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Generate impression based on findings. | 45 year old female with history of benign biopsy in the left breast in 2013. Family history breast cancer in her mother at the age of 50. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A metallic clip is present at left retroareolar region. Several scattered circumscribed small masses are noted, unchanged in size or appearance. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Right groin pain. There is a heterogeneously-attenuating soft tissue mass-like lesion in the right medial upper thigh measuring 9.0 cm TV x 8.5 cm AP x 10.0 cm CC. This appears located between the pectineus and obturator externus muscles with splaying of the musculature, though an intramuscular component cannot be excluded. No definite cystic changes, calcifications, or macroscopic fat is evident in this lesion. The vasculature of the right thigh remains separate from this lesion. This lesion abuts the right pubis and ischium without osseous changes evident. This lesion does not extend to the underlying femur. There is mild soft tissue edema at the medial aspect of the proximal right thigh.Extensive vascular calcifications are noted. The visualized intra-abdominal and soft tissue structures are otherwise unremarkable. | Large heterogeneous mass in the proximal right medial thigh. The differential for this appearance is broad, including non-neoplastic and neoplastic processes. Non-neoplastic etiologies include hematoma or infection. Neoplastic etiologies should also be considered, however, the appearance of this lesion is nonspecific on noncontrast CT and further evaluation with MR is recommended. |
Generate impression based on findings. | 14-year-old male, evaluate PICC locationVIEW: Chest AP (one view) 2/12/15 17:25 Right PICC tip at the cavoatrial junction. The cardiothymic silhouette is normal. No focal pulmonary opacities or pleural effusions. No pneumothorax. | Right PICC tip at cavoatrial junction. |
Generate impression based on findings. | right side weakness and numbness NONCONTRAST CT HEADNo evidence of acute ischemic or hemorrhagic lesion on this scan.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. CTA HEAD AND NECKThere is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins are normal.There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. Right carotid bulb shows minimal irregularity indicate small atheromatous plaque with ulceration.There is normal contrast opacification through bilateral ICAs, and ACAs.Left MCA M2 (inferior division) shows about 50% of luminal narrowing and there are multiple minimal luminal irregularities on bilateral MCA branches indicating intracranial atherosclerosis. Vertebrobasilar system appears to be small in diameter with minimal luminal irregularities again represent intracranial atherosclerosis.Bilateral Pcom arteries are fetal origin and Acom artery is also patent.No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage. | No evidence of acute ischemic or hemorrhagic lesion.No evidence of extracranial and intracranial significant arterial stenosis or narrowing. No intracranial aneurysm.Mild to minimal intracranial atherosclerosis as described above. |
Generate impression based on findings. | Female 59 years old Reason: r/o diverticulitis, adhesions History: LLQ pain, hx of colon cancer ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Mild thickening of the rectum adjacent to the anastomosis, nonspecific and of uncertain etiology and significance.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No CT findings to explain patient's left lower quadrant pain. |
Generate impression based on findings. | Male 54 years old Reason: Pt with recent fall on 2/10 now with left shoulder pain and reduced mobility. Please eval for fracture. Pending d/c History: shoulder pain. There is no acute fracture or dislocation. Chronic appearing deformity of the metaphysis of the left humerus is compatible with a prior fracture. There is mild to moderate degenerative arthritic changes affect the glenohumeral and acromioclavicular joints. Axillary surgical clips are noted. | No acute fracture or dislocation. Mild to moderate osteoarthritis of the glenohumeral and acromioclavicular joints. |
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. A cluster of coarse microcalcifications in the left upper outer breast are unchanged. 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. | 53 year old with a lump in the left breast for 3 weeks. Three standard views of both breasts with two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. New oval mass with microlobulations, measuring 23 mm, is present in the posterior upper outer quadrant in the left breast. There is an additional circumscribed mass, measuring 7 mm, locating 2.5 cm inferior to the main mass. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in right breast. Focused ultrasound was performed for the left breast and left axilla. There is a microlobulated mass measuring 21 x 18 x 23 mm, at 1 o'clock position, 10 cm from nipple, in the left breast, corresponding to the mammographic findings. This is highly suggestive for malignancy. Additional hypoechoic 6 mm mass is present at 1 o'clock position, 7 cm from nipple, in the left breast, corresponding to the small mass on mammogram. This small mass is located 2.5 cm inferior to the main mass. There is an enlarged lymph node, 36 x 20 mm, with effaced hilum. | 1. Palpable mass in the left breast at 1 o'clock position; highly suggestive of malignancy by mammographic and sonographic appearance. Additional mass in the left breast at 1 o'clock position, locating 2.5 cm inferior to the main mass.2. Abnormally enlarged lymph node in the left axilla.3. No mammographic evidence of malignancy in the right breast.Recommend surgical consultation and core biopsy of the left breast mass and axillary lymph node. Results and recommendations were discussed with the patient.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | Male 59 years old Reason: S/P fall and S/P right fibular fracture; Eval for right knee patella fracture or soft tissue injury History: Left knee pain. Limited study of the left knee reveals a small suprapatellar joint effusion without radiographic evidence of an underlying fracture or dislocation. Vascular surgical clips along the medial thigh and calf are noted. | Small joint effusion without radiographic evidence of an underlying fracture or dislocation in this limited study of the left knee. |
Generate impression based on findings. | Female 44 years old Reason: polycystic kidney ds (autos dom); RUQ pain after eating. History: as above. Pls check liver, GB, and kidneys B LIVER: Liver measures 14 cm. there are numerous cysts in the liver, some of which are minimally complex.BILIARY TRACT: Gallbladder is unremarkable. No evidence of intra-or extrahepatic biliary dilatation.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted. Spleen measures 9 cm.RIGHT KIDNEY: Numerous cysts in the right kidney of various size, compatible with patient's known history of adult onset polycystic kidney disease. OTHER: No significant abnormalities noted. | Numerous cysts in the liver and the right kidney compatible with patient's known history of adult onset polycystic kidney disease |
Generate impression based on findings. | 7-year-old female with fever and increased work of breathing. Concern for pneumonia.VIEW: Chest AP (one view) 2/12/2015 22:12 Left upper extremity PICC tip has been retracted and now located in the SVC/RA junction. Right internal jugular central venous catheter is no longer seen. Gastrostomy tube partially visualized in the stomach. Left chest wall vagal nerve stimulatory device is again seen with leads in the left neck.Cardiothymic silhouette is normal. No focal pulmonary opacities. No pleural effusion or pneumothorax.Right curvature of the thoracic spine is again seen. | Left upper extremity PICC tip now located in the SVC/RA junction. Otherwise no interval change. |
Generate impression based on findings. | 86-year-old female. Increased work of breathing. Evaluate for PE versus aspiration. PULMONARY ARTERIES: Hypoattenuation in a right upper lobe segmental artery (series 10, image 100) is consistent with a pulmonary embolus, of indeterminate age.LUNGS AND PLEURA: Calcified lung nodules consistent with healed granulomatous disease.No focal airspace consolidation or pleural effusion.MEDIASTINUM AND HILA: Moderate coronary artery calcification.Cardiomegaly with ICD leads in the right atrial appendage and right ventricle. No pericardial effusion.Severe calcified atherosclerotic disease of the thoracic aorta with extensive mural thrombus. Ectatic descending thoracic aorta measures 3.9 cm at the diaphragmatic hiatus.Saccular degenerative aneurysm in the aortic arch with a large amount of thrombus has a diameter of 2.3 cm (series 10, image 86), new from prior.Severe atherosclerotic narrowing of the proximal left subclavian artery.Calcified mediastinal and hilar lymph nodes consistent with healed granulomatous disease.CHEST WALL: Mild degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Thickening of the bilateral adrenal glands. Atrophic right kidney. Severe calcified atherosclerotic disease of the abdominal aorta and its branch vessels. Calcified splenic granuloma. | 1. Right upper lobe solitary age indeterminate segmental pulmonary embolus. 2. Severe atherosclerotic disease of the thoracic aorta with an ectatic descending thoracic aorta and a saccular degenerative aneurysm in the aortic arch.PULMONARY EMBOLISM: PE: Positive.Chronicity: Indeterminate.Multiplicity: Single.Most Proximal: Segmental.RV Strain: Negative. Findings communicated to Dr. Welch at time of dictation over the phone. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast reduction surgery. 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. Global architectural changes are compatible with given history of bilateral breast reduction. Scattered, benign appearing microcalcifications are noted. 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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 20 years old Reason: eval for dislocation History: pain and deformity of left shoulder. There is no acute fracture or dislocation. The bones are unremarkable. | No acute fracture or dislocation. |
Generate impression based on findings. | 55 years, Male. Reason: conduit emptying History: no Right chest tube and central venous catheter is noted. Drain projects over the left hemiabdomen. IVC filter is noted. Previously seen right rib fracture is not imaged on the current study.Barium is noted within the large bowel and appendix. Focal narrowing in the descending colon that does not change between the two images acquired 3 minutes apart. Nonobstructive bowel gas pattern. | Nonspecific, fixed, narrowing of the mid descending colon. Clinical correlation is advised. |
Generate impression based on findings. | Male 71 years old Reason: osteomyelitis History: chronic cellulitis. A shallow soft tissue defect of the anterior thigh is seen with deeper reticulations of the soft tissue, compatible with cellulitis. No acute osseous abnormalities are identified. Specifically, there is no radiographic evidence of cortical destruction or periosteal reaction to suggest osteomyelitis. There are moderate osteoarthritic changes of the knee joint. Vascular calcifications are noted. | Cellulitis without radiographic evidence of osteomyelitis. If there is continued clinical concern for osteomyelitis, an MRI is recommended as clinically warranted. |
Generate impression based on findings. | Reason: 67yo F w/ NSCLC, concern for pleural effusion History: as above LUNGS AND PLEURA: A right lower lobe mixed density rounded lesion is increased in size compared to the prior exam, difficult to measure on noncontrast imaging, but estimated measurement is 6.1 x 5.9 cm (series 5, image 53), increased in size from the prior exam dated 10/2014. Progressive right lower lobe atelectasis/consolidation associated with bronchial narrowing due to extrinsic compression.Right basilar loculated low-density pleural fluid collection is similar in size and appearance compared to the prior exam. Nodular pleural thickening appears increased from previous exams.For reference, a right basilar pleural nodule measure 12 x 11 mm (series 5, image 59), previously measuring 9 x 7 mm on 10/2014.Previously referenced pleural-based right upper lobe nodule measures 6 mm (series 7, image 27), unchanged.Additional areas of pleural nodularity in the right lung are stable to mildly increased in size from the prior exams.The left lung remains essentially clear.MEDIASTINUM AND HILA: The heart is normal in size. Mild pericardial thickening, unchanged. Severe coronary artery calcification.Reference right supraclavicular lymph node measures up to 9 mm in short axis (series 5, image 12), unchanged.Reference prevascular lymph node measures up to 4 mm (series 5, image 31), unchanged.Additional scattered small mediastinal and hilar lymph nodes are unchanged.CHEST WALL: A prominent right axillary lymph node measures up to 9 mm (series 5, image 54), not significantly changed.Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. An approximately 2-cm subcapsular right hepatic lobe hypodensity is partially visualized, suggestive of metastatic disease. | 1. Increasing size of a right lower lobe rounded density, with additional increasing areas of nodular pleural thickening in the right lung, and persistent loculated right subpulmonic effusion. Findings suggestive of progressive pleural metastatic disease.2. Stable mild right supraclavicular and right axillary lymph node prominence.3. Partially visualized right hepatic lobe hypodensity was not visible on prior imaging, suggestive of metastatic disease. Dedicated abdominal CT can be done for further evaluation if clinically warranted.Findings discussed with Dr. Hoffman at 9:50 AM. |
Generate impression based on findings. | 12 year old female with epigastric and right lower quadrant pain. Evaluate for appendicitis. LIVER: Normal echogenicity with no intra or extrahepatic biliary ductal dilatation. GALLBLADDER, BILIARY TRACT: The visualized gallbladder appears normal in echogenicity.PANCREAS: No significant abnormality noted.SPLEEN: Normal echogenicity measuring up to 11.1 cm in length.KIDNEYS: Visualized kidneys are normal in echogenicity with no evidence of hydronephrosis.ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Visualized structure in the right lower quadrant measures up to 5-6 mm in diameter may represent an appendix, however it is unclear whether this is truly the appendix and therefore study is inconclusive to rule out appendicitis. There is a small amount of free fluid in the lower abdomen. Scattered mildly prominent mesenteric lymph nodes in the periumbilical region. | The appendix is not definitively visualized and study is inconclusive for ruling out appendicitis. There is small amount of free fluid in the lower abdomen. Scattered mildly prominent lymph nodes in the periumbilical region.Findings were discussed with ED physician Dr. Christine Babcock by phone on 2/13/2015 at 10:20 AM. |
Generate impression based on findings. | Female 74 years old Reason: fx, dislocation History: knee pain s/p fall. There is no acute fracture or dislocation. There are small tricompartmental osteophytes and near bone on bone apposition in the patellofemoral compartment. The distribution of the osteoarthritis is suggestive of CPPD arthropathy.A well corticated ossicle is superimposed on the tibial spine. It is unclear if this is a loose body within the joint; serial imaging will help to differentiate this. | 1.No evidence of acute fracture or dislocation.2.Severe osteoarthritis in a pattern suggestive of CPPD arthropathy, please correlate clinically.3.Superimposed ossicle in the tibial spine may reflect a loose body within the joint. Serial imaging will help to differentiate this. |
Generate impression based on findings. | Altered mental status No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. Global parenchymal volume loss is commensurate with patient's advanced age. No extra-axial collections. There is moderate degree of hypoattenuation in the periventricular and subcortical white matter which is nonspecific but most likely represents chronic small vessel ischemic changes.The visualized portions of the paranasal sinuses are clear. There is near complete opacification of the right mastoid are cells similar to small prior. There is cerumen in the right external auditory canal. There is a 14-mm lytic lesion involving the left greater sphenoid wing remains unchanged since 11/17/2013. | 1. No evidence of acute intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2. 14-mm lytic lesion involving the left greater sphenoid wing differential which includes benign and neoplastic etiologies. Lesion is unchanged since 11/17/2013 and further evaluation with MRI can be considered as clinically warranted. |
Generate impression based on findings. | Reason: new pontine stroke History: as above Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. The left common carotid artery originates from the innominate artery.The left vertebral artery is small. There are atherosclerotic calcifications present at the origin of the right to vertebral artery associated with high grade stenosisAtherosclerotic calcifications are present at the carotid bifurcations left more than right.There are multi-level degenerative changes in the cervical spine.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The right A1 segment is hypoplastic. The right posterior communicating artery is small. The left posterior communicating artery is barely perceptibleThere is extracranial origin of the left posterior inferior cerebellar artery. The left vertebral artery is hypoplastic distally.There is approximately 60% stenosis at the left posterior cerebral artery P2 segment.There is 50% stenosis at the left M1 segment just proximal to the bifurcation..There is mild narrowing at the proximal left middle cerebral artery superior division there is mild focal dilation of the proximal portion of the inferior division of the right middle cerebral arteryCT head:A hypodense focus is present in the left pons which was also present on the prior exam.The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present.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 demonstrate mucosal thickening. 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.Subacute infarction involving the left pons. There is no evidence for hemorrhagic conversion.2.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. 3.There are atherosclerotic calcifications present at the origin of the right to vertebral artery associated with high grade stenosis. Please note that the distal left vertebral artery is hypoplastic.4.There is a 60% stenosis at the proximal left P2 segment of the posterior cerebral artery.5.There is 50% stenosis at the left M1 segment just proximal to the bifurcation. |
Generate impression based on findings. | 12-week-old female, evaluate subclavian lineVIEW: Chest AP (one view) 2/12/15 20:05 Interval placement of right subclavian line with tip in the right atrium. ETT tip at thoracic inlet. Enteric tube and side port in the proximal stomach. The cardiothymic silhouette is normal.Bilateral pulmonary opacities and left pleural effusion with slight interval improvement in right upper lobe atelectasis. No pneumothorax. | New right subclavian line tip in the right atrium. Persistent left pleural effusion. |
Generate impression based on findings. | 5 year old male with bruise. Rule out fracture. VIEWS: Forearm AP and Lateral (2 views) 2/13/2015 No evidence of joint effusion. No fracture or dislocation. | Normal examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. 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 can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Female 74 years old Reason: fracture, dislocation History: fall, shoulder pain. There is no acute fracture or dislocation. There are mild to moderate osteoarthritic changes affecting the glenohumeral and the acromioclavicular joints. | No acute fracture or dislocation. Mild to moderate osteoarthritis as described above. |
Generate impression based on findings. | 38-day-old female with scalp hematoma status post blunt head trauma.VIEWS: C-spine AP and lateral (two views) 2/13/2015 Vertebral body and disk space are maintained. No prevertebral soft tissue swelling. No evidence of fracture or dislocation. | Normal examination. |
Generate impression based on findings. | 12-day-old male status-post CDH repair, evaluate ETT and lungsVIEW: Chest AP (one view) 2/13/15 6:40 or ETT above the carina, below the thoracic inlet. Epidural catheter tip position slightly retracted. Enteric tube tip in the stomach. Right peripherally inserted catheter coiled in the axillary vessels. Soft tissue swelling overlies the right chest wall.The cardiothymic silhouette is unchanged. Increased right pleural effusion. Right basilar opacity not significantly changed. | ETT tip in appropriate location. Increased right pleural effusion. |
Generate impression based on findings. | Female 80 years old Reason: pain History: pain. There is diffuse demineralization of the bones. There are small osteophytes affecting the bones of the midfoot and hindfoot as well as ankle joint. There is a questionable small effusion anteriorly, however there is no underlying fracture or dislocation. | Mild to moderate degenerative changes of the ankle joint without evidence of fracture or dislocation. |
Generate impression based on findings. | Leukocytosis. Sacral decubitus ulcer. The bones are diffusely demineralized. There is no definite erosion to suggest osteomyelitis.Moderate degenerative changes affect the lumbar spine. The vertebral body heights and intervertebral disk spaces are maintained. The alignment is anatomic. No fracture is evident.Atherosclerotic ossification of the abdominal aorta and common iliac arteries is noted. | No radiographic evidence of osteomyelitis. If clinical suspicion for osteomyelitis remains high, cross sectional imaging with CT or MRI is recommended. |
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. There is a possible architectural distortion seen best on the MLO tomosynthesis (43/69) of the left upper breast. Degenerating fibroadenoma with calcification is seen in the right superomedial breast. | Possible architectural distortion in the left upper breast. Further evaluation with spot compression and possible ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Male 56 years old Reason: low back pain History: low back pain. There is there is an anterior wedge deformity of the T12 vertebral body with mild loss of intervertebral disk space. There is no acute fracture or malalignment. There are moderate degenerative arthritic changes including anterior vertebral body osteophytes and facet arthropathy. There is preservation of the remaining lumbar spine vertebral body heights and lumbar spine alignment. Note is made of vascular calcifications of the abdominal aorta and bilateral iliac arteries. | Moderate degenerative changes of the lumbar spine as described above. |
Generate impression based on findings. | Newly diagnosed leukemia. There is moderate opacification of the ethmoid sinuses diffusely. There is mild mucosal thickening in the bilateral frontoethmoid recesses and inferior frontal sinuses. There is mild mucosal thickeing in portions of the sphenoid sinuses as well. The maxillary sinuses are essentially clear. The nasal cavity is also clear. The nasal septum is slightly deviated towards the right. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, and orbits appear to be unremarkable. There appears to be a partially-empty sella. | Scattered paranasal sinus opacification in an sporadic pattern. |
Generate impression based on findings. | Assault/battery Brain: No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift, or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus.Calvarium is intact. There is subgaleal hematoma in the left frontotemporal scalp.Maxillofacial:There are no fractures identified involving the maxillofacial bones. Bilateral nasal bones, orbits, paranasal sinuses, and zygomatic arches remain intact. Mandible including the temporomandibular joints are intact. Pterygoid plates are intact.Trace mucosal thickening in the left maxillary sinus. Cervical:There is no evidence of acute fracture or subluxation within the cervical spine. There is straightening of the cervical curvature, which may be positional. Alignment is otherwise maintained. Vertebral body heights are maintained. There is no significant spinal canal or neural foraminal stenosis. Paraspinous soft tissues are unremarkable.There is mild nonspecific prominence of the neck lymph nodes which may be reactive. There is a 19 x 19 mm ovoid soft tissue left submandibular lesion with attenuation measuring approximately 50 Hounsfield units and likely represents a hematoma. There are overlying inflammatory changes. | 1. No evidence of acute intracranial hemorrhage or mass effect. Left frontotemporal sugaleal hematoma. No calvarial fracture.2. No maxillofacial fracture. Mild diffuse prominence of the neck lymph nodes throughout is nonspecific and may be reactive. Ovoid, approximately 2 cm lesion in the left submandibular soft tissues likely represents a hematoma. 3. No fracture or subluxation in the cervical spine. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts with a repeat right MLO view 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: eval for infection and for IPF History: sob CHEST:LUNGS AND PLEURA: Small pleural effusions with overlying consolidation.Air collections in the the left lower lobe are suggestive of cavitation.No evidence of interstitial lung disease, although the basilar compression atelectasis would obscure this.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.A moderate pericardial effusion is present.There are no coronary calcifications visible.Right jugular catheter, tip in SVC.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of IV and 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: Calcification in the right side of the pelvis could be a calcified node from prior granulomatous disease.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Left lower lobe consolidation with collections of air consistent with a lung abscess, which could be the result of aspiration. Bilateral pleural effusions are present. |
Generate impression based on findings. | Female 69 years old Reason: new pain without injury in region of left posterior ribs(approx. ribs 5-7) near the midline .Known myeloma. History: see1 There is no acute fracture or dislocation. No lytic appearing lesion is seen in the posterior left sixth rib, which is not seen on the prior exam and is suspicious for myelomatous depositions. An old healed fracture is seen in the posterolateral aspect of the left seventh rib. The visualized vertebral body heights are preserved. | Lytic appearing lesion in the posterior left sixth rib suspicious for myelomatous deposition. |
Generate impression based on findings. | Female 38 years old Reason: s/p islet cell transplant 2/12/15. Please evaluate portal vein patency tomorrow, 2/13/15 History: As above LIVER: Mild hepatomegaly 23 cm in length. No evidence of perihepatic or subcapsular fluid. Marked coarse echogenicity with no discrete focal lesions.Flow in the portal vein is pulsatile hepatopedal flow with a peak velocity of .4 m/sec, right portal vein and left portal vein .2 m/sec respectively.GALLBLADDER, BILIARY TRACT: No intrahepatic or extra hepatic biliary dilatation. Common hepatic duct .2 cm in diameter.Although the patient was n.p.o. since 10 p.m., gallbladder is not distended and this probably accounts for the slightly thickened gallbladder wall. No evidence of gallstones. No tenderness to compression.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: 11.1 cm in length. No hydronephrosis or hydroureter.OTHER: Left kidney 10.8 cm in length. Morphologically normal.Spleen 10.2 cm in length.No evidence of ascites. | Coarse hepatic texture. No evidence of perihepatic fluid. Patent hepatic vasculature with prominent portal venous flow. |
Generate impression based on findings. | Rheumatoid arthritis in flair. Synovitis. RIGHT HAND: Findings compatible with severe rheumatoid arthritis at the PIP joints and MCP joints, particularly of the 2nd and 3rd digits, with ankylosis of the carpal bones are minimally progressed compared to prior. Superimposed degenerative changes are noted. LEFT HAND: Findings compatible with severe rheumatoid arthritis at the PIP joints and MCP joints, particularly of the 2nd and 3rd digits, with ankylosis of the carpal bones are minimally progressed compared to prior. Superimposed degenerative changes are noted. PELVIS: The upper pelvis is obscured by bowel gas and stool, limiting evaluation. Mild osteoarthritis affects the hip joints. Moderate degenerative changes are present in the lower lumbar spine, which is partially imaged. No erosions are evident. RIGHT KNEE: There is bone on bone apposition of the medial tibiofemoral compartment with mild varus deformity of the knee indicating severe osteoarthritis. No erosions are evident.LEFT KNEE: There is marked tricompartmental osteoarthritis with mild varus deformity of the knee indicating moderate osteoarthritis. No erosions are evident.RIGHT FOOT: The bones are demineralized. There are chronic appearing erosions in the first and fifth metatarsal heads and joint space narrowing of the intertarsal joints compatible with rheumatoid arthritis. Scattered degenerative changes are also noted.LEFT FOOT: The bones are demineralized. There are chronic appearing erosions in the first and fifth metatarsal heads and joint space narrowing of the intertarsal joints compatible with rheumatoid arthritis. Scattered degenerative changes are also noted. | Findings compatible with rheumatoid arthritis, minimally progressed. Additional arthritic changes as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. An area focal asymmetry is present in the left upper central breast. Benign intramammary lymph node in the left outer breast also noted. Normal-sized lymph nodes project in each axilla. A few scattered benign calcifications are present. No suspicious microcalcifications or areas of architectural distortion are present. | Left breast focal asymmetry for which comparison to prior exams is necessary.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OC - OLD FILM FOR COMPARISON |
Generate impression based on findings. | 74 year old female with right mastectomy in 2007, followed by 5 years of aromatase inhibitor. Family history of breast carcinoma in her sister and paternal aunt. No current breast complaints. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. The asymmetry in the medial breast is unchanged. The benign calcifications appear stable. No dominant mass, suspicious microcalcifications or areas of architectural distortion are seen in the left breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, left unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. A stable focal asymmetry with associated calcifications is seen in the right supero-medial breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Reason: stroke mechanism History: stroke mechanism Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.There are multilevel degenerative changes present in the cervical spine with a disk protrusion at C3-4 and C5-6. There are uncovertebral osteophytes at C5-6 associated with encroachment on exiting nerve roots. There is some degree of spinal stenosis present at C5-6.Atherosclerotic calcifications are present at the carotid bifurcations.There are periapical lucencies and dental caries along the patient's remaining dentitionBrain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The anterior communicating artery and the posterior communicating arteries are identified and are intact.There is extracranial origin of the left posterior meningeal artery which has a tortuous origin. In the left vertebral artery is larger than the right vertebral artery intracraniallyThe proximal right common card artery is partially obscured by beam hardening artifact from contrast within the right subclavian veinCT head:There is a hypodense focus present along the posterior limb of the right internal capsule.Periventricular and subcortical white matter hypodensities of a mild degree are present.The CSF spaces are appropriate for the patient's stated age with no midline shift. The visualized portions of the paranasal sinuses demonstrate small mucus retention cysts in the right maxillary sinus. The visualized portions of the mastoid air cells are partially opacified. The visualized portions of the orbits are intact.There is cerumen within the left external auditory canal . | 1.Lacunar infarct involving the posterior limb of the right internal capsule2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 3.There is no significant cervicocerebral occlusive disease appreciated.4.No evidence for aneurysm.5.Degenerative changes are present in the cervical spine worst at C5-6 where there is some mild spinal stenosis suspected. |
Generate impression based on findings. | 53 years, Female, Reason: evaluate for dissection History: cool RLE with inablilty to move.. Please note that arterial phase of CTA was not obtained as the patient moved during injection. Delayed phase images were subsequently obtained, however arterial evaluation is limited.CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. No suspicious nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion.CHEST WALL: Suture anchors from bilateral rotator cuff repairs.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No aneurysmal dilatation of the aorta. No obvious filling defects within the aorta, iliac or femoral arteries given the limitations of this delayed phase of examination. No dissection.BOWEL, MESENTERY: Small umbilical hernia containing a loop of bowel. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: UTERUS, ADNEXA: Fibroid uterus. Small amount of free fluid in the pelvis is likely physiologic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Limited CTA is patient moved during arterial phase of contrast administration. Limited arterial evaluation on delayed phase images show no aneurysmal dilatation, dissection or obvious filling defects within the aorta, iliac or femoral arteries. |
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. Stable benign morphology mass with biopsy clip in the right upper central breast. Left upper outer quadrant area focal asymmetry is unchanged. Normal-sized lymph nodes in each axilla are stable. A few scattered benign calcifications are present. | 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. | Male 18 years old Reason: eval fx History: same. Two intramedullary vertical orthopedic screws are seen affixing the patella in anatomic alignment. The fracture line appears somewhat indistinct with bony bridging, compatible with partial interval healing. There is no acute fracture or dislocation. No joint effusion. | Orthopedic hardware affixing healing patellar fracture. If prior images are available, this could increase the sensitivity of the study. |
Generate impression based on findings. | Reason: PE? History: SOB PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is upper normal in diameter.LUNGS AND PLEURA: Right greater than left small pleural effusions, increased from the prior exam, with associated mild compressive atelectasis. Diffuse interlobular septal thickening and mild central bronchial thickening, suggestive of pulmonary edema, improved from the prior exam.Bibasilar subsegmental linear atelectasis/scarring. No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: The heart is mildly enlarged without pericardial effusion. Mild coronary artery calcification.Aberrant right subclavian artery, a normal variant.No mediastinal or hilar lymphadenopathy.CHEST WALL: Diffuse lytic lesions throughout the visualized skeleton, compatible with a known history of multiple myeloma.Multiple thoracic vertebral body compression deformities appear similar to the prior exam.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No evidence of pulmonary embolism.2. Cardiomegaly with mildly decreased pulmonary edema, and increased small pleural effusions. Findings compatible with CHF.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 97 years old Reason: r/o acute process History: abd pain Without the administration of oral or intravenous contrast, there is decreased sensitivity for the detection of bowel, solid organ and vascular pathology. Given these limitations, the following observations were made:ABDOMEN: LUNG BASES: Bibasilar atelectasis/scarring. Dense atherosclerotic calcifications of the thoracic aorta and moderate coronary artery calcifications.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Dense atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Above average stool burden.BONES, SOFT TISSUES: Moderate degenerative changes of the thoracic spine. Osteopenia is present.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diffuse colonic and sigmoid diverticulosis is redemonstrated. Small amount of chronic free fluid in the left lower quadrant adjacent to the sigmoid colon, similar to previous study (series 3, image 104). No evidence of pneumoperitoneum or abscess.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Diverticulosis with nonspecific chronic small fluid collection in the left lower quadrant. Correlate clinically for left lower quadrant pain. 2.No evidence of acute abdominal pathology to account for diffuse abdominal pain. |
Generate impression based on findings. | Male 19 years old Reason: pain History: pain. There is an orthopedic screw affixing the fifth metatarsal bone in persistent unchanged anatomic alignment. The fracture line is less distinct with some bony bridging consistent of interval healing. No new fracture or dislocation is identified. | Healing 5th metatarsal fracture with repair.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: SOB, h/o PE History: above PULMONARY ARTERIES: Technically adequate examination with no sign of pulmonary embolism.Pulmonary artery diameter at upper limits of normal.LUNGS AND PLEURA: Small lung volumes with basilar subsegmental atelectasis.Patchy ground glass and interstitial opacity with bronchial thickening in the right upper lobe, of uncertain chronicity, possibly secondary to previous infection.No pleural effusions.MEDIASTINUM AND HILA: Calcified right hilar and subcarinal lymph nodes compatible with previous infection.Moderate coronary artery calcification.No pericardial effusion.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 sign of pulmonary embolism.2. Basilar atelectasis and focal interstitial opacity in the right upper lobe of uncertain chronicity, most likely post infectious.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Ms. Spielman is a 58-year-old female with biopsy proven complex sclerosing lesion in the right superior breast. She presents today for ultrasound guided wire localization of this area prior to excisional biopsy by Dr. Chhablani. On review of the prior studies, an area of architectural distortion is again identified in the right superior breast. There are two percutaneously placed biopsy clips in this area, including a Hydromark clip and a ribbon clip. This will be the target for today's ultrasound guided wire localization. Target architectural distortion morphology is located in the right breast in the superior region located posteriorly at 12 o’clock. The procedure, risks including bleeding, mistargeting and infection, and benefits of needle-wire localization were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed to confirm patient identity and site of procedure. The right breast was cleansed with chlorhexidine. Local anesthesia was obtained using 2% Lidocaine. Using aseptic technique and continuous ultrasound guidance, a 7-cm Kopans needle was placed through the lesion, adjacent to the Hydromark clip as visualized by ultrasound. The positioning of the needle was confirmed after adjusting tip depth so the needle tip was approximately 2cm deep to the center of the target. A spring wire was then deployed. Two view orthogonal mammograms reveal the spring wire to be in excellent position, between the Hydromark clip and ribbon clip. The mammogram was annotated and reviewed with Dr. Chhablani prior to the patient's procedure. Patient tolerated the procedure well and was sent to the holding area in stable condition. Dr. Sheth performed the procedure under direct supervision of Dr. Abe, who was present during the procedure at all times.Orthogonal digital specimen radiographs revealed the distortion, three clips and spring wire to be within the specimen. | Successful needle localization of the right breast distortion.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
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. An asymmetry is seen on the CC view in the right medial breast, at approximately 3.5 cm depth. No other suspicious masses, microcalcifications or areas of architectural distortion are present. | Asymmetry in the right medial breast. 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. | CVA There is moderate amount of subarachnoid hemorrhage involving the posterior fossa including the prepontine and. perimedullary cistern as well as the cisterna magna. Subarachnoid hemorrhage extends superiorly to the level of the interpeduncular cistern. Hemorrhage extends into the cervical spinal canal. There is mild mass effect on the brainstem related to the hemorrhage.There is hypoattenuation with volume loss involving the bilateral anterior frontal as well as superficial aspects of the left lateral frontal, temporal, and parietal lobes. There is additional small area of hypoattenuation in the subcortical right frontal white matter. There is ex vacuo dilatation of the left lateral ventricle. There is also mild diffuse enlargement of the ventricular system consistent with mild hydrocephalus.No intracranial mass. No midline shift or uncal herniation. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | 1. Moderate degree of subarachnoid hemorrhage centered within the posterior fossa and extending into the cervical canal. There is mild mass effect on the brainstem related to the hemorrhage.2. Hypodensity favored to represent chronic infarcts involving the bilateral anterior frontal as well as laterally involving the superficial aspect of the left frontotemporoparietal lobes.3. There is mild hydrocephalus with some component of the enlarged left lateral ventricle representing ex vacuo dilatation.Dr. Ali discussed findings with Dr. Cheema at 915 hrs on 2/13/2015 |
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. Bilateral benign morphology calcifications and areas of focal asymmetry are stable. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her sister diagnosed at age 42. 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. A few left breast benign calcifications are noted. Low left axillary lymph node is of normal size and unchanged. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts with an additional right MLO view 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. | 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 can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | History of cervical cancer, evaluate for progression of disease. CHEST:LUNGS AND PLEURA: Scattered calcified and noncalcified pulmonary micronodules, likely representing prior granulomatous infection, unchanged. MEDIASTINUM AND HILA: Right-sided central venous catheter with tip in the right atrium. Multiple calcified lymph nodes at right hilum and subcarinal regions. Nonspecific small right subcarinal lymph node measures 7 mm in short axis (series 4, image 31), not seen on prior exam. CHEST WALL: Previously hypermetabolic left axillary lymph node (series 4, image 20) measures 6 mm in the short axis, 8 mm previously.ABDOMEN:LIVER, BILIARY TRACT: Ill-defined low attenuation lesion within segment 7 (series 4, image 82) measures 0.8 x 0.9 cm, was not well visualized on the prior exam, and is non-specific. Cholelithiasis without CT evidence of cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Previously identified mesenteric lymph node (series 4, image 128) measures 2.3 x 1.2 cm, unchanged. Lymph node was not hypermetabolic on prior PET/CT and remains of uncertain clinical significance. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Large cervical mass (series 4, image 186) adjacent to bladder measures approximately 6.6 x 5.0 cm, previously 6.4 x 5.4, similar to prior. Pelvic surgical clips noted.BLADDER: No significant abnormality noted.LYMPH NODES: Scattered subcentimeter pelvic and inguinal lymph nodes noted, not significantly changed. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the lower lumbar spine.OTHER: No significant abnormality noted. | 1.Large cervical mass compatible with patient's known cancer, similar to prior. 2.Previously described mesenteric lymph node, left axillary lymph node, and scattered small pelvic lymph nodes are stable.3.New subcentimeter mediastinal lymph node and subcentimeter low-attenuation hepatic lesion are nonspecific but should be followed on subsequent examinations.4.Cholelithiasis. |
Generate impression based on findings. | Hodgkin lymphoma status post 6 cycles of ABVD. RADIOPHARMACEUTICAL: 11.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 85 mg/dL. Today's CT portion grossly demonstrates opacification of the left frontal sinus suggestive of sinusitis as well as a right maxillary sinus retention cyst/polyp. Today's PET examination demonstrates complete resolution of hypermetabolic tumor activity previously seen in the neck and chest. No suspicious FDG avid lesion is identified to indicate tumor activity currently in the neck, chest, abdomen, or pelvis. A small focus of curvilinear uptake within the left pelvis correlates with benign physiologic activity within the left ureter. | Complete metabolic response to therapy without FDG avid tumor currently. |
Generate impression based on findings. | Male 65 years old Reason: AKI on CKD, poor response to diuresis, unknown etiology of CKD History: tachypnea. Unable to place patient decubitus position, incubated.RIGHT KIDNEY: 11 .5 cm in length. Increased echogenicity consistent with medical renal disease. Extrarenal pelvis. No hydronephrosis. Small cyst, unchanged. Limited color Doppler shows blood flow to the kidney.LEFT KIDNEY: 9 cm in length. Prominent echogenicity consistent medical renal disease.URINARY BLADDER: Collapsed with Foley catheter in place.OTHER: No significant abnormalities noted. | Echogenic kidneys consistent with medical renal disease. No hydronephrosis. |
Generate impression based on findings. | Male 11 years old Reason: eval fracture alignment History: wrist injuryVIEWS: Right wrist AP, lateral and oblique 2/13/50 (3 views) Interval cast removal. Healing fracture of the distal metadiaphysis of the right radius with periosteal reaction and callus formation is noted. Mild dorsal angulation is unchanged. | Healing fracture unchanged in alignment after cast removal. |
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. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 28 years old Reason: appy History: RLQ abd pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Above average stool burden. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No evidence of acute appendicitis. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of acute appendicitis. No acute pathology to account for patient's right lower quadrant pain. |
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. 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. | Asymptomatic female presents for routine screening mammography. History of two left breast benign biopsies. Two standard digital views 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. Bilateral benign calcifications and areas of focal asymmetry are stable. Normal-sized lymph nodes in each axilla are also 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: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. She reports yellow-colored right breast nipple discharge, which was also reported on prior mammograms. Personal history of benign right breast biopsy in 2009. Two standard digital views with additional right CC view 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. Biopsy marker clip identified in the right retroareolar breast. Scattered benign calcifications are present bilaterally. Stable benign accessory breast tissue projects over the axillae. Stable focal asymmetry in the right upper outer breast, unchanged for many years. 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: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in paternal grandmother. 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. Asymmetry identified in the right lateral breast (best seen on the tomosynthesis CC view.). No suspicious microcalcifications or areas of architectural distortion are present. | Asymmetry in the right lateral breast best seen on tomosynthesis. Attempts to obtain patient's prior mammogram should be made in order to confirm stability of this finding.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OC - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Persistent vomiting. 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 are secretions within the right sphenoid sinus. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | 1. No evidence of acute intracranial hemorrhage, mass, or ventriculomegaly.2. Secretions within the right sphenoid sinus may represent sinusitis. |
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. There is an intramammary lymph node in the left upper breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, 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. Previous benign left breast biopsy. History of right breast cysts. Two standard digital views of both breasts with repeat right CC view 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 mass in the left breast at posterior depth. Involution of right retroareolar cysts since 2011. Bilateral benign calcifications and retroareolar focal asymmetries 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. | Total hip replacement Bilateral total hip arthroplasty devices are situated in near-anatomic alignment. Surgical drain and soft tissue gas at the right hip reflect recent surgery. The right hip total arthroplasty device is without radiographic evidence of hardware complication. Poorly defined lucency in the adjacent acetabulum is unchanged.Lucency is again noted in the superior aspect of the left acetabulum, possibly representing a large pre-existing cyst or particle wear osteolysis. | Total hip arthroplasty devices, as above. |
Generate impression based on findings. | Female 32 years old Reason: assess alignment to r/o stress fracture History: LBP. There is no acute fracture or malalignment. The lumber spine vertebral body heights and intravertebral disk spaces are preserved. There is no evidence of instability. | No acute fracture or malalignment. No evidence of instability. |
Generate impression based on findings. | Female 35 years old Reason: eval gall bladder / biliary tree for pathology History: abdominal pain, nausea, diarrhea after PO intake. Limited by body habitus.LIVER: 19.1 cm in length. Diffusely echogenic consistent with fatty infiltration. No focal lesions.Flow in the portal vein is hepatopedal with a peak velocity of .2 m/secGALLBLADDER, BILIARY TRACT: Multiple gallstones. No evidence of tenderness to compression, wall thickening or pericholecystic fluid. No intra-or extrahepatic biliary dilatation. Common hepatic duct measures .3 cm in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Morphologically normal 10.6 cm in length.OTHER: Left kidney morphologically normal 10.7 cm in length.Spleen 11.9 cm length. Small accessory spleen noted. | Cholelithiasis no evidence of cholecystitis or biliary dilatation. Echogenic liver consistent with diffuse fatty infiltration. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional bilateral MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. 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. | Chronic lymphoid leukemia follow up. There has been slight interval increase in size of a few cervical and upper mediastinal lymph nodes, although these remain not significantly enlarged based on size criteria. The Waldeyer ring structures are not enlarged. There is an unchanged subcentimeter nodule with a punctate calcification in the left thyroid lobe. The salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unchanged, including nonunion of posterior C1 arch and torus mandibularis. The airways are patent. The imaged intracranial structures are unremarkable. There is a stable punctate calcification of the left lung apex. There is interval resolution of the air-fluid level in the left maxillary sinus and scattered paranasal sinus mucosal thickening. There is decreased opacification of the mastoid air cells. | Slight interval increase in size of a few cervical and upper mediastinal lymph nodes, which is nonspecific. |
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. Benign intramammary lymph node identified in the left upper outer breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views, repeat right CC view, 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. Benign circumscribed masses and parenchymal asymmetries are stable in the right breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with repeat right CC view 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. Stable benign intramammary lymph node in the right upper outer breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. 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 almost entirely fatty. 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. Family history of breast cancer in maternal cousin. 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. 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: R/O ICH or fracture History: Pediatric Trauma There is redemonstration of a 12 x 37 mm axial dimension extra-axial CSF density lesion adjacent to the right flow associated with the lobe of adjacent bone remodeling. This was also present on the prior exam and is unchanged.There is soft tissue thickening present along the left temporal and frontal scalp tissues. There is no associated intracranial coup or contrecoup injury identified.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 demonstrate mucosal thickening and partial opacification. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.A cystic lesion adjacent to the right frontal lobe most likely represents arachnoid cyst and is stablesoft tissue swelling along the left scalp is present which most like represents a subgaleal hematoma |
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. There is a stable asymmetry in the right outer breast which may represent a normal-sized intramammary lymph node. 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. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her mother and two maternal cousins. Two standard digital views 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. An area of asymmetry on the left MLO view centrally is not changed back to 2009. | 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. | Newly diagnosed leukemia. LUNGS AND PLEURA: Calcified granulomas consistent with granulomatous disease.No focal airspace consolidation or pleural effusion.Mild dependent atelectasis.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion.Severe coronary artery calcification.CHEST WALL: Minimal degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Calcified atherosclerotic disease of the aorta and splenic artery. | No evidence of infection. Severe coronary artery calcification. No other significant abnormality. |
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 heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Benign intramammary lymph nodes in the right superior breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female 72 years old Reason: r/o cholecystitis History: abd pain, elevated LFT, fevers Limited by bandages. Left upper quadrant cannot be visualized.LIVER: 19.7 cm in length. Slight coarse echotexture. No focal lesions. Flow in the portal vein is hepatopedal, peak velocity .4 m/secGALLBLADDER, BILIARY TRACT: Extensive cholelithiasis. No evidence of gallbladder wall thickening or pericholecystic fluid. No intra-tic or extrahepatic biliary dilatation evident.PANCREAS: Poorly visualized.RIGHT KIDNEY: 9.8 cm in length. Large lower pole cyst measuring about 3.9 x 3.3 cm. No hydronephrosis.OTHER: Left upper quadrant obscured by bandages. Left kidney and spleen could not be visualized. | Limited exam. Cholelithiasis without biliary dilatation. |
Generate impression based on findings. | 2-year-old male, evaluate for interval healingVIEWS: Left forearm, AP and lateral (two views) 2/13/15 9:32 An external fixation device affixing the proximal radius and ulna and distal forearm and metacarpals is unchanged in alignment without evidence of new hardware complication. Interposed bone graft with osseous bridging between the proximal and distal aspects of the radius and ulna is again visualized without significant interval change. | External fixation of radial or ulnar osteotomies appearing similar to the prior exam. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with a repeat left MLO view 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. Normal lymph nodes project in each axilla. Right upper outer breast intramammary lymph nodes are normal-sized and 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. | Female 68 years old Reason: right shoulder s/p removal of arthroplasty components and placement of prostalac. History: above. There has been interval removal of total shoulder arthroplasty device and placement of methacrylate. The joint appears to be in near-anatomic alignment. There is a new oblique fracture of the remaining humeral tuberosity/neck with medial displacement of the distal fracture fragment. Superficial skin staples are noted. An orphaned fractured screw from prior shoulder arthroplasty device is seen near the acromioclavicular joint. | 1.Interval removal of total shoulder arthroplasty device and placement of methacrylate with shoulder joint in near anatomic alignment. 2.New fracture of the humeral tuberosity as described above. |
Generate impression based on findings. | Ms. Garnett is a 56 year old female with a prior history of fat necrosis/oil cyst formation that had resolved by July 2013 by ultrasound. Family history of breast cancer in mother (diagnosed at the age of 80) and sister (diagnosed at the age of 60). No current breast related complaints. Three standard views of both breasts with additional bilateral MLO and CC views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign coarse calcifications are present bilaterally. There has been an interval resolution of previously identified area of fat necrosis in the left breast. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Restaging of NSCLC. Exam is significantly degraded by motion artifact.LUNGS AND PLEURA: Moderate right pleural effusion, increased from prior, with adjacent atelectasis obscuring the previously seen subpleural right lower lobe nodule.New small left pleural effusion. Bilateral pulmonary nodules consistent with metastases. Left lower lobe nonreference 10 mm nodule (series 7, image 66), previously was a micronodule.Reference left upper lobe nodule is 9-mm (series 7, image 14), 8 mm. Reference left upper lobe nodule is 9 mm (series 7, image 31), unchanged.Paramediastinal architectural distortion and bronchiectasis consistent with radiation reaction and scarring.Endoluminal debris in the right mainstem bronchus and bronchus intermedius.MEDIASTINUM AND HILA: Large anterior mediastinal mass extending across midline and involving the chest wall measures 7.2 x 10 cm, previously 6.3 x 9.9 cm (series 5, image 24), not significantly changed.The mass is again seen to encase and obstruct the right brachiocephalic vein and SVC with extensive collateral venous flow in the chest wall. Reference subcarinal lymph node is 16 mm in short axis (series 5, image 38), previously 18 mm.Mild coronary artery calcification. CHEST WALL: Mixed sclerotic and lucent appearance of the sternum and manubrium and erosion of the right clavicle and bilateral anterior first and right second ribs, unchanged. This may represent metastatic disease and/or radiation osteonecrosis.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Refer to separately dictated same day CT abdomen/pelvis report.. | 1. Moderate right pleural effusion, increased from prior, and new small left pleural effusion. 2. Significantly increased size of a left lower lobe nonreference nodule, most likely a metastasis. Other reference nodules and anterior mediastinal mass are not significantly changed (except for a right lower lobe nodule, which couldn't be assessed due to obscuration by the pleural effusion). |
Generate impression based on findings. | Female 6 years old Reason: eval distal radius fracture VIEWS: Right forearm AP and lateral 2/13/15 at 944 hours. (Two views) Healing distal metaphyseal fracture of the right radius is in anatomic alignment. Cast material obscures fine bone details. | Healing fracture unchanged in alignment after casting. |
Generate impression based on findings. | 38 day old female with history of trauma. There is no evidence of acute intracranial hemorrhage. The gray-white differentiation is preserved. The basal cisterns are intact. The ventricles and sulci are symmetric. There is no evidence of depressed calvarial fracture. The soft tissues of the scalp are within normal limits. The orbits are normal. | No evidence of acute intracranial hemorrhage or calvarial fracture. |
Generate impression based on findings. | Intramedullary nail Intramedullary rod and screw device is present in the left femur, without radiographic evidence of hardware complication. Skin staples and soft tissue gas reflect recent surgery. The permeative lucency in the distal diaphysis with associated endosteal scalloping is again seen.Mild osteoarthritis affects the left knee with a Pellegrini-Stieda lesion. | Postoperative changes, as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her maternal niece. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Bilateral benign morphology masses and areas of asymmetry are stable. Bilateral benign calcifications are also noted. Normal-sized lymph nodes in each axilla are stable. | 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. | Female 95 years old Reason: r/o fracture History: LLE edema, no DVT. There are moderate degenerative arthritic changes of the left hip joint and pubic symphysis. There is no acute fracture or dislocation.Four views of the knee reveal moderate enthesopathic changes of the patella and chondrocalcinosis. There is no acute fracture or dislocation. | Moderate degenerative changes of the left hip and left knee without evidence of fracture or dislocation. |
Generate impression based on findings. | SNHL, bilateral. Possible cochlear implant candidate. Right: The external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The inner ear structures are unremarkable. The facial nerve describes a normal course. The jugular bulb and carotid canal are intact. Left: The external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The inner ear structures are unremarkable. The facial nerve describes a normal course. The jugular bulb and carotid canal are intact. Miscellaneous: There is scattered paranasal sinus opacification. | No evidence of temporal bone structural anomalies that may potentially interfere with cochlear implantation. |
Generate impression based on findings. | 63 year-old female with history of bleeding from tracheostomy site. Please note that this study was protocoled to evaluate the vasculature which results in decreased sensitivity to subtle changes in soft tissue lesions.Head: There is no evidence of acute intracranial hemorrhage. The gray-white differentiation is preserved. The basal cisterns are intact. The ventricles and sulci are symmetric. There is mild/moderate mucosal thickening of the visualized paranasal sinuses. There is opacification of the right mastoid air cells.The skull is diffusely sclerotic which is nonspecific. Multiple lytic calvarial lesions are again identified and are relatively stable. Reference lesion in the left frontal bone measures 50 x 38 mm, previously 49 x 36 (24/80232).Neck: There is a large infiltrative mass within the thyroid bed measuring up to 65 mm, previously 61 mm (112/80883). This mass invades the paraglottic and glottic tissues as well as the trachea and thyroid cartilage. The airway inferior to the tracheostomy is patent. Superiorly there is circumferential narrowing of the airway by tumor.Left paratracheal node measures 28 x 16 mm (image 50/80883). Subcutaneous nodule overlying the manubrium measures 22 x 27 mm. There also appears to be increased lysis of the underlying manubrium suggesting tumor involvement. Left level 3 lymphadenopathy again noted.The parotid and submandibular glands are unremarkable.Right upper lobe subpleural nodule has increased in size. Right chest port is incompletely imaged.Angiography: There is no evidence of flow-limiting stenosis, aneurysmal dilatation, or contrast extravasation in the head or neck. Specifically, the vessels near the tracheostomy tube are intact although it should be noted that the tumor and adjacent metastatic deposits seem to be highly vascular. Mild calcification at the carotid bifurcations in the neck bilaterally. There is a persistent trigeminal artery on the right which is dilated and ectatic. The basilar artery is hypoplastic. The left PCOM is not visualized. The left carotid artery is deviated medially at the level of the sella. The right cavernous carotid artery is prominent. | 1. There is no significant vascular abnormality in the neck. Specifically, no evidence of any actively extravasating vessel is seen.2. Anomalous intracranial vasculature including a persistent trigeminal artery. There is no evidence of aneurysmal dilatation or flow limiting stenosis.3. Diffuse metastatic disease as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her mother at age 44 and grandmother in her 60's. The patient is currently breast-feeding. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is extremely dense, limiting the sensitivity of mammography and increasing the importance of physical examination. 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: NSD - Screening Mammogram. |
Generate impression based on findings. | Female 22 years old Reason: evaluate for renal stone History: L flank pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Distal non-obstructing left ureteral calculus measuring up to 4 mm (series 3, image 131) at the vesicoureteral junction. Additional subcentimeter non-obstructing left midpole renal calculus. No hydronephrosis or hydroureter bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Non-obstructing subcentimeter stone at the left ureterovesical junction. Additional non-obstructing subcentimeter left renal calculus. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Patient has history of prior abscess drained from the right breast in 1960s. 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. No suspicious masses, architectural distortion, or microcalcifications 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. | Male 54 years old Reason: MGUS History: hx of MGUS, right hip pain. SKULL: Two views of the skull are unremarkable, without evidence of myelomatous lesions.CERVICAL SPINE: Two views of the cervical spine demonstrate straightening of the cervical spine and small anterior osteophytes of vertebral bodies. There is a anterior wedge deformity of the C7 vertebral body. The remaining vertebral body heights and intravertebral disk spaces are maintained. No discrete myelomatous lesions.THORACIC SPINE: Two views of the thoracic spine are unremarkable with vertebral body heights and intravertebral disk spaces maintained. No evidence of myelomatous lesions. Tiny anterior vertebral body osteophytes are noted.LUMBAR SPINE: Single view of the lumbar spine is unremarkable; vertebral body heights and intravertebral disk spaces are maintained. No evidence of myelomatous lesions. Moderate degenerative changes affect the lumbar spine with sparing of the L4/L5 vertebral bodies.RIBS: AP views of the ribs are unremarkable without evidence of myelomatous lesions. There is a nonobstructive bowel gas pattern.PELVIS: AP view of the pelvis is unremarkable, without evidence of myelomatous lesions.UPPER EXTREMITY: The two views of the bilateral humeri are unremarkable without evidence of myelomatous lesions. Two views of the bilateral forearms are unremarkable without evidence of myelomatous lesions.LOWER EXTREMITY: Three views of the right femur are unremarkable without evidence of myelomatous lesions.Three views of the left femur demonstrate a chronic deformity of the mid diaphysis compatible with prior injury and surrounding metallic fragments. There is no evidence of myelomatous lesions.The right tibia/fibula is unremarkable without evidence of myelomatous lesions. The left tibia/fibula is unremarkable without evidence of myelomatous lesions. | 1.Indeterminate anterior wedge deformity of the C7 vertebral body.2.No discrete myelomatous lesions identified. |
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