instruction
stringclasses 1
value | input
stringlengths 6
8.98k
| output
stringlengths 5
3.11k
|
|---|---|---|
Generate impression based on findings.
|
55-year-old female with history of left hip prosthesis. The bones appear slightly demineralized.Left femur: Hardware components of an intramedullary rod and screw device affixing a comminuted intertrochanteric fracture are in gross anatomic alignment without radiographic evidence of hardware complication. The fracture lines are less distinct indicating some interval healing. Pelvis: Again seen are the aforementioned postsurgical changes at the left hip. There is slight acetabular overcoverage of the right femoral head. There are mild degenerative changes at the pubic symphysis. Surgical clips project over the left lower pelvis.
|
Orthopedic fixation of healing left proximal femoral fracture as above.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of benign right breast needle biopsy. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Arterial 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.
|
Dysphagia. The thyroid gland is heterogeneous with multiple nodules, the largest of which measures up to approximately 15 mm. There is also a punctate calcification in the left thyroid lobe. There is no evidence of significant cervical lymphadenopathy based on size criteria. The salivary glands are unremarkable. The major cervical vessels are patent. There is multilevel degenerative spondylosis, including a mildly prominent anterior disc-osteophyte complex at C5-6. The airways are patent. Some of the remaining teeth are carious. There is encephalomalacia in the right posterior cerebral artery territory. There is opacification of the right posterior ethmoid air cells. The imaged portions of the lungs are clear.
|
1. Multilevel degenerative spondylosis, including a mildly prominent anterior disc-osteophyte complex at C5-6. 2. Chronic right posterior cerebral artery territory infarct.3. Multiple nonspecific thyroid nodules. A thyroid ultrasound may be useful for further evaluation.4. Some of the remaining teeth are carious.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and an additional right MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. 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.
|
67-year-old male with history of renal cell carcinoma and pain. There is a lucent lesion of the left femoral head/neck compatible with renal cell carcinoma metastasis which has increased in size when compared to the study from 7/2013. This lesion now measures approximately 6 cm in the greatest dimension and occupies the entire width of the femoral neck. Cortical penetration is better appreciated on the most recent CT scan from 12/9/14. We see no additional lytic lesions. There are scattered arterial calcifications within the soft tissues.
|
Enlargement of renal cell carcinoma metastasis in the left femoral head/neck with cortical penetration better appreciated on recent CT from 12/9/14 concerning for impending pathologic fracture.
|
Generate impression based on findings.
|
Reason: pt with a history of renal cell cancer, needs baseline scans as we plan to initiate therapy History: renal cell cancer CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Status post CABG with severe coronary arterial calcification. Normal heart size without pericardial effusion.CHEST WALL: Median sternotomy.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Small left adrenal nodule unchanged, most likely a benign adenoma.KIDNEYS, URETERS: Small left renal cysts unchanged. No hydronephrosis. Status post right nephrectomy.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy. The majority of the retroperitoneal lymph nodes are unchanged in size, such as aortocaval lymph nodes measuring 2.1 x 2.5 cm (series 3 image 106) and 2.6 x 2.4 cm (series 3 image 132). However, an enlarged node at the iliac bifurcation measures 1.9 x 1.6 cm (series 3 image 143), decreased in size from 2.2 x 2.1 cm previously.BOWEL, MESENTERY: No acute abnormalities. Interposed colon in the right renal fossa.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Calcification anterior to the bladder unchanged.LYMPH NODES: As above. No pelvic lymphadenopathy.BOWEL, MESENTERY: Stable postoperative changes at the rectosigmoid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
1. Retroperitoneal lymphadenopathy, the majority of which is stable compared to the prior exam. Interval decrease in size of an enlarged node at the iliac bifurcation with reference measurements provided.2. Other findings as described above without acute interval change.
|
Generate impression based on findings.
|
4 year old female with pain at the tarsometatarsal joint.VIEWS: Left and right foot AP/oblique/lateral (6 views) 1/28/2015, 1005 hour No acute fracture or malalignment. Mild pes planus bilaterally.
|
Mild pes planus deformity bilaterally.
|
Generate impression based on findings.
|
Concern for dental abscess. Admitted to MICU due to concern for angioedema. Airway intact, mild swelling of tongue. History of poor dentition, dental caries, pain with palpation at left bottom first premolar (Tooth 21) with mild swelling, but no fluctuance. Neck: Numerous maxillary and mandibular teeth are carious. However, there is no discernible evidence of adjacent inflammatory changed. The airways are patent, without convincing evidence of pharyngeal mucosal space edema. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are unremarkable. There is mild multilevel degenerative spondylosis and loss of the usual cervical lordosis. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.Head: 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 mastoid air cells are clear. The skull and scalp soft tissues are unremarkable.
|
1. No evidence of angioedema or airway stenosis in the neck.2. Multiple dental caries without definite associated soft tissue abscess, although assessment for abscess is limited without intravenous contrast. 3. No evidence of intracranial hemorrhage or mass.
|
Generate impression based on findings.
|
30 year old female with history of malrotation s/p LADD procedure in November 2014, now presents with continually worsening abdominal pain. Scout radiograph showed a nonobstructive bowel gas pattern. Initial fluoroscopic evaluation demonstrated normal passage of contrast through the esophagus and stomach into the proximal small bowel. The duodenum did not cross the midline and proximal small bowel loops were in the right abdomen, compatible with persistent malrotation. Transit time to the colon was 3 hours 30 minutes. Fluoroscopic evaluation demonstrated multiple areas of converging and tethered bowel loops in the right hemiabdomen and pelvis, which exhibit angulated morphology and do not easily separate upon compression. One of these areas in the pelvis near the ileocecal valve obscures and makes assessment of the terminal ileum difficult. Findings are compatible with nonobstructive adhesions. Small bowel mucosa was unremarkable, without evidence of ulcers, sinus tracts, or fistulae. No separation of bowel loops was present to suggest fibrofatty proliferation. No definite persistent intraluminal filling defect. The proximal colon was grossly normal. TOTAL FLUOROSCOPY TIME: 7:21 mm:ss
|
1.Multifocal nonobstructive adhesive disease in the right hemiabdomen and pelvis as described above.2.Findings compatible with persistent intestinal malrotation.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of breast cancer in mother and maternal grandmother. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Benign intramammary lymph nodes are present bilaterally. Scattered 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: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
75-year-old male with history of hip prosthesis. Left hip: Hardware components of a left total hip arthroplasty device are situated in anatomic alignment without radiographic evidence of hardware complication. A small amount of heterotopic mineralization is noted within the adjacent soft tissues.Pelvis: Again seen are the aforementioned postsurgical changes at the left hip. Mild osteoarthritis and chondrocalcinosis affect the right hip. There are mild degenerative changes at the pubic symphysis.
|
Left total hip arthroplasty as above.
|
Generate impression based on findings.
|
There is minimal right maxillary and ethmoid sinus mucosal thickening. The frontal sinuses are not pneumatized. There are streaky opacities in the nasal cavity. There is S-shaped nasal septal deviation. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. There is an unchanged well-defined subcentimeter lucency in the left orbital rim, which may represent an epidermoid cyst. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable.
|
Streaky opacities in the nasal cavity may represent rhinitis. Otherwise, no evidence of acute sinusitis.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. History of benign left breast biopsy. History of bilateral cyst aspirations. History of breast cancer in maternal great aunt and paternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Linear marker was placed on the scar overlying the left breast. Stable postsurgical architectural distortion is present. Stable benign calcifications are present, including rim calcifications in cyst walls.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
Stable postsurgical architectural distortion in the left breast. Stable benign calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram.
|
Generate impression based on findings.
|
65-year-old male status post anterior and posterior cervical fusion. The bones of the cervical spine appear demineralized. There is orthopedic hardware reflecting anterior and posterior fusion from C3 through C6 appearing similar to the prior study. We see no evidence of acute hardware complication. Amorphous bone graft material is noted along the posterior aspect of the cervical spine appearing similar to prior. Alignment is within normal limits. Surgical clips and tracheostomy tube are noted anteriorly.
|
Postoperative changes of anterior and posterior cervical fusion as described above.
|
Generate impression based on findings.
|
59 years, Male. Reason: Evaluate for free air History: post upper endoscopic therapy, abdominal pain. Nonobstructive bowel gas pattern. No free air on upright view. Scattered surgical clips.
|
Nonobstructive bowel gas pattern. No free air.
|
Generate impression based on findings.
|
Mesothelioma ABDOMEN:LUNG BASES: Extensive hilar and pleural metastatic disease again noted; please refer to the chest CT report from the same dayLIVER, BILIARY TRACT: New 1 x 1.2 cm low-attenuation focus within segment 6 of the right lobe of the liver best seen on image 56 SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable renal sinus cysts.RETROPERITONEUM, LYMPH NODES: No significant change in bulky retroperitoneal adenopathy. Reference retrocrural lymph node best seen on image 37 measures 2.4 x 1.6 cm. Reference aortocaval lymph node best seen on image 47 measures 3 x 2 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate gland stableBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
New segment 6 right lobe liver lesion worrisome for new metastatic focus. No significant change in extensive retroperitoneal metastatic adenopathy.
|
Generate impression based on findings.
|
A lobulated, mixed groundglass and ossific attenuation mass is present in the left frontoethmoid recess, which measures up to 25 mm. The mass partially obstructs the left frontoethmoidal recess, but there is no associated erosion of the surrounding paranasal sinus walls. The right frontal sinus is clear. The anterior ethmoid air cells, maxillary sinuses, and ostiomeatal units are clear. There is mild mucosal thickening of the right posterior ethmoid air cells. There is mild bilateral mucosal thickening of the sphenoid sinuses and a small retention cyst in the right sphenoid sinus. The bilateral sphenoethmoidal recesses are clear. There is mild S-shaped nasal septal deviation. The nasal turbinate morphology is within normal limits. The nasal cavity is clear. The lamina papyracea are intact. The ethmoid roof is relatively symmetric. The ventricles and sulci appear prominent, consistent with mild age related volume loss. There is evidence of prior craniotomy. A partially-imaged catheter fragment is present in the midline of the frontal region.
|
1. A left frontoethmoid osteoma measures up to 25 mm, without associated erosion of the paranasal sinus walls. 2. Scattered mild mucosal thickening of the paranasal sinuses.3. A partially imaged catheter fragment is present in the midline of the frontal region.
|
Generate impression based on findings.
|
Female 74 years old Reason: eval for ascites or other abnormalities History: abdominal tightness and bloating, obese abdomen difficult exam LIVER: The liver measures 12.9 cm in length. There is no focal liver lesion. The main portal vein is patent and demonstrates normal directional flow with peak velocity of 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder without gallstones, gallbladder wall thickening or pericholecystic fluid. There is no biliary dilatation.PANCREAS: The pancreas is poorly visualized due to overlying bowel gasKIDNEYS: The right kidney measures 11.1 cm. The left kidney measures 11.6 cm. There is no hydronephrosis.OTHER: The spleen measures 11.2 cm. No ascites.
|
Unremarkable study. In particular no evidence of ascites.
|
Generate impression based on findings.
|
RIGHT TEMPORAL BONE: The external auditory canal is clear. The tympanic membrane is faintly visualized. The scutum remains sharp.The tympanic cavity and mastoid air cells are clear. The ossicular chain and tegmen tympani are intact.The inner ear structures have a normal morphology. The bony coverings of the cochlea, vestibule, semicircular canals, and facial nerve canal are intact. The vestibular aqueduct is within normal limits in size. No abnormalities of the osseous internal auditory canal are demonstrated.LEFT TEMPORAL BONE: The external auditory canal is clear. The tympanic membrane is faintly visualized. The scutum remains sharp.The tympanic cavity and mastoid air cells are clear. The ossicular chain and tegmen tympani are intact.The inner ear structures have a normal morphology. The bony coverings of the cochlea, vestibule, semicircular canals, and facial nerve canal are intact. The vestibular aqueduct is within normal limits in size. No abnormalities of the osseous internal auditory canal are demonstrated.Incidental note is made of an asymmetrically prominent left jugular bulb which is only covered by very thin barely visualized bone along its lateral aspect, although no true dehiscence is identified at this time.There is likely artifactual superimposed hyperdensity along the left ventral pons.
|
1. No evidence of temporal bone fracture.2. No definite CT evidence of cochlear abnormality as suspected by history.3. Asymmetrically prominent left jugular bulb which incidentally is only covered by very thin layer of bone although no true dehiscence identified at this time.
|
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.
|
70-year-old male status post right TKA Hardware components of a right total knee arthroplasty device are situated in near-anatomic alignment without evidence of complication. Osteoarthritis affecting the contralateral knee is seen on the frontal view.
|
TKA without evidence of complication.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. 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.
|
14-year-old male with right middle finger buckle fracture Again seen is a cortical buckle fracture along the ulnar aspect of the base of the proximal phalanx of the middle finger without significant change. Alignment is anatomic.
|
Cortical buckle fracture at the base of the proximal phalanx of the middle finger.
|
Generate impression based on findings.
|
67-year-old male status post rotator cuff repair with pain. Contrast opacifies the glenohumeral joint with extension into the subacromial-subdeltoid bursa consistent with a full thickness rotator cuff tear, which appears to involve much of the distal supraspinatus tendon. There does not appear to be much retraction of the tendon. A suture anchor within the humeral head is noted from prior rotator cuff repair. Moderate to severe acromioclavicular joint osteoarthritis and moderate glenohumeral joint osteoarthritis. A fluid density collection extending superior to the AC joint is consistent with a subarticular ganglion cyst from a chronic rotator cuff tear.
|
Full thickness rotator cuff tear of the distal supraspinatus tendon and additional findings as described above.
|
Generate impression based on findings.
|
54-year-old female with history of pain. Evaluate for inflammatory arthritis. Right hand: There is slight narrowing of the fourth MCP joint of uncertain clinical significance. There may be minimal juxta-articular osteoporosis at the MCP joints, but this is equivocal and of uncertain clinical significance. There is no evidence of osseous erosions or specific radiographic findings of inflammatory arthritis. Minimal osteoarthritis affects the DIP joints.Left hand: Minimal osteoarthritis affects the DIP joints. There may be mild juxta-articular osteoporosis at the MCPJs, but this is equivocal and of uncertain clinical significance. There is no evidence of osseous erosions or specific radiographic findings of inflammatory arthritis.Left knee: Tiny osteophytes indicate minimal osteoarthritis, which is essentially normal given the patient's age. Tiny osteophytes are also appreciated on the right knee as seen on the frontal view.
|
1.Minimal narrowing of the right fourth MCP joint and equivocal juxta-articular osteoporosis, but otherwise no specific radiographic evidence of inflammatory arthritis.2.Minimal osteoarthritis of the left knee.
|
Generate impression based on findings.
|
Reason: r/o hydronephrosis, stone, infection History: drc urinary flow, left flank pain, drainage ABDOMEN:LUNG BASES: Bronchial wall thickening suggestive of reactive airways disease/bronchitis. Basilar subsegmental atelectasis. No pleural effusions.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Interval decrease in size of both kidneys since the prior examination with improvement of perinephric stranding. Punctate bilateral renal calculus without obstructing stone or hydronephrosis.RETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Punctate calcification in the bladder on the left likely represents a passed stone (series 3 image 88). The bladder wall is thickened. The bladder is partially collapsed with a Foley catheter in place. A small focus of air in the bladder lumen is likely postprocedural.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
1.Punctate calcification in the bladder lumen likely represents a passed stone. No evidence of obstructing stone or hydronephrosis. Interval improvement in renal enlargement/perinephric stranding seen previously. 2.Persistent bladder wall thickening suggestive of cystitis.3.Bronchial wall thickening suggesting reactive airways disease/bronchitis.
|
Generate impression based on findings.
|
46 year old female with a history of right mastectomy for breast cancer and left breast lift in 2014. Patient feels a small lump in the left breast. Three standard views with two spot compression views of the left 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 triangular marker is placed at lower outer quadrant of left breast, indicating the area of palpable concern. No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted at the area of palpable concern or elsewhere in left breast. With physical exam, no discrete mass was palpated. Focused ultrasound did not detect any abnormalities at the area of palpable concern.
|
No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, left 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.
|
Asymptomatic female presents for routine screening mammography. Three standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Round markers were placed on skin lesions overlying both breasts. Focal asymmetry is present in the right upper outer quadrant.No suspicious microcalcifications or areas of architectural distortion are present.
|
Focal asymmetry in the right upper outer quadrant. Comparison to known outside mammograms is recommended. If the finding is new or the prior mammograms cannot be obtained, spot compression imaging will be needed.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: O - Old Study For Comparison.
|
Generate impression based on findings.
|
63-year-old male with history of prosthetic assessment. The bones are demineralized.Right hip: Hardware components of a right total hip arthroplasty are situated in near-anatomic alignment without radiographic evidence of hardware complication. Redemonstrated is a comminuted intertrochanteric fracture. The fracture lines are slightly indistinct along the medial aspect indicating some interval healing.Pelvis: Again shown is the aforementioned right total hip arthroplasty. There is an incompletely imaged intra-medullary rod and screw device in the left proximal femur. There also appears to be a focal lesion within the left iliac bone which may represent a myelomatous deposit appearing similar to prior.
|
Right total hip arthroplasty and other findings as described above.
|
Generate impression based on findings.
|
57 year old with history of left mastectomy for breast cancer. 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. 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.
|
Male 51 years old; Reason: s/p rectal cancer and liver mets History: None CHEST:LUNGS AND PLEURA: Right upper lobe micro-nodule is increased in size and probably cavitated (image 53; series 4); it now measures 1.0 x 0.8 cm. There is a new subcentimeter right lower lobe nodule (image 53) and enlarging subcentimeter right middle lobe nodule (image 69). MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Right-sided Port-A-Cath with the tip at the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Status post left hepatectomy. Minimal fluid along the resection site. Thrombosis of the left portal vein is unchanged. Nonspecific right hepatic lobe hypoattenuating lesion appears stable compared to prior studies.SPLEEN: Mild splenomegaly as noted previously.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post low anterior resection with associated postsurgical changes. Unremarkable appearance of the anastomosis. Unremarkable appearance of the small bowel anastomosis.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: Status post low anterior resection with associated postsurgical changes. Unremarkable appearance of the anastomosis. Unremarkable appearance of the small bowel anastomosis. Scattered sigmoid colon diverticula.BONES, SOFT TISSUES: Two ventral hernias are again noted containing bowel, currently nonobstructive. Hypoattenuating structure in the right inguinal mesentery is unchanged and has previously been identified as hernia repair mesh.OTHER: No significant abnormality noted
|
Enlarging pulmonary nodules, presumably representing metastases.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of breast cancer in maternal aunt. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable benign 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: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
76 years, Female. Reason: eval Dobbhoff placement History: s/p Dobbhoff Motion artifacts limits evaluation. Previously seen NG tube appears removed. Dobbhoff tube tip appears advanced and overlies the descending duodenum. Residual contrast seen in the colon. Nonobstructive bowel gas pattern. Left hip prosthesis is noted.
|
Motion artifacts limits evaluation. Previously seen NG tube appears removed. Dobbhoff tube tip appears advanced and overlies the descending duodenum.
|
Generate impression based on findings.
|
Reason: 56 yr old female with metastatic stage IV ovarian cancer, '12 posterior exenteration and chemotherapy. Currently s/p Cycle 6 Doxil therapy. PLease assess current disease status and compare with 7/14 baseline scan. History: abdominal masses CHEST:LUNGS AND PLEURA: Unchanged nodular pleural thickening in the right lung base, partially calcified. Mild irregularity along the pleural surface of the left lung base is new since the prior study (series 5 image 86). No pleural effusions or new suspicious nodules/masses. Scattered micronodules are unchanged.MEDIASTINUM AND HILA: Partially calcified cardiophrenic lymph node unchanged. No mediastinal or hilar lymphadenopathy. No visible coronary arterial calcification. Normal heart size without pericardial effusion.CHEST WALL: Partially calcified right axillary lymph node unchanged in size measuring 1.3 cm (series 3 image 34). Right chest port with tip in the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Reticular hypoattenuating pattern along the periphery of the liver appears somewhat more prominent compared with prior studies.SPLEEN: Surgically absent.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered retroperitoneal and peritoneal calcified nodules are not significantly changed most compatible with treated disease.BOWEL, MESENTERY: Status post partial gastrectomy. BONES, SOFT TISSUES: Bilobed cystic lesion in the posterior right paraspinal musculature is unchanged in size. Calcified nodules in the anterior subcutaneous fat are unchanged.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Partially calcified inguinal lymph nodes are not significantly changed. Reference right inguinal lymph node measures 1.8 x 1.6 cm (series 3 image 27) previously 1.8 x 2.0 cmBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
1. Increased conspicuity of reticular hypoattenuating pattern along the periphery of the liver and new mild left pleural irregularity are indeterminate. Continued close attention to these regions on follow up studies is recommended. 3. Otherwise stable calcified lymph nodes and peritoneal/soft tissue lesions.
|
Generate impression based on findings.
|
Male 28 years old Reason: CXR findings concerning for atypical infection; neutropenic s/p stem cell transplant History: Neutropenic fever, dry cough x 2 months LUNGS AND PLEURA: Diffuse bilateral upper lobe predominant groundglass opacities with air bronchograms suggestive of multifocal PCP or viral pneumonia, pulmonary hemorrhage, or drug toxicity. No pleural effusions. No suspicious masses or nodules. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Left PICC with tip in the left subclavian vein. Air filled esophagus.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Distended stomach filled with enteric contents. Incompletely imaged hypodense lesion in the right liver lobe.
|
Diffuse bilateral upper lobe predominant groundglass opacities in a patient with CML is suggestive of multifocal PCP or viral pneumonia, pulmonary hemorrhage, or drug toxicity.
|
Generate impression based on findings.
|
51-year-old female with history of left heel pain. There is thickening of the distal Achilles' tendon suggestive of tendinopathy with prominent enthesopathic changes at its insertion on the calcaneus. There is also a bony spur along the posterior aspect of the calcaneus suggestive of a Haglund deformity. Mild osteoarthritis affects the midfoot and first MTP joint.
|
Findings suggestive of distal Achilles tendinopathy as well as a Haglund deformity of the calcaneus. This can be further evaluated with MRI if clinically warranted.
|
Generate impression based on findings.
|
Female 51 years old Reason: r/o portal and hepatic vein thrombus, re-eval cirrhosis History: AMS, cirrhosis LIMITED ABDOMENLIVER: The liver measures 16.2 cm in length. Coarsened hepatic parenchymal echotexture and nodular contour consistent with the provided history of liver cirrhosis. No focal hepatic mass is identified.BILIARY TRACT: Status post cholecystectomy. No biliary dilatation.PANCREAS: Unremarkable appearance of the pancreatic head. The body and tail are obscured by bowel gas.SPLEEN: Splenomegaly at 15.1 cm. KIDNEYS: The left kidney measures 12.0 cm. There is no hydronephrosis. The right kidney measures 11.6 cm. There is a 1.0-cm stone in the midpole of the right kidney. There is no hydronephrosis.OTHER: No significant abnormalities noted.
|
1. Cirrhotic liver morphology without focal mass lesion.2. Splenomegaly.3. Patent hepatic vasculature.
|
Generate impression based on findings.
|
There are multiple enhancing expansile calvarial lesions, the largest of which is centered in the occipital bone extending cranially to the left of midline. The common foci of susceptibility noted within the mass which may represent foci of mineralization or residual flecks of calvarium. There is a more cystic appearing component of this mass along the right lateral aspect. The mass overall measures approximately 7.2 cm transverse by 3.2-cm AP. This is more bilateral predominantly posterior dural thickening and enhancement both supratentorially and infratentorially. Abnormal marrow signal and enhancement is seen extending up to the lambdoid, with overlying soft tissue thickening and enhancement in the deep subcutaneous soft tissues. Additional prominent calvarial lesion is seen along the high left parietal region.There is suggestion of a very thin residual CSF cleft between the occipital calvarial based mass with pachymeningeal involvement. There is mild mass effect upon the posterior cerebellar hemispheres and left occipital lobe. There is no definite leptomeningeal enhancement although 3-D T1 postcontrast images were inadvertently not obtained. The normal flow void associated with the right transverse sinus is not visualized, although lack of patency of the vessel cannot be confirmed on 3-D T1 postcontrast images. Cranial extension of this mass abuts the left lateral aspect of the superior sagittal sinus but without deformity of the vessel. The left transverse sinus flow void appears present.The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift. There are no areas of abnormal signal or pathological intra-axial enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the remainder of the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is trace fluid within bilateral mastoid air cells. There is a chronic right lamina papyracea defect with extension of orbital fat into the area of prior injury. There is also mild deformity of the right medial rectus muscle without entrapment.CERVICAL SPINE
|
1. No definitive intracranial leptomeningeal metastatic disease, although please note that thin section 3-D T1 post contrast images were inadvertently not obtained.2. Scattered large calvarial enhancing masses consistent with metastatic disease, with pachymeningeal involvement, and more diffuse smooth dural enhancement consistent with probable packing and dural spread of tumor. Mild mass effect upon adjacent cerebellum and left occipital lobe with abutment of the left superior sagittal sinus. Right transverse sinus flow void not well visualized with probable thrombosis from adjacent tumor.3. No definite leptomeningeal or epidural metastatic disease in the cervical spine although diffuse osseous metastatic disease is noted. Epidural spread of tumor suspected along the visualized upper thoracic spine with involvement of multiple foramina which are narrowed. MRI of the thoracic and lumbar spine recommended for a complete evaluation at which time 3D T1 post contrast images of the brain may be obtained at no additional charge.
|
Generate impression based on findings.
|
History of headaches, evaluate for structural cause. There is a partially empty sella. 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 mastoid air cells are clear. There is a left maxillary sinus retention cyst. The skull and scalp soft tissues are unremarkable. There is a left lens implant.
|
1. Nonspecific partially empty sella, which can occur in the setting of pseudotumor cerebri.2. No evidence of intracranial hemorrhage or mass effect. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
|
Generate impression based on findings.
|
Reason: 39 y/o M with dysphagia to solids History: as above Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Double contrast evaluation of the esophagus and gastric cardia/fundus showed suspected narrowing at the GE junction (series 15) measuring 1.2cm in length and 3mm in diameter. Liquid contrast passed freely, but there was transient holdup of the barium pill even with extra sips of water. The pill eventually passed spontaneously within 5 minutes.Fluoroscopic evaluation of esophageal peristalsis demonstrated mild dysmotility with proximal escape.During the exam, no spontaneous or provoked gastroesophageal reflux was observed. TOTAL FLUOROSCOPY TIME: 6:11 Minutes
|
1.Suspected narrowing of the GE junction with transient holdup of the barium pill as above. Endoscopic evaluated if clinically indicated. 2.No reflux or hiatal hernia.3.Mild dysmotility with proximal escape.
|
Generate impression based on findings.
|
86 year old presents for short-term follow-up of right breast calcifications and annual mammogram of the left breast. Family history of breast cancer in mother diagnosed at the age of 27. 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, A stable 8 mm group of amorphus calcifications is present and unchanged in the right upper outer quadrant. Marked arterial calcifications are present 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.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts and an additional left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Round marker was placed on a skin lesion overlying the left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. Mammography is most sensitive when evaluating for interval changes. If patient submits outside mammogram, comparison will be made. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram.
|
Generate impression based on findings.
|
59 year old male status post hepatectomy with correct counts. Attending: Dr. Millis. No unexpected radiopaque foreign body. Raytec sponge overlying the right sacrum is sutured to the ostomy site. Abdominal drain enters the right upper quadrant. IVC filter in expected position. Bilateral surgical staples. Foley catheter in bladder. Nonobstructive bowel gas pattern. Small left pleural effusion.
|
No unexpected radiopaque foreign body. Findings were discussed with the attending surgeon, Dr. Millis, via telephone on 1/28/2015 at 10:55.
|
Generate impression based on findings.
|
51 year-old female with left hip pain There is mild acetabular sclerosis suggesting mild bilateral osteoarthritis affecting the hips. No fracture or malalignment.
|
Mild osteoarthritis.
|
Generate impression based on findings.
|
Chronic sinusitis and nasal blockage. There are bubbly secretions in the right maxillary sinus. There is a subcentimeter retention cyst in the right sphenoid sinus. There is opacification of a right anterior ethmoid air cell. The other paranasal sinuses are clear. There is minimal opacification near the left olfactory recess of the nasal cavity. There is mild nasal septal deviation towards the left. 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. There is a less conspicuous linear lucency in the left frontal process of the maxillary bone with mild deformity. There are degenerative changes involving the right temporomandibular joint. The mastoid air cells and middle ears are clear.
|
1. Findings suggestive of acute sinusitis.2. Chronic fracture of the left nasal skeleton and right temporomandibular joint degenerative changes.
|
Generate impression based on findings.
|
76-year-old male, evaluate for odontoid mobility There is moderate degenerative disk disease at C3/4 and C4/5. There is no evidence of instability on flexion or extension views. No gross abnormality of the odontoid process. Vascular stent and arterial calcifications project over the carotid arteries.
|
Degenerative disease without evidence of instability. If there is high suspicion for odontoid abnormality, CT is recommended.
|
Generate impression based on findings.
|
Metastatic urothelial carcinoma status post lung resections and radiation therapy CHEST:LUNGS AND PLEURA: Interval decrease in size of right infrahilar nodular focus best seen on image 59 of series 3 now measuring 1.2 x 0.9 cm; this is in comparison to 2.1 x 1.7 cm on 11/20/2014.Left lower lobe peripheral scarring and atelectasis unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right nephrectomy site clear. Stable left renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomyBLADDER: Stable neobladderLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Interval decrease in size of right infrahilar nodular focus. Otherwise stable examination.
|
Generate impression based on findings.
|
Mitral valve disorder and atrial fibrillation. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Small mediastinal lymph nodes. For reference purposes, pretracheal lymph node measures 1.5 x 1.1 cm (image 214; series 25). Coronary artery calcifications. Aorta and great vessels grossly within normal limits. Ascending aorta measures 3.9 cm in diameter.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Gallstones. No enhancing liver lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Kidneys are nodular in contour. Right lower pole nonobstructive renal calculus. Punctate left renal calculi, nonobstructive.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate measuring 7.6 x 6.7 cm with numerous calcifications.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
|
Small mediastinal lymph nodes. Enlarged prostate. Nonobstructive renal calculi. Gallstones.
|
Generate impression based on findings.
|
Male 23 months old with nasal reflux EXAMINATION: Oropharyngeal motility study 1/28/2015 Name of speech pathologist, speech and language therapist, supervised the examination.1:02 seconds of fluoroscopy was used.PRESENTATION: The patient was presented with thin liquids via straw, half-strength nectar via straw, full strength nectar via straw. Additionally, the patient was presented with table purée and soft solids.RESULTS: Spilling of thin liquids into the puriforms was noted with swallow triggering. Reduced contact between the velum and the posterior pharyngeal wall resulted in small nasopharyngeal reflux and residual contrast along the posterior floor of the nose. Mild residue was noted along the base of tongue and piriform sinus. Trace penetration was noted with thin liquids via straw, with spontaneous ejection.
|
Trace penetration with thin liquids via straw without cough.Please see the speech and language therapist's report for feeding recommendations.
|
Generate impression based on findings.
|
14 year old female with ankle pain and swelling after injury.VIEWS: Right ankle AP/oblique/lateral (3 views) 1/28/2015 Soft tissue swelling over the lateral malleolus. No acute fracture or malalignment is evident.
|
Soft tissue swelling without evidence of fracture or malalignment.
|
Generate impression based on findings.
|
History of severe left frontal headache. No intracranial hemorrhage is identified. No intracranial mass, evidence of mass-effect or significant midline shift is present The ventricles and sulci are prominent, consistent with moderate age-related volume loss. No extra-axial collections are identified. 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. There is a also a more focal punctate focus of hypoattenuation in the right basal ganglia. There is near complete opacification of the left frontal sinus, the left anterior ethmoid air cells, the right posterior ethmoid air cells and the right sphenoid sinus. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable.
|
1. No evidence of intracranial hemorrhage or mass effect. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.2. Near complete opacification of the bilateral frontal sinuses, ethmoid air cells, and right sphenoid sinus, in a left osteomeatal unit obstructive pattern and right sphenoethmoid obstructive pattern, respectively. Dedicated paranasal sinus imaging may be useful for further characterization.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.
|
Generate impression based on findings.
|
Male 72 years old Reason: HCC Screening and GB polyp History: HCC Screening and GB polyp LIVER: The liver measures 13.3 cm in length and demonstrates coarsened hyperechoic echotexture consistent with chronic liver disease. There is a new 0.8 x 0.6 x 0.6 cm hyperechoic lesion. The portal vein is patent and demonstrates normal directional flow with peak velocity of 0.1 m/sec. Liver granuloma again noted.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder. The gallbladder polyp identified on prior study is not identified today.PANCREAS: The pancreas is obscured by bowel gas.KIDNEYS: The right kidney measures 10.5 cm. The left kidney measures 9.9 cm. There is no hydronephrosis.OTHER: Spleen measures 9.6 cm. No ascites.
|
New 0.8-cm hyperechoic liver lesion, suspicious in the context of this patient with hepatitis C. Further evaluation with liver protocol MRI is recommended for further evaluation.Findings discussed by myself Dr. Ward with Dr. Adebajo at time of reporting 01/28/15.
|
Generate impression based on findings.
|
Carcinoid tumor of the lung status post resection. CHEST:LUNGS AND PLEURA: Postsurgical volume loss on the right. No signs of recurrent or metastatic disease in the lungs.MEDIASTINUM AND HILA: Severe coronary artery calcifications. Normal heart size. No pericardial fluid. No lymphadenopathy.CHEST WALL: T12 compression fracture. Degenerative changes of the spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesions in the liver too small to characterize but unchanged and probably cysts. Cholecystectomy clips.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta. Mild fusiform ectasia of the distal abdominal aorta unchanged. No lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: L1 compression deformity and unchanged. Sclerotic lesion in L4 unchanged.OTHER: No significant abnormality noted.
|
No signs of recurrent or metastatic disease. Severe coronary artery calcifications.
|
Generate impression based on findings.
|
2-year-old male with cough/feverVIEWS: Chest AP/lateral (two views) 01/28/15 Cardiothymic silhouette is normal. No pleural effusion or pneumothorax. Mild bronchial wall thickening suggestive of bronchiolitis/reactive airway disease. Left lung base opacity likely represents atelectasis.
|
Bronchiolitis/reactive airway disease.
|
Generate impression based on findings.
|
Abnormal CT scan unclear history of lung nodules. History of rheumatoid arthritis. LUNGS AND PLEURA: Mild centrilobular and paraseptal emphysema, unchanged allowing for differences in technique. Scattered areas of superimposed cyst formation and subpleural scarring in the anterior lung fields typical of rheumatoid lung disease. Very subtle bronchiectasis and bronchial wall thickening involving some of the segmental level airways, but no bronchiolitis.Flat 6-mm nodule right middle lobe may occur along a septum (5/190). Proximal to this there is minimal endobronchial debris (5/186. Previously seen 3-mm solid nodule in the right upper lobe is now less well-defined, measuring 6-mm (5/82). This appears less dense and more linear on the current study and occurs adjacent to an area of emphysema (coronal image 26).The current examination was not protocoled with an expiration sequence however on the outside examination there is mild diffuse mosaic attenuation of the lung parenchyma suggestive of a small airways disease process.MEDIASTINUM AND HILA: Severe coronary artery calcifications involving the left anterior descending and circumflex branches. Normal heart size. No pericardial fluid. Scattered small subcentimeter mediastinal lymph nodes.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Limited scanning range. The stomach is markedly distended with fluid but it appeared normal on the prior study, correlate for recent fluid or meal ingestion prior to study.
|
1. No suspicious pulmonary nodules. 6-mm nodular density right upper lobe is most likely benign and can be conservatively follow up with CT in 6 months. 2. Small foci of endobronchial debris with signs of small airways disease on the previous outside examination may be due to a remote previous airways process such as follicular bronchiolitis although there is no evidence of active bronchiolitis or conclusive evidence of LIP on the current study.2. Mild rheumatoid lung disease.3. Severe coronary artery calcifications involving the LAD and circumflex branches.
|
Generate impression based on findings.
|
2-year-old female with intermittent cough and mucus productionVIEWS: Chest AP/lateral (two views) 01/28/15 Cardiothymic silhouette is normal. Large lung volumes. No pleural effusion or pneumothorax. No focal pulmonary opacities. Minimal bronchial wall thickening compatible with reactive airway disease/bronchiolitis pattern.
|
Reactive airway disease/bronchiolitis pattern.
|
Generate impression based on findings.
|
Reason: s/p almost 2.5 yr s/p robotic converted to open right lower lobectomy for T1bN0M0 stage IA squamous cell carcinoma and almost 3 yrs s/p VATS left upper lobectomy for a T1aN0M0 stage IA adenocarcinoma and T1aN0M0 Stage IA squamous cell carcinoma History: annual f/u LUNGS AND PLEURA: Moderate emphysema, reticular opacities and micronodules, unchanged.No suspicious nodules.MEDIASTINUM AND HILA: Severe coronary artery calcification.Moderately enlarged right paratracheal lymph nodes, unchanged.Previously described enlarged right hilar lymph node is not clearly identified due to lack of contrast material.CHEST WALL: Small bone island T12.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Small right adrenal adenoma, unchanged.
|
Mild nonspecific lymphadenopathy, and no other specific evidence of recurrent disease.
|
Generate impression based on findings.
|
53 year old with highly likely benign right breast microcalcifications for short-term follow-up of the right breast and annual mammogram of the left breast. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. The calcifications in the right central breast are unchanged. 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 normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of benign left breast biopsies. History of breast cancer in mother. Two standard digital views and tomosynthesis of both breasts and an additional left MLO 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. Two percutaneously placed clips are present in the left breast. Stable calcifications are present bilaterally. A benign oil cyst is present in the central right breast.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
Stable bilateral calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
Male 2 months old Reason: is there any aspiration pneumonia History: apneic episode with emesis and increased WOBVIEW: Chest AP (one view) 1/28/2015 The nasogastric tube is looped in the esophagus, with the tip at the thoracic inlet. There is new left lower lobe and right middle lobe atelectasis. The cardiothymic silhouette is upper limits of normal in size. No pleural effusion or pneumothorax.
|
NG tube looped in the esophagus with the tip in the thoracic inlet. Bibasilar atelectasis.These findings were relayed to the primary team at 11:42 on 1/28/2015 via telephone.
|
Generate impression based on findings.
|
Knee arthroplasty, revision Components of a long stem total knee aortoplasty device are situated in gross anatomic alignment as seen on this single intraoperative radiograph; the proximal extent of the prosthesis is not included on the field of view of this study. An orthopedic pin/screw also overlies the proximal tibia. Callus formation along the distal femoral metadiaphysis indicates a healing fracture.
|
Interoperative radiograph of the knee showing hardware components of a total knee arthroplasty in gross anatomic alignment.
|
Generate impression based on findings.
|
Male 52 years old; Reason: Right upper quadrant pain radiating to epigastric region possibly gallbladder Angiographic images are unremarkable. There is prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is normal excretion of tracer into the intrahepatic ducts, common bile duct, gallbladder and duodenum, indicating patent common bile and cystic ducts.
|
Normal hepatobiliary imaging. No evidence of acute cholecystitis.
|
Generate impression based on findings.
|
Lung carcinoma. Baseline study for clinical trial requiring pelvic CT 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.
|
Generate impression based on findings.
|
12-month-old femaleVIEWS: Chest AP (one views) 01/28/15 Aortic arch, cardiac apex, and stomach are left-sided. No pleural effusion or pneumothorax. Minimal bibasilar atelectasis. Peribronchial cuffing suggestive of bronchiolitis/reactive airway disease.
|
Bronchiolitis/reactive airway disease.
|
Generate impression based on findings.
|
Dorsal spine pain T10 -- T11. Elevated sed rate. Rule out pathologic process in the dorsal vertebra. There are anterior vertebral body osteophytes at T9/10. There are mild osteoarthritic changes of the costovertebral articulations at T9 and T10. Intravertebral disk spaces and vertebral heights are within normal limits. I see no focal lesions of bone. Surgical clips are noted in the right upper quadrant, presumably from prior cholecystectomy.
|
Mild degenerative arthritic changes as described above.
|
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 almost entirely fatty, unchanged in pattern and distribution. Stable benign intramammary lymph nodes are present in the right upper outer quadrant.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.
|
Male 63 years old; Reason: pt with a history of prostate cancer, please assess for disease progression History: prostate cancer CHEST:LUNGS AND PLEURA: Moderate to severe upper lobe predominant emphysema. Calcified upper lobe predominant nodules likely from old granulomatous disease. The pleural spaces are clear.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Sclerotic metastatic disease to the T8 spine has improved.OTHER: ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal collecting system. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Few scattered retroperitoneal lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: The prostate is enlarged. There is enhancing soft tissue that protrudes into the bladder.BLADDER: No significant abnormality notedLYMPH NODES: Small retroperitoneal and pelvic nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic lesion in the right sacrum.OTHER: No significant abnormality noted
|
1.Improvement in the thoracic vertebral body sclerotic lesion.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts and an additional right MLO 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.
|
7-year-old male with refractory stage IV neuroblastoma on therapy CHEST:LUNGS AND PLEURA: No pleural effusions. No focal pulmonary opacities. Minimal bibasilar atelectasis.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No significant mediastinal lymphadenopathy. There is a right hilar lymph node that measures 10 mm (series 3, image 28).CHEST WALL: Left chest port tip is in the right atrium. No axillary, cardiophrenic, or retrocrural lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant change in multiple retroperitoneal soft tissue masses including reference lesion posterior to the left renal vein (series 3, image 82) now measures 1.8 x 1.0 cm, previously measuring 1.8 x 1.0 cm.BOWEL, MESENTERY: Balloon type gastrostomy tube is noted. The bowel is within normal limits without evidence of obstruction.BONES, SOFT TISSUES: Multiple ill-defined, mixed lucent/sclerotic lesions throughout the osseous structures appear similar to the prior examination. A left paraspinal soft tissue lesion that invades the spinal canal T6 vertebral level (series 8024, image 17) is unchanged. MR may be considered for further evaluation.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The bowel is within normal limits without evidence of obstruction.BONES, SOFT TISSUES: Multiple ill-defined, mixed lucent/sclerotic lesions throughout the osseous structures appear similar to the prior examination. OTHER: No significant abnormality noted
|
No significant change in retroperitoneal, paraspinal, and osseous metastatic disease.
|
Generate impression based on findings.
|
Lung cancer, on chemotherapy, assess response. Signs and Symptoms: fatigue. CHEST:LUNGS AND PLEURA: No pleural fluid or pneumothorax. Interval resolution of peribronchovascular distribution groundglass opacity seen previously in the left lung as well as decreased in some of the peripheral opacities which are now more linear and scarlike in appearance.Largest nodule in the right upper lobe measures 23 x 25 mm, previously 36 x 28 mm (5/20).MEDIASTINUM AND HILA: Improvement in mediastinal and hilar lymphadenopathy, fluid and infiltrative soft tissue. For reference, a low right paratracheal lymph node measures 7 mm, previously 13-mm (3/27). No pericardial fluid.CHEST WALL: Small low cervical lymph nodes are improved in size. Skeletal metastases increased in size and numberABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Filter in the intrahepatic IVC.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Left adrenal gland nodule unchanged.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: Interval increase in size and number of skeletal lesions.OTHER: No significant abnormality noted.
|
Improved size of pulmonary lesions, some of which may have been postinflammatory or infarcts. Skeletal lesions increased in size and number. Left adrenal gland nodules stable. Improved lymphadenopathy.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Round marker was placed on a skin lesion overlying the right breast. 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: NSA - Screening Mammogram.
|
Generate impression based on findings.
|
Large B-cell lymphoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Stable negative examination. No new adenopathy.
|
Generate impression based on findings.
|
Female 58 years old; Reason: breast cancer with liver mets, please use immune response criteria for measuring lesions History: pre chemo CHEST:LUNGS AND PLEURA: There are post radiation changes in the left upper lobe with linear areas of parenchymal abnormality anteriorly. There is a small left pleural effusion.There is scattered peripheral ground-glass opacity in the right lung base.There are scattered subsegmental pulmonary emboli.MEDIASTINUM AND HILA: Heart size is normal. There is pericardial thickening anteriorly. Enlarged mediastinal lymph nodes measures 1.6 x 1.1 cm (image 30/series 3) CHEST WALL: Right axillary lymphadenopathy with a reference node measuring 1.6 x 1.4 cm (image 29/series 3). Left breast thickening.Large right thyroid nodule.ABDOMEN:LIVER, BILIARY TRACT: Extensive metastatic disease to the liver. The left portal vein is narrowed. Extensive parenchymal abnormality involving the left hepatic lobe. A reference segment 8 lesion measures 1.1 x 0.9 cm (image 85/series 3). SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal nodule.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal lymphadenopathy. Aortocaval lymph node measures 1.6 x 1.1 cm (image 126/series 3). Extensive thrombus within the IVC that extends from the right common femoral vein.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.
|
1.Extensive mediastinal, right axillary, hepatic and retroperitoneal disease.2.Subsegmental pulmonary emboli.3.Extensive IVC thrombus extending into right common iliac vein.4.Findings #1,2,3 discussed with Dr Janisch.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of breast cancer in maternal second cousin. Two standard digital views of both breasts and an additional left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Mass like asymmetry is present in the left retroareolar region. Scattered benign calcifications are present bilaterally.No suspicious microcalcifications or areas of architectural distortion are present.
|
Mass like asymmetry in the left retroareolar region. Spot compression imaging and ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
|
Generate impression based on findings.
|
43 year-old female with known right breast cysts presents for annual mammogram. 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. Circumscribed mass with halo sign at 12 o'clock position in the right breast, which is a known cyst, appears larger than that on the prior study. Ultrasound study for this area is performed later. No suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. Focused ultrasound of the right breast is performed. Three simple cysts are seen at 12 o'clock position in the right 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.
|
Left knee pain. Suspect osteoarthritis. Two views of the left knee are provided. There is perhaps minimal narrowing of the medial tibiofemoral compartment as well as mild chronic-appearing enthesopathic changes at the quadriceps insertion on the superior aspect of the patella. These findings are essentially within normal limits considering the patient's age and are not necessarily of any current clinical significance.The right knee likewise appears normal for age as seen on the frontal view.
|
Minimal degenerative changes as described above, with no additional findings to account for the patient's pain.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of breast cancer in both grandmothers. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Partially visualized mass is present in the far posterior aspect of the left breast near the 6 o'clock position.No suspicious microcalcifications or areas of architectural distortion are present.
|
Partially visualized left breast mass. Spot compression imaging and ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required.
|
Generate impression based on findings.
|
Back pain The bones appear demineralized suggesting osteopenia/osteoporosis. Vertebral body heights are preserved. Moderate degenerative disk disease affects L4/5, and mild degenerative disk disease affects L1/2. Severe facet joint osteoarthritis affects the lower lumbar spine, and there are grade 1 anterolistheses of L4 and L5. Mild osteoarthritis affects both sacroiliac joints. Surgical clips in the right upper quadrant presumably reflect prior cholecystectomy.
|
Degenerative disk disease and osteoarthritis as described above.
|
Generate impression based on findings.
|
Pain, swelling, decreased range of motion at the PIP joint. Evaluate for fracture. There is soft tissue swelling about the PIP joint. On the lateral view, there is focal lucency along the dorsal aspect of the articular surface of the base of the middle phalanx which I suspect represents a nondisplaced central slip avulsion fracture. The fracture fragment itself is small measuring 2-3 mm on the lateral view.
|
Findings suggestive of a nondisplaced central slip avulsion fracture of the base of the middle phalanx. This was relayed to Ashley Martin at the time of dictation.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. Personal history of rectal cancer diagnosed at the age of 62. 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. Round markers were placed on skin lesions overlying both breasts. A linear marker was placed on the scar overlying the right breast. Developing density with calcifications is present in the central left breast for which spot compression imaging is recommended. Additional stable benign calcifications are present bilaterally, including arterial calcifications.No suspicious masses or areas of architectural distortion are present.
|
Developing density and calcifications in the central left breast. 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.
|
CVA There is interval development of an intraparenchymal hematoma centered within the right thalamus measuring approximately 4.5 x 3.6 x 4.9 cm in the AP, transverse, and craniocaudal dimensions. There is extension into the lateral ventricles with blood products also extending into the third and fourth ventricles. Ventricular system is dilated consistent with acute hydrocephalus. There is leftward midline shift measuring 8 to 9 mm at the level of foramen of Monroe. There is partial effacement of the suprasellar cistern. No uncal or tonsillar herniation. There is mild diffuse sulcal effacement.There are secretions in the nasopharynx and evidence of intubation.
|
1. Large intraparenchymal hemorrhage centered within the right thalamus with intraventricular extension.2. Acute hydrocephalus.3. Mild diffuse sulcal effacement, mild leftward midline shift, and partial effacement of the suprasellar cistern indicative of some downward herniation. No uncal or tonsillar herniation. Dr. Ali discussed finding with Gina Bradley (neurosurgery ANP) at 1213 hrs on 1/28/2015.
|
Generate impression based on findings.
|
Tenderness over L4. History of chronic steroid use. Rule out fracture. There is perhaps mild facet joint osteoarthritis affecting the lower lumbar levels. Tiny osteophytes project from the anterior aspects of the lower lumbar vertebrae. Vertebral body heights and intervertebral disk spaces are within normal limits considering the patient's age. Alignment is within normal limits.
|
Possible mild facet joint osteoarthritis of the lower lumbar spine.
|
Generate impression based on findings.
|
TachypneaVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax.
|
Bronchiolitis or reactive airway disease.
|
Generate impression based on findings.
|
Right shoulder decreased range of motion. Status post fall with right shoulder pain. The bones appear demineralized. There is an ossicle anterior to the acromion process that likely represents a normal variant os acromiale. I see no fracture. The humeral head is slightly high-riding which may reflect chronic rotator cuff atrophy or tear. Mild osteoarthritis affects the glenohumeral joint and moderate osteoarthritis affects the acromioclavicular joint. Faint calcific densities along the superior aspect of the humeral head may represent calcific tendinosis of the rotator cuff. Calcification along the glenoid may represent chondrocalcinosis of the labrum and articular cartilage. Leads of a cardiac conduction device are incompletely imaged on this study.
|
Degenerative arthritic changes of the shoulder as described above and possible os acromiale. I see no definite fracture.
|
Generate impression based on findings.
|
NG replacementVIEW: Chest AP 1/28/15 Nasogastric tube tip in the stomach. Cardiothymic silhouette normal. Patchy atelectasis in the right upper lobe and left lower lobe. No pleural effusion or pneumothorax.
|
Nasogastric tube tip in the stomach.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. History of breast cancer in mother. 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. 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.
|
Asymptomatic female presents for routine screening mammography. 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. 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.
|
Asymptomatic female presents for routine screening mammography. History of breast cancer in maternal aunt. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
No mammographic evidence of malignancy. Screening mammography is most sensitive when evaluating for interval changes. If patient submits outside studies, comparison will be made. 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.
|
There is reversal of the normal cervical lordosis centered at C4-C5. There is prevertebral soft tissue thickening and edema, most prominent at the level of C3-C4. There is enhancing soft tissue in the ventral epidural space posterior to the C4-C5 vertebral bodies. The vertebral body heights are grossly preserved. There is loss of disc height at multiple levels, including C4-C5, C5-C6 and C6-C7. There is heterogeneous marrow signal involving the C3 vertebral body with diffusely abnormal signal/infiltration of the C4 and C5 vertebral bodies. Abnormal T2 hyperintensity and mild enhancement also noted within the C4-C5 space. Abnormal T2 hyperintensity and enhancement also seen to extend into the posterior elements on the right at C4. There is effacement of the thecal sac at C4-C5 without frank cord compression. There is multilevel degenerative cervical spondylosis.
|
Prominent enhancing prevertebral and ventral epidural soft tissue, most prominent at the C3-C5 levels, contributing to moderate spinal canal stenosis without definite cord compression. There is also abnormal marrow signal of C3-C5 vertebral bodies with more diffuse marrow infiltration at C4 and C5 vertebral bodies. Differential considerations include neoplasm (with epidural tumor) and/or infection (with C4-5 discitis-osteomyelitis with epidural abscess).Findings discussed with NP Borrelli on 1/28/2015 at 12:55pm.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of breast cancer in sister diagnosed at the age of 89 and paternal niece. 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.
|
Lung cancer diagnosed in 2005. Chemotherapy follow-up examination. CHEST:LUNGS AND PLEURA: Postsurgical changes of right upper lobe wedge resection. Severe centrilobular emphysema. 12mm right lower lobe groundglass nodule (6/149) unchanged compared to recent previous, slowly increasing in size compared to remote examinations (5-mm in 2005).Nodule in the right lower lobe (5/64) with relatively flat borders, present since 2005, unchanged allowing for increase in adjacent emphysema (9 x 8mm, likely benign)Second solid subpleural nodule in the right lower lobe is also unchanged since 2005, compatible with a benign lesion (5/72).Scarring and atelectasis left lower lobe. Subcentimeter nodule right lower lobe (5/64) unchanged from recent studies is but new from remote earlier studies and should continue to be monitored.MEDIASTINUM AND HILA: Ectatic thoracic aorta. Mildly enlarged main pulmonary artery. Moderate circumferential pericardial fluid collection, slightly larger. Conglomerate right hilar lymphadenopathy measures 2.4 x 3.7-cm, previously 2.5 x 3.7 cm (4/51).Interval enlargement of nonindex low left paratracheal lymph node measuring 14 mm, previously 9-mm (4/44), subcarinal lymph node and a nonindex right inferior interlobar lymph node (4/58). CHEST WALL: Severe scoliosis and degenerative changes. Subcentimeter lymph nodes in the left low cervical region (4/9, 4/14) are unchanged over multiple prior studies dating back to at least 2012.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatomegaly with intrapelvic extension of the right hepatic lobe.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Cortical thinning, hypoattenuating cortical lesions too small to characterize but may reflect cysts. Hemorrhagic or proteinaceous cyst in the in the lateral aspect of the right kidney, interpolar level .PANCREAS: Exophytic cystic lesion arising from the tail of the pancreas is unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.Nonspecific thickening of the gastric antrumBONES, SOFT TISSUES: Scoliosis and degenerative changes of the spine.OTHER: No significant abnormality noted.
|
1. Interval enlargement of non-index lymph nodes in the low wall left paratracheal, subcarinal and right inferior interlobar regions. No significant change in measurement of confluent right hilar lymphadenopathy.2. No significant change in pulmonary nodules; the groundglass density right lower lobe lesion remains at least mildly suspicious for an indolent primary adenocarcinoma. 3. Slight increase in volume of pericardial fluid.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of ovarian cancer in mother and sister. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Two stable benign masses are present in the right breast.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
Stable right breast masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
Distal femur fracture being treated nonoperatively Again seen is a transverse fracture of the distal femoral diaphysis with mild impaction; alignment is near-anatomic. A small amount of callus has formed along the fracture indicating an attempt at healing. Overall, the bones are demineralized suggesting osteoporosis. There may also be a small amount of gas within the joint, perhaps from recent intervention.
|
Distal femoral fracture as above.
|
Generate impression based on findings.
|
Prostate carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Left thyroid cystic focus. Mildly enlarged mediastinal lymph nodes. A representative right paratracheal lymph node best seen on image 42 measures 1.2 x 1 cm.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Stable subcentimeter cystic fociSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable bilateral cysts.RETROPERITONEUM, LYMPH NODES: Stable shotty retroperitoneal lymph nodes. Reference retrocrural lymph node best seen on image 88 of series 4 measures 1.2 x 0.7 cm.BOWEL, MESENTERY: Stable subtle soft tissue infiltration within the mesenteric.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Stable mildly enlarged prostateBLADDER: No significant abnormality notedLYMPH NODES: Stable left pelvic adenopathy. Reference left external lymph node best seen on image 160 of series 4 measures 1.2 x 1.3 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted
|
Stable examination.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, 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: NSC - Screening Mammogram.
|
Generate impression based on findings.
|
Postop prosthetic assessment Again seen is an intramedullary rod and screw/nail device affixing intercalary allograft between the native proximal and distal femoral diaphysis. The osteotomy margins remain visible, appearing similar to those seen on the prior study, although there has perhaps been slight increase in bone formation along the medial aspect of the distal osteotomy. Thin lucency along the distal margin of the rod as well as the distal screw also appears similar to that seen on the prior study.
|
Orthopedic fixation of allograft as described above appearing similar to that seen on the prior study.
|
Generate impression based on findings.
|
CLL CHEST:LUNGS AND PLEURA: Stable biapical scarring.New 0.5-cm right middle lobe micronodule seen on image 68 of series 4; other micronodules stable. Relatively stable right pleural effusion.MEDIASTINUM AND HILA: Stable right thyroid nodule. Bilateral supraclavicular adenopathy relatively stable.CHEST WALL: Stable reference right axillary lymph node best seen on image 25 of series 3 measuring 1.1 x 1 cm.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable retroperitoneal adenopathy. Reference left periaortic lymph node conglomerate best seen on image 104 series 3 measures 3 x 0.8 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus absent or atrophicBLADDER: No significant abnormality noted.LYMPH NODES: Stable left pelvic adenopathy. Reference left inguinal lymph node seen on image 164 measures 0.8 x 0.4 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
0.5-cm micronodule in the right middle lobe not identified on prior studies. Would recommend special attention to this lung nodule on future scans.Otherwise stable adenopathy.
|
Generate impression based on findings.
|
Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A ribbon clip is present adjacent to a stable lobulated mass in the right upper outer quadrant. Stable benign calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present.
|
Stable right breast mass. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.
|
Generate impression based on findings.
|
Female 28 years old; Reason: Appy History: RLQ pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes in the thoracolumbar spine with pedicle screw fixationOTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Small cysts are noted in the right adnexa. There is thickening of the peritoneum on the right indicating inflammation. There is a small amount of fluid adjacent to the rectum/adnexa measuring 3.3-cm.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The base and midportion of the appendix are normal in caliber. The distal portion is inseparable from the inflammation adjacent to the right adnexa.There is enhancing soft tissue between the posterior aspect of the uterus and rectum with some rectal wall thickening measuring 2.1 x 2.0 cm (image 84/series 3).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
|
1.Abnormal CT scan with inflammation in the right lower pelvis.2.The base and midportion of the appendix are normal. Its distal tip terminates within the right lower pelvic inflammation. Given this finding acute appendicitis is not entirely excluded.3.Soft tissue mass between the posterior aspect of the uterus and rectum. Differential considerations include endometriosis given the patient's age4.Right adnexal cysts with peritoneal thickening.Recommend follow up pelvic sonography or MRI for further evaluation of the pelvic mass and right adnexa.
|
Generate impression based on findings.
|
Postop evaluation Again seen are components of a "reverse" total shoulder arthroplasty situated in near anatomic alignment. The components appear similar to those seen on the prior study accounting for slight positional differences. Since the prior study, there appears to have been resorption of bone along the lateral aspect of the remaining proximal humeral diaphysis, with small foci of mineralization in the adjacent soft tissues as well as adjacent soft tissue swelling. Lucency at the cement bone interface also appears slightly more prominent on the current study. I cannot exclude the possibility of loosening, although the true clinical significance of these finding is uncertain. Note is again made of a severe thoracic scoliosis.
|
Reverse total shoulder arthroplasty device as described above.
|
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.