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Generate impression based on findings. | Female 60 years old Reason: eval fracture History: s/p fall, with swelling Bone mineralization is normal. Alignment is anatomic. There is moderate lateral compartment joint space narrowing with osteophyte formation. No joint effusion is evident. There is moderate soft tissue swelling of the prepatellar soft tissues. No... | Prepatellar soft tissue swelling without evident underlying fracture.Moderate right knee osteoarthritis. |
Generate impression based on findings. | 59-year-old female with biopsy proven left breast carcinoma presents for bracketed wire localization. On review of the prior and today's studies, a spiculated asymmetry with calcifications at upper outer quadrant in the left breast. Calcifications span 5 cm, anterior-posterior. The procedure, risks including bleeding a... | Successful needle localization of the left breast malignancy.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Male 37 years old; Reason: eval for recurrence History: testicular cancer, s/p chemo CHEST:LUNGS AND PLEURA: Subcentimeter right upper lobe pulmonary nodule (image 59/series 6). The pleural spaces are clear. No dominant lung lesion.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymp... | 1.Stable exam without evident metastatic disease. |
Generate impression based on findings. | Male 70 years old; Reason: s/p resection of large IVC sarcoma in October 2014 f/b RT completed 1/14/15 - please eval for recurrence or metastatic disease History: Sarcoma CHEST:LUNGS AND PLEURA: Calcified nodular changes in the left upper lobe. A few scattered pulmonary nodules some of them along the fissure as seen on... | 1.Postsurgical changes from resection and reconstruction of the IVC. There is a new soft tissue mass along the lateral aspect of the IVC and a new hypodense hepatic lesion. These may represent areas of residual and metastatic disease. Further elevation with an abdominal MRI may have utility to further characterize the ... |
Generate impression based on findings. | Female 51 years old Reason: pain History: pain Right knee: Severe osteoarthritis affects the right knee with tricompartmental osteophytes, severe medial compartment joint space narrowing. No joint effusion. There is genu varus. No significant joint effusion.Left knee: Severe osteoarthritis affects the left knee with tr... | Severe bilateral knee osteoarthritis. |
Generate impression based on findings. | 19 years, Male. Reason: ng History: ng Residual contrast within the renal collecting systems and bladder. NG tube side-port projects over the distal esophagus with tip projecting over the gastric cardia. Persistent dilated small bowel loops measuring up to 5.9 cm with relative paucity of bowel gas distally.Note that th... | NG tube side-port projects over the distal esophagus, advancement recommended. Dilated loop of small bowel compatible with small bowel obstruction better seen on recent CT. |
Generate impression based on findings. | Male 72 years old Reason: Eval for disease recurrence or metastasis s/p whipple for IPMN History: whipple for IPMN ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Postsurgical changes related to Whipple procedure... | Stable postsurgical changes in the pancreas. No evidence of recurrent or residual disease. |
Generate impression based on findings. | Ms. Heins is a 70 year old female with a personal history of left breast lumpectomy in 1992 for cancer followed by radiation and hormonal therapy. She also had a benign right breast surgery approximately 27 years ago. Family history of breast cancer in mother. Three standard views of both breasts were performed digital... | Stable postsurgical changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnos... |
Generate impression based on findings. | New Stage 2B cervical cancer with positive pelvic and common iliac nodes on pelvic MRI.RADIOPHARMACEUTICAL: 12.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 88 mg/dL. Today's CT portion grossly demonstrates scattered calcified nodules in lungs and subcarinal region compatible with prior granulomatous pro... | 1.Markedly hypermetabolic cervical mass consistent with the patients diagnosis of cervical cancer.2.Multiple hypermetabolic bilateral pelvic and abdominal retroperitoneal metastases at least to the level of the aortic bifurcation, or possibly slightly more superior to this level as detailed above. |
Generate impression based on findings. | Clinical question:Rule out bleed. Signs and symptoms: Left headache, CVA on January 28. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Periventricular and subcortical patchy foci of low attenuation of white ma... | 1.No acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.2.Age indeterminant small vessel ischemic strokes. |
Generate impression based on findings. | Facial pain and pressure; nasal congestion. There is mild mucosal thickening and bubbly secretions in the right sphenoid sinus. There are also a subcentimeter right posterior ethmoid sinus retention cyst. The other paranasal sinuses are essentially clear. The nasal cavity is clear. The nasal septum is essentially midli... | Findings suggestive of acute right sphenoid sinusitis. |
Generate impression based on findings. | Male 27 years old Reason: right knee pain History: right knee pain Bone mineralization is normal. Alignment is anatomic. The joint spaces are normal. Small enthesophyte projects from the inferior pole of the patella. There is nonspecific mild edema along the anterior aspect of the knee. No acute fracture or dislocation... | No evident fracture. |
Generate impression based on findings. | 59 year old woman with history of metastatic rectal cancer status post partial colectomy and lung resection now with lower abdominal pain and possible parastomal hernia. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the... | 1.Post surgical changes of a proctectomy and partial colectomy with end colostomy.2.Parastomal hernia containing loops of small bowel without evidence of obstruction.3.Hepatic steatosis. |
Generate impression based on findings. | Female 57 years old Reason: liver dopplers - Evaluate liver for focal lesion, cirrhosis - evaluate for thrombus of liver vasculature History: elevated transaminases LIMITED ABDOMENLIVER: The liver measures 18.9 cm in length. The hepatic parenchyma is coarsely echogenic consistent with chronic liver disease.BILIARY TRAC... | 1. Coarsely echogenic hepatic parenchyma consistent with provided history of chronic liver disease. 2. Patent hepatic vasculature.3. The gallbladder is distended and there is a 1.9-cm shadowing gallstone lodged within the gallbladder neck.Findings discussed by myself Dr. Ward with J Labas APN 02/12/2015 |
Generate impression based on findings. | Female 65 years old Reason: right shoulder pain History: right shoulder pain Right shoulder: Bone mineralization is normal. Alignment is anatomic. Mild osteoarthritis affects the right shoulder with mild joint space narrowing and small inferomedial humeral head osteophytes.There are enthesopathic changes at the suprasp... | Mild bilateral shoulder osteoarthritis, right greater than left. Enthesopathic changes suggests underlying rotator cuff disease. |
Generate impression based on findings. | 73-year-old female patient with concern for esophageal stricture or other abnormality. Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions. An AICD, right upper quadrant cholecystectomy clips, and posterior spinal fusion hardware was noted.There were no morph... | 1.Hiatal hernia and minor motility abnormality.2.No evidence of esophagitis or esophageal stricture. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. A focal asymmetry is present in the right breast near 12:00. A typically benign morpho... | Right breast focal asymmetry and typically benign morphology mass in the left superior breast. Attempts to obtain patient's prior mammograms should be made in order to confirm benignity of these findings.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Clinical suspicion of breast cancer recurrence in R SCV node, evaluate for extent of disease. There is are enlarged right level 5 lymph nodes, with a dominant lymph node that measures up to 34 mm. There is stranding of the surrounding fat and possible infiltration of the adjacent deltoid. There is a punctate calcificat... | 1. Right level 5 lymphadenopathy with suggestion of extracapsular spread and/or lymphedema.2. Evidence of acute sinusitis. |
Generate impression based on findings. | There is minimal right maxillary sinus mucosal thickening. The remaining paranasal sinuses and imaged mastoid air cells are clear. There are no sinus air-fluid levels or bubbly secretions. The ostiomeatal complexes are patent. The nasal septum is deviated to the left with a small left septal spur present. The nasal ca... | No significant paranasal sinus disease. |
Generate impression based on findings. | Male 70 years old; Reason: eval for progression History: metastatic prostate cancer CHEST:LUNGS AND PLEURA: Post surgical changes in the right lung base. No new dominant lesion. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: H... | 1.Sclerotic changes in the left scapula suspicious for bony metastases. No new sites of disease. Correlate with bone scan done on the same day for better evaluation of skeletal metastases. |
Generate impression based on findings. | Female 57 years old; Reason: history localized renal pelvis cancer, assess for recurrence History: none CHEST:LUNGS AND PLEURA: Scattered nonspecific micronodules are stable, for example series 5 and image 33. No suspicious pulmonary lesion. No pleural effusion.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopa... | 1.Stable pulmonary micronodules which are nonspecific.2.No evidence of disease recurrence in the left nephrectomy bed.3.Stable reference left para-aortic lymph node.4.Stable appearance of anterior pelvic fluid collection. |
Generate impression based on findings. | Status post fractureVIEWS: Right forearm AP lateral and 2/12/15 (two views) Cast material obscures fine bone details. Healing fracture of the right radius and ulna with dorsal angulation are unchanged in alignment. | Healing fractures, unchanged in alignment. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Strong family history of breast cancer in two maternal aunts, maternal great aunt, maternal cousin, two paternal aunts, and paternal cousin. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 5-year-old male with sepsis, concern for intra-abdominal infectious source. ABDOMEN:LUNG BASES: Bibasilar atelectasis. No suspicious pulmonary nodules or masses. No pleural effusion.LIVER, BILIARY TRACT: Liver is normal with no intra-or extrahepatic biliary ductal dilatation. Gallbladder is normal. SPLEEN: Spleen is no... | 1. New thrombus in the left common and external iliac vein. 2. Collection along the right pelvic sidewall may represent a hematoma, possible infected fluid collection given focus of gas, or an undescended testicle. 3. Interval enlargement of both kidneys as described above. |
Generate impression based on findings. | Reason: r/o PE, tachy s/p TKA History: tachycardia, post op PULMONARY ARTERIES: No evidence of pulmonary embolism. Main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Right middle lobe subsegmental atelectasis and scattered mild nodularity likely related to inflammatory process, including mucus plugging or asp... | 1. No evidence of pulmonary embolism.2. Right middle lobe subsegmental atelectasis likely related to mucus plugging or mild aspiration.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 65-year-old female with difficult, incomplete colonoscopy in the past, overdue for colon cancer screening The scout film showed a nonspecific bowel gas pattern without any evidence of obstruction or ileus. Barium flowed freely from the rectum to the cecum with visualization of the appendix. There is no evidence of obst... | No evidence of mass or polyps. Small scattered diverticula. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother and maternal aunt. Two standard digital views (total of 10 images) of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and di... | Bilateral benign calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are ultrasound images of left axilla (1/13/15) performed at Advocate Trinity Hospital, and digital mammographic images (1/26/15) performed at High Tech Medical Park. For comparison, digital mammographic images (11/12/12) are available. ULTRASOUND IMAGES... | Large mass in the left axilla, which is proven to be malignant. No mammographic evidence for malignancy in either breast. If the malignant mass in the left axilla is suspicious for metastatic lymph node from breast primary, breast MRI might be an option to look for a primary breast lesion.BIRADS: 6 - Known cancer.RECOM... |
Generate impression based on findings. | Ms. Silva is a 85 year old female with a personal history of left breast lumpectomy in 2010 for DCIS status post radiation and hormonal therapy. No current breast related complaints. Three standard views of both breasts with a laterally exaggerated left CC view were performed digitally and reviewed with the aid of R2 C... | Stable postsurgical changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnos... |
Generate impression based on findings. | 55-year-old male status post esophagectomy with gastric pull up on 2/6/15, evaluate for leak Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions. Right chest port tip projects over the superior cavoatrial junction. Water-soluble contrast swallow demonstrated ... | No anastomotic leak is evident. |
Generate impression based on findings. | Male 4 years old Reason: evaluate for healing of fracture History: left elbow fractureVIEWS: Left elbow AP, lateral and oblique 2/12/15 (3 views) Cast material obscures fine bone details. Fracture line is not visualized. Alignment is anatomic. | Anatomic alignment after casting. |
Generate impression based on findings. | Thyroid cancer on clinical trialsRADIOPHARMACEUTICAL: 13.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 92 mg/dL. Today's CT portion grossly demonstrates multiple osseous lesions in the spine and pelvis which have not significantly changed. A spinal stabilization device in the lower thoracic spine, with a... | Multifocal osseous metastases remain significantly metabolically active and have progressed slightly in activity from the previous exam, although no new lesions are identified. |
Generate impression based on findings. | Male 55 years old Reason: fracture History: eval for healing There is a healing tibial plateau fracture extending from the medial tibial metaphysis to the lateral tibial plateau with intra-articular cortical stepoff. There is callus formation at the fracture site. Alignment is unchanged from prior.There is severe media... | Healing tibial plateau fracture without evident change in alignment. The severe medial compartment joint space narrowing which is new from prior and is likely due to the weight-bearing views. |
Generate impression based on findings. | Reason: evaluate PE History: exertional dyspnea, dizziness, PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Scattered benign appearing micronodules, some calcified. No suspicious pulmonary nodules or masses. Minimal basilar subsegmental scarring. N... | No 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. | Female 50 years old Reason: knee pain for 3 weeks History: knee pain for 3 weeks Bone mineralization is normal. Alignment is near-anatomic. There is mild to moderate medial compartment joint space loss with developing tricompartmental osteophytes, worst in the medial compartment. No joint effusion is evident. No acute ... | Mild/moderate left knee osteoarthritis. |
Generate impression based on findings. | 72-year-old with personal history of right lumpectomy for breast cancer. No current complaints. Status post left breast reduction. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pa... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Status post fractureVIEWS: Right wrist AP and lateral 2/12/15 (two views) Healing fracture of the distal radius with periosteal reaction is in anatomic alignment. | Healing fracture, in anatomic alignment as described. |
Generate impression based on findings. | Thyroid cancer. Compare to previous with measurements. CHEST:LUNGS AND PLEURA: Interval resolution of right middle lobe opacities with mild residual scarring.No suspicious pulmonary or pleural metastases.Mild radiation reaction in the right apex, unchanged. Small amount of debris in the left dependent trachea.MEDIASTIN... | No evidence of metastases. Interval resolution of right middle lobe opacities with residual mild scarring. |
Generate impression based on findings. | History of prostate cancer, evaluate for progression. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Moderate coronary artery calcifications noted. Moderate to severe hiatal hernia with a patulous esophagus but no evidence of focal wall thickening. No hilar or mediastinal lymphadenopathy.... | 1.Slight interval increase in size of right iliac lymph nodes. Otherwise stable exam. 2.No osseous metastasis identified, but nuclear medicine bone scan is more sensitive. |
Generate impression based on findings. | Fall on outstretched hand.VIEWS: Left wrist AP, lateral and oblique. Left elbow AP, lateral and oblique on 2/12/15. (Six views) Left wrist and elbow : There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Status for nonaccidental trauma. Evaluate for evidence of fracture with two weeks follow-up. 2/12/15EXAMINATION: Skull AP/lateral, cervical spine AP/lateral, thoracolumbar spine AP/lateral, right humerus AP, left humerus AP, right forearm AP, left forearm AP, right hand PA, left hand PA, chest AP, ribs right oblique/le... | No evidence of acute or healing fractures. |
Generate impression based on findings. | Follow-up of recurrent follicular (poorly differentiated thyroid) carcinoma status post TFHX. There are extensive post-treatment findings in the neck, including total thyroidectomy, neck dissection, and mucosal edema related to radiation. There is no significant interval change in the ill-defined residual mass posterio... | 1. No significant interval change in the residual mass posterior to the cricoid and nodularity in the left anterior neck treatment bed. However, a PET/CT may be useful for better delineation of residual tumor.2. Unremarkable corpectomy at T1 with posterior surgical fusion without evidence of hardware complications. |
Generate impression based on findings. | One day old male, 25 week premature intubated with UAC, UVC; assess lines and tubes. VIEW: Chest AP and Abdomen AP (Two views) 2/11/2015 20:19 Endotracheal tube below the thoracic inlet. NG tube with side port above the GE junction. Umbilical artery catheter tip at T7 vertebral body level. Umbilical venous catheter tip... | 1. NG tube with side port above the GE junction.2. Diffuse bilateral pulmonary hazy opacities likely related to ARDS. |
Generate impression based on findings. | Male 56 years old Reason: r/o fracture History: shoulder pain, bony mets Bone mineralization is normal. Alignment is anatomic. There is mild joint space narrowing with developing osteophytes. No acute fracture or malalignment. Mild to moderate osteoarthritis affects the left AC joint.There are permeative changes involv... | No acute fracture of the left shoulder.Metastases to the left third rib. |
Generate impression based on findings. | 75 year old female. Persistent crackles in bases. Apical scarring on XR. LUNGS AND PLEURA: Very mild bilateral lower lobe bronchiectasis. Mild paraseptal emphysema in the medial aspect of the lower lobes. Minimal centrilobular emphysema.No apical scarring. No focal airspace consolidation or pleural effusion.MEDIASTINUM... | Very mild lower lobe bronchiectasis. Mild emphysema. No significant acute abnormality to explain the patient's symptoms. |
Generate impression based on findings. | Female 77 years old Reason: eval for fracture healing History: eval Postsurgical changes in the fibula with plate and syndesmotic screws without hardware complication. Joint alignment is anatomic. The fracture lines are less evident indicating ongoing healing.Soft tissue swelling persists. | Orthopedic fixation of ankle fractures as detailed above. |
Generate impression based on findings. | 57F breast ca with lung, brain mets History: neutropenic fever history. Prior CT imaging with high suspicion for drug reaction; interval steroid treatment. LUNGS AND PLEURA: Interval near complete resolution of diffuse ground glass opacity throughout the lungs.Additional interval resolution of small bilateral pleural e... | 1. Near complete resolution of diffuse ground glass opacities throughout the lungs and pleural effusions.2. Diffuse pulmonary metastases and mediastinal/hilar lymphadenopathy appear similar to the prior CT exam dated 01/23/2015.3. Stable hepatic and splenic metastatic disease. No new sites of disease identified. |
Generate impression based on findings. | Male 67 years old Reason: HBV, eval for HCC History: HBV LIVER: The liver measures 14.8 cm in length. Coarsened heterogeneous echotexture consistent with chronic liver disease. No focal liver lesion. The portal vein is patent and demonstrates normal directional flow with peak velocity of 0.2 m/sec.GALLBLADDER, BILIARY ... | Coarsened heterogeneous hepatic echotexture consistent with chronic liver disease. No focal liver lesion. |
Generate impression based on findings. | Grayscale, Color and spectral Doppler were performed on inflow and outflow vessels of the liver.LIVER: Normal echogenicity measuring up to 15.5 cm in longitudinal dimension. No evidence of intrahepatic or extrahepatic biliary duct dilatation. Normal flow and direction of the main portal vein with peak systolic velocit... | Patent vasculature with no evidence of biliary dilatation as clinically questioned. |
Generate impression based on findings. | Ms. Blagojevich is a 49 year old female with a personal history of benign left breast biopsy 1994. Family history of breast cancer in mother (diagnosed at age of 42), sister (diagnosed at age of 44), and paternal grandmother (diagnosed at age of 50). Three standard views of both breasts, additional right MLO view, and ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. The patient did ask about alternative screening methods, including whole breast ultrasound and tomosynthesis. She would like to get tomosynthesis for next year's ... |
Generate impression based on findings. | 75-year-old female. Metastatic pancreatic cancer. Staging. LUNGS AND PLEURA: Moderate right pleural effusion with adjacent atelectasis..Multiple scattered ill-defined nodular opacities bilaterally, most in the left lung base, are favored to be infectious/inflammatory although follow-up is recommended to exclude metasta... | 1. Moderate right pleural effusion, correlate with thoracentesis as clinically warranted to assess for a malignant effusion.2. Multiple bilateral ill-defined nodular opacities, favored to be infectious/inflammatory though follow-up recommended to exclude the less likely possibility of metastases.3. Known liver metastas... |
Generate impression based on findings. | Female 50 years old Reason: please eval liver echotexture and kidneys for obstruction History: AKI in liver failure LIVER: The liver is coarsely echogenic with a nodular contour consistent with cirrhosis. No focal liver lesion is identified .GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. No biliary dilatation... | 1. Cirrhotic liver morphology with increasing abdominal ascites. Sluggish bidirectional portal vein flow with poor visualization of the right and left portal vein branches as well as the hepatic veins. Consider triphasic MRI liver for further evaluation.2. Medical renal disease. |
Generate impression based on findings. | Male 31 years old; Reason: assess for progression of Hodgkin's lymphoma History: None CHEST:LUNGS AND PLEURA: Paramediastinal radiation changes are stable. Clustered micronodules in the right lower lobe (image 56 of series 5) are unchanged.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion.Centrally ca... | 1.Decrease in the size of the calcified lymph nodes.2.Increase in the size of the noncalcified lymph node especially the right pericardiophrenic lymph node.3.Further evaluation of the abnormal lymph nodes it suggested as these nodes are showing increase in size. |
Generate impression based on findings. | Male 44 years old Reason: restaging scans s/p 6 cycles of investigational agent History: hx of metastatic renal cell cancer CHEST:LUNGS AND PLEURA: Nonspecific minimal right posterior pleural thickening. Interval resolution of left lower lobe micronodule seen on previous exam which was likely inflammatory in etiology.M... | 1.Stable right renal mass with interval development of adjacent abdominal wall soft tissue mass.2.Minimally increased size of retroperitoneal lymph nodes.3.Stable osseous metastatic disease. |
Generate impression based on findings. | Female 54 years old Reason: pain in thumb and possible carpal tunnel History: pain in thumb and possible carpal tunnel Bone mineralization is normal. Alignment is anatomic. There is interphalangeal joint space narrowing and developing osteophytes.Moderate osteoarthritis affects the basilar joint with joint space narrow... | Osteoarthritis without underlying fracture. |
Generate impression based on findings. | Male 73 years old; Reason: 73M s/p cystectomy with distention and leukocytosis; please abscess or fluid collection History: as above ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality n... | 1.Persistent small bowel obstruction with a transition point in the right lower abdomen near the site of prior ileal harvest near an area of extensive inflammation extending to a large pelvic abscess as detailed above.2.Consider withdrawing enteric tube to the stomach |
Generate impression based on findings. | 8-year-old male status post surgery for hip dislocationVIEWS: Pelvis AP (one view) 2/12/15 11:15 Note is made of an overlying SPICA cast obscuring underlying osseous detail. Postoperative changes of varus derotation osteotomy, with a plate and screw device affixing the proximal femur in near-anatomic alignment without ... | VDRO in near-anatomic alignment without evidence of complication. |
Generate impression based on findings. | 49-year-old with history of left mastectomy for breast cancer. No current complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass,... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 35 years old; Reason: eval for SBO vs appy History: RLQ pain, diffuse abd pain ABDOMEN:LUNGS BASES: No significant abnormality.LIVER, BILIARY TRACT: No focal liver lesions. No biliary dilatation. Hepatic and portal veins enhance normally without evidence of thrombus. Gallstones.SPLEEN: Granulomata, unchanged.PANCR... | 1.Continual bowel wall thickening in the region of the jejunum as described previously; consider correlation with small bowel study. 2.Decreased ascites |
Generate impression based on findings. | Female 84 years old Reason: evaluate size of right renal mass; no need to visualize left kidney History: small right renal mass RIGHT KIDNEY: The right kidney measures 8.5 cm. There is a 2.2 x 1.8-cm exophytic hypoechoic mass arising from the lower pole of the right kidney and consistent with complex cystic/solid renal... | Solid right renal mass measuring 2.2 cm remains suspicious for renal cell carcinoma. The 0.8-cm left renal mass identified on recent CT is not clearly visualized. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or ar... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Status post left nephrectomy in 2011. AML with hematuria. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Probable hemangioma in the right lobe of the liver (image 50; series 8061) measures 3 cm in diameter, not substantially changed compared to prior. Subcentimeter cyst also noted in the righ... | Slight interval enlargement of presumed lipid poor right angiomyolipoma. Unchanged hepatic hemangioma. Status post left nephrectomy and splenectomy |
Generate impression based on findings. | Chronic sinusitis. The frontal sinuses are not pneumatized and there is minimal mucosal thickening in the maxillary sinuses. The paranasal sinuses are clear. The nasal cavity is also clear. The nasal septum is deviated slightly to the left with an associated spur. The lamina papyracea and ethmoid roofs are intact. The ... | No evidence of sinusitis. |
Generate impression based on findings. | 4-year-old male with history of supracondylar fractureVIEWS: Right elbow, AP and lateral (two views) 2/10/15 11:29 Interval removal of multiple K wires affixing a supracondylar fracture. There is mild residual deformity consistent with a healed fracture. Alignment is anatomic. No joint effusion. | Healed supracondylar fracture in near-anatomic alignment. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of prior benign left breast biopsy. Two standard digital views of both breasts, repeat right MLO view and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, u... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 50 years old Reason: please eval liver echotexture and kidneys for obstruction History: AKI in liver failure LIVER: The liver is coarsely echogenic with a nodular contour consistent with cirrhosis. No focal liver lesion is identified .GALLBLADDER, BILIARY TRACT: Status post cholecystectomy. No biliary dilatation... | 1. Cirrhotic liver morphology with increasing abdominal ascites. Sluggish bidirectional portal vein flow with poor visualization of the right and left portal vein branches as well as the hepatic veins. Consider triphasic MRI liver for further evaluation.2. Medical renal disease. |
Generate impression based on findings. | Female 4 months old Reason: Is central line in correct placement? History: Peripheral TPNVIEW: Chest AP (one view) 2/12/15 at 1124 hours. Central line has been retracted and it is no longer in the venous system. Cardiac silhouette size is normal. No focal opacities, effusions or pneumothorax. | Retraction of central line which is no longer in the venous system. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Increasing obscured ... | 1. Two obscured masses in the right breast may represent enlarging cysts. Further evaluation with spot compression and ultrasound is recommended.2. At the time of diagnostic evaluation, the right CC view should be repeated due to motion artifact.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: ... |
Generate impression based on findings. | Male 70 years old; Reason: eval for mets History: prostate cancer, rising psa ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. Nonspecific hypodense focus is located in segment 8 of the liver measuring 9 mm - image 22/series 5. Hepatic and portal veins are patent... | 1.No lymphadenopathy in the abdomen or pelvis.2.Sclerotic changes involving the right 10th and 11th ribs. Correlation with nuclear medicine bone scan results are suggested.3.Left renal atrophy due to ostial plaque at the origin of the left renal artery. This can be further evaluated and treated if needed.4.Nonspecific ... |
Generate impression based on findings. | 70 years, Male. Reason: 70yo M with IABP and back pain, assess location with 2 view film. History: IABP Atherosclerotic calcifications of the aorta and iliac arteries. Degenerative disk disease at the L4-L5 level. IABP marker projects over the L1 level. On the lateral view, the IABP marker is angled anteriorly with res... | IABP marker projects over the L1 vertebral body level and may be in the superior mesenteric artery. This was discussed with the clinical service at 1330 on 2/12/15. |
Generate impression based on findings. | Female 76 years old Reason: knee pain History: knee pain Status post total right knee arthroplasty. There is thin lucency at the bone cement interface of the tibial prosthesis . There is mild varus of the tibial shaft in relation to the femur.Heterotopic ossification in the lateral aspect the patella appears similar fr... | Subtle new lucency at the bone cement interface of the right tibial prosthesis. Clinical correlation for loosening is suggested. |
Generate impression based on findings. | 73-year-old with history of left breast cancer status post lumpectomy presents for routine follow-up. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No do... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 63 years, Male. Reason: 63yo M with OHT on immunosuppression with new abd pain. History: abd pain Nonobstructive bowel gas pattern. Average stool burden. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Left ankle injuryVIEWS: Left ankle, AP, lateral and oblique 2/12/15 (3 view/s) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 59 years, Male. Reason: Dobbhoff History: Dobbhoff ECMO tubing, Swan-Ganz catheter, cholecystectomy clips, mediastinal staples, chest tubes, and mediastinal drains are noted. Dobbhoff tube tip objects over the proximal duodenum. Retrocardiac opacity persists.Nonobstructive bowel gas pattern. Note that the pelvis is exc... | Dobbhoff tube tip objects over the proximal duodenum. |
Generate impression based on findings. | Restaging diffuse large B-cell lymphoma. Posttreatment evaluation due to a questioned FDG avid focus on prior PET.RADIOPHARMACEUTICAL: 15.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 160 mg/dL. Today's CT portion grossly demonstrates right chest Port-A-Cath with tip in right atrium. Large peripherally c... | No suspicious FDG avid lesion to indicate tumor activity currently in the neck, chest, abdomen or pelvis. |
Generate impression based on findings. | Female 76 years old Reason: evaluate right hip pain History: s/p right THA, with continues pain in the right hip. Components of a total right hip arthroplasty are situated in near-anatomic alignment without radiographic evaluation of hardware complication.Pelvic radiograph demonstrates the aforementioned right hip arth... | Total right hip arthroplasty and degenerative changes as detailed above. |
Generate impression based on findings. | Male 48 years old Reason: MVC pt History: neck pain Bone mineralization is normal. Alignment is anatomic. There is disk space narrowing at C5-C6 with endplate osteophytes and sclerosis. There is mild bony neural foraminal narrowing at this level.No evident fracture. | Osteoarthritic changes without evidence of acute fracture. |
Generate impression based on findings. | Male 49 years old Reason: 49yo M w/ L hip pain History: L hip pain Bone mineralization is normal. Alignment is anatomic. The joint spaces are normal. No acute fracture or dislocation is evident. | Unremarkable radiographs of the left hip. |
Generate impression based on findings. | Female 80 years old Reason: eval of OA, pt s/p stroke, residual R sided weakness History: same Bone mineralization is normal. Alignment is anatomic. Moderate osteoarthritis affects the right knee with moderate lateral joint space narrowing and tricompartmental osteophytes. No joint effusion. No acute fracture or malali... | Moderate right knee osteoarthritis. |
Generate impression based on findings. | Initial treatment strategy for lymphoma. Anterior mediastinal mass with lymphadenopathy.RADIOPHARMACEUTICAL: 10.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 81 mg/dL. Today's CT portion of the neck grossly demonstrates extensive left posterior jugular and left supraclavicular enlarged lymph nodes. Air i... | 1.Extensive markedly hypermetabolic tumor, likely lymphoma, in the neck and thorax involving lymph nodes extending from the jugular through the cardiophrenic regions as well as thoracic osseous and intramuscular hypermetabolic tumor involvement.2.No convincing FDG avid tumor below the diaphragm. Several cutaneous and b... |
Generate impression based on findings. | Clinical question: Intraoperative head CT for navigation. Signs and symptoms: Intraoperative head CT 6876. Nonenhanced head CT:Preoperative study.Examination is performed while a stereotactic device in place to patient's calvarium. Examination is performed as a surgical guidance and is not a diagnostic test. There is a... | 1.Surgical planning head CT as detailed above.2.Postbiopsy exam via a left frontal burr hole demonstrate punctate high density likely metallic in the left frontal lobe within the region of edema and small amount of expected post procedural air. |
Generate impression based on findings. | Patient with cirrhosis. Acute kidney injury, likely prerenal with right pleural effusion after thoracentesis with bloody fluid. Concern for hepatic hydrothorax. Please evaluate. The following observations made given limitations of an unenhanced study.CHEST:LUNGS AND PLEURA: Large bilateral pleural effusions (right grea... | 1. Large bilateral pleural effusions (right greater than left) with overlying atelectasis and scattered groundglass opacity. 2. Moderate pelvic ascites. 3. Findings compatible with cirrhosis and portal hypertension including varices and splenomegaly. 4. Regarding the clinical query, there is no definite evidence of pne... |
Generate impression based on findings. | Male 60 years old Reason: 60yo M with hepatits B and ?complex renal cyst, liver protocol for HCC screening and evaluate renal cyst. History: HCC screening, eval of renal cyst. Noncontrast CT images are also obtained through the abdomen. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Multiple ... | Hepatic and renal cysts. Fat containing umbilical hernia. |
Generate impression based on findings. | Female 74 years old Reason: evaluate for chronic pancreatitis History: abdominal pain ABDOMEN:LUNG BASES: Focal atelectasis in the right lung base.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Slightly atrophic but otherwise unremarkable pancreas.ADRENAL GLANDS:... | Slightly atrophic pancreas without any other abnormality.Calcified fibroid in the uterus. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. There is an area focal asymmetry in the anterior depth of the right upper central brea... | Right breast focal asymmetry for which comparison to prior outside mammograms is necessary.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Reason: 80 yo F with new SOB, reports only 5pky hx of smoking with moderate obstructive airway disease and low DLCO on PFTs. Eval for emphysema, ILD, mass History: sob LUNGS AND PLEURA: 4.9 by 4.5-cm left lower lobe mass abutting the diaphragm and present anteriorly on the major fissure (image 189 series 4) with intern... | 1. Right lower lobe mass consistent with lung cancer, although organizing pneumonia is in the differential diagnosis.2. Moderate upper lobe predominant emphysema, without evidence of pulmonary fibrosis or small airways disease..3. Hepatic and adrenal hypoattenuating lesions, not fully characterized without contrast but... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microca... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 51 years old Reason: possible scaphoid fracture History: possible scaphoid fracture Benign-appearing elongated lesion in the metadiaphysis is unchanged. A cortical step of along the distal radius is only subtly visible suggestive of ongoing healing.There is a subtle band of sclerosis through the waist of the sca... | Findings most suggestive of a nondisplaced healing scaphoid fracture as there is a band of sclerosis in the area of prior lucency.Cortical step-of in the distal radius is less evident suggestive of healing. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of left cyst aspiration. Family history of breast cancer in maternal aunt. Two standard digital views, additional left MLO view, and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchym... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bilateral benign breast biopsies. Family history of breast cancer in sister. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandula... | Stable bilateral focal asymmetries. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female 74 years old Reason: oa assess History: pain Right hip: Two views of the right hip shows mild joint space narrowing and small acetabular osteophytes. No acute fracture or dislocation.Right hip: Bone mineralization is normal. Alignment is anatomic. There is moderate tricompartmental joint space loss and osteophyt... | Moderate bilateral knee osteoarthritis.Mild right hip osteoarthritis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views along with additional bilateral MLO views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No su... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bilateral breast reduction in 1998. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Architectural distortion compa... | No mammographic evidence of malignancy. Changes compatible with breast reduction. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms ar... |
Generate impression based on findings. | Male 64 years old; Reason: gross hematuria History: gross hematuria ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Small lipoma in the pancreatic head and tail.ADRENAL GLANDS: No significant abnormality noted... | 1.8-mm right ureteropelvic junction stone likely the cause of the patient's hematuria. |
Generate impression based on findings. | Left wrist painVIEWS: Left wrist AP and lateral 2/12/15 (two views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Male 60 years old Reason: Patient w/ fever, dilation of right renal collecting system, eval for kidney stone History: malaise, fever, chills, dysuria, renal failure ABDOMEN: Lack of intravenous and enteric contrast makes the examination suboptimal. LUNG BASES: Small pleural effusions with overlying atelectasis. Multipl... | 1. Acute obstructing right distal ureteral stone with hydroureter and mild hydronephrosis.2. Multiple new nonspecific ground glass opacities in the right lower lobe which may be due to aspiration, infection, edema, or malignancy. Recommend dedicated thoracic CT to further characterize. |
Generate impression based on findings. | 85 year-old female. History of breast cancer status post left lumpectomy. Left lung nodule. Follow-up. LUNGS AND PLEURA: Scattered pulmonary nodules, including a 10-mm left lower lobe nodule, unchanged from 2011 and most likely benign (series 4, image 62).Diffuse mild subpleural reticulation consistent with interstitia... | 1. Subcentimeter left internal mammary lymph node is unchanged, most likely benign.2. Stable pulmonary nodules since 2011, most likely benign. No additional CT follow-up for these nodules is recommended.3. Diffuse mild subpleural interstitial fibrosis consistent with interstitial lung disease, unchanged from 11/2014. |
Generate impression based on findings. | 76 show female: h/o exertional dyspnea x 2 months, h/o restrictive lung pattern 1/13 pfts, but has h/o lung surgery for benign mass. evaluate for emphysema History: dyspnea LUNGS AND PLEURA: Surgical changes of a left lower lobe resection, with linear scarring and focal emphysema distal to the suture line. Dilated airw... | 1. Mild bronchiectasis and air trapping may be related to mild small airways disease.2. Surgical changes of a left lower lobe resection with focal emphysema distal to the suture line.3. No evidence of diffuse emphysema or pulmonary fibrosis. |
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