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Generate impression based on findings. | Male 62 years old; Reason: hematuria History: hematuria ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. Multiple well marginated fluid attenuating foci in the liver most likely represent cysts.The hepatic and portal veins are patent. No biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts. They show no appreciable enhancement and meet the criteria for simple cysts. No nephrolithiasis or hydronephrosis.The ureters are normal in caliber and course.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Prostate is enlarged measuring 8.6 x 8.9 cm (image 125 series 7)BLADDER: There are multiple stones within the urinary bladder.LYMPH NODES: There are small pelvic lymph nodesBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Enlarged prostate.2.Bladder calculi possibly the source of the patient's hematuria. |
Generate impression based on findings. | T2N0 right oral tongue squamous cell carcinoma treated with CRT completed in 6/2009 with right partial glossectomy for salvage in 10/2009 now with recurrent right oral tongue SCC. On IRB 121554 re-irradiation clinical trial. Started induction chemotherapy with carbo/abraxane on 1/9/15 which will be followed by CRT. Neck: Extensive streak artifact related to dental amalgam obscures much of the oral cavity, thereby precluding assessment of the tongue lesion. There is no discernible significant lymphadenopathy in the neck based on size criteria. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is a left subclavian venous catheter. There is partially imaged scoliosis and surgical rods. The imaged portions of the lungs are clear.Head: There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is a persistent right maxillary sinus retention cyst. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | 1. Extensive streak artifact related to dental amalgam obscures much of the oral cavity, thereby precluding assessment of the tongue lesion. Therefore, PET or MRI may be generally useful for follow up.2. No evidence of significant cervical lymphadenopathy.3. No evidence of intracranial metastases. |
Generate impression based on findings. | Male 64 years old; Reason: Pt is a 64 yo male w/ hx of lymphoma; pre-auto sct evaluation History: Evaluate CHEST:LUNGS AND PLEURA: Few scattered pulmonary nodules. The nodule in the left upper lobe seen on image 50/series 6 is calcified.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No mediastinal lymphadenopathy.Chest wall port terminates at the cavoatrial junction.CHEST WALL: Small axillary lymph nodes.OTHER: ABDOMEN:LIVER, BILIARY TRACT: There is widening of the hepatic fissures and subtle nodularity along its undersurface suggestive of chronic liver disease. No focal hepatic lesions. Hepatic and portal veins are patent.Status post cholecystectomy. SPLEEN: Spleen is enlarged measuring 18 cm. There are portosystemic collaterals near the spleen. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small left renal cyst. No hydronephrosis or nephrolithiasis in either kidney.RETROPERITONEUM, LYMPH NODES: No mesenteric or retroperitoneal lymphadenopathy.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 pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Findings suggestive of chronic liver disease with splenomegaly and varices.2.No enlarged lymph nodes by CT size criteria. |
Generate impression based on findings. | 57 year old man with abdominal pain and history of mass in head of pancreas on EGD, liver lesion seen on prior imaging. CHEST:LUNGS AND PLEURA: No suspicious nodules or masses.MEDIASTINUM AND HILA: Mild coronary artery calcifications are present.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Several small low attenuation hepatic lesions are present which are suspicious for metastases. The largest is in segment 8 (series 11, image 94) and measures 1.3 x 1.2 cm. The portal venous system is patent.Cholelithiasis without CT evidence of cholecystitis. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: There is atrophy of the pancreatic body and tail. The pancreatic duct is not dilated. There is an ill-defined, heterogenous mass in head of the pancreas (series 11, image 111) measuring approximately 2.0 x 2.3 cm. The mass appears to invade the second portion of the duodenum.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mild atherosclerotic disease affects the abdominal aorta. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Distention of the stomach which may be related to narrowing of the second portion of the duodenum due to pancreatic head mass. Otherwise normal caliber bowel without evidence of obstruction. Residual high density contrast material is present in the colon.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine. Postsurgical changes of L4-S1 lumbar fusion.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber small and large bowel without evidence of obstruction.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine. Postsurgical changes of L4-S1 lumbar fusion.OTHER: No significant abnormality noted | 1.Pancreatic head mass measuring approximately 2.0 x 2.3 cm suspicious for adenocarcinoma. Possible invasion into the second portion of the duodenum. Gastric distention which may be related to duodenal narrowing from the mass.2.Several small low-attenuation hepatic lesions which are suspected to be metastases. MR may be helpful for additional evaluation. |
Generate impression based on findings. | Female 53 years old Reason: Congenital talipes equinovarus; Contracture of tendon (sheath). Status post calcaneal osteotomy with two screws in place. An orthopedic screw affixes the medial malleolus of the distal tibia, unchanged from prior exam. There are two screws through first TMT joint in anatomic alignment. Osteoarthritic changes affect the tarsometatarsal joints. There is an angular deformity of the proximal fourth metatarsal diaphysis which is compatible with an old traumatic fracture. Calcification is seen in the plantar facia. | Postoperative changes as detailed above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Scattered benign calcifications, including arterial calcifications, are present. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 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 version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views (total of 14 images) of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications are present bilaterally. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Female 42 years old Reason: fracture History: proximal knee/tib fib pain with ankle fracture. There is no acute fracture or dislocation. No joint effusion. The bones appear unremarkable. | No acute fracture or dislocation. |
Generate impression based on findings. | Reason: r/o PE, also assess lung parenchyma History: elevated d-dimer, CXR findings, heroin use (intranasal), hypoxia, hemoptysis PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery measures up to 3.8 cm in diameter, suggesting pulmonary hypertension.LUNGS AND PLEURA: Bilateral patchy, geographic groundglass opacity throughout the lungs, with a slight perihilar and upper lobe predominance. No focal areas of dense consolidation. No suspicious pulmonary nodules or masses. Very small right pleural effusion.MEDIASTINUM AND HILA: The heart is enlarged without pericardial effusion. No visible coronary artery calcifications.Scattered mildly prominent mediastinal and hilar lymph nodes. A right paratracheal lymph node measures up to 11 mm (series 7, image 105).CHEST WALL: Mild degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small right fat-containing Bochdalek hernia. | 1. No evidence of pulmonary embolism.2. Bilateral central-predominant groundglass opacity may represent hemorrhage or atypical edema related to drug use.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | LIVER: Normal echogenicity measuring up to 5.1 cm in length. No intra-or extrahepatic biliary ductal dilatation.GALLBLADDER, BILIARY TRACT: Contracted gallbladder with no evidence of sludge or cholelithiasis. The gallbladder wall measures up to 1 mm in thickness, within normal limits. There is no pericholecystic fluid. The common bile duct measures up to 1 mm in diameter.PANCREAS: Normal echogenicity with no evidence of pancreatic ductal dilatation.SPLEEN: Normal echogenicity measuring up to 2.3 cm in length.KIDNEYS: Normal echogenicity with no evidence of hydronephrosis. Right kidney measures up to 3.5 cm in length. Left kidney measures up to 3.7 cm in length.ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No significant abnormality noted. | Normal examination with no evidence of biliary atresia. Contracted gallbladder with no evidence of sludge or cholelithiasis. |
Generate impression based on findings. | Female 42 years old Reason: eval for medial space widening History: fx. Again seen is a oblique fracture of the distal fibula with lateral displacement of the distal fragment; the fibular fracture is about the level of the joint line. The lateral joint space is mildly increased. Medially, the joint space is unremarkable. | Distal fibular fracture with lateral joint space widening. |
Generate impression based on findings. | Lymphoma; pre-auto stem cell transplant evaluation. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The Waldeyer ring structures are not enlarged. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | No significantly enlarged lymph nodes by CT size criteria. |
Generate impression based on findings. | 13 year-old male, evaluate for fractureVIEWS: Right thumb, AP and lateral (two views) 2/12/15 15:38 Alignment is anatomic. There is no evidence of fracture. Mild soft tissue swelling about the PIP joint. | Soft tissue swelling without discrete fracture identified. |
Generate impression based on findings. | History of non-Hodgkin lymphoma and EBV status post 3 cycles of chemotherapy. Restaging exam.RADIOPHARMACEUTICAL: 11.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 88 mg/dL. Today's CT portion grossly demonstrates a right chest Port-A-Cath with tip in the SVC. Sliding hiatal hernia is noted. A ventral abdominal hernia is also present. Extensive atherosclerotic including coronary arterial calcifications are seen. A hypodense left inferior renal lesion is likely a cyst.Today's PET examination demonstrates complete interval resolution of previous extensive hypermetabolic tumor of the neck, chest, abdomen and pelvis without suspicious lesion to indicate FDG avid tumor currently. | Complete interval resolution of previous extensive hypermetabolic tumor without FDG avid tumor currently in the neck, chest, abdomen or pelvis. |
Generate impression based on findings. | Punch in left jaw on 1/25/15. There is no evidence of maxillofacial fractures. The temporomandibular joints are intact. The dentition appears unremarkable. The paranasal sinuses are clear. The nasal cavity is also clear. The nasal septum is essentially midline. 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. | No evidence of maxillofacial fractures. |
Generate impression based on findings. | Female 32 years old Reason: ?change since MRI in the past. recent new pain after shovelling snow-mostly sacral and low lumbar with some radiation to the buttock on the right. History: see 1plus known Sickle-c disease-says pain is not typical of sickling.. Vertebral body heights and disk spaces are preserved. Alignment is anatomic without evidence of fracture or subluxation. Note is made of right upper quadrant surgical clips and of intrauterine device. | No acute fracture or subluxation. |
Generate impression based on findings. | 43 years, Female. Reason: r/o obstruction History: abdominal pain, persistent nausea/vomiting Right transpedicular screw and rod device at T11-T12. Nonobstructive bowel gas pattern. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female 52 years old Reason: r/o cholecystitis History: abd pain, n/v, cholelithiasis, heavy etoh use LIVER: The liver measures 18.1 cm in length. Hepatic parenchyma is diffusely echogenic consistent with fatty infiltration. The main portal vein is patent and demonstrates normal directional flow.GALLBLADDER, BILIARY TRACT: Small shadowing calculi within the gallbladder. There is no gallbladder wall thickening or pericholecystic fluid. There is no biliary dilatation. The patient is sonographic Murphy sign negative.PANCREAS: Unremarkable where visualized.KIDNEYS: The left kidney measures 11.2 cm. The right kidney measures 11.1 cm. There is no hydronephrosis.OTHER: The spleen measures 8.1 cm. | 1. Diffuse hepatic steatosis.2. Cholelithiasis without sonographic evidence of acute cholecystitis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of benign left breast biopsy and left cyst aspiration. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Several benign morphology masses are present in both breasts, several of which have coarse internal calcifications and are compatible with hyalinizing fibroadenomas. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Bilateral stable benign morphology masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | History of esophageal cancer and SRS to two enhancing brain lesions. Recent brain MRI demonstrated increasing enhancing lesion. Evaluate for radiation necrosis versus progressive tumor.RADIOPHARMACEUTICAL: 12.8 mCi F-18 fluorodeoxyglucose (FDG)BLOOD GLUCOSE (FASTING): 107 mg/dL Today's CT portion grossly demonstrates hypodensity, likely edema, in the left posterior parieto-occipital region. A burr hole is seen in the adjacent posterior left calvarium.Today's PET examination was registered both to the CT as well as the comparison MR images on a separate workstation. No intracranial focus of elevated glucose metabolism is identified. Specifically, the region of the left posterior parieto-occipital enhancing lesion on MRI demonstrates no significant FDG accumulation. In fact, there appears to be subtle decrease in uptake here. Similarly, the subcentimeter right cerebellar enhancing lesion on MRI demonstrates no appreciable increase in radiotracer accumulation although given its small size, sensitivity for characterization is diminished. | No hypermetabolic intracranial lesion. Specifically be left posterior parieto-occipital enhancing lesion on MRI demonstrates no elevated metabolic activity. This favors radiation necrosis for the etiology. |
Generate impression based on findings. | There is no acute intracranial hemorrhage, mass effect, or midline shift. There is a dural based enhancing lesion along the posterior falx measuring 5 mm in thickness and 16x19 mm in the AP and craniocaudal dimensions. No associated mass effect. No abnormal parenchymal enhancement in the brain. The ventricles, sulci, and cisterns are normal in size and configuration with preserved gray-white differentiation. The calvarium is unremarkable without destructive osseous lesions. The imaged portions of the orbits, paranasal sinuses, and mastoid air cells are unremarkable. | No definite CT evidence of intracranial metastatic disease. There is a 5 mm enhancing lesion along the posterior falx which may represent a small meningioma. If clinically indicated MRI can be considered. |
Generate impression based on findings. | Male 70 years old Reason: Pancreas cancer hx of whipple surgery now progressive disease prior imaging suggestive of liver and lung mets please assess and provide index lesion measurements for RECIST History: As above CHEST:LUNGS AND PLEURA: Multiple small lung nodules predominantly in the right lower lobe have not significantly changed from outside CT dated 1/26/2015. An index nodule measures 8-mm in diameter image number 57, series number 4.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Changes secondary to Whipple surgery. Residual pancreas is very atrophic. There is a 9-mm hypodense lesion in the residual pancreas, best seen on image number 119, series number 3.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Ill-defined small soft tissue density around the aorta and IVC. Metastatic adenopathy cannot be excluded. Left para-aortic index nodule measures 1.4 x 1 cm on image number 128, series number 3. There is thrombus involving the infrahepatic IVC and left renal vein.The thrombus has progressed from the previous study. Intrahepatic and suprahepatic IVC are patent.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 | Small lung lesions suspicious for metastatic disease. Possible metastatic retroperitoneal adenopathy.Interval progression of the left renal vein and infrahepatic IVC thrombus.Dr. Catenacci was notified and acknowledged about the above findings at the time of the dictation. |
Generate impression based on findings. | History of metastatic bladder cancer, baseline exam prior to starting new systemic therapy; please provide bi-dimensional measurements. CHEST:LUNGS AND PLEURA: Numerous, bilateral scattered pulmonary nodules compatible with metastases. Largest nodule is in right lower lobe (series 5, image 45) measuring 2.9 x 2.6 cm, previously 2.2 x 2.4 cm. No focal consolidation or pleural effusions.MEDIASTINUM AND HILA: Several small mediastinal lymph nodes are non-specific. Calcified hilar lymph nodes likely related to prior granulomatous disease. Mild coronary artery calcifications.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. No biliary ductal dilatation. Contracted gallbladder with cholelithiasis.SPLEEN: Splenic coarse calcifications from prior granulomatous disease. PANCREAS: Pancreas is severely atrophic.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Postsurgical changes from left nephroureterectomy. There is ill-defined soft tissue attenuation within the surgical bed which may be postsurgical. This is also a discrete soft tissue nodule in the surgical bed (series 3, image 112) which measures 0.9 x 1.2 cm and is nonspecific but should be followed on subsequent exams. The right kidney is unremarkable. RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Severe degenerative changes of the lumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Severe degenerative changes of the lumbar spine.OTHER: No significant abnormality noted | 1.Postsurgical changes from left nephroureterectomy. Non-specific soft tissue nodule in the surgical bed should be followed on subsequent exams.2.Multiple pulmonary mets, increased in size from prior. 3.Cholelithiasis. |
Generate impression based on findings. | 53 year-old male. Esophageal perforation. CHEST:LUNGS AND PLEURA: Interval placement of a pigtail drain in the right loculated small pleural effusion, which is mildly decreased in size.Decreased fluid and increased air within the small loculated left basilar pleural effusion. Previously seen extravasated oral contrast has resolved, presumably drained.Small amount of loculated pleural fluid anteriorly and medially on the left, unchanged.Two left chest tubes are unchanged, tips terminating at the posterior left mid-pleural space and adjacent to the anterior mediastinum.Dependent intraluminal debris in the trachea and scattered mucus impaction of left lower lobe bronchi. Atelectasis bilaterally adjacent to the loculated pleural fluid.MEDIASTINUM AND HILA: Tracheostomy tube, unchanged.Right internal jugular vein thrombosis, in retrospect present on prior exam.Normal heart size without pericardial effusion. No visible coronary artery calcification.RIght PICC tip in the SVC.Endoscopic clip is again seen in the mid esophagus.CHEST WALL: Mild degenerative changes of the thoracolumber spine.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: Left renal cyst. No hydronephrosis. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.NG tube tip in the gastric body. Gastrostomy tube terminates in the stomach. Jejunostomy tube, unchanged.BONES, SOFT TISSUES: Mild degenerative changes of the thoracolumber spine.OTHER: No significant abnormality noted. | 1. Interval placement of pigtail drain in the right basilar loculated pleural effusion, which is mildly decreased in size. Left loculated pleural effusion is also mildly smaller. 2. Thrombosed right IJ vein. |
Generate impression based on findings. | This scan is a 30-year-old female with recently biopsied right breast mass with pathology revealing microabscesses. On physical examination by Dr. Chhablani today, the mass appears to have enlarged. Upon physical exam, the previously biopsied mass in the right upper inner breast appears to have enlarged in the interim. There is minimal skin thickening and redness overlying this mass.A targeted right breast ultrasound was performed for the palpable area of concern. In the right upper inner breast 10 o'clock location, approximately 1 to 5 cm from the nipple, there is a mixed echogenic lesion with irregular borders measuring approximately 7.2-cm. The appearance is compatible with phlegmon. No drainable fluid collection or discrete abscess is identified. | Enlarging right upper inner breast mass with sonographic features compatible with phlegmon. No drainable fluid collection or discrete abscess is identified. All findings were relayed to Dr. Chhablani at time of dictation, who will be re-biopsying the lesion to send additional tissue for antibiotic sensitivity.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 16 year-old female with peripheral edema, hypoalbuminemia, low complement. Evaluate for vasculitis, mass. LIVER: Normal echogenicity measuring up to 14.1 cm in length. No intra-or extra hepatic biliary ductal dilatation. GALLBLADDER, BILIARY TRACT: Normal echogenicity with no pericholecystic fluid. The gallbladder wall measures up to 2 mm in thickness, within normal limits. Common bile duct measures up to 4 mm in diameter.PANCREAS: Normal echogenicity with no pancreatic ductal dilatation. SPLEEN: Normal echogenicity measuring up to 10.0 cm in length. KIDNEYS: Right kidney measures up to 10.6 cm in length. Left kidney measures up to 11.2 cm in length and contains a duplicated collecting system. No evidence of hydronephrosis. ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: No bowel wall thickening is noted. Small amount of free fluid in the pelvis. | 1. Small amount of free fluid in the pelvis with no other abnormality noted. 2. Left kidney with a duplicated collecting system. |
Generate impression based on findings. | There are unchanged postoperative findings related to left frontoparietal craniotomy for left MCA clipping with associated streak artifact limiting evaluation. There is stable encephalomalacia in the left anterior temporal lobe. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are unchanged. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are otherwise unremarkable. | Stable postoperative findings related to left MCA aneurysm clipping with no evidence of acute intracranial hemorrhage or skull fracture. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. A small circumscribed asymmetry is present in the left retroareolar region on CC view, likely a benign etiology.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 48 year-old female patient status post lap sleeve on 1/27/2014 presents with persistent nausea and retching. Scout radiograph of the stomach showed a staple line from prior gastric sleeve surgery.Single contrast evaluation of the esophagus demonstrated spontaneous gastroesophageal reflux to the level of the aortic arch while patient was in the upright position.Single contrast evaluation of the stomach demonstrates a pouch in the proximal most portion of the stomach measures 2.7 x 1.5 cm (CC x AP) and 1.9 cm in width (series 17, 18, 19). Immediately distal to this pouch at the junction of the fundus and body, the stomach is highly attenuated. However, there is spontaneous flow of barium through this segment. The remaining portion of the distal stomach is also attenuated. Spontaneous, rapid emptying of contrast into the duodenal sweep was observed. The duodenal bulb and sweep were within normal limits. TOTAL FLUOROSCOPY TIME: 2:58 minutes | 1.Pouch in the proximal portion of the stomach with attenuation of the distal portion of the gastric sleeve. Although there is spontaneous flow of contrast through this area, this attenuation may obstruct solid material.2.Spontaneous high volume reflux in the upright position.3.Findings discussed with Dr. Prachand. |
Generate impression based on findings. | Reason: head and neck cancer/ per protocol scans History: see above CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.No focal airspace consolidation.No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. No visible coronary artery calcification.No mediastinal or hilar lymphadenopathy.CHEST WALL: Left chest port, tip in the SVC. Metallic spinal fixation rods.ABDOMEN: Streak artifact from metallic spinal hardware and 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.Gastrostomy tube in place.BONES, SOFT TISSUES: Metallic spinal fixation hardware.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 85 years, Female. Reason: confirm dobhoff placement History: confirm dobhoff placement Pelvis excluded from field-of-view.Dobbhoff tube is supra-diaphragmatic corresponding to the location of the intrathoracic stomach as seen on the CT scan. Consider advancing tube to infra-diaphragmatic stomach.Nonobstructive bowel gas pattern.Chronic chest findings please refer to chest x-ray | Dobbhoff tube probably in hiatal hernia supradiaphragmatic.Discussed with hospitalist. |
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 version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Bilateral benign morphology masses and focal asymmetries are stable. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Bilateral stable breast masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 29 years, Female. Reason: assess stool burden, and also to check rectal tube placement. History: severe constipation NG tube tip projects over the second portion of the duodenum. Surgical clips are seen in the right upper quadrant and left upper quadrant. Suture material noted in the left upper quadrant. Rectal tube is coiled in the rectum with tip in the distal descending colon. Ileus type bowel gas pattern. Interval decrease in stool burden. | Rectal tube is coiled in the rectum with tip in the distal descending colon. Interval decrease in stool burden. |
Generate impression based on findings. | 11-week-old female with cough and feverVIEWS: Chest AP/lateral (two views) 2/12/15 16:15 Bronchial wall thickening, large lung volumes and retrocardiac atelectasis. The ventricular apex, aorta, and stomach are left-sided. The cardiothymic silhouette is normal. | Bronchial wall thickening and large lung volumes suggesting bronchiolitis or reactive airway disease. |
Generate impression based on findings. | 66 years, Male. Reason: Dobbhoff History: Dobbhoff Dobbhoff tube tip projects over the second portion of the duodenum. Mitral valve prosthesis is again noted. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip projects over the second portion of the duodenum. |
Generate impression based on findings. | Male 59 years old; Reason: 59 yo with right flank pain History: right flank pain, assess for stones ABDOMEN:LUNG BASES: Calcified granuloma in the right lower lobe.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Calcified splenic granulomas.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Kidneys are normal in morphology. No calcified stones or hydronephrosis is present in either kidney. The ureters are normal in caliber and course. No perinephric fluid collections or inflammation.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber and course.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Coarse calcifications are present within the prostate gland.BLADDER: No distal ureteral or bladder calculi.LYMPH NODES: No significant abnormality noted. BOWEL, MESENTERY: Postsurgical changes in the rectum. There is soft tissue thickening in the presacral space, unchanged.BONES, SOFT TISSUES: OTHER: No significant abnormality noted. | 1.No nephrolithiasis or hydronephrosis.2.No bladder calculi.3.No bowel obstruction. |
Generate impression based on findings. | 56 years, Female. Reason: r/o obstruction History: abdominal pain Surgical sutures project over the lower abdomen. Diffusely gas distended loops of colon with amorphous stool. Above average stool burden. Air-fluid levels noted in the colon on upright views.Nonobstructive bowel gas pattern. | Diffuse gas distended loops of colon with above average stool burden suggestive of obstipation. |
Generate impression based on findings. | 65-year-old female. Head and neck cancer. Compare to previous. CHEST:LUNGS AND PLEURA: Stable calcified and noncalcified micronodules, which are most likely post inflammatory.No suspicious pulmonary nodules or masses are identified.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Calcified left hilar and mediastinal nodes consistent with healed granulomatous disease.Normal heart size without pericardial effusion. No visible coronary artery calcification.Postsurgical findings of thyroidectomy. Right tracheoesophageal groove mass, refer to separately dictated CT soft tissue neck for further details.CHEST WALL: Multilevel degenerative disk disease of the thoracolumbar spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Mild hepatic steatosis. Cholecystectomy clips.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Bilateral adrenalectomies with surgical clips on the right.KIDNEYS, URETERS: Multiple subcentimeter foci in the kidneys, too small to characterize, unchanged and likely cysts. Bilateral nonobstructive renal stones.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: Wide-mouthed ventral hernia containing a nonobstructed bowel loop. L5 sclerotic focus is stable from 2009, likely benign. Multilevel degenerative disk disease of the thoracolumbar spine.OTHER: No significant abnormality noted. | No evidence of metastases in the chest or abdomen. Right tracheoesophageal groove mass, refer to separately dictated CT neck report for further details. |
Generate impression based on findings. | Female 72 years old Reason: Weight bearing views. Evaluate extent of osteoarthritis compared to 2013 films. History: worsening left knee pain There is moderate medial compartment and extensor compartment joint space narrowing in the left knee with tricompartmental osteophytes. There is a small joint effusion.The bones are demineralized. Small ossicle adjacent to the fibular head. No acute fracture or malalignment.Contralateral right knee shows mild osteoarthritic changes. | Moderate left knee osteoarthritis. |
Generate impression based on findings. | Right hip pain Mild osteoarthritis affects the right hip, without significant interval change at the hip joint. No malalignment is present. | Mild osteoarthritis |
Generate impression based on findings. | Left breast cancer.RADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 0.5 mCi Tc-99m filtered sulfur colloid was injected subcutaneously. Following injection, intraoperative probe localization was performed. No images were acquired. | Successful left breast injection for intraoperative identification of sentinel lymph node. |
Generate impression based on findings. | NONCONTRAST: There are chronic infarcts in the left inferior parietal lobule and bilateral cerebellar hemispheres. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are unchanged. There is no midline shift or herniation. There is mild left maxillary sinus mucosal thickening. The skull and extracranial soft tissues are unremarkable. CTA HEAD: The intracranial internal carotid arteries are normal in course and caliber with the exception of minimal right proximal cavernous carotid calcification. The middle and anterior cerebral arteries are unremarkable. The distal right vertebral artery is hypoplastic. The vertebral arteries, basilar artery, and posterior cerebral arteries are otherwise normal in course and caliber. There is no evidence of flow-limiting stenosis or aneurysm.CTA NECK: There is mild atherosclerotic plaque at the bilateral carotid bifurcations. There are also mild calcifications at the proximal left vertebral artery. Otherwise, there are no flow limiting stenoses in the carotid or vertebral arteries in the neck. The great vessel origins are patent. There are post-treatment findings related to tonsillectomy, neck dissection, and right hemithyroidectomy. There is an unchanged heterogeneous appearance of the remaining left thyroid lobe, with coarse calcifications and a dominant hyperattenuating nodule as well as a hypoattenuating nodule. Otherwise, there is no evidence of mass lesions within the right thyroidectomy bed. The remaining salivary glands appear unchanged. There is biapical pulmonary scarring. The airways are patent. There are degenerative changes in the cervical spine with mild to moderate spinal canal stenosis at C5-6 and neural foraminal narrowing at C3-4, C5-6 and C6-7, better detailed on MRI cervical spine from earlier today. | 1. No evidence of significant steno-occlusive arterial disease in the head or neck.2. Chronic infarcts in the cerebellum and left parietal lobe, but no acute intracranial hemorrhage or mass effect. 3. Postoperative findings in the neck without evidence of significant adenopathy.4. Multilevel cervical spondylosis, which is better depicted on the previous cervical spine MRI. |
Generate impression based on findings. | Female 54 years old Reason: fracture History: lateral hip pain post fall No acute fracture or dislocation of the left hip joint. Frontal view of the right hip joint demonstrates mild osteoarthritic changes. | No acute fracture or dislocation of the left hip joint. Mild osteoarthritic changes of the right hip joint. |
Generate impression based on findings. | 4 y/o female, trauma.VIEWS: Chest AP (one view), cervical spine AP and lateral (two views), pelvis AP (one view), right forearm, AP and lateral (two views) 2/12/15 16:26 The aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal. No focal lung opacity, pleural effusion or pneumothorax is seen. Vertebral body heights and disk spaces are normal. No fracture is seen. No prevertebral soft tissue swelling is identified.The femoral heads are directed into the acetabula. No pelvic fracture is seen. The radius and ulna are intact. | Normal chest, cervical spine, pelvis, and forearm. |
Generate impression based on findings. | Female 39 years old Reason: Upper abdominal pain with positive Murphy's sign. Evaluate for cholelithiasis and evidence of cholecystitis. History: Upper abdominal pain with positive Murphy's sign. LIVER: The liver measures 20.1 cm. Hyperechoic hepatic echotexture suggestive of fatty infiltration. No focal liver lesion.GALLBLADDER, BILIARY TRACT: Unremarkable gallbladder without gallstones, gall bladder wall thickening or pericholecystic fluid.PANCREAS: Unremarkable where visualized.KIDNEYS: The left kidney measures 14.5 cm. The right kidney measures 13.8 cm. There is no hydronephrosis.OTHER: The spleen measures 11.2 cm. | 1. No evidence of cholelithiasis or acute cholecystitis. 2. The liver parenchyma is diffusely echogenic suggestive of fatty infiltration. |
Generate impression based on findings. | Female 5 years old Reason: eval post-reduction History: thumb painVIEWS: Left hind AP and lateral view of the first digit 2/12/15 at 1640 hrs. (Two views) Cast material obscures bone details. Assessment of post reduction status is not possible. | Fracture obscured by cast. |
Generate impression based on findings. | Refractory Hodgkin's lymphoma status post two cycles of ICE. Restaging exam.RADIOPHARMACEUTICAL: 14.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 96 mg/dL. Today's CT portion grossly demonstrates enlarged right supraclavicular lymph node with adjacent surgical clips. Enlarged anterior mediastinal soft tissue density is also noted. Right chest Port-A-Cath has tip in right atrium.Today's PET examination demonstrates a small to medium sized significantly hypermetabolic focus (SUV max = 7.5) corresponding to a right supraclavicular lymph node adjacent to surgical clips. This is highly suspicious for current tumor activity.In the anterior mediastinum, there are several additional small and medium sized significantly hypermetabolic lymph nodes most notably right of midline (SUV max = 8.3), also highly suspicious for persistent tumor activity.No additional suspicious FDG avid lesion is identified. Diffusely increased marrow activity suggests benign stimulation. | 1.Right supraclavicular and anterior mediastinal lymph nodes are significantly hypermetabolic and consistent with current metabolically active tumor.2.No suspicious FDG avid elsewhere. If there is an outside baseline FDG-PET that could be submitted for comparison, this may be useful for additional characterization. |
Generate impression based on findings. | hypertensive crisis Mild diffuse brain atrophy with non specific small vessel disease, no change since prior exam.No evidence of acute ischemic or hemorrhagic lesion.Opacifications on bilateral maxillary sinuses, ethmoid sinus, frontal sinus and sphenoid sinus.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The mastoid air cells are clear. | 1. No evidence of acute ischemic or hemorrhagic lesion on this scan.2. Non specific small vessel disease, no change since prior exam.3. Pan sinusitis |
Generate impression based on findings. | NPH No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | HIV with persistent headache No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | altered mental status No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The mastoid air cells are clear.Retention cyst on the right maxillary sinus. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | recurrent seizures No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | altered mental status, left side weakness There is ill defined subtle low attenuation on the right pre central gyrus, right parietal, left occipital and right occipital lobes. Comparing to prior exam, there is no significant interval change.These findings may suggest possible acute ischemic infarction or other parenchymal process. Therefore, brain MRI with Gadolinium enhancement study needs to be considered for further evaluation. The ventricles, sulci, and cisterns are symmetric and unremarkable. The osseous structures are unremarkable. The mastoid air cells are clear.Bilateral maxillary sinus opacifications. | Multifocal subtle low attenuations as described above. Brain MRI can be considered for further evaluation. |
Generate impression based on findings. | worsening mental status No evidence of acute ischemic or hemorrhagic lesion.Multiple variable sized tissue losses on bilateral basal gangalia and thalami indicating multiple lacunes.Non specific small vessel ischemic disease, progressed since prior exam.Underlying brain shows mild diffuse brain atrophy which shows progression since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | 1. No evidence of acute ischemic or hemorrhagic lesion.2. Progressed small vessel ischemic disease and mild brain atrophy since prior exam. |
Generate impression based on findings. | Female 86 years old Reason: eval intra abd pathology History: abd pain, leukocytosis ABDOMEN: The exam is limited secondary to respiratory motion.LUNG BASES: Please refer concomitant CT of the chest for detailed findings of the lung bases.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic right kidney with limited contrast excretion. Hypodense lesion within the right kidney likely representing a renal cyst. RETROPERITONEUM, LYMPH NODES: Long segments of mural thrombus within the thoracic and abdominal aorta. There are several ulcerative plaques most prominent in the thoracic aorta. Aneurysmal dilatation of the abdominal aorta measuring up to 3.8 cm best seen on coronal images (series 80972, image 25) with extensive semi-circumferential mural thrombus extending from the anterior and left aortic wall. Extensive atherosclerotic calcifications of the abdominal aorta with dense calcifications of the celiac artery and SMA. The celiac artery and SMA are patent.Dense calcifications of the bilateral iliac arteries. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate degenerative changes of the thoracic spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Nonspecific segmental bowel wall thickening and submucosal edema of the sigmoid colon, best seen on coronal images (series 80972, images 24-30).BONES, SOFT TISSUES: Moderate degenerative changes of the lumbar spine.OTHER: Separate thrombi within the right internal iliac (series 13, image 107) and right femoral veins (series 13, image 128). | 1.Nonspecific bowel wall thickening and submucosal edema of the sigmoid colon which may be secondary to ischemic or infectious etiology.2.Aneurysmal dilatation of the abdominal aorta with extensive calcifications and mural thrombus as above.3.Distinct thrombi within the right internal iliac and right femoral veins. |
Generate impression based on findings. | Reason: 25 year old female status post lap cholecystectomy and abdominal washout; evaluate for additional fluid collections, contrast extravasation History: tachycardia, diaphoresis Timing of contrast bolus slightly delayed due to combination of exam within concomitant pulmonary embolism chest CT.ABDOMEN:LUNG BASES: Small left pleural effusion and basilar atelectasis/consolidation. Please see chest CT from same day for full details regarding chest. LIVER, BILIARY TRACT: Diffusely decreased attenuation of the liver compatible with fatty infiltration. Status post cholecystectomy. Biliary stent with distal tip in the duodenum.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: Enteric tube with tip in the gastric antrum. Mildly prominent loops of small bowel without collapse distally compatible with ileus patternBONES, SOFT TISSUES: Midline abdominal surgical defect with multiple drains in the peritoneal cavity. Mild anasarca.OTHER: Previously seen multiloculated abdominal fluid collections have nearly resolved with minimal residual scattered fluid/mesenteric fat stranding. No large loculated fluid collections remain to suggest abscess.PELVIS:UTERUS, ADNEXA: IUD within the uterus.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Mildly prominent loops of small bowel without collapse distally compatible with ileus patternBONES, SOFT TISSUES: No significant abnormality notedOTHER: Multiloculated pelvic fluid collection has nearly resolved with minimal residual fluid/fat stranding. | 1.Findings compatible with interval abdominal washout with interval near resolution of previously seen multiloculated abdominal fluid collections with small amount of residual scattered fluid/stranding. No remaining large loculated collections.2.Mild ileus pattern. 3.Hepatic steatosis. |
Generate impression based on findings. | 35 years, Female. Reason: 35yoF with recent actively bleeding pyloric ulcer s/p IR embolization today History: R sided abd pain with rebound tenderness Lung bases are clear.Interval GDA embolization with embolization clips projected over the right upper abdomen. Nonobstructive bowel gas pattern. No intramural air or free into peritoneal. No subdiaphragmatic free air in the upright images. Intravenous contrast is identified in the collecting system and bladder.IUD projects over the pelvis . | Nonobstructive bowel gas pattern. No subdiaphragmatic free air on upright radiograph. |
Generate impression based on findings. | 81 year old female with flank pain, evaluate for nephrolithiasis. ABDOMEN:LUNG BASES: Partially visualized cardiac pacemaker leads. Cardiomegaly. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple punctate calcifications near the hilum of the left kidney may represent vascular calcifications are nonobstructive calyceal calculi. No hydronephrosis or obstructing renal calculi. Fluid density structure adjacent to the right renal hilum thought to be a prominent extrarenal pelvis.Small wedge-shaped area of low-attenuation within the lower pole of the left kidney which lacks peripheral cortical enhancement and has some volume loss compatible with small infarct or scar. No adjacent fat stranding. Delayed images demonstrate symmetric contrast excretion without obvious calyceal filling defect. RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications of the abdominal aorta and its branches. BOWEL, MESENTERY: Normal caliber bowel evidence without evidence of obstruction. Colonic diverticulosis without evidence of complicated diverticulitis.BONES, SOFT TISSUES: Degenerative changes affect the visualized lumbar spine including grade 1 anterolisthesis of L4 on L5 and severe degenerative disk disease at L5-S1.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: There is a 2.0-cm round, simple fluid attenuation lesion in the right pelvis (series 3, image 78) which is thought to represent a benign adnexal cyst. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber bowel evidence without evidence of obstruction. Colonic diverticulosis without evidence of complicated diverticulitis.BONES, SOFT TISSUES: Degenerative changes affect the visualized lumbar spine including grade 1 anterolisthesis of L4 on L5 and severe degenerative disk disease at L5-S1.OTHER: No significant abnormality noted | 1.Punctate calcifications in left renal hilum which may represent vascular calcifications or nonobstructive calyceal calculi. No hydronephrosis or obstructing renal calculi.2.Small left renal infarct/scar. 3.Colonic diverticulosis without evidence of complicated diverticulitis. |
Generate impression based on findings. | facial droop No evidence of acute ischemic or hemorrhagic lesion.No change of non specific small vessel disease since prior exam.Right temporal calcified mass is again demonstrated, no change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | 1. No evidence of acute ischemic or hemorrhagic lesion.2. Non specific small vessel ischemic disease.3. No change of right temporal mass lesion since prior exam.If clinically indicated, consider brain MRI for further evaluation. |
Generate impression based on findings. | 81 year old female with left flank pain, evaluate for nephrolithiasis. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: Partially visualized cardiac pacemaker leads. Cardiomegaly. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple punctate calcifications near the hilum of the left kidney may represent vascular calcifications are nonobstructive calyceal calculi. No hydronephrosis or obstructing renal calculi. Fluid density structure adjacent to the right renal hilum thought to be a prominent extrarenal pelvis.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications of the abdominal aorta and its branches. BOWEL, MESENTERY: Normal caliber bowel evidence without evidence of obstruction. Colonic diverticulosis without evidence of complicated diverticulitis.BONES, SOFT TISSUES: Degenerative changes affect the visualized lumbar spine including grade 1 anterolisthesis of L4 on L5 and severe degenerative disk disease at L5-S1.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: There is a 2.0-cm round, simple fluid attenuation lesion in the right pelvis (series 3, image 78) which is thought to represent a benign adnexal cyst. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber bowel evidence without evidence of obstruction. Colonic diverticulosis without evidence of complicated diverticulitis.BONES, SOFT TISSUES: Degenerative changes affect the visualized lumbar spine including grade 1 anterolisthesis of L4 on L5 and severe degenerative disk disease at L5-S1.OTHER: No significant abnormality noted | 1.Punctate calcifications in left renal hilum which may represent vascular calcifications or nonobstructive calyceal calculi. No hydronephrosis or obstructing renal stones.2.Colonic diverticulosis without evidence of complicated diverticulitis. |
Generate impression based on findings. | History of lung cancer now with new brain metastases, restaging. Exam limited by patient motionABDOMEN:LUNG BASES: Please see chest CT from the same day for details regarding the chest. New pleural based left lower lobe nodule (series 8039, image 24). LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hydronephrosis seen on the prior has resolved. Multiple bilateral renal cysts not significantly changed from prior.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal caliber bowel without evidence of small bowel obstruction.BONES, SOFT TISSUES: Multilevel degenerative changes affect the visualized spine. OTHER: Trace ascites. Diffuse anasarca. Numerous venous collaterals presumed secondary to common iliac vein occlusive disease, unchanged. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter present. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Multilevel degenerative changes affect the visualized spine. Severe degenerative changes affect the hip joints. OTHER: Trace ascites. Diffuse anasarca. | 1.Please see chest CT from same day for detail regarding the chest including new pleural based left lower lobe nodule.2.Study somewhat limited by motion, but no specific evidence of metastatic disease or acute process in the abdomen/pelvis. |
Generate impression based on findings. | 85 years, Female. Reason: ng tube History: c dif NG tube is coiled with side-port and tip projecting over the supradiagphragmatic stomach, tip pointed towards the fundus. Bilateral lung base opacities, increased on the right. Centralized loops of nondilated small bowel. Note that the pelvis is excluded from the field-of-view. | NG tube within a supradiagphragmatic stomach with projecting over the presumed fundus. Nonspecific bowel gas pattern. |
Generate impression based on findings. | 92 years, Female. Reason: 92 yo with lower abdominal pain History: abdominal pain Nonobstructive bowel gas pattern. Average stool burden. Vascular calcifications noted. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | cerebrovascular accident No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | 85 years, Female. Reason: Advanced Dobbhoff \R\15cm, confirm placement History: Advanced Dobbhoff \R\15cm, confirm placement Dobbhoff tube is looped projecting over a supradiaphragmatic stomach with possible kinking of the tip. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view.Chest findings are unchanged. | Looped Dobbhoff tube over the supradiaphragmatic stomach with possible kinking of the tip. |
Generate impression based on findings. | 67 years, Female. Reason: Constipation History: Constipation Right lower lobe consolidation and volume loss, is better evaluated on recent CT chest 12/11/14.Scattered loops of mildly prominent small bowel with mild mural thickening in a nonobstructive pattern, with gas identified in the distal colon and rectum. Average stool burden in the right colon. | 1. Nonobstructive bowel gas pattern. Average stool burden.2. Right lower lobe consolidation and volume loss, is better evaluated on recent CT chest 12/11/14. |
Generate impression based on findings. | 72 years, Female, Reason: eval source of infection History: s/p LVAD, sepsis. CHEST:LUNGS AND PLEURA: Small bilateral pleural effusions, left greater than right. Left basilar consolidation with patchy right basilar opacities. There is septal thickening in the bases which may reflect mild edema. A small focus of air is present in the right pleural effusion consistent with a tiny pneumothorax.MEDIASTINUM AND HILA: Endotracheal tube terminates 4.5 cm from the carina. ICD. Scattered mediastinal lymphadenopathy with an enlarged precarinal node measuring 1.2 cm (3/39). Likely left hilar lymphadenopathy. Atherosclerotic calcifications of the aorta and its branches. Prosthetic mitral valve. Prevascular edema with a small amount of pneumomediastinum. There is an LVAD device producing extensive streak artifact, limiting evaluation in this region. Soft tissue infiltration surrounding the drive line measuring slightly higher than fluid likely represents a seroma/hematoma. Median sternotomy wires. Severe cardiomegaly.CHEST WALL: See above. No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Renal hypodensities are incompletely characterized but likely represent cysts. RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications of the aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse anasarca. LevoscoliosisOTHER: No significant abnormality notedPELVIS: FemaleUTERUS, ADNEXA: No significant abnormality noted.BLADDER: Foley catheter.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Left sacroiliitis. Mild degenerative changes at L5-S1.OTHER: No significant abnormality noted. | 1.Left basilar consolidation and patchy right basilar opacities with bilateral pleural effusions.2.Postsurgical changes including pneumomediastinum and a small right pneumothorax.3.Collection surrounding the drive line in the anterior subcutaneous tissues likely represents a seroma/hematoma, although developing abscess/phlegmon cannot be excluded. |
Generate impression based on findings. | Female, 49 years old s/p tumor debulking. RFO Trigger: Surgical teams. Suspected RFO Location: Abdomen. Suspected RFO: Sponges. No unexpected radiopaque foreign bodies. JP drain projects over the mid pelvis and coiled tubing projects over the right hemiabdomen. Nonobstructive bowel gas pattern. | No unexpected radiopaque foreign bodies. Findings were discussed with attending surgeon, Dr. Tenney, over phone, at 0541 on 2/12/2015. |
Generate impression based on findings. | Reason: intraoperative head ct for surgical planning History: same CT scans were obtained before and after stereotactic placement of deep brain stimulating device. The pre-contrast study demonstrates no significant lesions appear to be post device placement study demonstrates intracranial air and a left-sided burr hole as well as a deep brain stimulator device with the tip in the left thalamus. No abnormal mass lesions are appreciated intracranially. No acute intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin. | 1.No evidence for acute intracranial hemorrhage or edema.2.Status post deep brain stimulator placement with expected postoperative changes3. |
Generate impression based on findings. | 56 year old female. Stem cell transplant patient with x-ray concerning for opacity in LLL. History of ALL. LUNGS AND PLEURA: Small cluster of groundglass opacities in the posterior aspect of the left anterior lobe consistent with infection.Left lower lobe bronchial wall thickening with areas of mucous plugging.Left basilar linear scarringMEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Minimal coronary artery calcification. Normal heart size without pericardial effusion.Round fluid attenuation lesion adjacent to the right heart border is unchanged and likely a pericardial cyst.Right chest wall port tip terminates in the SVC.CHEST WALL: Mild degenerative changes of the thoracic spine. Borderline enlarged bilateral axillary lymph nodes, increased in size from prior, likely reactive.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Unchanged right hepatic lobe hypodensity, likely a cyst. | Left upper lobe cluster of groundglass opacities consistent with infection. |
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 extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSD - 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: CVA History: AMS acute mental status change The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin.Atherosclerotic calcifications are present along the distal internal carotid arteries. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | 15-year-old female with chest pain, evaluate for collapseVIEW: Chest AP (one view) 2/13/15 1:14 ET tube at the thoracic inlet. Spinal fusion hardware from T2 to L1 is again noted. Right PICC tip extends to the cavoatrial junction. NG-tube tip and side-port in the stomach.Increased small right pleural effusion and unchanged adjacent pulmonary opacity. No pneumothorax. The cardiothymic silhouette is normal. | Increased right pleural effusion and unchanged adjacent pulmonary opacity. |
Generate impression based on findings. | Female 48 days old Reason: Evaluate lung fields History: History of complete AV canal repair, intubatedVIEW: Chest AP (one view) 2/13/15 at 531 hours. NG tube terminates at the stomach. Epicardial pacer leads mediastinal clips unchanged. Cardiac silhouette size is enlarged but stable. Worsening pain left upper and lingular atelectasis. No effusions or pneumothorax. | Worsening in left upper and lingular opacities as described. |
Generate impression based on findings. | 24 years, Male. Reason: SLE pt on occasional narcotics for severe joint pain, +C diff c/o N/V/D/abdominal pain, c/f ileus History: as above Elevation of the left hemi-diaphragm. Nonobstructive bowel gas pattern. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Reason: eval intracranial abnl History: AMS Motion artifact partially obscures the upper half of the patient's headThere is redemonstration of a calcific lesion adjacent to the temporal horn of the right lateral ventricle anterior aspect of the right temporal lobe. This currently measures 18 x 13 mm axial dimensions and previously measured 14 x 12 mm axial dimensions in 2006 there are some associated calcifications. There is a prior CTA from 3/22/2007 indicating this is not an aneurysm.Periventricular and subcortical white matter hypodensities of a moderate degree are present.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Since the previous exams a partially calcified mass in the right temporal lobe is stable since the prior exam from 12/12/15. One possibility is that this represents a primary brain neoplasm such as oligodendroglioma in a periventricular region.3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 4.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.5.Motion artifact partially obscures the upper half of the patient's head there is resultant a subtle lesion that developed in the upper head with not be detected as readily if the study was done without motion artifact. |
Generate impression based on findings. | 16-year-old female with back pain status post assault (was thrown) with L3/L4 tenderness to palpation.VIEWS: Lumbar spine AP and lateral, L5/S1 lateral (3 views) 2/12/2015 Mild rightward curvature of the lumbar spine. Vertebral body and disk space heights are maintained. No evidence of fracture or dislocation. | No fracture or dislocation. |
Generate impression based on findings. | Female 48 days old Reason: follow-up to evaluate L atelectasis History: atelectasisVIEW: Chest AP (one view) 2/12/15 at 2129 hrs. NG tube, mediastinal clips and epicardial pacer leads unchanged. Cardiac silhouette size is enlarged but stable. Slight improvement in left lung atelectasis. No effusions or pneumothorax. | Interval slight improvement in left lung atelectasis. |
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 areas of architectural distortion are present. Benign morphology masses and areas of focal asymmetry are unchanged. | 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. | 56 years, Male. Reason: DHT placement into stomach History: DHT placed Surgical clips project over the left hemipelvis. Dobbhoff tube tip projects over the gastric fundus. Sutures project over the right hemiabdomen. Nonobstructive bowel gas pattern. The lung bases are clear. | Dobbhoff tube tip projects over the gastric fundus. |
Generate impression based on findings. | Female 59 years old Reason: CLL in follow up History: please compare to prior exams CHEST:LUNGS AND PLEURA: Index left lower lobe nodule now measures 8-mm in diameter on image number 76 considered number 5, not significantly changed in size compared to previous study. No new nodules.MEDIASTINUM AND HILA: Index pretracheal lymph node now measures 10 x 7 mm on image number 31, series number 3, not significantly changed from previous study. A second more inferior precarinal node is also unchanged measuring 10 x 12 mm on image number 42, series number 3.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Calcified splenic artery aneurysm measuring 1.5-cm in diameter, unchanged.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small renal cysts are unchanged.RETROPERITONEUM, LYMPH NODES: Index periceliac enlarged lymph node measures 1.7 x 1.4 cm on image number 106, series number 3, minimally enlarged compared to previous study. Other retroperitoneal lymph nodes are also stable to minimally enlarged compared to previous study.BOWEL, MESENTERY: Index conglomerate of lymph nodes in the small bowel mesentery now measures 5.8 by 2.9 cm on image number 141, series number 3, grossly stable.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: Index left pelvic lymph node now measures 2.3 by 0.9 cm on image number 181, series number 3, not significantly changed from previous study.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable to minimally increased in size retroperitoneal lymph nodes. Otherwise no significant change from previous study. |
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, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Male 60 years old; Reason: rule out Fournier's gangrene, soft tissue infection of bilateral thighs History: fever, tachycardia, skin breakdown on left lateral thigh, scrotum, medial left gluteal region No contrast enhancement is evident, secondary to the aforementioned extravasation.The patient is status post left AKA. There is diffuse soft tissue swelling at the distal aspect of the remaining left thigh, compatible with cellulitis. No soft tissue gas is seen to suggest Fournier's gangrene. No loculated or drainable fluid collection is present to suggest abscess formation. The soft tissue edema extends to the lateral aspect of the thigh, which extends beyond the field of view of this study. If CT evaluation of the lateral soft tissues of the thigh remains clinically necessary, reattempted imaging is recommended.Portions of the distal femur appear indistinct and osteomyelitis cannot be excluded.The soft tissues of the gluteal region and right thigh are unremarkable. The visualized intra-abdominal contents are unremarkable. | 1. Left thigh cellulitis without evidence of abscess formation or Fournier's gangrene.2. Soft tissue edema extending laterally beyond the field of view of this study. If CT evaluation of the lateral soft tissues of the thigh remains clinically necessary, reattempted imaging is recommended. Findings were discussed with Dr. Wolfson at 1731 on 2/12/153. Portions of the distal femur appear indistinct and osteomyelitis cannot be excluded. Serial imaging may be helpful to increase sensitivity.4. Contrast extravasation, as above. |
Generate impression based on findings. | Reason: follow up study History: ACOM aneurysm s/o clipping The patient is status post right-sided craniotomy for anterior communicating artery aneurysm clip placement. The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. In addition, a ventriculostomy tube has been placed which courses to the right frontal lobe into the frontal horn of the right lateral ventricle with tip in the body of the left lateral ventricle. There is some intraventricular blood present. There is no evidence for ventriculomegaly.There is hypodensity present along the anterior aspect of the right temporal lobe as well as the gyrus rectus bilaterally and the a small portion of the medial aspect of the left frontal lobe extending to the cingulate gyrus and superior frontal gyrus. Another hypodense focus is present along the right caudate nucleus.The visualized portions of the paranasal sinuses demonstrate mucosal thickening .. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Status post ventriculostomy tube placement. The lateral ventricles are stable.2.Status-post a recent craniotomy for anterior communicating artery aneurysm clip placement.3.Hypodensities along the anterior aspect of the right temporal lobe as well as the inferomedial aspects of the frontal lobes, right caudate nucleus and the medial left frontal lobe are present. One possibility includes that this reflects ischemic insult. |
Generate impression based on findings. | Reason: 25 F s/p lap chole and abd washout History: tachycardia, diaphoresis PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal caliber.LUNGS AND PLEURA: Small areas of basilar segmental atelectasis bilaterally. Very small pleural effusions, left greater than right.Scattered benign appearing pulmonary micronodules, some calcified. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: The heart is mildly enlarged, without pericardial effusion. No visible coronary artery calcifications.Right arm PICC, tip at the cavoatrial junction. Nasogastric tube extends into the stomach.No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No evidence of pulmonary embolism.2. Bilateral basilar atelectasis.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 83 year old male. Dyspnea on exertion. PULMONARY ARTERIES: No evidence of pulmonary embolism. Main pulmonary artery diameter is 33 mm, but still smaller than the aorta.LUNGS AND PLEURA: Significant motion artifact limits evaluation. Calcified lung nodules consistent with healed granulomatous disease. Scattered noncalcified micronodules are most likely also post-inflammatory.Left basilar subsegmental atelectasis/scarring. Diffuse mild bronchial wall thickening suggestive of bronchitis or asthma.No focal airspace consolidation or pleural effusion.MEDIASTINUM AND HILA: Borderline enlarged right paratracheal lymph node, likely reactive. No other mediastinal or hilar lymphadenopathy.No visible coronary artery calcification. Mild atherosclerotic calcification of the thoracic aorta.No pericardial effusion. Mild cardiomegaly. CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified hepatic granulomata. Also had atherosclerotic disease of the abdominal aorta. | No evidence of pulmonary embolism. Motion degraded exam. Diffuse bronchial wall thickening consistent with bronchitis or asthma.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 73 years, Male. Reason: s/p NGT reposition History: s/p NGT reposition NG tube tip projects over the gastric antrum. Gas distended loops of small bowel measuring up to 5 cm with gaseous distention of large bowel. Note that the pelvis and portion of the left hemiabdomen is excluded from the field of view. | NG tube tip projects over the gastric antrum. High grade ileus versus partial small bowel obstruction. |
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. There is a focal asymmetry in the right superolateral breast. No other suspicious masses, microcalcifications, or areas of architectural distortion are present. | Right breast focal asymmetry for which further evaluation with spot compression views and possible ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Acute respiratory distress syndrome.VIEW: Chest AP (one view) 2/13/15 at 520 hours. ET tube terminates above the carina. Central line tip is in the SVC. Gastrostomy tube is noted. Cardiac silhouette size is normal. Right upper and left lower lobe opacities are likely atelectases. No effusions or pneumothorax. | Multifocal opacities as described. |
Generate impression based on findings. | Female 76 years old Reason: cholangitis History: s/p ERCP 2/10, now with abd pain, fever ABDOMEN:LUNG BASES: Small left pleural effusion and atelectasis.LIVER, BILIARY TRACT: Mild to moderate biliary dilatation with moderate dilatation of the common bile duct is again noted. Pneumobilia secondary to recent instrumentation. Subcentimeter cyst in the left lobe.SPLEEN: Mild splenomegaly.PANCREAS: Again noted small cystic lesions in the pancreas. Mild peripancreatic fat stranding around the pancreatic head and duodenum may represent focal pancreatitis.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Small retroperitoneal lymph nodes. An index left para-aortic node measures 1.3 x 0.8 cm on image number 59, series number 3.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: Borderline enlarged pelvic lymph nodes. Index left iliac node measures 1.3 by 0.9 cm on image number 80, series number 3.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | CT findings suggestive of possible focal pancreatitis involving the head of the pancreas. Mild to moderate biliary dilatation and pneumobilia.Borderline enlarged retroperitoneal and pelvic nodes of uncertain etiology and significance. |
Generate impression based on findings. | 8 year old male with bruising of tip of finger, assess for fractureVIEWS: Hand PA, right finger PA and lateral (3 views) 2/12/15 Minimal soft tissue swelling overlying the distal 5th digit. No evidence of fracture or dislocation. Alignment is normal. | Minimal soft tissue swelling adjacent to the distal 5th digit with no evidence of fracture or dislocation. |
Generate impression based on findings. | 66 years, Male, Reason: 66yo M w/ hx head neck cancer, presenting w/ diarrhea/colits, assess for degree History: as above. ABDOMEN:LUNG BASES: Left basilar mass measures 3.3 x 2.5 cm in (4/23), previously 2.7 x 2.5 cm and is suspicious for metastases. Lingular nodule measures 0.8 cm (4/3), unchanged. Additional scattered ill-defined and ground glass opacities in the right lower lobe have increased and may represent aspiration/infection. Loculated small left pleural effusion is unchanged. LIVER, BILIARY TRACT: Ill-defined hepatic hypodensity in the left hepatic lobe is stable measuring 2.6 cm (3/46), previously 2.8 cm. Right hepatic lobe lesion measures 1.3 cm (3/46), previously 1.2 cm. A more inferior right hepatic lobe lesion is more conspicuous measuring 2.1 cm (3/55), previously 1.9 cm which may be due to differences in phase of contrast administration. In addition, another right hepatic lobe lesion is less conspicuous, also likely due to differences in phase of contrast.SPLEEN: No significant abnormality notedPANCREAS: Pancreatic tail cyst is unchanged. Prominent pancreatic duct is unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal sinus cysts, left greater than right.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Gastrostomy tube.BONES, SOFT TISSUES: Multilevel osseous metastases throughout the spine are grossly unchanged. Sclerotic foci in the right femoral head and neck are unchanged. Sclerotic foci in the left acetabulum is increased from the CT dated 10/14/2013 and not visualized the more recent chest/upper abdomen CTs. Left isheal sclerotic foci is unchanged.OTHER: No significant abnormality notedPELVIS: MalePROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Bowel wall thickening and adjacent fat stranding most severe in the rectosigmoid but also involving the descending and transverse colon suggests a nonspecific colitis.BONES, SOFT TISSUES: See aboveOTHER: No significant abnormality noted | 1.Nonspecific colitis, most severe in the rectosigmoid.2.Scattered ill-defined and ground glass opacities in the right lower lobe likely represents aspiration/infection.3.Increasing pulmonary metastases.4.Hepatic metastases are likely stable accounting for differences in technique.5.Loculated left pleural effusion is stable. 6.Diffuse sclerotic osseous metastases are unchanged from recent chest and abdomen CT of 1/8/2015, however there are new pelvic metastases since the last chest, abdomen and pelvis exam of 7/12/2013. |
Generate impression based on findings. | 36 years, Female, Reason: intrabdominal inflammatory process History: abd distension. ABDOMEN:LUNG BASES: Centrilobular and paraseptal emphysematous changes with basilar reticular opacities and trace effusions. Cardiomegaly with a small pericardial effusionLIVER, BILIARY TRACT: Hepatic hypodensities too small to characterize. Hepatic granulomas.SPLEEN: Ill-defined nonspecific splenic hypodensity.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large amount of desiccated stool in the colon.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: FemaleUTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Mild bilateral inguinal lymphadenopathy including an enlarged left inguinal lymph node measuring 1.6 cm (3/99).BOWEL, MESENTERY: See above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of free fluid in the pelvis is likely physiologic. | 1.Large amount of desiccated stool in the colon. Otherwise no additional findings the patient's pain.2.Cardiomegaly with small pericardial effusion.3.Nonspecific interstitial lung disease and trace effusions. |
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 areas of architectural distortion are present. No significant change in benign morphology left breast masses which are likely intramammary lymph nodes. Small focal asymmetries elsewhere in each breast are also unchanged. Normal morphology axillary lymph nodes are present bilaterally. | 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. | Reason: Evaluate IPH History: IPH, elevated ICP's There is redemonstration of a hematoma centered in the left thalamus and extending into the left basal ganglia measuring approximately 47 by 42 mm axial dimensions and previously measuring the same. There is associated vasogenic edema and midline shift. Edema extends into the brainstem. There is associated uncal and transtentorial herniation as well as subfalcine herniation. The septum pellucidum is shifted approximately 18 mm to the right of midline and previously was one shifted approximately the same.The right lateral ventricle is enlarged. A ventriculostomy tube courses to the right frontal lobe into the right lateral ventricle with tip in the body of the right lateral ventricleThe visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. Atherosclerotic calcifications are present along the distal internal carotid arteries. | 1.Large left sided intraparenchymal hemorrhage remains stable in size. There is associated uncal and transtentorial herniation , subfalcine herniation as well as significant midline shift.2.Ventriculomegaly is present which has not changed since the prior exam. The patient is status post ventriculostomy tube placement. |
Generate impression based on findings. | 59 years, Male. Reason: ileus? History: yes Corkscrew tacks project over the pelvis. Dobbhoff tube tip projects over the fourth portion of the duodenum. Nasogastric tube tip projects over the gastric stomach. Left chest tube is noted.Air distended transverse colon measuring up to 6 cm. | Focal large bowel ileus. |
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