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Generate impression based on findings. | 71 years, Male. Reason: ngt placement History: failed swallow evaluation Dobbhoff tube tip projects over the gastric fundus. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view..Median sternotomy wires are noted. | Dobbhoff tube tip projects over the gastric fundus. |
Generate impression based on findings. | Female 63 years old Reason: assess for trombosis History: transaminitis, hyperbilirubinemia, h/o hep C LIMITED ABDOMENLIVER: The liver has a nodular contour with widened fissures. Liver measures 12 cm in length. The parenchyma is severely coarse and echogenic. No suspicious hepatic lesions. BILIARY TRACT: The gallbladder is absent. Common duct measures 7mm.PANCREAS: The pancreas is obscured due to bowel gas.KIDNEYS: The right kidney measures 10 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. The left kidney is obscured.SPLEEN: The spleen is obscuredOTHER: Ascites | 1.Cirrhotic liver with patent vasculature. |
Generate impression based on findings. | Ms. Hernandez is a 43 year old female with a personal history of recent right cyst aspiration in February 2014. No current breast related complaints. Three standard views of both breasts with one left spot compression 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. Previously aspirated cyst in the right outer breast is no longer seen on today's exam. There is a left inner breast asymmetry which largely disperses on spot compression views. Stable focal asymmetries elsewhere bilaterally. There are no suspicious microcalcifications or areas of architectural distortion identified in either breast. LEFT BREAST ULTRASOUND | Simple cysts in the left breast. No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in one year to confirm stability of these findings. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 49 years old; Reason: s/p ORIF right femur supracondylar fx, evaluate for healing Two views of the right femur demonstrate a plate and screw device affixing the distal femoral fracture in near anatomic alignment. A small amount of periosteal reaction adjacent to the fracture is indicative of some interval healing. There is no radiographic evidence of hardware complication. A small knee joint effusion is present. A plate and screw device affixes the proximal tibia in near anatomic alignment. | Orthopedic fixation of a healing distal femoral fracture. |
Generate impression based on findings. | Known fracture, prior to cast removal. Evaluation of osseous detail is limited by overlying cast material. Three views of the right wrist demonstrate mild deformity of the distal radius. The fracture line appears less distinct, indicative of some interval healing. There is associated positive ulnar variance. The mildly displaced ulnar styloid fracture is again seen, though assessment of interval healing is limited by overlying cast. | Distal radial and ulnar fractures, as above. |
Generate impression based on findings. | 58-year-old male with left knee pain. Four views of the right knee show mild medial joint space narrowing and mild osteophyte formation. No joint effusion. No evidence of a fracture or dislocation.Four views of the left knee show mild medial joint space narrowing and mild osteophyte formation. No joint effusion. No evidence of a fracture or dislocation. | Mild osteoarthritic changes of the knees without fracture or dislocation. |
Generate impression based on findings. | 35 years, Female. Reason: assess for obstruction History: h/o ventral hernia and abscess, now constipated Surgical clips and hardware are seen in the mid abdomen. Relative paucity of bowel gas. | Nonspecific bowel gas pattern. |
Generate impression based on findings. | 7 year old female with posterior neck pain status post motor vehicle accident.VIEWS: AP and Lateral (Two views) of the C1-T1 There is no evidence of prevertebral soft tissue thickening, fracture or malalignment. Vertebral disk space is within normal limits. There is no evidence of tracheal deviation. There is straightening of the cervical spine which is likely due to c-collar. | Normal examination. There are no findings to explain the patient's symptoms. |
Generate impression based on findings. | 71 years, Male. Reason: Dobbhoff placement History: myasthenia Median sternotomy wires are again noted. Dobbhoff tube tip with guidewire projects over the gastric body. The tip of the tube may be kinked. Left greater than right lung base opacities and left pleural effusion.Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip projects over the gastric body and may be kinked. |
Generate impression based on findings. | Swelling and tenderness of the left foot.VIEWS: Left foot AP, lateral and oblique on 2/9/15 (3 views) Improvement in osseous changes related to rickets. Soft tissue swelling with no fracture or malalignment. | Soft tissue swelling with no fracture or malalignment. |
Generate impression based on findings. | 17-year-old male with bumps of the right foot in a history of osteosarcoma of the right calcaneus. Left foot: Again seen are postoperative changes of calcaneal osteosarcoma resection and bone graft affixed with two screws. Surgical clips are again seen in the soft tissues. No evidence of recurrence or residual tumor. No change since prior exam.Left foot: Normal appearance of the left foot. | Postsurgical changes from calcaneal osteosarcoma resection and reconstruction without interval change. Normal left foot. |
Generate impression based on findings. | Right base of thumb pain Moderate osteoarthritis affects the first carpometacarpal joint. Mild osteoarthritis affects the IP joints. | Osteoarthritis, as above. |
Generate impression based on findings. | Female 26 years old; Reason: left thumb metacarpal giant cell tumor, s/p excision and autograft ICBG reconstruction, evaluate for recurrence Three views of the left hand demonstrate bone graft material occupying most of the first metacarpal. Focal lucency at the lateral aspect of the bone graft, along with new angulation of the first metacarpal, is consistent with fracture. We see no soft tissue mass to confirm tumor recurrence. | Post operative changes of the first metacarpal and slightly angulated fracture, as above. |
Generate impression based on findings. | Or abdominal pain on the right lower abdominal quadrant.VIEW: Abdomen AP (one view) 2/9/15 1442 hrs. Right lower abdominal quadrant and pelvic surgical clips are noted. No specific abdominal gas pattern. No evidence of free air, ascites or obstruction. | No evidence of free air. |
Generate impression based on findings. | Reason: 72 y.o.Male with HPT History: HPT There are several nodules present in the soft tissues of the lower neck . Their locations and serial Hounsfield units on dynamic CT or listed below along with some density units of normal structures:Houndsfield units through nodules (0seconds, 25 seconds, 55 seconds, 85 seconds):nodule beneath right thyroid lobe (axial image 51/83): 57.5HU, 73.5HU, 116 HU, 99.5HU.Right thyroid (image # 47/83 ):: 131HU, 145HU, 231HU, 207HURight Carotid artery (image # ):: 75.6HU, 311HU, 180HU, 155HU.Right Jugular vein (image # 30 ):: 81.6HU, 75.0HU, 3610HU, 196HU.Right submandibular gland (image # 28 ): 41.3HU, 48.5HU, 121HU, 110HU.Right sternocleidomastoid muscle: (image # 22 ): 39.3HU, 50.1HU, 66.8HU, 67.4HUCT neck:Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland has been at least partially removed. There are surgical clips in the surgical bed which partially obscure visualization at the level of the thyroid bed.The airway appears patent.The upper esophagus is air filled.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits and paranasal sinuses demonstrate mucus retention cysts in the visualized portions of the maxillary sinuses. The visualized portions of the mastoid air cells are clear. There is mucosal thickening in the right maxillary sinus. The ethmoid air cells and frontal sinuses and the upper parts of the maxillary sinuses are not included on this exam.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact. Atherosclerotic calcifications are present at the carotid bifurcations.The cervical vertebral bodies in general are intact . There are endplate and uncovertebral osteophytes present at C3-4, C4-5, C5-6 and C6-7 with associated narrowing of the spinal canal and the neural foramina. There is associated loss of disk space height and endplate reactive change at multiple levelsParathyroid sampling:Intraprocedural images demonstrate the location of venous sampling.Reported PTH, Intact values (REF 15-75 pg/mL):FEMORAL VEIN: 96SUPERIOR VENA CAVA: 179INNOMINATE VEIN JUNCTION: 836LEFT INNOMINATE VEIN: 227LEFT INTERNAL JUGULAR VEIN, LOWER: 147LEFT INTERNAL JUGULAR VEIN,MID: 157LEFT INTERNAL JUGULAR VEIN, UPPER: 98RIGHT INTERNAL JUGULAR VEIN, LOWER: 100RIGHT INTERNAL JUGULAR VEIN, MID: 121RIGHT INTERNAL JUGULAR VEIN, UPPER: 112 | 1.No parathyroid adenoma is clearly appreciated. The thyroid beds are obscured by metal artifact. As a result a parathyroid adenoma in the thyroid bed may be obscured by metal artifact.2.Localization on PTH was via the innominate vein junction3.Status post thyroid surgery4.Multilevel degenerative changes are present in the cervical spine. |
Generate impression based on findings. | There is mild nasal septal deviation to the left with a prominent left sided nasal septal bony spur impinging on the left middle nasal turbinate. There is a minimally displaced left nasal bone fracture, and minimal nondisplaced right nasal bone deformity with mild inward bowing. There is no overlying soft tissue swelling. The calvarium, mandible, lamina papyracea, pterygoid plates, zygomas and orbits are intact. There are bilateral concha bullosae. There is minimal bilateral maxillary sinus mucosal thickening. The remaining imaged paranasal sinuses and mastoid air cells are clear. The imaged intracranial structures are within normal limits. | 1.Minimally displaced left and nondisplaced right nasal bone fractures.2.Mild leftward nasal septal deviation with prominent left nasal bony spur impinging on the left middle nasal turbinate. |
Generate impression based on findings. | Reason: s/p crani History: ha The patient is status post recent left parietal craniotomy for removal of an extra-axial mass. There are air bubbles present at the prior tumor bed site. There is some subdural air are present at the craniotomy site. Surgical clips are present along the scalp tissues.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.Status post left-sided parietal craniotomy for removal of an extra-axial mass previously adjacent to the left paracentral lobule. There are postoperative changes present. No intraparenchymal hemorrhage is appreciated. |
Generate impression based on findings. | Female 55 years old; Chronic arthralgias of hands, +CCP. RIGHT HAND: Minimal osteoarthritis affects the DIP joints. We see no erosions or specific radiographic features of rheumatoid arthritis.LEFT HAND: Minimal osteoarthritis affects the DIP joints. We see no erosions or specific radiographic features of rheumatoid arthritis.RIGHT FOOT: Minimal osteoarthritic changes affect the foot, appearing similar to prior. Calcaneal heel spur and enthesopathic changes at the Achilles tendon insertion site are again seen.LEFT FOOT: Minimal osteoarthritic changes affect the foot, appearing similar to prior. Calcaneal heel spur and enthesopathic changes at the Achilles tendon insertion site are again seen. | Minimal osteoarthritic changes and other findings as described above. No specific radiographic features of rheumatoid arthritis. |
Generate impression based on findings. | A right frontal approach ventriculostomy catheter is present with its tip in the right frontal horn. There is no CT evidence of postprocedural complication. Ventriculomegaly is present involving the lateral, third, and fourth ventricles. There appears to be mass effect within the dilated fourth ventricle displacing cerebellar parenchyma superoposteriorly and slightly displacing the pons anteriorly (best seen sagittal reformatted series 80481 image 17/31). Additionally, there is an apparent septation involving the right lateral ventricle spanning its width in transverse fashion. Hemorrhage is noted layering within the bilateral occipital horns (right greater left), although it is difficult to differentiate what may be layering blood versus adjacent parenchymal hemorrhage. The corpus callosum is poorly defined posteriorly, demonstrating thinning anteriorly to its mid-body aspect. | 1.A right frontal approach ventriculostomy catheter is present with its tip in the right frontal horn without CT evidence of postprocedural complication. 2.Ventriculomegaly is present involving the lateral, third, and fourth ventricles. There appears to be mass effect within the dilated fourth ventricle displacing cerebellar parenchyma superoposteriorly and slightly displacing the pons anteriorly. 3.Hemorrhage is noted layering within the bilateral occipital horns (right greater left), although it is difficult to differentiate what may be layering blood versus adjacent parenchymal hemorrhage. |
Generate impression based on findings. | 69 year old female with a questionable history of osteomyelitis, ulcer and discolored second toe of the left foot. Again seen are a sideplate and screw device affixing a previous distal fibular fracture which is in anatomic alignment. The fracture line is indistinct.Diffuse soft tissue swelling and osteopenia is noted of the foot. Degenerative changes are noted in the first PIP joint. | Post fixation of a distal fibular fracture without complications. |
Generate impression based on findings. | Reason: 72 y.o. F with HPT History: HPT There are several nodules present in the soft tissues of the lower neck . Their locations and serial Hounsfield units on dynamic CT or listed below along with some density units of normal structures:Houndsfield units through nodules (0seconds, 25 seconds, 55 seconds, 85 seconds):nodule beneath right thyroid lobe (axial image 51/83): 57.5HU, 73.5HU, 116 HU, 99.5HU.Right thyroid (image # 47/83 ):: 131HU, 145HU, 231HU, 207HURight Carotid artery (image # ):: 75.6HU, 311HU, 180HU, 155HU.Right Jugular vein (image # 30 ):: 81.6HU, 75.0HU, 3610HU, 196HU.Right submandibular gland (image # 28 ): 41.3HU, 48.5HU, 121HU, 110HU.Right sternocleidomastoid muscle: (image # 22 ): 39.3HU, 50.1HU, 66.8HU, 67.4HUCT neck:Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.Within the visceral space the thyroid gland has been at least partially removed. There are surgical clips in the surgical bed which partially obscure visualization at the level of the thyroid bed.The airway appears patent.The upper esophagus is air filled.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits and paranasal sinuses demonstrate mucus retention cysts in the visualized portions of the maxillary sinuses. The visualized portions of the mastoid air cells are clear. There is mucosal thickening in the right maxillary sinus. The ethmoid air cells and frontal sinuses and the upper parts of the maxillary sinuses are not included on this exam.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact. Atherosclerotic calcifications are present at the carotid bifurcations.The cervical vertebral bodies in general are intact . There are endplate and uncovertebral osteophytes present at C3-4, C4-5, C5-6 and C6-7 with associated narrowing of the spinal canal and the neural foramina. There is associated loss of disk space height and endplate reactive change at multiple levelsParathyroid sampling:Intraprocedural images demonstrate the location of venous sampling.Reported PTH, Intact values (REF 15-75 pg/mL):FEMORAL VEIN: 96SUPERIOR VENA CAVA: 179INNOMINATE VEIN JUNCTION: 836LEFT INNOMINATE VEIN: 227LEFT INTERNAL JUGULAR VEIN, LOWER: 147LEFT INTERNAL JUGULAR VEIN,MID: 157LEFT INTERNAL JUGULAR VEIN, UPPER: 98RIGHT INTERNAL JUGULAR VEIN, LOWER: 100RIGHT INTERNAL JUGULAR VEIN, MID: 121RIGHT INTERNAL JUGULAR VEIN, UPPER: 112 | 1.No parathyroid adenoma is clearly appreciated. The thyroid beds are obscured by metal artifact. As a result a parathyroid adenoma in the thyroid bed may be obscured by metal artifact.2.Localization on PTH was via the innominate vein junction3.Status post thyroid surgery4.Multilevel degenerative changes are present in the cervical spine. |
Generate impression based on findings. | Female, 46 years old, with left and right-sided weakness. Assess for stroke. Grey-white differentiation is preserved. No evidence of parenchymal edema or mass effect is detected. Patchy periventricular and basal ganglia hypoattenuation is again seen similar to prior, a nonspecific finding. No evidence of intracranial hemorrhage or any abnormal extra-axial fluid collection is detected. The ventricles are normal in size and morphology.The osseous structures of the skull are intact. The paranasal sinuses and mastoid air cells are clear. | 1. Patchy peri-ventricular and basal ganglia hypoattenuation is seen, similar to the prior examination. This is a nonspecific finding which may reflect age indeterminate microvascular ischemic disease, among other etiologies. Correlation with history and risk factors is suggested.2. Otherwise, no evidence of any acute intracranial abnormality is detected on this examination. If clinical concern persists, further evaluation with MRI would be beneficial. |
Generate impression based on findings. | Fall. Fracture? There is a complete subcapital fracture of the femoral neck with slight valgus angulation. Hip joint alignment is normal. | Femoral neck fracture as above. |
Generate impression based on findings. | There are post-surgical findings related to a left parietal mass biopsy. There is interval increase in size of the large intraparenchymal hemorrhage in the left frontoparietal region that measures up to 55 mm, previously 40 mm, with a small amount of associated subarachnoid hemorrhage. There are new scattered smaller foci of surrounding intraparenchymal hemorrhage. There is increased local mass effect on the left lateral ventricle with surrounding edema. There is interval increase left to right midline shift measuring 8 mm. There is no significant change in the left subdural hematoma along the left frontotemporal convexity measuring up to 5 mm in width. There is a background of mild parenchymal volume loss. There are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with mild age-indeterminate small vessel ischemic changes. There are chronic lacunar infarcts in the right basal ganglia. The imaged portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is mild scalp emphysema and minimal subgaleal hematoma at the burr hole site. There are bilateral lens implants. There is marked flattening and sclerosis of the right mandibular condyle. | 1. Post-surgical findings related to left parietal lobe mass biopsy with interval increase in size of extensive intraparenchymal hemorrhage, with new adjacent small foci of hemorrhage and a small amount of subarachnoid hemorrhage in the left frontoparietal region with rightward midline shift measuring 8 mm.2. Unchanged left frontotemporal convexity subdural hematoma measuring 5 mm in width. 3. Mild age-indeterminate small vessel ischemic changes and evidence of basal ganglia lacunar infarcts.4. Advanced right temporomandibular joint degenerative change.Urgent findings discussed with Dr. Vasenina on 2/9/2015 at 3:45 pm. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | History of treated urachal cancer, now with diffuse metastases. There are numerous areas of increased uptake involving the bilateral ribs, spine, pelvis, bilateral humeri, and proximal femurs. The most prominent lesions involve the left posterior 8th rib, left mid-humerus, and distal right humerus. Degenerative related uptake is noted in the bilateral shoulders. | 1. Numerous osseous lesions involving the axial and appendicular skeleton compatible with metastatic disease. 2. Prominent left mid-humerus lesion; if the patient complains of focal pain in this region, dedicated radiographs may be considered. |
Generate impression based on findings. | Reason: Pt with LUL NSCLC s/p radiation, surveillance scan (f/u R nodule). History: Pt with LUL NSCLC s/p radiation, surveillance scan (f/u R nodule). CHEST:LUNGS AND PLEURA: Previously referenced pleural-based left upper lobe mass now measures 2.8 x 2.2 cm (image 53, series 5), previously 3.3 x 2.7 cm. Previously referenced to right lower lobe nodule now measures 13 mm (image 53, series 5), previously 8 mm. Additional new solid nodules are seen adjacent to this area. A new nodule is seen in the right lung base (image 73, series 5) and in the left lower lobe as well (image 64, series 5). Moderate centrilobular emphysema is present. Debris is seen within the trachea. Peripheral fibrosis is unchanged from the prior study.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is seen. Cardiomegaly is unchanged with atrial enlargement. Severe coronary calcifications are noted. Left atrial appendage filling defect has been stable since the examination dated 7/18/2007.CHEST WALL: Gynecomastia is again noted. New lytic right seventh posterior rib lesion is seen.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Nonspecific hypodense 1.5-cm lesion is seen in the dome of the liver. This is suspicious for metastatic disease.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral hypodense renal lesions are unchanged and compatible with renal cysts.PANCREAS: Pancreatic duct dilation without stenosis or mass lesion is unchanged.RETROPERITONEUM, LYMPH NODES: Abdominal aortic aneurysm with stent graft in place is unchanged from the prior study.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Gastrostomy tube is seen in place.BONES, SOFT TISSUES: New lytic lesion involving the right L3 pedicle is present. Wedge deformity of the L3 vertebral body is unchanged. | 1.Decrease in size of referenced left upper lobe mass, however increase in size and number of lower lobe nodules compatible with metastatic disease.2.New lytic osseous lesions compatible with metastases.3.New nonspecific hypodense liver lesion is suspicious for metastatic disease. |
Generate impression based on findings. | Reason: LLL nodule, s/p non diagnostic CT guided bx. plan for bronch. please do super D protocol History: cough, lung mass LUNGS AND PLEURA: Diffuse pleural calcifications and circumferential left pleural nodular thickening appears similar to the prior exam. A prominent mass along the left major fissure measures up to 6.3 x 5.1 centimeters (series 5 and image 55), stable to slightly decreased in prominence from the prior exam, with small areas of central necrosis. The mass may be located within the major fissure. Redemonstration of additional areas of scattered left lung consolidation, unchanged. No focal air space consolidations or pleural effusion involving the right lung. Scattered pulmonary micronodules are unchanged.MEDIASTINUM AND HILA: Scattered mildly enlarged mediastinal lymph nodes. A prevascular lymph node measures up to 1.1 cm (series 3, and 26). A left paratracheal lymph node measures up to 1.4 cm (series 3, image 37).CHEST WALL: Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Planning exam for bronchoscopic biopsy. Circumferential left pleural nodular thickening, a large left lung mass, and mediastinal lymphadenopathy are again seen, similar to the comparison CT exam. Primary lung cancer is suspected, although the appearance and possible intra-fissural location make mesothelioma an additional consideration. |
Generate impression based on findings. | Female 31 years old; Reason: 31 yo with RLQ tenderness, nausea, emesis, assess for acute appendicitis History: RLQ tenderness, concern for appendicitis ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Nonspecific prominent mesenteric lymph nodes in the right abdomen.BOWEL, MESENTERY: The appendix is dilated measuring 1.1 cm (series 3, image 102) in maximal and transverse dimension, with associated inflammatory changes in the right lower quadrant. A 2-mm density in the distal appendix is suggestive of an appendicolith.No drainable fluid collections.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. | Uncomplicated acute appendicitis. |
Generate impression based on findings. | Patient with metastatic breast cancer. Please evaluate for disease status. Increased radiotracer uptake is seen along the midthoracic spine, appearing similar to the prior examination. Faint punctate focus of increased activity overlying the L5 vertebra is unchanged. Increased radiotracer uptake corresponding to the right greater trochanter and right iliac crest is unchanged.Stable increased radiotracer uptake of the left tarsal bones, likely degenerative in etiology. Increased uptake within the right tarsal bones and toes are likely degenerative. | Unchanged foci of increased radiotracer uptake without new suspicious lesion. |
Generate impression based on findings. | 5-year-old female with crush injury of the left hand, slammed in door. Evaluate for fracture.VIEWS: AP view of Left hand, AP and lateral views of the left fourth finger There is no soft tissue thickening. There is no evidence of fracture. Alignment is normal. | Normal examination. |
Generate impression based on findings. | There is interval placement of a deep brain stimulator with tip in the region of the left basal ganglia with a small amount of pneumocephalus. There is no evidence of acute intracranial hemorrhage on this limited examination. The ventricles and sulci are normal in size and there is no evidence of midline shift. The paranasal sinuses and mastoid air cells are clear. | Interval placement of deep brain stimulator with electrode tip in the left basal ganglia, without evidence of acute intracranial hemorrhage.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Urgent change in planned procedure. Laparoscopic median arcuate ligament release. Mesenteric bypass. Retained foreign object policy.VIEW: Abdomen AP (one view) 02/09/15, 1515 and 1517 Feeding tube tip is in stomach. Surgical clips are seen in left upper quadrant. Triangular air collection right upper quadrant is most likely free peritoneal air. No unexpected foreign body. | No unexpected foreign body.These findings were discussed by telephone with Dr. Skelly, the attending surgeon, on 02/09/15 at 1540. |
Generate impression based on findings. | Female 16 years old Reason: injured Sun, eval for fx History: pain and swellingVIEWS: Left ankle and knee AP, lateral and oblique. 2/9/15 (6 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 57-year-old with history of cysts. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Interval decrease in bilateral breast masses compatible with involuting cysts. Focal asymmetry in the left upper central breast is stable allowing for the involution of the cysts. No new dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. | Involuting cysts. 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. | Female 15 years old Reason: r/o fracture History: patella medially shifted <1min 2/6/15VIEWS: Left knee AP and bilateral oblique. 2/9//15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 54 year old female patient with metastatic breast cancer. Evaluate for progression of disease. Again seen is increased uptake of the right anterior chest which may represent post-therapeutic changes. There is redemonstration of increased uptake in the calvarium, thoracolumbar spine, ribs, proximal left humerus, and proximal left femur. An area of uptake within the posterior right 9th rib appears more prominent compared to the prior examination, however, when this lesion does not appear to have significantly changed when comparing corresponding recent and remote CTs of the chest, abdomen, and pelvis. | No significant change in number or distribution of areas of increased uptake. |
Generate impression based on findings. | History of metastatic renal cancer on therapy. CHEST:LUNGS AND PLEURA: There is a new right lower lobe solid pulmonary nodule (series 4, image 80) measuring 0.9 x 0.9 cm and compatible with new metastasis. Scattered nonspecific micronodules are unchanged compared to prior study. Small left pleural effusion seen on the prior exam has resolved.MEDIASTINUM AND HILA: Atherosclerotic disease affects the thoracic aorta and coronary arteries. The ascending aorta measures 4.6 cm in maximum dimension, similar to prior.CHEST WALL: Destructive left rib lesion measures 6.1 x 3.0 cm (series 3, image 37); previously 6.1 x 3.0 cm. Destructive lesion in the T6 vertebral body measures 3.5 x 3.2 cm (series 3, image 44), previously 3.5 x 3.2 cm. Again noted is vertebral body height loss at this level with mild encroachment on the spinal canal which is unchanged. Partially visualized orthopedic hardware affixes the left humerus.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Stable left adrenal nodule measures 1.6 x 1.5 cm (series 3, image 92), previously 1.6 x 1.5 cm.KIDNEYS, URETERS: Postoperative changes relating to prior right partial nephrectomy. Bilateral renal hypodensities are too small characterize but appear unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right iliac/supraacetabular destructive lesion measures 5.8 x 2.6 cm (series 3, image 173), previously 5.8 x 2.6 cm. There has been interval orthopedic fixation of the left proximal femoral metastatic lesion with a dynamic rod and screw device. Degenerative changes affect the thoracolumbar spine including moderate compression deformity of T6 appearing similar to prior. There is a new lytic lesion within the L2 vertebral body compatible with new metastasis. There is a new soft tissue mass in the left gluteal region (series 3, image 163) compatible with metastatic disease.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Brachytherapy seeds in the prostate bed.BLADDER: No significant abnormality notedLYMPH NODES: Interval increase in size of pelvic lymph nodes (for example series 3, image 168) compatible with worsening metastatic disease.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Right iliac/supraacetabular destructive lesion measures 5.8 x 2.6 cm (series 3, image 173), previously 5.8 x 2.6 cm. There has been interval orthopedic fixation of the left proximal femoral metastatic lesion with a dynamic rod and screw device. Degenerative changes affect the thoracolumbar spine including moderate compression deformity of T6 appearing similar to prior. There is a new lytic lesion within the L2 vertebral body compatible with new metastasis. There is a new soft tissue mass in the left gluteal region (series 3, image 163) compatible with metastatic disease.OTHER: No significant abnormality noted | 1.Interval progression of disease including new right lower lobe pulmonary metastasis, new L2 vertebral body lytic lesion, new soft tissue metastatic lesion in left gluteal region, and increase in size of pelvic lymph nodes. Additional reference lesions similar to prior.2.Interval orthopedic fixation of left proximal femur metastatic lesion.3.Stable left adrenal nodule. |
Generate impression based on findings. | 81 years old female. Reason: history of metastatic colorectal cancer. This study was performed for restaging.RADIOPHARMACEUTICAL: 10.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's CT portion grossly demonstrates a new mass in the right lower lobe. There is a large hiatal hernia. There is a new pleural based nodule in the right middle lobe.Today's PET examination demonstrates intense FDG uptake in the new mass in the right lower lobe with maximal SUV of 6.2. There is increased metabolic activity in the new right middle lobe pleural based nodule with the maximal SUV of 3.6. In addition there is a new focus increased activity in the right upper lobe at perihilar region with SUVmax of 2.9. Several new foci of increased activity are seen in the right lower lobe pleura/parahepatic space of the peritoneal cavity. There is a small hypermetabolic lymph node in the right retrocrural space. The focus of increased activity in the umbilicus is stable. Previously identified abnormal focal FDG uptake in the right iliac bone, liver and near the dome of the right diaphragm have resolved.Previously identified two foci of increased activity in the peritoneal soft tissue densities adjacent to the umbilicus and in the right lower quadrant of the abdomen have resolved. | 1.New right lower lobe mass and right middle lobe nodule with increased metabolic activity, consistent with pulmonary metastases or lung cancer. 2.A new small right retrocrural hypermetabolic lymph node, suspicious for metastasis.3.A new focus of increased activity in the right lung upper lobe without definite CT correlation, suspicious for pulmonary metastasis.4.Interval improvement of the hepatic and peritoneal FDG avid lesions.5.Stable increased metabolic activity in the umbilicus, which is nonspecific. |
Generate impression based on findings. | 3-year-old male with history of chronic granulomatous disease. Pre-transplant evaluation. CHEST:LUNGS AND PLEURA: The numerous bilateral cavitary lesions seen on prior CT have resolved. Scattered bilateral streaky opacities, some of which demonstrate tree in bud configuration. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Normal heart size. No significant mediastinal or hilar lymphadenopathy. Normal thymus.CHEST WALL: Enlarged left axillary lymph node measures 9 x 7 mm on series 4, image 16.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant retroperitoneal or mesenteric lymphadenopathy.BOWEL, MESENTERY: No evidence of bowel obstruction or free air.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Prominent left external iliac lymph node measures 6 x 5 mm on series 4, image 100. Scattered bilateral inguinal lymph nodes are also noted.BOWEL, MESENTERY: No evidence of bowel obstruction or free air.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Prominent left axillary, left external iliac, and inguinal lymph nodes. Please see measurements above.2.Scattered bilateral streaky opacities in the lungs, some of which demonstrate tree in bud configuration. Findings may represent aspirated secretions or atypical infection. Previously seen cavitary lesions have resolved. |
Generate impression based on findings. | Male 68 years old Reason: assess for small bowel pathology History: sepsis, ARDS ABDOMEN:LUNG BASES: Small bilateral pleural effusions with bibasilar consolidation/atelectasis.LIVER, BILIARY TRACT: Diffusely hypoattenuating liver parenchyma consistent with fatty infiltration. SPLEEN: 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: Dilated loops of small bowel measuring up to 3.5 cm with a transition point involving the ileum in the right lower quadrant. Findings may be chronic in nature given similar findings in prior CT study dated 7/26/2014.No pneumoperitoneum or portal venous gas.Postoperative changes from prior bowel resection.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Atherosclerotic calcifications of aorta.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Collapsed bladder with Foley catheter in place.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Findings consistent with small bowel obstruction with a transition point involving the ileum in the right lower quadrant. Findings may be chronic/intermittent in nature given similar prior imaging findings. 2.Bibasilar consolidation which could represent pneumonia/atelectasis with associated small pleural effusions. |
Generate impression based on findings. | Female 49 years old Reason: Pt with stenotic IC valve, and Crohn's disease. Evaluate for small bowel disease. History: RLQ abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Postsurgical changes related to prior liver resection and cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypoattenuating lesion in the right kidney likely represents a renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The distal 8 cm of terminal ileum demonstrates mucosal hyper enhancement with luminal narrowing, as well as mural thickening and stratification of the bowel wall. There is mild mesenteric hyperemia. The remainder of the colon and bowel are unremarkable. Mildly prominent mesenteric lymph nodes are likely reactive.No evidence of abscess. No evidence of bowel obstruction.BONES, SOFT TISSUES: Laxity of the anterior wall.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Heterogeneously enhancing bulky uterus is most compatible with underlying fibroid disease.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The distal 8 cm of terminal ileum demonstrates mucosal hyperenhancement with luminal narrowing, as well as mural thickening and stratification of the bowel wall. There is mild mesenteric hyperemia. The remainder of the colon and bowel are unremarkable. Mildly prominent mesenteric lymph nodes are likely reactive.No evidence of abscess. No evidence of bowel obstruction.BONES, SOFT TISSUES: Scattered punctate osseous sclerotic foci are suggestive of bone islands.OTHER: No significant abnormality noted | 1. Narrowing, mural thickening and mucosal hyperenhancement of the terminal ileum with mild inflammatory changes in the surrounding mesentery. The findings are suggestive of acute on chronic inflammation.2. No abscess or bowel obstruction. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or skull fracture. |
Generate impression based on findings. | 50 year-old male with left knee pain. Four views left knee show no evidence of acute fracture or dislocation. No joint space narrowing or appreciable osteophyte formation. | Normal examination of the left knee. |
Generate impression based on findings. | 55 years, Male. Reason: Dobbhoff re-placement History: as above Dobbhoff tube tip projects over the gastric antrum. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view.Lung bases are clear. | Dobbhoff tube tip projects over the gastric antrum. |
Generate impression based on findings. | Fall. Fracture? Mild osteoarthritis affects the knee. I see no fracture, malalignment, or joint effusion. | Mild osteoarthritis without fracture evident. |
Generate impression based on findings. | 55 years, Male. Reason: eval Dobbhoff placement History: s/p Dobbhoff Dobbhoff tube tip projects over the gastric body. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view.Lung bases are clear. | Dobbhoff tube tip projects over the gastric body. |
Generate impression based on findings. | There is minimal bilateral maxillary sinus mucosal thickening. Otherwise, the paranasal sinuses are clear without evidence of air-fluid levels. The nasal cavity is clear. There is no significant nasal septal deviation. The bilateral mastoid air cells are clear. The lamina papyracea are intact bilaterally. The floor of the anterior cranial fossa and cribriform plate region are intact. The nasal septum is midline. The imaged portions of the intracranial structures, orbits, and the nasopharynx appear unremarkable. | Minimal maxillary sinus mucosal thickening without evidence of air-fluid levels.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Heart transplant workup. Two standard digital views of both breasts including repeat right MLO and left CC views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. A few benign calcifications are again noted. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 22-year-old male with arthritis and left knee pain. Evaluate osteotomy status. Four views of the left knee show postsurgical changes from a prior bilateral ACL reconstruction with osseous tunneling. Severe joint space narrowing is noted about the medial aspect of the knee with osteophytes which has progressed from the previous exam. | Severe medial compartment osteoarthritis of the left knee which has progressed from the previous exam. |
Generate impression based on findings. | Left proximal tibia lesion, evaluate for interval change There is a thin elongated ovoid focus of sclerosis within the anterolateral aspect of the proximal tibial diaphysis measuring just over 1.5 cm in longitudinal dimension and no more than 3 mm in transverse dimension. It may be based along the endosteum, but this is equivocal. I suspect that it either represents a bone island or perhaps a focus of fibrous dysplasia. I see no aggressive characteristics. | Elongated sclerotic focus in the proximal tibia perhaps representing a benign bone island. |
Generate impression based on findings. | Male 33 years old; Right elbow limited ROM. Pain. Severe osteoarthritis affects the right elbow, as seen on the prior radiographs, with joint space narrowing, large osteophytes, and subchondral cysts. Multiple loose bodies are present within the joint space. A large loose body in the olecranon fossa measures approximately 2 cm in greatest dimension. A large loose body in the anterior aspect of the joint measures approximately 2 cm in greatest dimension. Multiple additional smaller loose bodies are present within the joint space. Slight elevation of the anterior and posterior fat pads is due to intra-articular loose bodies and a small amount of joint fluid.Small foci of heterotopic mineralization are present in the soft tissues adjacent to the elbow joint, perhaps representing a combination of capsular and tendon mineralization. The biceps and brachialis tendons appear normal. The triceps tendon appears normal. The remaining soft tissue structures appear unremarkable, given the inherent limitations of noncontrast CT. | Severe osteoarthritis of the right elbow with multiple loose bodies within the joint. |
Generate impression based on findings. | Evaluate pin fixation Three views of the right hand reveal no change in position of the pins in the fourth and fifth digits. The fractures and osteotomies have not healed at this time. | No change in position in PIN fixation |
Generate impression based on findings. | There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | No evidence of acute intracranial hemorrhage, mass, or cerebral edema.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Patient slipped on ice and fell striking head. Evaluate for subdural hematoma. There is no evidence of intracranial hemorrhage or mass effect. There is mild parenchymal volume loss. The basal cisterns are patent. There is no midline shift or herniation. There are calcifications of the cavernous portion of the internal carotid arteries. There is mild mucosal thickening of the bilateral ethmoid and maxillary sinuses. The other imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. However, there are punctate calcification in the left orbital apex, possibly associated with slight asymmetric effacement of the orbital fat. | 1. No evidence of intracranial hemorrhage or depressed calvarial fracture.2. punctate calcification in the left orbital apex may be vascular in nature or represent dural calfication, although a small optic nerve sheath meningioma cannot be excluded. An orbit MRI may be useful for further evaluation, if clinically warranted.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Left lower extremity numbness, weakness. Assess alignment, fracture. Again seen are posterior stabilization rods with screws entering the L2 through L5 vertebrae. I see no hardware complications. Amorphous bone graft material is again seen along the right lateral aspect of the lumbar spine. Multilevel degenerative disk disease appears similar to that seen on the prior study. There is perhaps minimal retrolisthesis of L2, but otherwise alignment is within normal limits. The bones appear demineralized, suggesting osteopenia. I see no acute fracture. | Degenerative disk disease and postoperative changes appear similar to those seen on the prior study. I see no fracture. |
Generate impression based on findings. | Male 53 years old; Reason: 53 yo male with hypoechoic pancreatic focus on ultrasound, please evaluate with CT History: 53 yo male with hypoechoic pancreatic focus on ultrasound, please evaluate with CT ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Diffuse hepatic steatosis. No focal liver lesion is identified. Patent hepatic vasculature. No intra-or extrahepatic biliary duct dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No focal pancreatic mass. No pancreatic duct dilatation. No peripancreatic fluid.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Nonspecific prominent portacaval lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small periumbilical hernia containing omental fat.PELVIS:PROSTATE/SEMINAL VESICLES: 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.No focal pancreatic mass.2.Diffuse hepatic steatosis. |
Generate impression based on findings. | Pain over entire right hip and entire right knee. 2 views of the right hip demonstrate mild osteoarthritis. We see no fracture.4 views of the right knee demonstrate hardware components of a total knee arthroplasty device situated in near anatomic alignment and without radiographic evidence of hardware complication. Anterior soft tissue swelling limits evaluation of the patellar tendon. | Right hip osteoarthritis and right total knee arthroplasty, without fracture. |
Generate impression based on findings. | Foot pain or treadmill. Evaluate for stress fracture Three views of the left foot are unremarkable. No evidence of stress fracture. No radiographic abnormalities.. | Negative left foot examination |
Generate impression based on findings. | Possible stress fracture. Two views of the right tibia and fibula demonstrate chronic appearing periosteal reaction along the anteromedial tibia which may indicate a healing stress fracture, though this is equivocal and appears similar to that seen on the prior study. We see no discrete fracture line. | Findings which may represent a healing tibial stress fracture, appearing similar to prior. |
Generate impression based on findings. | 10-year-old male status post renal transplant for posterior urethral valves. BLADDER Wall Thickness: Borderline bladder wall thickening to 4 mm, stable. Contents: Distended and normal. Distal Ureter -- SFU Grade** Transplant: 0 Ureteral Jets Transplant: Not observed KIDNEYS: Transplant kidney is noted in the right iliac fossa. The native kidneys have been surgically removed. Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Transplant: 1-2 Length*** Transplant: 10.7 cm Mean for age: 9.1 cm Range for age: 7.5 - 10.8 cmADDITIONAL OBSERVATIONS: No peritransplant fluid collection is noted. | 1.Grade 1-2 hydronephrosis in transplant kidney, not significantly changed.2.Stable mild bladder wall thickening.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | History of metastatic esophageal cancer. CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. No suspicious nodules or masses.MEDIASTINUM AND HILA: Right-sided chest port tip with tip in the distal SVC. No mediastinal or hilar lymphadenopathy. Mild coronary artery calcifications. Mild eccentric thickening of the distal esophagus appearing similar to prior. CHEST WALL: Nonspecific sclerotic focus in the right second rib similar to prior.ABDOMEN:LIVER, BILIARY TRACT: Tiny subcentimeter low attenuation hepatic lesion in right posterior hepatic lobe (series 5, image 84) similar to prior exam but new from more remote exams, should be followed on subsequent imaging. SPLEEN: No significant abnormality notedPANCREAS: Progressive atrophy of the pancreatic tail.ADRENAL GLANDS: Mild nodularity of the left adrenal gland less prominent than the prior exam.KIDNEYS, URETERS: Bilateral renal hypodensities are unchanged, likely cysts.RETROPERITONEUM, LYMPH NODES: Gastrohepatic nodal mass measures 3.5 x 3.0 cm (series 5, image 98), unchanged in size. This lesion partially encases the adjacent splenic artery, which remains patent, and is inseparable from the pancreatic body.Enlarged right para-aortic node (series 5, image 125) measures 1.5 x 1.4 cm, previously 2.1 x 1.9 cm.BOWEL, MESENTERY: There has been interval placement of a gastroesophageal junction stent which appears to have migrated into the gastric body. Normal caliber bowel without evidence of obstruction. BONES, SOFT TISSUES: Moderate degenerative changes of the spine including bridging osteophytes appearing similar to prior. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Bilateral inguinal hernia repairs.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There has been interval placement of a gastroesophageal junction stent which appears to have migrated into the gastric body. Normal caliber bowel without evidence of obstruction. BONES, SOFT TISSUES: Moderate degenerative changes of the spine including bridging osteophytes appearing similar to prior. OTHER: No significant abnormality noted. | 1.Interval placement of gastroesophageal junction stent which has migrated into the gastric body.2.Reference gastrohepatic nodal mass which is inseparable from the pancreas unchanged in size. Progressive atrophy of the pancreatic tail.3.Reference periaortic lymph node decreased in size. 4.No new sites of metastatic disease identified. |
Generate impression based on findings. | Pain. Minimal osteoarthritis affects the left glenohumeral joint, essentially within normal limits for the patient's age. We see no additional shoulder findings to account for the patient's pain, although degenerative arthritic changes are present in the cervical spine. | Minimal osteoarthritic changes of the glenohumeral joint. Degenerative changes in the cervical spine may be better evaluated with dedicated cervical spine imaging if clinically warranted. |
Generate impression based on findings. | Female 51 years old; Reason: SLE pt with mild Jaccoud's arthropathy c/o pain R 5th MTP at site of bunion. History: pain R 5th MTP at site of bunion. Bilateral pes planus is noted. No evidence of acute fracture or dislocation. No evidence of osteoarthritis. | Bilateral pes planus deformity. |
Generate impression based on findings. | Pain. Osteoarthritis versus avascular necrosis. RIGHT KNEE: The right knee appears normal for the patient's age. No frank osteoarthritic disease or osteonecrosis is seen.LEFT KNEE: There is moderate medial joint compartment narrowing with small tricompartmental osteophytes indicating moderate osteoarthritis, which has progressed compared to the prior study. Subchondral sclerosis in the medial compartment is likely degenerative in etiology though we cannot entirely exclude osteonecrosis. LEFT ANKLE: Small osteophytes at the tibiotalar joint indicate mild osteoarthritis and appear similar to the prior study. Poorly defined lucency in the 5th metatarsal base with adjacent ossicle likely reflects a prior fracture. This may be better evaluated with dedicated foot radiographs, if clinically warranted. | Osteoarthritis and other findings, as above. |
Generate impression based on findings. | Female 44 days old Reason: 6 wk F s/p aortic arch reconstruction, vsd patch closure, extubated today. Evaluate for atelectasis. History: Status Post-Op Cardiac SurgeryVIEW: Chest AP (one view) 2/9/15 at 1631 hrs. Right IJ venous access terminates at the right atrium, however has been slightly retracted. Mediastinum tips on epicardial pacer leads as well as NG tube unchanged. Interval removal of ET tube. Cardiac silhouette size is enlarged but stable. Subsegmental atelectasis of the right upper lobe. No effusions or pneumothorax. | Interval retraction of right IJ venous access and removal of ET tube.Right upper lobe subsegmental atelectases development. |
Generate impression based on findings. | Left hip replacement in 1999, now with hip pain. Again seen are hardware components of a left total hip arthroplasty device. There is slight eccentric positioning of the head of the femoral component within the acetabular component, suggestive of liner wear. Otherwise, there is no radiographic evidence of complication. We see no fracture. Mature heterotopic ossification is present along the greater trochanter. Degenerative disk disease affects the visualized lower lumbar spine. | Left total hip arthroplasty device and other findings, as above. We see no fracture. |
Generate impression based on findings. | Pain after fall on ice. Fracture? Four views of the right elbow are provided. There is a comminuted intra-articular fracture of the radial head with approximately 2 mm of depression of the articular surface. Elevation of the distal humeral fat pad likely reflects hemarthrosis.Two views of the right forearm reveal the aforementioned radial head fracture. The distal radius and ulna appear normal. | Radial head fracture as above. |
Generate impression based on findings. | Point tenderness for 1.5 weeks over left third metatarsal. Evaluate for third metatarsal shaft fracture. A small focus of poorly defined density is noted on the oblique view along the medial aspect of the neck of the third metatarsal. This could represent periosteal reaction from underlying stress fracture in the correct clinical context. I see no discrete fracture line. The remainder of the foot is unremarkable. | Possible third metatarsal stress fracture. If further imaging evaluation is warranted, repeat radiographs may be obtained in 7 to 10 days. This was relayed to Dr. Mimoto at the time of dictation. |
Generate impression based on findings. | Hip pain and weakness after fall. Knee weakness and pain after fall. Two views of the right knee are provided. I see no fracture, malalignment, or joint effusion. Mild osteoarthritis affects the knee.Two views of the right hip are provided. Evaluation of the hip is limited by factors related to portable technique. Given this limitation, I see no fracture or malalignment. | Mild osteoarthritis of the right knee. I see no fracture. If there is strong clinical concern for femoral neck fracture, then dedicated radiographs or cross-sectional imaging of the right hip performed in the radiology department may be considered. |
Generate impression based on findings. | Left hip pain for two weeks There is mild deformity of the acetabulum, with a horizontal roof. I suspect that this is due to the patient's known diagnosis of achondroplasia, revealed by the medical record. Lack of sphericity of the femoral head with a slightly underdeveloped femoral neck is also likely due to achondroplasia. I see no acute abnormalities. | Mild deformity of the hip likely due to achondroplasia as described above. I see no acute abnormalities. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Female 62 years old Reason: please evaluate prior to starting new tx, provide bi-dimensional measurements per RECIST v 1.1 History: metastatic colon cancer CHEST:LUNGS AND PLEURA: Bilateral numerous lung metastases. An index right upper lobe nodule measures 1.4 by 1 cm on image number 29, series number 8.MEDIASTINUM AND HILA: Borderline enlarged mediastinal and bilateral hilar lymph nodes. Index subcarinal node measures 1.7 x 1 cm on image number 41, series number 7.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left kidney is not visualized. Right kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: Retroperitoneal adenopathy. An index aortocaval node measures 1.9 x 1.3 cm on image number 101, series number 7.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: At the level of the aortic bifurcation anterior to the iliac arteries there is a 2.2 x 2 cm ill-defined soft tissue in image number 140, series number 7. This is suspicious for metastatic mesenteric adenopathy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Metastatic numerous lung nodules. Borderline enlarged mediastinal and hilar lymph nodes. Predominantly upper abdominal retroperitoneal adenopathy and mesenteric adenopathy suspicious for metastatic disease. |
Generate impression based on findings. | Female 80 years old Reason: Met breast cancer needs re-evalation and compare to prior scan 1/2/15. Per RECIST 1:1 with bi-dimensional measurements. History: Met breast cancer needs re-evalation and compare to prior scan 1/2/15. Per RECIST 1:1 with bi-dimensional measurements. CHEST:LUNGS AND PLEURA: Biapical scarring, unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Extensive sclerotic bone metastases are grossly unchanged.ABDOMEN:LIVER, BILIARY TRACT: Interval increase in the size of the segment two lesion. The lesion now measures 1.5 cm in diameter on image number 77, series number 3. This lesion was measuring 6 mm in diameter on a simple appearing cyst near the falciform ligament is unchanged. image number 81, series number 4.SPLEEN: No significant abnormality noted.PANCREAS: Subcentimeter cystic lesion in the body of the pancreas is unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Extensive bone metastases are grossly unchanged.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: Ill-defined subcutaneous soft tissue density mass on the right side of the gluteal region measuring 3.3 by 2.7-cm on image number 172, series number 3. This lesion was incompletely imaged on the previous study, therefore, cannot be optimally measured on the previous study. Extensive diffuse bone metastases, again noted.OTHER: No significant abnormality noted. | Extensive diffuse bone metastases throughout the skeleton. Right gluteal subcutaneous soft tissue mass suspicious for metastatic disease.Interval increase in the size of the left lobe hepatic lesion suspicious for metastatic disease. |
Generate impression based on findings. | Female 42 years old Reason: portal venous thrombus on RUQ History: elevated lipase ABDOMEN:LUNG BASES: Diffuse dense groundglass opacities and air space opacities are unchanged from previous CT.LIVER, BILIARY TRACT: Moderate hepatomegaly. Liver measures 23 cm in vertical dimension. Mild periportal edema. Portal vein and its branches are patent. No focal liver lesions. No evidence of intra-or extrahepatic biliary dilatation.SPLEEN: Small splenic infarct.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Persistent nephrogram of the kidneys on the delayed phase is suggestive of impaired renal function. Correlation with renal function tests is recommended.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of ascites. Gastrostomy tube is in place.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Leiomyomatous uterus. Some of the fibroids are exophytic. Ovaries cannot be optimally evaluated due to the presence of numerous fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Moderate hepatomegaly. Small splenic infarct. No evidence of portal vein thrombosis.Persistent nephrogram of the kidneys on the delayed phase is suggestive of impaired renal function. Correlation with renal function tests is recommended.Leiomyomatous uterus.Diffuse air space opacities and groundglass opacities in the lungs are stable. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present bilaterally. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother, diagnosed at the age of 55. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign lymph nodes project over the axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of ovarian cancer in mother, diagnosed in her 60s. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. Physical examination is of increased importance for patients with dense breasts. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Bilateral asymmetries, including in the right retroareolar region are not significantly changed. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt, maternal niece, and maternal cousin. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications, including arterial calcifications, are seen in both breasts. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt (diagnosed at the age 55), and ovarian cancer in mother (diagnosed at the age of 45). Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Scattered benign calcifications, including arterial calcifications, are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of ovarian cancer in maternal aunt. Personal history of left cyst aspiration in 2013. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Benign morphology masses in both breasts are compatible with simple cysts, as previously evaluated by prior ultrasounds. However, recently aspirated cyst in the upper outer left breast is no longer present on today's exam. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Bilateral breast cysts of varying sizes. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Asymmetry in the far posterior left breast is present (only seen on the left MLO view). No suspicious masses, microcalcifications or areas of architectural distortion are present in the right breast. | Focal asymmetry in the far posterior left breast. Additional imaging, including spot compression views and possible ultrasound, recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt and maternal cousin. Personal history of colon cancer. Two standard digital views, additional left MLO view, and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable asymmetries are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal grandmother. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Clinical question: CVA. Signs and symptoms: CVA. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Very mild patchy foci of periventricular and subcortical low-attenuation white matter is a nonspecific finding however often representing small vessel ischemic strokes of indeterminate age and considering patient's stated age of 49 possibility of demyelinating disease should also be considered.There is mild prominence of cortical sulci and ventricular system for age an unremarkable exam otherwise. Unremarkable orbits, paranasal sinuses, mastoid air cells and calvarium. | 1.No acute intracranial process.2.Findings suggestive of mild chronic nonhemorrhagic small vessel ischemic strokes as detailed. |
Generate impression based on findings. | Female 10 years old Reason: MVA History: pain over acromiumVIEWS: Left clavicle AP and axial 2/9/15 (two views) There is no evidence of fracture, malalignment or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in two sisters (diagnosed at the age of 46 and 50). Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Multiple partially obscured masses are present in the breasts. There are no suspicious microcalcifications or areas of architectural distortion. | Bilateral partially obscured masses. Additional evaluation, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Clinical question: CVA. Signs and symptoms: LUE numbness and weakness. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Findings suggestive of mild to moderate age indeterminate small vessel ischemic strokes are noted. There is resultant mild prominence of cortical sulci and ventricular system.Unremarkable non-enhanced head CT otherwise. Unremarkable calvarium, paranasal sinuses, orbits and mastoid air cells. | Mild to moderate age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Female 9 years old Reason: pneumonia History: fever, cough, chest painVIEWS: Chest PA/lateral (two views) 2/9/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Left lower lobe opacity, either atelectasis or pneumonia.. No effusions or pneumothorax. | Left lower lobe opacity as described. |
Generate impression based on findings. | concussion No evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. 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. Right transverse sinus is prominent which is a normal finding. | No evidence of acute ischemic or hemorrhagic lesion on this scan. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views, additional right MLO view, and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Multiple benign morphology masses in both breasts are stable. There are several lucent peripherally calcified asymmetries present in the left superior breast, compatible with oil cysts. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Bilateral stable benign morphology masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Clinical question: Evaluate size of hemorrhage. Signs and symptoms: Evaluate size of hemorrhage. Nonenhanced head CT:Acute hematoma in the left hemisphere measuring at 55 x 36 -mm in size without convincing evidence of any significant change in its size, density or extend. Surrounding vasogenic edema and associated mass-effect with resultant 7.8 mm deviation of midline to the left shows no gross interval change. Tiny left-sided subdural knees as a result of extension of hemorrhage from parenchyma also remain similar to prior exam and measures at approximately 4.6 mm thickness.Ventricular system remain within normal size and stable since prior exam.There is no convincing evidence of any new foci of ischemic change or hemorrhage. | 1.Stable left hemispheric acute hematoma with a small extension into the left subdural space, surrounding vasogenic edema and overall mass effect and deviation of midline to the right of approximately 7.8 mm.2.No convincing evidence of any new finding since prior study. |
Generate impression based on findings. | altered mental status No evidence of acute ischemic or hemorrhagic lesion on this scan.Mild diffuse brain atrophy is age appropriate.Patchy low attenuations on bilateral periventricular white matter indicate non specific small vessel disease. 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.Non specific small vessel ischemic disease. |
Generate impression based on findings. | Clinical question: Evaluate for cerebral edema, CVA. Signs and symptoms: First time seizure. Nonenhanced head CT:No detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There is mild prominence of cerebellar and vermian folia the patient stated age however stable since multiple prior exam.Few nonspecific small foci of subcortical hypoattenuation grossly similar to prior MRI examination findings. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and grade I right sided differentiation otherwise.Unremarkable calvarium, skull, paranasal sinuses, mastoid air cells and middle air cavities. | No acute intracranial process. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Long-standing creamy nipple discharge from the left breast. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Scattered benign calcifications are present in both breasts. Focal asymmetry in the right lateral breast is identified. No suspicious masses, microcalcifications or areas of architectural distortion are present in the left breast. | Focal asymmetry in the right breast. An attempt to obtain the patient's prior mammograms should be made for comparison purposes.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | altered mental status, headache No evidence of acute ischemic or hemorrhagic lesion on this scan.There is focal low attenuation within the right transverse sinus which most likely represent arachnoid granulation.The ventricles, sulci, and cisterns are symmetric and unremarkable. 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. | No evidence of acute ischemic or hemorrhagic lesion on this scan. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in sister, diagnosed at the age of 39. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Cluster of coarse calcifications in the central right breast is unchanged, compatible with a hyalinizing fibroadenoma. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
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