stable postoperative changes of a gastrojejunostomy. Normal caliber bowel loops without obstruction, wall thickening, fluid collections, or pneumoperitoneum.BONES, SOFT TISSUES: Moderate degenerative changes of the thoracolumbar spine.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Mild degenerative changes of the hips are again seen.
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Stable examination without evidence of recurrence or metastatic disease.
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Generate impression based on findings.
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Male; 74 years old. Reason: pt with h/o esophageal ca s/p newer chemotherapy History: doing fairly ok now needs disease evaluation compare to previous scans and comment CHEST:LUNGS AND PLEURA: Innumerable pulmonary nodules have increased in size, many now cavitating, with reference left basilar nodule, best seen on image 70 of series 4, measuring 1.4 x 1.7 cm, previously 1.2 x 1.2 cm. Reference right upper lobe nodule, best seen on image 33 of series 4, has increased in size now measuring 1.5 x 0.9 cm, previously 0.8 x 0.6 cm. Postoperative changes of gastric pull up and stent are noted. Stable patchy right lower lobe consolidation, pleural effusion and bilateral emphysematous changes.MEDIASTINUM AND HILA: Stable mediastinal and supraclavicular lymphadenopathy. Reference prevascular lymph node, best seen on image 35 of series 3, measures 4 mm.CHEST WALL: Partial resection of right sixth rib again noted.ABDOMEN:LIVER, BILIARY TRACT: New and enlarged hypodense liver lesions consistent with metastatic disease again noted. Segment two lesion best seen on image 88 of series 3 measures 4.7 x 3.0 cm, previously 3.4 x 2.6 cm. Previously referenced segment two lesion, best seen on image 83 of series 3, has increased in size measuring 3.0 x 3.5 cm, previously 2.6 x 2.9 cm. Cholelithiasis.SMV thrombosis again noted with numerous venous collaterals.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable subcentimeter hypodense lesion of the right kidney. No evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: IVC filter in expected location.BOWEL, MESENTERY: J-tube present in the proximal jejunum. No evidence of obstruction or pneumoperitoneum.BONES, SOFT TISSUES: Moderate degenerative joint disease of the thoracic spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Progression of metastatic disease with measurements as dictated above.
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Generate impression based on findings.
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60 year old female. Reason: eval caliber of tracheal stenosis History: stridor, tracheal stenosis w/ stent. LUNGS AND PLEURA: A tracheal stent is unchanged in position with the proximal concentric narrowing redemonstrated. However, the distal aspect is discontinuous posteriorly with an 8-mm flap extending into the tracheal lumen (image 23, series #5).Left apical consolidation has significantly improved. Cavitation within the consolidated lung, though not seen on the prior exam, appears similar to exam dated 9/6/2011.The right upper lobe nodule measures 9 x 4 mm (image 16, series #5), unchanged. The collapsed right middle lobe is unchanged since 2006. New right basilar subsegmental atelectasis is noted, possibly related to aspiration.Mild centrilobular emphysema is redemonstrated.MEDIASTINUM AND HILA: Mild coronary calcifications are noted. LAD stent. Mildly enlarged. Mediastinal lymph nodes, unchanged.CHEST WALL: Stable focal sclerosis in the inferior aspect of the vertebral body of L1.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Small calcified gallstones, increased in number.Left kidney superior pole simple cyst.
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1.Tracheal stent appears broken distally with a metal flap projecting intraluminally.2.Improved left upper lobe consolidation with residual cavitation.3.Chronic right middle lobe collapse. New right lower lobe subsegmental atelectasis, possibly related to aspiration.4.Unchanged right upper lobe nodule.
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Generate impression based on findings.
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59 year old female status post hemicolectomy with wound infection. Please evaluate for intra-abdominal abscess. Severe abdominal pain in the left upper and left lower quadrants. ABDOMEN:LUNG BASES: No significant abnormality noted. Prominent cardiophrenic lymph node, unchanged. Again seen are mediastinal and hilar lymphadenopathy which is incompletely visualized on this examination but grossly appears unchanged, and may be related to the patient's history of sarcoidosis.LIVER, BILIARY TRACT: Calcified granuloma in the liver. Gallstones without evidence of acute cholecystitis. Postsurgical changes consistent with the known history of hepatectomy. The reference focus of hypoattenuation in the lateral segment measures 3.7 x 1.3 cm, previously 5.5 x 1.5 cm (35; series 3).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Note is made of a simple cyst along the interpolar region of the left kidney, unchanged. Probable peripelvic cysts along the inferior pole of the right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Note is made of multiple angulated loops of small bowel, suggestive of adhesions. There are no dilated loops of bowel to suggest obstruction. No free intraperitoneal air, pneumatosis intestinalis, or portal venous gas. Postsurgical changes consistent with the stated history of hemicolectomy.BONES, SOFT TISSUES: There is infiltration of the subcutaneous fat of the anterior abdomen along the midline. There is an associated sinus tract extending from the skin surface into the subcutaneous fat in this region. There is no evidence of intra-abdominal extension. There is no fluid collection to suggest abscess formation.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical changes consistent with the stated history of hemicolectomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. Nonspecific fat stranding in the soft tissues along the anterior abdomen with an associated sinus tract extending from the skin surface. Superimposed infection cannot be excluded, however, there is no evidence of abscess formation, as clinically questioned. 2. Gallstones without evidence of acute cholecystitis.
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Generate impression based on findings.
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38-year-old male with history of lung nodule seen on radiograph. LUNGS AND PLEURA: There is an approximately 1 centimeter right upper lobe well-circumscribed calcified nodule. This corresponds to the previously seen nodule on radiography. Left lung base subsegmental atelectasis/scarring and small scattered foci of groundglass opacities and bronchial wall thickening are seen.MEDIASTINUM AND HILA: Small lymph nodes are seen throughout the mediastinum. Several coarsely calcified mediastinal and hilar lymph nodes are seen.CHEST WALL: Mild degenerative disease affects the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Coarse calcifications in the area of the pancreas, as well as extensive mesenteric stranding better seen on CT of the abdomen on 12/23/2013.There is a fluid collection just inferior and posterior to the stomach which contains an air-fluid level. This could represent sequela of a drainage procedure, however nonspecific.
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Calcified, benign appearing granuloma in the right upper lung corresponds with the previously noted nodule on chest radiography.
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Generate impression based on findings.
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Clinical question: Status post lumbar fusion L4 -- L5. Patient is now complaining of right thigh pain. Attention to right side screw placement. Signs and symptoms: As above. Nonenhanced lumbar spine CT:Examination is suboptimal due to patient's large body habitus as well as streak artifacts from postoperative fixating metallic hardware. There is mild levoscoliosis centered at L4 level, and mild anterolisthasis at L4 - L5 level without significant change since prior MRI exam dated 11 -- 12 -- 12.There is evidence of prior posterior approach fusion of L4 and L5 utilizing bilateral transpedicular screws at both levels as well as fusion of the disk space.At L4 level bilateral transpedicular screws appears to be entirely within the pedicles and without projection into the spinal canal or the neural foramina.Similar observation is also made of bilateral transpedicular screws at L5 level. Bilateral fixating rods appear unremarkable.At the L4 level there is a linear defect traversing the left transverse process (axial series 9 image 279 through 289) consistent with a fracture or post op changes.On coronal reformatted series 80940 images 18, 19 and 20 there is evidence of a linear defect across the left L5 lamina it also suspect a fracture.Redemonstration of previously seen widened left articulating facet which on prior MRI demonstrated fluid signal intensity content.There is mild compression fracture of the superior endplate of L5 with extensive sclerotic changes of the endplates consistent with chronic fracture. This finding however is new since prior MRI exam from 11 -- 12 -- 12.
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1.Postoperative changes of posterior fusion at L4 -- L5 including placement of bilateral interpedicular screws at L4 and L5 without evidence of extension of placed screws into the neural foraminal or spinal canal. The appropriateness of the position should be decided by the referring clinical physician. There is also evidence of fusion of disk at this level with metallic and bony fragments within the intervertebral disk space.2.Limited exam due to patient's large body size as well as extensive streak artifact from fixating screws and rods.3.Evidence of complex fracture involving the left transverse process and laminae of L4 as detailed.4.Within the limitation of the exam there is no convincing finding to explain patient's right sided thigh pain.
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Generate impression based on findings.
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Renal cell carcinoma status post partial nephrectomy ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 1 x 1.1 cm intermediate attenuation cystic focus arising from the posterior aspect of the right renal upper pole best seen on image 70 of series 4. This focus has increased in size when compared to 7/16/2012 when it measured to 0.8 x 0.5 cm. and was barely perceptible on 11/29/2011.Stable contour deformities consistent with right partial nephrectomy. Stable subcentimeter nonobstructing right renal stone.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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1 cm intermediate attenuation cystic focus arising from the left kidney which has demonstrated subtle but consistent growth dating back to 2011. A slowly growing neoplastic process must be considered. Recommend correlation with dedicated renal CT or MR.
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Generate impression based on findings.
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9 year-old male status post fall. The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. 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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33 year-old female with nasal congestion and discharge. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. Examination shows postsurgical changes of right antrectomy, uncinectomy and ethmoidectomy. There is mild to moderate mucosal thickening in the right maxillary sinus and frontal-ethmoid recess. There is mild leftward nasal septal deviation. The frontal sinuses, left frontal-ethmoid recess, left 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 are normal. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable.
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Status post right sided endoscopic paranasal sinus surgery. Mild to moderate mucosal thickening in the right maxillary sinus and frontal-ethmoid recess.
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Generate impression based on findings.
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55-year-old female with a history of breast cancer and "nonuniform density of the ribs" CHEST:LUNGS AND PLEURA: New small right pleural effusion.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Innumerable mixed lytic/sclerotic lesions are seen throughout the visualized axial spine, ribs and visualized portions of the pelvis.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: Right hydronephrosis/hydroureter with the distal ureter not well visualized.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: Innumerable mixed lytic/sclerotic lesions are seen throughout the visualized axial spine, ribs and visualized portions of the pelvis.OTHER: Small amount of free fluid in the abdomen.
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1.Innumerable mixed lytic/sclerotic lesions are seen throughout the visualized axial spine, ribs and visualized portions of the pelvis.2.Right hydronephrosis/hydroureter with the distal ureter not well visualized. This finding is new when compared to prior CT.
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Generate impression based on findings.
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39-year-old male with gross hematuria. ABDOMEN:Extensive metal streak artifact from posterior spinal fixation device limits examination.LUNG BASES: No significant abnormality noted. Sternotomy wire incompletely visualized. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypodensity in the inferior pole of the left kidney is too small to characterize, but likely represents a simple cyst. No evidence of hydronephrosis, hydroureter, or perinephric fat stranding. No focal mass lesions are identified, however, the medial aspect of the kidneys are poorly evaluated secondary to extensive metal streak artifact. No filling defects are identified within the collecting systems on delayed sequences. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Note is made of a posterior spinal fixation device affixing the visualized portion of the lower thoracolumbar spine, without evidence of hardware complication. Note is multiple exostoses along the right and left iliac bones and femora. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Note is made of a posterior spinal fixation device affixing the visualized portion of the lower thoracolumbar spine, without evidence of hardware complication. Note is multiple exostoses along the right and left iliac bones and femora. OTHER: Small left hydrocele.
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1. No findings to account for the patient's hematuria. 2. Multiple exostoses involving the pelvis and proximal femora.
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Generate impression based on findings.
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Male; 34 years old. Reason: obstruction vs. constipation vs. other acute intraabdominal process History: diffuse abdominal pain x 1mo, severe constipation, N/V ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No suspicious lesions identified. The gallbladder is distended and unremarkable.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: The bowel is well opacified with contrast. No evidence of obstruction, pneumatosis, or pneumoperitoneum. The appendix is normal. Minimal amount of inspissated stool.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 radiographic evidence to account for the patient's symptoms.
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Generate impression based on findings.
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Male; 68 years old. Reason: acute intraabdominal process History: abdominal pain in RUQ and b/l lower quadrants, +Murphy's, N/V/D, black stools ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Numerous subcentimeter liver hypodensities are incompletely characterized on this exam but likely represent benign cysts. Cholelithiasis without evidence of acute cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts and dystrophic calcifications.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate amount of ascites.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The bladder wall is uniformly thickened.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Findings consistent with renal osteodystrophy.OTHER: No significant abnormality noted
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1.Cholelithiasis without evidence of acute cholecystitis.2.Moderate amount of ascites3.Diffuse bladder wall thickening which favors chronic inflammatory changes.
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Generate impression based on findings.
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55 year-old female with altered mental status. Mild ventriculomegaly unchanged from previous head CT. The cisterns are symmetric and unremarkable. Focus of hypodensity at right globus pallidus likely represents old lacunar infarct. Encephalomalacia of the left subinsular, sequela of old infarct. Scattered periventricular and subcortical white matter hypoattenuation most likely represents sequela of small vessel ischemic disease. 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 CT evidence for acute intracranial pathology.
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Generate impression based on findings.
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20 year-old male patient with fever and white count. Evaluate for osteomyelitis/sacral decubitus ulcer for abscess or other fluid collection. Again seen is extensive subcutaneous and muscular edema within the right buttock predominately affecting the gluteus maximus muscle with subcutaneous ulceration containing air along the right lower buttock/upper thigh. There is tracking of air to ischial bone and possible bone destruction (series 80260 image 109), compatible with osteomyelitis. There is no evidence of a mature abscess or drainable fluid collection. There is mild extension and air tracking into the posterior margin of the adductor magnus.Foley catheter noted.
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Right inferior gluteal ulceration with sinus tract and air extending to bone compatible with osteomyelitis. No evidence of drainable fluid collection.
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Generate impression based on findings.
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17 year-old female with history of recurrent osteosarcoma status post resection and chemotherapy LUNGS AND PLEURA: Postsurgical changes from right lower lobe and left upper lobe resections appear similar to the prior exam. No consolidation or pleural effusions. 2-mm micronodule along the minor fissure (4/46) is unchanged and likely represents an intrapulmonary lymph node. No new suspicious nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion.CHEST WALL: Sclerotic foci in the right 6th rib with linear lucencies in right 6th and 7th ribs appear similar to the exam from 3/12/2013 and may be related to old trauma.UPPER ABDOMEN: No significant abnormality noted in the visualized upper abdomen.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Female 73 years old; Reason: Assess for cause of weight loss, possible stricture in terminal ileum on colonoscopy History: Anorexia, weight loss, diarrhea ABDOMEN:LUNGS BASES: The descending thoracic aorta is tortuous. No nodule detected.LIVER, BILIARY TRACT: Incidental note note is made of a Riedel's lobe. No focal lesion detected. Patient is status post cholecystectomy with residual mild intrahepatic ductal dilation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Too small to characterize lesions in kidneys bilaterally likely represent cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Noncontinuous focal areas of bowel wall thickening in the distal ileum with extensive stenosis of the terminal ileum are noted. Prominent vasa recta is seen in the right lower quadrant with subtle mesenteric inflammation.Diverticulosis is noted in the colon. No evidence of diverticulitis or obstruction seen.No free air, fistulous connection, or obstruction seen.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: Noncontinuous focal areas of bowel wall thickening in the distal ileum with extensive stenosis of the terminal ileum are noted. Prominent vasa recta is seen in the right lower quadrant with subtle mesenteric inflammation.Diverticulosis is noted in the colon. No evidence of diverticulitis or obstruction seen.No free air, fistulous connection, or obstruction seen.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Skip lesions of edematous mucosa in the distal ileum with stricturing of the terminal ileum with thickened wall. These findings are nonspecific however findings are likely due to inflammatory process like Crohn's disease.
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Generate impression based on findings.
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Male 73 years old; Reason: eval diverticulitis History: LLQ abd pain, rectal bleeding ABDOMEN:LUNGS BASES: Bibasilar atelectasis and vascular congestion noted. The heart is mildly enlarged.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: A few too small to characterize lesions in the kidneys bilaterally. A 2.4 x 1.6 cm lesion measuring 60 HU is also incompletely characterized given lack of pre contrast imaging.No hydronephrosis detected.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Long segment colonic wall thickening and pericolonic edema in the descending colon extending to the proximal sigmoid colon is noted. No obstruction or free air is identified. Free fluid is layering in the pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Long segment (approximately 20 cm coronal series image 71) colonic wall thickening and pericolonic edema in the descending colon extending to the proximal sigmoid colon is noted. No obstruction or free air is identified. Free fluid is layering in the pelvis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Colitis of the descending colon which is nonspecific, correlate for infectious versus inflammatory etiology. Neoplasm is thought less likely given its long segment involvement. 2. Indeterminate renal lesions bilaterally, dedicated renal CT or MR advised.
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Generate impression based on findings.
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Reason: h/o met parotid gland ca, compare to previous, measurements pls. Pt w/ ESRD, on dialysis. OK to use dye per Dr. Villaflor History: none CHEST:LUNGS AND PLEURA: Stable scattered nonspecific micronodules.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal.Severe coronary artery calcification.Right chest Port-A-Cath with its tip in the SVC.CHEST WALL: Stable left axillary lymph node (image 11 series 3) measuring 17 mm x 10 mm, previously, measuring 18 mm x 9 mm.Redemonstration of gynecomastia with mild skin thickening in left chest wall.Degenerative changes in the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable, small hypoattenuating lesion inferiorly in right lobe of the liver, unchanged.Cholelithiasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic kidneys with cystic changes compatible with chronic endstage renal disease.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.Ascites unchanged from the prior exams. Peritoneal dialysis catheter identified in the lower abdomen.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No suspicious pulmonary nodules or masses.2.Stable exam without evidence of new sites of disease.3.Ascites unchanged from the prior two exams.
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Generate impression based on findings.
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77-year-old male. Reason: s/p LLL resection History: s/p LLL resection. LUNGS AND PLEURA: New left-sided pigtail catheter in the posterior left posterior upper lobe lies at the superior aspect of a moderate-sized, multiloculated left hydropneumothorax, mildly decreased in size. At its base, a left-sided chest tube tracks along the left hemidiaphragm and terminates at the posterior left cardiophrenic angle. A second smaller hydropneumothorax with questionable communication with the previously mentioned collection is located in the left apex tracking inferiolaterally and is moderately improved with a second pigtail catheter in the mid left upper lung at the base of the second collection.Interval removal of the apically directed left chest tube. The associated consolidation has also decreased moderately.Significant left-sided volume loss from a left lower lobe resection. A left-sided central venous catheter terminates at the right atrium.MEDIASTINUM AND HILA: Prominent mediastinal lymph nodes are unchanged. Moderate atherosclerotic calcifications of the aorta and coronary arteries are noted.CHEST WALL: Degenerative changes of the thoracolumbar spine. Postsurgical changes in the left lateral chest and abdominal wall with soft tissue edema and small seroma, grossly unchanged from the prior exam.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. The atherosclerotic calcification of the abdominal aorta and its branches
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1.Mild to moderate decrease in loculated left sided hydropneumothoraces.2.Moderately decreased left lung consolidation.
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Generate impression based on findings.
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4 year-old male status post fall 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 paranasal sinus mucosal thickening.
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No acute intracranial abnormality.
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Generate impression based on findings.
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11 year-old male with chronic nasal obstruction. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structures is unremarkable. Other then minimal mucosal thickening in the maxillary sinuses and posterior left ethmoids, the remaining sinuses are clear and there are no air-fluid levels. The osteomeatal complexes, sphenoethmoidal recesses, and frontoethmoidal recesses are patent. The intersphenoid septum is normal. There is minimal right septal deviation. The cribriform plate, lateral lamellae, fovea ethmoidalis and lamina papyraceae appear normal.
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Other then minimal mucosal thickening in the maxillary sinuses and posterior left ethmoids, the remaining sinuses are clear and there are no air-fluid levels.
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Generate impression based on findings.
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54-year-old female with history of non-Hodgkin's lymphoma post stem cell transplant. CHEST:LUNGS AND PLEURA: Apical pleural scarring without change. Small lingular nodules without change. These may represent small nodes.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No change in mild retroperitoneal adenopathy. Reference portacaval lymph node on image 90/204 measures 0.7 x 2.3 cm without change.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Mildly enlarged uterus with calcified fibroids. Right adnexal cyst has resolved.BLADDER: No significant abnormality noted.LYMPH NODES: Left external iliac lymph node on image 170/204 measures 0.6 x 1.3 cm, unchanged to decreased in size. Other smaller nodes are stable.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No progressive or new adenopathy.
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Generate impression based on findings.
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31 year-old female with chronic nasal obstruction. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There are retention cyst and minimal mucosal thickening in the dependent right and left maxillary sinuses, respectively. The frontal sinuses, frontal-ethmoid recesses, anterior/posterior ethmoids, 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. 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 mild maxillary sinus inflammatory disease.
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Generate impression based on findings.
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Female 39 years old; Reason: Rectal Cancer: Restaging PET/CT History: none CHEST:LUNGS AND PLEURA: Biapical scarring/atelectasis.MEDIASTINUM AND HILA: Anterior mediastinal soft tissue measures 2.0 x 0 .9 cm, previously 2.2 x 0.9 cm (image 33/series 401). Subcarinal lymphadenopathy measures 12 mm in the short axis (42; series 401). Although this appears similar to the prior study, this appears to have increased in size when compared to the prior studies dating back to 9/16/2011. While these findings may represent metastatic disease, in conjunction with the wall thickening of the esophagus, a primary esophageal neoplasm cannot be excluded. Right chest wall port terminates at the cavoatrial junction. Mild concentric wall thickening in the distal esophagus is nonspecific.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Liver has a smooth contour with patent vasculature. Post operative changes adjacent to the liver. No suspicious hepatic lesions.SPLEEN: Splenomegaly, unchanged. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right pelvic kidney; no hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: Multiple prominent mesenteric lymph nodes, appearing similar to the prior study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small ventral hernia containing fat and a loop of small bowel without evidence of obstruction or strangulation.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Reference right external iliac lymph node, partially calcified measures 0.7 x 0 .7 cm, previously 0.8 x 0.6 cm (image 164/series 401).BOWEL, MESENTERY: Post operative changes in the rectum. Post operative changes in the small bowel in the left lower abdomen.BONES, SOFT TISSUES: Sclerotic focus in the right femoral neck, likely a benign bone island, unchanged.OTHER: No significant abnormality noted.
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1. Persistent subcarinal lymphadenopathy. Although this appears similar to the prior study, this appears to have increased in size when compared to the prior studies dating back to 9/16/2011. While these findings may represent metastatic disease, in conjunction with the nonspecific wall thickening of the distal esophagus, a primary esophageal neoplasm cannot be excluded. Further evaluation with endoscopy could be considered if clinically indicated. 2. No significant interval change in other reference measurements, as provided above.
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Generate impression based on findings.
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66-year-old male with history of eosinophilic and organizing pneumonia, pneumothorax and worsening pulmonary edema . Assess lung pathology given worsening hypoxia. LUNGS AND PLEURA: Right pneumothorax again seen, with chest tube unchanged in position. Debris is seen within the right-sided chest tube. Bilateral basilar bronchiectasis with consolidation/atelectasis. Diffuse groundglass opacities with some sparing of the apices an accompanying septal thickening. No significant pleural effusion.MEDIASTINUM AND HILA: Mildly enlarged lymph nodes are scattered throughout the mediastinum, nonspecific.CHEST WALL: Degenerative disease affects the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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1.Basilar predominant bronchiectasis with consolidation in and fibrosis most likely chronic in nature.2.Diffuse groundglass opacities with sparing of the apices. Differential includes acute on chronic hypersensitivity pneumonitis, eosinophilic pneumonia with accompanying organizing pneumonia, drug reaction or less likely NSIP.
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Generate impression based on findings.
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Female; 70 years old. Reason: XL-184-308 Follow-up. Please acquire ARTERIAL AND DELAYED VENOUS enhancement. Must be performed on TC162 scanner. Call HIRO 2-9172 w/ questions. History: hx/o RCC assessment after 8 wks of investigational study drug CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules again noted. Left upper lobe reference nodule, best seen on image 33 of series 10 measures 6 x 6 mm, previously 6 x 6 mm. Reference left lower lobe nodule, best seen on image 50 of series 10, measures 9 x 5 mm, previously 11 x 8 mm.MEDIASTINUM AND HILA: Right hilar mass, best seen on image 53 series 9, measures 2.4 x 3.1 cm, previously 3.0 x 2.3 cm.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: There is been interval progression in size and number of hepatic metastatic lesions. Segment 7 reference lesion is seen on image 77 of series 6 measures 1.5 x 1.6 cm, previously 1.4 x 1.1 cm. Segment 8 reference lesion in the hepatic dome, best seen on image 15 of series 7, measures 8 x 5 mm, previously 6 x 5 mm. Large left lobe lesion best seen on image 88 of series 9 measures 2.6 x 2.8 cm, previously 1.8 x 1.8 cm.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Small left adrenal gland nodule is unchanged.KIDNEYS, URETERS: Status post right nephrectomy. Multiple small hypoattenuating lesions of the left kidney are stable in appearance.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Interval progression of metastatic disease with reference measurements as above.
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Generate impression based on findings.
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Clinical question: 67-year-old female with history of AML status post SCT collapse with low platelet count, fall with injury to the head. Ruled out intracranial hemorrhage. Signs and symptoms: Fall and injury to the head. Nonenhanced head CT:There is no detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Excessive nonspecific periventricular and subcortical low attenuation of white matter remain grossly similar to prior exam.Similar findings are also present in bilateral basal ganglia as well similar to prior study.Unremarkable cerebral cortex and cortical sulci. Unremarkable ventricles and CSF spaces and with maintained midline.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits.Unremarkable and well pneumatized all visualized paranasal sinuses, bilateral master air cells and middle ear cavities.
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1.No acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.2.Stable extensive periventricular, subcortical and bilateral basal ganglia foci of low-attenuation.
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Generate impression based on findings.
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18-year-old male with history of ulcerative colitis status post total proctocolectomy with ileostomy and Hartman's pouch, with confirmed pancreatitis. ABDOMEN:LUNG BASES: Multiple pulmonary micronodules, appearing similar to prior study. No new pulmonary nodules or masses are identifiedLIVER, BILIARY TRACT: No focal hepatic lesions.SPLEEN: Normal spleen size.PANCREAS: The tail and distal body of the pancreas are mildly enlarged and edematous. However, there is no definitive peripancreatic fat stranding in the surrounding area. The splenic and portal vein appear patent. No evidence of a splenic artery pseudoaneurysm. No fluid collection to suggest pseudocyst formation.ADRENAL GLANDS: Adrenal glands normal in appearance.KIDNEYS, URETERS: Kidneys enhance symmetrically without renal lesion.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postoperative changes consistent with the stated history of proctocolectomy with ileoanal anastomosis. There are dilated loops of small bowel in the right hemiabdomen which appear decreased in size when compared to the prior study and are likely related to the stated history of proctocolectomy with ileoanal anastomosis. There is no convincing evidence of obstruction. No free intraperitoneal air, pneumatosis intestinalis, or portal venous gas. 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 lymphadenopathy.BOWEL, MESENTERY: Mild presacral soft tissue thickening adjacent to the pouch is likely postsurgical change, unchanged. Postoperative changes consistent with the stated history of proctocolectomy with ileoanal anastomosis. There are dilated loops of small bowel in the right hemiabdomen which appear decreased in size when compared to the prior study and are likely related to the stated history of proctocolectomy with ileoanal anastomosis. There is no convincing evidence of obstruction. No free intraperitoneal air, pneumatosis intestinalis, or portal venous gas. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Duplicated IVC.
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The distal body and tail of the pancreas appear mildly enlarged and edematous consistent with uncomplicated acute pancreatitis.
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Generate impression based on findings.
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Male; 79 years old. Reason: r/o worsening perforation History: guarding, recent perf seen on CT in Nov 2013 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: There is been progression in size and number of multiple pulmonary nodules bilaterally. Reference left lower lobe nodule, best seen on image 1 of series 5, measures 1.1 x 0.8 cm.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: Bilateral percutaneous nephrostomy tubes present. Stable tortuous and dilated right ureter. No evidence of hydronephrosis. Right renal calculi are unchanged.RETROPERITONEUM, LYMPH NODES: Mild aneurysmal dilatation of the distal aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Bilateral fat containing inguinal hernias.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter present within bladder. Large trigone mass, best seen on image 106 of series 4, measures 7.7 x 6.1 cm. No evidence of bladder rupture.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Interval progression of pulmonary metastatic disease without evidence of bladder rupture.
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Generate impression based on findings.
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Reason: eval rib fx, hemothorax, ?infection History: fall, weakness LUNGS AND PLEURA: Moderate size right pleural effusion is identified with underlying right basilar atelectasis.No significant pulmonary edema.Scattered calcified and noncalcified micronodules compatible with prior granulomatous disease.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Prominent mediastinal lymph nodes are nonspecific.Cardiac enlargement without evidence of pericardial effusion.Marked coronary artery and aortic calcification.CHEST WALL: Marked soft tissue edema within the visualized chest and abdominal walls with extensive anasarca.Old fracture deformities involving the right ribs. No acute fracture can be identified.Severe degenerative changes, kyphosis, and stable anterior wedging of multiple thoracic vertebrae.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy.Bilateral renal hypodensities, most likely representing cysts.Marked atherosclerosis of the aorta and its branches.
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1.Evaluate with moderate sized right pleural effusion and accompanying basilar atelectasis.2.Severe edema and anasarca involving the chest and abdominal body wall.3.No acute rib fracture identified. No evidence of a hemothorax.
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Generate impression based on findings.
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Reason: evaluate for response. History: 67 year old female with a history of sarcoma. CHEST:LUNGS AND PLEURA: Again seen are multiple pulmonary nodules, which appear increased in size and number. Reference right apical nodule measures 6 mm, previously 5 mm (series 5, image 18). There is interval development of nodular interlobular septal thickening and scattered nodular groundglass opacities which are most consistent with lymphangitic spread of tumor. No pleural effusions. Interval development of small bilateral pleural effusions. In the presence of interlobular septal thickening, this raises the question of a component of mild superimposed pulmonary edema.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Mild coronary artery calcifications. No lymphadenopathy.CHEST WALL: Persistent T1 vertebral body metastatic lesion. T2 vertebral body lytic lesion, unchanged.ABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic metastases are again seen, appearing increased in size compared to the prior study. Reference right hepatic lobe lesion measures 1.6 cm, previously 1.5 cm (series 3, image 93). There is mild left sided intrahepatic biliary ductal dilation, appearing similar to the prior study. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Chronic left hydronephrosis appears increased when compared to the prior study. Left nephroureteral stent terminates in the bladder. Bilateral nonobstructive renal calculi.RETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes are again seen. Atherosclerosis of the abdominal aorta and its branches.BOWEL, MESENTERY: Mesenteric lymphadenopathy appears similar to the prior study. BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Reference large pelvic mass measures 8.2 x 6.8 cm, previously 8.0 x 6.8 cm (series 3, image 154) extends to the left pelvic side wall and invades the adjacent small bowel loops, left ureter, and possibly the sigmoid colon.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Left lower quadrant colostomy. There is a parastomal hernia containing multiple loops of small bowel without evidence of obstruction or strangulation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Increasing pulmonary and hepatic metastases with persistent osseous lesions.2.No significant interval change in large reference pelvic mass with extension to the left pelvic sidewall and invasion of adjacent small bowel loops, left ureter, and possibly the sigmoid colon.3.Chronically obstructed left kidney with increasing hydronephrosis.4.Small bilateral pleural effusions.
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Generate impression based on findings.
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Abnormal symphysis pubis CT examination was performed with sagittal and coronal reconstructions. Evaluation of the images reveals vacuum phenomena in both sacroiliac joints, excluding the diagnosis of sacroiliitis.Examination of the pubic symphysis reveals marked sclerosis and some widening at the physis. There are small subchondral cysts. In addition there is some gas within the symphysis, excluding the possibility of infection.This appearance of the pubic symphysis is classic for osteitis pubis which is a non-infectious inflammation
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Osteitis pubis
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Generate impression based on findings.
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Female; 62 years old. Reason: 62yo female with recurrent fallopian tube cancer. Assess for disease progression History: supraclavicular LAD CHEST:LUNGS AND PLEURA: Bilateral emphysematous changes and apical scarring again noted. Multiple lung nodules bilaterally have increased in size and number. Additionally, multiple foci of septal and pleural-based thickening bilaterally could be secondary to inflammatory changes, but widespread metastatic disease must be considered.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Left supraclavicular lymph node best seen on image 5 of series 3 measures 2.5 x 1.3 cm, previously 2.4 x 1.2 cm. .ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic calcifications of the abdominal aorta and its branches. Multiple surgical clips in the retroperitoneum from lymph node dissection.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: PELVIS:UTERUS, ADNEXA: Surgically absent.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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Bilateral lung lesions have increased in size and number which could be secondary to inflammatory changes, but widespread metastatic lung disease must be considered. Left supraclavicular adenopathy consistent with metastatic focus.
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Generate impression based on findings.
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Reason: PE? History: chest pain, hx sickle cell disease PULMONARY ARTERIES: Technically good quality study with no evidence of pulmonary embolism.LUNGS AND PLEURA: Left lower lobe consolidation and left pleural effusion.Nonspecific opacity right lung base.MEDIASTINUM AND HILA: No significant mediastinal lymphadenopathy.Fullness of the left hilum may be reactive nodes given the above described pneumonia.CHEST WALL: Mild endplate depression mid thoracic vertebra possibly related to the patient's known sickle cell disease.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Splenic atrophy.
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1. No evidence of pulmonary embolism.2. Left basilar consolidation and left pleural effusion consistent with pneumonia.
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Generate impression based on findings.
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57-year-old male. Reason: evaluate right lower chest mass - possible right lung herniation after chest tube History: intermittent soft mass. CHEST:LUNGS AND PLEURA: Small right pleural effusion and basilar atelectasis. Surgical clips in the anterior basis bilaterally.MEDIASTINUM AND HILA: Moderate cardiomegaly. Mild coronary artery, valvular and aortic calcifications.CHEST WALL: Soft tissue thickening of the right anterior chest wall at the level of the xiphoid process. The thoracic fascia is intact with no evidence of herniation of intrathoracic contents. Median sternotomy fixation intact.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis without evidence of acute infection.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral simple cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Soft tissue thickening of the right anterior chest wall at the level of the xiphoid process. No evidence of herniation.
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Generate impression based on findings.
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Reason: please assess for lymphadenopathy and supraclavicular mass History: please assess for lymphadenopathy and supraclavicular mass LUNGS AND PLEURA: Minimal dependent atelectasis or scarring, otherwise unremarkable lungs and pleura. MEDIASTINUM AND HILA: Left vertebral artery arises directly from the arch, normal variant.There is no mediastinal or hilar lymphadenopathy.Moderate coronary calcification proximal LAD.CHEST WALL: Degenerative abnormalities affect the thoracic spine with marked hypertrophy/osteophyte formation.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No mediastinal or hilar lymphadenopathy, or other significant abnormality.
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Generate impression based on findings.
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33-year-old male with history of esophageal cancer ("~9cm tumor"). Recent chemo/radiation therapy please evaluate for changes since prior imaging. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Esophageal thickening from approximately level of T9-10 and extending down to just inferior to the GE junction. Although the orientation of this thickening makes measurement difficult, it has decreased in size from the prior CT scan on 10/10/2013. One area of esophageal wall thickening (series 41, image 81) anterior to T9/10 measures approximately 1 cm, compared with the prior measurement of approximately 1.7 centimeters on 10/10/13.Several calcified lymph nodes are noted.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: 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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Lower esophageal thickening has decreased in size from the prior CT scan on 10/10/13 as described above.
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Generate impression based on findings.
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Reason: copd, lung transplant eval History: as above, shortness of breath LUNGS AND PLEURA: Moderate centrilobular and paraseptal emphysema is present, with large lung volumes.Right middle lobe and lingular scarring is present.MEDIASTINUM AND HILA: Mild coronary artery calcification is present.No mediastinal or hilar lymphadenopathy a minimal amount of pericardial fluid is present, the heart size is normal.Normal caliber main pulmonary artery. Calcified mediastinal and hilar lymph nodes are present, from healed granulomatous infection. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Numerous splenic calcifications may be from prior histoplasmosis. No other significant upper abdominal abnormality.
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COPD/emphysema and prior granulomatous disease.
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Generate impression based on findings.
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4 year-old female with sore throat, neck swelling and neck pain. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Limited view of the intracranial structure is unremarkable. Examination shows diffuse inflammatory changes of the soft tissues in the submental and submandibular spaces. There appears an area of hypoattenuation between anterior bellies of the digastric muscles. There is no definite rim enhancement of the area. There are multiple enlarged, enhancing lymph nodes in the neck. There is prominent Waldeyer's ring. There is hyperemia of the submandibular glands. There is no evidence of retropharyngeal fluid collection. The airway is patent. There is effacement of the left piriform sinus. The epiglottis, vallecula, right piriform sinus, and vocal cords are normal. The parotid 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. Findings are compatible with submental and submandibular cellulitis with formation of phlegmon or early abscess between anterior bellies of the digastric muscles. 2. Reactive cervical lymphadenopathy. 3. No evidence of airway compromise or retropharyngeal fluid collection.
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Generate impression based on findings.
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Evaluate for reverse ball-and-socket prosthesis There are marked degenerative changes involving the glenohumeral joint with sclerosis and articular irregularity. There appears to be a large joint effusion. The humeral head is high riding consistent with a chronic tear versus atrophy. There's been little change from the previous exam of October
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Marked degenerative changes in the glenohumeral joint with a high riding humeral head
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Generate impression based on findings.
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65 year old female with history of fever and leukocytosis. Assess for right lower lobe pneumonia and pleural effusion CHEST:LUNGS AND PLEURA: Postsurgical findings consistent with history of right middle lobectomy. Previously described patchy righty interstitial and air space opacities have slightly increased in extent over the interval. A cavitary space near the right hilum is again seen, although it appears somewhat smaller when compared to prior.Persistent right paramediastinal scarring and bronchiectasis consistent with radiation change. Severe diffuse centrilobular emphysema.MEDIASTINUM AND HILA: Vascular calcifications of the aorta and mild coronary artery calcifications are again seen. No appreciable adenopathy.CHEST WALL: Right chest wall fluid collection with internal foci of air is again seen, most likely related to prior chest tube however correlates for symptoms/signs of infection.ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips. Atherosclerotic calcifications of the aorta. LIVER, BILIARY TRACT: Fat-containing mass within the dome of the liver with peripheral calcification appears similar to the prior study.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Again seen is enlargement of pancreatic tail with mild surrounding mesenteric fat stranding suggestive of pancreatitis. 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: Posterior to the right iliac wing are several foci of gas within the gluteal musculature which may be related to injection although correlate with symptoms of infection, particularly since these foci of gas are not completely visualized.OTHER: No significant abnormality noted.
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1.Slight interval increase in the right lung patchy perihilar and basilar air space opacities, suspicious for infection superimposed on underlying radiation changes.2.Right lateral chest surround the with focus of internal gas, correlate for infection.3.Right gluteal foci of gas are partially visualized, correlate with signs and symptoms of infection.4.Pancreatic tail enlargement appears similar to prior.
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Generate impression based on findings.
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30 year-old female with history of productive cough and cavitary lesions seen the on radiograph. LUNGS AND PLEURA: Again seen is a left mid lung cavitary process involving the left upper and left lower lobe posteriorly. Within this process are air bronchograms and multiple foci of gas. The remainder of the lung parenchyma apart from this process is within normal limits. MEDIASTINUM AND HILA: Given at this exam was performed without contrast, the mediastinum is within normal limits.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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Left mid lung cavitary process is again seen, with multiple foci of gas internally. The remaining lung, apart from this process, is within normal limits.
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Generate impression based on findings.
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Clinical question: Evaluate for stroke. Signs and symptoms: Left-sided facial droop and lower extremity weakness. Nonenhanced head CT: No detectable acute intracranial process.CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes. Examination demonstrates fairly extensive subcortical and periventricular low attenuation white matter which considering patient's stated age of 88 likely representing advanced age indeterminate small vessel ischemic strokes. Similar changes are also present in bilateral basal ganglia and right paramedian pons.Unremarkable cerebral cortex.Moderately bilateral cavernous carotid vascular calcification.Paranasal sinuses are well pneumatized. There is a sclerotic bony thickening of the left chamber of the sphenoid sinus likely secondary to prior chronic long-standing sinus disease. Remote residual cortical thickening still present.Bilateral mastoid air cells and middle air cavities are pneumatized and unremarkable.Unremarkable images through the orbits.
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1.No acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes. 2.Extensive age indeterminate small vessel ischemic strokes.
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Generate impression based on findings.
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-Year-old male with rectal pain. Evaluate for abscess. PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Just above the anal verge, there is a somewhat lobulated fluid attenuation with several gas bubbles and peripheral enhancement at midline. Although a portion this could represent ano-rectal lumen, given low position findings are suspicious for abscess. The central portion measures 2 x 3.1 cm with anterolateral extension. However, the ischio rectal fossa appears unremarkable, there is no infiltrative change in perirectal/perianal fat and no fistulous tracts are identified. Levator musculature appears maintained.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Ano-rectal abscess. See above.
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Generate impression based on findings.
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Altered mental status. Nonenhanced head CT:Examination demonstrates a new focus of parenchymal hemorrhage in the left cerebellum posteriorly measuring at 17 x 15-mm in its transaxial dimensions. There is some surrounding vasogenic edema present also. No significant mass effect.Right occipital subarachnoid hemorrhage demonstrated slight interval decrease in its density.Interval increased subarachnoid and parenchymal hemorrhage in the right posterior temporal lobe since prior exam. There is also increase in subarachnoid hemorrhage and parenchymal edema in the left high convexity frontal lobe and subtle increase in right frontal subarachnoid hemorrhage.Foci of increased hemorrhage demonstrates subtle regional mass-effect and without detectable mass effect on the lateral ventricles or midline shift.Ventricular system remain within normal size.Calvarium and soft tissues of the scalp are unremarkable.Images through the orbits are unremarkable with the exception of a chronic blowout fracture of left lamina papyracea.Neck CTA:Partially visualized aortic arch demonstrate dissection of the aortic arch and with symmetrical contrast filling of the aorta on both sides of the dissection.The dissection extends minimally into the very proximal left subclavian artery and the very proximal left common carotid artery.The brachial cephalic and bilateral subclavian arteries are unremarkable.Right common carotid artery and right internal and external carotid arteries are unremarkable.The left common carotid artery as well as left internal and external carotid arteries are unremarkable.Bilateral vertebral arteries are visualized and remain unremarkable through the entire cervical course.Head CTAbilateral vertebral arteries are well visualized across the skull base and in the supraclinoid portion. The left pica arises from the left vertebral artery extracranially at the level of foramen magnum which is a normal anatomical variation.Right pica branch is unremarkable. Basilar artery and its branches are unremarkable and in particular without evidence of an aneurysm. Left internal carotid artery remains unremarkable and patent across the skull base and in its supraclinoid portion. The ophthalmic artery is visualized and unremarkable.The left anterior and middle cerebral arteries are visualized and unremarkable. The anterior communicating artery is identified and unremarkable.The right internal carotid artery remains patent and unremarkable across the skull base and in its supraclinoid portion.A small posterior communicating artery is identified and unremarkable.In the right anterior and middle cerebral arteries are visualized and unremarkable in particular no evidence of an aneurysm is identified.There is normal visualization of all intracranial venous sinuses which remain patent and unremarkable.
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1.Nonenhanced head CT demonstrate interval increased hemorrhage in the supratentorial space and the suspected a small focus of left posterior frontal parenchymal hemorrhage. There is also new hemorrhage in the posterior fossa in the dorsal aspect of the left cerebellum with subtle surrounding edema.2.Partially visualized superior aspect of the aortic arch demonstrate a previously known dissection which extends minimally into the very proximal left subclavian and left common carotid artery without vascular lumen compromise. Unremarkable CTA of the neck otherwise.3.CTA of the head demonstrate no evidence of an aneurysm. All the vasculature at the level of the circle of Willis are well visualized and without evidence of pathology. There is also no convincing evidence of any abnormal increased vascularity or aneurysm at multiple foci of intracranial hemorrhage seen on above head CT. Note should be made that CTA may be insensitive for detection of small aneurysm at the very distal smaller branches of the intracranial circulation.
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Generate impression based on findings.
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74-year-old male. Reason: r/o PE, also evaluate for other causes of hypoxiaAdditional history per chart: Silicosis, pulmonary hypertension. PULMONARY ARTERIES: Technically inadequate for evaluation of a pulmonary embolism. No pulmonary embolus identified.LUNGS AND PLEURA: Small bilateral pleural effusions with fluid also tracking along the right major fissure.Extensive basilar predominant fibrotic changes diffusely throughout both lungs with marked honeycombing and traction bronchiectasis. Bullae formation is seen, with large right apical bulla.Mild centrilobular and paraseptal emphysema is also noted.MEDIASTINUM AND HILA: Moderate cardiomegaly. Atherosclerotic calcification of the thoracic aorta, its branches, and coronary arteries. Scattered nonenlarged mediastinal and hilar lymph nodes are noted.CHEST WALL: Extensive degenerative changes of the thoracolumbar spine. Median sternotomy fractured wires as previously identified.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Moderate atherosclerotic calcification of the abdominal aorta and its branches. Narrowing at the ostium of the SMA is questioned, though incompletely evaluated without arterial phase contrast imaging.Sludge and/or small gallstones in the gallbladder without evidence of inflammation.
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1.No evidence of pulmonary embolism.2.Moderate cardiomegaly, small bilateral effusions, and probable interstitial edema suggestive of CHF.3.Extensive, severe basilar predominant interstitial fibrosis in a UIP pattern, presumably secondary to silicosis given the patient's history.4.Upper lobe predominant centrilobular and paraseptal emphysema, compatible with combined pulmonary fibrosis and emphysema (CPFE).
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Generate impression based on findings.
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67 year-old male with lethargy. There is confluent hypoattenuation in the cerebral white matter and foci of hypoattenuation in the right basal ganglia. 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. Intracranial arterial calcification. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear except for opacification of the right maxillary sinus, which is small in size.
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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. Confluent hypoattenuation in the cerebral white matter and foci of hypoattenuation in the right basal ganglia are nonspecific but could represent advanced small vessel ischemic disease and right basal ganglia lacunar infarcts of indeterminate age. Differential considerations may include encephalopathy of various etiology and encephalitis.
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Generate impression based on findings.
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69 year-old female with right facial numbness, ear pain and slurred speech. 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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56 year-old female status post fall. There is a small focus of hypoattenuation in the anterior left thalamus. The ventricles, sulci, and cisterns are symmetric and 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. The osseous structures are unremarkable. There is partial opacification of the mastoids. There appears postsurgical change of a transphenoidal pituitary surgery or sinus surgery. Clinical correlation. There is mild paranasal sinus mucosal thickening.
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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. A small lacunar infarct in the anterior left thalamus, likely chronic. Brain volume loss.
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Generate impression based on findings.
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Female; 21 years old. Reason: e. faecalis bacteremia. looking for a source History: bacteremic 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: Bibasilar atelectasis. Small right pleural effusion.LIVER, BILIARY TRACT: No suspicious lesions identified. No intra or extrahepatic ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No evidence of nephrolithiasis or hydronephrosis.RETROPERITONEUM, LYMPH NODES: Scattered nonpathologic-sized retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Normal bowel wall caliber. No evidence of obstruction, pneumatosis, or pneumoperitoneum. No mesenteric fluid collections or inflammatory changes.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: The bladder wall is moderately thickened, likely secondary to partial distention.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of free fluid in the pelvis, likely physiologic.
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No radiographic evidence for source of bacteremia.
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Generate impression based on findings.
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Male 64 years old; Reason: metastatic cholangiocarcinoma, restaging History: metastatic cholangiocarcinoma, restaging CHEST:LUNGS AND PLEURA: Biapical scarring/atelectasis. Right upper lobe subcentimeter pulmonary nodule measures 6 mm, previously 5 mm (image 41, series 4).MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Right chest port tip terminates in the azygos vein.ABDOMEN:LIVER, BILIARY TRACT: The hypoattenuating lesion within the left lobe of the liver is much larger, measuring 10.1 x 8 .9 cm, previously 8.0 x 6.8 cm (series 3 image 95). The satellite index lesions also appear more conspicuous and are increased in size compared to previous. The left portal vein is not opacified which is unchanged in the prior exam. The right portal vein is patent. The left hepatic vein and left hepatic artery are attenuated comment not well visualized on this examination. There is left-sided intrahepatic biliary ductal lesion, appearing similar to the prior study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple subcentimeter densities in the kidneys are too small to characterize and unchanged from the prior exam.RETROPERITONEUM, LYMPH NODES: The index porta hepatis lymph node measures 3.7 x 3 .1 cm, previously 3.9 x 2.9 cm (image 108, series 3).BOWEL, MESENTERY: Diverticulosis, without evidence of diverticulitis. Oral contrast reaches the distal descending colon. No dilated loops of bowel to suggest obstruction.BONES, SOFT TISSUES: Foci of soft tissue density with internal foci of gas density are likely iatrogenic. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. The reference hepatic lesion appears larger when compared to the prior exam. There is also interval increase in size and conspicuity of the non reference satellite lesions. The reference porta hepatis lymphadenopathy appears unchanged.2. Interval repositioning of the Port-A-Cath with the tip in the azygos vein. There is also an apparent filling defect along the tip of the catheter which is suspicious for thrombus formation. These findings were relayed to Dr. Abbo via phone at 9:02 am on 12/27/13.
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Generate impression based on findings.
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Male 37 years old; Reason: abscess Rt cheek, lower jaw History: facial swelling. The right parotid gland is swollen and demonstrates increased enhancement compared to the left parotid gland. There is no organized fluid collection to indicate abscess. No visible sialolith to indicate obstruction of the parotid duct. However soft tissue stranding and swelling is seen within the right face adjacent to Stensen's duct. Multiple right-sided lymph nodes are seen with the largest measuring 1.0 cm in preauricular soft tissues (series 5 and image 34).The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. The maxilla, mandible, sphenoid boned, nasal bones, zygoma, hard palates, pterygoid plates, visualized cervical spine and TMJs are intact, without fracture.The frontal sinuses, frontal-ethmoid recesses, anterior/posterior ethmoids, sphenoid sinuses, and maxillary sinuses are well developed and clear. The osteomeatal complexes are normal with intact uncinate processes and patent infundibuli. The intersphenoid septum is normal. There is nasal septal deviation with spur formation. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable.
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Swelling and enhancement of the right parotid gland and Stensen's duct with associated reactive lymphadenopathy but no organized fluid collection to indicate abscess. Findings consistent with right-sided parotitis.
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Generate impression based on findings.
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24 year-old female with headache. 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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Female 53 years old; Reason: eval for appendicitis History: RLQ abdominal pain. ABDOMEN:LUNGS BASES: 1.5-cm partially calcified pleural-based nodule in the right lung base (series 10218 image 7) is noted. Bibasilar atelectasis seen.LIVER, BILIARY TRACT: Numerous hypodense lesions with peripheral nodular enhancement are noted. These are incompletely characterized given single phase of contrast however likely represent hemangiomas.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: Submucosal fat deposition in the cecum terminal ileum may represent prior colitis. No evidence of active inflammation noted. No obstruction, free air, or abscess collections are identified. The appendix is clearly visualized and morphologically normal.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Patient is status post implanted devices in the fallopian tubes. Air in vaginal cuff is nonspecific.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Submucosal fat deposition in the cecum terminal ileum may represent prior colitis. No evidence of active inflammation noted. No obstruction, free air, or abscess collections are identified. The appendix is clearly visualized and morphologically normal.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No acute intra-abdominal pathology detected.2.Hepatic lesions which likely represent hemangiomas although incompletely characterized on this single phase of contrast. Dedicated renal CT or MR advised for full characterization if clinical suspicion for metastatic disease persists.3.1.5-cm pleural-based right lower lobe nodule with peripheral calcification. This likely represents a benign hamartoma however, without prior imaging available for comparison, neoplasm cannot be excluded. Obtaining prior imaging woudl be best method to definitively characterize. If further imaging now would be helpful, dedicated chest CT advised for full characterization of the lungs.
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Generate impression based on findings.
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Female; 53 years old. Reason: renal mass seen on back MRI, please characterize and rule out mets History: renal mass seen on back MRI, please characterize and rule out mets CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No suspicious lesion identified. Cholelithiasis without evidence of acute cholecystitis. No intra or extrahepatic ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No evidence of suspicious lesions. Previously identified left upper pole lesion on MRI corresponds to the inferior aspect of the spleen. No hydronephrosis or nephrolithiasis.RETROPERITONEUM, 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 noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Multiple uterine fibroids 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 evidence of suspicious renal mass.2.Cholelithiasis without evidence of acute cholecystitis.
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Generate impression based on findings.
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Female 22 years old; Reason: eval for obstruction History: LLQ abdominal, post-splenectomy 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: Patient is status post colectomy with J-pouch formation. The small bowel proximal to the J-pouch is dilated measuring roughly 4 cm, however this is unchanged since previous study. No evidence of fistula, abscess, or inflammation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No definite lymphadenopathy detected.BOWEL, MESENTERY: Patient is status post colectomy with J-pouch formation. The small bowel proximal to the J-pouch is dilated measuring roughly 4 cm, however this is unchanged since previous study. No evidence of fistula, abscess, or inflammation.Dilation of the rectum with stool is stable without evidence of free air, or perirectal inflammation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Distended J-pouch without evidence of obstruction.
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Generate impression based on findings.
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50 year-old female. Status post MVR and chest tube pull. Assess for intra-pleural fluid, particularly on the right side. LUNGS AND PLEURA: Interval removal of right anterior chest tube and placement of a posterior chest tube, which terminates in the right apex.There is marked interval increase in size of the large complex right pleural collection. Multiple high density locules, some with fluid-fluid levels, likely represent evolving hematoma. Several pockets of air are also present, probably introduced through the chest tube. Superimposed infection of this collection cannot be excluded. Near complete compressive atelectasis of the right lung.Small left pleural effusion. Interval decrease in previously seen interstitial and airspace opacities in the left lung.MEDIASTINUM AND HILA Leftwards mediastinal shift due to the aforementioned large complex right pleural collection. Tracheostomy tube terminates at the thoracic inlet. Mitral valve prosthesis. Pericardial leads.CHEST WALL: Median sternotomy. Large subcutaneous and muscle hematomas in the right chest wall along tract of removed chest tube. Anasarca.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. NG tube tip terminates in the stomach. Cholecystectomy clips. Small amount of ascites.
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Marked interval increase in size of right hemothorax.
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Generate impression based on findings.
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Female; 53 years old. Reason: mets lung cancer, s/p almost 3 yrs of Crizotinib for ALK+ lung cancer, pls c/w previous study to evalaute tx response. History: lung ca CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Reference prevascular lymph node, best seen on image 25 of series 3, measures 1.5 x 0.9 cm, previously 1.4 x 0.9 cm.CHEST WALL: Nonpathologic appearing enlarged lymph nodes in bilateral axilla are unchanged.ABDOMEN:LIVER, BILIARY TRACT: No suspicious hepatic lesions. Status post cholecystectomy.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: Nonpathologic sized retroperitoneal and mesenteric lymphadenopathy is unchanged.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Interval resection of left adnexal ovarian dermoid.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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Postsurgical changes as described above. No evidence of disease progression.
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Generate impression based on findings.
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Non-Hodgkin's lymphoma CHEST:LUNGS AND PLEURA: Stable right middle lobe subcentimeter peripheral nodule best seen on image 47 of series 5 measuring 0.4 cm in diameter.MEDIASTINUM AND HILA: Interval decrease in size of mediastinal and hilar adenopathy. Reference right paratracheal lymph node best seen on image 32 of series 3 now measures 1.1 x 0.6 cm; this is in comparison to 1 x 1.8 cm on 8/8/2013. Reference right hilar lymph node best seen on image 42 of series 3 now measures 1.5 x 1.4 cm; this is in comparison to 1.8 x 2.2 cm on 8/8/2013.CHEST WALL: Interval decrease in size of bilateral axillary adenopathyABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Interval decrease in size of retroperitoneal adenopathy. Reference portacaval lymph node best seen on image 106 series 3 now measures 1.8 x 0.6 cm; this is in comparison to 3 x 1.1 cm on 8/8/2013.BOWEL, MESENTERY: Interval decrease in size of mesenteric adenopathyBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Interval decrease in size of pelvic and inguinal adenopathy. Reference right external iliac lymph node best seen on image 161 of series 3 now measures 0.9 x 0.9 cm; this is comparison to 1.5 x 0.9 cm on 8/8/2013. Reference right inguinal lymph node best seen on image to 15 of series 3 measures 1.6 x 1.2 cm; this is in comparison to 1.9 x 1.6 cm on 8/8/2013BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Continued interval decrease in size of adenopathy with no new adenopathy noted.
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Generate impression based on findings.
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66-year-old female. SOB. History of RUL lung cancer s/p radiation, currently on chemotherapy. Concern for pneumonitis or cancer. LUNGS AND PLEURA: Extensive ground-glass opacities in the mid to lower lung zones bilaterally. There is associated traction bronchiectasis and architectural distortion. Findings most consistent with radiation pneumonitis. Consolidation in the right middle and lower lobe may also represent post-radiation reaction, however infection is also a possibility. 8 x 18 mm nodule in the right upper lobe (series 80236, image 50).Mild centrilobular emphysema.MEDIASTINUM AND HILA: Moderate coronary artery calcifications. Calcified mediastinal and hilar lymph nodes. No pathologically enlarged lymph nodes by CT size criteria.CHEST WALL: Moderate degenerative arthritic changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified splenic granulomas.
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1. Extensive bilateral pulmonary opacities consistent with radiation pneumonitis.2. Focal consolidation in right middle and lower lobes could also reflect post-radiation changes but infection is also a possibility. 3. 8 x 18 mm right upper lobe nodule.
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Generate impression based on findings.
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Male 73 years old; Reason: Evaluate for progression of metastaic disease; compare to previous scan. CHEST:LUNGS AND PLEURA: Interval development of right upper lobe ground glass opacities, which are nonspecific. Stable right suprahilar and left infrahilar scar-like opacities and volume loss. Hypoattenuating area with foci of air is noted more inferiorly to the previously referenced hilar lymph node reported below. This is non specific but has enhancing lung parenchyma around the lesion. Abnormality has appeared similar dating back to January 2013 with slight increase in size, and varying air suggested within. This lesion cannot be completely characterized but consideration for post obstruction necrosis or necrotic tumor with slow growth. Low grade infection cannot be excluded.Calcified and noncalcified micronodules are unchanged compared to prior examination. No new or suspicious nodules.MEDIASTINUM AND HILA: Infrahilar lymph node measures 1.2 x 1.1 cm (series 3 image 51), relatively unchanged.CHEST WALL: Partially calcified left axillary lymph nodes unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate with calcifications and seminal vesicles, stable.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: Multilevel degenerative changes and degenerative disk disease in the thoracic and lumbar spine. Spondylolisthesis of L5 on S1. Left inguinal hernia with nonspecific soft tissue attenuation, stable.
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1. No significant interval change in reference left infrahilar lymph node.2. Non specific hypoattenuating parenchymal lung lesion with foci of air, inferior to the left hila. Minimally changed over the past 12 months, and is of uncertain etiology, including post obstructive necrosis, low grade infectious process or necrotic tumor.
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Generate impression based on findings.
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Male; 69 years old. Reason: microscopic hematuria, assess for urinary source History: microscopic hematuria, assess for urinary source ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant lesions identified. The gallbladder is unremarkable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 7mm left non-obstructing calyceal calculus is unchanged. No evidence of hydronephrosis or suspicious parenchymal lesions. No perirenal fluid collections. There is a right duplicated collecting system. The left ureter was visualized in its entirety without evidence of filling defects, hydroureter or suspicious masses. The right ureter was incompletely visualized, but there is no evidence of hydroureter or filling defects in the visualized portions.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: The bladder is moderately distended. Two polyploid filling defects are identified on delayed phase in the right aspect of the bladder wall. The first more superior lesion, best seen on image 102 of series 8, measures 11 mm. A second more inferior lesion, best seen on image 104 of series 8, measures 10 mm. No evidence of regional lymphadenopathy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Polyploid filling defects of the bladder wall as described above. Follow up is recommended.2.Stable left nephrolithiasis.
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Generate impression based on findings.
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75-year-old female. Reason: eval right lung fields History: hypoxia, chest pain. ? Lobectomy. LUNGS AND PLEURA: Large right pleural effusion with extensive compressive atelectasis with only a small volume of aerated right upper lobe. Effusion measures near water density. No obvious nodules. Left lung is clear.MEDIASTINUM AND HILA: Severe cardiomegaly. Severe, dense atherosclerotic calcification of the coronary arteries, aortic valve, and thoracic aorta. Stable large right-sided thyroid nodule.CHEST WALL: Anasarca.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Atherosclerotic calcification of the abdominal aorta and its branches. Dense calcified splenic artery. Status post cholecystectomy. Stable hypodense lesion in the right lower liver.
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Large right pleural effusion with associated compressive atelectasis.Anasarca.
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Generate impression based on findings.
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55-year-old male with a history of resection of the terminal ileum for Crohn's disease on 3/17/89. Does this patient have Crohn's disease of the small bowel? ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status-post cholecystectomy. Subcentimeter hypodensity in the left lobe of the liver is too small to characterize but likely represents a simple cyst.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 dilated loops of bowel to suggest obstruction. No free intraperitoneal air, pneumatosis intestinalis, portal venous gas. No evidence of stricture or active inflammation. 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 dilated loops of bowel to suggest obstruction. No free intraperitoneal air, pneumatosis intestinalis, portal venous gas. No evidence of stricture or active inflammation. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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Postsurgical changes without findings to suggest active inflammatory bowel disease.
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Generate impression based on findings.
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Status post fall, orbital and nasal injury patient on Pradaxa. Unenhanced head CT:There is no detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Heavy bilateral cavernous carotid, left vertebral and minimally the right vertebral artery vascular calcification is noted.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation. Bilateral mastoid air cells and middle ear cavities remain well pneumatized and unremarkable.Limited images through the orbits demonstrate no retro-orbital abnormalities. There is absence of the left lens likely result of prior surgery.Very limited view of the maxillofacial region demonstrate left minimally depressed nasal bone fracture. For further evaluation recommend dedicated maxillofacial CT.
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1.Unremarkable nonenhanced head CT for any acute intracranial, calvarial or scalp pathology.2.Unremarkable intracranial contents.3.Minimally depressed left nasal bone fracture.
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Generate impression based on findings.
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Female 45 years old; Reason: evaluate for signs of small bowel or colon vasculitis, history of lupus, abdominal pain and diarrhea. History: pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Subcentimeter hypodensity in the spleen is too small to characterize but may represent a hemangioma, unchanged. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter hypodensity in the left kidney is too small to characterize, but likely represents a simple cyst.RETROPERITONEUM, LYMPH NODES: Numerous retroperitoneal lymph nodes are noted, not pathologically enlarged by CT criteria.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic focus in the right femoral neck and pelvis likely benign bone islands, unchanged. OTHER: Calcification in left breast. Correlation with recent mammography is recommended.PELVIS:UTERUS, ADNEXA: Calcifications are noted in the uterus, likely from degenerating fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No findings to account for the patients pain. No acute intra-abdominal process.
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Generate impression based on findings.
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44-year-old female with moyamoya and intracranial hemorrhage There has been interval right craniectomy for cerebral edema decompression with mild transcranial herniation. Previously demonstrated 10 mm right to left midline shift now measures 6 mm. As before there is diffuse right hemispheric edema with loss of gray-white interface from infarction. No significant interval change of the size of right basal ganglia hemorrhage as well as the extent of SAH. The left temporal horn remains mildly dilated, unchanged in extent. Basilar cisterns remain effaced
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1.There has been interval right craniectomy for cerebral edema decompression with mild transcranial herniation.2.Unchanged right thalamic as well as subarachnoid hemorrhage.
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Generate impression based on findings.
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57 year-old male. Restaging for head and neck small cell cancer. CHEST:LUNGS AND PLEURA: Stable scattered micronodules. No suspicious pulmonary nodules. Mild paraseptal emphysema in the upper lobes.MEDIASTINUM AND HILA: Debris in the dependent aspect of the trachea. Severe coronary artery calcifications. No mediastinal or hilar lymphadenopathy.CHEST WALL: Right chest all Port-A-Cath tip is in the inferior SVC.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: 15 mm hypodense lesion in the lower pole of the left kidney containing punctate calcifications is incompletely characterized but unchanged. Two left renal cysts. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Moderate calcified atherosclerotic calcification of abdominal aorta. No abdominal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Percutaneous pigtail catheter tip terminates in the stomach.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No evidence of metastasis in the chest or abdomen.
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Generate impression based on findings.
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Female 60 years old; Reason: pt with metastatic breast cancer s/p several cycles of chemo please assess response to therapy and compare to previous imaging History: MBC CHEST:LUNGS AND PLEURA: Moderate centrilobular emphysema.Persistent right lung pleural thickening and loculated pleural effusion. Note is made of a 10-mm groundglass nodule, previously 10 mm, in the left upper lobe (18; series 5), unchanged.MEDIASTINUM AND HILA: Heart size is normal. Left lower lobe pulmonary emboli are new.Right chest wall port terminates at the cavoatrial junction.CHEST WALL: Sclerotic osseous metastatic disease.ABDOMEN:LIVER, BILIARY TRACT: Hypodensity adjacent to the falciform, unchanged. No new suspicious hepatic lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Probable renal cysts.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease of the aorta.BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: Extensive osseous metastatic disease. There is endplate depression consistent with a vertebral body compression fracture of the T9 vertebral body, appearing similar to the prior study.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: Colonic diverticulosis.BONES, SOFT TISSUES: Osseous metastatic disease.OTHER: No significant abnormality noted.
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1.Persistent extensive osseous metastatic disease affecting the axial and proximal appendicular skeleton. 2.No significant interval change in T9 vertebral body compression fracture, likely pathologic. 3.Persistent 10 mm left upper lobe ground glass nodule; continued surveillance recommended
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Generate impression based on findings.
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1-year-old male with history of Wilms tumor and enlarged right hilar lymph node, status post left nephrectomy here for surveillance evaluation. LUNGS AND PLEURA: No focal pulmonary nodules or masses to suggest metastatic disease. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Previously noted enlarged right hilar lymph node is smaller in size measuring 9 mm in diameter (series 3, image 18), previously measuring 9 mm. Heart size is normal. No pericardial effusion.CHEST WALL: Left Port-A-Cath with tip in the right atrium. The bones appear normal. No axillary lymphadenopathy.UPPER ABDOMEN: A round homogeneous, simple fluid attenuation lesion is partially visualized arising from the right kidney likely represents a cyst and is unable to be measured at the same level as the previous measurements. Status post left nephrectomy. Surgical clips in the left hemiabdomen are noted.
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1.Interval decrease in right hilar lymph node which is of uncertain significance.2.No evidence of pulmonary metastatic disease.
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Generate impression based on findings.
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43 year old female and a cancer stage III, status post CRT done January, 2011. Evaluate interval change. Remote history of Hodgkin's lymphoma status post radiation therapy to thorax. CHEST:LUNGS AND PLEURA: No change. Biapical pleural/parenchymal scarring. No, new or suspicious pulmonary nodules. No pulmonary airspace disease. No pleural disease.MEDIASTINUM AND HILA: Calcified lymph nodes from prior granulomatous disease again seen, unchanged. No suspicious areas of lymph node enlargement or other masses. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 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: Stable since 2011 left enhancing adnexal mass (series 3, images, 161 through 164) measuring approximately 3 0.5 x 2.6 cm. This abuts the uterus, and has been presumed to be exophytic leiomyoma. No other abnormalities.BLADDER: No significant abnormality noted.LYMPH NODES: No abnormal lymph nodes seen.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1. No evidence for metastatic or recurrent tumor. 2. No change left parauterine/left adnexal mass since 2011. 3. Stable examination since 12/28/12.
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Generate impression based on findings.
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Male; 55 years old. Reason: lung cancer s/p 45 cycles of chemotherapy please evaluate for disease and compare with previous scan using the same target lesions History: lung cancer CHEST:LUNGS AND PLEURA: Minimal interval increase in size left pulmonary nodules and pleural thickening. Reference pleural thickening adjacent to the mediastinum, best seen on image 38 of series 3, measures 13 mm, previously 11 mm. Pleural nodularity along the left major fissure, best seen on image 42 of series 5, measures 2.8 x 2.0 cm, previously 2.3 x 1.6 cm.Small pericardial effusion and loculated left pleural effusion at the left lung base is unchanged.MEDIASTINUM AND HILA: Reference left pericardiophrenic lymph node, best seen on image 78 of series 3, measures 1.2 x 0.8 cm, previously 1.1 x 0.9 cm.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Punctate hypodense hepatic lesions are too small to characterize. The gallbladder is unremarkable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Right adrenal calcifications are unchanged.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant retroperitoneal lymphadenopathy.BOWEL, MESENTERY: 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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Slight increase in size of left lung lesions with measurements as dictated above, but otherwise stable exam.
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Generate impression based on findings.
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54 year old female. History of thyroid cancer status post CRT. Compare to previous. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Mild right apical scarring. Small left upper lobe pleural nodule with an associated area of linear scarring, which may be post inflammatory or post traumatic in origin, unchanged (series 5, image 55)MEDIASTINUM AND HILA: Extensive post-surgical changes from subtotal thyroidectomy and neck dissection.No mediastinal or hilar lymphadenopathy.CHEST WALL: Degenerative arthritic changes of the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Less than 5 mm hypodense focus in right hepatic lobe, too small to characterize, but unchanged. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Homogeneously low density right adrenal nodule measures 2.4 x 2.2 cm (series 3, image 85), most likely an adenoma given its stability dating back to 7/2013.KIDNEYS, URETERS: Left renal cyst. Additional hypodensities in both kidneys are too small to characterize but unchanged, probably 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.G-tube noted.BONES, SOFT TISSUES: Degenerative arthritic changes of the lumbar spine. Spinal stenosis at the L3-4 level is present due to posterior element hypertrophy and posterior disk osteophyte complex.OTHER: No significant abnormality noted.
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1. No definite evidence of metastasis in the chest or abdomen.2. Right adrenal nodule is most likely a benign adenoma given its stability dating back to 7/2013, this can be confirmed with dedicated adrenal MRI/CT imaging3. Spinal stenosis at L3-4, correlate with neurologic symptoms and exam.
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Generate impression based on findings.
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Clinical question: History of non-Hodgkin's lymphoma, status post 5 cycles of chemotherapy, assess response to treatment. Signs and symptoms: History of NHL. Enhanced neck CT:Examination demonstrates significant interval improvement of multiple bilateral cervical lymph nodes since prior exam.Previously measured bilateral reference nodes are remeasured in on current study as listed below.1.Left-sided level la (series 4 image 110) measuring at 4.4 x 7.2 previously measured 14.5 x 10.6 mm.2.Left level Ib (series 4 image 96) measuring at 6 times 9.5-mm compared to prior measurement of 9.5 x 16.5-mm.3.left level 2 (series 4 image 86) measuring at 3.7 x 6.8 millimeter compared to prior measurement of 7 x 10mm.4.Right level 5 (series 4 image 113) measuring at 5 x 10-mm compared to prior measurement of 8 x 16-mm.5.Left level 4 (series 4 image 170) measuring at 6.8 x 11.5-mm compared to prior study measurement of 12 x 20-mm.6.Left occipital subcutaneous lymph node in measuring approximately 10 mm in length and without interval change since prior exam.Multiple additional smaller nodes are again identified and unremarkable exam otherwise and stable since prior study.
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Significant interval decreased size of bilateral cervical lymph nodes. Please reviewed detailed/measured reference nodes above.
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Generate impression based on findings.
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46-year-old female status post laparoscopic cholecystectomy postoperative day two. Persistent pneumoperitoneum and abdominal pain. ABDOMEN:LUNG BASES: There are small bilateral pleural effusions with underlying atelectasis/consolidation.LIVER, BILIARY TRACT: Status post cholecystectomy. Probable fatty infiltration of the liver. 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: Note is made of extensive free intraperitoneal air and a moderate amount of abdominopelvic free fluid. No loculated collection is identified adjacent to a loop of bowel to suggest focal injury and no bowel loop shows focal abnormalities to suggest potential site of injury. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Note is made of extensive free intraperitoneal air and a moderate amount of abdominopelvic free fluid. No loculated collection is identified adjacent to a loop of bowel to suggest focal injury. PELVIS:UTERUS, ADNEXA: Atrophic or surgically absent. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Note is made of extensive free intraperitoneal air and a moderate amount of abdominopelvic free fluid. No loculated collection is identified adjacent to a loop of bowel to suggest focal injury and no bowel loop shows focal abnormalities to suggest potential site of injury. BONES, SOFT TISSUES: No significant abnormality notedOTHER:
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1. Free intraperitoneal air and free abdominopelvic fluid are slightly more pronounced then typically expected postoperatively. Although this may still be within the realm of normal, correlation with the patient's surgical history is recommended. However, no loculated collection adjacent to a loop of bowel is identified to suggest/localize a focal injury. 2. Small bilateral pleural effusions with underlying atelectasis.
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Generate impression based on findings.
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46-year-old female. Reason: persistent pneumoperitoneum shown CXR, s/p lap cholecystectomy History: some abd pain, shortness of breath. PULMONARY ARTERIES: Technically limited exam due to patient's body habitus. Exam adequate for detection of pulmonary embolism to the lobar levels. No central or lobar pulmonary embolus identified.LUNGS AND PLEURA: Low lung volumes. Small bilateral pleural effusions and basilar atelectasis.MEDIASTINUM AND HILA: Normal heart size. No pericardial effusion. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small pockets of free intraperitoneal air are seen in the upper abdomen.
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No evidence of pulmonary embolism in this technically limited exam.Small bilateral pleural effusions.
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Generate impression based on findings.
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62-year-old male. History of base of tongue cancer, T3/4N2bM0. LUNGS AND PLEURA: Biapical scarring. Mild to moderate centrilobular emphysema.Unchanged 5 mm flat nodule in the left lower lobe, unchanged and most likely benign (series 4, image 76). No suspicious pulmonary nodules or masses. MEDIASTINUM AND HILA: Mild coronary artery calcifications. No mediastinal or hilar lymphadenopathy. Atherosclerotic calcification of the aortic arch with mural plaque formation, unchanged.CHEST WALL: Degenerative arthritic changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of intrathoracic metastasis.
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Generate impression based on findings.
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Clinical question: Rule out adenopathy/recurrence. Signs and symptoms: History of thyroid cancer, status post recurrence. Now status post surgery and XRT. Enhanced neck CT:Limited view of intracranial space is unremarkable.The skull base including cavernous sinuses, bilateral petrous bones are unremarkable. Unremarkable nasopharynx, nasal passage and bilateral intra-temporalis fossa.Unremarkable alternatives of sinuses and bilateral mastoid air cells.Unremarkable oropharynx, oral cavity and bilateral parapharyngeal spaces.There is no evidence of recurrence of bilateral level 2 cervical lymph nodes. This is a similar observation is prior exam.By CT size criteria there is no detectable suprahyoid or infrahyoid lymph nodes.Stable postsurgical changes of bilateral neck and thyroid region with several postoperative surgical clips.Unremarkable salivary glands.No detectable enhancing soft tissue in the thyroid bed.Unremarkable vasculature of the neck.Unremarkable very limited view of of the lung fields. Please review the dictated report from CT of chest performed this date.No no detectable lytic or sclerotic bony changes of vision of exam.
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By CT size criteria there is no detectable cervical adenopathy.
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Generate impression based on findings.
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Female 62 years old; Reason: metastatic thyroid ca to chest, on therapy, eval for dz, compare to previous with measurements History: as above. Head CT: No evidence of an intracranial mass, hemorrhage, or infarction. There is no abnormal intracranial enhancement. The ventricles are stable in size and configuration. The right mastoid air cell is under-pneumatized and the left mastoid air cells are partially opacified.Neck CT: There are post-treatment findings related to thyroidectomy and tracheostomy. There has been continued interval stable to decrease in size and cystic transformation of the cervical lymphadenopathy. Reference measurements are as follows:1. Left level IB (series 5, image 96): 7 x 7 mm, previously 8 x 6 mm.2. Left level 4 (series 5, image 119): 10 x 13, previously 12 x 12 mm.3. Midline level 6 (series 5, image 123): 20 x 9 mm, previously 22 x 13 mm.4. Left level 6 (series 5, image 147): 9 x 8 mm, previously 13 x 7 mm.5. Left parastomal (series 5, image 145): 26 x 11 mm, previously 32 x 16 mm. This is also smaller as measured by sagittal images series 80594, image 60 where is measures 11.9 cm in AP dimension versus 15 mm previously.6. Left level 6 (series 6, image 160): 9 x 10 mm, previously 12 x 9 mm.There has also been interval decrease in size of a cystic nodule within the upper right chest wall subcutaneous tissues, now measuring 7 x 7 mm, previously 10 x 8 mm. No lytic or blastic osseous lesions are identified. The surrounding airway is patent. Mild mucosal thickening in the maxillary sinuses. Refer to the separate chest CT report for additional details.
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1. Continued interval stable to decreased metastatic cervical lymphadenopathy.2. No evidence of intracranial metastatic disease.
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Generate impression based on findings.
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62-year-old male. Reason: s/p esophagectomy History: esophageal cancer. CHEST:LUNGS AND PLEURA: Chronic aspiration at the bases.MEDIASTINUM AND HILA: Stable postoperative changes of esophagectomy and gastric pull-up. Previously focal wall thickening is stable measuring 8 mm (image 30, series #3), unchanged from 9/12/2012 and likely represents postoperative changes. No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Previously seen flash filling hemangioma in the right lobe of the liver is unchanged. Cholelithiasis.SPLEEN: Small splenule is noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Redemonstrated right renal calyceal diverticulum with 6-mm nonobstructing dependent stone.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcification of the abdominal aorta and its branches, without focal ectasia.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Postoperative changes are described above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Stable postoperative changes without evidence of recurrence or metastatic disease.
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Generate impression based on findings.
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Female 58 years old; Reason: h/o met HNC, compare to previous, measurements pls History: none. As on the prior examination, diffuse stranding through the fascial planes of the anterior neck is seen. Interval slight decrease in the mucosal edema/hyperemia is also demonstrated involving the tongue base, larynx and hypopharynx. These findings are likely related to therapy.No focal soft tissue mass or pathologic enhancement is demonstrated within the neck. No abnormal lymphadenopathy is noted. The cervical vessels are patent. Atherosclerotic calcification is present at both carotid bifurcations. The right internal jugular vein is normal in caliber at the skull base but tapers to a thin string above the entry of the right chest porta catheter, at which point it no longer opacifies, a stable finding. The salivary glands are free of focal lesions. Left maxillary mucosal thickening and mild bilateral ethmoid sinus petrosal thickening. Enlarged left thyroid lobe likely goiter.Bilateral apical lung masses are better assessed on the accompanying dedicated chest CT.The cervical lordosis is reversed. There are bulky anterior osteophytes at C4 through C6. No concerning or focally destructive bony lesions are seen.
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Stable treatment-related changes in the neck. No evidence of recurrence or lymphadenopathy.
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Generate impression based on findings.
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58-year-old female with metastatic lung cancer status post chemotherapy. CHEST:LUNGS AND PLEURA: Right upper lobe mass measures 47 x 36 mm (series 6, image 30), unchanged. Reference left upper lobe nodule measures 14 x 14 mm, previously 13 x 13 mm (series 6, image 46). Unchanged ill-defined nodular opacities in the left apex (series 6, image 12). Moderate centrilobular emphysema.MEDIASTINUM AND HILA: Reference left paratracheal lymph node measures 8 mm, unchanged (series 4, image 19). Reference subcarinal lymph node measures 9 mm, unchanged (series 4, image 39). CHEST WALL: Reference right lower neck node measure 12 mm, unchanged (series 4, image 7). Unchanged T10 compression fracture. Degenerative arthritic changes of the thoracic spine.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No suspicious liver lesions. Cholelithiasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Stable 10 mm right adrenal gland nodule (series 4, image 98). KIDNEYS, URETERS: Bilateral renal cysts. 4 mm nonobstructing stone in lower pole left kidney, unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Small soft tissue mass in the left posterior chest wall consistent with known metastases, series 4, image 95, unchanged.OTHER: No significant abnormality noted.
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Stable pulmonary masses, reference lymph nodes, and small left posterior chest wall soft tissue metastases. No new sites of disease.
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Generate impression based on findings.
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28 year old female. Reason: r/o adenopathy, recurrence History: h/o thyroid cancer, s/p surgery and now XRT. LUNGS AND PLEURA: No suspicious pulmonary nodules identified.MEDIASTINUM AND HILA: No, mediastinal or hilar lymphadenopathy. The previously enlarged right paratracheal lymph node remains resolved.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 recurrence or metastatic disease.
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Generate impression based on findings.
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65-year-old male. Reason: 64Yrs male 27 months s/p left lower lobe wedge excision of a T1aN0M0 stage IA adenocarcinoma and 14 years s/p left upper lobectomy for management of a T2N0M0 stage IB lymphoepithelioid tumor History: history of lung cancer. Streak artifact from right orthopedic shoulder prosthesis limits evaluation at the level of the thoracic inlet.LUNGS AND PLEURA: Left-sided postsurgical volume loss. No suspicious pulmonary nodules identified.MEDIASTINUM AND HILA: Scattered nonenlarged mediastinal nodes are stable. No mediastinal or hilar lymphadenopathy. Normal heart size. No pericardial effusion. Coronary artery calcifications and stents.CHEST WALL: Right humeral head orthopedic prosthesis. Healed left sixth rib posteriolateral fracture may be postsurgical. Degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of IV and enteric contrast material markedly limits sensitivity for abdominal pathology. Punctate splenic calcifications are consistent with prior granulomatous disease. Nonobstructing left renal calculus.
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No evidence of recurrence or metastatic disease.
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Generate impression based on findings.
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Reason: h/o HNC, s/p CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Moderate coronary artery calcifications are present, as well as a minimal pericardial effusion.A right jugular port catheter terminates at the SVC/RA junction level.CHEST WALL: Low neck soft tissue swelling, see separately reported soft tissue neck CT. Degenerative abnormalities affect the thoracic spine. ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: NoneSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Nonobstructing right renal calculus, kidneys otherwise unremarkable.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Gastrostomy tube, tightly tethered to the anterior abdominal wall.BONES, SOFT TISSUES: Degenerative abnormalities affect the lumbar spine.OTHER: No significant abnormality noted.
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No evidence of metastases, or other significant abnormality.
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Generate impression based on findings.
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66 year-old male with T1N0 base of tongue cancer, pyriform, and FOM cancer. Evaluation of the tongue and floor of mouth are limited by streak artifact from dental amalgam. Post surgical changes from a right floor of mouth wide local excision, excision of the right submandibular gland, and bilateral neck dissection are again identified. The previously noted submental fluid collection has resolved, and there are no new mass lesions or areas of abnormal enhancement to suggest disease recurrence. There is no lymphadenopathy by CT size criteria. Post-treatment changes are more prominent compared to prior CT, including somewhat increased stranding and infiltration of subcutaneous neck fat, increased thickening of the aryepiglottic folds with new piriform sinus effacement, and hyperemia of the left submandibular gland. The parotid glands and thyroid gland are unremarkable. The visualized lung apices are within normal limits. The carotid arteries and jugular veins are patent. Atherosclerotic calcifications are noted at both carotid bifurcations. There is mild mucosal thickening in the bilateral maxillary sinuses, and partial opacification of the left mastoid air cells. There is grade 1 anterolisthesis of C2 on C3, grade 1 retrolisthesis of C3 on C4, and multilevel osteophytes and reactive endplate changes. Multilevel neuroforaminal narrowing is also noted, most pronounced from C3-C7. There is severe loss of intervertebral disk height at C3/4, C5/6, and C6/7. There is mild loss of intervertebral disk height at C2/3. Findings are consistent with moderate multilevel degenerative disease. No evidence of osseous metastatic disease.
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1.Postsurgical changes s/p wide local excision at the floor of the mouth, with interval resolution of previously seen submental fluid collection and increased prominence of post-treatment changes as detailed above. 2.No findings to suggest disease recurrence or metastatic adenopathy. 3.Multilevel degenerative disease of the cervical spine as described above.
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Generate impression based on findings.
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20 year-old female with chronic nasal congestion. The orbits are unremarkable. The mastoids are clear. Limited view of the intracranial structure is unremarkable. There is mild mucosal thickening in the bilateral maxillary sinuses. The frontal sinuses, frontal-ethmoid recesses, anterior/posterior ethmoids, 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. The cribriform plate, fovea ethmoidalis and lamina papyraceae appear normal. The osseous structures are unremarkable. Prominent adenoids, which is common finding for the patient's age.
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Unremarkable CT paranasal sinus apart from mild maxillary sinus mucosal thickening.
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Generate impression based on findings.
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70 year old female. Reason: Gastric cancer please compare to previous imaging and provide measurements for all index including Gastrohepatic lymph node as required for RECIST History: As above CHEST:LUNGS AND PLEURA: Slight interval increase in scattered bilateral nodular ground-glass opacities which are nonspecific but not typical appearance of metastases from gastric cancer. A reference, left lower lobe ground glass opacity measures 2.5 x 1 .2 cm, previously 2.2 x 1.1 cm (36; series 4). Unchanged nodular opacity at the right base. No pleural effusions.MEDIASTINUM AND HILA: Reference right paratracheal lymph node measures 2.5 x 1 .5 cm, previously 2.5 x 1.6 cm (series 3, image 41). Reference right hilar lymph node measures 1.7 x 1 .3 cm, previously 1.8 x 1.2 cm (series 3, image 50). Heart size is normal. No pericardial effusion.CHEST WALL: Nodular thyroid with calcifications as noted previously. Right chest wall Port-A-Cath tip at the superior cavoatrial junction. Healing left rib fractures. No suspicious osseous lesions.ABDOMEN:LIVER, BILIARY TRACT: Innumerable hepatic metastases, some of which appear decreased in size whereas others are stable, however, no lesions appear increased in size, when compared to the prior study. Reference right hepatic lobe mass measures 2.9 x 3.4 cm, previously 3.2 x 3.8 cm (series 3, image 86). An additional reference lesion measures 1.5 x 1.5 cm, previously 2.1 x 1.9 cm (105; series 3). Prominent gastrohepatic lymph nodes can appear as on the prior study.SPLEEN: Stable splenomegaly. Large accessory splenule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Mildly nodular adrenal glands, unchanged.KIDNEYS, URETERS: Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: Reference left periaortic lymph node measures 1.2 x 0 .8 cm, previously 1.3 x 0.6 cm (series 3, image 115).BOWEL, MESENTERY: No evidence of bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Calcified fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of free fluid in the pelvis.
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1.Interval increase in size of the previously described pulmonary groundglass opacities which do not have the typical imaging appearance of metastatic disease although multifocal adenocarcinoma in situ is a differential consideration.2.Persistent mediastinal and hilar adenopathy. 3.Persistent hepatic metastases, some of which appear decreased in size, with reference measurements as above.
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Generate impression based on findings.
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Clinical question: Rule out stenosis. Signs and symptoms: Possible acute stroke. Nonenhanced head CT:No detectable acute intracranial process.As was noted on prior exam there is evidence of age indeterminate small muscle ischemic strokes evident by the ventricle and subcortical low attenuation of white matter. Minimal similar findings within the right basal ganglia and right thalamus as well as right paramedian pons is also present.No detectable territorial ischemic change.Unremarkable cerebral cortex and cortical sulci. Normal size of ventricular system and with maintained midline. Essentially unremarkable images through posterior fossa with the exception of mild vascular calcification of the vertebral basilar system.Next CTA:The visualized aortic arch and the origins of major vessels are unremarkable.Brachiocephalic and bilateral subclavian arteries are unremarkable.Right common carotid artery is widely patent and unremarkable however demonstrate tortuosity in its lower cervical segment.Right internal and external carotid arteries are widely patent however a small non-lumen compromising plaque at the origin of right internal carotid artery is present.Left common carotid artery is unremarkable. The the left internal carotid artery demonstrates minimal atherosclerotic calcification is at its origin and unremarkable otherwise.Unremarkable larger ( dominant ) left vertebral artery throughout its cervical course and across the skull base.A very small caliber right vertebral artery is present. It demonstrate a small calcific plaque at its origin with suspected high-grade muscular lumen compromise. It remains patent through its cervical course however there is very poor and faint to nearly nondetectable in its intradural component. Possibility of complete occlusion in its immediate intracranial segment is suspected.Head CTA:Bilateral internal carotid arteries are patent in the upper cervical segments and across the skull base. Patent and unremarkable bilateral anterior and middle cerebral arteries. Unremarkable anterior communicating artery and bifurcation of middle cerebral larger branches.Highly suspected complete occlusion of a very small hypoplastic right vertebral artery at its intracranial component.A dominant left vertebral artery remains widely patent and with a normal appearing left ankle branch. There is a prominent right aica/pica common trunk resident arising from the basilar artery. Basilar artery is patent however it demonstrate multiple foci of vascular lumen compromise and mild ectasia secondary to atherosclerotic disease. Bilateral posterior cerebral arteries demonstrate extensive atherosclerotic disease with multiple foci of moderate to high-grade stenosis.
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1.Nonenhanced head CT demonstrate no acute intracranial process. Age indeterminate small less ischemic strokes as detailed. 2.CTA of the neck demonstrates very small hypoplastic right vertebral artery. There is a small calcific plaque at the origin of this hypoplastic right vertebral with suspected high-grade stenosis. The right vertebral artery remains patent in its cervical portion however there is highly suspected complete occlusion of its intracranial segment. A dominant left vertebral artery remains widely patent and unremarkable. Minimal atherosclerotic plaque at the origin of bilateral internal carotid arteries without vascular lumen compromise is present. Unremarkable neck CTA otherwise.3.CTA of brain demonstrates unremarkable bilateral internal carotid arteries, anterior and middle cerebral arteries and their branches. Complete occlusion of a small hypoplastic right vertebral artery in its intracranial segment. Patent dominant left vertebral artery and basilar artery and their branches. There is atherosclerotic disease of basilar artery and with resultant multiple foci of mild vascular lumen compromise and ectasia. Extensive atherosclerotic disease of bilateral posterior cerebral arteries with multiple foci of moderate to high-grade stenosis. There is a normal appearing left pica branch and a right aica/pica common trunk arising from the basilar artery.
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Generate impression based on findings.
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52-year-old male. Metastatic laryngeal cancer to the lung status post CRT and laryngectomy. On therapy. CHEST:LUNGS AND PLEURA: Volume loss and scarring extending from the right hilum to the apex with associated soft tissue measuring up to 17 mm in thickness is unchanged (series 3, image 50). Left apical fibrosis.No suspicious pulmonary nodules or masses. Severe emphysema. Persistent bilateral bronchial debris. Bronchial and bronchiolar wall thickening in the right lower lobe with centrilobular groundglass nodules and solid nodules consistent with aspiration bronchiolitis. Small right pleural effusion and interval resolution of left pleural effusion.MEDIASTINUM AND HILA: No change in reference mediastinal lymph nodes, including a prevascular lymph node that is 6 mm and a right paratracheal lymph node that is 15 mm (series 3, image 42). Decreased small pericardial effusion.Tracheostomy tube is unchanged. Severe coronary calcifications.CHEST WALL: Right chest wall port. Degenerative arthritic changes of the thoracic spine.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: Necrotic/cystic left adrenal gland mass is not significantly changed.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Calcified atherosclerotic calcification of the abdominal aorta. BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.G-tube is noted. Prominent loop of bowel in the central upper abdomen with surgical sutures likely reflects a post-surgical anastomosis. BONES, SOFT TISSUES: Pedicular screws at L4. Degenerative arthritic changes of the thoracolumbar spine. Superior endplate pathologic compression deformity of T2, unchanged from 9/2013.OTHER: No significant abnormality noted.
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Stable examination with reference measurements provided. No new sites of disease. Left pleural effusion has resolved. Persistent aspiration bronchiolitis most severe in the right lower lobe.
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Generate impression based on findings.
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76-year-old male with a history of bladder cancer. Status post TURBT. Evaluate for recurrence. ABDOMEN:LUNG BASES: Scattered pulmonary micronodules, appearing similar to the prior study. No new pulmonary nodules or masses are identified. There are marked coronary artery calcifications.LIVER, BILIARY TRACT: Subcentimeter nonenhancing hypodensity in the left lobe of the liver likely represents a cyst. Gallstones without evidence of acute cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality noted. No nephrolithiasis, hydronephrosis or mass identified. The right ureter is opacified along its entire length. The left ureter is opacified nearly along its entire length with the exception of its distal most portion, including its insertion upon the bladder.RETROPERITONEUM, LYMPH NODES: No adenopathy. Dense vascular calcification of the aorta. Prominent retroperitoneal nodes, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The previously described polypoid filling defect along the inferolateral wall of the urinary bladder is not appreciated on today's examination. LYMPH NODES: Bilateral femoral lymph nodes, and the reference left measuring 1.5 x 1.1 cm, previously 1.6 x 1.3 cm on image 146; series 9. Other prominent external iliac nodes are again seen.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1. No significant interval change in reference pelvic adenopathy.2. Gallstones without evidence of acute cholecystitis.
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Generate impression based on findings.
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81 year-old male with hoarseness secondary to vocal cord tumor. The orbits are unremarkable. The paranasal sinuses and mastoid air cells are clear. Limited view of the intracranial structure is unremarkable. The previously seen enhancing lesion in the anterior two third of the right true vocal cord now measures 10 x 6 x 5 mm (AP x TR x CC), compared to 19 x 7 x 7-mm on the prior. The laryngeal ventricle and paraglottic space are presered. The right anterior commissure is probably involved. The thyroid and arytenoid cartilages appear intact. The right false and left true and false vocal cords appear unremarkable. No lymphadenopathy is noted. There are excessive lymphoid tissues at the base of the tongue with partial effacement of the vallecula. There appears effacement of the right piriform sinus. The oral cavity, oro/nasopharynx, hypopharynx, and subglottic airways are unremarkable/patent. The epiglottis are normal. The parotid, submandibular, and thyroid glands are unremarkable. The carotid arteries and jugular veins are patent. The osseous structures are unremarkable. There are multilevel disc osteophyte complexes and neuroforaminal narrowing of the cervical spine. Please refer to dedicated CT chest for pulmonary findings.
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Interval decrease in size of a right vocal cord mass as described above. No cervical lymphadenopathy.
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Generate impression based on findings.
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72 year-old male. Explanation of neck mass, acute hemoglobin drop. Mass noted on CXR. CHEST:LUNGS AND PLEURA: Left perihilar irregular, necrotic mass measures 5.2 x 6.5 cm (series 3, image 38) with extension to the pleural surface associated pleural mass on series 5, image 34. It is continuous with the left main pulmonary artery and mainstem bronchus with loss of fat planes. The mass encases and markedly attenuates left upper lobe and lingular segmental bronchi and arteries. Post-obstructive subsegmental atelectasis in lingula.Nonspecific subpleural groundglass opacities in the right lower lobe.Lower lobe bronchial wall thickening. Mild upper lobe paraseptal and centrilobular emphysema.MEDIASTINUM AND HILA: Severe coronary artery calcifications. Aforementioned left perihilar mass extending into left aspect of mediastinum. Small mediastinal lymph nodes. No mediastinal or contralateral hilar lymphadenopathy by CT size criteria.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No suspicious hepatic mass. Tiny hypoattenuating focus in the liver on series 3, image 78, too small to characterize but likely a cyst. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Moderate calcified atherosclerotic disease of abdominal aorta and branch vessels with mural thrombus formation.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Moderate degenerative arthritic changes of the lumbar spine.OTHER: No significant abnormality noted.
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1. Left perihilar irregular necrotic mass compatible with a primary lung malignancy with extension to the mediastinum and pleural surface. 2. No hematoma identified to explain hemoglobin drop.
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