index
int64 25
522k
| report_id
int64 738k
1.26M
| subject_id
int64 3
100k
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stringlengths 373
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292k
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
246,669
| 986,877
| 27,729
|
[**2178-10-8**] 1:53 PM
CHEST PORT. LINE PLACEMENT; -77 BY DIFFERENT PHYSICIAN [**Name Initial (PRE) 5**] # [**Clip Number (Radiology) 5478**]
Reason: ET tube placement
Admitting Diagnosis: NEPHROLITHIASIS
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
70 year old man with sepsis s/p intubation
REASON FOR THIS EXAMINATION:
ET tube placement
______________________________________________________________________________
FINAL REPORT
HISTORY: Check placement of ET tube and central catheter.
FINDINGS: In comparison with earlier films of this date, there has been
placement of an endotracheal tube that lies at the lower clavicular level,
about 5 cm above the carina. Right internal jugular catheter extends to the
mid portion of the superior vena cava at the level of the carina.
IMPRESSION: A little change in the appearance of the heart and lungs.
| 987
|
Check placement of ET tube and central catheter.
| null |
ET tube placement
______________________________________________________________________________
FINAL REPORT
|
In comparison with earlier films of this date, there has been
placement of an endotracheal tube that lies at the lower clavicular level,
about 5 cm above the carina. Right internal jugular catheter extends to the
mid portion of the superior vena cava at the level of the carina.
|
A little change in the appearance of the heart and lungs.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 125,904
|
105,773
| 840,628
| 9,016
|
[**2180-10-16**] 8:38 AM
CAROT/CEREB [**Hospital1 **] Clip # [**Clip Number (Radiology) 28959**]
Reason: STROKE
Admitting Diagnosis: STROKE
Contrast: OPTIRAY Amt: 200
********************************* CPT Codes ********************************
* [**Numeric Identifier 2075**] TRANSCATH THROMBOYSUS INFUSION [**Numeric Identifier 479**] SEL CATH 3RD ORDER [**Last Name (un) 480**] *
* -51 MULTI-PROCEDURE SAME DAY [**Numeric Identifier 479**] SEL CATH 3RD ORDER [**Last Name (un) 480**] *
* -59 DISTINCT PROCEDURAL SERVICE [**Numeric Identifier 761**] TRANS CATH INFUSSION *
* [**Numeric Identifier 483**] CAROTID/CERVICAL BILAT -59 DISTINCT PROCEDURAL SERVICE *
* [**Numeric Identifier 484**] CAROTID/CEREBRAL BILAT -59 DISTINCT PROCEDURAL SERVICE *
****************************************************************************
______________________________________________________________________________
FINAL REPORT
PREOPERATIVE DIAGNOSIS: Left MCA acute thrombosis.
POSTOPERATIVE DIAGNOSIS: Same, status post superselective intraarterial
thrombolysis via both a right internal carotid artery and a left internal
carotid artery intracranial approach with partial recanalization.
INDICATION: Mr. [**Known lastname 28799**] presented with an acute left MCA thrombosis. He is
undergoing this procedure in order to attempt endovascular recanalization
using thrombolytic therapy in a superselective manner.
ANESTHESIA: Monitored anesthesia care with local infiltration to general
anesthesia.
CONSENT: The patient and his family were given a full and complete
explanation of the procedure. Specifically, the indications, risks, benefits,
and alternatives to the procedure were explained in detail. In addition, the
possible complications, such as the risk of bleeding, infection, stroke,
neurological deficit or deterioration, groin hematoma, and other unforeseen
complications, including the risk of coma and even death, were outlined. The
patient and his family understood and wished to proceed with the operation.
PROCEDURE IN DETAIL: The patient was brought into the Endovascular Suite and
placed on the table in supine position. The right groin area was prepped and
draped in the usual sterile fashion. A 19-gauge single-wall needle was then
used to puncture the right common femoral artery, and upon the return of brisk
arterial blood, a 5 French vascular sheath, then 6 French via the right side
were inserted over a guide wire and kept on a heparinized saline drip. Next, a
diagnostic catheter was used to selectively catheterize the following vessels:
right common carotid artery, left common carotid artery, left internal carotid
artery, right internal carotid artery.
RESULTS: Injection of the right common carotid artery revealed mild changes
of carotid atherosclerosis at the bifurcation and a tortuous anatomy. The
intracranial circulation revealed a right internal carotid artery perfusing
both anterior cerebral artery territory via a patent anterior communicating
artery. Injection of the left common carotid artery revealed an occlusion of
the left internal carotid artery. The left external carotid artery is patent
and provides some flow via collaterals to the posterotemporal lobe. At this
point, an initial attempt was made to use a microcatheter going through the
(Over)
[**2180-10-16**] 8:38 AM
CAROT/CEREB [**Hospital1 **] Clip # [**Clip Number (Radiology) 28959**]
Reason: STROKE
Admitting Diagnosis: STROKE
Contrast: OPTIRAY Amt: 200
______________________________________________________________________________
FINAL REPORT
(Cont)
right internal carotid artery into the intracranial circulation into the right
anterior cerebral artery and into the anterior communicating complex. Multiple
attempts at going into the right anterior cerebral artery in a retrograde
fashion were unsuccessful, so with the microcatheter in the anterior
communicating complex, TPA was instilled along with a small dose of RheoPro.
This was not successful. After recanalizing the left middle cerebral artery,
accordingly an ipsilateral approach was attempted this time. With the guide
catheter into the left internal carotid artery, a microcatheter was used to
cross the thrombosis and occlusion of the left internal carotid artery origin
and navigate laterally into the intracranial portion of the left internal
carotid artery, where with the microcatheter in this position, TPA and RheoPro
were instilled. The microcatheter was then advanced into the left middle
cerebral artery and again additional thrombolytic therapy was performed. This
was unfortunately not completely successful and accordingly, after discussing
with the Neurology Team, the decision was made to halt additional treatment.
IMPRESSION: Attempted unsuccessful recanalization of the thrombosed left
middle cerebral artery using both a contralateral and ipsilateral approach
with a microcatheter and thrombolytic therapy.
| 5,308
| null | null | null |
Injection of the right common carotid artery revealed mild changes
of carotid atherosclerosis at the bifurcation and a tortuous anatomy. The
intracranial circulation revealed a right internal carotid artery perfusing
both anterior cerebral artery territory via a patent anterior communicating
artery. Injection of the left common carotid artery revealed an occlusion of
the left internal carotid artery. The left external carotid artery is patent
and provides some flow via collaterals to the posterotemporal lobe. At this
point, an initial attempt was made to use a microcatheter going through the
(Over)
[**2180-10-16**] 8:38 AM
CAROT/CEREB [**Hospital1 **] Clip # [**Clip Number (Radiology) 28959**]
Reason: STROKE
Admitting Diagnosis: STROKE
Contrast: OPTIRAY Amt: 200
______________________________________________________________________________
FINAL REPORT
(Cont)
right internal carotid artery into the intracranial circulation into the right
anterior cerebral artery and into the anterior communicating complex. Multiple
attempts at going into the right anterior cerebral artery in a retrograde
fashion were unsuccessful, so with the microcatheter in the anterior
communicating complex, TPA was instilled along with a small dose of RheoPro.
This was not successful. After recanalizing the left middle cerebral artery,
accordingly an ipsilateral approach was attempted this time. With the guide
catheter into the left internal carotid artery, a microcatheter was used to
cross the thrombosis and occlusion of the left internal carotid artery origin
and navigate laterally into the intracranial portion of the left internal
carotid artery, where with the microcatheter in this position, TPA and RheoPro
were instilled. The microcatheter was then advanced into the left middle
cerebral artery and again additional thrombolytic therapy was performed. This
was unfortunately not completely successful and accordingly, after discussing
with the Neurology Team, the decision was made to halt additional treatment.
|
Attempted unsuccessful recanalization of the thrombosed left
middle cerebral artery using both a contralateral and ipsilateral approach
with a microcatheter and thrombolytic therapy.
|
IMPRESSION
| true
| true
| false
| false
| false
| 2
|
['history', 'comparison', 'procedure']
|
No History section found; No Comparison section found; No Technique/Procedure section found
| 54,227
|
77,803
| 837,004
| 13,373
|
[**2198-8-21**] 3:59 PM
ERCP S&I ([**Numeric Identifier 285**]) Clip # [**Clip Number (Radiology) 4527**]
Reason: R/O Anastomotic stricture
Admitting Diagnosis: S/P LIVER TRANSPLANT WITH SVT
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
49 year old man with OLTx. T Tube cholangiogram showed anastomotic stricture.
ERCp to treat.
Exam performed [**2198-8-16**], req sent [**2198-8-20**]
REASON FOR THIS EXAMINATION:
R/O Anastomotic stricture
______________________________________________________________________________
FINAL REPORT
INDICATION: Orthotopic liver transplant with T2 cholangiogram showing
anastomotic stricture.
VIEWS: Only four (4) fluoroscopic spot images from ERCP are present, although
eight (8) images are submitted on the accompanying ERCP report.
FINDINGS: The fluoroscopic spot images demonstrate a short smooth stricture
of the distal common bile duct with proximal dilatation of the biliary tree.
The submitted ERCP report images demonstrate placement of a stent across the
anastomic stricture. The visualized pancreatic duct appeared unremarkable.
No filling defects were identified.
| 1,290
| null | null |
R/O Anastomotic stricture
______________________________________________________________________________
FINAL REPORT
INDICATION: Orthotopic liver transplant with T2 cholangiogram showing
anastomotic stricture.
VIEWS: Only four (4) fluoroscopic spot images from ERCP are present, although
eight (8) images are submitted on the accompanying ERCP report.
|
The fluoroscopic spot images demonstrate a short smooth stricture
of the distal common bile duct with proximal dilatation of the biliary tree.
The submitted ERCP report images demonstrate placement of a stent across the
anastomic stricture. The visualized pancreatic duct appeared unremarkable.
No filling defects were identified.
|
The submitted ERCP report images demonstrate placement of a stent across the
anastomic stricture. The visualized pancreatic duct appeared unremarkable. No filling defects were identified.
|
FALLBACK_LAST_SENTENCES
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 38,885
|
459,419
| 1,174,968
| 54,826
|
[**2178-1-6**] 3:46 PM
MR HEAD W & W/O CONTRAST Clip # [**Clip Number (Radiology) 20684**]
Reason: Please provide [**Hospital1 **]-dimensional measurements for all lesions a
Contrast: MAGNEVIST Amt: 20
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
70 year old man with metastatic melanoma
REASON FOR THIS EXAMINATION:
Please provide [**Hospital1 **]-dimensional measurements for all lesions and record on
oncology table and assess for metastatic disease status prior to HD IL2
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Metastatic melanoma, to assess for metastatic disease prior to
HDIL2 treatment.
COMPARISON: None.
TECHNIQUE: MR of the head without and with IV contrast.
FINDINGS:
There are a few small scattered FLAIR hyperintense foci in the frontal and the
parietal lobe subcortical white matter without associated negative
susceptibility or decreased diffusion. These do not demonstrate enhancement.
On the post-contrast images, there is no focus of abnormal enhancement noted
in the brain parenchyma or the meninges to suggest metastatic disease. The
ventricles and extra-axial CSF spaces are mildly prominent, related to mild
volume loss.
There is mild mucosal thickening in the ethmoid air cells and in the right
side of the frontal sinus as well as in the mastoid air cells on both sides.
Degenerative changes are noted in the cervical spine, with disc osteophyte
complexes indenting the thecal sac. There is prominent subcutaneous fat in
the region of the left temple, to correlate with clinical history for any
procedure in this location.
IMPRESSION:
1. No focal areas of abnormal enhancement in the brain parenchyma or the
meninges to suggest osseous metastatic lesions. Nonspecific FLAIR
hyperintense foci likely relate to small vessel ischemic changes. To
correlate for risk factors. Mild degenerative changes in the cervical spine
and mild mucosal thickening in the paranasal sinuses and the mastoid air cells
as described above. Followup if clinically indicated.
| 2,276
| null |
None.
|
Please provide [**Hospital1 **]-dimensional measurements for all lesions and record on
oncology table and assess for metastatic disease status prior to HD IL2
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Metastatic melanoma, to assess for metastatic disease prior to
HDIL2 treatment.
|
There are a few small scattered FLAIR hyperintense foci in the frontal and the
parietal lobe subcortical white matter without associated negative
susceptibility or decreased diffusion. These do not demonstrate enhancement.
On the post-contrast images, there is no focus of abnormal enhancement noted
in the brain parenchyma or the meninges to suggest metastatic disease. The
ventricles and extra-axial CSF spaces are mildly prominent, related to mild
volume loss.
There is mild mucosal thickening in the ethmoid air cells and in the right
side of the frontal sinus as well as in the mastoid air cells on both sides.
Degenerative changes are noted in the cervical spine, with disc osteophyte
complexes indenting the thecal sac. There is prominent subcutaneous fat in
the region of the left temple, to correlate with clinical history for any
procedure in this location.
|
1. No focal areas of abnormal enhancement in the brain parenchyma or the
meninges to suggest osseous metastatic lesions. Nonspecific FLAIR
hyperintense foci likely relate to small vessel ischemic changes. To
correlate for risk factors. Mild degenerative changes in the cervical spine
and mild mucosal thickening in the paranasal sinuses and the mastoid air cells
as described above. Followup if clinically indicated.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 247,243
|
51,960
| 788,268
| 24,748
|
[**2187-4-14**] 4:36 PM
FEMORAL VASCULAR US LEFT Clip # [**Clip Number (Radiology) 88419**]
Reason: L. GROIN BRUIT, R/O PSEUDO
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
74 year old man with recent cardiac cath - developed a left leg hematoma
REASON FOR THIS EXAMINATION:
pseudoaneurysm
______________________________________________________________________________
FINAL REPORT
INDICATION: Recent cardiac catheterization with left leg hematoma.
LEFT LOWER EXTREMITY VASCULAR ULTRASOUND: The left common femoral artery and
vein were interrogated. There is normal color flow and wave form of both the
artery and vein. There is normal augmentation of the common femoral vein. No
vascular abnormalities were demonstrated.
IMPRESSION: Normal appearance of common femoral artery and vein. No
pseudoaneurysm.
| 973
| null | null |
pseudoaneurysm
______________________________________________________________________________
FINAL REPORT
INDICATION: Recent cardiac catheterization with left leg hematoma.
LEFT LOWER EXTREMITY VASCULAR
|
The left common femoral artery and
vein were interrogated. There is normal color flow and wave form of both the
artery and vein. There is normal augmentation of the common femoral vein. No
vascular abnormalities were demonstrated.
|
Normal appearance of common femoral artery and vein. No
pseudoaneurysm.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 25,011
|
362,395
| 1,099,421
| 21,202
|
[**2145-9-8**] 11:01 AM
LIVER OR GALLBLADDER US (SINGLE ORGAN) PORT Clip # [**Clip Number (Radiology) 16524**]
Reason: evaluate for gallbladder pathology
Admitting Diagnosis: SEPSIS
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
55 year old man with elevated alk phos, s/p allo SCT, now with hypotension
REASON FOR THIS EXAMINATION:
evaluate for gallbladder pathology
______________________________________________________________________________
FINAL REPORT
INDICATION: 55-year-old man with elevated alk phos. Previous bone marrow
transplant. Evaluate for gallbladder pathology.
FINDINGS: A 12-mm diameter area of intermediate echogenicity at the lumen of
the gallbladder neck is consistent with findings on previous ultrasound scan
[**2145-2-9**], and most likely represents a gallbladder polyp. No calculi are
seen within the gallbladder. The gallbladder wall is otherwise not
significantly thickened. No intrahepatic or extrahepatic biliary duct
dilatation. No focal parenchymal abnormality is seen in the liver.
IMPRESSION:
1. Polyp at neck of gallbladder (1.2cm), which was also seen on prior
ultrasound scan [**2145-2-9**]. This has not changed significantly since prior
ultrasound scan, but followup imaging is advised.
| 1,386
| null | null |
evaluate for gallbladder pathology
______________________________________________________________________________
FINAL REPORT
INDICATION: 55-year-old man with elevated alk phos. Previous bone marrow
transplant. Evaluate for gallbladder pathology.
|
A 12-mm diameter area of intermediate echogenicity at the lumen of
the gallbladder neck is consistent with findings on previous ultrasound scan
[**2145-2-9**], and most likely represents a gallbladder polyp. No calculi are
seen within the gallbladder. The gallbladder wall is otherwise not
significantly thickened. No intrahepatic or extrahepatic biliary duct
dilatation. No focal parenchymal abnormality is seen in the liver.
|
1. Polyp at neck of gallbladder (1.2cm), which was also seen on prior
ultrasound scan [**2145-2-9**]. This has not changed significantly since prior
ultrasound scan, but followup imaging is advised.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 187,227
|
32,559
| 769,248
| 8,566
|
[**2124-10-25**] 11:39 AM
[**Last Name (un) 264**] DUP EXTEXT BIL (MAP/DVT) Clip # [**Clip Number (Radiology) 71784**]
Reason: PE ASSESS FOR BILATERAL LEG DVT
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
48 year old man with HTn, here with question PE, probably PNA. Please r/o
bilat DVT.
REASON FOR THIS EXAMINATION:
r/o bilateral leg PE
______________________________________________________________________________
FINAL REPORT
INDICATION: Pulmonary symptoms consistent with pulmonary embolism.
BILATERAL LOWER EXTREMITY VENOUS DOPPLER ULTRASOUND: There is normal
compressibility, flow and augmentation of the bilateral common femoral,
superficial femoral, saphenous and popliteal veins.
IMPRESSION: No evidence of DVT bilaterally.
| 897
| null | null |
r/o bilateral leg PE
______________________________________________________________________________
FINAL REPORT
INDICATION: Pulmonary symptoms consistent with pulmonary embolism.
BILATERAL LOWER EXTREMITY VENOUS DOPPLER
|
There is normal
compressibility, flow and augmentation of the bilateral common femoral,
superficial femoral, saphenous and popliteal veins.
|
No evidence of DVT bilaterally.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 14,522
|
93,193
| 833,509
| 6,365
|
[**2200-7-4**] 12:40 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 30812**]
Reason: r/o ptx after line change
Admitting Diagnosis: PANCREATIC PSEUDOCYST
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
71 year old man with trach - resp. distress/low sats.
REASON FOR THIS EXAMINATION:
r/o ptx after line change
______________________________________________________________________________
FINAL REPORT
INDICATION: Tracheostomy, with respiratory distress and low oxygen
saturations. Evaluate for pneumothorax after line change.
COMPARISON: [**2200-6-15**].
AP UPRIGHT AP VIEW CHEST: Patient s/p median sternotomy and CABG. Tracheostomy
tube is seen in appropriate position. Left subclavian central venous catheter
is seen with tip in appropriate location within the proximal superior vena
cava. Low lung volumes are present bilaterally. There is continued bilateral
perihilar haziness and vascular engorgement present, consistent with
congestive heart failure, which is slightly improved since the prior study.
There is persistent left basilar collapse/consolidation and small bilateral
pleural effusions, left greater than right. No definite pneumothorax is
identified.
IMPRESSION:
1) Persistent left basilar collapse/consolidation with small bilateral pleural
effusions.
2) Slight interval improvement in moderate congestive heart failure.
3) No definite pneumothorax identified.
| 1,582
| null |
[**2200-6-15**].
AP UPRIGHT AP VIEW
|
r/o ptx after line change
______________________________________________________________________________
FINAL REPORT
INDICATION: Tracheostomy, with respiratory distress and low oxygen
saturations. Evaluate for pneumothorax after line change.
|
Patient s/p median sternotomy and CABG. Tracheostomy
tube is seen in appropriate position. Left subclavian central venous catheter
is seen with tip in appropriate location within the proximal superior vena
cava. Low lung volumes are present bilaterally. There is continued bilateral
perihilar haziness and vascular engorgement present, consistent with
congestive heart failure, which is slightly improved since the prior study.
There is persistent left basilar collapse/consolidation and small bilateral
pleural effusions, left greater than right. No definite pneumothorax is
identified.
|
1) Persistent left basilar collapse/consolidation with small bilateral pleural
effusions.
2) Slight interval improvement in moderate congestive heart failure.
3) No definite pneumothorax identified.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 47,522
|
440,857
| 1,188,102
| 13,837
|
[**2163-6-15**] 5:19 PM
CTA AORTA/BIFEM/ILIAC RUNOFF W/W&WO C AND RECONS Clip # [**Clip Number (Radiology) 31197**]
Reason: Evaluation of LE vasculature prior to potential angioplasty
Admitting Diagnosis: CELLULITIS
Contrast: OPTIRAY Amt: 100
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
76 year old woman with ESRD on HD (Tues, Thus, Sat), PVD here with necrotizing
1st and 2nd RLE digit
REASON FOR THIS EXAMINATION:
Evaluation of LE vasculature prior to potential angioplasty and stenting for
ischemic 1st and 2nd RLE digits. Per vascular, please obtain images from
infra-renally level
No contraindications for IV contrast
______________________________________________________________________________
WET READ: KKgc WED [**2163-6-15**] 9:29 PM
1. Extensive atherosclerotic calcification of the abdominal aorta, common,
internal and external iliac arteries. Significant stenosis at the origins of
both renal arteires, with atrophic kidneys. Moderate stenosis at the origins
of the Celiac, SMA axis, with opacification of the distal vessels. Significant
stenosis of both internal iliac arteries, without occlusion.
2. Right lower extremity: Extensive calcification in the R Ext.iliac A, but
this is patent. Extensive calcification in the patent distal R SFA.
Siginificant stenosis/possible occlusion at the distal R poplieal artery.
Opacification of the Antr.tib, Postr.tib and peroneal A's limited by extensive
calcification and stenotic lumen. Very minimal flow seen in the distal R
postr. tibial.A
3. Left lower extremity: Extensive calcification in the L Ext.iliac A, but
this is patent. Extensive calcification in the patent distal R SFA. Although
minimal flow is seen in the distal popliteal artery, flow in the anterior and
peroneal arteries are difficult to visualize, given the extensive
calcification and stenosis. Very minimal flow is seen in the left posterior
tibial artery. Kkaliann [**Numeric Identifier 31198**].
______________________________________________________________________________
FINAL REPORT
CT ANGIOGRAPHY OF THE ABDOMEN, PELVIS AND LOWER EXTREMITIES
HISTORY: End-stage renal disease with peripheral vascular disease and
necrosis along the first and second right lower extremity digits. Evaluation
of vascular disease requested.
COMPARISONS: None.
TECHNIQUE: Following a non-contrast scan spanning the abdomen, pelvis and
entire lower extremities, CT angiography was performed in arterial and delayed
phases including sagittal and coronal reconstructions, as well as multiplanar
curved reformatted, maximum intensity projection and volume-rendered
reconstructions.
FINDINGS: Mild basilar atelectasis is noted. There are no pleural effusions.
A small portion of the dome of the liver is excluded. The heart is mildly
enlarged with extensive vascular calcifications. The left ventricle may be
mildly dilated.
(Over)
[**2163-6-15**] 5:19 PM
CTA AORTA/BIFEM/ILIAC RUNOFF W/W&WO C AND RECONS Clip # [**Clip Number (Radiology) 31197**]
Reason: Evaluation of LE vasculature prior to potential angioplasty
Admitting Diagnosis: CELLULITIS
Contrast: OPTIRAY Amt: 100
______________________________________________________________________________
FINAL REPORT
(Cont)
A small calcified stone layers within the gallbladder. The liver, spleen,
adrenal glands are unremarkable. The kidneys are atrophic, particularly the
right. A hypodense focus in the interpolar region of the left kidney measures
8 mm in diameter, too small to characterize. Small central calcifications are
probably vascular, although very small stones are not entirely excluded.
Along the posterior upper pole, there is a suggesting cyst arising from the
left lower pole, measures 24 mm in diameter.
There are widespread vascular calcifications. Extensive calcifications make
it difficult to evaluate for narrowing, but mild narrowing is expected that
both the celiac and mesenteric arterial origins without post-stenotic
dilatation. There is apparently high-grade stenosis along the origin of the
left main renal artery with a very thready narrowed artery immediately beyond
the first centimeter. The inferior mesenteric artery is patent.
The left internal iliac artery is markedly narrowed, and the gluteal branch
may be occluded or hightly stenotic near its origin. Slight post-stenotic
dilatation is present. The artery is opacified distally. Similarly, there is
at least moderate narrowing of the right internal iliac artery. Narrowing
appears relatively mild, however, along the common and external iliac
arteries.
On the right, the superficial femoral artery is irregular, narrowed and
heavily calcified. There are mild focal stenoses at the origin of the
superficial femoral artery, at the distal thigh and at the popliteal artery.
The proximal right anterior tibial artery is opacifies. Distally it is
occluded with distal collateral opacification of the dorsalis pedis via a
prominent collateral from the peroneal artery via the interosseous membrane.
The dorsal pedis is irregularly narrowed. The tibioperoneal trunk is
moderately stenotic. A short high grade stenosis is noted at the origin of
the posterior tibial artery, whose mid to distal part does not opacify.
On the left, there superficial femoral and popliteal arteries are again
irregular, narrowing and heavily calcified. The anterior tibial is narrowed
and opacifies poorly but is perhaps not entirely occluded. The dorsalis pedis
again seems to partly opacify via small collateral pathways, however,
including from the peroneal artery. The posterior tibial again appears
occluded.
Diffuse edema is present. There are no suspicious bone lesions. No frank
bone destruction is seen. The bones appear demineralized.
Impression:
(Over)
[**2163-6-15**] 5:19 PM
CTA AORTA/BIFEM/ILIAC RUNOFF W/W&WO C AND RECONS Clip # [**Clip Number (Radiology) 31197**]
Reason: Evaluation of LE vasculature prior to potential angioplasty
Admitting Diagnosis: CELLULITIS
Contrast: OPTIRAY Amt: 100
______________________________________________________________________________
FINAL REPORT
(Cont)
1. Widespread severe vascular disease including highly attenuated or occluded
anterior and posterior tibial arteries bilaterally, as described in more
detail above.
2. Gallstones.
| 6,736
|
End-stage renal disease with peripheral vascular disease and
necrosis along the first and second right lower extremity digits. Evaluation
of vascular disease requested.
|
None.
|
Evaluation of LE vasculature prior to potential angioplasty and stenting for
ischemic 1st and 2nd RLE digits. Per vascular, please obtain images from
infra-renally level
No contraindications for IV contrast
______________________________________________________________________________
WET READ: KKgc WED [**2163-6-15**] 9:29 PM
1. Extensive atherosclerotic calcification of the abdominal aorta, common,
internal and external iliac arteries. Significant stenosis at the origins of
both renal arteires, with atrophic kidneys. Moderate stenosis at the origins
of the Celiac, SMA axis, with opacification of the distal vessels. Significant
stenosis of both internal iliac arteries, without occlusion.
2. Right lower extremity: Extensive calcification in the R Ext.iliac A, but
this is patent. Extensive calcification in the patent distal R SFA.
Siginificant stenosis/possible occlusion at the distal R poplieal artery.
Opacification of the Antr.tib, Postr.tib and peroneal A's limited by extensive
calcification and stenotic lumen. Very minimal flow seen in the distal R
postr. tibial.A
3. Left lower extremity: Extensive calcification in the L Ext.iliac A, but
this is patent. Extensive calcification in the patent distal R SFA. Although
minimal flow is seen in the distal popliteal artery, flow in the anterior and
peroneal arteries are difficult to visualize, given the extensive
calcification and stenosis. Very minimal flow is seen in the left posterior
tibial artery. Kkaliann [**Numeric Identifier 31198**].
______________________________________________________________________________
FINAL REPORT
CT ANGIOGRAPHY OF THE ABDOMEN, PELVIS AND LOWER EXTREMITIES
|
Mild basilar atelectasis is noted. There are no pleural effusions.
A small portion of the dome of the liver is excluded. The heart is mildly
enlarged with extensive vascular calcifications. The left ventricle may be
mildly dilated.
(Over)
[**2163-6-15**] 5:19 PM
CTA AORTA/BIFEM/ILIAC RUNOFF W/W&WO C AND RECONS Clip # [**Clip Number (Radiology) 31197**]
Reason: Evaluation of LE vasculature prior to potential angioplasty
Admitting Diagnosis: CELLULITIS
Contrast: OPTIRAY Amt: 100
______________________________________________________________________________
FINAL REPORT
(Cont)
A small calcified stone layers within the gallbladder. The liver, spleen,
adrenal glands are unremarkable. The kidneys are atrophic, particularly the
right. A hypodense focus in the interpolar region of the left kidney measures
8 mm in diameter, too small to characterize. Small central calcifications are
probably vascular, although very small stones are not entirely excluded.
Along the posterior upper pole, there is a suggesting cyst arising from the
left lower pole, measures 24 mm in diameter.
There are widespread vascular calcifications. Extensive calcifications make
it difficult to evaluate for narrowing, but mild narrowing is expected that
both the celiac and mesenteric arterial origins without post-stenotic
dilatation. There is apparently high-grade stenosis along the origin of the
left main renal artery with a very thready narrowed artery immediately beyond
the first centimeter. The inferior mesenteric artery is patent.
The left internal iliac artery is markedly narrowed, and the gluteal branch
may be occluded or hightly stenotic near its origin. Slight post-stenotic
dilatation is present. The artery is opacified distally. Similarly, there is
at least moderate narrowing of the right internal iliac artery. Narrowing
appears relatively mild, however, along the common and external iliac
arteries.
On the right, the superficial femoral artery is irregular, narrowed and
heavily calcified. There are mild focal stenoses at the origin of the
superficial femoral artery, at the distal thigh and at the popliteal artery.
The proximal right anterior tibial artery is opacifies. Distally it is
occluded with distal collateral opacification of the dorsalis pedis via a
prominent collateral from the peroneal artery via the interosseous membrane.
The dorsal pedis is irregularly narrowed. The tibioperoneal trunk is
moderately stenotic. A short high grade stenosis is noted at the origin of
the posterior tibial artery, whose mid to distal part does not opacify.
On the left, there superficial femoral and popliteal arteries are again
irregular, narrowing and heavily calcified. The anterior tibial is narrowed
and opacifies poorly but is perhaps not entirely occluded. The dorsalis pedis
again seems to partly opacify via small collateral pathways, however,
including from the peroneal artery. The posterior tibial again appears
occluded.
Diffuse edema is present. There are no suspicious bone lesions. No frank
bone destruction is seen. The bones appear demineralized.
|
(Over)
[**2163-6-15**] 5:19 PM
CTA AORTA/BIFEM/ILIAC RUNOFF W/W&WO C AND RECONS Clip # [**Clip Number (Radiology) 31197**]
Reason: Evaluation of LE vasculature prior to potential angioplasty
Admitting Diagnosis: CELLULITIS
Contrast: OPTIRAY Amt: 100
______________________________________________________________________________
FINAL REPORT
(Cont)
1. Widespread severe vascular disease including highly attenuated or occluded
anterior and posterior tibial arteries bilaterally, as described in more
detail above.
2. Gallstones.
|
IMPRESSION
| true
| true
| true
| true
| true
| 5
|
[]
|
OK
| 235,115
|
63,330
| 808,109
| 18,988
|
[**2177-10-24**] 1:37 PM
MRA CHEST W&W/O CONTRAST; -59 DISTINCT PROCEDURAL SERVICE Clip # [**Clip Number (Radiology) 106951**]
MRA ABDOMEN W&W/O CONTRAST; -59 DISTINCT PROCEDURAL SERVICE
MRA PELVIS W&W/O CONTRAST; -59 DISTINCT PROCEDURAL SERVICE
MR DOUBLE DOSE CONTRAST
Reason: patient with known aneurysm, possible dissectionEVAL FROM NE
Admitting Diagnosis: ANEURYSM AORTA;TELEMETRY
Contrast: MAGNEVIST Amt: 40
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
84 year old man with above/back pain
REASON FOR THIS EXAMINATION:
patient with known aneurysm, possible dissectionEVAL FROM NECK TO ILIACS from
dissection
______________________________________________________________________________
FINAL REPORT
HISTORY: Back pain in a patient with an aortic aneurysm seen on outside CTA of
the chest abdomen and pelvis.
TECHNIQUE: Multiplanar T1 and T2 weighted images of the chest abdomen and
pelvis were obtained prior to the administration of intravenous gadolinium
followed by multiplanar fat suppressed 3D images of the chest abdomen and
pelvis after the administration of intravenous gadolinium.
FINDINGS:
There is a descending thoracic aortic aneurysm which extends into the abdomen.
Its largest dimensions are 7.7 x 5.5 cm which occurs near the level of the
diaphragm. The transverse aortic arch measures 4.4 cm and is aneurysmal.
No ascending aortic aneurysm.
There are multiple levels of penetrating ulcers as well as extensive mural
thrombus. There is no evidence of an intimal flap. There is evidence of
extremely slow flow within the descending aorta. At the level of the
thoracoabdomial junction there is high signal in the wall on T1 weighted
images, raising suspicion for intramural hematoma, age indeterminant.
The distance from the takeoff of the left subclavian artery to the celiac axis
is 27.4 cm.
There is extensive iliofemoral atherosclerotic disease. This includes near
occlusion of the left common iliac artery several cm distal to its origin. In
addition there is extensive atherosclerotic disease of the more distal iliac
system as well as the left femoral system. The left SFA does not appear to
enhance and the profunda femoris may be feeding the more distal left leg.
On the right there is mild aneurysmal dilatation of the right external artery
at 1.2 cm which leads more distally to a thin and nearly atretic external
iliac artery. At the level of the right mid femoral head the common femoral
artery measures 8 mm and there is an area more centrally within the common
femoral artery on the right contains a large area of eccentric plaque reducing
the enhancing lumen to 4 mm. Again on the right superficial femoral artery
does not appear to enhance but instead the more distal length is most likely
(Over)
[**2177-10-24**] 1:37 PM
MRA CHEST W&W/O CONTRAST; -59 DISTINCT PROCEDURAL SERVICE Clip # [**Clip Number (Radiology) 106951**]
MRA ABDOMEN W&W/O CONTRAST; -59 DISTINCT PROCEDURAL SERVICE
MRA PELVIS W&W/O CONTRAST; -59 DISTINCT PROCEDURAL SERVICE
MR DOUBLE DOSE CONTRAST
Reason: patient with known aneurysm, possible dissectionEVAL FROM NE
Admitting Diagnosis: ANEURYSM AORTA;TELEMETRY
Contrast: MAGNEVIST Amt: 40
______________________________________________________________________________
FINAL REPORT
(Cont)
perfused by the profunda femoris.
Incidentally noted is occlusion of the left internal jugular vein.
IMPRESSION: Thoracoabdominal aortic aneurysm with maximal diameter of 7.7 x
5.5 cm without evidence of aortic dissection or extension of the aneurysm
proximal to the takeoff of the left subclavian artery.
2. Extensive iliofemoral atherosclerotic disease as described.
KEYWORD: AORTA
| 3,921
|
Back pain in a patient with an aortic aneurysm seen on outside CTA of
the chest abdomen and pelvis.
| null |
patient with known aneurysm, possible dissectionEVAL FROM NECK TO ILIACS from
dissection
______________________________________________________________________________
FINAL REPORT
|
There is a descending thoracic aortic aneurysm which extends into the abdomen.
Its largest dimensions are 7.7 x 5.5 cm which occurs near the level of the
diaphragm. The transverse aortic arch measures 4.4 cm and is aneurysmal.
No ascending aortic aneurysm.
There are multiple levels of penetrating ulcers as well as extensive mural
thrombus. There is no evidence of an intimal flap. There is evidence of
extremely slow flow within the descending aorta. At the level of the
thoracoabdomial junction there is high signal in the wall on T1 weighted
images, raising suspicion for intramural hematoma, age indeterminant.
The distance from the takeoff of the left subclavian artery to the celiac axis
is 27.4 cm.
There is extensive iliofemoral atherosclerotic disease. This includes near
occlusion of the left common iliac artery several cm distal to its origin. In
addition there is extensive atherosclerotic disease of the more distal iliac
system as well as the left femoral system. The left SFA does not appear to
enhance and the profunda femoris may be feeding the more distal left leg.
On the right there is mild aneurysmal dilatation of the right external artery
at 1.2 cm which leads more distally to a thin and nearly atretic external
iliac artery. At the level of the right mid femoral head the common femoral
artery measures 8 mm and there is an area more centrally within the common
femoral artery on the right contains a large area of eccentric plaque reducing
the enhancing lumen to 4 mm. Again on the right superficial femoral artery
does not appear to enhance but instead the more distal length is most likely
(Over)
[**2177-10-24**] 1:37 PM
MRA CHEST W&W/O CONTRAST; -59 DISTINCT PROCEDURAL SERVICE Clip # [**Clip Number (Radiology) 106951**]
MRA ABDOMEN W&W/O CONTRAST; -59 DISTINCT PROCEDURAL SERVICE
MRA PELVIS W&W/O CONTRAST; -59 DISTINCT PROCEDURAL SERVICE
MR DOUBLE DOSE CONTRAST
Reason: patient with known aneurysm, possible dissectionEVAL FROM NE
Admitting Diagnosis: ANEURYSM AORTA;TELEMETRY
Contrast: MAGNEVIST Amt: 40
______________________________________________________________________________
FINAL REPORT
(Cont)
perfused by the profunda femoris.
Incidentally noted is occlusion of the left internal jugular vein.
|
Thoracoabdominal aortic aneurysm with maximal diameter of 7.7 x
5.5 cm without evidence of aortic dissection or extension of the aneurysm
proximal to the takeoff of the left subclavian artery.
2. Extensive iliofemoral atherosclerotic disease as described.
KEYWORD: AORTA
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 31,180
|
489,012
| 1,238,241
| 92,063
|
[**2126-5-22**] 2:36 PM
[**Numeric Identifier 64915**] INJ PARAVERT F JNT C/T 1 LEV; [**Numeric Identifier 64916**] INJ PARAVERT F JNT C/T 2 LEVClip # [**Numeric Identifier 64917**] INJ PARAVERT F JNT C/T 3 LEV
Reason: 85 year old woman with T-pain
Contrast: ISOVUE Amt: 5
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
85 year old woman with T-pain
REASON FOR THIS EXAMINATION:
85 year old woman with T-pain
______________________________________________________________________________
FINAL REPORT
THE SPINE CENTER AT [**Hospital1 **]
Procedure Note
Medial Branch Nerve Diagnostic Block
T7, T8, T9 bony levels
BILATERAL
Interval History:
Denies interval change in health. Has thoracic pain and wants injections for
this. Denies fevers or recent illness, blood thinners, new allergies. Will not
be driving today.
Physical Exam:
AFVSS
A Ox3 fluent NAD
Nonfocal motor, gait intact
Skin on back normal
Procedure: Medial Branch Nerve Diagnostic Block Pre-Procedure
Diagnosis/ Indication: Back pain, facet-joint pain
Post-Procedure Diagnosis: Same
Physicians: [**Doctor Last Name 16537**] (Attending, present for all)
Consent obtained: Yes. The procedure and risks were explained and informed
consent was obtained from the patient.
Position of patient: Prone
Preparation: Sterile chloroprep
Sedation: N/A
Local anesthetic: Small amount lidocaine 1% superficially
Needle: 25 G 3.5 inch spinal
Fluoroscopy: Lumbar, sacral
Contrast: None
Approach: Posterior
Pre-injection aspiration: No blood
Injectate: each site, 0.4 mL BUPIVAcaine 0.25%
Blood loss: Zero mL
Specimens: None
Complications: None
Other: Well-tolerated
Findings: None; skin normal post-procedure
Narrative: The patient was placed in the prone position on a fluoroscopy
table, and sterile prep was performed. The patient was monitored throughout
(Over)
[**2126-5-22**] 2:36 PM
[**Numeric Identifier 64915**] INJ PARAVERT F JNT C/T 1 LEV; [**Numeric Identifier 64916**] INJ PARAVERT F JNT C/T 2 LEVClip # [**Numeric Identifier 64917**] INJ PARAVERT F JNT C/T 3 LEV
Reason: 85 year old woman with T-pain
Contrast: ISOVUE Amt: 5
______________________________________________________________________________
FINAL REPORT
(Cont)
the procedure. At T7, 8, 9 bony levels: Fluoroscopy was used to identify the
junction of the transverse process and the superior articular process (or
sacral ala for L5 medial branch nerve). After local anesthetic, the spinal
needle was advanced under intermittent fluoroscopic guidance, until abutting
os, at the location of the medial branch of the posterior primary ramus. After
a negative pre-injection aspiration, medication was slowly injected.
Well-tolerated. Observed afterwards in the recovery room, and there was no
motor block or sensory deficit. The patient had someone to drive them home.
Discharged in stable condition, with written instructions.
Plan:
S/P Medial Branch Nerve Diagnostic Block
T7, T8, T9 bony levels
BILATERAL
At discharge she had uncertain relief; will consider alternate block next
encounter; see clinic note.
All universal protocol elements and radiology procedure policies were
followed, as confirmed by the radiology tech.
[**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 64918**], M.D.
| 3,502
|
Denies interval change in health. Has thoracic pain and wants injections for
this. Denies fevers or recent illness, blood thinners, new allergies. Will not
be driving today.
Physical
| null |
85 year old woman with T-pain
______________________________________________________________________________
FINAL REPORT
THE SPINE CENTER AT [**Hospital1 **]
Procedure Note
Medial Branch Nerve Diagnostic Block
T7, T8, T9 bony levels
BILATERAL
Interval
|
None; skin normal post-procedure
Narrative: The patient was placed in the prone position on a fluoroscopy
table, and sterile prep was performed. The patient was monitored throughout
(Over)
[**2126-5-22**] 2:36 PM
[**Numeric Identifier 64915**] INJ PARAVERT F JNT C/T 1 LEV; [**Numeric Identifier 64916**] INJ PARAVERT F JNT C/T 2 LEVClip # [**Numeric Identifier 64917**] INJ PARAVERT F JNT C/T 3 LEV
Reason: 85 year old woman with T-pain
Contrast: ISOVUE Amt: 5
______________________________________________________________________________
FINAL REPORT
(Cont)
the procedure. At T7, 8, 9 bony levels: Fluoroscopy was used to identify the
junction of the transverse process and the superior articular process (or
sacral ala for L5 medial branch nerve). After local anesthetic, the spinal
needle was advanced under intermittent fluoroscopic guidance, until abutting
os, at the location of the medial branch of the posterior primary ramus. After
a negative pre-injection aspiration, medication was slowly injected.
Well-tolerated. Observed afterwards in the recovery room, and there was no
motor block or sensory deficit. The patient had someone to drive them home.
Discharged in stable condition, with written instructions.
Plan:
S/P Medial Branch Nerve Diagnostic Block
T7, T8, T9 bony levels
BILATERAL
At discharge she had uncertain relief; will consider alternate block next
encounter; see clinic note.
All universal protocol elements and radiology procedure policies were
followed, as confirmed by the radiology tech.
[**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 64918**], M.D.
|
Plan:
S/P Medial Branch Nerve Diagnostic Block
T7, T8, T9 bony levels
BILATERAL
At discharge she had uncertain relief; will consider alternate block next
encounter; see clinic note. All universal protocol elements and radiology procedure policies were
followed, as confirmed by the radiology tech. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 64918**], M.D.
|
FALLBACK_LAST_SENTENCES
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 267,732
|
358,613
| 1,095,912
| 74,869
|
[**2150-9-8**] 10:35 AM
CHEST PORT. LINE PLACEMENT; -77 BY DIFFERENT PHYSICIAN [**Name Initial (PRE) 7**] # [**Clip Number (Radiology) 67418**]
Reason: 40 cm Picc placed in left brachial vein, need Picc tip place
Admitting Diagnosis: ? SEROTONIN SYNDROME
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
74 year old woman with new Picc
REASON FOR THIS EXAMINATION:
40 cm Picc placed in left brachial vein, need Picc tip placement
______________________________________________________________________________
FINAL REPORT
PROCEDURE: Chest port line placement.
REASON FOR EXAM: New left PICC line.
FINDINGS:
Since the previous study earlier the same date, the new PICC line tip is just
below the cavoatrial junction. ET tube is below the thoracic inlet and 2 cm
above the carina. Right central venous line tip is in the right atrium. It
is satisfactory.
Left lower lobe atelectasis is unchanged, left perihilar and infrahilar
consolidation has slightly worsened, most likely aspiration or pneumonia. The
right lung is grossly clear.
IMPRESSION: Worsening left perihilar and infrahilar consolidation.
Satisfactory position of the new left PICC line is at the cavoatrial junction.
| 1,324
| null | null |
40 cm Picc placed in left brachial vein, need Picc tip placement
______________________________________________________________________________
FINAL REPORT
|
Since the previous study earlier the same date, the new PICC line tip is just
below the cavoatrial junction. ET tube is below the thoracic inlet and 2 cm
above the carina. Right central venous line tip is in the right atrium. It
is satisfactory.
Left lower lobe atelectasis is unchanged, left perihilar and infrahilar
consolidation has slightly worsened, most likely aspiration or pneumonia. The
right lung is grossly clear.
|
Worsening left perihilar and infrahilar consolidation.
Satisfactory position of the new left PICC line is at the cavoatrial junction.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 184,788
|
109,185
| 843,434
| 13,325
|
[**2108-11-9**] 9:57 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 29405**]
Reason: ET tube placement
Admitting Diagnosis: SEPSIS
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
67 year old man with CLL, transaminitis, s/p central line attempts, w/
new fever s/p intubation.
REASON FOR THIS EXAMINATION:
ET tube placement
______________________________________________________________________________
FINAL REPORT
INDICATION: 67 y/o man with CLL, transaminitis, new fever. Evaluation for ETT
placement.
COMPARISONS: Supine AP portable chest x ray of [**2108-11-8**].
TECHNIQUE: Supine AP portable chest x ray.
FINDINGS: The ETT, NG tube, and right IJ central venous catheter remain in
unchanged positions. Cardiac and mediastinal contours are stable. There is
persistent left lower lobe atelectasis or consolidation. Nodular opacities are
again seen in the left mid lung zone with no clear change, allowing for
differences in technique. Otherwise, the lungs are unchanged in appearance.
There is no definite pleural effusion on the right, although the right
costophrenic angle is not fully seen on this view. No evidence of pneumothorax
is seen.
IMPRESSION: No significant interval change. Again noted is an area of left
lower lobe atelectasis or consolidation with an adjacent pleural effusion.
Also, unchanged lung nodules are seen in the left lateral lung zone.
| 1,561
| null |
Supine AP portable chest x ray of [**2108-11-8**].
|
ET tube placement
______________________________________________________________________________
FINAL REPORT
INDICATION: 67 y/o man with CLL, transaminitis, new fever. Evaluation for ETT
placement.
|
The ETT, NG tube, and right IJ central venous catheter remain in
unchanged positions. Cardiac and mediastinal contours are stable. There is
persistent left lower lobe atelectasis or consolidation. Nodular opacities are
again seen in the left mid lung zone with no clear change, allowing for
differences in technique. Otherwise, the lungs are unchanged in appearance.
There is no definite pleural effusion on the right, although the right
costophrenic angle is not fully seen on this view. No evidence of pneumothorax
is seen.
|
No significant interval change. Again noted is an area of left
lower lobe atelectasis or consolidation with an adjacent pleural effusion.
Also, unchanged lung nodules are seen in the left lateral lung zone.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 56,159
|
361,363
| 1,097,301
| 60,624
|
[**2138-9-25**] 7:33 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 78134**]
Reason: / ptx after CT removal
Admitting Diagnosis: CONGESTIVE HEART FAILURE;S/P CARDIAC INTERVENTION
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
78 year old man with CABG
REASON FOR THIS EXAMINATION:
/ ptx after CT removal
______________________________________________________________________________
FINAL REPORT
HISTORY: CABG with chest tube removal, to evaluate for pneumothorax.
FINDINGS: In comparison with the study of [**9-23**], the left chest tube has been
removed and there is no evidence of pneumothorax. All the other monitoring
and support devices have been removed. Mild atelectatic changes are again
seen at the left base.
| 898
|
CABG with chest tube removal, to evaluate for pneumothorax.
| null |
/ ptx after CT removal
______________________________________________________________________________
FINAL REPORT
|
In comparison with the study of [**9-23**], the left chest tube has been
removed and there is no evidence of pneumothorax. All the other monitoring
and support devices have been removed. Mild atelectatic changes are again
seen at the left base.
|
FINDINGS: In comparison with the study of [**9-23**], the left chest tube has been
removed and there is no evidence of pneumothorax. All the other monitoring
and support devices have been removed. Mild atelectatic changes are again
seen at the left base.
|
FALLBACK_LAST_SENTENCES
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 186,591
|
147,188
| 894,400
| 3,888
|
[**2150-2-8**] 9:12 AM
ABDOMEN U.S. (COMPLETE STUDY); DUPLEX DOPP ABD/PEL Clip # [**Clip Number (Radiology) 69045**]
Reason: with dopplers to r/o portal thrombus
Admitting Diagnosis: VARICEAL BLEED
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
41 year old man with etoh cirrhosis here.
REASON FOR THIS EXAMINATION:
with dopplers to r/o portal thrombus
______________________________________________________________________________
FINAL REPORT
INDICATION: 41-year-old man with alcoholic cirrhosis. Rising LFTs.
TECHNIQUE: Right upper quadrant ultrasound with Doppler/duplex evaluation of
the portal venous system.
FINDINGS: The liver is diffusely echogenic and small in size, with a large
amount of ascites. The gallbladder is seen with sludge, however, there is no
intrahepatic biliary ductal dilatation. The right kidney measures 13.9 cm.
The left kidney measures 13.2 cm. The spleen is enlarged at 16.7 cm.
DOPPLER EVALUATION: Interrogation of the portal veins with color flow and
spectral analysis reveals reversal of normal direction of portal flow. Hepatic
veins, while maintaining normal direction, are attenuated.
IMPRESSION:
1. Reversal of normal portal flow. No evidence of portal thrombus.
2. Echogenic, small shrunken liver, with ascites. Focal liver lesions in
this echogenic liver cannot be excluded on the basis of this study.
Findings were discussed with Dr. [**Last Name (STitle) 18**] by telephone at time of interpretation.
| 1,603
| null | null |
with dopplers to r/o portal thrombus
______________________________________________________________________________
FINAL REPORT
INDICATION: 41-year-old man with alcoholic cirrhosis. Rising LFTs.
|
The liver is diffusely echogenic and small in size, with a large
amount of ascites. The gallbladder is seen with sludge, however, there is no
intrahepatic biliary ductal dilatation. The right kidney measures 13.9 cm.
The left kidney measures 13.2 cm. The spleen is enlarged at 16.7 cm.
DOPPLER EVALUATION: Interrogation of the portal veins with color flow and
spectral analysis reveals reversal of normal direction of portal flow. Hepatic
veins, while maintaining normal direction, are attenuated.
|
1. Reversal of normal portal flow. No evidence of portal thrombus.
2. Echogenic, small shrunken liver, with ascites. Focal liver lesions in
this echogenic liver cannot be excluded on the basis of this study.
Findings were discussed with Dr. [**Last Name (STitle) 18**] by telephone at time of interpretation.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 76,078
|
111,393
| 843,016
| 19,216
|
[**2182-10-21**] 1:37 PM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 60313**]
Reason: assess for effusion or CHF
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
52 year old woman with sob
REASON FOR THIS EXAMINATION:
assess for effusion or CHF
______________________________________________________________________________
FINAL REPORT
INDICATION: 52-year-old with shortness of breath.
PORTABLE UPRIGHT FRONTAL RADIOGRAPH. Comparison was made to study performed 2
hours prior.
FINDINGS:
There has been interval development of mild interstitial edema with septal
lines and upper zone redistribution of the pulmonary vasculature. There are
no focal consolidations. There is no pneumothorax. No other changes compared
to the prior study.
IMPRESSION:
Interval development of increasing interstitial edema.
| 990
| null | null |
assess for effusion or CHF
______________________________________________________________________________
FINAL REPORT
INDICATION: 52-year-old with shortness of breath.
PORTABLE UPRIGHT FRONTAL RADIOGRAPH. Comparison was made to study performed 2
hours prior.
|
There has been interval development of mild interstitial edema with septal
lines and upper zone redistribution of the pulmonary vasculature. There are
no focal consolidations. There is no pneumothorax. No other changes compared
to the prior study.
|
Interval development of increasing interstitial edema.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 57,481
|
373,934
| 1,109,790
| 86,831
|
[**2130-12-24**] 11:24 AM
LIVER OR GALLBLADDER US (SINGLE ORGAN) Clip # [**Clip Number (Radiology) 103969**]
Reason: RUQ U/S and mark for possible paracentesis please, for r/o c
Admitting Diagnosis: SHORTNESS OF BREATH;WEAKNESS
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
58 yo male with esophageal CA in remission and hepatitis C called out from the
micu s/p prolonged intubation for respiratory failure thought to be ARDS [**2-27**]
cirrhosis now with fever to 99.6, increased WBC, increased LFTs.
REASON FOR THIS EXAMINATION:
RUQ U/S and mark for possible paracentesis please, for r/o cholecystits
______________________________________________________________________________
WET READ: ENYa SUN [**2130-12-24**] 12:35 PM
Limited 4 Quadrant U/S. Deepest pocket of ascites marked at RLQ.
______________________________________________________________________________
FINAL REPORT
HISTORY: 58-year-old man with esophageal cancer, now in remission, also known
history of hepatitis C. Assess for abdominal ascites and mark for possible
site for paracentesis. Also rule out for acute cholecystitis.
LIMITED FOUR-QUADRANT ULTRASOUND: There is moderate ascites throughout all
four quadrants. Limited evaluation of the liver demonstrates a diffusely
echogenic liver without definite focal lesion, compatible with the history of
hepatitis C. The gallbladder is non-distended. There is normal hepatopetal
portal venous flow. The spleen measures 14.0 cm.
The deepest pocket of ascites is identified and marked in the right lower
quadrant, approximately 10 cm in maximum depth, and 1 cm from superficial
skin/soft tissue.
IMPRESSION:
1. Diffusely echogenic liver compatible with the hepatitis C history.
Non-distended gallbladder makes acute cholecystitis unlikely.
2. Moderate ascites in all four quadrants, with the deepest pocket marked in
the right lower quadrant.
| 2,040
|
58-year-old man with esophageal cancer, now in remission, also known
history of hepatitis C. Assess for abdominal ascites and mark for possible
site for paracentesis. Also rule out for acute cholecystitis.
LIMITED FOUR-QUADRANT
| null |
RUQ U/S and mark for possible paracentesis please, for r/o cholecystits
______________________________________________________________________________
WET READ: ENYa SUN [**2130-12-24**] 12:35 PM
Limited 4 Quadrant U/S. Deepest pocket of ascites marked at RLQ.
______________________________________________________________________________
FINAL REPORT
|
There is moderate ascites throughout all
four quadrants. Limited evaluation of the liver demonstrates a diffusely
echogenic liver without definite focal lesion, compatible with the history of
hepatitis C. The gallbladder is non-distended. There is normal hepatopetal
portal venous flow. The spleen measures 14.0 cm.
The deepest pocket of ascites is identified and marked in the right lower
quadrant, approximately 10 cm in maximum depth, and 1 cm from superficial
skin/soft tissue.
|
1. Diffusely echogenic liver compatible with the hepatitis C history.
Non-distended gallbladder makes acute cholecystitis unlikely.
2. Moderate ascites in all four quadrants, with the deepest pocket marked in
the right lower quadrant.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 193,594
|
275,545
| 1,031,947
| 13,373
|
[**2202-8-25**] 10:52 PM
ERCP BILIARY&PANCREAS BY GI UNIT Clip # [**Clip Number (Radiology) 6031**]
Reason: Please review ERCP films
Admitting Diagnosis: CHOLEDOCHOLITHIASIS
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
53 year old man for PD stent removal
REASON FOR THIS EXAMINATION:
Please review ERCP films
______________________________________________________________________________
FINAL REPORT
ERCP
INDICATION: 53-year-old man with pancreatic duct stent removal.
COMPARISON: [**2202-7-20**] and CT from [**2202-5-18**].
FINDINGS: Four fluoroscopic images are submitted after ERCP performed by
gastroenterology. They show a pancreatic duct stent which was subsequently
removed.
IMPRESSION: Removal of plastic pancreatic duct stent. For further details,
see the gastroenterology report on the same date.
| 974
| null |
[**2202-7-20**] and CT from [**2202-5-18**].
|
Please review ERCP films
______________________________________________________________________________
FINAL REPORT
ERCP
INDICATION: 53-year-old man with pancreatic duct stent removal.
|
Four fluoroscopic images are submitted after ERCP performed by
gastroenterology. They show a pancreatic duct stent which was subsequently
removed.
|
Removal of plastic pancreatic duct stent. For further details,
see the gastroenterology report on the same date.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 141,947
|
407,108
| 1,141,606
| 99,213
|
[**2132-8-9**] 1:25 PM
TRAUMA #3 (PORT CHEST ONLY) Clip # [**Clip Number (Radiology) 91617**]
Reason: TRAUMA
______________________________________________________________________________
WET READ: IPf SAT [**2132-8-9**] 1:36 PM
NG tube too high, tip at the GE junction, should be advanced several
centimeters.
______________________________________________________________________________
FINAL REPORT
HISTORY: Trauma.
TECHNIQUE: Portable chest radiograph, single view.
COMPARISON: No prior.
FINDINGS: Overlying trauma board gives suboptimal evaluation of the chest.
There is an overlying tubular structure at the right mediastinum, which gives
suboptimal evaluation of the right upper chest. In the visualized portion of
the lungs, there is no focal lung consolidation or evidence of contusion. No
pleural effusion. Small right pneumothorax seen on subsequent CT not well
appreciated on the current study. Hilar, mediastinal and cardiac silhouette
are within normal limits. There is an endotracheal tube with tip 6.8 cm above
carina. There is an NG tube in place with tip too high, projecting at the GE
junction, should be advanced at least 6 cm, so that it is well within the
stomach. A mildly displaced fracture of the posterior right 8th rib and
possibly right 9th rib are noted.
IMPRESSION:
1. Suboptimal evaluation of the chest due to overlapping trauma board and
tubular structure overlying the right mediastinum; small right pneumothorax
seen on subsequent CT not well appreciated on the current study. Mildly
displaced posterior right 8th and 9th rib fractures.
2. High riding nasogastric tube, tip at the GE junction, should be advanced
so that it is well within the stomach, at least 6 cm. Finding posted on the ED
dashboard.
| 1,857
|
Trauma.
|
No prior.
|
Portable chest radiograph, single view.
|
Overlying trauma board gives suboptimal evaluation of the chest.
There is an overlying tubular structure at the right mediastinum, which gives
suboptimal evaluation of the right upper chest. In the visualized portion of
the lungs, there is no focal lung consolidation or evidence of contusion. No
pleural effusion. Small right pneumothorax seen on subsequent CT not well
appreciated on the current study. Hilar, mediastinal and cardiac silhouette
are within normal limits. There is an endotracheal tube with tip 6.8 cm above
carina. There is an NG tube in place with tip too high, projecting at the GE
junction, should be advanced at least 6 cm, so that it is well within the
stomach. A mildly displaced fracture of the posterior right 8th rib and
possibly right 9th rib are noted.
|
1. Suboptimal evaluation of the chest due to overlapping trauma board and
tubular structure overlying the right mediastinum; small right pneumothorax
seen on subsequent CT not well appreciated on the current study. Mildly
displaced posterior right 8th and 9th rib fractures.
2. High riding nasogastric tube, tip at the GE junction, should be advanced
so that it is well within the stomach, at least 6 cm. Finding posted on the ED
dashboard.
|
IMPRESSION
| true
| true
| true
| true
| true
| 5
|
[]
|
OK
| 213,545
|
229,942
| 993,747
| 32,788
|
[**2128-2-6**] 7:17 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 55578**]
Reason: r/o inf
Admitting Diagnosis: TACCHYCARDIA/BRADYCARDIA;ATRIAL FLUTTER\A-FLUTTER ABLATION;BV PACER
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
83 year old man with
REASON FOR THIS EXAMINATION:
r/o inf
______________________________________________________________________________
FINAL REPORT
HISTORY: Sternal dehiscence.
FINDINGS: In comparison with the most recent study on [**2-5**], there has been
placement of a nasogastric tube that extends to the stomach. Remainder of the
study is unchanged.
| 761
|
Sternal dehiscence.
| null |
r/o inf
______________________________________________________________________________
FINAL REPORT
|
In comparison with the most recent study on [**2-5**], there has been
placement of a nasogastric tube that extends to the stomach. Remainder of the
study is unchanged.
|
[**2128-2-6**] 7:17 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 55578**]
Reason: r/o inf
Admitting Diagnosis: TACCHYCARDIA/BRADYCARDIA;ATRIAL FLUTTER\A-FLUTTER ABLATION;BV PACER
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
83 year old man with
REASON FOR THIS EXAMINATION:
r/o inf
______________________________________________________________________________
FINAL REPORT
HISTORY: Sternal dehiscence. FINDINGS: In comparison with the most recent study on [**2-5**], there has been
placement of a nasogastric tube that extends to the stomach. Remainder of the
study is unchanged.
|
FALLBACK_LAST_SENTENCES
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 117,202
|
255,235
| 1,004,448
| 27,365
|
[**2185-3-3**] 4:47 PM
CHEST (PA & LAT) Clip # [**Clip Number (Radiology) 66757**]
Reason: eval for PNA, CM, Pulm edema
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
65 year old man with chest pain, now resolved
REASON FOR THIS EXAMINATION:
eval for PNA, CM, Pulm edema
______________________________________________________________________________
FINAL REPORT
TWO VIEWS OF THE CHEST [**2185-3-3**]
HISTORY: 65-year-old man with chest pain, now resolved.
FINDINGS: Bedside AP and lateral views labeled "upright" are compared with
recent single view dated [**2185-2-25**]. In the interval, the findings of CHF have
largely resolved, with small pleural effusions, layering posteriorly. The
lung volumes remain relatively low with retrocardiac atelectasis. No focal
consolidation is seen. A right subclavian central venous catheter reaches the
cavoatrial junction, as before.
IMPRESSION: Significant interval improvement in findings of CHF with residual
bilateral pleural effusions and subsegmental atelectasis.
| 1,191
|
65-year-old man with chest pain, now resolved.
| null |
eval for PNA, CM, Pulm edema
______________________________________________________________________________
FINAL REPORT
TWO VIEWS OF THE CHEST [**2185-3-3**]
|
Bedside AP and lateral views labeled "upright" are compared with
recent single view dated [**2185-2-25**]. In the interval, the findings of CHF have
largely resolved, with small pleural effusions, layering posteriorly. The
lung volumes remain relatively low with retrocardiac atelectasis. No focal
consolidation is seen. A right subclavian central venous catheter reaches the
cavoatrial junction, as before.
|
Significant interval improvement in findings of CHF with residual
bilateral pleural effusions and subsegmental atelectasis.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 130,650
|
199,046
| 945,529
| 16,549
|
[**2113-2-2**] 10:18 AM
CT CHEST W&W/O C Clip # [**0-0-**]
Reason: evaluate for infiltrates, assess for sternal fluid collectio
Admitting Diagnosis: PNEUMONIA
Contrast: OPTIRAY Amt: 75
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
63 year old woman s/p CABG c/b sternal osteo and debridement, p/w fevers, noted
to have fluid collection at sternal notch at OSH CT chest and LLL infiltrate
REASON FOR THIS EXAMINATION:
evaluate for infiltrates, assess for sternal fluid collection - ?abscess vs.
seroma vs. fat pad
CONTRAINDICATIONS for IV CONTRAST:
CrCl 34 ml/min
______________________________________________________________________________
FINAL REPORT
INDICATION: 63-year-old woman status post CABG complicated by sternal
osteomyelitis and debridement, presenting with fevers. Noted air-fluid
collections or sternal notch at outside hospital CT. Evaluate for infiltrates
and stomach fluid collection.
TECHNIQUE: CT chest with contrast.
Comparison is made to CT torso of [**2112-11-26**].
FINDINGS: The patient is status post CABG and there is has been resection of
the sternum for osteomyelitis. At the level of the superior sternal notch,
there is a 4.0 x 3.5 x 5 cm (transverse, AP, and craniocaudal dimensions,
respectively), fluid collection which has enlarged from the reference scan
from an outside hospital. There is a slightly hyper- attenuating rim. There is
mild stranding in the surrounding subcutaneous fat. Staple material is seen in
the region. The fluid collection associated stranding are extending
posteriorly into the anterior mediastinum. Several lymph nodes are seen in the
mediastinum, which do not meet size criteria for pathologic enlargement and
appear stable when compared to [**2112-11-26**]. The airways are patent to
the subsegmental bronchi level. There is a homogeneously enhancing left lower
lobe opacity consistent with atelectasis. Minimal dependent atelectasis is
also seen at the right lung base. The lungs are otherwise clear. There is
mild cardiomegaly. There is no pericardial effusion.
No acute pathology is detected in the partially visualized upper abdominal
organs. There is mild fat stranding in the subcutaneous tissues inferiorly to
the described sternal fluid collections extending down to the level of the
upper abdomen.
BONE WINDOWS: Patient is status post resection of the sternum for
osteomyelitis. No suspicious lytic or blastic lesions are seen.
IMPRESSION:
1. 4 x 3.5 x 5 cm fluid collection with slightly hyperenhancing rim at the
level of the superior sternal notch, status post sternal debridement for
osteomyelitis. This fluid collection could represent a postsurgical seroma,
but superinfection cannot be excluded.
(Over)
[**2113-2-2**] 10:18 AM
CT CHEST W&W/O C Clip # [**0-0-**]
Reason: evaluate for infiltrates, assess for sternal fluid collectio
Admitting Diagnosis: PNEUMONIA
Contrast: OPTIRAY Amt: 75
______________________________________________________________________________
FINAL REPORT
(Cont)
2. Left lower lobe atelectasis. No evidence of pneumonia.
| 3,400
| null | null |
evaluate for infiltrates, assess for sternal fluid collection - ?abscess vs.
seroma vs. fat pad
CONTRAINDICATIONS for IV CONTRAST:
CrCl 34 ml/min
______________________________________________________________________________
FINAL REPORT
INDICATION: 63-year-old woman status post CABG complicated by sternal
osteomyelitis and debridement, presenting with fevers. Noted air-fluid
collections or sternal notch at outside hospital CT. Evaluate for infiltrates
and stomach fluid collection.
|
The patient is status post CABG and there is has been resection of
the sternum for osteomyelitis. At the level of the superior sternal notch,
there is a 4.0 x 3.5 x 5 cm (transverse, AP, and craniocaudal dimensions,
respectively), fluid collection which has enlarged from the reference scan
from an outside hospital. There is a slightly hyper- attenuating rim. There is
mild stranding in the surrounding subcutaneous fat. Staple material is seen in
the region. The fluid collection associated stranding are extending
posteriorly into the anterior mediastinum. Several lymph nodes are seen in the
mediastinum, which do not meet size criteria for pathologic enlargement and
appear stable when compared to [**2112-11-26**]. The airways are patent to
the subsegmental bronchi level. There is a homogeneously enhancing left lower
lobe opacity consistent with atelectasis. Minimal dependent atelectasis is
also seen at the right lung base. The lungs are otherwise clear. There is
mild cardiomegaly. There is no pericardial effusion.
No acute pathology is detected in the partially visualized upper abdominal
organs. There is mild fat stranding in the subcutaneous tissues inferiorly to
the described sternal fluid collections extending down to the level of the
upper abdomen.
BONE WINDOWS: Patient is status post resection of the sternum for
osteomyelitis. No suspicious lytic or blastic lesions are seen.
|
1. 4 x 3.5 x 5 cm fluid collection with slightly hyperenhancing rim at the
level of the superior sternal notch, status post sternal debridement for
osteomyelitis. This fluid collection could represent a postsurgical seroma,
but superinfection cannot be excluded.
(Over)
[**2113-2-2**] 10:18 AM
CT CHEST W&W/O C Clip # [**0-0-**]
Reason: evaluate for infiltrates, assess for sternal fluid collectio
Admitting Diagnosis: PNEUMONIA
Contrast: OPTIRAY Amt: 75
______________________________________________________________________________
FINAL REPORT
(Cont)
2. Left lower lobe atelectasis. No evidence of pneumonia.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 101,286
|
356,654
| 1,101,252
| 76,732
|
[**2185-8-30**] 12:29 PM
CHEST (PORTABLE AP); FOLLOW-UP,REQUEST BY RAD. Clip # [**Clip Number (Radiology) 7501**]
Reason: evaluate for mediastinal air and pneumothorax
Admitting Diagnosis: BRANCHIAL STENOSIS
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
80 year old woman with rigid bronchoscopy and stent removal
REASON FOR THIS EXAMINATION:
evaluate for mediastinal air and pneumothorax
______________________________________________________________________________
FINAL REPORT
TYPE OF EXAMINATION: Chest AP portable single view.
INDICATION: Evaluate for mediastinal air or pneumothorax. The patient is
status post rigid bronchoscopy and stent removal.
FINDINGS: AP single view of the chest has been obtained with patient in
sitting semi-upright position and analysis is performed in direct comparison
with the next preceding similar study of [**2185-8-18**]. Comparison
demonstrates that the previously described stent located in the intermediate
bronchus of the right side has been removed. Otherwise, the previously
described status post right upper lung lobectomy and radiation scarring appear
unchanged. No pneumothorax has developed. No new pulmonary, vascular or
parenchymal abnormalities in the noninfected left-sided lung.
IMPRESSION: Stent removal, but otherwise stable chest findings. No evidence
of pneumothorax or pneumomediastinum following bronchoscopic procedure.
| 1,541
| null | null |
evaluate for mediastinal air and pneumothorax
______________________________________________________________________________
FINAL REPORT
TYPE OF
|
AP single view of the chest has been obtained with patient in
sitting semi-upright position and analysis is performed in direct comparison
with the next preceding similar study of [**2185-8-18**]. Comparison
demonstrates that the previously described stent located in the intermediate
bronchus of the right side has been removed. Otherwise, the previously
described status post right upper lung lobectomy and radiation scarring appear
unchanged. No pneumothorax has developed. No new pulmonary, vascular or
parenchymal abnormalities in the noninfected left-sided lung.
|
Stent removal, but otherwise stable chest findings. No evidence
of pneumothorax or pneumomediastinum following bronchoscopic procedure.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 183,563
|
332,260
| 1,081,331
| 54,265
|
[**2194-7-5**] 8:31 AM
ERCP BILIARY ONLY BY GI UNIT Clip # [**Clip Number (Radiology) 57539**]
Reason: Please review ERCP images done [**7-5**]
Admitting Diagnosis: CHOLANGITIS
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
Jaundice, fever, gallstones, acute cholangitis
REASON FOR THIS EXAMINATION:
Please review ERCP images done [**7-5**]
______________________________________________________________________________
FINAL REPORT
INDICATION: 84-year-old female with fever, jaundice, and gallstones,
consistent with acute cholangitis.
COMPARISON: None available.
FINDINGS: Eight spot fluoroscopic images from ERCP procedure, performed
without a radiologist present, are submitted for review. Scout images are
unremarkable. Subsequent images demonstrate introduction of an endoscope
within the duodenum, and cannulation of and contrast injection into the common
bile duct. There are innumerable filling defects throughout the common duct,
with moderate diffuse dilatation of a common duct measuring up to 1.5 cm.
Final images demonstrate placement of a plastic common bile duct stent, with
residual filling defects seen adjacent to the stent, consistent with retained
stones. Per real-time findings, further stone removal was not attempted given
setting of acute cholangitis.
IMPRESSION:
1. Innumerable filling defects within the common duct, consistent with
stones. There is moderate duct dilatation.
2. Placement of common bile duct stent, with numerous residual retained
common duct stones present at the termination of procedure.
Please refer to the GI procedure note in the online medical record for further
details.
| 1,806
| null |
None available.
|
Please review ERCP images done [**7-5**]
______________________________________________________________________________
FINAL REPORT
INDICATION: 84-year-old female with fever, jaundice, and gallstones,
consistent with acute cholangitis.
|
Eight spot fluoroscopic images from ERCP procedure, performed
without a radiologist present, are submitted for review. Scout images are
unremarkable. Subsequent images demonstrate introduction of an endoscope
within the duodenum, and cannulation of and contrast injection into the common
bile duct. There are innumerable filling defects throughout the common duct,
with moderate diffuse dilatation of a common duct measuring up to 1.5 cm.
Final images demonstrate placement of a plastic common bile duct stent, with
residual filling defects seen adjacent to the stent, consistent with retained
stones. Per real-time findings, further stone removal was not attempted given
setting of acute cholangitis.
|
1. Innumerable filling defects within the common duct, consistent with
stones. There is moderate duct dilatation.
2. Placement of common bile duct stent, with numerous residual retained
common duct stones present at the termination of procedure.
Please refer to the GI procedure note in the online medical record for further
details.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 170,407
|
506,652
| 1,209,404
| 92,895
|
[**2155-10-1**] 7:02 PM
CT HEAD W/O CONTRAST Clip # [**Clip Number (Radiology) 41962**]
Reason: ? ICH
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
61 year old man with syncope on coumadin, ? head strike
REASON FOR THIS EXAMINATION:
? ICH
No contraindications for IV contrast
______________________________________________________________________________
WET READ: NATg WED [**2155-10-1**] 7:36 PM
neg acute
______________________________________________________________________________
FINAL REPORT
CLINICAL INFORMATION: 61-year-old male with syncope on Coumadin and head
strike. Evaluate for ICH.
COMPARISON: None.
TECHNIQUE: Axial images were acquired of the head without contrast and
reformatted in the coronal and sagittal planes.
FINDINGS: There is no acute intracranial hemorrhage, extra-axial collection,
or mass effect. The ventricles and sulci are mildly prominent, compatible
with age appropriate atrophy, but are normal in configuration. [**Doctor Last Name **]
matter/white matter differentiation is preserved throughout. The orbits are
normal in appearance. The visualized soft tissues are normal. The mastoid
air cells are clear bilaterally. The visualized portions of the paranasal
sinuses are clear. There is no osseous abnormality.
IMPRESSION: No acute intracranial process.
| 1,484
| null |
None.
|
? ICH
No contraindications for IV contrast
______________________________________________________________________________
WET READ: NATg WED [**2155-10-1**] 7:36 PM
neg acute
______________________________________________________________________________
FINAL REPORT
CLINICAL INFORMATION: 61-year-old male with syncope on Coumadin and head
strike. Evaluate for ICH.
|
There is no acute intracranial hemorrhage, extra-axial collection,
or mass effect. The ventricles and sulci are mildly prominent, compatible
with age appropriate atrophy, but are normal in configuration. [**Doctor Last Name **]
matter/white matter differentiation is preserved throughout. The orbits are
normal in appearance. The visualized soft tissues are normal. The mastoid
air cells are clear bilaterally. The visualized portions of the paranasal
sinuses are clear. There is no osseous abnormality.
|
No acute intracranial process.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 280,178
|
224,338
| 951,253
| 20,169
|
[**2193-4-13**] 6:07 AM
ABDOMEN U.S. (COMPLETE STUDY); -59 DISTINCT PROCEDURAL SERVICE Clip # [**Clip Number (Radiology) 78446**]
DUPLEX DOPP ABD/PEL
Reason: mark for possible tap; also eval patency of vessels
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
68 year old woman with NASH/schisto cirrhosis s/p TIPS here w/ascites
s/p TIPS revision now with abd pain
REASON FOR THIS EXAMINATION:
mark for possible tap; also eval patency of vessels
______________________________________________________________________________
WET READ: JWK SAT [**2193-4-13**] 9:32 AM
Patent TIPS with increased velocities. Clinical correlation is requested
Nodular liver with moderate amount of ascites
______________________________________________________________________________
FINAL REPORT
INDICATION: 69-year-old female with cirrhosis status post TIPS, now with
abdominal pain.
COMPARISON: [**2193-4-10**].
ABDOMINAL ULTRASOUND: The liver is shrunken and nodular consistent with
cirrhosis. The gallbladder is unremarkable without evidence of stones. The
right kidney measures 10.1 cm. The left kidney measures 9.4 cm. There are no
stones or hydronephrosis bilaterally. The spleen is unremarkable. The
visualized portions of the aorta are of normal caliber throughout. There is
mild-to-moderate amount of ascites within the abdomen.
There is patent wall-to-wall flow throughout the TIPS with velocities ranging
from 50 to 144 cm per second. The wave forms demonstrate incresed pulsatility
within the distal TIPS. The main, right, and left hepatic veins are patent
with appropriate triphasic flow. The main portal vein is patent. The main
hepatic artery, right hepatic artery, left hepatic artery are patent with
brisk systolic upstrokes.
IMPRESSION:
1. Patent TIPS with wall-to-wall flow. Mildly elevated velocities. Clinical
correlation is requested.
2. Cirrhotic liver with moderate amount of ascites.
| 2,070
| null |
[**2193-4-10**].
ABDOMINAL
|
mark for possible tap; also eval patency of vessels
______________________________________________________________________________
WET READ: JWK SAT [**2193-4-13**] 9:32 AM
Patent TIPS with increased velocities. Clinical correlation is requested
Nodular liver with moderate amount of ascites
______________________________________________________________________________
FINAL REPORT
INDICATION: 69-year-old female with cirrhosis status post TIPS, now with
abdominal pain.
|
The liver is shrunken and nodular consistent with
cirrhosis. The gallbladder is unremarkable without evidence of stones. The
right kidney measures 10.1 cm. The left kidney measures 9.4 cm. There are no
stones or hydronephrosis bilaterally. The spleen is unremarkable. The
visualized portions of the aorta are of normal caliber throughout. There is
mild-to-moderate amount of ascites within the abdomen.
There is patent wall-to-wall flow throughout the TIPS with velocities ranging
from 50 to 144 cm per second. The wave forms demonstrate incresed pulsatility
within the distal TIPS. The main, right, and left hepatic veins are patent
with appropriate triphasic flow. The main portal vein is patent. The main
hepatic artery, right hepatic artery, left hepatic artery are patent with
brisk systolic upstrokes.
|
1. Patent TIPS with wall-to-wall flow. Mildly elevated velocities. Clinical
correlation is requested.
2. Cirrhotic liver with moderate amount of ascites.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 114,558
|
81,978
| 818,236
| 19,847
|
[**2123-2-28**] 1:23 PM
CHEST (PA & LAT) Clip # [**Clip Number (Radiology) 51409**]
Reason: cough
______________________________________________________________________________
[**Hospital 3**] MEDICAL CONDITION:
68 year old man with myeloma s/p bone marrow transplant with new fever spikes.
Concern for pulmonary source.
REASON FOR THIS EXAMINATION:
cough
______________________________________________________________________________
FINAL REPORT
CLINICAL INDICATION: Multiple myeloma, s/p bone marrow transplants, new fever.
COMPARISON: No images available, the report from [**2123-1-26**].
CHEST, PA AND LATERAL:
FINDINGS: There are bilateral pleural effusions, which were not mentioned on
the previous study and are most likely new in nature. There is reactive
atelectasis/consolidation with bilateral lower lobes. The cardiac,
mediastinal and hilar contours are unremarkable. The patient is s/p median
sternotomy with numerous surgical clips. There is no pneumothorax. The
pulmonary vasculature is within normal limits. Note is made of multiple
compression fractures in the thoracic vertebrae on the lateral film, most
likely relating to the patient's history of multiple myeloma.
IMPRESSION: Bilateral pleural effusions with reactive atelectasis. No focal
opacities identified.
| 1,402
| null |
No images available, the report from [**2123-1-26**].
CHEST, PA AND LATERAL:
|
cough
______________________________________________________________________________
FINAL REPORT
CLINICAL INDICATION: Multiple myeloma, s/p bone marrow transplants, new fever.
|
There are bilateral pleural effusions, which were not mentioned on
the previous study and are most likely new in nature. There is reactive
atelectasis/consolidation with bilateral lower lobes. The cardiac,
mediastinal and hilar contours are unremarkable. The patient is s/p median
sternotomy with numerous surgical clips. There is no pneumothorax. The
pulmonary vasculature is within normal limits. Note is made of multiple
compression fractures in the thoracic vertebrae on the lateral film, most
likely relating to the patient's history of multiple myeloma.
|
Bilateral pleural effusions with reactive atelectasis. No focal
opacities identified.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 40,940
|
350,604
| 1,085,582
| 82,211
|
[**2143-8-1**] 11:07 AM
CHEST (PORTABLE AP); -77 BY DIFFERENT PHYSICIAN [**Name Initial (PRE) 7**] # [**Clip Number (Radiology) 68442**]
Reason: evaluate for location of HD
Admitting Diagnosis: PNEUMONIA
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
65 year old man with HD line not flushing
REASON FOR THIS EXAMINATION:
evaluate for location of HD
______________________________________________________________________________
FINAL REPORT
HISTORY: HD line not flushing.
FINDINGS: In comparison with the earlier study of this date, there is no
change radiographically in the position of the hemodialysis catheter. Lower
lung volumes and extensive bilateral pulmonary opacifications persist.
| 831
|
HD line not flushing.
| null |
evaluate for location of HD
______________________________________________________________________________
FINAL REPORT
|
In comparison with the earlier study of this date, there is no
change radiographically in the position of the hemodialysis catheter. Lower
lung volumes and extensive bilateral pulmonary opacifications persist.
|
[**2143-8-1**] 11:07 AM
CHEST (PORTABLE AP); -77 BY DIFFERENT PHYSICIAN [**Name Initial (PRE) 7**] # [**Clip Number (Radiology) 68442**]
Reason: evaluate for location of HD
Admitting Diagnosis: PNEUMONIA
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
65 year old man with HD line not flushing
REASON FOR THIS EXAMINATION:
evaluate for location of HD
______________________________________________________________________________
FINAL REPORT
HISTORY: HD line not flushing. FINDINGS: In comparison with the earlier study of this date, there is no
change radiographically in the position of the hemodialysis catheter. Lower
lung volumes and extensive bilateral pulmonary opacifications persist.
|
FALLBACK_LAST_SENTENCES
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 180,062
|
520,338
| 1,260,208
| 64,666
|
[**2118-1-26**] 5:13 PM
CT CHEST W/CONTRAST; CT ABD & PELVIS W & W/O CONTRAST, ADDL SECTIONSClip # [**Telephone/Fax (1) 58879**]
Reason: staging
Admitting Diagnosis: WEAKNESS
Contrast: OMNIPAQUE Amt: 130
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
64 year old woman with known lung adenocarcinoma, now with concern for brain
mets
REASON FOR THIS EXAMINATION:
staging
No contraindications for IV contrast
______________________________________________________________________________
WET READ: MJMgb WED [**2118-1-26**] 9:43 PM
No acute findings. Please see final report regarding restaging.
______________________________________________________________________________
FINAL REPORT
HISTORY: Known lung adenocarcinoma, now with concern for brain metastases,
staging exam.
TECHNIQUE: Helical CT acquisition in noncontrast phase through the abdomen,
post-contrast phase through the chest abdomen and pelvis and 3 minutes delayed
series through the abdomen. Coronal and sagittal reformats provided by
technologist. Uneventful administration of 130 mL Omnipaque IV contrast and
900 cc PO contrast.
DLP: 1,501 mGy-cm.
COMPARISON: For CT chest [**2117-12-30**], PET-CT [**2117-5-12**].
FINDINGS:
There is marked kyphosis of the cervical spine. No lower cervical adenopathy.
There is rightward deviation of the trachea likely due to volume loss on the
right. The patient is status post right lung pneumonectomy with rightward
mediastinal shift. Fluid is noted in the right hemithorax, unchanged from
comparison with calcification along the right pleura diffusely.
Patient is status post wedge resection in the left upper lobe and lower lobe.
A 1.7 x 0.9 cm area of left upper lobe nodularity is not significantly changed
from recent comparison . The previously described subtle areas of
ground-glass opacity in the lingula (series 3:28)is less conspicuous on
today's exam. The patient is also status post wedge resection in the left
lower lobe/lingula. There is pleural thickening in the left lower lobe which
is unchanged from comparison and may represent scarring or. No new nodules or
masses are seen on the left.
Heart size is within normal limits. There is no mediastinal or hilar
adenopathy by CT size criteria. The normal appearance of the gastroesophageal
junction.
No liver lesions identified. Normal appearance of the gallbladder, pancreas,
(Over)
[**2118-1-26**] 5:13 PM
CT CHEST W/CONTRAST; CT ABD & PELVIS W & W/O CONTRAST, ADDL SECTIONSClip # [**Telephone/Fax (1) 58879**]
Reason: staging
Admitting Diagnosis: WEAKNESS
Contrast: OMNIPAQUE Amt: 130
______________________________________________________________________________
FINAL REPORT
(Cont)
adrenals, kidneys, ureters and bladder. The pelvic organs are within normal
limits for size.
Small and large bowel are unobstructed.
Osseous structures demonstrate marked scoliosis of the lumbar and thoracic
spine. There is grade 1 anterolisthesis of L4 on L5. No acute osseous
abnormality is evident.
IMPRESSION:
1. Postsurgical changes in the lungs with stable nodularity in the left upper
lobe.
2. The left lung ground-glass opacities described previously are not as
apparent on today's exam.
| 3,453
|
Known lung adenocarcinoma, now with concern for brain metastases,
staging exam.
|
For CT chest [**2117-12-30**], PET-CT [**2117-5-12**].
|
staging
No contraindications for IV contrast
______________________________________________________________________________
WET READ: MJMgb WED [**2118-1-26**] 9:43 PM
No acute findings. Please see final report regarding restaging.
______________________________________________________________________________
FINAL REPORT
|
There is marked kyphosis of the cervical spine. No lower cervical adenopathy.
There is rightward deviation of the trachea likely due to volume loss on the
right. The patient is status post right lung pneumonectomy with rightward
mediastinal shift. Fluid is noted in the right hemithorax, unchanged from
comparison with calcification along the right pleura diffusely.
Patient is status post wedge resection in the left upper lobe and lower lobe.
A 1.7 x 0.9 cm area of left upper lobe nodularity is not significantly changed
from recent comparison . The previously described subtle areas of
ground-glass opacity in the lingula (series 3:28)is less conspicuous on
today's exam. The patient is also status post wedge resection in the left
lower lobe/lingula. There is pleural thickening in the left lower lobe which
is unchanged from comparison and may represent scarring or. No new nodules or
masses are seen on the left.
Heart size is within normal limits. There is no mediastinal or hilar
adenopathy by CT size criteria. The normal appearance of the gastroesophageal
junction.
No liver lesions identified. Normal appearance of the gallbladder, pancreas,
(Over)
[**2118-1-26**] 5:13 PM
CT CHEST W/CONTRAST; CT ABD & PELVIS W & W/O CONTRAST, ADDL SECTIONSClip # [**Telephone/Fax (1) 58879**]
Reason: staging
Admitting Diagnosis: WEAKNESS
Contrast: OMNIPAQUE Amt: 130
______________________________________________________________________________
FINAL REPORT
(Cont)
adrenals, kidneys, ureters and bladder. The pelvic organs are within normal
limits for size.
Small and large bowel are unobstructed.
Osseous structures demonstrate marked scoliosis of the lumbar and thoracic
spine. There is grade 1 anterolisthesis of L4 on L5. No acute osseous
abnormality is evident.
|
1. Postsurgical changes in the lungs with stable nodularity in the left upper
lobe.
2. The left lung ground-glass opacities described previously are not as
apparent on today's exam.
|
IMPRESSION
| true
| true
| true
| true
| true
| 5
|
[]
|
OK
| 290,198
|
217,133
| 956,556
| 10,187
|
[**2142-5-17**] 9:08 AM
TIB/FIB (AP & LAT) LEFT; TIB/FIB (AP & LAT) RIGHT Clip # [**Clip Number (Radiology) 106408**]
Reason: S/P BILATERAL TIB/FIB FX
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
39 year old man with increased pain and swelling over recent ex fix
REASON FOR THIS EXAMINATION:
s/p l tib/fib fx
______________________________________________________________________________
FINAL REPORT
INDICATION: Followup tibia and fibular fractures.
FINDINGS: Total of eight radiographs comprising four views of the left tibia
and fibula, and four views of the right tibia and fibula were reviewed and
compared to multiple prior radiographs dating back to [**2141-12-5**].
RIGHT TIBIA AND FIBULA: Again seen at the lateral aspect of the proximal
tibia is a plate with multiple screws, unchanged in position. Fracture line
is no longer visible, and there is no evidence of hardware loosening. Also
seen is a second more distal lateral plate and screws fixing a mid diaphyseal
tibial fracture. There is callus formation at the fracture site, and the
fracture line is minimally visible at the lateral margin of the fracture site.
Deformity related to comminuted mid fibular diaphyseal fracture appears
unchanged, with exuberant callus formation. Multiple surgical clips are seen
in the soft tissues of the right lower extremity. Joint spaces are
maintained.
LEFT TIBIA AND FIBULA: Again seen is a comminuted fracture of the mid
diaphysis of the left tibia, fixed with intramedullary rod and two proximal
and two distal interlocking screws. Bridging callus formation in both the
tibia and fibula is unchanged. Lucencies within the tibia related to prior
external fixation device are unchanged. Multiple surgical clips are seen
overlying the soft tissues of the left lower extremity. Note is again made of
diffuse demineralization.
IMPRESSION: Unchanged appearance of ORIF bilateral tibia and fibular
fractures. No evidence of hardware loosening.
| 2,120
| null | null |
s/p l tib/fib fx
______________________________________________________________________________
FINAL REPORT
INDICATION: Followup tibia and fibular fractures.
|
Total of eight radiographs comprising four views of the left tibia
and fibula, and four views of the right tibia and fibula were reviewed and
compared to multiple prior radiographs dating back to [**2141-12-5**].
RIGHT TIBIA AND FIBULA: Again seen at the lateral aspect of the proximal
tibia is a plate with multiple screws, unchanged in position. Fracture line
is no longer visible, and there is no evidence of hardware loosening. Also
seen is a second more distal lateral plate and screws fixing a mid diaphyseal
tibial fracture. There is callus formation at the fracture site, and the
fracture line is minimally visible at the lateral margin of the fracture site.
Deformity related to comminuted mid fibular diaphyseal fracture appears
unchanged, with exuberant callus formation. Multiple surgical clips are seen
in the soft tissues of the right lower extremity. Joint spaces are
maintained.
LEFT TIBIA AND FIBULA: Again seen is a comminuted fracture of the mid
diaphysis of the left tibia, fixed with intramedullary rod and two proximal
and two distal interlocking screws. Bridging callus formation in both the
tibia and fibula is unchanged. Lucencies within the tibia related to prior
external fixation device are unchanged. Multiple surgical clips are seen
overlying the soft tissues of the left lower extremity. Note is again made of
diffuse demineralization.
|
Unchanged appearance of ORIF bilateral tibia and fibular
fractures. No evidence of hardware loosening.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 110,834
|
229,494
| 990,364
| 30,869
|
[**2123-11-22**] 2:30 PM
CT HEAD W/O CONTRAST; -77 BY DIFFERENT PHYSICIAN [**Name Initial (PRE) 7**] # [**Clip Number (Radiology) 42453**]
Reason: exam this am was limited due to artifacts
Admitting Diagnosis: SUBDURAL HEMATOMA;SUBARACHNOID HEMORRHAGE
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
88 year old woman s/p SDH evacuation
REASON FOR THIS EXAMINATION:
exam this am was limited due to artifacts
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Status post fall, on Coumadin, with known subdural hematoma;
query interval change.
COMPARISON: [**11-21**] and [**2123-11-22**].
TECHNIQUE: Non-contrast head CT.
FINDINGS: Previously seen scalp eletrodes have been removed. The patient is
status post left frontal, parietal, and temporal bone craniotomy and
evacuation of left convexity subdural hematoma. A small amount of extra-axial
blood is seen along the left cerebral hemisphere, adjacent to the falx and
layering on the tentorium. The degree of rightward shift of normally midline
structures (4 mm) is essentially unchanged from [**2123-11-21**]. A small
amount of subarachnoid blood is again seen in the left vertex, essentially
unchanged from [**2123-11-21**]. Again a 1.9-cm lesion is seen in the left
lateral cerebellar hemisphere consistent with a meningioma. Expected
postoperative pneumocephalus has decreased and there is a persistent left
subgaleal scalp hematoma. The paranasal sinuses and mastoid air cells are
essentially normally aerated.
IMPRESSION: Status post craniotomy and evacuation of left subdural hematoma,
similar to prior CT but with reduced pneumocephalus. No new hemorrhage
identified.
| 1,881
| null |
[**11-21**] and [**2123-11-22**].
|
exam this am was limited due to artifacts
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Status post fall, on Coumadin, with known subdural hematoma;
query interval change.
|
Previously seen scalp eletrodes have been removed. The patient is
status post left frontal, parietal, and temporal bone craniotomy and
evacuation of left convexity subdural hematoma. A small amount of extra-axial
blood is seen along the left cerebral hemisphere, adjacent to the falx and
layering on the tentorium. The degree of rightward shift of normally midline
structures (4 mm) is essentially unchanged from [**2123-11-21**]. A small
amount of subarachnoid blood is again seen in the left vertex, essentially
unchanged from [**2123-11-21**]. Again a 1.9-cm lesion is seen in the left
lateral cerebellar hemisphere consistent with a meningioma. Expected
postoperative pneumocephalus has decreased and there is a persistent left
subgaleal scalp hematoma. The paranasal sinuses and mastoid air cells are
essentially normally aerated.
|
Status post craniotomy and evacuation of left subdural hematoma,
similar to prior CT but with reduced pneumocephalus. No new hemorrhage
identified.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 116,954
|
439,358
| 1,200,985
| 99,408
|
[**2116-9-7**] 3:14 PM
CHEST (PORTABLE AP); -59 DISTINCT PROCEDURAL SERVICE Clip # [**Clip Number (Radiology) 12458**]
Reason: rule out pneumothorax.
Admitting Diagnosis: SOB
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
53 year old woman with left sided pleural effusion s/p thoracentesis.
REASON FOR THIS EXAMINATION:
rule out pneumothorax.
______________________________________________________________________________
FINAL REPORT
INDICATION: 53-year-old woman with left-sided pleural effusion status post
thoracentesis. Rule out pneumothorax.
COMPARISON: Multiple chest radiographs, the latest from [**2116-9-7**] at 9 a.m.
ONE VIEW OF THE CHEST:
The lungs show bilateral lower lobe opacities consistent with atelectasis.
Left effusion has decreased in size after thoracentesis. Persistent small
right effusion. The cardiac silhouette and hilar contours are normal. The
mediastinal silhouette shows a gastric pullthrough, medially, unchanged. No
pneumothorax is present. A right-sided subclavian catheter terminates with
its tip in the mid SVC.
IMPRESSION:
No pneumothorax. The left effusion has decreased follwoing thoracentesis.
These findings were communicated to [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 11375**] MD via telephone at 16:54
on [**2116-9-7**].
| 1,440
| null |
Multiple chest radiographs, the latest from [**2116-9-7**] at 9 a.m.
ONE VIEW OF THE
|
rule out pneumothorax.
______________________________________________________________________________
FINAL REPORT
INDICATION: 53-year-old woman with left-sided pleural effusion status post
thoracentesis. Rule out pneumothorax.
|
The lungs show bilateral lower lobe opacities consistent with atelectasis.
Left effusion has decreased in size after thoracentesis. Persistent small
right effusion. The cardiac silhouette and hilar contours are normal. The
mediastinal silhouette shows a gastric pullthrough, medially, unchanged. No
pneumothorax is present. A right-sided subclavian catheter terminates with
its tip in the mid SVC.
|
No pneumothorax. The left effusion has decreased follwoing thoracentesis.
These findings were communicated to [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 11375**] MD via telephone at 16:54
on [**2116-9-7**].
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 234,112
|
470,324
| 1,204,593
| 51,856
|
[**2163-9-16**] 8:44 PM
CHEST (PA & LAT) Clip # [**Clip Number (Radiology) 95458**]
Reason: worsening of PNA
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
56 year old man with known atypical PNA and new altered MS
REASON FOR THIS EXAMINATION:
worsening of PNA
______________________________________________________________________________
FINAL REPORT
EXAM: Chest frontal and lateral views.
CLINICAL INFORMATION: 56-year-old male with history of known atypical
pneumonia and new altered mental status.
COMPARISON: [**2163-9-11**].
FINDINGS: Frontal and lateral views of the chest are obtained. In the
interval since the prior study, there is slight increase in interstitial
markings in the left mid to lower lung which may relate to patient's atypical
pneumonia or other inflammatory process. No pleural effusion or pneumothorax
is seen. The cardiac and mediastinal silhouettes are unremarkable.
IMPRESSION: More conspicuous increased interstitial markings in the left mid
to lower lung may relate to patient's atypical pneumonia or other inflammatory
process.
| 1,246
| null |
[**2163-9-11**].
|
worsening of PNA
______________________________________________________________________________
FINAL REPORT
|
Frontal and lateral views of the chest are obtained. In the
interval since the prior study, there is slight increase in interstitial
markings in the left mid to lower lung which may relate to patient's atypical
pneumonia or other inflammatory process. No pleural effusion or pneumothorax
is seen. The cardiac and mediastinal silhouettes are unremarkable.
|
More conspicuous increased interstitial markings in the left mid
to lower lung may relate to patient's atypical pneumonia or other inflammatory
process.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 254,687
|
208,904
| 967,534
| 9,356
|
[**2113-6-23**] 4:48 PM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 72671**]
Reason: recent run of asystole, please eval for new changes
Admitting Diagnosis: END STAGE LIVER DISEASE
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
50 year old man s/pliver tx, now s/p stent and thrombolysis of portal vein
REASON FOR THIS EXAMINATION:
recent run of asystole, please eval for new changes
______________________________________________________________________________
FINAL REPORT
STUDY: Single portable AP chest radiograph.
INDICATION: Status post liver transplant and run of asystole. Evaluate for
new changes.
COMPARISON: [**2113-6-21**].
FINDINGS: The patient remains intubated, the ETT tube in satisfactory
position. Nasogastric tube and right internal jugular vascular sheath remain
in stable position. There is overall slight decrease in lung volumes when
compared to previous study, with increased vascular prominence and bilateral
hilar opacity consistent with pulmonary edema. Obscuration of the left
hemidiaphragm is again appreciated, consistent with atelectasis vs. effusion,
although a consolidative process cannot be excluded.
IMPRESSION:
1. Development of mild pulmonary edema.
2. Unchanged appearance of lines and tubes.
3. Continued obscuration of the left hemidiaphragm consistent with
atelectasis and probable effusion, although a consolidative process cannot be
entirely excluded.
| 1,603
| null |
[**2113-6-21**].
|
recent run of asystole, please eval for new changes
______________________________________________________________________________
FINAL REPORT
STUDY: Single portable AP chest radiograph.
INDICATION: Status post liver transplant and run of asystole. Evaluate for
new changes.
|
The patient remains intubated, the ETT tube in satisfactory
position. Nasogastric tube and right internal jugular vascular sheath remain
in stable position. There is overall slight decrease in lung volumes when
compared to previous study, with increased vascular prominence and bilateral
hilar opacity consistent with pulmonary edema. Obscuration of the left
hemidiaphragm is again appreciated, consistent with atelectasis vs. effusion,
although a consolidative process cannot be excluded.
|
1. Development of mild pulmonary edema.
2. Unchanged appearance of lines and tubes.
3. Continued obscuration of the left hemidiaphragm consistent with
atelectasis and probable effusion, although a consolidative process cannot be
entirely excluded.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 106,445
|
509,075
| 1,251,912
| 48,222
|
[**2167-10-3**] 8:09 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 59604**]
Reason: ? infiltrate
Admitting Diagnosis: BOWEL OBSTRUCTION
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
51 year old woman with CD s/p SBO s/p exlap now with some desats
REASON FOR THIS EXAMINATION:
? infiltrate
______________________________________________________________________________
FINAL REPORT
HISTORY: Postoperative with desaturation.
FINDINGS: In comparison with the study of [**9-30**], there are continued low lung
volumes. Nasogastric tube has been removed and right PICC line extends to the
mid portion of the SVC.
There is increased opacification at the right base with poor definition of the
heart border. Although this could represent crowding of vessels, in the
appropriate clinical setting, supervening pneumonia would have to be seriously
considered. Some atelectatic changes are seen in the retrocardiac region at
the left base.
| 1,115
|
Postoperative with desaturation.
| null |
? infiltrate
______________________________________________________________________________
FINAL REPORT
|
In comparison with the study of [**9-30**], there are continued low lung
volumes. Nasogastric tube has been removed and right PICC line extends to the
mid portion of the SVC.
There is increased opacification at the right base with poor definition of the
heart border. Although this could represent crowding of vessels, in the
appropriate clinical setting, supervening pneumonia would have to be seriously
considered. Some atelectatic changes are seen in the retrocardiac region at
the left base.
|
There is increased opacification at the right base with poor definition of the
heart border. Although this could represent crowding of vessels, in the
appropriate clinical setting, supervening pneumonia would have to be seriously
considered. Some atelectatic changes are seen in the retrocardiac region at
the left base.
|
FALLBACK_LAST_SENTENCES
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 281,967
|
397,469
| 1,131,925
| 44,245
|
[**2199-3-17**] 1:16 PM
CTA HEAD W&W/O C & RECONS; CTA NECK W&W/OC & RECONS Clip # [**Clip Number (Radiology) 84987**]
CT BRAIN PERFUSION
Reason: eval for acute process
Contrast: OPTIRAY Amt: 110
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
55 year old woman with ? CVA- h/o ischemic CVA w/ hemorrhagic conversion after
TPA in past, on coumadin
REASON FOR THIS EXAMINATION:
eval for acute process
No contraindications for IV contrast
______________________________________________________________________________
WET READ: PXDb SUN [**2199-3-17**] 2:20 PM
No acute intracranial process. Encephalomalacia from Right frontal and left
parietal old infarcts. No vascular thrombosis, aneurysm. On CTP: There is
no evidence of acute infarct. Full read pending reformats. [**First Name8 (NamePattern2) 826**] [**Doctor Last Name 827**] [**Numeric Identifier 828**]
WET READ VERSION #1 PXDb SUN [**2199-3-17**] 1:38 PM
No acute intracranial process. Encephalomalacia from Right frontal and left
parietal old infarcts. No vascular thrombosis, aneurysm. Full read pending
reformats. [**First Name8 (NamePattern2) 826**] [**Doctor Last Name 827**] [**Numeric Identifier 828**]
______________________________________________________________________________
FINAL REPORT
EXAMINATION: CTA head and neck with and without contrast and perfusion.
HISTORY: 55-year-old female with questionable CVA and history of ischemic
CVAs with hemorrhagic conversion after TPA in the past, now on Coumadin;
evaluation for acute process.
TECHNIQUE: Multiplanar CTA of the head and neck was performed with and
without intravenous contrast administration. Additional 3D reconstructed
images of the intra- and extra-cranial arterial vasculature were obtained.
Additional perfusion images were performed.
COMPARISON: MR head [**2198-12-9**] and CT head [**2198-12-8**].
FINDINGS:
NECT HEAD: Again identified are regions of cystic encephalomalacia in the
right frontal and left frontoparietal lobes, consistent with prior infarction.
There is no evidence of acute territorial infarction or hemorrhage. The
ventricles and cortical sulci are prominent for the patient's age of 55 years
without evidence of mass effect or shift of the normally midline structures.
The [**Doctor Last Name 181**]-white matter differentiation is otherwise preserved. The visualized
paranasal sinuses and mastoid air cells are well aerated.
CTA HEAD: There is an effective PICA termination of the right vertebral
artery. The left vertebral artery is dominant. The basilar artery is
relatively diminutive in size. There is a fetal PCA on the right with a
hypoplastic right P1 segment. There is a normal number and caliber of the
opercular branches of the middle cerebral arteries, bilaterally. The
remainder of the intracranial vertebrobasilar system, as well as the internal
carotid, anterior, middle, and posterior cerebral arteries are normal in
(Over)
[**2199-3-17**] 1:16 PM
CTA HEAD W&W/O C & RECONS; CTA NECK W&W/OC & RECONS Clip # [**Clip Number (Radiology) 84987**]
CT BRAIN PERFUSION
Reason: eval for acute process
Contrast: OPTIRAY Amt: 110
______________________________________________________________________________
FINAL REPORT
(Cont)
course and caliber without evidence of occlusion, flow-limiting stenosis,
arteriovenous malformation, or aneurysm greater than 2 mm.
CT PERFUSION: There is expected markely decreased perfusion in the regions of
known cystic encephalomalacia within the right frontal and left frontoparietal
regions.
CTA NECK: The vertebral artery origins are patent. The paired vertebral
arteries are normal in course and caliber without evidence of flow-limiting
stenosis, occlusion, or dissection. There is an effective-PICA termination of
the right vertebral artery. The origins of the great vessels at the level of
the aortic arch are unremarkable. The common, internal, and external carotid
arteries are normal in course and caliber without evidence of flow-limiting
stenosis, occlusion, or dissection. The lung apices are clear. The airway is
patent. The thyroid gland is within normal limits. There are no
pathologically enlarged lymph nodes by CT criteria. There are multilevel
spondylotic changes of the cervical spine without evidence of high-grade
spinal canal or neural foraminal narrowing.
IMPRESSION:
1. No evidence of acute territorial infarction or hemorrhage.
2. Stable appearance of old infarctions in the right frontal lobe and left
frontoparietal lobes with expected markedly diminished perfusion.
3. No evidence of occlusion, flow-limiting stenosis, aneurysm greater than 2
mm, or arteriovenous malformation involving the intra- or extracranial
arterial vasculature.
| 5,007
|
55-year-old female with questionable CVA and history of ischemic
CVAs with hemorrhagic conversion after TPA in the past, now on Coumadin;
evaluation for acute process.
|
MR head [**2198-12-9**] and CT head [**2198-12-8**].
|
eval for acute process
No contraindications for IV contrast
______________________________________________________________________________
WET READ: PXDb SUN [**2199-3-17**] 2:20 PM
No acute intracranial process. Encephalomalacia from Right frontal and left
parietal old infarcts. No vascular thrombosis, aneurysm. On CTP: There is
no evidence of acute infarct. Full read pending reformats. [**First Name8 (NamePattern2) 826**] [**Doctor Last Name 827**] [**Numeric Identifier 828**]
WET READ VERSION #1 PXDb SUN [**2199-3-17**] 1:38 PM
No acute intracranial process. Encephalomalacia from Right frontal and left
parietal old infarcts. No vascular thrombosis, aneurysm. Full read pending
reformats. [**First Name8 (NamePattern2) 826**] [**Doctor Last Name 827**] [**Numeric Identifier 828**]
______________________________________________________________________________
FINAL REPORT
|
NE
|
1. No evidence of acute territorial infarction or hemorrhage.
2. Stable appearance of old infarctions in the right frontal lobe and left
frontoparietal lobes with expected markedly diminished perfusion.
3. No evidence of occlusion, flow-limiting stenosis, aneurysm greater than 2
mm, or arteriovenous malformation involving the intra- or extracranial
arterial vasculature.
|
IMPRESSION
| true
| true
| true
| true
| true
| 5
|
[]
|
OK
| 207,612
|
51,182
| 788,948
| 10,250
|
[**2163-5-21**] 3:16 PM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 89638**]
Reason: assess CHF
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
[**Age over 90 **] year old woman with O2 requirement, poor u/o
REASON FOR THIS EXAMINATION:
assess CHF
______________________________________________________________________________
FINAL REPORT
INDICATION: Oxygenation.
PORTABLE CHEST: Heart is enlarged. There is no overt evidence of failure. The
lungs are clear. Positioning makes it difficult to exclude an infiltrate at
the left base. A calcified mitral annulus does, however, overlie the left
lower lobe.
IMPRESSION: No appreciable change in the chest since [**2163-5-15**].
| 853
| null | null |
assess CHF
______________________________________________________________________________
FINAL REPORT
INDICATION: Oxygenation.
PORTABLE
|
Heart is enlarged. There is no overt evidence of failure. The
lungs are clear. Positioning makes it difficult to exclude an infiltrate at
the left base. A calcified mitral annulus does, however, overlie the left
lower lobe.
|
No appreciable change in the chest since [**2163-5-15**].
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 24,555
|
122,444
| 864,404
| 11,618
|
[**2161-4-23**] 3:29 PM
CAROTID SERIES COMPLETE PORT Clip # [**Clip Number (Radiology) 48736**]
Reason: PREOP CABG
Admitting Diagnosis: CORONARY ARTERY DISEASE;CONGESTIVE HEART FAILURE
______________________________________________________________________________
FINAL REPORT
HISTORY: 65-year-old female for preoperative evaluation for CABG.
FINDINGS:
Duplex evaluation of bilateral extracranial internal carotid arteries and
vertebral arteries was performed. No prior comparison. Peak velocities on the
right are 102, 70, 163 cm per second in the right ICA, CCA and ECA
respectively, corresponding to ICA to CCA ratio of 1.45. Similar velocities
on the left are 109, 75, 167 cm per second, corresponding to ICA to CCA ratio
of 1.45. Minimal plaque formation is seen at bilateral carotid bifurcation.
Antegrade flow is seen in both vertebral arteries.
IMPRESSION:
Less than 40% stenosis bilateral internal carotid and extracranial internal
carotid arteries.
| 1,051
|
65-year-old female for preoperative evaluation for CABG.
| null | null |
Duplex evaluation of bilateral extracranial internal carotid arteries and
vertebral arteries was performed. No prior comparison. Peak velocities on the
right are 102, 70, 163 cm per second in the right ICA, CCA and ECA
respectively, corresponding to ICA to CCA ratio of 1.45. Similar velocities
on the left are 109, 75, 167 cm per second, corresponding to ICA to CCA ratio
of 1.45. Minimal plaque formation is seen at bilateral carotid bifurcation.
Antegrade flow is seen in both vertebral arteries.
|
Less than 40% stenosis bilateral internal carotid and extracranial internal
carotid arteries.
|
IMPRESSION
| true
| true
| true
| false
| false
| 3
|
['comparison', 'procedure']
|
No Comparison section found; No Technique/Procedure section found
| 63,749
|
511,690
| 1,255,765
| 70,989
|
[**2109-9-9**] 8:09 AM
MR PELVIS W&W/O CONTRAST Clip # [**Clip Number (Radiology) 42869**]
Reason: assess right adnexa lesion on recent pelvic us
Contrast: GADAVIST Amt: 19
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
52 year old woman with right adnexa lesion on recent us and uterine bleeding
REASON FOR THIS EXAMINATION:
assess right adnexa lesion on recent pelvic us
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
EXAM: MRI pelvis.
CLINICAL INDICATION: Right adnexal lesion on recent ultrasound and uterine
bleeding. Assess right adnexa.
COMPARISON: Pelvic ultrasound [**2109-8-26**].
FINDINGS:
There is a large mass obstructing the right fallopian tube measuring up to 3
cm in transverse dimension and extending approximately 7.3 cm from the
infundibular portion through the ampullary portion of the right fallopian
tube. The mass is primarily isointense relative to the uterine myometrium on
[**Name (NI) **] and T2-WI with a small focus of susceptibility identified (4:86)
suggestive of old hemorrhagic products. This lesion enhances with contrast,
though to a lesser degree than the myometrium. A small amount of debris is
noted layering in the isthmic portion. The mass does not appear to extend
beyond the wall of the fallopian tubes. There is questionable extension
beyond the fimbria towards the right ovary but no clear connection is
identified. The right ovary is normal in appearance measuring 1.3 x 2.5 cm.
Normal appearance of the left fallopian tube and ovary which measures 1.4 x
2.5 cm.
The uterus has numerous fibroids, the largest is noted anteriorly measuring
4.7 x 4.8 cm. There is also a 1.8 cm partially submucosal fibroid noted in
the posterior body of the uterus with an approximate 20% submucosal component.
A Lippes loop IUD device is noted within the uterine cavity with a moderate
amount of fluid.
Prominent pelvic side wall nodes are noted bilaterally measuring up to 7 mm in
short axis with preserved morphology. No suspicious pelvic sidewall nodes are
noted.
There is a small amount of free fluid in the pelvis. Visualized colon is
unremarkable.
No suspicious osseous or musculoskeletal lesions.
Incidental note of a small left-sided urethral diverticulum.
IMPRESSION:
(Over)
[**2109-9-9**] 8:09 AM
MR PELVIS W&W/O CONTRAST Clip # [**Clip Number (Radiology) 42869**]
Reason: assess right adnexa lesion on recent pelvic us
Contrast: GADAVIST Amt: 19
______________________________________________________________________________
FINAL REPORT
(Cont)
1. 7.3 x 3 cm mass in the right fallopian tube likely represents a primary
fallopian carcinoma. No evidence of contralateral or metastatic disease.
2. Normal appearance of the right ovary. The fallopian tube mass extends to
the fimbria of the fallopian tube without clear ovarian involvement.
3. Fibroid uterus with a partially submucosal fibroid (20%) in the posterior
base.
4. Moderate amount of fluid in the uterine cavity.
| 3,354
| null |
Pelvic ultrasound [**2109-8-26**].
|
assess right adnexa lesion on recent pelvic us
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
|
There is a large mass obstructing the right fallopian tube measuring up to 3
cm in transverse dimension and extending approximately 7.3 cm from the
infundibular portion through the ampullary portion of the right fallopian
tube. The mass is primarily isointense relative to the uterine myometrium on
[**Name (NI) **] and T2-WI with a small focus of susceptibility identified (4:86)
suggestive of old hemorrhagic products. This lesion enhances with contrast,
though to a lesser degree than the myometrium. A small amount of debris is
noted layering in the isthmic portion. The mass does not appear to extend
beyond the wall of the fallopian tubes. There is questionable extension
beyond the fimbria towards the right ovary but no clear connection is
identified. The right ovary is normal in appearance measuring 1.3 x 2.5 cm.
Normal appearance of the left fallopian tube and ovary which measures 1.4 x
2.5 cm.
The uterus has numerous fibroids, the largest is noted anteriorly measuring
4.7 x 4.8 cm. There is also a 1.8 cm partially submucosal fibroid noted in
the posterior body of the uterus with an approximate 20% submucosal component.
A Lippes loop IUD device is noted within the uterine cavity with a moderate
amount of fluid.
Prominent pelvic side wall nodes are noted bilaterally measuring up to 7 mm in
short axis with preserved morphology. No suspicious pelvic sidewall nodes are
noted.
There is a small amount of free fluid in the pelvis. Visualized colon is
unremarkable.
No suspicious osseous or musculoskeletal lesions.
Incidental note of a small left-sided urethral diverticulum.
|
(Over)
[**2109-9-9**] 8:09 AM
MR PELVIS W&W/O CONTRAST Clip # [**Clip Number (Radiology) 42869**]
Reason: assess right adnexa lesion on recent pelvic us
Contrast: GADAVIST Amt: 19
______________________________________________________________________________
FINAL REPORT
(Cont)
1. 7.3 x 3 cm mass in the right fallopian tube likely represents a primary
fallopian carcinoma. No evidence of contralateral or metastatic disease.
2. Normal appearance of the right ovary. The fallopian tube mass extends to
the fimbria of the fallopian tube without clear ovarian involvement.
3. Fibroid uterus with a partially submucosal fibroid (20%) in the posterior
base.
4. Moderate amount of fluid in the uterine cavity.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 283,921
|
489,431
| 1,234,592
| 86,692
|
[**2161-3-18**] 8:55 AM
CHEST (PA & LAT) Clip # [**Clip Number (Radiology) 66628**]
Reason: Is the pacemaker lead positioned appropriately?
Admitting Diagnosis: TACHYCARDIA
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
66 year old woman with tachy-brady syndrome s/p single chamber pacemaker.
REASON FOR THIS EXAMINATION:
Is the pacemaker lead positioned appropriately?
______________________________________________________________________________
FINAL REPORT
INDICATION: History of tachybrady syndrome and a new single-chamber pacer
placement.
TECHNIQUE: PA and lateral chest radiographs.
COMPARISON: [**2161-3-13**].
FINDINGS: The left-sided pacemakerlead terminates in the right ventricle.
There is no break in the wire. There is no pneumothorax. Moderate
cardiomegaly is unchanged. There is no focal consolidation, pulmonary
vascular congestion, or pleural effusion. Mild basilar atelectasis is
unchanged.
IMPRESSION: Pacemaker lead terminates in the right ventricle.
MJMgb
| 1,235
| null |
[**2161-3-13**].
|
Is the pacemaker lead positioned appropriately?
______________________________________________________________________________
FINAL REPORT
INDICATION: History of tachybrady syndrome and a new single-chamber pacer
placement.
|
The left-sided pacemakerlead terminates in the right ventricle.
There is no break in the wire. There is no pneumothorax. Moderate
cardiomegaly is unchanged. There is no focal consolidation, pulmonary
vascular congestion, or pleural effusion. Mild basilar atelectasis is
unchanged.
|
Pacemaker lead terminates in the right ventricle.
MJMgb
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 268,035
|
378,784
| 1,124,271
| 73,565
|
[**2199-1-18**] 9:45 AM
UNILAT UP EXT VEINS US LEFT Clip # [**Clip Number (Radiology) 11832**]
Reason: PAIN AND SWELLING ASSESS FOR DVT OR JOINT INFLAMMATION
Admitting Diagnosis: SEPSIS
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
58 year old woman with L shoulder pain and erythema on abx for GBS bacteremia.
REASON FOR THIS EXAMINATION:
Please assess for DVT or joint inflammation.
______________________________________________________________________________
FINAL REPORT
LEFT UPPER EXTREMITY ULTRASOUND [**2199-1-18**]
INDICATION: Left shoulder pain and erythema, on antibiotics for bacteremia.
?DVT.
FINDINGS: Grayscale, color and pulse wave Doppler son[**Name (NI) 250**] were performed on
the left internal jugular, subclavian, axillary, brachial, basilic and
cephalic veins. Normal flow, waveforms, compressibility and augmentation were
demonstrated. No intraluminal thrombus was identified.
IMPRESSION: No evidence of left upper extremity DVT.
| 1,122
| null | null |
Please assess for DVT or joint inflammation.
______________________________________________________________________________
FINAL REPORT
LEFT UPPER EXTREMITY ULTRASOUND [**2199-1-18**]
INDICATION: Left shoulder pain and erythema, on antibiotics for bacteremia.
?DVT.
|
Grayscale, color and pulse wave Doppler son[**Name (NI) 250**] were performed on
the left internal jugular, subclavian, axillary, brachial, basilic and
cephalic veins. Normal flow, waveforms, compressibility and augmentation were
demonstrated. No intraluminal thrombus was identified.
|
No evidence of left upper extremity DVT.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 196,466
|
148,668
| 886,611
| 26,271
|
[**2164-11-7**] 10:52 AM
CAROTID SERIES COMPLETE Clip # [**Clip Number (Radiology) 9511**]
Reason: LEFT HEMISPHERIC CVA
Admitting Diagnosis: STROKE;TELEMETRY
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
75 year old man with stroke
REASON FOR THIS EXAMINATION:
any carotid stenosis?
______________________________________________________________________________
FINAL REPORT
Carotid series complete.
REASON: Stroke.
FINDINGS: Duplex evaluation was performed of both carotid and vertebral
arteries. Moderate plaque was identified.
On the right, peak systolic velocities are 135, 156, 121 in the ICA, CCA, ECA
respectively. The ICA to CCA ratio is 0.9. This is consistent with a 40-59%
stenosis.
On the left, peak systolic velocities are 96, 142, 116 in the ICA, CCA, ECA
respectively. The ICA to CCA ratio is 0.7. This is consistent with less than
40% stenosis.
There is antegrade flow in the right vertebral artery. In the left vertebral
artery, there is to and fro flow with monophasic brachial artery tracing.
IMPRESSION: Moderate plaque with a right 40-59% and a left less than 40%
internal carotid artery stenosis. Of note, both carotid arteries show plaque
that extends more proximally into the common carotid artery. In addition,
there is ultrasound finding of a subclavian steal on the left.
| 1,487
| null | null |
any carotid stenosis?
______________________________________________________________________________
FINAL REPORT
Carotid series complete.
REASON: Stroke.
|
Duplex evaluation was performed of both carotid and vertebral
arteries. Moderate plaque was identified.
On the right, peak systolic velocities are 135, 156, 121 in the ICA, CCA, ECA
respectively. The ICA to CCA ratio is 0.9. This is consistent with a 40-59%
stenosis.
On the left, peak systolic velocities are 96, 142, 116 in the ICA, CCA, ECA
respectively. The ICA to CCA ratio is 0.7. This is consistent with less than
40% stenosis.
There is antegrade flow in the right vertebral artery. In the left vertebral
artery, there is to and fro flow with monophasic brachial artery tracing.
|
Moderate plaque with a right 40-59% and a left less than 40%
internal carotid artery stenosis. Of note, both carotid arteries show plaque
that extends more proximally into the common carotid artery. In addition,
there is ultrasound finding of a subclavian steal on the left.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 76,728
|
45,371
| 783,027
| 10,476
|
[**2193-4-2**] 2:50 AM
BABYGRAM (CHEST ONLY) Clip # [**Clip Number (Radiology) 84160**]
Reason: S/P INTUBATION
______________________________________________________________________________
FINAL REPORT
INDICATIONS:
CHEST: Cardiomediastinal silhouette is normal. The lungs are clear.
Endotracheal tube is 2 cm above carina. There is a line to the right of the
spine at the level of T9 that probably represents a venous line in the IVC.
| 522
| null | null | null |
Cardiomediastinal silhouette is normal. The lungs are clear.
Endotracheal tube is 2 cm above carina. There is a line to the right of the
spine at the level of T9 that probably represents a venous line in the IVC.
|
The lungs are clear. Endotracheal tube is 2 cm above carina. There is a line to the right of the
spine at the level of T9 that probably represents a venous line in the IVC.
|
FALLBACK_LAST_SENTENCES
| true
| true
| false
| false
| false
| 2
|
['history', 'comparison', 'procedure']
|
No History section found; No Comparison section found; No Technique/Procedure section found
| 21,289
|
297,104
| 1,052,109
| 80,805
|
[**2189-1-22**] 7:33 PM
CHEST (PA & LAT) Clip # [**Clip Number (Radiology) 51917**]
Reason: contusion? rib fx?
Admitting Diagnosis: PNEUMONIA
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
67 year old man with h/o fall with L middle/upper lobe consolidation, pneumonia
vs. contusion
REASON FOR THIS EXAMINATION:
contusion? rib fx?
______________________________________________________________________________
WET READ: [**First Name9 (NamePattern2) 11851**] [**Doctor First Name 141**] [**2189-1-22**] 8:54 PM
Left moderate pleural effusion, and right upper lobe consolidation similar in
appearance. Left lower lobe atelectasis unchanged.
______________________________________________________________________________
FINAL REPORT
HISTORY: Consolidation with history of fall.
FINDINGS: In comparison with study of [**1-20**], the moderate left pleural
effusion persists. Right upper lobe consolidation is similar in appearance to
the previous study. Left basilar atelectasis is unchanged.
| 1,168
|
Consolidation with history of fall.
| null |
contusion? rib fx?
______________________________________________________________________________
WET READ: [**First Name9 (NamePattern2) 11851**] [**Doctor First Name 141**] [**2189-1-22**] 8:54 PM
Left moderate pleural effusion, and right upper lobe consolidation similar in
appearance. Left lower lobe atelectasis unchanged.
______________________________________________________________________________
FINAL REPORT
|
In comparison with study of [**1-20**], the moderate left pleural
effusion persists. Right upper lobe consolidation is similar in appearance to
the previous study. Left basilar atelectasis is unchanged.
|
FINDINGS: In comparison with study of [**1-20**], the moderate left pleural
effusion persists. Right upper lobe consolidation is similar in appearance to
the previous study. Left basilar atelectasis is unchanged.
|
FALLBACK_LAST_SENTENCES
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 153,120
|
407,194
| 1,142,301
| 86,024
|
[**2151-5-26**] 6:44 PM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 91521**]
Reason: evaluate for acute process
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
71 year old woman with IPH
REASON FOR THIS EXAMINATION:
evaluate for acute process
______________________________________________________________________________
FINAL REPORT
CHEST RADIOGRAPH PERFORMED ON [**2151-5-26**].
COMPARISON: None.
CLINICAL HISTORY: Intraparenchymal hemorrhage, question acute process in the
chest.
FINDINGS: AP portable supine chest radiograph is obtained. The lungs are
clear though low lung volumes somewhat limit evaluation. No large pleural
effusion or pneumothorax is seen. Heart size appears upper limits of normal,
though suboptimally assessed on supine AP film. Bony structures appear
grossly intact.
IMPRESSION: Grossly unremarkable.
| 1,017
|
Intraparenchymal hemorrhage, question acute process in the
chest.
|
None.
CLINICAL
|
evaluate for acute process
______________________________________________________________________________
FINAL REPORT
CHEST RADIOGRAPH PERFORMED ON [**2151-5-26**].
|
AP portable supine chest radiograph is obtained. The lungs are
clear though low lung volumes somewhat limit evaluation. No large pleural
effusion or pneumothorax is seen. Heart size appears upper limits of normal,
though suboptimally assessed on supine AP film. Bony structures appear
grossly intact.
|
Grossly unremarkable.
|
IMPRESSION
| true
| true
| true
| true
| true
| 5
|
[]
|
OK
| 213,592
|
47,100
| 786,852
| 22,908
|
[**2111-3-19**] 1:43 AM
CHEST (PRE-OP PA & LAT) Clip # [**Clip Number (Radiology) 68756**]
Reason: CORONARY ARTERY DISEASE\CATH
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
44 year old man with 3VD
REASON FOR THIS EXAMINATION:
pre op CABG
______________________________________________________________________________
FINAL REPORT
HISTORY: 3 vessel disease, preop.
TECHNIQUE: Chest PA & lateral.
There are no prior studies for comparison.
FINDINGS: The heart and mediastinum are normal in size. The aorta is unfolded.
The pulmonary vessels are within normal limits. There are no consolidations,
pleural effusions or pneumothoraces. The lung volumes are decreased
bilaterally likely related to poor inspiratory effort. The bones are
unremarkable.
IMPRESSION: No evidence of heart failure or pneumonia.
| 968
|
3 vessel disease, preop.
| null |
pre op CABG
______________________________________________________________________________
FINAL REPORT
|
The heart and mediastinum are normal in size. The aorta is unfolded.
The pulmonary vessels are within normal limits. There are no consolidations,
pleural effusions or pneumothoraces. The lung volumes are decreased
bilaterally likely related to poor inspiratory effort. The bones are
unremarkable.
|
No evidence of heart failure or pneumonia.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 22,204
|
61,247
| 802,879
| 1,109
|
[**2103-9-25**] 12:04 PM
MR HEAD W/O CONTRAST; MR-ANGIO HEAD Clip # [**Clip Number (Radiology) 102308**]
Reason: head w/ contrast, diffusion, MRA for stroke protocol, please
Admitting Diagnosis: STROKE;TELEMETRY
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
63 year old woman with L hemiparesis
REASON FOR THIS EXAMINATION:
head w/ contrast, diffusion, MRA for stroke protocol, please page neurology
with any questions
______________________________________________________________________________
FINAL REPORT
INDICATION: Left hemiparesis.
TECHNIQUE: Multiplanar T1 and T2-weighted brain imaging is performed.
Additionally, diffusion weighted imaging is performed.
There is increased signal of the right MCA territory both in diffusion
weighted imaging and FLAIR imaging. There is also subtly increased signal in
a similar distribution on T2-weighted imaging. This effects the right caudate
head, as well as the anterior limb of the right internal capsule.
Additionally, there is a focal, 1-2 cm area of increased signal on FLAIR and
diffusion weighted in the left frontal lobe as well. There is no significant
mass effect or shift of normally midline structures. The ventricles,
cisterns, and sulci remain preserved. There is no evidence of hemorrhage.
Incidental note is made of empty sella. The soft tissues and osseous
structures are otherwise unremarkable.
IMPRESSION: Large right MCA distribution infarction, subacute. Additionally,
a focus of infarction involving the left frontal lobe, presumably represents a
sequelae from embolus.
MRA: Two and three dimensional time-of-flight imaging with multiplanar
reconstructions are performed.
FINDINGS: There is loss of signal beginning at the mid-portion of the right
M1 artery, without distal flow. The remainder of the arteries of the circle
of [**Location (un) **] and vertebral basilar system remain patent. There is no evidence of
aneuryms or arterial venous malformation.
IMPRESSION: Occlusion of the mid-portion of the right M1 portion of the MCA.
| 2,196
| null | null |
head w/ contrast, diffusion, MRA for stroke protocol, please page neurology
with any questions
______________________________________________________________________________
FINAL REPORT
INDICATION: Left hemiparesis.
|
There is loss of signal beginning at the mid-portion of the right
M1 artery, without distal flow. The remainder of the arteries of the circle
of [**Location (un) **] and vertebral basilar system remain patent. There is no evidence of
aneuryms or arterial venous malformation.
|
Large right MCA distribution infarction, subacute. Additionally,
a focus of infarction involving the left frontal lobe, presumably represents a
sequelae from embolus.
MRA: Two and three dimensional time-of-flight imaging with multiplanar
reconstructions are performed.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 30,076
|
272,228
| 995,027
| 30,472
|
[**2190-2-21**] 8:43 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 32764**]
Reason: r/o inf, eff
Admitting Diagnosis: CORONARY ARTERY DISEASE\CORONARY ARTERY BYPASS GRAFT WITH MVR AND TVR/SDA
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
76 year old woman with post cabg / confusion
REASON FOR THIS EXAMINATION:
r/o inf, eff
______________________________________________________________________________
FINAL REPORT
Status post CABG, now confused.
CHEST:
Heart and mediastinum appear normal following CABG. The lung fields are
clear. There is no pneumothorax. No evidence of pneumonia is present.
IMPRESSION: No failure. No pneumonia. No pneumothorax.
| 836
| null | null |
r/o inf, eff
______________________________________________________________________________
FINAL REPORT
Status post CABG, now confused.
|
Heart and mediastinum appear normal following CABG. The lung fields are
clear. There is no pneumothorax. No evidence of pneumonia is present.
|
No failure. No pneumonia. No pneumothorax.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 140,259
|
515,410
| 1,254,059
| 54,077
|
[**2192-8-15**] 3:50 PM
CT ABD & PELVIS WITH CONTRAST Clip # [**Clip Number (Radiology) 39843**]
Reason: r/o IVC obstruction and mechanical ureteral/urethral obstruc
Admitting Diagnosis: LOWER EXTREMITY EDEMA;STAGE 4 CANCER
______________________________________________________________________________
FINAL ADDENDUM
ADDENDUM: The distended and incompletely opacified left common iliac,
external iliac, common femoral, and superficial femoral veins that were
reported as concerning for thrombus on the initial interpretation could also
represent dilated unopacified veins secondary to severe compression of the
left common iliac vein near its confluence with the IVC, especially in light
of the venous ultrasound of [**2192-8-14**] showing no thrombus. However, its
appearance is concerning for interval development of thrombus, and a repeat
ultrasound is recommended to assess the common femoral and superficial femoral
vein for thrombus.
[**2192-8-15**] 3:50 PM
CT ABD & PELVIS WITH CONTRAST Clip # [**Clip Number (Radiology) 39843**]
Reason: r/o IVC obstruction and mechanical ureteral/urethral obstruc
Admitting Diagnosis: LOWER EXTREMITY EDEMA;STAGE 4 CANCER
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
73 year old man with metastatic colon ca p/w urinary obstruction + scrotal
edema and B/L LE edema.
REASON FOR THIS EXAMINATION:
r/o IVC obstruction and mechanical ureteral/urethral obstruction.
No contraindications for IV contrast
______________________________________________________________________________
WET READ: NATg WED [**2192-8-15**] 6:29 PM
1. Confluent aortocaval lymphadenopathy which appears to obliterate the
infrarenal IVC. The left common iliac vein is hypodense and expanded
extending to the left common femoral vein, concerning for deep venous
thrombosis.
2. Edematous abnormal loop in the right upper quadrant with abnormal mucosal
enhancement which may be infectious, inflammatory, or ischemic in nature.
3. Diffuse bony abnormality, not significantly changed compared with prior
studies.
______________________________________________________________________________
FINAL REPORT
HISTORY: 73-year-old male with metastatic colon cancer who presents with
urinary obstruction and scrotal edema as well as bilateral lower extremity
edema, rule IVC obstruction or mechanical obstruction.
COMPARISON: [**2192-7-23**], and as far back as [**2191-6-19**].
TECHNIQUE: Axial CT images were acquired of the abdomen and pelvis following
the uneventful administration of 130 cc of Omnipaque intravenously, as well as
oral contrast. These were reformatted into coronal and sagittal planes.
FINDINGS:
LUNG BASES: There is bibasilar atelectasis, without pleural or pericardial
effusion. A central venous catheter tip terminates at the cavoatrial
junction. A small left ventricular papillary muscle calcification is
incidentally noted. Paraortic lymphadenopathy is increased in size compared
with prior, now measuring 1.3 cm in short axis on the left, previously 0.8 cm.
ABDOMEN: There is an unchanged appearance of focal fatty infiltration along
the fissure for the falciform ligament. The liver is otherwise normal in
appearance without focal lesions. The spleen is normal in size and
appearance. The gallbladder is prominent, but thin-walled without evidence of
acute inflammatory change. The pancreas is normal in appearance. The
adrenals are normal bilaterally. The kidneys demonstrate symmetric contrast
enhancement and brisk bilateral excretion without hydronephrosis.
Confluent lymphadenopathy encases the aorta from the level of the SMA
inferiorly and tracks along the common iliac arteries bilaterally. At the
(Over)
[**2192-8-15**] 3:50 PM
CT ABD & PELVIS WITH CONTRAST Clip # [**Clip Number (Radiology) 39843**]
Reason: r/o IVC obstruction and mechanical ureteral/urethral obstruc
Admitting Diagnosis: LOWER EXTREMITY EDEMA;STAGE 4 CANCER
______________________________________________________________________________
FINAL REPORT
(Cont)
level of the renal veins, the IVC is patent, however inferior to this the IVC
enters a zone of confluent lymphadenopathy, and cannot be appreciated. The
right iliac vein and common femoral vein are seen to fill with contrast. No
contrast is seen within the left common iliac and femoral veins which appear
distended, either due to delayed contrast filling, or the presence of
thrombus. The aorta remains normal in caliber, its major branches remain
patent.
The stomach is filled with positive contrast, is collapsed and is not well
evaluated. Small bowel is opacified by positive contrast. Within the right
upper quadrant just inferior to the gallbladder, there is a focal abnormal
small bowel loop which demonstrates wall thickening and mucosal
hyperenhancement (2; 48, 300B:17). There is no intraperitoneal free fluid or
free air.
PELVIS: The bladder contains a Foley catheter, and excreted contrast, and is
markedly thick walled. The colon is unchanged in appearance, without focal
lesions seen though no contrast has reached the colon. There is asymmetric
thickening of the rectum.
There is marked scrotal edema, and bilateral lower extremity edema.
BONE WINDOWS: There are multiple mixed areas of sclerosis and lysis mostly
abutting the lumbar and thoracic vertebral body endplates, which are unchanged
from the prior study. No new compression deformity is seen. Within the right
seventh rib there is irregularity that may represent metastasis or less likely
fracture.
IMPRESSION:
1. Confluent aortocaval lymphadenopathy from metastatic rectal cancer, which
appears to obliterate the infrarenal IVC. The left common iliac vein is
hypodense and expanded extending to the left common femoral vein, consistent
with deep venous thrombosis.
2. Edematous abnormal loop in the right upper quadrant with abnormal mucosal
enhancement which may be infectious, post-radiation, or ischemicture.
3. Diffuse bony abnormality, not significantly changed compared with prior
studies, concerning for metastases, with clear right rib metastasis.
4. Bladder wall thickening is likely post-radiation change, more striking in
comparison with [**Month (only) 8351**]; superimposed infection is possible.
(Over)
[**2192-8-15**] 3:50 PM
CT ABD & PELVIS WITH CONTRAST Clip # [**Clip Number (Radiology) 39843**]
Reason: r/o IVC obstruction and mechanical ureteral/urethral obstruc
Admitting Diagnosis: LOWER EXTREMITY EDEMA;STAGE 4 CANCER
______________________________________________________________________________
FINAL REPORT
(Cont)
| 7,117
|
73-year-old male with metastatic colon cancer who presents with
urinary obstruction and scrotal edema as well as bilateral lower extremity
edema, rule IVC obstruction or mechanical obstruction.
|
[**2192-7-23**], and as far back as [**2191-6-19**].
|
r/o IVC obstruction and mechanical ureteral/urethral obstruction.
No contraindications for IV contrast
______________________________________________________________________________
WET READ: NATg WED [**2192-8-15**] 6:29 PM
1. Confluent aortocaval lymphadenopathy which appears to obliterate the
infrarenal IVC. The left common iliac vein is hypodense and expanded
extending to the left common femoral vein, concerning for deep venous
thrombosis.
2. Edematous abnormal loop in the right upper quadrant with abnormal mucosal
enhancement which may be infectious, inflammatory, or ischemic in nature.
3. Diffuse bony abnormality, not significantly changed compared with prior
studies.
______________________________________________________________________________
FINAL REPORT
|
LUNG BASES: There is bibasilar atelectasis, without pleural or pericardial
effusion. A central venous catheter tip terminates at the cavoatrial
junction. A small left ventricular papillary muscle calcification is
incidentally noted. Paraortic lymphadenopathy is increased in size compared
with prior, now measuring 1.3 cm in short axis on the left, previously 0.8 cm.
|
The distended and incompletely opacified left common iliac,
external iliac, common femoral, and superficial femoral veins that were
reported as concerning for thrombus on the initial interpretation could also
represent dilated unopacified veins secondary to severe compression of the
left common iliac vein near its confluence with the IVC, especially in light
of the venous ultrasound of [**2192-8-14**] showing no thrombus. However, its
appearance is concerning for interval development of thrombus, and a repeat
ultrasound is recommended to assess the common femoral and superficial femoral
vein for thrombus.
[**2192-8-15**] 3:50 PM
CT ABD & PELVIS WITH CONTRAST Clip # [**Clip Number (Radiology) 39843**]
Reason: r/o IVC obstruction and mechanical ureteral/urethral obstruc
Admitting Diagnosis: LOWER EXTREMITY EDEMA;STAGE 4 CANCER
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
73 year old man with metastatic colon ca p/w urinary obstruction + scrotal
edema and B/L LE edema.
REASON FOR THIS
|
IMPRESSION
| true
| true
| true
| true
| true
| 5
|
[]
|
OK
| 286,646
|
82,826
| 819,613
| 22,801
|
[**2179-3-13**] 10:29 AM
CT CHEST W/CONTRAST; CT ABDOMEN W/CONTRAST Clip # [**Clip Number (Radiology) 10006**]
CT PELVIS W/CONTRAST
Reason: evaluate pna
Admitting Diagnosis: THROMBOTIC THROMBOCYTOPENIC PUPURA
Field of view: 40
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
72 year old man with thrombocytopenia, ?[**Hospital 10007**] transferred from osh, c diff, pna.
REASON FOR THIS EXAMINATION:
evaluate pna
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Thrombocytopenia. Pneumonia and adrenal mass by outside hospital
CT.
COMPARISON: Outside comparisons are not available.
TECHNIQUE: Contiguous axial images through the chest, abdomen and pelvis were
obtained following the administration of oral contrast. Intravenous contrast
was not used due to the patient's elevated creatinine.
CHEST: An endotracheal tube and a nasogastric tube are present. There is no
axillary, hilar or mediastinal lymph adenopathy. Small flecks of calcium are
seen within the aortic arch. There is calcification within the LAD. There is
consolidation within the right lower lobe with an associated small pleural
effusion. Patchy foci of ground glass opacity are also seen within the right
upper lobe. Small vague patchy density is seen at the left lung base, which
may relate to atelectasis. There is also a small amount of
atelectasis/consolidation at the extreme left lung base posteriorly. There is
a trace pericardial effusion.
ABDOMEN WITH ORAL CONTRAST: The liver is diffusely low density, consistent
with fatty infiltration. There is a calcified gallstone measuring
approximately 1 cm in an otherwise unremarkable-appearing gallbladder.
Scattered calcifications are seen within the spleen, likely residua of
granulomatous disease. The pancreas, left adrenal gland, and left kidney are
within normal limits. There is a large heterogeneous density mass likely
arising from the right adrenal gland measuring at least 5.7 x 6.8 cm.
Additionally, there is thickening of the right crus of the diaphragm with
mottled attenuation. The features of this are consistent with a hematoma,
although an underlying lesion is not excluded within the adrenal gland. There
is a tiny (2 mm) nonobstructing stone at the lower pole of the right kidney.
There is no retroperitoneal lymph adenopathy. There is no free abdominal
fluid. The opacified loops of bowel are normal in caliber.
PELVIS WITH CONTRAST: There is a Foley catheter within the bladder, which is
not fully distended. There is a moderate amount of iatrogenic air within the
bladder. The prostate gland, seminal vesicles, and pelvic loops of bowel are
grossly unremarkable. There is no inguinal or deep pelvic lymph adenopathy.
There is no free pelvic fluid.
(Over)
[**2179-3-13**] 10:29 AM
CT CHEST W/CONTRAST; CT ABDOMEN W/CONTRAST Clip # [**Clip Number (Radiology) 10006**]
CT PELVIS W/CONTRAST
Reason: evaluate pna
Admitting Diagnosis: THROMBOTIC THROMBOCYTOPENIC PUPURA
Field of view: 40
______________________________________________________________________________
FINAL REPORT
(Cont)
BONE WINDOWS: There are no suspicious lytic or sclerotic bony lesions.
IMPRESSION:
1. Pneumonia.
2. Coronary artery calcifications and trace pericardial effusion.
3. Fatty liver.
4. Cholelithiasis without acute cholecystitis.
5. Tiny nonobstructing right lower pole renal stone.
6. Large mass probably arising from the right adrenal gland with features
consistent with hemorrhage. Thickening of the right diaphragmatic crus with
similar-appearance. Vascularity was not assessed due to lack of i.v contrast.
An underlying lesion within the adrenal gland is not excluded. An MR
examination is recommended to evaluate this possibility
Images were reviewed with the medicine team caring for the patient at the time
of the interpretation.
| 4,200
| null |
Outside comparisons are not available.
|
evaluate pna
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Thrombocytopenia. Pneumonia and adrenal mass by outside hospital
CT.
|
An endotracheal tube and a nasogastric tube are present. There is no
axillary, hilar or mediastinal lymph adenopathy. Small flecks of calcium are
seen within the aortic arch. There is calcification within the LAD. There is
consolidation within the right lower lobe with an associated small pleural
effusion. Patchy foci of ground glass opacity are also seen within the right
upper lobe. Small vague patchy density is seen at the left lung base, which
may relate to atelectasis. There is also a small amount of
atelectasis/consolidation at the extreme left lung base posteriorly. There is
a trace pericardial effusion.
ABDOMEN WITH ORAL CONTRAST: The liver is diffusely low density, consistent
with fatty infiltration. There is a calcified gallstone measuring
approximately 1 cm in an otherwise unremarkable-appearing gallbladder.
Scattered calcifications are seen within the spleen, likely residua of
granulomatous disease. The pancreas, left adrenal gland, and left kidney are
within normal limits. There is a large heterogeneous density mass likely
arising from the right adrenal gland measuring at least 5.7 x 6.8 cm.
Additionally, there is thickening of the right crus of the diaphragm with
mottled attenuation. The features of this are consistent with a hematoma,
although an underlying lesion is not excluded within the adrenal gland. There
is a tiny (2 mm) nonobstructing stone at the lower pole of the right kidney.
There is no retroperitoneal lymph adenopathy. There is no free abdominal
fluid. The opacified loops of bowel are normal in caliber.
PELVIS WITH CONTRAST: There is a Foley catheter within the bladder, which is
not fully distended. There is a moderate amount of iatrogenic air within the
bladder. The prostate gland, seminal vesicles, and pelvic loops of bowel are
grossly unremarkable. There is no inguinal or deep pelvic lymph adenopathy.
There is no free pelvic fluid.
(Over)
[**2179-3-13**] 10:29 AM
CT CHEST W/CONTRAST; CT ABDOMEN W/CONTRAST Clip # [**Clip Number (Radiology) 10006**]
CT PELVIS W/CONTRAST
Reason: evaluate pna
Admitting Diagnosis: THROMBOTIC THROMBOCYTOPENIC PUPURA
Field of view: 40
______________________________________________________________________________
FINAL REPORT
(Cont)
BONE WINDOWS: There are no suspicious lytic or sclerotic bony lesions.
|
1. Pneumonia.
2. Coronary artery calcifications and trace pericardial effusion.
3. Fatty liver.
4. Cholelithiasis without acute cholecystitis.
5. Tiny nonobstructing right lower pole renal stone.
6. Large mass probably arising from the right adrenal gland with features
consistent with hemorrhage. Thickening of the right diaphragmatic crus with
similar-appearance. Vascularity was not assessed due to lack of i.v contrast.
An underlying lesion within the adrenal gland is not excluded. An MR
examination is recommended to evaluate this possibility
Images were reviewed with the medicine team caring for the patient at the time
of the interpretation.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 41,441
|
224,954
| 949,585
| 21,799
|
[**2137-3-26**] 9:48 PM
CHEST (PORTABLE AP); -59 DISTINCT PROCEDURAL SERVICE Clip # [**Clip Number (Radiology) 82615**]
Reason: eval for pneumonia
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
64 year old woman with hypoxia, fever, cough
REASON FOR THIS EXAMINATION:
eval for pneumonia
______________________________________________________________________________
FINAL REPORT
INDICATION: Hypoxia, fever and cough. Evaluate for pneumonia.
COMPARISON: [**2133-1-24**].
UPRIGHT AP CHEST: Patient is rotated toward the right. Cardiac and
mediastinal contours are unchanged. There is mild congestive failure and
increased density in the left lower lung field raising the possibility of
pneumonia. There is a small left pleural effusion. No pneumothorax.
| 890
| null |
[**2133-1-24**].
UPRIGHT AP
|
eval for pneumonia
______________________________________________________________________________
FINAL REPORT
INDICATION: Hypoxia, fever and cough. Evaluate for pneumonia.
|
Patient is rotated toward the right. Cardiac and
mediastinal contours are unchanged. There is mild congestive failure and
increased density in the left lower lung field raising the possibility of
pneumonia. There is a small left pleural effusion. No pneumothorax.
|
There is mild congestive failure and
increased density in the left lower lung field raising the possibility of
pneumonia. There is a small left pleural effusion. No pneumothorax.
|
FALLBACK_LAST_SENTENCES
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 114,858
|
484,775
| 1,248,597
| 72,999
|
[**2194-6-19**] 9:39 AM
CHEST PORT. LINE PLACEMENT Clip # [**Clip Number (Radiology) 5783**]
Reason: PICC line placement
Admitting Diagnosis: CHEST PAIN
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
77 year old man with PE/MRSA bacteremia/ epidural abscess with new picc line
REASON FOR THIS EXAMINATION:
PICC line placement
______________________________________________________________________________
FINAL REPORT
INDICATION: 77-year-old man with PE/MRSA bacteremia/epidural abscess with new
PICC line placement, evaluate position.
COMPARISON: [**2194-6-19**].
TECHNIQUE: Portable upright chest radiograph.
FINDINGS: ET tube is 5 cm above the carina. There is interval placement of a
left PICC line with the tip terminating in the lower SVC. opacification at
both bases likely represents a combination of small pleural effusions and
atelectasis. No other significant changes compared to the prior study.
IMPRESSION:
Interval placement of a left PICC line with the tip terminating in the lower
SVC.
| 1,173
| null |
[**2194-6-19**].
|
PICC line placement
______________________________________________________________________________
FINAL REPORT
INDICATION: 77-year-old man with PE/MRSA bacteremia/epidural abscess with new
PICC line placement, evaluate position.
|
ET tube is 5 cm above the carina. There is interval placement of a
left PICC line with the tip terminating in the lower SVC. opacification at
both bases likely represents a combination of small pleural effusions and
atelectasis. No other significant changes compared to the prior study.
|
Interval placement of a left PICC line with the tip terminating in the lower
SVC.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 264,564
|
280,962
| 1,018,159
| 19,569
|
[**2184-6-30**] 2:57 PM
CT CHEST W/O CONTRAST Clip # [**0-0-**]
Reason: Pls eval for interval change in ground glass opacities, effu
Field of view: 40
______________________________________________________________________________
FINAL ADDENDUM
ADDENDUM: In the second to the last paragraph in the body of the report, the
word "note" should be changed to "no". The corrected sentence should state
"No substantial changes are seen in the upper abdomen compared to the recent
CT."
[**2184-6-30**] 2:57 PM
CT CHEST W/O CONTRAST Clip # [**0-0-**]
Reason: Pls eval for interval change in ground glass opacities, effu
Field of view: 40
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
218 pound 53 year old male patient with history of AML, s/p SCT treated for
ARDS in the past, and then for COP. Evaluate for change in ground glass
opacities
REASON FOR THIS EXAMINATION:
Pls eval for interval change in ground glass opacities, effusions, evidence of
infection
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
CT CHEST.
COMPARISON: [**2184-5-26**] and [**2184-4-26**] chest CTs.
INDICATION: AML. History of cryptogenic organizing pneumonia.
TECHNIQUE: Volumetric, multidetector CT acquisition of the chest was
performed without intravenous or oral contrast. Images were presented for
display in the axial plane at 5-mm and 1.25-mm collimation.
FINDINGS: There has overall been interval improvement in widespread areas of
ground-glass opacification in both lungs, with residual opacities remaining,
most pronounced in the mid and lower lung with residual areas of ground-glass
attenuation and reticulation. Many of these areas correspond to more dense
areas of ground glass on the [**2184-5-26**] scan and mixed areas of
consolidation and glass on the earlier study of [**2184-4-13**] Although
previously present opacities have largely improved and a few have resolved,
there are scattered new areas of ground-glass attenuation, including
peribronchovascular ground glass foci within the left upper lobe anteriorly
(24, 3) and focal worsening of ground-glass opacification and peribronchiolar
nodules in a lobular distribution in the periphery of the right upper lobe
(26, 3). The recently described new ground-glass opacities in the right upper
and middle lobe on the [**2184-5-26**] scan show overall marked improvement.
Mediastinal and mild bilateral hilar lymphadenopathy is unchanged. Heart size
remains normal, and a small pericardial effusion is unchanged. Trace left
pleural effusion is again demonstrated, and right pleural effusion has
resolved in the interval.
Exam was not tailored to evaluate the subdiaphragmatic region, but adrenal
glands are well visualized and normal in appearance. The liver is hyperdense,
probably due to previous transfusions and less likely amiodarone therapy.
Note, substantial changes are seen in the upper abdomen compared to the recent
CT.
Skeletal structures demonstrate no suspicious lytic or blastic skeletal
lesions.
(Over)
[**2184-6-30**] 2:57 PM
CT CHEST W/O CONTRAST Clip # [**0-0-**]
Reason: Pls eval for interval change in ground glass opacities, effu
Field of view: 40
______________________________________________________________________________
FINAL REPORT
(Cont)
IMPRESSION:
Overall continued improvement in diffuse lung parenchymal abnormalities,
probably related to the provided history of cryptogenic organizing pneumonia.
A few new minimal foci of ground-glass attenuation are identified in both
upper lobes and may be due to recurrent sites of cryptogenic organizing
pneumonia. Superimposed infection is also possible in the appropriate
clinical setting.
| 4,141
| null |
[**2184-5-26**] and [**2184-4-26**] chest CTs.
INDICATION: AML. History of cryptogenic organizing pneumonia.
|
Pls eval for interval change in ground glass opacities, effusions, evidence of
infection
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
CT CHEST.
|
There has overall been interval improvement in widespread areas of
ground-glass opacification in both lungs, with residual opacities remaining,
most pronounced in the mid and lower lung with residual areas of ground-glass
attenuation and reticulation. Many of these areas correspond to more dense
areas of ground glass on the [**2184-5-26**] scan and mixed areas of
consolidation and glass on the earlier study of [**2184-4-13**] Although
previously present opacities have largely improved and a few have resolved,
there are scattered new areas of ground-glass attenuation, including
peribronchovascular ground glass foci within the left upper lobe anteriorly
(24, 3) and focal worsening of ground-glass opacification and peribronchiolar
nodules in a lobular distribution in the periphery of the right upper lobe
(26, 3). The recently described new ground-glass opacities in the right upper
and middle lobe on the [**2184-5-26**] scan show overall marked improvement.
Mediastinal and mild bilateral hilar lymphadenopathy is unchanged. Heart size
remains normal, and a small pericardial effusion is unchanged. Trace left
pleural effusion is again demonstrated, and right pleural effusion has
resolved in the interval.
Exam was not tailored to evaluate the subdiaphragmatic region, but adrenal
glands are well visualized and normal in appearance. The liver is hyperdense,
probably due to previous transfusions and less likely amiodarone therapy.
Note, substantial changes are seen in the upper abdomen compared to the recent
CT.
Skeletal structures demonstrate no suspicious lytic or blastic skeletal
lesions.
(Over)
[**2184-6-30**] 2:57 PM
CT CHEST W/O CONTRAST Clip # [**0-0-**]
Reason: Pls eval for interval change in ground glass opacities, effu
Field of view: 40
______________________________________________________________________________
FINAL REPORT
(Cont)
|
In the second to the last paragraph in the body of the report, the
word "note" should be changed to "no". The corrected sentence should state
"No substantial changes are seen in the upper abdomen compared to the recent
CT."
[**2184-6-30**] 2:57 PM
CT CHEST W/O CONTRAST Clip # [**0-0-**]
Reason: Pls eval for interval change in ground glass opacities, effu
Field of view: 40
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
218 pound 53 year old male patient with history of AML, s/p SCT treated for
ARDS in the past, and then for COP. Evaluate for change in ground glass
opacities
REASON FOR THIS
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 144,888
|
39,453
| 778,610
| 11,611
|
PERSANTINE MIBI Clip # [**Clip Number (Radiology) 26808**]
Reason: CAD.
______________________________________________________________________________
FINAL REPORT
HISTORY: Eighty-one year old man with history of polycythemia and MI in
[**2161-11-6**] and [**2162-1-6**].
SUMMARY OF EXERCISE DATA FROM THE REPORT OF THE EXERCISE LAB:
Persantine was infused intravenously for approximately 4 minutes at a dose of
approximately 0.142 mg/kg/min.
No pain symptoms or ST segment changes were recorded.
INTERPRETATION: One to three minutes after the cessation of infusion,
MIBI was administered IV.
Image Protocol: Gated SPECT.
Resting perfusion images were obtained with thallium.
Tracer was injected 15 minutes prior to obtaining the resting images.
Stress images show moderate lateral and inferior wall areas of decreased tracer
uptake.
Resting perfusion images show partial reversibility of the lateral wall
perfusion defect and complete reversal of the inferior wall defect.
Ejection fraction calculated from gated wall motion images obtained after
Persantine administration shows a left ventricular ejection fraction of
approximately 49%. There is mild left ventricular dilatation and grossly normal
wall motion.
The above findings are consistent with partially reversible ischemic changes in
the lateral wall and reversible perfusion defect of the inferior wall at the
left ventricle.
IMPRESSION: Partially reversible lateral wall perfusion defect. Reversible
inferior wall perfusion defect of left ventricle.
/nkg
[**First Name8 (NamePattern2) 33**] [**Known lastname **], M.D.
[**Initials (NamePattern4) **] [**Last Name (NamePattern4) 35**] [**Last Name (NamePattern1) 36**], M.D. Approved: [**First Name8 (NamePattern2) 398**] [**2162-1-12**] 1:54 PM
RADLINE [**Telephone/Fax (1) 30**]; A radiology consult service.
To hear preliminary results, prior to transcription, call the
Radiology Listen Line [**Telephone/Fax (1) 31**].
| 2,139
|
Eighty-one year old man with history of polycythemia and MI in
[**2161-11-6**] and [**2162-1-6**].
SUMMARY OF EXERCISE DATA FROM THE REPORT OF THE EXERCISE LAB:
Persantine was infused intravenously for approximately 4 minutes at a dose of
approximately 0.142 mg/kg/min.
No pain symptoms or ST segment changes were recorded.
| null | null |
One to three minutes after the cessation of infusion,
MIBI was administered IV.
Image Protocol: Gated SPECT.
Resting perfusion images were obtained with thallium.
Tracer was injected 15 minutes prior to obtaining the resting images.
Stress images show moderate lateral and inferior wall areas of decreased tracer
uptake.
Resting perfusion images show partial reversibility of the lateral wall
perfusion defect and complete reversal of the inferior wall defect.
Ejection fraction calculated from gated wall motion images obtained after
Persantine administration shows a left ventricular ejection fraction of
approximately 49%. There is mild left ventricular dilatation and grossly normal
wall motion.
The above findings are consistent with partially reversible ischemic changes in
the lateral wall and reversible perfusion defect of the inferior wall at the
left ventricle.
|
Partially reversible lateral wall perfusion defect. Reversible
inferior wall perfusion defect of left ventricle.
/nkg
[**First Name8 (NamePattern2) 33**] [**Known lastname **], M.D.
[**Initials (NamePattern4) **] [**Last Name (NamePattern4) 35**] [**Last Name (NamePattern1) 36**], M.D. Approved: [**First Name8 (NamePattern2) 398**] [**2162-1-12**] 1:54 PM
RADLINE [**Telephone/Fax (1) 30**]; A radiology consult service.
To hear preliminary results, prior to transcription, call the
Radiology Listen Line [**Telephone/Fax (1) 31**].
|
IMPRESSION
| true
| true
| true
| false
| false
| 3
|
['comparison', 'procedure']
|
No Comparison section found; No Technique/Procedure section found
| 18,105
|
359,874
| 1,095,994
| 89,002
|
[**2135-8-30**] 3:58 PM
CT HEAD W/O CONTRAST Clip # [**Clip Number (Radiology) 64310**]
Reason: 41 yo s/p EVD and coiling acomm
Admitting Diagnosis: SUBARACHNOID HEMORRHAGE
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
41 year old woman with sah, s/p acomm coil
REASON FOR THIS EXAMINATION:
41 yo s/p EVD and coiling acomm
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Subarachnoid hemorrhage, status post endovascular coiling of
anterior communicating artery aneurysm and status post ventriculostomy.
COMPARISON: Head CTA performed at 12:09 p.m. on [**2135-8-30**], prior to
the intervention.
TECHNIQUE: Non-contrast head CT.
FINDINGS: There is a new coil pack in the anterior aspect of the suprasellar
cistern, with associated artifact slightly limiting evaluation at this level.
Extensive subarachnoid hemorrhage is again seen, with the greatest density of
blood in the anterior interhemispheric fissure, and also extensive blood
burden in the sylvian fissures, cerebral sulci, and basal cisterns. No
significant change is appreciated in the distribution or extent of the
hemorrhage. Extensive hemorrhage in the lateral, third and fourth ventricles
is not significantly changed. There is a new left frontal approach
ventriculostomy, which crosses the septum pellucidum and terminates along the
ependymal margin of the frontal [**Doctor Last Name 503**] of the right lateral ventricle, slightly
above the foramen of [**Last Name (un) **]. Due to differences in patient positioning, it is
not clear whether the temporal horns of the lateral ventricles have slightly
decreased in size. Otherwise, the ventricles do not appear significantly
changed in size, with persistent hydrocephalus. There is no evidence of a new
large parenchymal infarction.
Nasopharyngeal secretions are likely related to the presence of the
endotracheal and orogastric tubes.
IMPRESSION:
1. Unchanged extensive subarachnoid and intraventricular hemorrhage.
2. Status post ventriculostomy with questionable minimal decreased size of
the temporal horns of the lateral ventricles. Otherwise, no significant
change in hydrocephalus.
DFDkq
| 2,482
| null |
Head CTA performed at 12:09 p.m. on [**2135-8-30**], prior to
the intervention.
|
41 yo s/p EVD and coiling acomm
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Subarachnoid hemorrhage, status post endovascular coiling of
anterior communicating artery aneurysm and status post ventriculostomy.
|
There is a new coil pack in the anterior aspect of the suprasellar
cistern, with associated artifact slightly limiting evaluation at this level.
Extensive subarachnoid hemorrhage is again seen, with the greatest density of
blood in the anterior interhemispheric fissure, and also extensive blood
burden in the sylvian fissures, cerebral sulci, and basal cisterns. No
significant change is appreciated in the distribution or extent of the
hemorrhage. Extensive hemorrhage in the lateral, third and fourth ventricles
is not significantly changed. There is a new left frontal approach
ventriculostomy, which crosses the septum pellucidum and terminates along the
ependymal margin of the frontal [**Doctor Last Name 503**] of the right lateral ventricle, slightly
above the foramen of [**Last Name (un) **]. Due to differences in patient positioning, it is
not clear whether the temporal horns of the lateral ventricles have slightly
decreased in size. Otherwise, the ventricles do not appear significantly
changed in size, with persistent hydrocephalus. There is no evidence of a new
large parenchymal infarction.
Nasopharyngeal secretions are likely related to the presence of the
endotracheal and orogastric tubes.
|
1. Unchanged extensive subarachnoid and intraventricular hemorrhage.
2. Status post ventriculostomy with questionable minimal decreased size of
the temporal horns of the lateral ventricles. Otherwise, no significant
change in hydrocephalus.
DFDkq
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 185,599
|
482,274
| 1,186,066
| 48,539
|
[**2115-3-11**] 10:58 PM
L-SPINE (AP & LAT) Clip # [**Clip Number (Radiology) 8665**]
Reason: Evidence of fracture?
Admitting Diagnosis: POST ARREST
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
36 year old man with sz disorder s/p fall to bathroom complaining of LB pain.
REASON FOR THIS EXAMINATION:
Evidence of fracture?
______________________________________________________________________________
FINAL REPORT
LUMBAR SPINE [**2115-3-11**]
CLINICAL INFORMATION: Evidence of fracture, seizure, fall, low back pain.
FINDINGS:
Three views of the lumbar spine demonstrate mild narrowing of the left
femoroacetabular joint. There is mild scoliosis of the thoracolumbar spine.
The ventricular lead of a pacemaker is identified. No fracture of L2 through
L5 is identified. However, there is a compression fracture of L1, with
compression of the superior endplate, and a sclerotic fracture line. Given
the mechanism of fall, if there is acute pain referable to L1, then this would
be considered an acute finding. There is no apparent retropulsion of the
posterior margin of L1 into the spinal canal. No other fractures are
identified at this time. Facet joints are aligned. There is early
calcification of the aorta.
IMPRESSION:
Compression fracture of L1 with anterior wedge deformity, likely an acute
finding. No other fractures identified.
| 1,531
| null | null |
Evidence of fracture?
______________________________________________________________________________
FINAL REPORT
LUMBAR SPINE [**2115-3-11**]
CLINICAL INFORMATION: Evidence of fracture, seizure, fall, low back pain.
|
Three views of the lumbar spine demonstrate mild narrowing of the left
femoroacetabular joint. There is mild scoliosis of the thoracolumbar spine.
The ventricular lead of a pacemaker is identified. No fracture of L2 through
L5 is identified. However, there is a compression fracture of L1, with
compression of the superior endplate, and a sclerotic fracture line. Given
the mechanism of fall, if there is acute pain referable to L1, then this would
be considered an acute finding. There is no apparent retropulsion of the
posterior margin of L1 into the spinal canal. No other fractures are
identified at this time. Facet joints are aligned. There is early
calcification of the aorta.
|
Compression fracture of L1 with anterior wedge deformity, likely an acute
finding. No other fractures identified.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 262,844
|
91,907
| 831,376
| 16,533
|
[**2188-5-30**] 6:28 AM
CT C-SPINE W/CONTRAST; CT RECONSTRUCTION Clip # [**Clip Number (Radiology) 19441**]
Reason: eval injury
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
38 year old man with found down
REASON FOR THIS EXAMINATION:
eval injury
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATIONS: Found down, possible cervical spine injury.
TECHNIQUE: Contiguous axial images were obtained through the cervical spine.
Coronal and sagittal reformatted images were prepared. No prior cervical spine
imaging studies are available for comparison.
FINDINGS: Today's study is normal. There is no evidence of fracture or
subluxation. Soft tissue contrast resolution is limited in the absence of
intrathecal contrast. However, no intraspinal soft tissue abnormalities are
detected.
An endotracheal tube and nasogastric tube are in place.
IMPRESSION: Normal study. No evidence of fracture or subluxation.
| 1,140
| null | null |
eval injury
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATIONS: Found down, possible cervical spine injury.
|
Today's study is normal. There is no evidence of fracture or
subluxation. Soft tissue contrast resolution is limited in the absence of
intrathecal contrast. However, no intraspinal soft tissue abnormalities are
detected.
An endotracheal tube and nasogastric tube are in place.
|
Normal study. No evidence of fracture or subluxation.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 46,846
|
190,185
| 937,139
| 15,178
|
[**2139-11-25**] 8:00 PM
MR L SPINE W/O CONTRAST Clip # [**Clip Number (Radiology) 82089**]
Reason: right leg pain, occasional wekaness, previous pelvis fractur
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
23 year old woman with
REASON FOR THIS EXAMINATION:
right leg pain, occasional wekaness, previous pelvis fracture
______________________________________________________________________________
FINAL REPORT
MRI OF THE LUMBAR SPINE WITHOUT CONTRAST.
INDICATION: 23-year-old woman with right leg pain. Weakness. Previous
pelvic fracture.
TECHNIQUE: Sagittal T2, sagittal T1, sagittal STIR, axial T2, and axial T1-
weighted images of the lumbar spine were obtained. No comparisons.
FINDINGS: There is maintenance of the normal lumbar spine lordosis without
listhesis. Vertebral body heights are maintained. Intervertebral disc spaces
are preserved. Normal disc signal is seen at every level. The conus
terminates at T12-L1. No intrinsic cord signal abnormality is seen. No
abnormal edema is noted in the posterior paraspinal soft tissues.
At L4-5, there is a minimal concentric disc bulge. Mild bilateral facet joint
hypertrophy is seen. No central canal stenosis or neural foraminal narrowing
is seen.
At L5-S1, there is a mild concentric disc bulge and mild bilateral facet joint
hypertrophy. No central canal stenosis or neural foraminal narrowing is seen.
IMPRESSION:
Minimal degenerative changes of lower lumbar spine without evidence of central
canal stenosis or neural foraminal narrowing.
| 1,693
| null | null |
right leg pain, occasional wekaness, previous pelvis fracture
______________________________________________________________________________
FINAL REPORT
MRI OF THE LUMBAR SPINE WITHOUT CONTRAST.
INDICATION: 23-year-old woman with right leg pain. Weakness. Previous
pelvic fracture.
|
There is maintenance of the normal lumbar spine lordosis without
listhesis. Vertebral body heights are maintained. Intervertebral disc spaces
are preserved. Normal disc signal is seen at every level. The conus
terminates at T12-L1. No intrinsic cord signal abnormality is seen. No
abnormal edema is noted in the posterior paraspinal soft tissues.
At L4-5, there is a minimal concentric disc bulge. Mild bilateral facet joint
hypertrophy is seen. No central canal stenosis or neural foraminal narrowing
is seen.
At L5-S1, there is a mild concentric disc bulge and mild bilateral facet joint
hypertrophy. No central canal stenosis or neural foraminal narrowing is seen.
|
Minimal degenerative changes of lower lumbar spine without evidence of central
canal stenosis or neural foraminal narrowing.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 96,749
|
404,574
| 1,150,924
| 77,383
|
[**2147-9-9**] 11:00 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 82214**]
Reason: Placement of dobhoff
Admitting Diagnosis: ANEMIA
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
45 year old woman with dobhoff for alcoholic cirrhosis
REASON FOR THIS EXAMINATION:
Placement of dobhoff
______________________________________________________________________________
FINAL REPORT
HISTORY: For Dobbhoff placement.
FINDINGS: In comparison with study of [**9-5**], the tip of the Dobbhoff tube has
been pulled back to the body of the stomach. There is increased opacification
at the left base with some substantial clearing at the right base. This is
consistent with pneumonia and associated pleural effusion.
Upper lung zones are clear and there is no evidence of pulmonary vascular
congestion.
| 972
|
For Dobbhoff placement.
| null |
Placement of dobhoff
______________________________________________________________________________
FINAL REPORT
|
In comparison with study of [**9-5**], the tip of the Dobbhoff tube has
been pulled back to the body of the stomach. There is increased opacification
at the left base with some substantial clearing at the right base. This is
consistent with pneumonia and associated pleural effusion.
Upper lung zones are clear and there is no evidence of pulmonary vascular
congestion.
|
There is increased opacification
at the left base with some substantial clearing at the right base. This is
consistent with pneumonia and associated pleural effusion. Upper lung zones are clear and there is no evidence of pulmonary vascular
congestion.
|
FALLBACK_LAST_SENTENCES
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 212,070
|
158,246
| 897,748
| 3,184
|
[**2162-1-15**] 4:40 PM
CHEST (PORTABLE AP); -77 BY DIFFERENT PHYSICIAN [**Name Initial (PRE) 73**] # [**Clip Number (Radiology) 83181**]
Reason: evaluate L lung re-expansion s/p 800cc [**Female First Name (un) **]
Admitting Diagnosis: CHEAT PAIN
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
43 year old man with esophageal stricture s/p esophagoscopy and dilatation
with sob.
REASON FOR THIS EXAMINATION:
evaluate L lung re-expansion s/p 800cc [**Female First Name (un) **]
______________________________________________________________________________
FINAL REPORT
POSTERIOR CHEST PORTABLE SINGLE AP VIEW
HISTORY: 43-year-old man with esophageal stricture S/P esophagoscopy and
dilatation with SOB. Evaluate left lung re-expansion.
Comparison is made to prior study dated [**2162-1-15**] at 8:03 a.m.
FINDINGS: There has been interval decrease in the dilatation of the thoracic
stomach/esophagus. There is unchanged dilatation of a loop of small bowel
within the thoracic cavity with diameter of 5.6 cm.
There has been decrease in the left basal volume loss. The right lung is
clear
Unchanged appearance of the small bowel loops in the abdominal cavity.
IMPRESSION:
1. Interval decrease in the dilatation of the thoracic stomach/esophagus.
2. Interval decrease in the left pleural effusion and associated left
retrocardiac atelectasis.
3. Unchanged dilatation of air-filled loops of small bowel in the abdominal
cavity.
| 1,587
|
43-year-old man with esophageal stricture S/P esophagoscopy and
dilatation with SOB. Evaluate left lung re-expansion.
Comparison is made to prior study dated [**2162-1-15**] at 8:03 a.m.
| null |
evaluate L lung re-expansion s/p 800cc [**Female First Name (un) **]
______________________________________________________________________________
FINAL REPORT
POSTERIOR CHEST PORTABLE SINGLE AP VIEW
|
There has been interval decrease in the dilatation of the thoracic
stomach/esophagus. There is unchanged dilatation of a loop of small bowel
within the thoracic cavity with diameter of 5.6 cm.
There has been decrease in the left basal volume loss. The right lung is
clear
Unchanged appearance of the small bowel loops in the abdominal cavity.
|
1. Interval decrease in the dilatation of the thoracic stomach/esophagus.
2. Interval decrease in the left pleural effusion and associated left
retrocardiac atelectasis.
3. Unchanged dilatation of air-filled loops of small bowel in the abdominal
cavity.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 81,054
|
27,428
| 767,048
| 23,286
|
[**2141-7-27**] 1:11 PM
CT HEAD W/ & W/O CONTRAST; CT 100CC NON IONIC CONTRAST Clip # [**Clip Number (Radiology) 65847**]
Reason: 26 week GA infant now DOL 24 with E. Coli bacteremia and can
Contrast: OPTIRAY Amt: 2 CC
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
As above
REASON FOR THIS EXAMINATION:
26 week GA infant now DOL 24 with E. Coli bacteremia and candidal urinary tract
infection. Ultrasound of brain shows ventricular septations, irregular
ventricular walls consistent with ventriculitis, hypoechoic lesion in right
cerebellum, and ventriculomegaly of all ventricles.
Please assess the nature of the cerebellar lesion ? infarction vs abscess.
Assess regarding cerebral edema, other areas of parenchymal involvement, nature
of ventricular septations.
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
FINDINGS: There is a right cerebellar hemorrhage and some low density in the
cerebellar hemisphere consistent with edema and displacement of the fourth
ventricle. The fourth ventricle is somewhat enlarged, suggesting entrapment.
Following administration of contrast, there is some contrast enhancement
adjacent to the cerebellar hematoma, which may be reactive. There is some
enhancement of the margins of the ventricular system, suggesting
ventriculitis. The lateral ventricles are mildly dilated. Supratentorial
white matter is of low attenuation, most likely related to prematurity. The
possibility of entrapment of the fourth ventricle could be better evaluated
with MR.
IMPRESSION: Right cerebellar hemorrhage. See above discussion regarding the
appearance of the ventricular system.
| 1,840
| null | null |
26 week GA infant now DOL 24 with E. Coli bacteremia and candidal urinary tract
infection. Ultrasound of brain shows ventricular septations, irregular
ventricular walls consistent with ventriculitis, hypoechoic lesion in right
cerebellum, and ventriculomegaly of all ventricles.
Please assess the nature of the cerebellar lesion ? infarction vs abscess.
Assess regarding cerebral edema, other areas of parenchymal involvement, nature
of ventricular septations.
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
|
There is a right cerebellar hemorrhage and some low density in the
cerebellar hemisphere consistent with edema and displacement of the fourth
ventricle. The fourth ventricle is somewhat enlarged, suggesting entrapment.
Following administration of contrast, there is some contrast enhancement
adjacent to the cerebellar hematoma, which may be reactive. There is some
enhancement of the margins of the ventricular system, suggesting
ventriculitis. The lateral ventricles are mildly dilated. Supratentorial
white matter is of low attenuation, most likely related to prematurity. The
possibility of entrapment of the fourth ventricle could be better evaluated
with MR.
|
Right cerebellar hemorrhage. See above discussion regarding the
appearance of the ventricular system.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 12,048
|
408,107
| 1,145,452
| 88,632
|
[**2136-8-29**] 3:45 PM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 84390**]
Reason: please confirm placement of NGTube
Admitting Diagnosis: ANEMIA;RENAL FAILURE;ASCITES
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
53 year old man with ICH
REASON FOR THIS EXAMINATION:
please confirm placement of NGTube
______________________________________________________________________________
FINAL REPORT
INDICATION: Evaluation of NG tube placement.
TECHNIQUE: Portable chest radiograph is obtained.
COMPARISON: Comparison is made to prior radiograph from [**2136-8-28**].
FINDINGS: There is no NG tube identified. Otherwise, the cardiomediastinal
silhouette, the lung fields, and the pleural surfaces remain unchanged in
comparison to prior film. These findings were communicated to the patient's
primary medical team.
IMPRESSION: No NG tube present.
| 1,030
| null |
Comparison is made to prior radiograph from [**2136-8-28**].
|
please confirm placement of NGTube
______________________________________________________________________________
FINAL REPORT
INDICATION: Evaluation of NG tube placement.
|
There is no NG tube identified. Otherwise, the cardiomediastinal
silhouette, the lung fields, and the pleural surfaces remain unchanged in
comparison to prior film. These findings were communicated to the patient's
primary medical team.
|
No NG tube present.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 214,161
|
478,201
| 1,220,579
| 71,125
|
[**2101-11-8**] 10:50 AM
CHEST (PRE-OP PA & LAT) Clip # [**Clip Number (Radiology) 107872**]
Reason: KNEE REPLACEMENTS TOTAL RIGHT. RIGHT KNEE OSTEOARTHRITIS
______________________________________________________________________________
FINAL REPORT
HISTORY: 65-year-old male with right knee osteoarthritis, in need of
preoperative radiograph.
STUDY: PA and lateral chest radiograph.
COMPARISON: None.
FINDINGS: The cardiomediastinal and hilar contours are normal. The lungs are
clear. There is no pleural effusion or pneumothorax.
IMPRESSION: No acute cardiopulmonary process.
| 674
|
65-year-old male with right knee osteoarthritis, in need of
preoperative radiograph.
STUDY: PA and lateral chest radiograph.
|
None.
| null |
The cardiomediastinal and hilar contours are normal. The lungs are
clear. There is no pleural effusion or pneumothorax.
|
No acute cardiopulmonary process.
|
IMPRESSION
| true
| true
| true
| true
| false
| 4
|
['procedure']
|
No Technique/Procedure section found
| 260,171
|
104,938
| 839,903
| 21,011
|
[**2116-9-7**] 8:20 PM
CT HEAD W/O CONTRAST Clip # [**Clip Number (Radiology) 83906**]
Reason: . Evaluate for hemorrhagic complication.
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
61 year old man with right MCA stroke, intraarterial thrombolysis and worsening
headache. Evaluate for hemorrhagic complication.
REASON FOR THIS EXAMINATION:
. Evaluate for hemorrhagic complication.
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Right MCA stroke. Intra-arterial thrombolysis. Worsening
headache. Evaluate for intracranial hemorrhage.
TECHNIQUE: Noncontrast head CT.
COMPARISON: None.
FINDINGS: The exam is limited by considerable motion artifact. Hyperdensity
in the right basal ganglia is consistent with acute hemorrhage. No other
areas of hemorrhage are detected. There is no significant associated mass
effect. The ventricles remain symmetric, and the cisterns are patent. The
left cerebral hemisphere is normal. The visualized paranasal sinuses and
mastoid air cells are clear. The calvarium is intact.
IMPRESSION: Motion limited study. Right basal ganglia hyperdensity consistent
with acute hemorrhage without significant associated mass effect.
| 1,435
| null |
None.
|
. Evaluate for hemorrhagic complication.
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Right MCA stroke. Intra-arterial thrombolysis. Worsening
headache. Evaluate for intracranial hemorrhage.
|
The exam is limited by considerable motion artifact. Hyperdensity
in the right basal ganglia is consistent with acute hemorrhage. No other
areas of hemorrhage are detected. There is no significant associated mass
effect. The ventricles remain symmetric, and the cisterns are patent. The
left cerebral hemisphere is normal. The visualized paranasal sinuses and
mastoid air cells are clear. The calvarium is intact.
|
Motion limited study. Right basal ganglia hyperdensity consistent
with acute hemorrhage without significant associated mass effect.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 53,751
|
32,973
| 773,740
| 10,924
|
[**2159-10-20**] 11:03 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 76694**]
Reason: s/p diuresis thoracentesis. Evaluate for change in effusion
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
40 year old woman with MR, CHF, right pleural effusion s/p tap and drainage.
r/o TB.
REASON FOR THIS EXAMINATION:
s/p diuresis thoracentesis. Evaluate for change in effusion and pulm
congestion
______________________________________________________________________________
FINAL REPORT
HISTORY: S/P diuresis and thoracentesis, evaluate for change in effusion and
pulmonary congestion.
REFERENCE EXAM: [**10-15**].
FINDINGS: The cardiac silhouette continues to be enlarged. There has been
interval decrease in the vascular congestion and interstitial infiltrates.
There continues to be a hazy increased opacity in the right lateral lung that
could still represent an infiltrate but continued follow up is recommended.
Small pleural effusions are present. The patient is s/p mitral valve
replacement.
IMPRESSION: Overall improvement in vascular congestion, however, there
continues to be a right lateral lung infiltrate.
| 1,299
|
S/P diuresis and thoracentesis, evaluate for change in effusion and
pulmonary congestion.
REFERENCE
| null |
s/p diuresis thoracentesis. Evaluate for change in effusion and pulm
congestion
______________________________________________________________________________
FINAL REPORT
|
The cardiac silhouette continues to be enlarged. There has been
interval decrease in the vascular congestion and interstitial infiltrates.
There continues to be a hazy increased opacity in the right lateral lung that
could still represent an infiltrate but continued follow up is recommended.
Small pleural effusions are present. The patient is s/p mitral valve
replacement.
|
Overall improvement in vascular congestion, however, there
continues to be a right lateral lung infiltrate.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 14,701
|
186,075
| 925,933
| 1,923
|
[**2118-7-27**] 7:47 AM
PICC LINE PLACMENT SCH Clip # [**Clip Number (Radiology) 45768**]
Reason: picc placement
Admitting Diagnosis: PNEUMONIA
********************************* CPT Codes ********************************
* [**Numeric Identifier 253**] PICC W/O [**Numeric Identifier 30989**] FLUOR GUID PLCT/REPLCT/REMOVE *
* [**Numeric Identifier 255**] US GUID FOR VAS. ACCESS C1751 CATH [**Last Name (LF) 30990**],[**First Name3 (LF) **]/CENT/MID(NOT D *
****************************************************************************
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
80 year old woman with infected hip, no iv access
REASON FOR THIS EXAMINATION:
picc placement
______________________________________________________________________________
FINAL REPORT
INDICATION: 80-year-old female with infected hip requiring IV antibiotics.
RADIOLOGISTS: Dr. [**Last Name (STitle) 29845**] and Dr. [**Last Name (STitle) 29638**]. The attending radiologist, Dr.
[**First Name8 (NamePattern2) 22981**] [**Name (STitle) 29638**], was present and supervising throughout the procedure.
TECHNIQUE/FINDINGS: The patient was brought to the Radiology Suite and placed
supine on the angiography table. Following a preprocedure timeout including
the patient's name, and two patient identifiers, the left arm was sterilely
prepped and draped. Ultrasound was used to identify the left brachial vein,
which was patent and compressible. After the infusion of 1% lidocaine for
local anestheia and under ultrasound guidance, the left brachial vein was
accessed with a 22 gauge needle. A 0.015 inch guide wire was advanced through
the needle and positioned in the SVC under flyoroscopic guidance. Pre- and
post- venous access hard copy ultrasound images were obtained to document
vessel patency. The needle was exchanged for a 4 French micropuncture sheath,
and the wire was advanced to the distal SVC. Based on the markings on the
wire, a PICC line was cut to the length of 37 cm. The inner dilator was
removed, and the PICC was advanced over the wire and positioned in the distal
SVC. A fluoroscopic image was obtained documenting tip position. Both lumens
flushed and aspirated well, were capped and heplocked. A statlock device was
used to fasten the PICC line to the skin, and a sterile transparent dressing
was applied. There were no procedural complications.
MEDICATIONS: 1% lidocaine for local anesthesia.
IMPRESSION: Successful placement of a 37 cm 5 French double lumen PICC by way
of the left brachial vein with the tip in the distal SVC. The line is ready
for use.
| 2,776
| null | null |
picc placement
______________________________________________________________________________
FINAL REPORT
INDICATION: 80-year-old female with infected hip requiring IV antibiotics.
RADIOLOGISTS: Dr. [**Last Name (STitle) 29845**] and Dr. [**Last Name (STitle) 29638**]. The attending radiologist, Dr.
[**First Name8 (NamePattern2) 22981**] [**Name (STitle) 29638**], was present and supervising throughout the procedure.
TECHNIQUE/
|
The patient was brought to the Radiology Suite and placed
supine on the angiography table. Following a preprocedure timeout including
the patient's name, and two patient identifiers, the left arm was sterilely
prepped and draped. Ultrasound was used to identify the left brachial vein,
which was patent and compressible. After the infusion of 1% lidocaine for
local anestheia and under ultrasound guidance, the left brachial vein was
accessed with a 22 gauge needle. A 0.015 inch guide wire was advanced through
the needle and positioned in the SVC under flyoroscopic guidance. Pre- and
post- venous access hard copy ultrasound images were obtained to document
vessel patency. The needle was exchanged for a 4 French micropuncture sheath,
and the wire was advanced to the distal SVC. Based on the markings on the
wire, a PICC line was cut to the length of 37 cm. The inner dilator was
removed, and the PICC was advanced over the wire and positioned in the distal
SVC. A fluoroscopic image was obtained documenting tip position. Both lumens
flushed and aspirated well, were capped and heplocked. A statlock device was
used to fasten the PICC line to the skin, and a sterile transparent dressing
was applied. There were no procedural complications.
MEDICATIONS: 1% lidocaine for local anesthesia.
|
Successful placement of a 37 cm 5 French double lumen PICC by way
of the left brachial vein with the tip in the distal SVC. The line is ready
for use.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 94,644
|
321,675
| 1,076,522
| 53,285
|
[**2158-4-9**] 4:31 PM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 61812**]
Reason: eval chest tube placement, PTX
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
60 year old man with lung [**Hospital **] transferred from osh s/p R thoracostomy for CT
evidence of PTX
REASON FOR THIS EXAMINATION:
eval chest tube placement, PTX
______________________________________________________________________________
FINAL REPORT
CHEST RADIOGRAPH PERFORMED ON [**2158-4-9**]
Comparison is made with outside hospital chest CT performed at approximately
12:30 p.m. today as well as chest radiographs dated today at approximately 2
p.m.
CLINICAL HISTORY: Patient is a 60-year-old man with lung cancer, transferred
from outside hospital status post right chest tube placement for spontaneous
pneumothorax.
FINDINGS: Single AP upright portable chest radiograph is obtained. A chest
tube is seen with its tip in the right lung apex. Subcutaneous emphysema is
noted along the chest tube insertion site and in the right lateral chest wall.
There is no evidence of pneumothorax on the current exam. Please note, prior
chest radiograph from outside hospital demonstrated a large right-sided
pneumothorax. There is persistent right lower lung atelectasis. A cavitary
gas-filled structure in the right lower lobe is again noted which is better
assessed on the outside hospital CT and is compatible with a large cavitary
tumor. The left lung remains clear. Underlying emphysema is better assessed
on prior CT. Heart size cannot be assessed. Bony structures appear grossly
intact.
IMPRESSION:
1. No residual pneumothorax status post chest tube insertion.
2. Large cavitary mass in the right lower lobe, better assessed on prior
outside hospital CT.
3. Persistent right lung base atelectasis.
Findings were discussed with Dr. [**First Name8 (NamePattern2) 8851**] [**Last Name (NamePattern1) 8576**] at the time of initial review.
Please note outside hospital CT could not be uploaded to PACS due to lack of
DICOM format. Attempts were made unsuccessfully.
| 2,250
|
Patient is a 60-year-old man with lung cancer, transferred
from outside hospital status post right chest tube placement for spontaneous
pneumothorax.
| null |
eval chest tube placement, PTX
______________________________________________________________________________
FINAL REPORT
CHEST RADIOGRAPH PERFORMED ON [**2158-4-9**]
Comparison is made with outside hospital chest CT performed at approximately
12:30 p.m. today as well as chest radiographs dated today at approximately 2
p.m.
CLINICAL
|
Single AP upright portable chest radiograph is obtained. A chest
tube is seen with its tip in the right lung apex. Subcutaneous emphysema is
noted along the chest tube insertion site and in the right lateral chest wall.
There is no evidence of pneumothorax on the current exam. Please note, prior
chest radiograph from outside hospital demonstrated a large right-sided
pneumothorax. There is persistent right lower lung atelectasis. A cavitary
gas-filled structure in the right lower lobe is again noted which is better
assessed on the outside hospital CT and is compatible with a large cavitary
tumor. The left lung remains clear. Underlying emphysema is better assessed
on prior CT. Heart size cannot be assessed. Bony structures appear grossly
intact.
|
1. No residual pneumothorax status post chest tube insertion.
2. Large cavitary mass in the right lower lobe, better assessed on prior
outside hospital CT.
3. Persistent right lung base atelectasis.
Findings were discussed with Dr. [**First Name8 (NamePattern2) 8851**] [**Last Name (NamePattern1) 8576**] at the time of initial review.
Please note outside hospital CT could not be uploaded to PACS due to lack of
DICOM format. Attempts were made unsuccessfully.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 165,032
|
374,546
| 1,109,040
| 56,890
|
[**2113-12-5**] 3:56 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 37695**]
Reason: please eval for interval change or infectious process
Admitting Diagnosis: CHRONIC IMMUNE DEMYELINATING POLYNEUROPATHY
______________________________________________________________________________
[**Hospital 3**] MEDICAL CONDITION:
57 year old woman with unknown peripheral neuropathy causing poor respiratory
function
REASON FOR THIS EXAMINATION:
please eval for interval change or infectious process
______________________________________________________________________________
FINAL REPORT
PROCEDURE: Chest portable AP.
REASON FOR EXAM: Peripheral neuropathy.
FINDINGS: In comparison to the previous chest radiograph, new perihilar
haziness with upper lobe vascular congestion is consistent with mild pulmonary
edema. Heart size is top normal and widening of the mediastinum is due to
lipomatosis. Left lower lobe atelectasis unchanged since CT [**2113-12-3**].
IMPRESSION: Interval development of mild pulmonary edema, early followup
chest radiograph following treatment is recommended.
| 1,196
| null | null |
please eval for interval change or infectious process
______________________________________________________________________________
FINAL REPORT
|
In comparison to the previous chest radiograph, new perihilar
haziness with upper lobe vascular congestion is consistent with mild pulmonary
edema. Heart size is top normal and widening of the mediastinum is due to
lipomatosis. Left lower lobe atelectasis unchanged since CT [**2113-12-3**].
|
Interval development of mild pulmonary edema, early followup
chest radiograph following treatment is recommended.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 193,947
|
344,799
| 1,100,144
| 60,893
|
[**2125-11-5**] 8:20 AM
PORTAL VENOGRAPHY Clip # [**Clip Number (Radiology) 45497**]
Reason: Please do portal venogram to eval for narrowing in the proxi
Contrast: OPTIRAY Amt: 110
********************************* CPT Codes ********************************
* [**Numeric Identifier 12148**] TRANSCATH PLCMT INTRAVAS STENT [**Numeric Identifier 15116**] PERC PORTAL VEIN CATH *
* -51 MULTI-PROCEDURE SAME DAY [**Numeric Identifier 10203**] INJ SINUS TRACT, THERAPUTIC *
* -51 MULTI-PROCEDURE SAME DAY [**Numeric Identifier 12150**] INTRO INTRAVASCULAR STENT *
* [**Numeric Identifier 87**] MOD SEDATION, FIRST 30 MIN. [**Numeric Identifier 88**] MOD SEDATION, EACH ADDL 15 MIN *
* [**Numeric Identifier 88**] MOD SEDATION, EACH ADDL 15 MIN [**Numeric Identifier 88**] MOD SEDATION, EACH ADDL 15 MIN *
* [**Numeric Identifier 88**] MOD SEDATION, EACH ADDL 15 MIN [**Numeric Identifier 88**] MOD SEDATION, EACH ADDL 15 MIN *
* [**Numeric Identifier 88**] MOD SEDATION, EACH ADDL 15 MIN *
****************************************************************************
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
63 year old woman with residual focal narrowing noted in the proximal portal
vein. Pt is s/p liver transplant. pleas eval .please schedule with Dr [**First Name4 (NamePattern1) **]
[**Last Name (NamePattern1) 45498**]
REASON FOR THIS EXAMINATION:
Please do portal venogram to eval for narrowing in the proximal main portal
vein. Pt is s/p liver transplant. With Dr [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **].
______________________________________________________________________________
FINAL REPORT
PORTAL VENOGRAM: [**2125-11-5**]
CLINICAL HISTORY: 63-year-old female status post orthotopic liver transplant
on [**2125-9-13**], underwent recent workup for elevated liver function tests
demonstrating portal venous anastomotic stenosis on CTA. Request for
transhepatic portal venogram pressure measurements and possible balloon
dilatation and/or stent.
OPERATORS: Drs. [**First Name8 (NamePattern2) 234**] [**Last Name (NamePattern1) 896**] and [**First Name8 (NamePattern2) 732**] [**Last Name (NamePattern1) 155**]. Dr. [**Last Name (STitle) 155**], the attending
radiologist, was present and supervising throughout the entire procedure.
ANESTHESIA: Moderate sedation was provided by administering divided doses of
a total of 125 mcg of fentanyl and 3 mg of Versed throughout the total
intraservice time. 2 hours during which the patient's hemodynamic parameters
were continuously monitored.
PROCEDURE AND FINDINGS: After the risks, benefits and alternatives of the
procedure as well as conscious sedation were explained to the patient,
informed consent was obtained. The patient was placed supine on the
intervention table and the right upper abdomen was prepped and draped in the
usual sterile fashion. A preprocedure timeout was performed. A scout image
of the abdomen was obtained demonstrating a plastic biliary stent in place.
Using fluoroscopic guidance and following injection of 5 mL of 1% lidocaine
for local anesthesia, a 22-gauge Chiba needle was advanced into the right
hepatic parenchyma and injection of contrast was performed until opacification
of a right portal branch was identified. A 0.018 nitinol guidewire was then
advanced through the needle into the main portal vein. An Accustick sheath
(Over)
[**2125-11-5**] 8:20 AM
PORTAL VENOGRAPHY Clip # [**Clip Number (Radiology) 45497**]
Reason: Please do portal venogram to eval for narrowing in the proxi
Contrast: OPTIRAY Amt: 110
______________________________________________________________________________
FINAL REPORT
(Cont)
system was then advanced over the wire. The wire was then removed as well as
the inner portion of the Accustick system. Injection of contrast demonstrated
and confirmed opacification of the portal vein. A 0.035 Glidewire then
advanced through the Accustick sheath and access was gained into the main
portal vein. The Accustick sheath was then exchanged for a 5- French straight
catheter. A portal venogram was then performed. Portogram again demonstrated
stenosis of the mid portal vein at the presumed anastomosis. Pressure
measurement in the portal vein central to the stenosis shows a measurement of
approximately 14 mmHg with a pressure of 13 mm peripherally (intrahepatic).
Findings were discussed with Dr. [**First Name8 (NamePattern2) 1085**] [**Last Name (NamePattern1) 30**] and a decision was made to
place a stent across the area of portal narrowing.
The straight catheter was used to advance a 0.035 [**Doctor Last Name 66**] wire into the splenic
vein and the catheter was exchanged for a 7-French vascular sheath. A 10 mm 4
cm biliary stent was then advanced over the wire up to the level of stenosis
and deployed under fluoroscopic guidance. Balloon dilatation was then
performed inside of the stent with an 10-mm balloon. Post- stent venogram was
then performed demonstrating good angiographic results with no areas of
residual stenosis in the portal vein. Post-procedure pressure measurements in
the portal vein central to the stenosis shows a decreased pressure measurement
of 11 mm (compared to 14 mm previously), and a pressure of 11 mm peripherally
(13 mmHg previously). The wire and catheter were then removed and the 7-
French sheath was removed with subsequent embolization of the tract created to
access the portal vein with Gelfoam. The patient tolerated the procedure
well. There were no immediate post-procedural complications.
IMPRESSION: Transhepatic portal venogram demonstrating hepatopetal portal
flow and focal stenosis at the portal venous anastomosis. Successful stenting
of the portal vein with a 10 mm x 4 cm stent with good angiographic results.
Hepatic parenchymal tract between the portal vein access and capsule embolized
with Gelfoam pledgets.
| 6,333
|
63-year-old female status post orthotopic liver transplant
on [**2125-9-13**], underwent recent workup for elevated liver function tests
demonstrating portal venous anastomotic stenosis on CTA. Request for
transhepatic portal venogram pressure measurements and possible balloon
dilatation and/or stent.
OPERATORS: Drs. [**First Name8 (NamePattern2) 234**] [**Last Name (NamePattern1) 896**] and [**First Name8 (NamePattern2) 732**] [**Last Name (NamePattern1) 155**]. Dr. [**Last Name (STitle) 155**], the attending
radiologist, was present and supervising throughout the entire procedure.
ANESTHESIA: Moderate sedation was provided by administering divided doses of
a total of 125 mcg of fentanyl and 3 mg of Versed throughout the total
intraservice time. 2 hours during which the patient's hemodynamic parameters
were continuously monitored.
PROCEDURE AND
| null |
Please do portal venogram to eval for narrowing in the proximal main portal
vein. Pt is s/p liver transplant. With Dr [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **].
______________________________________________________________________________
FINAL REPORT
PORTAL VENOGRAM: [**2125-11-5**]
CLINICAL
|
After the risks, benefits and alternatives of the
procedure as well as conscious sedation were explained to the patient,
informed consent was obtained. The patient was placed supine on the
intervention table and the right upper abdomen was prepped and draped in the
usual sterile fashion. A preprocedure timeout was performed. A scout image
of the abdomen was obtained demonstrating a plastic biliary stent in place.
Using fluoroscopic guidance and following injection of 5 mL of 1% lidocaine
for local anesthesia, a 22-gauge Chiba needle was advanced into the right
hepatic parenchyma and injection of contrast was performed until opacification
of a right portal branch was identified. A 0.018 nitinol guidewire was then
advanced through the needle into the main portal vein. An Accustick sheath
(Over)
[**2125-11-5**] 8:20 AM
PORTAL VENOGRAPHY Clip # [**Clip Number (Radiology) 45497**]
Reason: Please do portal venogram to eval for narrowing in the proxi
Contrast: OPTIRAY Amt: 110
______________________________________________________________________________
FINAL REPORT
(Cont)
system was then advanced over the wire. The wire was then removed as well as
the inner portion of the Accustick system. Injection of contrast demonstrated
and confirmed opacification of the portal vein. A 0.035 Glidewire then
advanced through the Accustick sheath and access was gained into the main
portal vein. The Accustick sheath was then exchanged for a 5- French straight
catheter. A portal venogram was then performed. Portogram again demonstrated
stenosis of the mid portal vein at the presumed anastomosis. Pressure
measurement in the portal vein central to the stenosis shows a measurement of
approximately 14 mmHg with a pressure of 13 mm peripherally (intrahepatic).
Findings were discussed with Dr. [**First Name8 (NamePattern2) 1085**] [**Last Name (NamePattern1) 30**] and a decision was made to
place a stent across the area of portal narrowing.
The straight catheter was used to advance a 0.035 [**Doctor Last Name 66**] wire into the splenic
vein and the catheter was exchanged for a 7-French vascular sheath. A 10 mm 4
cm biliary stent was then advanced over the wire up to the level of stenosis
and deployed under fluoroscopic guidance. Balloon dilatation was then
performed inside of the stent with an 10-mm balloon. Post- stent venogram was
then performed demonstrating good angiographic results with no areas of
residual stenosis in the portal vein. Post-procedure pressure measurements in
the portal vein central to the stenosis shows a decreased pressure measurement
of 11 mm (compared to 14 mm previously), and a pressure of 11 mm peripherally
(13 mmHg previously). The wire and catheter were then removed and the 7-
French sheath was removed with subsequent embolization of the tract created to
access the portal vein with Gelfoam. The patient tolerated the procedure
well. There were no immediate post-procedural complications.
|
Transhepatic portal venogram demonstrating hepatopetal portal
flow and focal stenosis at the portal venous anastomosis. Successful stenting
of the portal vein with a 10 mm x 4 cm stent with good angiographic results.
Hepatic parenchymal tract between the portal vein access and capsule embolized
with Gelfoam pledgets.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 176,689
|
226,024
| 951,274
| 1,699
|
[**2170-3-3**] 9:55 AM
CHEST (PRE-OP PA & LAT) Clip # [**Clip Number (Radiology) 80912**]
Reason: LIVER FAILURE
Admitting Diagnosis: LIVER FAILURE
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
68 year old man with HCC, cirrhosis. Preop CXR for liver transplant.
REASON FOR THIS EXAMINATION:
preop cxr
______________________________________________________________________________
FINAL REPORT
INDICATIONS: Hepatitis C cirrhosis. Pre-operative chest radiograph prior to
liver transplant.
PA AND LATERAL CHEST: Comparison is made to chest radiographs from [**9-26**], [**2169**]. Cardiac size is within normal limits. There is no CHF or
consolidation. There is minor left lower lobe atelectasis. There is no
pleural effusion. Osseous structures are unchanged in appearance, again
demonstrating increased thoracic kyphosis.
IMPRESSION: No acute cardiopulmonary abnormality.
| 1,042
| null | null |
preop cxr
______________________________________________________________________________
FINAL REPORT
INDICATIONS: Hepatitis C cirrhosis. Pre-operative chest radiograph prior to
liver transplant.
PA AND LATERAL
|
Comparison is made to chest radiographs from [**9-26**], [**2169**]. Cardiac size is within normal limits. There is no CHF or
consolidation. There is minor left lower lobe atelectasis. There is no
pleural effusion. Osseous structures are unchanged in appearance, again
demonstrating increased thoracic kyphosis.
|
No acute cardiopulmonary abnormality.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 115,343
|
242,567
| 994,365
| 29,058
|
[**2192-1-17**] 3:50 PM
CT CHEST W/CONTRAST Clip # [**Clip Number (Radiology) 43060**]
Reason: evaluate for interval change
Contrast: OPTIRAY Amt:
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
43 year old woman with HIV, cough (non-productive), and SOB, with expanding
pulmonary nodules
REASON FOR THIS EXAMINATION:
evaluate for interval change
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: 43-year-old with HIV, nonproductive cough, and dyspnea, prior
studies demonstrating worsening centrilobular nodules. Assess for interval
change.
COMPARISON: CT chest of [**2191-12-28**].
TECHNIQUE: Axial MDCT images of the chest with 75 cc of nonionic Optiray
contrast with coronal and sagittal reformatted images.
FINDINGS: There has been significant improvement in the previously seen
diffuse centrilobular nodules. Specifically, the centrilobular nodules in the
right upper and middle lobes have improved, the nodules in the lower lobe have
nearly resolved, and the centrilobular nodules in the lingula appear
essentially unchanged. There is moderate paraseptal and centrilobular
emphysema. No nodules concerning for malignancy. There is a dominant bulla in
the medial left upper lobe abutting the mediastinum measuring 2.6 cm,
unchanged from the prior study. There is no pneumothorax. Mild enlargement of
the main pulmonary artery (3.5 cm), suggests pulmonary arterial hypertension.
Small anterior pericardial effusion persists. There is persisting contour
abnormality about the hepatic dome which demonstrates fat attenuation
consistent with a lipoma and unchanged from the prior study. No osseous
abnormalities. Coronal and sagittal reformatted images confirm the above
findings.
IMPRESSION:
1) Significant improvement in diffuse centrilobular nodules, likely due to
resolving infectious bronchiolitis
2) Moderate paraseptal and centrilobular emphysema. 2.6-cm dominant bulla in
left upper lobe.
3) Mild enlargement of the main pulmonary artery, suggestive of pulmonary
arterial hypertension.
4) Stable small pericardial effusion.
| 2,327
| null |
CT chest of [**2191-12-28**].
|
evaluate for interval change
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: 43-year-old with HIV, nonproductive cough, and dyspnea, prior
studies demonstrating worsening centrilobular nodules. Assess for interval
change.
|
There has been significant improvement in the previously seen
diffuse centrilobular nodules. Specifically, the centrilobular nodules in the
right upper and middle lobes have improved, the nodules in the lower lobe have
nearly resolved, and the centrilobular nodules in the lingula appear
essentially unchanged. There is moderate paraseptal and centrilobular
emphysema. No nodules concerning for malignancy. There is a dominant bulla in
the medial left upper lobe abutting the mediastinum measuring 2.6 cm,
unchanged from the prior study. There is no pneumothorax. Mild enlargement of
the main pulmonary artery (3.5 cm), suggests pulmonary arterial hypertension.
Small anterior pericardial effusion persists. There is persisting contour
abnormality about the hepatic dome which demonstrates fat attenuation
consistent with a lipoma and unchanged from the prior study. No osseous
abnormalities. Coronal and sagittal reformatted images confirm the above
findings.
|
1) Significant improvement in diffuse centrilobular nodules, likely due to
resolving infectious bronchiolitis
2) Moderate paraseptal and centrilobular emphysema. 2.6-cm dominant bulla in
left upper lobe.
3) Mild enlargement of the main pulmonary artery, suggestive of pulmonary
arterial hypertension.
4) Stable small pericardial effusion.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 123,584
|
298,827
| 1,052,479
| 11,643
|
[**2192-1-1**] 12:37 PM
CHEST (PA & LAT) Clip # [**Clip Number (Radiology) 27528**]
Reason: effusion, infiltrate?
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
64 year old woman with altered mental status, recent Dx of spiculated lung mass
on CT.
REASON FOR THIS EXAMINATION:
effusion, infiltrate?
______________________________________________________________________________
FINAL REPORT
INDICATION: 64-year-old female with altered mental status and spiculated lung
mass. Evaluate for effusion or infiltrates.
COMPARISON: CXR [**2191-12-26**] and CT chest [**2191-12-27**].
UPRIGHT AND LATERAL CHEST: Hyperinflation of the lungs and flattening of the
diaphragms is again consistent with known emphysema. The heart size is
unchanged, with a tortuous thoracic aorta demonstrating atherosclerotic
calcifications. A previously noted right PIC catheter has been removed. No
definite new lung consolidation is identified and there is no evidence of
pleural effusion or pneumothorax. The known small right upper lobe spiculated
nodule is not well identified on this study.
IMPRESSION:
1. No evidence of acute cardiopulmonary process.
2. Known right upper lobe spiculated nodule not well identified on the
current study.
| 1,405
| null |
CXR [**2191-12-26**] and CT chest [**2191-12-27**].
UPRIGHT AND LATERAL
|
effusion, infiltrate?
______________________________________________________________________________
FINAL REPORT
INDICATION: 64-year-old female with altered mental status and spiculated lung
mass. Evaluate for effusion or infiltrates.
|
Hyperinflation of the lungs and flattening of the
diaphragms is again consistent with known emphysema. The heart size is
unchanged, with a tortuous thoracic aorta demonstrating atherosclerotic
calcifications. A previously noted right PIC catheter has been removed. No
definite new lung consolidation is identified and there is no evidence of
pleural effusion or pneumothorax. The known small right upper lobe spiculated
nodule is not well identified on this study.
|
1. No evidence of acute cardiopulmonary process.
2. Known right upper lobe spiculated nodule not well identified on the
current study.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 153,905
|
14,635
| 754,564
| 4,001
|
[**2123-3-24**] 8:22 AM
CAROTID SERIES COMPLETE Clip # [**Clip Number (Radiology) 40863**]
Reason: 89 year old woman with mulitple vascular risk factors and li
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
89 year old woman with
REASON FOR THIS EXAMINATION:
89 year old woman with mulitple vascular risk factors and likely left MCA TIA.
______________________________________________________________________________
FINAL REPORT
HISTORY: Left MCA distribution, TIA.
FINDINGS: There is diffuse plaque involving the common carotid artery on the
right and extending into the ICA and ECA. The peak systolic velocities are
241, 94 and 197 cm/second for the ICA, CCA and ECA respectively. The ICA to
CCA ratio is 2.6. The findings indicate a 60-69% right ICA stenosis.
On the left, there is moderate calcified ICA plaque. The peak systolic
velocities are 251, 110 and 261 cm per second for the ICA, CCA and ECA
respectively. The ICA to CCA ratio is 2.3. Findings indicate a 70-79% left
ICA stenosis. There is antegrade flow in both vertebral arteries.
IMPRESSION: Bilateral calcified plaque, that on the right associated with a
60-69% ICA stenosis, that on the left associated with a 70-79% ICA stenosis.
| 1,376
|
Left MCA distribution, TIA.
| null |
89 year old woman with mulitple vascular risk factors and likely left MCA TIA.
______________________________________________________________________________
FINAL REPORT
|
There is diffuse plaque involving the common carotid artery on the
right and extending into the ICA and ECA. The peak systolic velocities are
241, 94 and 197 cm/second for the ICA, CCA and ECA respectively. The ICA to
CCA ratio is 2.6. The findings indicate a 60-69% right ICA stenosis.
On the left, there is moderate calcified ICA plaque. The peak systolic
velocities are 251, 110 and 261 cm per second for the ICA, CCA and ECA
respectively. The ICA to CCA ratio is 2.3. Findings indicate a 70-79% left
ICA stenosis. There is antegrade flow in both vertebral arteries.
|
Bilateral calcified plaque, that on the right associated with a
60-69% ICA stenosis, that on the left associated with a 70-79% ICA stenosis.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 5,983
|
518,300
| 1,232,253
| 79,031
|
[**2164-2-18**] 2:13 PM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 50557**]
Reason: line tip position
Admitting Diagnosis: AORTIC STANOSIS\AORTIC VALVE REPLACEMENT /SDA
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
46 year old woman with right line change over a wire
REASON FOR THIS EXAMINATION:
line tip position
______________________________________________________________________________
FINAL REPORT
CHEST RADIOGRAPH
INDICATION: Right line change.
COMPARISON: [**2164-2-17**].
FINDINGS: As compared to the previous radiograph, the patient has been
extubated and the nasogastric tube has been removed. Also, the Swan-Ganz
catheter has been changed and replaced by a right internal jugular vein
catheter.
The lung volumes have decreased. There is a newly appeared bilateral pleural
effusion, right more than left, with subsequent areas of atelectasis. The
size of the cardiac silhouette is bigger than on the previous image. The
pre-existing millimetric left apical pneumothorax is minimally larger than
yesterday. A millimetric pneumothorax is now also seen on the right.
The referring physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 2674**], was paged for notification at 2:56 p.m.,
[**2164-2-18**], and the findings were subsequently discussed on the telephone.
| 1,485
| null |
[**2164-2-17**].
|
line tip position
______________________________________________________________________________
FINAL REPORT
CHEST RADIOGRAPH
INDICATION: Right line change.
|
As compared to the previous radiograph, the patient has been
extubated and the nasogastric tube has been removed. Also, the Swan-Ganz
catheter has been changed and replaced by a right internal jugular vein
catheter.
The lung volumes have decreased. There is a newly appeared bilateral pleural
effusion, right more than left, with subsequent areas of atelectasis. The
size of the cardiac silhouette is bigger than on the previous image. The
pre-existing millimetric left apical pneumothorax is minimally larger than
yesterday. A millimetric pneumothorax is now also seen on the right.
The referring physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 2674**], was paged for notification at 2:56 p.m.,
[**2164-2-18**], and the findings were subsequently discussed on the telephone.
|
A millimetric pneumothorax is now also seen on the right. The referring physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 2674**], was paged for notification at 2:56 p.m.,
[**2164-2-18**], and the findings were subsequently discussed on the telephone.
|
FALLBACK_LAST_SENTENCES
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 288,778
|
401,646
| 1,134,415
| 62,945
|
[**2118-6-15**] 1:35 PM
TIPS Clip # [**Clip Number (Radiology) 86566**]
Reason: please retry to place TIPS
Admitting Diagnosis: ETOH WITHDRAWAL;CIRRHOSIS
Contrast: VISAPAQUE Amt: 260
********************************* CPT Codes ********************************
* [**Numeric Identifier 36**] INSERT HEPATIC HUNT TIPS -79 UNRELATED PROCEDURE/SERVICE DURI *
* [**Numeric Identifier 2009**] INITAL 3RD ORDER ABD/PEL/LOWER -51 MULTI-PROCEDURE SAME DAY *
* [**Numeric Identifier 5625**] ADD'L 2ND/3RD ORDER ABD/PEL/LO [**Numeric Identifier 5625**] ADD'L 2ND/3RD ORDER ABD/PEL/LO *
* [**Numeric Identifier 5625**] ADD'L 2ND/3RD ORDER ABD/PEL/LO PARACENTESIS DIAG. OR THERAPEUTIC *
* -59 DISTINCT PROCEDURAL SERVICE [**Numeric Identifier 2012**] VISERAL SEL/SUPERSEL A-GRAM *
* -59 DISTINCT PROCEDURAL SERVICE [**Numeric Identifier 2012**] VISERAL SEL/SUPERSEL A-GRAM *
* -59 DISTINCT PROCEDURAL SERVICE [**Numeric Identifier 4617**] EA ADD'L VESSEL AFTER BASIC A- *
* [**Numeric Identifier 4617**] EA ADD'L VESSEL AFTER BASIC A- [**Numeric Identifier 4617**] EA ADD'L VESSEL AFTER BASIC A- *
* GUIDANCE FOR [**Female First Name (un) **]/ABD/PARA CENTESIS -59 DISTINCT PROCEDURAL SERVICE *
****************************************************************************
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
49 year old man with ETOH cirrhosis massive GIB from esophageal varices and
failed attempt at TIPS overnight now with [**Last Name (un) **] in place
REASON FOR THIS EXAMINATION:
please retry to place TIPS
______________________________________________________________________________
FINAL REPORT
CLINICAL HISTORY: 49-year-old male with ETOH cirrhosis and massive upper GI
bleed from esophageal varices. Patient is post failed attempt at TIPS and
presents with rebleeding.
COMPARISON: TIPS procedure from [**2118-6-14**].
OPERATORS: The procedure was performed by Drs. [**First Name8 (NamePattern2) 234**] [**Last Name (NamePattern1) 896**] (fellow) and
[**First Name8 (NamePattern2) 732**] [**Last Name (NamePattern1) 155**]. Dr. [**Last Name (STitle) 155**], the attending interventional radiologist, was
present and supervised throughout the entire procedure.
ANESTHESIA: General endotracheal anesthesia.
PROCEDURES:
1. Ultrasound-guided paracentesis.
2. TIPS procedure including portal venography and pressures.
3. Triple-lumen trauma catheter via right IJ.
PROCEDURE AND FINDINGS: After the risks and benefits of the procedure were
explained to the [**Hospital 353**] healthcare proxy, informed consent was obtained.
The patient was brought to the angiography suite, and his indwelling right
neck trauma catheter and right flank were prepped and draped in usual sterile
fashion. A preprocedural timeout and huddle were performed per [**Hospital1 184**]
protocol. A scout image of the abdomen was obtained showing [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 11194**]
balloon in the gastric lumen.
Under ultrasound guidance, the peritoneal space in the right mid abdomen was
accessed with an 18-gauge needle, through which a wire was advanced into the
right upper quadrant followed by an Omniflush catheter. The wire was removed,
and the Omniflush catheter was attached to vacuum drainage allowing for
(Over)
[**2118-6-15**] 1:35 PM
TIPS Clip # [**Clip Number (Radiology) 86566**]
Reason: please retry to place TIPS
Admitting Diagnosis: ETOH WITHDRAWAL;CIRRHOSIS
Contrast: VISAPAQUE Amt: 260
______________________________________________________________________________
FINAL REPORT
(Cont)
removal of 3 liters of bloody ascitic fluid over the course of the entire
procedure.
Under fluoroscopic guidance, [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 66**] wire was advanced through the indwelling
right IJ central venous line with its tip positioned in the IVC. The central
line was exchanged for a 10 French sheath which was extended down to the
orifice of the hepatic veins. Using modified C2 catheter, the right hepatic
vein was cannulated. This was verified with a venogram with visualization on
a lateral view. The Glidewire was exchanged for a 0.035 stiff Amplatz wire,
and the [**Last Name (un) 67**]-Tip sheath was then advanced into the hepatic vein. A 9 French
angled sheath was then positioned in the right hepatic vein, and the guide
wire was removed and replaced with [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 37**]-[**Last Name (un) 38**] needle. Using the [**Last Name (un) 37**]-
[**Last Name (un) 38**] needle, several passes were made trying to access the right portal
vein. These attempts were unsuccessful.
Decision was made to place a wire for guidance into the portal system via a
patent umbilical vein. Under ultrasound guidance, the umbilical vein was
accessed with a micropuncture kit, and a Glidewire was placed through the
micropuncture sheath into the left portal vein under fluoroscopic guidance. 5
French Glide catheter was advanced over the needle and parked at the
confluence of the right and left portal vein to serve as a guide for needle
placement.
Next, using this guidance, [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 37**]- [**Last Name (un) 38**] kit was used to obtain access into
the right portal vein. The needle was removed, and a 0.035 Glidewire was
advanced through the catheter into the main portal vein. A straight
multipurpose catheter was advanced over the wire into the main portal vein,
and a CO2 portogram was performed demonstrating the presence of a large
umbilical vein from the left portal vein and confirming the position of the
right portal vein. Catheter was removed, and the intrahepatic parenchymal
tract was dilated with a 10-mm balloon and a 10 mm x 8 cm (covered) and 2 cm
(uncovered) stent was deployed followed by balloon dilatation with the 10-mm
balloon.
A subsequent CO2 venogram was performed demonstrating good flow through the
shunt with persistent but slightly delayed hepatofugal blood flow through the
patent umbilical vein. A straight multipurpose catheter was used to obtain
pressure, demonstrating a pressure of 23 mmHg in the main portal vein and 16
mmHg in the right atrium for a portosystemic gradient of 23. The catheter and
vascular sheath were removed, and manual compression was held for hemostasis.
The patient tolerated the procedure well and was returned back to the MICU to
remain intubated.
IMPRESSION:
1. Successful TIPS from the right hepatic vein into the right portal vein
with placement of a 10 mm x 10 cm (8 cm covered/2 cm uncovered) stent.
(Over)
[**2118-6-15**] 1:35 PM
TIPS Clip # [**Clip Number (Radiology) 86566**]
Reason: please retry to place TIPS
Admitting Diagnosis: ETOH WITHDRAWAL;CIRRHOSIS
Contrast: VISAPAQUE Amt: 260
______________________________________________________________________________
FINAL REPORT
(Cont)
2. Portosystemic gradient of 7 mmHg after creating the TIPS shunt.
3. Removal of 3 liters of bloody ascitic fluid.
MEDICAL HISTORY: 49- year- old man with alcoholic cirrhosis and massive upper
GI bleed. The patient first had a failed TIPS attempt and subsequently had a
successful TIPS placement. After the first procedure, the patient had a CT
angiogram of the abdomen which showed findings concerning for hepatic artery--
> bile duct fistula with findings suggestive of active contrast extravasation
into the right hepatic duct and onwards into the duodenum. A request was
placed for hepatic arteriogram and embolization of any arterial biliary
fistula.
COMPARISON: CTA abdomen and pelvis performed on [**2118-6-15**] and mesenteric
arteriogram performed on [**2118-6-16**].
CLINICIANS: Dr. [**First Name8 (NamePattern2) 9422**] [**Name (STitle) 90**] and Dr. [**First Name8 (NamePattern2) 4100**] [**Name (STitle) 4101**]. Dr. [**First Name (STitle) 4101**] is the attending
radiologist, who was present and supervising throughout.
ANESTHESIA: General anesthesia was provided. Local anesthesia with 1%
lidocaine.
PROCEDURE AND FINDINGS: An informed telephone consent was obtained from the
[**Hospital 353**] healthcare proxy after explaining the procedure, benefits,
alternatives and risks involved. The patient was already in the angiography
suite and just had a successful TIPS shunt placement under general anesthesia.
The right groin was prepped and draped in the usual sterile fashion. A
preprocedure huddle and timeout were performed as per [**Hospital1 184**] protocol.
Under fluoroscopic and palpatory guidance, access was obtained into right
common femoral vein using a micropuncture set. Through the micropuncture
sheath, [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 89**] wire was placed and advanced into the aorta. The
micropuncture sheath was then exchanged for a 5 French vascular sheath, the
side arm of which was connected to a continuous saline flush. Through the
vascular sheath, a 5 French C2 Glide Cobra catheter was placed and the celiac
artery was catheterized. Then, the catheter was further advanced in to the
right hepatic artery over a Glidewire. An arteriographic run was performed
from this location which did not show any active contrast leakage into the
biliary system. Then, using a Renegade Hi-Flow microcatheter and a Transcend
wire, three terminal branches of the right hepatic artery were sequentially
catheterized, performing branch arteriograms. Again, they did not show any
contrast leak into the biliary system. The arteriovenous fistula which was
noted on the previous arteriogram was still present, but the flow was less
compared to the earlier study. Then, the microcatheter was withdrawn and the
left hepatic artery was selectively catheterized. A left hepatic arteriogram
was performed which again showed an arteriovenous fistula but no contrast
(Over)
[**2118-6-15**] 1:35 PM
TIPS Clip # [**Clip Number (Radiology) 86566**]
Reason: please retry to place TIPS
Admitting Diagnosis: ETOH WITHDRAWAL;CIRRHOSIS
Contrast: VISAPAQUE Amt: 260
______________________________________________________________________________
FINAL REPORT
(Cont)
leakage into the biliary system. Attempt was then made to selectively
catheterize a small branch of the right hepatic artery supplying liver segment
IV. However, this was unsuccessful. No intervention was performed as there
was no evidence of any contrast leakage into the biliary system on all of the
above arteriograms. The microcatheter and C2 Cobra catheter were then
removed. The vascular sheath was removed and the arterial access site in the
right common femoral artery closed with an Angio-Seal device and digital
pressure. Sterile dressings were applied. The patient tolerated the
procedure well and there were no immediate complications. At the end of the
procedure, the patient was safely transferred back to ICU.
IMPRESSION: Right and left hepatic arteriograms and selective hepatic branch
arteriograms showing no evidence of any active arterial contrast extravasation
into the biliary system. As noted in the previous study, two areas of
arteriovenous fistulae were again seen with interval reduction in the flow
rate.
| 11,962
|
49-year-old male with ETOH cirrhosis and massive upper GI
bleed from esophageal varices. Patient is post failed attempt at TIPS and
presents with rebleeding.
|
TIPS procedure from [**2118-6-14**].
OPERATORS: The procedure was performed by Drs. [**First Name8 (NamePattern2) 234**] [**Last Name (NamePattern1) 896**] (fellow) and
[**First Name8 (NamePattern2) 732**] [**Last Name (NamePattern1) 155**]. Dr. [**Last Name (STitle) 155**], the attending interventional radiologist, was
present and supervised throughout the entire procedure.
ANESTHESIA: General endotracheal anesthesia.
|
please retry to place TIPS
______________________________________________________________________________
FINAL REPORT
CLINICAL
|
After the risks and benefits of the procedure were
explained to the [**Hospital 353**] healthcare proxy, informed consent was obtained.
The patient was brought to the angiography suite, and his indwelling right
neck trauma catheter and right flank were prepped and draped in usual sterile
fashion. A preprocedural timeout and huddle were performed per [**Hospital1 184**]
protocol. A scout image of the abdomen was obtained showing [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 11194**]
balloon in the gastric lumen.
Under ultrasound guidance, the peritoneal space in the right mid abdomen was
accessed with an 18-gauge needle, through which a wire was advanced into the
right upper quadrant followed by an Omniflush catheter. The wire was removed,
and the Omniflush catheter was attached to vacuum drainage allowing for
(Over)
[**2118-6-15**] 1:35 PM
TIPS Clip # [**Clip Number (Radiology) 86566**]
Reason: please retry to place TIPS
Admitting Diagnosis: ETOH WITHDRAWAL;CIRRHOSIS
Contrast: VISAPAQUE Amt: 260
______________________________________________________________________________
FINAL REPORT
(Cont)
removal of 3 liters of bloody ascitic fluid over the course of the entire
procedure.
Under fluoroscopic guidance, [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 66**] wire was advanced through the indwelling
right IJ central venous line with its tip positioned in the IVC. The central
line was exchanged for a 10 French sheath which was extended down to the
orifice of the hepatic veins. Using modified C2 catheter, the right hepatic
vein was cannulated. This was verified with a venogram with visualization on
a lateral view. The Glidewire was exchanged for a 0.035 stiff Amplatz wire,
and the [**Last Name (un) 67**]-Tip sheath was then advanced into the hepatic vein. A 9 French
angled sheath was then positioned in the right hepatic vein, and the guide
wire was removed and replaced with [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 37**]-[**Last Name (un) 38**] needle. Using the [**Last Name (un) 37**]-
[**Last Name (un) 38**] needle, several passes were made trying to access the right portal
vein. These attempts were unsuccessful.
Decision was made to place a wire for guidance into the portal system via a
patent umbilical vein. Under ultrasound guidance, the umbilical vein was
accessed with a micropuncture kit, and a Glidewire was placed through the
micropuncture sheath into the left portal vein under fluoroscopic guidance. 5
French Glide catheter was advanced over the needle and parked at the
confluence of the right and left portal vein to serve as a guide for needle
placement.
Next, using this guidance, [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 37**]- [**Last Name (un) 38**] kit was used to obtain access into
the right portal vein. The needle was removed, and a 0.035 Glidewire was
advanced through the catheter into the main portal vein. A straight
multipurpose catheter was advanced over the wire into the main portal vein,
and a CO2 portogram was performed demonstrating the presence of a large
umbilical vein from the left portal vein and confirming the position of the
right portal vein. Catheter was removed, and the intrahepatic parenchymal
tract was dilated with a 10-mm balloon and a 10 mm x 8 cm (covered) and 2 cm
(uncovered) stent was deployed followed by balloon dilatation with the 10-mm
balloon.
A subsequent CO2 venogram was performed demonstrating good flow through the
shunt with persistent but slightly delayed hepatofugal blood flow through the
patent umbilical vein. A straight multipurpose catheter was used to obtain
pressure, demonstrating a pressure of 23 mmHg in the main portal vein and 16
mmHg in the right atrium for a portosystemic gradient of 23. The catheter and
vascular sheath were removed, and manual compression was held for hemostasis.
The patient tolerated the procedure well and was returned back to the MICU to
remain intubated.
|
1. Successful TIPS from the right hepatic vein into the right portal vein
with placement of a 10 mm x 10 cm (8 cm covered/2 cm uncovered) stent.
(Over)
[**2118-6-15**] 1:35 PM
TIPS Clip # [**Clip Number (Radiology) 86566**]
Reason: please retry to place TIPS
Admitting Diagnosis: ETOH WITHDRAWAL;CIRRHOSIS
Contrast: VISAPAQUE Amt: 260
______________________________________________________________________________
FINAL REPORT
(Cont)
2. Portosystemic gradient of 7 mmHg after creating the TIPS shunt.
3. Removal of 3 liters of bloody ascitic fluid.
MEDICAL
|
IMPRESSION
| true
| true
| true
| true
| true
| 5
|
[]
|
OK
| 210,165
|
391,144
| 1,149,202
| 59,415
|
[**2149-9-8**] 10:08 PM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 51699**]
Reason: Please evaluate NG tube placement. Also evaluate lung fields
Admitting Diagnosis: LIVER DISEASE;ENCEPHALOPATHY
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
58 year old man with ETOH cirrhosis and AMS.
REASON FOR THIS EXAMINATION:
Please evaluate NG tube placement. Also evaluate lung fields for acute process.
______________________________________________________________________________
FINAL REPORT
HISTORY: Alcoholic cirrhosis and altered mental status, for NG tube
placement.
FINDINGS: In comparison with the study of [**8-19**], there is little overall
change in the cardiac silhouette. The pulmonary vessels appear mildly
prominent and there may be minimal atelectatic changes at the bases.
There has been interval placement of a nasogastric tube that extends at least
to the body of the stomach.
| 1,071
|
Alcoholic cirrhosis and altered mental status, for NG tube
placement.
| null |
Please evaluate NG tube placement. Also evaluate lung fields for acute process.
______________________________________________________________________________
FINAL REPORT
|
In comparison with the study of [**8-19**], there is little overall
change in the cardiac silhouette. The pulmonary vessels appear mildly
prominent and there may be minimal atelectatic changes at the bases.
There has been interval placement of a nasogastric tube that extends at least
to the body of the stomach.
|
FINDINGS: In comparison with the study of [**8-19**], there is little overall
change in the cardiac silhouette. The pulmonary vessels appear mildly
prominent and there may be minimal atelectatic changes at the bases. There has been interval placement of a nasogastric tube that extends at least
to the body of the stomach.
|
FALLBACK_LAST_SENTENCES
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 203,797
|
320,119
| 1,075,958
| 30,349
|
[**2110-4-10**] 12:10 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 49940**]
Reason: pneumonia, pleural effusion
Admitting Diagnosis: BOWEL OBSTRUCTION
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
63 year old man with fever
REASON FOR THIS EXAMINATION:
pneumonia, pleural effusion
______________________________________________________________________________
FINAL REPORT
CHEST RADIOGRAPH
INDICATION: Pneumonia, pleural effusion.
COMPARISON: [**2110-4-7**].
FINDINGS: Due to patient position, the right hemithorax is less transparent
than on the left. On today's radiograph, there is a subtle increase in
vascular diameter and mild blunting of both costophrenic sinuses, presumably
due to small pleural effusions. In combination with slightly increasing size
of the cardiac diameter, these findings are suggestive of moderate
overhydration. In addition, the right lung base has increased in density, so
that developing pneumonia cannot be excluded. A repeat radiograph should be
performed within six to eight hours.
The responsible nurse [**First Name8 (NamePattern2) **] [**First Name4 (NamePattern1) 732**] [**Last Name (NamePattern1) **] was notified by telephone at
the time of dictation.
| 1,388
| null |
[**2110-4-7**].
|
pneumonia, pleural effusion
______________________________________________________________________________
FINAL REPORT
CHEST RADIOGRAPH
INDICATION: Pneumonia, pleural effusion.
|
Due to patient position, the right hemithorax is less transparent
than on the left. On today's radiograph, there is a subtle increase in
vascular diameter and mild blunting of both costophrenic sinuses, presumably
due to small pleural effusions. In combination with slightly increasing size
of the cardiac diameter, these findings are suggestive of moderate
overhydration. In addition, the right lung base has increased in density, so
that developing pneumonia cannot be excluded. A repeat radiograph should be
performed within six to eight hours.
The responsible nurse [**First Name8 (NamePattern2) **] [**First Name4 (NamePattern1) 732**] [**Last Name (NamePattern1) **] was notified by telephone at
the time of dictation.
|
In addition, the right lung base has increased in density, so
that developing pneumonia cannot be excluded. A repeat radiograph should be
performed within six to eight hours. The responsible nurse [**First Name8 (NamePattern2) **] [**First Name4 (NamePattern1) 732**] [**Last Name (NamePattern1) **] was notified by telephone at
the time of dictation.
|
FALLBACK_LAST_SENTENCES
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 164,255
|
303,053
| 1,038,375
| 15,041
|
[**2177-10-28**] 10:01 AM
CHEST (PRE-OP PA & LAT) Clip # [**Clip Number (Radiology) 30261**]
Reason: pt with pelvic mass, scheduled for tahbso on [**Numeric Identifier 30262**]
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
pelvic mass, scheduled for tahbso on [**11-4**]
REASON FOR THIS EXAMINATION:
pt with pelvic mass, scheduled for tahbso on [**Numeric Identifier 30262**]
______________________________________________________________________________
FINAL REPORT
HISTORY: Preoperative.
FINDINGS: No evidence of acute cardiopulmonary disease. Minimal atelectatic
changes at the bases.
| 750
|
Preoperative.
| null |
pt with pelvic mass, scheduled for tahbso on [**Numeric Identifier 30262**]
______________________________________________________________________________
FINAL REPORT
|
No evidence of acute cardiopulmonary disease. Minimal atelectatic
changes at the bases.
|
[**2177-10-28**] 10:01 AM
CHEST (PRE-OP PA & LAT) Clip # [**Clip Number (Radiology) 30261**]
Reason: pt with pelvic mass, scheduled for tahbso on [**Numeric Identifier 30262**]
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
pelvic mass, scheduled for tahbso on [**11-4**]
REASON FOR THIS EXAMINATION:
pt with pelvic mass, scheduled for tahbso on [**Numeric Identifier 30262**]
______________________________________________________________________________
FINAL REPORT
HISTORY: Preoperative. FINDINGS: No evidence of acute cardiopulmonary disease. Minimal atelectatic
changes at the bases.
|
FALLBACK_LAST_SENTENCES
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 155,996
|
111,621
| 842,422
| 2,197
|
[**2164-9-18**] 2:59 PM
IVC GRAM/FILTER Clip # [**Clip Number (Radiology) 28680**]
Reason: please place IVC filter, please if able to do today
Admitting Diagnosis: SUBARACHNOID HEMORRHAGE
Contrast: OPTIRAY Amt: 20
********************************* CPT Codes ********************************
* [**Numeric Identifier 878**] INTERUP IVC [**Numeric Identifier 879**] INTRO CATH SVC/IVC *
* -51 MULTI-PROCEDURE SAME DAY [**Numeric Identifier 880**] PERC PLCMT IVC FILTER *
* [**Numeric Identifier 881**] IVC GRAM -59 DISTINCT PROCEDURAL SERVICE *
* C1880 VENA CAVA FILTER *
****************************************************************************
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
43 year old man with SAH
REASON FOR THIS EXAMINATION:
please place IVC filter, please if able to do today
______________________________________________________________________________
FINAL REPORT
HISTORY: 43 year old male with subarachnoid hemorrhage, long term
immobilization, needs IVC filter.
PROCEDURE/FINDINGS: The procedure was performed by Dr. [**First Name8 (NamePattern2) 1874**] [**Name (STitle) 1875**] and Dr.
[**First Name4 (NamePattern1) 923**] [**Last Name (NamePattern1) 924**], with Dr. [**Last Name (STitle) 924**], attending radiologist, present and
supervising.
After obtaining informed consent from the family of the patient, the patient
was placed supine on the angiographic table. The right groin was prepped and
draped in standard sterile fashion. The right common femoral vein was
accessed using fluoroscopic guidance with the 19 gauge needle after
administration of local 1% Lidocaine. An 035 guidewire was advanced through
the needle into the inferior vena cava under fluoroscopy. A 5 French
Omniflush catheter was then advanced over [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 94**] wire. The wire was
removed and a venogram was performed with injection of approximately 25 cc of
nonionic contrast. The venogram demonstrated normal IVC anatomy, with the
renal veins seen at the level of L2. The Omniflush catheter was then
exchanged for a 7 French Optease IVC filter delivery system. Under
fluoroscopic guidance the filter was deployed in the infrarenal location.
Final fluoroscopic image demonstrated the filter to be in good position and
orientation. The catheter delivery system was removed and pressure was
applied to the right groin until hemostasis was achieved.
COMPLICATIONS: None.
IMPRESSION:
Successful placement of a temporary Optease IVC filter in infrarenal location.
Normal anatomy of IVC.
(Over)
[**2164-9-18**] 2:59 PM
IVC GRAM/FILTER Clip # [**Clip Number (Radiology) 28680**]
Reason: please place IVC filter, please if able to do today
Admitting Diagnosis: SUBARACHNOID HEMORRHAGE
Contrast: OPTIRAY Amt: 20
______________________________________________________________________________
FINAL REPORT
(Cont)
| 3,364
|
43 year old male with subarachnoid hemorrhage, long term
immobilization, needs IVC filter.
PROCEDURE/
| null |
please place IVC filter, please if able to do today
______________________________________________________________________________
FINAL REPORT
|
The procedure was performed by Dr. [**First Name8 (NamePattern2) 1874**] [**Name (STitle) 1875**] and Dr.
[**First Name4 (NamePattern1) 923**] [**Last Name (NamePattern1) 924**], with Dr. [**Last Name (STitle) 924**], attending radiologist, present and
supervising.
After obtaining informed consent from the family of the patient, the patient
was placed supine on the angiographic table. The right groin was prepped and
draped in standard sterile fashion. The right common femoral vein was
accessed using fluoroscopic guidance with the 19 gauge needle after
administration of local 1% Lidocaine. An 035 guidewire was advanced through
the needle into the inferior vena cava under fluoroscopy. A 5 French
Omniflush catheter was then advanced over [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 94**] wire. The wire was
removed and a venogram was performed with injection of approximately 25 cc of
nonionic contrast. The venogram demonstrated normal IVC anatomy, with the
renal veins seen at the level of L2. The Omniflush catheter was then
exchanged for a 7 French Optease IVC filter delivery system. Under
fluoroscopic guidance the filter was deployed in the infrarenal location.
Final fluoroscopic image demonstrated the filter to be in good position and
orientation. The catheter delivery system was removed and pressure was
applied to the right groin until hemostasis was achieved.
COMPLICATIONS: None.
|
Successful placement of a temporary Optease IVC filter in infrarenal location.
Normal anatomy of IVC.
(Over)
[**2164-9-18**] 2:59 PM
IVC GRAM/FILTER Clip # [**Clip Number (Radiology) 28680**]
Reason: please place IVC filter, please if able to do today
Admitting Diagnosis: SUBARACHNOID HEMORRHAGE
Contrast: OPTIRAY Amt: 20
______________________________________________________________________________
FINAL REPORT
(Cont)
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 57,606
|
70,774
| 811,365
| 7,223
|
[**2152-11-23**] 7:32 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 3645**]
Reason: interval change
Admitting Diagnosis: RUPTURED AAA
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
43 year old man s/p aortic aneurysm repair
hypoxemia increasing vent requirments
REASON FOR THIS EXAMINATION:
interval change
______________________________________________________________________________
FINAL REPORT
INDICATION: S/P aortic aneurysm repair, hypoxemia. Assess for change.
PORTABLE AP VIEW OF CHEST: Please note that this is a re-dictation of an exam
initially performed on [**2152-11-23**]. Allowing for differences in technique and
position, there has been no significant change since the exam of [**2152-11-17**]. The
left sided central venous catheter, ETT and NG tube are unchanged in position.
The heart size and mediastinal/hilar contours are stable. There are persistent
bilateral pleural effusions with probable bibasilar atelectasis. The
visualized soft tissues and osseous structures are stable.
IMPRESSION: Allowing for differences in patient positioning, no significant
change since the exam of [**2152-11-17**].
| 1,347
| null | null |
interval change
______________________________________________________________________________
FINAL REPORT
INDICATION: S/P aortic aneurysm repair, hypoxemia. Assess for change.
PORTABLE AP VIEW OF
|
Please note that this is a re-dictation of an exam
initially performed on [**2152-11-23**]. Allowing for differences in technique and
position, there has been no significant change since the exam of [**2152-11-17**]. The
left sided central venous catheter, ETT and NG tube are unchanged in position.
The heart size and mediastinal/hilar contours are stable. There are persistent
bilateral pleural effusions with probable bibasilar atelectasis. The
visualized soft tissues and osseous structures are stable.
|
Allowing for differences in patient positioning, no significant
change since the exam of [**2152-11-17**].
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 34,958
|
231,791
| 990,250
| 29,682
|
[**2116-12-13**] 8:43 PM
CHEST (PRE-OP PA & LAT) Clip # [**Clip Number (Radiology) 50437**]
Reason: HYPERPARATHYROIDISM
Admitting Diagnosis: HYPERPARATHYROIDISM
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
20 year old woman with
REASON FOR THIS EXAMINATION:
preop
______________________________________________________________________________
FINAL REPORT
PREOPERATIVE PA AND LATERAL CHEST X-RAY, [**2116-12-13**] AT 20:50 HOURS.
HISTORY: Preop for parathyroid adenoma removal.
COMPARISON: Multiple priors, the most recent dated [**2116-10-26**].
FINDINGS: Lung volumes are mildly diminished. There is an indwelling large
bore dual-lumen dialysis catheter now from a left internal jugular approach
where previously it was from a right internal jugular approach. There is no
consolidation or edema. The mediastinum is unremarkable. The cardiac
silhouette is borderline enlarged but stable. No effusion or pneumothorax is
seen. Again noted is a marked levoconcave scoliosis of the thoracic spine.
IMPRESSION: No acute pulmonary process.
| 1,215
|
Preop for parathyroid adenoma removal.
|
Multiple priors, the most recent dated [**2116-10-26**].
|
preop
______________________________________________________________________________
FINAL REPORT
PREOPERATIVE PA AND LATERAL CHEST X-RAY, [**2116-12-13**] AT 20:50 HOURS.
|
Lung volumes are mildly diminished. There is an indwelling large
bore dual-lumen dialysis catheter now from a left internal jugular approach
where previously it was from a right internal jugular approach. There is no
consolidation or edema. The mediastinum is unremarkable. The cardiac
silhouette is borderline enlarged but stable. No effusion or pneumothorax is
seen. Again noted is a marked levoconcave scoliosis of the thoracic spine.
|
No acute pulmonary process.
|
IMPRESSION
| true
| true
| true
| true
| true
| 5
|
[]
|
OK
| 118,172
|
311,914
| 1,047,316
| 45,589
|
[**2172-11-13**] 4:09 PM
CHEST (PORTABLE AP); -77 BY DIFFERENT PHYSICIAN [**Name Initial (PRE) 7**] # [**Clip Number (Radiology) 26103**]
Reason: Position of Dobhoff and check S/P bronch
Admitting Diagnosis: THYMOMA/SDA
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
34 year old woman with Thymoma excision
REASON FOR THIS EXAMINATION:
Position of Dobhoff and check S/P bronch
______________________________________________________________________________
PROVISIONAL FINDINGS IMPRESSION (PFI): PMB FRI [**2172-11-13**] 8:16 PM
Indwelling device is in standard position. Small biapical pneumothoraces.
______________________________________________________________________________
FINAL REPORT
COMPARISON: Chest radiograph earlier the same date.
FINDINGS: New Dobbhoff tube terminates within the stomach. Other indwelling
devices are in standard position. Small biapical pneumothoraces are present,
with the right newly appreciated and the left in retrospect unchanged.
Cardiomediastinal contours are unchanged. Left lower lobe atelectasis and
left effusion slightly improved.
| 1,223
| null |
Chest radiograph earlier the same date.
|
Position of Dobhoff and check S/P bronch
______________________________________________________________________________
PROVISIONAL FINDINGS IMPRESSION (PFI): PMB FRI [**2172-11-13**] 8:16 PM
Indwelling device is in standard position. Small biapical pneumothoraces.
______________________________________________________________________________
FINAL REPORT
|
New Dobbhoff tube terminates within the stomach. Other indwelling
devices are in standard position. Small biapical pneumothoraces are present,
with the right newly appreciated and the left in retrospect unchanged.
Cardiomediastinal contours are unchanged. Left lower lobe atelectasis and
left effusion slightly improved.
|
Small biapical pneumothoraces are present,
with the right newly appreciated and the left in retrospect unchanged. Cardiomediastinal contours are unchanged. Left lower lobe atelectasis and
left effusion slightly improved.
|
FALLBACK_LAST_SENTENCES
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 160,216
|
141,325
| 849,023
| 26,300
|
LUNG SCAN Clip # [**Clip Number (Radiology) 101671**]
Reason: PLEUIITIC R SIDED CP, DM, EKG CHANGES, EVALUATE FOR PE.
______________________________________________________________________________
FINAL REPORT
HISTORY: Pleuritic right sided chest pain, diabetes, EKG changes.
DECISION: Ventilation and perfusion images were obtained.
REPORT:
Ventilation images obtained with Tc-[**Age over 90 26**]m aerosol in 8 views demonstrate a
postero-basilar left lower lobe ventilation defect. Tracer activity is also
seen along the esophagus.
Perfusion images in the same 8 views show matching postero-basilar left lower
lobe subsegmental perfusion abnormalities.
Chest x-ray appears essentially clear.
The above findings are consistent with a low likelihood of pulmonary embolism.
IMPRESSION: Low likelihood of pulmonary embolism.
/nkg
[**Last Name (NamePattern5) 29**], M.D. Approved: TUE [**2192-1-10**] 11:32 AM
West [**Medical Record Number 101125**]
RADLINE [**Telephone/Fax (1) 31**]; A radiology consult service.
To hear preliminary results, prior to transcription, call the
Radiology Listen Line [**Telephone/Fax (1) 32**].
| 1,370
|
Pleuritic right sided chest pain, diabetes, EKG changes.
DECISION: Ventilation and perfusion images were obtained.
| null | null |
Ventilation images obtained with Tc-[**Age over 90 26**]m aerosol in 8 views demonstrate a
postero-basilar left lower lobe ventilation defect. Tracer activity is also
seen along the esophagus.
Perfusion images in the same 8 views show matching postero-basilar left lower
lobe subsegmental perfusion abnormalities.
Chest x-ray appears essentially clear.
The above findings are consistent with a low likelihood of pulmonary embolism.
|
Low likelihood of pulmonary embolism.
/nkg
[**Last Name (NamePattern5) 29**], M.D. Approved: TUE [**2192-1-10**] 11:32 AM
West [**Medical Record Number 101125**]
RADLINE [**Telephone/Fax (1) 31**]; A radiology consult service.
To hear preliminary results, prior to transcription, call the
Radiology Listen Line [**Telephone/Fax (1) 32**].
|
IMPRESSION
| true
| true
| true
| false
| false
| 3
|
['comparison', 'procedure']
|
No Comparison section found; No Technique/Procedure section found
| 73,431
|
148,459
| 886,190
| 19,606
|
[**2116-10-4**] 5:05 PM
MRA ABDOMEN W&W/O CONTRAST; MR CONTRAST GADOLIN Clip # [**Clip Number (Radiology) 99674**]
Reason: Assess vessles for patency
Admitting Diagnosis: CHOLECYSTITIS
Contrast: MAGNEVIST Amt: 40
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
47 year old woman with thickening of entire colon and elevated Creatine
REASON FOR THIS EXAMINATION:
Assess vessles for patency
______________________________________________________________________________
FINAL REPORT
MRA OF THE ABDOMEN WITH AND WITHOUT CONTRAST DATED [**2116-10-4**].
CLINICAL HISTORY: 47-year-old woman with thickening of entire colon and
elevated creatinine, assess the vessels for patency.
TECHNIQUE: In- and out-of-phase T1, HASTE and pre- and post-gadolinium
dynamic sequences were performed at 3 Tesla. Images were reformatted on a
separate workstation.
COMPARISON: MRA of the abdomen dated [**2116-4-19**].
FINDINGS: Study is somewhat limited due to patient's body habitus. The
surface coil was not able to be used.
Evaluation of the mesenteric vessels shows a normal-appearing celiac axis, SMA
and [**Female First Name (un) **]. The aorta is normal in caliber, without evidence for atheromatous
disease. There are single normal appearing renal arteries bilaterally.
The evaluation of venous structures shows a patent IMV. Common iliac veins
and IVC are also patent.
Limited evaluation of the colon shows significant colonic wall thickening in
the cecum and ascending colon. The remainder of the bowel is unremarkable.
There is a small pleural effusion at the right base. Limited imaging through
the liver shows no evidence for focal mass or intrahepatic biliary dilatation.
Common bile duct is normal in diameter. The pancreas and adrenal glands are
unremarkable. The spleen is mildly enlarged, measuring up to 14.8 cm in
diameter.
As in the prior study, there are several borderline-sized lymph nodes in the
periaortic region, measuring up to 1.2 cm in short axis. There is a small-to-
moderate amount of free fluid in the perihepatic space and along the pericolic
gutters.
IMPRESSION:
1. Widely patent celiac axis, SMA and [**Female First Name (un) **]. Patent SMV.
2. Limited evaluation of the colon shows wall thickening within the cecum
and ascending colon. Prior CT scan from [**Hospital 539**] Hospital shows evidence for
(Over)
[**2116-10-4**] 5:05 PM
MRA ABDOMEN W&W/O CONTRAST; MR CONTRAST GADOLIN Clip # [**Clip Number (Radiology) 99674**]
Reason: Assess vessles for patency
Admitting Diagnosis: CHOLECYSTITIS
Contrast: MAGNEVIST Amt: 40
______________________________________________________________________________
FINAL REPORT
(Cont)
pneumatosis in the ascending colon. As discussed with Dr. [**Last Name (STitle) 6685**], a CT scan
will be evaluated to further evaluate this finding.
3. Free fluid in the perihepatic space and pericolic gutters.
| 3,168
|
47-year-old woman with thickening of entire colon and
elevated creatinine, assess the vessels for patency.
|
MRA of the abdomen dated [**2116-4-19**].
|
Assess vessles for patency
______________________________________________________________________________
FINAL REPORT
MRA OF THE ABDOMEN WITH AND WITHOUT CONTRAST DATED [**2116-10-4**].
CLINICAL
|
Study is somewhat limited due to patient's body habitus. The
surface coil was not able to be used.
Evaluation of the mesenteric vessels shows a normal-appearing celiac axis, SMA
and [**Female First Name (un) **]. The aorta is normal in caliber, without evidence for atheromatous
disease. There are single normal appearing renal arteries bilaterally.
The evaluation of venous structures shows a patent IMV. Common iliac veins
and IVC are also patent.
Limited evaluation of the colon shows significant colonic wall thickening in
the cecum and ascending colon. The remainder of the bowel is unremarkable.
There is a small pleural effusion at the right base. Limited imaging through
the liver shows no evidence for focal mass or intrahepatic biliary dilatation.
Common bile duct is normal in diameter. The pancreas and adrenal glands are
unremarkable. The spleen is mildly enlarged, measuring up to 14.8 cm in
diameter.
As in the prior study, there are several borderline-sized lymph nodes in the
periaortic region, measuring up to 1.2 cm in short axis. There is a small-to-
moderate amount of free fluid in the perihepatic space and along the pericolic
gutters.
|
1. Widely patent celiac axis, SMA and [**Female First Name (un) **]. Patent SMV.
2. Limited evaluation of the colon shows wall thickening within the cecum
and ascending colon. Prior CT scan from [**Hospital 539**] Hospital shows evidence for
(Over)
[**2116-10-4**] 5:05 PM
MRA ABDOMEN W&W/O CONTRAST; MR CONTRAST GADOLIN Clip # [**Clip Number (Radiology) 99674**]
Reason: Assess vessles for patency
Admitting Diagnosis: CHOLECYSTITIS
Contrast: MAGNEVIST Amt: 40
______________________________________________________________________________
FINAL REPORT
(Cont)
pneumatosis in the ascending colon. As discussed with Dr. [**Last Name (STitle) 6685**], a CT scan
will be evaluated to further evaluate this finding.
3. Free fluid in the perihepatic space and pericolic gutters.
|
IMPRESSION
| true
| true
| true
| true
| true
| 5
|
[]
|
OK
| 76,634
|
351,183
| 1,085,204
| 46,041
|
[**2160-6-3**] 7:34 AM
CHEST (PORTABLE AP); -59 DISTINCT PROCEDURAL SERVICE Clip # [**Clip Number (Radiology) 78914**]
Reason: eval for PNA
Admitting Diagnosis: ISCHEMIC CARDIOMYOPATHY
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
60 year old man s/p cardiogenic shock now with persistent elevated WBC
REASON FOR THIS EXAMINATION:
eval for PNA
______________________________________________________________________________
FINAL REPORT
HISTORY: Cardiogenic shock with persistent increase in white blood count.
FINDINGS: In comparison with the study of [**5-31**], there is little overall
change in the appearance of the heart and lungs. The opacification in the
medial upper portion of the left upper lung persists. The tip of the
nasogastric tube cannot be evaluated since the bottom of the image is at the
diaphragmatic level.
Right lung is clear.
| 989
|
Cardiogenic shock with persistent increase in white blood count.
| null |
eval for PNA
______________________________________________________________________________
FINAL REPORT
|
In comparison with the study of [**5-31**], there is little overall
change in the appearance of the heart and lungs. The opacification in the
medial upper portion of the left upper lung persists. The tip of the
nasogastric tube cannot be evaluated since the bottom of the image is at the
diaphragmatic level.
Right lung is clear.
|
The opacification in the
medial upper portion of the left upper lung persists. The tip of the
nasogastric tube cannot be evaluated since the bottom of the image is at the
diaphragmatic level. Right lung is clear.
|
FALLBACK_LAST_SENTENCES
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 180,398
|
493,785
| 1,228,198
| 49,555
|
[**2168-3-10**] 8:23 AM
CT CHEST W/O CONTRAST Clip # [**Clip Number (Radiology) 32900**]
Reason: Please assess for changes, possible placement of endobronchi
Admitting Diagnosis: VOCAL CORD DISFUNCTION
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
75 year old woman with COPD and persistent pneumothoraces.
REASON FOR THIS EXAMINATION:
Please assess for changes, possible placement of endobronchial valve.
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Patient with COPD and persistent pneumothorax. Assess for
interval change.
COMPARISONS: [**2168-2-22**], [**2168-2-3**], [**2168-1-9**].
TECHNIQUE: MDCT-acquired contiguous images through the chest were obtained
without intravenous contrast at 1.25-mm slice thickness. Coronally and
sagittally reformatted images were displayed.
FINDINGS:
CT OF THE CHEST:
Tracheostomy tube is appropriately positioned. There is marked anterior
bowing of the posterior wall of the trachea (2:20) due to tracheomalacia,
slightly more conspicuous than before. Left chest tube, enters laterally,
courses anteriorly and terminates just above the left hemidiaphragm (2:42).
Numerous top normal size mediastinal lymph nodes are not significantly changed
from prior. For example, a 9-mm pretracheal lymph node is stable (2:23). The
aorta and other great vessels are unremarkable. Heart is minimally enlarged
without pericardial effusion. Central venous catheter ends in mid SVC.
Many large, recently acquired cystic lucencies in the left lung apex have not
significantly changed since [**2168-2-22**]. A small left pneumothorax is still
present posteriorly and anteriorly. A moderate volume of consolidation at the
base of the left lung and a small non-hemorrhagic pleural effusion are new
since prior. Bronchiectasis and bronchial wall thickening, most pronounced at
both lung bases is more conspicuous. Scattered mucoid impactions are
unchanged. Extensive subcutaneous emphysema mostly in the left anterior
chest wall has minimally increased from prior.
This study is not tailored for subdiaphragmatic evaluation; however, partially
imaged upper abdominal organs are unremarkable. A 1.6 x 1.6 cm hypodense
(10HU) lesion arising from the upper pole of the left kidney is a cyst (2:53).
OSSEOUS STRUCTURES: No suspicious lytic or sclerotic lesion is seen.
IMPRESSION:
1. Multicystic abnormality in the left lung apex, likely pneumatoceles, not
(Over)
[**2168-3-10**] 8:23 AM
CT CHEST W/O CONTRAST Clip # [**Clip Number (Radiology) 32900**]
Reason: Please assess for changes, possible placement of endobronchi
Admitting Diagnosis: VOCAL CORD DISFUNCTION
______________________________________________________________________________
FINAL REPORT
(Cont)
significantly changed since [**2168-2-22**].
2. Small left pneumothorax.
3. New left lower lobe pneumonia and accompanying nonhemorrhagic pleural
effusion.
4. Diffuse bilateral bronchial wall thickening, mucoid impaction, and
bronchiectasis, likely reflect chronic recurrent aspiration.
| 3,435
| null |
[**2168-2-22**], [**2168-2-3**], [**2168-1-9**].
|
Please assess for changes, possible placement of endobronchial valve.
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Patient with COPD and persistent pneumothorax. Assess for
interval change.
|
CT OF THE
|
1. Multicystic abnormality in the left lung apex, likely pneumatoceles, not
(Over)
[**2168-3-10**] 8:23 AM
CT CHEST W/O CONTRAST Clip # [**Clip Number (Radiology) 32900**]
Reason: Please assess for changes, possible placement of endobronchi
Admitting Diagnosis: VOCAL CORD DISFUNCTION
______________________________________________________________________________
FINAL REPORT
(Cont)
significantly changed since [**2168-2-22**].
2. Small left pneumothorax.
3. New left lower lobe pneumonia and accompanying nonhemorrhagic pleural
effusion.
4. Diffuse bilateral bronchial wall thickening, mucoid impaction, and
bronchiectasis, likely reflect chronic recurrent aspiration.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 271,078
|
248,578
| 988,799
| 29,950
|
[**2190-12-31**] 1:58 AM
MR HEAD W & W/O CONTRAST Clip # [**Clip Number (Radiology) 74737**]
Reason: r/o mass, bleed, amyloid
Admitting Diagnosis: STROKE;TELEMETRY;TRANSIENT ISCHEMIC ATTACK
Contrast: MAGNEVIST Amt: 12
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
82 year old woman with L frontal ICH
REASON FOR THIS EXAMINATION:
r/o mass, bleed, amyloid
No contraindications for IV contrast
______________________________________________________________________________
WET READ: DJD FRI [**2190-12-31**] 4:03 AM
8.3cm x 4.3cm L frontal hemmhorage. Causes focal frontal transfalcine shift to
R ~4mm and impression on the L frontal [**Doctor Last Name 39**]. DDX: Amyloid angiopathy, AVM,
bleeding tumor, anticoagulants w/wo trauma, HTN possible but not typical
location [**Name Initial (MD) **] [**Name8 (MD) 7778**] MD)
______________________________________________________________________________
FINAL REPORT
HISTORY: 82-year-old female with left frontal intracranial hemorrhage, rule
out mass, bleed, angiopathy.
TECHNIQUE: Multiplanar T1- and T2-weighted images were obtained prior to and
after the administration of IV gadolinium contrast.
COMPARISON: CT head [**2190-12-30**].
FINDINGS: There is a 8.3 cm x 4.7-cm left frontal intraparenchymal
hemorrhage. This demonstrates predominantly isointense signal on T1-weighted
images and hypointense signal on T2/FLAIR images, consistent with
predominantly acute hemorrhage products. Within this intraparenchymal
hemorrhage, there is a smaller foci of hyperintense signal on T1-weighted
images, suggestive of subacute blood products. There is an associated
rightward shift of the midline of approximately 4 mm with mass effect on the
frontal [**Doctor Last Name 39**] of the left lateral ventricle. There is also increased subdural
FLAIR signal overlying the intraparenchymal hemorrhage, suggestive of subdural
extension of the hemorrhage.
There is no abnormal contrast enhancing lesion identified. On gradient echo
images, there is susceptibility of this left frontal intraparenchymal
hemorrhage and there is also an additional smaller focus of susceptibility in
the left parietal lobe, which may be more chronic in nature.
The differential diagnosis for these findings includes amyloid angiopathy
versus an underlying mass lesion. If there is a continued clinical concern for
underlying lesion, repeat images in six to eight weeks may be obtained for
further evaluation.
There is no evidence of major vascular territorial infarction.
IMPRESSION: 8.3 x 4.7 cm left frontal intraparenchymal hemorrhage,
predominantly acute in nature, with mass effect on the lateral ventricle and 4
mm right shift of midline. Small subdural extension is seen as well overlying
(Over)
[**2190-12-31**] 1:58 AM
MR HEAD W & W/O CONTRAST Clip # [**Clip Number (Radiology) 74737**]
Reason: r/o mass, bleed, amyloid
Admitting Diagnosis: STROKE;TELEMETRY;TRANSIENT ISCHEMIC ATTACK
Contrast: MAGNEVIST Amt: 12
______________________________________________________________________________
FINAL REPORT
(Cont)
the intraparenchymal hemorrhage. Differential diagnostic considerations
include amyloid angiopathy versus an underlying mass lesion. If there is a
continued clinical concern for an underlying lesion, repeat scanning in six to
eight weeks is recommended.
| 3,651
|
82-year-old female with left frontal intracranial hemorrhage, rule
out mass, bleed, angiopathy.
|
CT head [**2190-12-30**].
|
r/o mass, bleed, amyloid
No contraindications for IV contrast
______________________________________________________________________________
WET READ: DJD FRI [**2190-12-31**] 4:03 AM
8.3cm x 4.3cm L frontal hemmhorage. Causes focal frontal transfalcine shift to
R ~4mm and impression on the L frontal [**Doctor Last Name 39**]. DDX: Amyloid angiopathy, AVM,
bleeding tumor, anticoagulants w/wo trauma, HTN possible but not typical
location [**Name Initial (MD) **] [**Name8 (MD) 7778**] MD)
______________________________________________________________________________
FINAL REPORT
|
There is a 8.3 cm x 4.7-cm left frontal intraparenchymal
hemorrhage. This demonstrates predominantly isointense signal on T1-weighted
images and hypointense signal on T2/FLAIR images, consistent with
predominantly acute hemorrhage products. Within this intraparenchymal
hemorrhage, there is a smaller foci of hyperintense signal on T1-weighted
images, suggestive of subacute blood products. There is an associated
rightward shift of the midline of approximately 4 mm with mass effect on the
frontal [**Doctor Last Name 39**] of the left lateral ventricle. There is also increased subdural
FLAIR signal overlying the intraparenchymal hemorrhage, suggestive of subdural
extension of the hemorrhage.
There is no abnormal contrast enhancing lesion identified. On gradient echo
images, there is susceptibility of this left frontal intraparenchymal
hemorrhage and there is also an additional smaller focus of susceptibility in
the left parietal lobe, which may be more chronic in nature.
The differential diagnosis for these findings includes amyloid angiopathy
versus an underlying mass lesion. If there is a continued clinical concern for
underlying lesion, repeat images in six to eight weeks may be obtained for
further evaluation.
There is no evidence of major vascular territorial infarction.
|
8.3 x 4.7 cm left frontal intraparenchymal hemorrhage,
predominantly acute in nature, with mass effect on the lateral ventricle and 4
mm right shift of midline. Small subdural extension is seen as well overlying
(Over)
[**2190-12-31**] 1:58 AM
MR HEAD W & W/O CONTRAST Clip # [**Clip Number (Radiology) 74737**]
Reason: r/o mass, bleed, amyloid
Admitting Diagnosis: STROKE;TELEMETRY;TRANSIENT ISCHEMIC ATTACK
Contrast: MAGNEVIST Amt: 12
______________________________________________________________________________
FINAL REPORT
(Cont)
the intraparenchymal hemorrhage. Differential diagnostic considerations
include amyloid angiopathy versus an underlying mass lesion. If there is a
continued clinical concern for an underlying lesion, repeat scanning in six to
eight weeks is recommended.
|
IMPRESSION
| true
| true
| true
| true
| true
| 5
|
[]
|
OK
| 127,043
|
499,478
| 1,238,312
| 69,219
|
[**2167-4-16**] 7:38 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 114278**]
Reason: Evaluate for improvement in pulmonary edema and for monitori
Admitting Diagnosis: WIDE COMPLEX TACHYCARDIA
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
66 year old man with multiple recent V.Fib arrests who has had persistant
hypoxia despite diuresis
REASON FOR THIS EXAMINATION:
Evaluate for improvement in pulmonary edema and for monitoring of CVL
______________________________________________________________________________
FINAL REPORT
STUDY: Chest radiograph.
INDICATION: Multiple recent V-fib arrests, extensive hypoxia. For
evaluation.
TECHNIQUE: Single portable AP radiograph was obtained.
COMPARISON: [**2167-4-14**].
REPORT:
Heart size is likely increased, notwithstanding the portable AP projection.
A left-sided central line is identified, likely in the cavoatrial junction,
not significantly changed from before. No pneumothorax.
There are patchy changes, much more pronounced than on the prior study,
projected over the right chest, which appear almost nodular in places.
Questionable right-sided rib fractures also noted. I am not certain as to
whether recent CPR was performed.
Relatively low lung volumes persist. Extrapleural thickening along the left
side in particular, unchanged. There is minor-to-moderate background
pulmonary edema.
CONCLUSION:
The salient finding appears to be development of some nodular opacities, with
appearances suggestive of rib fractures along the right chest wall. There is
background pulmonary edema.
| 1,751
| null |
[**2167-4-14**].
|
Evaluate for improvement in pulmonary edema and for monitoring of CVL
______________________________________________________________________________
FINAL REPORT
STUDY: Chest radiograph.
INDICATION: Multiple recent V-fib arrests, extensive hypoxia. For
evaluation.
|
Heart size is likely increased, notwithstanding the portable AP projection.
A left-sided central line is identified, likely in the cavoatrial junction,
not significantly changed from before. No pneumothorax.
There are patchy changes, much more pronounced than on the prior study,
projected over the right chest, which appear almost nodular in places.
Questionable right-sided rib fractures also noted. I am not certain as to
whether recent CPR was performed.
Relatively low lung volumes persist. Extrapleural thickening along the left
side in particular, unchanged. There is minor-to-moderate background
pulmonary edema.
|
The salient finding appears to be development of some nodular opacities, with
appearances suggestive of rib fractures along the right chest wall. There is
background pulmonary edema.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 275,034
|
115,611
| 859,183
| 9,893
|
[**2183-4-15**] 5:15 PM
PORTABLE ABDOMEN Clip # [**Clip Number (Radiology) 42367**]
Reason: assess for obstruction(please do upright film)
Admitting Diagnosis: RULE-OUT MYOCARDIAL INFARCTION;TELEMETRY
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
77 year old woman post RV infarct, now with ++bowel sounds, distension and
belching
REASON FOR THIS EXAMINATION:
assess for obstruction(please do upright film)
______________________________________________________________________________
FINAL REPORT
INDICATION: 77-year-old female status post right ventricular infarct, now
with positive bowel sounds and distention. Evaluate for obstruction.
There are no prior studies for comparison.
PORTABLE ABDOMEN: The exam is suboptimal secondary to patient positioning.
Only the upper abdomen is included within the imaged plane. Gas is seen
extending throughout multiple loops of small and large bowel. The transverse
colon measures upper limits of normal at 4.8. There is no acute evidence of
obstruction, with no air-fluid levels identified. The surrounding soft
tissues reveal clear lung bases.
IMPRESSION: Suboptimal study. Transverse colon measures upper limits of
normal with no air-fluid levels to indicate acute obstruction.
| 1,411
| null | null |
assess for obstruction(please do upright film)
______________________________________________________________________________
FINAL REPORT
INDICATION: 77-year-old female status post right ventricular infarct, now
with positive bowel sounds and distention. Evaluate for obstruction.
There are no prior studies for comparison.
PORTABLE
|
The exam is suboptimal secondary to patient positioning.
Only the upper abdomen is included within the imaged plane. Gas is seen
extending throughout multiple loops of small and large bowel. The transverse
colon measures upper limits of normal at 4.8. There is no acute evidence of
obstruction, with no air-fluid levels identified. The surrounding soft
tissues reveal clear lung bases.
|
Suboptimal study. Transverse colon measures upper limits of
normal with no air-fluid levels to indicate acute obstruction.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 59,976
|
39,860
| 777,878
| 5,969
|
[**2116-12-27**] 3:03 AM
CT HEAD W/O CONTRAST Clip # [**Clip Number (Radiology) 77881**]
Reason: assess the intracranial hemorrhage
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
80 year old woman with thalamic hemorrhage and shift
REASON FOR THIS EXAMINATION:
assess the intracranial hemorrhage
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Thalamic hemorrhage assess.
TECHNIQUE: Noncontrast head CT.
FINDINGS:
There is a 3 cm x 2.5 cm hemorrhage within the right thalamus with surrounding
hypodensity indicating edema with slight shift of the normally midline
structures to the left with extension as interventricular hemorrhage within
the right lateral ventricle, left lateral ventricle and fourth ventricle.
There is prominence of the ventricles bilaterally. The temporal [**Doctor Last Name 39**] of the
right lateral ventricle is dilated. There is a small area of hypodensity
within the right cerebellar hemisphere. There is periventricular white matter
low attenuation consistent with chronic microvascular ischemic change. No
extraaxial collections are identified. The osseous structures and visualized
paranasal sinuses are normal.
IMPRESSION: 1. There is a large right thalamic hemorrhage with slight shift of
the normally midline structures to the left. There is interventricular
extension. There is dilatation of the ventricles consistent with non-
communicating hydrocephalus.
2. Probable chronic right cerebellar infarction.
These findings were directly communicated to the clinicians caring for the
patient at the time of the examination.
| 1,830
| null | null |
assess the intracranial hemorrhage
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT
INDICATION: Thalamic hemorrhage assess.
|
There is a 3 cm x 2.5 cm hemorrhage within the right thalamus with surrounding
hypodensity indicating edema with slight shift of the normally midline
structures to the left with extension as interventricular hemorrhage within
the right lateral ventricle, left lateral ventricle and fourth ventricle.
There is prominence of the ventricles bilaterally. The temporal [**Doctor Last Name 39**] of the
right lateral ventricle is dilated. There is a small area of hypodensity
within the right cerebellar hemisphere. There is periventricular white matter
low attenuation consistent with chronic microvascular ischemic change. No
extraaxial collections are identified. The osseous structures and visualized
paranasal sinuses are normal.
|
1. There is a large right thalamic hemorrhage with slight shift of
the normally midline structures to the left. There is interventricular
extension. There is dilatation of the ventricles consistent with non-
communicating hydrocephalus.
2. Probable chronic right cerebellar infarction.
These findings were directly communicated to the clinicians caring for the
patient at the time of the examination.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 18,312
|
9,259
| 748,723
| 24,322
|
[**2158-1-3**] 4:54 PM
CT HEAD W/O CONTRAST Clip # [**Clip Number (Radiology) 39576**]
Reason: ERvaluate for hydrocephalous.Fluctuating level of consciousn
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
80 year old man with intraventricular bleed in lateral ventricles found on CT
at [**Hospital6 **] [**1-1**]. Patient is inattentive, confused but alert.
?intraparenchymal bleed. Also has old right temporal infarct.
Foe reevaluation of the hgh and vent. size.
Ev for hydocephalous.
REASON FOR THIS EXAMINATION:
ERvaluate for hydrocephalous.Fluctuating level of consciousness
______________________________________________________________________________
FINAL REPORT
HISTORY: Inattentive and confused. Intraventricular bleed in lateral
ventricles found on CT scan at [**Hospital6 **].
COMPARISONS: [**2157-12-31**]
TECHNIQUE: Noncontrast head CT.
FINDINGS: Again noted is high attenuation material in the occipital horns of
both lateral ventricles representing hemorrhage. This appearance is unchanged
in the interval since prior exam. The ventricles remain somewhat prominent
relative to cerebral sulci, and are unchanged in the interval. No parenchymal
hemorrhage is seen.
IMPRESSION: Bilateral intraventricular hemorrhage, left greater than right
with prominence of ventricles relative to the cerebral sulci- ? early
commmunicating hydrocephalus. No significant change since prior study. See
previous report for detailed description.
| 1,631
|
Inattentive and confused. Intraventricular bleed in lateral
ventricles found on CT scan at [**Hospital6 **].
|
[**2157-12-31**]
|
ERvaluate for hydrocephalous.Fluctuating level of consciousness
______________________________________________________________________________
FINAL REPORT
|
Again noted is high attenuation material in the occipital horns of
both lateral ventricles representing hemorrhage. This appearance is unchanged
in the interval since prior exam. The ventricles remain somewhat prominent
relative to cerebral sulci, and are unchanged in the interval. No parenchymal
hemorrhage is seen.
|
Bilateral intraventricular hemorrhage, left greater than right
with prominence of ventricles relative to the cerebral sulci- ? early
commmunicating hydrocephalus. No significant change since prior study. See
previous report for detailed description.
|
IMPRESSION
| true
| true
| true
| true
| true
| 5
|
[]
|
OK
| 3,615
|
324,791
| 1,068,413
| 19,590
|
[**2130-4-26**] 12:22 PM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 67564**]
Reason: infiltrate?
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
78 year old man with sob
REASON FOR THIS EXAMINATION:
infiltrate?
______________________________________________________________________________
FINAL REPORT
HISTORY: 78-year-old male with shortness of breath, to assess for a
cardiopulmonary process.
TECHNIQUE: Single portable AP radiograph of the chest was performed.
Comparison is made with prior radiograph of [**2130-1-31**].
FINDINGS:
There is persistent cardiomegaly with prominence of the pulmonary vasculature
and upper lobe diversion. There is no acute focal consolidation.
CONCLUSION:
Overall findings are consistent with mild-to-moderate CHF. Please ensure
followup to clearance.
| 973
|
78-year-old male with shortness of breath, to assess for a
cardiopulmonary process.
| null |
infiltrate?
______________________________________________________________________________
FINAL REPORT
|
There is persistent cardiomegaly with prominence of the pulmonary vasculature
and upper lobe diversion. There is no acute focal consolidation.
|
Overall findings are consistent with mild-to-moderate CHF. Please ensure
followup to clearance.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 166,669
|
324,297
| 1,067,636
| 30,911
|
[**2124-3-24**] 9:55 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 63280**]
Reason: assess for pulmonary edema
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
[**Age over 90 **] year old man with SOB, h/o CHF
REASON FOR THIS EXAMINATION:
assess for pulmonary edema
______________________________________________________________________________
FINAL REPORT
INDICATION: [**Age over 90 **]-year-old male with shortness of breath and history of
congestive heart failure. Assess for pulmonary edema
COMPARISON: [**2124-3-8**].
SINGLE UPRIGHT AP VIEW OF THE CHEST: There has been interval increase in
bilateral pleural effusions and vascular engorgement. There is stable
cardiomegaly. These findings are consistent with congestive heart failure.
Underlying infectious process cannot be excluded. The aorta is tortuous as
before. No pneumothorax is seen.
IMPRESSION: Findings consistent with congestive heart failure with increased
bilateral pleural effusions compared to prior study. Underlying infection
cannot be excluded.
| 1,207
| null |
[**2124-3-8**].
SINGLE UPRIGHT AP VIEW OF THE
|
assess for pulmonary edema
______________________________________________________________________________
FINAL REPORT
INDICATION: [**Age over 90 **]-year-old male with shortness of breath and history of
congestive heart failure. Assess for pulmonary edema
|
There has been interval increase in
bilateral pleural effusions and vascular engorgement. There is stable
cardiomegaly. These findings are consistent with congestive heart failure.
Underlying infectious process cannot be excluded. The aorta is tortuous as
before. No pneumothorax is seen.
|
Findings consistent with congestive heart failure with increased
bilateral pleural effusions compared to prior study. Underlying infection
cannot be excluded.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 166,417
|
387,911
| 1,107,788
| 73,463
|
[**2200-12-14**] 4:38 PM
CHEST (PRE-OP PA & LAT) Clip # [**Clip Number (Radiology) 94982**]
Reason: CHOLELITHIASIS
Admitting Diagnosis: CHOLELITHIASIS
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
84 year old man pre-op for lap chole.
REASON FOR THIS EXAMINATION:
Pre-op CXR.
______________________________________________________________________________
FINAL REPORT
STUDY: Preop AP and lateral chest radiograph, [**2200-12-14**].
HISTORY: 84-year-old man who is preop laparoscopic cholecystectomy.
FINDINGS: Median sternotomy wires are seen. There is coarsening of the
bronchovascular markings which is stable. There is no focal consolidation.
There is some atelectasis at the left base. The PICC line has been removed in
the interim. No pneumothoraces are seen. Aortic valve replacement is seen.
IMPRESSION:
No signs for acute cardiopulmonary process.
| 1,031
|
84-year-old man who is preop laparoscopic cholecystectomy.
| null |
Pre-op CXR.
______________________________________________________________________________
FINAL REPORT
STUDY: Preop AP and lateral chest radiograph, [**2200-12-14**].
|
Median sternotomy wires are seen. There is coarsening of the
bronchovascular markings which is stable. There is no focal consolidation.
There is some atelectasis at the left base. The PICC line has been removed in
the interim. No pneumothoraces are seen. Aortic valve replacement is seen.
|
No signs for acute cardiopulmonary process.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 201,809
|
14,531
| 754,308
| 19,755
|
[**2113-2-10**] 8:14 PM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 55446**]
Reason: Please evaluate ETT tube placement
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
65 year old woman with metastatic colon CA now in respiratory failure s/p
intubation
REASON FOR THIS EXAMINATION:
Please evaluate ETT tube placement
______________________________________________________________________________
FINAL REPORT
INDICATION: ET tube placement.
PORTABLE CHEST: Comparison to earlier film from 11:30 A.M. same day.
There is a new ET tube in place, with tip in satisfactory position,
approximately 2 cm above the carina. There is a peripherally inserted central
venous catheter which has its tip in the region of the SVC. There is a new NG
tube whose tip is not included on this film but is well below the level of the
left hemidiaphragm. The cardiac and mediastinal contours are prominent,
presumably reflecting low lung volumes and portable supine film technique.
Evaluation of the lungs is limited. Minimal streaky increased density in the
right mid chest may reflect plate-like atelectasis. Minimal prominence of
markings in left retrocardiac area may reflect crowding of normal
bronchovascular structures although early parenchymal abnormality here cannot
be excluded and follow up films are recommended. No evidence of pleural
effusion.
IMPRESSION:
1) New ET tube in satisfactory position.
2) NG tube tip below hemidiaphragm.
3) PICC tip in SVC.
4) Low lung volumes.
5) Likely subsegmental atelectasis right mid chest.
6) Minimal patchy increased density in left retrocardiac area; early/limited
parenchymal infiltrate cannot be excluded. Follow up films are recommended.
| 1,872
| null | null |
Please evaluate ETT tube placement
______________________________________________________________________________
FINAL REPORT
INDICATION: ET tube placement.
PORTABLE
|
Comparison to earlier film from 11:30 A.M. same day.
There is a new ET tube in place, with tip in satisfactory position,
approximately 2 cm above the carina. There is a peripherally inserted central
venous catheter which has its tip in the region of the SVC. There is a new NG
tube whose tip is not included on this film but is well below the level of the
left hemidiaphragm. The cardiac and mediastinal contours are prominent,
presumably reflecting low lung volumes and portable supine film technique.
Evaluation of the lungs is limited. Minimal streaky increased density in the
right mid chest may reflect plate-like atelectasis. Minimal prominence of
markings in left retrocardiac area may reflect crowding of normal
bronchovascular structures although early parenchymal abnormality here cannot
be excluded and follow up films are recommended. No evidence of pleural
effusion.
|
1) New ET tube in satisfactory position.
2) NG tube tip below hemidiaphragm.
3) PICC tip in SVC.
4) Low lung volumes.
5) Likely subsegmental atelectasis right mid chest.
6) Minimal patchy increased density in left retrocardiac area; early/limited
parenchymal infiltrate cannot be excluded. Follow up films are recommended.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 5,935
|
37,954
| 774,857
| 5,806
|
[**2156-1-5**] 8:27 AM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 72997**]
Reason: R/O RADIOLOGIC SIGNS OF PNEUMO, WIDENED MEDIASTINUMPT S/P AS
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
56 year old man with
REASON FOR THIS EXAMINATION:
R/O RADIOLOGIC SIGNS OF PNEUMO, WIDENED MEDIASTINUMPT S/P ASYSTOLIC EVENT & CPR
______________________________________________________________________________
FINAL REPORT
INDICATION: Asystolic event with CPR. Question pneumothorax.
COMPARISON: [**2156-1-2**].
FINDINGS: The extreme left base is excluded from the image. The ET tube is
in proper position and NG tube courses in the direction of the stomach. There
is slight left ventricular enlargement and the mediastinum is slightly
widened, but these are probably positional. Diaphragms are elevated
bilaterally. There is slight upper zone redistribution which is likely
postural in nature. The lungs are clear. There are no pleural effusions or
pneumothoraces. The soft tissues are unremarkable.
IMPRESSION: Appropriate ET tube placement. No pneumothorax.
| 1,244
| null |
[**2156-1-2**].
|
R/O RADIOLOGIC SIGNS OF PNEUMO, WIDENED MEDIASTINUMPT S/P ASYSTOLIC EVENT & CPR
______________________________________________________________________________
FINAL REPORT
INDICATION: Asystolic event with CPR. Question pneumothorax.
|
The extreme left base is excluded from the image. The ET tube is
in proper position and NG tube courses in the direction of the stomach. There
is slight left ventricular enlargement and the mediastinum is slightly
widened, but these are probably positional. Diaphragms are elevated
bilaterally. There is slight upper zone redistribution which is likely
postural in nature. The lungs are clear. There are no pleural effusions or
pneumothoraces. The soft tissues are unremarkable.
|
Appropriate ET tube placement. No pneumothorax.
|
IMPRESSION
| true
| true
| false
| true
| true
| 4
|
['history']
|
No History section found
| 17,269
|
38,003
| 773,869
| 10,704
|
[**2144-12-21**] 1:15 PM
CHEST (PORTABLE AP) Clip # [**Clip Number (Radiology) 69882**]
Reason: r/o free air
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
57M trauma pt with sepsis
REASON FOR THIS EXAMINATION:
r/o free air
______________________________________________________________________________
FINAL REPORT
INDICATION: Trauma and left lung collapse.
AP CHEST: Tracheostomy tube lies 4 cm from the carina. The feeding tube loops
on itself, terminating in the upper esophagus; a subsequent CXR from the same
day shows that this has been removed. Lung volumes are low and the right lung
is grossly clear. In comparison to the prior study of [**2144-12-17**] at 2:29 pm,
there is increasing atelectasis of the left lower lobe and lingula. Moderate
shift of the heart and mediastinal structures to the left has occurred.
Respiratory motion and atelectatic lung obscure detail of both hemidiaphragms
making evaluation for free air impossible. Multiple rib fractures along the
left hemithorax are unchanged from prior study.
IMPRESSION: Increasing atelectasis of left lung, with shift of heart and
mediastinum to this side. Feeding tube looped in esophagus. Study is
inadequate to evaluate for free air. Unchanged multiple left-sided rib
fractures.
| 1,428
| null | null |
r/o free air
______________________________________________________________________________
FINAL REPORT
INDICATION: Trauma and left lung collapse.
AP
|
Tracheostomy tube lies 4 cm from the carina. The feeding tube loops
on itself, terminating in the upper esophagus; a subsequent CXR from the same
day shows that this has been removed. Lung volumes are low and the right lung
is grossly clear. In comparison to the prior study of [**2144-12-17**] at 2:29 pm,
there is increasing atelectasis of the left lower lobe and lingula. Moderate
shift of the heart and mediastinal structures to the left has occurred.
Respiratory motion and atelectatic lung obscure detail of both hemidiaphragms
making evaluation for free air impossible. Multiple rib fractures along the
left hemithorax are unchanged from prior study.
|
Increasing atelectasis of left lung, with shift of heart and
mediastinum to this side. Feeding tube looped in esophagus. Study is
inadequate to evaluate for free air. Unchanged multiple left-sided rib
fractures.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 17,301
|
315,032
| 1,051,252
| 8,258
|
[**2116-11-30**] 10:49 AM
ESOPHAGUS Clip # [**Clip Number (Radiology) 23950**]
Reason: eval diverticulum and pharnygoceles
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
75 year old woman with pharyngoceles on Video swallow
REASON FOR THIS EXAMINATION:
eval diverticulum and pharnygoceles
______________________________________________________________________________
FINAL REPORT
HISTORY: Zenkers diverticulum on previous video swallow.
TECHNIQUE: Barium swallow.
FINDINGS: Under rapid imaging, the pharynx was assessed during oral barium
swallow in the lateral and frontal position. This was significant for a
wide-necked Zenker's diverticulum approximately the size of one cervical
vertebral body. The diverticulum failed to empty completely despite repeated
attempts at swallow. There was no penetration or aspiration. Small bilateral
pharyngoceles were seen on frontal views transiently. Double contrast images
of the esophagus showed free passage of oral barium from the esophagus into
the stomach and proximal small bowel with no obstruction or stricture. Primary
peristaltic contractions were normal. There was no hiatal hernia. No mucosal
abnormalities or filling defects in the esophagus were present. Note was made
of tertiary contractures. Limited views of the stomach and proximal small
bowel were unremarkable. There was no gastroesophageal reflux despite
eliciting maneuvers. Ingestion of an oral barium tablet, showed hold-up in
the diverticulum and subsequent passage after repeated water swallows where it
was again transiently held up at the gastroesophageal junction prior to
passing into the stomach.
IMPRESSION:
1) Wide neck Zenker's diverticulum and small bilateral pharyngoceles.
2) Hold up of oral barium tablet in the Zenker's diverticulum where
subsequently it passes with repeated swallows.
| 2,023
|
Zenkers diverticulum on previous video swallow.
| null |
eval diverticulum and pharnygoceles
______________________________________________________________________________
FINAL REPORT
|
Under rapid imaging, the pharynx was assessed during oral barium
swallow in the lateral and frontal position. This was significant for a
wide-necked Zenker's diverticulum approximately the size of one cervical
vertebral body. The diverticulum failed to empty completely despite repeated
attempts at swallow. There was no penetration or aspiration. Small bilateral
pharyngoceles were seen on frontal views transiently. Double contrast images
of the esophagus showed free passage of oral barium from the esophagus into
the stomach and proximal small bowel with no obstruction or stricture. Primary
peristaltic contractions were normal. There was no hiatal hernia. No mucosal
abnormalities or filling defects in the esophagus were present. Note was made
of tertiary contractures. Limited views of the stomach and proximal small
bowel were unremarkable. There was no gastroesophageal reflux despite
eliciting maneuvers. Ingestion of an oral barium tablet, showed hold-up in
the diverticulum and subsequent passage after repeated water swallows where it
was again transiently held up at the gastroesophageal junction prior to
passing into the stomach.
|
1) Wide neck Zenker's diverticulum and small bilateral pharyngoceles.
2) Hold up of oral barium tablet in the Zenker's diverticulum where
subsequently it passes with repeated swallows.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 161,821
|
48,532
| 785,908
| 5,969
|
[**2117-3-27**] 9:33 AM
CT HEAD W/O CONTRAST Clip # [**Clip Number (Radiology) 77818**]
Reason: ?bleed/hydrocephalus
______________________________________________________________________________
[**Hospital 4**] MEDICAL CONDITION:
67 yo woman, R putaminal haemorrhage, worsening bilateral spasticity and
obtundation ?re-bleed/hydrocephalus
REASON FOR THIS EXAMINATION:
?bleed/hydrocephalus
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT (REVISED)
INDICATION: 68 y/o female with history of right putamen hemorrhage and
worsening obtundation. Evaluate for hemorrhage, hydrocephalus.
TECHNIQUE: CT imaging of the brain without contrast enhancement. Comparison
is made to prior studies from [**2117-2-9**] and [**2117-1-27**].
FINDINGS: There is no intra axial or extra axial hemorrhage. The ventricles
and sulci are unchanged in size with no evidence of hydrocephalus. There is an
area of low attenuation in the region of the right thalamus which is
consistent with the patient's history of prior right thalamus hemorrhage.
There is no evidence of intraparenchymal hemorrhage. There is evidence of low
attenuation within the periventricular white matter consistent with chronic
microvascular infarct. There is no evidence of major vascular territorial
infarcts.
Bone windows show no evidence of fracture. There is evidence of a fluid level
within the right sphenoid sinus. The remainder of the visualized paranasal
sinuses are clear.
IMPRESSION:
1) No evidence of intra axial or extra axial hemorrhage or hydrocephalus.
2) Area of low attenuation in the region of right thalamus consistent with
resolution of right sided thalamus hematoma. Low attenuation within the
periventricular white matter consistent with chronic microvascular infarct.
3) Fluid level within the right sphenoid sinus.
4) MRIwith contrastmay be performed to exclude underlying other etiologies, if
clinically warranted.
| 2,097
| null | null |
?bleed/hydrocephalus
No contraindications for IV contrast
______________________________________________________________________________
FINAL REPORT (REVISED)
INDICATION: 68 y/o female with history of right putamen hemorrhage and
worsening obtundation. Evaluate for hemorrhage, hydrocephalus.
|
There is no intra axial or extra axial hemorrhage. The ventricles
and sulci are unchanged in size with no evidence of hydrocephalus. There is an
area of low attenuation in the region of the right thalamus which is
consistent with the patient's history of prior right thalamus hemorrhage.
There is no evidence of intraparenchymal hemorrhage. There is evidence of low
attenuation within the periventricular white matter consistent with chronic
microvascular infarct. There is no evidence of major vascular territorial
infarcts.
Bone windows show no evidence of fracture. There is evidence of a fluid level
within the right sphenoid sinus. The remainder of the visualized paranasal
sinuses are clear.
|
1) No evidence of intra axial or extra axial hemorrhage or hydrocephalus.
2) Area of low attenuation in the region of right thalamus consistent with
resolution of right sided thalamus hematoma. Low attenuation within the
periventricular white matter consistent with chronic microvascular infarct.
3) Fluid level within the right sphenoid sinus.
4) MRIwith contrastmay be performed to exclude underlying other etiologies, if
clinically warranted.
|
IMPRESSION
| true
| true
| false
| false
| true
| 3
|
['history', 'comparison']
|
No History section found; No Comparison section found
| 22,968
|
16,594
| 757,076
| 20,582
|
[**2123-4-13**] 11:43 AM
CHEST (SINGLE VIEW) PORT Clip # [**Clip Number (Radiology) 113790**]
Reason: R basilic picc line placement for IV abx at rehab/home. Plea
______________________________________________________________________________
[**Hospital 2**] MEDICAL CONDITION:
67 year old woman with pneumonia
REASON FOR THIS EXAMINATION:
R basilic picc line placement for IV abx at rehab/home. Please page [**Numeric Identifier 901**] with
wet read ASAP. Thank you.
______________________________________________________________________________
FINAL REPORT
HISTORY: Right-sided PICC line placement. Assess position.
SINGLE VIEW OF THE CHEST: Comparison is made to previous exam of one day
earlier. There has been interval placement of a right-sided PICC, with the
tip overlying the cavoatrial junction. The tip of a left-sided central venous
catheter is unchanged in position. The cardiac silhouette and
mediastinal/hilar contours are stable. There has been slight resolution of the
previously described patchy opacities of the right lung. The left lung is
unchanged. Soft tissues and osseous structures are unremarkable.
IMPRESSION:
1. Tip of right-sided PICC overlying the cavoatrial junction. No
pneumothorax.
2. Slight interval resolution of multiple right-sided patchy lung opacities.
| 1,401
|
Right-sided PICC line placement. Assess position.
SINGLE VIEW OF THE
| null |
R basilic picc line placement for IV abx at rehab/home. Please page [**Numeric Identifier 901**] with
wet read ASAP. Thank you.
______________________________________________________________________________
FINAL REPORT
|
Comparison is made to previous exam of one day
earlier. There has been interval placement of a right-sided PICC, with the
tip overlying the cavoatrial junction. The tip of a left-sided central venous
catheter is unchanged in position. The cardiac silhouette and
mediastinal/hilar contours are stable. There has been slight resolution of the
previously described patchy opacities of the right lung. The left lung is
unchanged. Soft tissues and osseous structures are unremarkable.
|
1. Tip of right-sided PICC overlying the cavoatrial junction. No
pneumothorax.
2. Slight interval resolution of multiple right-sided patchy lung opacities.
|
IMPRESSION
| true
| true
| true
| false
| true
| 4
|
['comparison']
|
No Comparison section found
| 6,918
|
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