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Generate impression based on findings. | Right lower lip adenoid cystic carcinoma. There is enhancement of the right lower lip with soft tissue defect from biopsy. There is no measurable mass. There is no evidence of significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is mild cervical spondylosis with spurring at the left C5-6 level, contributing to moderate left foraminal stenosis. The osseous structures are otherwise unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. There is a mucous retention cyst in the right maxillary sinus. The imaged portions of the lungs are clear. | 1. Asymmetric enhancement of the right lower lip without measurable mass. 2. No evidence of significant cervical lymphadenopathy. |
Generate impression based on findings. | Wound posterior right hand No fracture, dislocation or radiopaque foreign body | No acute abnormality |
Generate impression based on findings. | Kidney stone. Following observations are made given limitations of an unenhanced study.ABDOMEN:LUNG BASES: Moderate coronary artery calcifications.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenic granulomas.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atherosclerotic calcifications. No renal calculi. No evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Ventral bowel hernia containing fat.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Right bypass graft | No evidence of renal calculi. No CT findings to explain left flank pain. |
Generate impression based on findings. | Anemia and tachycardia. Rule out intra-abdominal hemorrhage. The following observations are made given the limitations of an unenhanced study.ABDOMEN:LUNG BASES: Bilateral pleural effusions with overlying compressive-type atelectasis, larger compared to prior. Severe coronary artery calcifications. Moderate pericardial effusion.LIVER, BILIARY TRACT: No significant abnormality noted. Gallstones.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: End-stage kidneys.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bony changes compatible with secondary hyperparathyroidism.OTHER: Moderate ascites with high density fluid predominantly in the left lower quadrant and pelvis compatible with intraperitoneal hemorrhage. Severe arterial calcifications, likely secondary end-stage renal disease.PELVIS:UTERUS, ADNEXA: Status post hysterectomy. Ovaries not visualized.BLADDER: Foley catheter decompresses the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Transplant kidney in the right iliac fossa. | Intraperitoneal hemorrhage predominating in the left lower quadrant and pelvis. End-stage kidneys with findings compatible to renal osteodystrophy. Bilateral pleural effusions with overlying compressive atelectasis. Ascites. Moderate pericardial effusion. |
Generate impression based on findings. | Reason: intracranial bleed/ lesion History: AMS There is encephalomalacia present along the left temporal lobe involving left inferior temporal gyrus and adjacent fusiform gyrus associated with ex vacuo effect. There is redemonstration of a hypodensity in the left pons.Periventricular and subcortical white matter hypodensities of a mild degree are present.There are calcifications present at the the globus pallidi bilaterally. Atherosclerotic calcifications are present along the distal internal carotid arteries.The visualized portions of the paranasal sinuses demonstrate an air fluid level in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. There is medial bowing of the right lamina papyracea suggestive of prior medial blow out fracture.Incidental note is made of hyperostosis frontalis interna. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Encephalomalacia involving the left temporal lobe is suspected to be a result of prior vascular injury3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 4.Opacities in the left maxillary sinus raise the question of acute sinusitis. Please correlate with the patient's clinical history and symptoms.5.Hypodensity in the left pons is suggestive of prior lacunar infarct which is unchanged since prior exams |
Generate impression based on findings. | fall No evidence of acute ischemic or hemorrhagic lesion on this scan.Mild non specific small vessel ischemic disease, no change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion on this scan. |
Generate impression based on findings. | Abdominal pain. Rule-out intra-abdominal process. ABDOMEN:LUNG BASES: Minimal right subsegmental atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: T11 vertebral body segmentation defect.OTHER: Ventral hernia containing colon, nonobstructive.PELVIS:UTERUS, ADNEXA: No significant abnormality noted. Status post hysterectomy. Ovaries appear to be within normal limits for age.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Fluid in the pelvic cul-de-sac. | No definite CT findings to explain abdominal pain. Nonobstructive ventral hernia containing colon. Small amount of fluid in the pelvic cul-de-sac. T11 vertebral body congenital segmentation defect. |
Generate impression based on findings. | left arm numbness No evidence of acute ischemic or hemorrhagic lesion on this scan.Left side craniotomy with surgical clip on the Acom area indicating prior aneurysm clipping, no change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion on this scan.No change of prior surgical clipping on Acom aneurysm since prior exam. |
Generate impression based on findings. | 67 year old male with left groin pain and decreased range or motion. Two views of the left hip show no acute fracture or dislocation. There is mild osteoarthritis with osteophyte formation. | Mild osteoarthritis without evidence of fracture or dislocation. |
Generate impression based on findings. | Reason: r/o ICH, meningitis History: vomiting, HA, neck stiffness There is subarachnoid blood present along the suprasellar cistern and sylvian fissures as well as the prepontine cistern and intrapeduncular cistern with a thicker clocked centered in the intrahemispheric fissure in the anterior communicating artery region..There is sulcal effacement in the presence and the mild ventriculomegaly with mild enlargement of the temporal horns of the lateral ventricles.The visualized portions of the paranasal sinuses demonstrate partial opacification of the maxillary sinuses and to a lesser degree ethmoid air cells and sphenoid sinuses. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Subarachnoid hemorrhage with suspected clot at the region of the anterior communicating artery associated with mild ventriculomegaly. |
Generate impression based on findings. | 30 year old female felt a pop during therapy now with pain and swelling. Four views of the right knee show a comminuted fracture of the distal femur with approximately 1.2 cm of posterior displacement. There is extensive heterotopic bone formation, demineralization, degenerative changes and muscular atrophy compatible with a neuropathic joint.Four views of the left knee show severe degenerative changes and fracture of the proximal tibia with callus formation. There is also a fracture of the proximal fibula with callus formation and heterotopic bone formation. This is also compatible with a neuropathic joint. | Findings compatible with neuropathic joint of the knees bilaterally with multiple fractures. |
Generate impression based on findings. | altered mental status, left pupil bigger than that of the right side Evolving left thalamic ICH demonstrates smaller acute hemorrhagic portion since prior exam. The degree of midline shift appears to be stable (about 13mm) since prior exam.The amount of IVH has significantly reduced since prior exam.The location of the ventriculostomy tip appears to be stable at the level of 3rd ventricle.The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | Left thalamic ICH with mass effects demonstrates interval normal evolution since prior exam.Stable degree of midline shift toward right side since previous exam.Significantly reduced the amount of IVH since prior exam. |
Generate impression based on findings. | Epigastric pain history of pancreatitis ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No pancreatic or peripancreatic inflammation identified there noted to pancreatic edema or pseudoaneurysm. Note that mild pancreatitis may be occult on CT.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Minimal fluid in the pelvic cul-de-sac, possibly physiologic. | No CT findings to explain abdominal pain. No CT evidence of pancreatitis although mild pancreatitis may be occult on imaging. |
Generate impression based on findings. | Female, 33 years old. Obese s/p C-section. Time stamped 13:44 hours, 2/8/2015. Note the examination is limited by body habitus. Given this limitation, no radiopaque foreign objects are seen. Nonobstructive bowel gas pattern. An epidural catheter projects over the upper lumbar spine. | Limited examination without evidence of radiopaque foreign objects. Findings discussed with the attending surgeon, Dr. Boyle, via telephone by Dr. Bennet at 2:06 PM on 2/8/2015. |
Generate impression based on findings. | Reason: presence of aneurysm History: SAH on CT Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.Brain CTA: The right A1 segment is dominant. The left A1 segment is hypoplastic. There is an aneurysm present at the right side of the anterior communicating artery measuring 3 x 2.5 mm in axial dimensions directed towards the left posteriorly and superiorly.There is a 2-mm by 1.5-mm aneurysm present at the anterior communicating artery which is directed anteriorly.There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The posterior communicating arteries are identified and are intact. There right is medium size whereas the left is tiny.CT head:There is subarachnoid blood present along the suprasellar cistern and sylvian fissures as well as the prepontine cistern and intrapeduncular cistern with a thicker clocked centered in the intrahemispheric fissure in the anterior communicating artery region..There is sulcal effacement in the presence and the mild ventriculomegaly with mild enlargement of the temporal horns of the lateral ventricles.The visualized portions of the paranasal sinuses demonstrate partial opacification of the maxillary sinuses and to a lesser degree ethmoid air cells and sphenoid sinuses. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.There is a posteriorly directed 3mm anterior communicating aneurysm present with associated subrachnoid hemorrhage and mild ventriculomegaly. There is an anterior directed 2mm ACOMA aneurysm. The fact that there are two aneurysms present along the anterior communicating artery suggests that the anterior communicating artery may be dysplastic.2.No evidence for cervicocerebral occlusive disease |
Generate impression based on findings. | 85 years, Male. Reason: 85M s/p distal ureterectomy, now with distention and nausea; please assess for ileus History: as above Nephroureteroscopy tube overlies the right hemipelvis. Pelvic drain tip projects over the left hemipelvis. Aortic graft is present. Diffusely gas distended loops of small and large bowel.Degenerative changes with mild levoscoliosis affect the lumbar spine. | Ileus type bowel gas pattern. |
Generate impression based on findings. | 70 year old male with right knee pain. Two views of the right knee show mild degenerative changes with osteophyte formation and sharpening of the tibial spines. No evidence of acute fracture or dislocation. | Mild osteoarthritis without evidence of fracture or dislocation. |
Generate impression based on findings. | 57 year old male with pain. Single stress view of the right ankle shows the aforementioned fracture of the distal fibula with slight lateral translation. Again seen is widening of the medial tibiotalar joint space indicating, deltoid ligamentous injury. Surrounding soft tissue swelling is again noted. | Distal spiral fibular fracture with extension into the joint and widening of the medial talotibial joint space indicating a deltoid ligament injury. |
Generate impression based on findings. | Mental cell lymphoma The following observations are made given the limitations of an unenhanced studyCHEST:LUNGS AND PLEURA: Biapical pleural-based nodules. For reference purposes, the nodule at the left apex measures 3.1 x 2.3 cm (image 11; series 3). Bilateral pulmonary micronodules should be followed.MEDIASTINUM AND HILA: Subcarinal lymph node measures 1.5 x 1.9 cm (image 43; series 3). Mild coronary artery calcificationsCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: End-stage kidneys.RETROPERITONEUM, LYMPH NODES: Ill-defined mass posterior to the liver (image 95; series 3) measures 3.4 x 3.3 cm. Presumed aortocaval adenopathy measures 2.0 x 2.8 cm (image 118; series 3); this can also be vascular (aortic aneurysm) in the proper clinical context and cannot be differentiated from adenopathy on an unenhanced study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: 1.3 x 1.0 cm right common iliac lymph node (image 152; series 3).BOWEL, MESENTERY: Diverticulosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Transplant kidney in right iliac fossa. | Multiple lesions in the chest, abdomen, and pelvis with reference measurements given above. |
Generate impression based on findings. | 57 year old male with pain. Three views of the right ankle and right foot show a distal spiral fibular fracture with extension into the joint. There is overlying soft tissue swelling. There is widening of the medial tibiotalar joint indicating deltoid ligament injury. | Distal spiral fibular fracture with extension into the joint and widening of the medial talotibial joint space indicating a deltoid ligament injury. |
Generate impression based on findings. | altered mental status No evidence of acute ischemic or hemorrhagic lesion on this scan.There are evidence of encephalomalacia on the right frontal and temporal lobes as well as right insular cortex, basal ganglia and thalamus indicating chronic infarction with right ventricular ex vacuo change. No change since prior exam.There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion on this scan.Chronic infarction with encephalomalacia on the right frontal and temporal lobe as well as right insular, basal ganglia and thalamus, no change since prior exam. |
Generate impression based on findings. | 33-year-old female patient with history of abdominal distention. Evaluate for obstruction. Nonobstructive bowel gas pattern. Postsurgical changes again noted in the right upper quadrant. IVC filter noted. | No evidence of bowel obstruction. |
Generate impression based on findings. | Male 31 years old; Reason: evaluate for bowel obstruction vs. ileus History: nausea, emesis, distension sinus to gastric resection and recent umbilical hernia repair. ABDOMEN:LUNG BASES: Mild bibasilar atelectasis.LIVER, BILIARY TRACT: Hepatic steatosis.SPLEEN: Splenomegaly at 15.2 cm.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Caval filter in situ.BOWEL, MESENTERY: Postsurgical changes related to partial gastrectomy. Postsurgical changes relating to recent umbilical hernia repair with this presumably accounting for small foci of free intraperitoneal air. Enteric contrast passes to the mid small bowel without evidence of obstruction. Several loops of mildly distended small and large bowel loops raises the possibility of a mild postoperative ileus.BONES, SOFT TISSUES: Postsurgical changes in the periumbilical region with small amounts of periumbilical fluid.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes related to partial gastrectomy. Postsurgical changes relating to recent umbilical hernia repair with this presumably accounting for small foci of free intraperitoneal air. Enteric contrast passes to the mid small bowel without evidence of obstruction. Several loops of mildly distended small and large bowel loops raises the possibility of a mild postoperative ileus.BONES, SOFT TISSUES: Mild compression deformity of the T10, T11 and T12 vertebral bodies. Screw fixation of the bilateral femoral necks.OTHER: Mild free fluid. | 1. Postsurgical changes relating to recent umbilical hernia repair. Mildly distended small and large bowel loops raises the possibility of a mild postoperative ileus. No evidence of bowel obstruction.2. Diffuse hepatic steatosis with mild splenomegaly. |
Generate impression based on findings. | 59 year old female with right anterolateral foot swelling/redness s/p steroid injection. Three views of the right foot show mild swelling about the dorsum of the foot. There are degenerative changes about the first MTP joint without acute fracture or dislocation. Hallux valgus deformity is noted. | Soft tissue swelling about the dorsum of the foot but no fracture or dislocation. |
Generate impression based on findings. | 76-year-old female with stage IV melanoma. Reevaluate disease status following additional immunotherapy therapy. CHEST:LUNGS AND PLEURA: The reference right lower lobe solid pulmonary nodule (series 5, image 77) measures 1.4 x 0.9 cm, increased from 1.0 x 0.8 cm previously. The reference left lower lobe pulmonary nodule (series 5, image 35) measures 0.4 x 0.6 cm, previously 0.6 x 0.6 cm. The left upper lobe anterior lung nodule and left medial apical lung nodule seen on more remote scans are no longer seen. No new parenchymal lung nodules are identified. No pleural disease.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Bilateral breast prostheses appear similar prior.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy with expected mild biliary ductal prominence. No focal hepatic lesions are identified.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable appearance with small right kidney subcentimeter hypoattenuating lesion (series 4, image 133) too small to characterize. RETROPERITONEUM, LYMPH NODES: Retroperitoneal and gastrohepatic lymphadenopathy appears similar to prior. The reference left para-aortic lymph node (series 4, image 118) measures 1.1 x 1.3 cm, previously 1.3 x 1.4 cm. Moderate atherosclerotic calcifications affect the abdominal aorta and its branchesBOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. No intraperitoneal free air, fluid, or discrete masses. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Left lower abdominal wall cluster of subcutaneous soft tissue nodules has increased in size. The reference nodule (series 4, image 161) measures 3.1 x 1.9 cm, previously 1.4 x 1.8 cm. Additional non-reference subcutaneous nodules have also increased in size, for example in the right gluteal subcutaneous tissue (series 4, image 173). Degenerative changes seen throughout the visualized osseous structures without focal lesions.OTHER: No significant abnormality noted. | 1.Interval progression of disease including increase in size of right lower lobe nodule, increase in size of left lower abdominal wall soft tissue nodules, and increase in size of non-reference right gluteal nodule.2.Additional reference lesions including retroperitoneal lymphadenopathy are similar to prior. |
Generate impression based on findings. | 28 year old female who slammed her finger in the door. Three views of the left index finger show soft tissue swelling and subtle irregularity indicating probable laceration about the dorsal aspect of the distal phalanx. No evidence of foreign body, fracture or dislocation. | Likely laceration of the dorsal aspect of the distal phalanx of the index finger without evidence of foreign body, acute fracture or dislocation. |
Generate impression based on findings. | 57 years, Female. Reason: distension History: distension Percutaneous biliary drain projects over the right hemi-abdomen. Midline surgical staples are present. Air-fluid levels are seen within the stomach with otherwise relative paucity of bowel gas. | Presumed post-operative ileus. |
Generate impression based on findings. | 66-year-old female patient with history of poorly functioning G-tube. G-tube projects over the expected location of the stomach on AP and lateral views. There is enteric contrast in the duodenum and proximal jejunum. Nonobstructive bowel gas pattern.AICD is partially visualized. | Findings compatible with functioning G-tube without evidence of obstruction. |
Generate impression based on findings. | 55 year old female with pain to the mid-humerus Four views of the left shoulder and two views of the left humerus show hardware components of a total reverse shoulder arthroplasty device which is situated in near-anatomic alignment without evidence of complication or loosening. No evidence of fracture or dislocation. Degenerative changes are noted about the shoulder. | Total reverse shoulder arthroplasty device in near-anatomic alignment without evidence of complication, fracture or dislocation. |
Generate impression based on findings. | 11-year-old male with right inferior knee pain.VIEWS: Right knee AP, oblique, lateral (3 views) 2/8/2015 at 1248 No acute fracture or dislocation. Alignment is anatomic. No joint effusion is present. Mild fragmentation of the tibial tuberosity, likely normal variant. | No acute fracture or dislocation. |
Generate impression based on findings. | Female 63 years old; Reason: fx? History: hip pain s/p fall Two views of the right hip show an impaction fracture about the right femoral neck. Single AP view of the pelvis shows no evidence of a pelvis fracture. The aforementioned right femoral neck fracture is again seen. The left hip appears without fracture or dislocation. Degenerative changes of the lower lumbosacral spine and SI joints without evidence of a pelvis fracture. Vascular calcifications are noted in the soft tissues.Two views of the right femur again show the aforementioned right hip fracture. | Mild impaction fracture about the right femur. |
Generate impression based on findings. | 61-year-old male patient with flank pain and constipation. Nonobstructive bowel gas pattern with average stool burden. Radiopaque object projects over the midthoracic spine, compatible with a bullet. Bilateral hip arthroplasties and vascular calcifications noted. | Nonobstructive bowel gas pattern with average stool burden. |
Generate impression based on findings. | 54 year old female with right knee pain. Mild osteoarthritis with medial osteophyte formation and osteophytes at the undersurface of the patella. No evidence of an acute fracture or dislocation. No joint effusion | Mild osteoarthritis without evidence of acute fracture or dislocation. |
Generate impression based on findings. | Ms. Cotten is a 62 year old female recalled from screening mammogram for a focal asymmetry in the far posterior central left breast. An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Spot compression views of the posterior central left breast demonstrate persistence of an ovoid circumscribed mass with benign features. There are no new suspicious microcalcifications or areas of architectural distortion identified in the left breast. LEFT BREAST ULTRASOUND | High probability benign lesion in the posterior central left breast, likely representing a complicated cyst. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended in 6 months to confirm stability of these findings. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Reason: Pretransplant w/u. Please perform ILD protocol. History: Pretransplant w/u LUNGS AND PLEURA: Right lower lobe calcified granuloma. Minimal basal subsegmental atelectasis. No abnormal pulmonary nodules or masses. No focal airspace consolidation. No significant air trapping seen on expiratory images. No pneumothorax or pleural effusions. MEDIASTINUM AND HILA: Cardiomegaly. Post-surgical changes involving the mitral, aortic, and tricuspid valves. Dense calcifications of the aortic arch. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Left chest AICD device. Left arm PICC with tip in the subclavian vein.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Extensive colonic diverticulosis partially visualized. Calcified gallstone. Trace ascites. | No evidence of ILD. |
Generate impression based on findings. | 6-year-old female status post ingestion of penny.VIEW: Chest PA and lateral (two views), Abdomen AP (one view) 2/8/2015 at 1401 Chest: Normal cardiothymic silhouette. No focal pulmonary opacity, pleural effusion, or pneumothorax.Abdomen: Radiopaque foreign body representing swallowed penny overlies the right lower quadrant. Nonobstructive bowel gas pattern. No pneumatosis, free air, or portal venous gas. | 1.Swallowed penny overlies the right lower quadrant. No further radiologic follow-up is recommended unless clinically indicated.2.Normal chest radiograph. |
Generate impression based on findings. | 36 year old female right heel pain Three views of the right ankle show soft tissue swelling about the plantar aspect of the heel without underlying osseous abnormality or radiopaque foreign body. | Soft tissue swelling without evidence of acute fracture or radiopaque foreign body of the right heel. |
Generate impression based on findings. | Respiratory failure. Tachypnea.VIEW: Chest AP (one view) 2/9/15 at 508 hours. ET tube tip is at the thoracic inlet. Spinal rods residual thoracolumbar dextroscoliosis unchanged. Right IJ venous access tip is likely at the SVC. Right upper extremity PICC tip is at the right atrium. A drain type catheter overlies the right upper abdominal quadrant.Cardiac silhouette size is normal. Biphasic streaky opacities, likely subsegmental atelectasis unchanged. No effusions or pneumothorax. | Persistent bibasilar opacities as described. |
Generate impression based on findings. | 19 year old male with elbow pain. Patient was hit by a car while riding a bike. Four views of the left elbow show no evidence of acute fracture or dislocation. No evidence of joint effusion.Two views of the left humerus show no evidence of fracture or dislocation of the shoulder or elbow.Four views of the left knee show no evidence of a fracture or dislocation. No joint effusion. | No evidence of a fracture or dislocation of the left elbow, left humerus or left knee. |
Generate impression based on findings. | Unspecified fallClinical question: eval for ICHSigns and Symptoms: fall The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin. Incidental note is made of hyperostosis frontalis interna. Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries. Calcifications are present along the falx cerebri. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Female 22 years old; Reason: abdominal pain, eval shunt catheter History: abdominal pain, eval shunt catheter The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: Mild left basal atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate non obstructing right renal calculus.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Gastrojejunostomy tube in situ with the tip in the proximal jejunum.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Right ventral abdominal wall access ventriculoperitoneal shunt in situ with tip in the pelvis, repositioned since prior CT and with expected trace ascites in the pelvis.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Above average stool burden within the large bowel.BONES, SOFT TISSUES: Subcutaneous stimulator with electrodes entering via a left sacral foramen. This is unchanged in position.OTHER: No significant abnormality noted. | 1.Visualized portions of the shunt catheter are intact terminating in the pelvis. No specific cause for patient's abdominal pain is identified. |
Generate impression based on findings. | Female 30 years old; Reason: r/o stone History: RIght CVA tenderness The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild right hydroureter with minimal right hydronephrosis. There is associated right perinephric stranding. No renal, ureteric or bladder stone.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Mild right hydronephrosis and hydroureter with associated perinephric stranding. No stone is identified within the collecting system. The appearance is suggestive of a passed stone. Pyelonephritis could have a similar appearance however this is felt less likely. |
Generate impression based on findings. | Knee pain status post fall RIGHT HIP: Mild osteoarthritis of the right hip. No fracture or malalignment.RIGHT KNEE: Severe osteoarthritis of the right knee. No fracture or malalignment. | Osteoarthritis, without fracture. |
Generate impression based on findings. | Coronary atherosclerosis. Previous head and neck radiation. Preop. Dr. Balky wants arch vessels and internal mammary artery looked at. Abnormal carotid ultrasound. CHEST:LUNGS AND PLEURA: New spiculated right apical nodule measuring 1.4 x 1.6 cm (image 17; series 4); primary lung carcinoma versus metastases. Nodule at the right lung base (image 73) measures 4.3 x 2.5 cm. Bilateral pleural effusions.MEDIASTINUM AND HILA: Atherosclerosis of the aorta. The ascending aorta measures 3.9 cm in diameter and the descending thoracic aorta measures 2.5 cm in diameter (image 44; series 8). Moderate coronary artery calcifications. Aortic valvular calcifications. New enlarged mediastinal lymph nodes. For reference purposes, a pre-carinal lymph node measures 2.7 x 1.8 cm (image 37; series 8). The great vessels are patent although there is a moderate to high-grade stenosis of the left subclavian artery (image 18). With regard to the clinical query, both internal mammary arteries are widely patent.CHEST WALL: No significant abnormality notedUPPER ABDOMEN: High-grade SMA stenosis. The celiac axis is widely patent. Correlate with clinical symptoms. Splenic granulomata. | 1. New right lung pulmonary nodules; metastases versus primary lung carcinoma. Dr. Balky was notified of this finding at the time of dictation. Bilateral pleural effusions.2. New mediastinal lymphadenopathy.3. Moderate to severe left subclavian artery stenosis. Internal mammary arteries are widely patent although the left subclavian stenosis is proximal to the left IMA. 4. High-grade SMA stenosis; correlate with symptoms of chronic mesenteric ischemia. |
Generate impression based on findings. | Reason: CVA History: HA; episode of dysarthria The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Incidental note is made of hyperostosis frontalis interna. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Pupils non reactive, Cheyne-Stoke breathing, and not responding to sternal rub. Evaluate for stroke. There is no evidence of intracranial hemorrhage. There are scattered punctate areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with mild chronic small vessel ischemic changes. There is a focal hypoattenuation in the right basal ganglia, which is age-indeterminate. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is debris in the left sphenoid sinus. The other imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No acute intracranial abnormality. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern, MRI of the brain is recommended. |
Generate impression based on findings. | Reason: iph History: as above There is a redemonstration of a hematoma centered in the left thalamus associated with intraventricular blood. Since the prior exam the density of the intraparenchymal hematoma has decreased as has the density of the intraventricular blood. Overall there is less blood in the lateral ventricles on the current exam versus the prior.The temporal horns of the lateral ventricles are dilated but not substantially changed since the prior.There are periventricular white matter hypodensities present.Since the prior exam the patient has developed a right-sided subdural effusion which is approximately 6 mm in thickness.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Atherosclerotic calcifications are present along the distal internal carotid arteries. | 1.There is a right-sided subdural effusion which has developed since the prior exam .2.Continued evolution of a left thalamic and brainstem hematoma associated with intraventricular blood. |
Generate impression based on findings. | Cardiac dysfunction. Intubated.VIEW: Chest AP (one view) 02/09/15, 0516 Endotracheal tube tip is below thoracic inlet. Two feeding tubes are present. One has its tip in fundus and the other in body. Right internal jugular line tip is at junction of superior vena cava and right atrium.Cardiothymic silhouette is mildly enlarged. Focal opacity in left lower lobe persists. No other focal opacity is identified. | Persistent left lower lobe opacity. This may be atelectasis or pneumonia. |
Generate impression based on findings. | Status post fall with frontal hematoma. There is a small left frontal scalp hematoma. There is no evidence of intracranial hemorrhage or depressed calvarial fracture. The ventricles and sulci are prominent, consistent with mild age-related volume loss. There are scattered punctate areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with mild age-indeterminate small vessel ischemic changes. The basal cisterns are patent. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. | 1. Small left frontal scalp hematoma. No evidence of intracranial hemorrhage or depressed calvarial fracture.2. Mild age-indeterminate small vessel ischemic changes. |
Generate impression based on findings. | There is a background of scattered patchy periventricular and subcortical white matter T2 hyperintensities with a more conspicuous pattern of gyriform T2 hyperintensity involving the superior frontal gyri and cingulate gyri. The bilateral medial temporal lobes are symmetric. There is a small cortical defect at the right superior temporal gyrus, which likely represents a prior ischemic lesion.The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There is no diffusion abnormality. No blood sensitive sequence is available, but there is no gross intracranial hemorrhage. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is near complete opacification of the right maxillary sinus and moderate mucosal thickening of the bilateral ethmoid and sphenoid sinuses. There is near complete opacification of the right and partial opacification of the left mastoid air cells. | 1. Scattered patchy periventricular and subcortical white matter signal abnormalities with a more conspicuous pattern of gyriform T2 hyperintensities in the superior frontal and cingulate gyri. Findings are of uncertain etiology, but may reflect sequela of prior ischemic injury, vasculitis, or a PRES-like phenomenon. Infection is felt to be less likely, but cannot be entirely excluded.2. Cortical defect at the right superior temporal gyrus, likely represents a chronic ischemic lesion.3. Extensive paranasal sinus disease.4. Near complete opacification of the right and partial opacification of the left mastoids. |
Generate impression based on findings. | 11-week-old former 27 week gestational age patient with atelectasis and history of pleural effusion.VIEW: Chest AP (one view) 02/09/15, 0608 Endotracheal tube tip is between thoracic inlet and carina. Feeding tube has its side port at GE junction.Soft tissue edema persists.A small to moderate left pleural effusion is present. Coarse lung opacities from chronic lung disease persists. Focal opacities are seen in both bases. Cardiothymic silhouette is upper limits of normal to mildly enlarged. | Increase in left pleural effusion. |
Generate impression based on findings. | 9-year-old male with development of hypoxemia. Please assess ET tube.VIEW: Chest AP (one view) 2/9/2015 0525 ET tube tip at the level of the carina. Feeding tube tip in gastric body. Left central venous catheter tip in superior vena cava. Right upper extremity PICC tip at the junction of the right brachiocephalic vein and superior vena cava.Upper normal cardiac silhouette is unchanged. Persistent bilateral pleural effusions and basilar opacities suggestive of pulmonary edema, right greater than left. Retrocardiac atelectasis is again noted. | 1.ET tube tip at the level of the carina.2.Persistent retrocardiac atelectasis and pulmonary edema pattern. |
Generate impression based on findings. | Exam is limited by patient motion. The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified. Normal flow-voids are demonstrated in the major intracranial vascular structures. There are no abnormal enhancing lesions. The mesial temporal lobes and fornices are symmetric. There is no evidence of cortical dysplasia or heterotopic grey matter. | Exam is limited by patient motion. Given this caveat, unremarkable exam with no findings to explain the patient's symptoms. |
Generate impression based on findings. | 9-year-old male status post NG tube placement.VIEW: Chest AP (one view) 2/8/2015 1451 ET tube tip between the thoracic inlet and carina. Feeding tube tip in gastric body. Left central venous catheter tip in the superior vena cava. Right upper extremity PICC tip at the junction of the right brachiocephalic vein and superior vena cava.Upper normal cardiac silhouette is unchanged. Bilateral pleural effusions and basilar opacities suggestive of pulmonary edema, slightly worsened on the right. Retrocardiac atelectasis is again noted. | 1.Feeding tube tip in gastric body.2.Persistent retrocardiac atelectasis and slightly worsened pulmonary edema pattern. |
Generate impression based on findings. | RSV bronchiolitis and right-sided atelectasis.VIEW: Chest AP (one view) 02/09/15, 0540 Feeding tube tip is in first portion of duodenum.Right middle lobe atelectasis is present. Right upper lobe has reexpanded. Subsegmental atelectasis continues in right lower lobe. Left lung herniates across the midline. Lung volumes are large. Cardiothymic silhouette is normal. | Wandering atelectasis on a background of bronchiolitis. |
Generate impression based on findings. | There is a small retention cyst in the left maxillary sinus, unchanged. There is mildly worsened opacification right sphenoid sinus and a small stable retention cyst in the left sphenoid sinus. There are no bubbly secretions or air-fluid levels in the paranasal sinuses. There is minimal left mastoid air cell opacification again seen with a resolved opacification of the right mastoid air cells. The imaged intracranial structures are within normal limits. | Mild chronic sinus findings as detailed above with no evidence of acute sinusitis. There is complete opacification of the right sphenoid sinus which is worsened from prior exam. Resolved right mastoid air cell opacification. Other findings are grossly stable. |
Generate impression based on findings. | Female 87 years old; Reason: pain with ambulation. Acute onset. Assess for etiology. Mild osteoarthritis. No fracture or malalignment. Pellegrini-Stieda lesion noted, indicating prior MCL injury. | Osteoarthritis, without fracture. |
Generate impression based on findings. | Pericardial and pleural effusions.VIEW: Chest AP (one view) 2/9/15 at 535 hours. Central line terminates at the RA/SVC junction. Left-sided chest drain and pericardial catheter are again noted. Cardiac silhouette size is enlarged, likely due to residual pericardial effusion. Left lower lobe opacity on underlying poor effusion unchanged. | No change in residual pericardial effusion, and coronal opacity and underlying pleural effusion. |
Generate impression based on findings. | Reason: please compare to previous, specifically the subdural hygroma History: AMS, seizures, ICPH There is redemonstration of a 16 x 10 mm hematoma centered in the left superior frontal gyrus which appears stable when compared to the previous exam. There is redemonstration of bilateral subdural effusions measuring 11 mm on the left hand 8 mm on the right. These are slightly larger on the current exam compared to the prior where they measured 10 and 5 mm respectively and with Subarachnoid hyperdensities adjacent to the right temporal lobe have decreased in density compared to the prior exam.Subdural effusions in the posterior fossa are stable.There is redemonstration of small hypodense foci in the thalami bilaterally and to a lesser degree basal ganglia Atherosclerotic calcifications are present along the distal vertebral arteries. Atherosclerotic calcifications are present along the distal internal carotid arteries.Periventricular and subcortical white matter hypodensities of a mild degree are present.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Bilateral subdural effusions are mildly enlarged when compared to the prior exam 2.Stable intraparenchymal hemorrhage in the left temporal lobe with continued evolution.3.Evolution of subarachnoid blood products in the right temporal lobe4.Redemonstration of old lacunar infarcts in the thalami and basal ganglia5.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | Left knee and hip pain LEFT HIP: Total hip arthroplasty device in anatomic alignment, without radiographic evidence of hardware complication. No fracture or malalignment.LEFT KNEE: Mild osteoarthritis. No fracture of malalignment. No joint effusion evident. | No fracture or malalignment. |
Generate impression based on findings. | 74-year-old female with right lower extremity weakness since yesterday. Evaluate for stroke or bleed. No CT evidence of acute large territorial ischemia. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild cerebral volume loss evidenced by sulcal and ventricular system prominence. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. | No acute intracranial hemorrhage or CT evidence of ischemia. If there is high clinical suspicion for ischemia, further evaluation with MRI is recommended. |
Generate impression based on findings. | 52 years, Male. Reason: Dobbhoff placement History: as above Bilateral percutaneous nephrostomy tubes are again noted. Dobbhoff tube tip projects over the gastric fundus with guidewire partially retracted.Nonspecific bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tip projects over the gastric fundus. |
Generate impression based on findings. | Pain RIGHT HIP: No fracture or malalignment. RIGHT FEMUR: No fracture or malalignment. No osseous lesions evident.RIGHT KNEE: No fracture or malalignment. Subcentimeter tibial enostosis noted. No knee joint effusion evident. | No fracture or malalignment. |
Generate impression based on findings. | 65 years, Female. Reason: eval ng History: Dobbhoff placement Spinal fixation hardware and intervertebral disk spacers are again noted. Common bile duct stent is present. Dobbhoff tube tip projects over the gastric antrum. Bibasilar opacities better evaluated on prior radiograph.Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tip projects over the gastric antrum. |
Generate impression based on findings. | Status post fracture.VIEWS: Right first finger AP and lateral 2/9/15 (two views) No acute or healing fracture noted. Normal alignment. No soft tissue swelling or joint effusion. | Normal examination. |
Generate impression based on findings. | 2-year-old female with pain in left wrist.VIEWS: Left wrist AP, oblique, lateral (3 views) , Left elbow AP, oblique, lateral (3 views) 2/8/2015 at 1600 Elbow: No acute fracture or dislocation. No evidence of elbow joint effusion.Wrist: No acute fracture or dislocation. Alignment is anatomic. | Normal examination of the left wrist and elbow. |
Generate impression based on findings. | 23-year-old female status post gastric bypass surgery, Roux-en-Y (2007) with weight gain for the past year Scout radiograph of the abdomen showed a nonobstructive bowel gas pattern. Cholecystectomy clips are in the right upper quadrant.Single contrast evaluation of the esophagus and gastric cardia/fundus revealed postoperative changes of a Roux-en-Y gastric bypass surgery. No strictures or fistulas were identified. Rapid transit of contrast from the gastric pouch into the small bowel was noted. The gastric pouch measures approximately 3.5 x 2.7 cm. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave.TOTAL FLUOROSCOPY TIME: 2:38 minutes | Rapid transit of contrast from gastric pouch into small bowel. No evidence of gasto-gastric fistula. |
Generate impression based on findings. | Reason: r/o PE History: tachycardia, cough, hypoxia, h/o ILD PULMONARY ARTERIES: No evidence of an acute pulmonary embolus.LUNGS AND PLEURA: There is redemonstration of extensive diffuse peripheral honeycombing and traction bronchiectasis. Increasing multifocal subpleural areas of consolidation are suggestive of organizing pneumonia as well as chronic aspiration/infection.No pleural effusions.MEDIASTINUM AND HILA: Stable mildly prominent scattered mediastinal lymph nodes without definite lymphadenopathy.There is mild cardiac enlargement with interval increasing size of a small pericardial effusion.CHEST WALL: Mild degenerative changes throughout the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. Status post cholecystectomy. | 1.No evidence of an acute pulmonary embolus.2.Extensive interstitial fibrotic changes in an atypical UIP pattern there is only related this patient's underlying scleroderma. These have progressed over the last two exams dated 5/1714 and 6/27/14.3.Increasing subpleural areas of consolidation suggestive of organizing pneumonia and may be related to chronic aspiration and/or infection.4.Small pericardial effusion mildly increased in size since the prior exam.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Fracture partially seen on chest radiograph. Proximal humeral diaphyseal fracture with increased callus formation and unchanged deformity. No new fracture or malalignment. | Healed proximal humeral diaphyseal fracture. |
Generate impression based on findings. | Reason: Hx copd now for lung transplant evaluation History: sob LUNGS AND PLEURA: Severe emphysema is seen throughout the lungs. No consolidation or pleural effusion. No air trapping is seen on expiratory phase imaging. Debris is noted in the trachea.MEDIASTINUM AND HILA: Incidental note is made of a common origin of the right brachiocephalic and left common carotid arteries, and normal variant. No mediastinal or hilar lymphadenopathy is seen. The heart is normal in size and there is no pericardial effusion. Mild coronary artery calcifications are present.CHEST WALL: No axillary lymphadenopathy is seen.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Nodularity of the adrenal glands, left greater than right, is unchanged from the prior study. | Severe emphysema compatible with given diagnosis of COPD. |
Generate impression based on findings. | Reason: history of RCC with mets, complaining of shoulder pain History: right scapular pain LUNGS AND PLEURA: Stable to slightly increased size of diffuse pulmonary metastases, with the reference left upper lobe nodule measuring 1.5 x 1.3 cm (series 7, image 24), previously measuring 1.4 x 1.2 cm. No new lesions are definitively seen. New areas of consolidation in the right upper and middle lobes are likely post-obstructive.MEDIASTINUM AND HILA: Stable appearance of the conglomerate right paratracheal lymph nodes, measuring 4.0 x 5.1 cm (series 5, image 19), unchanged. Additional non-reference lymph nodes appear similar to the prior exam. CHEST WALL: Soft tissue nodule in the right breast now measures 2.2 x 2.0 cm (series 5 and image 27), previously measuring 1.3 x 1.2 cm. Additional soft tissue nodules within the left breast (series 5, image 32) not definitively seen on the prior CT examination. Two new 1-2-cm soft tissue nodules in the subcutaneous tissue superficial to the right scapula are new (progressed from one punctate soft tissue nodule, previously too small to characterize) from the prior exam (image 36/88). Findings compatible with progression of additional metastatic disease. Unchanged degenerative disease of the thoracic spine. No new focal osseous lesions are seen.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Probably increase in size of liver lesions though these are only partially visualized. | 1. No evidence of osseous metastases though there are two new 1-2 cm soft tissue nodules in the subcutaneous tissue superficial to the right scapula. These findings are compatible with progression of additional metastatic disease2. New and increased soft tissue nodules in the bilateral breasts.3. Stable to slightly increased pulmonary and mediastinal metastases, with increased post-obstructive consolidation in the right upper and middle lobes. |
Generate impression based on findings. | Fusion A posterior stabilization device is in place with left pedicle screws entering the L3, L4, and L5 vertebrae and right pedicle screws entering the L3 and L4 vertebrae. A fractured right pedicle screw is present at L5, likely from prior hardware. Bone graft material is noted in the L3/4 disk space.Mild levoscoliosis of the lumbar spine again noted. Partial sacralization of L5 with hypertrophy of the left transverse process is similar to prior. | Postoperative changes as described above. |
Generate impression based on findings. | Female; 84 years old. Reason: Gallstones, Gallbladder distention, evaluation for Cholecystostomy History: OSH transfer for septic shock GALLBLADDER, BILIARY TRACT: The gallbladder wall measures 3 intake my mm. There is no pericholecystic fluid. The common bile duct measures 4 mm. A small shadowing stone is redemonstrated in the gallbladder neck. | Small shadowing stone in the gallbladder neck with no evidence of acute cholecystitis. Given the patient's persistent pain, MRI/MRCP is recommended. |
Generate impression based on findings. | Reason: h/o larynx cancer History: r/o chest mets LUNGS AND PLEURA: Tracheostomy tube is seen in place. Large right apical bullae and fibrosis is unchanged from the prior study. No consolidation or pleural effusion is present. Right middle lobe and right basilar lung scarring is unchanged. No suspicious pulmonary nodule or mass is identified.MEDIASTINUM AND HILA: An enlarged right lower cervical lymph node is seen. Please see dedicated CT soft tissue neck report for further details. Right port catheter is seen in place with its tip at the cavoatrial junction. There is no mediastinal or hilar lymphadenopathy. The heart is normal in size and there is no pericardial effusion. No coronary artery calcifications are seen.CHEST WALL: Posterior spinal fixation device and multilevel laminectomies are seen the lower cervical and thoracic spine, unchanged from the prior study. Right-sided rib resections of the third and sixth ribs are again noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Gastrostomy tube is partially visualized. Small left renal cyst is unchanged. Nonspecific subcentimeter left liver hypodensity is unchanged. | No evidence of pulmonary metastases. No change in right apical bullae/scarring. |
Generate impression based on findings. | Ms. Vellender is a 54 year old female with a personal history of right breast lumpectomy in 2011 for IDC followed by radiation and tamoxifen therapy. Personal history of benign right breast MR-guided biopsy. She has no current breast related complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the right breast. There are stable postsurgical changes including architectural distortion, increased density, and surgical clips present within the right lumpectomy site. Coarse dystrophic calcifications have developed in a benign fashion in the lumpectomy site. Percutaneously placed clip in the superior right breast is stable, from prior benign MR-guided biopsy.There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Postsurgical changes of the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | ORIF Interval plate and screw fixation of the fracture through the posterior aspect of the right mandibular body/right mandibular angle, in anatomic alignment. The fracture through the left mandibular body remains nondisplaced. The patient is edentulous. Temporomandibular joint alignment appears normal. | Mandibular fractures with right mandibular fracture fixation. |
Generate impression based on findings. | Headache. An intraspinal shunt device is seen, exiting at the C1/2 level. The shunt catheter coils over the right lateral aspect of the occiput and courses inferiorly off of the field of view. There is no kink or discontinuity in the radiopaque portions of the shunt catheter. A valve is noted, with setting to be interpreted by the clinical service. Additional U-shaped tubing projecting over the upper cervical spine may represent an orphaned shunt catheter. | Shunt catheter as described above. |
Generate impression based on findings. | PHARYNX/LARYNX: The left arytenoid cartilage is rotated and sclerotic which also includes sclerosis of the left thyroid cartilage, correlating with the location of the patient's known malignancy. There is fairly significant soft tissue asymmetry including the pyriform sinus, false cords, and true cords with loss of paraglottic fat on the left, but no discrete soft tissue mass or pathologic enhancement. GLANDS: The postcontrast appearance of the salivary glands is unremarkable. The thyroid gland is unremarkable. ORAL CAVITY: The oral tongue and floor of mouth are unremarkable, within the limitations of this exam as there is artifact from dental amalgam.CERVICAL SOFT TISSUES: There are scattered small cervical lymph nodes, none pathologically enlarged by size criteria. Compared with the prior study from 2013, a left submandibular lymph node is decreased in size now measuring 6 mm in short axis (series 4 image 137), previously 9 mm. OTHER: Pulmonary groundglass opacities likely reflect phase of respiration. Somewhat patulous upper esophagus. | 1. Rotated and sclerotic left arytenoid cartilage involving the left thyroid cartilage correlates with the location of the patient's biopsy proven and resected malignancy. Soft tissue asymmetry of the pyriform sinus, false cords, and true cords likely reflects postoperative changes. 2. No discrete soft tissue mass, pathologic enhancement, or lymphadenopathy. |
Generate impression based on findings. | No CT evidence of acute large territorial ischemia. Very small region of hyperdensity in the region of the left MCA precentral branch (series 4, image 14). No evidence of acute intracranial hemorrhage. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There are no extraaxial fluid collections or subdural hematomas. Mastoid air cells are clear. Moderate opacification of the left maxillary sinus. | No CT evidence of acute territorial ischemia with a nonspecific small hyperdense focus in left MCA precentral branch. An MRI exam has been obtained at the time of this dictation. Please refer to that report for further details. |
Generate impression based on findings. | Reason: evaluation for LVAD History: History of asthma and COPD LUNGS AND PLEURA: Mild bronchial/bronchiolar wall thickening with the diffuse centrilobular groundglass opacities compatible bronchiolitis.No focal areas of consolidation.No pleural effusions.Minimal scarring/discoid atelectasis at the lung bases.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Left-sided ICD with lead wires in the right atrial appendage and right ventricle.Right IJ Swan-Ganz with its tip in the pulmonary artery.Moderate cardiac enlargement without evidence of a pericardial effusion.Moderate coronary artery calcification.CHEST WALL: Degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Mild bronchial/bronchiolar wall thickening and centrilobular groundglass opacities compatible with bronchiolitis and/or reactive airway disease.. No evidence of pulmonary edema or pleural effusions. |
Generate impression based on findings. | Fall, hip pain Surgical staples, drain, and skin staples noted in the upper right thigh, reflecting recent surgery.No fracture or malalignment of the right hip. | No fracture or malalignment. |
Generate impression based on findings. | There are unchanged postoperative findings related to left parotid resection with no locoregional tumor recurrence or significant cervical lymphadenopathy. The thyroid and remaining major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unchanged with cervical degenerative changes. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | Stable postoperative findings with no locoregional tumor recurrence or significant cervical lymphadenopathy. |
Generate impression based on findings. | 88 year-old male with dizziness and right leg weakness. Evaluate for stenosis or occlusion. HEAD:There is hyperdense focus in the expected location of a small precentral branch of left MCA. No CT evidence of acute large territorial ischemia. Patchy periventricular hypodensities consistent with age indeterminate small vessel ischemic disease. No evidence of acute intracranial hemorrhage. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There are no extraaxial fluid collections or subdural hematomas. Mastoid air cells are clear. Moderate opacification of the left maxillary sinus. CTA NECK:The aortic arch origins of the right brachiocephalic, left common carotid, and left subclavian arteries are normal. The bilateral vertebral artery origins are normal. There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. Mild atherosclerotic calcifications at the common carotid bifurcation bilaterally.Incidentally noted, extensive ossification of the posterior longitudinal ligament as well as diffuse idiopathic skeletal hyperostosis resulting in mild to moderate cervical spinal canal stenosis. Additionally, there is narrowing of the neural foramina at C3/4 and C4/5.CTA HEAD:Normal contrast opacification is present through bilateral petrous/cavernous/supraclinoid internal carotid arteries, anterior cerebral arteries, and the right middle cerebral artery. Fenestration of the distal right A1 segment is present. Precentral branch of left MCA does not opacify.). Posterior circulation (vertebral-basilar, superior cerebellar, and posterior cerebral arteries) and distal intracranial vasculature demonstrate normal contrast opacification. Dimunitive P1 segment of left posterior cerebral artery with bilateral fetal origins of the posterior communicating arteries. There is no evidence of dissection or vascular malformation.The superficial and deep intracranial venous drainage is unremarkable. | 1.Lack of opacification of left MCA pre-central M3 branch raises suspicion of complete or partial occlusion. Subsequent MRI examination demonstrates evidence of acute to subacute ischemic injury. Please refer to MRI examination report for further details.2.Extensive OPLL and DISH of the cervical spine resulting in mild to moderate central spinal canal stenosis as well as neural formina narrowing as above. |
Generate impression based on findings. | fall 2 days, prior on aspirin There is focal low attenuation on the right putamen which indicate age indeterminate likely subacute or older ischemic infarction. On the posterior aspect of the lesion, there is focal subtle increased attenuation (series 5, image 14/27) which may indicate possible petechial hemorrhage. Further evaluation with brain MRI can be considered if clinically indicated.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | 1. Low attenuation lesion on the right putamen suggest age indeterminate ischemic infarction. Focal increase attenuation posterior aspect of the lesion may indicate possible focal petechial hemorrhage. 2. Brain MRI can be considered for further evaluation if clinically indicated. The findings were discussed with ER attending at the time of this dictation. |
Generate impression based on findings. | Reason: LUQ abdominal pain, Chest pain, History: as above CHEST:LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules are present. No consolidation or pleural effusion is noted.MEDIASTINUM AND HILA: Residual thymic tissue is present. No mediastinal hilar lymphadenopathy seen. The heart is normal in size and there is no pericardial effusion. No coronary artery calcifications are present.CHEST WALL: No axillary lymphadenopathy.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Accessory spleens are seen medial to the spleen.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypodense left renal lesion is incompletely characterized, however likely represents a cyst. No hydronephrosis.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No bowel obstruction or free intraperitoneal air. The appendix is normal.BONES, SOFT TISSUES: No significant abnormality noted. | No evidence of pneumonia. No findings to account for the patient's symptoms. |
Generate impression based on findings. | Intubated. Respiratory insufficiency.VIEW: Chest AP (one view) 02/09/15, 0447 Endotracheal tube tip is at carina. Lung volumes are large. Subsegmental atelectasis is present in left lower lobe. Cardiothymic silhouette is normal. | Subsegmental atelectasis in left lower lobe persists. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Bilateral apical fibrotic changes related to prior radiation.The large amounts of mucus and debris within the right central and lower lobe bronchi.Increasing subpleural consolidation/atelectasis in tree in bud opacities and right lower lobe compatible with chronic aspiration.No suspicious pulmonary nodules or masses.Small right pleural effusion.MEDIASTINUM AND HILA: Stable prominent precarinal lymph node (image 41 series 3) measuring 11 mm in its short axis.Prominent right paratracheal and subcarinal lymph nodes are unchanged.Cardiac size is normal without evidence of a pericardial effusion.Moderate coronary artery calcification.CHEST WALL: Degenerative changes in the thoracic spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.G-tube in place.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evidence of metastatic disease.2.Increasing right bronchial debris with progression of right lower lobe aspiration bronchiolitis and subpleural areas of consolidation/atelectasis compatible with chronic aspiration pneumonia.3.New small right pleural effusion . |
Generate impression based on findings. | Female 16 years old Reason: pain VIEWS: Right wrist AP and lateral 2/9/15 (two views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 66 years, Female. Reason: ro obstruction History: abd pain Spinal fixation hardware and intravertebral disk spacers are present.Mildly distended loops of small and large bowel in ileus type bowel gas pattern. | Ileus type bowel gas pattern. |
Generate impression based on findings. | History of smoking, lung cancer screening LUNGS AND PLEURA: Mild upper lobe predominant centrilobular emphysema is present. No suspicious pulmonary nodule or mass is identified.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is seen. The heart is normal in size and there is no pericardial effusion. Mild coronary artery calcifications are seen with left anterior descending coronary stent in place.CHEST WALL: No axillary lymphadenopathy. Healed left 11th and 12th rib fractures again noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Hypodense liver lesions, largest of which is seen in the left liver, have not significantly changed from prior studies and likely represents cysts. Small hiatal hernia is present. | Mild upper lobe predominant emphysema without suspicious pulmonary nodule or mass. |
Generate impression based on findings. | 43 day old former twin 27 to 28 week gestational age patientVIEW: Chest AP (one view) 02/09/15, 0553 Feeding tube tip is distal to GE junction and not included on image.Cardiothymic silhouette is normal. Hazy lung opacities persist. Lung volumes are large. | Continued hazy lung opacities. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 38 years old; Reason: pelvic pain and fever History: pelvic pain and fever ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal morphology. No suspicious hepatic lesions. Hepatic and portal veins are patent. Gallbladder and biliary tree are without diagnostic abnormality.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber and course. The colon is unremarkable.BONES, SOFT TISSUES: Surgical changes in the lumbar spine with focal kyphotic deformity of the L1 vertebral body..OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Right adnexal corpus luteal cyst. Dilated tubular structure in the right pelvis that appears to originate from the right adnexa and may represent a dilated tube. It has mild thickening of its wall.To a lesser degree there is mild dilatation of the left fallopian tube.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber and course. Terminal ileum is normal. The appendix is located retrocecally as seen on image 82/series 3; it is normal in caliber without surrounding inflammatory changes.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Abnormal CT scan with tubular structure adjacent to the right adnexa which has a corpus luteal cyst. Differential considerations hydrosalpinx or pyosalpinx. Further evaluation of pelvic sonography may be useful. |
Generate impression based on findings. | Male; 55 years old. Reason: with attention to the carotids History: right carotid body tumor, assess and c/w CT from 2012 A solid, hypoechoic mass compatible with patient's known carotid body tumor is seen at the carotid bifurcation. There is vascular flow on color Doppler images. This measures 4.0 x 2.9 x 2.2 cm and previously measured 4.0 x 3.1 x 2.3 cm on the outside CT of the neck. | Stable size of patient's known right carotid body tumor. |
Generate impression based on findings. | Reason: h/o vocal cord cancer and CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules, one of which is calcified, are unchanged from the prior study. No suspicious pulmonary nodule or mass is seen. No consolidation or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy seen. Minimal coronary artery calcifications are present. The heart is normal in size and there is no pericardial effusion.CHEST WALL: No axillary lymphadenopathy is seen.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter liver hypodensity is too small to characterize, however it is unchanged on multiple prior studies.SPLEEN: Accessory spleens are seen lateral and anterior to the spleen.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypodense right renal lesions are compatible with cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Ms. Sopocy is a 62 year old female with a personal history of right breast lumpectomy in 2007 for IDC followed by chemo radiation therapy. Family history of breast cancer in maternal aunt. No current breast related complaints. Three standard views of both breasts and a laterally exaggerated right CC view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the right breast. There are stable postsurgical changes including architectural distortion, increased density, and surgical clips present within the right lumpectomy site. Scattered benign calcifications are present bilaterally. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Stable postsurgical changes of the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | History of small cell lung cancer, compare to previous exam. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: A new small right pleural effusion is present. Please refer to dedicated chest CT for full evaluation of the lungs. LIVER, BILIARY TRACT: No focal hepatic lesions are identified. SPLEEN: Mild splenomegaly appearing similar to prior.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left lower pole renal cyst unchanged. The right kidney is within normal limits.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications affect the abdominal aorta and its branches. The infrarenal aorta is dilated up to 3.9 cm in AP dimension, unchanged.The reference perigastric lymph node (series 20881, image 40) measures 1.6 x 1.3 cm, unchanged.BOWEL, MESENTERY: Colonic diverticulosis without evidence of complicated diverticulitis.BONES, SOFT TISSUES: Sclerotic lesions involving L3 and T12 vertebral bodies are unchanged.OTHER: There is a trace amount of scattered ascites and mesenteric fluid which is nonspecific. Mild anasarca. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colonic diverticulosis without evidence of complicated diverticulitis.BONES, SOFT TISSUES: Sclerotic lesions involving L3 and T12 vertebral bodies are unchanged. Mild anasarca.OTHER: There is a trace amount of scattered ascites and mesenteric fluid which is nonspecific. | 1.New small right pleural effusion. Please see accompanying chest CT from same day for full details.2.Stable exam with unchanged perigastric lymph node and vertebral body sclerotic lesions.3.Unchanged mildly dilated abdominal aorta to 3.9 cm.4.Mild anasarca and nonspecific scattered ascitic fluid. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 4 months old; Reason: ex 29 wk male, hx pulm HTN, diaphoresis, tachycardia, desaturations, rule out pna vs atelectasis VIEW: Chest AP (one view) 12:50:24 ET tube with tip below the thoracic inlet and above the carina. NG tube with sideport above the gastroesophageal junction, tip extends beyond the inferior margin of the image. Cardiothymic silhouette is normal. Interval increase in multifocal opacities in the right upper lobe right lower lobe on background of bronchopulmonary dysplasia and chronic lung disease. There are no pleural effusions or pneumothorax. | 1. Interval increase in right upper lobe and right lower opacity, which may represent either infection or atelectasis, on background of bronchopulmonary dysplasia and chronic lung disease suggestive of pulmonary interstitial emphysema.2. NG tube with sideport above the gastroesophageal junction. |
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