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Generate impression based on findings. | Reason: 37 y/o woman with breast cancer metastatic to bone currently on chemotherapy. Evaluate for extent of disease. History: New mid-chest pain. CHEST:LUNGS AND PLEURA: Interval resolution of the previously noted focal area of groundglass opacity in the left lower lobe.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Right chest Port-A-Cath with its tip in the SVC.CHEST WALL: Extensive sclerotic metastases throughout the axial skeleton including the sternum, vertebrae, and ribs unchanged.Partial collapse of the T7 vertebra is stable.No Axley lymphadenopathy.Previously noted enhancing left breast nodule has resolved.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: Right renal cyst stable.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: Numerous sclerotic metastases within the lumbar vertebrae and visualized pelvis.OTHER: No significant abnormality noted. | 1.Widespread osseous metastases with in the visualized axial skeleton without evidence of new sites of disease.2.Interval clearing of left breast nodules previously noted.3.Interval clearing of left lower lobe groundglass opacities. |
Generate impression based on findings. | 33 years, Male. Reason: cause of suprapubic pain? urinalysis unremarkable. 33M NK lymphoma, HLH. same pain as on admission that had resolved. History: suprapubic pain; hyperactive bowel sounds Nonobstructive bowel gas pattern. Splenomegaly is noted. | No acute intra-abdominal pathology visualized to account for patient's symptoms. |
Generate impression based on findings. | Chronic nasal obstruction and rhinorrhea; markedly deviated nasal septum seen on prior MRI, questionable right sided concha bullosa. The nasal septum and 7 mm wide spur are deviated towards the left. There is a right concha bullosa. There is mild mucosal thickening within the maxillary sinuses. The other paranasal sinuses are clear. The nasal cavity is also clear. 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. There is periodontal lucency associated with several maxillary teeth. | 1. The nasal septum and 7 mm wide spur are deviated towards the left and right concha bullosa.2. Mild mucosal thickening within the maxillary sinuses. The other paranasal sinuses are clear. |
Generate impression based on findings. | Preop for total knee arthroplasty. Status post gunshot wound Three views of the right knee with weight-bearing reveal severe osteoarthritis with marked medial joint space narrowing. There is medial and lateral ossified formation. Marked narrowing of the patellofemoral joint with osteophyte formation Two views of the right tibia and fibula again reveal posterior arthritis of the right knee. Exam is otherwise unremarkable. Bone length study demonstrates one degree of varus angulation | Severe osteoarthritis. Preoperative examination |
Generate impression based on findings. | 45 years, Female. Reason: eval for kidney stone History: right flank pain Nonobstructive bowel gas pattern with average stool burden. No abnormal calcifications are seen to suggest renal calculi. Intrauterine device is noted. | No evidence of renal calculi. |
Generate impression based on findings. | Abdominal pain, evaluate for intraabdominal infection and colitis. ABDOMEN:LUNG BASES: Previously seen diffuse pulmonary opacities have resolved. Minimal residual basilar atelectasis/scarring. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse circumferential colonic wall thickening with surrounding inflammatory changes compatible with pancolitis. There is also wall thickening of the rectum. There is a small amount of free fluid in the pelvis but no loculated fluid collections. No intraperitoneal free air or portal venous gas. Small bowel normal caliber without evidence of obstruction. BONES, SOFT TISSUES: Previously seen anasarca has nearly resolved with mild residual soft tissue edema in the soft tissues of the back. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diffuse circumferential colonic wall thickening with surrounding inflammatory changes compatible with pancolitis. There is also wall thickening of the rectum. There is a small amount of free fluid in the pelvis but no loculated fluid collections. No intraperitoneal free air or portal venous gas. Small bowel normal caliber without evidence of obstruction. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Diffuse pancolitis likely from inflammatory/infectious etiology, clostridium difficile colitis is a differential consideration. No evidence of obstruction.2.Interval resolution of diffuse pulmonary opacities.3.Near resolution of anasarca. |
Generate impression based on findings. | There are postsurgical changes of corpectomy at T9 and posterior spinal fusion extending from the T6 to T12 levels. There is diffuse heterogeneity of the bone marrow compatible which is nonspecific but compatible with known multiple myeloma.There is minimal loss of height involving the T4 vertebral body. There is also mild loss of height which is suspected involving the T6 and T12 vertebral bodies, further evaluation of which is difficult due to distortion related to the extensive susceptibility artifact.No obvious spinal canal or neural foramina stenosis is appreciated within the limitations of the study.Moderate right pleural effusion.LUMBAR SPINE | 1. Postsurgical changes of T9 corpectomy and posterior spinal fusion from T6 to T12. CT may be helpful to better evaluate the hardware if clinically warranted although no hardware fracture or displacement is seen on prior radiographs from 9/24/2013.2. Mild compression fractures are seen at T4, T6, and T12. Compared to MRI dated 7/30/2012, T4 and T6 compression fractures are stable to minimally worse. T12 compression fracture is new since 7/30/2012 but grossly unchanged since radiograph from 3/13/2013. Susceptibility artifact limits evaluation however no definite edema in the vertebral bodies is seen at these levels.3. Edema involving the L5-S1 disk space is likely on a degenerative basis.4. Right pleural effusion. |
Generate impression based on findings. | Reason: lung nodule History: lung nodule LUNGS AND PLEURA: Severe centrilobular emphysema. Status post right upper lobe resection with stable linear and nodular scarring near the right lung apex.An 11 x 11 mm anterior left upper lobe ground glass nodule (series 7, image 61) is unchanged in appearance. A previously identified branching nodular lingular density adjacent to the fissure appears unchanged (series 7, image 83).The previously described ground glass nodule in the superior segment of the left lower lobe is not seen on this exam. Resolution of other scattered small nodules and new scattered small peribronchovascular left lower lobe nodules are likely related to inflammatory process, including aspiration. Additional scattered micronodules and calcified granulomas are unchanged. MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. No visible coronary artery calcifications. Scattered small mediastinal and hilar lymph nodes are unchanged. No evidence of hilar or mediastinal lymphadenopathy. CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Stable 1cm left upper lobe ground glass nodule. Continued followup is recommended for this lesion.2. Resolution of scattered small nodules and new scattered small peribronchovascular left lower lobe nodules are likely related to inflammatory process, including aspiration. 3. Additional scattered small lung nodules, some calcified, appear stable.4. Severe emphysema. |
Generate impression based on findings. | 64 year old male. Persistent subcutaneous emphysema. Evalaute for placement of IR drain/new airspaces in lung. Malignant mesothelioma s/p pleurectomy and decortication. LUNGS AND PLEURA: Interval placement of a small bore chest tube in the left base anterior moderate pneumothorax (series 5, image 60), which is not significantly changed in size. Large bore left chest tube terminating at the apex, unchanged. Mild increase in small pneumothorax at the left apex. Small left basilar pleural fluid, mildly decreased.Left upper lobe lobe anterior nodular pleural thickening at the level of the aortic arch, unchanged, may represent residual tumor or postoperative loculated fluid.Small amounts of air along the right lung pleural fissures, likely representing interstitial emphysema unchanged. Small amount of extrapleural interstitial air anteriorly on the right, unchanged.Left hemidiaphragm elevation with overlying subsegmental atelectasis. Surgical diaphragmatic mesh in place.MEDIASTINUM AND HILA: Severe pneumomediastinum, unchanged.No visible coronary artery calcification.Catheter tip in the SVC.CHEST WALL: Extensive subcutaneous emphysema in the chest wall and neck, unchanged. Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Interval placement of small bore chest tube in a moderate left anterior pneumothorax, which is not significantly changed in size. |
Generate impression based on findings. | Reason: History of metastatic breast cancer, on treatment. Compare to prior imaging, evaluate for response \T\ extent of disease. History: History of metastatic breast cancer, on treatment. Compare to prior imaging, evaluate for response \T\ extent of disease. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: Right chest Port-A-Cath with its tip in the SVC.No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.CHEST WALL: No axillary lymphadenopathy.T10 corpectomy and left lateral fusion redemonstrated.Stable fracture deformity of the left eighth rib.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Stable small splenic hypo-attenuating lesions too small to characterize.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: Stable osteolytic lesions within the pelvis and interval kyphoplasty at L2 with extension of cement material into the L2-3 intravertebral disk and minimally into the left anterior epidural space.OTHER: No significant abnormality noted. | 1.Resolved left axillary lymphadenopathy. No new sites of osseous metastases.2.Interval kyphoplasty at the L2 level |
Generate impression based on findings. | Dyspnea and the large mediastinal mass, most likely lung primary.RADIOPHARMACEUTICAL: 11.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 78 mg/dL. Today's CT portion grossly demonstrates near complete atelectasis and consolidation of the right upper lobe secondary to proximal bronchial obstruction similar to that seen on the recent previous chest CT. Prominence of the right paratracheal and right hilar region is noted. Multinodular enlarged thyroid is again visualized. Dense benign type calcification again seen in the right breast. Degenerative disease is noted in the spine. Bilateral adrenal nodules are not appreciably changed in size. Mild calcification in the wall of the gallbladder or possibly a large partially calcified gallstone.Today's PET examination demonstrates significantly increased FDG avid activity in the right paratracheal/right hilar region with a SUVmax of 23 corresponding with the location of the primary lung malignancy. There is likely right paratracheal lymph node involvement. Mild increased activity is seen in the adjacent right lung indicating atelectasis. No distant metastases are visualized, including no abnormal activity in the bilateral adrenal nodules. | 1.Significantly increased FDG avid activity in the right perihilar/paratracheal region corresponding to the primary lung malignancy.2.There is likely right paratracheal lymph node involvement. 3.No distant metastases, including no abnormal activity in the bilateral adrenal nodules. |
Generate impression based on findings. | Status post fall. Wrist pain Three Views of the left wrist reveal no evidence of any fractures or dislocations. No radiographic abnormalities | Negative left wrist examination |
Generate impression based on findings. | Lymphoma and recurrent fevers. There is minimal mucosal thickening in the right maxillary sinus without an air-fluid level. The ethmoid sinuses, frontal sinuses, and sphenoid sinuses are clear. The nasal cavity is also clear. 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. | Minimal right maxillary mucosal thickening without specific findings of acute sinusitis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Follow up fracture Two views of the left femur reveal a comminuted intratrochanteric fracture that is fixed with a trochanteric femoral nail. The bones appear in near anatomic alignment. No change in position from the previous exam. | Rodding of comminuted intratrochanteric fracture |
Generate impression based on findings. | 54 years, Female. Reason: assess for stool burden or SB obstruction History: bloating/abdominal pain/ constipation Nonobstructive bowel gas pattern with slightly greater than average stool burden in the colon. | Slightly greater than average stool burden without evidence of obstruction. |
Generate impression based on findings. | Metastatic RCC. Evaluate for response to therapy. There is redemonstration of increased radiotracer uptake within the proximal right humerus, with a photopenic center, and the mid-left humerus. Focal radiotracer uptake in the right posterior fifth rib and T8 vertebrae are unchanged. There is new soft tissue activity within the right lateral thigh and medial lower leg soft tissues which is non-specific and may represent dystrophic calcification. There are degenerative changes of the knees, shoulders, and sternoclavicular joints with more prominent activity in the right acetabulum. | 1. Stable appearance of existing metastatic lesions without definite new lesion. 2. New non-specific soft tissue uptake may represent dystrophic calcification. |
Generate impression based on findings. | 51 year-old woman history of known right breast cancer on neoadjuvant chemotherapy. Three standard views of the right breast and repeat right ML 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. Biopsy clips are noted in the right breast at the 11:30 position (anterior and posterior depth) without a visible mass, suspicious microcalcifications, or significant architectural distortion. A small right axillary lymph node is also noted with a biopsy clip. | Decrease in size of right breast mass without residual visible mass. Patient is scheduled for surgery next week, management as per surgery service is recommended.BIRADS: 6 - Known cancer.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 56 years, Male. Reason: Assess fecal load History: Diarrhea/ constipation; on morphine pump Nonobstructive bowel gas pattern. Average stool burden in the colon. Pump device projects over the right lower abdomen with tubing extending to the spine. | Average stool burden within the colon and nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 31 years old Reason: eval for fracture History: s/p fall w back and l hip pain. We have 5 views of the lumbar spine. Vertebral body height and disk spaces are preserved. There is near-anatomic alignment of the lumbar spine. No acute fracture or subluxation is noted.AP view of the pelvis and left hip demonstrate osteophyte formation and a bony prominence at the left femoral head/neck, and changes consistent with bilateral femoral acetabular impingement. Bilateral accessory acetabular ossicles are noted. | No acute fracture or subluxation. Chronic changes consistent with bilateral femoral acetabular impingement are noted. |
Generate impression based on findings. | History of metastatic breast cancer to bone. Evaluate bone involvement/spine. History of thoracic metastatic lesion resection and fusion. There is redemonstration of increased radiotracer uptake within the left posterior 9th rib and faintly increased activity within the L2 vertebrae corresponding to healing pathologic fractures on CT. A photopenic lesion within the left posterior 10th rib is unchanged. Increased uptake within the calvarium is similar to the prior study. No new osteoblastic metastatic lesions are identified. Small focus of uptake within the right upper chest correlates to the right chest port. | Multiple osseous metastatic foci are similar to the prior examination. Note that disease burden may be underestimated on bone scan due to the lytic nature of some of the lesions, which may not be visibile on bone scan. Please refer to CT to better visualize these lytic lesions. |
Generate impression based on findings. | Kidney donor, living kidney donor protocol. CT Angiography: There is no evidence of aortic aneurysm, dissection, or significant stenosis. The origins of the great vessels, celiac axis, SMA, and renal arteries are patent. No evidence of atherosclerotic disease. There is a replaced right hepatic artery, normal variant.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: Kidneys are normal in size and morphology without focal masses. Right kidney measures 7.0 x 11.5 cm. Left kidney measures 7.8 x 11.9 cm. No nephrolithiasis or hydronephrosis. The right kidney is supplied by a single renal artery without early branching. The right kidney is drained by two renal veins. The left kidney is supplied by a main renal artery without early branching and an inferior pole accessory artery. The left kidney is drained by a single renal vein. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered small mesenteric lymph nodes are present but are not pathologically enlarged by size criteria. 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: No significant abnormality notedOTHER: No significant abnormality noted | 1.Two orthotopic kidneys without significant abnormality. 2.Left kidney with inferior pole accessory artery. 3.Right kidney drained by two renal veins. |
Generate impression based on findings. | 4-year-old male with hip subluxationVIEWS: Pelvis AP and frog leg (two views) 2/10/15 10:48 The femoral heads are well directed with respect to the normal acetabula. The bones of the pelvis appear normal. | Normal examination. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none LUNGS AND PLEURA: Surgical changes of resection of the right lung base, with decreased adjacent consolidation and decreased small right pleural effusion. Stable right middle lobe and right lower lobe perihilar consolidation.Reference necrotic nodule in the right lower lobe measures 31 x 17 mm (series 4, image 67), previously measuring 37 x 21 mm.3-mm right upper lobe nodule (series 6, image 38), unchanged.No new pulmonary nodules or masses. No new focal air space consolidation.MEDIASTINUM AND HILA: The heart is normal in size with trace pericardial fluid. Mild coronary artery calcification.Reference right hilar mass measures 19 x 13 mm (series 4, image 53), previously measuring 20 x 17 mm.Reference nodal mass adjacent to the IVC is decreased in size, measuring 30 x 33 mm (series 4, image 61). Improvement is particularly noted on coronal images, measuring 26 x 14 mm (coronal image 46), decreased in size from the prior exam (see coronal image 45 from 12/31/2014).Reference subcarinal lymph node measures 17 x 8 mm (series 4, image 39), previously measuring 20 x 11 millimeters.A previously described partially occlusive thrombus in the SVC, inferior to the catheter tip is not clearly seen on this exam.CHEST WALL: Right chest wall port, tip in the SVC. Mild degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Cholelithiasis. | Continued overall improvement in right-sided intrapulmonary and pleural metastatic disease. |
Generate impression based on findings. | Reason: lung cancer History: history of LUL lobectomy for Stage IIB adenocarcinoma. Being followed for RUL GGO and LUL nodule LUNGS AND PLEURA: Status post left upper lobectomy.9-mm right apical ground glass nodule (image 18 series 5) is unchanged.Stable 6-mm left lower lobe ground glass opacity (image 133 series 6).Stable perifissural right middle groundglass nodule (image 196 series 6) measuring 5 mm.Stable right basilar ground glass nodule (image 274 series 6) measuring 9 mm.No new suspicious pulmonary nodules or masses.No pleural effusions.Mild upper lobe predominant centrilobular emphysema.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Mild enlargement of the pulmonary artery which may represent pulmonary arterial hypertension.CHEST WALL: Degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Stable multiple subcentimeter groundglass nodules compatible with atypical adenomatous hyperplasia or possibly adenocarcinoma in situ. Continued annual follow up examination is recommended. |
Generate impression based on findings. | 59-year-old female with ankle and foot pain. Diffuse soft tissue swelling is noted about the ankle and foot. No acute fracture or dislocation is identified. Incidental note is made of a type 1 accessory navicular. | Diffuse soft tissue swelling without acute fracture identified. |
Generate impression based on findings. | 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. The calvarium is unremarkable without fracture. The imaged portions of the orbits, paranasal sinuses, and mastoid air cells are unremarkable. | No evidence of acute intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct and posterior reversible encephalopathy syndrome.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 1-year and 10 month old female, rule out ricketsEXAMINATION: Right wrist PA, Right knee AP (2 views) 2/10/2014 12:21 No widening of the physis. No metaphyseal cupping or fraying is seen. Normal alignment with no evidence of fracture or dislocation. | Normal examination. No evidence of rickets. |
Generate impression based on findings. | 75 years, Female, Reason: 75 year-old female, underwent colonoscopy today with concern for malignancy at distal sigmoid colon. CT chest/abd/pelvis for staging and to rule out perforation given friability of mass History: as above. CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. Nonspecific lingular nodule measuring 6 mm (6/70). Moderate centrilobular emphysema. Right apical scarring. Additional scattered micronodules are nonspecific.MEDIASTINUM AND HILA: Subcentimeter thyroid nodule. Severe atherosclerotic calcifications of the aortic arch. Severe coronary artery calcifications.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a long segment of bowel wall thickening measuring 4 cm and enhancement within the sigmoid colon. There is an exophytic component extending superior to this region of bowel measuring 1.5 x 1.0 cm which may represent an adjacent lymph node. Within the small bowel in the mid pelvis, there is an additional region of narrowing and adjacent inflammatory changes. Thickening is noted at the terminal ileum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: FemaleUTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: See above.BONES, SOFT TISSUES: Mild degenerative changes of the spineOTHER: No significant abnormality noted. | 1.Long segment of bowel thickening and pericolonic inflammatory changes in the sigmoid colon with an adjacent enlarged mesenteric lymph node is suspicious for neoplasm. 2.Additional regions of narrowing with adjacent inflammatory changes within the mid small bowel and terminal ileal thickening are nonspecific3.Nonspecific micronodules in the lingula. Follow-up is recommended. |
Generate impression based on findings. | Female 54 years old Reason: hallux valgus History: pain. There is hallux valgus of the right foot. There are no acute fractures or dislocations. The soft tissues are within normal limits. | Hallux valgus of the right foot. |
Generate impression based on findings. | 62 year old female with right shoulder pain. No acute fracture or dislocation is identified. Alignment is anatomic. No significant degenerative changes. | Normal examination. |
Generate impression based on findings. | 37 year old female with history of Lisfranc injury status post orthopedic fixation. Two orthopedic screws affix the medial cuneiform to the first metatarsal. An additional screw affixes the head of the second metatarsal to the medial cuneiform. A 4th screw affixes the middle cuneiform to the second metatarsal. A fifth screw affixes the third metatarsal to the lateral cuneiform. There is a calcaneal defect at the site of a prior orthopedic alignment device which has been removed. Overall alignment is anatomic and there is no evidence of hardware complication or loosening. | Orthopedic fixation as described above without evidence of hardware complication or significant interval change. |
Generate impression based on findings. | Female 50 years old Reason: neck and right arm pain History: neck and right arm pain. Intravertebral disk spaces are preserved. There is no acute fracture or subluxation. Cervical spine is in anatomic alignment. | No acute fracture or subluxation. |
Generate impression based on findings. | 17 year-old female with headache, rule out shunt malfunctionVIEWS: Abdomen, AP and lateral (two views) 2/11/15 14:18 A lumbar catheter enters into the spinal canal at the level of L3/4 with its tip extending superiorly to T11. The Strata valve is is not seen en face and its setting cannot be evaluated. The shunt catheter extends anteriorly and inferiorly within the soft tissues across the abdomen, and pelvis with its tip in the right lower quadrant. No evidence of kinking or discontinuity of the radiopaque portions of shunt catheter.Nonobstructive bowel gas pattern. Note is made of elevated BMI. | No evidence of shunt malfunction. |
Generate impression based on findings. | 49 year old female. 1 month bilateral lung transplant per protocol. PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Postsurgical findings of bilateral lung transplant. Small bilateral pleural effusions. Left upper lobe 5 mm groundglass nodule (series 9, image 33).MEDIASTINUM AND HILA: Dilated main pulmonary artery measuring 30 mm suggestive of pulmonary artery hypertension, unchanged.Mild coronary artery calcification.No mediastinal or hilar lymphadenopathy.Normal heart size without pericardial effusion.CHEST WALL: Mild degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No evidence of pulmonary embolism. 2. 5 mm left upper lobe groundglass nodule is indeterminate, follow-up in 3 months is recommended.3. Small bilateral pleural effusions.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 55-year-old female with right hip prosthesis and concern for loosening. Evaluate for bone stock. Exam is limited by significant streak artifact from metal hardware.There is a total right hip arthroplasty device with marked vertical displacement of the acetabular component, also seen on prior radiographs. As a result, the right femoral head appears to articulate with the ilium. Limited exam precludes full evaluation of bone stock around the femoral head and acetabular component. There is no evidence of femoral stem loosening or bone resorption about the femoral stem. | 1.Vertical displacement of the acetabular component of the total right hip arthroplasty device as seen on prior radiographs.2.No evidence of bone resorption about the femoral stem. Evaluation of bone stock about the more proximal hardware is limited by significant streak artifact. |
Generate impression based on findings. | 46 year-old female with right shoulder pain. No acute fracture or dislocation. The humeral head articulates normally with the glenoid on the axillary view. | Normal examination. |
Generate impression based on findings. | Male 71 years old; Reason: muscle invasive bladder cancer - CT for preoperative staging History: muscle invasive bladder cancer - CT for preoperative staging CHEST:LUNGS AND PLEURA: Severe emphysema. There are soft tissue masses in the upper lobes slightly larger on the left. The lesion on the left measures 3.1 x 2.2 cm on image 23/series 9Similar appearing lesions are located in the right upper lobe.The lesions are lower in attenuation and some of them are associated with impacted bronchi. Imaging findings are suggestive of a bronchocele.Dilated right lower lobe pulmonary likely due to perfusional differences between the two lobes as there is better lung parenchyma in the right lower lobe.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple scattered hepatic cysts. No suspicious hepatic lesions. The hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: Bladder wall thickening with nodular enhancement along the left lateral aspect.LYMPH NODES: No pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right hip prosthesis.OTHER: No significant abnormality noted. | 1.Asymmetric bladder wall thickening and hyper enhancement compatible with the patient's known malignancy.2.No evidence of distant metastatic disease in the abdomen or pelvis.3.Abnormal lung findings which appear stable from prior. The lack of interval change favors a benign process. |
Generate impression based on findings. | AORTOGRAM: Normal caliber aorta with no evidence of stenosis or aneurysm. Normal appearing single bilateral renal arteries. PELVIC ANGIOGRAM: Common, internal and external iliac arteries are widely patent. LEFT LOWER EXTREMITY: The common and deep femoral arteries widely patent. The superficial femoral artery is occluded just after its origin. There are pre-existing metallic stents which are occluded. The popliteal artery is patent and reconstitutes above the knee via numerous collaterals.. The trifurcation is patent. The anterior tibial artery is patent proximally however it occludes in its distal two thirds. The posterior tibial artery is diminutive however patent. Dominant runoff to the foot is via the peroneal artery which reconstitutes the distal posterior tibial artery and dorsalis pedis via collaterals.RIGHT LOWER EXTREMITY: The common femoral artery is free of significant disease with suitable puncture location and size for a closure device.CONTRAST: 72 mL VisipaqueFLUOROSCOPY TIME: 15.7 MinutesAIR KERMA: 174.14 MGyESTIMATED BLOOD LOSS: Less than 5cc. | Aortogram and left leg angiogram with findings as noted above. Occlusion of the left superficial femoral artery with reconstitution of left popliteal artery via collaterals. The peroneal artery runoff.PLAN: The patient will follow-up in vascular clinic to discuss surgical options. |
Generate impression based on findings. | LIVER: Normal echogenicity measuring up to 15.4 cm in longitudinal dimension. No intra-or extrahepatic biliary ductal dilatation. No perihepatic fluid.GALLBLADDER, BILIARY TRACT: Normal echogenicity, nondistended. No cholelithiasis, gallbladder wall thickening (1 mm in thickness) or pericholecystic fluid. Common bile duct measures up to 3 mm in diameter.PANCREAS: Normal echogenicity with no pancreatic ductal dilatation. SPLEEN: Normal echogenicity, measuring up to 10.3 cm in longitudinal dimension.KIDNEYS: Normal echogenicity bilaterally. The right kidney measures up to 10.5 cm in longitudinal dimension, and the left kidney measures up to 10.0 cm in longitudinal dimension. No evidence of nephrolithiasis or hydronephrosis. ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted. | Normal examination. |
Generate impression based on findings. | Clinical question: Signs and symptoms: Follow-up from previous CTh. Signs and symptoms: Same. Unenhanced head CT:Examination demonstrates interval increased size of right lateral ventricle. The trigonal right lateral ventricle measures approximately 21 mm in transverse axis compared to prior study measurement of 14. The right frontal horn of lateral ventricle there is a 10-mm compared to prior study measurement of 4 mm. There is also interval enlargement of right temporal horn the lateral ventricle measuring 11.5-mm compared to prior study measurement of 7.8.A severely compressed left lateral ventricle demonstrate no significant change.No definite change in the size of the large acute hematoma in the left basal ganglia/thalamus. Surrounding vasogenic edema and associated mass effect and including deviation of midline to the right is again noted. Rightward midline deviation measures 12.7-mm compared to prior study measurement of approximately 16mm. | 1.Slight interval increased size of right lateral ventricle since prior study as measured above.2.No significant change in the size, extent and surrounding vasogenic edema of the left hemispheric hematoma.3.Slight interval decreased midline shift to the right to 12.7-mm at the level of septum pellucidum compared to prior study remeasurement of 16. |
Generate impression based on findings. | 54 year old male. History of recurrent thyroid cancer. RUL PET avid nodule. LUNGS AND PLEURA: Previously seen right upper lobe nodule has resolved, and was most likely infectious/inflammatory. Scattered nodules bilaterally, measuring up to 5 mm right lower lobe nodule (series 6, image 62); prior PET-CT images are nondiagnostic for these small nodules and comparison cannot be performed. MEDIASTINUM AND HILA: Postsurgical findings of total thyroidectomy.Left high paratracheal lymph node at the level of thoracic inlet is 13 mm in short axis (series 4, image 8), hypermetabolic on prior PET, highly suspicious for a local lymph node metastasis. An adjacent 10-mm lymph node posterior to the manubrium (series 4, image 13), mildly hypermetabolic on prior PET, suspicious for another metastasis although inflammatory/infectious etiologies are also conceivable. These lymph nodes are not significantly changed in size.Mild coronary artery calcification.Normal heart size without pericardial effusion.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Nonobstructive bilateral renal stones. Coarse calcification in the pancreatic head. | 1. Interval resolution of right upper lobe nodule, which was most likely infectious/inflammatory. Scattered nodules bilaterally, measuring up to 5 mm, outside hospital images for comparison if available is requested to determine their stability; if this is not possible, follow-up CT in 6 to 12 months is recommended.2. Left paratracheal enlarged lymph node, hypermetabolic on prior PET, highly suspicious for a local metastasis. An adjacent borderline enlarged node is also suspicious for a metastasis. |
Generate impression based on findings. | Reason: assess for lung cancer History: hyponatremia, CXR: elevation of R.hemithorax LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No focal airspace consolidation. Minimal basilar scarring/subsegmental atelectasis. No pleural effusions.MEDIASTINUM AND HILA: Heterogeneous thyroid nodules, left greater than right, unchanged from the prior CT exam.The heart is normal in size without pericardial effusion. Severe coronary artery calcifications. Atherosclerotic calcification of the thoracic aorta and its branches. No mediastinal or hilar lymphadenopathy.CHEST WALL: Status post left mastectomy, left axillary lymph node dissection. No axillary lymphadenopathy. Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. 25 x 16 mm heterogeneous left adrenal nodule (series 4, image 89), previously measuring 29 x 21 mm. | 1. No suspicious pulmonary nodules or masses. No other acute cardiopulmonary abnormality.2. Heterogeneous approximately 2cm left adrenal nodule, slightly decreased from the prior CT exam dated 08/2012, likely benign. |
Generate impression based on findings. | 40 years, Female, Reason: kidney stones History: flank. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hepatomegaly. Diffuse hypoattenuation suggests steatosis.SPLEEN: Multiple small splenules.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydronephrosis. No nephrolithiasis. There is a punctate stone in the region of the left UVJ which was present on the prior exam and is suspected to represent a phlebolith. No definite ureteral stones.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postoperative changes of ileocecectomy.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: FemaleUTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Rectal wall thickening seen previously is no longer evident.BONES, SOFT TISSUES: Mild degenerative changes of the visualized spine.OTHER: No significant abnormality noted | No CT findings to account for the patient's symptoms. |
Generate impression based on findings. | Clinical question: Head and neck cancer, please evaluate for abnormality? CVA. Signs and symptoms: None Nonenhanced head CT:Examination demonstrates a new focus of cortical and subcortical white matter low attenuation which result in effacement of adjacent cortical sulci in the left angular gyrus and consistent with a subacute nonhemorrhagic ischemic stroke.There are two small linear foci of low-attenuation in the posterior aspect of bilateral cerebellar hemispheres is stable since prior head CT from 2014 and highly suggestive of small bilateral chronic ischemic strokes of the cerebellum.Unremarkable cerebral cortex, cortical sulci, ventricular system and the CSF spaces otherwise.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells. | 1.Small right angular gyrus subacute nonhemorrhagic ischemic stroke with subtle regional mass-effect.2.Small bilateral cerebellar chronic ischemic strokes since multiple prior exams. |
Generate impression based on findings. | 14 year-old female with knee pain. Evaluate for fracture.VIEWS: Knees standing AP/notch, knees merchant, right knee lateral, left knee lateral ( right knee - 4 views, left knee -- 4 views) 14:15 Articular surfaces of the distal femurs and proximal tibias are smooth. No loose bodies are present. Alignment is normal. No joint effusion is present. No fracture or dislocation is seen. | Normal examination. |
Generate impression based on findings. | History hepatocellular carcinoma now status post Therasphere mapping. CHEST:LUNGS AND PLEURA: Moderate centrilobular and paraseptal emphysema. MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. Severe atherosclerotic calcifications of the coronary arteries. Moderate hiatal hernia.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic morphology the liver.Hepatic segment 7 TACE defect now measures 2.2 cm (series 10, image 30), unchanged. Adjacent arterially enhancing lesion in the superior aspect of the the described defect demonstrates washout and measures 1.6 x 1.8 cm (series 80777, image 50), previously 1.6 x 1.8 cm. This lesion is consistent with a HCC.The arterially enhancing lesion with washout in the hepatic dome (segment 7) measures 1.4 x 1.8 cm (series 10, image 18), previously 1.4 x 1.8 cm. This lesion is consistent with a HCC.Additional arterial enhancing lesion in segment 7 without washout measures 1.4 x 1.2 cm (series 10, image 22), previously 1.2 x 1.2 cm. Additional arterial enhancing lesion with washout in the inferior right hepatic lobe (segment 6) now measures 1.1 x 1.1 cm (series 10, image 34), previously 1.1 x 1.0 cm.Numerous small hypoattenuating lesions in the liver are unchanged.SPLEEN: There is a new wedge-shaped peripheral area of low attenuation compatible with a splenic infarct which affects less than 10% of the splenic parenchyma. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter low attenuation lesions within the bilateral kidneys too small to characterize.RETROPERITONEUM, LYMPH NODES: Aortoiliac stent and infrarenal abdominal aortic aneurysm again identified, which appears stable in size now measuring up to 3.2 cm in maximal diameter.BOWEL, MESENTERY: There is colonic diverticulosis without evidence of diverticulitis. Enhancement in the distal esophagus and proximal stomach compatible with varices and enhancement in the rectum consistent with hemorrhoids.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: There is colonic diverticulosis without evidence of diverticulitis. Enhancement in the distal esophagus and proximal stomach compatible with varices and enhancement in the rectum consistent with hemorrhoids.BONES, SOFT TISSUES: Fluid collection in the subcutaneous fat superficial to the right femoral artery is likely postprocedural in etiology, similar to prior. OTHER: No significant abnormality noted. | 1.Multiple arterially enhancing hepatic lesions compatible with HCC as detailed above, not significantly changed from prior. 2.Cirrhotic morphology of the liver with findings compatible with portal hypertension.3.New small splenic infarct. |
Generate impression based on findings. | Evaluate portal venous flow biliary tract patency. Hyperbilirubinemia. LIMITED ABDOMENLIVER: The liver measures 15 cm in length. It remains slightly echogenic but there is no evidence of intrahepatic biliary ductal dilatation.BILIARY TRACT: The common duct measures 2 mm which is within normal limits.PANCREAS: No significant abnormalities noted.SPLEEN: Spleen measures 13.6 cm in length. Splenic varices. RIGHT KIDNEY: No hydronephrosis of either kidney. The right kidney measures 9.5 cm in length and the left kidney measures 11.8 cm in length.OTHER: No significant abnormalities noted. | Patent hepatic vasculature. No evidence of dilated bile ducts. Varices. Echogenic liver as noted previously. |
Generate impression based on findings. | Adenocarcinoma of lung, some increasing chest pain and syncope. PULMONARY ARTERIES: Excellent infusion quality. No evidence of embolus. The right upper lobe pulmonary artery is encased and narrowed by tumor but remains patent. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Moderate right pleural effusion. Compressive atelectasis in the dependent right lung. Centrilobular and paraseptal emphysema.The right upper lobe bronchus is encased by adenopathy/tumor, the segmental airways of the right upper lobe are thickened, as are the airways of the right middle and to a lesser extent lower lobes.Spiculated nodule at the right apex measures 2.5-cm transverse x 2.6-cm craniocaudal on coronal image 52.No contralateral suspicious nodules or pleural fluid.MEDIASTINUM AND HILA: Confluent mediastinal and hilar lymphadenopathy, right greater than left with flattening of the trachea in the AP dimension at the level of the aortic arch to a luminal dimension of 5-mm. Lymphadenopathy at this level in the right paratracheal region measures 3.1-cm and slightly compresses the superior vena cava. There is tumor extension locally into the superior vena cava seen on series 7 image 149. At the thoracic inlet, there is confluent tumor extending from the low right cervical region into the tracheoesophageal groove, inseparable from the lateral wall and posterior membrane of the trachea and the right lateral wall of the esophagus which is deviated leftward. Tumor also extends posteriorly to invade the anterior paravertebral fat of the upper thoracic spine.Tumor/lymphadenopathy at the level of the right hilum measures 2.8-cm in short axis (7/157). Mild subcarinal, inferior interlobar and lobar lymphadenopathy is present on the right. Small lymph nodes on the left in the hilum and left paratracheal regions are isoattenuating to lymphadenopathy elsewhere. Lymphadenopathy at the level of the carina extends across the midline to the left. Moderate coronary artery calcifications. Mild cardiomegaly. Small volume of pericardial fluid, probably physiologic. No signs of right heart strain.CHEST WALL: Multiple chest wall metastases on the right with rib destruction. Soft tissue tumor at the right thoracic inlet (7/54). Low right cervical lymphadenopathy is present. Mildly enlarged subpectoral lymph nodes on the right.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range is unremarkable. | No evidence of pulmonary embolus. Right apical spiculated nodule consistent with tumor. Confluent tumor/lymphadenopathy extends from the lower right cervical space to involve the right hilum with probable contralateral nodal metastases. Flattening of the distal trachea and proximal mainstem bronchi by adenopathy/tumor. Focal filling defect in the superior vena cava is consistent with localized endovascular tumor extension. Right pleural effusion. Multiple chest wall and nodal metastases.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Negative. |
Generate impression based on findings. | Mesothelioma, compared to prior CHEST:LUNGS AND PLEURA: Scattered right hemithorax changes remain unchanged and compatible with known underlying mesothelioma. Underlying subpleural reticulation and subtle honeycombing again consistent with fibrotic changes greater in both bases. No new superimposed focal findings. Moderate emphysematous changes. No new effusionReference measurements:1. At the level of the main pulmonary artery (image 46 series 3) a 4 o'clock lesion when measured similarly remains 4 mm.2. At the level of the right inferior pulmonary vein (image 61 series 3), the 5 and 6 o'clock measurements remain 5 and 6 mm with a small overlying effusion.3. At the level of the right ventricle (image 76 series 3) the 5 and 6 o'clock measurements are also unchanged at 4 and 6 mm when measured similarlyMEDIASTINUM AND HILA: Mild cardiomegaly with moderate coronary calcifications.Persistent borderline lymphadenopathy, with the reference subaortic lymph node remaining 10 mm (image 38 series 3). A right hilar lymph node is also cysts similar measuring 13 mm (image 43 series 3).Small hiatal herniaCHEST WALL: No significant abnormality noted.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: No significant abnormality noted.OTHER: No significant abnormality noted. | Unchanged reference measurements |
Generate impression based on findings. | HCC screening. Chronic hepatitis C. LIVER: Liver slightly echogenic with coarsened echotexture but without focal lesions. No intrahepatic biliary ductal dilation. Portal vein is patient with flow toward the liver. Liver measures 15.5 cm in length.GALLBLADDER, BILIARY TRACT: Common duct measures 4 mm which is within normal limits. Gallbladder is collapsed due to a recent meal (patient ate two hours prior to the exam).PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: No hydronephrosis of either kidney. The right kidney measures 10.1 cm in length and the left kidney measures 11.4 cm in length.OTHER: No significant abnormalities noted. | Echogenic liver without focal lesions. Collapsed gallbladder secondary to a recent meal. |
Generate impression based on findings. | Right parotiditis and history of treated supraglottic squamous cell carcinoma. There is interval resolution of the left parotid gland swelling and stranding of the overlying subcutaneous tissues. The other salivary glands appear unchanged. There are post-treatment findings in the supraglottic region without evidence of residual measurable tumor. Likewise, there is no evidence of significant cervical lymphadenopathy. There is mild plaque at the carotid bifurcations. There is left internal jugular venous catheter. The airways are patent. There is an unchanged calcification within a right thyroid lobe subcentimeter nodule. There is prominent ossification of the posterior longitudinal ligament with moderate spinal canal stenosis. There are bilateral maxillary sinus retention cysts. There is a subcentimeter left frontoethmoid sinus osteoma. There is staphylomatous deformity of the right globe. The imaged intracranial structures are unremarkable. There are emphysematous changes in the imaged portions of the lungs. | 1. No of residual measurable tumor supraglottic laryngeal carcinoma or evidence of significant cervical lymphadenopathy.2. Interval resolution of the left parotitis.3. Persistent right thyroid lobe nodule with calcification. A thyroid ultrasound may be useful for further evaluation.4. Prominent ossification of the posterior longitudinal ligament with moderate spinal canal stenosis. |
Generate impression based on findings. | 66-year-old female. Tachycardia, tachypnea. PULMONARY ARTERIES: Motion artifact somewhat limits exam, which is diagnostic for PE to the segmental arterial level. Interval resolution of previously seen partially occlusive pulmonary emboli in the left upper and right middle lobes. No pulmonary embolism is identified on today's exam.LUNGS AND PLEURA: Large right and moderate left pleural effusions, mildly decreased in size on the left. Septal thickening and bilateral mild patchy groundglass opacities consistent with mild pulmonary edema likely due to CHF.Reference 5 mm right upper lobe groundglass nodule (series 9, image 23), 5 mm left upper lobe groundglass nodule (series 9, image 20), and 10 mm left upper lobe groundglass nodule (series 9, image 51), not significantly changed.Mild centrilobular emphysema.Previously noted right basilar suture material and pleural calcifications are not well seen due to significant motion artifact.MEDIASTINUM AND HILA: Severe coronary artery calcification. Mild cardiomegaly.No mediastinal or hilar lymphadenopathy.CHEST WALL: Very mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Splenic calcifications consistent with healed granulomatous disease. | 1. Interval resolution of previously seen pulmonary emboli. No current evidence of pulmonary embolism to the segmental level.2. Pleural effusions and mild pulmonary edema, likely related to CHF.3. Reference groundglass nodules are unchanged and indeterminate. Continued follow-up in 7-13 months is recommended.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 67 years old Reason: evaluate for any abscesses - signs of infection - especially groin areas. History: persistent fevers, groin lines that were infected with MDROs CHEST: The exam is suboptimal secondary to motion artifact.LUNGS AND PLEURA: Nonspecific left upper lobe mass-like opacity measuring 2.2 x 1.1 cm (series 5, image 25).Right lower lobe atelectasis/scarring. Small right pleural effusion. Motion artifact limits fine parenchymal details.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. Enteric tube with tip in the gastric body..CHEST WALL: Central venous catheter with tip in the SVC.Mild degenerative changes of the thoracic spine.ABDOMEN:LIVER, BILIARY TRACT: Gallbladder wall thickening with adjacent soft tissue edema which is worrisome for acute cholecystitis.SPLEEN: No significant abnormality noted..PANCREAS: No significant abnormality noted..ADRENAL GLANDS: Calcified left adrenal mass which is likely benign in etiology.KIDNEYS, URETERS: Bilateral hypodense lesions, favor benign complex cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace ascites.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Foley catheter in place. No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Gallbladder wall thickening with adjacent soft tissue edema which is worrisome for acute cholecystitis. Recommend right upper quadrant ultrasound.2.Nonspecific nodular opacity in the left upper lobe. Recommend follow-up to resolution. |
Generate impression based on findings. | 67 years, Male. Reason: NGT placement advanced History: NGT placement Dobbhoff tube with tip projecting over the gastric fundus. Nonobstructive bowel gas pattern with multiple air-filled loops of bowel. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip projecting over the gastric fundus. |
Generate impression based on findings. | 19 year-old male with history of cystic fibrosis. Evaluate bronchiectasis.VIEWS: Chest PA/lateral (two views) 2/11/2015 Left chest wall Port-A-Cath tip terminates in the right atrium. Gastrostomy tube in the stomach. Cardiac silhouette is normal. AP diameter of the chest is increased unchanged from prior exam. Diffuse bronchiectasis with bronchial wall thickening and large lung volumes not significantly changed. Slight interval decrease in non-specific right peripheral nodular opacities. No definite mucus plugging is seen. | Chronic changes of cystic fibrosis with slight decrease in nonspecific right peripheral nodular opacities. |
Generate impression based on findings. | Lung cancer, follow-up CHEST:LUNGS AND PLEURA: Interval progression of the numerous bilateral pulmonary nodules and masses with increasing confluence. The left lower lobe mass currently measures 4.2 x 3.9 cm (image 34 series 7) with increasing fullness and decreased lobularity. The reference right lower lobe nodule (image 52 series 7) currently measures 5.2 x 2.8 cm, previously 4.2 x 2.4 cm pleural thickening and changes are again observed. The left upper lobe mass measures 5.7 x 4.6 cm (image 39 series 7), previously 4.4 x 3.8 cm. Numerous additional nodules . No effusions. Diffuse moderate scattered emphysematous changes demonstrates similar increasesMEDIASTINUM AND HILA: Increasing mediastinal and hilar lymphadenopathy. Reference right hilar lymph node currently measures 1.6 cm in the left hilar node 1.5 cm, both image 44 series 5), unchanged. The reference left paratracheal lymph node remains 10 mm (image 34 series 5).No gross cardiac or mediastinal abnormalities.CHEST WALL: Bilateral breast implants. Scattered unchanged sclerotic vertebral metastases, presumably post treatmentABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No suspicious hepatic lesions,, however a hemangioma is suggested the right lower lobe. Gallbladder unremarkableSPLEEN: 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: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval increasing size of multiple numerous bilateral pulmonary nodules and masses, representing known metastatic disease. Grossly stable lymphadenopathy |
Generate impression based on findings. | Metastatic prostate cancer and wheezing. Known right pelvic lesion. The right ischial metastasis is again visualized and is unchanged. New left third and fourth rib lesions indicate likely new rib fractures. The previous fracture of the left fifth rib remains stable and the activity in the previous left 7th rib fracture remains decreased. Unchanged L1 activity compatible with degenerative changes. The degenerative changes of sternoclavicular joints, bilateral shoulders, knees, and feet are also unchanged. | Stable right ischial metastasis. Probable new fractures in left ribs. |
Generate impression based on findings. | 67 year old woman with history of prior abnormal mammogram and left breast biopsy. Three standard views of both breasts 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. There is a new, approximately 0.6 x 0.5 cm circumscribed round mass at the 12 o'clock position of the right breast at approximately 2 cm depth. This mass does not have associated calcifications and is typically benign is appearance. This mass persists on spot compression views. Multiple additional well-defined, oval and round masses scattered throughout the right breast are either stable or have decreased in size.A biopsy clip is noted in the left breast. There is no significant interval change in the appearance of the left breast without suspicious mass, calcifications, or architectural distortion. ULTRASOUND | Waxing and waning simple cysts without 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. | Male 59 years old Reason: 59yo M w/ pancreatic Ca p/w anasarca and ascites History: evaluate liver and abdominal organs Somewhat limited by patient discomfort during the exam. LIVER: The liver has a nodular contour. Liver measures 14.5 cm in length. The parenchyma demonstrates a coarsened echotexture. No discrete hepatic lesion is identified.BILIARY TRACT: Status post cholecystectomy. Common duct measures 4 mm. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is obscured due to bowel gas. The pancreatic duct measures 1.1 cm.KIDNEYS: The right kidney measures 9.1 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. The left kidney measures 10.6 cm. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 11.2 cm. in length. OTHER: There is a large amount of ascites. | 1.Patent hepatic vasculature.2.Cirrhotic liver morphology.3.Large amount of ascites. |
Generate impression based on findings. | Cervical radiculopathy The cervical vertebral bodies are appropriate height. There is minimal anterolisthesis of C4 on C5. Alignment is otherwise maintained. No fractures are identified in the cervical spine. No suspicious bony lesions are identified in the cervical spine.Degenerative changes are seen including disk osteophyte complex and intervertebral disk space narrowing at C5-C6, degenerative changes at the anterior C1-C2 level, and facet arthropathy at multiple levels. Individuals levels as below:C2-3: Minimal left neural foraminal narrowing related to uncovertebral hypertrophy and facet arthropathy. No significant compromise to the spinal canal or right neural foramen.C3-4: Minimal right neural foraminal narrowing related to uncovertebral hypertrophy and facet arthropathy. No spinal canal or left neural foraminal narrowing.C4-5: Uncovertebral hypertrophy and facet arthropathy result in moderate right neural foramina narrowing. No significant spinal canal or left neural foramina narrowing.C5-6: There is disk osteophyte complex with bilateral uncovertebral hypertrophy. There is minimal spinal canal narrowing. There is moderate bilateral neural foramina stenosis. C6-7: No significant compromise to the spinal canal or neural foramina.C7-T1: No significant compromise to the spinal canal or neural foramina.Paraspinous soft tissues are unremarkable. | Degenerative changes in the cervical spine with moderate bilateral neural foraminal stenosis at C5-C6 and on the right at C4-C5. |
Generate impression based on findings. | 23-year-old female patient with infertility. Scout AP film of the pelvis was normal. Opacification of the uterine cavity revealed a normally oriented uterine cavity with filling defects in the uterine cavity, likely representing blood clots, as the patient was actively bleeding. Both tubes were not opacified by contrast, indicating that the fallopian tubes are not patent. TOTAL FLUOROSCOPY TIME: 1:58 minutes | Bilateral nonpatent fallopian tubes. |
Generate impression based on findings. | Right lower lobe lobectomy for squamous cell carcinoma LUNGS AND PLEURA: Stable appearing severe centrilobular emphysema without evidence of superimposed acute abnormality. Mild basilar atelectasis and/or scarring with no effusions. No suspicious nodules or masses. Scattered micronodulesThe scarlike opacity in the right upper lobe remains unchanged (image 66 series 4). When measured similarly, 16 mm remains.MEDIASTINUM AND HILA: Moderate coronary calcifications with similar atherosclerotic disease of aorta. Cardiac and paracardial otherwise within limitsNo lymphadenopathyCHEST WALL: Severe degenerative changes without evidence of superimposed new lytic or blastic lesionsUPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Incompletely visualized left kidney, please consider dedicated imaging | Severe centrilobular emphysema without suspicious new nodules or masses. Right lobe suspected scarring unchanged |
Generate impression based on findings. | Periumbilical abdominal pain, diarrhea. Assess for Crohn's disease. 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. No evidence of bowel dilatation, bowel wall edema, or ascites. Volumen identified throughout the small bowel and colon. The terminal ileum appears unremarkable without evidence of inflammation. Appendix is visualized and appears normal.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No CT findings to explain periumbilical abdominal pain. No CT evidence of Crohn's disease as clinically queried. |
Generate impression based on findings. | Cough and a newly diagnosed lung malignancy.RADIOPHARMACEUTICAL: 11.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 109 mg/dL. Today's CT portion again grossly demonstrates a large right lower lobe mass with chest wall invasion and large right hilar mass most compatible with a primary lung malignancy with metastasis. Thyromegaly is noted. Apical emphysema again seen. linear opacities in the lung bases in addition to the mass likely represent atelectasis. Diaphragmatic hernias are seen bilaterally in the lung bases. The large left renal lesion is again seen and may represent a metastasis or a second primary malignancy. Degenerative changes are seen in both hips. Today's PET examination demonstrates significantly increased FDG avid activity in the right lung base mass, right hilar mass, mediastinum, left kidney and pituitary region. Additional scattered increased activity is noted in the left para-aortic region adjacent to the left kidney.The right lung base mass with chest wall invasion has an SUVmax of 25.3 and the right hilar/infrahilar mass has an SUVmax of 22.5. The pretracheal lymph node has an SUVmax of 3.2 and prevascular node has SUVmax of 2.45. A right superior mediastinal lymph node has a SUVmax of 3.0. The left axillary region activity is nonspecific. The left renal lesion has an SUVmax of 17.4 consistent with tumor either primary or metastasis. The retroperitoneal left para-aortic lymph nodes demonstrate increased activity. Increased activity of the hips probably represents degenerative change. Within the prostate are multifocal areas of increased activity with an SUVmax of 4.5 in the most active lesion which can be due to an infectious or neoplastic etiology. | 1.Significantly increased FDG avid activity in the right lung base mass with chest wall invasion, right hilar/infrahilar mass, and throughout the mediastinum are compatible with a primary lung malignancy with metastases.2.Abnormally increased activity in the large left renal mass is compatible with either metastasis or a primary malignancy.3.Multi-focal significant increased activity in the prostate gland may represent infection or a prostate malignancy.4.A hypermetabolic pituitary mass represents either a pituitary macroadenoma, carcinoma or a metastasis. MRI brain and pituitary may provide further information if clinically warranted. |
Generate impression based on findings. | Male 42 years old Reason: ro SBO History: RLQ pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy.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: Postsurgical changes from prior ileocecectomy and additional prior small bowel resections. No evidence of acute inflammation or small bowel obstruction.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: Submucosal fat infiltration in the distal colon is similar to prior study and likely represents chronic inflammation related to Crohn's disease. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of active bowel inflammation or small bowel obstruction. |
Generate impression based on findings. | 36-year-old female with pain over the lumbar region. No acute fracture or malalignment. Vertebral body heights are preserved. | Normal examination. |
Generate impression based on findings. | 17-week-old female with history of HLH, pretransplant evaluation CHEST:LUNGS AND PLEURA: No suspicious nodules, opacities or pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal.CHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. The liver measures 9.6 cm in craniocaudad dimension. The gallbladder is partially collapsed and otherwise unremarkable.SPLEEN: The spleen measures 5.6 cm in craniocaudad dimension.PANCREAS: Normal parenchymal enhancement.ADRENAL GLANDS: Normal bilateral adrenal gland morphology.KIDNEYS, URETERS: Symmetrically renal cortical enhancement without hydronephrosis.RETROPERITONEUM, LYMPH NODES: A central venous catheter extends to the IVC just inferior to the right atrium. No lymphadenopathy. BOWEL, MESENTERY: The bowel is normal in caliber.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Mild ascites.PELVIS:UTERUS, ADNEXA: The uterus and adnexa appear normal for age.BLADDER: Moderately distended.LYMPH NODES: Small bilateral prominent inguinal lymph nodes. No lymphadenopathy.BOWEL, MESENTERY: The bowel is normal in caliber.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Mild ascites. | Mild ascites without evidence of lymphadenopathy. |
Generate impression based on findings. | Frontal sinuses and sphenoid sinuses have not yet pneumatized, which is within normal limits for age. Maxillary and ethmoid sinuses are partially pneumatized and demonstrate opacification, which is nonspecific. The nasal cavity is clear. No findings to suggest an aggressive sinonasal process. Visualized brain parenchyma and soft tissues are unremarkable. | Please note imaging evaluation for sinusitis in this age group is very limited. Frontal and sphenoid sinuses have not yet pneumatized. There is partial opacification of the partially pneumatized maxillary sinus and ethmoid air cells, which can be normal in this age group. |
Generate impression based on findings. | Female 64 years old Reason: 64 y/o with history of stage 3 colon ca s/p hemicolectomy please restage History: see above CHEST:LUNGS AND PLEURA: Left lower lobe solid nodule measures 0.5 x 0.5 cm (image 60; series 4), unchanged. Additional ground glass nodules in the left lung base are not significantly changed. Lobe predominant paraseptal emphysema.MEDIASTINUM AND HILA: No lymphadenopathy. Small mediastinal lymph nodes are unchanged.CHEST WALL: T3 and T12 compression fractures are unchanged. Nonspecific sclerosis of upper thoracic vertebral bodies is unchanged.ABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration is again noted. Subcentimeter right hepatic hypoattenuating lesion is too small to characterize.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta.BOWEL, MESENTERY: Postoperative changes of the ascending colon. No evidence of obstruction.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: Subcentimeter right internal obturator lymph node is stable. This is not enlarged using CT size criteria.BOWEL, MESENTERY: Postoperative changes of the ascending colon. No evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Solid left lower lobe pulmonary micronodules which is unchanged. Otherwise stable examination. |
Generate impression based on findings. | Male 19 years old Reason: follow up History: follow up. A plate and screws device affixes the distal fibula and screw affixes the medial distal tibia, both in anatomic alignment. There is an associated irregularity of the medial malleolus. No fracture line is seen. There is medial greater than lateral soft tissue swelling. | Postsurgical changes as described above without distinct fracture line. Medial greater than lateral soft tissue swelling. |
Generate impression based on findings. | Dyspnea on exertion status post lung transplant. Additional history of Crohn's disease and small bowel adenocarcinoma. History of left lung transplant and kidney transplant. LUNGS AND PLEURA: The transplanted the left lung is well expanded however within the left lower lobe, there are multifocal clustered airspace opacities ranging density from groundglass to subs solid. Some of these air space nodules are confluent, measuring up to 1 cm (5/132). At least two small foci of cystic bronchiectasis in the left lower lobe (5/227), present previously dating back to 2011 given the benefit of retrospect. On the expiration sequence, there is airtrapping within the left lower lobe indicative of small airways disease. Small area of focal consolidation is noted in the inferomedial aspect of the left lower lobe abutting the fissure and the left cardiac border which appeared scarlike previously, currently measuring 10 x 23 mm (5/232). On prior remote examination neck, there may be a small calcification in this area suggestive of a granulomatous process.No pleural fluid or pneumothorax. The stents in the left main bronchus is patent and similar in position.Lipid containing nodular opacity occurring along the juncture of the fissures between the right middle and lower lobes measures 13 x 12 mm (4/55), previously 14 x 13 mm, smaller but present previously and on the 4/16/2013 scan, probably benign.Groundglass opacity, bronchiectasis and subpleural honeycombing in the native right lung not significantly changed.MEDIASTINUM AND HILA: Unchanged rightward mediastinal shift. Left bronchial stent. Postsurgical changes of a left lung transplant. Main pulmonary artery appears enlarged measuring 3-cm in transverse dimension. Mild coronary artery calcifications. Normal heart size common no pericardial fluid.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Left upper quadrant splenulus, one of which contains a peripherally calcified nodule, unchanged. Surgical clips left upper quadrant. Dense opacity in the distribution of the splenic artery may represent vascular calcification. Diffuse fatty infiltration of the liver. Cholecystectomy. | 1. Left lower lobe bronchiolitis pattern with confluent nodular opacities and evidence of bronchiolar disease. Bronchopneumonia is the most likely diagnosis however in the absence of clinical signs of infection recurrent complication related to the patient's primary disease such as granulomatous or eosinophilic bronchiolitis may be considered. 2. Increased focal consolidation in the left lower lobe despite patency of the leading airways may be followed by CT in 3-4 months to differentiate between organizing pneumonia and a non- benign process.3. No significant change in interstitial lung disease involving the native right lung since the previous study. |
Generate impression based on findings. | Female, 58 years old, with several intracranial aneurysms, assess for change. Plan for surgery/coiling. Non-angiographic findings:Evidence of left pterional craniotomy is again seen. A left paraclinoid aneurysm clip and adjacent aneurysm coiling are stable in position. Extensive encephalomalacia involving the left middle and inferior frontal gyri as well as the left basal ganglia is unchanged. Encephalomalacia also involves the left parietal occipital lobe.No new discrete lesions are seen. Extensive ex vacuo dilatation of the left lateral ventricle is unchanged. No evidence of acute intracranial hemorrhage is detected.Angiographic findings:The cavernous and supraclinoid left ICA are not adequately visualized due to streak artifact from adjacent aneurysm clip and coil. The right cavernous and supraclinoid ICA are moderately secured by the same artifact. The left PCA and SCA are also partly obscured by artifact.An aneurysm arising from the communicating segment of the right ICA continues to measure approximately 7 to 8 mm in maximum diameter and has not significantly changed in size or morphology.The terminal left ICA does not opacify well and as such the 2-mm suspected left anterior choroidal aneurysm is not as well appreciated on the present study.The left ICA is of smaller caliber than the right, similar to prior. The proximal left MCA segments demonstrate relatively normal caliber, but the MCA vessels become narrowed more distally, similar to prior. The right MCA vessels demonstrate relatively normal caliber. The ACA vessels demonstrate relatively normal caliber with resolution of scattered previously seen areas of focal narrowing. Scattered narrowing is suspected within the distal PCAs. | 1. An aneurysm arising from the communicating segment of the right ICA shows no significant interval change in size or morphology.2. A suspected 2-mm aneurysm at the level of the left anterior choroidal artery is not as well seen on the present study, perhaps secondary to differences in technique and distribution of artifact.3. The left ICA remains smaller in caliber than the right and the more distal left MCA vessels are also of small caliber, similar to prior.4. Previously seen scattered focal areas of narrowing in the ACA vessels have resolved.5. Scattered areas of focal narrowing are suspected within the distal PCAs. |
Generate impression based on findings. | Male 67 years old Reason: r/o fracture History: fell back onto concrete steps, persistent pain wraps around to abdomen for one month. There is moderate kyphosis of the thoracic spine. Vertebral body heights are preserved. There is no definite fracture. | No definite evidence of fracture. |
Generate impression based on findings. | Testicular cancer staging prior to retroperitoneal lymph node dissection. ABDOMEN:LUNG BASES: No significant abnormality identifiedLIVER, 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: 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: No significant abnormality notedOTHER: No significant abnormality noted | No CT evidence of metastatic disease in the abdomen or pelvis. |
Generate impression based on findings. | Right lower quadrant pain, vomiting, and previous history of obstruction. 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: Normal caliber bowel without evidence of obstruction. Appendix well visualized and unremarkable. No periappendiceal fat stranding. There is a small amount of fluid adjacent to the base of the cecum (series 3, image 105) with an attenuation of approximately 35 HU of uncertain clinical significance. The adjacent cecum appears unremarkable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Appendix well visualized and unremarkable. No periappendiceal fat stranding. There is a small amount of fluid adjacent to the base of the cecum (series 3, image 105) with an attenuation of approximately 35 HU of uncertain clinical significance. The adjacent cecum appears unremarkable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No evidence of bowel obstruction. 2.Normal appearing appendix.3.Small amount of free fluid adjacent to the base of the cecum of unclear significance. The adjacent cecum appears unremarkable. |
Generate impression based on findings. | Male 67 years old Reason: Dedicated pancreas study for 67 y/o M with CLL on ibrutinib, increased abdominal pain, h/o of pancreas lesion. Eval for increased LAN, pancreatic lesion,any abnormal findings History: abd pain, diarrhea, night sweats, elevated LFT CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: Mild splenomegaly, unchanged.PANCREAS: No pancreatic lesion.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nonobstructing left renal calculus.Multiple bilateral renal hypodensities which are unchanged and likely represent cysts.RETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal and mesenteric lymphadenopathy which has slightly increased in size. A reference left para-aortic node measures 2.2 x 1.7 cm (series 8, 68), previously 1.8 x 1.5 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: Exam is suboptimal secondary to streak artifact from bilateral hip arthroplasties.PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Persistent lymphadenopathy. Reference left external iliac node cannot be measured secondary to streak artifact.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Mild degenerative changes of the lumbar spine.OTHER: No significant abnormality noted | 1.Extensive mesenteric and retroperitoneal lymphadenopathy has slightly increased in size.2.No pancreatic lesion. |
Generate impression based on findings. | Reason: HNSCC 30D post CRT evaluation. Compare to previous. History: as above LUNGS AND PLEURA: Mild centrilobular emphysema. Mild bronchial wall thickening. A right lower lobe solid pulmonary nodule measures 6 mm (series 5, image 60) and was not clearly seen on prior imaging. Additional scattered pulmonary and pleural micronodules, unchanged. Mild dependent atelectasis and minimal basilar subsegmental atelectasis/scarring. No focal air space consolidation. No pleural effusion.MEDIASTINUM AND HILA: Heterogeneous density right thyroid lobe nodule, unchanged. The heart is normal in size without pericardial fusion. Severe coronary artery calcification. Aortic valve calcification. Atherosclerotic calcification of the thoracic aorta and its branches. Left central venous catheter, tip in the SVC. Scattered small mediastinal and hilar lymph nodes. A subcarinal lymph node measures up to 11 mm in short axis (series 3, image 44), stable dating back to 01/2014.CHEST WALL: Degenerative disease of the thoracic spine, with flowing osteophytes suggestive of DISH.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Status post cholecystectomy. | 1. New right lower lobe 6-mm solid pulmonary nodule. Followup imaging is recommended in 3-6 months in a high risk patient.2. A mildly enlarged subcarinal lymph node is stable dating back to 01/2014, nonspecific in etiology. |
Generate impression based on findings. | 13-month-old male with shortness of breath, history of ASD VIEWS: Chest AP/lateral (two views) 2/11/15 Mild bronchial wall thickening, suggesting bronchiolitis or reactive airway disease. No consolidation or pleural effusion. Although the transverse diameter of the heart appears mildly increased on the frontal view, the AP diameter is normal on the lateral view. The aortic arch, cardiac apex and stomach are left-sided. | Bronchiolitis or reactive airway disease without enlargement of the cardiac silhouette. |
Generate impression based on findings. | Headache No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus.There are multiple areas of hypoattenuation in the periventricular and subcortical white matter which are better seen on prior MRI. Relatively more prominent of these lesions is in the right parietal subcortical white matter and was present on recent MRI. Calvarium is intact. There is moderate paranasal sinus opacification particularly the sphenoid sinus and right maxillary sinus and was seen on recent MRI. Partial mastoid air cell opacification again seen. | 1. No evidence of acute intracranial hemorrhage or mass effect. 2. Multiple areas of hypoattenuation in the periventricular and subcortical white matter are of uncertain etiology but are present on recent MRI from 2/8/2015. These may be related to vasculopathy related to lupus or PRES. MR can better assess for interval change.3. Moderate paranasal sinus opacification, particularly of the sphenoid sinus and right maxillary sinus, and was seen on recent MRI. |
Generate impression based on findings. | 58-year-old male. History of AML with suspected fungal pneumonia. Evaluate for interval improvement. LUNGS AND PLEURA: Small to moderate right partially loculated pleural effusion is unchanged.Right lower lobe consolidation consistent with infection, unchanged.Small left upper lobe subpleural nodular opacity is unchanged.Very mild centrilobular and paraseptal emphysema.MEDIASTINUM AND HILA: Severe coronary artery calcification.Small mediastinal lymph nodes, unchanged.Normal heart size without pericardial effusion. Hypoattenuating blood pool consistent with anemia.Right PICC tip in the SVC.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Right lower lobe consolidation consistent with chronic infection and associated pleural effusion, unchanged. No significant acute abnormality. |
Generate impression based on findings. | 3 year-old male with history of trauma. Head: There is no evidence of acute intracranial hemorrhage. The gray-white differentiation is preserved. The basal cisterns are intact. The ventricles and sulci are symmetric. There is no depressed calvarial fracture. The soft tissues of the scalp are unremarkable.Cervical spine: There is no evidence of acute cervical spine fracture. Alignment is anatomic. Vertebral body heights and intervertebral disc spaces are well maintained. The prevertebral soft tissues are within normal limits. The airway is patent. | 1. No evidence of acute intracranial hemorrhage.2. No acute cervical spine fracture. |
Generate impression based on findings. | History of Crohn's disease and hernia surgery now with left lower quadrant pain, evaluate for small bowel obstruction. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is a low attenuation hepatic lesion in segment 6 (series 3, image 51) measuring 3.0 x 2.4 cm which is incompletely characterized, favor benign. An additional incompletely characterized subcentimeter low attenuation lesion is present in segment 5, favor benign.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: There is circumferential wall thickening involving the distal approximately 30 cm of the distal ileum. There is a transition point proximal to inflamed ileum (coronal series, image 59) proximal to which the small bowel is dilated up to 4.0 cm compatible with small bowel obstruction. A small amount of perihepatic free fluid is present. Pelvic free fluid and inflammatory stranding is also present. There are small foci of air adjacent to the inflamed loops of terminal ileum in the pelvis (series 3, image 132 and series 3, image 141) which may represent early abscess or developing fistula. No drainable abscesses are present. 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: There is circumferential wall thickening involving the distal approximately 30 cm of the distal ileum. There is a transition point proximal to inflamed ileum (coronal series, image 59) proximal to which the small bowel is dilated up to 4.0 cm compatible with small bowel obstruction. A small amount of perihepatic free fluid is present. Pelvic free fluid and inflammatory stranding is also present. There are small foci of air adjacent to the inflamed loops of terminal ileum in the pelvis (series 3, image 132 and series 3, image 141) which may represent early abscess or developing fistula. No drainable abscesses are present. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Acute inflammation of the terminal ileum likely related to Crohn's disease causing proximal small bowel obstruction.2.Small foci of gas in the pelvis raise the possibly a small abscess or developing fistula. No drainable abscess. 3.Low-attenuation hepatic lesions incompletely characterized but favor benign.Findings communicated with Dr. Touissaint at 4:30 p.m. on 2/11/2015. |
Generate impression based on findings. | There are post-treatment findings with persistent diffuse pharyngeal mucosal space, retropharyngeal space, and parapharyngeal space edema. There is interval increase in size of a heterogeneous left level 2 lymph nodes that measure up to 16 mm in short axis, previously 12 mm in short axis. There is also an adjacent ill-defined heterogeneous lymph node that measures 18 mm in short axis, previously 11 mm, with tumor extending along the lateral aspect of the left soft palate treatment bed, collectively forming a conglomerate mass. In addition, there is a newly apparent pathological-appearing left level 3 lymph node that measures 9 mm. The lesions abut the left carotid space and compress the left internal jugular vein. There is unchanged hyperemia of the submandibular glands. The thyroid gland is unremarkable. There is mild plaque at the carotid bifurcations. There is unchanged multilevel degenerative spondylosis. There are multiple dental caries. There is mild paranasal sinus mucosal thickening. There is pulmonary emphysema in the lung apices. Please also refer to the separately dictated chest CT report. | 1. Interval disease progression in left neck, including lymphadenopathy with suggestion of extracapsular extension and perhaps tumor recurrence along the lateral aspect of the left soft palate treatment bed.2. Extensive dental disease. |
Generate impression based on findings. | Female 29 years old Reason: fx f/u History: pain. Sideplate and screws affixing the distal ulna and radius diaphyseal fractures. The radial fracture line is indistinct with callus formation indicating interval healing. The ulnar fracture line, while identifiable, appears somewhat less distinct when compared to the prior exam suggesting interval healing. | Orthopedic fixation of healing distal radius and ulnar fractures. |
Generate impression based on findings. | T1N0 right parotid adenoid cystic carcinoma, status post radiation therapy and surgery with right jaw pain. Evaluate for right jaw osteomyelitis. There are stable postoperative findings related to right parotidectomy and right face and neck radiation therapy. The other salivary glands are unchanged and there is no evidence of measurable mass lesions in the treatment bed. However, there is interval increase in size of the lucency within the right mandibular ramus, now including the retromolar trigone area, which may reflect excision and curettage. There are unchanged mildly prominent left level 4 and upper mediastinal lymph nodes. The thyroid gland appears unchanged with suggestion of a subcentimeter left lobe nodule. The major cervical vessels are patent. There is straightening of the cervical lordosis. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | 1. Postoperative findings related to right parotidectomy without evidence of measurable mass lesions. 2. No definite significant lymphadenopathy to suggest metastatic disease. 3. Interval right mandibular ramus debridement, with a new defect in the retromolar trigone area, which may reflect excision and curettage, and otherwise persistent lucencies more posteriorly, which likely represent sequela of osteomyelitis or osteonecrosis, but no evidence of fluid collection to suggest abscess. |
Generate impression based on findings. | There is extensive opacification involving the bilateral anterior and posterior ethmoid air cells, sphenoid sinuses, left greater than right maxillary sinus, as well as right greater than left frontal sinus. Multiple areas of hyperdensity are noted throughout the paranasal sinuses. There is diffuse mucoperiosteal thickening consistent with underlying chronic sinus disease. Left maxillary sinus polypoid opacification extends into and narrows the left nasal cavity.No masses or fat stranding is seen in the retrobulbar soft tissues. No mass effect on the extraocular muscles or optic nerve.There is evidence of prior endoscopic sinonasal surgeries and bony remodeling related to the chronic sinus disease. There is prominent osseous erosion involving the left anterior ethmoid region with soft tissue extending superficially to the level of the nasolabial fold and medial canthus. | 1. Extensive paranasal sinus opacification is most compatible with chronic sinonasal polyposis or allergic fungal sinusitis. Multiple areas of hyperdensity are seen which may be related to inspissated secretions versus chronic fungal colonization. Bony remodeling and erosions are also seen, particularly in the left anterior ethmoid region, which can be seen with polyposis or allergic fungal sinusitis. 2. Soft tissue is seen extending from the anterior ethmoid sinus on the left superficially to the level of the nasolabial fold and medial canthus. No intraorbital soft tissue extension is appreciated. No appreciable mass effect on the optic nerve or extraocular muscles. |
Generate impression based on findings. | Reason: evaluate for underlying lung issue History: shortness of breath PULMONARY ARTERIES: No pulmonary arterial filling defects is to the segmental level. Main pulmonary arteries normal in caliber. No evidence of right heart strain.LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No focal air space consolidations. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. No visible coronary artery calcifications. No mediastinal or hilar lymphadenopathy.Small hiatal hernia.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of pulmonary embolism or other acute cardiopulmonary abnormality.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Alignment is anatomic. Vertebral body and disk space heights are preserved without fracture. No spinal canal or neural foraminal stenosis at any level.There are inflammatory changes along the posterior paraspinal subcutaneous tissues without discrete fluid collections. The paraspinal musculature is otherwise unremarkable. Colonic wall thickening is better visualized on prior CT from the same day. Contrast opacifies the bowel and collecting system. | 1. Posterior paraspinal subcutaneous inflammatory changes without discrete fluid collections. Lumbar spine is otherwise unremarkable. 2. Colonic wall thickening and mesenteric inflammation is better visualized on CT abdomen from the same day. |
Generate impression based on findings. | Breast cancer CHEST: Scattered micronodules and a loop solitary calcified granuloma in the right upper lobe. No superimposed acute abnormalities, specifically no suspicious nodules or masses. No effusions. Mild centrilobular emphysematous changes.LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Multiple nodules the throughout the partially visualized thyroid, consider dedicated imagingNo lymphadenopathy.The cardiac and pericardium are within limitsSmall hiatal herniaCHEST WALL: Bilateral breast implants . Mild scoliosis with minimal degenerative changes. No suspicious lytic or blastic osseous lesionsABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: A well-defined suspected hepatic cyst in the dome of the liver. No suspicious lesions. Gallbladder unremarkableSPLEEN: 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: As aboveOTHER: No significant abnormality noted. | No suspicious abnormalities to suggest anesthetic disease. |
Generate impression based on findings. | 57-year-old female presents with right knee pain and swelling status post fall. No acute fracture or dislocation. Alignment is anatomic. Mild sharpening of the tibial spines is noted. | Mild degenerative changes without fracture. |
Generate impression based on findings. | Male 79 years old Reason: rectal cancer s/p resection with ileostomy, eval for anastomotic leak History: fluid and tissue protruding through rectum CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without acute inflammation.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: Status post diverting loop ileostomy. No evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Mild atherosclerotic calcifications of the aorta. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foci of air within the bladder, likely postprocedural. No evidence of fistulous communication.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is a no clear continuity between with the distal colon and the anus with disruption of suture lines. An associated complex gas collection is present in the presacral space with connection to the anus. These findings are worrisome for dehiscence of the coloanal anastomosis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Disruption of the connection between the distal colon and the anus with associated presacral complex gas collection which drains to the anus. Findings are worrisome for dehiscence of coloanal anastomosis. |
Generate impression based on findings. | 75 year-old female with left knee pain and swelling. Evaluate for septic arthritis. No acute fracture or dislocation. No evidence of knee joint effusion or bony erosive changes. Generalized osteopenia is present. | No radiographic evidence of septic arthritis or other acute findings to account for the patient's pain. |
Generate impression based on findings. | 68-year-old male with history of esophagectomy. Evaluate for neurologic pathology. Please note that portable technique limits evaluation particularly in the posterior fossa as well as in the detection of subtle abnormalities.Within these limitations, there is no gross acute intracranial hemorrhage. The gray white differentiation is preserved. There are no large areas of edema or mass effect. There is a tiny round focus of hypoattenuation within the genu the corpus callosum adjacent to the right lateral ventricle which is non-specific. The basal cisterns are intact. The ventricles and sulci are symmetric. There are incompletely imaged endotracheal and nasogastric tubes. The visualized paranasal sinuses are clear. The mastoid air cells are opacified. | Limited study.1. No gross acute intracranial hemorrhage.2. Tiny focus of hypoattenuation within the genu of the corpus callosum is nonspecific, but may be vascular in etiology. If patient care warrants further imaging, an MRI may be obtained when clinically feasible. |
Generate impression based on findings. | There is no acute intracranial hemorrhage, mass effect, or midline shift. There is possible symmetric low attenuation of the gray and white matter of the posterior parietal and occipital lobes. The ventricles, sulci, and cisterns are normal in size and configuration. There is a normal variant cavum septum pellucidum. The calvarium is unremarkable without fracture. There is partial paranasal sinus opacification. The orbits and calvarium appear unremarkable. | 1. No acute intracranial hemorrhage, mass effect, or cerebral edema.2. Please note CT is insensitive for evaluation of acute ischemic injury. There is possible low attenuation in the bilateral parieto-occipital region which may be artifactual. If there is significant suspicion for hypoxic-ischemic injury, consider MRI for further evaluation. |
Generate impression based on findings. | Female 57 years old Reason: follow up History: follow up. Again seen is an oblique fracture through the distal fibula with minimal lateral displacement of the distal fracture fragment. The fracture line appears somewhat less distinct when compared to the prior exam, which suggests interval healing. There is interval increase in soft tissue swelling along the medial ankle. | 1.Increased soft tissue swelling along medial ankle. 2.Interval healing of distal fibular fracture as described above. |
Generate impression based on findings. | 55-year-old female status post collision with automobile. Three views of the right wrist demonstrate no acute fracture or dislocation. Alignment is anatomic.Five views of the lumbar spine demonstrate no acute fracture or malalignment. Vertebral body heights are preserved. There is mild disk space narrowing at L2/L3 and L3/L4 with associated anterior osteophytes at these levels, unchanged since the prior study. | No acute fractures seen. Unchanged mild degenerative changes in the lumbar spine. |
Generate impression based on findings. | 3-day-old male evaluate for evidence of pneumatosisVIEWS: Abdomen, Ap and lateral (two views) 2/11/15 16:29 NG-tube tip and side-port at the EG junction. UVC catheter in the portal vein. Portal venous gas, likely related to UVC catheter again noted. No evidence of bowel wall pneumatosis. Hazy basilar pulmonary opacities are again noted. | No evidence of pneumatosis. NG tube at the EG junction. |
Generate impression based on findings. | Female 21 years old Reason: evaluate for appendicitis History: diffuse abdominal pain 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: Appendix is not well visualized. However, no evidence of right lower quadrant inflammation to suggest acute appendicitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Trace amount of ascites in the pelvis. Right ovarian cyst measuring 2.1 cm may represent a corpus luteum. If any ovarian pathology is clinically suspected further evaluation with pelvic ultrasound is recommended.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Right ovarian cyst measuring 2.1 cm may represent a corpus luteum. If any ovarian pathology is clinically suspected further evaluation with pelvic ultrasound is recommended. |
Generate impression based on findings. | Female 58 years old Reason: r/o intraabdominal source for GERD symptoms and worsening abdominal pain History: epigastric and diffuse abdominal pain The study is limited due to lack of intravenous contrast.ABDOMEN:LUNG BASES: Large hiatal hernia, containing most of the stomach, not significantly changed from previous study.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: Shotty retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No significant change from previous study. Large hiatal hernia containing most of the stomach is unchanged. |
Generate impression based on findings. | Umbilical hernia without mention of obstruction or gangrene. Observations are made given the limitations of an unenhanced study.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: No significant abnormality notedOTHER: Tiny periumbilical hernia containing fat (image 62; series 80253).PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Tiny periumbilical hernia containing fat. |
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