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Generate impression based on findings.
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60-year-old male patient with history of lymphoma and known right lower quadrant soft tissue mass, right ventricular mass. Evaluate for lymphadenopathy. CHEST:LUNGS AND PLEURA: Examination of the lungs is mildly limited by patient motion. Endotracheal tube terminates in the mid trachea. Upper lobe predominant moderate centrilobular emphysema. There are moderate-sized bilateral pleural effusions with overlying compressive atelectasis. No suspicious nodules are noted in the lung parenchyma. MEDIASTINUM AND HILA: Cardiac size is within normal limits without pericardial effusion. Interventricular septal fullness noted and is incompletely evaluated. There is no significant mediastinal lymphadenopathy. Right sided central venous catheter terminates in the superior vena cava. CHEST WALL: Mild diffuse anasarca is noted. Mild to moderate multilevel degenerative changes affect the thoracic spine.ABDOMEN:LIVER, BILIARY TRACT: No hepatic lesions are identified. There is mild periportal edema.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality notedADRENAL GLANDS: Intra-abdominal anasarca limits evaluation of the adrenal glands, however, the left adrenal gland appears diffusely enlarged (coronal series 80224 image 43).KIDNEYS, URETERS: There is hydronephrosis of the right kidney with atrophy of the renal parenchyma, likely due to chronic obstruction of the right ureter by a large right pelvic mass.There are multiple infiltrative hypoattenuating lesions in the left kidney parenchyma and multiple soft tissue lesion in the perinephric space. There is no hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Left IVC filter in place. There are multiple soft tissue lesions in the peritoneal cavity (coronal series 80224 images 45, 37 and 27). Retroperitoneal mass extending to the pelvis as described below.BOWEL, MESENTERY: No specific evidence of bowel lymphoma. No bowel thickening or evidence of obstruction.BONES, SOFT TISSUES: Moderate multilevel degenerative changes affect the thoracolumbar spine. There are multiple soft tissue nodules in the posterior abdominal wall, predominantly on the right (series 3 images 116, 123, 131, 140). Questionable anterior abdominal wall injection granulomas.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter in place with iatrogenic air in the bladder.LYMPH NODES: Bilateral pelvic lymphadenopathy.BOWEL, MESENTERY: No specific evidence of bowel lymphoma. No bowel thickening or evidence of obstruction.BONES, SOFT TISSUES: Moderate multilevel degenerative changes affect the thoracolumbar spine. There is grade 2 anterolisthesis of L5 on S1 with severe degenerative changes at L5-S1 and bilateral spondylolysis.OTHER: There is a large soft tissue lesion in the right hemipelvis that encases and mildly attenuates the right common iliac artery, however, evaluation of the vessels is limited. The soft tissue mass appears to involve the right iliopsoas muscle, gluteus muscles posteriorly and possibly the iliacus muscle anteriorly. The total extent of this mass measures approximately 14 by 6.2 cm in axial dimension and 15 cm in craniocaudal dimension. There are multiple satellite lesions adjacent to this prominent mass.
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1.Multiple intraperitoneal and soft tissue masses as described above.2.Chronic appearing obstruction of the right kidney due to large soft tissue mass in the right hemipelvis.3.Multiple soft tissue lesions in the left kidney and enlarged left adrenal gland compatible with lymphoma involvement.4.Interventricular septal thickening is suggestive of a right ventricular mass, however, it is incompletely evaluated on this examination.
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Generate impression based on findings.
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Fall. Rule out fracture. Right ankle injury.EXAMINATION: Right tibia-fibula AP/lateral (two views) 01/23/15 No fracture is identified. The bones are normal in appearance. A small amount of soft tissue swelling is seen over the anterior tibia.
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No fracture. If there is ankle pain, ankle radiographs may be helpful for further evaluation.
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Generate impression based on findings.
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Stab wound to chest and left pneumothorax. Chest tube.VIEW: Chest AP (one view) 01/24/15, 0610 Midline abdominal staples and left chest tube remain in place. Small left apical pneumothorax continues.Cardiothymic silhouette is normal. Subsegmental atelectasis is present in left upper lobe. No other focal opacities are identified.
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Continued small left apical pneumothorax.
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Generate impression based on findings.
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81 year old female with Stage IV T4aN0Mx squamous cell carcinoma of the left oropharynx,base of tongue, palatine tonsil, and retromolar trigone presenting for possible pneumonia and chin wound currently on antibiotic. There are post-treatment findings in the neck, including left neck dissection, tracheostomy, and radiation therapy effects as well as interval resection of the left mandibular body and flap reconstruciton. There is a 21 x 28 mm peripherally enhancing fluid collection within the surgical bed of the left parapharyngeal space. There is effacement of the fat planes of the left masticator space. The left internal carotid artery courses just posterior to this lesion and is narrowed. The left jugular vein has been sacrificed. The right carotid artery and jugular vein are patent. There is diffuse mucosal edema of the larynx and hypopharynx. There is mucosal thickening and fluid within the right sphenoid sinus and fluid within the left mastoid air cells and middle ear cavity. The right submandibular gland and the parotid glands are unremarkable. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. There are bilateral lens implants. There are new nodules within the right upper lobe measuring up to 5 mm as well as a 46 x 16 mm consolidation. There is an unchanged approximately 1 cm nodule within the right thyroid lobe.
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1.Extensive post-treatment findings including interval resection of the left mandibular body and flap reconstruction.2.A peripherally enhancing fluid collection within the left parapharyngeal space surgical bed may represent recurrent necrotic tumor, abscess, or a peripherally enhancing post-operative fluid collection.3.No evidence of significant lymphadenopathy.4.Interval development of right upper lobe pulmonary nodules which may be infectious or metastatic.5.Right upper lobe consolidation suspicious for pneumonia.6.Probable sinusitis and left otomastoiditis. 7.Unchanged approximately 1 cm right thyroid nodule.
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Generate impression based on findings.
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Left-sided weakness. Evaluate for CVA. There is no evidence of acute intracranial hemorrhage. Redemonstrated is encephalomalacia in the right occipital, parietal and posterior temporal lobe with ex vacuo dilation of the atria of the right lateral ventricle appearing similar to the most recent previous MRI from 2012.Marked and multifocal periventricular, subcortical and thalamic hypoattenuation which is nonspecific but compatible with chronic small vessel ischemic disease, similar to the prior exam.No abnormal mass lesions are appreciated intracranially. The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear.
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1.No evidence of acute intracranial hemorrhage or other acute abnormality.2.Encephalomalacia in the right occipital, parietal and posterior temporal lobe with ex vacuo dilation of the atria of the right lateral ventricle appearing similar to the most recent previous MRI from 2012. Since CT is insensitive for the detection of acute ischemic infarct, MRI would provide further information if there is continued clinical concern for acute ischemia.3.Marked chronic small vessel ischemic disease, similar to the exam from 2012.
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Generate impression based on findings.
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Sciatica. Check for fracture Moderate degenerative changes observed involving L5-S1 with relative preservation of vertebral body heights disk spaces and alignment proximally. Lower facet sclerosis.Cholecystectomy clips.
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Moderate osteoarthritic changes centered on L5-S1I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
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Generate impression based on findings.
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Evaluate for subdural hematoma. There is hyperattenuation in the left convexity subdural collection compatible with acute on chronic subdural hematoma. Overall this collection measures up to 18 mm in maximal thickness which is unchanged. There has been interval near complete resolution of the right frontal convexity subdural fluid collection. The trace posterior fossa low attenuation subdural fluid collections are also not visualized and likely resolved.Note is made of interval mild increase in the ventricles, including the third and fourth ventricles. There is minimal rightward midline shift. No evidence of acute intra-axial hemorrhage.Mild cerebral white matter hypoattenuation, which likely represents small vessel ischemic disease. There is also unchanged prominent basal ganglia perivascular spaces. There are vertebrobasilar calcifications. The imaged paranasal sinuses and mastoid air cells are clear. There is a right occular lens implant.
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1.New hyperattenuation in the left convexity subdural collection compatible with acute on chronic subdural hematoma, which is unchanged in thickness.2.Unchanged, minimal rightward midline shift and mild mass effect upon the underlying brain parenchyma. 3.Interval near complete resolution of the right frontal convexity subdural fluid collection and resolution of the trace posterior subdural collections. 4.Mild interval increase in the ventricles, including the third and fourth ventricles.
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Generate impression based on findings.
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The paranasal sinuses are clear. There are bilateral Haller cells. The nasal cavity is also clear. There is no significant nasal septal deviation. The lamina papyracea and ethmoid roofs are intact. The carotid groove and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable.
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Interval resolution of sinusitis.
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Generate impression based on findings.
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23-year-old female status post trauma Foot: Alignment is anatomic. There is no fracture or other specific finding to account for the patient's symptoms.Elbow: Normal alignment. No joint effusion or fracture.
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No fracture or malalignment.
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Generate impression based on findings.
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24-year-old female patient with intermittent flank pain and hematuria. Evaluate for renal calculus. ABDOMEN:LUNG BASES: Trace bilateral dependent atelectasis.LIVER, BILIARY TRACT: Layering hyperattenuating material in the gallbladder is compatible with sludge.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is mild left-sided hydronephrosis and hydroureter extending to an obstructive 3-mm renal calculus in the distal ureter. There is no hydronephrosis in the right kidney. There are bilateral punctate nonobstructive renal calculi, most prominent in the inferior pole of the left kidney.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy. The abdominal aorta is normal in caliber.BOWEL, MESENTERY: There is no evidence of bowel thickening or bowel obstruction. The appendix is well-visualized and is within normal limits.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: The right ovary is mildly enlarged with a likely physiologic cyst.BLADDER: There are no bladder calculi.LYMPH NODES: There is no pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Obstructive renal calculus in the distal left ureter with associated mild left hydronephrosis and hydroureter.2.Punctate bilateral nonobstructing renal calculi.
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Generate impression based on findings.
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Female 42 years old; Reason: evaluate for source of abdominal pain History: generalized abdominal pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Status post cholecystectomy. No biliary dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 5-mm nonobstructing stone in the mid right kidney. Punctate, nonobstructing stone in the upper right kidney. Mild prominence of the right renal collecting system. Left kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: A couple ovoid high densities in the colon are likely ingested pills.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: The uterus is not well-visualized and may have been removed.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No acute abdominal or pelvic pathology.
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Generate impression based on findings.
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43-year-old female patient with left lower quadrant abdominal pain. ABDOMEN:LUNG BASES: Scattered bibasilar atelectasis and right lower lobe granuloma.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: There are prominent retroperitoneal lymph nodes that are not pathologically enlarged and are nonspecific. The abdominal aorta is normal in caliber.BOWEL, MESENTERY: No bowel wall thickening or evidence of bowel obstruction. The appendix is well-visualized and is within normal limits.BONES, SOFT TISSUES: There is dextroscoliosis of the thoracolumbar spine. There is a fat containing periumbilical hernia with mild inflammatory changes of the contained fat.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Exophytic lesion arising from the uterine fundus likely represents a leiomyoma, although no comparisons were available at the time of dictation. Left adnexal cyst is likely physiologic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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No acute intra-abdominal abnormalities to account for patient's pain.
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Generate impression based on findings.
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No evidence of acute intracranial hemorrhage. No mass effect, midline shift or herniation. The ventricles and sulci are normal in size. There are no extraaxial fluid collections or subdural hematomas. Large right maxillary polyp. The remaining visualized paranasal sinuses and mastoid air cells appear normal. Nondisplaced right nasal bone fracture with minimal medial deviation, which is age indeterminate given lack of ancillary evidence of an acute fracture such as adjacent edema or fluid in the nasal cavity. No depressed calvarial fracture. Left frontal scalp defect, likely represents the clinically visualized laceration.
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1.No evidence of acute intracranial hemorrhage or other acute intracranial abnormality.2.Age-indeterminate, minimally deviated non-displaced right nasal bone fracture.3.Left frontal scalp laceration without calvarial fracture.
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Generate impression based on findings.
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Evaluate interval change in left thalamic ICH/IVH and SAH. No significant change in the size of the large intraparenchymal hemorrhage and associated vasogenic edema centered in the left thalamus with intraventricular extension. No significant change in the midline shift. Interval removal of the right transfrontal ventricular catheter. The size of the ventricles are slightly increased, including the temporal horns. Again visualized is persistent hyperattenuation along the posterior aspect of the cerebellum which is similar to the prior exam. There is persistent periventricular hypoattenuation that likely represents transependymal CSF flow.
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1.No significant change in the large ICH and associated vasogenic edema centered in the left thalamus with intraventricular extension.2.Interval removal of the ventricular catheter with slight increase in the size of the ventricles, including the temporal horns.3.Persistent unchanged posterior fossa subarachnoid hemorrhage.
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Generate impression based on findings.
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9-year-old female with lateral malleolus tender to palpationVIEWS: Left ankle AP/oblique/lateral (3 views) 01/24/15, 0951 Moderate soft tissue swelling overlying the lateral malleolus. Irregularity along the lateral aspect of the distal fibula may represent a Salter III fracture.
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Probable Salter III fracture of the distal fibula.
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Generate impression based on findings.
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There are many small focal enhancing lesions noted along conus and cauda equina as well as sporadic cauda equina nerve root enhancement. In addition, an enhancing lesion is visualized within the canal at 4-5, which was also present previously and is unchanged. There has been resection of a cystic enhancing lesion at the L1-2 level with persistent intrathecal enhancement, which may represent residual lesion or granulation tissue. A mixture of air and fluid are seen within the epidural space posteriorly from L1 through L3 which narrows the central spinal canal. Air is also noted within the intrathecal sac.A intensely enhancing right paraspinal muscle mass is partially visualized and is unchanged in appearance.
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1.Postoperative changes at the L1-L2 vertebral level from resection of a intradural cystic schwannoma with persistent intradural enhancement which may represent residual lesion versus granulation tissue.2.Admixture of posterior epidural fluid with air at the operative site which causes central canal narrowing.3.Multiple enhancing foci elsewhere which are stable and consistent with the patient's diagnosis of schwannomatosis.
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Generate impression based on findings.
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14-year-old female status post bowel resection, abdominal painVIEWS: Abdomen AP supine/erect (two views) 01/24/15, 1007 hrs NG tube is coiled in the stomach with tip in the proximal gastric body. Sutures and vessel loops are unchanged. Right lower quadrant stoma is present.No pneumoperitoneum, pneumatosis intestinalis, or portal venous gas. Scattered, isolated, and air distended loops of small bowel with otherwise absent bowel gas. Right lower lobe opacity may represent atelectasis or aspiration.
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Abnormal bowel gas pattern. Right lower lobe atelectasis or aspiration.
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Generate impression based on findings.
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Female 50 years old; Reason: stone and eval for diverticulitis (i know suboptimal w/o contrast) History: L flank pain radiating to LLQ ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Enlarged left kidney, with moderate perinephric fat stranding and mild perirenal fluid. Mild left hydronephrosis and hydroureter secondary to a 3-mm stone at the left vesicoureteral junction.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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1.3-mm obstructing stone at the left UVJ with proximal moderate hydroureteronephrosis. Given degree of periureteral and perinephric stranding, superimposed infection is not excluded, and correlation with lab values suggested.
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Generate impression based on findings.
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Female 51 years old; Reason: r/o obstruction History: abdominal pain, constipation ABDOMEN:LUNG BASES: Grossly stable scattered pulmonary nodules. Again demonstrated is debris within the right lower lobe bronchus with peribronchial thickening and patchy consolidation, likely related to chronic aspiration, somewhat improved from prior study.LIVER, BILIARY TRACT: Mild gallbladder distention. Cholelithiasis. No biliary dilatation. No suspicious hepatic lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Again seen are two nonobstructing 1 cm stones in the right renal collecting systems with interval decrease in caliceal dilatation and proximal ureteral dilatation. No increase in size of a left lower pole nonobstructing stone measuring 6 mm.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia.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: Somewhat stable appearance of the dilated stool filled rectum with circumferential thickening of the rectal wall. No significant perirectal induration. Compared to the prior study the stool filled appearance and dilatation has extended into parts of the sigmoid colon. This causes displacement and compression of the urinary bladder and uterus anteriorly.BONES, SOFT TISSUES: Osteopenia.OTHER: No significant abnormality noted.
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1.Very dilated and stool filled rectum and distal sigmoid colon, further described above, contributing to an above average stool burden.2.Nonobstructing bilateral nephrolithiasis.3.Cholelithiasis.4.Likely chronic aspiration, further detailed above.
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Generate impression based on findings.
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There is agenesis of the corpus callosum with the superior aspect of the third ventricle extending slightly cephalad in the left paramedian direction. There are no findings of ventricular obstruction or dilatation.There is a left temporo-occipital cleft extending from the brain surface to the occipital horn of the left lateral ventricle lined by gray matter with apposed surfaces. Along the adjacent ventricular surface is associated gyral migration anomaly.The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. Fluid is present within bilateral middle air cavities.
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1.Agenesis of the corpus callosum.2.Left temporo-occipital closed-lip schizencephaly.
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Generate impression based on findings.
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41-year-old female patient with constipation and KUB with air-fluid levels. ABDOMEN:LUNG BASES: Scattered atelectasis noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There are mild inflammatory changes involving the cecum with prominent adjacent lymph nodes. There is thickening and narrowing of the terminal ileum. The bowel immediately proximal to the narrowed terminal ileum is mildly dilated. The appendix is not well-visualized. These findings are similar, yet slightly less severe compared to prior examination in 2009.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The sigmoid colon and rectum are within normal limits.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Obstructive inflammatory changes in the terminal ileum and ileocolic junction with proximal small bowel dilatation. Given lymphadenopathy and grossly similar appearance on prior examination in 2009, a chronic inflammatory process, such as Crohn's, is favored versus a chronic infectious etiology. An underlying neoplasm cannot be excluded.
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Generate impression based on findings.
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Artifact is present anteriorly on several sequences due to the presence of braces. Given the caveat:The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. A mucus retention cyst is present within the right sphenoid sinus, otherwise the paranasal sinuses and mastoid air cells are clear. Coronal images of the temporal lobes demonstrate the temporal horns, hippocampal formations and parahippocampal gyri to be normal in size and symmetric bilaterally without signal abnormalities or masses identified within the medial temporal lobes on either side. There is no evidence of mesial temporal sclerosis and there are no foci of heterotopic gray matter.
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Artifact is present anteriorly on several sequences due to the presence of braces. Given the caveat, negative noncontrast brain MRI. Specifically, there are no MRI findings to explain the patient's seizures.
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Generate impression based on findings.
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Reason: Painful Varicose Veins - Resistant to Treatment. History: Investigate for more central occlusion/stenosis or pelvic congestion. LOWER CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: 2.5-cm ovoid, likely varice, seen at the gastroesophageal junction (3:38), stable. A couple small periesophageal lymph nodes are stable, measuring up to 1 cm, and nonspecific.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted. 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: 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: Atrophic or has been removed.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Fat-containing umbilical hernia.OTHER: No significant abnormality noted.
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1. Essentially unremarkable patent abdominal vasculature.2. A couple prominent stable periesophageal lymph nodes are nonspecific, but continued follow-up is suggested.
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Generate impression based on findings.
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73-year-old female pre-kidney transplant patient presents for evaluation of vasculature and cyst on left kidney. ABDOMEN:LUNG BASES: Cardiomegaly is noted. Bilateral basilar atelectasis noted.LIVER, BILIARY TRACT: Liver granuloma noted.SPLEEN: Soft tissue nodules adjacent to the spleen are thought to represent splenules.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral atrophic kidneys. There multiple small cysts in the right kidney.Multiple cysts noted the left kidney. There is a septated cystic lesion in the midpole of the left kidney with an enhancing nodular component. The entire extent of the complex cystic lesion measures approximately 20.8 x 2.3 cm (series 6 image 40). The additional cystic lesions are unremarkable. The left renal vein is grossly patent without filling defects.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic changes affect the abdominal aorta. Vascular calcifications are noted in the bilateral renal arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Multiple calcified lesions within the uterus are suggestive of leiomyomata.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: There is a small amount of free fluid within the pelvis.There are moderate circumferential calcifications involving the right common iliac artery and mild calcifications involving the left common iliac artery. There are minimal calcifications in the bilateral external iliac arteries, left slightly greater than right.
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1.Left complex cystic renal lesion is suspicious for renal cell malignancy.2.Minimal to moderate calcifications in the iliac arteries and their branches as described above.
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Generate impression based on findings.
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Reason: NGT placement History: NGT Dobbhoff tube projects at the gastric antrum. A newly placed nasogastric tube tip projects over the gastric body.
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Line placement as described above.
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Generate impression based on findings.
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Reason: Please evaluate for Dobhoff positioning History: As above Dobbhoff tube projects over the gastric body. Bilateral partially visualized nephroureteral catheters are seen. Residual oral contrast is seen within the large bowel.
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Dobbhoff tube placement as above.
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Generate impression based on findings.
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Reason: Evaluate for retained foreign object. Pt s/p C/S History: See above No unexpected radiopaque foreign body. Linear radiopaque density projecting over the right sacroiliac joint is an IUD placed intraoperatively as discussed with resident physician Dr. Siddiqui.
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No unexpected radiopaque foreign body.
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Generate impression based on findings.
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There are a few punctate foci of restricted diffusion within both right and left cerebellar hemispheres (left greater than right) with associated T2 hyperintensity. Additionally, there is a linear focus of what appears to be restricted diffusion within the right posterolateral pons (series 301 image 205), although this occurs in a location prone to artifact, is not associated T2 hyperintensity, and thus artifact is favored.There are foci of T2 hyperintensity within the white matter and pons without associated restricted diffusion or mass effect. A small amount of susceptibility abnormality is noted with the pontine involvement.Abnormalities involving the posterior circulation are better demonstrated on previous CTA.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Scattered sporadic foci of mucosal thickening can be found throughout the paranasal sinuses and the mastoid air cells are clear.
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1.There are a few punctate foci of restricted diffusion within both right and left cerebellar hemispheres (left greater than right) with associated T2 hyperintensity. Additionally, there is a linear focus of what appears to be restricted diffusion within the right posterolateral pons (series 301 image 205), although this occurs in a location prone to artifact, is not associated T2 hyperintensity, and thus artifact is favored.2.Chronic small vessel ischemic disease.3.Abnormalities involving the posterior circulation are better demonstrated on previous CTA.
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Generate impression based on findings.
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Male 26 years old; Reason: evaluating changes in rll lesion on previous History: as above LUNGS AND PLEURA: Right lower lobe partially solid partially groundless nodular opacity appears stable compared to prior study with interval development of architectural distortion with associated scarring. There is a new extremely small faint ground glass opacity in the right lower lobe (series 5, image 181). There is a stable right lower lobe calcified granuloma.MEDIASTINUM AND HILA: Normal sized heart with no evidence of pericardial effusion. There is hypoattenuation of the blood pool consistent with anemia. No visible coronary artery calcification.The main pulmonary artery is markedly enlarged in caliber measuring up to 4.0 cm.There is no mediastinal or hilar adenopathy.Central venous catheter with tip in the distal SVC.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Stable right lower lobe partially solid partially ground glass opacity with new evidence of scarring consistent with resolving infection. There are no specific findings to suggest an acute fungal infection.2. New extremely small faint ground glass opacity in the right lower lobe adjacent to the calcified granuloma could represent mild aspiration or infection.3. Enlarged main pulmonary artery consistent with pulmonary arterial hypertension.
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Generate impression based on findings.
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Reason: stool burden History: constipation, abd pain Small bowel air-fluid levels and prominent proximal small bowel loops with paucity of colonic air.
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Finding suspicious for small bowel obstruction.
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Generate impression based on findings.
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Reason: Patient with worsening distension and abdominal pain History: as above Nonobstructive gas pattern. Brachytherapy seeds project over the prostate. Aortic biiliac graft is seen. Scoliosis. Multilevel degenerative changes.
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Nonobstructive gas pattern.
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Generate impression based on findings.
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Reason: placement of dobhoff tube History: malnutrition with anasarca. Dobbhoff tube tip projects over the gastric body.
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Dobbhoff tube placement as above.
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Generate impression based on findings.
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Reason: DHT placement History: as above Dobbhoff tube tip projects over the gastric fundus. Unchanged lower thoracic findings from chest radiograph on 1/22/2015. Persistent to slightly more prominent gaseous distention of small and large bowel loops favoring ileus.
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Dobbhoff tube placement as above.
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Generate impression based on findings.
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Reason: gas pattern History: nausea Nonobstructive gas pattern. Slightly limited by motion.
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Nonobstructive gas pattern.
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Generate impression based on findings.
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75 year-old female with delusions. Redemonstrated is periventricular hypoattenuation compatible with small vessel ischemic disease of indeterminate ages. Bilateral buphthalmos is again noted. Hyperdense focus adjacent to the lateral aspect of the left globe is unchanged.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated. No intracranial hemorrhage or edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1. No acute intracranial abnormalities.2. Small vessel ischemic disease of indeterminate ages.
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Generate impression based on findings.
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Reason: eval for obstruction History: vomiting Stool filled sigmoid colon. Nonobstructive gas pattern. Thoracic findings are further characterized on same day chest radiograph. Feeding tube tip projects over the gastric body.
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Stool filled sigmoid colon grossly stable from recent CT. Nonobstructive gas pattern.
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Generate impression based on findings.
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59-year-old male patient with history of stage IV melanoma presents following additional immunotherapy. CHEST:LUNGS AND PLEURA: Right lower lobe pulmonary nodule measures 0.9 x 0.6 cm (series 4 image 85), previously 1.0 x 0.6 cm. Other subcentimeter right pulmonary nodules remain unchanged.Reference left subpleural nodule measures 0.5 x 0.4 cm (series 4 image 90), previously 0.6 x 0.47 m. Other left lower lobe pulmonary nodules remain unchanged. The pleural spaces remain clear.MEDIASTINUM AND HILA: The cardiac size is within normal limits without pericardial effusion. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Healed right posterior rib fractures are again noted.ABDOMEN:LIVER, BILIARY TRACT: Several well marginated hepatic cysts are not significantly changed compared to prior examination. Reference left hepatic lobe segment 3 lesion measures 1.6 x 1.5 cm (series 3 image 136), previously 1.7 x 1.5 cm. No new hepatic lesions are identified.SPLEEN: Hypervascular focus in the posterior aspect of the spleen likely represents a hemangioma and is unchanged from prior.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic changes affect the abdominal aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is mild dextroscoliosis of the thoracolumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Calcific density at the base of the penis likely represents a corpus cavernosus calcification.BLADDER: No significant abnormality noted.LYMPH NODES: Left external iliac lymph node currently measures 1.7 x 0.6 cm (series 3 image 85), previously 1.6 x 0.8 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild to moderate multilevel degenerative changes affect the lower lumbar spine.OTHER: No significant abnormality noted.
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No significant interval change in referenced lesions or new sites of disease.
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Generate impression based on findings.
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Reason: Eval Dobhoff tube placement History: resistance when flushing Dobbhoff tube tip projects over transverse duodenum.
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Dobbhoff tube tip placement as above.
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Generate impression based on findings.
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Reason: 64 y/o woman with metastatic breast cancer receiving chemotherapy. Evaluate treatment response and extent of disease. History: Worsening of chronic cough. CHEST:LUNGS AND PLEURA: New mild reticulonodular opacities at the right apex suggestive of infection.Moderate right pleural effusion, decreased compared to previous.Atelectasis and scarring in the left lower lobe, unchanged.MEDIASTINUM AND HILA: Decreased mediastinal lymphadenopathy, with a reference a right paratracheal lymph node measuring 8 mm, decreased from 17 mm previously (series 3/29).Enlarged lower left paratracheal nodes, also slightly decreased.A right hilar node measures 13 mm, unchanged.A subcarinal lymph node measures 19 mm in short axis, slightly increased from previous when using comparable measurements.Calcified lymph nodes compatible with previous granulomatous infection.Moderately large pericardial effusion, unchanged.No visible coronary artery calcifications.CHEST WALL: Left breast implant.Marked decrease in left axillary lymph node measuring 10 mm, compared to 15 mm in short axis previously (series 3/33).Mixed lytic and sclerotic metastases in the upper thoracic vertebrae with partial collapse, unchanged.Pathological fracture in the lower sternum, and bilateral rib metastases also unchanged.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Marked increase in the size of a right lobe hepatic metastasis measuring 6.0 x 4 .7 cm, increased from 3.6 x 3.3 cm previously. Other hepatic metastases are relatively stable.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Enlarged retrocrural lymph node measuring 11 mm (series 3/81) decreased from 14 mm previously.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: See code "chest wall " portion of the report.OTHER: No significant abnormality noted.
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Mixed response with decrease in right pleural effusion and lymphadenopathy but increase in a hepatic metastasis.
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Generate impression based on findings.
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Reason: 24 yo male with ileal inflammation on colonoscopy and anal pain and tenderness concerning for perianal fistula/abscess. Please perform Crohn's protocol with imaging through the mid thighs History: regional enteritis, anal pain PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: At the 3 o'clock position, there is a subtle linear track extending from the anus inferiorly, into a wider continuous tract measuring approximately 1 cm in maximal dimension with surrounding inflammation, eventually terminating at the left gluteal cleft. Minimal inflammation is also seen along the right gluteal cleft (1004:89)BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Perianal fistulous tract measuring up to 1 cm in maximal dimension emanating from the 3 o'clock position, further described above.
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Generate impression based on findings.
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1 day old term male with fever and seizure like activity. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is nonspecific fluid within the mastoid air cells and middle ear cavities. The skull is unremarkable. There is 5-mm caput succedaneum overlying the vertex.
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1.No evidence of intracranial hemorrhage or gross structural abnormality.2.5-mm caput succedaneum overlying the vertex.
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Generate impression based on findings.
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Reason: 77y.o. female w/possible lung lesion over the right first costochondral junction on CXR. Please further eval. History: ? lung lesion on CXR LUNGS AND PLEURA: No suspicious pulmonary nodules. A possible opacity described on a recent chest radiograph was likely due to an artifact.MEDIASTINUM AND HILA: No lymphadenopathy.Moderate coronary artery calcification.Small pericardial effusion of uncertain significance.Catheter tip in the SVC.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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No significant pulmonary abnormalities. Small pericardial effusion.
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Generate impression based on findings.
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Male 36 years old Reason: h/o liver transplant c/b remote h/o hepatic artery thrombosis now w/ acute liver decompensation and eval for re-transplant; eval for thrombosis History: decompensating liver dx LIVER: Status post transplant. Heterogeneity of the hepatic parenchyma. Patent hepatic vasculatureBILIARY TRACT: No ductal dilatation. PANCREAS: Visualized portions are unremarkableKIDNEYS: The right kidney measures 8.4 cm with a stable cyst. Left kidney measures 9.4 cm with a stable cyst.SPLEEN: Splenomegaly, measuring up to 17 cm. OTHER: No significant abnormalities noted.
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1.Patent hepatic transplant vasculature.
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Generate impression based on findings.
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Reason: evaluate left nodular opacity History: abnormal cxr LUNGS AND PLEURA: Mild scarring in the lingula and at the lung bases.Scattered micronodules and small scarlike opacities.No suspicious nodules.MEDIASTINUM AND HILA: No lymphadenopathy.Moderate coronary artery calcification.No pericardial effusion.Tortuous and ectatic descending aorta, not significantly changed.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Multiple hepatic hypodensities consistent with cysts.Cholelithiasis.Aneurysmal dilation of the celiac artery, measuring 20 mm in diameter (series 3/100) unchanged from previous.
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Mild scarring and no other significant pulmonary abnormalities.
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Generate impression based on findings.
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Fever and neutropenia. Osteosarcoma.VIEW: Chest AP (one view) 01/24/15, 1205 Right internal jugular dual-lumen power port catheter tip is at junction of superior vena cava and right atrium.Cardiothymic silhouette is normal. No focal lung opacity is present.
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No pneumonia.
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Generate impression based on findings.
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60 year old female with T3N1 cervical esophageal SCC who completed chemo / RT in August 2013 now presenting for followup. There are post radiotherapy changes within the medial upper lobes. There is no evidence of mass lesions or significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. There is fluid within the right sphenoid sinus. There is a C6-C7 anterior cervical fusion.
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No evidence of locoregional tumor recurrence or significant lymphadenopathy.
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Generate impression based on findings.
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Back wound drainage. Evaluate for lumbar abscess. Surgery included L3-4 laminectomy and L3-S1 spinous process fusion on 12/26/14. Post-surgical changes are noted of a left L3/4 partial facetectomy, laminotomy, and ligamentum flavum resection as well as an interspinous fusion from L3-L5. There is prominent adjacent soft tissue signal abnormality with T2 hyperintensity and enhancement along the operative site, the paraspinal musculature and the epidural space. However, no mass effect is visualized on the thecal sac and there is no drainable fluid collection or abscess.The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. T12/L1: No significant spinal canal stenosis or neuroforaminal narrowing.L1/2: No significant spinal canal stenosis or neuroforaminal narrowing.L2/3: Mild disk dessication. Mild loss of disk height. Facet hypertrophy and ligamentum flavum thickening. No significant spinal canal stenosis or neuroforaminal narrowing.L3/4: There has been interval improvement in the lateral recess and central canal stenosis status-post left laminotomy, partial left facetectomy and ligamentum flavum resection. There is persistent moderate disk disease and mild loss of disc height. The lateral left-sided broad-based disk protrusion is again noted which results in moderate left neural foraminal compromise and localized mass effect on the left L3 nerve root beyond the neural foramina. Unchanged mild to moderate right neuroforaminal narrowing. L4/L5 Mild to moderate disk desiccation with mild loss of disk height. Mild-moderate facet hypertrophy with facet effusions and ligamentum flavum thickening. Mild central spinal stenosis and compromise of the lateral recesses. There is moderate right neuroforaminal compromise. L5/S1: Redemonstration of stable bony fusion at the level of disk anteriorly and without evidence of spinal stenosis or neuroforaminal compromise.SI Joints: Unremarkable SI joints.
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1.Post-surgical changes of a left L3/4 partial facetectomy, laminotomy and ligamentum flavum resection as well as an interspinous fusion from L3-L5. At L3/4, there has been interval improvement in the lateral recess and central canal stenosis.2.Soft tissue signal abnormality with enhancement in the operative site, the paraspinal musculature, and the epidural space. However, no mass effect is visualized on the thecal sac and there is no drainable fluid collection or abscess.3.Additional degenerative changes as described above are not significantly changed from the prior exam.
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Generate impression based on findings.
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The lower-most containing identifiable ribs is presumed to be T12. With this numbering nomenclature, there is transitional anatomy with lumbarization of S1. There is a rudimentary disc and bilateral pseudoarticulations at S1/2.Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable. There are no significant stenoses.
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The lower-most containing identifiable ribs is presumed to be T12. With this numbering nomenclature, there is transitional anatomy with lumbarization of S1. There is a rudimentary disc and bilateral pseudoarticulations at S1/2. Otherwise negative lumbar spine without contrast.
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Generate impression based on findings.
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BRAIN:The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. NECK:There is mild pharyngeal tonsillar enlargement and reactive adenopathy but no evidence of phlegmon or abscess formation. Mild Diffuse mild adenopathy is noted in the neck, right greater than left, which is likely reactive. The parotid and submandibular glands are normal in size and symmetric bilaterally without masses. There is no airway compromise. The lung apices are clear.
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1.No evidence of acute intracranial hemorrhage or other acute intracranial abnormality.2.Mild pharyngeal tonsillar enlargement and reactive adenopathy without abscess or phlegmon3.No evidence of a retropharyngeal abscess.
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Generate impression based on findings.
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There is no evidence of intracranial mass, mass effect, or midline shift. Redemonstrated is minimal periventricular white matter hypoattenuation, which likely represents chronic microvascular ischemic disease. The ventricles are normal in size and configuration. There is no acute intracranial hemorrhage. Fluid is present within the right sphenoid sinus and left mastoid air cells.Please see soft tissue neck CT images/dictation for discussion of extracranial soft tissue abnormalities.
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No acute intracranial abnormality.
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Generate impression based on findings.
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58-year-old female with dizziness. Evaluate the posterior circulation. NONCONTRAST CT HEADThe ventricles, sulci, and cisterns are symmetric and unremarkable. Scattered periventricular and subcortical white matter hypoattenuation which is nonspecific but compatible with age indeterminate small vessel ischemic changes. 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. CTA HEAD AND NECKThere is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins are normal. There is a right dominant vertebral artery and hypoplastic left vertebral artery which terminates intracranially as the right PICA.There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. There is normal contrast opacification through anterior circulation (bilateral petrous/cavernous/supraclinoid internal carotid arteries, anterior and middle cerebral arteries). The Anterior communicating artery is visualized.Within the posterior circulation, there is a persistent fetal origin of the right PCA with a hypoplastic right P1 segment, which is a normal variant. The left PCA arises from the basilar artery and there is a normal caliber left posterior communicating artery. The basilar artery, AICA and SCA arteries appear normal. There is a normal left PICA arising from the left vertebral artery.No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.
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1.No evidence of acute intracranial hemorrhage or other acute intracranial abnormality.2.No significant steno-occlusive disease, dissection or aneurysm of the major intracranial arteries or arteries of the neck.
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Generate impression based on findings.
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42 year old female with blindness, headache and left facial numbness. There is no evidence of intracranial hemorrhage. There is atherosclerotic calcification of the distal internal carotid arteries. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged mastoid air cells are clear. There is mild left sphenoid sinus mucosal thickening. The skull and extracranial soft tissues are unremarkable. There is unchanged elongation of the right globe compatible with staphyloma and there is increased opacification and unchanged small size of the left globe compatible with history of retinal detachment and prior surgeries.
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1.No evidence of intracranial hemorrhage.2.Right globe staphyloma and increased opacification of the left globe with unchanged small size compatible with history of retinal detachment and prior surgeries.
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Generate impression based on findings.
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79 year old male with dizziness. There is no evidence of intracranial hemorrhage. There are unchanged mild patchy regions of low-attenuation within the supratentorial white matter most compatible with chronic small vessel ischemic disease. Thre is atherosclerotic calcification of the distal internal carotid arteries. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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No evidence of intracranial hemorrhage.
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Generate impression based on findings.
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Multiple bowel resections. Elevated lipase and abdominal pain. Possible necrotizing pancreatitis. ABDOMEN:LUNG BASES: Small right pleural effusion and right lower lobe opacity are new findings.LIVER, BILIARY TRACT: Normal appearance. Gallbladder is distended.SPLEEN: Normal in appearance.PANCREAS: Normal enhancement. No loculated peripancreatic fluid collection.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple striated nephrograms are present bilaterally and are a new finding. No pelvicaliceal dilation is seen.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No dilated bowel loops are present. Free peritoneal fluid is noted. Right lower quadrant fluid appears to have a wall around it. This collection measures approximately 5 cm in maximum diameter. Surgical clips are present. A right lower quadrant stoma is identified. A nasogastric tube is present.BONES, SOFT TISSUES: Postoperative changes are noted in the abdominal wall.OTHER: No significant abnormality noted
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No evidence of necrotizing pancreatitis. New right lower lobe opacity and right pleural effusion may represent pneumonia with parapneumonic effusion. Probable pyelonephritis. Possible loculated right lower quadrant fluid collection.
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Generate impression based on findings.
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Fecal disimpaction. Evaluate residual stool burden.VIEW: Abdomen AP (one view) 01/24/15, 1438 A catheter is present within the ascending colonic enema channel.A moderate amount of feces is seen in the hepatic flexure and proximal transverse colon. A moderate to large amount of feces is present in the distal transverse colon and splenic flexure. The stool in the rectosigmoid is no longer visualized. No free peritoneal air is seen.
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Decrease in stool burden.
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Generate impression based on findings.
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Postoperative findings related to a soft tissue flap in the left posterior and lateral neck. No evidence of mass lesions or significant cervical lymphadenopathy by CT size criteria. A stable left level IIa reference lymph node is unchanged, measuring measures 6 x 5 mm, re-measured at 6 x 5 on the prior exam. The left level IIb reference lymph node measures 8 x 5 mm compared to 8 x 6 mm previously and is therefore stable. Stable right level 3 reference lymph node measures 5 x 5 mm, previously 9 x 5 mm (series 8, image 65). The thyroid and major salivary glands are unchanged. The major cervical vessels are patent. The osseous structures are unchanged. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.
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1.Stable to perhaps slightly smaller reference lymph nodes in the neck.
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Generate impression based on findings.
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There is a partial L3 vertebra, deficient left laterally, resulting in levoscoliosis with its apex at L3. There has been prior posterior fusion from L2 through L4 including bilateral pedicle screws at L2 and L4, and on the right at L3, as well as L3 laminectomy. Enhancement is noted along the operative tract, the paraspinal musculature, and along the epidural space. A tiny fluid collection is evident on the left lateral aspect of the L4 spinous process. Otherwise there is no evidence of abscess or significant fluid collection.There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. There is no abnormal intrathecal enhancement.T12/L1: UnremarkableL1/2: Asymmetric bulge to the right without resulting stenosisL2/3: Asymmetric bulge to the right without resulting stenosisL3/4: Congenital deformity results in narrowing of the left neural foramen in combination with slight adjacent endplate spurring and asymmetric disc bulge. The central canal and right neural foramen are widely patent.L4/5: Asymmetric bulge to the right, ligamentum flavum thickening, and moderate to severe bilateral facet hypertrophy. There is mild central, mild to moderate right lateral recess, and moderate right neural foraminal stenosis.L5/S1: Asymmetric bulge to the right and mild bilateral facet hypertrophy. There is mild right neural foraminal stenosis.
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1.There is a partial L3 vertebra, deficient left laterally, resulting in levoscoliosis with its apex at L3. 2.There has been prior posterior fusion from L2 through L4 including bilateral pedicle screws at L2 and L4, and on the right at L3, as well as L3 laminectomy. Enhancement is noted along the operative tract, the paraspinal musculature, and along the epidural space. A tiny fluid collection is evident on the left lateral aspect of the L4 spinous process. Otherwise there is no evidence of abscess or significant fluid collection.3.L3/4: Congenital deformity results in narrowing of the left neural foramen in combination with slight adjacent endplate spurring and asymmetric disc bulge. The postoperative central canal and right neural foramen are widely patent.4.L4/5: Mild central, mild to moderate right lateral recess, and moderate right neural foraminal stenosis.5.L5/S1: Mild right neural foraminal stenosis.
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Generate impression based on findings.
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Within the left level neck IVB region is 3 x 4 cm mass-like lesion (series 6, image 81), most likely representing a conglomerate of enlarged lymph nodes. Small bilateral mucous retention cysts are noted in the maxillary sinuses. The parotid and submandibular glands are normal in size and symmetric bilaterally without masses. There are no thyroid masses. The lung apices are clear. See the accompanying chest CT for full characterization of the partially visualized mediastinal and bilaterally axial lymphadenopathy.
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1.Mass-like lesion in the level IVB region of the left neck likely represents a conglomerate of enlarged lymph nodes.2.See the accompanying chest CT for full characterization of the partially visualized mediastinal and bilaterally axial lymphadenopathy.
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Generate impression based on findings.
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Shortness of breath. Rule-out pneumonia.VIEW: Chest AP (one view) 01/24/15, 1603 Cardiothymic silhouette and pulmonary vascularity are normal. Lung volumes are mildly to moderately increased. Bronchial wall thickening is noted. Right middle lobe subsegmental atelectasis is resolving. No focal air space disease is seen.
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Bronchiolitis/reactive airways disease pattern.
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Generate impression based on findings.
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Hypoxia. Seizure disorder and hip surgery. Rule out PE. PULMONARY ARTERIES: No filling defects are identified in the main, right, and left pulmonary arteries. Segmental arteries proximally are probably normal. The distal aspects of the segmental arteries cannot be evaluated adequately.The right heart is not enlarged. Heart size is normal. Branching pattern of the great vessels is normal.LUNGS AND PLEURA: The lower lobes are consolidated. Small bilateral pleural effusion is identified.MEDIASTINUM AND HILA: No lymphadenopathy is present.CHEST WALL: Endotracheal tube tip is below thoracic inlet. Right PICC tip is in right atrium.UPPER ABDOMEN: Enhancement pattern of the spleen is due to rapid injection of contrast material. A small amount of free fluid is present in the upper abdomen.
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No pulmonary embolus in the main, right, left, or proximal segmental pulmonary arteries. Consolidation of both lower lobes and small bilateral pleural effusion.
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Generate impression based on findings.
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Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. Abnormal pelvic intestinal loops are only partially imaged. Previous MR enterography demonstrated abnormality. Please see previous report. Redemonstrated is a simple right renal cyst.Disc desiccation and mild disc height loss are present at L3/4 and L4/5. A Schmorl's node is evident along the superior L4 endplate.T12/L1: UnremarkableL1/2: UnremarkableL2/3: UnremarkableL3/4: Mild disc bulge without stenosisL4/5: UnremarkableL5/S1: There is a small broad-based left paracentral protrusion with prominent annular tear which abuts and slightly flattens the left S1 nerve root sheath origin.
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1.Abnormal pelvic intestinal loops are only partially imaged. Previous MR enterography demonstrated abnormality. Please see previous report.2.L5/S1: There is a small broad-based left paracentral protrusion with prominent annular tear which abuts and slightly flattens the left S1 nerve root sheath origin.
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Generate impression based on findings.
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23 female with VP shunt experiencing headache, abdominal pain, and vomiting Redemonstrated is a right transfrontal ventriculoperitoneal shunt catheter with tip terminating at the body of the left lateral ventricle. Ventricle caliber and morphology are unchanged from prior CT. The left lateral ventricle remains nearly completely effaced, and the right ventricle caliber is unchanged. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is redemonstration of hypoplastic left cerebellar hemisphere. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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1. No evidence of intracranial hemorrhage, mass, or cerebral edema2. Stable positioning of the right frontal approach ventricular shunt catheter. Stable caliber of the ventricular system.3. Stable posterior fossa asymmetry secondary to hypoplastic left cerebellar hemisphere.
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Generate impression based on findings.
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There has been interval decrease in the amount of intraventricular hemorrhage, especially notable involving the left lateral and fourth ventricles. The parenchymal portion of the intracranial hemorrhage also appears slightly decreased in size. There are no foci of interval new hemorrhage. There has also been slight decrease in lateral ventricular sizes.There is no significant mass effect. There is decreasing midline shift to the left. There is no extraaxial fluid collection. There is mild scattered mucosal thickening within the ethmoid air cells. Tiny mucosal retention cysts are noted in the maxillary sinuses. The visualized portions of the mastoids/middle ears are clear.
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1.There has been interval decrease in the amount of intraventricular hemorrhage, especially notable involving the left lateral and fourth ventricles. 2.The parenchymal portion of the intracranial hemorrhage also appears slightly decreased in size. 3.There are no foci of interval new hemorrhage. 4.There has also been slight decrease in lateral ventricular sizes.
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Generate impression based on findings.
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Is a well-circumscribed 5 x 5 mm focus within the choroid of the right lateral ventricle measuring -41 Hounsfield units consistent with fat. The ventricles and sulci are normal in size. There are no parenchymal masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear.
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1.Incidental 5-mm choroidal lipoma.2.No acute intracranial abnormality.
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Generate impression based on findings.
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Female 71 years old; Reason: right flank pain History: right flank pain The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: 5-mm left basal pulmonary nodule is nonspecific. Bibasal atelectasis. LIVER, BILIARY TRACT: Subcentimeter liver calcifications are suggestive of prior granulomatous process.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Fragmented right staghorn calculus with components involving the upper, mid and lower pole calyces as well as the renal pelvis. There is mild/moderate right hydronephrosis and minimal right perinephric stranding. There is right hydro-ureter to the level of just proximal to the VUJ where there is a 3-mm partially obstructing renal calculus. There are additional calculi within the urinary bladder. The largest measures 9 mm.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right wide mouthed ventral abdominal wall hernia containing non obstructed bowel loops.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: The uterus is atrophic.BLADDER: Gallbladder wall thickening, likely related to under distention.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Thoracolumbar scoliosis with degenerative changes most marked at the L5-S1 level. Severe bilateral degenerative changes of both hip joints.OTHER: No significant abnormality noted.
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1.Mild/moderate right hydronephrosis with partially obstructing distal right ureteric calculus with additional calcifications within the bladder likely representing passed stones. Right renal staghorn calculus.2.Left basal pulmonary nodule requires follow-up as per Fleischner guidelines.
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Generate impression based on findings.
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97 years, Female. Reason: pls eval for stool burden, distention History: abdominal pain Average stool burden. No evidence of obstruction. Atherosclerotic calcifications aortic, iliac and femoral vasculature. Generalized severe osteoporosis. Degenerative changes lumbar spine.
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No findings to explain abdominal pain.
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Generate impression based on findings.
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37 years, Male. Reason: ulcerative colitis r/o toxic megacolon History: fevers colitis Moderately dilated loops of jejunum with non-differential air-fluid levels. Paucity of colonic gas. No evidence of toxic megacolon. No intramural air or free air.Caval filter in expected position. Lung bases clear. No evidence of organomegaly. Osseous structures are normal.
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Small bowel ileus involving primarily jejunum, obstruction unlikely. Given history of fever correlate for small bowel infectious process. No evidence of toxic megacolon.
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Generate impression based on findings.
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Female 44 years old; Reason: hx of incisional hernias here with intractable vomiting, pls eval for bowel obstruction History: vomiting, hx of SBO ABDOMEN:LUNG BASES: Stable appearance of nodular pleural thickening in the left lower lobe at site of prior surgery with associated rib resection and myositis ossificans.LIVER, BILIARY TRACT: Mild nonspecific distention of the gallbladder.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Two ventral abdominal wall hernias are again identified containing the bowel. Superior ventral incisional Richter's hernia containing a single wall of transverse colon without evidence of obstruction. More inferior ventral hernia containing only mesenteric fat. Left lateral wall hernia containing mesenteric fat and non obstructed bowel.Changes relating to prior sleeve gastrectomy with resection of the excluded stomach. Distention of the lower esophagus. Desiccated feces again noted at the level of the small bowel to small bowel anastomosis, unchanged compared to prior study and suggestive of stasis. 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: Two ventral abdominal wall hernias are again identified containing the bowel. Superior ventral incisional Richter's hernia containing a single wall of transverse colon without evidence of obstruction. More inferior ventral hernia containing only mesenteric fat. Left lateral wall hernia containing mesenteric fat and nonobstructed bowel.Changes relating to prior sleeve gastrectomy with resection of the excluded stomach. Distention of the lower esophagus. Desiccated feces again noted at the level of the small bowel to small bowel anastomosis, unchanged compared to prior study and suggestive of stasis. BONES, SOFT TISSUES: Partially evaluated stabilization rods in the thoracolumbar spine.OTHER: No significant abnormality noted.
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1.Stable appearance of intra-abdominal wall hernias without evidence of bowel obstruction at this time.2.Changes related to prior sleeve gastrectomy.3.Nonspecific gallbladder distention.
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Generate impression based on findings.
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29 years, Female. Reason: 29 yo w/gastroparesis here w/ sbo new onset r sided pain History: new onset r sided pain Mildly dilated loops of bowel in the left upper quadrant probably colonic with several suture lines noted. Given history of the surgery continued follow-up advised to rule out early obstruction. Paucity of gas elsewhere. No intramural air or free air.Surgical clips upper abdomen. Lung bases clear. Central line visualized the distribution of cavoatrial junction.
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No evidence of obstruction but there are persistent dilated loops of bowel in the left upper quadrant with evidence of prior surgery in the area. If symptoms persist or worsen follow-up plain films may be obtained.
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Generate impression based on findings.
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91 years, Male. Reason: LLQ pain, r/o obstruction History: see 1 Scattered bowel gas nonobstructive pattern consistent with generalized ileus. No intramural air or free air. Extensive atherosclerotic calcifications particularly aorta and branch vessels including splenic artery. Surgical clips lower chest. Sternotomy. Lung bases clear. Osteoporosis.
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Generalized ileus. No obstruction.
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Generate impression based on findings.
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55 years, Male. Reason: post Dobbhoff placement History: see above Pelvis and portions of the right abdomen are excluded from the field of view.About two and does should be sure gastric body. Stomach distended. Scattered mild dilated loops of small bowel consistent generalized ileus. Average stool burden. Lung bases and osseous structures are unremarkable.
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Dobbhoff tube in distribution the gastric body. Generalized ileus. Gastric distention related to placement of the Dobbhoff tube.
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Generate impression based on findings.
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68 years, Male. Reason: ileus History: as above Persistent marked dilatation of transverse colon. Scattered bowel gas elsewhere. Gas distended stomach with percutaneous gastrostomy tube overlying proximal gastric body. This pattern is unchanged from the prior several examinations. No intramural air or free air.Bullae and fibrotic changes right lung base. Prosthetic right femoral head. Pelvic calcifications pelvis probably all phleboliths. Radiopaque object right lower quadrant probably T-tac from gastrostomy tube placement.
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Persistent colonic ileus. No intramural air or free air
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Generate impression based on findings.
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Female 33 years old; Reason: severe abd pain, diffuse, can't localize History: severe acute onset abd pain, distended abd, vomiting The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: Evidence of prior sternotomy.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: Mild symmetric perinephric stranding. No hydronephrosis or renal stone.RETROPERITONEUM, LYMPH NODES: Mild nonspecific prominence of retroperitoneal lymph nodes measuring up to 8 mm in short axis dimension which do not not meet CT criteria for enlargement.BOWEL, MESENTERY: The appendix is identified in the right lower quadrant. Appendicolith within the appendix tip while there is mild periappendiceal fluid there is no appendix wall thickening, or secondary signs of appendicitis. BONES, SOFT TISSUES: Umbilical hernia containing only mesenteric fat.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Bulky uterus raising the possibility of fibroids. The bilateral ovaries are measured at the upper limits of normal for patient age. There is trace pelvic free fluid.BLADDER: No significant abnormality noted.LYMPH NODES: Mildly prominent pelvic sidewall lymph nodes are nonspecific.BOWEL, MESENTERY: Please see above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is mild free fluid tracking along the paracolic gutters.
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1. Appendicolith and mild periappendiceal fluid but no evidence of acute appendicitis.2. Bilateral adnexal structures are incompletely evaluated in the absence of intravenous contrast however appear at upper limits of normal for patient age. There is low suspicion for ovarian torsion or ovarian lesion unless symptoms are localized to this region in which case pelvic sonogram may be helpful for further evaluation.
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Generate impression based on findings.
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Female 63 years old Reason: obstructive uropathy. History: volume overload. RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: 12.3 cm in length. Normal echogenicity.COLLECTING SYSTEM/URETER: Foley catheter in a collapsed urinary bladder.URINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels No significant abnormality noted:Iliac artery normal arterial shape waveform peak systolic velocity .48 m/sec. Some variation between systoles, correlate with EKG.At the anastomosis normal waveform peak systolic velocity 1.7 m per sec and resistive index .88Renal arteries peak systolic velocity and resistive indices as follows: proximal artery 2.2 m per sec and resistive index .9mid artery 1.1 m per sec and resistive index .9hilum .45 m per sec and resistive index .77resistive indices in the segmental arteries range from .8 to .85OTHER: Ascites.
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No evidence of renal artery stenosis. Elevated resistive indices nonspecific possibly medical renal disease a low echogenicity is normal.Some irregularities in distance between systoles correlate with EKG.Ascites.
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Generate impression based on findings.
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Hypodense foci are present within the white matter without associated mass effect. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear.
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Small vessel ischemic disease of indeterminate ages, which was demonstrated as chronic disease on the 2013 MRI. If there is continued clinical concern for acute ischemia, MRI would be recommended.
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Generate impression based on findings.
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Female 70 years old; Reason: eval for pathology History: abd pain, fever ABDOMEN:LUNG BASES: Mild bibasal dependent atelectasis. Nonspecific density within the lower left breast is incompletely evaluated. LIVER, BILIARY TRACT: Cholelithiasis. No intra-or extrahepatic biliary duct dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter hypoattenuating renal lesions are too small characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is mesenteric haziness predominantly centered in the pelvis where there is pain 3.9 x 2.6 cm air-fluid collection (series 3, image 101). There is severe sigmoid colon diverticulosis with marked inflammatory changes and focal asymmetric bowel wall thickening near the above described collection (series 3, image 105).Additionally, there is small bowel dilatation measuring of 2.4 cm in the lower abdomen without a clear transition point. There is associated submucosal edema. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate volume pneumoperitoneum and mild pelvic free fluid. PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is mesenteric haziness predominantly centered in the pelvis where there is pain 3.9 x 2.6 cm air-fluid collection (series 3, image 101). There is severe sigmoid colon diverticulosis with marked inflammatory changes and focal asymmetric bowel wall thickening near the above described collection (series 3, image 105).Additionally, there is small bowel dilatation measuring of 2.4 cm in the lower abdomen without a clear transition point. There is associated submucosal edema. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate volume pneumoperitoneum and mild pelvic free fluid.
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1. Perforated sigmoid diverticulitis with adjacent inflammatory changes including a 3.9-cm air-fluid collection. Adjacent distended and edematous small bowel is likely secondary to the above-described inflammatory process. The possibility of small bowel ischemia was raised however at surgery the small bowel was determined to be edematous but nonischemic.2. Medial left breast nodule is incompletely imaged. Consider mammogram for further evaluation.3. Cholelithiasis.
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Generate impression based on findings.
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20-year-old male experiencing headache, has VP shunt No evidence of acute ischemic or hemorrhagic lesion. Redemonstrated is a ventriculostomy shunt entering via a right frontal burr hole with its tip located at the left side of the foramen of Monroe, unchanged in position. Hypodensity tracking along the catheter is stable. There has been no change of hypodense foci within the right middle frontal deep white matter and left frontoparietal white matter. The ventricular sizes are unchanged. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection or acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
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1.Stable ventricular sizes and location of VP shunt.2.No CT evidence for an acute intracranial process.
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Generate impression based on findings.
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Male 63 years old Reason: h/o prostate vs testicular cancer, unknown pathology, p/w cord compression, eval for metastatic disease History: back pain, L hip and leg pain, s/p b/l orchiectomy CHEST:LUNGS AND PLEURA: Severe centrilobular and paracentral emphysema. Calcified and noncalcified pulmonary micronodules common nonspecific.MEDIASTINUM AND HILA: Mild atherosclerotic disease. Mild coronary artery calcification. No pathologic size lymph nodes.CHEST WALL: Sclerotic and lytic lesions consistent with metastatic disease. Compression fracture T8. Destructive soft tissue mass T6 with involvement of posterior elements and encroachment on the spinal canal. Please refer to MRI of the spine 1/23/15.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodensities are nonspecific.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal lymph nodes. For baseline purposes left para-aortic lymph node series 3 image 126, measures 2.7 x 1.4 cmBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic lytic lesions consistent with metastatic disease.Air in the subcutaneous tissues right abdomen possibly from injection site. Series 3 image 128OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality note.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Diffuse lytic sclerotic lesions destructive lesion please refer to MRI report.OTHER: Atherosclerotic disease. No evidence of aneurysm.
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Osseous metastatic disease with destructive lesions with complications as described above in the chest and pelvis.Small nonspecific retroperitoneal lymph nodes.Lung emphysema and nonspecific pulmonary micronodules.Small volume contrast extravasation (see technique for details).
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Generate impression based on findings.
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Female 55 years old; Reason: eval of acute onset anterior pubic pain History: as above ABDOMEN:LUNG BASES: Mild basal atelectasis. Left lower lobe pulmonary cyst.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis. The appendix is identified in the right lower quadrant and is unremarkable.BONES, SOFT TISSUES: Trace fluid within the pubic symphysis, with mild adjacent inflammatory changes are nonspecific and may be reactiveOTHER: No significant abnormality noted.
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1.Trace fluid in the pubic symphysis with adjacent inflammatory changes is non specific but may be reactive in etiology.
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Generate impression based on findings.
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Female 28 years old; Reason: r/o acute appy, TOA, other acute intraabdominal process History: R flank and lower abdominal pain, vaginal discharge, N/V ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The left kidney is malrotated with contour irregularity likely related to variant anatomy.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix is identified in right lower quadrant and is unremarkable.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Unremarkable appearance of the bilateral adnexa without inflammatory changes.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 appendicitis or tubo-ovarian abscess.
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Generate impression based on findings.
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60 year-old female. Rule out PE. PULMONARY ARTERIES: Technically adequate exam for evaluation of pulmonary embolism. No pulmonary embolus is identified.LUNGS AND PLEURA: Severe upper lobe predominant centrilobular emphysema. There is a 2.2 x 2.5 spiculated semisolid right upper lobe nodule (image 54, series 10), concerning for primary lung malignancy. Small bilateral pleural effusions are present, right greater than left.MEDIASTINUM AND HILA: Calcified subcarinal and right hilar lymph nodes likely represent prior granulomatous disease. Other prominent subcarinal, AP window, and superior mediastinal lymph nodes are not enlarged by CT size criteria, though given the suspicious right lobe lesion, mediastinal lymph node metastases are a consideration.CHEST WALL: Moderate diffuse anasarca.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Trace perihepatic ascites, incompletely evaluated. Left adrenal nodularity.
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1.No evidence of pulmonary embolism.2.Right upper lobe spiculated mass, concerning for primary lung malignancy. This lesion is amenable to percutaneous biopsy if clinically indicated.3.Prominent mediastinal lymph nodes and left adrenal nodularity are nonspecific; metastatic disease is a diagnostic consideration.4.Small bilateral pleural effusions, right greater than left.5.Trace perihepatic ascites, incompletely evaluated.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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Male 69 years old; Reason: tumor burden, biliary dilation History: elevated bili, vomiting ABDOMEN:LUNG BASES: Mild right basal atelectasis.LIVER, BILIARY TRACT: No suspicious hepatic lesion. Patent hepatic vasculature. No intra-or extrahepatic biliary duct dilatation.SPLEEN: Status-post splenectomy.PANCREAS: Postsurgical changes of distal pancreatectomy and splenectomy. Previously described soft tissue within the surgical bed adjacent to a surgical clip is not significantly changed compared to prior study (series 3, image 42/43). Unchanged appearance of the remainder of the pancreas.ADRENAL GLANDS: Unchanged left adrenal thickening.KIDNEYS, URETERS: Unchanged renal hypodensities.RETROPERITONEUM, LYMPH NODES: Small gastrohepatic and retroperitoneal lymph nodes are again noted. Reference left para-aortic node measures 1.3 x 0.8 cm (series 3, image 48), previously 1.3 x 0.7 cm. Reference portal caval node measures 1.5 x 0.8 cm (series 3, image 37), previously 0.9 x 0.8 cm.BOWEL, MESENTERY: Diffuse omental and peritoneal nodularity is again identified. This has increased compared to prior study. The reference nodule in the left paracolic region measures 2.0 x 1.7 cm (series 3, image 46), previously 1.4 x 1.2 cm. Suggestion of mucosal irregularity along the lateral pyloric channel ( series 3, image 43). This is nonspecific however in the correct clinical context may represent an ulcer.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Severe calcific arteriosclerosis of the abdominal aorta and branch vessels.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Moderate degenerative changes of the visualized spine with multiple persistent scattered lucencies in the bilateral iliac bones and left 10th rib.OTHER: No significant abnormality noted.
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1.Increased omental and mesenteric nodularity consistent with worsening carcinomatosis.2.Stable soft tissue in the pancreatic resection bed.3.Reference lymph nodes are increased in size.4.Scattered osseous lucencies are unchanged.
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Generate impression based on findings.
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Male 55 years old Reason: assess for mets History: assess for mets. CHEST:LUNGS AND PLEURA: Right upper lobe subpleural mass series 2 image 40, measures 5 x 2 cm with destruction of adjacent rib.Additional right and left lower lobe subpleural nodules consistent with metastases.MEDIASTINUM AND HILA: Enlarged heterogeneous left thyroid lobe with nodules.Small AP window and right paratracheal nodes.Heavy atherosclerotic calcifications coronary arteries.CHEST WALL: In addition to the rib destruction described above, additional osseous metastases are seen.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 7.9 x 6.7-cm heterogeneous, hypervascular mass in the upper pole of the left kidney most compatible with renal cell carcinoma.Left renal vein is patent. There are adjacent collaterals indicating some possible venous insufficiency.No other masses are seen.No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications, no evidence of aneurysm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Destructive soft tissue mass involving posterior elements of L3 and L4 encroachment spinal canal. Please refer to MRI of 1/24/15.Additional destructive soft tissue lesions in the posterior elements of L1.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Severe atherosclerotic calcifications. No evidence of aneurysm.
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left upper pole renal mass consistent with renal cell carcinoma but pulmonary and osseous metastases as detailed above.
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Generate impression based on findings.
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60 year-old male with history of PE and chronic DVT. Shortness of breath. Rule out PE. PULMONARY ARTERIES: Technically adequate exam for evaluation of pulmonary embolism. No pulmonary embolus is identified.LUNGS AND PLEURA: Severe centrilobular emphysema. No focal consolidation. Minimal scarring at the lung bases. Diffuse peribronchial thickening, but particularly at the lung bases. Minimal dependent atelectasis. No significant pleural effusion. No suspicious pulmonary nodules. Left lower lobe granuloma.MEDIASTINUM AND HILA: Heart size upper limits of normal. Trace pericardial effusion. No mediastinal or hilar lymphadenopathy. Tracheal debris is noted.CHEST WALL: Moderate degenerative changes affect the visualized spine. No focal suspicious osseous lesions identified.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips. Incompletely imaged left renal cystic lesion, previously identified as a cyst. G-tube partially imaged.
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No evidence of pulmonary embolism.Bronchial wall thickening may represent bronchitis or asthma.Tracheal debris compatible with aspiration.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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Female 24 years old Reason: r/o pneumonia, abscess History: fever, leukocytosis CHEST:LUNGS AND PLEURA: Areas of consolidation in both lung apices seen consistent with airspace disease, rule out pneumonia.Nodular opacities measuring up to 1.7 x 1 cm series 5 image 85 in both apices.Nodular opacity superior segment left lower lobe.Bibasilar septal thickening left greater than right suggesting edema.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Mild intrahepatic biliary prominence, unchanged from prior exam no discrete transition zone. No focal liver lesions.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: Subtle mild haziness in the region of the splenic flexure and related to history of inflammatory bowel disease. No bowel wall thickening or abnormal bowel wall enhancement. No free or loculated intraperitoneal fluid.Diverting ileostomy. Oral contrast is seen to progress to the ostomy bag. No evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Mild prominence iliac nodes right external iliac chain in particular.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: JP drain in catheter seen in the perianal area. No measurable fluid or soft tissue collections around the catheter. Perirectal fat is normal. Ischio rectal fossa fat is normal.OTHER: No significant abnormality noted.
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Multifocal airspace disease consistent with infection.Catheter with no measurable loculated collections. Expected postsurgical changes with diverting ileostomy. Subtle fat stranding around the splenic flexure questionable significance but may be related to inflammatory bowel disease. Mild biliary prominence unchanged.
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Generate impression based on findings.
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Female 46 years old; Reason: r/o dissection History: back pain, hypertensive, on HD CHEST:LUNGS AND PLEURA: 1.8 x 1.1 cm area of focal bronchiectasis with associated peripheral soft tissue thickening is nonspecific but appears chronic. Multiple nonspecific pulmonary nodules measuring up to 4 mm (series 9, image 29) which are nonspecific. Comparison to outside CT imaging of the chest versus short interval follow-up CT is recommended to confirm stability/resolution. Mild left pleural effusion with compressive atelectasis.MEDIASTINUM AND HILA: Extensive mediastinal and hilar lymphadenopathy. A reference prevascular lymph node measures 2.7 x 1.4 cm (series 10, image 50. Right internal jugular venous catheter terminates at the cavoatrial junction. Enlarged right supraclavicular lymph node measuring 1.5 x 11 cm (series 10, image one).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: The right kidney is markedly atrophic. There is severe left hydronephrosis and hydroureter which appears chronic in etiology and unchanged compared to prior study. RETROPERITONEUM, LYMPH NODES: Multiple prominent retroperitoneal lymph nodes measuring up to 0.6 cm in short axis dimension which do not meet CT criteria for enlargement.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild stranding along the right colon appears slightly improved from prior study. There is mild fascial thickening in the right paracolic region however the appearance is not significantly changed compared to prior study. No evidence of obstruction or pneumatosis.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Nonspecific bladder wall thickening with associated mucosal hyper enhancement which may reflect cystitis although the bladder is nondistended which limits evaluation.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small volume ascites. Peritoneal dialysis catheter in place.CT ANGIOGRAM:No evidence of aortic aneurysm or dissection. There is mild arteriosclerosis of the thoracic and abdominal aorta.Patent origins of the celiac trunk and SMA with conventional anatomy. Patent origins of the bilateral renal arteries and IMA. The bilateral common iliac, external and internal iliac arteries and common femoral arteries are patent without significant stenosis.
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1.No evidence of aortic aneurysm or dissection.2.Diffuse mediastinal and hilar lymphadenopathy with associated enlarged right supraclavicular lymph node is nonspecific.3.Focal bronchiectasis with peripheral soft tissue thickening in the right upper lobe with multiple associated lung nodules. While this may be infectious/inflammatory in etiology correlation with smoking history as well as outside CT imaging/follow-up CT is recommended to confirm stability/resolution.4.Mild thickening of the proximal colon with adjacent fascial thickening persists but is improved compared to prior study5.Nonspecific bladder wall thickening with associated mucosal hyper enhancement which may reflect cystitis although the bladder is nondistended which limits evaluation.Findings discussed with Dr Chi ( Resident ) ext 45968 by myself Dr Ward 01/25/15 9:43 a.m.
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Generate impression based on findings.
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Hypodense foci are present within the white matter without associated mass effect. There is mild diffuse volume loss without a specific lobar predominant atrophy pattern. There are no findings of ventricular obstruction or hydrocephalus. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear.
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Small vessel ischemic disease of indeterminate ages. If there is continued clinical concern for acute ischemia, MRI would be recommended.
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Generate impression based on findings.
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37-year-old female with chest pain, syncope shortness of breath. Paraplegia from gunshot wound. PULMONARY ARTERIES: Technically adequate exam for evaluation of pulmonary embolism. No pulmonary embolus is identified.LUNGS AND PLEURA: Moderate upper lobe predominant paraseptal emphysema, greater than expected for patient's age. 5-mm right upper lobe semi-solid nodule (image 41, series 80675; image 18, series 10). Additional scattered calcified and noncalcified micronodules are present bilaterally. Punctate metallic densities in the right apex and one in the spinal canal at the level of T4-5 are compatible with ballistic fragments from prior gunshot wound.MEDIASTINUM AND HILA: Heart size is normal with no pericardial effusion. Trachea and mainstem bronchi are patent. No mediastinal or hilar lymphadenopathy.CHEST WALL: Chronic appearing deformity of the right third and fourth posterior ribs.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Incompletely evaluated left adrenal nodularity.
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1.No evidence of pulmonary embolism.2.Moderate paraseptal emphysema. Given no smoking history per electronic medical record, associations with IV drug abuse and HIV may be considered in this patient.3.Left adrenal nodularity is incompletely evaluated. Dedicated adrenal imaging may be considered if clinically indicated.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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Male 39 years old; Reason: evidence of pancreatitis or any complications of pancreatitis? History: history of chronic pancreatitis, presenting with usual symptoms. Exam is not sensitive for detecting lesions in the solid organs of vasculature due to the lack of intravenous contrast. Given that limitation, the following observations are made:ABDOMEN:LUNGS BASES: Basilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted. No evidence of fatty liver.SPLEEN: No significant abnormality noted.PANCREAS: Given limitation of no intravenous contrast, there is no evidence of peripancreatic fat stranding or fluid. No pancreatic calcifications or hemorrhage. No obvious pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Greater than average stool burdened throughout the colon. Correlate clinically.Mild haziness in the mesentery may reflect fluid status correlate clinically. No small bowel wall thickening or dilatation. No intramural air or free air.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Prominent colonic stool burdened throughout correlate for colonic inertia. 2.No CT signs of pancreatitis given limitations of no intravenous contrast.
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Generate impression based on findings.
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Scattered foci of hypodensity are present within the white matter without associated mass effect. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. Opacification is noted within a single left ethmoid air cell. Otherwise the visualized portions of the paranasal sinuses and mastoid air cells are clear.
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Small vessel ischemic disease of indeterminate ages. If there is continued clinical concern for acute ischemia, MRI would be recommended.
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Generate impression based on findings.
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Female 45 years old Reason: Eval for malignancy History: eval for malignancy. CHEST:LUNGS AND PLEURA: Multifocal areas of groundglass opacity scattered throughout the lungs primarily upper lobes bilaterally. Also areas of groundglass or atelectasis in the lobes. Currently for infection. No evidence of pleural effusions.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Status post left mastectomy. Left breast prosthesis.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right upper pole hypoattenuating lesion consistent with simple cyst measuring 3-cm in diameter. No evidence of hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse jejunal prominent caliber. Questionable transition zone in the left hemipelvis. Correlate for adhesions and any prior abdominal surgery or obstructive symptoms. No intramural air or free air. No free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: Sagittal series #80239, image #55, there is a hypoattenuating mass within the spinal canal at the level of the L2 -- L3 disk space concerning for metastasis. It measures 1.6 x 1.6 cm.no additional metastases seen.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Nonspecific hypoattenuating appearance of the low uterine segment/cervix, probably normal for age. See sagittal image 63 and axial series image 191. BLADDER: Distended.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Multifocal ground glass opacities in the lungs currently for infection.Prominent jejunum correlate for any abdominal symptoms and possible adhesions. Questionable transition zone of quadrant.Hyperattenuating mass in the spinal canal of uncertain etiology. Correlate rule out metastases from breast carcinoma.
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Generate impression based on findings.
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50 year old female with head and neck trauma. HEAD: There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is a left maxillary sinus retention cyst. The imaged mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. CERVICAL SPINE: The vertebral column alignment is within normal limits. There is a normal relationship of the dens with the arch of C1. There is no acute fracture or pre-vertebral soft tissue swelling. There is no significant spinal canal stenosis. The visualized lung apices appear normal. Soft tissue detail is limited within the lower neck due to soft tissue shoulder attenuation.
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1.No evidence of intracranial hemorrhage or skull fracture.2.No evidence of cervical spine fracture.
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Generate impression based on findings.
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Pain and swelling. History of trauma to fourth digit.VIEWS: Right hand PA, ring finger oblique/lateral (3 views) 01/24/15 Soft tissue swelling surrounds the middle phalanx of the ring finger. An oblique fracture extends through the lateral condyle in and probably enters the articular surface. Posteriorly the fracture has a buckling component.
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Fracture of middle phalanx of ring finger.
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Generate impression based on findings.
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Intubated. History of epilepsy. Hip surgery.VIEW: Chest AP (one view) 01/25/15, 0401 Endotracheal tube tip is just below thoracic inlet. Right upper extremity PICC tip is in right atrium. A gastrostomy tube is seen. The spica cast extends to the upper abdomen.Cardiothymic silhouette is normal. Opacities continue in both lung bases. Right pleural effusion appears smaller.
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Persistent opacities in the bases.
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Generate impression based on findings.
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Male 91 years old; Reason: 91M h/o CAD, recent influenza, neutropenic p/w weakness, diarrhea, and sepsis. Please r/o PNA, intra-abdominal catastrophe History: see 1 The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:CHEST:LUNGS AND PLEURA: There is a 1.4 x 1.7 cm spiculated opacity in the left upper lobe (series 80236, image 16), worrisome for a primary pulmonary malignancy.There is bibasal dependent atelectasis with possible mild superimposed consolidation in the right ureter.MEDIASTINUM AND HILA: Severe coronary artery calcification. CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Hypoattenuating lesions within the liver the appearance of hepatic cysts. There is trace cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: The pancreas is atrophic.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple hypoattenuating renal lesions, some of which are too small characterize. The larger lesions demonstrate attenuation suggestive of simple cysts. The kidneys are atrophic.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Severe thoracic, abdominal aortic and branch vessel calcific arteriosclerosis. Linear calcification within the distal abdominal aorta and left common iliac artery suggests chronic dissection.PELVIS:PROSTATE, SEMINAL VESICLES: Marked abnormal enlargement of the prostate gland.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Severe colonic diverticular disease without CT evidence of diverticulitis. The proximal ascending colon is poorly opacified with enteric contrast however this may relate to non distention.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
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1.Spiculated left upper lobe pulmonary lesion suspicious for primary pulmonary malignancy.This was conveyed through stat consult by the resident on call to the referring service at time of reporting.
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Generate impression based on findings.
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Cough and shortness of breath. Rule-out pneumonia.VIEW: Chest AP (one view) 01/24/15, 1738 Cardiothymic silhouette is normal. Mild peribronchial thickening is present. Subsegmental atelectasis is seen in the medial lung bases. No air space opacity is identified.
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Bronchiolitis/reactive airways disease pattern.
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Generate impression based on findings.
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9-week-old former 27 to 28 week gestational age patient with respiratory distressVIEW: Chest AP (one view) 01/24/15, 1936 Endotracheal tube tip is below thoracic inlet. Feeding tube tip is distal to GE junction and not included on the image. Left chest tube remains in place.Soft tissue edema continues.Cardiac silhouette size is upper limits of normal. Hazy and coarse opacities are present bilaterally. No pneumothorax is seen. In part, the hazy opacities may be related to layering pleural effusion.
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Continued bilateral opacities.
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Generate impression based on findings.
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70 years, Male. Reason: eval abdominal distension History: abdominal pain Nonobstructive bowel gas pattern. No intramural or free air given that limitation supine view. Osseous and soft tissue structures are unremarkable.
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No evidence of any acute abdominal process.
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Generate impression based on findings.
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50 years, Male. Reason: obstruction? History: see abovr Mildly dilated loops of small bowel centralization consistent ileus and ascites. Small amount of nondilated colonic gas. No obvious intramural or free air. Osseous structures are unremarkable.
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Small bowel ileus. No evidence of obstruction. Ascites.
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Generate impression based on findings.
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78 years, Male. Reason: eval Dobbhoff placement History: do hoff pulled out to 45 Pelvis and portion of the right abdomen excluded from field of view.Dobbhoff tube in distribution of distal esophagus and it should be advanced.Nonobstructive bowel gas pattern.
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Dobbhoff tube in distribution of the distal esophagus - should be advanced.
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