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Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 51 year-old male with history of assault. There is a comminuted fracture about the anterior aspect of the maxilla involving the alveolar process of the incisors and lateral incisors. The incisors and left lateral incisor are absent. There is associated air density within the anterior soft tissues as well as moderate swelling/hematoma. There is also cortical fragmentation and suspected comminuted fracture along the anterior aspect of the mandible involving the alveolar processes of the lower incisors. The mandibular lateral incisors are absent. There is additional soft tissue swelling/hematoma about the right cheek, but the underlying bones appear unremarkable. Although there is extensive right periorbital soft tissue swelling, the globes and bones of the orbit are intact. There is no evidence of retrobulbar hematoma.There is mild mucosal thickening within the paranasal sinuses, however no air-fluid levels are appreciated. The mastoid air cells are clear. The lamina papyracea, TMJs, zygomatic arches and nasal bones are intact. | 1. Comminuted facture along the anterior aspect of the maxilla involving the alveolar processes and absent teeth as described above.2. Cortical fragmentation along the anterior aspect of the mandible with missing lateral incisors likely representing additional fracture which involve the alveolar processes. Remainder of the mandible is intact.3. Extensive soft tissue swelling/hematoma about the anterior soft tissues and right cheek. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Mammogram works best when searching for changes. Submission of prior mammogram is, therefore, recommended for future reference. If the patient submits her old mammograms, we can compare them with the current study to establish stability.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Redemonstration of multifocal areas of acute intraparenchymal hemorrhage with surrounding vasogenic edema, largest in the left parietal lobe and also involving the left frontal lobe. Hyper and hypo attenuation in the occipital lobes and right cerebellum is also stable since the prior study from 2/10/15. Mild mass effect in these regions are unchanged without midline shift or frank herniation. Chronic left occipital and medial temporal lobe encephalomalacia is again noted. The bones of the calvarium are unremarkable without fracture. The orbits and paranasal sinuses are unremarkable. | 1. No interval change in multifocal areas of intraparenchymal hemorrhage with surrounding edema. Mild associated mass effect. Possibilities again include hemorrhagic infarcts (including septic embolic) and other etiologies such as metastatic disease. 2. Sequelae of chronic left PCA infarction. |
Generate impression based on findings. | 7-year-old male with diffuse rebound tenderness. Rule out constipation.VIEW: Abdomen AP (one view) 2/10/2015 Nonobstructive bowel gas pattern. Moderate stool burden. No evidence of pneumatosis intestinalis, pneumoperitoneum, portal venous gas or ascites. | Normal examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Scattered benign calcifications are noted 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Altered mental status, on Coumadin No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent mild chronic small vessel ischemic changes.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | No evidence of intracranial hemorrhage or mass effect. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. There is a new focal asymmetry at lower inner quadrant in the left breast.No suspicious microcalcifications or areas of architectural distortion are present. | A new focal asymmetry at lower inner quadrant in the left breast. Spot compression views and possible ultrasound study are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Male 24 years old Reason: fall, back pain History: see above. Thoracic spine: There is slight anterior wedging of T11, which we suspect is chronic in etiology, and associated with small anterior vertebral body osteophytes. We see no definite acute fracture, alignment is within normal limits.Lumbar spine: We see no fracture. Intervertebral disk spaces are within normal limits. There is a fusion anomaly of the posterior arch of L5, which is of doubtful significance. There may be mild facet joint osteoarthritis affecting L5/S1. | No fracture or other acute findings to account for patient's pain. Other findings as above. |
Generate impression based on findings. | 40 year-old recall from screening for a left breast mass. An ML view, laterally exaggerated CC view and 3 spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Left upper outer quadrant breast mass at posterior depth partially disperses on spot compression. An underlying normal-sized lymph node may be present given the appearance of the ML spot view. Morphologically, this had a typically benign appearance on tomosynthesis. No suspicious microcalcifications or areas of architectural distortion in the left breast. ULTRASOUND | No suspicious mammographic or sonographic finding. Suggestion of normal intramammary lymph node. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended next year, and if stable at that time routine screening may be subsequently appropriate. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 56 years, Male. Reason: constipation History: abdominal pain Stones project over the paramedian left upper abdomen. Moderate stool burden throughout the colon. No pneumoperitoneum. Nonobstructive bowel gas pattern. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 62 year old female with history of left hemiplegia and dysarthria. There is no evidence of acute intracranial hemorrhage. There is moderate confluent hypoattenuation within the periventricular and subcortical white matter. The gray-white differentiation is preserved. No midline shift or mass effect. The basal cisterns are intact and symmetric. No hydrocephalus. The visualized paranasal sinuses are clear. Evidence of right-sided mastoidectomy. The calvarium and soft tissues of the scalp are otherwise unremarkable. | 1.No evidence of acute intracranial hemorrhage.2.Moderate periventricular white matter hypoattenuation compatible with moderate age-indeterminate ischemic small vessel disease. Please note that CT is insensitive for the detection of acute ischemic infarction. If patient care warrants further imaging, an MRI may be obtained. |
Generate impression based on findings. | 80 years, Female. Reason: Dobbhoff History: Dobbhoff Dobbhoff tube tip projects over the gastric body. Nonobstructive bowel gas pattern.Bibasilar opacities. | Dobbhoff tube tip projects over the gastric body. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 58 years, Male. Reason: abd fullness, discomfort History: see above Gas distended loops of small bowel with relative paucity of distal bowel gas.Radiodense material projects over the left upper quadrant, may represent contrast or ingested material. | Ileus type bowel gas pattern versus early obstruction. |
Generate impression based on findings. | Intracranial hemorrhage, evaluate of hydrocephalus. Compared to 2/8/2015, there is slight evolution of large left sided intraparenchymal hematoma centered within the left thalamus, measuring 5.1 x 4.5 x 4.1 cm in the AP, transverse, and craniocaudal dimensions. There is surrounding vasogenic edema slightly increased since prior involving the left frontal and temporal lobes. Again seen is mass-effect with effacement of the lateral ventricles and mild entrapment of the right lateral ventricle. There is rightward midline shift measuring up to 2 cm at the level of the septum pellucidum above the foramen of Monro, previously approximately 1.5 cm at the same level. There is also mild increase in downward herniation including with increased effacement of the suprasellar cistern. There is mild left uncal herniation with slight widening of the left ambient cistern. Unchanged position of the right transfrontal EVD.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | 1. Compared to 2/8/2015, evolution of large intraparenchymal hematoma centered within the left thalamus with mild increase in surrounding edema. There is also mild worsening of rightward midline shift and downward herniation with diffuse effacement of the suprasellar cistern.2. Unchanged size of the entrapped, mildly enlarged right lateral ventricle.Dr. Ali discussed findings with Gina Bradley and Dr. Newey (neuro ICU) at 900 hrs on 2/11/2015. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. A marker clip is again seen at anterior upper inner quadrant in the left 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Reason: head and neck cancer/ per protocol scans History: see above CHEST:LUNGS AND PLEURA: Left upper lobe paramediastinal mass measures 30 x 25 mm (series 3, image 31), previously assuring 27 x 18 mm. The mass shows central necrosis, air-fluid level, and encasement/narrowing of the left main pulmonary artery. Stable appearance of adjacent atelectasis/scarring.Decreased prominence of right middle and lower lobe patchy groundglass opacities, likely due to prior aspiration. Stable scattered micronodules, some calcified.New small to moderate right pleural effusion, with minimal associated compressive atelectasis. No left pleural effusion. MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Severe coronary artery calcifications. Scattered small lymph nodes appear unchanged. CHEST WALL: Multiple chest wall soft tissue metastases:Right chest wall mass with destruction of the right fourth rib, now measuring up to 62 x 38 mm (series 3, image 44), previously measuring 58 x 43 mm. Increase in size of enhancing soft tissue posterior to the right scapula, with central necrosis (series 3, image 14).Right paraspinal mass (coronal image 30, axial image 47) at the level of the T7/T8, with replacement of the T8 right transverse process, largerLeft trapezius nodule is larger (3/5)Mass posterior to the cranial aspect of the right scapula and the level of the glenoid (coronal image 45, axial image 14), larger.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Numerous hypodense heterogeneous hepatic lesions, compatible with metastatic disease, increased in size. Reference lesion now measuring 32 x 24 mm (series 3, image 105), previously measuring 14 x 13 mm.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Stable mild left adrenal nodularity.KIDNEYS, URETERS: Stable right renal cyst.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Increase in size of a portocaval lymph node with central necrosis, now measuring up to 17 mm (series 3, image 94) previously measuring 13 mm.Atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disease of the lumbar spine.OTHER: No significant abnormality noted. | 1. Increase in size measurement of a left upper lobe paramediastinal mass, with central necrosis, encasement/narrowing of the left pulmonary artery, and distal left upper lobe segmental atelectasis.2. Increase in size of reference hepatic metastases and portocaval lymph node.3. Multiple enlarging soft tissue metastases as detailed in the body report. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Abdominal pain after bariatric surgery. Limited exam due to patient large body habitus.LIVER: The liver measures 15.3 cm in length. No intrahepatic biliary ductal dilatation. Portal vein is patent with flow towards the liver on color Doppler imaging.GALLBLADDER, BILIARY TRACT: No significant abnormalities noted. Common duct measures 5 mm in diameter which is at the upper limits of normal in sizePANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No hydronephrosis of either kidney. 1 cm near anechoic nodule in the right kidney probably represents a cyst but is nonspecific. The right kidney measures 9.2 cm in length and the left kidney measures 10.6 cm in length. Both kidneys are echogenic compatible with medical renal disease. OTHER: No findings to explain left upper quadrant pain. The spleen measures 10.7 cm in length and is morphologically unremarkable. | No findings to explain left upper quadrant pain. Echogenic kidneys compatible with medical renal disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Mammogram works best when searching for changes. Submission of prior mammogram is, therefore, recommended for future reference. If the patient submits her old mammograms, we can compare them with the current study to establish stability.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Lung cancer status post 6 cycles of chemotherapy. Neck: There is no significant cervical lymphadenopathy. For example, a left level 4 lymph node measures 6 mm in short axis, previously 7 mm, and a left level 5B lymph node measures 3 mm in short axis, previously 4 mm. The thyroid and major salivary glands are unremarkable. There is mild plaque at the proximal right internal carotid artery. The major cervical vessels are otherwise patent. There is mild multilevel degenerative spondylosis and reversal of the usual cervical lordosis. The airways are patent. There are unchanged subcentimeter nodules in the subcutaneous tissues of the posterior lower neck. Head: There is no evidence of acute intracranial mass or abnormal enhancement. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. There is mild mucosal thickening in the left maxillary sinus. The skull and scalp soft tissues are unremarkable. | 1. No evidence of recurrent metastatic lymphadenopathy in the neck. 2. No evidence of intracranial metastases. |
Generate impression based on findings. | Ms. Zugalj is a 69 years year old female recalled from screening mammogram for calcifications in the right breast. Result history left breast biopsy. No current breast related complaints. An ML view and two spot magnification views of the right 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. Spot magnification views of the right central breast demonstrate scattered round, punctate calcifications that have progressed in a benign type fashion. Additional coarse, ductal calcifications just lateral to these calcifications have also increased in a benign type fashion. There is no new mass or areas of architectural distortion identified in the right breast. | Scattered benign calcifications that have progressed in a benign fashion in the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. There are stable benign calcifications in both breasts. There is a stable focal asymmetry in the left breast at upper outer quadrant. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | There is no acute intracranial hemorrhage or new mass effect. There has been interval revision of a right frontal ventriculostomy catheter for a right parietal approach ventriculostomy catheter with its tip in the left ventricle. Marked ventriculomegaly involving the lateral ventricles and third ventricle has mildly decreased since the prior study.Mild nonspecific white matter hypoattenuation is unchanged. There is a mega-cisterna magna. There is scattered opacification of the ethmoid air cells. The remaining paranasal sinuses are unremarkable. | 1. No evidence of traumatic injury. 2. New right parietal approach ventriculostomy catheter with mild interval decrease in ventriculomegaly since the prior study. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts (total 8 images) were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. Scattered benign calcifications are unchanged in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | There is interval development of multifocal areas of acute intraparenchymal hemorrhage with surrounding vasogenic edema, relatively largest in the left parietal lobe, measuring up to 2 cm in diameter. Small hemorrhages and edema include the left frontal and bilateral occipital lobes. There is possible focus of high attenuation in the left cerebellum which may represent additional focus versus artifact. Possible chronic infarct in the right cerebellum. Mild mass effect in these regions without midline shift or downward herniation. Chronic left occipital and medial temporal encephalomalacia is again noted. The bones of the calvarium are unremarkable without fracture. The orbits and paranasal sinuses are unremarkable. | 1. Multifocal areas of acute intraparenchymal hemorrhage with surrounding edema. No significant mass effect or herniation. Differential considerations for this appearance include hemorrhagic embolic infarcts. Hemorrhagic metastases can also be considered and MRI may be helpful for further evaluation as clinically warranted. 2. Stable sequelae of chronic left PCA infarction. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Tongue squamous cell carcinoma, status post surgery, radiation, re-irradiation, and stereotatic RT to lung lesion, treated with docetaxel for metastatic disease. Neck: The images area degraded by patient motion. There are post-treatment findings in the neck. There is an enhancing mass within the left trapezius muscle, which measures 24 x 43 mm, previously 16 x 28 mm. There is also increase in size of a heterogeneously enhancing mass in the medial right deltoid muscle that measures 15 x 25 mm, previously 10 x 18 mm. There is no evidence of significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is mild multilevel degenerative spondylosis. The airways are patent. There is a partially-imaged cavitary left lung mass. Head: There is no evidence of intracranial mass. The grey-white matter differentiation appears to be intact. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. There is persistent complete opacification of the left maxillary sinus. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | 1. Interval increase in size of the intramuscular metastasis.2. No evidence of intracranial metastases.3. Partially-imaged cavitary left lung mass. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Metastatic breast cancer. Baseline. ABDOMEN:LUNG BASES: Pulmonary metastases. For reference purposes, a nodule at the right lung base measures 1.9 x 1.7 cm (image 14; series 80494).LIVER, BILIARY TRACT: Liver metastases. For reference purposes, a lesion in the inferior right lobe measures 5.3 x 6.5 cm (image 43; series 80420). Mild intrahepatic biliary ductal dilatation. Portal vein is patent. Probable gallstones.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Probable renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Presumed postsurgical changes the GE junction.BONES, SOFT TISSUES: Postsurgical changes of the abdominal wall.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Right common femoral lymph node measures 1.5 x 1.0 cm (image 125; series 80420)BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Metastatic disease. Reference measurements are given above. |
Generate impression based on findings. | 47-year-old with history of prior abnormal mammograms presents currently without complaints. Three standard views of both breasts (9 images) and 4 left spot compression views 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. Area of focal asymmetry in the left lower central breast was evaluated with spot compression. This area persisted with a typically benign morphology. Other areas of bilateral focal asymmetry are stable. Interval involution of a cyst in the left outer breast. No new dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast. ULTRASOUND | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male 34 years old Reason: R/O fracture History: pain. The proximal tibia and fibula appear normal. A plate and screw device affixes healed fracture/osteotomies of the distal tibia/fibula in near-anatomic alignment. Two screws affix the fused subtalar joint as well as a healed calcaneal osteotomy in near-anatomic alignment. Three screws affix a fused talonavicular joint in near anatomic alignment. Lucencies within the middle and lateral cuneiform bones may be postoperative as well. There is mild chronic deformity of the ankle, with mild osteoarthritic changes, but we see no acute fracture of the bones of the ankle. There is mild soft tissue swelling about the ankle.The bones of the foot are demineralized. There is a nondisplaced fracture of the neck of the second metatarsal. There is mild deformity of the base of the first metatarsal, which we suspect represents an old fracture, although we cannot entirely exclude the possibility of an acute fracture at this site, and correlation with patient's site of pain is recommended. Mild degenerative arthritic changes also affect the midfoot. | 1.Acute fracture of the neck of the second metatarsal.2.Mild deformity of the base of the first metatarsal may reflect old trauma, but we cannot exclude the possibility of acute fracture if patient complains of pain at this site.3.Extensive postoperative changes and other findings as described above.Dr. Teresita Hogan was notified by phone of the above findings at 0950 on 2/11/2015. |
Generate impression based on findings. | Left-sided weakness. There is no evidence of intracranial hemorrhage or mass effect. There is mild parenchymal volume loss. There is no midline shift or herniation. There is mucosal thickening in the left maxillary sinus. The mastoid air cells are clear. There is mild plagiocephaly. The extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern, MRI of the brain is recommended.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. A loosely clustered linear calcifications are present at upper inner quadrant in the left breast.No suspicious masses or areas of architectural distortion are present. | A loosely clustered linear calcifications at upper inner quadrant in the left breast. Magnification views are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EA - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Obese male with hepatomegaly on physical exam. Patient history of cysts or steatosis. LIVER: The liver measures 29 cm in length. There is an infiltrative, complex mass encompassing nearly the entire right lobe; correlation with cross-sectional imaging is recommended. Minimal perihepatic ascites noted. Portal vein is patent with flow towards the liver on color Doppler imaging.GALLBLADDER, BILIARY TRACT: Common duct measures 5 mm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No hydronephrosis of either kidney. The right kidney measures 10.2 cm in length and the left kidney measures 10.5 cm in length.OTHER: The spleen measures 12.3 cm in length. Incidental splenule noted. | Large infiltrative mass in the right lobe liver; correlation with cross-sectional imaging is advised. Clinical service notified of these findings at the time of dictation. |
Generate impression based on findings. | Noncontrast head CT: There is no acute intracranial hemorrhage, mass effect, or midline shift. The ventricles, sulci, and cisterns are normal in size and configuration with preserved gray-white differentiation. There is leftward nasal septal deviation, otherwise the calvarium is unremarkable without fracture. The imaged portions of the orbits, paranasal sinuses, and mastoid air cells are unremarkable. CTA brain: Contrast symmetrically opacifies the anterior and posterior circulation. The anterior communicating and bilateral posterior communicating arteries are visualized with left PCOM larger than right. There is no aneurysm, dissection, or flow limiting stenosis identified. There is normal superficial and deep intracranial venous drainage. CTA neck: There is variant anatomy of the aortic arch with the brachiocephalic and left common carotid arteries sharing a common trunk. Mild atherosclerotic changes are seen at the carotid bifurcations, left worse than right, with less than 50 percent stenosis. Contrast opacifies the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries without aneurysm, dissection, or flow limiting stenosis. The bilateral vertebral arteries are patent. There is a dominant left vertebral artery. There are no acute abnormalities of the imaged neck soft tissues. Incidental note is made of a hyperattenuating right thyroid nodule. Mild degenerative changes affect the cervical spine. | 1. No significant stenosis in the intracranial or extracranial circulation in the neck. Specifically, no significant stenosis in the vertebrobasilar system. Mild atherosclerotic changes at the internal carotid artery origins. Opthalmic artery origins are patent.2. No acute intracranial abnormalities. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. There is a stable circumscribed mass at upper inner quadrant in the left breast, and stable asymmetry at posterior lower aspect in the right breast on MLO viewNo suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 37-year-old female with history of left ventricular thrombus, facial numbness and speech difficulty. 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. The visualized paranasal sinuses, mastoid air cells, and orbits are unremarkable. The calvarium and soft tissues of the scalp are normal. | No evidence of intracranial hemorrhage or mass effect. Please note that CT is insensitive for detection of acute ischemia. If patient care warrants further imaging, an MRI may be obtained. |
Generate impression based on findings. | Male 65 years old Reason: r/o fracture History: pain. There is a hairline lucency in the distal radial metaphysis indicating a nondisplaced radial fracture. We see no extension to the articular surface on this study. There is mild soft tissue swelling about the wrist. | Distal radius fracture. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 77 years, Male, Reason: pancreatic cancer and elevated CA19.9 and SOB History: as above. CHEST:LUNGS AND PLEURA: Posterior right lower lobe nodule minimally increased in size measuring 9 mm (4/44), previously 7 mm. No focal consolidation or pleural effusion. No new nodules or masses. Micronodule along the right major fissure likely represents an intrapulmonary lymph node. Additional scattered micronodules are unchanged and nonspecific. Tree in bud opacities seen previously have resolved.MEDIASTINUM AND HILA: Severe coronary artery calcifications and LAD stent.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Postsurgical changes of Whipple procedure. Pneumobilia has decreased. Mild intrahepatic biliary ductal dilatation is unchanged.SPLEEN: Small splenule.PANCREAS: Atrophic pancreatic tail status post Whipple with dilated duct, unchanged. No definite tissue within the surgical bed to suggest recurrence.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Large bilateral renal sinus cysts, left greater than right. Minimal left-sided hydronephrosis. Additional hepatic hypodensities are unchanged and likely represent cysts.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the aorta and its branches. IVC filter is unchanged in position. Peripancreatic lymph node seen previously measures 1.1 X 1.0 cm (3/100), previously 1.1 x 1.0 cm. No new lymphadenopathy.BOWEL, MESENTERY: Postsurgical changes of Whipple procedure.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: MalePROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bilateral sacroiliitis with fusion of the sacroiliac joints.OTHER: No significant abnormality noted. | 1.Right lower lobe pulmonary nodule is minimally increased in size and remains nonspecific. No new pulmonary nodules.2.Stable peripancreatic lymph node. No new lymphadenopathy. |
Generate impression based on findings. | Fatty liver disease. Elevated alcohol use. Abnormal liver function tests. LIVER: The liver measures 17.7 cm in length. The echogenic compatible with fatty infiltration. No focal abnormalities identified. The portal vein is patent with flow towards the liver on color Doppler imaging.GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. The common duct measures 3 mm which is within normal limits.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No hydronephrosis of either kidney. The right kidney measures 10.8 cm in length and the left kidney measures 11.4 cm in length.OTHER: The spleen measures 10.1 cm in length. | Fatty liver. Status post cholecystectomy. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. Scattered benign calcifications are noted in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Metastatic breast carcinoma CHEST:LUNGS AND PLEURA: While the right upper lobe index nodule has not significantly changed (seen on image 23 series 5 measuring 0.9 x 0 .7 cm), there has been slight interval increase in size of several of the previously noted numerous bilateral pulmonary metastatic nodules. An example is a left lingular nodule best seen on image 53 of series 5 now measuring 0.8 x 0.6 cm; this is in comparison to 0.5 x 0.4 cm on 11/13/2014.MEDIASTINUM AND HILA: Interval increase in size of mediastinal and bilateral hilar metastatic adenopathy. Reference right hilar mass best seen on image 54 series 3 now measures 3.6 x 2.2 cm; this is in comparison to 3 x 2.1 cm on 11/13/2014.CHEST WALL: Relatively stable reference anterior mediastinal mass invading the anterior chest wall with associated sclerotic sternal bony changes best seen on image 43 of series 3 measuring 7.3 x 2.8 cm.ABDOMEN:LIVER, BILIARY TRACT: Interval appearance of multiple subcentimeter low attenuation foci involving both lobes of the liver. A representative segment 6 right lobe lesion best seen on image 93 of series 3 measures 0.5 x 0.4 cm.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable left renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Slight interval increase in size of several of the pulmonary metastatic nodules. Interval increase in size of bilateral hilar and mediastinal metastatic lesions. New subcentimeter hypoattenuating bilobar liver lesions suspicious for new metastatic foci. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 74 years, Female. Reason: evaluate dobhoff placement History: s/p dobhoff Dobbhoff tube tip projects over the gastric body and appears to be kinked. Mild left curvature of the lumbar spine. Nonobstructive bowel gas pattern. The lung bases are clear. | Dobbhoff tube tip projects over the gastric body and appears to be kinked. Follow-up radiograph is recommended. Findings text paged to Dr. Vasenina at 1404 on 2/11/15. |
Generate impression based on findings. | 88 years, Male. Reason: 88 yo M s/p NG placement, please verify placement History: as above Exam is degraded by motion. Dobbhoff tube tip projects over the proximal gastric body. IVC filter noted. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip projects over the proximal gastric body, recommend advancement. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 70 year-old woman with history of right breast papillary carcinoma resected in June 2014, annual diagnostic mammogram. Three standard views of both breasts and 2 spot compression views of the right 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. Surgical clips and post-operative changes are seen in the right retroareolar region. Spot magnification views show no suspicious microcalcifications or masses at the surgical site. There are bilateral benign-appearing masses, none of which have changed significantly in morphology from prior exams. Scattered, benign appearing calcifications are also noted in the breast bilaterally. Benign appearing lymph nodes are projected over the right axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 56-year-old female. Metastatic breast cancer. Baseline prior to starting a treatment regimen. Known metastatic disease to the liver, lung, bone, and brain. LUNGS AND PLEURA: Multiple bilateral pulmonary nodules, highly suspicious for metastases. For reference a right lung base nodule is 19 x 16 mm (series 7, image 60).Patchy groundglass opacities in the dependent aspect of the lower lobes suggestive of aspiration and/or infection. Mild scarring in the anterior left upper lobe.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Normal heart size without pericardial effusion. No coronary artery calcification.Right chest port tip terminates at the cavoatrial junction.CHEST WALL: No axillary lymphadenopathy. Left axillary surgical clips. Bilateral mastectomies and evidence of reconstructive surgery. Orthopedic hardware in the right proximal humerus for fixation of a pathologic fracture.Mild degenerative changes of the thoracolumbar spine. Mild age indeterminate compression deformities of mid thoracic vertebrae.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Multiple liver metastases and probable right adrenal metastasis, refer to same day separately dictated CT abdomen/pelvis for further details. Bilateral renal cysts. Postsurgical changes at the GE junction. | 1. Liver and pulmonary metastases and probable right adrenal metastasis.2. Patchy groundglass opacities in the lower lobes suggestive of aspiration and/or infection. |
Generate impression based on findings. | 76-year-old female with bilateral total knee arthroplasties. Three views of the left knee demonstrate components of a total arthroplasty device with long femoral and tibial stems in anatomic alignment. There is no evidence of hardware complication or loosening. No acute fractures.Three views of the right knee also demonstrate components of a total arthroplasty device in anatomic alignment. There is no evidence of hardware complication or loosening. No acute fractures. | Bilateral total knee arthroplasties as described above without evidence of complication or significant interval change. |
Generate impression based on findings. | Pulmonary nodule,patient with history of tobacco use. Follow-up LUNGS AND PLEURA: Bilateral apical scarring unchanged. Moderate centrilobular emphysema with scattered micronodules, many calcified and all appear unchanged. The large 10 x 12 mm solid noncalcified nodule in the right middle lobe (image 69 series 4) remains unchanged. A mildly irregular margin with scattered satellite micronodules appear all unchanged.Mild bronchial wall thickening is also similar in nonspecific. No effusionsMEDIASTINUM AND HILA: Borderline subcarinal lymph node remains 12 mm (image 54 series 3). The AP window node should not be measured and currently demonstrates a discretely fatty center. No other suspicious lymph nodes.No visible coronary calcifications and the pericardium and heart are otherwise unremarkable.Moderate hiatal herniaCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Unchanged large solid nodule in the right middle lobe, stable since 5/2/14. Although again suspicious of granulomatous infectious change such as histoplasmosis, serial imaging to confirm stability in one more year would be confirming. Additionally a PET scan would also provide further characterization and potentially exclude concern. |
Generate impression based on findings. | 27 years, Male, Reason: Abdominal pain h/o SBO History: RLQ RUQ pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Metallic densities are unchanged and likely represent bullet fragments.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Appendix is not visualized, however there is no pericecal inflammatory changes to suggest acute appendicitis. No bowel wall thickening or dilatation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: MalePROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of small bowel obstruction or other findings to explain patient's symptoms. |
Generate impression based on findings. | Female 51 years old Reason: 51yr old female with history of MM; post-auto sct evaluation History: evaluate lesions. SKULL: Two views of the skull again show lesions of multiple myeloma similar to those of the prior study.CERVICAL SPINE: Two views of the cervical spine show scattered lucencies in the posterior elements that may represent myelomatous deposits, unchanged. Lucencies in the mandible also likely represent myelomatous deposits, unchanged. Degenerative arthritic changes of the cervical spine are unchanged.THORACIC SPINE: The bones appear demineralized which may reflect widespread myelomatous involvement, but we see no discrete myelomatous lesions. LUMBAR SPINE: Two views of the lumbar spine show no discrete lytic lesions. Moderate degenerative disk disease affects T12/L1.RIBS: AP views of the ribs show multiple healing/healed fractures bilaterally, as well as poorly defined lucencies likely representing myelomatous lesions, appearing similar to those on the prior study. Myelomatous lesions are also noted in the left scapula.PELVIS: AP view of the pelvis shows multiple poorly defined lucencies that presumably represent multiple myeloma, similar to the prior study.UPPER EXTREMITY: Two views of both humeri reveal lesions of multiple myeloma, appearing similar to the prior study.AP views of both forearms show no definite myelomatous lesions.LOWER EXTREMITY: Two views of the right femur show a few small lucent lesions compatible with myeloma, appearing similar to the prior study. Two views of the left femur show a few small lucent lesions compatible with myeloma, appearing similar to the prior study.AP views of the right and left tibia/fibula show no definite myelomatous lesions. | Findings compatible with multiple myeloma appearing similar to the prior study. |
Generate impression based on findings. | Acute kidney failure; abdominal pain. Biliary disease and liver disease. Abdominal pain, nausea and vomiting. LIVER: The liver measures 16.1 cm in length. No focal lesions. Portal vein is patent with flow towards the liver on color Doppler imaging.GALLBLADDER, BILIARY TRACT: Cholelithiasis. No evidence of wall thickening or pericholecystic fluid. The common duct measures 5 mm which is within normal limits.PANCREAS: No significant abnormality noted.SPLEEN: Spleen measures 9.8 cm in length.KIDNEYS: No hydronephrosis of either kidney. Right kidney measures 12.4 cm in length and the left kidney measures 11.7 cm in length. Right renal cyst. Both kidneys are echogenic compatible with medical renal disease. ABDOMINAL AORTA: Abdominal aorta measures 2.6 cm proximally, 2.5 cm at its midpoint and 2 cm distally.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted. | Echogenic kidneys compatible with medical renal disease. Gallstones. No findings to explain nausea and vomiting. |
Generate impression based on findings. | Reason: CXR with left basilar scarring/volume loss, restrictive PFT. unclear etiology, patients reports history of severe PNA in 2003. History: dyspnea LUNGS AND PLEURA: Elevation of the left hemidiaphragm with volume loss in left lower lobe, basilar scarring/atelectasis, and mild bronchiectasis.No suspicious pulmonary nodules or masses.No evidence of pulmonary edema.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Calcified mediastinal lymph nodes compatible with prior granulomatous disease.Cardiac size is normal without evidence of pericardial effusion.Evidence of a prior CABG with marked coronary artery calcification and LAD stent.CHEST WALL: Degenerative changes within the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Volume loss in the left lung with elevation of the left hemidiaphragm and evidence of fibrosis, atelectasis, and bronchiectasis the left lung base.2.No evidence of pulmonary edema or pleural effusions. 3.No suspicious pulmonary nodules or masses. |
Generate impression based on findings. | Sternocleidomastoid muscle sprain with swelling, tenderness, and pain. The right sternocleidomastoid muscle appears grossly unremarkable. There is no evidence of significant cervical lymphadenopathy based on size criteria. There is a right thyroid nodule that measures up to 16 mm, previously 12 mm in 2011. There is a subcentimeter air-filled right lateral pharyngeal pouch. The salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unchanged. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | 1. The right sternocleidomastoid muscle appears grossly unremarkable.2. No evidence of significant cervical lymphadenopathy. 3. Increase in size of a nonspecific right thyroid nodule since 2011. 4. Small right lateral pharyngeal pouch. |
Generate impression based on findings. | 51-year-old male status post right total hip arthroplasty. Two views of the right hip demonstrate a total arthroplasty device in anatomic alignment. There is no evidence of hardware complication or loosening. No acute fractures.Single AP view of the pelvis demonstrates the previously described hip arthroplasty device as well as 4 parallel orthopedic pins affixing the left proximal femur in anatomic alignment. Joint space narrowing and subchondral sclerosis are compatible with underlying osteoarthritis. | Total right hip arthroplasty and left hip pinning as described above without evidence of complication or significant interval change. |
Generate impression based on findings. | Female 18 years old Reason: Signs of colitis ? History: hematochezia ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Spinal fusion hardware of the thoracolumbar spine without evidence of malfunction. Rightward curvature of the lower thoracic spine is noted.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Hypodense lesion within the right adnexa which likely represents a physiologic cyst.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Evaluation of the distal colon is limited secondary to collapse of the bowel. Within these limitations there is no evidence of bowel wall or rectal thickening to suggest colitis or proctitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No definitive evidence of colitis or proctitis. No significant abnormality to explain the patient's symptoms. |
Generate impression based on findings. | 48-year-old female. Asthma with nasal polyposis. Cough. Salicylates causing adverse effect in therapeutic use. LUNGS AND PLEURA: Diffuse bronchial/bronchiolar wall thickening and scattered endobronchial mucous plugging.There are extensive tree-in-bud opacities in the bilateral lower lobes and the right upper lobe, new/increased from prior exam.Subpleural reticulation in the anterior aspect of the left upper lobe, most likely represents post radiation change.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Normal heart size without pericardial effusion.No visible coronary artery calcification.CHEST WALL: Postoperative changes of left breast lumpectomy with surgical clips. Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Stable left adrenal nodule which measures -9 HU, consistent with a benign adenoma. | New/increased tree-in-bud opacities in the bilateral lower lobes and right upper lobe with associated diffuse bronchial/bronchiolar wall thickening, consistent with an infectious bronchiolitis. |
Generate impression based on findings. | Reason: Pleural mesothelioma. Please compare to prior exam per recist criteria. History: Pleural mesothelioma. CHEST:LUNGS AND PLEURA: Redemonstration of volume loss and postsurgical changes in left hemithorax.Reference pleural measurements are as follows:1. At the level of the aortic arch (series 3, image 30): The lesion at the 7 o'clock position measures 2 mm, unchanged. The lesion at the 9 o'clock position is not being measured on this exam. The lesion at the 1 o'clock position measures 7 mm, previously measuring 7 mm.2. At the level of the main pulmonary artery (series 3, image 36): The lesion at the 3 o'clock discission measures 4 mm, previously measuring 3 mm.The lesion at the 12 o'clock position is not being measured on this exam. The lesion at the 8 o'clock position measures 5 mm, previously measuring 5 mm.3. At the level of the intraventricular septum (series 3, image 50): The lesion at the 5 o'clock position measures 4 mm, unchanged. The lesion at the 7 o'clock position measures 4 mm, unchanged.Left pleural thickening extends into the deep left costophrenic angle, unchanged in appearance.Scattered pulmonary nodules, unchanged. Mild centrilobular emphysema. Small left pleural effusion is slightly decreased.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Moderate coronary artery calcification. Scattered small mediastinal and hilar lymph nodes are unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatic cysts, unchanged.SPLEEN: Tiny hypoattenuating focus, unchanged.ADRENAL GLANDS: Stable mild nodularity of the left adrenal gland.KIDNEYS, URETERS: Probable renal cysts, unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta and its branches.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. | Stable appearance of nodular pleural thickening on the left, with reference measurements as above. No specific evidence of metastatic disease in the upper abdomen. |
Generate impression based on findings. | Dyspnea on exertion. Idiopathic pulmonary fibrosis LUNGS AND PLEURA: Extensive bilateral and basilar predominant extensive fibrotic changes including honeycombing and traction bronchiectasis. Architectural distortion remains consistent with a UIP pattern without evidence of superimposed focal air space abnormality. Irregular pleural thickening is also observed most prominent in the right lower hemithorax.The scattered superimposed groundglass opacities are again identified without significant change, remaining nonspecific. No suspicious superimposed pulmonary nodules are identified. Postsurgical changes including suture material and prior wedge resection with minimal volume loss noted in the right lung. No effusions.MEDIASTINUM AND HILA: Nonspecific mediastinal and bihilar lymphadenopathy, essentially unchanged. The reference right paratracheal node currently measures 13 mm (image 25 series 4) from a prior measurement of 15 mm. This may be due to slight differences in volume averaging. Other lymph nodes appear identical throughout and many remain partially calcified suggesting old granulomatous disease exposure.Coronary calcifications without interval change with borderline to mild cardiomegaly. No additional cardiac or pericardial abnormality, however prominent pulmonary arteries again support suspected pulmonary hypertensionSmall hiatal herniaCHEST WALL: Scattered moderate degenerative changes with preservation of disk spaces. Suspected diffuse idiopathic skeletal hyperostosisUPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Atherosclerotic changes without additional abnormality this limited view of the upper abdomen | UIP pattern consistent with stated history of IPF, no distinct superimposed acute or new pulmonary process. |
Generate impression based on findings. | Peritoneal mesothelioma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Stable left adrenal nodule best seen on image 43 of series 7 measuring 1.4 x 1.1 cm.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Status post ventral hernia repairOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterus absent or atrophicBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Status post ventral hernia repair. No evidence for acute, inflammatory, or metastatic process. |
Generate impression based on findings. | 57 years, Male, Reason: periotoneal mesothelioma on observation, eval EOD, compare to previous History: none. ABDOMEN:LUNG BASES: For findings in the chest, please see dedicated chest CT performed on the same day. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Status-post splenectomyPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Minimal bilateral hydronephrosis.RETROPERITONEUM, LYMPH NODES: Reference left para-aortic node measures 1.5 x 1.1-cm (9/72), previously 1.1 x 1 cm. Additional retroperitoneal lymphadenopathy is increased including a gastroesophageal node (9/46).BOWEL, MESENTERY:Soft tissue mass encasing the distal esophagus has increased in size measuring 3.8 cm and coronal images (80522/55), previously 2 cm.Extensive peritoneal soft tissue compatible with mesothelioma has overall increased. Soft tissue within the mesentery and pelvis encasing multiple bowel loops has also increased. No evidence of small bowel obstruction. For reference:Left paracolic gutter soft tissue nodule measures 1.5 cm in short axis (9/64), previously 0.8 cmSoft tissue encasing the posterior aspect of the liver measures 3.6 cm (9/56), previously 2.6 cm.Right paracolic gutter soft tissue is significantly increased measuring 5.5 cm (9/87), previously 2.8 cm.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Increased small amount of scattered abdominopelvic ascitesPELVIS: MalePROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Soft tissue anterior to the urinary bladder measures 4.3 cm in AP dimension (9/132), previously 1.7 cm. Additional soft tissue encasing multiple bowel loops has significantly progressed.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Significant progression in the peritoneal mesothelioma with soft tissue encasing multiple bowel loops.2.Soft tissue mass encasing the distal esophagus has increased.3.Increased retroperitoneal adenopathy.4.Increased abdominopelvic ascites.5.For findings in the chest, please see dedicated chest CT performed on the same day. |
Generate impression based on findings. | Reason: metastatic lung CA, on new medication, evaluate for status of disease History: anterior chest pain CHEST:LUNGS AND PLEURA: Interval reduction in the left lingular and right lower lobe nodules.Reference right lower lobe nodule (image 64 series 4) now measuring 3 mm x 4 mm previously measuring 10 mm x 10 mm.Reference subpleural lingular nodule (image 46 series 4) now measuring 4 mm x 6 mm previously measuring 18 mm x 15 mm.No new pulmonary nodules.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.CHEST WALL: Sclerotic lesions within the sternum and T1 vertebrae are unchanged.Mild anterior wedging of the T8 vertebrae unchanged.Mild degenerative changes within the thoracic spine.No axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Grade 1 spondylolisthesis of L4 on L5 secondary to spondylo-arthrosis of the facet joints. Previously demonstrated right iliac sclerotic focus not imaged on the current exam.OTHER: No significant abnormality noted. | 1.Significant interval treatment response of pulmonary metastatic nodules with almost complete resolution.2.Stable sternal and T1 osseous metastases.3.No new sites of disease identified. |
Generate impression based on findings. | Male 73 years old Reason: r/o stone History: right CVAT ABDOMEN:LUNG BASES: Stable bibasilar emphysematous changes. Calcified left basilar granuloma.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild right hydronephrosis with proximal right hydroureter due to multiple 3 to 4-mm renal stones in the distal right ureter (series 3, image 113-120).Nonobstructive left renal calculus. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Mild cardiomegaly without pericardial effusion. Moderate atherosclerotic calcification of the aorta and its branches.Mild aneurysmal dilatation of the abdominal aorta.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Acute ureteral obstruction due to multiple distal right ureteral stones. |
Generate impression based on findings. | History of metastatic apocrine adenocarcinoma to retroperitoneal, mediastinal and cervical lymph nodes along with vertebral metastases, now s/p 6 cycles of chemotherapy, compare with last 2 studies. CHEST:LUNGS AND PLEURA: Moderate right pleural effusion with associated basilar atelectasis, similar to prior. Reference right intercostal lymph node (series 3, image 86) measures 0.9 x 0.6 cm, measured 0.9 x 0.6 cm on 12/15/2014. Right basilar pleural thickening unchanged. MEDIASTINUM AND HILA: Reference right hilar lymph node measures 1.5 x 1.9 cm (series 3, image 48), previously 1.6 x 2.0 cm. Reference right prevascular lymph node measures 0.9 x 0.8 cm (series 3, image 41), previously 1.1 x 1.1 cm. Non reference mediastinal lymph nodes stable to slightly decreased. CHEST WALL: Postsurgical changes related to left axillary lymph node dissection. Multiple subcentimeter cardiophrenic lymph nodes appear to similar to prior. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Reference aortocaval lymph node measures 1.0 x 1.0 cm (series 3, image 117), previously 1.0 x 1.0 cm. Reference left para-aortic node measures 1.4 x 1.5 cm (series 3, image 121), previously 1.6 x 2.0 cm. Non reference retroperitoneal lymph nodes stable to slightly decreased.BOWEL, MESENTERY: There is colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: There are numerous lytic lesions present in the bilateral femoral heads, pelvis, ribs, right scapula and diffusely throughout the spine compatible with metastatic disease, but without significant interval change.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: There is no evidence of pelvic lymphadenopathy on the basis of size criteria.BOWEL, MESENTERY: There are bilateral fat containing inguinal hernias.BONES, SOFT TISSUES: There are numerous lytic lesions present in the bilateral femoral heads, pelvis, ribs, right scapula and diffusely throughout the spine compatible with metastatic disease, but without significant interval change.OTHER: No significant abnormality noted | 1.Lymphadenopathy overall stable to slightly decreased. Interval decrease in size of reference right prevascular lymph node and left para-aortic lymph node. Additional reference lesions not significantly changed.2.Stable diffuse osseous metastatic disease; however, nuclear medicine bone scan may better evaluate the extent of osseous metastatic disease.3.Right pleural thickening and moderate pleural effusion with associated basilar atelectasis not significantly changed. |
Generate impression based on findings. | Mesothelioma, follow-up CHEST:LUNGS AND PLEURA: No any significant chronic right subpulmonic pneumothorax, unchanged. Minimal basilar atelectasis with elevated right hemidiaphragm. Pleural calcifications again suggesting asbestos exposure with interval increasing pleural nodular disease. No significant effusions. Unchanged left basilar pulmonary cystReference measurements:1. at the level of the aortic arch (image 26 series 3), the 12 and 4 o'clock measurements are currently 4 and 24 mm, previously 3 and 12 mm when measured equivalently.2. at the level of the pulmonary artery (image 37 series 3), the 12 and one o'clock measurements are 9 and 15 mm, previously 5 and 6 mm3. at the level of the suprahepatic IVC (image 58 series 3), the 3 o'clock and 5 o'clock measurements are 5 and 3 mm, previously 3 and 2 mm.MEDIASTINUM AND HILA: Interval increasing lymphadenopathy, the right paratracheal reference lymph node (image 25 series 3) measures 14 mm, previously 9 mm when measured equivalently. The previous reference lymph node is less well visualized and confluent, however although currently measures 13 mm (image 30 series 3) from a prior measurement of 10 mm when measured equivalently (previously identified is 13 measured diagonally).Cardiac appearance is within normal limits without significant abnormality, pericardium is grossly intact. Moderate coronary calcifications largely at the origins of the coronaries. SVC catheterSmall hiatal hernia.CHEST WALL: Left chest wall port and mild scattered degenerative changes without new suspicious lytic or blastic lesions. More severe degenerative changes incompletely visualized in the upper lumbar spineABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Small suspected hepatic cyst unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Mild nodularity of the adrenals, specifically a left adrenal nodule unchangedKIDNEYS, URETERS: Stable and unchanged right renal cyst. Left kidney unremarkablePANCREAS: 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, scattered non-pathologically sized mesenteric lymph nodes all unchanged.BONES, SOFT TISSUES: Degenerative changes described aboveOTHER: No significant abnormality noted. | Right pleural nodularity demonstrates interval increased size, reference measurements provided. Associated increasing lymphadenopathy |
Generate impression based on findings. | Malignant neoplasm of peritoneum (mesothelioma) on observation. LUNGS AND PLEURA: Bilateral pleural plaques and a sub-pleural scarring in the lateral left upper lobe unchanged. Small left pleural fluid collection is new compared to the previous study, but there is no measurable pleural thickening.MEDIASTINUM AND HILA: Distal paraesophageal mass inseparable from the distal thoracic esophagus, collectively measuring 6.5 x 4.8 cm in transverse dimensions (6/81), previously 5.4 x 3.8 cm (prior series 3 image 74).A new subcentimeter posterior para-aortic lymph node is noted (series 6 image 76). Otherwise, no significant mediastinal lymphadenopathy. No conclusive coronary artery calcifications on this non-gated exam.CHEST WALL: Left axillary lymphadenopathy has resolved, the previously measured lymph node is no longer enlarged measuring 4 mm, previously 9-mm (6/31) and will be dropped as a reference lesion on future exams.T10 sclerotic focus unchanged on all prior exams, likely a benign bone island.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Peritoneal disease incompletely included in the scanning range and will be discussed in the separately reported abdomen and pelvis portion of the examination. | 1. Enlarging distal paraesophageal mass is consistent with tumor extending through the diaphragmatic hiatus.2. New small left pleural fluid collection and new subcentimeter adjacent posterior para-aortic lymph node suspicious for intrathoracic disease, but no discrete be measurable pleural disease on the left.3. Diaphragmatic and intraperitoneal disease will be discussed in a separately reported abdomen and pelvis section of the exam.4. Resolution of left axillary lymphadenopathy. |
Generate impression based on findings. | 8-year-old male. Evaluate for hip subluxationEXAMINATION: Pelvis 2 view 2/10/2015 12:11:27 No evidence of fracture or dislocation. Alignment is normal. | Normal examination. |
Generate impression based on findings. | 32-year-old female with haustral colitis status post colectomy with ileostomy, status post ileostomy takedown and revision, relocated to left hemiabdomen. Patient presents with pain in right hemiabdomen exacerbated with bending and walking and relieved with left side down lateral decubitus positioning. During pain, there is decreased output from ostomy and increased output with left side down lateral decubitus positioning. The scout image shows a nonobstructive bowel gas pattern. Fluoroscopic evaluation showed fixed angulation of distal ileum approximately 18 cm proximal to the ileostomy suggestive of adhesions. There is another loop of small bowel in the right upper quadrant that appears fixed and slightly angulated suggestive of a nonobstructive adhesion. Normal mucosa was noted throughout the small bowel, with no ulcers, sinus tracts, or fistulae. No separation of bowel loops was present to suggest fibrofatty proliferation. Transit time to the ileostomy was 60 minutes. No internal hernias or ventral hernias were evident. TOTAL FLUOROSCOPY TIME: 8:20 minutes | At least two nonobstructive adhesions as described above may explain the patients symptoms. |
Generate impression based on findings. | History of sinusitis. There is fluid within the maxillary sinuses. The other paranasal sinuses are clear. The nasal cavity is also clear. There is minimal nasal septal deviation. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. | Fluid within the maxillary sinuses suggests acute sinusitis. |
Generate impression based on findings. | 13-year-old female with low oxygen saturations and febrile illness.VIEW: Chest AP (one view) 2/10/15 15:09 Right chest wall port with catheter at the cavoatrial junction. Low lung volumes with elevation of the right hemidiaphragm and basilar atelectasis, appearing similar to the prior exam. | Low lung volumes and elevation of the right hemidiaphragm without significant interval change. |
Generate impression based on findings. | 41 year-old woman with history of focal asymmetry in the right breast on screening mammography. An ML view and two spot compression 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. The focal asymmetry seen on the screening mammogram disperses on compression. There are no dominant masses, suspicious microcalcifications, or areas of architectural distortion in the right breast. Benign appearing lymph nodes are projected over the right axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 13 year old male, slammed right middle finger in door one day agoEXAMINATION: Right hand 3 views 2/10/2015 13:24:48 Normal alignment. No effusion or fracture is noted. | Normal examination. |
Generate impression based on findings. | NSCLC on Tarceva with new bone mets.RADIOPHARMACEUTICAL: 13.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 110 mg/dL. Today's CT portion grossly demonstrates a right upper lobe nodule and right hilar lymphadenopathy. Pleural thickening is noted in the right lung base with adjacent streaky opacities. Diffuse skeletal lesions are noted. Maxillary mucosal sinus thickening is incidentally seen.Today's PET examination demonstrates significantly increased activity in the left lateral mass of C1 or the adjacent prevertebral space with a SUVmax of 10.3. Multiple foci of increased activity are also noted in the C7, L4 and S2 vertebral bodies; right T8 posterior element; right T11 posterior element; right scapula; throughout the pelvis; left proximal femur; multiple ribs and sternum. The right upper lobe nodule has mild activity with SUVmax of 2.4. The right hilum has a hypermetabolic lymph node with SUVmax of 4.8. The right lung base pleural thickening demonstrates increased activity with SUVmax of 7.2. Small lymph nodes in the right inguinal region have mild increased activity which may represent inflammatory change. | 1.Significantly increased FDG avid lesions within the skeleton indicating diffuse osseous metastases as described above.2.The left C1 lateral mass and/or adjacent prevertebral space activity is highly suspicious for a metastatic lesion. 3.The right upper lobe lung nodule with only mild activity may represent residual tumor or post-surgical change.4.The right hilum lymphadenopathy and right pleural thickening are suspicious for metastatic lesions. |
Generate impression based on findings. | 2 year and 6 month old male. Evaluate belly EXAMINATION: Abdomen AP (single view) 2/10/2015 13:09:24 Moderate fecal burden. Nonobstructive bowel gas pattern. No evidence of pneumatosis intestinalis, pneumoperitoneum, portal venous gas or free air. | Moderate fecal burden without obstruction. |
Generate impression based on findings. | Pleural mesothelioma. CHEST:LUNGS AND PLEURA: Postsurgical appearance of the right hemithorax. Trace pleural fluid adjacent to the liver. Reference right pleural lesions as follows:Level of the carina (3/43): Three o'clock position 18 mm, unchanged. Four o'clock position 8 mm, previously 11-mm.Level of right mainstem bronchus (3/48): One o'clock position 3 mm, previously 4-mm. Four o'clock position 18 mm, previously 21-mm.MEDIASTINUM AND HILA: Unchanged anterior pericardial thickening with reference to the left of midline measuring 12 mm, previously 14-mm (3/75). Patulous, mildly thickened thoracic esophagus containing an air-fluid level; from the level of the carina to the esophageal hiatus, the lateral wall of the esophagus is inseparable from adjacent pleural tumor, unchanged.Mediastinal pleural tumor is inseparable in the right lateral wall and posterior membrane of the distal trachea and the posterior wall of the right mainstem bronchus, unchanged. Small enhancing mediastinal and right hilar lymph nodes are unchanged (including lower left paraesophageal chain).CHEST WALL: An enlarged left internal mammary chain lymph node (3/67) is unchanged. Postsurgical changes. Areas of nodular soft tissue thickening along the right lateral chest wall (sagittal image 16, axial image 93) about the same.Tumor extending through intercostal spaces in the low lateral right thorax (3/107), about the sameABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Heterogeneous enhancement pattern of the liver with hypoattenuating focal lesion in the right hepatic lobe (3/95) appearing smaller. Bandlike area of hypoattenuation in the right hepatic lobe posterior to the gallbladder fossa, about the same. Enhancement along the falciform ligament previously appearing hypoattenuating, may be due to perfusion abnormality or hemangioma.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Mild focal fluid and soft tissue stranding right upper quadrant beneath the gallbladder.BONES, SOFT TISSUES: Mild thickening of right peritoneal fascial plane, best appreciated on the coronal image 69, with subtle nodularity about the same. This area should be continued to be monitored on subsequent exams.OTHER: No significant abnormality noted. | Right pleural mesothelioma measurements without significant change. Chest wall and mediastinal extension of disease about the same. Asymmetric peritoneal thickening and nodularity in the right hemi abdomen should continue to be monitored. |
Generate impression based on findings. | 62 year old female. Peritoneal mesothelioma on observation, evaluate EOD. Compare to previous. LUNGS AND PLEURA: Stable calcified and noncalcified micronodules, which are most likely post inflammatory.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.No visible coronary artery calcification.Right chest port tip terminates at the caval atrial junction.CHEST WALL: Mild degenerative changes of the thoracolumber spine. No suspicious focal osseous lesion is identified.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Refer to same date separately dictated CT abdomen/pelvis report. | No evidence of metastatic disease in the chest. |
Generate impression based on findings. | The patient submitted outside mammograms and ultrasound dated 2/12/2008 and 2/17/2007, from Mercy Hospital. Submitted outside study was compared to the current mammograms dated 10/20/2014 and 2/3/2015. The submitted studies are of significantly different technique than the current studies. There has been interval decrease in the size of multiple masses, compatible with involuting cysts. Allowing for differences in technique and artifacts on the prior studies, the calcifications are similar to the prior studies. | No mammographic evidence of malignancy. Presuming her recent ultrasound finding does not require additional imaging follow up, the recommendation would be for a bilateral diagnostic mammogram in October 2015 to prove stability of all her findings. BIRADS: 3 - Probably benign finding.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Male 53 years old Reason: Pt is a 53 y/o male with met rcc, evaluate for response to sunitinib History: met rcc CHEST:LUNGS AND PLEURA: Right basilar scarring/atelectasis. Scattered pulmonary micronodules, unchanged.No suspicious pulmonary nodules or masses.No pleural effusions.Persistent elevation of the right hemidiaphragm, which may be related to phrenic nerve paralysis.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size without pericardial effusion.Mild coronary artery calcifications.CHEST WALL: Redemonstrated are lytic lesions in the posterior right 5th rib (series 3, image 37) and lateral right 10th rib (series 3, image 107), with associated pathologic fractures. These lesions are grossly unchanged.Mild degenerative changes of the thoracic spine.ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis. Status-post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right superior pole defect from prior partial nephrectomy is unchanged.No definite evidence of recurrent disease.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Unchanged small fat-containing umbilical hernia.BONES, SOFT TISSUES: No significant abnormality notedOTHER: 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: Unchanged subcentimeter lytic lesions in the sacrum and pelvis.OTHER: No significant abnormality noted | Stable examination in a patient status post partial right nephrectomy with osseous metastases. |
Generate impression based on findings. | Reason: lung cancer History: 20 months after RLL lobectomy for Stage IB NSCLC. Following right lung GGO. LUNGS AND PLEURA: Postsurgical changes at the right lower lobe resection. Previously visualized right upper lobe ground glass opacity measures 13 x 13 mm (series 4, image 44), previously measuring 13 mm, stable compared to the prior exam.Right basilar calcified granuloma and scattered pulmonary micronodules, some calcified, are unchanged. No new suspicious pulmonary nodules or masses. No focal air space consolidation. Continued slight interval improvement in small right pleural fluid collection.MEDIASTINUM AND HILA: The heart is normal in size without significant pericardial effusion. Mild coronary artery calcification. Scattered calcified mediastinal and hilar lymph nodes from prior granulomatous disease, unchanged. Small hiatal hernia.CHEST WALL: Degenerative disease of the thoracic spine. 1-2 cm nodular soft tissue density in the right breast (series 3, image 49) was not definitively seen on prior imaging. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Stable 13mm right lung subsolid nodule. Continued annual followup imaging is recommended. No definite evidence of recurrent or metastatic disease.2. Newly seen 1-2 cm nodular soft tissue density in the right breast may represent volume averaging. Correlate with physical exam. |
Generate impression based on findings. | History of duodenal neuroendocrine tumor. Question of metastases. Normal physiologic radiotracer distribution is seen in the spleen, kidneys, liver, gallbladder, bowel and bladder. There is no abnormal focus of activity to indicate an octreotide avid lesion. | No octreotide avid tumor is identified. |
Generate impression based on findings. | 15 year-old female with low back pain. Evaluate for spondylitis.VIEWS: Lumbar spine AP, right oblique, left oblique, lateral, lumbosacral junction lateral (5 views) 2/11/2015 10:17:11 Alignment is normal. Vertebral body height and disk space are maintained. No pars defects are present. No evidence of fracture or dislocation. Moderate feces in the rectosigmoid colon. | Normal examination. |
Generate impression based on findings. | Reason: s/p MIE 8 months out History: esophageal cancer, follow up CHEST:LUNGS AND PLEURA: Redemonstration of severe apical predominant centrilobular and paraseptal emphysema. Large number of new scattered solid pulmonary nodules compatible with diffuse pulmonary metastases. For reference, a left upper lobe nodule measures 9 x 8 mm (series 4, image 81). A right lower lobe nodule measures 13 x 11 mm (series 4, image 84).Multiple bilateral nodular and lobulated upper lobe opacities with peripheral calcifications seen on prior exams appear unchanged. A previously described subpleural right lung nodule is slightly increased in prominence, measuring up to 5 mm (series 4, image 52), previously measuring 4 mm.Stable basilar atelectasis. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size. Trace pericardial fluid. Moderate coronary artery calcification. Scattered small mediastinal and hilar lymph nodes, unchanged. Surgical changes, dilation, and wall thickening of the esophagus.CHEST WALL: Left chest port, tip in the SVC.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: New hypodense right hepatic lobe lesion measures 13 x 10 mm (series 3, image 16), suspicious for additional metastatic disease.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cysts, unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable small left para-aortic lymph nodes. Atherosclerotic calcification of the abdominal aorta and its branches.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. Multiple new solid pulmonary nodules bilaterally, compatible with diffuse pulmonary metastases.2. New right hepatic lobe hypoattenuating lesion, suspicious for additional metastatic disease. |
Generate impression based on findings. | 65 year-old woman with history of right IDC status post mastectomy 10/12. 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. No dominant masses, suspicious microcalcifications, or areas of architectural distortion are seen in the left breast. Benign appearing lymph nodes are projected over the left axilla. | 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. | 55-year-old with history of focal pain in her right outer breast. The patient denies any palpable abnormality. Three standard views of both breasts and a left lateral exaggerated CC view 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. Stable benign morphology mass in the right upper outer breast. Bilateral benign calcifications are again noted, some are more coarse and minimally progressed in a benign fashion. No new dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. ULTRASOUND | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male 42 years old Reason: eval chronic R knee pain, poss OA, poss retained missile from prev GSW History: same. Four views of the right knee show metallic densities along the posterolateral aspect of the distal femoral metaphysis compatible with bullet fragments. We see no underlying fracture or osteoarthritis.The left knee appears normal as seen on the frontal views. | Bullet fragments as described above. We otherwise see no specific radiographic findings to account for patient's knee pain. |
Generate impression based on findings. | cT3N0 squamous cell carcinoma of the supraglottic larynx, status post treatment. There are post-treatment findings, including total laryngectomy with flap reconstruction and tracheostomy tube insertion. There is no evidence mass lesions in the neck or significant cervical lymphadenopathy. However, a partially-imaged right lower paratracheal lymph node appears to have increased in size. There is a persistent right submandibular gland calcification that likely represents a sialolith. The residual thyroid gland is unchanged. The osseous structures are unchanged, including multilevel degenerative spondylosis. There is a right internal jugular venous catheter. The partially imaged intracranial structures are grossly unremarkable. There is a new right apical nodule that measures up to 12 mm. | 1. Stable post-treatment findings in the neck without evidence of locoregional recurrent tumor or significant cervical lymphadenopathy. However, a partially-imaged right lower paratracheal lymph node appears to have increased in size. Please refer to the separate chest CT report for additional details.2. New right apical nodule that measures up to 12 mm, which may represent a metastasis or primary lung neoplasm. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | 11 year old female, postoperative scan for renal stones ABDOMEN:LUNG BASES: Mild left basilar atelectasis.LIVER, BILIARY TRACT: Normal hepatic morphology. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Interval removal of left ureteropelvic stone and placement of left nephroureteral catheter with tip in the bladder. There is mild residual left hydronephrosis. A small, nonobstructive left inferior pole kidney stone measures approximately 5 mm. No right nephrolithiasis, hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Scattered subcentimeter lymph nodes at the mesenteric root.BOWEL, MESENTERY: The bowel is normal in caliber.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Large bilateral ovarian cystic lesions appear similar to the prior study. The largest cyst on the left measures 9.9 cm and previously measured 9.9 cmBLADDER: The bladder is markedly distended with fluid.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Interval removal of ureteropelvic calculus and placement of left nephroureteral catheter with mild residual hydronephrosis.2. Nonobstructive left nephrolithiasis.3. Bilateral large ovarian cystic lesions appearing similar to the prior exam. |
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