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Description: 19593791-RR-43Abstract: ## STUDY:
MRI of the cervical spine with contrast.
MRI OF THE CERVICAL SPINE.
## CLINICAL INDICATION:
History of multiple sclerosis, rule out abnormal
enhancing lesions.
## FINDINGS:
The visualized elements of the posterior fossa, demonstrates a
focal area of enhancement on the left cerebellar tonsil, measuring
approximately 4 mm in size and previously demonstrated on the concurrent MRI
of the brain.
The alignment and configuration of the cervical vertebral bodies appears
maintained. The signal intensity throughout the cervical spinal cord,
demonstrates vague areas of high signal intensity on T2 and STIR sequence, for
example on the image 14, 16, series #17, none of these lesions demonstrate
enhancement. There is also mild-to-moderate atrophy within the cervical
spinal cord. Multilevel degenerative changes are detected consistent with
posterior disc bulge at C3/C4, causing mild anterior thecal sac deformity,
also mild bilateral uncovertebral hypertrophy is demonstrated at this level.
At C4/C5, left uncovertebral hypertrophy is seen, causing mild left side
neural foraminal narrowing (image 18, series #17).
At C5/C6 level, posterior disc bulging is identified, causing mild anterior
thecal sac deformity, slightly asymmetric towards the right, resulting in
right-sided neural foraminal narrowing (image 22, series #17).
C6/C7 level appears unremarkable. The upper thoracic spine is also normal.
No abnormalities are demonstrated in the paravertebral structures.
## IMPRESSION:
No focal areas of enhancement are demonstrated throughout the
cervical spinal cord, however, there is moderate atrophy and vague areas of
high signal intensity on T2 as described above, likely consistent with chronic
demyelination in this patient with history of multiple sclerosis.
Multilevel degenerative changes throughout the cervical spine as described
above.
Focal area of enhancement on the left cerebellar tonsil, previously
demonstrated on the concurrent MRI of the brain.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "N/A", "time": "2146-11-04 19:40:00"} | 1,604,800 |
Description: 19593791-RR-46Abstract: ## HISTORY:
Known nephrolithiasis, assess for stones and renal abnormalities.
## IMPRESSION:
Compared to the most recent prior study of :
1. Slight decrease in stone burden involving the kidneys bilaterally, the
right with greater extent than the left.
2. No definite renal parenchymal loss compared to the prior exam.
3. Improvement of renal collecting system fullness bilaterally, especially on
the left.
4. At least one if not two, 1-2 mm bladder calculi, new compared to the prior
study.
Remainder of the exam is unchanged including minimal atherosclerotic disease
of the distal aorta and its branches, degenerative changes of the spine,
uncomplicated suprapubic tube, areas of renal cortical thinning.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "N/A", "time": "2147-03-13 13:20:00"} | 1,604,801 |
Description: 19593791-RR-52Abstract: MR EXAMINATION OF THE BRAIN WITHOUT AND WITH CONTRAST,
## HISTORY:
male with MS and new seizures; evaluate for new brain
lesions.
## FINDINGS:
The study is compared with most recent enhanced MR examination of
, as well as the remote study of .
Again demonstrated is the extensive confluent T2-/FLAIR-hyperintensity
throughout bihemispheric subcortical and periventricular white matter, with
similar abnormality involving the posterior fossa, including the brainstem,
cerebellar peduncles and cerebellar hemispheres. Allowing for the motion
artifact, above, the overall appearance is unchanged. By and in-large, the
extensive lesions demonstrate intrinsic T1-hypointensity, representing "black
holes" of irreversible demyelination. However, there is a prominent
curvilinear or "targetoid" 16 mm focus of enhancement in the right corona
radiata with a possible second enhancing focus in the corresponding location
on the left. The right-sided focus appears new since the examination,
though previously, there was a smaller, more nodular focus in the immediately
adjacent centrum semiovale. Allowing for the marked limitation in the
post-contrast imaging, no other definite enhancing focus is seen, with
apparent interval resolution of the left-sided subcortical white matter,
temporal lobar and cerebellar hemispheric foci. Currently, there is no
pathologic leptomeningeal or dural focus of enhancement.
There is no definite focus of slow diffusion to suggest an acute ischemic
event, and the principal intracranial vascular flow-voids, including those of
the dural venous sinuses are preserved and these structures enhance normally.
In comparison to the more remote study there is no definite progression of the
marked global atrophy (particularly given the patient's age) or the severe
diffuse atrophy of the corpus callosum. Limited imaging of the upper cervical
spinal cord, through the mid-C4 level, demonstrates no definite abnormality.
## IMPRESSION:
The study, particularly the post-contrast MP-RAGE acquisition, is
quite limited by motion artifact, with:
1. No significant change in the overall extensive demyelinating "disease
burden."
2. Curvilinear rim-enhancing focus in the right corona radiata appears new
since the study and likely represents a site of active inflammation;
allowing for the limitation above, there is no definite additional enhancing
focus, with apparent interval resolution of many of the foci demonstrated on
that study.
3. Marked global and corpus callosal atrophy, not significantly changed since
the study.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "21428749", "time": "2147-10-17 20:51:00"} | 1,604,802 |
Description: 19593791-RR-61Abstract: ## FINDINGS:
A new right PICC line is coiled within the right subclavian vein. As compared
to most recent prior radiograph, there is no significant change in low lung
volumes and platelike atelectasis at the left lung base. Normal heart size.
No pleural effusion or pneumothorax. Air-filled loops of colon are visible in
the upper abdomen.
## IMPRESSION:
New right PICC line is coiled within the right subclavian vein and needs to be
repositioned. No evidence of complication, particularly no pneumothorax.
Telephone notification to , IV nurse, at 16:39 on .
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "29401529", "time": "2148-06-17 15:39:00"} | 1,604,803 |
Description: 19593791-RR-62Abstract: ## INDICATION:
man with mispositioned right PICC.
## OPERATORS:
Dr. (attending), Dr. (resident). The
attending was present and supervised throughout the procedure.
## ANESTHESIA:
The patient's hemodynamic parameters were continuously monitored
throughout the total intraoperative time of 35 minutes.
## PROCEDURE AND FINDINGS:
Informed consent was obtained. The patient was brought to the angiography
suite and placed supine on the imaging table. The right arm and indwelling
right basilic approach single lumen PICC were prepped and draped in the usual
sterile fashion. A preprocedural timeout and huddle were performed per
protocol.
A fluoroscopic scout image demonstrated the indwelling right PICC to be
mispositioned, coiled in the right subclavian vein. Under fluoroscopic
guidance, a Nitinol wire was threaded through the PICC. Mild difficulty was
encountered while advancing the wire through the right subclavian vein,
indicating possible stenosis. The wire tip was placed in the IVC and the PICC
was removed. A peel-away sheath was then placed over a guidewire and a
single lumen PICC measuring 41 cm in length was then placed through the
peel-away sheath with its tip positioned in the SVC under fluoroscopic
guidance. Position of the catheter was confirmed by a fluoroscopic spot film
of the chest. The peel-away sheath and guidewire were then removed. The
catheter was secured to the skin, flushed, and a sterile dressing applied.
The patient tolerated the procedure well. There were no immediate
complications.
## IMPRESSION:
1. Successful fluoroscopically guided placement of new right basilic 4
single-lumen PICC. Final internal length is 41 cm, with the tip positioned in
the mid-SVC. The line is ready to use.
2. Mild difficulty encountered while passing guidewire through the right
subclavian vein, suggesting mild stenosis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "29401529", "time": "2148-06-17 17:20:00"} | 1,604,804 |
Description: 19593791-RR-72Abstract: ## INDICATION:
year old man with left calculus of kidney // wiring for pcnl
## OPERATORS:
Dr. radiology fellow), Dr.
resident), and Dr. radiology attending)
performed the procedure. The attending, Dr. was present and supervising
throughout the procedure. Dr. radiologist, personally
supervised the trainee during the key components of the procedure and reviewed
and agreed with the trainee's findings.
## ANESTHESIA:
Moderate sedation was provided by administrating divided doses of
100mcg of fentanyl and 2 mg of midazolam throughout the total intra-service
time of 37 min during which the patient's hemodynamic parameters were
continuously monitored by an independent trained radiology nurse. 1% lidocaine
was injected in the skin and subcutaneous tissues overlying the access site.
## CONTRAST:
20 ml of Optiray contrast.
## PROCEDURE:
1. Left ultrasound guided renal collecting system access.
2. Left nephrostogram.
3. Left collecting system sheath and wire placement.
## PROCEDURE DETAILS:
Following the discussion of the risks, benefits and
alternatives to the procedure, written informed consent was obtained from the
patient. The patient was then brought to the angiography suite and placed
prone on the exam table. A pre-procedure time-out was performed per
protocol. The left flank was prepped and draped in the usual sterile fashion.
Pre-procedure ultrasound confirmed the absence of left hydronephrosis. A large
lower pole echogenic stone with posterior acoustic shadowing was again
visualized. The stone was targeted with ultrasound. After the injection of 5
cc of 1% lidocaine in the subcutaneous soft tissues, the left renal collecting
system was accessed through a posterior lower pole calyx under ultrasound
guidance using a 21 gauge Cook needle. Ultrasound images of the access were
stored on PACS. After advancing the needle to the stone, fluoroscopy
confirmed needle position relative to the stone. Gentle contrast injection did
not clearly opacify the collecting system. Initially, neither a headliner or
Nitinol wire could be advanced through the needle tip. The access needle was
removed and new access was obtained to the lower pole stone. Now a headliner
wire could be advanced. The wire was carefully advanced while slowly
withdrawing the needle until the wire passed easily into the renal collecting
system. The wire was advanced into the ureter. After a skin , the needle
was exchanged for an Accustick sheath. One the tip of the sheath was in the
collecting system; the sheath was advanced over the wire, inner dilator and
metallic stiffener. The wire and inner dilator were then removed and diluted
contrast was injected into the collecting system to confirm position. An
Amplatz wire was advanced through the sheath and advanced into the distal
ureter. The Accustick sheath was then removed and a 6 bright tip sheath
was advanced into the mid to distal ureter. Contrast was injected to confirm
position. Two wires were advanced through the sheath into the distal
ureter. The sheath was secured to the skin with 0 silk suture. The external
wires were left in their cases. A dry sterile bandage was applied. The
patient tolerated the well without any immediate post-procedure complications.
## FINDINGS:
1. 1.8 cm calculus in a posterior left lower pole calyx.
2. No hydronephrosis or hydroureter.
3. Sheath and wire placement through the stone containing posterior left lower
pole calyx and into the distal left ureter
## IMPRESSION:
Successful ultrasound- and fluoroscopically-guided collecting system access of
a stone containing posterior left lower pole calyx prior to percutaneous
lithotripsy.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "26780405", "time": "2150-05-18 10:52:00"} | 1,604,805 |
Description: 19593791-RR-73Abstract: ## INDICATION:
MS and urinary retention s/p suprapubic tube p/w decreased urine
output.
## FINDINGS:
The right kidney measures 11.9 cm. The left kidney measures 11.2 cm. There is
no hydronephrosis within either kidney.
Large echogenic foci are seen within both kidneys, compatible with known renal
stones. The largest in the right kidney measures 16 mm. Complete evaluation
of the left kidney is limited by patient habitus and positioning.
A catheter is seen within the collapsed bladder.
## IMPRESSION:
1. No hydronephrosis.
2. Bilateral renal stones.
.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "28477193", "time": "2150-04-13 13:44:00"} | 1,604,806 |
Description: 19593791-RR-77Abstract: ## INDICATION:
year old man with stones // eval stone burden and stent
## FINDINGS:
A double J stent is seen along the course of the left ureter, with the distal
end projecting over the left flank and the distal end projecting over the
urinary bladder. Multiple calcifications are seen along the course of the
stent, which may represent stones. Large calcifications projecting over the
right kidney are compatible with staghorn calculi, better seen on prior CT.
There is no intra-abdominal free air. There is a large fecal load in the
rectum which is dilated to 10.6 cm and a gas filled colon with dilatation of
the sigmoid to 12 cm. Significant fecal load is also seen in the ascending
colon.
## IMPRESSION:
1. Left-sided double-J stent in appropriate position. Small calcifications
along the course of the stent may represent ureteral stones.
2. Staghorn calculi in the right kidney redemonstrated.
3. Large rectal fecal load with associated dilatation of the gas-filled
sigmoid.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "N/A", "time": "2150-10-15 16:06:00"} | 1,604,807 |
Description: 19593791-RR-78Abstract: ## EXAMINATION:
CT ABD AND PELVIS W/O CONTRAST
## INDICATION:
year old man with history of kidney stones. Evaluate for
stones.
## ABDOMEN:
Evaluation of the intra-abdominal solid organs is limited by lack of
intravenous contrast and streak artifact secondary to the patient's arms being
on top of his abdomen.
The kidneys are irregular in contour, with several bilateral stones, with the
largest stone at the interpolar region of the right kidney measuring up to 1.9
cm, however several other stones measure greater than 1 cm at the upper and
lower poles of the right kidney. There is no right-sided hydronephrosis. The
left kidney contains a 1.6 x 1.5 cm stone at the lower pole, a 8 mm stone at
the midpole, and a third 6 mm stone at the midpole. There is mild, chronic
left-sided hydronephrosis with the double-J stent beginning in the mid left
ureter, terminating in the bladder. Imaged bowel is normal in caliber without
obstruction. No retroperitoneal and mesenteric lymphadenopathy.
## PELVIS:
The urinary bladder is completely decompressed, with a double-J stent
from the left ureter, and a suprapubic catheter. The rectum contains a
considerable amount of stool. There is no pelvic free fluid or pelvic
lymphadenopathy.
## VESSELS:
The aorta is normal in caliber with mild calcium burden.
## OSSEOUS STRUCTURES:
Sclerotic focus in left iliac bone is likely a bone
island, unchanged from . No concerning osseous lesions are seen.
## IMPRESSION:
1. Multiple bilateral renal calculi, with the largest measuring up to 1.9 cm
at the midpole of the right kidney. No right-sided hydronephrosis.
2. Chronic left-sided hydronephrosis, unchanged since .
3. Left ureteral double-J stent with superior pigtail within the proximal
ureter, and inferior pigtail within the bladder.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "N/A", "time": "2150-11-09 12:27:00"} | 1,604,808 |
Description: 19593791-RR-81Abstract: ## INDICATION:
year old man with stones. Evaluate stone burden and stent.
## FINDINGS:
A left double-J stent appears appears to have slipped inferiorly with the more
proximal pigtail in the proximal ureter, similar in location compared to the
prior CT of . Allowing for differences in technique extensive renal
calculi appear similar to the prior CT of . The largest calculus on
the right measures 1.7 cm and on the left measures 2.1 cm. Calcifications in
the pelvis are most likely vascular.
There are no abnormally dilated loops of large or small bowel. Supine
assessment limits detection for free air; there is no gross pneumoperitoneum.
Bone islands in the left iliac bone are noted.
## IMPRESSION:
1. A left double-J stent appears appears to have slipped inferiorly into with
the more proximal pigtail in the proximal ureter, similar in location compared
to the prior CT of .
2. The stone burden in both kidneys appears similar to the prior CT of .
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "N/A", "time": "2151-04-03 11:52:00"} | 1,604,809 |
Description: 19593791-RR-83Abstract: ## EXAMINATION:
CT abdomen pelvis without contrast.
## INDICATION:
with h/o neurogenic bladder w/ chronic suprapubic catheter
and b/l staghorn kidney stones w/ L stent placed in . Attempted to
remove L stent last week, but it was tethered and was pushed back into the
bladder. Assess for ureteral stent location, nephrolithiasis, and
hydronephrosis
## DOSE:
Acquisition sequence:
1) CT Localizer Radiograph
2) CT Localizer Radiograph
3) Spiral Acquisition 5.7 s, 62.5 cm; CTDIvol = 16.9 mGy (Body) DLP =
1,058.5 mGy-cm.
Total DLP (Body) = 1,058 mGy-cm.
## LOWER CHEST:
Limited assessment of the lung bases demonstrates bilateral
lower lobe atelectasis. Coronary artery calcifications are present. There is
no evidence of pleural or pericardial effusion.
## HEPATOBILIARY:
The liver demonstrates homogeneous attenuation throughout.
There is no evidence of focal lesions within the limitations of an unenhanced
scan. 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 within the limitations of an unenhanced scan. There is no
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 again noted to be irregular in contour with several
bilateral stones largest at the interpolar region of the right kidney
measuring up to 2.4 cm with multiple additional stones measuring greater than
1 cm in the upper and lower poles of the right kidney. Mild right
hydronephrosis with mild right hydroureter is stable. The left kidney
contains a conglomerate of stones within the interpolar region measuring
approximately 1.7 x 0.4 cm. Within the lower pole a 2.1 x 0.9 cm stone is
noted. There is progression of chronic left hydronephrosis which is now
severe with associated hydroureteronephrosis. A double-J stent starts in the
mid left ureter and terminates in the bladder, unchanged in position since
prior examination and approximately 7.5 cm from the left UPJ. No perinephric
abnormality.
## GASTROINTESTINAL:
The stomach is unremarkable. Small bowel loops demonstrate
normal caliber and wall thickness throughout. A large amount of stool is seen
within the rectum and sigmoid colon anteriorly displacing the bladder and
distal ureters. The colon is otherwise within normal limits. The appendix is
normal.
## PELVIS:
The urinary bladder is decompressed with a suprapubic catheter. There
is no free fluid in the pelvis.
## REPRODUCTIVE ORGANS:
The prostate is normal in size.
## LYMPH NODES:
Few prominent retroperitoneal lymph nodes largest measuring 1.6
x 0.6 cm (02:49) within the left para-aortic region is noted. There is no and
large retroperitoneal or mesenteric lymph nodes by CT size criteria. There is
no pelvic or inguinal lymphadenopathy.
## VASCULAR:
There is no abdominal aortic aneurysm. Minimal atherosclerotic
disease is noted.
## BONES:
2 densely sclerotic lesions measuring 1.2 x 0.8 and 0.5 x 1 cm (2:85,
90) are stable and most consistent with bone islands. There is no evidence of
worrisome osseous lesions or acute fracture.
## SOFT TISSUES:
A small fat containing umbilical hernia is present. The
abdominal and pelvic wall is within normal limits.
## IMPRESSION:
1. Progression of now severe left hydroureteronephrosis
2. Double-J left ureteral stent with superior pigtail within the mid ureter
and inferior pigtail within the bladder, unchanged since prior examination.
3. Multiple bilateral renal calculi largest measuring up to 2.4 cm within the
right kidney and 2.1 cm within the lower pole of left kidney.
4. Stable mild right hydroureteronephrosis.
5. Abundant stool burden within the rectum and sigmoid colon.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "24389732", "time": "2151-04-08 21:35:00"} | 1,604,810 |
Description: 19593791-RR-86Abstract: ## EXAMINATION:
CT OF THE ABDOMEN PELVIS WITHOUT INTRAVENOUS CONTRAST ; LOW-DOSE
TECHNIQUE.
## INDICATION:
BILATERAL NEPHROLITHIASIS. EVALUATE STONE BURDEN
## LOWER CHEST:
Visualized lung fields are within normal limits. There is no
evidence of pleural or pericardial effusion.
## HEPATOBILIARY:
The liver demonstrates homogeneous attenuation throughout.
There is no evidence of focal lesions within the limitations of an unenhanced
scan. No evidence of steatosis (60 . There is no evidence of intrahepatic
or extrahepatic biliary dilatation. The gallbladder is within normal limits.
## PANCREAS:
The pancreas is atrophic with fatty infiltration, without evidence
of focal lesions within the limitations of an unenhanced scan. There is no
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 right kidney measures 11.38 cm and the left 10.69 cm. Bilateral
scarring is seen peripherally in the lower poles. Hypo density in the upper
pole is noted with no interval change since the previous study. There is
significant calcification burden with no significant change since . Average attenuation of calcification is 502 . On the right, the
calcification is pretty much casting the entire collecting systems. On the
left, the mid and lower pole only. The a right ureteral stent has been
removed
## GASTROINTESTINAL:
The stomach is unremarkable. Small bowel loops demonstrate
normal caliber and wall thickness throughout. There is considerable stool
burden throughout the colon and the marked distention of the rectal ample with
large amount of fecal load
## PELVIS:
The urinary bladder was empty at the time of the exam, contains a
suprapubic catheter.
## LYMPH NODES:
There is no retroperitoneal or mesenteric lymphadenopathy. There
is no pelvic or inguinal lymphadenopathy.
## VASCULAR:
There is no abdominal aortic aneurysm. Minimal 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. No significant change in extensive bilateral, right greater than left,
stone burden compared to the previous exam of
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "N/A", "time": "2151-07-24 12:53:00"} | 1,604,811 |
Description: 19593791-RR-88Abstract: ## INDICATION:
year old man with stone s/p difficult PCNL, patient with large
residual stone burden // stone burden following PCNL
## CTU:
Multidetector CT of the abdomen and pelvis were acquired
without intravenous contrast administration with the patient in supine
position. The non-contrast scan was done with low radiation dose technique.
Coronal and sagittal reformations were performed and reviewed on PACS.
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 8.5 s, 55.4 cm; CTDIvol = 6.4 mGy (Body) DLP = 351.2
mGy-cm.
Total DLP (Body) = 351 mGy-cm.
## FINDINGS:
Evaluation of the intra-abdominal solid organs is limited by streak artifact
from patient's arms and lack of intravenous contrast.
## HEPATOBILIARY:
The liver demonstrates homogeneous attenuation throughout.
There is no evidence of focal lesions within the limitations of an unenhanced
scan. 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 within the limitations of an unenhanced scan. There is no
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:
Patient undergone Interval right percutaneous nephrostomy and
nephrolithotomy. There is a nephrostomy tube present in the lower pole of the
right kidney, terminating in the lower lateral pole calyx, as well as the
nephroureteral catheter extending from the right kidney interpolar access site
and terminating in the bladder. There has been interval decrease in the stone
burden in the right kidney, particularly in the interpolar region. The
largest remaining stones on the right measure 2.7 cm in the upper pole, 1.7 cm
in the midpole, and 1.9 cm in the lower pole. There is no significant change
in stone burden the left kidney, with the largest stone in the lower pole
measuring up to 2.1 cm, and 1.8 cm in the midpole. There is no evidence of
suspicious focal renal lesions or hydronephrosis. The proximal left ureter is
dilated to the midportion, without evidence of obstruction. There is no
perinephric abnormality.
## GASTROINTESTINAL:
The stomach is unremarkable. Small bowel loops demonstrate
normal caliber and wall thickness throughout. There is significant stool
burden throughout the colon and marking distention of the rectum with
significant fecal load. The appendix is normal.
## PELVIS:
The bladder was empty at the time of exam. A suprapubic catheter and a
foley catheter are present. There is no free fluid in the pelvis. .
## REPRODUCTIVE ORGANS:
The reproductive organs are unremarkable.
## LYMPH NODES:
There is no retroperitoneal or mesenteric lymphadenopathy. There
is no pelvic or inguinal lymphadenopathy.
## 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:
1. Interval decrease in stone burden in the right kidney, particularly at the
interpolar region, as described above, status post nephrolithotomy.
2. Status post percutaneous nephrostomy, with a nephrostomy tube in the lower
pole of the right kidney, and nephroureteral catheter extending from the right
interpolar access site to the bladder.
3. Dilation of the proximal to mid left ureter, with no evidence of
obstruction. No left hydronephrosis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "24076865", "time": "2151-10-29 10:01:00"} | 1,604,812 |
Description: 19593791-RR-89Abstract: ## INDICATION:
w/ sup o2 requirement, fevers to 103, 8L fluid // assess for
acute process vs atalectasis assess for acute process vs atalectasis
## IMPRESSION:
Compared to chest radiographs since most recently .
Lung volumes are chronically low. Cardiac silhouette is minimally larger.
There is new right perihilar opacification and fullness in the right lower
paratracheal station of the mediastinum. There 3 ways these to explain this:
1. Mild pulmonary edema and mediastinal venous engorgement ; 2. A right
hilar mass, postobstructive pneumonia, and ipsilateral lower paratracheal
adenopathy ; 3. Right lung pneumonia, leading to cardiac decompensation. I
favor the third possibility, but careful clinical and radiographic followup is
recommended.
Scarring or chronic subsegmental atelectasis in the left lung is unchanged.
Distension of the segment of colon interposed between the liver and right
hemidiaphragm is chronic.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "24076865", "time": "2151-10-30 08:32:00"} | 1,604,813 |
Description: 19593791-RR-90Abstract: ## INDICATION:
year old man with MS, nephrolithiasis s/p PCNL c/b sepsis with
desats to 80's and new O2 requirement. // rule out pneumonia rule out
pneumonia
## FINDINGS:
Portable upright chest radiograph at 13:34 is submitted.
## IMPRESSION:
The lung volumes remain low with streaky opacity at the left base 's favoring
atelectasis. Overall, there is increasing hazy opacity within the right lung
which may reflect a combination of increasing airspace disease as well as
layering pleural fluid. These findings, given the asymmetry, would be
concerning for evolving pneumonia or aspiration. Clinical correlation is
recommended. No pneumothorax. Interposition of the colon beneath the right
hemidiaphragm and liver consistent with Chiladiti's.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "24076865", "time": "2151-11-03 13:26:00"} | 1,604,814 |
Description: 19593791-RR-92Abstract: ## EXAMINATION:
CT abdomen and pelvis without IV contrast.
## INDICATION:
year old man with nephrolithiasis s/p right PCNL. Please get
stone protocol CT scan. // stone burden after surgery
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 9.7 s, 63.0 cm; CTDIvol = 4.4 mGy (Body) DLP = 282.0
mGy-cm.
Total DLP (Body) = 282 mGy-cm.
## FINDINGS:
Images of the lower chest and upper abdomen are limited by extensive streak
artifact from the patient's arms.
## LOWER CHEST:
There is a moderate-sized nonhemorrhagic right pleural effusion
with associated right lower lobe consolidation concerning for atelectasis
versus pneumonia. There is mild dependent atelectasis on the left. No
pericardial effusion.
## HEPATOBILIARY:
The liver demonstrates homogeneous attenuation throughout.
There is no evidence of focal lesions within the limitations of an unenhanced
scan. There is no evidence of intrahepatic or extrahepatic biliary
dilatation. The gallbladder is distended, but there are no signs of
cholecystitis.
## PANCREAS:
The pancreas has normal attenuation throughout, without evidence of
focal lesions within the limitations of an unenhanced scan. There is no
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 right nephroureteral stent is unchanged in position. Two
percutaneous nephrostomy drains are unchanged in position. There are multiple
small locules of air within the collecting system of the right kidney, likely
due to recent intervention. Evaluation of the stone burden on the right is
limited due to contrast from the patient's recent nephrostogram. The largest
conglomeration of stones within the right upper pole is no longer visualized.
The largest stone on the right measures 17 mm within the lower pole (series 3,
image 53). There has been no change in size or distribution of the multiple
stones within the left kidney measuring up to 21 mm. The hydronephrosis on
the left has improved compared to , now mild.
## GASTROINTESTINAL:
The stomach is unremarkable. Small bowel loops demonstrate
normal caliber and wall thickness throughout. There is a large fecal load
within the ascending colon and the rectum. The appendix is normal.
## PELVIS:
The bladder is decompressed by a suprapubic catheter. There is no
free fluid in the pelvis.
## REPRODUCTIVE ORGANS:
The reproductive organs are unremarkable.
## LYMPH NODES:
There are multiple subcentimeter periaortic retroperitoneal lymph
nodes. There are no pathologically enlarged retroperitoneal or mesenteric
lymphadenopathy. There is no pelvic or inguinal lymphadenopathy.
## VASCULAR:
There is no abdominal aortic aneurysm. Moderate atherosclerotic
disease is noted.
## BONES:
The sclerotic foci within the left iliac wing are stable since at least
. Degenerative changes are noted within the lumbar spine.
There is no evidence of worrisome osseous lesions or acute fracture.
## SOFT TISSUES:
The abdominal and pelvic wall is within normal limits.
## IMPRESSION:
1. Unchanged position of right nephroureteral stent and 2 percutaneous
nephrostomy drains.
2. Evaluation of the stone burden on the right is somewhat limited due to
contrast from the patient's recent nephrostogram. Within these limitations,
the largest conglomeration of stones within the right upper pole is no longer
visualized. There continues to be a 17 mm stone within the right lower pole.
3. Unchanged size and distribution of renal stones on the left, with improved
hydronephrosis, now mild.
4. Moderate-sized right pleural effusion with associated consolidation,
concerning for atelectasis versus aspiration pneumonia.
5. Large stool ball within the rectum.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "24076865", "time": "2151-11-06 10:35:00"} | 1,604,815 |
Description: 19593791-RR-93Abstract: ## INDICATION:
s/p two-stage staghorn procedures. Inferior pole
nephrostomy/tubes remain. // Assess for interval change.
## FINDINGS:
There has been interval removal of a right superior nephrostomy drain. An
inferior right nephrostomy drain appears to be in place, similar to the prior
CT from . A double-J catheter appears to extend from the level of
the proximal ureter, to the bladder, also similar in position compared to the
prior CT. Calcific densities along the course of the right double-J catheter,
are likely secondary to renal calculi. Multiple calculi are seen throughout
the right kidney, with the largest measuring 1.6 cm within the inferior pole
of the right kidney, corresponding to the calculus seen on the prior CT. The
small and large bowel loops, are mildly distended, which may suggest ileus. No
evidence of pneumatosis or pneumoperitoneum. The stone burden on the left, is
not well assessed on this exam.
## IMPRESSION:
1. Interval removal of a right superior nephrostomy drain.
2. Double-J ureteral stent extends from the proximal right ureter to the
bladder, with calcific density seen along the course of the ureter.
3. Similar calculus burden within the right kidney, compared to the prior CT,
with the largest calculus within the inferior pole measuring up to 1.6 cm.
4. Left-sided stone burden not well assessed on this exam.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593791", "visit_id": "24076865", "time": "2151-11-07 14:12:00"} | 1,604,816 |
Description: 19593885-RR-18Abstract: ## INDICATION:
year old woman with memory loss. ? brain abnormalities // ?
brain abnormalities
## FINDINGS:
Focal area of slow diffusion is identified in the splenium of the corpus
callosum (image 19, series 702), which is also visible on T2 and FLAIR
sequences, likely consistent with a subacute ischemic area. There is no
evidence of hemorrhagic transformation. The ventricles and sulci are
prominent, suggesting cortical volume loss, this finding is more significant
in the temporal lobes and parietal convexity. Subcortical and periventricular
areas of high-signal intensity detected on FLAIR and T2 weighted images are
nonspecific and may reflect changes due to small vessel disease. The major
vascular flow voids are present and demonstrate normal distribution
## IMPRESSION:
1. Focal area of slow diffusion identified in the splenium of the corpus
callosum, visible on T2 FLAIR and diffusion weighted maps, these likely
consistent with subacute ischemic event.
2 Multiple subcortical and periventricular areas of high-signal intensity on
FLAIR and T2 weighted sequence, are nonspecific and may reflect changes due to
small vessel disease.
3. Prominent ventricles and sulci, more significant in the temporal parietal
lobes suggesting cortical volume loss.
## NOTIFICATION:
The findings were discussed by Dr. with NP on
the telephone on at 12:04 , 5 minutes after discovery of the
findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593885", "visit_id": "N/A", "time": "2193-04-29 09:37:00"} | 1,604,817 |
Description: 19593902-RR-15Abstract: ## INDICATION:
year old man with left chest pain, left abdominal pain and
left leg pain// aneurysm? dissection?
## FINDINGS:
The aorta measures 3.6 cm in the proximal portion, 3.0 cm in mid portion and
2.5 cm in the distal abdominal aorta. There is moderate calcified
atherosclerotic plaque.
Wall-to-wall color flow is seen within the aorta with appropriate arterial
waveforms.
The right common iliac artery measures 1.2 cm and the left common iliac artery
measures 0.9 cm.
There is severe right hydronephrosis. There is no left hydronephrosis.
## IMPRESSION:
1. Dilation of the proximal abdominal aorta up to 3.6 cm.
2. No aortic dissection visualized.
3. Severe right hydronephrosis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593902", "visit_id": "N/A", "time": "2144-02-18 22:16:00"} | 1,604,818 |
Description: 19593902-RR-16Abstract: ## EXAMINATION:
CT abdomen and pelvis without contrast
## INDICATION:
year old man with LLQ pain and severe right hydronephrosis. PO
contrast no IV given Cr please.// diverticulitis? obstruction of right ureter?
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 5.3 s, 57.5 cm; CTDIvol = 16.8 mGy (Body) DLP = 967.2
mGy-cm.
Total DLP (Body) = 967 mGy-cm.
## LOWER CHEST:
There is a partially visualized 5 mm perifissural nodule in the
right lower lobe (2:1). There is a likely 4 mm pulmonary nodule in the left
lower lobe (2:5). There is no evidence of pleural or pericardial effusion.
## HEPATOBILIARY:
The liver demonstrates homogeneous attenuation throughout.
There is no evidence of focal lesions within the limitations of an unenhanced
scan. 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 within the limitations of an unenhanced scan. There is no
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:
There is severe right cortical thinning. There are focal areas of
marked left cortical atrophy. There is no evidence of focal renal lesions
within the limitations of an unenhanced scan. There is severe right
hydronephrosis, with dilation of the proximal and mid ureter approximately to
the level of the aortic bifurcation (2:53). There is medialization of the
bilateral ureters. There is no nephrolithiasis. There is no perinephric
abnormality.
## GASTROINTESTINAL:
The stomach is unremarkable. Small bowel loops demonstrate
normal caliber and wall thickness throughout. The colon and rectum are within
normal limits. The appendix is normal (2:62).
## 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 normal.
## LYMPH NODES:
There is abnormal soft tissue anterior to the aorta and extending
down to the aortic bifurcation and along the iliac vessels. There is no
retroperitoneal or mesenteric lymphadenopathy. There is no pelvic or inguinal
lymphadenopathy.
## 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:
An umbilical hernia containing fat is noted.
## IMPRESSION:
-Severe chronic right hydronephrosis, with dilation of the right ureter
approximately to the level of the aortic bifurcation. There is
retroperitoneal soft tissue extending along the aorta and iliac vessels, and
medialization of the bilateral ureters, likely representing retroperitoneal
fibrosis causing hydronephrosis.
-Possible tiny basal pulmonary nodules. Follow-up CT can be performed in
year if risk factors for pulmonary neoplasm
## RECOMMENDATION(S):
The updated findings were discussed by Dr. with
Dr. on the telephone on at 9:39 am, 2 minutes after discovery
of the findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593902", "visit_id": "28456582", "time": "2144-02-19 00:27:00"} | 1,604,819 |
Description: 19593928-RR-23Abstract: ## HISTORY:
Right groin pain. No physical exam evidence of hernia. Assess for
evidence of sports hernia or other cause.
## PELVIC MRI WITHOUT CONTRAST:
There is trace edema in the parasymphyseal portion of both right and left
superior pubic rami (3:9, 7:14). There is minimal degenerative signal in the
adductor tendons adjacent to this (2:9). However, no adductor tendon tear is
detected and no fracture line, pubic symphysis diastasis, or pubic symphysis
fluid is detected. The adductor muscles are within normal limits in signal
intensity and morphology.
The hip joints are within normal limits, without effusion and with preserved
glenohumeral cartilage. Mild marrow edema along the femoral head and neck
junction on both sides is likely reactive. Mild soft tissue edema is also
seen overlying both greater trochanters, slightly more prominent on the right,
a relatively common finding. No frank bursal fluid is detected. Visualized
portions of the proximal femur and proximal thigh musculature are within
normal limits.
Muscles and tendons and the remainder of the bones about the pelvic girdle are
within normal limits.
Limited assessment of intrapelvic soft tissue structures is grossly
unremarkable. No significant free fluid or enlarged lymph nodes are detected.
There is no evidence of inguinal hernia. A few nonenlarged inguinal nodes are
seen bilaterally.
## IMPRESSION:
Trace marrow edema about the pubic symphysis with mild degenerative signal in
the right and left adductor tendons. The small amount of marrow edema could
reflect very mild changes of stress reaction. No adductor tendon tear or
pubic ramus fracture is identified.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593928", "visit_id": "N/A", "time": "2133-03-09 17:39:00"} | 1,604,820 |
Description: 19593980-RR-13Abstract: ## HISTORY:
Low back and leg pain, bony abnormality.
lspine, 2 vws
There is a transitional level, levels are assigned for the purposes of this
report only. For this report, there is a rudimentary rib on the right at T12
and the first non-rib-bearing vertebral body is designated L1.
There is mild left convex curvature centered at L2/3. Lumbar lordosis is
preserved. There is mild disc space narrowing at L3/4 and L4/5 posteriorly
with minimal (4.8 mm) retrolisthesis of L3 on L4. There is marginal spurring
along the anterosuperior corner of L3. Vertebral body and disc heights are
otherwise preserved. No focal lytic or sclerotic lesion is identified. There
is mild facet arthrosis at L4 through S1.
There is a tiny (3.4 mm) ovoid density over the right upper quadrant--this may
very well represent material within the bowel, but the differential diagnosis
could include a small renal or gallbladder calculus.
## IMPRESSION:
Mild curvature and degenerative change, as described.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593980", "visit_id": "N/A", "time": "2116-03-14 13:15:00"} | 1,604,821 |
Description: 19593980-RR-14Abstract: ## EXAM:
MRI of the lumbar spine.
## CLINICAL INFORMATION:
Patient with status post epidural injection and
presenting with pain, question of abscess.
## FINDINGS:
From T11-12 to L1-2, no abnormalities are seen.
At L2-3 and L3-4, mild degenerative disc disease is seen.
At L4-5, disc bulging is identified indenting the thecal sac with mild
bilateral foraminal narrowing with disc bulging in contact with exiting nerve
roots.
At L5-S1 level, no abnormalities are seen. A tiny Tarlov cyst is seen in the
sacral spinal canal. Following gadolinium, no abnormal enhancement is seen.
There is no evidence of discitis, osteomyelitis or epidural abscess seen.
## IMPRESSION:
Mild multilevel degenerative changes. No evidence of spinal
stenosis. No signs of discitis or osteomyelitis. No evidence of epidural
abscess.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19593980", "visit_id": "N/A", "time": "2116-06-30 01:36:00"} | 1,604,822 |
Description: 19594133-RR-18Abstract: DIGITAL DIAGNOSTIC BILATERAL MAMMOGRAM,
## CLINICAL INFORMATION:
Inner mid bilateral breast pain-- none today.
## FINDINGS:
Routine views of both breasts were performed using GE digital
mammography. The patient is unaware as to the location of her previous
mammogram exams for comparison.
Both breasts demonstrate scattered fibroglandular densities. In the upper
central left breast, a few areas of asymmetry are present which are pliable,
likely breast tissue. An ML magnification view was performed to evaluate
questionable calcifications in the far superior aspect of the left breast
which reveals no clustered microcalcifications. Left breast utrasound was
performed targeted to the upper central aspect for pliable density thought to
be breast tissue.
No ultrasound abnormality is seen while scanning the upper left breast from
o'clock.
## IMPRESSION:
No radiographic evidence of malignancy. Annual mammogram is
recommended according to the patient's age and risk factors. Results
discussed with the patient.
BI-RADS 1 - negative.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594133", "visit_id": "N/A", "time": "2186-05-14 13:29:00"} | 1,604,823 |
Description: 19594133-RR-20Abstract: ## HISTORY:
New onset left lower quadrant pain. Evaluate for adnexal pathology.
No priors are available.
PELVIC ULTRASOUND
## LMP:
Started one day prior.
Transabdominal and transvaginal images were obtained, transvaginal images were
used for better assessment of endometrial cavity and adnexal structures. The
uterus is anteverted and enlarged measuring 8.9 x 7.0 x 8.4 cm and contains
multiple predominantly intramural fibroids, which deviates the adjacent
endometrial canal preventing accurate measurement of its size. The largest
myoma is fundal and posterior measuring 5.3x 4.8 x 5.2 cm. Both right and left
ovaries are unremarkable in appearance and displaying normal arterial and
venous waveforms. A 1-cm hemorrhagic corpus luteum is noted within the right
ovary. There is trace free fluid noted adjacent to the right adnexa.
## IMPRESSION:
1. No sonographic evidence of ovarian torsion.
2. Fibroid uterus.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594133", "visit_id": "N/A", "time": "2186-09-20 00:12:00"} | 1,604,824 |
Description: 19594133-RR-21Abstract: ## HISTORY:
Sudden onset of left lower quadrant pain with normal pelvic
ultrasound.
## BONE WINDOWS:
No malignant-appearing osseous lesions are present.
## IMPRESSION:
No etiology for acute left lower quadrant pain identified. Reidentification of
fibroid uterus. Slight heterogeneous perfusion of the dominant right-sided
myoma may suggest a component of fibroid necrosis contributing to the
patient's pain.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594133", "visit_id": "N/A", "time": "2186-09-20 03:32:00"} | 1,604,825 |
Description: 19594187-RR-12Abstract: ## EXAMINATION:
CT HEAD W/O CONTRAST
## INDICATION:
year old man with head injury following fall // r/o head
bleed
## FINDINGS:
There is no evidence of acute intracranial hemorrhage, edema, mass effect, or
large territorial infarction. Prominent ventricles and sulci suggest
age-related involutional changes or atrophy. The basal cisterns appear patent
and there is preservation of gray-white matter differentiation.
There is a nondisplaced right nasal bone fracture of indeterminate age. The
paranasal sinuses, mastoid air cells, and middle ear cavities are clear.
Surgical hardware is partially imaged at the anterior lateral left maxillary
sinus. . Atherosclerotic mural calcification of the bilateral internal carotid
arteries is noted. The globes are intact.
## IMPRESSION:
No acute intracranial abnormality.
Nondisplaced right nasal bone fracture of indeterminate age.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594187", "visit_id": "N/A", "time": "2188-07-21 19:14:00"} | 1,604,826 |
Description: 19594197-RR-13Abstract: ## FINDINGS:
The osseous structures are diffusely demineralized. Comminuted fracture of
the left femoral neck involving the greater trochanter is demonstrated with
mild proximal displacement and varus angulation of the dominant distal
fracture fragment. No dislocation is seen. A sclerotic focus overlies the
right femoral head, which could reflect a bone island. Clips are noted
projecting over the left aspect of the sacrum. No diastases of the pubic
symphysis or sacroiliac joints is present. There are is mild joint space
narrowing involving both hips. Moderate degenerative changes are noted within
the lower lumbar spine. Prominent small bowel loop within the left pelvis
measures up to 5.2 cm.
## IMPRESSION:
1. Comminuted left femoral neck fracture involving the greater trochanter.
2. Distended small bowel loop in the left pelvis measuring up to 5.2 cm for
which clinical correlation is recommended.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594197", "visit_id": "25257283", "time": "2131-04-02 19:01:00"} | 1,604,827 |
Description: 19594197-RR-16Abstract: ## EXAMINATION:
CT HEAD W/O CONTRAST Q111 CT HEAD
## INDICATION:
with fall, unknown head strike, left hip fx evaluate for
injury.
## FINDINGS:
There is no evidence ofhemorrhage, edema, or mass. There is prominence of the
ventricles and sulci suggestive of involutional changes. An area of
encephalomalacia involving the left cerebellar hemisphere suggests chronic
infarction (3:11).
There is no evidence of fracture. Trace mucosal thickening of the anterior
ethmoidal air is noted with trace fluid in the right mastoid air cells. The
visualized portion of the remaining paranasal sinuses and middle ear cavities
are otherwise clear. The visualized portion of the orbits are unremarkable.
## IMPRESSION:
1. No acute intracranial process.
2. Involutional changes and apparent chronic left cerebellar infarction.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594197", "visit_id": "25257283", "time": "2131-04-02 20:35:00"} | 1,604,828 |
Description: 19594197-RR-17Abstract: ## EXAMINATION:
CT C-SPINE W/O CONTRAST Q311 CT SPINE
## INDICATION:
with fall, unknown head strike, left hip fracture evaluate
for injury.
## DOSE:
Acquisition sequence:
1) CT Localizer Radiograph
2) CT Localizer Radiograph
3) Spiral Acquisition 12.8 s, 19.5 cm; CTDIvol = 29.0 mGy (Body) DLP =
545.8 mGy-cm.
Total DLP (Body) = 557 mGy-cm.
## FINDINGS:
Moderate multilevel degenerative changes are noted including minimal
anterolisthesis of C4 on C5 and C5 on C6. Alignment is otherwise normal. No
fractures are identified. Moderate multilevel degenerative changes with
intervertebral disc space narrowing, anterior and posterior osteophytic
spurring, and endplate sclerosis is present, most pronounced at C3-4, C4-5,
and C5-6. There is no evidence of critical spinal canal or neural foraminal
stenosis. There is no prevertebral soft tissue swelling.
A spiculated density in the left upper lung may represent scarring, however
dedicated chest CT is recommended for further evaluation. A benign bone
island is incidentally noted in the left second rib (6b:40). Imaged thyroid
gland is unremarkable.
## IMPRESSION:
1. No acute fracture.
2. Moderate multilevel degenerative changes including mild anterolisthesis of
C4 on C5 and of C5 on C6.
3. Left apical lung spiculated density may represent scarring. Consider
dedicated chest CT for further evaluation.
## RECOMMENDATION(S):
Left apical lung spiculated density may represent scarring. Consider dedicated
chest CT for further evaluation.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594197", "visit_id": "25257283", "time": "2131-04-02 20:36:00"} | 1,604,829 |
Description: 19594197-RR-18Abstract: ## EXAMINATION:
FEMUR (AP AND LAT) LEFT
## INDICATION:
History: with hip fx // eval for injury
## FINDINGS:
Again seen is a fracture of the left proximal femoral neck, with slight valgus
angulation. There is osteopenia. At the periphery of these films, mild
degenerative changes are noted in the right knee. No knee joint
lipohemarthrosis. Question heterotopic ossification adjacent to the proximal
tibia medially.
## IMPRESSION:
Fracture of the left proximal femoral neck, with slight varus angulation. No
lateral view of the proximal femur available.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594197", "visit_id": "25257283", "time": "2131-04-03 01:56:00"} | 1,604,830 |
Description: 19594197-RR-20Abstract: ## INDICATION:
year old woman s/p L hip hemiarthroplasty. // year old
woman s/p L hip hemiarthroplasty. year old woman s/p L hip
hemiarthroplasty.
## FINDINGS:
The patient is status post left hip hemiarthroplasty. There is no evidence of
perihardware lucency or fracture. The soft tissue air is postoperative in
nature. Skin staples are noted. A sclerotic focus projecting over the right
femoral head likely represents a bone island. Severe degenerative changes are
noted of the lumbar spine.
## IMPRESSION:
Expected postoperative findings status post left hip hemiarthroplasty.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594197", "visit_id": "25257283", "time": "2131-04-03 16:43:00"} | 1,604,831 |
Description: 19594197-RR-22Abstract: ## INDICATION:
year old woman with l pelvis fx // l pelvis fx
## FINDINGS:
Compared with the prior study, the skin staples have been removed in the
subcutaneous emphysema has resolved. Again seen is a left hip
hemiarthroplasty with cemented femoral stem, in overall anatomic alignment.
No periarticular fracture is detected. Small foci of ossification near the
left proximal femur are again noted. Otherwise, doubt significant interval
change. Again seen are advanced degenerative changes in the mid/lower lumbar
spine and clips over the pelvis. Also again seen is the ovoid radiodensity
overlying the right proximal femur.
## IMPRESSION:
Status post placement of left hip hemiarthroplasty, in overall anatomic
alignment.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594197", "visit_id": "N/A", "time": "2131-04-29 12:30:00"} | 1,604,832 |
Description: 19594198-RR-22Abstract: ## EXAMINATION:
UNILAT LOWER EXT VEINS LEFT
## INDICATION:
year old man with left knee/leg swelling, page me w/ wet
// r/o DVT, cyst
## FINDINGS:
There is normal compressibility, flow, and augmentation of the left common
femoral, femoral, and popliteal veins. Normal color flow is demonstrated in
the tibial vein. Peroneal vein were not visualized.
There is normal respiratory variation in the common femoral veins bilaterally.
A 5.1 x 3.5 x 2.0 cm medial popliteal fossa ( ) cyst.
## IMPRESSION:
1. Peroneal vein was not visualized. No evidence of deep venous thrombosis in
the left lower extremity veins.
2. 5.1 cyst.
## NOTIFICATION:
Results were discussed with the ordering physician by
sonographer at 1:30 pm 10 min after discovery of findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594198", "visit_id": "N/A", "time": "2142-07-12 12:59:00"} | 1,604,833 |
Description: 19594198-RR-23Abstract: ## EXAMINATION:
KNEE (3 VIEWS) LEFT
## INDICATION:
year old man with left knee pain // left knee pain left
knee pain
## RIGHT KNEE:
There is a moderate suprapatellar joint effusion. Small superior
patellar osteophyte and enthesophyte. The joint spaces are well preserved.
No fracture or dislocation. No suspicious lytic or sclerotic lesion is
identified. No soft tissue calcification or radio-opaque foreign body is
detected.
## LEFT KNEE:
Limited assessment on single AP standing view is grossly
unremarkable.
## IMPRESSION:
Moderate joint effusion on the right, small patellar enthesophyte and
osteophyte.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594198", "visit_id": "N/A", "time": "2142-07-14 11:35:00"} | 1,604,834 |
Description: 19594198-RR-24Abstract: ## EXAMINATION:
UNILAT LOWER EXT VEINS LEFT
## FINDINGS:
There is normal compressibility, flow, and augmentation of the left common
femoral, femoral, and popliteal veins. Normal color flow and compressibility
is demonstrated in the posterior tibial and peroneal veins.
There is normal respiratory variation in the common femoral veins bilaterally.
The previously visualized left posterior fossa cyst now has a more
oblong appearance and extends into the posterior calf concerning for ruptured
cyst.
## IMPRESSION:
1. No evidence of deep venous thrombosis in the left lower extremity veins.
2. Likely ruptured left popliteal fossa cyst with fluid extending into
the posterior calf
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594198", "visit_id": "N/A", "time": "2142-08-02 16:10:00"} | 1,604,835 |
Description: 19594198-RR-26Abstract: ## EXAMINATION:
US DRAIN/INJ INTERMED JOINT/BURSA W US GUID
## INDICATION:
year old man with painful knee. // aspiration fluid
collection posterior knee. Please see recent MRI. ? infectious etiology.
## FINDINGS:
Small effusion, with loculation along the lateral aspect of the joint
just lateral to the quadriceps tendon. Some hyperemia about this region is
noted.
## IMPRESSION:
1. Imaging Findings - small effusion.
2. Procedure - Uneventful ultrasound-guided aspiration of the left knee
joint.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594198", "visit_id": "N/A", "time": "2142-09-26 14:20:00"} | 1,604,836 |
Description: 19594198-RR-28Abstract: ## INDICATION:
History: with left knee osteomyelitis
## FINDINGS:
No acute fracture or dislocation is identified. Cortical irregularity is seen
involving lateral aspect of the distal femur which is suspicious for
osteomyelitis. Large joint effusion is increased in size compared to the
prior study. There is no subcutaneous gas. Joint spaces are maintained with
minimal degenerative spurring seen in the patellofemoral compartment. Small
superior patellar enthesophyte is noted. No concerning focal lytic or
sclerotic osseous abnormalities are otherwise demonstrated.
## IMPRESSION:
Increased size of large joint effusion. Cortical irregularity involving the
lateral aspect of the distal femur is suspicious for osteomyelitis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594198", "visit_id": "25696734", "time": "2142-09-29 10:17:00"} | 1,604,837 |
Description: 19594198-RR-29Abstract: ## INDICATION:
year old man with 54cm left SL heparin dependent PICC.
// 54cm left SL heparin dependent PICC. Contact name:
:
## FINDINGS:
Compared with the prior study, a new left subclavian PICC line has been
placed. Allowing for lordotic positioning, the tip overlies the right atrium.
No obvious pneumothorax detected. No CHF, focal infiltrate or effusion is
detected. Retrocardiac atelectasis is similar to the prior film.
## IMPRESSION:
PICC line tip overlying the right atrium. Clinical correlation is requested.
Retraction by approximately 4.4 cm could help to position in the distal SVC.
## RECOMMENDATION(S):
PICC line tip overlying the right atrium. Clinical
correlation is requested. Retraction by approximately 4.4 cm of the to
position in the distal SVC.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594198", "visit_id": "25696734", "time": "2142-09-30 11:57:00"} | 1,604,838 |
Description: 19594228-RR-10Abstract: ## INDICATION:
Patient with abdominal pain, and vomiting.
## CT OF THE ABDOMEN:
Lung bases are clear without discrete lesions or pleural effusions. Heart
size is normal without pericardial effusion. Small hiatal hernia is noted.
Liver enhances homogeneously without discrete lesions. There is no evidence
of intrahepatic or extrahepatic biliary duct dilatation. The hepatic
vasculature is patent. Gallbladder is incompletely distended. There is no
gallbladder wall thickening or pericholecystic fluid collections to suggest
acute inflammation. There are no calcified gallstones within its lumen. The
spleen is unremarkable. The pancreas enhances homogeneously without ductal
dilatation or peripancreatic fluid collection. The adrenal glands are normal.
The kidneys enhance and excrete contrast symmetrically without hydronephrosis
or renal masses.
The imaged small and large bowel loops are normal in caliber. There is no
evidence of bowel wall thickening or bowel obstruction. The appendix is
visualized and is normal. There is a cluster of lymph nodes in the right
lower abdomen, measuring up to 9 mm in short axis (301B:23), which appears
slightly more conspicuous compared to the prior exam. There is no free air or
free fluid within the abdomen. The intra-abdominal aorta and its branches are
normal in caliber and appear patent.
## CT OF THE PELVIS:
Bladder, prostate gland, rectum and sigmoid colon are unremarkable. There are
no pathologically enlarged pelvic or inguinal lymph nodes. There is no free
air or free fluid within the pelvis.
## OSSEOUS STRUCTURES:
No suspicious lytic or sclerotic lesion is seen.
## IMPRESSION:
1. Cluster of ileocecal lymph nodes in the right lower abdomen are prominent
in size, which may represent mesenteric adenitis. The above findings are
slightly more conspicuous from exam.
2. Normal appendix.
3. Small hiatal hernia.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594228", "visit_id": "N/A", "time": "2165-12-27 21:46:00"} | 1,604,839 |
Description: 19594228-RR-12Abstract: ## INDICATION:
male with bloody diarrhea, protracted vomiting and
abdominal pain. Evaluate for colitis or Crohn's disease.
## MR ENTEROGRAPHY:
Oral contrast reaches the large bowel beyond the ileocecal
valve. The small bowel is normal in caliber and mural fold pattern. There is
no wall thickening, stricture, abnormal enhancement, or extraintestinal
findings. Mesenteric nodes are noted in the right lower quadrant, similar to
the prior CT, measuring up to 11 mm.
## MRI ABDOMEN:
The liver, gallbladder, adrenal glands, kidneys and spleen are
normal. There is no intra- or extra-hepatic bile duct dilation. The pancreas
is normal in signal intensity without abnormal enhancement or peripancreatic
fluid collection.
## MRI PELVIS:
The urinary bladder, distal ureters, prostate, sigmoid colon and
rectum are normal. There is no pelvic or inguinal lymphadenopathy. There is
no free fluid in the pelvis.
Bone marrow signal is normal.
## IMPRESSION:
1. No evidence of colitis or Crohn's disease.
2. Unchanged right lower quadrant mesenteric lymph nodes suggests mesenteric
adenitis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594228", "visit_id": "28931634", "time": "2165-12-31 12:34:00"} | 1,604,840 |
Description: 19594228-RR-13Abstract: ## HISTORY:
Right index finger injury.
## FINDINGS:
Mildly displaced fracture of the volar aspect of the base of the middle
phalanx of the index finger with intra-articular extension to the PIP joint is
noted. No dislocation is identified. Bone mineralization is normal. Joint
spaces are preserved. No radiopaque foreign body is seen. No focal lytic,
sclerotic, or erosive changes are seen present.
## IMPRESSION:
Mildly displaced fracture of the volar aspect of the base of the middle
phalanx of the index finger compatible with a volar plate fracture.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594228", "visit_id": "N/A", "time": "2166-09-20 15:50:00"} | 1,604,841 |
Description: 19594228-RR-14Abstract: ## HISTORY:
Right index finger fx. Review of OMR indicates hyperextension injury
to the PIP joint
RIGHT INDEX FINGER, THREE VIEWS.
No clinical detail is available. Possible mild soft tissue swelling adjacent
to the PIP joint. On the lateral view, a slightly distracted 2.3 mm volar
plate fracture fragment is noted arising from the base of the middle phalanx,
with fx extending to the articular surface at the PIP joint. The lateral view
also raises the question of a small (1.8 mm) bone fragment or exostosis along
the dorsal surface of the distal portion of the distal phalanx.
The appearance is similar to the radiographs dated .
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594228", "visit_id": "N/A", "time": "2166-09-30 09:38:00"} | 1,604,842 |
Description: 19594228-RR-16Abstract: ## HISTORY:
Right small finger fracture.
FINGER, VWS
Although the requisition refers to the right small finger, the technologist
has labeled this as the second digit. Hand films dated were of the
right index finger. The prior films showed a small fracture fragment adjacent
to the volar base of the middle phalanx of the index finger.
On today's exam, there is a small fracture at the volar base of the middle
phalanx of the imaged finger, non-displaced, but possibly slightly distracted
superiorly. Allowing for differences in positioning, I doubt significant
interval change in alignment. There is mild surrounding soft tissue swelling.
No aggressive osteolysis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594228", "visit_id": "N/A", "time": "2166-11-11 09:48:00"} | 1,604,843 |
Description: 19594228-RR-8Abstract: ## INDICATION:
male with acute onset nausea, vomiting, and
epigastric pain. Question pancreatitis, cholecystitis or intussusception.
## CT ABDOMEN:
The lung bases are clear without pleural effusion. The heart is
normal in size without pericardial effusion. The liver, gallbladder, spleen,
pancreas, and adrenal glands appear unremarkable. Bilateral kidneys enhance
symmetrically without hydronephrosis or hydroureter. Small and large bowel
loops are normal in caliber. There is no free air or free fluid. The
appendix appears normal. Mildly prominent right lower quadrant lymph nodes
could be reactive.
## CT PELVIS:
The bladder, distal ureters, rectum, and prostate appear
unremarkable. There is no inguinal or pelvic lymphadenopathy. There is no
free fluid within the pelvis.
## BONE WINDOWS:
Osseous structures are intact without suspicious focal lytic or
blastic lesions.
## IMPRESSION:
No acute intra-abdominal or pelvic process.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594228", "visit_id": "N/A", "time": "2164-06-26 20:03:00"} | 1,604,844 |
Description: 19594228-RR-9Abstract: CT OF THE ABDOMEN AND PELVIS WITH IV CONTRAST
## INDICATION:
man with abdominal pain, weight loss, nausea,
vomiting, fullness in the right lower quadrant. Evaluate for evidence of
obstruction, Crohn's disease.
CT OF THE ABDOMEN AND PELVIS WITH IV CONTRAST
## IMPRESSION:
No etiology for the patient's pain identified. No evidence of
Crohn's disease or obstruction.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594228", "visit_id": "N/A", "time": "2165-11-20 08:02:00"} | 1,604,845 |
Description: 19594281-RR-4Abstract: ## INDICATION:
man with sudden-onset left upper quadrant pain.
## FINDINGS:
Limited view of lung bases is clear. There is no pleural effusion.
Liver enhances homogeneously without focal lesions. There is no biliary
dilatation. Portal vein is patent. Gallbladder, spleen, pancreas, adrenal
glands, and bilateral kidneys are within normal limits. Stomach is
unremarkable. Loops of small bowel are normal in course and caliber. There
is no obstruction. Colon is within normal limits. There is no mesenteric or
retroperitoneal lymphadenopathy. There is no intra-abdominal free air or
fluid.
The bladder is moderately distended and appears normal. Seminal vesicles and
prostate are unremarkable. There is no pelvic free fluid or lymphadenopathy.
No bony abnormality is identified.
## IMPRESSION:
No acute intra-abdominal process.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594281", "visit_id": "N/A", "time": "2135-01-19 03:45:00"} | 1,604,846 |
Description: 19594281-RR-7Abstract: ## INDICATION:
Status post fall with bruising over left eye, nausea and
vomiting, evaluate for intracranial hemorrhage.
## FINDINGS:
There is no evidence of hemorrhage, edema, mass effect, or large territorial
infarction. The ventricles and sulci are normal in size and configuration.The
basal cisterns appear patent and there is preservation of gray-white matter
differentiation.
No fracture is identified. The visualized paranasal sinuses, mastoid air
cells, and middle ear cavities are clear.
## IMPRESSION:
No evidence of acute intracranial process.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594281", "visit_id": "N/A", "time": "2135-10-06 22:03:00"} | 1,604,847 |
Description: 19594394-RR-13Abstract: CT OF THE ABDOMEN AND PELVIS WITH CONTRAST,
## INDICATION:
female with diffuse abdominal pain, worse in the
periumbilical region.
## ABDOMEN:
Liver, spleen, pancreas, adrenals, and gallbladder are unremarkable.
Aside from a few scattered hypodensities within the kidneys, which are too
small to be characterized, there is no distinct renal abnormality. There is
no hydronephrosis, and the renal parenchyma enhances symmetrically.
Stomach, small bowel, and colon are normal in appearance.
## PELVIS:
Rectum and sigmoid are within normal limits. The cecum is well
opacified with contrast material. Through the appendix is not definitively
visualized, there is no inflammatory process identified within the right lower
quadrant.
Aorta and its major branches are normal in caliber throughout.
There is no abdominal or pelvic lymphadenopathy by size criteria.
## OSSEOUS STRUCTURES:
There are no suspicious osseous lesions.
Lung bases are clear.
## IMPRESSION:
No acute abnormality identified.
Findings were discussed with Dr. at the time of interpretation.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594394", "visit_id": "N/A", "time": "2129-02-20 14:42:00"} | 1,604,848 |
Description: 19594394-RR-16Abstract: ## HISTORY:
Chronic diarrhea as a child. Worsening abdominal pain. Evaluate
for small-bowel obstruction.
## FINDINGS:
The MR imaging was performed slightly earlier than expected following oral
administration of VoLumen. As such, the ileum is mostly collapsed. However,
there is no definitive area of abnormal bowel enhancement detected. There is
no evidence for a small bowel obstruction. The colon is stool filled,
especially in the right colon.
Ascites is noted, especially in the perihepatic region as well as perisplenic
region. Free fluid is also noted in the pelvis. Physiological follicles are
identified in the ovaries, compatible with patient's age.
The included portions of the liver, spleen, gallbladder, kidneys, and pancreas
appear unremarkable.
The included osseous structures are within normal limits.
Multiplanar 2D and 3D reformations provided multiple perspectives for the
dynamic series.
## IMPRESSION:
1. No suspicious bowel pathology. Of note, the ileum is mostly collapsed at
the time of imaging. However, no suspicious bowel enhancement is seen when
reviewing the MRI in conjunction with the prior CT. If symptoms persist and
there is continued concern for ileal pathology, additional imaging with CT
using VoLumen and IV contrast could be performed. This finding was discussed
with at the time of dictation.
2. Mild ascites.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594394", "visit_id": "29464162", "time": "2129-02-25 09:57:00"} | 1,604,849 |
Description: 19594433-RR-17Abstract: ## INDICATION:
year old man with R wrist pain// R wrist pain
## FINDINGS:
No acute fractures or dislocations are seen.There are mild to moderate
degenerative changes of the distal radioulnar joint and scattered mild
elsewhere in the wrist. There is minimal positive ulnar variance. Subtle
lucency in the proximal ulnar aspect of the lunate as can be seen in ulnar
abutment. Bone mineralization is appropriate for age.
## IMPRESSION:
Mild-to-moderate degenerative changes of the distal radioulnar joint and
findings suggestive of mild ulnar abutment without acute osseous abnormality
seen.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594433", "visit_id": "N/A", "time": "2188-01-10 07:26:00"} | 1,604,850 |
Description: 19594433-RR-19Abstract: ## EXAMINATION:
CT LOW DOSE LUNG SCREENING
## INDICATION:
years old, current smoker, 72 pack years, asymptomatic// CT
Lung Cancer Screening Annual CT Lung Cancer Screening Annual
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 4.8 s, 31.4 cm; CTDIvol = 2.6 mGy (Body) DLP = 80.8
mGy-cm.
Total DLP (Body) = 81 mGy-cm.
## FINDINGS:
Neck, thoracic inlet, axillae:
No abnormality
Breast, chest wall and bones:
No abnormality
## NODULES:
Dominant nodule:
Stable 4.5 minutes right upper lobe pulmonary nodule (6, 73).
Other nodules:
Stables 8 mm right middle lobe pulmonary nodule (5, 143). Stable 3 mm right
middle lobe pulmonary nodule (5, 143). Stable calcified right middle lobe
pulmonary nodule (5, 154).
## PARENCHYMA:
Diffuse peribronchial thickening and interstitial prominence.
Pleura and airways:
Mild airway wall thickening
## IMPRESSION:
Stable pulmonary nodules ranging in size from 4-8 mm. No new pulmonary
nodules
Low lung volumes with prominence of the interstitium which could be related to
bronchitis.
## RECOMMENDATION(S):
Continue low-dose lung cancer screening CT in 12 months
Incidental findings**:
None
Radiology is an ACR accredited CT lung cancer screening site.
**All recommendations regarding incidental findings are based on ACR
guidelines for the management of these findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594433", "visit_id": "N/A", "time": "2188-03-18 10:08:00"} | 1,604,851 |
Description: 19594433-RR-20Abstract: ## INDICATION:
hx of tobacco use, eval aorta // hx of tobacco use, eval aorta
## FINDINGS:
The aorta measures 2.3 cm in the proximal portion, 2.0 cm in mid portion and
1.8 cm in the distal abdominal aorta. There is mild calcified atherosclerotic
plaque.
Wall-to-wall color flow is seen within the aorta with appropriate arterial
waveforms.
The right common iliac artery measures 1.3 cm and the left common iliac artery
measures 1.2 cm.
The right kidney measures 9.6 cm and the left kidney measures 10.3 cm. Limited
views of the kidneys are unremarkable without hydronephrosis.
## IMPRESSION:
Atherosclerotic aorta however no aneurysm visualized.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594433", "visit_id": "N/A", "time": "2189-03-03 08:06:00"} | 1,604,852 |
Description: 19594434-RR-9Abstract: ## INDICATION:
Evaluation of patient with hematuria.
## FINDINGS:
CT OF THE ABDOMEN WITH AND WITHOUT IV CONTRAST:
The visualized lung bases are
clear. The visualized portions of the heart are normal.
The liver, gallbladder, bilateral adrenal glands, bilateral kidneys, spleen,
pancreas, stomach, and visualized loops of small and large bowel are within
normal limits. Of incidental note is the presence of a retroaortic left renal
vein. Incidentally noted is a splenule. Otherwise, no free fluid or free air
throughout the abdomen. No mesenteric or retroperitoneal lymphadenopathy.
The abdominal aorta is normal in caliber and contour.
Both kidneys enhance symmetrically and excrete promptly and are within normal
limits. There is no evidence of hydronephrosis or stones. The ureters are
normal in caliber without calculi.
CT OF THE PELVIS WITH AND WITHOUT IV CONTRAST:
The distal ureters are within
normal limits with bilateral jets seen in the bladder. The bladder is within
normal limits. The prostate, sigmoid colon, and rectum are within normal
limits. No free fluid or free air in the pelvis. No pelvic or inguinal
lymphadenopathy. There is diverticulosis of the sigmoid colon without
diverticulitis.
## OSSEOUS STRUCTURES:
No suspicious lytic or sclerotic osseous lesions.
## IMPRESSION:
No acute intra-abdominal or intrapelvic process. No calculi seen
within the kidneys, ureters, or bladder, and no cause for the patient's
hematuria identified.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594434", "visit_id": "N/A", "time": "2131-04-20 16:53:00"} | 1,604,853 |
Description: 19594478-RR-9Abstract: MRI OF THE PELVIS
## INDICATION:
man with perianal abscess status post I&D x2. Pain
and pressure approximately 2 cm from anal verge and palpable mass. Rule out
acute process.
## FINDINGS:
There is a 2.2 x 1 cm fluid-containing rim-enhancing collection without any
associated fistula in the perineum, approximately 2 cm anterior to the
anterior border of the anus. This most probably represents the lesion
corresponding to patient's area of discomfort.
There is no perianal fistula or abscess. Anus, rectum, bladder and prostate
are unremarkable. There is a small simple hydrocele on the right.
Multiplanar 2D and 3D reformations and subtraction images provided multiple
perspectives for dynamic series (319).
## IMPRESSION:
2.2 x 1 cm collection in the perineum, anterior to the anus, without any
associated fistula.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594478", "visit_id": "N/A", "time": "2184-10-19 17:54:00"} | 1,604,854 |
Description: 19594498-RR-21Abstract: ## EXAMINATION:
MRI THORACIC AND LUMBAR PT6 MR SPINE
## INDICATION:
Muscle atrophy of lower extremity. // year old male lower
back pain and dramatic left quadricep atrophy pls eval. year old male
lower back pain and dramatic left quadricep
## THORACIC SPINE:
Thoracic alignment is anatomic. Minimal anterior wedge
deformity of T12 is unchanged from prior CT examination of with
superior endplate Schmorl's node. There is no associated edema pattern. Disc
heights are maintained. There is no abnormal cord signal.
Mild multilevel degenerative changes including small disc bulges do not result
in significant spinal canal or neural foraminal narrowing.
The visualize prevertebral paraspinal soft tissues are unremarkable.
## LUMBAR SPINE:
Lumbar alignment is anatomic. Vertebral body heights are
preserved. type 2 L4-L5 and L5-S1 endplate changes are identified.
Loss of disc height and signal at L4-L5 and L5-S1 is moderate. Vacuum disc
phenomenon at both these levels are identified. The conus medullaris
terminates at the L1 vertebral level, within expected limits. There is no
signal abnormality of the visualized cord or conus.
## L1-L2 AND L2-L3:
There is no significant spinal canal or neural foraminal
narrowing.
## L3-L4:
A disc bulge results in mild spinal canal narrowing. Prominent
bilateral facet arthropathy is identified. In conjunction with the disc
bulge, this results in mild to moderate bilateral neural foraminal narrowing.
## L4-L5:
A disc bulge with thickening of the ligamentum flavum results in
severe spinal canal narrowing, crowding the cauda equina. Prominent bilateral
facet arthropathy is identified, resulting in moderate to severe bilateral
neural foraminal narrowing.
## L5-S1:
A disc bulge crowds the bilateral subarticular zones contacting the
traversing nerve roots without significantly narrow the spinal canal. In
conjunction with facet arthropathy there is moderate bilateral neural
foraminal narrowing.
The visualize prevertebral and paraspinal soft tissues are unremarkable.
## IMPRESSION:
1. At L4-L5, a large disc bulge and thickening of the ligamentum flavum
results in severe spinal canal narrowing, crowding the cauda equina. In
conjunction with facet arthropathy there is moderate bilateral neural
foraminal narrowing at this level.
2. At L5-S1, a disc bulge crowds the bilateral subarticular zones contacting
the traversing nerve roots. In conjunction with facet arthropathy there is
moderate bilateral neural foraminal narrowing.
3. No significant spinal canal or neural foraminal narrowing of the thoracic
spine.
4. Chronic anterior wedge deformity of T12 with associated superior endplate
Schmorl's node, unchanged from examination of .
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594498", "visit_id": "N/A", "time": "2147-05-28 13:30:00"} | 1,604,855 |
Description: 19594565-RR-10Abstract: ## INDICATION:
year old woman who presented with progressive fatigue and
dyspnea on exertion found to have profound anemia and peripheral blasts,
concerning for high-risk MDS, discussing treatment options with patient, also
ruling out for active TB, now with malpositioned PICC based on CT scan //
eval for PICC placement and pulmonary edema Contact name: ,
## :
eval for PICC placement and pulmonary edema
## IMPRESSION:
Right PICC line tip is at the level of cavoatrial junction. Heart size and
mediastinum are stable. There is interval increase in bilateral pleural
effusions. There is vascular congestion and minimal interstitial pulmonary
which is similar to previous examination. There is no pneumothorax.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "23069063", "time": "2160-08-20 11:01:00"} | 1,604,856 |
Description: 19594565-RR-11Abstract: ## EXAMINATION:
LIVER OR GALLBLADDER US (SINGLE ORGAN)
## INDICATION:
year old woman who presented with progressive fatigue and
dyspnea on exertion found to have profound anemia and peripheral blasts,
concerning for high-risk MDS, discussing treatment options with patient, also
ruling out for active TB, now with elevated LFTs and positive HBcAB // eval
for signs of hepatitis
## LIVER:
The hepatic parenchyma appears coarsened. 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 3 mm.
## GALLBLADDER:
Multiple gallstones are seen within a nondistended gallbladder.
Gallbladder wall measures 0.3 cm.
## 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 7.9 cm.
## KIDNEYS:
Limited views of the right kidney show no hydronephrosis.
## RETROPERITONEUM:
The visualized portions of aorta and IVC are within normal
limits.
## IMPRESSION:
1. Mildly coarsened hepatic parenchyma.
2. Cholelithiasis without cholecystitis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "23069063", "time": "2160-08-20 17:40:00"} | 1,604,857 |
Description: 19594565-RR-13Abstract: ## EXAMINATION:
CHEST (PA AND LAT)
## INDICATION:
with neutropenic fever, please eval for occult pneumonia
## FINDINGS:
Evaluation is slightly limited by patient rotation. Right-sided Port-A-Cath
tip terminates at the SVC/right atrial junction. Mild enlargement of the
cardiac silhouette is unchanged. The aorta remains mildly tortuous with
atherosclerotic calcifications seen at the knob. Pulmonary vasculature is not
engorged. Bilateral pulmonary arterial enlargement is re- demonstrated.
Minimal blunting of the costophrenic angles posteriorly suggests trace
bilateral pleural effusions. Streaky atelectasis is demonstrated in the lung
bases. No focal consolidation or pneumothorax is present. Compression
deformity of a thoracic vertebra at the thoracolumbar junction is unchanged.
Moderate multilevel degenerative changes are again noted in the imaged
thoracic spine.
## IMPRESSION:
Trace bilateral pleural effusions and minimal bibasilar atelectasis. No focal
consolidation to suggest pneumonia.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "28900768", "time": "2160-09-18 20:14:00"} | 1,604,858 |
Description: 19594565-RR-20Abstract: ## EXAMINATION:
ABDOMEN US (COMPLETE STUDY)
## INDICATION:
year old woman with chronic hepatitis B// screening for HCC.
## LIVER:
The liver is mildly coarsened. 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 5 mm.
## GALLBLADDER:
Cholelithiasis without gallbladder wall thickening.
## PANCREAS:
The head and body of the pancreas are within normal limits. The tail
of the pancreas is not visualized due to the presence of gas.
## SPLEEN:
Normal echogenicity, measuring 7.7 cm.
## KIDNEYS:
Limited views of the right kidney show no hydronephrosis.
## RETROPERITONEUM:
The visualized portions of aorta and IVC are within normal
limits.
## IMPRESSION:
Coarsened liver with no suspicious hepatic lesions, splenomegaly or ascites.
Cholelithiasis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "N/A", "time": "2161-05-23 12:27:00"} | 1,604,859 |
Description: 19594565-RR-21Abstract: ## EXAMINATION:
CT pelvis and bilateral lower extremity.
## INDICATION:
year old woman with AML on chemotherapy who has acute pain in
the RLE// assess for hematoma or alternative cause of leg pain. Not overly
concerned for DVT which slightly lateral and superficial.
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 15.8 s, 68.5 cm; CTDIvol = 9.4 mGy (Body) DLP = 637.6
mGy-cm.
Total DLP (Body) = 638 mGy-cm.
## PELVIS:
The partially visualized small and large bowel are unremarkable. The
urinary bladder and distal ureters are unremarkable. There is no free fluid in
the pelvis.
## REPRODUCTIVE ORGANS:
The uterus and bilateral adnexae are within normal
limits.
## LYMPH NODES:
There is no pelvic or inguinal lymphadenopathy.
## VASCULAR:
Moderate atherosclerotic disease is noted.
BILATERAL LOWER EXTREMITIES TO THE KNEES:
## BONES:
There is no evidence of worrisome osseous lesions or acute fracture.
There is degenerative changes of bilateral sacroiliac joints with the vacuum
phenomenon.
## MUSCLE:
There is fatty atrophy of the bilateral gluteus maximus, right greater
than left tensor fascia muscles. In addition there is also fatty atrophy
of the right semitendinosus, biceps femoris long head, medial gastrocnemius,
and more inferolateral portions of the lateral gastrocnemius muscle. The
remaining portions of the right calf were not included in field of view.
There is asymmetric atrophy of the left psoas muscle (series 3, image 5).
There is no adjacent stranding.
No fatty atrophy in the left lower extremity was noted on the axial views.
## SOFT TISSUES:
No evidence of hematoma or fluid collection are noted in the
right lower extremity. No subcutaneous edema.
## JOINTS:
There is no joint effusion bilaterally.
## IMPRESSION:
1. No evidence of hematoma or fluid collections noted in the right lower
extremity down to the knees. However there is extensive fatty atrophy of the
muscles in the right lower extremity, not seen in the left, as detailed above.
2. No CT findings directly correlating to the reported history of right lower
extremity pain.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "22068112", "time": "2161-08-21 10:46:00"} | 1,604,860 |
Description: 19594565-RR-22Abstract: ## EXAMINATION:
UNILAT LOWER EXT VEINS RIGHT
## INDICATION:
year old woman with right thigh pain// please evaluate for
BOTH hematoma as well as for DVT of right leg
## FINDINGS:
There is normal compressibility, flow, and augmentation of the right common
femoral, femoral, and popliteal veins. Normal color flow and compressibility
are demonstrated in the posterior tibial and peroneal veins.
There is normal respiratory variation in the common femoral veins bilaterally.
There is a 2.1 cm medial popliteal fossa ( ) cyst.
The area of pain in the right lateral thigh was imaged. No sonographic
abnormalities were detected. No focal fluid collections are seen.
## IMPRESSION:
1. No evidence of deep venous thrombosis in the right lower extremity veins.
2. No focal fluid collections or other abnormalities in the area of pain in
the right lateral thigh on sonographic imaging.
3. 2.1 cyst.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "22068112", "time": "2161-08-20 15:53:00"} | 1,604,861 |
Description: 19594565-RR-23Abstract: ## EXAMINATION:
MRI MSK PELVIS CONTRAST; MR THIGH CONTRAST RIGHT
## INDICATION:
year old woman with MDS and right leg/hip pain/weakness.//
Evaluate for cause of right leg/hip pain/weakness and further evaluate atrophy
seen on CT as well as if atrophy is unilateral or bilateral.
## BONE:
There is diffuse marrow signal abnormality throughout the visualized
osseous structures of the pelvis and lumbar spine with diffuse stippled and
serpiginous T1 marrow signal abnormality which is Iso to hypointense on T1 and
STIR hyperintense with mild enhancement. No definite fractures are
identified. There are mild degenerative changes of the bilateral hips.
Degenerative changes of the visualized lower lumbar spine.
The stippled and serpiginous marrow signal abnormalities as described above
are seen throughout the bilateral femurs. In addition, there is an area of
more confluent T1 isointense and STIR hyperintense signal filling the majority
of the medullary cavity of the mid to distal femoral diaphysis, measuring
approximately 7.6 cm in cranial to caudal with less discrete superior and
inferior margins. This area demonstrates intramedullary enhancement as well
as enhancing circumferential periosteal edema and surrounding moderate
enhancing muscle edema of the vastus intermedius muscle and slightly of the
distal posterior lateral aspect of the vastus medialis muscle. No definite
endosteal scalloping is seen.
## SOFT TISSUES:
There is mild asymmetric fatty atrophy of the proximal left psoas muscle
(image 3:2). There is slightly asymmetric mild fatty atrophy of the right
tensor fascia . There is mild-to-moderate fatty atrophy of the long head
of the right biceps femoris and mild fatty atrophy of the proximal portion of
the right semitendinosis muscle.
Within the pelvis there is a 2.2 x 1.9 cm T2 hyperintense, T1 hypointense,
nonenhancing ovoid lesion superior to the uterus and anterior to the sacrum
most consistent with an adnexal cyst (image 7: 16). A more tubular T2
hyperintense, T1 isointense focus along the right pelvic sidewall adjacent to
the iliopsoas muscle without definite solid enhancement may represent slightly
engorged gonadal veins with or without and adnexal cystic appearing lesion
(image 4: . The more cystic appearing portion on the right measures 2.0
x 1.3 cm (image 4:16).
Small cyst along the anterior inferior aspect of the left acetabulum measuring
8 mm and may represent a small ganglion (image 04:30).
## IMPRESSION:
Aggressive appearing marrow replacing process of the mid to distal right
femoral diaphysis with surrounding periosteal reaction and muscle edema and
enhancement is concerning for an aggressive neoplastic process or infection.
Neoplastic considerations include an aggressive hematologic process given
patient's known myelodysplastic disorder, however the process of the right
femoral diaphysis appears different than the background appearance of the
patient's underlying disease. Metastatic disease or primary osseous neoplasm
would be considered less likely.
Diffuse stippled and serpiginous marrow signal abnormality of the visualized
pelvis, lumbar spine, and bilateral legs is most likely due to patient's
underlying myelodysplastic syndrome.
Likely bilateral adnexal cysts are incompletely characterized. Ultrasound
would be required for complete evaluation if clinically warranted.
## RECOMMENDATIONS:
Tissue sampling of the right femur could be considered for diagnosis purposes
if clinically warranted. This should be followed with subsequent MR imaging.
## NOTIFICATION:
The findings were discussed with M.D. by
, M.D. on the telephone on at 5:09 pm, 20 minutes after
discovery of the findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "22068112", "time": "2161-08-22 13:37:00"} | 1,604,862 |
Description: 19594565-RR-25Abstract: ## INDICATION:
year old woman with MDS and right leg pain with femur lesion
seen on MRI.// Evaluate for fracture in right femur at site of lesion seen on
MRI.
## FINDINGS:
There is some periosteal thickening involving the right femoral cortex at its
mid shaft, best seen on the frogleg view. This corresponds to the abnormality
within the right femur better assessed on the prior MRI. There are no
fractures seen. The femoral cortex appears relatively preserved without areas
of lucency or cortical breakthrough to suggest impending fracture.There are
moderate degenerative changes of the right knee with joint space narrowing and
spurring. Mild degenerative changes the right hip are also present.
## IMPRESSION:
There is some periosteal thickening along the right femoral cortex medially
seen best on the frogleg view. This can correspond to the marrow replacing
abnormalities seen on the recent MRI. There are no radiographic signs for
acute fracture or impending fracture.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "22068112", "time": "2161-08-23 15:47:00"} | 1,604,863 |
Description: 19594565-RR-28Abstract: ## EXAMINATION:
CHEST (PA AND LAT)
## INDICATION:
year old woman with latent TB, new cough. Evaluation for
pneumonia.
## FINDINGS:
Right Port-A-Cath ends at the proximal right atrium. Heart size is normal.
The mediastinal and hilar contours are normal. The pulmonary vasculature is
normal. No focal consolidation. No pleural effusion or pneumothorax is seen.
Calcified nodule in the lower left neck likely represents a calcified lymph
node, as previously demonstrated on CT from and likely related
to prior granulomatous disease. There is an avulsion fracture noted at the
tip of the left scapula.
## IMPRESSION:
No focal consolidation concerning for pneumonia.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "26784658", "time": "2161-10-05 14:10:00"} | 1,604,864 |
Description: 19594565-RR-29Abstract: ## EXAMINATION:
CT NECK W/CONTRAST (EG:PAROTIDS) Q22 CT NECK
## INDICATION:
year old woman with AML who presents with right cheek swelling
and erythema.// Evaluate for skin/soft tissue infection, parotitis,
lymphadenopathy.
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 3.8 s, 29.8 cm; CTDIvol = 8.2 mGy (Body) DLP = 243.8
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) = 261 mGy-cm.
## FINDINGS:
Extensive right facial fat stranding and platysmal thickening extending into
the anterior superior right neck with skin thickening is demonstrated. No
fluid collection identified. No definite periapical lucency. The deep neck
space fat planes, including the submandibular and masticator spaces, are
preserved.
Evaluation of the aerodigestive tract demonstrates no mass and no areas of
focal mass effect. There are multiple bilateral palatine tonsilliths.
The salivary glands enhance normally. No sialoliths. The thyroid gland
appears normal.A right level IB lymph node measures 1.4 cm and long axis
dimension, presumably reactive from the adjacent inflammatory process.
Calcified cervical lymph nodes presumably reflect prior granulomatous disease.
The neck vessels are patent.
The imaged portion of the lung apices are clear and there are no concerning
pulmonary nodules. The imaged thoracic aorta is top normal in caliber. There
are no concerning osseous lesions. Remote left first rib fracture is again
seen. Imaged aspect of the right globe demonstrates an elongated ovoid
appearance compatible with a staphyloma.
## IMPRESSION:
1. Right facial inflammation extending into the right anterior superior neck.
The deep neck space fat planes are preserved. No fluid collection.
2. No definite periapical lucency to suggest an odontogenic source. No
sialadenitis.
3. Unchanged bilateral calcified cervical lymph nodes which presumably reflect
prior granulomatous disease.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "20859244", "time": "2161-10-28 20:05:00"} | 1,604,865 |
Description: 19594565-RR-32Abstract: ## EXAMINATION:
HIP (UNILAT 2 VIEW) W/PELVIS (1 VIEW) LEFT
## INDICATION:
year old woman with refractory AML transformed from MDS who
presents with new left hip and thigh pain and swelling.// year old woman
with AML who presents with new left hip and thigh pain and swelling.
## FINDINGS:
There is mild spurring along the left acetabulum, without other evidence of
left hip degenerative change. No fracture of the left proximal femur/left hip
is detected. No obvious lytic or sclerotic lesion is detected involving the
left proximal femur.
A few small ossifications are noted in the soft tissues along the lateral
aspect of the left iliac crest. Because the extreme lateral edge of the iliac
crest is not included on these views, the possibility of small avulsed
fragments of bone from the left iliac crest cannot be excluded. Small foci of
heterotopic ossification could have a similar appearance. Otherwise, the left
iliac crest is within normal limits radiographically.
Limited assessment the right hip on AP view the pelvis shows degenerative
spurring about the hip, slightly more pronounced than on the left side.
Probable heterotopic ossification overlying the soft tissues adjacent to the
left lesser trochanter.
Pelvic girdle remains congruent. Allowing for overlying bowel gas, no obvious
lytic or sclerotic foci are noted. However, MRI from showed
multiple signal abnormalities about the bones of the pelvic girdle that are
not readily apparent radiographically. Probable dystrophic calcification
overlying the right sacral ala.
At the edge of these films, there advanced degenerative changes lower lumbar
spine, not fully evaluated on this examination.
## IMPRESSION:
The patient has diffuse marrow signal abnormality on the MRI,
that is not apparent radiographically. In this context, no obvious lytic or
sclerotic lesion is detected involving the left hip. No fracture or
dislocation is seen. Mild left hip osteoarthritis is noted.
Limited assessment of the right hip also shows mild osteoarthritis.
Small foci of ossification noted in the soft tissues adjacent the left iliac
crest--question heterotopic ossification versus small avulsed fragments of
bone. No definite donor site, though this assessment is somewhat limited by
exclusion of the extreme lateral upper edge of the iliac crest the
field-of-view for these radiographs.
Advanced degenerative changes lower lumbar spine, not fully evaluated on this
exam.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "N/A", "time": "2161-11-07 12:31:00"} | 1,604,866 |
Description: 19594565-RR-34Abstract: ## EXAMINATION:
MRI MSK PELVIS WANDW/O CONTRAST
## INDICATION:
year old woman with refractory AML transformed from MDS who
presents with new left hip and thigh pain and swelling.
## FINDINGS:
Please note the study is mildly degraded by motion.
There is diffuse T1 hypointensity in the bone marrow with relative sparing of
the greater trochanters, with intramedullary contrast-enhancement, much more
extensive than the low T1 signal seen on the MRI from . A few
scattered areas of bone marrow which drop in signal on out of phase images are
compatible with red marrow conversion, but most of the abnormal T1 hypointense
bone marrow does not drop in signal, concerning for leukemic infiltration.
Surrounding the imaged portion of the left femur, extending to the imaged
extent of the distal third of the femur, there is a thin rim of soft tissue
edema and enhancement, immediately about the periphery of the cortex, which
was not seen on . No fluid collection or soft tissue
enhancement further from the bone. This abnormality extends beyond the
inferior edge of these images in appears slightly more pronounced than on the
prior study..
Mild asymmetric fatty atrophy of the proximal left psoas muscle is again seen.
Mild bilateral acetabular spurring is again seen. 9 mm cyst along the
anterior left acetabulum (05:29) is unchanged since prior when measured
similarly.
Approximately 1.9 cm left adnexal cystic lesion (06:21) is unchanged since when measured similarly. Tubular T2 hyperintense structure
along the right pelvic sidewall with an associated cystic structure measuring
1.4 cm is also stable since prior. Limited assessment of intra-pelvic soft
tissue structures is otherwise grossly unremarkable. No gross intrapelvic
fluid or enlarged intrapelvic lymph nodes detected.
## IMPRESSION:
1. Interval progression of diffuse marrow infiltration (low T1 marrow signal
and marrow enhancement) in the imaged pelvis and proximal femurs is concerning
for worsening involvement of AML. Marked progression of red marrow
reconversion is considered less likely given findings on the out-of-phase
images.
2. Thin rim of soft tissue edema and enhancement surrounding the imaged left
femur (extending beyond the inferior edge of these images) is slightly more
pronounced than in . This is non-specific, of uncertain etiology
or significance.. The differential includes changes secondary to neoplastic
involvement. Inflammatory and infectious areas might also account for this
appearance but are considered less likely. Early bone infarct could also have
a similar appearance. (Soft tissue changes in the left thigh are seen only
immediately abutting the femur, without findings to suggest more extensive
soft tissue involvement.)
3. Right femoral marrow edema and surrounding muscle edema have improved
compared to .
4. Please note that the vasculature is not effectively evaluated on this non
angiographic study.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "N/A", "time": "2161-11-12 09:13:00"} | 1,604,867 |
Description: 19594565-RR-35Abstract: ## EXAMINATION:
UNILAT LOWER EXT VEINS
## INDICATION:
year old woman with AML, now with right lower extremity
swelling, ? DVT// year old woman with AML, now with right lower extremity
swelling, ? DVT
## FINDINGS:
There is normal compressibility, flow, and augmentation of the right common
femoral, femoral, and popliteal veins. Normal color flow and compressibility
are demonstrated in the tibial and peroneal veins.
There is normal respiratory variation in the common femoral veins bilaterally.
A 1.1 x 4 x 0.6 cm fluid collection is seen in the right popliteal fossa,
consistent with cyst.
Subcutaneous edema is seen in the right calf.
## IMPRESSION:
1. No evidence of deep venous thrombosis in the right lower extremity veins.
2. 4 cm right cyst.
## NOTIFICATION:
The findings were discussed with , M.D. by
, M.D. on the telephone on at 5:06 pm, 2 minutes
after discovery of the findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "N/A", "time": "2161-11-10 16:20:00"} | 1,604,868 |
Description: 19594565-RR-36Abstract: ## EXAMINATION:
BILAT LOWER EXT VEINS
## INDICATION:
year old woman with AML, here with worsening edema, R>L but
bilateral. significant interval worsening over past 1 day. please rule out
DVT.// rule out DVT
## FINDINGS:
There is normal compressibility, flow, and augmentation of the bilateral
common femoral, femoral, and popliteal veins. Normal color flow and
compressibility are demonstrated in the tibial and peroneal veins.
There is normal respiratory variation in the common femoral veins bilaterally.
In the right popliteal fossa there is a fluid collection that measures 2.3 x
1.8 x 0.7 cm consistent with cyst. There is soft tissue edema in the
right calf.
## IMPRESSION:
1. No evidence of deep venous thrombosis in the right or left lower extremity
veins.
2. Right cyst which measures 2.3 cm in length.
3. Soft tissue edema in the right calf.
## NOTIFICATION:
The findings were discussed with , M.D. by
, M.D. on the telephone on at 2:45 pm.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "N/A", "time": "2161-11-12 13:59:00"} | 1,604,869 |
Description: 19594565-RR-40Abstract: ## EXAMINATION:
CTA CHEST WITH CONTRAST
## INDICATION:
year old woman with refractory AML with new onset chest pain
and tachycardia, evaluate for PE.
## DOSE:
Acquisition sequence:
1) Sequenced Acquisition 0.5 s, 0.2 cm; CTDIvol = 7.2 mGy (Body) DLP = 1.4
mGy-cm.
2) Stationary Acquisition 0.8 s, 0.2 cm; CTDIvol = 7.0 mGy (Body) DLP = 1.4
mGy-cm.
3) Spiral Acquisition 4.6 s, 29.9 cm; CTDIvol = 5.7 mGy (Body) DLP = 167.4
mGy-cm.
Total DLP (Body) = 170 mGy-cm.
## HEART AND VASCULATURE:
Pulmonary vasculature is well opacified to the
subsegmental level without filling defect to indicate a pulmonary embolus. The
thoracic aorta is normal in caliber without evidence of dissection or
intramural hematoma. There is calcification of the mitral annulus. The
heart, pericardium, and great vessels are otherwise within normal limits. No
pericardial effusion is seen.
## AXILLA, HILA, AND MEDIASTINUM:
No axillary, mediastinal, or hilar
lymphadenopathy is present. No mediastinal mass.
## PLEURAL SPACES:
No pleural effusion or pneumothorax.
## LUNGS/AIRWAYS:
Lungs are clear without masses or areas of parenchymal
opacification. There is dependent atelectasis bilaterally. Scattered small
granulomas suggest prior granulomatous disease. The airways are patent to the
level of the segmental bronchi bilaterally.
## BASE OF NECK:
Visualized portions of the base of the neck show no abnormality.
## ABDOMEN:
Included portion of the upper abdomen is unremarkable.
## BONES:
No suspicious osseous abnormality is seen.? There is no acute fracture.
A chronic compression deformity of T12 with approximately 5 mm retropulsion is
grossly similar to the prior study. There is diffuse bridging osteophyte
formation along the right aspect of the vertebral bodies.
## IMPRESSION:
1. No evidence of pulmonary embolism or aortic abnormality.
2. No consolidations to suggest acute infection.
3. Unchanged chronic compression deformity of T12.
4. Diffuse idiopathic skeletal hyperostosis is noted.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "28323458", "time": "2161-11-23 13:58:00"} | 1,604,870 |
Description: 19594565-RR-42Abstract: ## EXAMINATION:
CT scan of the abdomen pelvis with intravenous contrast
## INDICATION:
year old woman with advanced AML and new fever and vomiting on
broad antibiotics.// Please eval for intra-abdominal infection or evidence of
obstruction
## 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 not administered.
Coronal and sagittal reformations were performed and reviewed on PACS.
## DOSE:
Acquisition sequence:
1) Sequenced Acquisition 0.5 s, 0.4 cm; CTDIvol = 4.8 mGy (Body) DLP = 1.9
mGy-cm.
2) Stationary Acquisition 0.9 s, 0.2 cm; CTDIvol = 11.4 mGy (Body) DLP =
2.3 mGy-cm.
3) Spiral Acquisition 8.6 s, 45.4 cm; CTDIvol = 10.7 mGy (Body) DLP = 491.0
mGy-cm.
Total DLP (Body) = 495 mGy-cm.
## LOWER CHEST:
The lung bases are clear. No pleural or pericardial effusion.
## HEPATOBILIARY:
The liver is unremarkable. Focal fatty infiltration adjacent
to the falciform ligament. No suspicious liver mass. The common bile duct is
prominent measuring up to 7 mm. The gallbladder is unremarkable.
## 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. 9 mm accessory splenic tissue adjacent to the
splenic hilum.
## ADRENALS:
The right and left adrenal glands are normal in size and shape.
## URINARY:
The kidneys are unremarkable. Subcentimeter renal cortical
hypodensities are too small to characterize but likely represent small cysts.
No hydronephrosis. There is no perinephric abnormality.
## GASTROINTESTINAL:
Small sliding-type hiatus hernia. The small and large bowel
are normal in caliber. Small bowel loops demonstrate normal caliber, wall
thickness, and enhancement throughout. The appendix is normal.
## PELVIS:
The bladder is only partially filled but appears grossly unremarkable.
There is no free fluid in the pelvis.
## REPRODUCTIVE ORGANS:
The uterus and adnexae are unremarkable.
## LYMPH NODES:
There is no retroperitoneal or mesenteric lymphadenopathy. There
is no pelvic or inguinal lymphadenopathy.
## VASCULAR:
There is no abdominal aortic aneurysm. Mild atherosclerotic disease
is noted.
## BONES:
Moderate compression deformity of the T12 vertebral body is stable
dating back to .
## SOFT TISSUES:
The abdominal and pelvic wall is within normal limits.
## IMPRESSION:
Unremarkable study. No explanation for the patient's symptoms is identified.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "28323458", "time": "2161-11-25 17:47:00"} | 1,604,871 |
Description: 19594565-RR-44Abstract: ## EXAMINATION:
MRI THORACIC AND LUMBAR PT6 MR SPINE
## HISTORY:
with known progressing AML, marrow infiltration of
the pelvic bones, presenting from home with fevers (ongoing issues), and new
left leg weakness IV contrast to be given at radiologist discretion as
clinically needed// presumed acute left leg weakness
## THORACIC:
There is diffuse decrease in thoracic bone marrow signal intensity in keeping
with history of AML and marrow infiltration. There is no compromise of the
thoracic cord in the spinal canal. No abnormal cord signal intensity.
Facet joint osteophyte result in moderate left T1-2 and mild left T2-3 neural
foraminal stenosis.
Chronic wedge type compression deformity of the T12 vertebral body appear
similar compared to prior CT chest done . Bony fragment
protrudes into the spinal canal by 5 mm, partially effacing the CSF space
anterior to the cord, but there is no cord deformation or cord compromise.
No high-grade thoracic neural foraminal stenosis at any other level.
## LUMBAR:
There is diffuse decrease in lumbar bone marrow signal intensity in keeping
with history of AML and marrow infiltration.
The conus terminates at the L1 level.
There is mild moderate multilevel degenerative changes of lumbar spine in the
form of disc desiccation, broad-based disc protrusion/bulge, facet joint
osteophytosis and ligamentum flavum hypertrophy as described below:
## L1-2:
Small central disc protrusion with superior migration, but no nerve root
compromise. Moderate right neural foraminal narrowing. The left neural
foramina is patent.
## L2-3:
There is bilateral articular joint facet hypertrophy, more significant
on the right with a sclerotic changes, causing moderate right-sided neural
foraminal narrowing..
## L3-4:
Mild diffuse disc bulge, bilateral articular joint facet hypertrophy
causes mild bilateral neural foraminal narrowing with no significant spinal
canal stenosis.
## L4-5:
Diffuse disc bulge causes anterior thecal sac deformity, contacting the
traversing nerve roots bilaterally, moderate articular joint facet hypertrophy
ligamentum flavum thickening are present resulting in moderate spinal canal
stenosis (image 16, series 17).
## L5-S1:
There is diffuse disc bulge, causing minimal bilateral neural foraminal
narrowing, slightly more pronounced on the left, moderate articular joint
facet hypertrophy is present. There is mild narrowing of the sacroiliac joint
space suggesting a sclerotic and degenerative changes.
## IMPRESSION:
1. Diffuse decrease in bone marrow signal intensity in keeping with history of
AML and marrow infiltration.
2. No evidence of epidural or paraspinal collections.
3. Chronic wedge type compression deformity of T12 appear similar compared to
prior imaging.
4. There is no evidence of thoracic spinal cord signal abnormality.
5. Multilevel, multifactorial degenerative changes throughout the lumbar
spine, more significant from L3-L4 through L5-S1 levels.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "21779010", "time": "2161-12-03 18:24:00"} | 1,604,872 |
Description: 19594565-RR-6Abstract: ## INDICATION:
year old woman who presented with progressive fatigue and
dyspnea on exertion found to have profound anemia and peripheral blasts,
concerning for MDS versus possible AML vs AMPL, with the latter suggested by
the possible Auer rods seen at . She is now transferred to for
further elucidation and treatment of this bone marrow process. // Shortness
of breath, ? intrapulmonary process Shortness of breath, ? intrapulmonary
process
## IMPRESSION:
Cardiomegaly is substantial. Pulmonary edema is interstitial, moderate.
Small pleural effusion, left more than right is demonstrated.
Diffuse infectious process in the lungs is a possibility that might be at
least in part obscured by pulmonary edema. Further assessment with chest CT
would be beneficial.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "23069063", "time": "2160-08-14 11:05:00"} | 1,604,873 |
Description: 19594565-RR-7Abstract: ## EXAMINATION:
CT CHEST W/O CONTRAST
## INDICATION:
year old woman with MDS concerning for AML vs APL, having
shortness of breath with possible consolidations vs edema seen on CXR. Assess
for effusions vs pneumonia
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 6.6 s, 34.9 cm; CTDIvol = 7.1 mGy (Body) DLP = 249.0
mGy-cm.
Total DLP (Body) = 249 mGy-cm.
## FINDINGS:
NECK, THORACIC INLET, AXILLAE, CHEST WALL:
Thyroid is normal. Supraclavicular
and axillary lymph nodes are nonenlarged.
## UPPER ABDOMEN:
Visualized solid organs are unremarkable.
## MEDIASTINUM:
Multiple calcified mediastinal lymph nodes are consistent with
prior granulomatous exposure. Upper paratracheal lymph nodes are noted
largest measuring 1.7 cm (02:21). No anterior mediastinal mass or hematoma.
## HILA:
Hilar lymph nodes are nonenlarged. Multiple punctate calcifications
are consistent with prior granulomatous exposure.
## HEART AND PERICARDIUM:
Heart is mildly enlarged. No pericardial effusion.
Mild aortic valve and mitral annular calcifications are present. Mild
atherosclerotic calcifications present. Ascending aorta is normal in caliber
without aneurysmal dilatation.
## PLEURA:
Small bilateral non hemorrhagic pleural effusions are noted. No
pleural calcifications or irregular pleural thickening. No pneumothorax. No
loculations.
## -PARENCHYMA:
Minimal interlobular septal thickening with mild thickening of
bilateral major fissures. Mild lingular and bibasilar atelectasis is noted.
No consolidation. Right apical pleuroparenchymal scarring is mild. 0.5 x 0.3
cm left upper lobe lesion is noted (04:57). 0.3 cm triangular-shaped left
perifissural nodule is consistent with lymphoid aggregate. Subcentimeter
calcified granulomas, largest measuring 0.9 cm in the right middle lobe.
-AIRWAYS: The airways are patent to the subsegmental level. No
bronchiectasis or bronchial wall thickening.
-VESSELS: The main pulmonary artery is mildly dilated.
## CHEST CAGE:
Visualized soft tissues are notable for diffuse anasarca and
otherwise unremarkable. No focal lytic or blastic lesions worrisome for
malignancy. No acute fracture. 0.5 cm densely sclerotic posterior fifth rib
lesion is consistent with a bone island. Moderate degenerative changes
thoracic spine with anterior osteophytes endplate sclerosis and disc space
narrowing. There is a superior endplate compression fracture of T10 with 0.4
cm retropulsion.
## IMPRESSION:
1. Mild pulmonary edema with small bilateral pleural effusions, mild
cardiomegaly, and mediastinal lymphadenopathy likely due to congestion.
2. 0.5 cm left upper lobe lesion likely represents scar however primary
malignancy would be similar in appearance.
3. Mild superior endplate compression fracture of T10 with 0.4 cm
retropulsion, of indeterminate age.
4. Findings suggestive of pulmonary hypertension.
## RECOMMENDATION(S):
1. Recommend follow-up CT chest in 6 months to assess for
change in left upper lobe scar like lesion.
2. Clinical assessment for focal tenderness at T10 is recommended.
## NOTIFICATION:
The findings were discussed with , M.D. by
, M.D. on the telephone on at 5:22 , 15 minutes after
discovery of the findings.
The updated impression was discussed with , M.D. by
, M.D. on the telephone on at 9:06 AM, 5 minutes after
discovery of the findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "23069063", "time": "2160-08-16 13:50:00"} | 1,604,874 |
Description: 19594565-RR-8Abstract: ## EXAMINATION:
CT NECK W/CONTRAST (EG:PAROTIDS) Q22 CT NECK
## INDICATION:
year old woman who presented with progressive fatigue and
dyspnea on exertion found to have profound anemia and peripheral blasts,
concerning for likely MDS, also with lymphadenopathy (left cervical) // eval
for lymphadenopathy
## DOSE:
Acquisition sequence:
1) Spiral Acquisition 4.3 s, 28.1 cm; CTDIvol = 7.1 mGy (Body) DLP = 193.7
mGy-cm.
Total DLP (Body) = 194 mGy-cm.
## FINDINGS:
Evaluation of the aerodigestive tract demonstrates no mass and no areas of
focal mass effect. There are multiple bilateral neck, left greater than
right, calcified lymph nodes from sequela of prior granulomatous process or
sequela of chronic infection. There is no neck adenopathy by size criteria.
No abnormal fluid collection is identified.
The salivary glands enhance normally and are without mass or adjacent fat
stranding. The thyroid gland appears normal. The neck vessels are patent. Of
note, the left PICC line is seen crossing over the confluence of the
brachiocephalic veins to terminate in the right brachiocephalic vein.
The imaged portion of the lung apices are grossly clear. Respiratory motion
artifact somewhat limits evaluation of pulmonary nodules. There are no
suspicious osseous lesions. The visualized skull-base appears normal. There
is healing or chronic ununited left first rib fracture, stable.
## IMPRESSION:
1. Multiple bilateral calcified cervical lymph nodes, likely sequela of prior
granulomatous process or sequela of chronic infection. There is no neck
adenopathy.
2. The left PICC line is seen crossing over the confluence of the
brachiocephalics and terminates in the right brachiocephalic vein. Adjustment
is recommended for optimal positioning.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594565", "visit_id": "23069063", "time": "2160-08-19 19:03:00"} | 1,604,875 |
Description: 19594570-RR-19Abstract: ## EXAMINATION:
CT HEAD W/O CONTRAST Q111 CT HEAD
## INDICATION:
year old woman with hx of pseudotumor cerebri and concussion
with R sided HA// ?SDH vs pseudotumor cerebri
## DOSE:
Acquisition sequence:
1) Sequenced Acquisition 16.0 s, 16.5 cm; CTDIvol = 48.8 mGy (Head) DLP =
802.7 mGy-cm.
Total DLP (Head) = 803 mGy-cm.
## FINDINGS:
There is no evidence of infarction, hemorrhage, edema, or mass. The
ventricles and sulci are normal in size and configuration. Partially empty
sella.. Posterior nasopharynx probable small cyst.
There is no evidence of fracture. The visualized portion of the paranasal
sinuses, mastoid air cells, and middle ear cavities are clear. The visualized
portion of the orbits are unremarkable. Partial opacification right concha
bullosa.
## IMPRESSION:
No acute intracranial findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594570", "visit_id": "N/A", "time": "2134-08-16 14:53:00"} | 1,604,876 |
Description: 19594570-RR-21Abstract: ## INDICATION:
year old woman with copper IUD p/w pelvic pain and menorrhagia
and prolonged periods// Evaluate IUD placement and any pelvic abnormality for
prolonged periods
## FINDINGS:
The uterus is anteverted and measures 8.5 cm x 3.3 cm x 4.4 cm. The
endometrium is heterogenous and measures 5 mm. The IUD appears malpositioned.
The IUD is seen in the lower uterine segment/cervix, with bilateral side bars
appear to be penetrating into the lower uterine myometrium.
The ovaries are normal. There is no free fluid.
## IMPRESSION:
The IUD appears malpositioned. The IUD is seen in the lower uterine
segment/cervix with both crossbars penetrating into the myometrium.
## NOTIFICATION:
The findings were discussed with , M.D. by
, M.D. on the telephone on at 4:56 pm, 20 minutes after
discovery of the findings.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594570", "visit_id": "N/A", "time": "2135-01-03 16:01:00"} | 1,604,877 |
Description: 19594577-RR-42Abstract: ## HISTORY:
Evaluation for esophageal obstruction in a patient with a history of
achalasia diagnosed years ago.
## SINGLE CONTRAST UPPER GI:
The esophagus is markedly dilated and tortuous. No
primary or secondary peristaltic contractions are observed. Residual food is
seen in the esophagus. Barium held up at the level of the gastroesophageal
junction for at least 5 minutes. At 5 minutes only a few drops of contrast
were seen entering into the stomach. Clips are visualized in the region of
the cervical esophagus related to the patient's prior thyroid surgery.
## IMPRESSION:
Achalasia causing severe obstruction at the GE junction with
marked esophageal dilation and food residue within the esophagus.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594577", "visit_id": "N/A", "time": "2166-02-09 10:03:00"} | 1,604,878 |
Description: 19594577-RR-44Abstract: ## INDICATION:
Evaluate for perforated viscus, epigastric and abdominal pain.
## FINDINGS:
There is mild right-sided atelectasis. The visualized heart and
pericardium are unremarkable.
The liver enhances homogeneously and there are no focal hepatic lesions.
There is no intrahepatic biliary duct dilatation. There is cholelithiasis.
Otherwise, the gallbladder is normal. The pancreas is normal. The spleen is
normal. The adrenal glands are normal. There is a subcentimeter hypodensity
in the left kidney that is too small to characterize. Otherwise, the kidneys
are normal. There is nonspecific thickening of the gastric antrum. The small
bowel is normal. The appendix is not visualized but there is no secondary
evidence of appendicitis. Colon is normal. There is no mesenteric or
retroperitoneal lymphadenopathy. No free air is identified. No free fluid.
There is a small umbilical hernia containing fat. The esophagus is patulous.
## PELVIS:
The prostate and seminal vesicles are unremarkable. The bladder is
normal. The rectum is normal. There is no free fluid in the pelvis. There
is no pelvic or inguinal lymphadenopathy.
The aorta is normal in caliber.
## IMPRESSION:
1. No free air.
2. Nonspecific thickening of the gastric antrum, can be seen in gastritis.
3. Cholelithiasis, but no evidence of cholecystitis.
4. Patulous esophagus consistent with known achalasia.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594577", "visit_id": "20893565", "time": "2166-05-30 05:45:00"} | 1,604,879 |
Description: 19594577-RR-47Abstract: ## HISTORY:
male with achalasia is status post pneumatic balloon
dilatation.
## SINGLE-CONTRAST UPPER GI:
In the anterior posterior, left posterior oblique,
and right posterior oblique positions, multiple fluoroscopic images were
acquired after administration of water-soluble contrast. No leak was
identified. The patient was subsequently administered thin barium contrast
and no leak was identified in the of aforementioned positions. Distal
esophageal narrowing with proximal dilatation was identified, consistent with
history of achalasia. Please note that contrast does not pass the GE junction
due to post=procedural edema.
## IMPRESSION:
No evidence of leak. Please note that contrast does not pass the GE junction
due to post-procedural edema.
These findings were communicated to Dr. by Dr. text
on at 12:03 upon request of ordering physician.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594577", "visit_id": "N/A", "time": "2166-07-01 11:23:00"} | 1,604,880 |
Description: 19594577-RR-48Abstract: ## EXAMINATION:
CT ABD AND PELVIS WITH CONTRAST
## INDICATION:
man with abdominal pain for a few hours.
## FINDINGS:
Partially imaged lung bases are notable for minimal dependent atelectasis.
There is no pleural effusion.
Liver enhances homogeneously without focal lesions or biliary dilatation. The
gallbladder is not distended, contains a stone and is also notable for fundal
adenomyomatosis. Spleen, pancreas, and adrenal glands are unremarkable.
Kidneys enhance and excrete symmetrically without concerning lesions or
hydronephrosis. Multiple sub cm hypodensities and bilateral kidneys are too
small to characterize.
A small hiatal hernia is present. The stomach is largely decompressed. Loops
of small bowel are normal in course and caliber without wall thickening or
signs of obstruction. Colon is unremarkable. There is no mesenteric or
retroperitoneal lymphadenopathy. There is no intra abdominal free air or
fluid. Abdominal aorta is of normal caliber throughout and the portal vein,
SMV, and splenic vein are patent.
Bladder and terminal ureters are within normal limits. The prostate and
seminal vesicles are unremarkable. There is no pelvic free fluid or
lymphadenopathy.
## IMPRESSION:
1. No acute intra-abdominal pathology.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594577", "visit_id": "N/A", "time": "2167-04-10 03:42:00"} | 1,604,881 |
Description: 19594599-RR-14Abstract: ## INDICATION:
female with upper abdominal pain and fever. Evaluate
for pneumonia.
## CHEST, PA AND LATERAL VIEWS:
There is opacity in the right middle lobe and
left mid lung consistent with infection. There is no pleural effusion or
pneumothorax. The heart size is normal. Mediastinal silhouette, hilar
contours and pulmonary vasculature are unremarkable.
## IMPRESSION:
Right middle lobe pneumonia and possible second focus of
infection in the left mid lung. Recommend radiographic follow up 4 to 6 weeks
after therapy to ensure resolution.
Findings discussed with at 7:40 AM at which time the patient was
discharged, but treated for pneumonia.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594599", "visit_id": "N/A", "time": "2195-01-01 01:46:00"} | 1,604,882 |
Description: 19594599-RR-18Abstract: ## INDICATION:
female with chest pain.
## PA AND LATERAL CHEST:
The lungs remain clear, without focal consolidation, effusion, or
pneumothorax. Asymmetric density in the left mid lung seen on the frontal
view only projecting over the ninth posterior rib likely represents nipple
shadow, though repeat radiographs with nipple markers is recommended on a
non-emergent basis to confirm this. The heart size is unchanged. There is no
pulmonary vascular congestion. The visualized osseous structures are
unremarkable.
## IMPRESSION:
No acute process. Asymmetric density in the left mid lung likely
represents a nipple shadow, though repeat radiographs with nipple markers
should be performed nonemergently for clarification.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594599", "visit_id": "N/A", "time": "2196-03-04 20:06:00"} | 1,604,883 |
Description: 19594599-RR-19Abstract: ## INDICATION:
female with three days of fever, cough, and
epigastric pain. Evaluate for cholecystitis.
## FINDINGS:
The liver is normal. There are no focal or textural abnormalities identified.
There is no intra- or extra-hepatic biliary ductal dilation. The common bile
duct measures less than 2 mm. The gallbladder is decompressed, without wall
thickening or pericholecystic fluid. There is no cholelithiasis or sludge
seen within. Normal antegrade flow is seen in the main portal vein. The
aorta and IVC are normal in caliber. Visualized pancreas is unremarkable
without ductal dilation. The tail is obscured by overlying bowel gas. There
is no free fluid in the abdomen.
## IMPRESSION:
Normal study. No sonographic evidence of cholecystitis. No
cholelithiasis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594599", "visit_id": "N/A", "time": "2196-03-04 23:38:00"} | 1,604,884 |
Description: 19594599-RR-24Abstract: ## HISTORY:
with fall, bilateral wrist/hand pain, right knee
pain
## LEFT HAND AND WRIST:
Linear lucency is seen involving the distal radius
extending to the articular surface, however there is no significant soft
tissue swelling. This could reflect a vascular channel rather than a
nondisplaced fracture. No other definite fracture is seen. No dislocation is
present. Joint spaces are preserved without significant degenerative changes.
Bone mineralization is normal. No concerning lytic or sclerotic osseous
abnormalities are detected. No radiopaque foreign body or soft tissue
calcification is present.
## RIGHT HAND AND WRIST:
No acute fracture or dislocation is present. Bone
mineralization is normal. Minimal degenerative spurring is seen involving the
triscaphe joint. Remaining joint spaces are preserved. No concerning lytic
or sclerotic osseous abnormalities seen. No radiopaque foreign body or soft
tissue calcification is present.
## IMPRESSION:
1. Linear lucency involving the distal radius extending to the articular
surface without associated soft tissue swelling. This could potentially
reflect a nondisplaced fracture or a vascular channel. Correlation with site
of tenderness is recommended.
2. No acute fracture or dislocation within the right hand or wrist.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594599", "visit_id": "N/A", "time": "2200-10-12 15:16:00"} | 1,604,885 |
Description: 19594599-RR-26Abstract: ## INDICATION:
year old woman with L distal styloid fx // assess fx
## FINDINGS:
Compared with , alignment is unchanged. Again seen is patchy
osteopenia involving the radial styloid and adjoining distal radius. The
distal radial fracture line remains faintly visible. Neutral angulation of the
distal radius articular surface is also unchanged. Linear sclerosis in
distal radius is again noted, though less pronounced on this study. Ulnar
positive variance is similar to prior. Focal lucency in the ulnar corner of
the proximal styloid of the proximal lunate is compatible with ulnolunate
abutment syndrome
There is mild surrounding soft tissue swelling and background osteopenia. Mild
first CMC osteoarthritis again noted.
## IMPRESSION:
Radial styloid fracture remains faintly visible, unchanged in alignment.
Neutral angulation of the distal radial articular surface, raising the
possibility of slight impaction, is also unchanged
Ulnar positive variance, with evidence of ulnar lunate abutment.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594599", "visit_id": "N/A", "time": "2200-12-16 09:21:00"} | 1,604,886 |
Description: 19594599-RR-28Abstract: ## INDICATION:
year old woman with L distal styloid fx // assess fx
## FINDINGS:
The known distal radial fracture is faintly visible at the distal articular
surface on the oblique view and there is faint residual sclerosis, but the
fracture line is is less apparent than on the radiograph.
Alignment is unchanged compared with . Ulnar positive variance
again noted. Mild surrounding soft tissue swelling may be present, best
correlated physical exam.
Note again made of first CMC/triscaphe joint degenerative changes, possible
background osteopenia, and ulnar positive variance with changes of ulnolunate
abutment.
## IMPRESSION:
Distal left radial fracture alignment unchanged. Fracture line remains
faintly visible.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594599", "visit_id": "N/A", "time": "2201-07-21 09:19:00"} | 1,604,887 |
Description: 19594599-RR-30Abstract: ## INDICATION:
year old woman with l wrist fx// l wrist fx
## FINDINGS:
There is mild soft tissue swelling about the wrist. No lucent or sclerotic
fracture line or displaced fracture fragment is detected involving the distal
ulna or radius. There is ulnar positive variance, with changes at the
proximal ulnar corner of the lunate suggestive of ulnar lunate abutment.
Minimal spurring at the ulnar styloid.
## IMPRESSION:
No acute fracture detected about the left wrist. Mild soft tissue swelling
present. If symptoms persist, consider followup radiographs in days..
Ulnar positive variance and findings compatible ulnolunate abutment.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594599", "visit_id": "N/A", "time": "2202-01-05 08:05:00"} | 1,604,888 |
Description: 19594611-RR-26Abstract: ## EXAM:
Lumbar spine, AP and lateral views.
## FINDINGS:
AP and lateral views of the lumbar spine were obtained. There are
mild scoliotic changes. There are severe multilevel degenerative changes
including disc space narrowing throughout and vacuum phenomenon. Anterior
osteophytes are seen. There is likely narrowing of the central canal. No
definite new loss of height is seen; however, cross-sectional imaging is more
sensitive. There may be further progression of right lateral loss of height
of L3 seen on the frontal view. The sacroiliac joints and pubic symphysis are
grossly intact.
## IMPRESSION:
Severe multilevel degenerative changes in the lumbar spine
without definite acute fracture; however, cross-sectional imaging is more
sensitive and should be considered if there is high concern for acute injury.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594611", "visit_id": "N/A", "time": "2162-05-21 21:19:00"} | 1,604,889 |
Description: 19594611-RR-27Abstract: ## EXAMINATION:
CT HEAD W/O CONTRAST
## INDICATION:
History: with fall // ICH, C-spine fracture, malalignment
## FINDINGS:
There is no evidence of hemorrhage, edema, mass effect, or infarction.
Prominent ventricles and sulci likely reflect age related atrophy. The basal
cisterns are patent. Gray-white matter differentiation is preserved.
No fracture is identified. The paranasal sinuses, mastoid air cells, and
middle ear cavities are clear. Mild mucosal thickening is noted in the ethmoid
air cells. The orbits are unremarkable.
## IMPRESSION:
Normal study.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594611", "visit_id": "N/A", "time": "2162-05-21 22:16:00"} | 1,604,890 |
Description: 19594611-RR-28Abstract: ## EXAMINATION:
CT C-SPINE W/O CONTRAST
## FINDINGS:
There is no evidence of fracture or subluxation. Cervical vertebral bodies are
normal in height and alignment. There is generalized demineralization, likely
due to osteoporosis. Multilevel degenerative changes are similar to the prior
examination and worst at the C3-4 level with loss of disc height, endplate
sclerosis, and posterior osteophytes resulting in mild to moderate spinal
canal narrowing and mild bilateral neural foraminal narrowing. There is no
prevertebral soft tissue thickening.
## IMPRESSION:
No evidence of acute fracture or subluxation.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594611", "visit_id": "N/A", "time": "2162-05-21 22:17:00"} | 1,604,891 |
Description: 19594611-RR-31Abstract: ## EXAMINATION:
CT HEAD W/O CONTRAST
## INDICATION:
An woman with a fall and head strike, rule out acute
injury.
## FINDINGS:
There is no hemorrhage, acute large vascular territorial infarction, mass,
edema, or shift of normally midline structures. The basal cisterns are
patent. Prominence of the ventricles and sulci is compatible with age-related
involutional change. The visualized paranasal sinuses and mastoid air cells
are clear. Atherosclerotic mural calcifications in the bilateral
intracranial carotid arteries are seen. The globes and orbits are intact.
There is no evidence of acute fracture.
## IMPRESSION:
No acute intracranial process.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594611", "visit_id": "N/A", "time": "2162-12-27 12:34:00"} | 1,604,892 |
Description: 19594611-RR-32Abstract: ## EXAMINATION:
CT C-SPINE W/O CONTRAST
## INDICATION:
An woman with a fall and head strike, evaluate for
acute injury.
## FINDINGS:
There is no evidence of acute fracture or dislocation. The vertebral bodies
are normally aligned. Multilevel degenerative changes are again noted,
including intervertebral osteophytes and vacuum disc phenomenon. There is no
critical central spinal canal narrowing. There is multilevel neural foraminal
narrowing due to uncovertebral osteophytes and facet arthropathy, worst at
C3-4 and C4-5, moderate. There is no prevertebral soft tissue swelling.
## IMPRESSION:
No evidence of acute fracture or dislocation.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594611", "visit_id": "N/A", "time": "2162-12-27 12:34:00"} | 1,604,893 |
Description: 19594611-RR-34Abstract: ## EXAMINATION:
DX HIP AND FEMUR
## HISTORY:
with s/p fall with head strike and right hip/knee
pain // r/o acute injury
## FINDINGS:
No evidence of acute fracture or dislocation is seen. The pubic symphysis and
sacroiliac joints are intact. Mild degenerative changes at the hip joints are
noted. There is chondrocalcinosis at the knee joint. There is a small
suprapatellar joint effusion. Tiny posterior patellar spur is noted.
## IMPRESSION:
No acute fracture or dislocation seen. Small suprapatellar joint effusion.
Knee joint chondrocalcinosis.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594611", "visit_id": "N/A", "time": "2162-12-27 12:55:00"} | 1,604,894 |
Description: 19594611-RR-35Abstract: ## EXAMINATION:
CT ABD AND PELVIS WITH CONTRAST
## INDICATION:
Nausea/vomiting, abdominal distention, and pain, in a patient
with prior abdominal surgery.
## FINDINGS:
Two sub-4 mm nodular opacities are seen in the right middle and lower lobes,
unchanged compared to . There is no pleural effusion. A trivial
pericardial effusion is noted. Cardiac pacer wires are noted.
## LIVER:
The liver enhances homogeneously without focal lesion or intrahepatic
biliary duct dilation. The portal vein is patent.The nondistended gallbladder
is within normal limits, without wall thickening or pericholecystic fluid.
## SPLEEN:
Hypodensities measuring up to 6 mm within the posterior spleen are
unchanged compared to . PA 20 mm hyperdense lesion within the
inferior aspect of the spleen also appears unchanged. These findings may
reflect hemangiomas.
## PANCREAS:
The pancreas again demonstrates fatty infiltration, without focal
lesion or peripancreatic stranding or fluid collection.
## ADRENALS:
The adrenal glands are unremarkable.
## KIDNEYS:
Multiple hypodensities are again seen within the bilateral kidneys,
the largest measuring up to 7.7 cm on the left and 3.6 cm in the right lower
pole. Other smaller hypodensities are too small to characterize, but likely
represent simple cysts as well. A 1.0 cm hypodensity in the lower pole of the
left kidney appears to be somewhat complex.
## GI:
The stomach is decompressed, but there is no obvious intraluminal mass or
wall thickening.The small and large bowel are within normal limits, without
wall thickening or evidence of obstruction.
## RETROPERITONEUM:
The aorta is normal in caliber, with minimal atherosclerotic
calcifications.There is no retroperitoneal or mesenteric lymph node
enlargement by CT size criteria.
## CT PELVIS:
The urinary bladder appears normal.No pelvic wall or inguinal lymph
node enlargement by CT size criteria is seen.There is no pelvic free fluid.
## OSSEOUS STRUCTURES:
No focal lesion suspicious for malignancy present.
## IMPRESSION:
1. No acute intra-abdominal process to explain the patient's symptoms.
2. 1-cm complex cyst in the lower pole of left kidney. Further evaluation with
ultrasound on a non urgent, outpatient basis is recommended.
3. Unchanged lesions within the spleen, likely representing hemangiomas.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594611", "visit_id": "N/A", "time": "2163-01-07 20:18:00"} | 1,604,895 |
Description: 19594611-RR-37Abstract: ## INDICATION:
female with chest pain and shortness of breath.
## FINDINGS:
The thyroid gland is heterogeneous with a 6 mm right hypodense nodule (2:11).
There is no supraclavicular lymph node enlargement. The airways are patent to
the subsegmental level. There is no mediastinal, hilar or axillary lymph node
enlargement by CT size criteria. The heart is mildly enlarged with no
pericardial effusion. A cardiac pacer device is seen with its leads in
appropriate position. No hiatal hernia or any other esophageal abnormality is
seen.
There is bilateral dependent atelectasis, most notable in the lower lobes.
There is a 11 mm ground-glass nodule in the right upper lobe, which appears
similar to prior exam taking into account differences in technique and
inspiratory effort (2:35). There are multiple bilateral pulmonary nodules
measuring up to 4 mm in size that are also stable from prior exam (on the
right series 3, images 77, 94, 106, 115 and 116 and on the left series 3,
image 82). No pleural effusion or pneumothorax is present.
## CTA:
The aorta and main thoracic vessels are well opacified. The aorta
demonstrates normal caliber throughout the thorax without intramural hematoma
or dissection. The pulmonary arteries are opacified to the subsegmental
level. There is no filling defect in the main, right, left, lobar or
subsegmental pulmonary arteries. No arteriovenous malformation is seen.
## BONES:
No focal osseous lesion concerning for malignancy. A stable 5 mm
calcification in the central canal at T4 may be secondary to degenerative
changes as an osteophyte from the facet versus osteochondroma or meningioma
(2:28). Old left seventh rib fractures noted.
Although this study is not designed for assessment of intra-abdominal
structures, there is a partially visualized cyst in the left upper quadrant,
and the other visualized organs are unremarkable.
## IMPRESSION:
1. No acute cardiopulmonary process. No pulmonary embolism.
2. 11 mm ground-glass nodule in the right upper lobe is similar to prior
exam. Recommend follow-up CT in year. Multiple other bilateral pulmonary
nodules measuring up to 4 mm are also stable and can be followed-up at time of
CT scan.
3. Stable 5 mm calcification in the spinal canal at T4 may be secondary to
degenerative change or represent an ostiochondroma or meningioma.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594611", "visit_id": "N/A", "time": "2163-01-21 21:10:00"} | 1,604,896 |
Description: 19594642-RR-10Abstract: ## INDICATION:
year old man with right distal ureteral stone // please
evaluate for hydronephrosis and presence of ureteral jets
## FINDINGS:
There is no hydronephrosis, or masses bilaterally. Normal cortical
echogenicity and corticomedullary differentiation are seen bilaterally. 2
nonobstructing stones are identified within the right kidney measuring 9 mm
within the lower pole and 4 mm within the upper pole.
Right kidney: 11.0 cm
Left kidney: 10.7 cm
The bladder is moderately well distended and normal in appearance. The known
right UVJ stone is visualized measuring 9 mm. Bilateral ureteral jets are
visualized.
## IMPRESSION:
1. Multiple nonobstructing right renal stones. No hydronephrosis.
2. Redemonstration of a 9 mm right UVJ stone. Bilateral ureteral jets were
noted.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594642", "visit_id": "N/A", "time": "2155-11-30 11:22:00"} | 1,604,897 |
Description: 19594642-RR-11Abstract: ## INDICATION:
year old man with right distal ureteral stone // please
evaluate for hydronephrosis and presence of ureteral jets
## FINDINGS:
There is no hydronephrosis or masses bilaterally. There are 3 nonobstructing
stones in the lower pole of the right kidney with the largest measuring 7 mm
in the maximal dimension. There is a 3 mm nonobstructing stool in the upper
pole of the right kidney. Normal cortical echogenicity and corticomedullary
differentiation are seen bilaterally.
Right kidney: 10.9 cm
Left kidney: 11.4 cm
The bladder is moderately well distended and normal in appearance. Bilateral
ureteral jets are demonstrated.
## IMPRESSION:
Bilateral nonobstructing nephrolithiasis..
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594642", "visit_id": "N/A", "time": "2156-01-29 14:36:00"} | 1,604,898 |
Description: 19594642-RR-12Abstract: ## EXAMINATION:
CT ABD AND PELVIS WITH CONTRAST
## NO PO CONTRAST; HISTORY:
with hx of nephrolithiasis
presenting with worsening diffuse abdominal painNO PO contrast // Reason for
diffuse abdominal pain
## SINGLE PHASE CONTRAST:
MDCT axial images were acquired through the
abdomen and pelvis following intravenous contrast administration.
Oral contrast was not administered.
Coronal and sagittal reformations were performed and reviewed on PACS.
## DOSE:
Acquisition sequence:
1) Stationary Acquisition 6.5 s, 0.5 cm; CTDIvol = 19.7 mGy (Body) DLP =
9.9 mGy-cm.
2) Spiral Acquisition 6.6 s, 51.6 cm; CTDIvol = 8.5 mGy (Body) DLP = 436.9
mGy-cm.
Total DLP (Body) = 447 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. Scattered subcentimeter hypodensities
are too small to characterize by CT but likely represent cysts or biliary
hamartomas. 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 previous 3 mm ureteral stone on the right has moved distally and
is now located within the distal right ureter at the ureteral vesicular
junction (series 2:148). There is resulting mild right hydro ureteral
nephrosis. An additional 4 mm stone in the lower pole of the right kidney,
nonobstructing, is redemonstrated. No areas of cortical hypoenhancement or
evidence of striated nephrogram.
## GASTROINTESTINAL:
The stomach is unremarkable. Small bowel loops demonstrate
normal caliber, wall thickness, and enhancement throughout. The colon and
rectum are within normal limits. Incidental note is again made of a fecalith
within the appendix, similar in appearance to prior. The distal tip of the
appendix measures 6 mm.
## 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 no retroperitoneal or mesenteric lymphadenopathy. There
is no pelvic or inguinal 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. 3 mm right ureteral stone has progressed and is now near the
ureterovesicular junction, with unchanged mild right hydroureteronephrosis.
No finding to suggest pyelonephritis.
2. The proximal appendix contains a fecalith and is mildly dilated at 9 mm,
previously 7 mm. In the absence of periappendiceal stranding, unclear if this
is acute. Recommend clinical follow up.
Meta Data: {"version": "mimic_iv", "note_type": "Radiology", "patient_id": "19594642", "visit_id": "N/A", "time": "2155-12-05 03:04:00"} | 1,604,899 |
Subsets and Splits