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Generate impression based on findings.
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Male 61 years old Reason: 61yo M with h/o significant EtOH use and elevated LFTs History: LFT elevation LIVER: The liver measures 16.2 cm in length. There is no focal hepatic lesion. The portal vein demonstrates normal directional flow with peak velocity of 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder without gallstones, gallbladder wall thickening or pericholecystic fluid. There is no biliary dilatation.PANCREAS: Unremarkable where visualized.KIDNEYS: The right kidney measures 10.2 cm in length. Multiple shadowing echogenic stones. The largest measures 1.2 x 1.1 x 1.4 cm in the mid/lower pole. There is no hydronephrosis.The left kidney measures 11.4 cm. There is a 4.9 x 4.1-cm solid, mildly hypoechoic lesion without color flow which distorts the normal contour of the renal parenchyma arising from the upper pole of the left kidney. OTHER: The spleen and measures 8.5 cm.
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1. Right renal calculi measuring up to 1.4 cm in the mid/lower pole without associated hydronephrosis.2. There is a 4.9-cm lesion arising from the upper pole of the left kidney which is suspicious for a mass lesion. Further evaluation with triphasic renal protocol CT is recommended for further evaluation.Findings discussed with Dr. Gibson on pager 2717, by myself Dr. Ward at time of reporting 01/26/15 12:15 p.m.
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Generate impression based on findings.
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53 year-old woman with history of multiple shoulder dislocations, now with right shoulder pain and limited range of motion. A small Hill-Sachs deformity cannot be excluded. Glenohumeral joint alignment is anatomic. Near severe osteoarthritis affects the glenohumeral joint with joint space narrowing and subchondral cysts. Mild osteoarthritis affects the acromioclavicular joint.
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Degenerative changes without acute fracture or malalignment.
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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, unchanged in pattern and distribution. Extensive bilateral ductal calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Benign bilateral periductal calcifications. 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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Reason: s/p right hepatic lobectomy now with +DVT on duplex. C/o SOB. R/O PE History: as above PULMONARY ARTERIES: Technically adequate study without pulmonary embolus. LUNGS AND PLEURA: 7 mm nodule in the superior segment of the right lower lobe, slightly increased in size since 9/2014 and obscured by pleural effusion on 7/2014. Right basilar scarring/atelectasis. No pleural effusions. MEDIASTINUM AND HILA: The left vertebral artery arises from the aortic arch. Normal heart size without pericardial effusion. No visible coronary calcifications. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Loculated fluid collection in the operative bed from prior hepatic lobectomy incompletely visualized. See separately dictated CT abdomen and pelvis for description of abdominal findings.
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1. No pulmonary embolus. 2. 7 mm nodule in the superior segment of the right lower lobe is increased in size since 9/2014, suspicious for metastatic disease given recent increase in size and history of malignancy. 3. See separately dictated CT abdomen and pelvis for description of abdominal findings. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
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Generate impression based on findings.
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65 year-old woman with question of left hip osteoarthritis. Left hip: Severe osteoarthritis affects the left hip with superior joint space narrowing and bone-on-bone apposition.Pelvis: In addition to left hip osteoarthritis, there is mild osteoarthritis of the right hip. Note is made of colostomy, scattered surgical staples, and spinal stimulator generator over the right hemipelvis. Severe degenerative changes also affect the partially visualized lumbar spine.
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Stable, severe osteoarthritis of the left hip with additional findings as above.
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Generate impression based on findings.
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Frequent desaturations and fever. Evaluate for pneumonia. Stem cell transplant.VIEW: Chest AP (one view) 01/26/15, 0958 Left central line tip is in superior vena cava. Right upper extremity PICC tip is in superior vena cava.Cardiothymic silhouette is normal in size. No focal lung opacity is seen.Bowel is observed in the right upper quadrant occupying the region of the liver resection.
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No pneumonia.
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Generate impression based on findings.
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Frontal sinus: There is mild mucosal thickening of the left frontal sinus. The left frontoethmoidal recess is opacified. Anterior ethmoids: There is mild mucosal thickening of the bilateral anterior ethmoid air cells, left greater than right.Maxillary sinuses: There is mild mucosal thickening, and lobulated mucus retention cysts within the bilateral maxillary sinuses, right greater than left. There is narrowing of the left infundibulum. Otherwise, the ostiomeatal units are clear.Posterior ethmoids: There is mucosal thickening of the bilateral posterior ethmoid sinuses, right greater than left.Sphenoid sinus: A small air-fluid level is present within the right sphenoid sinus. The left sphenoid sinus is clear. The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is no significant nasal septal deviation. The nasal turbinate morphology is within normal limits. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric.
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Mild scattered sinus inflammation.
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Generate impression based on findings.
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Metastatic neuroendocrine tumor with unknown primary, evaluate and compare to outside hospital CT CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodule. Small right pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. The heart size is normal. Mild to moderate coronary artery calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple metastatic lesions in the liver. Large metastatic mass involving the medial aspect of the right hepatic lobe and the lateral aspect of the left hepatic lobe measures 1.3 x 1.1 x 1.2 cm (series 7, image 88) and splays the portal vein branches, grossly unchanged. There is mild intrahepatic ductal dilation peripheral to this mass. A second lesion in the inferior right hepatic lobe measures 3.9 x 4.1 x 4.0 cm (series 7, image 116), grossly unchanged. There is a questionable new lesion superolateral to the lesion in the anterior right hepatic lobe (series 7, image 109), but conspicuity may be secondary to slight variations in contrast phase compared to the prior exam. Increasing intra-abdominal ascites with questionable omental soft tissue deposits in the anterior left upper quadrant suspicious for peritoneal carcinomatosis.SPLEEN: No significant abnormality noted.PANCREAS: No evidence of mass. The pancreatic duct is normal in caliber.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
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1.Extensive hepatic metastases. There is a questionable new lesion superolateral to the lesion in the inferior right hepatic lobe (series 7, image 109), but conspicuity may be secondary to slight variations in contrast phase compared to the prior exam. Appearance grossly similar to the prior exam otherwise. 2.Increasing ascites with questionable soft tissue deposits in the anterior left upper quadrant suspicious for peritoneal carcinomatosis.3.Small right pleural effusion.
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Generate impression based on findings.
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79-year-old woman, postoperative evaluation. Bilateral total hip arthroplasty devices are seen in near anatomic alignment without evidence of loosening or complication. Surgical suture is noted in the lower abdomen. Marked curvature and degenerative changes are seen affecting the lower lumbar spine.
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Bilateral total hip arthroplasties without evidence of complication.
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Generate impression based on findings.
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Hypoglycemia evaluate congestive heart failureVIEW: Chest AP 1/26/15 NG tube tip in the stomach. Cardiothymic silhouette at the upper limits of normal. Minimal patchy atelectasis in the 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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Asymptomatic female presents for routine screening mammography. History of benign bilateral breast biopsies. 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. A percutaneously placed in the right medial inferior breast is unchanged in position. Benign calcifications are present bilaterally including arterial calcifications.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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62 year-old woman with history of right hand numbness. The cervicothoracic junction is obscured on the lateral view due to overlying soft tissues. Otherwise, vertebral body and intervertebral disc heights are preserved. Alignment is anatomic. There is mild facet arthropathy, but the neural foramina appear grossly patent.
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Degenerative changes as described above.
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Generate impression based on findings.
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CoughVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Minimal 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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History of left breast papillomata and IDC status post lumpectomy, radiation and chemotherapy. 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. Postsurgical distortion and density in the left breast are unchanged. Biopsy clips at the left breast lumpectomy site and in the left axilla are noted. A few benign calcifications are again noted. Biopsy clip in the right lateral breast is unchanged.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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Fracture.VIEWS: Right knee AP/lateral/oblique (3 views) 01/26/15 A cast has been placed and bone detail is obscured. Buckling fracture of the proximal tibia is again visualized. Alignment is anatomic.
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Fracture in cast.
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Generate impression based on findings.
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62 year-old woman with history of right hand numbness. Bones are diffusely demineralized. There is no acute fracture or malalignment. Mild, scattered degenerative changes affect the MCP and interphalangeal joints.
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Mild scattered degenerative changes as described above.
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Generate impression based on findings.
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84 years, Female. Reason: Upper abdominal pain; pressure sensation in upper abdomen. Nonobstructive bowel gas pattern. No free air on upright view. Moderate stool burden. Normal variant right colon anatomy noted, with anterior subphrenic position of hepatic flexure. Lumbar levoscoliosis.
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Nonobstructive bowel gas pattern. No free air.
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Generate impression based on findings.
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Eight year old female with known tibial fracture.VIEWS: Right ankle AP lateral and oblique (3 views) 1/26/2015 The cast has been removed. Sclerosis, periosteal reaction and increasing indistinctness of the distal tibial metadiaphyseal fracture line is seen, consistent with healing. The bones of the ankle are in anatomic alignment.
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Healing distal tibial fracture as detailed above.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Left breast scar. Two standard digital views 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. Linear marker was placed on a scar overlying the left breast. Partially obscured mass is present in the left upper outer quadrant.No suspicious microcalcifications or areas of architectural distortion are present.
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Partially obscured mass in the left breast. Spot compression imaging and possible ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required.
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Generate impression based on findings.
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64 year-old woman with history of left total knee arthroplasty. Hardware components of a left total knee arthroplasty device are seen in near anatomic alignment. There is no evidence of loosening or hardware complication. Skin staples and soft tissue drain have been removed.Severe osteoarthritis affects the right knee and appears to have progressed from the prior study as seen on the frontal view.
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1.Left total knee arthroplasty without evidence of complication.2.Progression of degenerative changes affecting the right knee.
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Generate impression based on findings.
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Reason: evaluate for ich, mass, etc History: aphasia 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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin. Atherosclerotic calcifications are present along the distal vertebral arteries. Atherosclerotic calcifications are present along the distal internal carotid arteries.
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1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.
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Generate impression based on findings.
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FractureVIEWS: Left humerus AP and lateral Healing proximal humeral fracture with posterior medial angulation of the distal fracture fragment. There is bony remodeling and periosteal reaction reflecting interval healing.
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Healing proximal humeral fracture.
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Generate impression based on findings.
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20 years, Female. Reason: patient with constipation, abd discomfort, high stool burden, evaluate for gas and obstruction History: bloating, constipation Interval evacuation of previously seen stool in colon. Gas seen throughout colon. Non obstructive bowel gas pattern.
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Interval evacuation of previously seen stool in colon. Non obstructive bowel gas pattern.
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Generate impression based on findings.
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Female 49 years old; Reason: Metastatic ovarian cancer needs re-evaluation and compare to prior scans. Measurements where applicable. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Right-sided central venous catheter with tip in distal SVC, small thrombus seen around distal tip.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES, BOWEL, MESENTERY: Subcentimeter retroperitoneal lymph nodes, which do not meet CT size criteria for enlargement. Status post omentectomy. Interval decrease in size of focal omental nodularity adjacent to left psoas muscle, measuring 0.6 x 0.5 cm, image 139 series 3, previously measured 1 x 0.9 cm. Decreased size of additional reference focus adherent to terminal ileum, measuring 1.8 x 1.1 cm on image 135 series 3, previously measured 2 x 1.4 cm. Stable to minimal interval decrease in size of additional reference left pelvic lesion adjacent to rectum, measuring 2.6 x 2 cm, previously measured 2.9 x 1.9 cm. Again seen small bowel containing ventral abdominal hernias, no associated bowel obstruction.PELVIS:UTERUS, ADNEXA: Status post hysterectomy and bilateral oophorectomies.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structure stable in appearance, multilevel degenerative changes of spine. Persistent periumbilical soft tissue thickening in ventral abdominal wall. Again seen small bowel containing ventral abdominal hernias, no associated bowel obstruction.
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1. Abdominopelvic carcinomatosis, interval decrease in size of reference soft tissue nodules as above. 2. Right-sided central venous catheter with tip in distal SVC, small thrombus seen around distal tip.
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Generate impression based on findings.
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84 year-old woman with history of low back pain. Severe multilevel degenerative disease affects the lumbar spine, most severe at L2/L3 and sparing L1/L2. There is grade 1 anterolisthesis of L4 on L5 and grade 1 posterolisthesis of L2 on L3. Additionally, there is slight leftward curvature of the lower lumbar spine. There is severe facet joint arthropathy on the left and moderate facet arthropathy on the right. The sacroiliac joints are obscured by overlying bowel gas and stool.
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Severe degenerative changes of the lumbar spine as described above.
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Generate impression based on findings.
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History of right mastectomy in 2000 for DCIS. History of breast carcinoma in mother diagnosed at the age of 60. No new breast complaints. Three standard views of the left breast were performed digitally with spot compression MLO view and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Asymmetry in the left retroareolar breast disperses with spot compression. 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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Rectal cancer ABDOMEN:LUNG BASES: Please refer to separately dictated chest CT exam for additional findings.LIVER, BILIARY TRACT: Large septated collection in the right hepatectomy bed, the largest component of which measures 8.4 x 5.7 cm (series 13, image 25), previously 8.2 x 5.7 cm. There is no suspicious intrahepatic mass. No biliary ductal dilation. The hepatic vasculature is patent. Mild extrahepatic biliary ductal dilation status post cholecystectomy unchanged from the prior exam.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Right adrenal nodule appears similar to the prior exam.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Small amount of fluid in the endometrial canal with soft tissue prominence in the region of the cervix, unchanged.BLADDER: No significant abnormality noted.BOWEL, MESENTERY: Status post proctectomy with left lower quadrant colostomy. There is a small presacral fluid collection in the surgical bed measuring 4.3 x 1.7 cm (series 13, image 124).BONES, SOFT TISSUES: No significant abnormality noted.
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1.Status post proctectomy with small presacral fluid collection.2.Grossly stable septated fluid collection in the right hepatectomy bed.3.Stable right adrenal nodule.4.Small amount of fluid in the endometrial canal with soft tissue prominence in the region of the cervix, unchanged. Correlate with patient history and consider pelvic sonogram as clinically warranted.5.See separately dictated chest CT exam for additional findings.
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Generate impression based on findings.
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24-day-old male with history of multicystic dysplastic kidney with hydronephrosis. BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Length*** Right: 5.3 cm Mean for age: 4.2 cm Range for age: 3.7 - 5.7 cmADDITIONAL OBSERVATIONS: The previously seen multicystic dysplastic left kidney has involuted. The tubular structure in the expected location of the left ureter, which disappeared with voiding, probably represents the left ureter.
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1.Involution of the previously seen multicystic dysplastic left kidney. 2.Right kidney top normal in length.3.Tubular structure in the expected location of the left ureter, which disappeared with voiding, probably represents the left ureter.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469
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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 aunt. 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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Reason: s/p excision right shoulder chondrosarcoma History: hx: chondrosarcoma LUNGS AND PLEURA: Postoperative changes in both lungs of prior wedge resections. Interval improvement in left posterior upper lobe consolidation and loculated fluid seen previously. Soft tissue thickening along the staple line in the left lower lobe improved consistent with resolving hematoma. No new nodules, masses, or effusions. MEDIASTINUM AND HILA: Normal heart size. No pericardial effusion. Severe coronary artery calcifications. Scattered mediastinal and hilar lymph nodes unchanged from the prior exam. Small hiatal hernia. CHEST WALL: Stable right 5th and 6th rib deformities and thoracic spine degenerative changes. Prior clam shell sternotomy. UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Unchanged small para-aortic lymph nodes. Splenic granulomata.
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1. Postoperative changes of prior wedge resections with interval improvement in left posterior upper lobe consolidation and loculated fluid. No new suspicious lesions. 2. Other chronic findings as described above without acute interval change.
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Generate impression based on findings.
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Female, 79 years old, with history of pT3N2b left oral tongue squamous cell carcinoma status post resection. Since the prior examination, left hemiglossectomy and flap reconstruction have been performed. The previously seen left tongue tumor is no longer present. Extensive anatomic distortion with ill-defined soft tissue thickening and enhancement is evident centered on the left submandibular space with numerous intermixed surgical clips.Elsewhere the aerodigestive mucosa is free of suspicious lesions. No pathologically enlarged or morphologically suspicious lymph nodes are identified on either side of the neck. A tracheostomy is in place.The cervical vessels opacify normally. The left submandibular gland has been resected, but the residual salivary glands are free of focal lesions. A subcentimeter hypoattenuating lesion within the left thyroid lobe is unchanged.Emphysema is evident in the lung apices. No concerning osseous lesions are seen. Multilevel cervical spondylosis is seen similar to prior. Incidental note is made of a 7-mm subcutaneous nodule in the left cheek which is unchanged.
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Since the prior examination, left hemiglossectomy with flap reconstruction and extensive left neck dissection have been performed. Ill-defined soft tissue thickening and enhancement within the operative bed centered on the left submandibular space is nonspecific, particularly given that this is the first post-surgical exam.Otherwise, no definite evidence of local disease recurrence or pathologic adenopathy is seen.
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Generate impression based on findings.
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Left breast seed loc and SNBx .RADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 0.5 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. An initial focus of increased activity is noted in the breast, representing the sentinel node, which may be an intramammary lymph node. This region was marked as 'X' with an indelible marker.An additional focus of increased activity was also noted more superiorly along the medial aspect of the left breast, however less intense in comparison with the initial focus noted above. This may represent an additional lymph node of the same or separate drainage pathway as the sentinel lymph node. This was labeled with a dot with an indelible marker.
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Sentinel node identified which given its location may be intramammary. An additional focus identified along the superior medial aspect of the left breast was also highlighted, if an additional lymph node is needed surgically.
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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 70 and paternal 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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31 year old female with lateral knee pain Alignment is anatomic. No joint effusion is present. There is no evidence of fracture. Slight medial joint space narrowing suggests minimal osteoarthritis.
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No fracture or dislocation.
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Generate impression based on findings.
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77-year-old female status post TFN A trochanteric femoral nail affixes a right intertrochanteric fracture in near anatomic alignment without evidence of the hardware complication. Two screws affix the distal intramedullary rod. Callus formation indicates interval healing.
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Orthopedic fixation of healing right intertrochanteric fracture 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 heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Round markers were placed on skin lesions overlying both breasts. Stable benign calcifications are present bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present.
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Stable bilateral calcifications. 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: NSC - Screening Mammogram.
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Generate impression based on findings.
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41 year-old female with bilateral knee pain and swelling Right knee: The osseous structures are within normal limits for the patient's age. No joint effusion or malalignment.Left knee: The osseous structures are within normal limits for the patient's age. No joint effusion or malalignment.
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No specific findings to account for the patient's symptoms.
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Generate impression based on findings.
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15-year-old male with fever, clinical concern for renal or hepatic abscess. LIVER: The liver measures 16 cm in length and demonstrates appropriate parenchymal echogenicity. No intrahepatic lesions are identified. The main portal vein is patent demonstrating hepatopetal flow with a velocity of 40 cm/sec.GALLBLADDER, BILIARY TRACT: Dependent sludge is present within the gallbladder lumen, but there is no gallbladder wall thickening or pericholecystic fluid to suggest cholecystitis.PANCREAS: No significant abnormality noted.SPLEEN: No significant abnormality noted.KIDNEYS: The left kidney measures 10.5 cm in length, and there is no evidence of hydronephrosis, perinephric fluid or intraparenchymal abscess. The right kidney measures 11.7 cm in length, and there is grade 2 right hydronephrosis, but no evidence of perinephric fluid or intraparenchymal abscess. ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Dependent debris is present within the bladder lumen. A urinary catheter is in place.
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1.Grade 2 right hydronephrosis, without evidence of intrarenal or perinephric abscess as clinically questioned.2.Biliary sludge without evidence of cholecystitis.
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Generate impression based on findings.
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Reason: Patient is participating in research study. Evalute for lung disease History: History of rheumatoid arthritis LUNGS AND PLEURA: Mild basilar scarring/atelectasis without focal airspace opacity or pleural effusion. Bilateral basilar pleural calcification, which is suggestive of prior asbestos exposure. MEDIASTINUM AND HILA: Small calcified upper mediastinal lymph nodes. Normal heart size with severe coronary arterial calcifications. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. No evidence of rheumatoid related lung disease. 2. Severe coronary arterial calcifications.
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Generate impression based on findings.
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67-year-old male with left first MTP pain Mild hallux valgus deformity. Mild osteoarthritis affects the first MTP joint. Small posterior calcaneal spur.
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Mild hallux valgus deformity without fracture or dislocation.
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Generate impression based on findings.
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Asymptomatic female presents for routine screening mammography. Bilateral implants placed in 1988. Two full field and two implant displaced digital views 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. Retroglandular silicone implants are unchanged in position and contour. Stable benign calcifications 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: NSC - Screening Mammogram.
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Generate impression based on findings.
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43-year-old female with pain Small osteophytes and subchondral sclerosis, consistent with mild osteoarthritis affecting the right greater than left hips. Alignment is within normal limits. The osseous structures of the pelvis are otherwise unremarkable. There is some amorphous mineralization lateral to the superior left acetabulum, which may represent an injection granuloma.
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Osteoarthritis, right greater than left hip.
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Generate impression based on findings.
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PainVIEWS: Right foot AP, oblique and lateral No acute fracture or dislocation.
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Normal examination.
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Generate impression based on findings.
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64-year-old female with history of chondrosarcoma, postoperative follow-up evaluation Hardware components of a bipolar hip hemiarthroplasty device are situated in near-anatomic alignment without evidence of complication or tumor recurrence. Osteoarthritis affects the right knee.
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No evidence of hardware complication or tumor recurrence.
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Generate impression based on findings.
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53 -year-old old female with pain Moderate osteoarthritis affects the right hip. Osteoarthritis also affects the left hip as seen on the frontal view. Small bone islands are noted in the pelvis.
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Moderate osteoarthritis.
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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. No suspicious masses, microcalcifications or areas of architectural distortion are present.
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No mammographic evidence of malignancy. Mammography is most sensitive when comparing to prior studies. If the patient submits outside mammogram, comparison will be made. 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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T2N2c right base of tongue squamous cell carcinoma status post chemoradiation completed in September 2009. There are unchanged posttherapy findings within the neck without evidence of discrete mass lesions or significant cervical lymphadenopathy. The thyroid and major salivary glands are unchanged. The major cervical vessels are patent. There are moderate degenerative changes of the cervical spine with multilevel end plate degenerative change, loss of disc height, and disc osteophyte complexes that is worst at the C4-C5 level where there is mild to moderate spinal canal stenosis and moderate left neural foramen stenosis. The osseous structures are otherwise unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. There are unchanged reticular opacities within the anteromedial upper lobes which may be radiation related. The imaged portions of the lungs are otherwise clear. There is moderate paranasal sinus mucosal thickening. There is an unchanged dental caries and periapical lucency involving ADA tooth number 2.
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1.No evidence of locoregional tumor recurrence or significant lymphadenopathy.2.Dental caries and periapical lucency of ADA tooth number 2.3.Cervical spine degenerative changes most severe at the C4-C5 level. 4. Findings suggestive of acute sinusitis.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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79-year-old woman with history of T8 fracture, evaluate for displacement. Evaluation is limited due to marked thoracolumbar scoliosis and diffuse demineralization. Degenerative changes are seen affecting the entire thoracolumbar spine, similar to the prior examination. There is increased kyphosis of the thoracic spine with a new change in alignment at what appears to be T9. Although this may represent an increase in the rotatory component of scoliosis or artifact of positioning, displacement of the previously seen fracture and can also be considered.
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New change in alignment at what appears to be the T9 level. This may represent an increase in the rotatory component of scoliosis or artifact of positioning, however displacement of the previous is seen fracture cannot be excluded. CT can be considered for further evaluation.
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Generate impression based on findings.
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Reason: evaluate for stroke, purposeful movement on L, not right History: evalut for stroke The CSF spaces are appropriate for the patient's stated age with no midline shift. Since the previous exam the patient has developed a hypodense focus centered along the left paracentral lobule and adjacent right cingulate gyrus. This is in the distribution of the left superior internal parietal artery distribution. Another hypodense focus is present involving the left inferior parietal lobule which includes the supramarginal gyrus. This is in the distribution of the left angular artery. A smaller hypodense focus is present in the left insular cortexAtherosclerotic 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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are 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.Findings suggest subacute infarctions along the left middle and anterior cerebral artery distributions.
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Generate impression based on findings.
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Male 59 years old; Reason: Prostate cancer with bone mets compare to last CT History: post 2 cycles of chemo CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions. No pleural effusions.MEDIASTINUM AND HILA: Bilateral enlarged mediastinal lymph nodes. CHEST WALL: There is soft tissue anterior to the mid thoracic vertebral body that it extends into the left pleural space and to a lesser extent the right. Extensive osseous metastatic disease to the thoracic osseous structures.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodense hepatic lesions are too small to characterize and possibly benign.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild atrophy of the left kidney. There is a cortical cyst at the interpolar region of the right kidney.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta. No retroperitoneal lymphadenopathy. There are small upper abdominal retroperitoneal lymph nodes.BOWEL, MESENTERY: Postsurgical changes in the small bowel with a caliber change in the jejunum.BONES, SOFT TISSUES: Osseous metastatic disease to the spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: Sclerotic osseous metastatic disease.OTHER: No significant abnormality noted
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1.Osseous metastatic disease.
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Generate impression based on findings.
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Female 59 years old; Reason: Metastatic NET please assess and compare to previous scans and provide index lesion measurements for RECIST CHEST:LUNGS AND PLEURA: Visualized lung fields stable, no suspicious lung nodule delineated.MEDIASTINUM AND HILA: Mildly hypoattenuating intracardiac blood pool suggesting underlying anemia. Punctate thyroid calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable segment 4A lesion, measuring 1.4 x 1.1 cm, image 20 series 9. Enhancing segment 7 lesion demonstrating mild interval decrease in size, measuring 5 x 4 mm, coronal image 46 series 80637, previously measured 9 x 8 mm in coronal plane. Status post cholecystectomy. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable subcentimeter left adrenal nodule.KIDNEYS, URETERS: Stable bilateral renal hypoattenuating lesions including dominant bilateral hemorrhagic or proteinaceous material containing complex cysts, no definite associated enhancement seen, image 44 series 9 on left and image 50 on right.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic abdominal aortic disease.BOWEL, MESENTERY: Similar to prior imaging is 1.1 x 1 cm mesenteric nodule, image 130 series 12.PELVIS:UTERUS, ADNEXA: Not well assessed due to extensive beam hardening artifact.BLADDER: Not well assessed due to extensive beam hardening artifact.BONES, SOFT TISSUES: Bilateral total hip arthroplasties, with associated beam hardening artifact, making evaluation of pelvic structures suboptimal. Unchanged (from 6/26/14 CT study) 4.8 x 3.6 cm right vulvar/labial soft tissue lesion, may be a Bartholin's cyst. Visualized osseous structures stable in appearance, multilevel degenerative changes of spine, grade 1 anterolisthesis of L3 on L4. Mild improvement in subcutaneous induration/edema in right upper quadrant ventral abdominal soft tissues, likely postoperative in seen in etiology. Left buttock subcutaneous air and bilateral soft tissue nodularity, likely reflecting sequela of prior injections. Small fat containing umbilical hernia.
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1. Hepatic metastatic neuroendocrine tumor with stable reference segment 4A liver lesion and interval decrease in size of segment 7 focus.2. Similar to prior imaging is 1.1 x 1 cm mesenteric nodule. 3. Unchanged (from 6/26/14 CT study) 4.8 x 3.6 cm right vulvar soft tissue lesion, may be a complex Bartholin's cyst but correlation with patient's clinical history/physical exam recommended.
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Generate impression based on findings.
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77-year-old with history of left breast cancer status post lumpectomy, sentinel lymph node biopsy and radiation therapy in 2013. Three standard views of both breasts with left spot magnification views of the lumpectomy site 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. Postoperative distortion, density and multiple surgical clips are seen in the left retroareolar region. A few benign calcifications are noted near the lumpectomy site. Surgical clips also project in the left axilla. A right breast 10 o'clock mass is if anything less prominent on this examination, suggesting some interval involution of a cyst.
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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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Reason: eval ich, etc History: l sided weakness 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. An additional hypodense focus is present in the right basal ganglia. Compared to the previous exam these hypodense foci were presentNo 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 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.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 3.Lacunar infarct in the right basal ganglia is suspected to be old. It was present on the prior exam.4.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.5.
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Generate impression based on findings.
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75 year-old woman with two month history of pain in the right big toe. There is no acute fracture, malalignment, or finding suggestive of osteomyelitis. There is mild swelling of the great toe.
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No findings suggestive of osteomyelitis.
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Generate impression based on findings.
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Reason: postop baseline scans prior to adjuvant chemoradiation History: pT3N2b L oral tongue scc s/p surgical resection CHEST:LUNGS AND PLEURA: Previously noted focal nodular area of interstitial and groundglass opacity in the right upper lobe has resolved. Right basilar linear interstitial and groundglass opacity may be due to aspirate. There is a small associated punctate less than 4-mm nodule (image 89/112). These findings are more typical aspirate or infection than metastatic disease though continued follow up is recommended. Other small punctate nodules are unchanged. Emphysema.MEDIASTINUM AND HILA: Status-post tracheostomy. Severe coronary calcification. Scattered small subcentimeter lymph nodes are unchanged.CHEST WALL: Degenerative change involving spine.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: Atrophic left kidney. Right renal cyst unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Colonic diverticulosis. Gastrostomy tube present.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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Previously noted nodular area of interstitial and groundglass opacity in the right upper lobe has resolved. There is a new area of interstitial and nodular opacity at the right lung base which is more typical of aspirate or infection than metastatic disease though continued follow-up is recommended. Other small nonspecific pulmonary nodules are unchanged.
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Generate impression based on findings.
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69-year-old man status post right total knee arthroplasty. Hardware components of a total right knee arthroplasty device are seen in near anatomic alignment without evidence of complication. Surgical staples and soft tissue drain have been removed. Note is made of an intramedullary rod and screw device in the left tibia along with severe arthritic changes affecting the left knee.
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Total right knee arthroplasty without evidence of complication.
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Generate impression based on findings.
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Pain for two weeks in with point tenderness at T12.VIEWS: Thoracic spine AP/lateral/swimmers (3 views) 01/26/15 Vertebral body heights and disk spaces are maintained. No destructive process or fracture is identified. A right thoracic curve is present which may be related to splinting.
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No bone destruction or fracture. If pain persists MR may be helpful in further evaluation.
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Generate impression based on findings.
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52 year-old male, evaluate for metal in hip after gunshot wound No evidence of radiopaque foreign body. Mild osteoarthritis affects both hips. Alignment is within normal limits.
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No radiopaque foreign body.
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Generate impression based on findings.
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Multiple metastases seen on prior studies are not well identified on this non-enhanced exam. There is vasogenic edema in the frontal lobes, slightly decreased on the left. There is sulcal effacement and local mass effect in the left frontal and right frontal lobes associated with known metastatic lesions. Left lateral ventricle is minimally effaced, similar to the prior exam. No acute hemorrhage is identified.Scattered areas of hypoattenuation in the periventricular and subcortical white matter are nonspecific but likely represent chronic vessel ischemic disease. Focal hypodensity in the anterior limb of the left internal capsule likely represents an old lacunar infarct. There is no extraaxial fluid collection. Mucosal thickening and foci of air within the right maxillary sinus
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1.No acute intracranial hemorrhage.2.Multifocal areas of vasogenic edema associated with known brain metastases are minimally decreased in the left frontal lobe. For evaluation of metastatic lesions, an MRI may be considered.3.Mucosal thickening and foci of air within the right maxillary sinus may suggest a sinusitis.
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Generate impression based on findings.
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The patient submitted outside analog mammograms dated 5/13/2013 and 8/27/2009 from Provident Hospital in Chicago IL. Submitted outside studies were compared to the current mammogram dated 12/26/2014. Breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Stable benign masses are present bilaterally. Benign calcifications are present. No new masses, suspicious calcifications or areas of architectural distortion are present.
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Stable bilateral masses and calcifications. No mammographic evidence for malignancy. As long as the patient's physical examination is unchanged, annual screening mammogram is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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72 year-old woman with history of pain, evaluate for arthritis. Severe osteoarthritis affects the first MTP joint with marked joint space narrowing to near bone-on-bone apposition, subchondral sclerosis, and osteophyte formation. There is a hallux valgus deformity.
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Severe osteoarthritis of the first MTP joint and hallux valgus.
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Generate impression based on findings.
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47 years, Female. Reason: Rule out free air. Immunocompromised with C.diff History: Immunocompromised with abdominal pain and tenderness. Nonobstructive bowel gas pattern. No gross free air. Moderate vascular calcifications are noted.
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Nonobstructive bowel gas pattern without gross free air. However, supine radiographs are insensitive in the detection of small amounts of free air and erect or decubitus radiographs can be considered if clinical concern persists.
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Generate impression based on findings.
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36-year-old female with history of hip replacement, evaluate for dislocation Left hip: Hardware components of a total left hip arthroplasty are situated in near anatomic alignment. Lucency about the methacrylate plug on the left appears similar to the prior exam. No fracture is evident.Pelvis: Hardware components of the right total hip arthroplasty are noted in near-anatomic alignment. Lucency about the methacrylate plug and the femoral component appears similar to the prior exam. The distal aspect of the right femoral component is not visualized on this exam.
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Bilateral total arthroplasties without evidence of dislocation or fracture. Additional findings as described above.
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Generate impression based on findings.
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Female 58 years old; Reason: 58 yr old patient with endometrial cancer s/p 6 cycles of Taxol/Carboplatin. TAH/BSO/Debulking 8-8-14. eval disease process compare to 11-3-14 scan History: none ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right parapelvic and cortical cysts are noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.No evidence of recurrence or metastatic disease.
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Generate impression based on findings.
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Reason: 75 yo female with breast cancer and recurrent stage IIIC fallopian tube cancer, s/p chemotherapy, to evaluate lung nodules History: none LUNGS AND PLEURA: Post XRT fibrosis in anterior left upper lobe, unchanged. Punctate micronodules are unchanged. No new pulmonary nodules.MEDIASTINUM AND HILA: Severe coronary calcification. Small subcentimeter cardiophrenic lymph nodes are stable to marginally increased. These are similar in size to 3/17/2014 study.CHEST WALL: Interval removal of port catheter. Extensive postop change involving left breast, unchanged.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted.
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1. Punctate micronodules are unchanged and presumably postinflammatory.2. Small subcentimeter cardiophrenic lymph nodes are stable to marginally increased. These are similar in size to 3/17/2014 study.
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Generate impression based on findings.
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The patient submitted outside analog mammograms dated 5/13/2013 and 8/27/2009 from Provident Hospital in Chicago IL. Submitted outside studies were compared to the current mammogram dated 12/26/2014. Breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Stable benign masses are present bilaterally. Benign calcifications are present. No new masses, suspicious calcifications or areas of architectural distortion are present.
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Stable bilateral masses and calcifications. No mammographic evidence for malignancy. As long as the patient's physical examination is unchanged, annual screening mammogram is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
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Generate impression based on findings.
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The patient submitted outside digital mammogram dated 3/19/2014 and analog mammogram dated 4/13/2012, from Weiss Memorial Hospital in Chicago IL. Submitted outside studies were compared to the current mammogram dated 12/30/2014. The breast parenchyma is heterogeneously dense, which may obscure small masses, 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 is unremarkable, annual screening mammogram is recommended. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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The patient submitted outside digital mammogram dated 3/19/2014 and analog mammogram dated 4/13/2012, from Weiss Memorial Hospital in Chicago IL. Submitted outside studies were compared to the current mammogram dated 12/30/2014. The breast parenchyma is heterogeneously dense, which may obscure small masses, 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 is unremarkable, annual screening mammogram is recommended. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
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Generate impression based on findings.
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Reason: 48 yo F hx of sarcoid, RA with 4mm RLL nodule - needs 6 month f/u. She has chronic SOB History: nodule. chronic sob LUNGS AND PLEURA: Limited by hypoinflation. The previously noted micronodule is no longer visible. Other punctate micronodules are stable to multiple previous and presumably postinflammatory.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Small axillary nodesUPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy.
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Limited by hypoinflation. The previously noted micronodule is no longer visible. Other punctate micronodules are stable to multiple previous and presumably postinflammatory.
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Generate impression based on findings.
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The patient submitted outside digital mammograms dated 4/12/2013 and 8/10/2011, from Maricopa Integrated Health System in Phoenix AZ . Submitted outside studies were compared to the current mammogram dated 12/24/2014. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. AICD in the left chest wall obscures a portion of the left breast. No suspicious masses, microcalcifications or areas of architectural distortion are present
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No interval change or mammographic evidence of malignancy. As long as the patient's physical examination is unremarkable, bilateral 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: S/P crani for aneurysm clipping 10/24/13. Last OV doing well. Was to fu for left ear hearing issues/HAs. History: S/P crani for aneurysm clippping 10/24/13 surveillance Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The anterior communicating artery and the posterior communicating arteries are identified and are intact.CT head:The patient is status post left-sided craniotomy and cranioplasty for aneurysm clip placement along the anterior communicating artery. This clip obscures visualization of local structures.There is a small focus of encephalomalacia along the left inferior frontal gyrus pars orbitalis.There is redemonstration of a a 1.5x3-mm left sessile paraclinoid aneurysm present inferior to the level of the anterior clinoid. It is directed medially and inferiorly. This is stable.There is a small infundibulum at the origin of the right PCOMA.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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.
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1.The patient has undergone ACOMA aneurysm clipping. There is no obvious recurrence appreciated.2.Small left paraclinoid ICA aneurysm is stable.3.No evidence for cerebrovascular occlusive disease.
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Generate impression based on findings.
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The patient submitted outside digital mammograms dated 4/12/2013 and 8/10/2011, from Maricopa Integrated Health System in Phoenix AZ . Submitted outside studies were compared to the current mammogram dated 12/24/2014. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. AICD in the left chest wall obscures a portion of the left breast. No suspicious masses, microcalcifications or areas of architectural distortion are present
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No interval change or mammographic evidence of malignancy. As long as the patient's physical examination is unremarkable, bilateral 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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Fracture.VIEWS: Right little finger PA/lateral (two views) 01/26/15 Cast has been removed. Callus formation/periosteal reaction on encircles the fracture of the distal aspect of the proximal phalanx. Alignment is near-anatomic. Demineralization is present.
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Healing fracture proximal phalanx.
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Generate impression based on findings.
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Fracture.VIEWS: Right elbow AP/lateral (two views) 01/26/15 A cast obscures bone detail. Periosteal reaction encircle the distal humerus. Alignment is near anatomic.
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Healing supracondylar fracture.
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Generate impression based on findings.
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Reason: hx of right base of tongue ca, sp CRT, compare to previous, eval for dz History: as above LUNGS AND PLEURA: Scattered punctate calcified and noncalcified micronodules are stable and likely postinflammatory. Basilar scarring. No evidence of metastatic disease.MEDIASTINUM AND HILA: Grossly unchanged loculated right pericardial effusion/pericardial cyst. Coronary calcification. Minimal aspirated debris is noted in the trachea.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
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No evidence of metastatic disease.
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Generate impression based on findings.
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Male 36 years old; Reason: Assess vasculature and prior transplant locations prior to potential liver/kidney transplant History: Pre-surgical evaluation ABDOMEN:LUNG BASES: Chronic changes in the right middle lobe and right lower lobe compatible with metastatic calcification from renal disease.LIVER, BILIARY TRACT: There is an IVC stent and filter. Post surgical changes in the liver. There is mild intrahepatic pneumobilia centrally.SPLEEN: The spleen is enlarged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small hyperdense lesions in the left kidney. There are several renal cysts.RETROPERITONEUM, LYMPH NODES: No significant calcification in the abdominal aorta appearedBOWEL, MESENTERY: Colonic wall thickening involving the ascending colon. Mild colonic wall thickening involving the sigmoid colon.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant calcific arteriosclerotic disease of the pelvic vasculature.OTHER: Small amount of abdominal and pelvic ascites.
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1.No significant calcific arteriosclerotic disease.
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Generate impression based on findings.
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Male 51 years old; Reason: eval for appy History: anorexia x3d, fever, RLQ pain ABDOMEN:LUNG BASES: Partially visualized scattered multifocal patchy opacities and nodularity, predominantly in the right middle and lower lobes are nonspecific, but suspicious for multifocal infection.LIVER, BILIARY TRACT: Scattered, subcentimeter hepatic hypodensities are too small to accurately characterize.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cyst. No hydronephrosis. 1 cm nonobstructing stone in the upper right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No obstruction. No free intraperitoneal air. Incomplete colonic distention limits evaluation. No secondary signs of appendicitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Partially visualized multifocal opacities in the right lung are suspicious for multifocal pneumonia. Dedicated CT chest to evaluate extent is suggested.2.No acute abdominal or pelvic findings to account for patient's right lower quadrant pain.
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Generate impression based on findings.
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Metastatic breast cancer. In the right hemipelvis there are two small to medium-sized foci of mild osteoblastic activity both medial and lateral to the right sacroiliac joint. These are new from prior bone scan. They also correspond with hypermetabolic foci on recent FDG-PET scans and indicate sites of osseous metastases. As they have been decreasing on the most recent PET, the uptake on today's bone scan may reflect healing metastases although current activity of these lesions cannot be excluded.Previous bone scan moderate upper thoracic spine lesion of activity has essentially resolved today. There is otherwise no suspicious osteoblastic focus currently. Increased soft tissue activity in the left chest is consistent with inflammation.
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Two mildly avid osseous metastases in the right pelvis. While these are new from prior bone scan they may reflect healing metastases based on recent FDG-PET scans. No evidence of active osseous metastases elsewhere.
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Generate impression based on findings.
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Restaging relapsed Hodgkin lymphoma, status post chemotherapy November 2008.RADIOPHARMACEUTICAL: 11.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 86 mg/dL. Today's CT portion grossly demonstrates bilateral axillary enlarged lymph nodes. Enlarged lymph nodes are also seen in the bilateral obturator and inguinal locations. Stranding in the left groin suggestive of recent biopsy.Today's PET examination demonstrates multiple enlarged markedly hypermetabolic bilateral axillary lymph nodes, left greater than right (SUV max = 8.4), consistent with recurrent lymphoma.Multiple enlarged hypermetabolic pelvic lymph nodes are present involving the right common iliac, bilateral external iliac, bilateral obturator, and both inguinal locations (SUV max = 9.3), consistent with additional tumor activity.Extensive benign brown fat hypermetabolism is seen within the neck and thorax which may obscure subtle additional hypermetabolic lymph nodes in these regions although no discrete abnormal focus is identified.
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Multiple enlarged significantly hypermetabolic bilateral axillary and pelvic lymph nodes, consistent with recurrent tumor activity.
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Generate impression based on findings.
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Restaging multiple myeloma status post chemoradiation with stem cell transplantation.RADIOPHARMACEUTICAL: 14.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 102 mg/dL. Today's CT portion grossly demonstrates multiple lytic osseous lesions including the skull, left shoulder, left 11th rib, right mid humerus, and left posterior iliac wing. Scattered pulmonary parenchymal ground glass and scar like foci consistent with post inflammatory appearance. A medium peripherally calcified splenic lesion is noted. Scattered atherosclerotic including coronary arterial calcifications are noted. Linear stranding posterior to the left iliac wing consistent with post biopsy inflammation.Today's PET examination demonstrates no suspicious FDG avid lesions to indicate tumor activity currently on whole body PET.Faint bilateral hilar activity consistent with granulomatous inflammation. An osseous focus in the right lower thoracic spine corresponds with anterior osteophyte and is benign. Linear increased activity in the soft tissues posterior to the left iliac spine consistent with expected post biopsy inflammation.
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No suspicious FDG avid lesion to indicate tumor activity currently on whole body PET.
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Generate impression based on findings.
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Male 71 years old Reason: residual from feeding tube, abdominal distension, assess for obstruction/ileus History: as above Overall generalized paucity of bowel gas throughout the abdomen. No evidence of obstruction or pneumoperitoneum. Brachytherapy seeds projected over the lower pelvis.
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Paucity of bowel gas without overt evidence of obstruction.
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Generate impression based on findings.
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Pain and swelling Mild degenerative changes of the first MTP without additional acute superimposed focal abnormality. Specifically soft tissues alignment are within normal limits. Specifically, no evidence of subcutaneous gas, however specific site of concern was identified this may increase sensitivity. Diffuse demineralization however limits sensitivity of the osseous structures.
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Mild osteoarthritis without additional abnormality
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Generate impression based on findings.
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Male 63 years old; Reason: evaluate for renal recurrence History: hx of kidney cancer status post partial nephrectomy ABDOMEN:LUNG BASES: Partially visualized calcified mediastinal and hilar nodes.Enhancing subcentimeter nodule in the anterior right cardiophrenic space (7:26) is suspicious for metastatic focus.LIVER, BILIARY TRACT: 3.1 x 2.7 cm enhancing lesion at the bifurcation of the portal vein into the middle and left portal vein (7:40) follows blood pool, likely hemangioma. Other subcentimeter hypodensities with nodular enhancement (7:33, 7:32) are too small to adequately characterize and may represent hemangiomas or metastatic disease. Another similar lesion measures 3.2 x 2.2 cm (7:49) in the right hepatic lobe.2.2 x 1.9 cm vague hypodensity at the dome of the liver (7:25) is suspicious for metastatic disease, but incompletely characterized.Irregular continuous rim enhancing hypodensity seen in the posterior right hepatic lobe (7:38) measuring 1.5 x 1.4 cm is suspicious for capsular metastatic disease, and other similar appearing disease is noted posteriorly along the liver surface.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Postsurgical changes compatible with partial right nephrectomy are noted. Several enhancing soft tissue nodules are in the perinephric/pararenal space compatible with metastatic disease. A 1.1 x 9 mm metastasis contacting the parenchyma is immediately anterior to the right kidney (7: 79). Left parapelvic cysts.RETROPERITONEUM, LYMPH NODES, MESENTERY: Innumerable enhancing metastatic foci with central hypodensity/necrosis are seen. For example, 1.3 cm (7:53) adjacent to the gallbladder, 1.5 cm anterior to the gallbladder (7:53). Also, a large, necrotic peri-portal mass/node is seen measuring 3.2 x 2.3 cm (7:58). Numerous other peritoneal nodules are seen (7:93, 7:28). One lateral to the spleen measures 1.3 x 1.2 cm (7:28). Another large necrotic enhancing mass is seen adjacent to small bowel in a postsurgical site in the right lower quadrant, measuring 2.6 x 2.4 cm (7: 129)BOWEL: No significant abnormality noted.BONES, SOFT TISSUES: Metastatic focus seen in the right rectus abdominis measuring 1.1 x 1 cm (7:82). OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
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1.Status post partial right nephrectomy with widespread metastatic disease involving the peritoneum, retroperitoneum, right rectus abdominis, and possibly liver, further described above. Some of these liver lesions may represent hemangiomas, and if clinically indicated, further evaluation with MRI is suggested.
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Generate impression based on findings.
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Headache. There is no evidence of intracranial hemorrhage or mass. There is a punctate focus of hypoattenuation in the left basal ganglia. There is also mild patchy cerebral white matter hypoattenuation. There are bilateral basal ganglia calcifications. The ventricles are normal in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. There is partial opacification of the right sphenoid sinus with sclerosis of the surrounding walls. The skull and scalp soft tissues are unremarkable. There are bilateral lens implants.
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1. No evidence of acute intracranial hemorrhage.2. A punctate focus of hypoattenuation in the left basal ganglia may represent a lacunar infarct of indeterminate age and mild patchy cerebral white matter hypoattenuation may represent small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.3. Partial opacification of the right sphenoid sinus with features of chronic sinusitis.
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Generate impression based on findings.
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Check osteoarthritis Unchanged severe osteoarthritic changes with bone on bone narrowing, extensive subchondral cysts, sclerosis and osteophytes. Flattening of the femoral head shape again observed and similar to prior study. No evidence of dislocation or new superimposed acute abnormality such as a fracture.
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Severe right hip osteoarthritis, unchanged
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Generate impression based on findings.
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60 year-old with mass of the left breast. The patient has may have bumped her left breast, though a clear history is difficult to ascertain. Three standard views of the right breast, two standard views of the left breast and left spot compression views (a total of 11 images, the patient refused a left ML view) were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. There is a mixed density mass in the superficial anterior aspect of the left upper outer quadrant. There appear to be fat density areas within the mass. Associated with this is mild increased surrounding density suggesting edema. Scattered benign calcifications are present bilaterally. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the left breast. Normal-sized lymph nodes project in each axilla.ULTRASOUND
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Findings at the site of palpable concern may represent fat necrosis, though other etiologies are not excluded entirely at this time. Suggest a short term follow up unilateral mammogram with possible ultrasound in 6 to 12 weeks to ensure that the findings remain stable or are decreased.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months).
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Generate impression based on findings.
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Basketball injury two weeks ago and low back painVIEWS: Lumbar spine AP/lateral/lumbosacral junction lateral (3 views) 01/26/15 Vertebral body heights and disk spaces are maintained. No fracture is seen. No spondylolysis or spondylolisthesis is present.
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Normal examination. If pain persists MR may be helpful..
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Generate impression based on findings.
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Female, 54 years old. Enteric tube tip projected over the left upper quadrant. The upper portion of the tubing is incompletely imaged. Surgical staples projected over the central abdomen, left upper quadrant and left lower quadrant. Suture material projected over the pelvis consistent with completion proctectomy surgery. No evidence of retained radiopaque foreign body.
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No evidence of unexpected radiopaque foreign body.Findings conveyed to Dr. Hurst at 1 p.m. 01/26/15.
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Generate impression based on findings.
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Surveillance imaging, check hardware Unchanged anterior C5 to C7 fixation and posterior fixation of C3 through C5 fixation. Specifically the middle screw of the anterior sideplate again demonstrates surrounding lucency and is of uncertain significance however the proximal and distal anchoring screws are otherwise well engaged and unchanged. Similar lucency is observed surrounding the proximal posterior screws anchoring the C3 vertebral level; also unchanged.Cervical spine demonstrates straightening with associated fusion of C5 distally. Moderate to marked degenerative changes are otherwise observed in the mid cervical spine.No evidence of instability
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Unchanged lower anterior cervical and posterior mid cervical fixation with underlying associated fusion; as described
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Generate impression based on findings.
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Metastatic breast cancer, bacteremia, sinus congestion. There is an apparent air-fluid level in the right maxillary sinus. There is also moderate mucosal thickening in the left sphenoid sinus. The other paranasal sinuses are clear. There are bubble secretions within teh basal cavity. There is nasal septal deviation to the left. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. There are partially-imaged hyperattenuating lesions in the right cerebellar hemisphere, right precuneus, and left occipital lobe.
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1. Findings compatible with acute rhinosinusitis.2. Partially-imaged hyperattenuating intracranial lesions are compatible with hemorrhagic metastases. Please refer to the prior brain MRI report for additional details.
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Generate impression based on findings.
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Male 35 years old; Reason: pt with history of lymphoblastic lymphoma, reevaluation History: no sx or adenopathy at present CHEST:LUNGS AND PLEURA: Scattered micronodules, no pleural effusion.MEDIASTINUM AND HILA: Interval decrease in size of heterogeneous hypoattenuating anteromediastinal mass, measuring 4.3 x 2.9 x 3.2 cm in craniocaudal dimension, image 43 series 3, previously measured 4.7 x 3 x 4.3 cm.CHEST WALL: Gynecomastia bilaterally.ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis.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: Previously seen thrombus seen right sided iliac venous thrombus not as well as visualized, may reflect resolution and/or be due in part to differences in timing of IV contrast bolus.BOWEL, MESENTERY: Right lower quadrant postsurgical sequela.PELVIS:PROSTATE, SEMINAL VESICLES: Right testicle directed superiorly, towards junction of scrotum and inguinal canal.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance.
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1. Interval decrease in size of anteromediastinal mass.
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Generate impression based on findings.
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Evaluate NG tube and free air.VIEW: Abdomen AP (one view) 1/26/2015 The NG tube tip is at the level of the GE junction. Mild gaseous distention of the large bowel is seen, with moderate feces seen in the left colon. Incidental note is made of Chilaiditi syndrome. A ventriculoperitoneal shunt catheter is present within the abdomen, with the tip terminating in the right upper quadrant. Orphaned shunt catheter tubing is seen in the left upper quadrant. No pneumoperitoneum, portal venous gas or pneumatosis intestinalis is seen. Streaky left lower lobe opacity consistent with atelectasis.
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1.The NG tube tip is at the level of the GE junction. 2.Mild gaseous distention large bowel with feces present in the left colon3.Left lower lobe atelectasis.
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Generate impression based on findings.
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Hemophagocytic lymphohistiocytosis. Line placement.VIEW: Chest AP (one view) 01/26/15, 1239 Lower extremity central venous catheter is at junction of inferior vena cava and right atrium.Cardiothymic silhouette is normal. No focal lung opacities present.Mildly to moderately dilated gas filled stomach is seen.
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Lower extremity central line tip at junction of inferior vena cava and right atrium.
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Generate impression based on findings.
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Reason: are there enteric fistulas to the perineum? History: multiple ECFs after DLI; patient is s/p proctectomy and total colectomy. Scout radiograph showed a nonobstructive bowel gas pattern. Fluoroscopic evaluation showed normal mucosa throughout the small bowel. There was nonobstructive adhesion (image #12/1). Small bowel was located in the upper abdomen and none seen in mid/lower pelvis. No communication with bladder, rectum or perineum was noted. TOTAL FLUOROSCOPY TIME: 7:29 minutes
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Small bowel was located in the upper abdomen and none noted in mid/lower pelvis. No communication with bladder, rectum or perineum was noted. Nonobstructive adhesion was noted.
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Generate impression based on findings.
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17-year-old female with pain, evaluate for ligament disruption Intra-articular contrast is noted within the radioscaphoid joint without extension to the mid carpal or distal radioulnar joints. The scapholunate and lunotriquetral intrinsic ligaments are intact. The triangular fibrocartilage appears intact. There is also contrast distending the pisiform recess with perhaps some extension to the adjacent soft tissues. The extensor and flexor tendons are intact. The bone marrow signal is normal throughout.
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Intact intrinsic ligaments and triangular fibrocartilage without specific findings to account for the patient's pain.
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Generate impression based on findings.
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40 year old with history of benign appearing mass in right breast. 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. Stable bilateral benign morphology masses and benign calcifications. Some of the calcifications are within hyalinized fibroadenomas. Extensive ductal ectasia again noted bilaterally. No new dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast.
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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. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
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Generate impression based on findings.
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25 year-old female status post curettage of left calcaneus aneurysmal bone cyst. Evaluate for healing/recurrence. Increased density within the calcaneus, compatible with curettage and packing of known aneurysmal bone cyst, appears similar to that seen on the prior study. There may be mild maturation of bone along the superior aspect of the posterior calcaneal tuberosity. We see no findings to suggest tumor recurrence. The talus is slightly dorsiflexed, similar to that seen on the prior study.
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Postoperative changes of curettage and packing of aneurysmal bone cyst, appearing similar to those seen on the prior study.
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Generate impression based on findings.
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Small bowel carcinoid with hepatic disease, evaluate and compare to outside CT CHEST:LUNGS AND PLEURA: Lung nodule in the right upper lobe measures up to 9 mm (series 9, image 65), unchanged. Additional scattered pulmonary micronodules. Small bilateral pleural effusions, left greater than right.MEDIASTINUM AND HILA: Enlarged cardiophrenic lymph node measures 4.4 x 1.4 cm (series 7, image 83), unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic metastases appear similar to the prior exam given slight differences in phase of contrast. The largest lesion is in the left hepatic lobe and measures 5.0 x 3.7 cm (series 80252, image 37), previously 4.8 x 3.7 cm. Extensive perihepatic peritoneal soft tissue deposits appearing similar to the prior exam. Large amount of ascites, unchanged.SPLEEN: No significant abnormality noted.PANCREAS: Bulbous appearance of the pancreas; metastatic involvement is not excluded.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Peritoneal carcinomatosis. No evidence of bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Soft tissue deposit in the pelvis with findings suspicious for seminal vesicle invasion measures 4.5 x 3.2 cm (series 7, image 189), previously 4.6 x 3.2 cm.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.
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1.Liver metastases and peritoneal carcinomatosis appearing similar to the prior exam with measurements as above.2.Stable right upper lobe pulmonary nodularity and cardiophrenic lymph node.
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Generate impression based on findings.
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67-year-old female with previous subdural hematoma, evaluate for resolution. Right parietal burr hole is again demonstrated, compatible with prior subdural hematoma evacuation. No residual extra-axial collection is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present. The gray-white differentiation is maintained. The ventricles and sulci are prominent, consistent with mild age-related volume loss. No extra-axial collections are identified. Redemonstration of hypoattenuation in the right pre-central and post-central gyri is likely related to chronic ischemia. Stable bilateral cerebellar and left cerebral chronic infarcts. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent chronic small vessel ischemic changes, and are unchanged.There is mucosal thickening of the right anterior ethmoid air cells, otherwise the paranasal sinuses and mastoid air cells are clear. There is mild leftward deviation of the nasal septum. Chronic right lamina papyracea defect with extraconal orbital fat herniation is unchanged from prior exam. The skull and scalp soft tissues are otherwise unremarkable.
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No residual extra-axial collection.
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Generate impression based on findings.
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Reason: h/o poorly diff thyroid ca, as well as small cell carcinoma. Compare to outside, measurements pls History: none CHEST:LUNGS AND PLEURA: Status post right upper lobectomy, with continued decrease in postoperative soft tissue thickening along the staple line, now without discrete measurable component (0 mm on current, 10 x 10 mm on prior) No new nodules or masses. No pleural effusions. MEDIASTINUM AND HILA: Status post total thyroidectomy. No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion. Moderate coronary arterial 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: Small renal hypodensities are unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Postoperative changes of left aortofemoral bypass with chronic occlusion of the left limb partially imaged.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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Status post right upper lobectomy and thyroidectomy without evidence of metastatic disease or significant interval change.
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