instruction
stringclasses 1
value | input
stringlengths 6
8.98k
| output
stringlengths 5
3.11k
|
|---|---|---|
Generate impression based on findings.
|
Headache for 2 days, which disrupted sleep. Evaluate for intracranial abnormality. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
|
No evidence of intracranial hemorrhage, mass, or cerebral edema.
|
Generate impression based on findings.
|
Reason: interval change RLL cavitary lesion History: elevated WBC; chronic cough LUNGS AND PLEURA: Redemonstration of postsurgical changes of a right upper lobectomy including right volume loss and rightward shift of the mediastinum. Right lower lung fluid-filled necrotic cavity and overlying atelectasis/consolidation with air fluid level. Associated severe bronchiectasis also similar to prior. Scattered pleural calcifications.New left basilar patchy consolidation and bronchial wall thickening.Severe centrilobular emphysema. Nodular scarlike opacities in the left lung are unchanged.MEDIASTINUM AND HILA: Rightward shift of the mediastinum. Heart size is normal with no significant pericardial effusion. Severe coronary artery and aortic calcifications. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Stable postsurgical deformities of right-sided ribs. Multilevel compression depression deformities and kyphosis.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Moderate vascular calcifications.
|
1.Right postsurgical changes.2.Persistent fluid filled cavity in the right lung base with overlying atelectasis/consolidation with air fluid level suspicious for a persistent lung abscess.3.New left lower lobe patchy consolidation and bronchiectasis, likely infection related to aspiration.
|
Generate impression based on findings.
|
Paresthesias, evaluate for intracranial lesion No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. There is mild asymmetry involving the bilateral lateral ventricles which is a normal variant. No hydrocephalus. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact.
|
No evidence of acute intracranial hemorrhage or mass effect. If there is continued suspicion for intracranial pathology, MRI can be considered..
|
Generate impression based on findings.
|
45 years, Female. Reason: Evaluate for obstruction History: constipation. Mildly prominent left upper quadrant small bowel loops measuring up to 2.3 cm without evidence of obstruction. Residual oral contrast material is noted distally within the colon from recent CT scan.
|
Nonobstructive bowel gas pattern.
|
Generate impression based on findings.
|
Female 19 years old Reason: Eval for resolution of abscesses History: abscess on previous CT, ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is no evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is distention of the left renal vein proximal to where it passes posterior to the superior mesenteric artery, where it is narrowed. Distal to this the vein takes on a more normal caliber, suggestive of Nutcracker syndrome; correlate clinically. This is unchanged.RETROPERITONEUM, LYMPH NODES: Multiple unchanged retroperitoneal lymph nodes identified, presumably reactive in etiology.BOWEL, MESENTERY: Stable postsurgical changes including total colectomy, J-pouch formation and right lower quadrant diverting ileostomy formation. There are multiple small bowel to small bowel anastomoses. There is no evidence of bowel obstruction.There are multiple complex, partially interconnected fluid collections in the left hemipelvis which have decreased in size compared to prior. The largest measures 2.5 x 1.6 cm (image 109; series 4) along the left pelvic sidewall previously referenced most inferior posterior present anterior to the sacrum measures 1.7 x 0.8 cm (image 105; series 4). Phlegmonous change in the presacral space persists.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Significant volume of air within the bladder is evident, correlate for recent instrumentation.LYMPH NODES: Scattered prominent pelvic lymph nodes, which are presumably reactive in etiology.BOWEL, MESENTERY: See aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: Fluid collections are described above.
|
Slight interval decrease in size of multiple pelvic fluid collections. Evolving presacral pelvic phlegmon.
|
Generate impression based on findings.
|
Male 77 years old Reason: Patient with HCC and hx of epigastric abscess and recent PNA now with strep bacteremia, please evaluate for progression of disease, sources of infection/ abscess, consolidation, effusion History: As above CHEST:LUNGS AND PLEURA: Bilateral pleural effusions, mild on the right, moderate on the left, both slightly increased compared to prior study. There is compressive atelectasis. Right upper lobe opacification with adjacent scarring/atelectasis is not significantly changed compared to prior study.MEDIASTINUM AND HILA: Right paratracheal lymph node measures 1.2 x 1.1 (series 20, image 29), previously 1.2 x 1.0 cm. Mild coronary artery calcification.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. Confluent bilobar hepatocellular carcinoma again seen. This measures approximately 24.3 in maximum dimension (series 19, image 55), previously 22.2 cm in maximum dimension, with increasing central hypoattenuation, likely reflecting necrosis. The hepatic artery and main portal vein are patent. The left portal vein is occluded just distal to its origin, unchanged in appearance compared to prior study.Multiple enlarged porta hepatis nodes are unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral subcentimeter hypoattenuating renal lesions are too small characterize.RETROPERITONEUM, LYMPH NODES: Mild/moderate calcific arteriosclerosis of the abdominal aorta and branch vessels.BOWEL, MESENTERY: Peritoneal nodularity consistent with carcinomatosis is not significantly changed abdomen (for example; series 19, image 51).BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate abdominal and pelvic ascites, increased compared to prior study.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
1. Confluent bilobar hepatocellular carcinoma minimally increased in size compared to prior study. There is regional lymphadenopathy and peritoneal carcinomatosis, not significantly changed compared to prior study.2. Moderate ascites and bilateral pleural effusions, slightly increased compared to prior study.
|
Generate impression based on findings.
|
altered mental status No evidence of acute ischemic or hemorrhagic lesion.Minimal patchy low attenuations on bilateral periventricular white matter indicating non specific small vessel disease. No change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
|
No evidence of acute ischemic or hemorrhagic lesion.No change of non specific small vessel disease since prior exam.
|
Generate impression based on findings.
|
Reason: eval staging for metastatic breast cancer History: metastatic breast cancer CHEST:LUNGS AND PLEURA: Extensive pleural nodularity consistent with pleural-based metastatic disease. Surgical suture material from right lower lobe wedge resection. 6-mm nodule (series 4 image 55) in the left lung also suspicious. No pleural effusions.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy. Reference pretracheal node measures 13 mm in short axis (series 3 image 34). Severe coronary calcification. No pericardial effusion.CHEST WALL: Extensive lytic and sclerotic osseous metastases. See MRI cervical spine for further description of cervical spine findings.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: 1.5 cm right adrenal nodule (series 3 image 90) suspicious for metastatic disease.KIDNEYS, URETERS: Left renal cyst.RETROPERITONEUM, LYMPH NODES: Enlarged periportal lymph node measures 3.1 x 1.4 cm (series 3 image 96). Atherosclerotic calcification of the abdominal aorta and branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive sclerotic and lytic osseous metastases.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Calcified enlarged heterogeneous uterus, presumably reflecting fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive sclerotic and lytic osseous metastases.OTHER: No significant abnormality noted.
|
1. Extensive pleural and osseous metastatic disease. 2. Right adrenal nodule and left pulmonary nodule also suspicious for metastatic disease. 3. Mediastinal and mesenteric lymphadenopathy.
|
Generate impression based on findings.
|
47 year old female s/p left femoral catheter placement. Left femoral catheter tip at the L5/S1 level, likely in the left common iliac vein. Partially visualized right lower extremity vascular stent. Nonobstructive bowel gas pattern.
|
Left femoral catheter tip at L5/S1 level, tip likely in left common iliac vein.
|
Generate impression based on findings.
|
CHEST:LUNGS AND PLEURA: Moderate apical predominant emphysema. Scattered pulmonary micronodules, unchanged.MEDIASTINUM AND HILA: Moderate coronary artery and thoracic aorta atherosclerotic calcifications. The ascending aorta is ectatic, and measures 3.6 cm just superior to the coronary ostia. Heart size within normal limits, no pericardial effusion.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: Extensive atherosclerosis of the abdominal aorta, without dissection.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.VASCULATURE:Ectasia of the proximal right common iliac artery up to 1.8 cm. The celiac artery, superior mesenteric artery, renal arteries and and inferior mesenteric artery are widely patent.
|
1.Ascending aorta and right common iliac artery ectasia as above.2.Moderate pulmonary emphysema.
|
Generate impression based on findings.
|
Respiratory distress, status-post intubation.VIEW: Chest AP (one view) 1/28/2015, 08:01 Endotracheal tube tip terminates below thoracic inlet and above the carina. The left upper extremity PICC tip terminates in the left subclavian vein.Left lower and right lower lobe atelectasis persists. The cardiothymic silhouette is unchanged. There is severe levoscoliosis of the thoracolumbar spine.
|
Left lower and right lower lobe atelectasis unchanged.
|
Generate impression based on findings.
|
syncope and ataxia No evidence of acute ischemic or hemorrhagic lesion.Minimal non specific small vessel ischemic disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
|
No evidence of acute ischemic or hemorrhagic lesion.
|
Generate impression based on findings.
|
16 months old female with ventricular shunt and headache. There is an intact right parietal approach ventriculostomy catheter terminating within the body of the left lateral ventricle and unchanged ventriculomegaly. There are bilateral hyperattenuating subdural fluid collections that have decreased in size. For example, they currently measures up to 5 mm in thickness along the right cerebral convexity (previously 10 mm), and up to 7 mm in thickness along the left cerebral convexity (previously 13 mm). There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable.
|
Intact ventriculostomy catheter and unchanged ventriculomegaly with bilateral subdural fluid collections that have decreased in size.
|
Generate impression based on findings.
|
72-year-old female with a personal history of left breast cancer status post lumpectomy followed by mastectomy in 2013. The patient also underwent chemotherapy and hormonal therapy. She also has a history of left breast duct removal in 1980 and benign biopsy in 1982. Family history of ovarian cancer in sister diagnosed at 30. No current breast complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Multiple benign calcifications are present. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
|
Generate impression based on findings.
|
50 year old male s/p Dobbhoff placement. Pelvis excluded from field of view. Dobbhoff tube tip at junction of gastric fundus and body. Incompletely imaged but mildly dilated and centralized small bowel loops measuring up to 3 cm. Left retrocardiac opacity and left pleural effusion; please see same day chest radiography for further details.
|
1.Dobbhoff tip at junction of gastric fundus and body. 2.Incompletely imaged but mildly dilated and centralized small bowel loops, which likely represents persistent ileus and ascites.
|
Generate impression based on findings.
|
Male 7 years old; Reason: refractory stage 4 neuroblastoma on therapy; assess for response after 2 cycles of therapy There are several new additional MIBG avid osseous metastases in the lower thoracic and upper lumbar spine seen on SPECT images; the prior lesions in the lower thoracic and lumbar spine are not significantly changed. There is a new MIBG avid focus in the sacrum. Previously noted MIBG avid foci in the bilateral iliac bones and bilateral femuri are not significantly changed. There is redemonstration of multiple soft tissue metastases in the left suprarenal region as well as in the upper abdomen within or adjacent to the pancreatic head not significantly changed.There is normal physiologic radiotracer distribution is seen in the salivary glands, myocardium, liver, bowel, and bladder.
|
Interval progression of disease as described above.
|
Generate impression based on findings.
|
Ataxia, rule out bleed There is evidence of prior AVM embolization in the right parietal lobe. There is hypodensity in the right parietal lobe which may represent vasogenic edema and/or gliosis. There is mass-effect on the atrium of the right lateral ventricle and midline shift of 8 mm at the level of the foramen of Monro minimally worse compared to 1/14/2015. No evidence of acute hemorrhage. No significant change in asymmetric enlargement of the left lateral ventricle suggestive of a mild entrapment.There are small mucous retention cyst within the bilateral maxillary sinus.. Mastoid air cells are clear. Calvarium is intact.
|
1. Evidence of right parietal AVM status post embolization.2. There is surrounding hypoattenuation which may represent gliosis and/or edema. There is mass-effect and midline shift stable to mildly worse compared to 1/14/2015. No evidence of acute hemorrhage.
|
Generate impression based on findings.
|
Pain. Prosthetic assessment. Two views of the right hip are provided. Components of a total hip arthroplasty device are situated in near anatomic alignment without radiographic evidence of hardware complication.The AP view of the pelvis reveals the aforementioned right total hip arthroplasty device. Moderate osteoarthritis affects the left hip. Moderate degenerative arthritis also affects the pubic symphysis.
|
Right total hip arthroplasty and osteoarthritis as above.
|
Generate impression based on findings.
|
66 years, Male. Reason: check removal of ureteral stent s/p kidney transplant. Average to above average stool burden. Nonobstructive bowel gas pattern. Right ureteral stent has been removed. Vascular calcifications. Partially visualized right femoral orthopedic hardware.
|
Interval removal of ureteral stent. Nonobstructive bowel gas pattern.
|
Generate impression based on findings.
|
Reason: 63 y/o with R upper lobe mass with recurrent PTX, concern for malignancy vs infection, please eval for LAD, also need high resolution CT History: SOB, recurrent PTX. LUNGS AND PLEURA: Multiple right upper lobe irregular pulmonary nodules with associated scarlike opacities. For reference, right upper lobe spiculated pulmonary nodule measures 17 x 20 mm (series 4 image 33). Additional scattered bilateral pulmonary micronodules. Moderate right pneumothorax.Moderate bilateral lower lobe atelectasis/consolidation.Moderate centrilobular and paraseptal emphysema.No pleural effusions.MEDIASTINUM AND HILA: No significant mediastinal lymphadenopathy. Mildly enlarged right hilar lymph node measures 11 mm in the short axis (series 3 image 47). Severe coronary artery calcifications. Heart size is normal with trace pericardial effusion/thickening.CHEST WALL: Moderate amount of right chest wall subcutaneous emphysema.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Normal variant colonic anterior superimposition over the liver. Pancreatic calcifications.
|
1.Right upper lobe irregular nodules both suspicious for primary lung cancer.2.Moderate right pneumothorax and right chest wall subcutaneous emphysema.3.Moderate emphysema.4.Mildly enlarged right hilar lymph node.5.Severe coronary artery calcifications.
|
Generate impression based on findings.
|
Diffuse brain atrophy a bit more significant on bilateral mesial temporal area, no change since prior scan.Large right forehead subgaleal hematoma without underlying skull fracture.No evidence of intracranial acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear.
|
1. Large subgaleal hematoma without underlying skull fracture, right forehead.2. No evidence of intracranial acute ischemic or hemorrhagic lesion.3. Diffuse brain atrophy, no change since prior scan.
|
Generate impression based on findings.
|
Malignant pancreatic neoplasm. Biliary stent in place, now with fever. Evaluate for progression of disease, biliary obstruction or abscess. CHEST:LUNGS AND PLEURA: Lingular scarring unchanged. No suspicious pulmonary nodules or masses. No pleural effusion.MEDIASTINUM AND HILA: Reference subcarinal lymph node is roughly stable measuring 3.6 x 3.2 cm (image 41; series 16). Additional reference high right paratracheal lymph node has equivocally increased in size and measures 2.5 x 1.8 cm (series 16; image 15). No hilar lymphadenopathy. Cardiac size is within normal limits without pericardial effusion. Mild coronary artery calcifications. Right CVC tip in the cavoatrial junction. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Metallic stent with associated pneumobilia. No evidence of dilated biliary ducts. Gallbladder is increased in size with enhancing walls. No significant inflammatory changes. Suggest correlation with ultrasound given the patient's clinical status.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic mass is difficult to measure on today's exam and may have increased slightly in size. It currently measures approximately 4 0.6 x 3.9 cm (image 102; series 16). Stable persistent pancreatic ductal dilation. The portal vein, hepatic artery, and gastroduodenal artery structures remain encased. ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple prominent peripancreatic lymph nodes are again identified. Reference peripancreatic node is unchanged and measures 1.6 x 1.3 cm (series 16 image 100).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Anterior abdominal wall bilateral injection granulomas. Mild degenerative disease of the thoracolumbar spine. Lucent lesion in the T9 vertebral body appears stable and can be followed.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: Mild degenerative disease of the lumbosacral spine.OTHER: No significant abnormality noted.
|
Gallbladder appears distended on today's exam compared to prior; given clinical presentation, suggest correlation with right upper quadrant ultrasound exam. Neoplastic disease is roughly stable.
|
Generate impression based on findings.
|
Follow-up of recurrent acinic cell cancer treated with surgery, radiation, and TFHX. There are unchanged post-treatment findings related to right parotidectomy and neck dissection with right submandibular gland dissection. There is persistent ill-defined soft tissue in the treatment bed, but no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. There are denervation changes in the right tongue. The thyroid and remaining salivary glands are unchanged. The major cervical vessels are patent. The osseous structures are unchanged. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.
|
Unchanged post-treatment findings without evidence of measurable locoregional tumor recurrence or significant lymphadenopathy in the neck.
|
Generate impression based on findings.
|
Female 55 years old Reason: r/o PE, p/w DOE, hx of SLE on coumadin History: DOE PULMONARY ARTERIES: No evidence of acute pulmonary embolism. Pulmonary artery is normal in size. No evidence of right heart strain.LUNGS AND PLEURA: Scattered linear atelectasis/scarring. No pleural effusions. No suspicious masses or nodules. No ground glass opacities.MEDIASTINUM AND HILA: Normal heart size with small pericardial effusion. Small nonspecific mediastinal lymph nodes.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
|
No acute pulmonary embolism. Small pericardial fluid collection, correlate for possible uremic pericarditis is appropriate clinical context.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative.
|
Generate impression based on findings.
|
57-year-old male left lower quadrant pain in the setting of diverticulosis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple simple cysts in the left kidney. Subcentimeter hypodensities are identified bilaterally, which are too small to characterize, but may represent simple cysts. There is asymmetric fat stranding adjacent to the left kidney, new from prior examination. Again seen is a punctate, nonobstructing stone in the left kidney. There are multiple punctate calculi in the bladder. There is no evidence of hydronephrosis or ureterolithiasis.RETROPERITONEUM, LYMPH NODES: There is no evidence of retroperitoneal lymphadenopathy on the basis of size criteria.BOWEL, MESENTERY: There is colonic diverticulosis without evidence of diverticulitis. There is no evidence of bowel obstruction. Soft tissue density, with rim calcification anterior to the transverse colon may represent previous epiploic appendagitis or omental infarct.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The bladder is nondistended. There are multiple punctate calculi in the bladder.LYMPH NODES: There is no evidence of pelvic lymphadenopathy on the basis of size criteria.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
1. Multiple punctate calculi within the bladder with associated fat stranding adjacent to the left kidney. These findings likely represent recently passed renal calculi and may be the cause of the patient's pain. No evidence of hydroureteronephrosis.2. Punctate nonobstructing left renal calculus.
|
Generate impression based on findings.
|
4 year old female with head trauma. This exam is mildly degraded by motion artifact. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is a small focus of soft tissue swelling overlying the right aspect of frontal bone without underlying fracture.
|
No evidence of intracranial hemorrhage or skull fracture.
|
Generate impression based on findings.
|
Female 78 years old Reason: rule out cholecystitis History: pain, enlarged gall bladder, thickened wall the LIVER: The liver measures 18.0 cm in length. There is no focal liver lesion. The portal vein demonstrates normal directional flow with peak velocity of 0.4 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is distended and contains small shadowing calculi. Gallbladder wall is thickened measuring 0.5 cm. There is mild pericholecystic fluid. Mild dilatation of the common duct at 0.8 cm without filling defect identified.PANCREAS: Unremarkable the pancreatic head. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 10.7 cm. The left kidney measures 12.5 cm. There is no hydronephrosis.OTHER: No significant abnormalities noted.
|
Cholelithiasis and acute cholecystitis. Dr. Michael Ward notified at the time of dictation.
|
Generate impression based on findings.
|
Reason: acute PE? History: increasing SOB on OCP PULMONARY ARTERIES: Technically adequate. No acute pulmonary embolus.LUNGS AND PLEURA: No consolidation, pleural effusion, or pneumothorax.MEDIASTINUM AND HILA: No significant mediastinal or hilar lymphadenopathy. Heart size is with no paracardial effusion. No visible coronary artery calcifications.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.
|
No acute pulmonary embolus.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
|
Generate impression based on findings.
|
Linear STIR hyperintensity is seen along the medial right iliac bone, likely representing biopsy tract. Within the overlying subcutaneous soft tissues, there are a few oval foci of hypointense signal as well as mild diffuse surrounding decreased signal within the subcutaneous fat with mild skin thickening and T2 hyperintensity as well as enhancement. The underlying muscle fibers of the gluteus appear relatively symmetric to the contralateral side, without focal collection or edema.The lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body and disk heights are well-maintained. Marrow signal is relatively low which is a nonspecific finding but remains slightly higher than disk signal. No worrisome focal marrow signal abnormality is appreciated. There is no pathological enhancement. The distal spinal cord and conus are within normal limits with the conus terminating at the upper L1 level.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the lumbar spine. There is a small amount of fluid within the right perirenal space. There is trace fluid in the left perirenal space. Trace fluid is also seen in the right posterior pararenal space. There is partially visualized moderate free fluid within the pelvis.
|
1. Findings within the skin and subcutaneous soft tissues overlying the right posterior iliac bone likely relating to patient's known cellulitis and recent bone marrow biopsy. No definite associated abnormal marrow signal or enhancement, and no focal fluid collection/abscess.2. Nonspecific free fluid within the pelvis as well as the right greater the left perinephric space and right posterior pararenal space.
|
Generate impression based on findings.
|
Reason: eval for areas of bleeding, history of fall with L hip hematoma, hgb drop 11.5 -- 8.5, eval LVAD position changes History: anemia, LVAD, history of GIB CHEST:LUNGS AND PLEURA: Moderate centrilobular emphysema with curvilinear opacity in the right lower lobe cyst with atelectasis. A mild subpleural reticulation without discrete fibrosis. No pleural effusions.MEDIASTINUM AND HILA: Severe atherosclerotic and coronary calcifications. Prosthetic mitral valve. CHEST WALL: LVAD in place with associated marked streak artifact. ABDOMEN:LIVER, BILIARY TRACT: Increased hepatic attenuation consistent with amiodarone deposition. Status post cholecystectomy. Portions of the left hepatic lobe are obscured by streak artifact.SPLEEN: No significant abnormality noted.PANCREAS: Partially obscured by streak artifact.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications.BOWEL, MESENTERY: Focal dilation of bowel loops in the right abdomen to 3.3 cm without discrete transition point to indicate acute obstruction, may represent a focal ileus.BONES, SOFT TISSUES: Multilevel degenerative changes.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomyBLADDER: Bladder stone in the right dependent portion of the bladder.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Hematoma in the soft tissues lateral to the left hip measures at least 4.7 cm in axial dimension and is partially imaged. No fracture or dislocation.OTHER: No significant abnormality noted.
|
1.Left hip hematoma partially imaged.2.LVAD and other findings as described above.
|
Generate impression based on findings.
|
Reason: rule out PE, likely new cancer patient w /34% blasts History: SOB PULMONARY ARTERIES: Technically adequate. No acute pulmonary embolus.LUNGS AND PLEURA: Biapical pulmonary parenchymal scarring. Mild centrilobular and paraseptal emphysema. Right middle lobe and left lingular scarring/atelectasis. Bibasilar dependent atelectasis. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Subcentimeter right thyroid hypoattenuating nodules. Small nonenlarged mediastinal lymph nodes. No visible coronary artery calcifications. Moderate aortic calcifications. Heart size is normal with no pericardial effusion.CHEST WALL: Prominent axillary lymph nodes. Enlarged pericardial, paraesophageal, and retrocrural lymph nodes. For reference, right retrocrural lymph node measures 13 mm in the short axis (series 5 image 213). Dextroscoliosis of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Enlarged gastrohepatic lymph node measures 17 mm in the short axis. Small subcentimeter hypoattenuating focus in the liver is too small to characterize.
|
1.No acute pulmonary embolus.2.Mild emphysema.3.Lymphadenopathy in the chest and visualized upper abdomen, suspicious for metastases or lymphoma.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
|
Generate impression based on findings.
|
28 year old female who felt a small lump in the right breast presents for ultrasound study. The patient does not feel the lump today With physical exam, no discrete mass was palpated in the right breast around 12 o'clock position. Focused ultrasound did not detect any abnormalities at the area of palpable concern.
|
No mammographic evidence of malignancy. Clinical follow-up is recommended. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually at age 40. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: C - Clinical Correlation Needed.
|
Generate impression based on findings.
|
Renal cancer and right frontal bone lesion demonstrated on bone scan. The maxillofacial bone marrow is diffusely heterogeneous. There are more focal subcentimeter areas of concentric lucency and sclerosis in the right frontal bone anterior to the right frontal sinus and superolateral to the right orbital rim. The orbital contents, imaged intracranial structures, and facial soft tissues are unremarkable. The maxillary sinuses and mastoid air cells are clear.
|
The maxillofacial bone marrow is diffusely heterogeneous, with more focal subcentimeter areas of concentric lucency and sclerosis in the right frontal bone anterior to the right frontal sinus and superolateral to the right orbital rim. Differential considerations include renal osteodystrophy with early Brown tumors versus metastatic lesions.
|
Generate impression based on findings.
|
49 year old female with atypical intraductal proliferation, bordering on low grade DCIS, presents for needle localization. Target is a marker clip in the left breast located posteriorly at 3 o’clock. The procedure, risks including bleeding and infection, and benefits of needle-wire localization were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed to confirm patient identity and site of procedure. The left breast was placed in an alphanumeric grid using lateral to medial approach. When the target was positioned in the aperture of the grid, the skin was cleansed with chlorhexidine. Local anesthesia was obtained using 2% Lidocaine. Using coordinates from the grid, a 5 cm Kopans needle was placed through the clip. On orthogonal digital mammography, adequate positioning of the needle was confirmed after adjusting depth so the needle tip was approximately 2cm deep to the center of the target. A spring wire was then deployed. Repeat two view orthogonal digital mammograms reveal the spring wire to be in good position. The digital mammogram was annotated and reviewed with Dr. Jaskowiak prior to the patient's procedure. Patient tolerated the procedure well and was sent to the holding area in stable condition. Dr. Abe performed the procedure.Orthogonal digital specimen radiographs revealed the clip and spring wire to be within the specimen. There are calcifications at the inferior margin, and Dr. Jaskowiak will excise more tissue.
|
Successful needle localization of the left breast clip.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.
|
Generate impression based on findings.
|
Male 66 years old Reason: assess for fibrosis given hepatitis c infection History: as above LIVER: Liver measures 16.1 cm in length. The parenchyma is moderately echogenic and coarsened consistent patient history of chronic liver disease. No focal hepatic mass is identified. The main portal vein is patent and demonstrates normal directional flow with peak velocity of 0.1 m/sec.GALLBLADDER, BILIARY TRACT: There is a 4-mm hyperechoic non-shadowing, non-mobile lesion within the gallbladder consistent with a polyp. There is no biliary dilatation.PANCREAS: Unremarkable where visualized.KIDNEYS: The right kidney measures 9.3 cm. The left kidney measures 9.0 cm. There is no hydronephrosis. There is 1.3-cm left renal cyst.OTHER: The spleen measures 8.5 cm in length.
|
1. Coarsely echogenic hepatic parenchyma consistent with chronic liver disease. No focal hepatic mass.2. Gallbladder polyp.
|
Generate impression based on findings.
|
53 years, Male. Reason: NJ tube placement, esophageal tear History: NJ tube placement Motion artifact limits evaluation.Enteric tube tip overlies the gastric fundus. Residual contrast is seen in the large bowel. Additional amorphous hyperdensity seen in the left upper quadrant may be related to enteric contrast in the gastric fundus as well as in the left pleural space. Loculated large right pleural effusion is partially seen. Two left chest tubes are partially visualized. Please refer to recent chest radiography and CT imaging from same day for additional findings.
|
Enteric tube tip in gastric fundus.
|
Generate impression based on findings.
|
To lesion seen on abdominal ultrasound. Rule out cancer versus benign lesions. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: With respect to the indeterminate lesions described on the recent ultrasound examination:*The lesion in the right lobe (segment 6) measures 1.5 x 1.6 cm (image 36; series 4); it is hypodense and remains indeterminate on enhanced CT*The lesion in the left lobe immediately caudal to the heart (image 19; series 4) measures approximately 1.5 by 0.9 cm. Given small size, is difficult to characterize but on sagittal images it appears there may be peripheral puddling suggesting it represents a hemangioma. *There is a third lesion which was not identified on recent ultrasound exam in the left lobe measuring 7 mm in diameter enhances brightly with characteristics most suggestive of a hemangioma.Calcification is also noted posteriorly in the right lobe of liver. Gallstones as noted on recent CT examination.SPLEEN: Subcentimeter hypodense nodule in the cephalad portion of the spleen is probably benign.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomy. Ovaries not visualized.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Three liver lesions as described above. One is clearly a benign hemangioma, second is probably a hemangioma, and the third is indeterminate. In the absence of known malignancy, it is possible that the third lesion may represent an atypical hemangioma (given hemangiomas elsewhere the liver) however further characterization with dedicated liver MRI is advised. Gallstones.
|
Generate impression based on findings.
|
49 years, Female. Reason: abdominal pain History: abdominal pain, n/v Nonobstructive bowel gas pattern. No evidence of free air.
|
Nonobstructive bowel gas pattern. No evidence of free air.
|
Generate impression based on findings.
|
History of left mastectomy for DCIS in 2012. No new breast complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in right breast.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
|
Generate impression based on findings.
|
56 year-old male with swollen left knee, evaluate for septic versus inflammatory arthritis. History of metastatic melanoma. A large joint effusion is present. Tibiofemoral osteophytes indicate mild to moderate osteoarthritis. No focal lesions to indicate metastases or erosions are evident. Mild osteoarthritis affects the right knee as seen on the frontal view.
|
Large joint effusion and osteoarthritis as described above. Given the large joint effusion septic arthritis cannot be excluded, although the effusion itself is nonspecific.
|
Generate impression based on findings.
|
CLINICAL DATA: Age: 20 years. Sex : Female. Indication: Reason: r/o appy History: RLQ pain, vomiting, fever. 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: No significant abnormality noted.RETROPERITONEUM/LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Appendix within normal limits, no small bowel obstruction or free air.BONES, SOFT TISSUES: No significant abnormality noted.OTHER:No significant abnormality noted.PELVIS:UTERUS/ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of free fluid in the pelvis, nonspecific and likely physiologic.
|
No evidence of appendicitis, or other acute significant abnormality.
|
Generate impression based on findings.
|
Chest pain and upper abdominal pain CHEST:LUNGS AND PLEURA: Patchy air space opacity right lower lobeMEDIASTINUM AND HILA: Mildly enlarged mediastinal lymph nodes.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Mild hepatomegaly without mass or ductal dilatation. Hepatic vessels patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: 3.9 x 3.6 cm left adnexal cystic lesion best seen on image 149 of series 3.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.
|
Patchy air space opacity right lower lobe. While this may represent atelectasis, an early infectious or inflammatory focus cannot be excluded.Mild hepatomegaly without mass or ductal dilatation. No ascites.
|
Generate impression based on findings.
|
70 year-old female with pain Right hip: Hardware components of a total hip arthroplasty device are situated in near-anatomic alignment without evidence of complication.Left hip: Hardware components of a total hip arthroplasty device are situated in near-anatomic alignment without evidence of complication.Pelvis: The aforementioned total hip arthroplasty devices are again noted. Mild osteoarthritis affects the SI joints.Right knee: Narrowing of the medial joint compartment and patellofemoral joint as well as tricompartmental osteophytes indicate moderate to severe osteoarthritis.Left knee: Narrowing of the patellofemoral joint and small medial compartment osteophytes indicate moderate osteoarthritis.
|
Bilateral total hip arthroplasties and knee joint osteoarthritis as described above.
|
Generate impression based on findings.
|
Possible left submandibular lymphadenopathy - marble sized, nontender, non-mobile. The left submandibular space is unremarkable. Indeed, the salivary glands appear unremarkable. There is no evidence of significant cervical lymphadenopathy based on size criteria. There is a partially calcified left thyroid lobe nodule that measures up to 17 mm. There is mid atherosclerotic plaque at the carotid bifurcations. There is a left tonsillolith. The airways are patent. There is multilevel degenerative spondylosis. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.
|
1. No evidence of left submandibular region mass or significant lymphadenopathy in the neck based on size criteria. 2. Partially calcified left thyroid nodule measuring up to 17 mm. A thyroid ultrasound and FNA may be useful for further evaluation.
|
Generate impression based on findings.
|
headache, history of aneurysm coiling NONCONTRAST CT HEADNo evidence of acute ischemic or hemorrhagic lesion on this scan.There is about 10mm sized metallic artifacts indicating previously inserted aneurysm coil mass around Acom artery area. Due to metallic artifacts, precise evaluation of skull base area is not possible.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECKThere is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins are normal.There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries with some wall calcifications but without luminal stenosis. Intracranial ICAs, ACAs and MCAs appear to be normal without evidence of aneurysm.Vertebrobasilar system appears to be normal. There is normal superficial and deep intracranial venous drainage.
|
1. No evidence of acute ischemic or hemorrhagic lesion on this scan.2. Significant metallic artifacts due to prior aneurysm coil mass prevented precise evaluation of coiled aneurysm.3. No CTA evidence of intracranial arterial aneurysm.Comment: since any coiled aneurysm needs to be followed due to potential risk of recanalization. neurointerventional team will reach out the patient and will coordinate her clinic visit for a follow up. Discussed with ER attending at the time of this dictation.
|
Generate impression based on findings.
|
Reason: assess for esophageal abnormality, GERD and/or hiatal hernia History: chronic cough; intermittent dysphagia and epigastric pain/discomfort Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions. Please note that small right apical asymmetric airspace disease likely related to costochondral junction.Double contrast evaluation of the esophagus and gastric cardia/fundus revealed posterior cricoid plication at approximately C4/5 level, a normal variant. No other morphologic abnormalities of the mucosal surfaces or mural contours was noted. Fluoroscopic evaluation of esophageal peristalsis demonstrated mild dysmotility with proximal escape. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. No hiatal hernia was identified.TOTAL FLUOROSCOPY TIME: 5:01 minutes
|
1.Mild dysmotility with proximal escape.2.No reflux or hiatal hernia.
|
Generate impression based on findings.
|
Family history of breast cancer in her mother diagnosed at age 49. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. A questionable focal asymmetry is seen in the right 9 o'clock position. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast.Focused ultrasound was performed for the questionable focal asymmetry in the right 9 o'clock position. There are no solid or cystic lesions in this area.
|
No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram.
|
Generate impression based on findings.
|
There are a few punctate foci of T1 hyperintense signal in the left frontal corona radiata with restricted diffusion. There are no other area of abnormal signal. There is no other diffusion abnormality. There is mild prominence of the extra-axial CSF spaces. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. The pattern of myelination is appropriate for age. There is 6x3 mm T2 hyperintense lesion involving the soft tissues and calvarium along the superolateral aspect of the left orbit which may represent a benign small cystic lesion such as epidermoid.MRA HEAD
|
1. Restricted diffusion and T1 hyperintensity in the left frontal corona radiata consistent with recent white matter injury/ischemia.2. Patent intracranial vasculature.3. Incidentally seen 6x3 mm T2 hyperintense lesion involving the superolateral surface of the left orbit which may represent a benign small cystic lesion such as epidermoid. No intraorbital involvement.
|
Generate impression based on findings.
|
Bariatric surgery with nonintentional weight loss ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post gastric bypass. No evidence for acute, inflammatory, or neoplastic process. No bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Fibroid uterusBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Status post gastric bypass. No evidence for acute, inflammatory, or neoplastic process. No bowel obstruction.
|
Generate impression based on findings.
|
78-year-old female with abdominal pain and nausea. Rule out intra-abdominal pathology. ABDOMEN:LUNG BASES: Bibasilar scarring/atelectasis.LIVER, BILIARY TRACT: The gallbladder is distended. There is associated gallbladder wall thickening and pericholecystic fluid, as well as perihepatic free fluid. These findings are consistent with acute cholecystitis. Punctate dependent gallstones are identified within the gallbladder. There appears to be debris within the distal common bile duct, without definite radiopaque common duct stone identified.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypodensities in the kidneys are too small to characterize, but likely represent simple cysts.RETROPERITONEUM, LYMPH NODES: Vascular calcifications in the aorta and its branches. Moderate coronary calcificationsBOWEL, MESENTERY: Small hiatal hernia.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Foley catheter in place. Gas density within the bladder is nonspecific, but likely related to recent instrumentation.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Nonspecific sclerotic focus in the left ischium. Degenerative changes affect the hips bilaterally, right greater than left. Multilevel degenerative changes affect the visualized thoracolumbar spine.OTHER: No significant abnormality noted
|
1. Findings consistent with acute cholecystitis. Although no definitive radiopaque common duct stone is identified, there appears to be debris within the common bile duct.2. Nonspecific sclerotic lesion in the left ischium.
|
Generate impression based on findings.
|
CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Heart size within normal limits, and there is no pericardial effusion. No significant mediastinal or hilar lymphadenopathy. No appreciable coronary artery calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Redemonstration of the previously described bilobar, multifocal disease with tumor thrombus affecting the entire portal venous system. Multiple collaterals are visible at the hepatic hilum. Multiple additional smaller foci of abnormal arterial enhancement are seen in the left hepatic lobe.Although the patient's known HCC is multifocal and difficult to actually measure, a superior left hepatic lobe reference area of arterial enhancement (13/24) measures 3.5 x 6 cm. An additional right hepatic lobe medial mass with arterial enhancement (13/54) measures 4.1 x 5.2 cm.Hepatic arterial supply arises from the superior mesenteric artery. Liver volumetrics are as follows:Total hepatic volume is 2112 cm³.Right hepatic lobe volume is 1072 cm³.Left hepatic lobe volume is 1033 cm³.SPLEEN: Splenomegaly is again noted, measuring up to 16 cm in length.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Appendix within normal limits.BONES, SOFT TISSUES: Gynecomastia, without significant abnormality noted.OTHER: Small amounts of free fluid in the pelvis.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.
|
1. Findings consistent with given history of multifocal hepatocellular carcinoma.2. Splenomegaly3. Liver volumetrics are as follows: Total hepatic volume is 2112 cm³. Right hepatic lobe volume is 1072 cm³. Left hepatic lobe volume is 1033 cm³.4. The hepatic arterial supply is via the SMA.
|
Generate impression based on findings.
|
Patient with history of fever and neutropenia with perirectal pain PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Negative for acute, inflammatory or neoplastic process. No evidence for perirectal inflammatory process or abscess.
|
Generate impression based on findings.
|
68-year-old with 1 cm mass in her right breast for which ultrasound guided biopsy is requested.. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 10 mm at the 9 o’clock position with increased vascularity, 7 cm from the nipple. The lesion was readily visible. Pre-biopsy CC and ML views show the mass has not significantly changed since the previous mammograms. A stable lymph node is noted anterior to the mass of interest. PROCEDURE: The procedure and its risks, including bleeding, infection, and failure to diagnose, and expected benefits of ultrasound-guided core biopsy with percutaneous placement of a marking clip and post-procedure unilateral mammogram were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time-out form was completed to confirm patient identity and side/type of procedure.The right breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially, with 1% lidocaine with 1:100,000 epinephrine at depth. A 3 mm incision was made in the skin with a #11 scalpel blade. Using aseptic technique, continuous ultrasound guidance and a inferolateral to superomedial approach, four 14-gauge core needle (InRad) specimens were obtained of the lesion. Targeting was judged excellent. All specimens sank to the bottom of the prefilled container of 10% formalin. No specimens floated. Specimen quality was judged excellent.Specimens were sent to Pathology with an accompanying history sheet. Using continuous ultrasound-guidance a Hydromark clip was placed into the lesion in the usual manner. Pressure was held over the biopsy site until all bleeding subsided. The skin incision was closed with a Steri-Strip. Post-procedure digital right CC and ML views revealed the percutaneously placed clip to be in the expected location in the peripheral inferior aspect of the lesion. The lesion is obscured somewhat on the ML view, but the clip appears well located on the CC view. No evidence of hematoma or other complication.A pressure dressing was positioned over the biopsy site and an ice pack positioned over the pressure dressing. Post-procedure instructions were reviewed with the patient both verbally and in writing. She tolerated the procedure well with no evident complications and left the Breast Imaging Department in stable condition.The procedure was performed by Dr. Schacht. Dr. Schacht was present during the procedure at all times.
|
1. Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.2. Note is made that outside paperwork states that left breast mammograms were performed last November and these should be submitted for completeness. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter.
|
Generate impression based on findings.
|
Visual changes, hypotension, headache. Compared to prior CT dated 2/6/2014, there is decrease in hypodensity in the left occipital lobe with residual hypodensity which may represent small infarct as sequela of prior PRES and unchanged from MRI dated 8/7/2014. Unchanged dysplastic and dilated appearance of the lateral ventricles without evidence of acute hydrocephalus. Unchanged parenchymal volume loss. Cerebellar tonsils remain low-lying. No midline shift or uncal herniation. Minimal mucosal thickening in the maxillary sinuses. Mastoid air cells are clear. Calvarium is intact.
|
1. No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2. Sequela of prior PRES with left occipital hypodensity compatible with small chronic infarct and unchanged since prior MR brain from 8/2/2014.
|
Generate impression based on findings.
|
The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are scattered punctate and confluent areas of abnormal low density in the periventricular and subcortical white matter, consistent with grossly stable mild to moderate chronic small vessel ischemic changes, for the portions that are visualized previously on the CT face exam. Focal hypodensity in the left basal ganglia is consistent with a chronic lacunar infarct. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.There is a left sided scleral band. There is redemonstration of left supraorbital frontal scalp thickening and increased density which may relate to an area of residual scarring from previous trauma noted on September 2014 or a new area of hematoma/swelling. The right cerebellar tonsil is somewhat low-lying, with the tip located 6 mm below the level of the foramen magnum. There is significant thinning of the anterior wall of the sella with a somewhat bulbous appearance, although this is unchanged. Prior facial bone imaging demonstrated this area to be fluid density rather than soft tissue.
|
1. No acute intracranial hemorrhage. Grossly stable mild-moderate chronic small vessel ischemic changes which were partially visualized on the prior exam.2. Stable appearance of the sella with significant thinning of the anterior wall and a possible mildly expansile cystic anterior sellar structure, with mild mass effect upon the pituitary tissue. Dedicated MRI of the pituitary gland may be obtained as clinically indicated.
|
Generate impression based on findings.
|
Frequent sinusitis. There are postoperative findings related to endoscopic sinus surgery and Caldwell-Luc procedure bilaterally. There are defects in the lamina papyracea bilaterally. There is extensive opacification of the paranasal sinuses throughout. There are also apparent polypoid opacities in the nasal cavity. There is also diffuse extensive sclerosis of the paranasal sinus walls. There is mild nasal septal deviation anteriorly. The ethmoid roof appears to be intact. The mastoid air cells are clear. The orbital contents and intracranial structures are grossly unremarkable.
|
postoperative findings related to endoscopic sinus surgery and Caldwell-Luc procedure with evidence of chronic pansinusitis and possible nasal polyposis.
|
Generate impression based on findings.
|
Female 78 years old; Reason: 24 hr uptake and pattern of uptake diffuse vs nodular History: hyperthyroidism and toxic nodular goiter The thyroid images demonstrate heterogeneous activity in an enlarged thyroid gland. There are multiple cold nodules noted bilaterally, with the dominant nodule located in the inferior pole of the right lobe. The 24-hour uptake is 20.7 % (normal range 10-30% at 24-hours).
|
Enlarged thyroid gland with multiple cold nodules identified, with the dominant nodule located in the inferior pole of the right lobe.
|
Generate impression based on findings.
|
Recurrent sinusitis treated medically without resolution. There is mild mucosal thickening in the bilateral maxillary sinuses. There is opacification of the majority of the anterior and posterior ethmoid air cells with apparent fluid. There is near-complete opacification of the left sphenoid sinus. There is mild mucosal thickening of the right sphenoid sinus. There is opacification of the frontoethmoid recesses. The frontal sinuses are not pneumatized. There is extensive sclerosis and thickening of the paranasal sinuses walls diffusely. There are apparent polypoid opacities in the nasal cavity. There is mild nasal septal deviation towards the right. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable.
|
Diffuse paranasal sinus opacification with evidence of chronic sinusitis and suggestion of superimposed acute sinusitis and polyposis.
|
Generate impression based on findings.
|
History of recent syncope/fall with subdural hematoma, evaluate stability. Again demonstrated is subdural hematoma along the falx, extending around the left cerebral convexity. Stable appearance of foci of intraparenchymal and subarachnoid hemorrhage in the bilateral frontal lobes, left greater than right. A trace amount of hemorrhage is present in the right occipital horn. Isoattenuating fluid along the left frontal lobe may represent subacute hemorrhage. There is effacement of the left lateral ventricle and mild rightward midline shift, measuring up to 1-cm, which is unchanged. No acute calvarial fractures are identified. A small subgaleal hematoma overlies the posterior parietal bone. There is redemonstration of postoperative findings related to right frontal pterional craniotomy and resection of right anterior temporal lobe mass, with resultant encephalomalacia. The previously described left frontal subcortical hyperattenuation is not appreciated on this exam. The ventricles and sulci are prominent, consistent with mild age-related volume loss. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter, which are nonspecific, but favored to represent age-indeterminate small vessel ischemic changes, not significantly changed compared to prior exam. There are bilateral cataracts. Small retention cysts are present in the bilateral maxillary sinuses and there is an air-fluid level in the right sphenoid sinus. The mastoid air cells are clear.
|
1. There is an unchanged appearance of a subdural hematoma along the falx, extending around the left cerebral convexity, with resultant mild effacement of the left lateral ventricle and 1-cm rightward shift of the midline. 2. Stable multiple foci of intraparenchymal and subarachnoid hemorrhage with intraventricular extension.3. Stable postoperative findings related to right frontal pterional craniotomy and resection of right anterior temporal lobe mass.
|
Generate impression based on findings.
|
A patient submitted outside study for review. Submitted for review are ultrasound images of right breast (1/22/15) performed at AMIC. There is a circumscribed, lobulated hypoechoic mass measuring 11 x 6 x 11 mm at 8 o'clock position, 4 cm from nipple, in the right breast. No blood flow is detected with Doppler study. This mass lesion is likely a fibroadenoma.
|
Benign appearing mass in the right breast at 8 o'clock position, likely a fibroadenoma. Ultrasound follow-up in 6 months is recommended. If clinically indicated, ultrasound guided biopsy can be performed.BIRADS: 3 - Probably benign finding.RECOMMENDATION: X - No Letter.
|
Generate impression based on findings.
|
The scout lateral view and the sagittal reformatted images demonstrate minimal grade 1 retrolisthesis of C3 on C4 which appears degenerative in etiology and otherwise normal alignment of the cervical spine, with a normal cervical lordosis. The vertebral body heights are well-maintained. There is multilevel moderate space narrowing with ventral and dorsal osteophyte formation.There is no acute fracture.At C1-C2, there is a normal relationship of the dens with the arch of C1.There are moderate multilevel spondylotic changes with findings most conspicuous at C3-C4 where a there is perhaps mild central spinal stenosis although there is likely a moderate right foraminal narrowing. Other levels of scattered foraminal narrowing are seen with up to moderate-severe narrowing on the left at C5-C6.There are groundglass opacities dependently within the lung apices. There is significant enlargement of the right lobe of the thyroid gland, measuring up to 3.7 cm transverse. There are degenerative changes involving the right temporomandibular joint.
|
1. No acute fracture or traumatic subluxation. Degenerative grade 1 retrolisthesis of C3 on C4.2. Moderate multilevel spondylotic changes as detailed above, with up to moderate-severe left foraminal narrowing at C5-C6.3. Enlarged right lobe of the thyroid gland. Correlation with thyroid function tests is recommended and thyroid ultrasound may be obtained as clinically indicated.
|
Generate impression based on findings.
|
Female 59 years old Reason: cholelithiasis History: ruq pain LIVER: The liver measures 19.2 cm in length and demonstrates echogenic parenchyma suggestive of fatty infiltration. The main portal vein is patent and demonstrates normal directional flow with peak velocity of 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder without gallstones, wall thickening or pericholecystic fluid. There is no biliary dilatation.PANCREAS: Unremarkable where visualized.KIDNEYS: The right kidney measures 13.4 cm. 1.3-cm simple cyst in the lower pole. The left kidney measures 13.0 cm. 3.3-cm simple cyst in the upper pole.OTHER: The spleen measures 8.7 cm. Multiple hypoechoic lesions within the spleen measuring up to 1.2 cm. These may represent splenic cysts.
|
1. No evidence of cholelithiasis. 2. Mild hepatomegaly with echogenic parenchyma which can be seen with fatty infiltration.
|
Generate impression based on findings.
|
There is anterior cervical discectomy and fusion at C4-C5. There is minimal retrolisthesis of C3 on C4. There is otherwise a normal cervical lordosis. The vertebral body heights are well-maintained. There is variable multilevel disc space narrowing. No worrisome focal marrow signal abnormality is appreciated. Incidental note is made of an enlarged thyroid gland, left greater than right, with small thyroid nodules. Please refer to thyroid ultrasound dated 4/8/2014.C2/3: Unremarkable.C3/4: Minimal retrolisthesis of C3 on C4. Posterior disc osteophyte complex and bilateral uncinate hypertrophy, contributing to mild bilateral neuroforaminal stenosis. No significant spinal canal stenosis.C4/5: Status post anterior cervical discectomy and fusion. There is mild residual thinning of the spinal cord at this level with increased T2 signal, compatible with myelomalacia. Bilateral uncinate hypertrophy and/or hypertrophied bone, contributing to mild right neuroforaminal stenosis. No significant spinal canal stenosis.C5/6: Posterior disc osteophyte complex, bilateral uncinate hypertrophy, ligamentum flavum thickening, and bilateral facet hypertrophy, contributing to moderate to severe right and moderate left neuroforaminal stenosis. No significant spinal canal stenosis.C6/7: Posterior disc osteophyte complex and bilateral uncinate hypertrophy, contributing to moderate right and mild left neuroforaminal stenosis. No significant spinal canal stenosis.C7/T1: Unremarkable.T1/2 (sagittal images only): Disc bulge, grossly similar to prior study.T2/3 (sagittal images only): Disc bulge, grossly similar to prior study.
|
1. Evidence of anterior cervical discectomy and fusion at C4/C5. 2. Stable degenerative cervical spondylosis with stable minimal retrolisthesis of C3 on C4 and scattered foraminal stenoses as described. No significant spinal canal stenosis.
|
Generate impression based on findings.
|
Reason: Hx Lung cancer upper lobe Please compare to prior scans, measurements please History: none CHEST:LUNGS AND PLEURA: Stable right paramediastinal postradiation changes. No new or suspicious pulmonary nodules or masses. Bilateral dependent atelectasis. No pleural effusions.MEDIASTINUM AND HILA: Bilateral thyroid enlargement with heterogeneous nodules, similar to prior. Heart size is normal with no pericardial effusion. Moderate coronary artery calcifications. Mild aortic calcifications. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hypoattenuating foci within the liver, unchanged and likely benign cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cyst, unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta and its branches.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.
|
No evidence of recurrent or metastatic disease.
|
Generate impression based on findings.
|
Liver cancer history and questionable biliary obstruction. Abdominal pain. ABDOMEN:LUNG BASES: Trace right pleural effusion. Bi-basilar atelectasis. Incompletely imaged 6-mm nodule in the right lung (image 1; series 11) may represent a metastases. Correlation with chest CT advised as clinically indicated.LIVER, BILIARY TRACT: Innumerable lesions throughout the liver, predominating an enlarging the right lobe. Main portal vein and hepatic veins appear patent. No significant biliary ductal dilatation identified. Most of the disease is confluent making discrete measurements impossible. For reference purposes, an area of confluent lesions in the right lobe measures 21.4 x 14.5 cm (image 46; series 12).SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative disease in the spine.OTHER: Trace ascites.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Widespread hepatic metastases as described. Possible pulmonary metastasis; correlation with chest CT as clinically indicated.
|
Generate impression based on findings.
|
Reason: abscess; retroperitoneal hematoma History: hematuria; LVAD pt ABDOMEN:LUNG BASES: Right basilar consolidation with innumerable calcified micronodules unchanged. Left basilar scarring/atelectasis. No pleural effusions.LVAD device partially imaged with a small amount of nonspecific fluid surrounding the outflow tract without discrete fluid collection or abscess. LIVER, BILIARY TRACT: Cholelithiasis without specific secondary signs of inflammation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Renal scarring with marked right renal atrophy.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and branches.No retroperitoneal hematoma as clinically questioned.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
No evidence of retroperitoneal hematoma or other acute abnormalities to explain the patient's symptoms. LVAD and other chronic findings as described above.
|
Generate impression based on findings.
|
CLINICAL DATA: Age: 73 years. Sex : Female. Indication: Reason: abd pain with decrease appetite. R/o intra abd path History: pain with some wt loss, decrease appetite. Hx of Hep C not treated. 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: Bilateral hypoattenuating renal cysts.RETROPERITONEUM/LYMPH NODES: Atherosclerosis affects the aorta and its branches. The celiac trunk, SMA, renal arteries, and IMA are widely patent. The abdominal aorta is ectatic.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Scoliosis and degenerative changes are noted about the thoracolumbar spine.OTHER:Cardiomegaly is noted, without significant pericardial effusion.PELVIS:UTERUS/ADNEXA: No significant abnormality noted.BLADDER: Small right-sided bladder diverticulum.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple mineralized injection granulomas in the gluteus musculature. Scoliosis and degenerative changes are noted about the thoracolumbar spine.OTHER: No significant abnormality noted.
|
1.No distinct liver masses.2.No small bowel obstruction, significant ascites or other findings to explain the patient's symptoms.
|
Generate impression based on findings.
|
Periorbital erythema, edema. Preseptal cellulitis versus orbital cellulitis. Question abscess. Assess sinuses. There is edema involving the right preseptal soft tissues without evidence of post-septal extension. There is extensive opacification involving the paranasal sinuses including moderate opacification of the right frontal sinus and bilateral frontoethmoidal recess opacification. Moderate opacification is seen involving the bilateral ethmoid cavities and right greater than left maxillary sinuses. There is also moderate mucosal thickening involving the sphenoid sinus. Compared to 12/23/2014, there is mild worsening of the right maxillary, left ethmoid, and right sphenoid sinus opacification. The right maxillary infundibulum, right greater than left frontal recesses, and bilateral sphenoethmoidal recesses are opacified.There is sclerotic changes involving the ethmoid sinus and the right maxillary sinus indicative of chronic paranasal sinus disease. There are postsurgical areas including prior uncinectomies and ethmoidectomies. Leftward nasal septal deviation. Again seen is nodular soft tissue thickening involving the right medial canthus with erosive changes involving the right lateral nasal wall. Finding is unchanged since 9/25/2014.
|
1 There is thickening involving the right preseptal soft tissues which may represent cellulitis. No posterior extension to suggest orbital cellulitis. If there is high clinical suspicion, postcontrast CT may be helpful to evaluate for subperiosteal abscess.2. Nodular thickening at the right medial canthus with erosion of the adjacent right lateral nasal bone. Finding has been present since at least 9/25/2014 and may represent scar tissue and possibly related to prior surgery.3. Extensive paranasal sinus disease is slightly worse compared to 12/23/2014 as detailed above.
|
Generate impression based on findings.
|
64 years, Female. Reason: 64 y/o w GIB, assessment of endoscopic capsule History: GI bleed Capsule overlying the rectosigmoid colon.Extensive vascular calcification. Left upper quadrant clip and right lower quadrant anastomotic suture line again seen. Please refer to recent chest radiography for additional findings.
|
Capsule overlying region of rectosigmoid colon.
|
Generate impression based on findings.
|
67-year-old male, evaluate rotator cuff, history of prior repair Contrast is noted within the glenohumeral joint with extension into the subacromial subdeltoid bursa via defects within the distal supraspinatus tendon at its attachment (image 45 series 80220). There is no significant retraction of the supraspinatus tendon. The supraspinous muscle, infraspinatus muscle and the teres minor are mildly diffusely atrophied. Glenohumeral alignment is normal limits. Mild joint space narrowing and small osteophytes consistent with osteoarthritis. Widening of the acromioclavicular joint is presumably postoperative.
|
Full-thickness tear of the supraspinatus tendon attachment, without retraction of the tendon. Mild rotator cuff atrophy.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy. History of breast cancer in mother and sister. Three standard digital views of both breasts and a cleavage view 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. Round marker was placed on a skin lesion overlying the right breast. A linear marker was placed on a scar overlying the left breast. A new subcentimeter mass is present in the posterior depth of the left upper outer quadrant. Stable benign calcifications are present bilaterally.No suspicious microcalcifications or areas of architectural distortion are present.
|
New left breast mass. Spot compression imaging and possible ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
|
Generate impression based on findings.
|
Reason: s/p EPD for malignant meso History: for quality of life study patient CHEST:LUNGS AND PLEURA: Interval postsurgical changes of a left diaphragm/pleurectomy. Associated overlying left lower lobe atelectasis/scarring.Right middle lobe pulmonary micronodule compatible with an intrapulmonary lymph node, unchanged. No new or suspicious nodules or masses. MEDIASTINUM AND HILA: Small nonenlarged mediastinal lymph nodes. No significant mediastinal or hilar lymphadenopathy. No visible coronary artery calcifications. Heart size is normal with no pericardial effusion.CHEST WALL: Elevation of the left hemidiaphragm with diaphragmatic patch.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hepatic cysts and hemangiomas, unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cysts, unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
Postsurgical changes of interval left diaphragm/pleurectomy with left lower lobe atelectasis/scarring. No evidence of recurrent disease.
|
Generate impression based on findings.
|
13-year-old male status post trauma with left elbow painVIEWS: Left elbow AP/oblique/lateral (3 views) 01/28/15 No acute fracture or malalignment. No evidence of joint effusion.
|
Normal examination.
|
Generate impression based on findings.
|
Reason: Newly Dx HOP cancer. Needs pancreas protocol Ct Scan. History: Abdominal Pain ABDOMEN:LUNG BASES: No significant abnormality noted. Right breast implant partially imaged. LIVER, BILIARY TRACT: Small lesion in the hepatic dome with nodular discontinuous peripheral enhancement following blood pool is consistent with a hemangioma. Other small nonenhancing hepatic foci are most compatible with cysts, though some are too small to completely characterize. Biliary stent in place with associated pneumobilia.SPLEEN: No significant abnormality notedPANCREAS: Faintly enhancing soft tissue mass along the head of the pancreas is consistent with the patient's known malignancy. The mass measures 2.5 x 2.3 cm in greatest axial dimension (series 10 image 51) causing marked dilation of the pancreatic duct distally up to 8 mm.Tumor abuts portions of the common hepatic artery as well as the main portal vein at its origin without encasement. There is subtle soft tissue infiltration of the porta hepatis, which is indeterminate. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cyst. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Mildly prominent periportal lymph nodes are indeterminate. Retroaortic course of the left renal vein.BOWEL, MESENTERY: Large hiatal hernia. Colonic diverticulosis.BONES, SOFT TISSUES: Dextroscoliosis of the lumbar spine with multilevel degenerative changes.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Likely small uterine fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Dextroscoliosis of the lumbar spine with multilevel degenerative changes.OTHER: No significant abnormality noted
|
1. Pancreatic head mass as described above is consistent with the patient's known neoplasm.2. Indeterminate mildly prominent periportal lymph nodes and subtle soft tissue infiltration of the porta hepatis. 3. Hepatic lesions as described above have an overall benign appearance, though some are too small to characterize.
|
Generate impression based on findings.
|
56 year old female with history of left breast benign biopsy and right breast cyst aspiration. Known breast calcifications. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. A biopsy clip is again seen in the inferior left breast. Multiple clusters of calcifications are unchanged in both breasts. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
|
Generate impression based on findings.
|
Female 62 years old; Reason: Hep c cirrhosis and elevated AFP, evaluate for HCC. Creatnine normal. History: same ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Cirrhotic morphology redemonstrated. Scattered transient subcentimeter arterially enhancing foci, similar to earlier study, likely vascular shunts. No suspicious arterially enhancing lesion with subsequent washout on more delayed imaging seen. Cholelithiasis. Patent hepatic vessels. Patent portal veins. Patent splenic vein and SMV. Stable left lobe arterioportal fistula (probably segment two or 3). SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis. Hypoattenuating left renal lesions, too small to characterize but stable and most likely cysts as noted previously.RETROPERITONEUM, LYMPH NODES: Aortobiiliac atherosclerotic disease is unchanged. Stable mildly enlarged portacaval and porta hepatis lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONE, SOFT TISSUES: Stable degenerative disease spine, buttock calcified granulomas.
|
No substantial interval change. Left lobe arterioportal fistula. No suspicious lesions. Cholelithiasis.
|
Generate impression based on findings.
|
Reason: 73 yo W with NSCLC s/p wedge resection and SBRT to RUL, LLL in 1/2013 and RML lesion in 11/2014. Please assess for response History: None CHEST:LUNGS AND PLEURA: 25-mm and part solid lesion medially at the right apex (series 6/17), slightly more dense since the previous scan and more obviously increased since 3/10/2014, suspicious for a primary adenocarcinoma.Part solid mass in the superior segment of left lower lobe extending across the pleural fissure, measuring 46 mm in maximum axial diameter and with the largest solid component measuring approximately 7 x 17 mm, not significantly changed using comparable measurements, hila compatible with primary adenocarcinoma.Right upper lobe septated cystic lesion measuring 18 mm in diameter, increased since 2008, suspicious for primary carcinoma.Right middle lobe solid nodule adjacent to major fissure measuring 9 x 6 mm (series 6/54) unchanged from the previous scan but increased since 12/2/213, suspicious for primary carcinoma.Surgical staples in the right lower lobe.MEDIASTINUM AND HILA: No significant lymphadenopathy.No pericardial effusion.No visible coronary artery calcification.CHEST WALL: Moderate degenerative disease in the spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hemangiomas in the right lobe and cholelithiasis.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Aortic atherosclerosis and small gastrohepatic lymph nodes, unchanged.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
1. Two right upper lobe, one right middle lobe and one left lower lobe nodule, only minimally changed since the previous scan but all increased compared to earlier scans, consistent with synchronous primary carcinomas.2. No evidence of metastatic disease.
|
Generate impression based on findings.
|
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. No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
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.
|
Generate impression based on findings.
|
62 year old female with history of right breast LCIS status post lumpectomy 1/2012 on Arimidex therapy. Physician felt an area of dense tissue in the left breast and a lump in the eft axilla. Family history of breast carcinoma in four paternal aunts and a paternal cousin. Three standard views of both breasts and two spot magnification views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A linear marker has been placed on a scar overlying the upper inner right breast with subjacent expected postsurgical architectural distortion. A biopsy clip is seen within the lower inner right breast. Innumerable calcifications are seen throughout the right breast. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. Ultrasound study was performed for the palpable area of dense tissue near the nipple in the left breast at 9 to 11 o'clock position, and a palpable lump in the left axilla. Both areas of concern are marked. There is no solid or cystic lesions at the 9 to 11 o'clock position near the nipple. In the left axilla, there is a normal lymph node measuring 17 mm, at the marked area.
|
No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.
|
Generate impression based on findings.
|
Reason: esophageal tear History: SOB, vomiting CHEST:LUNGS AND PLEURA: Two left chest tubes. More anterior chest tube is located within the lung parenchyma associated with hyperdense fluid within the tip and adjacent to the tube compatible with hematoma. Second chest tube with tip in the left posterior hemithorax. Trace pneumothorax. Left hemithorax interstitial edema. Large right loculated pleural effusion with pleural thickening with overlying atelectasis. Small loculated left pleural effusion with pleural thickening with overlying atelectasis/consolidation, some of which is loculated within the major fissure and along the left mediastinum. Contrast material and small foci of gas are seen in the left lower pleural space. MEDIASTINUM AND HILA: Endotracheal tube above the carina. Enteric tube tip in the upper to mid esophagus. Small amount of fluid around the endotracheal tube above the cuff. Multiple small mediastinal lymph nodes. Mildly enlarged subcarinal lymph nodes, likely reactive.The esophagus is collapsed.CHEST WALL: Elevated left hemidiaphragm.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
1.Findings suggestive of distal esophogeal rupture with oral contrast provided prior to examination seen in the left pleural space. 2.Large loculated right and small left pleural effusions with pleural thickening suspicious for empyema. Overlying atelectasis/consolidation.3.Two chest tubes. More anteriorly located chest tube appears to have perforated the lung parenchyma with associated small hemorrhage. Trace left pneumothorax.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. History of ovarian cancer in sister diagnosed at age 62. Two standard digital views and tomosynthesis of both breasts and additional right CC and MLO views 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 linear marker was placed on the scar overlying the right breast. New calcifications are present in the medial superior left breast. Additional benign calcifications are present bilaterally. A stable focal asymmetry is present in the left upper outer quadrant.No suspicious masses or areas of architectural distortion are present.
|
New calcifications in the left breast. Spot magnification imaging is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
|
Generate impression based on findings.
|
66-year-old female, preoperative evaluation for osteoarthritis of the right knee There is approximately 4 degrees valgus orientation of the knee relative to the neutral mechanical axis. Severe osteoarthritis affects the knee. Hardware components of a total left knee arthroplasty device are noted on the AP view.
|
Severe osteoarthritis and mild valgus deformity.
|
Generate impression based on findings.
|
5-year-old male with throat pain and streaks of blood in sputum, reports swallowing a small plastic triangular lego 4 days agoVIEWS: Chest AP/lateral (two views) 01/28/15, 0944 hour Aortic arch, cardiac apex, and stomach are left-sided. Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. No focal pulmonary opacities. Mild to moderate bronchial wall thickening is suggestive of bronchiolitis/reactive airway disease. No radiopaque foreign body is identified.
|
No radiopaque foreign body is identified. Bronchiolitis/reactive airway disease.
|
Generate impression based on findings.
|
Assess for salivary gland/duct calculi. Right submandibular gland pain and swelling. There are calcific structures along the expected course of the right submandibular gland that measure up to 7 mm. There are also subcentimeter calcific structures within the right submandibular gland. There is minimal right submandibular ductal dilatation and no apparent inflammatory changes. The other salivary glands are unremarkable. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid appears unremarkable. The major cervical vessels are patent. There is multilevel mild degenerative spondylosis. The airways are patent. There are postoperative findings related to endoscopic sinus surgery with pansinus opacification and sclerosis of the sinus walls. The imaged intracranial structures are unremarkable. There is a nodule in the right lung apex that measures up to 5 mm.
|
1. Findings compatible with right submandibular sialolithiasis and sialodocholithiasis with minimal ductal dilatation and no apparent inflammatory changes. 2. Postoperative findings related to endoscopic sinus surgery with evidence of chronic pansinusitis. 3. Nonspecific nodule in the right lung apex that measures up to 5 mm. A follow up baseline chest CT may be useful.
|
Generate impression based on findings.
|
Two month old female with pleural effusion.VIEW: Chest AP (one view) 1/28/2015, 9:55 ET tube terminates below thoracic inlet. NG tube tip terminates in the body of the stomach. Left-sided chest tube unchanged. The cardiothymic silhouette size is normal. Slightly improved multifocal streaky opacities. Unchanged right-sided pleural effusion. Small left pneumothorax.The bowel gas pattern is nonobstructive. No pneumoperitoneum, portal venous gas or pneumatosis intestinalis is seen.
|
Slightly improved multifocal streaky opacities and unchanged right-sided pleural effusion.
|
Generate impression based on findings.
|
Reason: s/p 1 month bilateral lung txp. History: DOE PULMONARY ARTERIES: Technically adequate. No acute pulmonary embolus to the segmental level. The main pulmonary artery is slightly enlarged, measuring 3.1 cm, raising the question of pulmonary arterial hypertension.LUNGS AND PLEURA: Postsurgical changes of bilateral lung transplants. Small outpouching at the presumed right mainstem bronchus anastomosis, similar to prior with no associated pneumomediastinum or interstitial emphysema. Evaluation of fine parenchymal detail is limited by motion. Interval resolution of right lower lobe consolidation. Dependent atelectasis. Trace right pleural effusion.MEDIASTINUM AND HILA: Postsurgical changes of bilateral lung transplant. Interval resolution of the postsurgical pneumomediastinum. No visible coronary artery calcifications. Heart size is normal with no pericardial effusion. No significant mediastinal or hilar lymphadenopathy. CHEST WALL: Interval resolution of postsurgical subcutaneous emphysema with exception of a few small foci. Degenerative changes affect the visualized spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Probable left renal cyst, unchanged. Previously identified right hepatic lobe hypoattenuating focus is not well visualized, likely due to phase of contrast.
|
1.No acute pulmonary embolus.2.Mildly enlarged main pulmonary artery, raises the question of pulmonary arterial hypertension.3.Interval resolution of right lower lobe consolidation.4.Expected interval resolution of postsurgical left pneumothorax and near resolution of left chest wall subcutaneous emphysema.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable.
|
Generate impression based on findings.
|
12-year-old male complaining of right hip pain x 2 daysVIEWS: Pelvis AP/frog leg (two views) 01/28/15, 0952 hour No acute fracture or malalignment is evident. No evidence of slipped capital femoral epiphysis. Femoral heads are well seated in the the acetabula.
|
Normal examination.
|
Generate impression based on findings.
|
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. Benign intramammary and axillary lymph nodes are present bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
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.
|
Generate impression based on findings.
|
9-year-old female with nocturnal enuresisVIEW: Abdomen AP (one view) 01/28/15, 1010 hour Moderate amount of stool throughout the colon. Nonobstructive bowel gas pattern. No pneumatosis.
|
Moderate stool burden.
|
Generate impression based on findings.
|
CLINICAL DATA: Age: 71 years. Sex : Female. Indication: Reason: abdominal pain, stoma infection, leukocytosis History: abdominal pain, stoma infection, leukocytosis. Although this exam was performed with contrast, images were obtained at a delay such that very little venous phase contrast remains, limiting evaluation of the soft tissues.LUNG BASES: Minimal basilar scarring, and left lower lung suture line again seen. Mild dependent atelectasis.LIVER, BILIARY TRACT: Cholecystectomy clips.SPLEEN: No significant abnormality noted.PANCREAS: Fatty atrophy of the pancreas.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM/LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrants anterior abdominal wall ostomy site demonstrates soft tissue stranding and has the appearance of an open wound. This may represent cellulitis/wound infection. No loculated fluid collections. Several loops of small bowel have herniated into the subcutaneous fat at the ostomy site, however there is no bowel dilation or wall thickening to suggest incarceration/obstruction.BONES, SOFT TISSUES: Multiple right posterior healing rib fractures are again seen. Lower lumbar spine fixation hardware.OTHER:No significant abnormality noted.PELVIS:UTERUS/ADNEXA: No significant abnormality noted.BLADDER: Layering contrast within the bladder.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
Findings suggestive of right lower quadrant ostomy site wound infection/cellulitis, correlate with physical exam. No drainable fluid collection/abscess is noted at this time.
|
Generate impression based on findings.
|
New onset severe headache. There is no evidence of intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The orbits, skull, and scalp soft tissues are unremarkable.
|
No evidence of intracranial hemorrhage, mass, or cerebral edema.
|
Generate impression based on findings.
|
Complex fluid collection -- postoperative resolving hematoma. Pain and numbness in the right abdomen. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Unchanged left renal calculi. Previously described non obstructing right renal calculus measuring up to 7 mm now is located at the right ureterovesical junction (image 117; series 3). No evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: Left common iliac vein stent extending into the IVC is noted without evidence of thrombosis within the visualized venous system.BOWEL, MESENTERY: No significant abnormality noted. Appendix fills and appears normalBONES, SOFT TISSUES: Post surgical scarring is again seen along the lower anterior abdominal wall.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Postsurgical changes status post hysterectomy. The previously described collection in the left hemipelvis has resolved. Complex multiseptated lesion in the right adnexa and extending into the right lower quadrant adjacent to the cecum is again also seen, better characterized on the prior MRI; consider endometriosis. There is a 3.7 x 1.7 cm soft tissue nodule immediately deep to the rectus muscle (image 106; series 3) which is not changed substantially compared to the prior examination (image 104; series 3; 4/23/2013 study) and therefore probably benign.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
1. Right renal calculus is now located at the right ureterovesical junction. No evidence of associated hydronephrosis.2. Resolution of previously described postsurgical hematomas.3. Indeterminate complex cystic multiseptated lesion of the right adnexa now extends into the right lower quadrant adjacent to the cecum, probably due to distended bladder on today's exam; consider endometriosis.4: Stable soft tissue nodule deep to the rectus muscleThe findings are reviewed with Dr. Lee at the time of dictation. Plan is for FNA of soft tissue nodule deep to the rectus muscle; if no evidence of malignancy is found, surgical exploration will be performed.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of breast cancer in 4 paternal cousins. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram.
|
Generate impression based on findings.
|
Status post resection of craniopharyngioma, postop assessment. There is interval left frontal and parietal craniotomy with underlying pneumocephalus, extra-axial fluid measuring up to 6 mm, and dependent hyperdense fluid, and mild scalp swelling. There is also mild sulcal effacement in the left frontal lobe perhaps due to edema from retraction. The right frontal and right parietal craniotomy sites are unchanged. The left-sided cystic component of the suprasellar mass has decreased in size. However, the right-sided cystic component and more solid midline component with calcifications are grossly unchanged, accounting for differences in techniques. There is a small amount of hemorrhage in the surgical bed. There is persistent mass effect upon the third ventricle. The lateral ventricles appear smaller than in May 2014, but are not significantly changed from the MRI dated 1/13/15. There is no significant midline shift. An air-fluid level is present in the sphenoid sinus. There is scattered mild mucosal thickening of the bilateral maxillary sinuses and left ethmoid air cells. The portions of the mastoid air cells are mildly hypoplastic. The orbits are unremarkable.
|
1. Interval left frontal and parietal craniotomy with a small amount of hemorrhage in the surgical bed.2. Interval partial resection of suprasellar craniopharyngioma. In particular, the left-sided cystic component appears smaller, while the remainder of the tumor appears to be not significantly changed, accounting for differences in technique. MRI of the pituitary region may be useful for further characterization.3. The lateral ventricles appear smaller than in May 2014, but not significantly changed from the MRI dated 1/13/15. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
|
Generate impression based on findings.
|
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. Round markers were placed on skin lesions overlying both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
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.
|
Generate impression based on findings.
|
63 year old female with long-standing intermittent left breast pain presents for routine screening mammography. History of benign left breast biopsy. History of breast cancer in maternal aunt diagnosed at age 37. Two standard digital views of both breasts and an additional right CC view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Stable benign calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
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.
|
Generate impression based on findings.
|
Reason: mets lung cancer, s/p 13 cycles of ABT-700 + Erlotinib. Pls c/w previous study and evaluate tx response. History: lung ca CHEST:LUNGS AND PLEURA: Elevation of the left hemidiaphragm with overlying atelectasis, unchanged. Scattered pulmonary micronodules, unchanged. No new or suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Bilateral thyroid enlargement with heterogeneous nodules, similar to prior.Anterior mediastinal mass abutting the aortic arch and encasing the left common carotid artery and occluding the left brachiocephalic vein measures 2.5 cm (series 3 image 34), unchanged. Additional small nonenlarged mediastinal lymph nodes are also unchanged.Heart size is normal with no pericardial effusion. Mild coronary artery calcifications. Right chest port with catheter tip in the right atrium.CHEST WALL: Right chest port. Left lower cervical/supraclavicular lymphadenopathy again noted. Reference lymph node measures 14 mm in short axis (series 3 image 14), unchanged. Osseous bridging of the left fifth and sixth ribs are again noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatic hypoattenuating lesions are unchanged and likely represent benign cysts.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts, not significantly changed.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Previously identified likely benign water density lesions in the right anterior omentum, unchanged.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
Unchanged anterior mediastinal mass and left lower cervical/supraclavicular lymphadenopathy. No new sites of disease.
|
Generate impression based on findings.
|
History of papillary carcinoma status post resection with recurrent left isthmic nodule; here for repeat ethanol ablation. Left hypoechoic isthmic nodule now measures 0.5 cm. Status post thyroidectomy. Stable thyroidectomy bed without worrisome mass lesion.
|
Repeat ethanol ablation of subcentimeter hypoechoic left isthmic nodule in one month if surgical resection of this lesion is not performed. US FNA W/IMAGE GUIDANCE; 01/28/2014 CLINICAL INFORMATION AND PRE-OPERATIVE DIAGNOSIS: Thyroid carcinoma status post resection with suspicious right level 4 node.OPERATORS: Dr. Chang and Dr. Ward. The attending physician, Dr. Chang, performed the entire procedure.TECHNIQUE: Following a discussion of the procedure with the patient, including its risks, benefits, alternatives and steps to prevent infection, an informed written consent was obtained and documented in the patient's chart. The time-out form was completed to confirm patient identity and side/type of procedure.Localizing US demonstrated a suspicious 0.9 x 0.5 x 0.5 cm level 4 node in the right neck.The skin over the target area was cleansed with Betadine. Transducer was sterilely sheathed. Local anesthesia was obtained using 1% lidocaine, superficially and at depth. Using aseptic technique, and continuous ultrasound guidance, the lesion was sampled using 25 gauge needles. Four fine needle aspirations were performed.Cytology was present to confirm specimen adequacy. Specimen was handed to cytology. The patient tolerated the procedure well without immediate complications. Routine post procedure instructions were communicated to the patient.COMPLICATIONS: NoneESTIMATED BLOOD LOSS: Less than 5 cc. An adhesive bandage was placed on the patient’s skin.
|
Generate impression based on findings.
|
The sulci are within normal limits. The ventricles are somewhat small but likely still remaining within normal limits for a patient of this age. Gray white differentiation is intact. There is no midline shift or mass effect. There are scattered foci of hyperdensity along the superior anterior temporal lobes which likely represent foci of subarachnoid hemorrhage, although adjacent small areas of developing contusion involving parenchyma cannot be entirely excluded. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is a mild left posterior parietal subgaleal hematoma, without underlying fracture.
|
1. Scattered foci of subarachnoid hyperdensity along the anterior temporal lobes, consistent with acute blood products. The possibility of small adjacent developing contusions is not entirely excluded given the history of trauma.2. Left posterior parietal subgaleal hematoma without fracture.
|
Generate impression based on findings.
|
Reason: Pleural mesothelioma please compare to prior exam per recist criteria. History: Pleural mesothelioma LUNGS AND PLEURA: Nodular pleural thickening in the lower right hemithorax consistent with mesothelioma.Reference measurements as follows:1. At the level of the aortic arch (series 20236/33) 2 mm at two o'clock, (previously called at one o'clock), not significantly changed.2. At the level of the main pulmonary artery (series 20236/49) at the 12 o'clock position (previously called 11 o'clock) 8 mm, not significantly changed when using comparable measurements. At the 7 o'clock position 0 mm, unchanged.3. At the level of the right atrium (series 20236/70) at the 4 o'clock position 27 mm, not significantly changed. At the 7 o'clock position 13 mm, slightly increased from 10 mm previously.A lower right paravertebral mass (image 79) measures 32 mm in thickness, unchanged.Nonspecific micronodules in the left lung, unchanged, likely benign.No pleural effusions.MEDIASTINUM AND HILA: No significant abnormality noted.Bilateral mediastinal and hilar lymphadenopathy, right greater than left.Reference right hilar lymph node (image 50) 27 mm, not significantly changed.Large subcarinal lymph node (image 53) 34 mm, not significantly changed.No pericardial effusion.Moderate coronary artery calcification.Linear calcification adjacent to the right atrial appendage, unchanged.CHEST WALL: Low cervical and supraclavicular lymphadenopathy, and additional sites of mediastinal and internal mammary lymphadenopathy not significantly changed.Enhancing right posterior chest wall nodule compatible with metastasis (image 69) unchanged.Partly imaged soft tissue nodule at the 12 right costovertebral junction, partially imaged, compatible with metastasis.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Findings in the upper abdomen will be reported separately.
|
Stable disease.
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.