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Description: 19591277-RR-75Abstract: ## INDICATION:
year old woman with transbronchial biopsy // Evaluate for
pneumothorax
## FINDINGS:
Patient is status post transbronchial biopsy with right upper lobe atelectasis
and increasing consolidation, which may represent postoperative hematoma,
though aspiration or infection should be considered in the proper clinical
context. The left lung is grossly clear. There is no appreciable effusion.
No pneumothorax. Mild cardiomegaly is unchanged.
## IMPRESSION:
Right upper lobe atelectasis. Increasing consolidation in the right upper
lobe following transbronchial biopsy could represent postoperative hematoma,
though aspiration or infection should be considered in the proper clinical
context.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591277", "visit_id": "N/A", "time": "2169-05-03 13:47:00"} | 1,604,500 |
Description: 19591277-RR-77Abstract: ## EXAMINATION:
CT abdomen and pelvis with contrast
## INDICATION:
year old woman with kidney ca// Please evaluate for any
abnormalities
## ONCOLOGY 2 PHASE:
Multidetector CT of the abdomen and pelvis was
done as part of CT torso with IV contrast. A single bolus of IV contrast was
injected and the abdomen and pelvis were scanned in the portal venous phase,
followed by scan of the abdomen in equilibrium (3-min delay) phase.
Oral contrast was administered.
Coronal and sagittal reformations were performed and reviewed on PACS.
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 4.7 s, 51.9 cm; CTDIvol = 16.5 mGy (Body) DLP = 854.2
mGy-cm.
2) Spiral Acquisition 3.0 s, 32.5 cm; CTDIvol = 16.2 mGy (Body) DLP = 526.4
mGy-cm.
Total DLP (Body) = 1,381 mGy-cm.
## LOWER CHEST:
The lung bases are clear.
## HEPATOBILIARY:
The liver demonstrates homogenous attenuation throughout.
There are two subcentimeter hepatic cysts in segments VI and VII. There is no
evidence of intrahepatic or extrahepatic biliary dilatation. Multiple
air-containing stones are seen within the gallbladder (01:23). There is no
pericholecystic fluid or gallbladder wall thickening.
## PANCREAS:
The pancreas has normal attenuation throughout. There is a 1.6 cm
cystic lesion in the tail of the pancreas (01:27) and other scattered tiny
hypodensities throughout the pancreas are most compatible with side-branch
IPMNs, and better assessed on the prior MRI. No enhancing pancreatic lesions
are identified. There is no peripancreatic stranding.
## SPLEEN:
The spleen shows normal size and attenuation throughout.
Re-demonstrated is a 16 mm cyst in the inferior most portion of the spleen
(01:24)
## ADRENALS:
The right adrenal gland is unremarkable. The left adrenal gland
demonstrates nodular thickening, unchanged from prior.
## URINARY:
The kidneys are of normal and symmetric size with normal nephrogram.
Re-demonstrated are bilateral renal masses, which enhance heterogeneously
similar to renal cortex, on the right measuring 2.2 x 3.2 x 4.4 cm, and on the
left measuring 4.6 x 3.6 x 3.9 cm, compatible with renal cell carcinoma. The
mass on the right is located in the upper pole but extends into the renal
sinus fat. The mass on the left is centrally located within the renal sinus.
Fiducial seeds are seen within the left mass. There is no evidence of renal
vein invasion. These masses have not changed since the prior examination.
Bilateral renal cysts are also stable. There is no perinephric abnormality.
There are two left and one right renal arteries. A 2.2 x 1.2 cm right renal
artery aneurysm just inferior to the mass remains unchanged from prior.
## GASTROINTESTINAL:
The stomach is unremarkable. There is no small or large
bowel obstruction. There are scattered colonic diverticula, without evidence
of acute diverticulitis.
## PELVIS:
The urinary bladder and distal ureters are unremarkable. There is no
free fluid in the pelvis.
## REPRODUCTIVE ORGANS:
Multiple fibroids are seen within the enlarged uterus.
No adnexal masses are seen.
## LYMPH NODES:
Again noted is a mildly enlarged right common iliac lymph node on
series 2, 56 measuring 1.3 cm in short axis. Other nonenlarged
retroperitoneal lymph nodes remain unchanged.
## VASCULAR:
There is no abdominal aortic aneurysm. No significant
atherosclerotic disease is noted.
## BONES:
Mild anterolisthesis of L4 on L5 and L5 on S1 are noted. No suspicious
focal bony lesion or acute fracture is identified.
## SOFT TISSUES:
There is a tiny fat-containing umbilical hernia.
## IMPRESSION:
1. Unchanged appearance of bilateral renal masses, compatible with renal cell
carcinoma. No vascular invasion.
2. Unchanged 2.2 x 1.2 cm right renal artery aneurysm just inferior to the
mass.
3. Stable, mildly enlarged right common iliac lymph node. No other evidence
of abdominopelvic metastases. No new lesions seen.
4. Cholelithiasis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591277", "visit_id": "N/A", "time": "2169-12-14 08:09:00"} | 1,604,501 |
Description: 19591277-RR-78Abstract: ## EXAMINATION:
CT CHEST W/O CONTRAST
## INDICATION:
year old woman with pulmonary MAC, evaluate for interval
change.
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 4.5 s, 35.5 cm; CTDIvol = 15.9 mGy (Body) DLP = 563.8
mGy-cm.
Total DLP (Body) = 564 mGy-cm.
## FINDINGS:
The thyroid is unremarkable. There is no axillary or supraclavicular
adenopathy. There are prominent mediastinal lymph nodes, as seen previously
measuring up to 7 mm in the prevascular station, but none that are
pathologically enlarged. Heart size is normal. There is no pericardial
effusion. There is no thoracic aortic aneurysm. There is minimal
atherosclerotic disease. Main pulmonary trunk is normal in caliber. There
are moderate aortic valvular calcifications. There are no significant
coronary artery calcifications.
Airways are notable for mucous plugging in the right upper lobe posterior
bronchi in the region of a dense consolidative opacity. Overall extent of
this opacity has somewhat decreased from prior, for example in AP dimension
this now measures 2.7 cm, previously 3.1 cm. There are new nodular opacities
in the posterior left upper lobe (series 4, image 89). 4 mm left lower lobe
and 2 mm right lower lobe pulmonary nodules are stable (series 4, image 164,
110, 115). There is no pleural effusion or pneumothorax.
The thoracic esophagus is mildly patulous. Limited views of the upper abdomen
demonstrate a 1.5 cm right upper pole renal cyst. Bilateral centrally located
renal masses are only partially imaged on this examination.
## OSSEOUS STRUCTURES/SOFT TISSUES:
Unchanged sclerotic lesion in the T1
vertebral body. Pathologic fracture.
## IMPRESSION:
1. Mild interval decrease in size of right upper lobe consolidative opacity
felt to represent pulmonary MAC, given transbronchial biopsy pathology.
2. New small left upper lobe nodular opacities, likely reflects the same
infectious process.
3. Unchanged sclerotic lesion in T1, continued attention on follow-up imaging
is recommended.
4. Incompletely evaluated bilateral renal masses.
5. Stable millimetric pulmonary nodules.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591277", "visit_id": "N/A", "time": "2169-09-27 07:52:00"} | 1,604,502 |
Description: 19591277-RR-79Abstract: ## INDICATION:
year old woman with kidney ca// Please evaluate for any
abnormalities
## LOWER CHEST:
The imaged lung bases are clear. The imaged portion of the heart
is top-normal in size with areas of aortic valvular and mitral annular
calcification. No pleural or pericardial effusion is seen.
## HEPATOBILIARY:
The liver contains several tiny hypodensities, previously
characterized by MRI as simple cysts. No new liver lesion is seen. Main
portal vein and central branches are patent. No biliary ductal dilation. The
gallbladder contains numerous stones and there is no CT evidence for acute
cholecystitis.
## PANCREAS:
Several cystic lesions are noted within the pancreas, the largest of
which is seen in the distal body on series 2, image 24 measuring 16 x 16 mm,
unchanged from recent prior, better characterized on prior MR abdomen.
SPLEEN the spleen is normal in size. A hypodensity along the inferior pole of
the spleen is unchanged, likely a simple cyst.
## ADRENALS:
Left adrenal gland appears thickened as on prior without frank
nodule. The right adrenal gland is normal.
## URINARY:
Kidneys enhance symmetrically and demonstrate prompt excretion of
contrast. Bilateral renal masses are re-demonstrated. The right renal mass
is again seen arising from the upper pole measuring 3.3 x 4.9 x 3.6 cm
(previously 3.2 x 4.7 x 3.5 cm). Again, this lesion appears to enhance
heterogeneously and exert mild mass effect on the collecting system. Right
renal artery aneurysm along the inferior aspect of the mass is unchanged
measuring approximately 1.7 x 1.2 x 2.0 cm. On the left, a mass is again seen
in the interpolar region containing 2 fiducials. This lesion currently
measures 3.6 x 4.4 x 5.0 cm (previously 3.5 x 4.3 x 4.7 cm). There is
associated mass-effect on the central renal pelvis. Several small cysts are
noted within the kidneys, the largest on the right measuring 1.6 x 1.7 cm. No
evidence of vascular invasion.
## GASTROINTESTINAL:
The stomach is decompressed. The duodenum is normal.
Imaged small and large bowel loops are unremarkable. No free air or free
fluid is seen.
## LYMPH NODES:
No lymphadenopathy within the imaged portion of the abdomen.
## VASCULAR:
There is no upper abdominal aortic aneurysm. No significant
atherosclerotic disease is noted.
## BONES:
There is no evidence of worrisome osseous lesions or acute fracture.
Partially visualized facet arthropathy is noted in the lower lumbar spine.
There is grade 1 anterolisthesis of L4 relative to L5 which appears unchanged
from the prior exam.
## SOFT TISSUES:
The abdominal and pelvic wall is within normal limits.
## IMPRESSION:
1. Bilateral renal masses, consistent with renal cell carcinoma. Marginal
increase in size compared with prior. Fiducials again noted within the left
renal mass. No signs of vascular invasion.
2. Size stable right renal artery aneurysm adjacent to the mass.
3. Cholelithiasis without evidence of cholecystitis.
4. Pancreatic cystic lesions, grossly unchanged, better characterized on prior
MRI of the abdomen.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591277", "visit_id": "N/A", "time": "2170-06-21 08:19:00"} | 1,604,503 |
Description: 19591315-RR-21Abstract: ## EXAMINATION:
CT LOW EXT W/O C LEFT
## INDICATION:
year old woman with left knee pain. CT L knee for extent of
tibial plateau fracture.
## FINDINGS:
There is diffuse osteopenia, which limits detection of fracture. Allowing for
this, there is a comminuted fracture of the left lateral tibial plateau, with
extension into the tibia femoral joint space. There is approximately 4 mm of
depression of the lateral tibial articular surface (400b:61), with several
small adjacent bone fragments and an associated lipohemarthrosis (401b:75).
Faint sclerosis in subtle cortical irregularity is seen extending across the
midline to the medial metaphysis of the proximal tibia (400 b: 57) . In
addition, the sagittal images show vertical fracture extending into the
medial tibial plateau posteriorly, with minimal distraction and rotation
(401b:33, 2:83)). No medial tibial plateau depression is detected.
A small minimally displaced impaction fracture of the left fibula is also
present (400b:48).
Moderate adjacent soft tissue swelling is also present. Incidental note of is
made of chondrocalcinosis in the posterior joint capsule (2:48) and
tibiofemoral compartment.
## IMPRESSION:
1. Comminuted left lateral tibial plateau fracture, with 4 mm depression of
the lateral tibial articular surface and associated lipohemarthrosis.
2. Comminuted fracture the medial tibia including nondisplaced extension to
the posterior medial tibial plateau with more subtle nondisplaced component
extending to the medial proximal tibial metaphysis.
3. Minimally displaced impaction fracture of the left fibula.
## NOTIFICATION:
Notification of the medial tibial plateau component was emailed
to the ED QA Nurses and entered into the radiology critical results dashboard
at 13:31 on .
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591315", "visit_id": "26060369", "time": "2170-05-15 19:05:00"} | 1,604,504 |
Description: 19591359-RR-10Abstract: ## EXAMINATION:
CT abdomen and pelvis
## INDICATION:
year old man with rectal cancer// rectal cancer restaging
getting neoadjuvant chemo
## ONCOLOGY 2 PHASE:
Multidetector CT of the abdomen and pelvis was
done as part of CT torso with IV contrast. A single bolus of IV contrast was
injected and the abdomen and pelvis were scanned in the portal venous phase,
followed by scan of the abdomen in equilibrium (3-min delay) phase.
Oral contrast was administered.
Coronal and sagittal reformations were performed and reviewed on PACS.
## DOSE:
Acquisition sequence:
1) Sequenced Acquisition 0.5 s, 0.2 cm; CTDIvol = 7.3 mGy (Body) DLP = 1.5
mGy-cm.
2) Stationary Acquisition 12.4 s, 0.2 cm; CTDIvol = 165.1 mGy (Body) DLP =
33.0 mGy-cm.
3) Spiral Acquisition 10.3 s, 66.9 cm; CTDIvol = 7.9 mGy (Body) DLP = 520.9
mGy-cm.
4) Spiral Acquisition 4.9 s, 31.9 cm; CTDIvol = 8.4 mGy (Body) DLP = 263.8
mGy-cm.
Total DLP (Body) = 819 mGy-cm.
## LOWER CHEST:
Please refer to separate report of CT chest performed on the same
day for description of the thoracic findings.
## HEPATOBILIARY:
11 mm lesion at the hepatic dome (series 4, image 38) is
moderately decreased in size (previously 19 mm). An 11 mm hypodensity in
segment 5 (4, 49) previously measured 19 mm. Subcentimeter hypodensities in
segment 2 and 3 are compatible with simple cysts better evaluated on prior MR.
## :
The pancreas has normal attenuation throughout, without evidence of
focal lesions or pancreatic ductal dilatation. There is no peripancreatic
stranding.
## SPLEEN:
The spleen shows normal size and attenuation throughout, without
evidence of focal lesions.
## ADRENALS:
The right and left adrenal glands are normal in size and shape.
## URINARY:
The kidneys are of normal and symmetric size with normal nephrogram.
There is no evidence of focal renal lesions or hydronephrosis. There is no
perinephric abnormality.
## GASTROINTESTINAL:
The stomach is unremarkable. Small bowel loops demonstrate
normal caliber, wall thickness, and enhancement throughout. Asymmetric rectal
wall thickening compatible with known malignancy is noted.
## PELVIS:
The urinary bladder and distal ureters are unremarkable. There is no
free fluid in the pelvis.
## LYMPH NODES:
There is no retroperitoneal or mesenteric lymphadenopathy. There
is no pelvic or inguinal lymphadenopathy.
## VASCULAR:
There is focal ectasia of the infrarenal aorta measuring up to 2.2
cm with chronic eccentric thrombus, unchanged (11, 38). Moderate
atherosclerotic disease is noted.
## BONES:
There is no evidence of worrisome osseous lesions or acute fracture.
## SOFT TISSUES:
The abdominal and pelvic wall is within normal limits.
## IMPRESSION:
1. Known rectal cancer, better evaluated on MR. decrease in two
hepatic metastases. No new foci of metastatic disease.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-04-04 10:29:00"} | 1,604,505 |
Description: 19591359-RR-11Abstract: ## INDICATION:
male for staging after recent diagnosis of rectal
cancer
## DOSE:
Acquisition sequence:
1) Sequenced Acquisition 0.5 s, 0.2 cm; CTDIvol = 7.3 mGy (Body) DLP = 1.5
mGy-cm.
2) Stationary Acquisition 12.4 s, 0.2 cm; CTDIvol = 165.1 mGy (Body) DLP =
33.0 mGy-cm.
3) Spiral Acquisition 10.3 s, 66.9 cm; CTDIvol = 7.9 mGy (Body) DLP = 520.9
mGy-cm.
4) Spiral Acquisition 4.9 s, 31.9 cm; CTDIvol = 8.4 mGy (Body) DLP = 263.8
mGy-cm.
Total DLP (Body) = 819 mGy-cm.
** Note: This radiation dose report was copied from CLIP (CT ABD AND
PELVIS WITH CONTRAST)
## FINDINGS:
NECK, THORACIC INLET, AXILLAE, CHEST WALL:
The visualized portions of the base
of the neck show no abnormality. The thyroid is unremarkable. There is no
supraclavicular, infraclavicular, or axillary lymphadenopathy.
## MEDIASTINUM:
There is no mediastinal lymphadenopathy or mass. The distal
esophagus is patulous and there is a tiny hiatal hernia.
## HILA:
There is no hilar lymphadenopathy.
## HEART, PERICARDIUM, AND VASCULATURE:
The heart is normal in size. The
pericardium is unremarkable and there is no pericardial effusion. There is a
small amount of atherosclerotic calcification within the region of the left
main coronary artery. The thoracic aorta is normal in caliber and course with
minimal scattered calcified plaques about the aortic arch and descending
thoracic aorta. The tip of a left IJ venous catheter terminates in the lower
SVC.
## PLEURA:
There is no pleural effusion or pneumothorax.
## -PARENCHYMA:
There are no focal consolidations. A minimal amount of
dependent atelectasis is seen in the lung bases. Micronodule in the anterior
segment of the right upper lobe is unchanged (5:81).
-AIRWAYS: The airways are patent to the level of the bilateral segmental
bronchi.
-VESSELS: The main pulmonary artery is normal in diameter. The pulmonary
vasculature is opacified to the subsegmental level without filling defects.
## CHEST CAGE:
There are no suspicious osseous abnormalities. No acute fracture.
## UPPER ABDOMEN:
Please refer to the same day separate report of the abdomen and
pelvis for subdiaphragmatic findings.
## IMPRESSION:
-Stable right upper lobe micronodule is reassuring. No definite evidence of
metastatic disease within the chest.
-Please refer to the same day separate report of the abdomen and pelvis for
subdiaphragmatic findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-04-04 10:31:00"} | 1,604,506 |
Description: 19591359-RR-13Abstract: ## INDICATION:
year old man with metastatic rectal cancer to the liver, now
with daily headaches. Evaluate for metastatic disease.
## FINDINGS:
There is no evidence of acute intracranial hemorrhage, edema, masses, mass
effect, midline shift or infarction. The ventricles and sulci are prominent,
suggestive of involutional changes. Faint periventricular T2/FLAIR
hyperintensities are nonspecific, likely sequela of chronic small vessel
ischemic disease. There is no abnormal enhancement after contrast
administration. Major intracranial flow voids are preserved. Dural venous
sinuses are patent on post contrast MP-RAGE images.
Incidental note is made of a T1 and T2 hyperintense, circumscribed 2.1 x 0.7
cm subcutaneous collection adjacent to the left parietal calvarium (9:13,
4:13, 10:13) and measuring 1.2 by 0.6 cm in the left suboccipital region
(series 4, image 4). There is no internal enhancement.
There is moderate mucosal thickening and aerosolized secretions in the
bilateral maxillary sinuses, with an air-fluid level in the left maxillary
sinus, suggesting a component of acute sinusitis. Mild mucosal thickening is
identified in the ethmoidal air cells. The remaining paranasal sinuses are
clear. Trace fluid signal is identified in the bilateral mastoid air cells.
The imaged orbits are unremarkable.
## IMPRESSION:
1. No evidence of intracranial metastasis at this time.
2. Findings suggestive of acute maxillary sinusitis. Clinical correlation is
recommended
3. 2 left parietal and left suboccipital subgaleal lipomas.
4. Additional findings described above.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-05-04 12:44:00"} | 1,604,507 |
Description: 19591359-RR-14Abstract: ## INDICATION:
year old man with rectal cancer with oligio metastatic disease
(lilver). Eval for response to treatment or development of any new mets.//
rectal cancer restaging getting neoadjuvant chemo
## ONCOLOGY 2 PHASE:
Multidetector CT of the abdomen and pelvis was
done as part of CT torso with IV contrast. A single bolus of IV contrast was
injected and the abdomen and pelvis were scanned in the portal venous phase,
followed by scan of the abdomen in equilibrium (3-min delay) phase.
Oral contrast was administered.
Coronal and sagittal reformations were performed and reviewed on PACS.
## DOSE:
Acquisition sequence:
1) Sequenced Acquisition 0.5 s, 0.4 cm; CTDIvol = 5.6 mGy (Body) DLP = 2.2
mGy-cm.
2) Stationary Acquisition 1.2 s, 0.2 cm; CTDIvol = 19.4 mGy (Body) DLP =
3.9 mGy-cm.
3) Spiral Acquisition 10.1 s, 65.9 cm; CTDIvol = 8.9 mGy (Body) DLP = 578.5
mGy-cm.
4) Spiral Acquisition 5.0 s, 32.4 cm; CTDIvol = 9.1 mGy (Body) DLP = 287.4
mGy-cm.
Total DLP (Body) = 872 mGy-cm.
## FINDINGS:
Please refer to the separate chest CT dictation regarding intrathoracic
findings.
The liver density is decreased. An 8 mm segment II hepatic cyst is unchanged
in comparison to the MR examination from (series 5, image 45).
A 5 mm segment II/III cyst is also unchanged (series 5, image 46).
Previously-seen attached disease within segments VII and V are no longer
visualized. No new hepatic lesion is detected.
The gallbladder is decompressed, and appears normal. There is no intra
extrahepatic bile duct dilation. No radiopaque ductal stones are detected.
The pancreas demonstrates normal density and bulk, without duct dilation or
focal lesion.
The spleen size is within normal limits. There are no focal splenic lesions.
The adrenal glands are normal in size and shape.
The kidneys are normal in size and enhance symmetrically, without
hydronephrosis.
The stomach and intra-abdominal and intrapelvic loops of small and large bowel
are normal in caliber. A previously-seen rectal mass, best demonstrated on
the CT examination from and MRI from the same day, is no
longer appreciated. No new gastrointestinal lesion is detected.
The bladder is mildly distended, and appears normal. The prostate is normal
in size.
The abdominal aorta, celiac trunk, SMA, renal arteries, , and iliac
branches are patent and normal in caliber. There is a moderate soft plaque
along the left aspect of the infrarenal abdominal aorta, without flow limiting
stenosis (series 5, image 70). There is no dissection.
There is no mesenteric, retroperitoneal, inguinal, or intrapelvic
lymphadenopathy, and no ascites.
Left femoral head bone islands are unchanged (series 5, image 106, 109). A 4
mm nonspecific sclerotic focus within the left ilium is stable since , without aggressive features, also likely a bone island (series
5, image 93). There are no osseous lesions concerning for malignancy or
infection.
## IMPRESSION:
1. Previously-seen hepatic metastases within segments V and VII are no longer
currently visualized, reflecting treatment response. There is mild background
steatosis.
2. No new abdominopelvic metastasis or lymphadenopathy.
3. Previously-seen known rectal mass is no longer conspicuous on the current
study.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-06-03 14:18:00"} | 1,604,508 |
Description: 19591359-RR-15Abstract: ## INDICATION:
man with rectal cancer with oligometastatic
disease.
## DOSE:
Acquisition sequence:
1) Sequenced Acquisition 0.5 s, 0.4 cm; CTDIvol = 5.6 mGy (Body) DLP = 2.2
mGy-cm.
2) Stationary Acquisition 1.2 s, 0.2 cm; CTDIvol = 19.4 mGy (Body) DLP =
3.9 mGy-cm.
3) Spiral Acquisition 10.1 s, 65.9 cm; CTDIvol = 8.9 mGy (Body) DLP = 578.5
mGy-cm.
4) Spiral Acquisition 5.0 s, 32.4 cm; CTDIvol = 9.1 mGy (Body) DLP = 287.4
mGy-cm.
Total DLP (Body) = 872 mGy-cm.
** Note: This radiation dose report was copied from CLIP (CT ABD AND
PELVIS WITH CONTRAST)
## THORACIC INLET:
The thyroid is unremarkable. The visualized portions of the
base of the neck shows no abnormality. There are no enlarged supraclavicular
infraclavicular or axillary lymph nodes.
## BREAST AND AXILLA:
There are no enlarged axillary lymph nodes.
## MEDIASTINUM:
There are no enlarged mediastinal hilar lymph nodes. Heart size
is normal. There is no pericardial effusion.
## PLEURA:
There is no pleural effusion.
## LUNG:
Lungs are clear. No nodules or consolidations are seen. Previously
visualized tiny micronodule in the right upper lobe is no longer seen.
## BONES AND CHEST WALL:
Review of bones shows no lytic or sclerotic lesions
concerning for metastasis.
## UPPER ABDOMEN:
Limited sections through the upper abdomen are unremarkable.
## IMPRESSION:
No evidence of metastasis to the chest.
Please refer to dedicated report on abdomen which has been dictated
separately.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-06-03 14:20:00"} | 1,604,509 |
Description: 19591359-RR-16Abstract: ## INDICATION:
year old man with rectal cancer, liver mets// To assist in
surgery
## FINDINGS:
Intraoperative ultrasound was provided to Dr. the performance of
a possible laparoscopic resection OF hepatic lesions seen on prior CT imaging.
The liver was diffusely heterogeneous in appearance. The lesions seen in
and earlier, but no longer apparent on the CT from
were not reliably identified on intraoperative sonography, with attention
given to segments 5 and 7 in the region previously noted.
## IMPRESSION:
No identified lesions corresponding to the previously-seen hepatic lesions
from .
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "25672144", "time": "2147-07-18 07:00:00"} | 1,604,510 |
Description: 19591359-RR-17Abstract: ## INDICATION:
year old man with rectal cancer with oligio metastatic disease
(lilver).// rectal cancer restaging
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 5.5 s, 35.9 cm; CTDIvol = 6.2 mGy (Body) DLP = 220.1
mGy-cm.
Total DLP (Body) = 220 mGy-cm.
## THORACIC INLET:
Thyroid is unremarkable. Left-sided Port-A-Cath tip projects
to the cavoatrial junction
## BREAST AND AXILLA:
There are no enlarged axillary lymph nodes.
## MEDIASTINUM:
There are no enlarged mediastinal or hilar lymph nodes. Heart
size is normal. There is mild coronary artery calcification. There is no
pericardial effusion. The aorta and pulmonary artery normal in caliber.
## PLEURA:
There is no pleural effusion
## LUNG:
The airways are patent up to the subsegmental level. Lungs are well
expanded and clear. No new or growing lung nodules.
## BONES AND CHEST WALL:
Review of bones is unremarkable
## UPPER ABDOMEN:
Limited sections through the upper abdomen shows no focal liver
lesions. No adrenal masses are seen.
## IMPRESSION:
No evidence of metastasis to the chest. Please refer to dedicated report on
abdomen which has been dictated separately.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-10-03 15:18:00"} | 1,604,511 |
Description: 19591359-RR-18Abstract: ## EXAMINATION:
MRI of the Abdomen
## INDICATION:
year old man with oligio metastatic disease (liver).// met
rectal-- restaging.
## LOWER THORAX:
Lung bases are clear.
## LIVER:
The liver is normal in morphology and signal intensity. There are T2
intermediate multilobulated hyperintense lesions in segment VII and V which
demonstrate subtle rim enhancement in segment VII and peripheral and central
enhancement in segment V. These measure 0.8 x 0.8 cm and 2.3 x 1.8 cm,
respectively (series 5, image 7, 19). While these are smaller compared to the
prior MRI from when they measured up to 1.9 cm and 2.5 cm,
respectively, they have recurred compared to the CT scan from . No
new lesions are seen. A few scattered simple cysts versus biliary hamartomas
are again seen and unchanged, the largest measuring 0.9 cm in segment II.
There is no perihepatic ascites.
## BILIARY:
The gallbladder is unremarkable without evidence of stones. There is
no intra or extrahepatic biliary duct dilation.
## PANCREAS:
The pancreas is normal in morphology and signal intensity. There is
no main pancreatic duct dilation.
## SPLEEN:
The spleen is normal in size and signal intensity.
## ADRENAL GLANDS:
The right and left adrenal glands are unremarkable.
## KIDNEYS:
The kidneys are symmetric in size. There are few scattered sub
centimeter cortical cyst. There is no suspicious renal lesions. There is no
hydronephrosis.
## GASTROINTESTINAL TRACT:
There is no hiatal hernia. There is no bowel
obstruction. Ileostomy noted in the left lower quadrant.
## LYMPH NODES:
There are no enlarged mesenteric or retroperitoneal lymph nodes.
## VASCULATURE:
There is no abdominal aortic aneurysm. Hepatic arterial anatomy
is conventional. There is a single renal artery bilaterally. The portal vein
and hepatic veins are patent.
## OSSEOUS AND SOFT TISSUE STRUCTURES:
There is no worrisome bony lesion. There
is a T2 hyperintense lesion in the T9 vertebral body which is unchanged and
likely represents a hemangioma.
## IMPRESSION:
Recurrence of metastatic lesions in segment VII and V since ,
measuring 0.8 and 2.3 cm, respectively.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-10-03 15:44:00"} | 1,604,512 |
Description: 19591359-RR-19Abstract: ## INDICATION:
yo male with segment VII and V lesions compatible with
metastatic rectal cancer.// Please ablate the metastatic liver lesions.
## ANESTHESIA:
General anesthesia was administered by the anesthesiology
department.
## MEDICATIONS:
For full details please refer to anesthesiology notes.
## CONTRAST:
210 ml of Optiray contrast.
## RADIATION DOSE:
Acquisition sequence:
1) Spiral Acquisition 9.6 s, 29.5 cm; CTDIvol = 10.7 mGy (Body) DLP = 301.1
mGy-cm.
2) Spiral Acquisition 5.8 s, 17.8 cm; CTDIvol = 10.2 mGy (Body) DLP = 167.6
mGy-cm.
3) Spiral Acquisition 5.9 s, 17.9 cm; CTDIvol = 10.1 mGy (Body) DLP = 167.1
mGy-cm.
4) Spiral Acquisition 6.0 s, 18.3 cm; CTDIvol = 10.1 mGy (Body) DLP = 171.3
mGy-cm.
5) Spiral Acquisition 6.0 s, 18.3 cm; CTDIvol = 10.0 mGy (Body) DLP = 169.7
mGy-cm.
6) Spiral Acquisition 6.2 s, 19.0 cm; CTDIvol = 11.4 mGy (Body) DLP = 202.3
mGy-cm.
7) Spiral Acquisition 6.2 s, 19.0 cm; CTDIvol = 11.3 mGy (Body) DLP = 199.9
mGy-cm.
8) Spiral Acquisition 7.4 s, 22.5 cm; CTDIvol = 9.6 mGy (Body) DLP = 203.4
mGy-cm.
9) Spiral Acquisition 7.4 s, 22.5 cm; CTDIvol = 9.6 mGy (Body) DLP = 203.4
mGy-cm.
Total DLP (Body) = 1,798 mGy-cm.
## PROCEDURE:
1. CT/US-guided thermal ablation of Segment VII metastasis
2. CT/US-guided thermal ablation of Segment V metastasis
## PROCEDURE DETAILS:
Following explanation of the risks, benefits and alternatives to the
procedure, written informed consent was obtained from the patient. The patient
was then brought to the computed tomography suite and placed supine on the
imaging table. General anesthesia was induced by the anesthesiologist.
Following
scout imaging, the skin was marked and draped in the usual sterile fashion.
Under ultrasound, a microwave ablation probe (16g x 15 cm) was advanced into
the Segment V lesion, and several overlapping ablations were performed to
ablate the tumor plus an appropriate ablative margin. A contrast enhanced CT
was performed, and based on this, additional ablation was performed on the
inferomedial aspect to provide a better ablative margin. Following this, the
probe was withdrawn and was placed in the liver via a second access site, and
advanced into the hepatic dome, targeting a lesion that was thought to be the
second metastasis. The metastasis was difficult to visualize on CT and on US.
After positioning the probe, an ablation was performed. A contrast-enhanced
CT was then performed which demonstrated that the actual metastasis was
adjacent to the ablation zone. Therefore, the probe was withdrawn and
repositioned to target this and additional ablation was performed. Following
this, a contrast enhanced CT was performed demonstrating adequate lesion
coverage, and a small amount of periphepatic fluid. The skin was then
cleaned and a dry sterile dressing was applied. The patient was awakened from
general anesthesia without incident and there were no immediate post-procedure
complications. The patient was transferred to the post-anesthesia care unit
for further monitoring.
## FINDINGS:
Two target lesions, in Segment V and VII were identifed and ablated. As the
dome lesion was very difficult to see, initial ablation was anterior to the
target lesion, and additional ablation was performed to ablate the target
lesion.
## IMPRESSION:
Technically-successful ablation of two target lesions within the right hepatic
lobe.
## RECOMMENDATION(S):
The patient will be scheduled for a 1 month MRI and return
to clinic.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-10-29 09:02:00"} | 1,604,513 |
Description: 19591359-RR-20Abstract: ## EXAMINATION:
MRI of the Abdomen
## INDICATION:
year old man with liver lesion s/p ablation // Please
assess for interval change
## LIVER:
Again seen are treatment cavities, the largest seen in segment 5,
measuring 6.2 cm x 3.2 cm. 2 other ablation cavities are seen in segment 8
and 4A at the dome of the liver, measuring 3.4 cm x 4.1 cm and 1.7 cm x 2.5 cm
respectively. These demonstrate similar characteristics, with surrounding
high T1 rim with heterogeneous central cavity, representing coagulative
necrosis and hemorrhagic products. Post contrast administration, there is no
enhancement to suggest residual tumor. There is early arterial enhancement of
the surrounding liver parenchyma, compatible with post treatment changes. No
new liver lesion.
Scattered high T2 cysts are seen in the left lobe of the liver.
Portal vein and hepatic veins are patent.
## BILIARY:
No biliary duct dilatation. The gallbladder is unremarkable.
## PANCREAS:
Tiny 2 mm or less cystic structures within the head and uncinate
process of the pancreas, likely side branch intraductal papillary mucinous
neoplasms (IPMNs). This is stable compared to the previous examination.
## SPLEEN:
The spleen is unremarkable.
## KIDNEYS:
Multiple renal cysts are again seen..
## GASTROINTESTINAL TRACT:
No bowel obstruction in the upper abdomen. No
ascites. An ileostomy is seen in the left upper abdomen.
## LYMPH NODES:
No adenopathy in the upper abdomen.
## VASCULATURE:
The hepatic vasculature is patent.
## OSSEOUS AND SOFT TISSUE STRUCTURES:
Revisualization of the T9 and T12 lesions
containing high T1 signal, likely hemangiomas.
## IMPRESSION:
1. Post treatment cavities are seen within the liver without new metastatic
or recurrent disease.
2. Incidental findings as described above.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-12-02 14:05:00"} | 1,604,514 |
Description: 19591359-RR-21Abstract: ## INDICATION:
year old man with rectal cancer with oligio metastatic disease
(liver s/p RFA).// rectal cancer restaging
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 5.5 s, 35.9 cm; CTDIvol = 8.5 mGy (Body) DLP = 299.5
mGy-cm.
Total DLP (Body) = 300 mGy-cm.
## NECK, THORACIC INLET, AXILLAE:
The visualized thyroid is normal.
Supraclavicular and axillary lymph nodes are not enlarged.
## MEDIASTINUM:
Mediastinal lymph nodes are not enlarged.
## HILA:
Hilar lymph nodes are not enlarged.
## HEART:
The heart is not enlarged and there is minimal coronary arterial
calcification. There is no pericardial effusion.
## VESSELS:
Aortic caliber is normal. The main, right, and left pulmonary
arteries are normal caliber.
## PULMONARY PARENCHYMA:
No focal consolidation. No suspicious pulmonary nodule
or mass. There is no emphysema.
## AIRWAYS:
The airways are patent to the subsegmental level bilaterally.
## PLEURA:
There is no pleural effusion.
## CHEST WALL AND BONES:
There is no worrisome lytic or sclerotic lesion.
Multilevel degenerative changes are mild.
## UPPER ABDOMEN:
Limited evaluation of the upper abdomen demonstrates post
radiofrequency ablation cavities in segment V and VII. Otherwise the
visualized upper abdomen is unremarkable. Please see same day MRI for more
detailed evaluation of the abdomen.
## IMPRESSION:
1. No evidence of metastatic disease within the chest. No acute process
within the chest.
2. Please see same day MRI liver for more detailed evaluation of the abdomen.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-12-02 15:28:00"} | 1,604,515 |
Description: 19591359-RR-22Abstract: ## EXAMINATION:
MRI of the Abdomen
## INDICATION:
year old man with liver metastases s/p ablation // Please
assess for interval change
## LOWER THORAX:
There is no pleural effusion.
## LIVER:
There is no significant drop in signal on opposed phase imaging to
suggest hepatic steatosis.Trace perihepatic fluid is noted.
Patient is status post ablation of two right hepatic metastases, which was
performed on :
## 1. HEPATIC DOME (12:15):
There are two adjacent ablation zones measuring 3.6
x 3.2 cm and 2.9 x 1.6 cm, respectively. This was due to repositioning of the
probe during the ablation procedure for better targeting of the single
metastasis. Along the medial aspect of the more posteriorly located ablation
zone, there is a 0.8 x 0.7 cm hypoenhancing lesion with associated diffusion
restriction, suspicious for residual/recurrent tumor (12:16, 04:36).
## 2. SEGMENT V:
(12:40): Ablation cavity measuring 5.8 x 2.8 cm, unchanged from
prior. No new areas of nodular enhancement to suggest local recurrence.
Ill-defined areas of arterial hyperenhancement surrounding the treatment
cavity appears slightly decreased from prior, and are likely post-treatment
related.
## BILIARY:
There is no intrahepatic or extrahepatic biliary dilation.
Gallbladder is unremarkable.
## PANCREAS:
Again seen are sub-5 mm cystic lesions in the head and uncinate
process of the pancreas, which likely represent side branch intraductal
papillary mucinous neoplasms (IPMN). There is no main duct dilation.
## SPLEEN:
Spleen is normal in size, without focal lesions.
## ADRENAL GLANDS:
Normal in size and shape.
## KIDNEYS:
Kidneys are normal in size and shape. No solid parenchymal lesions
are identified. Subcentimeter simple cysts are noted in both kidneys. There
is no hydronephrosis.
## GASTROINTESTINAL TRACT:
Stomach is unremarkable. There is no bowel
obstruction or ascites.
## LYMPH NODES:
Retroperitoneal and mesenteric lymph nodes are not enlarged by
size criteria.
## VASCULATURE:
Abdominal aorta is not aneurysmal. Celiac artery, superior
mesenteric artery, and bilateral renal arteries are patent.
## OSSEOUS AND SOFT TISSUE STRUCTURES:
No focal osseous lesions are identified.
Soft tissues are unremarkable.
## IMPRESSION:
1. Findings suspicious for a 0.8 cm focus of residual/recurrent tumor along
the medial aspect of the segment VII ablation zone.
2. Sub-5 mm probable pancreatic side-branch IPMNs, which can be reassessed on
routine surveillance studies.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2148-02-26 15:30:00"} | 1,604,516 |
Description: 19591359-RR-23Abstract: ## INDICATION:
year old man with rectal cancer with oligio metastatic disease
(liver s/p RFA).// rectal cancer restaging
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 4.5 s, 35.5 cm; CTDIvol = 10.1 mGy (Body) DLP = 357.6
mGy-cm.
Total DLP (Body) = 358 mGy-cm.
## CHEST PERIMETER:
No thyroid findings warranting further imaging.
Supraclavicular and axillary lymph nodes are not enlarged and there are no
soft tissue abnormalities of concern in the imaged chest wall.
## CARDIO-MEDIASTINUM:
Esophagus is unremarkable. Atherosclerotic calcification
is not apparent head neck vessels and only mild in the coronary arteries.
Aorta and pulmonary arteries are normal size and pericardium is physiologic.
Aortic valvular calcification is mild.
## THORACIC LYMPH NODES:
Numerous lymph nodes in the mediastinum are measurable,
but not pathologically enlarged. There is no lymph node enlargement in the
chest.
## FOCAL LUNG LESIONS:
Bilobed 5 mm wide nodule, right lower lobe, 4:201, is new or substantially
larger today than in . No other lung lesions of concern.
Tracheobronchial tree is normal to subsegmental levels. There is no pleural
abnormality.
## CHEST CAGE:
Although there are no bone lesions in the imaged chest cage
suspicious for malignancy or infection, it should be noted that radionuclide
bone and FDG PET scanning are more sensitive in detecting early osseous
pathology than chest CT scanning.
## IMPRESSION:
5 mm right lower lobe lung nodule is new or substantially larger since . Could be malignant or inflammatory. No other findings suggest any
intrathoracic malignancy.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2148-02-26 14:35:00"} | 1,604,517 |
Description: 19591359-RR-26Abstract: ## INDICATION:
yo male with residual tumor near segment VII ablation site.
Please ablate the metastatic liver lesions.
## OPERATORS:
Dr. fellow and Dr.
radiologist. Dr. supervised the trainee during the key
components of the procedure and reviewed and agree with the trainee's
findings.
## ANESTHESIA:
General anesthesia was administered by the anesthesiology
department.
## MEDICATIONS:
For full details please refer to anesthesiology notes.
## CONTRAST:
70 ml of Optiray contrast.
## PROCEDURE:
Microwave ablation of a 0.8 cm focus of residual tumor at the
medial aspect of a segment 7 ablation cavity.
## PROCEDURE DETAILS:
Following explanation of the risks, benefits and alternatives to the
procedure, written informed consent was obtained from the patient. The patient
was then brought to the computed tomography suite and placed supine on the
imaging table. General anesthesia was induced by the anesthesiologist.
Following scout imaging, the skin was marked and draped in the usual sterile
fashion.
Under ultrasound and CT Guidance, a single microwave ablation probe was
advanced through the intercostal space until the tip of the probe was just
beyond the expected location of the hepatic segment 7 lesion.
Microwave ablation was performed for a total of 10 minutes at 60 watts. The
microwave ablation probe was then retracted and repositioned slightly more
posteriorly. A repeat microwave ablation was performed for a total of 5
minutes at 60 watts.
The probe was then withdrawn while ablating the access tract.
Contrast enhanced multiphase computed tomography was obtained. The skin was
then cleaned and a dry sterile dressing was applied. The patient was awakened
from general anesthesia without incident and there were no immediate
post-procedure complications. The patient was transferred to the
post-anesthesia care unit for further monitoring.
## FINDINGS:
Post ablation contrast enhanced CT demonstrates satisfactory coverage of the
ablation zone. No active extravasation.
## IMPRESSION:
Successful microwave ablation of the residual tumor at the margin of the
hepatic segment 7 ablation cavity.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2148-04-14 09:08:00"} | 1,604,518 |
Description: 19591359-RR-28Abstract: ## EXAMINATION:
MRI of the Abdomen
## INDICATION:
year old man with liver lesion s/p ablation // Please
assess for interval change
## LOWER THORAX:
Please refer to the separate report for the CT chest performed
the same day. An 8 mm right lower lobe pulmonary nodule is noted.
## LIVER:
There are expected post-ablation changes in segment related to the
interval microwave ablation, with surrounding perfusional changes.
Pre-existing ablation zones in segment and 5 are unchanged. There is
intrinsic T1 signal around the periphery of the ablation zones but no definite
nodular enhancement to suggest recurrence. There is a nonspecific 9 mm
arterially enhancing focus in segment 8 (series 1201, image 24), nonspecific
but not present on the previous study. This does not show washout or
pseudocapsule enhancement and there is no T2/diffusion abnormality. A few
small T2 hyperintensities in the left hepatic lobe are consistent with benign
cysts or biliary hamartomas.
## BILIARY:
The gallbladder is unremarkable. There is no biliary dilation.
## PANCREAS:
Unremarkable. No pancreatic ductal dilation.
## SPLEEN:
Normal in size and enhancement.
## ADRENAL GLANDS:
Normal in size and shape.
## KIDNEYS:
Unremarkable aside from tiny bilateral cysts. No hydronephrosis.
## GASTROINTESTINAL TRACT:
A left mid abdominal ostomy is noted. The visualized
bowel is otherwise grossly unremarkable.
## LYMPH NODES:
No enlarged lymph nodes in the field of view.
## VASCULATURE:
No evidence of abdominal aortic aneurysm. Major portal and
hepatic veins are patent.
## OSSEOUS AND SOFT TISSUE STRUCTURES:
No aggressive bone or soft tissue lesions
identified.
## IMPRESSION:
1. Post-ablation changes with no evidence of residual or recurrent tumor at
the periphery of the ablation zones.
2. New nonspecific 9 mm arterially enhancing focus in segment 8 can be
re-evaluated at next follow-up.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2148-05-11 15:35:00"} | 1,604,519 |
Description: 19591359-RR-29Abstract: ## INDICATION:
year old man with rectal cancer with oligio metastatic disease
(liver s/p RFA).// rectal cancer restaging
## FINDINGS:
No incidental thyroid findings. Left pectoral Port-A-Cath. No
supraclavicular, infraclavicular or axillary lymphadenopathy. All mediastinal
lymph nodes and hilar lymph nodes are normal in size. No incidental pulmonary
embolism. Stable mild coronary calcifications, no pericardial effusion. No
valvular calcifications, moderate interval enlargement of the known hepatic
lesions and other abdominal findings are described in detail in the dedicated
abdominal CT report. No abnormalities in the posterior mediastinum. No
osteolytic lesions at the level of the ribs, the sternum, or the vertebral
bodies. Stable mild degenerative vertebral disease. No vertebral compression
fractures.
No diffuse lung disease. No pleural effusions or other pleural abnormalities.
The airways are patent. The pre-existing nodule in the right lower lobe basis
(302, 161) has slightly increased in size and appears more bulky than on the
previous examination. The current diameter of the nodule is approximately 8
mm, as compared to 5 mm on the previous examination. No other nodules
currently visualized.
## IMPRESSION:
Interval growth of a solitary right lower lobe pulmonary nodule, from
approximately 5 to approximately 8 mm in diameter. No other nodules are
visualized. No adenopathy. No pleural abnormalities.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2148-05-11 16:36:00"} | 1,604,520 |
Description: 19591359-RR-31Abstract: ## EXAMINATION:
MRI of the Abdomen
## INDICATION:
year old man with liver lesion seg 8 in setting of prior met
CRC// Please assess for interval change
## LOWER THORAX:
Pulmonary nodules in the lingula and posterior right
costophrenic sulcus are again noted. Please refer to the separate report for
the CT chest for further detail of thoracic findings.
## LIVER:
There a few small hepatic cysts. 3 ablation zones in the right hepatic
lobe are stable in appearance with no recurrent solid enhancement. There are
a few stable areas of peripheral enhancement that appear related to vessels.
Previously demonstrated arterially enhancing focus in segment 8 is not
visualized on this study. No new lesions are demonstrated.
## BILIARY:
There is no biliary dilation. The gallbladder is unremarkable.
## SPLEEN:
The spleen is within normal limits of size and the parenchyma is
homogeneous.
## KIDNEYS:
Tiny subcentimeter cysts are noted bilaterally. No hydronephrosis.
## GASTROINTESTINAL TRACT:
There is a left lower quadrant colostomy. Visualized
bowel is otherwise grossly unremarkable.
## LYMPH NODES:
No lymphadenopathy in the field-of-view.
## VASCULATURE:
No abdominal aortic aneurysm.
## OSSEOUS AND SOFT TISSUE STRUCTURES:
Subcentimeter T2 hyperintense lesions in
T9 and T12 are most consistent with hemangiomas.
## IMPRESSION:
1. Stable hepatic post-ablation changes with no evidence of new or recurrent
metastatic disease.
2. Previously identified arterially enhancing focus in segment 8 is no longer
demonstrated and may have been related to early post-treatment changes.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2148-07-09 15:22:00"} | 1,604,521 |
Description: 19591359-RR-4Abstract: ## EXAMINATION:
CT scan of the abdomen pelvis before and after intravenous
contrast
## INDICATION:
year old man with new rectal cancer// Initial staging
## ONCOLOGY 3 PHASE:
Multidetector CT of the abdomen and pelvis was
done as part of CT torso without and with IV contrast. Initially the abdomen
was scanned without IV contrast. Subsequently a single bolus of IV contrast
was injected and the abdomen and pelvis were scanned in the portal venous
phase, followed by a scan of the abdomen in equilibrium (3-min delay) phase.
Oral contrast was administered.
Coronal and sagittal reformations were performed and reviewed on PACS.
## DOSE:
Total study DLP 1885.16 mGy cm.
## LOWER CHEST:
Please refer to separate report of CT chest performed on the same
day for description of the thoracic findings.
## HEPATOBILIARY:
There are multiple hypoattenuating liver lesions, measuring 1.9
cm in segment 5 and 1.9 cm in segment 7 which appear ill-defined on the
delayed phase and are suspicious for hepatic metastases. Additional
subcentimeter lesions within segment 2 are too small to characterize. The
liver parenchyma appears otherwise homogeneously enhancing. There is no
evidence of intrahepatic or extrahepatic biliary dilatation. The gallbladder
is within normal limits.
## PANCREAS:
The pancreas has normal attenuation throughout, without evidence of
focal lesions or pancreatic ductal dilatation. There is no peripancreatic
stranding.
## SPLEEN:
The spleen shows normal size and attenuation throughout, without
evidence of focal lesions.
## ADRENALS:
The right and left adrenal glands are normal in size and shape.
## URINARY:
The kidneys are of normal and symmetric size with normal nephrogram.
There is no evidence of focal renal lesions or hydronephrosis. There is no
perinephric abnormality.
## GASTROINTESTINAL:
The stomach is unremarkable. Small bowel loops demonstrate
normal caliber, wall thickness, and enhancement throughout. The colon is
unremarkable. There is thickening and hyper enhancement within the rectum
(axial series 3, image 112) particularly along the posterior wall likely
corresponding to the patient's known primary malignancy. Note is made that a
staging MRI was performed same date which will be reported separately and
which better characterizes the local staging for this lesion. The appendix is
normal.
## PELVIS:
The urinary bladder and distal ureters are unremarkable. There is no
free fluid in the pelvis.
## REPRODUCTIVE ORGANS:
The prostate and seminal vesicles are unremarkable.
## LYMPH NODES:
There is no retroperitoneal or mesenteric lymphadenopathy.
Subcentimeter lymph node noted along the course of the superior rectal artery.
there is no pelvic or inguinal lymphadenopathy.
## VASCULAR:
There is no abdominal aortic aneurysm. Moderate atherosclerotic
disease is noted with calcified and noncalcified plaque along the left lateral
wall of the infrarenal abdominal aorta.
## BONES:
Several sclerotic foci within the left femoral head and right pubic
bone adjacent to the symphysis are nonspecific and may represent small bone
islands. Peripherally sclerotic well-circumscribed lesion within the right
proximal femur is nonspecific but has a nonaggressive appearance.
## SOFT TISSUES:
The abdominal and pelvic wall is within normal limits.
## IMPRESSION:
1. Multiple hypodense hepatic lesions highly suspicious for metastatic
disease.
2. Hyperenhancing mass within the rectum, better characterized on MRI
performed same day, reported separately.
3. Moderate atherosclerotic disease within the infrarenal abdominal aorta.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-01-21 15:25:00"} | 1,604,522 |
Description: 19591359-RR-5Abstract: ## EXAMINATION:
MRI of the Pelvis
## INDICATION:
year old man with new rectal cancer, initial staging
## TUMOR:
There is a semi annular mass involving the posterior wall of the
primarily mid rectum.
Distance from anal verge (AV) (mm): 48
Extends cranio-caudally (CC) (mm): 48
Distal edge lies: at puborectalis sling
Upper border lies: 9 mm below peritoneal reflection
## STAGING
INVADING TUMOR EDGE:
From 8 o'clock to 4 o'clock
Muscularis propria: There is irregular enhancement of the inferoposterior
aspect of the muscularis propria layer, consistent with tumor involvement
(series 13, image 33). Tumor does however remains confined to and does not
extend beyond the muscularis propria.
Extramural spread (mm): None
Extramural venous invasion (EMVI): no
Peritoneal reflection: not involved
Adjacent pelvic organs , prostate, vagina): not involved
FOR DISTAL RECTAL TUMORS AT/BELOW LEVATOR ORIGIN
Intersphincteric plane: Free
External anal sphincter: not invaded
Ischiorectal fossa: not invaded
The internal anal sphincter is located approximately 5-10 mm below the distal
edge of the tumor.
CRM (Circumferential resection margin) - pick one
Pushing border of an involved node: 4 mm at: 6 o'clock (series 13, image 8).
## MINIMUM TUMOR DISTANCE TO MRF:
greater than 1 mm
There are three scattered mesorectal lymph nodes which measure between 4 and 5
mm and appearing encapsulated and without suspicious features (series 4, image
19, 20, 19). There is a 7 mm superior mesorectal lymph nodes which maintains
a normal morphologic shape (series 4, image 11).
There is a somewhat suspicious 4 mm left mesorectal lymph node at the level of
the lesion which demonstrates more hypointense T2 weighted signal than
adjacent lymph nodes, but remains encapsulated. Superior to the tumor there
is a suspicious lymph node measuring 6 mm with irregular borders (series 12,
image 9).
Mesorectal lymph nodes - Size (mm):
Mesorectal lymph nodes - location: At and above tumor
Mesorectal lymph nodes - heterogeneous signal: no
Mesorectal lymph nodes - capsular irregularity: yes
Mesorectal lymph nodes: N1 (< 4)
## METASTASIS:
M0
Views of the intrapelvic bowel loops are otherwise unremarkable. There is no
pelvic free fluid. Prostate demonstrates low signal in the peripheral zone
diffusely, likely secondary to prostatitis. There is no suspicious bony
lesion.
## IMPRESSION:
Semiannular mass spanning 4.8 cm involving the posterior primarily mid rectum
confined to the muscularis propria, consistent with MR stage T2 disease. At
least one suspicious lymph node in the superior mesorectal fascia posteriorly,
highly concerning for N1 disease.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-01-21 12:34:00"} | 1,604,523 |
Description: 19591359-RR-6Abstract: ## INDICATION:
man with new rectal cancer.
Staging.
## DOSE:
Acquisition sequence:Only scout image data available for this exam.
** Note: This radiation dose report was copied from CLIP (CT ABD AND
PELVIS W AND W/O CONTRAST, ADDL SECTIONS)
## FINDINGS:
NECK, THORACIC INLET, AXILLAE, CHEST WALL:
Thyroid is unremarkable.
No supraclavicular or axillary lymphadenopathy.
Chest wall is unremarkable.
## UPPER ABDOMEN:
Several hypodense round lesions in the liver, the largest 1.8
cm right lobe - will be reported separately in the same day CT of the abdomen
and pelvis, accession # .
## MEDIASTINUM:
There is no mediastinal, hila or any other intrathoracic
lymphadenopathy.
## HEART AND PERICARDIUM:
The heart is normal size and there is no pericardial
effusion.
Specks of calcifications in the coronaries including the left main coronary.
Major vessels are not distended.
## LUNG AND PLEURA:
Major airways are patent.
Micro nodule in the right upper lobe (series 302, image 82), otherwise the
lungs are clear.
No pleural effusion.
## CHEST CAGE:
No evidence of bony destructive lesions.
## IMPRESSION:
-Right upper lobe micro nodule, otherwise no clear evidence of intrathoracic
malignancy, attention follow-up studies is recommended.
-Please refer for the same day report of the CT of the abdomen and pelvis for
findings of the upper abdomen.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-01-21 15:35:00"} | 1,604,524 |
Description: 19591359-RR-7Abstract: ## EXAMINATION:
MRI of the Abdomen
## INDICATION:
year old man with rectal ca ? mets// please eval for mets
## LOWER THORAX:
The lung bases are clear. There are no pleural effusions.
## LIVER:
There is a slightly irregular 1.9 x 1.9 cm T2 hyper, T1 hypointense
lesion in segment 8 of the liver, which demonstrates peripheral enhancement
without fill-in on the post gadolinium sequences. A second lesion with
similar signal characteristics is seen in segment 5, measuring 1.8 x 2.5 cm.
There are few scattered hepatic cysts/biliary hamartomas, the largest in
segment 2 measuring up to 8 mm. Background liver signal is unremarkable,
without evidence of fatty infiltration or iron deposition.
## BILIARY:
There is no intra or extrahepatic biliary duct dilatation. The
gallbladder is unremarkable.
## PANCREAS:
The pancreas has normal signal intensity morphology. There are no
focal pancreatic lesions. The pancreatic duct is not dilated.
## SPLEEN:
The spleen is not enlarged.
## ADRENAL GLANDS:
The adrenal glands are unremarkable.
## KIDNEYS:
There are no focal renal lesions. There is no hydronephrosis.
## GASTROINTESTINAL TRACT:
The visualized bowel loops are unremarkable, without
evidence of obstruction.
## LYMPH NODES:
There is no lymphadenopathy in the upper abdomen.
## VASCULATURE:
The portal veins are patent.
## OSSEOUS AND SOFT TISSUE STRUCTURES:
No suspicious bone lesions.
## IMPRESSION:
2 suspicious hepatic lesions in segments 8 and 5, concerning for metastatic
disease.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591359", "visit_id": "N/A", "time": "2147-01-26 12:31:00"} | 1,604,525 |
Description: 19591376-RR-13Abstract: ## HISTORY:
Known cirrhotic with elevated CA . Pretransplant evaluation.
## BONE WINDOWS:
No malignant-appearing osseous lesions are noted.
## LIVER VOLUMES:
Total 1170cm3, right lobe 704cm3, left lobe 466 cm3
## IMPRESSION:
1. Cirrhotic liver with sequelae of portal hypertension including
splenomegaly, recanalized paraumbilical vein and esophageal varices. Mild
amount of ascites noted on the outside examination has since
resolved.
2. Slightly limited assessment of the liver for focal hepatic lesions due to
suboptimal arterial phase imaging from respiratory motion as detailed above.
Within these limitations, no arterial enhancing lesions with washout are
present. Several nodules within the liver due display "washout" compared to
surrounding parenchyma on delayed phase imaging (without arterial enhancement)
which are likely regenerative or dysplastic nodules and less likely
hypovascular HCCs.
Given the slightly limited arterial phase imaging on the current exam, would
suggest a short-term repeat multiphasic CT in months (patient likely
unable to tolerate breath-hold instructions of MRI).
3. Probable punctate new non-occlusive 3-4mm clot at the IVC/hepatic venous
confluence. Accessory right hepatic artery off the SMA with otherwise
conventional vascular anatomy.
4. No findings to suggest biliary malignancy with unchanged slightly
prominent extrahepatic biliary tree, likely related to post cholecystectomy
status.
Please see above technique regarding contrast allergy after today's
examination. Patient has tolerated prior exams with different contrast agents
without complication so suggest premedication prior to next CTA and use of
Visipaque contrast.
An email was sent to Dr. on date of exam communicating above findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591376", "visit_id": "N/A", "time": "2111-09-26 12:04:00"} | 1,604,526 |
Description: 19591376-RR-16Abstract: ## STUDY:
CT of the abdomen without and with contrast.
## INDICATION:
male with history of cirrhosis and the suspect IVC
thrombus on previous CT. Please assess vessel patency. Also, evaluate for
focal hepatic lesions.
## FINDINGS:
The visualized lung bases are clear without focal nodules, masses
or consolidations. On the non-contrast CT images of the abdomen, again noted
is a stable calcified granuloma involving the spleen. There are surgical
clips in the gallbladder fossa consistent with cholecystectomy. Again noted
are a few hyperdense nodules within the hepatic dome. These hyperdense
nodules are not significantly changed since previous study. Post contrast
administration, again noted is coarse architecture to the hepatic parenchyma.
No suspicious arterial enhancing nodules are seen.
There are again noted at least two hypoenhancing nodules seen within segment
VIII of the liver on the three-minute delayed images, which appear stable in
size since previous study. The previously noted hypoenhancing lesion on the
delayed phase image in segment VII is not clearly visualized on the current
study. These findings are suggestive of regenerative or dysplastic nodules.
Again noted are paraesophageal varices. The spleen is borderline enlarged
measuring 14 cm in size.
The pancreas, adrenal glands and kidneys are normal.
Evaluation of bowel is limited due to lack of oral contrast. However, no
gross mass lesions are seen.
The portal vein is patent. Again noted is a 3-mm filling defect at the
junction of the IVC and hepatic veins. The size and shape is not
significantly changed since previous study.
Scattered mesenteric and retroperitoneal lymph nodes are again seen.
No suspicious lesions are seen within the visualized osseous structures.
## IMPRESSION:
Hepatic cirrhosis with evidence of portal hypertension.
Redemonstration of small filling defect at the junction of the hepatic veins
and IVC. This is of unclear etiology and may represent a small lipoma versus
clot.
No enhancing lesions within the liver to suggest HCC. Several hypoenhancing
lesions within the liver on delayed phase images, which are not significantly
changed since previous study, could represent dysplastic or regenerative
nodules.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591376", "visit_id": "21673310", "time": "2112-01-27 12:33:00"} | 1,604,527 |
Description: 19591376-RR-18Abstract: ## INDICATION:
Cirrhosis with question of IVC thrombus. Assess vessel patency
and assess for focal liver lesions.
## FINDINGS:
The liver is nodular and coarse, consistent with known cirrhosis.
Within the right hepatic lobe, there is an essentially isoechoic 11 x 12 x 13
cm lesion, possibly correlating to the lesion seen on prior CT from . There is no intrahepatic biliary duct dilatation. The gallbladder is
surgically absent. The common duct is normal in caliber, measuring 6 mm. The
visualized portion of the pancreas is unremarkable. The pancreatic tail is
not well assessed secondary to overlying bowel gas. The spleen is mildly
enlarged, measuring 14.3 cm, not significantly changed. There is a small
volume of perihepatic ascites.
Color and spectral Doppler imaging was performed of the hepatic vasculature.
The main hepatic artery has sharp systolic upstroke and normal arterial
waveform. The main portal vein, right main portal vein, and left main portal
vein are patent with appropriate waveforms and directional flow.
Recanalization of the umbilical vein is noted. The hepatic veins are patent
with appropriate directional flow. The IVC is patent. The splenic vein and
SMV are patent.
## IMPRESSION:
1. Patent hepatic vasculature with appropriate directional flow. Patent IVC.
2. 13-mm right hepatic lobe isoechoic nodule, possibly correlating to the
lesion seen on prior CT from , although assessment is
incomplete on the current study. Further evaluation could be performed with
an MRI, if clinically indicated. Otherwise, short term ultrasound follow-up
in months is recommended.
3. Evidence of portal hypertension including small volume ascites and mild
splenomegaly.
Impression point #2 was entered into the critical results dashboard by Dr.
on the day of the study.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591376", "visit_id": "N/A", "time": "2112-07-17 11:39:00"} | 1,604,528 |
Description: 19591376-RR-21Abstract: ## INDICATION:
woman with liver lesion seen on ultrasound. The
patient is on liver transplant list. Please assess for focal liver lesions.
## FINDINGS:
The liver has an irregular outline consistent with the known
diagnosis of cirrhosis. Mulitple lesions are identified within the liver.
Lesion 1 - There is a dominant nodule within segment VIII measuring 21 x 15
mm (9; 35 and 1101; 44). It is hyperintense on T1-weighted imaging with a
hypointense correlate on T2-weighted imaging. After administration of
contrast, there is hyperenhancement within approximately 50% of the lesion
with washout on delayed phase imaging. The appearances are suspicious for a
focus of HCC within a dysplastic nodule. Biopsy is advised, however this may
be challenging as this nodule does not definitively correlate with that
identified on the prior ultrasound. A repeat ultrasound may be of benefit
specifically to assess for this lesion.
Lesion 2 - Posterolaterally to the IVC within segment VII, there is a 1.5-cm
lesion (1101; 34). This is of high signal on T1-weighted imaging however it
is not clearly seen on T2-weighted imaging. There is enhancement on arterial
phase post contrast imaging with washout on delayed phase imaging. This
lesion is also suspicious for a hepatocellular carcinoma.
Lesion 3 - Posteriorly within segment (1101; 41) there is a 12mm lesion.
This is bright on T1 weighted imaging and demonstrates arterial enhancement
after the administration of contrast, however there is no correlate on
T2-weighted imaging and no definite washout on delayed phase imaging. This
nodule is indeterminate in nature.
Lesion 4 - A further focus of arterial enhancement is noted within segment
VII,(1101; 39). This measures 6mm with no correlate on T2-weighted imaging or
pre contrast T1 weighted imaging. There is no definite washout. This is also
indeterminate in nature.
A 7-mm siderotic nodule is seen within segment . There are multiple
non-enhancing foci throughout the liver without obvious T2 or T1 correlates.
The portal and hepatic veins are patent. No intra- or extra-hepatic biliary
dilatation. Right and left hepatic arteries arise from the hepatic artery
proper via the celiac axis with an accessory right hepatic artery arising from
the superior mesenteric artery.
The spleen is enlarged measuring 14 cm and there are para-esophageal varices
consistent with portal hypertension. A calcified granuloma is noted within
the spleen. Lymph nodes measuring up to 9 mm in short axis dimension are seen
at the porta hepatis and at the celiac axis.
The pancreas enhances normally. No focal pancreatic lesions. No pancreatic
duct dilatation. Previous cholecystectomy noted.
The kidneys and adrenal glands are unremarkable. No hydronephrosis. No focal
lesions. The visualized small and large bowel are within normal limits on
this non-dedicated study.
Normal signal within the visualized skeletal system.
## IMPRESSION:
1. Arterially enhancing nodule measuring 2.0cm within segment VIII,
suspicious for a focus of hepatocellular carcinoma within a dysplastic nodule.
Biopsy is recommended; however this may be technically challenging and the
nodule may not correlate with the lesion identified on the recent ultrasound.
A repeat ultrasound may be of benefit specifically to assess for this lesion.
2. 1.5-cm lesion in segment VII, which also demonstrates hyperenhancement and
washout, also suspicious for hepatocellular carcinoma.
3. Indeterminate foci of arterial enhancement (within segment and segment
VII), which are indeterminate in nature.
4. There are features of cirrhosis and portal hypertension with splenomegaly
measuring 14 cm and para-esophageal varices.
5. Accessory right hepatic artery arising from the superior mesenteric
artery.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591376", "visit_id": "N/A", "time": "2112-11-28 15:21:00"} | 1,604,529 |
Description: 19591376-RR-24Abstract: ## INDICATION:
Abdominal pain and distention with history of HCC and likely
cirrhosis. Evaluate for portal vein thrombosis and assess for ascites.
## FINDINGS:
The liver echotexture is diffusely nodular, consistent with known
cirrhosis. The previously seen suspicious hepatic lesion identified on MR
from was not definitely imaged on the present study. The
portal vein is patent, with normal hepatopetal flow. The patient is status
post cholecystectomy. There is central intrahepatic biliary dilation and the
common duct is dilated to 1.2 cm, increased compared to prior MRI from , previously measuring 8 mm. The pancreatic duct caliber is at the
upper limits of normal. The spleen is top normal in size, measuring 13.0 cm.
There is no evidence of ascites.
## IMPRESSION:
1. Patent portal vein. No evidence of ascites.
2. Interval increase in the degree of biliary dilatation with the common duct
now measuring up to 1.2 cm. This finding is of uncertain clinical
significance and should be correlated with LFTs. If further evaluation is
warranted, an MRCP would be recommended.
3. Nodular liver, consistent with known cirrhosis. Known suspicious hepatic
lesion not definitely imaged.
Pertinent findings were discussed with Dr. by at 4:19
p.m. via telephone on the day of the study.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591376", "visit_id": "29361596", "time": "2112-12-15 14:31:00"} | 1,604,530 |
Description: 19591376-RR-25Abstract: ## INDICATION:
woman with hep C cirrhosis, HCC recently seen on MRI
two weeks ago. Increased total bili and CBD dilatation to 1.2 cm. Rule out
intra-biliary disease.
## FINDINGS:
Again appreciated is a nodular cirrhotic-appearing liver containing
multiple lesions. The previously mentioned lesions are unchanged in size and
appearance. There are two concerning lesions for HCC within segment VIII and
. Two indeterminate lesions are within segment and . There is no
new arterial enhancing nodule visualized.
The portal and hepatic veins are patent.
The patient is status post cholecystectomy. The common bile duct is dilated,
currently measuring 8 mm, not significantly changed from previous. The
pancreatic duct is not dilated. No obstructing mass lesion or calculus is
seen within the common bile duct. The intrahepatic biliary tree is not
dilated.
There is splenomegaly, with the spleen measuring 14 cm. A calcified granuloma
within the spleen is again noted as an area of susceptibility.
There is a significant amount of periportal and celiac lymphadenopathy,
unchanged.
The pancreas and adrenals are unremarkable.
The kidneys are unremarkable without focal parenchymal mass, lesion or
hydronephrosis.
There is no ascites.
There is a background of anasarca.
## BONES:
There are no suspicious bony abnormalities.
## IMPRESSION:
1. Stable appearance of the arterial enhancing lesions within the liver, two
of which are concerning for HCC, and two of which are indeterminate. No new
intrahepatic lesions are identified.
2. There is mild prominence of the extrahepatic biliary tree, without
obstructing mass lesion or calculus. These findings are expected
post-cholecystectomy.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591376", "visit_id": "29361596", "time": "2112-12-16 17:01:00"} | 1,604,531 |
Description: 19591420-RR-15Abstract: ## EXAMINATION:
FOREARM (AP AND LAT) LEFT
## INDICATION:
year old woman with LEFT ARM // LEFT ARM LEFT ARM
## FINDINGS:
Again visualized is the oblique fracture through the diaphysis of the ulna,
with half shaft with medial (ulnar) displacement of the distal fragment. No
change in alignment detected in comparison to the prior radiograph. No
interval bridging callus formation. No other fractures detected. The
proximal and distal radioulnar joints appear congruent. No radiopaque
foreign objects identified.
## IMPRESSION:
Unchanged alignment of the ulnar diaphyseal fracture. No interval callus
formation identified.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591420", "visit_id": "N/A", "time": "2145-02-24 09:00:00"} | 1,604,532 |
Description: 19591420-RR-21Abstract: ## EXAMINATION:
FOOT AP,LAT AND OBL RIGHT
## INDICATION:
year old woman with s/p surgery // s/p surgery s/p
surgery
## FINDINGS:
Compared with , no significant changes detected. Patient is
status post screw fixation for Lisfranc injury. There are 4 screws seen
across the medial column of the midfoot. Alignment is maintained. There is
no evidence of hardware loosening or failure. The bones appear relatively
demineralized, likely secondary to disuse. No new fracture or dislocation
identified.
## IMPRESSION:
1. Status post screw fixation for Lisfranc injury without evidence of
hardware-associated complications.
2. Disuse osteopenia.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591420", "visit_id": "N/A", "time": "2145-06-07 13:04:00"} | 1,604,533 |
Description: 19591506-RR-11Abstract: ## INDICATION:
year old man with ongoing night sweats and enlarged lymph
nodes. Please evaluate for lymphadenopathy. // year old man with ongoing
night sweats and enlarged lymph nodes. Please evaluate for lymphadenopathy.
## FINDINGS:
The thyroid is normal. Supraclavicular, axillary lymph nodes are not enlarged.
Mediastinal lymphadenopathy is present, in the right upper paratracheal lymph
node measures 10 mm. AP window lymph node measures 5 mm. Right lower
paratracheal station lymph node measures 9 mm. Right hilar lymph node
measures 22 x 21 mm. Aorta and pulmonary arteries are normal size. Cardiac
configuration is normal and there is no appreciable coronary calcification.
Aside from a cluster of peribronchial micro nodules in the lingula (4:205) the
lungs are clear. There is no pleural or pericardial effusion.
This examination is not tailored for subdiaphragmatic evaluation splenomegaly
has worsened. Now measures 16 cm. Multiple hypodense lesions in the spleen
are again noted also increase in size the largest now measuring 3.2 cm. There
are multiple pathologically enlarged retroperitoneal lymph nodes for example
the right periaortic node measuring 19 mm was 15 mm. Lymph node in the
splenic hilum measuring 22 mm was 18 mm. 1.3 cm lesion in the left kidney is
stable.
There are no bone findings of malignancy
## IMPRESSION:
Mediastinal and right hilar lymphadenopathy. Worsening retroperitoneal lymph
nodes, splenomegaly and splenic lesions still concerning for neoplastic
process such as lymphoma.
Small cluster of micronodules in the lingula are likely infection
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2158-05-06 15:18:00"} | 1,604,534 |
Description: 19591506-RR-13Abstract: ## EXAMINATION:
CT NECK W/CONTRAST (EG:PAROTIDS) Q22 CT NECK
## INDICATION:
year old man with ongoing night sweats and enlarged lymph
nodes. Please evaluate for lymphadenopathy.
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 5.9 s, 31.5 cm; CTDIvol = 9.8 mGy (Body) DLP = 311.8
mGy-cm.
Total DLP (Body) = 312 mGy-cm.
## FINDINGS:
There are multiple enlarged and rounded lymph nodes along the left anterior
cervical chain. For example a left level 2 lymph node measures 15 x 20 mm
(series 2, image 36), a heterogeneously enhancing left level 3 lymph node
measures 15 x 20 mm (series 2, image 43), and a left level 4 lymph node
measures 17 x 24 mm (series 2, image 60). A cluster of enlarged left
supraclavicular lymph nodes are also noted. Scattered right-sided cervical
lymph nodes are not enlarged by imaging size criteria.
Evaluation of the aerodigestive tract demonstrates no mass and no areas of
focal mass effect. A few punctate tonsilliths are noted bilaterally, likely
representing sequelae of prior inflammation.
The salivary glands enhance normally and are without mass or adjacent fat
stranding. The thyroid gland appears normal. There is no lymphadenopathy by
CT criteria. The neck vessels are patent.
The imaged portion of the lung apices are clear and there are no concerning
pulmonary nodules. There are no osseous lesions.
## IMPRESSION:
Extensive cervical lymphadenopathy predominantly along the left anterior chain
and left supraclavicular region in combination with enlarged hilar and
retroperitoneal lymph nodes and numerous hypodensities within the spleen is
suspicious for lymphoma.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2158-05-06 15:19:00"} | 1,604,535 |
Description: 19591506-RR-14Abstract: ## EXAMINATION:
male with retroperitoneal lymphadenopathy and
splenic lesions.
## INDICATION:
year old man with persistent lymphadenopathy// follow-up on
lymphadenopathy
## SINGLE PHASE SPLIT BOLUS CONTRAST:
MDCT axial images were acquired
through the abdomen and pelvis following intravenous contrast administration
with split bolus technique.
Oral contrast was administered.
Coronal and sagittal reformations were performed and reviewed on PACS.
## DOSE:
Acquisition sequence:
1) Stationary Acquisition 5.0 s, 0.5 cm; CTDIvol = 24.1 mGy (Body) DLP =
12.0 mGy-cm.
2) Spiral Acquisition 6.5 s, 71.4 cm; CTDIvol = 8.3 mGy (Body) DLP = 589.4
mGy-cm.
Total DLP (Body) = 601 mGy-cm.
## LOWER CHEST:
Visualized lung fields are within normal limits. There is no
evidence of pleural or pericardial effusion.
## HEPATOBILIARY:
The liver demonstrates homogenous attenuation throughout.
There is no evidence of focal lesions. There is no evidence of intrahepatic
or extrahepatic biliary dilatation. The gallbladder is within normal limits.
## PANCREAS:
The pancreas has normal attenuation throughout, without evidence of
focal lesions or pancreatic ductal dilatation. There is no peripancreatic
stranding.
## SPLEEN:
The spleen is markedly enlarged and measures 20 cm craniocaudally.
Innumerable hypo with dense lesions are identified within the spleen which are
most likely representing lymphoproliferative foci. The size of the lesions is
markedly increased when compared to the prior study. For example the largest
lesion measures on the current study 6.3 cm while previously it measured 2.5
cm. There is also increase in the size of the accessory spleen with
associated lymphomatous involvement. Currently measures 2.8 cm while it
previously measured 1.8 cm.
## ADRENALS:
The right and left adrenal glands are normal in size and shape.
## URINARY:
The kidneys are of normal and symmetric size with normal nephrogram.
There is no evidence of focal renal lesions or hydronephrosis. There is no
perinephric abnormality. A 1.5 cm renal cyst is identified in the interpolar
region of the left kidney. This is unchanged from the prior study.
## GASTROINTESTINAL:
The stomach is unremarkable. Small bowel loops demonstrate
normal caliber, wall thickness, and enhancement throughout. The colon and
rectum are within normal limits. The appendix is normal.
## PELVIS:
The urinary bladder and distal ureters are unremarkable. There is no
free fluid in the pelvis.
## REPRODUCTIVE ORGANS:
The visualized reproductive organs are unremarkable.
## LYMPH NODES:
There is marked retroperitoneal lymphadenopathy with interval
increase in the size of the lymph nodes. For example the largest left
para-aortic lymph node measures 2.5 cm currently while it measured 1.9 cm
previously. The largest intra retrocaval lymph node measures currently 1.8 cm
while it previously measured 1.5 cm. There is no obvious mesenteric
lymphadenopathy or pelvic lymphadenopathy.
## VASCULAR:
There is no abdominal aortic aneurysm. No atherosclerotic disease
is noted.
## BONES:
There is no evidence of worrisome osseous lesions or acute fracture.
## SOFT TISSUES:
The abdominal and pelvic wall is within normal limits.
## IMPRESSION:
1. Interval increase in size of the splenic focal lesions as also spleen size
as also the retroperitoneal lymphadenopathy. The constellation of findings is
compatible with interval worsening of the patient's lymphoproliferative
disorder. 2. Stable left renal cyst measuring 1.5 cm.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2158-09-15 14:28:00"} | 1,604,536 |
Description: 19591506-RR-15Abstract: ## EXAMINATION:
CT NECK W/CONTRAST (EG:PAROTIDS) Q22 CT NECK
## INDICATION:
year old man with persistent lymphadenopathy. Follow-up on
lymphadenopathy
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 3.9 s, 30.6 cm; CTDIvol = 10.6 mGy (Body) DLP = 324.8
mGy-cm.
Total DLP (Body) = 325 mGy-cm.
## FINDINGS:
In comparison to there is decreased size and conspicuity of
lymphadenopathy along the left anterior cervical chain. For example a left
level 2A lymph node measures 1.7 x 1.2 cm (previously 2 x 1.6 cm) (02:36), a
heterogeneously enhancing left level 3 lymph node measures 1.7 x 1.2 cm
(previously 2 x 1.5 cm) (02:45), and a left level 4 lymph node measures 2.1 x
1.1 cm (previously 2.4 x 1.7 cm) (2:60). A group of enlarged left
supraclavicular lymph nodes are unchanged. Subcentimeter right-sided cervical
lymph nodes are not enlarged by imaging size criteria and are unchanged in
appearance since prior examination.
Evaluation of the aerodigestive tract demonstrates no mass and no areas of
focal mass effect. Again seen are few punctate bilateral tonsilliths likely
sequelae of prior inflammation.
The salivary glands enhance normally and are without mass or adjacent fat
stranding. The thyroid gland appears normal.The neck vessels are patent.
The imaged portion of the lung apices are clear and there are no concerning
pulmonary nodules. Few subcentimeter mediastinal lymph nodes are unchanged in
appearance since prior examination. There are no osseous lesions. Please
correlate with chest CT of the same day for further details.
## IMPRESSION:
1. Decreased size and conspicuity of left cervical lymphadenopathy with
unchanged left supraclavicular lymphadenopathy since . No new
lymphadenopathy.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2158-09-15 14:28:00"} | 1,604,537 |
Description: 19591506-RR-16Abstract: ## DOSE:
DLP: Given in abdominal CT report.
## FINDINGS:
No incidental thyroid findings. No axillary lymphadenopathy on today's
examination. The size of the mediastinal lymph nodes has slightly decreased.
For example, a reference lesion in paratracheal location measures 5 mm in
diameter, as compared to 11 mm on the previous examination (2, 16). Lower
paratracheal lymph nodes have also decreased in size. The previously enlarged
right hilar lymph node (2, 29) is back to normal size. In the posterior
mediastinum, no evidence of lymphadenopathy is seen. The previous abdominal
lymphadenopathy (2, 70) as well as the splenic changes are addressed in the
dedicated abdominal CT report. Lytic lesions at the level of the ribs, the
sternum, or the vertebral bodies. Mild degenerative vertebral disease.
The airways are patent. No diffuse lung disease. No pleural thickening, no
pleural irregularities. The pre-existing clustered micronodules in the
lingular have almost completely resolved.
## IMPRESSION:
Substantial decrease in size of the pre-existing mediastinal and hilar lymph
nodes. Resolution of the clustered micronodules in the lingula. Upper
abdominal lymph nodes and splenic abnormalities appear unchanged but are
described in detail in the dedicated abdominal CT report.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2158-09-15 14:31:00"} | 1,604,538 |
Description: 19591506-RR-20Abstract: ## EXAMINATION:
Contrast-enhanced CT abdomen and pelvis
## INDICATION:
year old man with persistent lymphadenopathy// follow-up on
lymphadenopathy
## SINGLE PHASE SPLIT BOLUS CONTRAST:
MDCT axial images were
acquired through the abdomen and pelvis following intravenous contrast
administration with split bolus technique.
Oral contrast was administered.
Coronal and sagittal reformations were performed and reviewed on PACS.
## DOSE:
Acquisition sequence:
1) Stationary Acquisition 4.0 s, 0.5 cm; CTDIvol = 19.3 mGy (Body) DLP =
9.6 mGy-cm.
2) Spiral Acquisition 6.4 s, 70.4 cm; CTDIvol = 8.2 mGy (Body) DLP = 576.2
mGy-cm.
Total DLP (Body) = 586 mGy-cm.
## LOWER CHEST:
Please refer to the separately dictated report of CT chest.
## HEPATOBILIARY:
The liver demonstrates homogenous attenuation throughout.
There is no evidence of focal lesions. There is no evidence of intrahepatic
or extrahepatic biliary dilatation. The gallbladder is within normal limits.
## PANCREAS:
The pancreas has normal attenuation throughout, without evidence of
focal lesions or pancreatic ductal dilatation. There is no peripancreatic
stranding.
## SPLEEN:
The spleen remains markedly enlarged measuring 22 cm (previously
measured 20 cm. It again shows replacement with innumerable hypoenhancing
areas of varying sizes.
## ADRENALS:
The right and left adrenal glands are normal in size and shape.
## URINARY:
The kidneys are of normal and symmetric size with normal nephrogram.
Stable appearance of the small cortical cysts in the left kidney. There is no
hydronephrosis.
## GASTROINTESTINAL:
The stomach is unremarkable. Small bowel loops demonstrate
normal caliber, wall thickness, and enhancement throughout. The colon and
rectum are within normal limits. The appendix is normal.
## PELVIS:
The urinary bladder is markedly distended with normal wall thickness.
## REPRODUCTIVE ORGANS:
The visualized reproductive organs are unremarkable.
## LYMPH NODES:
Multiple enlarged retroperitoneal lymph nodes are again seen with
mild interval decrease in size, index ones are described as below:
Pre aortic infrarenal (series 2, image 66) measuring 1.3 cm (previously 1.4
cm).
Aortocaval (series 2, image 68) measuring 1.1 cm (previously 1.8 cm).
Aortocaval (series 2 image 70) measuring 1.4 cm (previously 1.5 cm).
## VASCULAR:
There is no abdominal aortic aneurysm. Mild atherosclerotic disease
is noted.
## BONES:
There is no evidence of worrisome osseous lesions or acute fracture.
## SOFT TISSUES:
The abdominal and pelvic wall is within normal limits.
## IMPRESSION:
Interval increase in the marked splenomegaly which shows multiple internal
hypodense rounded foci. Multiple prominent retroperitoneal lymph nodes
showing slight interval decrease in size.
Underlying neoplastic process cannot be excluded.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2159-03-25 13:18:00"} | 1,604,539 |
Description: 19591506-RR-21Abstract: ## EXAMINATION:
CT NECK W/CONTRAST W/ONC TABLES Q4847 CT NECK
## INDICATION:
year old man with persistent lymphadenopathy// follow-up on
lymphadenopathy
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 3.7 s, 29.1 cm; CTDIvol = 9.3 mGy (Body) DLP = 269.2
mGy-cm.
Total DLP (Body) = 269 mGy-cm.
## FINDINGS:
Dental amalgam streak artifact limits study.
Overall again is noted lymphadenopathy along the left anterior cervical chain,
slightly decreased compared to prior exam. For example redemonstrated is an
enlarged left level 2A lymph node, measuring 1.4 cm AP x 1.1 cm (02:31)
(previously 1.6 cm AP x 1.2 cm TV). Also again seen is a 1.5 cm AP x 1.2 cm
TV left level 3 lymph node (02:39), unchanged. Conglomerate left level 4
lymph nodes do not appear significantly changed allowing for beam hardening
artifact on the comparison study and measure 1.5 cm AP by 3.4 cm TV (2:61).
No significant change in the scattered prominent lymph nodes within the left
posterior cervical space, which do not meet pathologic size criteria.
Evaluation of the aerodigestive tract demonstrates no mass and no areas of
focal mass effect.
The salivary glands enhance normally and are without mass or adjacent fat
stranding. The thyroid gland appears normal.The neck vessels are patent.
The imaged portion of the lung apices are clear and there are no concerning
pulmonary nodules. There are no osseous lesions. Left maxillary sinus mucous
retention cyst is noted (see 02:15).
## IMPRESSION:
1. Dental amalgam streak artifact limits study.
2. Left anterior cervical chain lymphadenopathy, slightly decreased compared
to prior exam.
3. Paranasal sinus disease , as described.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2159-03-25 13:18:00"} | 1,604,540 |
Description: 19591506-RR-22Abstract: ## INDICATION:
man with persistent lymphadenopathy. Follow-up of
lymphadenopathy.
history of cervical left-sided swelling of lymph nodes for many years.
Splenomegaly.
## DOSE:
Acquisition sequence:
1) Stationary Acquisition 4.0 s, 0.5 cm; CTDIvol = 19.3 mGy (Body) DLP =
9.6 mGy-cm.
2) Spiral Acquisition 6.4 s, 70.4 cm; CTDIvol = 8.2 mGy (Body) DLP = 576.2
mGy-cm.
Total DLP (Body) = 586 mGy-cm.
** Note: This radiation dose report was copied from CLIP (CT ABD AND
PELVIS WITH CONTRAST)
## FINDINGS:
NECK, THORACIC INLET, AXILLAE, LYMPH NODES:
In the inferior aspect of the
right hilum, 2.5 x 0.9 cm lymph node is larger since when it measured
1.6 x 0.4 cm (4:128). Otherwise there has been no change in the left
supraclavicular 1.3 cm lymph node and few borderline mediastinal lymph nodes
(04:22, 90). No axillary lymphadenopathy.
Imaged thyroid is unremarkable.
## UPPER ABDOMEN:
Large hyperdense lesions replacing most of enlarged spleen
which appears mildly larger since . Please refer to separate detailed
concurrent CT of the abdomen and pelvis.
## HEART AND PERICARDIUM:
Heart and major vessels are normal in size and there is
no pericardial effusion.
## PLEURA:
There is no pleural space abnormalities.
## LUNG:
Airways are patent the subsegmental level.
No new nodules identified, with pre-existing micronodule in the right upper
lobe being stable since (4:95).
## CHEST CAGE:
Unremarkable with no evidence of lytic sclerotic bony destructive
lesion in the vertebra, ribs or sternum.
## IMPRESSION:
-Right hilum lymph node and spleen are larger in comparison to and
concerning for active lymphoid proliferation else there has been no change in
the borderline left supraclavicular and mediastinal lymph nodes.
-No new lung lesions.
-Subdiaphragmatic finding detailed in the concurrent separate report of CT of
the abdomen and pelvis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2159-03-25 14:35:00"} | 1,604,541 |
Description: 19591506-RR-26Abstract: ## INDICATION:
History: with R IJ CVL// check R IJ CVL placement
## FINDINGS:
Compared with chest radiograph performed earlier on same day, patient has
undergone interval placement of a right IJ central venous catheter, which
terminates in the SVC. Lung volumes are improved from prior, with improvement
in previously seen bibasilar opacities, likely representing improved
atelectasis. No focal consolidation. No pleural effusion or pneumothorax.
Cardiomediastinal silhouette is stable.
## IMPRESSION:
1. A right IJ central venous catheter terminates in the SVC. No pneumothorax.
2. Improved lung volumes with improvement in bibasilar opacities, likely
representing improved atelectasis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "26422534", "time": "2159-05-04 23:12:00"} | 1,604,542 |
Description: 19591506-RR-29Abstract: ## INDICATION:
year old man with hodgkins lymphoma on treatment with ABVD.
With Sharp abdominal pain. Please eval// year old man with hodgkins
lymphoma on treatment with ABVD. With Sharp abdominal pain. Please eval
## SINGLE PHASE SPLIT BOLUS CONTRAST:
MDCT axial images were
acquired through the abdomen and pelvis following intravenous contrast
administration with split bolus technique.
Oral contrast was administered.
Coronal and sagittal reformations were performed and reviewed on PACS.
## DOSE:
Acquisition sequence:
1) Stationary Acquisition 2.0 s, 0.5 cm; CTDIvol = 10.0 mGy (Body) DLP =
5.0 mGy-cm.
2) Spiral Acquisition 5.9 s, 46.1 cm; CTDIvol = 8.2 mGy (Body) DLP = 377.2
mGy-cm.
Total DLP (Body) = 382 mGy-cm.
## LOWER CHEST:
The lung bases are clear.
## ABDOMEN:
The liver, pancreas, adrenal glands and kidneys are unremarkable
except for stable left renal cysts. There is no biliary ductal dilatation.
The gallbladder is within normal limits.
The numerous splenic lesions are difficult to measure, however visually appear
markedly improved and a representative discrete lesion inferiorly now measures
1.7 cm, previously 3 cm. Additionally, the spleen measures up to 14.8 cm,
previously 17.5 cm.
## GASTROINTESTINAL:
There is no intestinal obstruction or ascites.
## PELVIS:
There is trace free fluid in the pelvis.
## LYMPH NODES:
The retroperitoneal adenopathy is improved. For example, an
anterior periaortic lymph node measures 0.6 cm, previously 1.3 cm; a left
periaortic lymph node measures 0.9 cm, previously 1.6 cm; and interaortocaval
lymph node measures 0.8 cm, previously 1.5 cm and a left common iliac lymph
node measures 0.8 cm, previously 1.3 cm. No enlarged mesenteric lymph nodes
are demonstrated.
## VASCULAR:
There is no abdominal aortic aneurysm.
## BONES:
No aggressive osseous lesions are seen.
## SOFT TISSUES:
The abdominal and pelvic wall is within normal limits.
## IMPRESSION:
Marked interval improvement of splenic involvement and retroperitoneal
adenopathy.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2159-06-10 12:17:00"} | 1,604,543 |
Description: 19591506-RR-31Abstract: ## EXAMINATION:
CHEST (PA AND LAT)
## INDICATION:
year old man with Hodgkin lymphoma on chemotherapy, with sore
throat and rhinorrhea. Please eval for infection// year old man with
Hodgkin lymphoma on chemotherapy, with sore throat and rhinorrhea. Please eval
for infection
## IMPRESSION:
In comparison with the study of , a the right IJ catheter is been
removed and replaced with a right IJ Port-A-Cath that extends to the lower
SVC. No evidence of pneumothorax.
Cardiac silhouette is within normal limits and there is no vascular
congestion, pleural effusion, or acute focal pneumonia. No evidence of hilar
or mediastinal adenopathy.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2159-09-07 13:11:00"} | 1,604,544 |
Description: 19591506-RR-33Abstract: ## INDICATION:
year old man with history of Hodgkin lymphoma. s/p chemo,
recent PET scan with increased size and FDG avidity of a small pre-vascular
lymph node and possible small FDG avid left hilar lymph nodes. Please eval//
year old man with history of Hodgkin lymphoma. s/p chemo, recent PET scan
with increased size and FDG avidity of a small pre-vascular lymph node and
possible small FDG avid left hilar lymph nodes. Please eval
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 5.1 s, 40.0 cm; CTDIvol = 5.4 mGy (Body) DLP = 214.5
mGy-cm.
Total DLP (Body) = 214 mGy-cm.
## CHEST PERIMETER:
There are no thyroid findings warranting further imaging.
Supraclavicular and axillary lymph nodes are not enlarged and there are no
soft tissue abnormalities in the chest wall. This study is not designed for
abdominal evaluation, but shows no adrenal abnormalities, and significant
improvement in previous splenomegaly, incompletely imaged, but, for example,
42 x mm today on the lowest level of imaging, previously 103 x mm in
.
## CARDIO-MEDIASTINUM:
Lower esophagus is mildly thick-walled, and patulous. This
could be in indication of early esophagitis. Clinical assessment advised.
Atherosclerotic calcification is not apparent head neck vessels. Right
jugular central venous line ends in the right atrium but contrast infusion
makes it difficult to locate the tip precisely. There is no obvious
associated thrombosis. Aorta and pulmonary arteries and cardiac chambers are
normal size and pericardium is physiologic.
## THORACIC LYMPH NODES:
No lymph nodes in the chest are pathologically enlarged
or clearly growing, as follows:
Right lower paratracheal mediastinum, 7 x 13 mm, 4:95, was 11 x 16 mm in
.
4 mm prevascular, 4:88, was 3 mm in .
Left hilum, 7 mm, was 11 mm in .
## LUNGS, AIRWAYS, PLEURAE:
Lungs are clear, tracheobronchial tree is normal to
subsegmental levels, there is no pleural abnormality.
## IMPRESSION:
Possible early esophagitis.
No evidence of intrathoracic malignancy. Previous borderline lymph node
enlargement and splenomegaly have receded, details above.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2159-12-16 07:51:00"} | 1,604,545 |
Description: 19591506-RR-34Abstract: ## EXAMINATION:
CT NECK W/CONTRAST (EG:PAROTIDS) Q22 CT NECK
## INDICATION:
year old man with history of Hodgkin lymphoma. s/p chemo,
recent PET scan with extensive brown fat in neck, making lymph nodes hard to
identify. please eval for enlarged lymph nodes// year old man with history
of Hodgkin lymphoma. s/p chemo, recent PET scan with extensive brown fat in
neck, making lymph nodes hard to identify. please eval for enlarged lymph
nodes
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 3.4 s, 27.1 cm; CTDIvol = 9.5 mGy (Body) DLP = 257.1
mGy-cm.
2) Sequenced Acquisition 0.5 s, 2.0 cm; CTDIvol = 4.4 mGy (Body) DLP = 8.8
mGy-cm.
3) Sequenced Acquisition 0.5 s, 2.0 cm; CTDIvol = 4.4 mGy (Body) DLP = 8.8
mGy-cm.
Total DLP (Body) = 275 mGy-cm.
## FINDINGS:
1.4 cm cystic/necrotic left level 2A lymph node, slightly decreased in size,
and more cystic today. Findings are likely treatment related. Other
etiologies, including infection, metastasis from primary squamous cell
carcinoma are unlikely unless clinically suspected.
Other previously seen large left level 2, 3, 4, 5 B lymph nodes have
drastically decreased, largest lymph node measures 0.6 cm short axis. No new
left neck adenopathy.
Subcentimeter right neck lymph nodes, normal by CT criteria.
No retropharyngeal adenopathy.
The salivary glands enhance normally and are without mass or adjacent fat
stranding. The thyroid gland appears normal.The neck vessels are patent.
Right Port-A-Cath in place.. Mild paranasal sinus disease.
Refer to chest CT from today for thoracic findings.
## IMPRESSION:
Improved adenopathy since prior.
Residual 1.4 cm left level 2 pathologic, cystic lymph node, likely treatment
related.
No new adenopathy or mass.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591506", "visit_id": "N/A", "time": "2159-12-16 07:51:00"} | 1,604,546 |
Description: 19591607-RR-13Abstract: ## INDICATION:
years old woman with rectal leakage and bladder prolapse.
## FINDINGS:
MRI OF THE PELVIS WITHOUT IV CONTRAST:
The visualized bowel and bladder are
unremarkable. No adnexal mass is seen. The uterus contains intramural masses
with hypointense signal on T2WI relative to the myometrium, which might
represent uterine fibroids, although low resolution and limited sequences of
the study did not allow good visualization of the junctional zone and thus the
masses cannot be differentiated from adenomyosis with confidence (4:7). T2
hyperintense well-defined with rounded lesions in the external os of the
cervix most probably represent nabothian cysts (03:22). There is no free fluid
or pelvic or inguinal lymphadenopathy. No bone marrow signal abnormality is
identified. Incidental note of sacral perineural cysts (Tarlov cysts) is made
(4:21).
## RESTING:
At rest, the bladder is 2.2 cm and the posterior fornix is 4.6 cm
above the pubococcygeal line. The anorectal junction is at the pubococcygeal
line with a normal anorectal angle. These are all within normal limits.
## SQUEEZING:
With squeezing, the bladder is 2.9 cm and the posterior fornix is
4.5 cm above the pubococcygeal line. The anorectal junction is 1 cm above the
pubococcygeal line with sharpening of the anorectal angle. These are within
normal limits.
## STRAINING:
No sufficient straining effort was demonstrated.
## DEFECATION:
With defecation, there is incomplete relaxation of the pelvic
muscles, especially the puborectalis (10:12), suggestive of dyssynergic
defecation. Small anterior rectocele 1.2 cm in size is demonstrated (11:8).
There is no abnormal descent of the anterior or posterior compartment during
defecation. There is no evidence of enterocele or sigmoidocele.
## IMPRESSION:
1. Incomplete relaxation of the external anal sphincter, specifically the
puborectalis, suggestive of dyssynergic defecation. Manometry of the anal
sphincter should be performed.
2. Small anterior rectocele during defecation.
3. Probably fibroid uterus, although adenomyosis cannot be ruled out on this
limited study. Pelvic ultrasound is advised.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591607", "visit_id": "N/A", "time": "2162-09-06 08:22:00"} | 1,604,547 |
Description: 19591741-RR-4Abstract: ## HISTORY:
Small left foot, question of DVT.
## FINDINGS:
Real-time two-dimensional grayscale and color Doppler images were
obtained of the left lower extremity. The waveforms at the common femoral
veins are symmetric bilaterally with appropriate response to Valsalva
maneuvers. In the left lower extremity the common femoral vein, proximal
greater saphenous vein, superficial femoral vein, popliteal vein, peroneal
vein and posterior tibial veins all are normal. There is no evidence of DVT.
Vessels compress appropriately and show wall-to-wall flow on color analysis
with appropriate response to waveform augmentation.
## IMPRESSION:
No evidence of DVT.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591741", "visit_id": "29880152", "time": "2170-12-25 13:39:00"} | 1,604,548 |
Description: 19591855-RR-17Abstract: ## INDICATION:
female who hit head on . Evaluate for acute
intracranial process.
## NON-CONTRAST HEAD CT:
There is no hemorrhage, edema, mass effect, or CT
evidence of acute large vascular territory infarction. The gray-white matter
differentiation is preserved. There is minimal prominence of the ventricular
system, suggesting slight parenchymal volume loss. There is no shift of
midline structures. The basilar cisterns are preserved. There are no
abnormal extra-axial fluid collections. The osseous structures and
surrounding soft tissues, including the globes and orbits, are unremarkable.
There are no fractures identified. The visualized paranasal sinuses
demonstrate mild mucosal thickening of left sided ethmoid air cells, but the
remainder are otherwise normally aerated.
## IMPRESSION:
No acute intracranial process. Mild mucosal disease in the
left ethmoid air cells.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591855", "visit_id": "N/A", "time": "2148-05-25 16:18:00"} | 1,604,549 |
Description: 19591855-RR-20Abstract: ## INDICATION:
female with abdominal bloating and abdominal pain.
## FINDINGS:
The liver is unremarkable in appearance with no focal liver lesion
identified. No biliary dilatation is seen and the common duct measures 0.4
cm. The portal vein is patent with hepatopetal flow. Several shadowing
gallstones are seen within the lumen of the gallbladder. These stones range
8-9 mm in size. There is no gallbladder wall edema and no pericholecystic
fluid is identified. The pancreas is unremarkable. The spleen is
unremarkable and measures 7.2 cm. No hydronephrosis is seen. The right
kidney measures 10 cm and the left kidney measures 10.1 cm. The aorta is of
normal caliber throughout. The visualized portion of the IVC is unremarkable.
## IMPRESSION:
Cholelithiasis with no sign of cholecystitis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591855", "visit_id": "N/A", "time": "2150-11-28 14:10:00"} | 1,604,550 |
Description: 19591855-RR-24Abstract: BILATERAL KNEE RADIOGRAPH PERFORMED ON
## CLINICAL HISTORY:
Bilateral knee pain, assess osteoarthritis.
## FINDINGS:
AP, lateral, sunrise views of both knees were provided.
## LEFT KNEE:
There is diffuse osteopenia, with tiny medial spurs at the
tibiofemoral joint. No joint effusion. Tiny dorsal patellar spur is also
noted. There is no appreciable joint effusion and the patellofemoral
alignment is maintained.
## RIGHT KNEE:
There is degenerative disease, mild with tiny spiking along the
tibial spines and small marginal spurs at the tibiofemoral joint. Small
dorsal patellar spurs with a moderate joint effusion is present. Bones are
demineralized though intact. Patellofemoral alignment is maintained.
## IMPRESSION:
Mild degenerative changes as stated, slightly more progressed on
the right as compared with the left.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591855", "visit_id": "N/A", "time": "2152-02-12 15:12:00"} | 1,604,551 |
Description: 19591855-RR-25Abstract: BILATERAL HAND RADIOGRAPHS PERFORMED ON
## CLINICAL HISTORY:
Osteoarthritis and psoriasis, assess features of arthritis.
## FINDINGS:
AP, lateral, oblique views of both hands were provided.
## RIGHT HAND:
There is mild osteoarthritis at first CMC and triscaphe
articulation. There is also mild IP arthritis at the thumb, and DIP arthritis
at the fifth finger is severe. Otherwise, the joints are maintained. Carpal
alignment is preserved. Soft tissues are normal. No fracture or dislocation.
## LEFT HAND:
There is mild-to-moderate triscaphe and basal joint
osteoarthritis. The PIP and DIP joints of the second through fifth fingers
appear maintained. Soft tissues are normal. Carpal alignment is preserved.
No fracture or dislocation. Soft tissues are normal.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591855", "visit_id": "N/A", "time": "2152-02-12 15:12:00"} | 1,604,552 |
Description: 19591855-RR-28Abstract: ## HISTORY:
with severe abd pain radiating to back BP 210s //
eval ? free air
## FINDINGS:
Lung volume is low. Mild bibasilar opacities are likely secondary to
atelectasis and/ or small pleural effusions. Cardiac silhouette is mildly
enlarged. The radiograph is labeled as upright, however patient position
appears supine or semi upright. Suboptimal patient position limits the
evaluation for pneumoperitoneum. Given the limitation, no evidence of large
pneumoperitoneum is identified.
## IMPRESSION:
Bibasilar atelectasis and/ or small pleural effusions. No evidence of large
pneumoperitoneum is identified. If there is clinical concern for
pneumoperitoneum, consider repeat radiograph with upright patient position or
CT.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591855", "visit_id": "24495526", "time": "2155-03-08 02:05:00"} | 1,604,553 |
Description: 19591855-RR-29Abstract: ## EXAMINATION:
CTA ABD AND PELVIS
## HISTORY:
with severe abd pain, lactate 4.7, abdominal labs
benign, diffuse abd ttp // eval ? aortic aneurysm
## ABDOMEN AND PELVIS CTA:
Non-contrast and multiphasic post-contrast
images were acquired through the abdomen and pelvis.
Oral contrast was not administered.
MIP reconstructions were performed on independent workstation and reviewed on
PACS.
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 6.7 s, 52.6 cm; CTDIvol = 7.9 mGy (Body) DLP = 416.1
mGy-cm.
2) Stationary Acquisition 3.5 s, 0.5 cm; CTDIvol = 16.9 mGy (Body) DLP =
8.4 mGy-cm.
3) Spiral Acquisition 6.7 s, 52.6 cm; CTDIvol = 19.8 mGy (Body) DLP =
1,044.2 mGy-cm.
Total DLP (Body) = 1,469 mGy-cm.
## VASCULAR:
There is no abdominal aortic aneurysm. There is moderate calcium burden in
the abdominal aorta and great abdominal arteries. Left hepatic artery arises
directly from celiac artery.
## LOWER CHEST:
Mild atelectasis is noted in bilateral lung bases. There is no
pleural effusion. Coronary artery calcification is moderate.
## HEPATOBILIARY:
The liver demonstrates homogenous attenuation throughout. There
is no evidence of focal lesions. There is no evidence of intrahepatic or
extrahepatic biliary dilatation. The gallbladder contains gallstones in the
gallbladder wall is thickened and edematous.
## PANCREAS:
The pancreas has normal attenuation throughout, without evidence of
focal lesions or pancreatic ductal dilatation. There is no peripancreatic
stranding.
## SPLEEN:
The spleen shows normal size and attenuation throughout, without
evidence of focal lesions.
## ADRENALS:
The right and left adrenal glands are normal in size and shape.
## URINARY:
The kidneys are of normal and symmetric size with normal nephrogram.
There is no evidence of stones, focal renal lesions, or hydronephrosis. There
are no urothelial lesions in the kidneys or ureters. There is no perinephric
abnormality.
## GASTROINTESTINAL:
Hiatal hernia is small. Small and large bowel loops are
normal caliber. Appendix contains air, has normal caliber without evidence of
fat stranding. There is no evidence of mesenteric lymphadenopathy.
## RETROPERITONEUM:
There is no evidence of retroperitoneal lymphadenopathy.
## PELVIS:
The urinary bladder and distal ureters are unremarkable. There is no
evidence of pelvic or inguinal lymphadenopathy. There is no free fluid in the
pelvis.
## BONES:
There is no evidence of worrisome osseous lesions or acute fracture.
## SOFT TISSUES:
The abdominal and pelvic wall is within normal limits.
## IMPRESSION:
1. Gallbladder wall is thickened and edematous, consistent with cholecystitis.
Gallbladder contains multiple gallstones.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591855", "visit_id": "24495526", "time": "2155-03-08 04:33:00"} | 1,604,554 |
Description: 19591855-RR-30Abstract: ## EXAMINATION:
LIVER OR GALLBLADDER US (SINGLE ORGAN) PORT
## HISTORY:
with abd ttp, concerning RUQ ttp, wall thickening on
CTA // further evaluate GB changes seen on CTA abd for ? cholecystitis, stone
burden
## LIVER:
The hepatic parenchyma appears within normal limits. The contour of the
liver is smooth. There is no focal liver mass. The main portal vein is patent
with hepatopetal flow. There is no ascites.
## BILE DUCTS:
There is no intrahepatic biliary dilation. The CHD measures 6 mm.
## GALLBLADDER:
Gallbladder wall is thickened with irregular mucosal surface.
Multiple gallstones are identified in the gallbladder neck.
## PANCREAS:
The imaged portion of the pancreas appears within normal limits,
without masses or pancreatic ductal dilation, with portions of the pancreatic
tail obscured by overlying bowel gas.
## SPLEEN:
Normal echogenicity, measuring 6.8 cm.
## IMPRESSION:
Thickened gallbladder wall with irregular mucosal surface is suspicious for a
cholecystitis with mucosal sloughing. Multiple gallstones are identified in
the gallbladder neck.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591855", "visit_id": "24495526", "time": "2155-03-08 05:40:00"} | 1,604,555 |
Description: 19591945-RR-17Abstract: ## :
CMR Staff: , MD
## GENDER:
Male Radiology Staff: , MD
## RACE:
Other Technologist: , RT
## STATUS:
Outpatient Nursing Support: , RN
## HEIGHT (IN):
66 Injection Site: right antecubical vein
## WEIGHT (LBS):
192 Contrast Type: Gd-BOPTA (Multihance)
## RHYTHM:
Sinus rhythm Creatinine Date:
## INDICATION:
year old man with atrial fibrillation, for assessment of
pulmonary vein anatomy prior to ablation.
CMR Measurements
Measurement Normal Range
Left Ventricle
LV End-Diastolic Dimension (mm) 56 <62
LV End-Diastolic Dimension Index (mm/m2) 28 <32
LV End-Systolic Dimension (mm) 38
LV End-Diastolic Volume (ml) 152 <196
LV End-Diastolic Volume Index (ml/m2) 76 <95
LV End-Systolic Volume (ml) 61
LV Stroke Volume (ml) 91
LV Stroke Volume Index (ml/m2) 45
LV Ejection Fraction (%) 60 >=54
LV Mass (g) 106
LV Mass Index (g/m2) 53 <80
Basal wall thickness (mm) 7 <12
Basal infero-lateral wall thickness (mm) 7 <11
Q-Flow Aortic Net Forward Stroke Volume (ml) 75
Q-Flow Aortic Total Stroke Volume (ml) 75
Q-Flow Aortic Cardiac Output (l/min) 4.5
Q-Flow Aortic Cardiac Index (l/min/m2) 2.2
LV Effective Forward Ejection Fraction (%) *49 >=54
Right Ventricle
RV End-Diastolic Volume (ml) 145
RV End-Diastolic Volume Index (ml/m2) 72 58-114
RV End-Systolic Volume (ml) 72
RV Stroke Volume (ml) 73
RV Stroke Volume Index (ml/m2) 36
RV Ejection Fraction (%) 50 >=46
Q-Flow Pulmonary Net Forward Stroke Volume (ml) 70
Q-Flow Pulmonary Total Stroke Volume (ml) 73
Qp/Qs 0.93 0.8-1.2
Atria
Left Atrial Dimension (Axial) (mm) *46 <40
Left Atrial Length (4-Chamber) (mm) *58 <52
Right Atrial Dimension (4-Chamber) (mm) *52 <50
Coronary Sinus Diameter (mm) 9 <15
Great Vessels
Ascending Aorta Diameter (mm) 34 <39
Ascending Aorta Diameter Index (mm/m2) 17 <20
Transverse Aorta Diameter (mm) 26
Transverse Aorta Diameter Index (mm/m2) 13
Descending Aorta Diameter (mm) 22 <28
Descending Aorta Index (mm/m2) 11 <14
Abdominal Aorta Diameter (mm) 23
Abdominal Aorta Diameter Index (mm/m2) 11
Main Pulmonary Artery Diameter (mm) 28 <29
Main Pulmonary Artery Diameter Index (mm/m2) 14 <15
Pulmonary Veins
Number of Left Pulmonary Veins 2
Number of Right Pulmonary Veins 2
Left Upper PV Dimension (mm) 19 x 13
Left Upper PV Cross-Sectional Area (mm2) 200
Left Lower PV Dimension (mm) 19 x 9
Left Lower PV Cross-Sectional Area (mm2) 135
Right Upper PV Dimension (mm) 33 x 19
Right Upper PV Cross-Sectional Area (mm2) 544
Right Lower PV Dimension (mm) 17 x 11
Right Lower PV Cross-Sectional Area (mm2) 197
Left Atrial Late Gadolinium Enhancement Negative
Valves
Aortic Valve Morphology Tricuspid
Aortic Valve Excursion Normal
Aortic Valve Area (cm2) 3.5 >=2
Aortic Valve Area Index (cm2/m2) 1.7
Aortic Valve Regurgitation (Visual) None present
Aortic Valve Regurgitant Volume (ml) 0
Aortic Valve Regurgitant Fraction (%) 0 <5
Mitral Valve Morphology Normal
Mitral Valve Excursion Normal
Mitral Valve Regurgitation (Visual) Present
Mitral Valve Regurgitant Volume (ml) 16
Mitral Valve Regurgitant Fraction (%) *18 <5
Pulmonary Valve Regurgitant Volume (ml) 3
Pulmonary Valve Regurgitant Fraction (%) 4 <5
Tricuspid Valve Morphology Normal
Tricuspid Valve Regurgitation (Visual) None present
Tricuspid Valve Regurgitant Volume (ml) 0
Tricuspid Valve Regurgitant Fraction (%) 0 <5
Pericardial
Pericardial Thickness (mm) 1 <4
* Mildly abnormal | ** Moderately abnormal | *** Severely abnormal
CMR Technical Information
Structure
" T1-Weighted (Black Blood): Dual-inversion T1-weighted fast spin echo images
were acquired in 5-mm contiguous axial slices to evaluate cardiac and vascular
anatomy.
## FUNCTION
" CINE SSFP:
Breath-hold SSFP cine images were acquired in 8-mm slices in the
4-chamber, 3-chamber, 2-chamber, and short axis orientations.
" Cine SSFP (Additional Aortic Valve Views): A short-axis series was acquired
at the level of the aortic valve.
" Cine SSFP (4-chamber stack): A 4-chamber stack was acquired.
" Cine SSFP (3-chamber stack): A 3-chamber stack was acquired.
" Cine SSFP (2-chamber stack): A 2-chamber stack was acquired.
## FLOW
" AORTIC VALVE FLOW:
Phase-contrast cine images were acquired transverse to
the proximal ascending aorta to quantify through-plane flow.
" Pulmonary Valve Flow: Phase-contrast cine images were acquired transverse
to the main pulmonary artery to quantify through-plane flow.
Viability
" LGE of the Pulmonary Veins: Late gadolinium enhancement (LGE) images of the
left atrium and pulmonary veins were acquired using a navigator-gated 3D
ultrafast gradient echo inversion-recovery sequence with spectral fat
saturation pre-pulses 15 minutes after injection of a total of 0.1 mmol/kg (18
mL) Gd-BOPTA (Multihance).
MRA
" MRA of the Pulmonary Veins: First-pass magnetic resonance angiography (MRA)
images of the pulmonary veins were acquired after administration of a bolus of
0.1 mmol/kg (18 mL) Gd-BOPTA (Multihance). Multiplanar reconstructions of the
pulmonary arteries were generated and analyzed on a workstation.
CMR Findings
Left Ventricle
" LV cavity size: Normal
" LV ejection fraction: Normal
" LV mass: Normal
## RIGHT VENTRICLE
" RV CAVITY SIZE:
Normal
" RV ejection fraction: Normal
" Intra-cardiac shunt: None present
## ATRIA
" LA SIZE:
Mildly enlarged
" RA size: Mildly enlarged
## GREAT VESSELS
" ASCENDING AORTIC DIAMETER:
Normal
" Main pulmonary artery diameter: Normal
Pulmonary Veins
" Number of Left Pulmonary Veins: 2
" Number of Right Pulmonary Veins: 2
" Late gadolinium enhancement of the left atrial wall: Negative
## VALVES
" AORTIC VALVE MORPHOLOGY:
Tricuspid
" Aortic stenosis: No
" Aortic regurgitation jet: None present
" Mitral regurgitation jet: Present
" Mitral regurgitation: Mild
" Tricuspid regurgitation jet: None present
## PERICARDIAL
" PERICARDIAL THICKNESS:
Normal
Non-Cardiac Findings
Nil.
Impression
Two right and 2 left pulmonary veins entering the left atrium, free of
stenosis.
Normal biventricular function.
Mild mitral regurgitation.
No evidence of left atrial hyperenhancement.
The esophagus is directly posterior to the left lower pulmonary vein (see
labeled clip in PACS).
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591945", "visit_id": "N/A", "time": "2154-08-27 09:46:00"} | 1,604,556 |
Description: 19591945-RR-19Abstract: ## INDICATION:
History of facial droop on the right, forehead sparing,
difficulty with slurred speech and since this morning. Evaluate for
intracranial hemorrhage.
## FINDINGS:
There is no acute hemorrhage, edema, mass effect, or territorial
infarction. The ventricles and sulci are normal in size and configuration.
There is dense calcification involving the vertebral arteries bilaterally as
well as the carotid arteries. The visualized paranasal sinuses, mastoid air
cells and middle ear cavities are clear. No acute fracture.
## IMPRESSION:
No acute intracranial process. Please note that MRI is more
sensitive for acute stroke. Dense calcifications involving the vertebral and
carotid arteries.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591945", "visit_id": "N/A", "time": "2155-01-12 10:29:00"} | 1,604,557 |
Description: 19591961-RR-15Abstract: ## HISTORY:
male with swelling in the neck/oropharynx and dysphagia.
## FINDINGS:
There is no soft tissue abnormality or pathologic lymphadenopathy
in the visualized portion of the upper mediastinum. The visualized portion of
the lungs appears normal.
In the neck, there are scattered level 2 lymph nodes, all within normal limits
by size criteria. The salivary and parotid glands appear normal. The
retropharyngeal, oropharyngeal and laryngeal soft tissues are unremarkable,
without evidence of an exophytic mass. In the nasopharynx, there is mild,
symmetric prominence of the posterior lymphoid tissues without evidence of a
focal mass. There is no evidence of an abscess.
There is no appreciable osseous abnormality. There is mild mucosal thickening
in the maxillary sinuses.
## IMPRESSION:
1. Symmetric prominence of the nasopharyngeal lymphoid tissue without
evidence of a mass. Direct visualization would be helpful.
2. No evidence of an abcess. No lymphadenopathy.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591961", "visit_id": "28673706", "time": "2181-06-25 15:49:00"} | 1,604,558 |
Description: 19591974-RR-13Abstract: ## EXAMINATION:
MRI HEAD W/O CONTRAST FOR DBS/VNS
## INDICATION:
year old man with Parkinsons Disease // to evaluate prior to
additional DBS surgery. Pt has DBS device that needs to be turned off/Please
page Dr. . Please do MRI under anesthesia
## FINDINGS:
There is no mass effect, hydrocephalus or midline shift. Bilateral deep brain
stimulators are identified. The tips extending towards the anterior basal
ganglia region. No evidence of significant surrounding edema seen.
## IMPRESSION:
Examination performed for DBS evaluation demonstrates bilateral stimulator
extending toward the inferior thalamic regions.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591974", "visit_id": "N/A", "time": "2130-12-15 14:39:00"} | 1,604,559 |
Description: 19591974-RR-14Abstract: ## EXAMINATION:
CT HEAD W/O CONTRAST
## INDICATION:
year old man s/p removal of L DBS electrode, please evaluate
for post op changes.
## FINDINGS:
The patient is status post removal of the left-sided deep brain stimulator
electrode, with small amount of air along the tract and expected postsurgical
changes. There is no evidence of infarction, hemorrhage, edema, or mass. The
ventricles and sulci are normal in size and configuration. A right sided deep
brain stimulator electrode is still present.
Other than the postsurgical changes, no osseous abnormalities seen. The
paranasal sinuses, mastoid air cells, and middle ear cavities are clear. The
orbits are unremarkable.
## IMPRESSION:
Status post removal of the left-sided deep brain stimulator electrode, with a
small amount of air along the tract. No evidence of new hemorrhage or
infarction.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591974", "visit_id": "29088370", "time": "2131-02-16 15:51:00"} | 1,604,560 |
Description: 19591974-RR-15Abstract: ## EXAMINATION:
MRI HEAD WANDW/O CONTRAST FOR DBS/VNS
## INDICATION:
year old man with Disease. Assess prior to L GPI
DBS Surgery stage I
## FINDINGS:
Interval removal of left-sided deep brain stimulator lead with tract defect
identified. The right deep brain stimulator lead is in place with right tip
in the right cerebral peduncle (04:52). There is no evidence of hemorrhage,
edema, masses, or infarction. Mild prominence of the ventricles and sulci are
consistent with age-related cortical volume loss and unchanged in appearance
since previous examination dated .
## IMPRESSION:
1. Right deep brain stimulator lead in right cerebral peduncle/inferior
thalamic region.
2. Status post removal of left-sided deep brain stimulator.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591974", "visit_id": "29690716", "time": "2131-03-14 07:46:00"} | 1,604,561 |
Description: 19591974-RR-18Abstract: ## EXAMINATION:
CT HEAD W/O CONTRAST
## INDICATION:
man status post deep brain stimulation stage 1 on the
left, evaluate for postoperative change.
## DOSE:
This study involved 3 CT acquisition phases with dose indices as
follows:
1) CT Localizer Radiograph
2) CT Localizer Radiograph
3) Sequenced Acquisition 7.2 s, 18.3 cm; CTDIvol = 55.2 mGy (Head) DLP =
1,009.3 mGy-cm.
Total DLP (Head) = 1,009 mGy-cm.
## FINDINGS:
New since prior study is replacement of the left-sided deep brain stimulator
electrode, with interval development of a moderate-sized pocket of
pneumocephalus layering in and anti-dependent fashion along the left frontal
cerebral convexity. The right deep brain stimulator electrode is in unchanged
position. Hardware artifact from the stimulator electrodes limits evaluation
of nearby structures; however, within this limitation there is no evidence of
hemorrhage, infarction, edema, or mass. The basal cisterns are patent. The
ventricles are normal in caliber and configuration. The visualized paranasal
sinuses and mastoid air cells are clear. The globes and bony orbits are
unremarkable.
## IMPRESSION:
1. Please note study is limited secondary to hardware artifact.
2. Interval replacement of left-sided deep brain stimulator electrode, with
new moderate left pneumocephalus.
3. Stable position of a right deep brain stimulator electrode.
4. Within limits of study, no acute intracranial abnormality.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591974", "visit_id": "29690716", "time": "2131-03-14 13:27:00"} | 1,604,562 |
Description: 19591974-RR-19Abstract: ## EXAMINATION:
CT HEAD W/O CONTRAST Q111 CT HEAD
## INDICATION:
year old man with disease // to evaluate p/o DBS
surgery
## DOSE:
This study involved 3 CT acquisition phases with dose indices as
follows: 1) CT Localizer Radiograph 2) CT Localizer Radiograph 3) Sequenced
Acquisition 6.4 s, 16.3 cm; CTDIvol = 54.9 mGy (Head) DLP = 897.1 mGy-cm.
Total DLP (Head) = 897 mGy-cm.
## FINDINGS:
Bilateral, frontal approach deep brain stimulator electrodes are noted in
unchanged position as compared to the prior examination. There has been
interval resolution of the prior left frontal pneumocephalus.
Note that the examination is limited secondary to extensive streak artifact
from the associated hardware. Within this limitation, there is no evidence for
hemorrhage, mass, edema, or infarction. The ventricles and sulci are mildly
enlarged, compatible with age related atrophic changes. The basal cisterns
remain patent.
The visualized portion of the paranasal sinuses, mastoid air cells, and middle
ear cavities are clear. The visualized portion of the orbits are unremarkable.
## IMPRESSION:
1. Limited examination without evidence for acute intracranial process.
2. Unchanged positioning of bilateral DBS electrodes.
3. Mild, global age-related cerebral atrophy.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591974", "visit_id": "N/A", "time": "2131-04-24 14:27:00"} | 1,604,563 |
Description: 19591974-RR-20Abstract: ## HISTORY:
with altered mental status x4 days, s/p
deep-brain stimulator // evaluate for acute process
## FINDINGS:
Lung bases are partially obscured by overlying pulse generator devices
bilaterally. There is no pneumothorax. Opacity at the left lung base most
likely represents atelectasis, but infection cannot be excluded in the
appropriate clinical setting. There is also subtle opacification of the left
apex, which may represent pleural scarring. No large pleural effusions are
seen. Cardiomediastinal silhouette is within normal limits. Median
sternotomy wires are intact. Patient is kyphotic. No acute osseous
abnormalities are identified. Surgical clips are seen in the epigastric
region.
## IMPRESSION:
Left lung base opacity most likely represents atelectasis, but infection or
aspiration should be considered in the appropriate clinical setting. No large
pleural effusions.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591974", "visit_id": "24071410", "time": "2131-05-22 14:35:00"} | 1,604,564 |
Description: 19591974-RR-21Abstract: ## EXAMINATION:
CT HEAD W/O CONTRAST
## INDICATION:
with altered mental status, s/p deep-brain
stimulator // evaluate for acute process
## FINDINGS:
There is no acute intracranial hemorrhage, major vascular territory
infarction, edema or mass effect. Ventricles and sulci are prominent,
suggestive of atrophy. Bilateral deep brain stimulators are unchanged in
position. Associated streak artifact limits the evaluation of adjacent
structures.
Atherosclerotic calcifications are noted in the carotid siphons bilaterally.
There is no evidence of fracture. Minimal mucosal thickening within the
bilateral ethmoid air cells. Remainder of the visualized paranasal sinuses,
mastoid air cells and middle ear cavities are clear. The visualized portion
of the orbits are unremarkable.
## IMPRESSION:
1. No acute intracranial process.
2. Unchanged position of bilateral deep brain stimulators.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591974", "visit_id": "24071410", "time": "2131-05-22 15:55:00"} | 1,604,565 |
Description: 19591974-RR-22Abstract: ## EXAMINATION:
CT C-SPINE W/O CONTRAST
## INDICATION:
with altered mental status, s/p deep-brain
stimulator // evaluate for acute process evaluate for acute process
## FINDINGS:
Cervical lordosis is exaggerated. Alignment of the cervical spine is
otherwise unremarkable. No fractures are identified. Multilevel degenerative
changes and noted throughout the cervical spine including anterior/posterior
osteophytes, loss of intervertebral disc space height and uncovertebral
hypertrophy, which results in up to mild spinal canal narrowing at C5-C6 and
C6-C7. No prevertebral soft tissue swelling.
Thyroid gland is not well visualized. Pleural parenchymal scarring is noted
at the bilateral lung apices.
## IMPRESSION:
No acute fracture or traumatic malalignment.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19591974", "visit_id": "24071410", "time": "2131-05-22 15:55:00"} | 1,604,566 |
Description: 19592126-RR-101Abstract: ## HISTORY:
male with abdominal pain concerning for intra-abdominal
infectious process. Patient with multiple cardiac procedures. Patient with
periumbilical pain for couple of days.
## CT ABDOMEN WITH IV CONTRAST:
The visualized lung bases appear clear. No
pleural or pericardial effusion is seen. Enlarged heart with pacemaker wires
is incompletely visualized. Tiny calcification is noted along the left
posterior sulcus, possibly within the lung or pleural surface.
The liver, spleen, pancreas, and adrenal glands appear normal. Multiple
hypodense lesions are noted in the kidneys bilaterally, the smallest of which
are too small to accurately characterize, and the larger of which represent
cysts, the largest of which is located on the left kidney, measuring 2 cm.
Otherwise, the kidneys enhance and excrete contrast symmetrically. The
stomach, small bowel, colon and appendix appear unremarkable and unchanged. No
free air or free fluid is noted in the abdomen. Note is made of tiny fat-
containing umbilical hernia. Atherosclerotic calcifications are noted along
the abdominal aorta, without aneurysmal dilatation. No adenopathy is noted.
## CT PELVIS WITH IV CONTRAST:
Beam-hardening artifact obscures evaluation of
the pelvis but the visualized non-distended urinary bladder, prostate, seminal
vesicles, and rectum appear unremarkable. Note is made of sigmoid
diverticulosis, without evidence of diverticulitis. No pelvic free fluid or
adenopathy is noted. A prominent right pelvic wall lymph node measures 8 mm
in short axis. Bilateral fat- containing inguinal hernias are as before.
## OSSEOUS STRUCTURES:
The patient is status post right total hip replacement,
with note made of heterotopic ossification surrounding the proximal femur.
There is convex left curvature of the upper lumbar spine. No region of bony
destruction is seen concerning for malignancy.
## IMPRESSION:
1. No acute intraabdominal pathology seen to account for the patient's
symptoms.
2. Sigmoid diverticulosis, without evidence of diverticulitis.
3. Bilateral fat containing inguinal hernia.
4. Status post cholecystectomy.
5. Bilateral renal cysts.
6. Atherosclerotic disease.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "28903299", "time": "2121-09-16 00:31:00"} | 1,604,567 |
Description: 19592126-RR-104Abstract: ## HISTORY:
male with coronary artery disease, aortic stenosis, CHF,
status post CABG, now presenting with chest pain and abdominal pain with
elevated amylase and lipase. Patient is former drinker but does not report
recent alcohol intake. Here to evaluate for cholelithiasis as etiology of
low-grade pancreatitis.
## RIGHT UPPER QUADRANT ULTRASOUND:
The liver appears unremarkable in
echotexture and architecture, without focal liver lesion seen. Flow in the
main portal vein is in normal hepatopetal direction. No intra- or extra-
hepatic biliary ductal dilatation is noted, with the common duct measuring 5
mm. Again the gallbladder is absent, consistent with prior cholecystectomy.
Visualization of the pancreatic tail is slightly limited due to overlying
bowel gas however the visualized pancreas appears unremarkable and unchanged.
No pancreatic ductal dilatation is noted. No ascites is seen. The spleen is
enlarged, measuring 13.8 cm.
## IMPRESSION:
1. Patient is status post cholecystectomy. No intra- or extra-hepatic
biliary ductal dilatation is noted. No choledocholithiasis seen.
2. Incidentally noted splenomegaly.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "25680361", "time": "2121-11-04 14:24:00"} | 1,604,568 |
Description: 19592126-RR-113Abstract: ## HISTORY:
male with right PICC line.
## CHEST, SUPINE PORTABLE FRONTAL VIEW:
The right PICC line courses through the
right axilla, and is definitely seen at the intersection with the right
ventricular pacer lead, at the medial aspect of the right anterior second rib.
Beyond this, the line is not definitely seen; however, a vertically oriented
line parallel to the spine is not identified on studies prior to the most
recent radiograph. This line terminates at the level of the ninth posterior
rib on the right.
The remainder of the study, including the enlarged cardiac silhouette and
position of pacemaker leads are unchanged. Mediastinal and hilar contours are
normal. No pleural effusion or pneumothorax and no lung consolidation is
identified.
## IMPRESSION:
PICC tip is not definitely seen, but may course parallel to the
spine. Lateral chest radiograph is recommended for further evaluation.
Dr this with of the venous access service on at approximately 2:00pm.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "25680361", "time": "2121-11-15 13:24:00"} | 1,604,569 |
Description: 19592126-RR-124Abstract: ## HISTORY:
male with left upper extremity edema and concern for
DVT.
## LEFT UPPER EXTREMITY VENOUS ULTRASOUND:
Gray-scale and color and pulsed wave
Doppler examination was performed over the right subclavian vein as well as
the left internal jugular, subclavian, axillary, brachial, basilic, and
cephalic veins. Note is made of nearly occlusive thrombosis of the left
cephalic, basilic, brachial, and axillary veins. Flow is demonstrated in the
left and right subclavian veins. More proximally, note is made of likely
pacemaker wire entering the left subclavian vein. The internal jugular vein
demonstrates normal compressibility and flow.
## IMPRESSION:
Left upper extremity DVT extending from the superficial cephalic
and basilic veins into the brachial and axillary deep veins.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "25680361", "time": "2121-11-21 17:10:00"} | 1,604,570 |
Description: 19592126-RR-127Abstract: ## FINDINGS:
The ET tube tip is 1.5 cm from the carina, but has already been
pulled back per Dr. . The NG tube tip is in the stomach, however,
could be advanced another 5-10 cm. The aberrant pacer wires are unchanged.
There has been prior sternotomy. There is cardiomegaly, without volume
overload. There is worsening of the left basilar atelectasis, as well as
a small left pleural effusion. The bones are unremarkable.
## IMPRESSION:
ET tube tip only 1.5 cm from the carina as detailed above. NG
tube tip in the stomach but could be further advanced 5-10 cm. Worsening of
retrocardiac atelectasis and additional small left pleural effusion.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "23077014", "time": "2121-11-29 05:47:00"} | 1,604,571 |
Description: 19592126-RR-74Abstract: ## INDICATION:
man with multiple medical problems with abdominal
pain and nausea.
## CT ABDOMEN WITHOUT IV CONTRAST:
The patient is status post cholecystectomy.
There is moderate cardiomegaly. Scarring is seen within the left costophrenic
angle. Given the limits of evaluation without IV contrast, the liver, spleen,
pancreas, adrenal glands, stomach, and abdominal loops of small bowel are
unremarkable. Bilateral hypoattenuating lesions in both kidneys, some with
associated rim calcifications were previously characterized as cysts. There
are no enlarged mesenteric or retroperitoneal lymph nodes. There is no free
air or free fluid in the abdomen.
## CT PELVIS WITHOUT IV CONTRAST:
There is sigmoid diverticulosis without
diverticulitis. The rectum, bladder, and prostate gland are unremarkable.
There are small fat-containing inguinal hernias.
## BONE WINDOWS:
Patient is status post right hip replacement. There is an old
right twelfth rib fracture posteriorly. There is a healed right L2 transverse
process fracture.
## IMPRESSION:
1. No acute intraabdominal pathology to account for the patient's symptoms.
2. Renal cysts.
3. Moderate cardiomegaly.
4. Diverticulosis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "N/A", "time": "2120-02-13 12:29:00"} | 1,604,572 |
Description: 19592126-RR-76Abstract: ## CLINICAL HISTORY:
Abdominal pain, dyspnea, low blood pressure, hypoxia,
please evaluate for dissection.
## CHEST FINDINGS:
The thoracic aorta is within normal limits, with no evidence
for aneurysm or dissection. The main, right and left pulmonary arteries
demonstrate no evidence for embolus. The heart is markedly enlarged, with
significant dilatation of the left ventricle. Also noted is a small air
collection within the right atrium, likely iatrogenic. Dual-lead pacemaker is
seen with its tip in the right and left ventricles. Calcified lymph nodes are
noted in the left hilar region, unchanged. There is aortic valve
calcification, unchanged.
Small bilateral pleural effusions are seen, right greater than left. Areas
ofcompressive atelectasis noted in the lingula. A small left posterior lower
lobe calcified granuloma is seen. There is interlobular septal thickening at
the lung bases, likely on the basis of fluid overload.
## ABDOMEN FINDINGS:
The liver, spleen, pancreas, and adrenal glands are grossly
within normal limits. The kidneys again demonstrate hypodense lesions, the
largest measuring 2.2 cm in the left interpolar region. These most likely
represent cysts appear unchanged. There is no hydronephrosis or hydroureter.
No abdominal lymphadenopathy is noted. There is a small hiatal hernia.
Diffuse diverticulosis of the sigmoid colon is again seen, with no evidence
for diverticulitis. The appendix is prominent based on the diameter but is
completely air-filled and with no surrounding inflammatory changes. Remainder
of the visualized bowel is unremarkable.
Mild abdominal aortic calcification is seen. There is no evidence for
aneurysm or dissection. Aortic branch vessels are within normal limits.
## PELVIS FINDINGS:
The presacral fat is preserved. There is no pelvic
lymphadenopathy. The urinary bladder is grossly unremarkable. Prostate gland
is grossly within normal limits.
The subcutaneous tissues are unremarkable. Right hip arthroplasty
noted, with associated streak artifact limiting evaluation of the pelvis.
## IMPRESSION:
1. No evidence for aortic dissection or aneurysm. No evidence of pulmonary
embolus.
2. Cardiomegaly with bilateral pleural effusions and bibasilar septal
thickening likely related to CHF/fluid overload.
3. Bilateral renal hypodense lesions likely cysts though incompletely
assessed. If needed, renal ultrasound may be obtained to further evaluate.
4. Diverticulosis without evidence for diverticulitis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "N/A", "time": "2120-04-18 19:06:00"} | 1,604,573 |
Description: 19592126-RR-77Abstract: ## CLINICAL INDICATION:
man with CHF and dyspnea, assess for
infiltrate. Patient with fever.
## FINDINGS:
A single portable image of the chest is compared to the prior
examination dated . There is motion artifact slightly degrading the
image quality. Allowing for differences in technique there is no significant
interval change. An AICD is unchanged in position with intact leads
terminating within the expected region of the right atrium and right
ventricle. Midline sternotomy wires are again seen. The heart remains
enlarged. The lungs are grossly clear. The bony thorax is grossly
unremarkable.
## IMPRESSION:
1. No active disease.
2. Stable cardiomegaly.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "N/A", "time": "2120-04-25 20:25:00"} | 1,604,574 |
Description: 19592126-RR-84Abstract: ## INDICATION:
Cellulitis requiring IV vancomycin.
The procedure was explained to the patient. A timeout was performed.
## RADIOLOGIST:
Drs. performed the procedure. Dr. ,
Attending , was present and supervised the entire procedure.
## IMPRESSION:
Uncomplicated ultrasound and fluoroscopically guided 4
single lumen PICC line placement via the right brachial venous approach. Final
internal length is 38 cm, with the tip positioned in distal SVC. The line is
ready to use.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "27559458", "time": "2120-10-06 16:13:00"} | 1,604,575 |
Description: 19592126-RR-86Abstract: ## HISTORY:
male with abdominal pain radiating to the back with
concern for pneumoperitoneum.
## ABDOMEN, UPRIGHT AND SUPINE VIEWS:
There is a nonobstructive bowel gas
pattern with gas distributed throughout normal caliber small and large bowel.
There are no air-fluid levels on the upright view. Gas mixed with stool
extends throughout the colon to the rectum. There is no evidence of
pneumatosis or pneumoperitoneum. The patient is status post cholecystectomy
with clips present in the right upper quadrant. Right hip prosthesis is noted
without evident complication on this limited view.
## IMPRESSION:
No obstruction or pneumoperitoneum.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "N/A", "time": "2120-12-10 22:40:00"} | 1,604,576 |
Description: 19592126-RR-87Abstract: ## HISTORY:
male with epigastric pain radiating to the back. Now
with profuse heme, positive black diarrhea.
## BONE WINDOWS:
The patient is status post ORIF of the right hip with the
bipolar prosthesis. No concerning osseous lesions are seen. Old right
posterior rib fractures and right L3 transverse process fracture are noted.
## IMPRESSION:
1. Extensive diverticulosis but no evidence of acute diverticulitis. Given
the clinical history of blood in stool, correlation with colonoscopy
suggested.
2. Cardiomegaly.
ER dashboard wet read placed at 4:00 a.m. on .
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "27675662", "time": "2120-12-11 01:02:00"} | 1,604,577 |
Description: 19592126-RR-88Abstract: ## CLINICAL INDICATION:
Dark stools with normal endoscopy.
## FINDINGS:
Comparison made to a prior CT dated . Minimal left basilar
atelectasis is seen.
The patient is status post cholecystectomy. Adrenal glands, spleen, pancreas,
and liver are grossly unremarkable. Multiple simple-appearing renal cysts
noted bilaterally. Several smaller hypoattenuating areas are also seen within
the kidneys bilaterally, which are too small to characterize but likely
represent simple cysts.
Diverticulosis is identified throughout the descending and sigmoid colon. The
bowel is otherwise grossly unremarkable. There is no evidence of acute
inflammation. There is no evidence of mesenteric ischemia. Evaluation of the
intra-abdominal vasculature reveals moderate diffuse atherosclerotic
calcification involving the abdominal aorta. The celiac axis is significantly
narrowed at its origin. However, the superior mesenteric artery and inferior
mesenteric artery are widely patent and unremarkable.
Fat-containing inguinal hernias are seen. Right total hip arthroplasty is
noted. Pelvic structures are otherwise grossly unremarkable.
No suspicious lytic or blastic bony lesions are seen.
## IMPRESSION:
1. No acute abnormality identified. Narrowing at the proximal aspect of the
celiac axis. Unremarkable superior and inferior mesenteric arteries noted.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "27675662", "time": "2120-12-17 11:20:00"} | 1,604,578 |
Description: 19592126-RR-91Abstract: ## HISTORY:
man with extensive cardiac history with ejection
fraction , now without a bowel movement for three days and denies
flatus. Concern for bowel obstruction.
## FINDINGS:
There is non-specific bowel gas in the abdomen. There are no
distended loops of bowel, or concerning air-fluid levels. There is air in the
rectum. There is a large amount of feces in the descending colon, suggesting
constipation.
Of note, there is a right hip hemiarthroplasty hardware, without apparent
hardware complication. There is a mild lumbar levoscoliosis. There are
surgical clips at the right upper quadrant, from prior cholecystectomy. There
are wires projected on to the heart, likely pacer wires.
## IMPRESSION:
No evidence of bowel obstruction. Likely constipation.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "24388915", "time": "2121-05-07 11:03:00"} | 1,604,579 |
Description: 19592126-RR-92Abstract: ## INDICATION:
man with chest pain and shortness of breath as well
as GI bleeding. Evaluate for acute cardiopulmonary process.
## FINDINGS:
The pacer/defibrillator leads are again seen terminating in the
right ventricle and coronary sinus. There are median sternotomy wires. An
additional disconnected pacer wire is seen within the left chest wall, as on
prior. There is no evidence of pneumonia. There is cardiomegaly, without CHF.
There is no pneumothorax or pleural effusion. Degenerative changes are seen at
the right humeral head. The bones are otherwise unremarkable.
## IMPRESSION:
No acute intrathoracic process. Cardiomegaly without CHF.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "27274596", "time": "2121-06-08 13:33:00"} | 1,604,580 |
Description: 19592126-RR-94Abstract: ## HISTORY:
male with abdominal pain. Please evaluate for
obstruction.
## FOUR VIEWS OF THE ABDOMEN:
There are moderately dilated loops of small bowel,
and multiple air-fluid levels are demonstrated on the left lateral decubitus.
There is no evidence of free air. Cholecystectomy clips in the right upper
quadrant and the right hip arthroplasty are again identified. There is air
within the rectum. The left hip demonstrates moderate degenerative change.
Midline sternotomy wires and a pacing device are identified.
## IMPRESSION:
Moderately dilated loops of small bowel and air-fluid levels are
consistent with ileus or early/partial small-bowel obstruction.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "27274596", "time": "2121-06-11 01:36:00"} | 1,604,581 |
Description: 19592126-RR-97Abstract: ## HISTORY:
male with ischemic CMP, CRI, admitted with melanoma and
lower abdominal and lower back pain. Evaluate for mesenteric ischemia.
## OSSEOUS STRUCTURES:
Patient status post total right hip replacement. No
suspicious lytic or sclerotic lesions identified.
## IMPRESSION:
No acute intra-abdominal process identified. The celiac axis,
SMA, and appear patent without thrombosis or occlusion. No secondary
signs to suggest mesenteric ischemia identified.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592126", "visit_id": "28605094", "time": "2121-06-22 20:01:00"} | 1,604,582 |
Description: 19592147-RR-19Abstract: ## EXAMINATION:
CT C-SPINE W/O CONTRAST
## HISTORY:
with no known PMH who presents after MVA.// r/o
bleed, fracture
## FINDINGS:
Alignment is normal. No evidence of acute fracture..There is no significant
canal or foraminal narrowing.There is no prevertebral edema.
The thyroid and included lung apices are unremarkable.
## IMPRESSION:
No acute fracture or traumatic malalignment.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592147", "visit_id": "N/A", "time": "2177-01-17 20:06:00"} | 1,604,583 |
Description: 19592374-RR-10Abstract: ## EXAMINATION:
KNEE (AP, LAT AND OBLIQUE) RIGHT
## INDICATION:
year old woman with hx Ewing sarcoma treated with radiation,
chemotherapy, resection and endoprosthesis in (proximal femur). Has
remaining distal femoral condyles. Seen in and doing well. Now new mass
medial distal thigh. ? recurrence or second malignancy // ? mass in distal
thigh or evidence of loosening of the distal femoral prosthesis
## FINDINGS:
Again seen is the patient's proximal femoral endoprosthesis. The distal tip
extends to the physeal line of the distal femur, with surrounding
methylmethacrylate. No evidence of loosening, failure or displacement is
identified. The lateral view shows anterior angulation of the femoral distal
femur with respect to the prosthesis, unchanged.
Again seen is osteoarthritis of the femorotibial joint, worse laterally, and
elongated appearance of the patella. Prominent trabeculae, possibly a bone
infarct, in the proximal tibia is unchanged and is also not significantly
changed compared with .
Musculature of the femur is atrophic. On the oblique view, a thin soft tissue
strand appears to demarcate an ovoid lucency in the soft tissues adjacent to
the medial distal femoral metadiaphysis, measuring approximately 2.3 x 4.0
cm, raising the possibility of a lipoma, in the area of the palpable
abnormality. This may correspond to a small ovoid soft tissue lucency seen
anterior to the distal quadriceps tendon on the lateral view.
## IMPRESSION:
Status post endoprosthesis in the distal femur for treatment of Ewing's
sarcoma, without evidence of loosening or failure. No findings suggestive of
bone tumor recurrence.
Possible ovoid soft tissue lucency, question lipoma, in the soft tissues along
the medial distal femoral metaphysis. This lies in the location of the
palpable abnormality. Ultrasound may help for further assessment.
Osteoarthritis in the right knee, unchanged.
## RECOMMENDATION(S):
Ultrasound to further evaluate the palpable abnormality in
the distal medial right thigh (felt in the region of the vastus medialis
obliquus).
## NOTIFICATION:
Findings and recommendation were discussed by Dr.
with Dr. 1 min after discovery of the findings at 09:14 on .
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592374", "visit_id": "N/A", "time": "2140-06-21 08:44:00"} | 1,604,584 |
Description: 19592374-RR-11Abstract: ## EXAMINATION:
US MSK KNEE(PATELLA TENDON) RIGHT
## INDICATION:
year old woman with hx Ewing sarcoma treated with radiation,
chemotherapy, resection and endoprosthesis in (right proximal
femur). Has remaining distal femoral condyles. Seen in and doing well.
Now new mass medial distal thigh. ? recurrence or second malignancy // ? mass
right distal thigh (medial distal thigh near VMO)
## FINDINGS:
There is a fusiform soft tissue mass measuring 3.4 x 2.0 x 2.7 cm in the
distal medial right thigh, just above the knee. The inferior aspect of the
lesion is 4.2 cm from the knee joint line. The lesion is lateral to the
quadriceps tendon. It is inseparable from the distal relatively atrophic a
appearing quadriceps muscle. It is 2 mm superficial to the distal femoral
anteromedial cortex. The lesion is relatively hyperechoic with some internal
vascularity.
## IMPRESSION:
Solid soft tissue mass is demonstrated in the distal medial right thigh. MRI
or CT could be considered for further tissue characterization however may be
degraded by artifact. The lesion would be amenable to ultrasound-guided
biopsy.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592374", "visit_id": "N/A", "time": "2140-06-21 09:09:00"} | 1,604,585 |
Description: 19592374-RR-12Abstract: ## EXAMINATION:
Ultrasound-guided right distal medial thigh mass biopsy.
## INDICATION:
year old woman with hx of Ewing sarcoma right femur
treated with chemo, radiation and resection/prosthesis. Now with new mass of
medial distal thigh imaged with USA and x-ray today. "Indeterminant" mass. At
risk for second malignancy. // Core needle biopsy and culture of mass of
right distal thigh to establish diagnosis.
## PHYSICIANS:
Dr. , (radiology fellow) and Dr.
, radiology attending, who was present for key points and
supervised the procedure.
## PROCEDURE DETAILS:
Following discussion of the risks, benefits and
alternatives to the procedure, informed written patient consent was obtained.
The patient was brought to the ultrasound suite and placed supine on the
ultrasound bed. An initial limited grayscale and color Doppler ultrasound was
performed to mark the site, please see below for details.
A preprocedure time-out was performed using 3 patient identifiers. The skin
was prepped and draped in the usual sterile fashion. Approximately 5cc of 1%
lidocaine was infiltrated into the skin and subcutaneous tissues for local
anesthesia. Using realtime ultrasound guidance, the 16gauge biopsy needle was
advanced to the lesion. A total of 4 passes were made. Specimens were placed
in formalin for pathology as requested.
The needle was removed and firm manual compression was applied achieve
hemostasis.
There were no immediate post-procedure complications
## FINDINGS:
Subcutaneous mass within the medial distal right thigh. This is unchanged in
appearance compared to the prior ultrasound dated , size
estimated at 3.1 x 1.7 x 3.7 cm.
## IMPRESSION:
1. Subcutaneous mass within the medial distal right thigh.
2. Technically successful ultrasound guided percutaneous biopsy
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592374", "visit_id": "N/A", "time": "2140-06-28 08:52:00"} | 1,604,586 |
Description: 19592374-RR-14Abstract: ## EXAMINATION:
US LOWER EXTREMITY, SOFT TISSUE RIGHT
## INDICATION:
Followup right femoral Ewing sarcoma, status chemotherapy,
radiation and resection of proximal femur by Dr. in with a
revision proximal femoral replacement in now with right distal thigh mass
(scheduled for biopsy tomorrow, s/p ultrasound) and heel mass. // please
evaluate new palpable heel mass that patient states is near the Achilles
tendon
## FINDINGS:
At the area of palpable abnormality, there is a 4 mm SI x 1 mm AP x 4 mm TV
ovoid hypoechoic focus with low-level internal echoes superficial to the
distal Achilles tendon, likely within the subcutaneous fat. There is no
evidence of vascularity, and the echogenicity is different from the biopsied
medial right thigh mass.
## IMPRESSION:
4 mm hypoechoic avascular lesion centered within the subcutaneous fat
superficial to the distal right Achilles tendon, different in echogenicity
from the concurrently biopsied distal right thigh mass. Differential
diagnosis includes xanthoma or sebaceous cyst.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592374", "visit_id": "N/A", "time": "2140-06-28 08:54:00"} | 1,604,587 |
Description: 19592374-RR-15Abstract: ## EXAMINATION:
MRI right thigh without and with contrast.
## INDICATION:
year old woman with hx of Ewing sarcoma of right femur s/p
chemo, radiation, resection and endoprosthesis ( ). Developed new "lump"
since . Bx shows atypical lipomatous tumor but concern about higher grade
liposarcoma given her prior radiation. Plan excision. // Want MRI for
surgical planning of the DISTAL thigh (VMO area). Might need metal subtraction
technique since she has a metal femoral endoprosthesis. Discussed at
conference and Dr. this area could be imaged by MR.
## :
Multiplanar, multi sequence MR imaging of the right thigh before
and after the intravenous administration of 7 cc Gadavist.
## FINDINGS:
Extensive susceptibility related to metallic distal femoral prosthesis
partially limits evaluation. Accounting for this:
There is an ovoid encapsulated lesion overlying the medial femoral condyle
measuring approximately 3.9 cm SI x 3.0 cm AP x 2.0 cm TV. The lesion
demonstrates predominantly T1 hyperintensity with wispy foci of internal T1
hypointensity with corresponding STIR hyperintensity. There is may be diffuse
enhancement on postcontrast imaging (100:14) although evaluation is limited
secondary to poor fat saturation. Faint intramuscular STIR hyperintensity
within the visualized lower thigh may represent mild edema versus atrophy.
There is a lobulated STIR hyperintense lesion within the proximal tibial
metadiaphysis measuring 3.0 cm SI x 1.7 cm TV, thinning the posterior cortex.
## IMPRESSION:
1. Probable atypical lipoma/ liposarcoma measuring 3.9 cm overlying the
postoperative distal medial femoral condyle.
2. 3.0 cm enchondroma within the proximal tibial metadiaphysis which is
suboptimally visualized on prior imaging, although likely seen on radiographs
from .
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592374", "visit_id": "N/A", "time": "2140-07-18 14:35:00"} | 1,604,588 |
Description: 19592374-RR-17Abstract: ## EXAMINATION:
CTA AORTA/BIFEM/ILIAC RUNOFF W/WANDWO C AND RECONS
## INDICATION:
year old woman with ewing sarcoma now with right lower
extremity swelling, discoloration, numbness. no pulses obtained with
doppler.//pls do with run off. right hip to foot.
## RUN OFF CTA:
Non-contrast images and arterial phase images were
acquired from diaphragm through toes. Delayed images were obtained from the
knees to the toes.
Oral contrast was not administered.
MIP reconstructions were performed on independent workstation and reviewed on
PACS.
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 11.2 s, 123.0 cm; CTDIvol = 3.3 mGy (Body) DLP =
405.6 mGy-cm.
2) Stationary Acquisition 3.0 s, 0.5 cm; CTDIvol = 14.4 mGy (Body) DLP =
7.2 mGy-cm.
3) Spiral Acquisition 15.6 s, 122.5 cm; CTDIvol = 14.1 mGy (Body) DLP =
1,726.0 mGy-cm.
4) Spiral Acquisition 7.4 s, 58.6 cm; CTDIvol = 6.3 mGy (Body) DLP = 365.8
mGy-cm.
Total DLP (Body) = 2,505 mGy-cm.
## HEPATOBILIARY:
The visualized inferior portion of the liver demonstrates
homogenous attenuation throughout. There is no evidence of focal lesions.
There is no evidence of intrahepatic or extrahepatic biliary dilatation. The
gallbladder is within normal limits, without stones or gallbladder wall
thickening.
## PANCREAS:
Visualized portion of the pancreatic head is unremarkable.
## URINARY:
Visualized portions of the kidneys over the evidence of stones, focal
lesions, or hydronephrosis.
## GASTROINTESTINAL:
Visualized small bowel loops are normal in caliber.
Visualized portions of the colon and rectum are within normal limits.
## RETROPERITONEUM:
There is no evidence of retroperitoneal lymphadenopathy.
## PELVIS:
The urinary bladder and distal ureters are unremarkable. There is no evidence
of pelvic or inguinal lymphadenopathy. There is no free fluid in the pelvis.
## REPRODUCTIVE ORGANS:
The uterus contains fibroids.
## BONES:
There is no evidence of worrisome osseous lesions or acute fracture. A
right femoral prosthesis is noted.
## SOFT TISSUES:
The abdominal and pelvic wall is within normal limits. There is
asymmetric atrophy of the muscles of the right thigh. There is subcutaneous
edema involving the lateral aspect of the distal right calf as well as the
lateral aspect of the right foot.
CTA abdomen:
No abdominal aortic aneurysm. No significant atherosclerotic disease is
present. The abdominal aorta, SMA, , left and right renal arteries are
patent without evidence of stenosis.
CTA pelvis:
The right common iliac, left common iliac, right and left external iliac,
right and left internal iliac arteries are patent without evidence of stenosis
or significant atherosclerotic disease.
CTA runoff left lower extremity:
The common femoral artery, superficial femoral artery, deep femoral artery,
popliteal artery, anterior tibial artery, posterior tibial artery, peroneal
artery are patent without evidence of stenosis. No significant
atherosclerotic disease. There is three-vessel runoff into the foot. The
dorsalis pedis and posterior tibial arteries in the foot are visualized and
patent.
CTA runoff right lower extremity:
The right-sided vessels are attenuated relative to the left side, likely due
to a combination of prior radiation therapy and asymmetric atrophy of the
right thigh muscles. The right common femoral artery is patent without
evidence of stenosis. There is mild atherosclerotic disease within the right
superficial femoral artery without evidence of significant stenosis. The
right deep femoral artery is significantly attenuated but appears patent. The
distal right superficial femoral and above the knee popliteal arteries are
partially obscured by artifact from the right femoral prosthesis. The
visualized right popliteal artery is patent. The right anterior tibial,
posterior tibial, and peroneal arteries are patent, however runoff into these
vessels is delayed relative to the left side. The right dorsalis pedis and
posterior tibial arteries within the foot are patent.
## IMPRESSION:
1. Relative diffuse attenuation of the right lower extremity arteries relative
to the left is likely secondary to prior radiation therapy and asymmetric
atrophy of the right-sided thigh muscles. Otherwise, normal three-vessel
runoff into the feet bilaterally without evidence of significant stenosis or
occlusion.
2. Subcutaneous edema of the right lateral calf and right lateral foot.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592374", "visit_id": "N/A", "time": "2141-05-07 15:11:00"} | 1,604,589 |
Description: 19592374-RR-18Abstract: ## INDICATION:
with weakness, no pulses. hx of prosthetic in r femur to
knee, hx ewing sarcoma// eval for hardware
## FINDINGS:
Large right femoral prosthesis is again noted with cement at its distal
aspect. Minimal residual native femur seen distally. There is no
periprosthetic lucency. Alignment of the remaining femur is similar compared
to prior. Osseous structures including the distal femur are demineralized.
Faintly visualized sclerotic area in the proximal right tibia is unchanged and
may represent enchondroma as seen on prior films. There is no fracture. High
density material projecting over the pelvis is likely excreted contrast in the
bladder. Fatty lesion in the distal right thigh described on interval MRI is
not clearly delineated by plain film.
## IMPRESSION:
No fracture. No hardware related complication.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592374", "visit_id": "N/A", "time": "2141-05-07 17:11:00"} | 1,604,590 |
Description: 19592374-RR-20Abstract: ## INDICATION:
year old woman with RLE numbness tingling no pulse// eval
vasculatyure
## FINDINGS:
Peak systolic velocities are as follows:
Common femoral artery waveform is monophasic. Peak systolic velocity is 64
cm/sec.
Profunda femoris artery waveform is monophasic. Peak systolic velocity is
53.2 cm/sec.
Proximal superficial femoral artery waveform is monophasic. Peak systolic
velocity is 56.5 cm/sec
Mid superficial femoral artery waveform is absence consistent with occlusion.
Note is made of collateral vessels at this level.
There is absence of signal extending from the distal superficial femoral
artery through to the anterior tibial, posterior tibial and peroneal arteries.
## IMPRESSION:
Occlusion of the mid superficial femoral artery with collateral formation.
There is absence of arterial waveforms in the posterior tibial, anterior
tibial, peroneal and dorsalis pedis arteries.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592374", "visit_id": "27580783", "time": "2141-05-10 15:36:00"} | 1,604,591 |
Description: 19592374-RR-21Abstract: ## EXAMINATION:
CTA LOWER EXT W/ANDW/O C AND RECONS BILATERAL
## INDICATION:
year old woman with right lower extremity numbness, no pulse.
CT with runoff// eval vessels
## RUN OFF CTA:
Non-contrast images and arterial phase images were
acquired from diaphragm through toes. Delayed images were obtained from the
knees to the toes.
Oral contrast was not administered.
MIP reconstructions were performed on independent workstation and reviewed on
PACS.
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 12.2 s, 134.0 cm; CTDIvol = 3.3 mGy (Body) DLP =
439.0 mGy-cm.
2) Stationary Acquisition 2.5 s, 0.5 cm; CTDIvol = 12.0 mGy (Body) DLP =
6.0 mGy-cm.
3) Spiral Acquisition 16.3 s, 128.7 cm; CTDIvol = 14.1 mGy (Body) DLP =
1,814.0 mGy-cm.
4) Spiral Acquisition 8.1 s, 63.8 cm; CTDIvol = 6.3 mGy (Body) DLP = 398.7
mGy-cm.
Total DLP (Body) = 2,658 mGy-cm.
## LOWER CHEST:
Minimal atelectasis is noted in the lung bases. There is no
pleural or pericardial effusion. Heart size is normal.
## HEPATOBILIARY:
The liver demonstrates homogenous attenuation throughout.
Scattered subcentimeter hypodensities within segment 4A and 7 of the liver
(03:20, 16) are too small to fully characterize, but likely reflect small
cysts or biliary hamartomas. There is no evidence of intrahepatic or
extrahepatic biliary dilatation. The gallbladder is within normal limits,
without stones or gallbladder wall thickening.
## PANCREAS:
The pancreas has normal attenuation throughout, without evidence of
focal lesions or pancreatic ductal dilatation. There is no peripancreatic
stranding.
## SPLEEN:
The spleen shows normal size and attenuation throughout, without
evidence of focal lesions.
## ADRENALS:
The right and left adrenal glands are normal in size and shape.
## URINARY:
The kidneys are of normal and symmetric size with normal nephrogram.
There is no evidence of stones or hydronephrosis. There are no urothelial
lesions in the kidneys or ureters. There is no perinephric abnormality. Fat
density 9 mm lesion arising from the upper pole of the left kidney is
compatible with an angiomyolipoma. Additional 2 mm fat density lesion in the
interpolar lesion of the left kidney may represent additional angiomyolipoma.
Additional subcentimeter hypodensities in the lower pole of the right kidney
are too small to characterize but likely represent simple cysts.
## GASTROINTESTINAL:
Small bowel loops demonstrate normal caliber, wall thickness
and enhancement throughout. Colon and rectum are within normal limits.
Appendix contains air, has normal caliber without evidence of fat stranding.
There is no evidence of mesenteric lymphadenopathy.
## RETROPERITONEUM:
There is no evidence of retroperitoneal lymphadenopathy.
## PELVIS:
The urinary bladder and distal ureters are unremarkable. There is no
evidence of pelvic or inguinal lymphadenopathy. There is no free fluid in the
pelvis.
## REPRODUCTIVE ORGANS:
The uterus contains multiple fibroids. No adnexal
abnormalities.
## BONES:
There is no evidence of worrisome osseous lesions or acute fracture.
Right femoral prosthesis is noted.
## SOFT TISSUES:
The abdominal and pelvic wall is within normal limits. There is
asymmetric atrophy of the right thigh muscles. There is mild subcutaneous
edema of the right lateral calf and right lateral foot, as seen previously.
## VASCULAR:
CT abdomen:
There is no abdominal aortic aneurysm. There is no calcium burden or
significant atherosclerotic disease in the abdominal aorta. The celiac axis,
SMA, , and bilateral renal arteries are patent without stenosis.
CT pelvis:
The right common iliac, left common iliac, right and left external iliac,
right and left internal iliac arteries are patent without evidence of stenosis
or significant atherosclerotic disease.
CTA runoff left lower extremity:
The common femoral, superficial femoral, deep femoral, popliteal, anterior
tibial, posterior tibial, and peroneal arteries patent without evidence of
stenosis or significant atherosclerotic disease. There is a normal
three-vessel runoff into the foot. The dorsalis pedis and posterior tibial
arteries in the foot are patent.
CTA runoff right lower extremity:
The right-sided arterial vasculature is diffusely attenuated relative to the
left. The right common femoral artery is patent without evidence of
flow-limiting stenosis. The right deep femoral artery is patent, but appears
markedly attenuated. There is mild to moderate diffuse calcified
atherosclerotic disease of the right superficial femoral artery which appears
patent to the midportion. The distal right superficial femoral artery and
above the knee popliteal artery are poorly visualized secondary to streak
artifact from the femoral prosthesis. The visualized portion of the right
popliteal artery is attenuated but patent. The anterior tibial, posterior
tibial, and peroneal arteries are patent to just above the level of the ankle
however with delayed slow flow into the runoff vessels compared to the
contralateral side, as seen on the previous exam. The posterior tibial artery
is seen patent at the level of the ankle, however both the posterior tibial
and dorsalis pedis arteries are not opacified within the foot.
## IMPRESSION:
1. Distal right superficial femoral artery and proximal right popliteal artery
are not well evaluated secondary to streak artifact from adjacent femoral
prostheses.
2. Diffuse attenuation of the right lower extremity arteries with delayed slow
flow into the right lower extremity runoff arteries relative to the left, as
seen on the prior exam from . Patent right three-vessel runoff to
the level of the ankle. The right posterior tibial and dorsalis pedis
arteries within the foot not opacified, likely due to slow flow.
3. Mild to moderate diffuse calcified atherosclerotic disease of the right
superficial femoral artery which otherwise appears patent to the midportion
without high-grade stenosis, as seen previously.
4. Normal three-vessel runoff to the left foot.
5. Incidentally noted angiomyolipomas of the left kidney measuring up to 9 mm.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592374", "visit_id": "27580783", "time": "2141-05-10 20:25:00"} | 1,604,592 |
Description: 19592374-RR-23Abstract: ## INDICATION:
year old woman with History of Ewing sarcoma, status post
chemotherapy, radiation and resection of her proximal femur by Dr. in
. Please include entire femur.// evaluate interval change of femur from
hip to knee
## FINDINGS:
Right femoral megaprosthesis is again seen. No evidence of hardware
complication. Bones appear osteopenic. Mild degenerative changes right knee
appears unchanged. Stippled mineralization within the proximal tibia
measuring approximately 2.6 x 1.7 x 2.0 cm appears relatively unchanged in
size from though there appears to be slight progression of
mineralization over time.
Vascular stent is again seen of the medial thigh. Soft tissue loss of the
distal right thigh appears similar.
## IMPRESSION:
Unchanged appearance of right femur prosthesis.
Likely cartilaginous lesion of the proximal right tibia does not appear to
have increased in size since though there appears to be slow progression
of matrix mineralization of this lesion.
## NOTIFICATION:
The findings were discussed with Dr, by
, M.D. on the telephone on at 10:44 am, 10 minutes after
discovery of the findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592374", "visit_id": "N/A", "time": "2142-04-17 10:03:00"} | 1,604,593 |
Description: 19592411-RR-28Abstract: ## INDICATION:
man status post ERCP with stent placement, now with
nausea, vomiting. Assess for obstruction or free air.
## FINDINGS:
Three frontal images of the abdomen show a normal bowel gas pattern
with no evidence of pneumatosis or free air. Large fecal load noted
throughout the colon. The stomach does not appear to be distended with air.
Note of biliary stent in the expected position in the right upper quadrant.
Degenerative changes are noted throughout the lower lumbar spine.
Calcification of pelvic vasculature with phleboliths noted.
## IMPRESSION:
Normal bowel gas pattern with no evidence of obstruction.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592411", "visit_id": "23156187", "time": "2138-12-14 08:36:00"} | 1,604,594 |
Description: 19592411-RR-29Abstract: ## INDICATION:
male with right upper quadrant pain and suspected CBD
stones and planned cholecystectomy.
## FINDINGS:
15 fluoroscopic spot views were submitted for review following
ERCP. These images demonstrate multiple small filling defects seen throughout
the common bile duct consistent with either small stones or sludge. The
biliary tree shows diffuse mild dilatation. There are some small filling
defects within the cystic duct that could represent either stones or bubbles.
Image 15 shows placement of a common bile duct stent.
## IMPRESSION:
1. Small filling defects scattered throughout the common bile
duct either representing stones or sludge. Mild dilation of the biliary tree.
Patient is status post biliary stent placement in the common bile duct.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592411", "visit_id": "23156187", "time": "2138-12-13 10:38:00"} | 1,604,595 |
Description: 19592411-RR-34Abstract: Department of Radiology
Standard Report - Normal Venous Vascular/US Exam
## STUDY:
Bilateral Lower Extremity Venous Duplex
## REASON:
prior history of PE , pre-op, assess for DVT and include iliac
veins.
## FINDINGS:
Duplex evaluation was performed on the bilateral lower extremity
veins.
There is normal compression and augmentation of the common femoral, proximal
femoral, mid femoral, distal femoral, popliteal, posterior tibial and peroneal
veins. There is normal phasicity of the common femoral veins bilaterally.
Bilateral iliac veins also seen without evidence of DVT.
## IMPRESSION:
No evidence of right or left lower extremity deep vein thrombosis,
including iliac veins.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592411", "visit_id": "N/A", "time": "2139-03-10 10:53:00"} | 1,604,596 |
Description: 19592411-RR-39Abstract: ## INDICATION:
man status post cholecystectomy and hernia repair,
now with nausea, vomiting and fevers. Please assess for intra-abdominal
abscess, postoperative collection.
## CT ABDOMEN:
There is mild bibasilar atelectasis. There are no focal hepatic
lesions. The patient is status post cholecystectomy with simple fluid
accumulation in the gallbladder fossa. There are small hypoattenuating
lesions in the spleen, unchanged from prior exam.
The kidneys are homogeneously enhancing and excreting urine without evidence
of hydronephrosis, stones or masses. There are scattered, non-pathologically
enlarged retroperitoneal lymph nodes. There is no mesenteric lymphadenopathy.
There is no free air. There is nonspecific mild stranding extending from the
inferior perineal space to the ascending colon without evidence of wall
thickening.
Unchanged large hiatal hernia is present. An NG tube ends in the corpus of
the stomach. The small bowel is normal. A curvilinear high attenuation
structure is identified in the lumen of the ascending colon. The colon is
otherwise normal.
## CT OF THE PELVIS:
The prostate is enlarged measuring 5 cm. The urinary
bladder is normal. There is no pelvic lymphadenopathy. There are no pelvic
hernias.
## BONES:
There are moderate-to-severe degenerative changes at the lumbar spine
with intervertebral disc disease at the L2/L3, L4/L5 and L5/S1. There are no
suspicious lytic or sclerotic bony lesions.
Patient is status post epigastric hernia repair. There are post-surgical
changes in the soft tissue stranding in the subcutaneous fat in the abdominal
wall and midline (series 2A, image 54)
## IMPRESSION:
1. Status post cholecystectomy with residual simple fluid in the gallbladder
fossa.
2. Foreign body in the ascending colon. Per report, the patient had a
previously placed biliary stent. The morphology of the foreign body would be
consistent with that structure, now apparently dislodged and migrated.
3. Mild stranding surrounding the ascending colon is nonspecific. No
evidence of colitis.
4. Unchanged hiatal hernia.
5. Post-surgical changes after epigastric hernia repair with subcutaneous
stranding in the midline abdominal wall.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592411", "visit_id": "26738053", "time": "2139-03-26 20:45:00"} | 1,604,597 |
Description: 19592411-RR-40Abstract: ## HISTORY:
Bacteremia, history of C3-5 discectomy and question spinal
osteomyelitis treated, evaluate for presence of hardware as evaluation for
MRI.
CERVICAL SPINE, THREE VIEWS INCLUDING SWIMMER'S VIEW. THORACIC SPINE, TWO
VIEWS. LUMBAR SPINE, TWO VIEWS. Technologist note is as follows: "Best
possible."
## CERVICAL SPINE:
On the neutral lateral view, C1 through the C5/6 disc is
demonstrated. There is straightening of lordosis. There is fusion across the
C4/5 vertebral bodies. No subluxation is detected. No prevertebral soft
tissue swelling is seen. Probable osteoarthritic changes at the atlantodental
interval. On the swimmer's view, the lower cervical spine remains obscured by
anatomy.
## THORACIC SPINE:
Detail is limited due to technical limitations, but there is
focal marked disc space narrowing in the upper thoracic spine, ? at the T8
through T10 level, with effacement of the presumptive T9/10 disc and small
marginal osteophytes. No spondylolisthesis. With the exception of the
endplate changes, the vertebral body heights are preserved. Remaining
vertebral body and disc heights are grossly preserved. There is mild right
convex curvature in the upper thoracic at T5/6.
## LUMBAR SPINE:
Detail obscured by bowel contrast on the frontal view. There
is slight straightening of lordosis. There is moderately severe narrowing at
L2/3 and L3/4 and mild narrowing at L5/S1. Minimal retrolisthesis of L2/3 and
minimal anterolisthesis of L4/5. Facet arthrosis. Aortic calcification.
Suggestion of unexplained density in the pelvis, ? bowel contrast. Limited
assessment of the lungs and the thoracic spine shows cardiomegaly as well as
density in the right cardiophrenic region(? known hiatal hernia).
## IMPRESSION:
1) Limited exam showing multilevel degenerative changes including fusion at
C4/5, a focal area of marked disc space narrowing in the lower thoracic spine
and areas of disc space narrowing in the lumbar spine at L2/3, L4/5 and L5/S1.
2) No radiopaque foreign body is detected over the course of the cervical,
thoracic, or lumbar spine allowing for the patient's clothing snaps.
3) Cardiomegaly. Right cardiophrenic density - ? hiatal hernia. Please see
details of prior surgical history as well as description of a foreign body in
the ascending colon on report from the abdominal CT.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592411", "visit_id": "26738053", "time": "2139-03-29 15:09:00"} | 1,604,598 |
Description: 19592411-RR-46Abstract: ## INDICATION:
male with MRSA and left PICC line. Known prior clot
in right upper extremity. Scan to evaluate any evidence of left arm DVT.
The right and left subclavian, and pulse Doppler waveforms are normal and
symmetric in appearance. The left internal jugular, axillary, brachial,
basilic and cephalic veins were all well visualized and easily compressible.
Color flow Doppler confirms patency of all these vessels as well as pulse
Doppler waveform analysis. The PICC line is visualized in the left basilic,
left axillary and left subclavian veins and there is no evidence of any clot
or fibrin sheath surrounding the PICC line where visualized.
## CONCLUSION:
No evidence of DVT in the left upper extremity.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19592411", "visit_id": "26738053", "time": "2139-04-05 09:09:00"} | 1,604,599 |
Subsets and Splits