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Generate impression based on findings. | Male 45 years old Reason: Evaluate abdominal wall for hernia/redundancy of bowel near the old stoma site with Pain and spasms. History: Abdominal pain and spasms with occasional partial obstructions ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No sign... | 1.No evidence of obstruction.2.Multiple areas of small bowel narrowing and angulation likely secondary to adhesions. 3.No evidence of herniation at the previous stoma site. |
Generate impression based on findings. | Reason: 46F with metastatic poorly differentiated HNC presented for surveillance films History: surveillance films CHEST:LUNGS AND PLEURA: Bilateral upper lobe scarring and subpleural linear and nodular scarring again seen, unchanged in appearance, compatible with post-radiation reaction. Residual nodular scarring in t... | Stable reticular and nodular lung scarring compatible with radiation reaction and prior aspiration. No specific evidence of metastatic disease. |
Generate impression based on findings. | No evidence of enhancement, enlargement, or surrounding inflammatory changes of the right and grant. Apparent enlargement of the left submandibular gland is most likely artifact of positioning. The parotid glands are normal in size and symmetric bilaterally without masses. There are no thyroid masses. There are no nas... | 1.No evidence of inflammatory changes or a radiopaque stone within the right submandibular gland as clinically questioned.2.Mild rotation of C1 relative to C2 which in part may be positional in etiology.3.Multilevel cervical spine degenerative changes, most severe at C5/6. |
Generate impression based on findings. | Lumbago There is mild degenerative disease at L5/S1. Streaky calcification within the L4/5 intervertebral disk space may reflect additional mild degenerative disk disease. There is a minimal anterolisthesis of L4 relative to L5, but otherwise alignment is normal. Vertebral body heights are preserved. | Mild degenerative disk disease. |
Generate impression based on findings. | Reason: midweek scan to followup prior CTH. Hx of Rapidly enlarging (since 2/3/15) bilateral subdural collections, could be related to ongoing bleeding into subdural spaces. History: see above There is redemonstration of a 16 x 10 mm hematoma centered in the left superior frontal gyrus which appears stable when compare... | 1.Bilateral subdural effusions are stable when compared to the prior exam 2.Stable intraparenchymal hemorrhage in the left frontal lobe with continued evolution.3.Evolution of subarachnoid blood products in the right temporal lobe4.Redemonstration of old lacunar infarcts in the thalami and basal ganglia5.Periventricula... |
Generate impression based on findings. | 83-year-old female with a history of right breast DCIS status post lumpectomy in 1999 and radiation. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Clinical question: Rule out ICH, stroke. Signs and symptoms: Left-sided weakness and AMS. Nonenhanced head CT:There is no convincing evidence of an acute intracranial process. CT however these insensitive for early detection of acute nonhemorrhagic ischemic strokes.The cerebral cortex, cortical sulci, ventricular syste... | Unremarkable nonenhanced head CT. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes. |
Generate impression based on findings. | Clinical question: New headache. Signs and symptoms, new headache. Nonenhanced head CT:There is no acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Mild to moderate periventricular and subcortical low attenuation of white matter grossly similar to prior ... | 1.No acute intracranial process.2.Findings on indeterminant small vessel ischemic strokes remains similar to prior exam.3.Well pneumatized paranasal sinuses and mastoid air cells/middle ear cavities. |
Generate impression based on findings. | History metastatic prostate cancer, evaluate for progression. CHEST:LUNGS AND PLEURA: Severe emphysema. Right lower lobe mass (series 5, image 86) measures 2.4 x 2.9 cm, previously 2.4 x 2.9 cm, unchanged. Scattered nonspecific micronodules, some of which are calcified, are also unchanged. No new suspicious nodules or ... | 1.Stable right lower lobe pulmonary mass lesion.2.Stable para-aortic and left common iliac adenopathy.3.Scattered sclerotic skeletal foci most likely metastases grossly similar to prior, though bone scan is more accurate indicator of metastatic skeletal disease. 4.No new lesions identified. 5.Severe emphysema. |
Generate impression based on findings. | 81 year old with history of left lumpectomy for IDC in 2003 and radiation therapy. No breast symptoms currently. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. There are stable... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Grave's disease. The thyroid images demonstrate a diffusely enlarged thyroid gland including enlargement of the pyramidal lobe. There is significantly increased uptake within a majority of the gland. There are medium sized hypofunctioning nodules in the right mid- and lower poles and possibly a third within the right u... | 1. Enlarged gland with diffusely increased uptake compatible with Grave's disease. 2. At least two hypofunctioning right thyroid nodules (most notably in the right mid and lower pole) with are indeterminate for malignancy; these may be further evaluated with ultrasound/biopsy as clinically warranted. |
Generate impression based on findings. | History of right buccal mucosa squamous cell carcinoma, T2N2bM0 who completed treatment in March 2011. Please compare to prior study. There are post-treatment findings related to remote right neck dissection, right submandibular gland resection and radiation treatment. There is no evidence of mass lesions or significan... | Posttreatment changes of the neck without evidence of tumor recurrence or cervical lymphadenopathy. |
Generate impression based on findings. | Infection and placement. Gunshot wound.VIEW: Chest AP (one view) 02/10/15, 0927 Left upper extremity PICC tip is in left brachiocephalic vein. Projectile fragment is again seen at the T12 level.Cardiothymic silhouette is normal. No focal lung opacity is present. No pneumothorax or pleural effusion is identified. | Left PICC tip in left brachiocephalic vein. |
Generate impression based on findings. | Ms. Beard is a 44 year old female with an incidentally detected benign morphology mass in the left superior breast. Patient strongly desired histologic sampling for pathologic confirmation. She presents today for ultrasound guided biopsy of this area. Left breast ultrasound re-identified the target lesion for biopsy. T... | Successful ultrasound-guided core biopsy of the left breast lesion with clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Male 54 years old Reason: 54yr old male with history of PCL, post-auto sct evaluation History: evaluate for multiple myeloma. SKULL: Two views of the skull show no definitive myelomatous lesions. CERVICAL SPINE: Two views of the cervical spine show no discrete myelomatous lesions. Severe degenerative disk disease affec... | Degenerative arthritic changes as described above. We see no discrete myelomatous lesions. |
Generate impression based on findings. | 53 year old male. Status post esophageal leak status post esophagectomy with increasing WBC. CHEST:LUNGS AND PLEURA: Moderate loculated right basilar pleural effusion with associated pleural thickening and foci of air, decreased from prior. Interval removal of right pigtail drain. Adjacent compressive atelectasis in th... | 1. Findings consistent with distal esophageal rupture with extravasation of oral contrast into the left pleural space.2. Moderate loculated right and small loculated left pleural effusions with associated pleural thickening highly suspicious for empyema, decreased from prior. Decreased atelectasis in the left base. Int... |
Generate impression based on findings. | 84 years, Female. Reason: evaluate for obstruction History: abdominal distention Multiple gas-filled loops of small and large bowel. A central grossly distended loop of large bowel measures 13.3 cm in maximum transverse dimension. Although there is no beaking at the inferior aspect of this loop which suggest a sigmoid ... | Massively distended colonic loop at risk for acute perforation. Concern for volvulus, possibly sigmoid volvulus. Urgent colonic decompression should be considered.Findings discussed by Dr. Dachman with Dr. Saint-Hilaire at 10 a.m. 02/10/15. |
Generate impression based on findings. | Reason: eval lung mass History: mets bony disease LUNGS AND PLEURA: A left perihilar mass measures up to 5.8 x 5.3 cm (series 5, image 37) and may include a component of distal atelectasis. The mass severely narrows the left upper lobe bronchus and encases the left descending pulmonary artery. Small associated subsegme... | 1. New large left perihilar mass, with additional lingular nodules and ipsilateral and contralateral mediastinal and hilar lymphadenopathy, suspicious for primary lung cancer. 2. Numerous lytic and sclerotic lesions in the vertebral bodies and ribs, suspicious for osseous metastatic disease. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (4/17/14) performed at Saint Elizabeth Medical Center. For comparison, digital mammographic images (12/20/12, 10/13/11) are available. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution.... | Partially visualized mass-like density at left axilla, seen only on MLO view. Since the study was performed 10 months ago, repeat left mammogram and possible ultrasound for the left axilla is recommended. Mammogram for right breast can be performed at the same time, as annual mammogram is due in two months.BIRADS: 0 - ... |
Generate impression based on findings. | Female 77 years old Reason: scoliosis evaluate. History: scoliosis evaluate. There is moderate to severe multilevel degenerative disk disease throughout the spine. There is approximately 15 degrees of dextroscoliosis measured from the superior endplate of T6 to the inferior endplate of L3. Please note that this measure... | Multilevel degenerative disk disease, mild scoliosis, and other findings as above. |
Generate impression based on findings. | 82-year-old with history of right lumpectomy for ILC in 2003 and radiation therapy. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. Post surgical c... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Lung mass consistent with lung cancer. Staging.RADIOPHARMACEUTICAL: 12.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 123 mg/dL. Today's CT portion grossly demonstrates a spiculated left upper lobe mass measuring approximately 4 cm which abuts the major fissure and is similar to the recent diagnostic ches... | 1.Markedly hypermetabolic left upper lobe mass consistent with lung cancer.2.Markedly hypermetabolic left hilar and AP window lymph nodes consistent with regional metastases. Additional mildly hypermetabolic left paratracheal and left supraclavicular lymph nodes may be benign though additional metastases cannot be excl... |
Generate impression based on findings. | Redemonstrated is posterior spinal fusion at L4-S1, utilizing posterior fusion rods, bilateral pedicle screws, interbody spacer devices and bone graft material. There is no evidence of hardware failure. There is some resorption of the right-sided bone graft material. The vertebral body heights are maintained. There is... | 1. Posterior spinal fusion at L4 through S1 without evidence of hardware failure.2. Degenerative spondylosis with bilateral mild neural foramen narrowing at L5-S1. No significant spinal canal stenosis. This is stable compared to the prior exam. |
Generate impression based on findings. | 46 year old male. Tongue cancer. CHEST:LUNGS AND PLEURA: Scattered calcified micronodules consistent with healed granulomatous disease. No suspicious nodules or masses are identified. No pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Normal heart size without pericardial effusion.No visi... | No evidence of metastatic disease in the chest or abdomen. |
Generate impression based on findings. | LIVER: Normal hepatic echotexture. No focal hepatic lesions.BILIARY TRACT: No gallbladder wall thickening or pericholecystic fluid. Common bile duct measures 2 mm. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreatic head and body are normal. The tail is obscured by gas.KI... | 1. Normal exam without evidence of biliary ductal dilatation or vascular abnormality.2. Low-lying kidneys and probable horseshoe kidney without hydronephrosis. |
Generate impression based on findings. | Female 53 years old Reason: osteoporosis History: mid-low back pain. The bones appear demineralized, suggesting osteopenia/osteoporosis. There are small osteophytes anteriorly at L2/L3. We see no compression fracture. | Demineralized bones and small vertebral body osteophytes. We see no compression fractures. |
Generate impression based on findings. | History of elevated PSA and bone METs, history of carcinoid. ABDOMEN:LUNG BASES: Coronary artery calcifications. Minimal left pleural thickening appearing similar to prior. Subacute fractures of the ninth and tenth posterior left ribs as well as sclerotic lesion in the left tenth posterior right rib.LIVER, BILIARY TRAC... | 1.Hyperenhancing liver lesion increased in size from prior and most likely representing carcinoid metastasis.2.Widespread sclerotic osseous metastases which may be from prostate or carcinoid primary, increased from prior. 3.Multilevel thoracolumbar vertebral body compression fractures which have progressed from prior.4... |
Generate impression based on findings. | 5-month-old female with CDH on outside hospital x-ray. Evaluate sidedness and anatomy for surgical planning. LUNGS AND PLEURA: No pulmonary nodules or masses are present. There is no pleural effusion or pneumothorax. MEDIASTINUM AND HILA: Heart and thymus are normal. Branching pattern of the great vessels is normal.CHE... | Morgagni hernia.Findings were discussed with Christa Fox by phone on 2/10/2015 at 1400. |
Generate impression based on findings. | 57-year-old female. Tachycardia, COPD exacerbation for evaluate for PE. PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Right upper lobe cavitary lesion is 86 x 65 m (series 10, image 32), previously 8.9 x 6.4 cm. It demonstrates eccentric wall thickening at its right anterior aspect, which like... | 1. No evidence of pulmonary embolism.2. Right upper lobe bilobed cavitary lesion is stable in overall size with mild decrease in its nondependent wall thickness (representing necrotic tissue). Associated internal debris is unchanged in volume though shifted inferiorly within this cavity.3. Tree in bud opacities in the ... |
Generate impression based on findings. | Intoeing. Left greater than right.VIEWS: Pelvis AP/frog leg (two views) 02/10/15 The round, smooth femoral heads are well directed into normally formed acetabula. No fracture is seen. | Normal examination. |
Generate impression based on findings. | Reason: h/o oral mucosa ca/CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Scattered benign-appearing pulmonary micronodules, some calcified, unchanged from the prior exam, compatible with previous infection and intrapulmonary lymph nodes. No new suspicious pulmonary nodules or masses. ... | No evidence of metastatic disease. |
Generate impression based on findings. | Metastatic breast cancer, on chemotherapy. Followup scan, restaging, response to therapy.RADIOPHARMACEUTICAL: 13.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 89 mg/dL. Today's CT portion again grossly demonstrates several stable right-sided rib fractures with callus formation. Also again visualized are ... | 1.Several small but markedly hypermetabolic right axillary lymph nodes are new from the previous exam and are very suspicious for progression of metastatic disease. No metastatic breast cancer activity elsewhere.2.Stable uterine and bilateral adnexal activity which may be benign although gynecological malignancy cannot... |
Generate impression based on findings. | 7-year-old female with constipation and abdominal painVIEW: Abdomen AP (one view) 2/10/15 10:32 The bowel gas pattern is nonobstructive. Small sized stool burden. | Normal exam. |
Generate impression based on findings. | Evaluate fracture Three views of the left fifth digit reveal a nondisplaced fracture of the proximal phalanx. The fracture line is indistinct consistent with healing. The bones are in anatomic alignment. | Healing fifth proximal phalanx |
Generate impression based on findings. | Female 47 years old Reason: 46 y/o F with dysphagia to solids, reported history of possible leiomyoma of proximal esophagus, evaluate for etiology of dysphagia and check if leiomyoma is rate-limiting to barium flow History: Dysphagia Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opaci... | 1. Prominence of the cricopharyngeus muscle impression consistent with a cricopharyngeal bar.2. 1.6 cm submucosal lesion within the proximal esophagus. Differential diagnoses include GIST, leiomyoma, lipoma, duplication cyst.3. Spontaneous gastroesophageal reflux to the level of the thoracic inlet with rapid clearing.I... |
Generate impression based on findings. | 14-year-old male post-op with pain in joints, ankle and footVIEWS: Left knee AP/Lateral (Two views) 2/10/2015 10:29:55 Left lateral tibial hemiepiphysiodesis with prongs of the staple not diverging. For assessment of left Blount's disease, please refer to same day bone length study. There is no evidence of fracture or ... | Prongs of the staple of left lateral tibial hemiepiphysiodesis not diverging. Please refer to same day bone length study for additional findings. |
Generate impression based on findings. | Reason: hx of recurrent PNA, concern for endobronchial obstruction vs organizing pna History: productive cough LUNGS AND PLEURA: Mild bronchial wall thickening without focal areas of consolidation or air space opacities.No pleural effusions.No suspicious nodules or masses.MEDIASTINUM AND HILA: Scattered mildly prominen... | Mild bronchial wall thickening without focal areas of consolidation or airspace opacity. |
Generate impression based on findings. | History of chronic mastoiditis status post right-sided mastoidectomy (8/8/14) and right-sided tympanostomy tube placement (8/12/14) presents with right ear purulent discharge x 2 weeks, right ear bleeding x 3 days, and fevers to 102.5F x 2 days. Evaluate for mastoiditis. RIGHT TEMPORAL BONE: There are post-surgical fin... | Post-surgical findings related to right cortical mastoidectomy with overlying soft tissue inflammatory changes, which may represent evolving post-operative change versus cellulitis. No definite fluid collection to suggest abscess. No definite bony erosive changes of the surgical defect; however, early osteomyelitis can... |
Generate impression based on findings. | 65 year old female status post right lumpectomy for DCIS in December 2010 followed by radiation, presents today for routine follow up. No current breast complaints. 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 fibr... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 42-year-old female with history of concussion. There is no evidence of acute intracranial hemorrhage. The gray-white differentiation is preserved. The ventricles and sulci are symmetric. The basal cisterns are intact. 11 mm calcification is seen along the right frontal convexity. No intracranial mass effect. No extra-a... | 1. No evidence of intracranial hemorrhage.2. 11 mm calcification along the right frontal convexity may represent a nonspecific dural calcification versus possibly a small calcified meningioma. No associated mass effect. |
Generate impression based on findings. | 78 year old female with history of right breast lumpectomy for carcinoma in 2009. No current breast complaints. 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 elements, unchanged in pattern and distrib... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 80 years, Male, Reason: metastatic prostate cancer, evaluation of disease during therapy with investigational treatment History: metastatic prostate cancer. CHEST:LUNGS AND PLEURA: 6-mm left upper lobe reference nodule is stable (4/38) scarring in the right middle lobe. No focal consolidation or pleural effusion.No new... | 1.Stable exam.2.Hyperattenuating lesion within the gallbladder is stable and may represent a stone or polyp. Ultrasound recommended for further evaluation. |
Generate impression based on findings. | Female, 46 years old, with history of right thyroid mass and necrotic lymphadenopathy, on pathology found to be an epithelioid malignant neoplasm compatible with poorly differentiated carcinoma, with osseous metastasis. Again seen is a centrally hypoattenuating, peripherally calcified nodule in the right thyroid lobe w... | 1.Stable nodule in the right thyroid lobe with no evidence of locally progress disease.2.Stable reference lymph nodes in the neck. |
Generate impression based on findings. | Reason: head and neck cancer History: hx of head and neck cancer LUNGS AND PLEURA: Right redemonstration of bilateral apical post radiation changes.Bilateral pleural effusions stable.Nonspecific focal air space opacities in the lingula and middle lobe most likely related to aspiration and atelectasis.A significant amou... | 1.Moderate-sized bilateral pleural effusions unchanged.2.Considerable amount of tracheal debris with evidence of atelectasis/aspiration.3.No evidence of metastatic disease. |
Generate impression based on findings. | Male 69 years old Reason: hx of bladder ca, hx of renal cell ca. surveillance scan. History: hx of bladder ca, hx of renal cell ca CHEST: LUNGS AND PLEURA: Subcentimeter nodule in the left major fissure, which is unchanged and likely represents an intrapulmonary lymph node.MEDIASTINUM AND HILA: Mild atherosclerotic cal... | 1.Stable postsurgical changes related to partial left nephrectomy and cystoprostatectomy with neobladder formation.2.No evidence of tumor recurrence or metastatic disease within the limitations of this noncontrast study. |
Generate impression based on findings. | History metastatic bladder carcinoma; request repeat biopsy per research protocol of right pelvic wall mass PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomyBLADDER: Unremarkable neobladderLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Significant interval decrease in size of right pelvic metas... | Interval decrease in size of right pelvic metastatic mass lesion. Due to the interval decrease in size of the mass and its now more medial location, no safe access to biopsy this lesion percutaneously could be found. As a result, the biopsy was not performed. |
Generate impression based on findings. | 62 year-old woman with a history of right lumpectomy in June 2007 for grade 3 invasive ductal carcinoma with high-grade DCIS. Patient is status post radiation and hormonal therapy. No current breast complaints. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. In view of dense breasts, annual screening MRI may be beneficial for this patient. Results and recommendations were discussed with the patient. BIRADS: 1 - ... |
Generate impression based on findings. | 61-year-old male with metastatic Prostate cancer. Please complete PCWG2 form. Multiple foci of increased radiotracer activity is again noted in the axial and proximal appendicular skeleton, including: the posterior right fifth and eighth ribs, the posterior left sixth rib, right humerus, left scapula, sternum, T12 vert... | Redemonstration of multifocal osseous metastases without significant interval change from the prior exam. |
Generate impression based on findings. | 56 year-old female with history of right breast carcinoma status post lumpectomy in 2005 with radiation and chemotherapy. No family history of breast cancer. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is com... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 77-year-old male status post cystoprostatectomy with rectal injury during surgery requiring temporary diverting ileostomy; status post ileal conduit. The scout film shows a nonobstructive bowel gas pattern. A catheter is within the diverting ileostomy on the left. Residual barium from prior barium enema study 1/5/15 is... | Findings compatible with nonobstructive adhesions as described above. |
Generate impression based on findings. | 64 years, Female, Reason: restaging scans s/p 9 cycles of investigational immunotherapy History: hx of metastatic bladder cancer. CHEST:LUNGS AND PLEURA: Left upper lobe part solid part cystic nodule is slightly increased in size measuring 1.3 x 1.1 cm (6/36), previously 0.9 x 0.6 cm. Right lower lobe solid nodule meas... | 1.Progression of pulmonary metastases with some nodules increased in size and others unchanged.2.Stable retroperitoneal lymphadenopathy. |
Generate impression based on findings. | Male, 46 years old, with history of cT1-T2 N2b stage IVa right base of tongue squamous cell carcinoma. Head:No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. Neck:The base of tongue tonsillar tissues are b... | 1. A base of tongue mass is evident on the right with extension into the right aspect of the vallecula. The left base of tongue tonsillar tissues are also slightly bulky and as such the possibility of extension to the contralateral side cannot be excluded.2. Pathologic adenopathy in the right neck involving level 2, po... |
Generate impression based on findings. | There is mild bilateral maxillary, scattered bilateral ethmoid and trace right sphenoid sinus mucosal thickening. The mastoid air cells are clear. There is narrowing of the ostiomeatal complexes which may be developmental, without frank obstruction. The nasal cavity is clear. The nasal septum is deviated to the left s... | Scattered mild paranasal sinus mucosal thickening as described above. |
Generate impression based on findings. | Reason: head and neck cancer for tumor assessment History: as above CHEST:LUNGS AND PLEURA: Unchanged uniformly distributed pulmonary cysts, previously suggested to be mild lymphangioleiomyomatosis.Mild basilar scarring.No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: No evidence of mediastinal or h... | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | 44 year old with history of left mastectomy for multicentric DCIS in 2014, presents for ultrasound study for palpable mass in left axilla, and annual right mammogram. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is extremely dense, unc... | 1. Suspicious mass in the left superior axilla. FNA under palpation guidance is recommended.2. No mammographic evidence for malignancy in the right breast.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Pain. Fracture? There is diffuse soft tissue swelling. There is also widening of the lateral aspect of the tibiotalar joint suggesting ligamentous laxity or disruption. A subcentimeter ossicle seen on the AP view distal to the fibular tip appears corticated and may represent old trauma but I do not see a donor site to ... | Diffuse soft tissue swelling and widening of the lateral aspect of the ankle joint may represent ligamentous laxity or disruption. I see no definite acute fracture. |
Generate impression based on findings. | Female 75 years old Reason: Pancreas NET to liver follow up CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Interval increase in the size of the liver metastases. Index left lobe le... | Interval increase in the size of the hepatic metastases and retroperitoneal adenopathy. Patient's known pancreatic tail mass is slightly decreased to unchanged. Gastric mass is unchanged. |
Generate impression based on findings. | Female 6 years old Reason: Prosthetic Mitral valve. Subaortic narrowing. Cardiac Morphology:Left Ventricle: Left ventricular concentric hypertrophy. There is a significant 6-mm narrowing of the subaortic outflow tract with mild to moderate dilatation of the sinus of Valsalva.Wall motion assessment: Not performed.Right ... | 1. Postsurgical changes of the mitral valve.2. 6-mm narrowing of the subaortic outflow tract with mild to moderate dilatation of the sinus of Valsalva.3. Left atrial dilatation and concentric left ventricular hypertrophy.Dr. Peter Varga was present during the elaboration of this report and agrees with the findings. |
Generate impression based on findings. | Head:No areas of abnormal attenuation or pathological enhancement. No mass effect or midline shift. There is no intracranial hemorrhage. Gray white matter differentiation is preserved. No extra-axial fluid collections. The ventricles and sulci are within normal limits for stated age. The visualized portions of the par... | Treatment-related changes without evidence of locoregional tumor recurrence. No significant cervical lymphadenopathy. No evidence of intracranial metastases. |
Generate impression based on findings. | Pain Moderate to severe osteoarthritis affects the first metatarsophalangeal joint. Mild osteoarthritis affects the interphalangeal joint of the great toe. There is mild deformity of the head of the fifth proximal phalanx which may be due to prior trauma or surgery. | Osteoarthritis and other findings as above. |
Generate impression based on findings. | Lumbago. Moderate to severe degenerative disk disease affects L2/3. Mild degenerative disk disease affects L4/5 and L5/S1. Alignment is within normal limits and I see no instability between the flexion and extension views. | Degenerative disk disease. |
Generate impression based on findings. | Follow-up laminectomy and fusion. Evaluate stability of spine, hardware and fusion. Surveillance imaging. Again seen are posterior rods with screws entering the C3 through C6 vertebrae. The hardware appears similar to that seen on the prior study, without acute complication evident. Evaluation of the lower cervical spi... | Postoperative changes of cervical spine fusion as described above without evidence of instability. |
Generate impression based on findings. | Reason: h/o cavernous and ophthalmic aneurysm History: surveillance Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The anterior communicating a... | 1.No evidence for aneurysm.2.No evidence for cerebral vascular occlusive diseaseCT ANGIO HEAD WWO, 2/10/2015 12:42 PMCLINICAL INFORMATION:Reason: h/o cavernous and ophthalmic aneurysm History: surveillanceCOMPARISON: 2/24/14TECHNIQUE: CT of the head without contrast and CTA of the head with contrast were obtained as fo... |
Generate impression based on findings. | Altered mental status, multiple CVA No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. There is global parenchymal volume loss relatively greater in the frontal lobes and advanced for age. There is ex... | 1. No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2. Chronic infarct involving the left subinsular white matter and left frontal corona radiata.3. Advanced chr... |
Generate impression based on findings. | Follow-up Again seen is a fracture of the patella with fracture fragments in near-anatomic alignment. On the AP view, the fracture is slightly less distinct on the current study when compared with the prior study, suggesting some interval healing. There is persistent anterior soft tissue swelling as well as a moderate-... | Healing patellar fracture and other findings as above. |
Generate impression based on findings. | Malignant melanoma CHEST:LUNGS AND PLEURA: Index right apical nodule measures 8 by 5 mm image number 17, series number 4, not significantly changed in size compared to previous study. Other non-reference nodules are also stable.MEDIASTINUM AND HILA: Index precarinal node measures 1.5 x 1 cm on image number 34, series n... | Slight interval increase in one of the non-reference left retroperitoneal lymph nodes. Other findings are grossly stable from previous study. |
Generate impression based on findings. | Pain after fall, injury I see no fracture or malalignment. Moderate osteoarthritis affects the acromioclavicular joint, with adjacent soft tissue calcification likely residing in the joint capsule. Mild osteoarthritis affects the glenohumeral joint, with faint calcification along the superior aspect of the humeral head... | Osteoarthritis and other degenerative arthritic changes as described above. I see no fracture. |
Generate impression based on findings. | Female 36 years old Reason: eval for disease progression. compare to study 7/2014 History: familial GIST ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No signific... | Mixed response with stable large left upper quadrant cystic mass and interval decrease in the size of the mesenteric masses as described above.Left adnexal cystic mass is increased in size but the left inguinal cystic lesion is decreased in size. |
Generate impression based on findings. | Status post right total knee arthroplasty Components of a right total knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. Skin staples, a drain, and foci of gas density in the soft tissues reflect recent surgery. | Postoperative changes of total knee arthroplasty as above. |
Generate impression based on findings. | Knee pain. Assess severity of DJD. Four views of the left knee are provided. There is moderate narrowing of the lateral tibiofemoral compartment with osteophyte formation that has progressed when compared with the prior study. Small patellofemoral osteophytes are also noted. The bones appear slightly demineralized, sug... | Moderate osteoarthritis. |
Generate impression based on findings. | Lumbar back pain Again seen is a posterior stabilization device with screws entering the L2, L3, and L4 vertebrae. I see no hardware complications. Severe degenerative disk disease affects L5/S1. Moderate degenerative disk disease affects the remaining lumbar levels. There are minimal anterolistheses of L1 and L2. Vert... | Postoperative changes of lumbar spine fusion and degenerative disk disease as described above. |
Generate impression based on findings. | Male 59 years old Reason: PSA 629- now with hip and back pain- family history of prostate cancer- biopsies to follow History: PSA 629- now with hip and back pain- family history of prostate cancer- biopsies to follow ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality no... | Extensive bone metastases throughout the entire skeleton. Extensive retroperitoneal and pelvic adenopathy. |
Generate impression based on findings. | Pain, history of recurrent ovarian cancer Moderate osteoarthritis affects the acromioclavicular joint. The glenohumeral joint appears normal, and I otherwise see no specific findings to account for the patient's scapular pain. There is a right-sided central venous access device with its tip overlying the cavoatrial jun... | Acromioclavicular joint osteoarthritis. |
Generate impression based on findings. | Left knee pain Four views of the left knee are provided. Small osteophytes and mild medial compartment narrowing indicate mild osteoarthritis. There may also be a small joint effusion. Mild irregularity of the articular surface of the medial femoral condyle probably represents osteophyte formation, although I cannot ex... | Mild osteoarthritis and other findings as above. |
Generate impression based on findings. | Male 24 years old Reason: 24 year old man with stage IVB DLBCLymphoma cycle 6 of R-CHOP and 2 cycles of HD MTX in need of restagin. Please compare to prior. History: DLBCL CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Interval increase in the size of a hypodense lesion at the inferior as... | Significant interval decrease in the size of the retroperitoneal and pelvic adenopathy and splenic size. Hepatic lesions are also significant decrease in size. Splenic lesion has resolved in the interval. Interval decrease in the size of the axillary lymph nodes.Interval increase in the size of the anterior mediastinal... |
Generate impression based on findings. | Clinical question: ICH? Signs and symptoms: Fall, head trauma on ASA. Unenhanced head CT:There is no evidence of an acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and myelination of brain.Unremarkable calvari... | 1.Negative head CT and without evidence of any posttraumatic findings.2.Mild bilateral maxillary chronic sinus disease. |
Generate impression based on findings. | Status post left total knee arthroplasty Components of a left total knee arthroplasty device are situated in near anatomic alignment without radiographic evidence of complication. Skin staples, a drain, and foci of gas density in the soft tissues reflect recent surgery. | Total knee arthroplasty as above. |
Generate impression based on findings. | Low back pain. Pars defect? For the purposes of this study I will designate 5 non-rib bearing lumbar type vertebra with an additional transitional lumbosacral vertebra ("T"). There is mild degenerative disk disease at L5/T. The remaining intervertebral disk spaces appear normal. Vertebral body heights are preserved. Al... | Mild degenerative disk disease without evidence of pars defect. |
Generate impression based on findings. | Fell yesterday onto buttocks with severe buttock pain. History of rheumatoid arthritis and steroid use. The bones appear slightly demineralized suggesting osteopenia. There is narrowing of both hip joints, left greater than right, with coxa profunda deformities and findings suggestive of acetabular overcoverage, perhap... | Arthritic changes as described above likely representing combination of rheumatoid arthritis an osteoarthritis. I see no fracture. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: No sign of pulmonary or pleural metastases.Mild apical paraseptal emphysema is unchanged.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy although there are calcified nodes from prior granulomatous infe... | 1. No evidence of metastatic disease or other significant abnormality.2. Gastrostomy tube reidentified, but the retention balloon is no longer inflated, which could increase the likelihood of accidental removal. |
Generate impression based on findings. | Back pain Severe degenerative disk disease affects L1/2, L2/3, and L3/4. Moderate degenerative disease affects L4/5 and L5/S1. There is also moderate to severe multilevel facet joint osteoarthritis. There is a slight leftward curvature of the lumbar spine. There are minimal anterolistheses of L3 and L4. Vertebral body ... | Degenerative disk disease and osteoarthritis appearing similar to, or perhaps slightly worse than that seen on the prior study. |
Generate impression based on findings. | Right flank pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty infiltration of the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, ... | Negative for acute, inflammatory, or neoplastic process. Fatty infiltration of the liver. |
Generate impression based on findings. | Persistent back pain with point tenderness on spinal processes Moderate to severe degenerative disk disease affects L5/S1. Severe facet joint osteoarthritis affects the lower lumbar spine. There are minimal anterolistheses of L4 and L5. Vertebral body heights are preserved. | Degenerative disk disease and facet joint osteoarthritis. |
Generate impression based on findings. | Reason: patient with R-MCA stroke History: R-MCA stroke. Evaluate for intracranial or extracranial cerebrovascular occlusion/stenosis. Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels... | 1.Occlusion of the midportion of the right M1 segment. Please note that the superior division which is partially occluded as origin immediately proximal to the mid M1 segment the occlusion site.2.Multiple intracranial foci of arterial narrowing involving posterior and anterior circulation.3.There is occlusion of the ri... |
Generate impression based on findings. | Again seen is intra- parenchymal hematoma in the left cerebral hemisphere centered in the left posterior frontal lobe measuring approximately 54 x 36 mm and unchanged. There is stable vasogenic edema surrounding the hemorrhage with an unchanged thin 4-mm left frontal hyperdense extra-axial hematoma. There is persisten... | Stable acute parenchymal hematoma in the left cerebral hemisphere with unchanged associated mass effect and midline shift. No new intracranial hemorrhage. |
Generate impression based on findings. | History of pancreatic mass on ultrasound. ABDOMEN:LUNG BASES: Minimal dependent atelectasis.LIVER, BILIARY TRACT: No focal hepatic lesions. No intrahepatic or extrahepatic biliary ductal dilatation. The portal venous system is patent.SPLEEN: No significant abnormality notedPANCREAS: There is a solid mass within the nec... | 1.Hyperenhancing pancreatic neck mass measuring 2.7 x 1.4 cm which most likely represents a pancreatic neuroendocrine tumor. No evidence of metastasis.2.Mild nonspecific thickening of the bilateral adrenal glands. |
Generate impression based on findings. | 50 year-old female. SOB, hypoxia. Evaluate for PE. PULMONARY ARTERIES: No evidence of pulmonary embolism to the segmental level.LUNGS AND PLEURA: Small bilateral pleural effusions with adjacent atelectasis.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Normal heart size without pericardial effusion.No vi... | 1. No evidence of pulmonary embolism.2. Bilateral small pleural effusions with adjacent atelectasis. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male 71 years old Reason: 71 y/o M with DLBCL s/p Rituxan monotherapy with PD needs restaging please History: R face/neck swelling CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No si... | Left lower pole nephrolithiasis. No measurable adenopathy. |
Generate impression based on findings. | Pain. Rule out arthritis. Four views of the left knee are provided. There is severe osteoarthritis of the medial tibiofemoral compartment with near bone-on-bone apposition. There are also tricompartment osteophytes. I see no large joint effusion.Osteoarthritis also affects the right knee as seen on the frontal view. A ... | Osteoarthritis as above. |
Generate impression based on findings. | Female 54 years old; Reason: evaluate neuroendocrine tumor, pancreas History: none ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Scattered tiny cysts are unchanged. Segment 7 hemangioma is unchanged. Additional hypervascular subcentimeter foci are unchanged. The hepatic and portal veins are... | 1.Postsurgical changes in the pancreas without a residual fluid collection or evidence for metastatic disease. |
Generate impression based on findings. | Male 65 years old Reason: s/p ex-lap with liver abscess drainage and unroofing 1/20/15. Please eval resolution of abscess to determine abx duration. History: as above This study is limited due to lack of intravenous contrastABDOMEN:LUNG BASES: Near atelectasis at the lung bases.LIVER, BILIARY TRACT: There is interval d... | Limited study due to lack of intravenous contrast. Slight interval decrease in the size of the patient's known hepatic abscess. Bilateral inguinal adenopathy, stable from previous study. Its etiology is unknown. |
Generate impression based on findings. | Right upper quadrant colic. OSH ultrasound with questionable stone vs gallbladder polyp. Angiographic images are unremarkable. Prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is normal excretion of tracer into the intrahepatic ducts, common bile ... | 1. Normal hepatobiliary imaging. No evidence of acute or chronic cholecystitis.2. Normal gall bladder contractile response to CCK. Note, however, the patient did report abdominal discomfort during the CCK portion of the exam which she described as similar to her typical symptoms. |
Generate impression based on findings. | Male 63 years old Reason: Rule out Renal Cell Cancer. Use renal protocol History: Post transplant erythrocytosis ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnor... | Atrophic kidneys without any focal lesions suspicious for renal cell carcinoma.Cholelithiasis.Left iliac fossa transplant kidney, unremarkable.Right iliac fossa cystic partially calcified lesion, likely representing an old rejected transplant. |
Generate impression based on findings. | 42 day-old male with emesis and bloody stoolsVIEW: Abdomen AP (one view) 2/10/15 12:39 A gastrostomy tube is again noted. The bowel gas pattern remains somewhat disorganized, but improved from the prior exam. No pneumatosis or evidence of obstruction. | Continued improvement in bowel gas pattern. |
Generate impression based on findings. | Left shoulder pain. Neck pain. Evaluate for degenerative disk disease. Four views of the left shoulder are provided. Mild osteoarthritis affects the glenohumeral joint. Mild to moderate osteoarthritis affects the acromioclavicular joint. A small ossicle along the superior aspect of the acromioclavicular joint may refle... | Osteoarthritis and degenerative disk disease as described above. |
Generate impression based on findings. | Distal radius fracture. ORIF Three views of the left wrist reveal some residual dorsal soft tissue swelling. There is a slightly distally displaced ulnar styloid fracture. The fracture of the radius is fixed with a sideplate and multiple screws. In anatomic alignment. No change in position from previous. | Fixation of distal radius fracture in anatomic alignment |
Generate impression based on findings. | 9 day old male status post PICC placementVIEW: Chest AP (one view) 2/10/15 Right PICC tip projects over the central right subclavian vein. NG tube tip and side-port project over the distal thoracic esophagus. Diaphragmatic hernia is again noted. | PICC tip at the right subclavian vein. |
Generate impression based on findings. | 56 years, Male. Reason: DHT placement History: - Dobbhoff tube tip with guide wire projects over the proximal gastric body. Surgical clips project over the left hemipelvis.Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip with guide wire projects over the proximal gastric body. |
Generate impression based on findings. | 87-year-old female. Axillary ulcer, here with fevers, leukocytosis. History of right breast cancer s/p mastectomy. EPIC history: 1.5 x 2 cm wound on right chest wall near axilla present for over a year. LUNGS AND PLEURA: Stable calcified and noncalcified micronodules, which are most likely post inflammatory. No suspici... | 1. No evidence of pneumonia.2. Right lateral chest wall ulcerating soft tissue lesion adjacent to the axilla is unchanged. Stable adjacent axillary lymphadenopathy.3. Mild increase in size of the proximal pancreatic body hypodense lesion, presumably an IPMN. There has been significant enlargement over the past 4 years,... |
Generate impression based on findings. | Bone pain with known bone metastases and getting radiation therapy. Numerous lesions are noted, including in the skull, thoracic spine, lower lumbar spine iliac wings and sacrum consistent with metastatic disease. A lesion more laterally in the left posterolateral 10th rib also likely represents a metastasis. Lesions i... | Multiple osseous metastases |
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