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Generate impression based on findings.
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Reason: eval for meningitis History: neck stiffness The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses demonstrate opacification of the left maxillary sinus which is incompletely evaluated on this exam. The visualized opacification appears to be hyperdense. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1.No evidence for acute intracranial hemorrhage mass effect or edema.2.MRI is more sensitive in detecting intracranial involvement from meningitis than non-contrast CT.3.Hyperdense opacification of the left maxillary sinus. This could relate to inspissated secretions, however, fungal sinusitis can not be excluded. The paranasal sinuses are incompletely evaluated. Please correlate with clinical symptoms.
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Generate impression based on findings.
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CoughVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Peribronchial wall thickening with patchy atelectasis right lower lobe. No pleural effusion or pneumothorax. G-tube in place.
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Bronchiolitis or reactive airway disease.
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Generate impression based on findings.
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Male 69 years old; Reason: Evaluate for pneumonia and/or retroperitoneal bleed History: Hb drop 2g in 24 hrs with IABP in place; LLL opacification on CXR; fever to 38.6 + cough CHEST:LUNGS AND PLEURA: Scattered calcified micronodules, likely reflecting sequela from prior granulomatous disease.MEDIASTINUM AND HILA: Calcified mediastinal and hilar lymph nodes, largest paraesophageal lymph node measuring up to 1.4 cm, likely reflecting sequela of prior granulomatous disease. Small noncalcified mediastinal lymph nodes also seen, including pretracheal lymph node measuring up to 1.1 cm in maximum short axis dimension, evaluation for hilar adenopathy suboptimal without IV contrast. Severe calcified coronary artery disease, mild cardiomegaly. Mild nonspecific circumferential distal esophageal wall thickening, image 77 series 4.CHEST WALL: Right-sided subpectoral fluid collection seen, relatively simple in attenuation with adjacent postprocedural sequela, may reflect evolving or maturing hematoma, measures approximately 3.7 x 2.7 cm on image 14 series 4. ABDOMEN:LIVER, BILIARY TRACT: Scattered hepatic and splenic calcified granulomata.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: Aortobiiliac atherosclerotic disease. Intra-aortic balloon pump, extending from approximately T7 level (located 5 mm below aortic knob) into distal abdominal aorta/proximal to bifurcation (at approximately L3 level). BOWEL, MESENTERY: Moderate to marked circumferential ascending colonic wall thickening with surrounding mild stranding (involved segment measures approximately 10 cm in length), no evidence of pneumatosis. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative disease of spine.
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1. Findings compatible with acute colitis affecting ascending colon, may be of infectious/inflammatory or ischemic etiology and correlation with patient's clinical history/laboratory values recommended.2. Right chest wall/subpectoral postprocedural hematoma. 3. Relatively distal location of intra-aortic balloon pump as described above.4. Mild nonspecific circumferential distal esophageal wall thickening, may be due in part to underdistention but correlation with patient's clinical history recommended.
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Generate impression based on findings.
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Little toe swelling. Evaluate for osteomyelitis.VIEWS: Left foot AP/lateral/oblique (3 views) 01/25/15 Soft tissue swelling surrounds the little toe. No bone destruction is seen.Periosteal reaction is noted along the medial aspect of the distal tibia. This is most likely physiologic in nature.
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Soft tissue swelling of the little toe with no bone destruction.
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Generate impression based on findings.
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Male 78 years old; Reason: r/o PE History: chest pain, prior h/o DVT (no longer on coumadin) The comparison chest radiograph performed on 1/23/2015 demonstrates no focal pulmonary opacities or pleural fluid. Focal nodular opacity in the left lower lobe as described in the chest x-ray report. Please refer to final Chest X-ray and CT report for additional findings.The ventilation images show a uniform distribution of activity on single-breath and wash-in images. There is persistent Xe-133 retention during the wash-out phase in the bilateral lung bases, left greater than the right, less prominent compared to prior study.The perfusion images show a physiologic distribution of pulmonary perfusion. There is mottled appearance of the bilateral lung bases which correlates with the areas of retention noted on the ventilation images. This correlates with a low probability scan.
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No specific scintigraphic findings to suggest pulmonary embolism.
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Generate impression based on findings.
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Altered mental statusVIEW: Chest AP 1/26/15 Cardiothymic silhouette normal. Patchy atelectasis right lower lobe. No pleural effusion or pneumothorax. The stomach is distended.
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Minimal patchy atelectasis right lower lobe without evidence of pneumonia.
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Generate impression based on findings.
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71-year-old female with left-sided weakness and altered mental status, history of previous stroke. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. There is encephalomalacia in the left basal ganglia and mild ex vacuo dilatation of the anterior horn of the left lateral ventricle, consistent with prior left lacunar infarct, which is more prominent than on previous exam. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminant small vessel ischemic changes. The ventricles and sulci are within normal limits for age. No extra-axial collections are identified. The paranasal sinuses and mastoid air cells are clear. The calvarium is intact.
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No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.
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Generate impression based on findings.
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Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Scattered micronodules unchanged. No new suspicious nodules or masses. Paramediastinal groundglass opacity consistent with prior radiation therapy. No pleural effusions. MEDIASTINUM AND HILA: Small hilar lymph nodes appear unchanged. No new adenopathy. Mild esophageal thickening unchanged. CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Unchanged renal cysts and other hypoattenuating foci too small to characterize. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Stable pulmonary micronodules. No specific evidence of metastatic disease.
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Generate impression based on findings.
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Possible fracture. Left humerus fracture.VIEWS: Left tibia fibula AP/lateral (two views) 01/25/15 Minimal cortical thickening is noted at the lateral aspect of the proximal mid tibia. This is associated with an ill-defined transverse band of sclerosis.
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Equivocal examination for fracture.
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Generate impression based on findings.
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No evidence of acute intracranial hemorrhage. No midline shift or herniation. Periventricular and subcortical white matter hypoattenuation which is nonspecific but compatible with age-indeterminate small vessel ischemic changes. The ventricles and sulci are normal in size. Prominent CSF attenuation spaces are noted in the inferior anterior temporal regions, left side more than right, which causes mild mass effect on the inferior aspect of the temporal lobes. The visualized portions of the paranasal sinuses and mastoid air cells are clear. No calvarial fractures.
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1.No definite acute abnormalities.2.Age indeterminate small vessel ischemic disease. 3.Bilateral prominence of the CSF spaces of the inferior middle cranial fossae, likely arachnoid cysts, left larger than right.
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Generate impression based on findings.
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NG tube placementVIEW: Chest AP and abdomen AP 1/25/15 Nasogastric tube tip in the stomach. Cardiothymic silhouette normal. Minimal atelectasis right upper lobe. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum.
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Nasogastric tube tip in the stomach.
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Generate impression based on findings.
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Headache, history of pseudotumor No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Again seen is global parenchymal volume loss, which is advanced for age, and not significantly changed since 12/8/2013. Multiple areas of hypoattenuation are seen in the periventricular and subcortical white matter, which are also not significantly changed in the interval. Gray-white differentiation is maintained. No extra-axial collections. No hydrocephalus. Empty sella is noted which is nonspecific but can be seen with pseudotumor. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact.
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1. No evidence of acute intracranial hemorrhage or mass effect. 2. Unchanged empty sella which is a normal variant but can be seen with pseudotumor. 3. Chronic white matter disease likely related to combination of multiple sclerosis and small vessel ischemic disease.
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Generate impression based on findings.
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Right-sided abdominal pain, evaluate for pyelonephritis, appendicitis, or hepatobiliary disease ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Mild hepatomegaly. Nonspecific hypervascular lesion in the right hepatic lobe (series 3, image 30). No biliary ductal dilation. The hepatic vasculature is patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: The kidneys enhance symmetrically without evidence of mass lesion or hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of bowel obstruction or acute appendicitis. PELVIS:UTERUS, ADNEXA: Intrauterine device noted. Low-attenuation adnexal foci likely physiologic. BLADDER: Distended bladder.BOWEL, MESENTERY: Small amount of free fluid in the pelvis, likely physiologic.BONES, SOFT TISSUES: No significant abnormality noted.
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1.No acute abnormality in the abdomen or pelvis.2.Mild hepatomegaly.3.Indeterminate hypervascular lesion in the right hepatic lobe; consider MRI as clinically warranted.
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Generate impression based on findings.
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Abdominal distentionVIEW: Abdomen AP 1/26/15 NG tube tip in the stomach. Gastrostomy tube in place. There is a left femoral line in place. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. Minimal atelectasis left lower lobe. There is lateral uncovering of both femoral heads right greater than left.
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Mild bowel dilation at the right lower quadrant without obstruction.I 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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53-year-old male with fever Multiple dental fillings are noted, but there is no bone destruction to indicate osteomyelitis or abscess. There are scattered lucencies within the teeth which may represent cavities. The maxillary sinuses are clear.
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No evidence of osteomyelitis or abscess.
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Generate impression based on findings.
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Male 30 years old Reason: RUQ US evaluate for stones, pancreatitis History: pancreatitis LIVER: The liver measures 17.0 cm in length. There is no focal liver lesion. The portal vein is patent and demonstrates normal directional flow.GALLBLADDER, BILIARY TRACT: There is no evidence of gallstones, gallbladder wall thickening or pericholecystic fluid. There is no biliary dilatation.PANCREAS: The pancreas is poorly visualized but appears mildly edematous where seen. This is better evaluated on recent CT exam.KIDNEYS: The right kidney measures 11.4 cm. The left kidney measures 11.2 cm. There is no hydronephrosis or shadowing renal stones.OTHER: The spleen measures 11.4 cm in length.
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No evidence of cholelithiasis or acute cholecystitis.
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Generate impression based on findings.
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Reason: evaluate for post-op changes, eval for ischemia and bleeding History: dysarthria, waxing and waning exam, left hemiparesis The patient is status post right craniotomy for EC-IC bypass. There is extra-axial air present intracranially. There is adjacent right scalp soft tissue swelling.There is some mild hypodensity involving the right angular gyrus which is stable since the prior exam.The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present. Punctate hypodensities are present in the basal ganglia, left centrum semiovale and brainstem.Atherosclerotic calcifications are present along the distal internal carotid arteries.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses demonstrate mucosal thickening in the right maxillary sinus as well as thickening of the walls of the right maxillary sinus.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
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1.Status post recent right craniotomy with continued evolution of postoperative changes. 2.There is any hypodensity in the right angular gyrus which could represent some ischemic injury.3.Punctate lesions in the basal ganglia, brainstem and the left centrum semiovale are suspected to represent lacunar infarcts of indeterminate age.4.CT is insensitive for early detection of nonhemorrhagic CVA.5.Periventricular and subcortical white matter changes of a mild degree are nonspecific.
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Generate impression based on findings.
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There are diffuse scattered peripheral subcentimeter enhancing foci throughout the cerebellum and cerebrum suspicious for metastatic foci. There is diffuse leptomeningeal enhancement which is most prominent in the posterior fossa and extends into arachnoid granulations in the right occipital calvarium. There is leptomeningeal enhancement along the folia also extending into the left internal auditory canal and along the right trigeminal nerve. There is a minimal associated cortical T2 hyperintensity. No associated diffusion restriction or susceptibility.The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. T2 hyperintensity within the pons is likely related to chronic ischemia. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Left lens is thin, likely related to cataracts.
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1.Numerous subcentimeter parenchymal enhancing lesions likely represent metastatic foci2.Leptomeningeal carcinomatosis with extension into the left internal auditory canal and along the right trigeminal nerve.3.T2 hyperintensity within pons may be secondary to chronic ischemic changes.
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Generate impression based on findings.
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Tachypnea evaluate pneumothoraxVIEW: Chest AP 1/26/15 Cardiothymic silhouette normal. Right chest tube in place. There is a small right apical pneumothorax not significantly changed. Patchy atelectasis in the right lower lobe and left lower lobe not significantly changed.
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Right apical pneumothorax not significantly changed.
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Generate impression based on findings.
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Reason: recurrent NSCLC? History: shortness of breath. LUNGS AND PLEURA: Right mediastinal and suprahilar mass measures 49 x 39 mm on image 26/85, stable to marginally increased.New moderate bilateral pleural effusions with compressive atelectasis.New patchy air space and groundglass opacity in the left upper lobe which may be due to aspirate or infection. Is not typical metastatic disease though continued follow up is recommended.MEDIASTINUM AND HILA: Borderline enlargement of a right paratracheal lymph node measuring 13 mm on image 29/85. Probable borderline enlargement of a subcarinal lymph node (image 33/85) though this is difficult to separate from trunk structures. Severe coronary artery calcification.CHEST WALL: Degenerative disease in the spine.Stable sclerosis and loss of height at the superior margin of the T3 vertebra is compatible with a partial compression fracture.Nonspecific nodular opacities in the left breast, without significant change.Contrast extravasation in soft tissues of right upper arm .UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Stable to marginally increased lung/mediastinal mass.2. New bilateral pleural effusions.3. New/increased mediastinal nodes which are nonspecific though continued follow up is recommended.4. New patchy air space and groundglass opacity in the left upper lobe which may be due to aspirate or infection. Is not typical metastatic disease though continued follow up is recommended.Contrast extravasation description:Supervising radiologist: Dr. Westin.Minor or major extravasation: MinorContrast type:90 cc of Contrast Type were administered. Comment on saline chaser if appropriateAmount extravasated: 90 ccLocation of extravasation: Right upper armSigns and symptoms: slight painTreatment given: cold compress, elevationDischarge instructions given: Yes
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Generate impression based on findings.
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31-year-old female with kidney disease, SLE, diffuse arthralgias, rule out effusions Right wrist: Alignment is anatomic. There are no erosions or other evidence of inflammatory osteoarthritis.Left wrist: Alignment is within normal limits.. There are no erosions or other evidence of inflammatory osteoarthritis.Right knee: Alignment is anatomic. No fracture is noted. No joint effusion. Left knee: Alignment is anatomic. No fracture is noted. No joint effusion. Right shoulder: Glenohumeral alignment is within normal limits. There are no significant degenerative changes or erosions.Left shoulder: Glenohumeral alignment is within normal limits. There are no significant degenerative changes or erosions.
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No evidence of inflammatory arthritis or other specific findings to account for the patient's symptoms.
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Generate impression based on findings.
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Evaluate pneumothoraxVIEW: Chest AP 1/26/15 Cardiothymic silhouette normal. The small left pneumothorax has decreased in size in the interval. Patchy atelectasis left lower lobe.
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Interval decrease in size of the small left pneumothorax.
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Generate impression based on findings.
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86-year-old female with right hand swelling and pain Interval development of multiple erosions within the metacarpal heads, first metacarpal base as well as fusion of the carpus/triscaphe joint as well as marked radioscaphoid joint space narrowing. Severe joint osteoarthritis affects the basilar joint and scattered interphalangeal joints. Subchondral cysts are noted within the distal radius and carpus.
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Interval development of erosions, severe radioscaphoid joint space narrowing and carpal fusion as described above, likely representing an underlying inflammatory arthritis. Severe osteoarthritis is also present.
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Generate impression based on findings.
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Reason: History of metastatic breast cancer on treatment. Compare to prior imaging, evaluate for response and extent of disease. History: History of metastatic breast cancer on treatment. Compare to prior imaging, evaluate for response and extent of disease. CHEST:LUNGS AND PLEURA: Bilateral confluent pulmonary metastases with areas of post-obstructive consolidation are not significantly changed in size compared with recent prior studies. No pleural effusions. MEDIASTINUM AND HILA: Pericardial thickening/small effusion unchanged. No visible coronary calcification. Hilar lymphadenopathy unchanged. CHEST WALL: Reference left axillary lymph node measuring 16 mm unchanged (series 3 image 16). Peripherally enhancing left breast mass measuring 20 x 20 mm also stable (image 36), as are left breast skin thickening and additional small enhancing foci. Extensive osseous metastases and spinal fixation hardware is similar to previous. ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Extensive osseous metastases and spinal fixation hardware is similar to previous. The right L3 pedicle screw terminates in the soft tissues.OTHER: No significant abnormality noted.
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Stable disease with reference measurements provided.
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Generate impression based on findings.
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Hypotension, 87 year old female with R hip surgery yesterday and acute Hg drop ABDOMEN:LUNG BASES: Small bilateral pleural effusions. Hiatal hernia.LIVER, BILIARY TRACT: Cholelithiasis without cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Age related bilateral cortical atrophy.RETROPERITONEUM, LYMPH NODES: Findings consistent with small right retroperitoneal hematoma. Moderate calcifications of the aorta with severe ostial calcification of the superior mesenteric artery and the right renal artery.BOWEL, MESENTERY: No evidence of bowel obstruction.BONES, SOFT TISSUES: Osteopenia. Grade 1 anterolisthesis of L4 on L5.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: Collapsed with Foley catheter.BOWEL, MESENTERY: Small amount of non-loculated complex fluid in the pelvis.BONES, SOFT TISSUES: There is a comminuted minimally displaced fracture anterior right acetabulum with an adjacent obturator internus hematoma measuring 7.4 x 4.3 cm. There are additional fractures of the superior and inferior pubic rami. A nondisplaced fracture is present along the anterior high right sacrum. Mild asymmetric enlargement of the right obturator externus and pectineus muscles may reflect additional sites of hematoma.
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1. Fractures of the aright acetabulum, superior/inferior pubic rami and right sacrum. 2. Right pelvic and retroperitoneal hematomas.
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Generate impression based on findings.
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Reason: status SDHs History: status SDHs There is redemonstration of a left sided extra-axial collection measuring 15 mm in width which is unchanged since the prior exam. There is approximately 2 mm shift of the septum pellucidum towards the right which is stable.Periventricular and subcortical white matter hypodensities of a moderate degree are present.Hypodense foci are redemonstrated in the basal ganglia bilaterally and do represent perivascular spaces.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.The visualized portions of the paranasal sinuses demonstrate partial opacification of the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The left eyeball lens is thin. There are scleral calcifications present adjacent to the insertion sites of the ciliary bodies most likely representing scleral plaque.
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1.Stable left-sided subdural hematoma associated with mild midline shift.
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Generate impression based on findings.
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FractureVIEWS: Right thumb AP and lateral Healing fracture involving the base of the proximal phalanx of the right thumb again noted. There is periosteal reaction reflecting interval healing. The alignment is anatomic.
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Healing fracture of the right thumb.
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Generate impression based on findings.
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15-year-old male with peritoneal symptoms and jaundice, rule out hepatic process. Within the limits of a non IV contrast enhanced examination which limits ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN: LUNG BASES: Streaky left basilar atelectasis is present.LIVER, BILIARY TRACT: No evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma seen.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydronephrosis or hydroureter is seen. Evaluation of the parenchyma is limited by lack of intravenous contrast administration.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: A moderate stool burden is distributed throughout the rectosigmoid colon. No evidence of bowel obstruction is present.BONES, SOFT TISSUES: A fluid collection is seen extending from the inferior pelvis along the left obturator muscle into the medial compartment of the thigh, which measures 3.7 x 6.1 x 6.0 cm, and is worrisome for an abscess. Infiltration of the left gluteal fat planes and overlying skin thickening consistent with cellulitis. A bullet is seen lodged in the intravertebral disc space of the vertebral bodies of T12/L1, and there is severe levoscoliosis of the thoracolumbar spine and diffuse muscular atrophy consistent with paraplegia.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Mild/moderate diffuse bladder wall thickening may reflect cystitis, although is nonspecific. A urinary catheter is in place. Focus of nondependent gas within the bladder lumen is presumably related to Foley catheter placement.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: A moderate stool burden is distributed throughout the rectosigmoid colon. No evidence of bowel obstruction is present.BONES, SOFT TISSUES: A fluid collection is seen extending from the inferior pelvis along the left obturator muscle into the medial compartment of the thigh, which measures 3.7 x 6.1 x 6.0 cm, and is worrisome for an abscess. Infiltration of the left gluteal fat planes and overlying skin thickening consistent with cellulitis. A bullet is seen lodged in the intravertebral disc space of the vertebral bodies of T12/L1, and there is severe levoscoliosis of the thoracolumbar spine and diffuse muscular atrophy consistent with paraplegia.OTHER: No significant abnormality noted
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1.No hepatic or renal pathology evident, although the examination is limited given the lack of intravenous contrast.2.Fluid collection extending from the inferior left pelvis into the medial compartment of the left thigh worrisome for an abscess.3.Cellulitis overlying the inferior pubic ramus. While there is no evidence of underlying osteomyelitis, further evaluation with MRI can be considered as clinically indicated.4.Mild/moderate diffuse lateral wall thickening, which may reflect cystitis.
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Generate impression based on findings.
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5 month old ex-35 week premie female with suspected NAT and ALTE at 2 months of age required CPR. There is no evidence of acute intracranial hemorrhage. There are bilateral symmetric regions of encephalomalacia within the bilateral frontal lobes as well as within the parietotemporal regions in a watershed distribution. There is no hydrocephalus, midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. A horizontal linear lucency through the occipital bone is compatible with accessary ossicle. The skull and extracranial soft tissues are unremarkable.
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1.Bilateral multifocal areas of encephalomalacia in a watershed distribution likely related to prior hypoxic ischemic injury.2.No evidence of acute intracranial hemorrhage or skull fracture. 3.Horizontal linear lucency in the occipital bone favored to be related developmental variant and less like remote fracture. Comparison with prior CT or radiograph can be obtained if available.
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Generate impression based on findings.
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Leukemia and bone marrow transplant. Cough and fever.VIEWS: Chest AP/lateral (two views) 01/26/15, 0156 and 0158 A patchy opacity is present in the medial aspect of the left lower lobe.Cardiothymic silhouette is normal.Right atrial line remains in place with unchanged configuration/curving of the tip. This suggests that the line is not free in the right atrium.
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Left lower lobe opacity most likely pneumonia.
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Generate impression based on findings.
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CoughVIEW: Chest AP 1/25/15 Cardiothymic silhouette normal. Right lower lobe opacity not significantly changed. Minimal atelectasis left lower lobe. Probable small right pleural effusion.
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Right lower lobe opacity likely pneumonia not significantly changed.
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Generate impression based on findings.
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Fatigue and weakness, Stage IIIC ovarian cancer, s/p TAH/BSO and 9 cycles chemotherapy. CHEST:LUNGS AND PLEURA: 3-mm nodule at the right lung apex (series 6, image 25), unchanged. No new suspicious nodule.MEDIASTINUM AND HILA: Unchanged subcentimeter left-sided calcified and non-calcified thyroid nodules. No mediastinal or hilar lymphadenopathy. Heart size is normal. No pericardial effusion.CHEST WALL: Right chest wall Port-A-Cath tip at the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Low-attenuation lesions in the left hepatic lobe measuring up to 0.8 x 0.6 cm (series 4, image 105), unchanged. Mild intrahepatic biliary ductal dilation status post cholecystectomy. The hepatic vasculature is patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral extrarenal pelvis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Decreased thickening of the gastric antrum compared to prior. No evidence of bowel obstruction. No free intraperitoneal fluid.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small fluid collection adjacent to rectosigmoid suture line; unchanged and likely a postoperative seroma.BONES, SOFT TISSUES: No significant abnormality noted.
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Stable examination as described. No new sites of neoplastic disease.
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Generate impression based on findings.
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Redemonstration of multiple supratentorial and infratentorial foci of enhancement, many of which have enlarged in the interim, most notably in the left basal ganglia, the left thalamus, and the inferior right cerebellar hemisphere. There are also numerous new foci of enhancement, including a large lesion in the medulla/upper spinal cord. The previously referenced left thalamic lesion has enlarged, currently measuring 10 mm, previously 7 mm. There has been interval development of associated FLAIR hyperintensity corresponding to multiple enhancing lesions, most pronounced in the bilateral basal ganglia, left precentral gyrus, the right occipital lobe, and the superior temporal gyrus. There is thickening and possible mild enhancement within the right internal auditory canal, as well as subtle linear/nodular enhancement of the cisternal and canalicular left VII/VIII cranial nerve complex. There is questionable asymmetric thickening of the cisternal right VI cranial nerve.Mild nonspecific periventricular and subcortical white matter high T2 signal is unchanged and is likely posttreatment related. Punctate susceptibility artifact is noted in the right cingulate gyrus. There is no significant mass effect or significant intracranial hemorrhage. The ventricles and sulci are stable. The cisterns remain patent. There is no midline shift. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. Redemonstration of fluid signal within the left mastoid air cells with corresponding mild intrinsic T1 hyperintensity suggesting proteinaceous material. Right maxillary sinus mucosal retention cyst is unchanged.
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1. Findings are consistent with progression of metastatic disease, including: interval enlargement of several supratentorial and infratentorial metastases, as well as numerous new enhancing lesions are identified. Notably, a large lesion is present in the medulla. 2. There has been development of mild T2 hyperintensity corresponding to multiple metastatic foci. 3. Given the suggestion of abnormal thickening/enhancement of several cranial nerves, the possibility exists that some component of the patient's intracranial disease may be leptomeningeal.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast cancer in paternal great-grandmother diagnosed at age 60. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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TachypneaVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and aortic arch left-sided. Minimal peribronchial wall thickening with subsegmental atelectasis left lower lobe. No pleural effusion or pneumothorax.
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Bronchiolitis or reactive airway disease.
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Generate impression based on findings.
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Cough. Leukemia and bone marrow transplant.VIEW: Chest AP (one view) 01/25/15, 1749 Right Port-A-Cath is again seen with tip in right atrium. The configuration of the tip is unchanged in the interval and has not changed in comparison with PET CT from 09/10/14. This suggests that the catheter is not free in the right atrium.Cardiothymic silhouette is normal in size. Subsegmental atelectasis is present in left lower lobe.
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Right atrial line may not be floating freely in right atrium.Subsegmental atelectasis left lower lobe.
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Generate impression based on findings.
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ConstipationVIEW: Abdomen AP 1/25/15 Moderate amount of fecal burden. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum.
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Moderate amount of fecal burden.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast cancer in mother. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable benign intramammary lymph nodes are present bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Reason: follow up chronic eosinophilic pneumonia. History: wheezing, shortness of breath LUNGS AND PLEURA: Left lower lobe now better aerated with resolution of the more dense airspace opacity. Residual coarse septal thickening which may represent atelectasis or scarring is seen.No change in other patchy areas of coarse septal thickening with peribronchial ground glass opacity, worst in the right upper lobe. Nonspecific bronchial wall thickening. No new areas of opacity. Calcified granulomas on the right.MEDIASTINUM AND HILA: Calcification involving the left anterior descending coronary artery again noted.CHEST WALL: Small cyst in right breast unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Calcified splenic granulomas. Small calcification near the splenic hilum likely a calcified subcentimeter splenic artery aneurysm. Punctate calcified hepatic granuloma.
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Left lower lobe now better aerated with resolution of the more dense air space opacity. Residual coarse septal thickening is seen. No change in other patchy areas of coarse septal thickening with peribronchial ground glass opacity, worst in the right upper lobe.
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Generate impression based on findings.
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Abdominal painVIEW: Abdomen AP 1/26/15 There is a metallic bullet fragment projected at T12. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. No abnormal bowel dilation. The bladder is distended. There is scoliosis and hip joint space narrowing bilaterally.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Reason: evaluate for malignancy History: bulky cervical adenopathy LUNGS AND PLEURA: 7 mm nodule in the left lower lobe (series 5 image 52), slightly increased in size from 2011 when it measured 5 mm. Mosaic attenuation pattern secondary to pulmonary arterial hypertension. Interval clearing of right upper lobe consolidation since 2011. No pleural effusions. MEDIASTINUM AND HILA: Enlarged mediastinal lymph nodes. Reference left paratracheal node measures 19 x 13 mm (series 4 image 13). Enlarged main pulmonary artery measures 4.5 cm suggests pulmonary arterial hypertension. Right ventricular enlargement likely secondary to pulmonary arterial hypertension. No visible coronary artery calcifications or pericardial effusion. CHEST WALL: Enlarged axillary lymph nodes, with the largest left axillary node measuring 2.1 x 1.6 cm (series 4 image 16), not included in the field of view on prior studies. Please see separately dictated neck CT for discussion of cervical lymph nodes. Multilevel thoracic spine degenerative changes. UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. New ascites and subcutaneous body wall edema.
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1. Enlarged nonspecific mediastinal and axillary lymph nodes. Please see separately dictated neck CT for discussion of cervical lymph nodes. 2. 7 mm left pulmonary nodule is slightly increased in size since 2011. Given this increase in size, a 6 month follow up examination is recommended to confirm stability. 3. New abdominal ascites partially imaged, which may be secondary to increased right sided pressures in the setting of pulmonary hypertension. 4. Marked pulmonary artery enlargement with mosaic attenuation pattern and right ventricular enlargement consistent with pulmonary arterial hypertension.
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Generate impression based on findings.
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Sepsis.VIEW: Chest AP (one view) 01/26/15, 0149 Projectile fragment is lodged at the T12 -- L1 disk space level. A right cervical rib is noted.Cardiothymic silhouette is normal. No focal lung opacity is present. Mild peribronchial thickening is identified.
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No pneumonia.
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Generate impression based on findings.
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Male 68 years old; Reason: restaging kidney cancer History: restaging kidney cancer, on bevacizumab CHEST:LUNGS AND PLEURA: Previously described pulmonary nodules have regressed and the reference nodule in the right lung has resolved completely. No consolidation or pleural effusion is seen.MEDIASTINUM AND HILA: Superior mediastinal lymphadenopathy has regressed. The reference prevascular lymph node measures 0.8 x 0.8 cm (image 20; series 10). Previously referenced left para-aortic lymph node has decreased in size now measuring 1.8 x 1.8 cm (image 64; series 10). Calcified subcarinal and right hilar lymph nodes are again seen. The heart is normal in size and a trace pericardial effusion is again noted. No coronary artery calcifications are present.CHEST WALL: Soft tissue metastasis adjacent to the right scapula now measures 2.5 x 1.6 cm (image 32; series 10), unchanged. However multiple additional intramuscular and subcutaneous enhancing nodules have decreased in size (for example, 3 subcentimeter lesions on image 59; series 10 are all smaller). Lytic lesion in the T7 vertebral body is stable. ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodense foci in the liver unchanged and remain too small to characterize. No new suspicious liver lesion is seen.SPLEEN: Calcified splenic granulomas are seen. 1 cm calcified splenic artery aneurysm is unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left upper pole renal mass extends towards the renal hilum and measures 7.5 x 6.6 cm (image 110; series 10) not significantly changed from the prior study with comparable measurements.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Colonic diverticulosis is present without complication.BONES, SOFT TISSUES: Multiple enhancing nodules in the paraspinal musculature and subcutaneous fat appear roughly stable (for example image 163 series 10 -- gluteal musculature). Multiple peritoneal nodules regressed slightly.Degenerative changes are seen throughout the spine with grade 1 anterolisthesis of L5 on S1 as noted previously.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colonic diverticulosis is present without complication.BONES, SOFT TISSUES: Multiple peritoneal, intramuscular, and subcutaneous metastases are roughly stable.
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Overall slight interval regression of disease with reference measurements given above.
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Generate impression based on findings.
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Mandible distraction.VIEWS: Mandible AP/left lateral/right lateral (3 views) 01/26/15 A staple, to use as a marker, was placed over the left mandibular distractor.The distractors are intact. Distraction at the osteotomy sites has increased. On the right, the distance between the plates is approximately 6 mm and on the left it is approximately 7 mm.Nasotracheal and nasoenteric tubes are present.
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Increase in distraction at mandibular osteotomy sites.
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Generate impression based on findings.
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Reason: Patient with h/o nsclc, f/u ct History: f/u ct CHEST:LUNGS AND PLEURA: Postsurgical changes at the right apex including paramediastinal atelectasis, traction bronchiectasis.Multiple scattered bilateral pulmonary nodules measuring up to 4 mm are stable. The reference nodule in the right lower lobe measures 4 mm (image 91/127) unchanged from the previous exam. No new pulmonary nodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Postop change.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Calcified granuloma.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Circumaortic left renal vein, normal anatomic variant.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Duodenal diverticulum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Continued stability of nonspecific pulmonary nodules measuring up to 4 mm, favoring a benign etiology. No definitive evidence of residual or recurrent disease.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. New loosely grouped calcifications are present in the left upper outer quadrant.No suspicious masses or areas of architectural distortion are present.
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New left breast calcifications. Magnification imaging is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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EmesisVIEW: Abdomen AP 1/25/15 Gastrostomy tube in place. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. There is lateral dislocation of the right hip. There is minimal uncovering of the left femoral head. The acetabula are dysplastic.
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Nonobstructive bowel gas pattern.
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Generate impression based on findings.
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Female 61 years old Reason: HCC screening History: HBV LIVER: The liver measures 19.0 cm in length. The parenchyma is coarsely echogenic consistent with chronic liver disease. No focal mass is identified. The portal vein is patent and demonstrates normal directional flow with peak velocity of 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Multiple gallstones are present within the gallbladder. There is no gallbladder wall thickening or pericholecystic fluid. There is no biliary dilatation.PANCREAS: The pancreatic head is unremarkable. The pancreatic body and tail are largely obscured by bowel gas.KIDNEYS: The left kidney measures 11.5 cm. The right kidney measures 10.7 cm. There is no hydronephrosis.OTHER: The spleen measures 7.6 cm in length.
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1. Coarsely echogenic hepatic parenchyma consistent with chronic liver disease. No focal hepatic mass.2. Cholelithiasis.
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Generate impression based on findings.
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Reason: 66yo M with h/o EtOH pancreatitis with new pulmonary nodules on CXR and extensive smoking/family history concerning for lung cancer. History: chest/abd pain, new pulmonary nodules LUNGS AND PLEURA: No significant pulmonary nodules. The abnormality on the chest radiograph likely represented areas of subsegmental linear atelectasis or aspirate at the right lung base. Mild emphysema. Minimal linear atelectasis or scarring in the left lower lobe.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Healed rib fractures on the left.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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No significant pulmonary nodules. The abnormality on the chest radiograph likely represented areas of subsegmental linear atelectasis or aspirate at the right lung base as well as nipple shadows creating a nodular artifact. Mild emphysema.
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Generate impression based on findings.
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IntubatedVIEW: Chest AP 1/25/15 ET tube tip immediately above the carina. There is a vagal stimulator device at the left supraclavicular region. Cardiothymic silhouette normal. Patchy atelectasis right lower lobe and left lower lobe. No pleural effusion or pneumothorax.
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Minimal patchy atelectasis bilaterally.
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Generate impression based on findings.
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82-year-old with history of left breast cancer status post lumpectomy and sentinel lymph node biopsy with reexcision in 2011. No current complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Stable postsurgical distortion and density in the left breast with multiple surgical clips in the left breast. Multiple clips are also again noted in the left axilla. Bilateral benign calcifications do not appear significantly changed. Left breast skin thickening and retraction are likely secondary to radiation therapy and do not appear changed.Benign appearing lymph nodes are projected over the right axilla.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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central adrenal insufficiency intubatedVIEW: Chest AP 1/26/15 ET tube tip immediately above the carina. There is a vagal stimulator device at the left supraclavicular region. Cardiothymic silhouette normal. The left lower lobe atelectasis has increased in the interval. No pleural effusion or pneumothorax. G-tube in place.
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Left lower lobe atelectasis has increased in the interval.
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Generate impression based on findings.
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Reason: h/o HNC/CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Mild left apical groundglass opacity and right basilar scarring/atelectasis unchanged. No new suspicious nodules or masses. No pleural effusions. MEDIASTINUM AND HILA: Small mediastinal lymph nodes unchanged. No adenopathy. Mild ectasia of the ascending aorta and circumferential narrowing of the proximal left common carotid artery unchanged. Mild coronary calcification. CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Nonspecific gastrohepatic and mesenteric lymph nodes with small calcifications are unchanged.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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No significant interval change or evidence of metastatic disease.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast cancer in mother diagnosed at age 50. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Male 59 years old; Reason: restaging CT 59M with colonCa CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Stable aneurysmal dilatation of ascending aorta, measuring 4.1 cm. Stable 2 x 1.5 cm prevascular soft tissue hypoattenuation, image 57 series 3, may reflect residual thymic tissue but underlying adenopathy a consideration and continued follow-up recommended. Additional subcentimeter mediastinal and hilar lymph nodes present.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: Unchanged subcentimeter hypoattenuating renal lesions, too small to characterize but most likely cysts. Mild asymmetric prominence of left intrarenal collecting system with 4 mm proximal ureteral stone, image 134 series 3. Symmetric nephrograms, no perinephric stranding or fluid.RETROPERITONEUM, LYMPH NODES: Interval decrease in size of reference portacaval lymph node, measuring 2.5 x 0.8 cm, image 119 series 3, previously measured 3 x 1.1 cm. Additional subcentimeter retroperitoneal/left paraaortic lymph nodes present. Incidentally seen retroaortic left renal vein.BOWEL, MESENTERY: Pelvic postsurgical changes seen, stable in appearance to prior study, including presacral edema/soft tissue attenuation and mild preanastomotic colon prominence seen, small anorectal fluid and circumferential wall prominence seen distally. Additional sites of postsurgical change seen, e.g., in left upper quadrant and lower abdomen. PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged calcification-containing prostate gland, measuring 5.3 cm in transverse dimension.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes of spine. Ventral abdominal subcutaneous scarring noted.
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1. Stable to interval decrease in size of reference lymph nodes. 2. Stable postsurgical changes in pelvis as above.3. Mild asymmetric prominence of left intrarenal collecting system with 4 mm proximal ureteral stone, correlation with patient's clinical history/symptoms and urinalysis recommended to exclude symptomatic obstructing stone.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Punctate hyperdense material seen only on the left MLO view superiorly, is present on the first tomosynthesis image compatible with dermal calcifications or artifact. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Left breast skin calcifications or artifact. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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NG tube placementVIEW: Abdomen AP 1/25/15 NG tube tip in the stomach. Gastrostomy tube in place. There is a left femoral line in place. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. Minimal atelectasis left lower lobe.
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NG tube tip in the stomach.
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Generate impression based on findings.
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Reason: assess vents History: post sah Compared to the prior exam the width of the third ventricle has decreased from 10 mm to 7mm. on coronal imaging the biventricular diameter at the level of foramen of Monro measures 35 mm and previously was the same. The temporal horns of the lateral ventricles are slightly less dilated compared to the prior exam.The patient is status post embolic coil occlusion of a basilar tip aneurysm.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Right sided periventricular hypodensity associated with volume loss in the right inferior parietal lobule remains stable since 1/15/15.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 evidence for acute intracranial hemorrhage mass effect or edema.2.Since the prior exam there is had been subtle decrease in the mild ventriculomegaly.
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Generate impression based on findings.
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Reason: Right single lung transplant 12/08 now with rejection History: sob LUNGS AND PLEURA: Postop change from right lung transplant. Emphysema in native left lung with scattered calcified nodules.Minimal emphysema in right transplanted lung. Patchy areas of groundglass opacity in the upper and lower lobes most notably in the upper lobe (image 40/101) where there is a small associated subcentimeter nodule. Scattered subpleural nodules at the right lung base in the periphery are unchanged. Trace pleural fluid.MEDIASTINUM AND HILA: Severe coronary calcification. Scattered small subcentimeter nodes.CHEST WALL: Healed rib fractures.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy.
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Patchy areas of groundglass opacity on the right, most notably in the upper lobe where there is a small associated subcentimeter nodule. This could be seen with bronchiolitis obliterans/rejection. Given the small nodular component, this should be followed on CT to exclude growth.
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Generate impression based on findings.
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74-year-old man status post cervical fusion, evaluate hardware and stability. Postoperative changes cervical spine fusion are seen with ACDF plate and screws at C5/C6 as well as posterior rod and pedicle screws from C2 to T2. The C5 and C6 vertebral bodies are fused. The cervicothoracic junction and upper thoracic spine are not well visualized on the lateral views due to overlying anatomy. However, there is no evidence of malalignment or hardware complication. There is no evidence of instability on flexion or extension views.
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Postoperative changes of cervical spine fusion without evidence of complication or instability.
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Generate impression based on findings.
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52 year-old woman status post right total knee arthroplasty. Hardware components of a right total knee arthroplasty device are seen in near anatomic alignment, similar to the prior examination. There is no evidence of loosening or hardware complication. Unchanged marked osteoarthritis is seen affecting the left knee on the frontal view.
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Right total knee arthroplasty device without evidence of complication.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Reason: RA, history of fungal infection, follow up nodules History: lung nodules LUNGS AND PLEURA: Grossly stable bilateral nonspecific pulmonary nodules. A nodule in superior segment of the right lower lobe (image 42/99) is no longer cavitary and is now solid and smaller. No new pulmonary nodules.MEDIASTINUM AND HILA: Small nonspecific thyroid nodules are unchanged. Severe coronary calcification.CHEST WALL: Suspected 2-cm right axillary lymph node not significantly changed. Postop change right breast.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Calcified granulomas in liver area. Hypodense splenic lesions are unchanged. Nonspecific nodular density in tail of pancreas is grossly unchanged but incompletely visualized. This could be further evaluated with a dedicated abdominal CT if clinically warranted.
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Grossly stable bilateral nonspecific pulmonary nodules. A nodule in superior segment of the right lower lobe is no longer cavitary and is now solid and smaller. No new pulmonary nodules.Other findings as above.
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Generate impression based on findings.
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ConstipationVIEW: Abdomen AP 1/26/15 Moderate amount of fecal burden without obstruction. No abnormal bowel dilation. No pneumatosis or pneumoperitoneum.
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Moderate amount of fecal burden.
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Generate impression based on findings.
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56 year old female with cyclical breast pain presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Stable benign intramammary lymph nodes are present.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. Patient's complaint of cyclical breast pain should be managed clinically. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Reason: h/o tonsil ca and CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Scattered punctate micronodules are stable and presumably postinflammatory. There is diffuse nonspecific mild to moderate bronchial wall thickening. No change in mild lingula ground glass opacity which is not typical of metastatic disease and may represent aspirate or infection.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Degenerative change involving the spine. Small presumed hemangiomas are unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis. Small subcentimeter hypodensity in left lobe as too small to characterize but stable and presumably benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered small subcentimeter lymph nodes are unchanged.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative change and presumed hemangiomas unchanged.OTHER: No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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History of right mastectomy in 2012 for DCIS. No new breast complaints. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Stable benign calcifications are present.No dominant mass, suspicious microcalcifications or areas of architectural distortion in the left breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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51 years, Male. Reason: Cause of abdominal pain? History: significant diarrhea, epigastric abdominal pain, also risk factors for mesenteric ischemia Nonspecific bowel gas pattern. Limited exam due to patient habitus.
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Nonspecific bowel gas pattern.
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Generate impression based on findings.
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Cough feverVIEWS: Chest AP and lateral 1/26/15 Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe. No pleural effusion or pneumothorax.
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Bronchiolitis or reactive airway disease.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable benign intramammary and axillary lymph nodes are present.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Reason: 66 yo female with history of CMML; pre-allo SCT evaluation History: evaluate LUNGS AND PLEURA: Minimal apical scarring bilaterally. Punctate 4-mm micronodule in left lower lobe (60/101) is nonspecific but most likely post inflammatory. Continued follow-up is recommended.MEDIASTINUM AND HILA: Severe coronary calcification. CHEST WALL: Left chest wall port with tip in SVC. Degenerative change involving the spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. Small splenule anteriorly.
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No acute cardiopulmonary abnormality. Punctate 4-mm micronodule in left lower lobe is nonspecific but most likely post inflammatory. Continued follow-up is recommended.
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Generate impression based on findings.
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Follow-up pancreatic cancer CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Low-attenuation right thyroid nodule appears unchanged from the prior exam. No mediastinal or hilar lymphadenopathy. Heart size is normal.CHEST WALL: Right chest wall Port-A-Cath tip in the distal SVC. Bilateral Bochdalek hernias.ABDOMEN:LIVER, BILIARY TRACT: Metallic stent in the common bile duct with stable intrahepatic biliary ductal dilation. Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic head mass anterior to the distal stent measures 2.0 x 1.3 cm (series 4, image 108), unchanged. The pancreas is markedly atrophied.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small gastrohepatic lymph nodes, unchanged. BOWEL, MESENTERY: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Left hip total arthroplasty with associated beam hardening artifact, making assessment of pelvic structure suboptimal. Degenerative changes of the thoracolumbar spine without evidence of suspicious osseous lesions.
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1.Pancreatic head mass, unchanged. 2.Stent occlusion with stable intrahepatic biliary ductal dilation; stent occlusion cannot be excluded.
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Generate impression based on findings.
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Reason: h/o HNC/CRT, compare to previous, measurements pls History: none There is effacement of fat planes surrounding the left carotid spaceWithin the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact. There is a small hypodense focus were demonstrated in right thyroid lobe.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses are clear. The mastoid air cells are clear.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact. Since the prior exam near left common carotid artery and appears to have narrowed and measures 4 mm in diameter in its midportion appeared more distally it measures 6 mm . Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries. Atherosclerotic calcifications are present at the carotid bifurcations. The right A1 segment appears very small compared to the left A1 segment. The posterior communicating arteries are not readily visualized on this exam.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. The C1 right lateral mass is posteriorly displaced relative to C2. Because the right mass is anteriorly displaced relative to CT this likely represents patient positioning.Incidental note is made of unerupted maxillary molars.
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1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy.2.Since the prior exam there is been some mild narrowing of the left common carotid artery with approximately 40% stenosis. This appears to have mildly progressed when compared to the prior exam. A dedicated vascular study may be helpful.3.An email was sent to Dr DeSouza with the above findings.
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Generate impression based on findings.
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finger pain, rule out fracture.VIEWS: Right hand PA and right thumb lateral and oblique No acute fracture or malalignment evident.
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Normal examination.
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Generate impression based on findings.
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FractureVIEWS: Left forearm AP and lateral Healing fracture involving the distal ulna in near anatomic alignment. There is periosteal reaction reflecting interval healing. Mild osteopenia noted not significantly changed.
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Healing distal ulna fracture.
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Generate impression based on findings.
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13 year old male with concern for VP shunt malfunction. There is a right parietal approach ventriculostomy catheter terminating near the foramen of Monro. There is asymmetry of the lateral ventricles with the left frontal horn and body being somewhat dilated, the right frontal horn and body being slitlike, and dilatation of the temporal horns, right greater than left. There may be mild dilatation of the fourth ventricle as well. There is no evidence of acute intracranial hemorrhage. There is significant crowding at the foramen magnum and herniation of the cerebral tonsils although the exact amount of herniation is difficult to determine. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
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1.Intact right parietal approach ventriculostomy catheter terminating near the foramen of Monro.2.Findings compatible with Chiari I malformation. 3.Enlargement of the left frontal horn and lateral ventricle body, bilateral temporal horns, and possibly of the fourth ventricle although no prior exam is available for comparison.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Three standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Reason: PTX History: Malignant mesothelioma POD5 s/p pleurectomy and decortication. LUNGS AND PLEURA: Small left pneumothorax with loculated hydropneumothorax in the posterior left lower lobe measuring 4.6 x 3.8 cm (series 4 image 56). Two left chest tubes in place. Left lung groundglass opacities, basilar consolidation, and irregular pleural thickening are consistent with the clinical history of mesothelioma status post recent surgery. Scattered right micronodules, some calcified. Small right pleural effusion and right basilar scarring/atelectasis. MEDIASTINUM AND HILA: Marked pneumomediastinum. Mild cardiomegaly without visible coronary arterial calcifications. Distended esophagus containing air and fluid. Right chest port terminates in the cavoatrial junction. CHEST WALL: Extensive subcutaneous emphysema extends throughout the chest wall and neck soft tissues bilaterally, the superior and inferior extent of which extends beyond the field of view of this examination. UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Postoperative changes of left pleurectomy and decortication with loculated hydropneumothorax and two chest tubes in place. 2. Left pulmonary groundglass opacities, basilar consolidation, and pleural thickening are consistent with recent postoperative changes and atelectasis. 3. Extensive subcutaneous emphysema extends beyond the field of view of this examination.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of left breast biopsy. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Linear marker was placed on a scar overlying the left breast. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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65 year old female status post lumpectomy for right breast IDC 7/2013, presents for routine follow up. Patient received neoadjuvant chemotherapy and adjuvant radiation. No current breast complaints. History of breast cancer in maternal grandmother. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Post lumpectomy changes, including architectural distortion and surgical clips, are again noted in the right breast. Mild right breast skin thickening is compatible with prior radiation therapy. A ribbon clip projects over a lymph node in the left axilla.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Stable post-treatment findings in the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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68 year old male with history of multiple small bowel resections presents with urgency and diarrhea. Evaluate for Crohn's disease. Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the colon was 15 minutes. Fluoroscopic evaluation showed postsurgical changes compatible with prior ileocecectomy and resection of the ileum with most of the jejunum remaining. The side-to-side anastomosis was patent and measured approximately 4.5 cm in transverse dimension. The remaining small bowel demonstrated normal mucosa without ulcers, sinus tracts, fistulae, or adhesions. No separation of bowel loops was present to suggest fibrofatty proliferation. No internal hernias or ventral hernias were evident. The visualized colon was grossly normal. TOTAL FLUOROSCOPY TIME: 3:04 mm:ss
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1.Postsurgical changes as described above with patent anastomosis.2.No evidence of active small bowel inflammation to indicate Crohn's disease.
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Generate impression based on findings.
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PICC placementVIEW: Chest AP 1/26/15 Cardiothymic silhouette normal. There is marked scoliosis unchanged. Placement of a left upper extremity PICC which is looped within the left subclavian vein. Patchy atelectasis right lower lobe.
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Malpositioned PICC.
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Generate impression based on findings.
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72-year-old with history of right lumpectomy followed by radiation therapy. No current complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Stable postsurgical change in the right breast with volume loss, surgical distortion and dystrophic calcifications. Other bilateral benign calcifications are also again noted. Stable asymmetry in the left outer breast.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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FractureVIEWS: Right wrist AP and lateral Healing buckle fracture involving the metaphysis of the distal radius in anatomic alignment. The overlying cast obscures fine bony detail.
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Healing buckle fracture distal radius in anatomic alignment.
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Generate impression based on findings.
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FractureVIEWS: Right wrist AP and lateral Healing fractures of the distal radius and ulna in near anatomic alignment. There is periosteal reaction and sclerosis reflecting interval healing. The overlying cast obscures fine bony detail.
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Healing distal forearm fractures as described above.
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Generate impression based on findings.
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Malignant neoplasm of tonsil Secondary and unspecified malignant neoplasm of lymph nodes, site unspecified(196.9)Radiotherapy follow-up examination There is some infiltration of the soft tissues surrounding the right suprahyoid carotid space. This is stable compared to the prior examWithin the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses are clear. The mastoid air cells are clear.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. There are some uncovertebral osteophytes present at C5-6 right more than left with encroachment of right-sided exiting nerve roots.
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1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. A total of 12 digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
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Generate impression based on findings.
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Male 60 years old Reason: ETOH cirrhosis evaluate for HCC History: ETOH cirrhosis LIVER: The liver measures 13.8 cm in length and demonstrates cirrhotic morphology. No focal hepatic lesion identified. The main portal vein is patent and demonstrates normal directional flow with a peak velocity of 0.2 m/sec.GALLBLADDER, BILIARY TRACT: There is no biliary dilatation. There is trace pericholecystic fluid. The gallbladder wall is mildly thickened, likely secondary to cirrhosis.PANCREAS: The pancreas is poorly visualized however where seen appears unremarkable.KIDNEYS: The right kidney measures 10.5 cm. The left kidney measures 10.3 cm. There is no hydronephrosis.OTHER: Splenomegaly measuring 20.4 cm. Trace abdominal ascites.
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1. Cirrhotic liver morphology without focal mass lesion. 2. Trace pericholecystic fluid and trace abdominal ascites.3. Splenomegaly.
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Generate impression based on findings.
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86-year-old with left breast pain for 3 months. The pain described is nonfocal, throughout the left lateral breast. No mass on physical exam is reported. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Bilateral benign calcifications are again noted.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Clinical correlation is recommended for the patient's nonfocal breast pain. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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79-year-old female with a history of a left breast lumpectomy in 2008 for IDC followed by radiation, hormone therapy and chemotherapy. She had a right breast cyst aspiration in 2013. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Postsurgical architectural distortion and skin thickening in the left breast are stable. There are multiple bilateral benign calcifications, including arterial calcifications and oil cysts, which are unchanged. A ribbon clip is noted in the location of the previous cyst aspiration.No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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Stable post-surgical changes and calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
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Generate impression based on findings.
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Male 34 years old; Reason: pain with discomfort above the right testis and small mass palpable in the region of the venous plexus History: scrotal pain RIGHT TESTIS: Right testes measures 4.0 x 2.1 x 3.0-cm; parenchymal echotexture is normal.LEFT TESTIS: Left testes measures 3.8 x 1.8 x 2.9 cm; parenchymal echotexture is normal.RIGHT EPIDIDYMIS: Right testicle epididymal head cyst measures 0.7 x 0.6 cmLEFT EPIDIDYMIS: No significant abnormalities noted.
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1.No focal intratesticular mass.2.Right epididymal head cyst.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of ovarian or uterine cancer in maternal grandmother. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable focal asymmetry is present in the central left breast. Benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Stable left breast asymmetry. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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Female 28 years old; Reason: 28 yo female with morbid obesity needing a kidney biopsy - preop planning for either urology or IR History: nephrotic syndrome ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Cholelithiasis, no secondary signs of acute cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Indeterminant left adrenal nodularity, primarily involving lateral limb, image 39 series 3, associated Hounsfield units of 24 seen.KIDNEYS, URETERS: Right kidney measures 9.7 cm in longitudinal dimension, while left kidney measures 10.2 cm. No hydronephrosis. No radiopaque intrarenal calculi. RETROPERITONEUM, LYMPH NODES: Multiple subcentimeter retroperitoneal/paraaortic lymph nodes. No calcified aortobiiliac atherosclerotic disease visualized, imaged performed to level of proximal common iliac arteries.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Focal right ventral abdominal subcutaneous induration, measures approximately 4 x 4 cm, image 48 series 3, may reflect prior procedural sequela or posttraumatic hematoma and correlation with patient's clinical history/physical exam recommended.
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1. No calcified atherosclerotic disease seen, appearance of kidneys as above.2. Focal right ventral abdominal subcutaneous induration, measures approximately 4 x 4 cm, may reflect prior procedural sequela/hematoma and correlation with patient's clinical history/physical exam recommended.3. Cholelithiasis, no secondary signs of acute cholecystitis.
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Generate impression based on findings.
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24 year-old woman with history of pain over the fourth carpometacarpal region. Additional history as per chart indicates patient punched a wall. Seen only on the lateral view is a minimally displaced oblique fracture through the base of the third metacarpal. The fracture line extends to the articular surface. There is a small amount of dorsal soft tissue swelling.
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Intra-articular fracture through the base of the third metacarpal.
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Generate impression based on findings.
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Female 73 years old; Reason: Right single lung transplant 12/08 now with rejection History: sob The comparison chest radiograph performed on 1/26/2015 demonstrates interval improvement in the right midlung air space opacities. There is mild blunting of the right costophrenic angle which is similar to prior study. Emphysematous changes in the left lung. Please refer to same day chest x-ray and CT scan for additional findings. The ventilation images show marked asymmetric distribution of radiotracer, relatively decreased in the left lung which correlates with the emphysematous changes in the left lung with hyperexpansion as well as the transplanted right lung with superimposed fibrotic changes noted on x-ray. The perfusion images demonstrate marked asymmetric perfusion, relatively decreased on the left. There is small subsegmental perfusion abnormality in the right lung which is difficult to identify given underlying chronic changes. There are no discrete superimposed acute ventilation-perfusion defects identified.Quantitation of relative single breath ventilation (using the posterior image):Left lung: 277% (upper lung55%; middle lung 13; lower lung 100%)Right lung: 733% (upper lung 200%; middle lung 33; lower lung 200%)Quantitation of relative pulmonary arterial perfusion (using anterior and posterior geometric means):Left lung: 255% (upper lung44%; middle lung 13; lower lung77%)Right lung: 755% (upper lung 188%; middle lung 38; lower lung 199%)
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Underlying diffuse asymmetric changes correlate with transplanted right lung with chronic underlying changes. No new super imposed findings to elevate this scan beyond a low probability for pulmonary embolism. Quantification calculations were provided as requested
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Generate impression based on findings.
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Male 55 years old; Reason: restaging CT 55M with colorectal CA with liver mets on chemo History: none CHEST:LUNGS AND PLEURA: Ground glass nodule in the left upper lobe measures 5 mm (image 57/series 4), unchanged. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: No significant abnormality notedOTHER: ABDOMEN:LIVER, BILIARY TRACT: Index left hepatic lobe segment two lesion measures 1.2 x 0.7 cm (image 83/series 3) previously, 1.2 x 1.0 cm.The segment 6 lesion measures 1.9 x 1.7 cm (image 96/series 3) previously, 1.9 x 1.7 cm.There a few scattered hepatic cysts.Hepatic vasculature are patent.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber. Postsurgical changes are noted in the ascending colonBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical changes in the colon.BONES, SOFT TISSUES: Postsurgical changes in the lumbar spine with associated degenerative change.OTHER: No significant abnormality noted
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1.No significant size change in the metastatic lesions in the liver.
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Generate impression based on findings.
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abdominal pain, evaluate for left ovarian vein thrombus as suggested on mesenteric doppler sono 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: Incompletely characterized low-attenuation right renal focus.RETROPERITONEUM, LYMPH NODES: There is mild calcification of the abdominal aorta and right common iliac artery. There is no arterial aneurysm or dissection flap. The celiac axis, SMA, IMA, renal, and iliac arteries are patent.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Poor opacification of the mid/distal ovarian veins without evidence of thrombus proximally. The left ovarian vein is asymmetrically prominent compared to the right without evidence of extrinsic compression.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Probable sacral Tarlov cyst formation.
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1.The left ovarian vein is asymmetrically prominent compared to the right without evidence of extrinsic compression; likely within normal limits. Poor opacification of the mid / peripheral ovarian veins without evidence of thrombus centrally. 2.Unremarkable CTA abdomen / pelvis.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. History of breast cancer in daughter. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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25 year old male with chronic postprandial nausea and vomiting, abdominal bloating. Evaluate for Crohn's disease. Upper GI:Double contrast visualization of the esophagus did not demonstrate any morphologic abnormalities of the mucosal surfaces or mural contours. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave. One episode of spontaneous gastroesophageal reflux was observed to the level of the mid esophagus. The stomach was normal in size, shape, and position. Spontaneous emptying of contrast into the duodenal sweep was observed. The gastric mucosal surface was normal.The duodenal bulb and sweep were within normal limits.Small Bowel:Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the colon was 30 minutes. Fluoroscopic evaluation demonstrated normal mucosa throughout the small bowel, without ulcers, sinus tracts, fistulae, or adhesions. No stricture or evidence of small bowel obstruction. No separation of bowel loops was present to suggest fibrofatty proliferation. The terminal ileum and ileocecal valve were normal in appearance. The ascending colon was grossly normal. TOTAL FLUOROSCOPY TIME: 6:09 mm:ss
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1.One episode of spontaneous GE reflux to the mid esophagus, but otherwise unremarkable upper GI study. 2.Unremarkable small bowel study, without evidence of Crohn's disease or other findings to account for the patient's symptoms.
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Generate impression based on findings.
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67 year old woman with history of fall and pain over the thumb. The bones are diffusely demineralized. There is no overt acute fracture or malalignment. Severe osteoarthritis affects the triscaphe joint. Mild to moderate osteoarthritis affects the interphalangeal joints, increasing in severity distally. Negative ulnar variance noted.
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Degenerative changes without overt acute fracture or malalignment.
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