instruction stringclasses 1 value | input stringlengths 6 8.98k | output stringlengths 5 3.11k |
|---|---|---|
Generate impression based on findings. | Occipital head pain No evidence of acute ischemic or hemorrhagic lesion on this scan.Focal low attenuation on the left basal ganglia suggesting prior lacunar infarction is again seen, no change since prior exam.Small lipoma on the right suboccipital soft tissue is re-demonstrated, no change since prior exam.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.No change of left basal ganglia lacune since prior exam. |
Generate impression based on findings. | 79 years, Male, Reason: Assess renal lesion (prior study was with contrast only; we would like a without contrast image to compare) History: right renal lesion. History of lung cancer ABDOMEN:LUNG BASES: Right lower lobe cavitary mass with peribronchial and pleural extension is unchanged in size measuring 5.8 x 3.3 cm (4/8), previously 6.0 x 3.4 cm. Additional paramediastinal fibrotic changes and a small right pleural effusion are unchanged. Severe coronary artery calcifications. Focal fat within the left crus of the diaphragm is stable.LIVER, BILIARY TRACT: Right hepatic subcapsular cyst is unchanged. Likely sludge within the gallbladder.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Intrarenal vascular calcifications. Right lower pole cortical hypoattenuating lesion is unchanged in size from the recent contrast enhanced study measuring 2.8 cm (3/73), previously 2.9 cm, but increased from the the study from 9/17/2014 where it measured 6 mm. There is no enhancement within the center of the lesion when compared to the prior study. There may be some borderline enhancement along the periphery and superior aspect of the lesion, measuring 45 Hounsfield units on the contrast enhanced study and 26 Hounsfield units on the current study. Perinephric stranding adjacent to this lesion is unchanged.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications of the aorta and its branch with areas of intramural thrombus, better evaluated on prior contrast study. Scattered small retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes of the visualized spine.OTHER: No significant abnormality noted | 1.Right lower pole lesion stable in size from the prior study but significantly increased from the study of 9/17/2014. Within the bulk of the lesion, no enhancement is evident, however there is borderline enhancement along the periphery and superior aspect of the lesion. A neoplasm is favored, likely a necrotic metastases, with focal pyelonephritis considered less likely.2.Right lower lobe cavitary mass and posttreatment changes 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 almost entirely fatty, unchanged in pattern and distribution. Bilateral benign morphology masses are present, the majority of which have decreased in size over the years, compatible with involuting cysts. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Bilateral involuting cysts. 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: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and bilateral additional MLO 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. Benign coarse calcifications in the right upper outer breast are stable. 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. | 82-year-old female with left upper quadrant and left back pain, nausea, and decreased appetite. ABDOMEN:LUNG BASES: Previously seen left basilar consolidation has resolved. There is an 8mm left lower lobe solid pulmonary nodule (series 4, image 30) which has slightly increased in size from prior. Cardiomegaly. Prosthetic mitral and aortic valves. Sternotomy changes, pacemaker, and percutaneous epicardial leads are partially visualized.LIVER, BILIARY TRACT: Low attenuation focal hepatic lesion in segment 8 (series 3, image 23) measures 1.5 x 1.3 cm, present on the 2007 exam and most likely benign. Cholelithiasis without evidence of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Subcentimeter right adrenal nodule stable.KIDNEYS, URETERS: Multiple wedge-shaped low-attenuation lesions within the left kidney which extend to the periphery involving approximately 50% of the renal parenchyma new from the prior study. The right kidney is atrophic and contains several cysts which appear similar to prior. RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications affect the abdominal aorta and its branches. The renal arteries appear patent. Calcified retroperitoneal lymph nodes appear similar to prior.BOWEL, MESENTERY: There is no evidence of acute high-grade bowel obstruction. There are, however, several mildly prominent loops of small bowel with a small bowel feces sign suggesting possible ileus. There is colonic diverticulosis without evidence of complicated diverticulitis.BONES, SOFT TISSUES: Moderate degenerative changes affect the visualized thoracolumbar spine and SI joints. Severe osteoarthritic changes affect the pubic symphysis.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: The uterus is surgically absent.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is no evidence of acute high-grade bowel obstruction. There are, however, several mildly prominent loops of small bowel with a small bowel feces sign suggesting possible ileus. There is colonic diverticulosis without evidence of complicated diverticulitis.BONES, SOFT TISSUES: Moderate degenerative changes affect the visualized thoracolumbar spine and SI joints. Severe osteoarthritic changes affect the pubic symphysis.OTHER: No significant abnormality noted | 1.New left renal infarcts involving approximately 50% of the renal parenchyma likely from cardioembolic source.2.8mm left lower lobe pulmonary nodule for which continued follow-up is recommended.3.Diverticulosis without complicated diverticulitis. Possible mild ileus pattern without evidence of high-grade bowel obstruction.4.Cholelithiases without cholecystitis. 5.Osteoarthritic changes including severe osteoarthritis of the pubic symphysis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history breast cancer in paternal aunt. 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 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. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 56 years, Male. Reason: 56 year old s/p ileostomy with abdominal pain and nausea. R/o obstruction History: NA Nonobstructive bowel gas pattern. Numerous surgical staples and suture material project over the abdomen. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Osteopenia both prematurity. No phosphate level.VIEWS: Last knee and wrist AP 2/9/15 at 2047 hrs. (Two views) Periosteal reaction of the distal femur proximal tibia and ulna is likely physiologic. Mild cupping and fraying of the distal metaphyses of the ulna is concerning for rickets. | Likely physiologic periosteal reaction of the distal ulna and femur as well as proximal tibia.Possible rickets. |
Generate impression based on findings. | 7-year-old male with pain after slammed finger in doorVIEWS: Right thumb, PA, lateral (3 views, ) 2/9/15 22:38 Alignment is anatomic. Mild soft tissue swelling about the IP joint without fracture. | Soft tissue swelling without fracture or dislocation. |
Generate impression based on findings. | Pain.VIEWS: Right wrist PA/lateral/oblique (3 views) 02/09/15 A joint effusion is present; the pronator quadratus fat pad is displaced. A 3 mm bone fragment is displaced from the lateral articular surface of the radius. Displacement is by approximately 3 mm. No other fracture is seen. | Radial articular fracture. |
Generate impression based on findings. | XR PORT ABDOMEN SINGLE VIEW AP, 2/9/2015 7:26 PM 84 years, Male. Reason: confirm NG tube placement after 3 cm advancement History: pls see above Nasogastric tube side port is projected over the proximal gastric body with tip projected over the distal gastric body. Heavy splenic artery calcification.Nonobstructive bowel gas pattern. The pelvis is excluded from the field-of-view. | Nasogastric tube side port projected over the proximal gastric body with tip projected over the distal gastric body. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 17 years, Female. Reason: please evaluate stool burden History: chronic abdominal pain and hx of constipation Nonobstructive bowel gas pattern. Desiccated stool noted in the sigmoid colon and rectum. | Desiccated stool in the sigmoid colon and rectum. |
Generate impression based on findings. | 67-year-old male. Severe SOB. Evaluate for PE. PULMONARY ARTERIES: No evidence of embolism. Main pulmonary artery diameter is 39 mm, suggestive of pulmonary artery hypertension.LUNGS AND PLEURA: Septal thickening and bilateral patchy groundglass opacities consistent with pulmonary edema. Bilateral lower lobe dependent opacities consistent with dense atelectasis, likely related to CHF. Small right pleural effusion and fluid in the left major fissure.Calcified nodules consistent with healed granulomatous disease.MEDIASTINUM AND HILA: No visible coronary artery calcification.No mediastinal or hilar lymphadenopathy.Mild cardiomegaly. No significant pericardial effusion.CHEST WALL: Multilevel mild degenerative changes of the thoracic spine. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis. | 1. No evidence of pulmonary embolism.2. Findings consistent with moderate pulmonary edema and dense dependent atelectasis due to congestive heart failure.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 41 years, Female. Reason: hx of bloating; r/o ileus History: occ bloating. past hx of abd surgery for esophageal cancer Nonobstructive gas pattern. There is an average amount of stool throughout the colon. Surgical changes are again noted in the upper abdomen as well as a gastric pull up. | Nonobstructive gas pattern. |
Generate impression based on findings. | Female 72 years old Reason: eval for diverticulitis History: LLQ pain CHEST:LUNGS AND PLEURA: Minimal basilar atelectasis with mild bilateral lower lobe bronchial wall thickening which may indicate reactive airways disease.MEDIASTINUM AND HILA: No significant abnormality noted. 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: Right superior pole cortically based exophytic mass which is isoattenuating to the renal parenchyma. The mass measures up to 1.0 cm (series 3, image 55) and is suspicious for neoplasm. Bilateral atrophic kidneys consistent with medical renal disease.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered diverticulosis of the descending colon without definite evidence of inflammation.BONES, SOFT TISSUES: Mild degenerative changes of the lumbar spine with severe degenerative changes at L5/S1.OTHER: Mild atherosclerotic calcifications of the aorta.PELVIS:UTERUS, ADNEXA: Surgically absent.BLADDER: Distended bladder which extends below the symphysis pubis and likely represents a cystocele. LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Rectocele is suspected. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Colonic diverticulosis without specific evidence of diverticulitis. No acute abnormality to account for the patient's left lower quadrant pain.2.Cortically-based right renal mass measuring 1.0 cm is suspicious for malignancy. Recommend triphasic CT to further evaluate. 3.Distended bladder which extends below the symphysis pubis and likely represents a cystocele. The findings were discussed by telephone with emergency department physician, Dr. Louissaint, at 9:15 am on 2/10/2015. |
Generate impression based on findings. | 16-week-old male status post intubation, confirm ETTVIEW: Chest AP (one view) 2/10/15 7:08 Interval placement of ETT with tip above the carina. NG tube tip and side-port project over the gastric body. Bilateral diffuse hazy pulmonary opacities are increased from the prior exam.The cardiothymic silhouette is unchanged. | ETT above the carina. Increased diffuse bilateral pulmonary opacities. |
Generate impression based on findings. | 88 years, Male. Reason: Check Dobhoff placement History: s/p DHT placement Dobbhoff tubing with tip projected over the distal gastric body. Bilateral nephroureteral stents are projected over the expected course of the ureters and are incompletely imaged. Cardiac conduction device, partially imaged, is projected over the left lower chest. Nonobstructive bowel gas pattern. Degenerative changes of the lumbar spine. Note, the lower pelvis is excluded from the field-of-view. | Dobbhoff tube with tip projected over the distal gastric body. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | One day old female with respiratory distress, acidosis. Evaluate for effusion, focal infiltrate.VIEW: Chest AP (one view), Abdomen AP (one view) 2/9/2015 22:48:30 Diffuse interstitial opacities without focal air space opacity or consolidation. No pleural effusion or pneumothorax. Cardiothymic silhouette is normal. Bowel gas pattern is slightly disorganized likely related to patient's age. No evidence of obstruction, pneumatosis intestinalis, free air, portal venous gas or ascites. | Diffuse interstitial opacities likely represents transient tachypnea of the newborn. |
Generate impression based on findings. | Cerebral palsy. Desaturations, constipation and firm abdomenVIEW: Abdomen AP (one view) 2/9/15 at 2135 hrs. Thoracolumbar dextroscoliosis, gastrostomy tube and left lower lobe atelectasis noted. Possible small right-sided pleural effusion is present as well. Disorganized, nonspecific abdominal gas pattern. No evidence of free air or obstruction. No fecal accumulation. | Left lower lobe opacity, likely atelectasis and possible small right-sided or effusion.Nonspecific abdominal gas pattern. |
Generate impression based on findings. | 86 years, Male. Reason: 86M with 4 days of nausea and emesis History: as above Four nephroureterostomy tubes, two on each side, are in place. Nonobstructive bowel gas pattern. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 41 years, Female. Reason: pain History: distension, pain Nonobstructive bowel gas pattern. The lung bases are clear. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Injury to third toe. Evaluate tarsal/metatarsal.VIEWS: Left foot AP/lateral (two views) 02/10/15 No soft tissue swelling is seen. The bones are normal in appearance. A fracture is not identified. | No fracture. |
Generate impression based on findings. | Reason: new cva History: facial droop The CSF spaces are appropriate for the patient's stated age with no midline shift. Subdural effusions in the posterior fossa probably related to atrophy. The ventricles are sizable which may also be related to atrophy.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma. Periventricular and subcortical white matter hypodensities of a moderate 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. The eyeball lenses are thin. Atherosclerotic calcifications are present along the distal internal carotid arteries. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.3.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. | 48 years, Female. Reason: evaluate for free air, obstruction History: abdominal pain Stimulator leads are partially visualized. IVC filter is present.Nonobstructive bowel gas pattern. No pneumoperitoneum. Note that the pelvis is excluded from the field-of-view. | Nonobstructive bowel gas pattern. No pneumoperitoneum. |
Generate impression based on findings. | Respiratory distress.VIEW: Chest AP (one view) 02/10/15, 0456 Tracheostomy tube remains in place. Feeding tube has been removed.Right base opacity is decreased. Residual subsegmental atelectasis is present. No other focal opacity is identified. Cardiac silhouette size is normal.Dilated bowel is present in the upper abdomen.Left thoracolumbar curve persists. | Improvement in appearance of chest with decrease in right lower lobe atelectasis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bilateral benign breast biopsies. Family history of breast cancer in mother. 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. Focal asymmetry noted in the right outer breast. Scattered benign calcifications, including arterial calcifications, are present bilaterally. No suspicious microcalcifications or areas of architectural distortion are present. | Right outer breast focal asymmetry for which further evaluation with spot compression views and possible ultrasound is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 5 month old male with omphalocele. NG tube placed, assess position. VIEW: Abdomen AP (one view) 2/9/2015 23:07:58 There are two feedings tubes terminating in the stomach which is located within a giant omphalocele. Left lower extremity PICC with tip at T11 vertebral body level unchanged. Giant omphalocele is again noted with persistent nonspecific bowel dilatation with distal air in the rectum. There is no evidence of obstruction, pneumatosis intestinalis, free air, portal venous gas or ascites. There is redemonstration of punctate foci of calcification in the external edge of the omphalocele. Streaky basilar opacities are unchanged. | 1. NG tube tip in the stomach with persistent nonspecific bowel dilatation. No evidence of obstruction. 2. Calcification at the external edge of the omphalocele is unchanged which may represent most likely wall calcification or meconium peritonitis. |
Generate impression based on findings. | 36-year-old male. Chest pain. Evaluate for PE. PULMONARY ARTERIES: Acute pulmonary emboli in the left lower lobe segmental and subsegmental arteries. LUNGS AND PLEURA: Peripheral left lower lobe wedge-shaped ground glass opacities consistent with an infarct due to the aforementioned pulmonary emboli.Faint scattered groundglass opacities bilaterally, most pronounced in the right middle lobe and lower lobe, similar to prior, likely represents resolving infection.MEDIASTINUM AND HILA: Minimal residual thymic tissue.Normal heart size. Minimal pericardial fluid anteriorly.Right central venous catheter tip at the right atrium.No mediastinal or hilar lymphadenopathy.No visible coronary artery calcification.No RV strain.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Atrophic left kidney. | Acute pulmonary emboli in the left lower lobe with associated infarct.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Segmental.RV Strain: Negative. |
Generate impression based on findings. | 6-week-old female postop cardiac surgery, now extubatedVIEW: Chest AP (one view) 2/10/15 5:21 Right central venous catheter tip at the cavoatrial junction. NG tube tip and side-port in the gastric body. Surgical clips are noted in the upper mediastinum. Epicardial pacer leads are unchanged in position. The cardiothymic silhouette is unchanged. Bronchial wall thickening and increased right upper and bibasilar subsegmental atelectasis. There is a right basilar lucency which is nonspecific, but may represent a small subpulmonic pneumothorax. | Increased basilar atelectasis and questionable right subpulmonic pneumothorax. |
Generate impression based on findings. | Reason: eval s/p aneurysm clipping History: sah Since the pervious exam the patient has undergone right-sided craniotomy for anterior communicating artery aneurysm clip placement. In addition, a ventriculostomy tube has been placed which courses to the right frontal lobe into the frontal horn of the right lateral ventricle with tip in the body of the left lateral ventricle. There is some intraventricular blood present. There attendant postoperative changes with scalp soft tissue swelling and intracranial airThe visualized portions of the paranasal sinuses demonstrate mucosal thickening and air-fluid level.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Status-post recent right-sided craniotomy for aneurysm clip placement. There is redemonstration of subarachnoid blood products and intraventricular blood. 2.A ventriculostomy tube is in place. There is no evidence for ventriculomegaly at this time. |
Generate impression based on findings. | Reason: eval for malignancy History: weakness, new pulm nodule LUNGS AND PLEURA: Scattered benign appearing pulmonary micronodules, some calcified. Focal pleural-based calcification in the left upper lobe (series 7, image 22). No suspicious pulmonary nodules or masses. Basilar subsegmental scarring/atelectasis. No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Moderate coronary artery calcification. Atherosclerotic calcification of the thoracic aorta, with mural thrombus involving the descending thoracic and abdominal aorta.CHEST WALL: Degenerative disease of the thoracic and visualized lumbar spine. Age indeterminate moderate compression fracture of the L2 vertebral body superior endplate.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Multiple renal cysts, partially visualized. Atherosclerotic calcification and mural thrombus involving the abdominal aorta, with marked narrowing of the celiac artery origin. The renal artery origins are widely patent. | 1. No acute cardiopulmonary abnormality. No suspicious pulmonary nodules or masses as questioned on recent chest radiograph.2. Atherosclerotic calcification and mural thrombus involving the descending thoracic and abdominal aorta, with marked narrowing of the celiac artery origin. Recommend followup with abdominal CT angiogram for further evaluation. |
Generate impression based on findings. | Hypoxia.VIEW: Chest AP (one view) 2/10/15 at 439 hours. ET tube terminates at the carina. Gastrostomy tube is present. Cardiac silhouette size is top normal. Streaky bibasilar opacities, likely subsegmental atelectasis are noted. | Multifocal subsegmental atelectases as described. |
Generate impression based on findings. | 9-year-old male, intubated, follow-up examVIEW: Chest AP (one view) 2/10/15 5:37 ETT above the carina. Left central venous catheter tip at the cavoatrial junction. Right PICC tip in the SVC. NG tube tip and side-port in the gastric body. The cardiothymic silhouette unchanged. Mild basilar predominant interstitial edema and small pleural effusions, not significantly change. | Mild unchanged pulmonary edema. |
Generate impression based on findings. | Female, 62 years old, with colon cancer. Evaluate prior to new treatment. CT head:The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No pathologic enhancement is detected. No intracranial hemorrhage or abnormal extra-axial fluid is seen. There is no evidence of mass effect or parenchymal edema. The ventricular system is normal in size and morphology. The visualized paranasal sinuses and mastoid air cells are clear. The bones of the calvarium and skull base are intact. CT C-spine:Trace anterolisthesis of C3 relative to C4, and C4 relative to C5, is seen. A mild levocurvature of the cervical spine may be positional.Vertebral body height is preserved. No concerning or destructive osseous lesions are detected. No fracture or acute abnormality is seen.C2-3: Minimal disk osteophyte formation. No significant spinal canal or neuroforaminal stenosis. C3-4: Minimal disk osteophyte formation. No significant spinal canal or neuroforaminal stenosis. C4-5: Minimal disk osteophyte formation. No significant spinal canal or neuroforaminal stenosis. C5-6: Severe loss of disk height with endplate irregularity and subchondral cyst formation. Disk osteophyte complex causing mild ventral spinal canal effacement. Mild left and moderate right foraminal narrowing. C6-7: Severe loss of disk height with endplate irregularity and subchondral cyst formation. Disk osteophyte complex causing mild ventral spinal canal effacement. Mild bilateral foraminal narrowing.C7-T1: Facet hypertrophy. No significant spinal canal or neuroforaminal stenosis.Stranding is evident through the partially visualized fascial planes of the left neck. CT T-spine:The thoracic kyphosis is mildly exaggerated, but alignment is otherwise unremarkable. Vertebral body heights and morphology are within normal limits. No concerning or destructive osseous lesions are seen.No evidence of significant degenerative disk disease, spinal canal or foraminal stenosis. Mild facet hypertrophy develops at lower levels.Numerous pulmonary nodules are identified bilaterally, along with atelectasis or scarring in the left lung apex. Scattered prominent para-aortic lymph nodes are also seen.CT L-spine:A grade 1 anterolisthesis of L4 relative to L5 likely secondary to facet hypertrophy at this level. Spinal alignment is otherwise unremarkable. Vertebral body height and morphology are normal. No concerning or destructive osseous lesions are seen.L1-2: Bulging disk. Mild spinal canal stenosis. Mild bilateral foraminal narrowing. L2-3: Bulging disk. Mild spinal canal stenosis. No significant foraminal narrowing. L3-4: Facet hypertrophy. Ligamentum flavum thickening. Bulging disk. Moderate spinal canal stenosis. No significant foraminal narrowing. L4-5: Bulky facet hypertrophy. Ligamentum flavum thickening. Loss of disk height with disk uncovering and bulging. Moderate to severe spinal canal stenosis. Moderate right foraminal narrowing. L5-S1: Mild facet hypertrophy. Loss of disk height with mild bulging and osteophyte formation. No significant spinal canal or foraminal stenosis.Scattered retroperitoneal surgical clips are seen. The left kidney is not visualized. Scattered prominent para-aortic and mesenteric lymph nodes are seen. | 1. No evidence to suggest metastatic disease to the brain or spine.2. Relatively mild degenerative findings are seen in the cervical spine.3. Moderate to severe degenerative findings are seen in the lumbar spine with significant spinal canal stenosis at L3-4 and L4-5.4. Multiple pulmonary nodules, as well as mesenteric and retroperitoneal adenopathy, are better assessed on the same day CAP CT. Stranding through the fascial planes in the left neck is of uncertain significance. |
Generate impression based on findings. | bihemispheric multifocal ischemic infarctions. NONCONTRAST CT HEADCLINICAL INFORMATION:headache during sexCOMPARISON: None.TECHNIQUE: MRI brain without and with contrast, MRA brain without contrast were performed. 20ml Multihance were administered intravenously. | 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. CTA HEAD AND NECKThere is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. 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. There is normal contrast opacification through bilateral ICAs, MCAs, and ACAs.Vertebrobasilar system appears to be normal.No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage. |
Generate impression based on findings. | Reason: Patient with history of stroke s/p LCEA. New RLE weakness/numbness/tingling in October 2014. Carotid duplex 1/30 with findings that could suggest possible distal ICA occlusion. Pls eval. Thanks History: 1 episode of RLE weakness/numbness/tingling 10/2014 Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is approximately 65% stenosis at the origin of the left subclavian artery from the aorta associated with calcified plaque. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. The patient is status post left-sided endarterectomy with pantaloon appearance of the LCCA bifurcation. The right vertebral artery is small. The left vertebral artery has a tortuous origin and is stenotic at its origin with approximately 50% stenosis at its origin.Atherosclerotic calcifications are present at the carotid bifurcations. The patient is status post thyroidectomy.The patient is status post anterior fusion at C3-4 and C4-5. There are degenerative changes in the cervical spine worst at C6-7 rather endplate and uncovertebral osteophytes narrowing the neural foramina spinal canal.Brain CTA: There is opacification of the distal internal carotid arteries, the distal left vertebral artery and the proximal anterior middle and posterior cerebral arteries. The anterior communicating artery and the posterior communicating arteries are identified. The distal right vertebral artery is occluded.There is a high-grade stenosis present along the ophthalmic segment of the left internal carotid artery associated with calcific plaque. On the basis of WASID criteria this is approximately 70% stenosis. Please note that calcific plaque may exaggerate a stenosis.The circle of Willis is functionally incomplete. The anterior communicating artery is medium-sized. There is triplication of the anterior cerebral artery A2 segments. The left A1 segment is hypoplastic and barely visible. The right posterior communicating artery is essentially a fetal origin for the posterior cerebral artery and at the right P1 segment is hypoplastic. The left anterior choroidal artery is identified, however, the left posterior communicating artery is hypoplastic with a stump like appearance at the left p1/p2 junction.The basilar artery is occluded between the levels of the anterior/inferior cerebellar arteries and the superior cerebellar arteries. The right vertebral artery is not identified along its intracranial portion. There is opacification of the distal right vertebral artery and the right posterior inferior cerebellar artery. The left posterior inferior cerebellar artery has extracranial origin.CT head:There is redemonstration of foci of encephalomalacia in the left centrum semiovale and subcortical white matter of the left middle frontal gyrus as well as white matter associated with the left parietal lobe and posterior temporal lobe and along the left occipital lobe. There is redemonstration of a hypodense lesion in the right internal capsule and basal ganglia.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. Atherosclerotic calcifications are present along the distal vertebral arteries. | 1.There is 70% stenosis along the left ICA ophthalmic segment. Please note that the left ICA effectively only supplies the left MCA due to hypoplastic left A1 segement and hypoplastic left PCOMA.2.Occlusion of the basilar artery. Collateral flow emanates through a hypoplastic right P1 segment and possibly through leptomeningeal collaterals from the posterior inferior cerebellar arteries. This suggests possible susceptibility to low perfusion states.3.Stenosis at the origins of the anterior/inferior cerebellar arteries.4.50% stenosis at origin of left vertebral artery.5.65% stenosis at the origin of the left subclavian artery6.Occlusion of the right vertebral artery distally but the proximal to the origin of the right posterior inferior cerebellar artery which appears to receive supply via reverse filling of the vertebrobasilar junction.7.Encephalomalacia in the left hemisphere predominantly in a watershed distribution.8.Status post left-sided endarterectomy9.Status post thyroidectomy10.Degenerative changes are present in the cervical spine.The patient is status post anterior fusion. |
Generate impression based on findings. | 2nd post reduction radiographs Osseous detail is obscured by overlying cast material.Interval further reduction of the ankle fracture-dislocation, with the distal fibular fracture, posterior malleolar fracture, and tibiotalar articulation now in anatomic alignment. No new fractures are seen. | Interval further reduction of the ankle fracture-dislocation, now in anatomic alignment. |
Generate impression based on findings. | 60-year-old male with surgical site abscess. 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: No significant abnormality notedLIVER, BILIARY TRACT: Postsurgical changes of liver transplant with expected pneumobilia. Reflux of enteric contrast into the biliary system indicates patent hepaticojejunostomy.SPLEEN: Mild splenomegaly appearing similar to prior.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mildly prominent gastrohepatic and hepatoduodenal lymph nodes again seen unchanged from prior examinations, expected finding in patients with chronic liver disease.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: There is a complex collection of fluid and gas within the anterior abdominal wall surgical site (series 3, image 54) measuring 2.5 x 5.3 centimeters in the axial dimension and up to 17.3 cm in the craniocaudal dimension (sagittal series, image 59) compatible with an abscess. The abscess is in continuity with underlying surgical mesh but does not appear to extend into the peritoneal cavity. Loops of small bowel are adherent to the abdominal wall subjacent to the abscess. Foci of high-density within the abscess may represent pieces of mesh versus enteric contrast from fistulous communication.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: There is a complex collection of fluid and gas within the anterior abdominal wall surgical site (series 3, image 54) measuring 2.5 x 5.3 centimeters in the axial dimension and up to 17.3 cm in the craniocaudal dimension (sagittal series, image 59) compatible with an abscess. The abscess is in continuity with underlying surgical mesh but does not appear to extend into the peritoneal cavity. Loops of small bowel are adherent to the abdominal wall subjacent to the abscess. Foci of high-density within the abscess may represent pieces of mesh versus enteric contrast from fistulous communication.OTHER: No significant abnormality noted | 1.Large anterior abdominal wall abscess in continuity with underlying mesh but which does not appear to extend into the peritoneal cavity. Loops of small bowel adhere to the subjacent abdominal wall.2.Foci of high attenuation within the abscess may represent pieces of mesh or enteric contrast from fistulous communication, recommend clinical correlation.3.Post surgical changes of liver transplant. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of benign left breast biopsy. Family history of breast cancer in mother and maternal first 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. Multiple benign circumscribed masses are present in both breasts, compatible with fibroadenomas. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Bilateral benign breast 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. | A patient submitted outside study for review. Submitted for review are digital mammographic images (12/26/14, 1/14/15), ultrasound images of right breast and right axilla (1/14/15), images from ultrasound guided biopsy of right breast and post procedural right mammographic images (1/22/15) performed at Advocate Trinity Hospital. For comparison, digital mammographic images (11/13/13) are available. DIGITAL MAMMOGRAPHIC IMAGES (12/26/14, 1/14/15):The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Irregularly shaped, ill-defined, spiculated mass, measuring approximately 2 cm, is present at lower inner quadrant in the right breast. New asymmetry is seen at posterior upper aspect of right breast on MLO view.Increase in the size of one of the right axillary lymph nodes.Skin thickening of the right breast is noted, and it has mildly increased when compared to the previous study. There is a stable calcified mass with marker clip at upper inner left breast. Stable circumscribed mass is also seen in the posterior 6 o'clock position. No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in left breast. ULTRASOUND IMAGES OF RIGHT BREAST AND RIGHT AXILLA (1/14/15):An irregularly-shaped hypoechoic mass, measuring 22 x 16 mm, with increased vascularity is visualized at the 4 o'clock position in the right breast, 6 cm from nipple, corresponding to an irregularly-shaped mass on the mammogram.In the right axilla, there is a lymph node with abnormally thickened cortex.IMAGES FROM ULTRASOUND GUIDED BIOPSY OF RIGHT BREAST AND POST PROCEDURAL RIGHT MAMMOGRAPHIC IMAGES (1/22/15):Ultrasound guided biopsy for the suspicious mass at 4 o'clock position in the right breast was performed with an appropriate needle placement. Postprocedural mammographic images show a marker clip at posterior portion of the irregularly-shaped mass.Per pathology report of the University of Chicago, the result was malignant; invasive ductal carcinoma grade 2 and ductal carcinoma in situ, intermediate and high nuclear grade. | Biopsy proven carcinoma in the right breast at 4 o'clock position. Increasing skin thickening and new asymmetry in the right breast. Abnormal lymph node in the right axilla. Breast MRI is recommended for evaluation of the extent of disease in the right breast.2. No mammographic evidence for malignancy in the left breast.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Status post reduction of ankle fracture. Osseous detail is obscured by overlying cast.Interval reduction of the ankle fracture-dislocation. The fibular fracture is in near anatomic alignment. The tibiotalar articulation is improved, thought there remains mild widening of the medial tibiotalar joint space and tibiotalar articulation anteriorly. A nondisplaced posterior malleolar fracture is now evident. | Ankle fracture-dislocation reduction, as above. |
Generate impression based on findings. | HEAD: The examination is limited due to "grainy" image quality likely secondary to low dose (mAs = 95) technique. There is no gross intracranial hemorrhage, or midline shift. There is no hydrocephalus. The skull is intact.MAXILLOFACIAL: There are postoperative findings related to partial left lobectomy and left maxillary antrostomy with persistent but mildly improved near complete opacification of the left maxillary sinus and mild scattered mucosal thickening of the right ethmoid air cells and residual left ethmoid air cells without significant change. There is mild nasal septal deviation to the right again seen. There is unchanged trace left sphenoid sinus mucosal thickening. There are no air-fluid levels or bubbly secretions. | 1.Poor scan quality likely due to low dose technique. No gross intracranial hemorrhage or hydrocephalus. 2.No evidence of acute sinusitis.3.Postoperative sinonasal anatomy with persistent but mildly improved near complete opacification of the left maxillary sinus, along with scattered mucosal thickening of the right ethmoid air cells, and residual left ethmoid air cells without significant change. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal grandmother and three maternal cousins. 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. Bilateral benign morphology masses are stable when compared to prior exams. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Bilateral benign breast 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. | There are patchy regions of restricted diffusion with associated T2/FLAIR signal abnormality in the right middle frontal gyrus and a punctate focus of restricted diffusion in the right thalamus consistent with acute ischemia. Additional regions of FLAIR/T2 signal abnormality in the periventricular and subcortical white matter consistent with chronic small vessel ischemic disease. No evidence of acute intracranial hemorrhage. Scattered foci of susceptibility consistent with remote microhemorrhage. Mild prominence of ventricles and sulci most likely secondary to age-related volume loss. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. | Findings consistent with non-hemorrhagic acute to subacute ischemia in the right MCA territory as above.Findings relayed to Dr. Jared Davis over the phone at approximately 8:37 am. |
Generate impression based on findings. | 5-year-old male with right IJ central line placement. Assess placement.VIEW: Chest AP (one view) 22:58:50 Right IJ central venous catheter with tip at the cavoatrial junction. ET tube tip below the thoracic inlet and above the carina. Two feedings tubes are present, one with tip in the fundus and the other extends beyond the inferior margin of the image. Cardiac size is top normal. Focal left lower lobe opacity unchanged. | 1. Right IJ central venous catheter with tip at the cavoatrial junction. 2. Persistent left lower lobe opacity unchanged. |
Generate impression based on findings. | 61-year-old male. Fever, cough, productive sputum. Small cell carcinoma. LUNGS AND PLEURA: New patchy ground glass and solid opacities in the left lower lobe consistent with aspiration and infection. Previously seen groundglass opacities in the anterior aspect of the left lower lobe have resolved.Circumferential nodular pleural thickening in the right hemithorax consistent with tumor, not significantly changed. Reference measurements, as follows:1. Aortic arch 3 o'clock position: 2.6 cm, unchanged (series 6, image 35).2. Subcarinal level 4 o'clock position: 7.2 cm, unchanged (series 6, image 47).3. Left atrium 12 o'clock position: 2.9 cm, unchanged (series 6, image 62).Interval removal of right pleurex catheter. Loculated pleural fluid is again seen, in the right major fissure and in the right lower thorax. There is right lower lobe and basilar atelectasis/consolidation, increased. Mild emphysema.MEDIASTINUM AND HILA: Interval resolution of previously seen acute pulmonary emboli in the distal left main pulmonary artery and its branches.Leftwards mediastinal shift, unchanged.Ipsilateral mediastinal and hilar lymphadenopathy, not significantly changed. The reference subcarinal lymph node is 2.4 cm (series 6, image 51), unchanged. Right internal mammary chain lymphadenopathy.Severe coronary artery calcification.Intraluminal debris is seen in the upper thoracic esophagus.CHEST WALL: Tumor is again seen to extend through the bony thorax to the right side of the sternum and through several intercostal spaces. Cortical erosions involving the right 7, 8, 9, and 11th ribs, similar to prior.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Small subcentimeter lymph nodes in the gastrohepatic ligament and at the celiac axis. | 1. New left lower lobe patchy opacities consistent with aspiration and infection.2. Extensive right hemithorax pleural tumor and mediastinal lymphadenopathy, not significantly changed.3. Interval resolution of previously seen acute left pulmonary emboli. |
Generate impression based on findings. | 11 week old female, follow bilateral pleural effusionsVIEW: Chest AP (one view) 2/10/15 6:02 ETT above the carina and below the thoracic inlet. NG tube tip and side-port in the stomach.Extensive bilateral palmar opacities and left pleural effusion. No pneumothorax. The cardiothymic silhouette is obscured.Nonspecific bowel gas pattern without evidence of obstruction. | Extensive bilateral pulmonary opacities and left pleural effusion. |
Generate impression based on findings. | Female 36 years old Reason: evaluate for injury History: pain s/p fall. Seen only on the oblique view is a step-off along the ulnar margin of the triquetrum, suspicious for a nondisplaced fracture. There is also soft tissue swelling along the proximal wrist. A lucency with sclerotic margins in the lunate bone may represent a cyst or ganglion.Three views of the hand show the aforementioned wrist findings. Remainder of the hand is unremarkable. | There is a step-off along the ulnar margin of the triquetrum seen only on the oblique view of the wrist. This could represent a fracture if it corresponds to site of patient's pain. CT can be considered for further evaluation if clinically warranted.Dr. Mulligan was notified by phone regarding these findings on 2/10/2015 at 0852. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother and maternal grandmother. Two standard digital views and additional bilateral MLO views 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. A vascular port and catheter tubing overly the upper outer breasts/axillary regions and these limit the field of view of this exam. No suspicious masses, microcalcifications or areas of architectural distortion are present within the visualized portions of the breasts. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Right ankle swelling status post fall Comminuted fracture of the distal fibula, with lateral angulation of the distal fracture fragment. Tibiotalar disarticulation, with 2 cm lateral and 2.5 cm posterior displacement of the talus relative to the tibia and compatible with deltoid ligament tear. | Ankle fracture-dislocation, as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in paternal grandmother and paternal great-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 composed of scattered fibroglandular density. There is a possible left retroareolar mass. No suspicious microcalcifications or areas of architectural distortion are present. | Possible left retroareolar mass. Comparison to prior studies is needed to ensure stability of this appearance. If they cannot be submitted, then diagnostic evaluation will be necessary. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Ms. Moore is a 55 year old female with a personal history of left breast mastectomy in 2002 followed by chemoradiation and hormonal therapy. No current breast related complaints. Three standard views of the right 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. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in the right breast. Benign lymph nodes project over the right axilla. | No mammographic evidence of malignancy. Given patient's young age at diagnosis and dense breast, consideration into obtaining a routine breast MRI should be made. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Pain.VIEWS: Right foot standing AP/lateral (2 views) 02/10/15 Pes planovalgus is present. No fracture is seen. | Pes planovalgus. |
Generate impression based on findings. | Postop.VIEWS: Left foot AP/lateral (two views) 02/10/15 Screws remain in place in the calcaneus. No fracture is seen. | Unchanged exam. Healed calcaneal osteotomy. |
Generate impression based on findings. | Reason: pe study History: hypoxemia PULMONARY ARTERIES: Suboptimal contrast bolus leads to near-nondiagnostic study for pulmonary embolism. No large central pulmonary embolism is seen. No evidence of right heart strain.LUNGS AND PLEURA: Right upper lobe calcified granuloma. No suspicious pulmonary nodules or masses. No focal air space consolidations. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. No visible coronary calcifications. No mediastinal or hilar lymphadenopathy.CHEST WALL: Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small perihepatic and perisplenic ascites. Hepatosplenomegaly. Status post TIPS procedure. | Nondiagnostic study for pulmonary embolism. No other acute cardiopulmonary abnormality.PULMONARY EMBOLISM: PE: Indeterminate.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Right groin pain.EXAMINATION: Pelvis AP/frog leg (two views) 02/06/15 Round, smooth femoral heads are well directed into normally formed acetabula. No fracture is seen.A moderate to large amount of feces is present in the rectosigmoid. | Normal appearance of bones. No evidence of avascular necrosis. |
Generate impression based on findings. | Male 30 years old Reason: fx? History: pain in the dorsum of hand and palmar area. There is a well corticated ossicle distal to the ulna which may represent an ulnar styloid fracture fragment or normal variant; we see no acute fracture. There is a small round lucency with sclerotic margins in the third metacarpal head which may represent a cyst or ganglion. | No acute fracture or other acute findings to account for patient's pain. Other findings as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and a repeat left MLO view 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. Stable bilateral asymmetries. Stable axillary lymph nodes. | 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. | Female 47 years old; Reason: pre-kidney transplant, assess aortic and iliac vessels for kidney transplants History: pre-kidney transplant, diminished pedal pulses ABDOMEN:LUNG BASES: Soft tissue nodule in the left lower lobe measures 10 mm on image 11/series 3, unchanged.LIVER, BILIARY TRACT: Liver is normal in morphology and unremarkable for unenhanced technique. Gallbladder stones layer within a nondistended gallbladder.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Probable renal cortical cysts.RETROPERITONEUM, LYMPH NODES: The aorta is normal in caliber and course. Few scattered focal calcifications in the common iliacs and infrarenal abdominal area. No calcific circumferential plaque.The smaller vessels (second and third order branches) show heavy calcification with a pattern suggestive of diabetes.BOWEL, MESENTERY: Postsurgical changes in the bowel in the left upper abdomen.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.No significant calcific plaque burden involving the aorta and iliac vessels.2.Severe calcific arteriosclerotic disease of the second and third order branch vessels.3.Left lower lobe soft tissue nodule follow -up is suggested.4.Cholelithiasis. |
Generate impression based on findings. | Female 72 years old Reason: eval for fx History: L hip pain. Small osteophytes indicate mild osteoarthritis. We see no fracture. | Mild osteoarthritis. No fracture. |
Generate impression based on findings. | Male 62 years old; Reason: cholangiocarcinoma History: cholangiocarcinoma ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Dominant right hepatic lobe mass measures 12.0 x 12.0 cm (image 37/series 11) previously, 11 x 11 cm.Satellite lesion measures 2.0-cm previously, 1.2-cm on image 39/series 11.There are multiple other scattered peripheral satellite lesions in the right hepatic lobe. There is mild ductal dilatation within the right hepatic lobe.Status post embolization of the right portal vein. Left portal vein is patent. 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: Mild calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Increase in the size of the dominant right hepatic lobe lesion. |
Generate impression based on findings. | Fracture The complete subcapital fracture of the femoral neck with slight valgus angulation is again seen and unchanged. The hip joint alignment is normal. No additional fractures are identified. | Femoral neck fracture, as above. |
Generate impression based on findings. | Male 21 years old Reason: post reduction History: same. Two views of the right hand were obtained following reduction and splint placement. Evaluation of fine detail is limited by overlying splint. Again seen is a fracture of the the fifth metacarpal neck that has been reduced such that there is now approximately 40 degrees of volar angulation of the distal fracture fragment. | Fifth metacarpal fracture post reduction as above. |
Generate impression based on findings. | Ankle pain Soft tissue swelling about the ankle. No fracture or malalignment. No joint effusion evident. | No fracture or malalignment. |
Generate impression based on findings. | Swelling. Soft tissue swelling about the ankle, particularly over the lateral malleolus. No fracture or malalignment. | No fracture or malalignment. |
Generate impression based on findings. | Ms. Jaeger is a 51 year old female with a personal history of right breast mastectomy in June 2013 for IDC followed by chemoradiation therapy. No current breast related complaints. Three standard views of the left breast 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. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in the left breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 71 years, Male. Reason: abdominal dist History: hiccups Midline surgical staples and left upper quadrant surgical sutures are noted. Interval removal of nasogastric and right-sided abdominal tube. Left abdominal tube is unchanged in position.Relative paucity of bowel gas throughout the abdomen. Right pleural effusion and overlying atelectasis. Retrocardiac opacity. | Nonspecific bowel gas pattern. |
Generate impression based on findings. | Pain status post fall No fracture or dislocation. High riding humeral head, compatible with chronic rotator cuff tear or rotator cuff atrophy. Humeral head degenerative subchondral cysts. | Degenerative changes, without fracture or dislocation. |
Generate impression based on findings. | Pain status post fall No fracture or malalignment. Mild osteoarthritis of the right hip. Vascular calcifications noted. | No fracture or malalignment. |
Generate impression based on findings. | Pain No fracture or malalignment. No joint effusion evident. | No fracture or malalignment. |
Generate impression based on findings. | Female 63 years old Reason: s/p R hip hemiarthroplasty History: see above. Components of a right hip hemiarthroplasty are situated in near anatomic alignment. Skin staples, a drain, and foci of gas in the soft tissues reflect recent surgery. | Right hip hemiarthroplasty as described above. |
Generate impression based on findings. | 59 years, Male. Reason: assess for obstruction or other causes of distention History: abdominal distention Partially visualized cardiac assist device line is seen at midline coursing above the field of view. Two tubes project over the left paramedian abdomen coursing above the field-of-view. Cholecystectomy clips are noted. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 15 year-old female with acute respiratory failure, intubated. Follow up exam.VIEW: Chest AP (one view) 2/10/2015 4:49:45 ET tube tip below the thoracic inlet. Spinal fusion instrumentation consisting of hooks, rods and pedicle screws extends from T2 to L1 with residual dextroscoliosis. Right upper extremity PICC with tip obscured by instrumentation. Right IJ central venous catheter is no longer visualized. Feeding tube tip distal to the proximal body of the stomach and not visualized as it extends beyond inferior margin of the image. Focal density overlying the junction of the left anterior second rib and posterior fifth rib. Hazy opacity in the lateral two thirds of the right lung base with preservation of the right heart border and hemidiaphragm and blood vessels can be seen coursing through the opacity. Persistent bibasilar streaky opacities likely atelectasis. Right pleural effusion.Cardiothymic silhouette is normal. | Increase in lung opacities in the interval. Probable layering right pleural effusion. |
Generate impression based on findings. | Mr. Grammer is a 68 year old male presenting with pain and discomfort in both breasts for one month. He denies a discrete mass, history of trauma, or fever/chills. Family history of breast cancer in maternal aunt. 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. There is no mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Bilateral benign gynecomastia without suspicious mammographic findings. Patient should follow up with his primary care physician for pain as clinically warranted.BIRADS: 2 - Benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | 71 years, Male, Reason: Patient with questionable small abdominal aortic aneurysm at OSH. Please eval. Thanks History: none. Former smoker. PAD and CAD.. CHEST:LUNGS AND PLEURA: Nodular pleural plaques within the right lung is well as along the left upper lobe. For reference, a posterior plaque along the right upper lobe measures 0.6 centimeters (11/34). Calcified plaques are also present along the diaphragms bilaterally. No suspicious parenchymal nodules or masses. No focal consolidation or pleural effusion. MEDIASTINUM AND HILA: Scattered small mediastinal lymph nodes. No hilar lymphadenopathy. Heart size is normal without pericardial effusion. Moderate coronary artery calcifications. Mild atherosclerotic calcifications of the aorta and its branches with areas of mural thrombus in the descending aorta.CHEST WALL: No significant abnormality notedABDOMEN: Evaluation of the upper abdomen is limited due to patient motionLIVER, BILIARY TRACT: Right hepatic granuloma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hyperattenuating lesion extending into the right renal sinus measures 2.3 cm and does not enhance on arterial phase images, however evaluation on the portal venous phase limited due to motion and volume averaging. Subcentimeter hypoattenuating lesions bilaterally likely represent cysts.RETROPERITONEUM, LYMPH NODES: The infrarenal abdominal aorta is aneurysmal measuring up to 3.0 x 2.9 cm (8/120) with atherosclerotic calcifications and multiple areas of mural thrombus. There is near complete thrombosis of the left common iliac immediately proximal to the bifurcation, however distal internal and external iliac branches reconstituted. Mild thickening of the right cruse of the diaphragm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative changes of the visualized spine.OTHER: No significant abnormality notedPELVIS: MalePROSTATE, SEMINAL VESICLES: Enlarged and multi-nodular prostate extending into the seminal vesicles bilaterally. Large left fat-containing inguinal hernia containing a loop of sigmoid colon. No evidence of obstructionBLADDER: 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.Mildly aneurysmal infrarenal aorta measuring up to 3 cm.2.Bilateral pleural plaques, some of which are calcified, are likely asbestos related.3.Hyperattenuating lesion in the right renal sinus. A benign complex cyst is favored. |
Generate impression based on findings. | There is normal alignment of the thoracic spine with preserved vertebral body heights. There is loss of disk height and multiple levels of the thoracic spine from T3-4 through T9-10, worst at T8-9 where there is severe loss of disk height, vacuum disk phenomenon and sclerotic endplate degenerative changes. In addition to these findings, there are additional findings levels as below. T7-8: Disk bulge without significant spinal canal stenosis.T8-9: Severe spinal canal stenosis from disk bulge and osteophytic ridging, facet hypertrophy and ligamenta flava thickening. Cord signal abnormality at this level seen on prior MRI is not depicted as CT is insensitive for detection of cord signal. There is bilateral neural foraminal stenosis at this level.The imaged lungs are clear. | Severe spinal canal stenosis at T8-9 as noted on the MRI. No significant interval change. |
Generate impression based on findings. | Reason: NO ORAL OR IV CONTRAST NEEDED. H/o esophageal leak. Stent migration over weekend while patient on full liquid diet. want to evaluate amount leaking in lungs/mediastinum History: NO ORAL OR IV CONTRAST NEEDED. esoph leak CHEST:LUNGS AND PLEURA: Bilateral chest tubes in place. Bilateral small pleural effusions, stable to decreased in size from the prior exam, with decreased associated atelectasis. Right basilar subsegmental atelectasis. Two left upper lobe nodular ground glass densities (series 4, images 31 and 34) appear similar to the prior exam. No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Esophageal stent now located more superiorly, with upper edge at the level of the aortic arch, and lower edge just distal to the GE junction. The previously visualized right paraesophageal mediastinal collection now measures up to 4.1 x 7.1 cm (series 3, image 69), increased in size from the prior exam, again extending to the diaphragm, and measuring above water density on noncontrast imaging. A previously described subcarinal lymph node measures up to 1.6 cm (series 3, image 43), unchanged within the limits of noncontrast imaging. Mild cardiomegaly. No visible coronary artery calcifications.CHEST WALL: 6-cm left axillary fat-containing mass is again seen, unchanged. Degenerative disease of the thoracic spine.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No focal liver lesions are seen within the limits of noncontrast imaging. No intrahepatic or extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Relative mild left renal atrophy.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.OTHER: No significant abnormality noted. | 1. Interval stent migration superiorly, with increased size of the previously visualized mediastinal fluid collection, now measuring up to approximately 7 x 4 cm. 2. Bilateral small pleural effusions, with bilateral chest tubes in place.3. Two indeterminate left upper lobe ground glass nodules may be followed up by CT in 6 to 12 months.3. Fat-containing left axillary mass may represent a lipoma, and is incompletely evaluated on noncontrast imaging. |
Generate impression based on findings. | Spinal fusion.VIEWS: Thoracic spine AP (one view), lumbar spine AP (one view) 02/10/15, 0829 and 0831 Surgery has been performed in the interval. Spinal fusion instrumentation extends from T3 to L2. Rods and hooks are intact and in this single plane. A drain is identified. There appears to be bone graft material along the left aspect of the thoracolumbar junction. Residual right thoracolumbar curve is seen. | Postoperative changes. |
Generate impression based on findings. | T2 hypointensity in the left thalamus with associated susceptibility and surrounding edema consistent with the known left thalamic bleed. No significant midline shift. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. The cerebellar tonsils are in normal position. The pituitary gland is normal in size. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. | Findings consistent with left thalamic hemorrhage with associated vasogenic edema. |
Generate impression based on findings. | There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage. There are no extraaxial fluid collections or subdural hematomas. Mild to moderate prominence of the ventricles and sulci most likely age related volume loss. Thickening of the wall of the left maxillary sinus, most likely chronic in etiology. The visualized portions of the paranasal sinuses and mastoid air cells are clear. Calvarium is intact. | No CT evidence of acute intracranial abnormality. |
Generate impression based on findings. | Cirrhosis with TIPS LIMITED ABDOMENLIVER: Cirrhotic liver.ABDOMINAL DOPPLER: Color and spectral Doppler were performed on inflow and outflow vessels.PORTAL VENOUS: Patent portal vessels with normal directional flow. Main portal in velocity 60 cm/sec. Undivided left portal vein still demonstrates pedal flow.Patent TIPS catheter without evidence for inflow or outflow compromise.HEPATIC ARTERIES: No significant abnormalities noted. HEPATIC VEINS: No significant abnormalities noted.INFERIOR VENA CAVA: No significant abnormalities noted.OTHER: Trace ascites | Patent TIPS catheter without evidence for inflow or outflow compromise; however the undivided left portal vein still demonstrates pedal flow. Patent main portal vein with normal directional flow. Trace ascites. |
Generate impression based on findings. | Left hip pain for months, difficult to bear weight There is sclerosis of the femoral head compatible with avascular necrosis. There is minimal flattening of the superior articular surface of the femoral head which may reflect mild subchondral collapse. | Avascular necrosis as above. |
Generate impression based on findings. | Severe pain, left hip Tiny osteophytes indicate mild osteoarthritis. There is slight prominence of the anterolateral aspect of the femoral head neck junction seen on the frog leg view, suggesting a mild cam deformity. There is also a subcentimeter ossicle along the superior rim of the acetabulum, of questionable clinical significance, but chronic in etiology. | Mild osteoarthritis of the left hip and other findings as above. |
Generate impression based on findings. | Follow-up A side plate and screws affix an oblique fracture of the distal fibula in near anatomic alignment. The fracture remains visualized on the lateral view. There is also a mildly displaced fracture of the "posterior malleolus" of the distal tibia, as well as a mildly displaced fracture through the tip of the medial malleolus appearing similar to the prior study. A small lucency in the lateral aspect of the talar dome may represent a degenerative cyst or osteochondral defect. There is mild diffuse soft tissue swelling. | Orthopedic fixation of distal fibular fracture and other findings as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in sister and maternal first cousin. 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. | Lumbago Mild degenerative disk disease affects the mid and lower lumbar spine. Small osteophytes project from the anterior aspects of the lumbar vertebrae. There appears to be moderate facet joint osteoarthritis of the mid and lower lumbar spine as well. There is a minimal rightward curvature of the lumbar spine but otherwise alignment is within normal limits. I see no frank compression fracture. | Facet joint osteoarthritis and mild degenerative disk disease. |
Generate impression based on findings. | Male 21 years old Reason: evaluate for injury History: pain s/p punching a wall. There is a comminuted fracture of the fifth metacarpal neck with approximately 70 degrees of volar angulation of the distal fracture fragment. The wrist and the remainder of the hand appear normal other than soft tissue swelling. | Fifth metacarpal fracture as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views (total of 8 images) 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. Several benign intramammary lymph nodes are noted in both breasts. 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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 3D time of flight MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal flow enhancement within the bilateral internal carotid arteries across the skull base in the supraclinoid segments. Patent bilateral anterior and middle cerebral arteries as well as their branches. Again noted is mild fusiform aneurysmal dilatation of proximal left A2 segment with patent bilateral anterior cerebral arteries. Bilateral vertebral arteries are patent with left dominant vertebral artery. The basilar artery is patent. Right superior cerebellar artery is hypoplastic. Patent left superior cerebellar and bilateral posterior cerebral arteries. Bilateral posterior communicating arteries are hypoplastic. | No significant interval change in the mild fusiform aneurysmal dilatation of proximal left A2 segment. |
Generate impression based on findings. | Follow-up A plate and screws affix a medial malleolar fracture in near-anatomic alignment. The fracture line is indistinct which may reflect some healing, appearing similar to the prior study. I see no hardware complications. | Orthopedic fixation of medial malleolar fracture. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother and maternal grandmother. 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. The left breast remains smaller than the right breast. Stable benign intramammary lymph node present in the right outer breast. 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. |
Generate impression based on findings. | Healing fracture of fifth toe. Pain. Again seen is a transverse fracture through the head/neck of the proximal phalanx of the fifth toe. The fracture remains visible; a small amount of callus along the fracture suggests an attempt at healing. Mild osteoarthritis affects the first metatarsophalangeal joint. Small midfoot osteophytes are also noted. There are posterior and plantar calcaneal spurs which are not necessarily of any clinical significance. | Fifth toe fracture and other findings as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of benign left breast biopsy. 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. | Asymptomatic female presents for routine screening mammography. Three 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. A few scattered benign calcifications are seen. | 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. | Female 63 years old Reason: right hip fracture History: intra-op. Evaluation of the pelvis is limited by oblique positioning and overlying artifact. Furthermore, the superior aspect of the pelvis is not included on the field-of-view. Trial components of a right hip hemiarthroplasty device are situated in near anatomic alignment. Gas overlying the hip reflects a surgical wound. | Right hip hemiarthroplasty trial components as described above. |
Generate impression based on findings. | Left knee pain Evaluation of the knee is slightly limited by factors related to portable technique. Moderate osteoarthritis affects the knee, particularly the medial compartment. A corticated 1.5-cm ossicle within the soft tissues medial to the medial femoral condyle may represent prior injury to the medial supporting structures of the knee or less likely a loose body in the joint. Apparent sclerosis of the proximal tibial metadiaphyses on the AP view probably simply represents summation artifact caused by the anterior tibial tuberosity. I see no fracture or malalignment. | Osteoarthritis and other findings as above. |
Generate impression based on findings. | Ms. Cohen is a 52 year old female with a personal history of right breast lumpectomy in Feb 2013 for IDC with tubular features followed by radiation therapy. 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 skin retraction present within the right lumpectomy site. 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. Consideration into breast MRI or whole breast ultrasound as an additional surveillance exam should be made, given patient's breast density. 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. | 66 year old male patient with melanoma of left forearm. Please do lymphoscintigraphy with mapping to identify sentinel lymph node.RADIOPHARMACEUTICAL: The left forearm was prepared in a sterile manner. A total of 0.54 mCi Tc-99m filtered sulfur colloid was injected in four peri-lesional sites. A focus of increased activity is noted in the left axilla, representing the sentinel node(s). This region was marked with an indelible marker. | Sentinel node identified in the left axilla. |
Generate impression based on findings. | Female 63 years old Reason: right hip fracture History: n/a. Evaluation of the pelvis is limited by oblique positioning and overlying artifact. Components of a right hip hemiarthroplasty device are situated in near anatomic alignment, although the distal extent of the femoral component is not included on the field of view of this study. The head of the femoral component does not yet appear to be attached. | Right hip hemiarthroplasty components as described above. |
Generate impression based on findings. | Gangrene. Osteomyelitis? Evaluation of the foot, and in particular the toes, is limited due to inability to optimally position the patient. There is loss of soft tissue along the distal end of the great toe. There also appears to be loss of bone along the distal aspect of the tuft of the distal phalanx, compatible with osteomyelitis. Overall, the bones appear demineralized suggesting osteopenia/osteoporosis. Arterial calcifications are noted in the soft tissues. | Findings compatible with osteomyelitis of the distal phalanx of the great toe. This was relayed to and acknowledged by Dr. Radovanovic over the phone at the time of dictation. This can be further evaluated with MRI if clinically warranted. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.