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Generate impression based on findings. | 49 year year old female with tachycardia, evaluate for abdominal infection. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: Right basilar atelectasis/consolidation.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: Infrarenal IVC filter noted. Nonspecific retroperitoneal lymphadenopathy. For example, left para-aortic lymph node (series 3, image 85) measures 1.3 cm in short axis.BOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Ventral hernia with mouth measuring 8.7 cm containing colon without evidence of obstruction. Abundant stool in the colon and rectum suggestive of constipation. There is a small collection along the right paracolic gutter with an attenuation slightly greater than simple fluid measuring 1.4 x 3.3 cm which is of uncertain etiology. Abscess is thought to be less likely given lack of surrounding fat stranding.BONES, SOFT TISSUES: Degenerative changes of the spine. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Suprapubic catheter with tip in collapsed bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Ventral hernia with mouth measuring 8.7 cm containing colon without evidence of obstruction. Abundant stool in the colon and rectum suggestive of constipation. There is a small collection along the right paracolic gutter with an attenuation slightly greater than simple fluid measuring 1.4 x 3.3 cm which is of uncertain etiology. Abscess is thought to be less likely given lack of surrounding fat stranding.BONES, SOFT TISSUES: There is a soft tissue defect overlying the left ischium with skin thickening and underlying sclerosis of the ischium compatible with patient's prior history of deep soft tissue ulcer and chronic osteomyelitis.OTHER: Degenerative changes of the spine. Small amount of pelvic free fluid. | 1.Right basilar atelectasis/consolidation.2.Ventral hernia without evidence of obstruction. Constipation. 3.Soft tissue collection along the right paracolic of uncertain etiology. Given lack of adjacent fat stranding, unlikely to be abscess.4.Non-specific retroperitoneal lymphoadenopathy. 5.Findings compatible with prior deep left gluteal soft tissue ulcer and underlying ischial chronic osteomyelitis. |
Generate impression based on findings. | Ms. Vines is a 76 year old female with a personal history of left cyst removal approximately 5 to 10 years ago. No current breast related 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 density. Linear marker was placed on a scar overlying the left breast. Scattered benign calcifications, including arterial calcifications, are present. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. Benign lymph nodes project over the axillae. | 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. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: infection? History: neutropenic fever, pneumonia CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Periventricular and subcortical white matter hypodensities of a moderate degree are present.There are calcifications present at the the globus pallidi bilaterally.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.CT maxillofacial bones:There are no fractures identified involving the maxillofacial bones.The skull base foramina are intact.The orbits are intact with no abnormal mass lesions in either orbit. The visualized eyeballs are intact lacrimal glands are unremarkable. Extraocular muscles are intact. The suprasellar cistern is unremarkable. The left eyeball lens is thin.Visualized portions of the mastoid air cells and middle ears are clear. The visualized portions of the paranasal sinuses and demonstrate a minor mucous retention cyst in the left sphenoid sinus which was also present on the prior examThe temporomandibular joints are narrow. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.3.CT of the maxillofacial bones is within normal limits.4.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of excisional biopsy on the left and percutaneous biopsy on right, both benign. 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. A ribbon clip is noted in a 2.5-cm circumscribed mass in the right superolateral breast. Round marker and a linear scar marker are noted over the left breast. A partially obscured mass in the left superomedial breast appears unchanged. Additional bilateral, benign morphology breast masses and focal asymmetries appear unchanged. No suspicious masses, microcalcifications, or areas of architectural distortion are present. | Bilateral unchanged, benign morphology masses. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Evaluate for sinus infection, potential fungal infection in febrile neutropenic patient with fever. There is moderate mucosal thickening in the bilateral maxillary, ethmoid, and sphenoid sinuses. There is also fluid within the bilateral frontal, sphenoid and portions of the ethmoid sinuses. There is extensive diffuse sclerosis and thickening of the paranasal sinus walls. The nasal cavity is clear. The nasal septum is deviated slightly to 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, orbits, and imaged intracranial structures appear to be unremarkable. There are degenerative changes affecting the left temporomandibular joint. There is a small skin excrescence along the right upper eyelid. | Acute upon chronic pansinusitis. |
Generate impression based on findings. | Male 71 years old Reason: hematuria History: hematuria ABDOMEN:LUNG BASES: Mild bibasilar atelectasis/scarring. No pleural effusion. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Calcified granulomata. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Hypodense lesion in the inferior pole of the left kidney consistent with a simple renal cyst.Intrinsically hyperdense lesion in the midpole of the right kidney, favor benign complex renal cyst.No renal calculus.No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the lumbar spine with rightward curvature.OTHER: Atherosclerotic calcifications of the aorta and its branches. No abdominal aortic aneurysm or dissection.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the lumbar spine with rightward curvature.OTHER: No significant abnormality noted | Negative examination. |
Generate impression based on findings. | Ms. Newark is a 49 year old female with a personal history of benign right breast biopsy in 2014 at an outside hospital. No current breast related 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 density. Benign intramammary lymph node identified in the left lateral breast. Biopsy marker clip present within the right medial breast, presumably from prior benign breast biopsy. 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.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made. The patient did sign a release form which will be faxed to the outside hospital to obtain prior mammograms for comparison purposes.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of excisional biopsy in 2010 enlarging fibroadenoma of the left breast. 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. Postsurgical changes are noted in the medial left breast, otherwise 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. | 15-year-old male with hand injury. Evaluate for fracture.VIEWS: Right hand PA and lateral (two views) 2/13/2015 There is a distal metaphyseal fracture of the 5th metacarpal bone with palmar and lateral angulation. | Distal metaphyseal fracture of the 5th metacarpal bone with palmar and lateral angulation. Findings were discussed with Dr. Jovito Angeles by phone on 2/13/2015 at 11:00 AM |
Generate impression based on findings. | Male 46 years old Reason: left shoulder pain History: pain. Again seen is a radiolucent fixation device between the distal clavicle and the coracoid in near-anatomic alignment. There is no evidence of hardware loosening. There is normal alignment of the glenohumeral joints. No acute fracture or dislocation. | Postoperative cortical ligament repair without radiographic evidence of hardware complication. |
Generate impression based on findings. | 47-year-old female with dysphasia, evaluate esophageal dysmotility or structural blockage Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Double contrast evaluation of the esophagus and gastric cardia/fundus revealed no morphologic abnormalities of the mucosal surfaces or mural contours. During the exam, provoked gastroesophageal reflux was observed up to the level of the lower esophagus with spontaneous clearance. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave. Barium pill swallow resulted in hang up of pill at the gastroesophageal junction with clearance after drinking water. Patient complained of sensation that the pill was stuck in the upper esophagus at this time - possibly referred globus sensation. No rings, webs, or strictures are noted.TOTAL FLUOROSCOPY TIME: 5:30 minutes | 1.Mild gastroesophageal reflux was noted without evidence of reflux esophagitis. 2.Delayed emptying of barium pill into the stomach may be the cause referred globus sensation. |
Generate impression based on findings. | 16-year-old male, evaluate for fractureVIEWS: Left ankle AP, oblique and lateral (3 views) 2/13/2015 10:07 Previously noted soft tissue swelling and joint effusion about the ankle and edema of Kager's fat pad have resolved. No evidence of fracture or dislocation. Again seen is a well corticated ossific density just inferior to the medial malleolus likely chronic in etiology. | Normal examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. Scattered calcifications are noted throughout the breasts 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: NSD - Screening Mammogram. |
Generate impression based on findings. | Reason: lung CA, not currently on therapy. followup. History: none CHEST:LUNGS AND PLEURA: Left hemithorax postsurgical and postradiation changes and volume loss appear similar to the prior exam. Large left pleural effusion, stable to slightly increased from prior exam, with associated compressive atelectasis.Right upper lobe 4-mm micronodule (series 6, image 33) is unchanged. Additional scattered pulmonary micronodules are unchanged. No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Severe coronary artery calcification. Decreased attenuation of the blood pool, suggestive of anemia.No mediastinal or hilar lymphadenopathy.CHEST WALL: Status post median sternotomy.Stable compression deformity of a midthoracic vertebral body.No axillary lymphadenopathy. Reference left axillary lymph node measures 5 mm (series 4, image 31), unchanged.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable nonspecific right hepatic lobe hypodensity (series 4, image 84).SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Bilateral nephrolithiasis, without evidence of obstruction.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disease of the lumbar spine.OTHER: No significant abnormality noted. | 1. No evidence of recurrent or metastatic disease.2. Stable post-treatment findings in the left hemithorax, with persistent large left pleural effusion. |
Generate impression based on findings. | Male 32 years old Reason: persistent R buttock pain, evaluating for sacroiliitis History: persistent R buttock pain. Bilateral sacroiliac joints are unremarkable. There is no acute fracture or malalignment. The vertebral body heights and intravertebral disk spaces are maintained. | No radiographic evidence of sacroiliitis as clinically questioned. |
Generate impression based on findings. | Possible stress fracture with LBP after fall, and history of L5-S1 surgery 6 years ago. There is no evidence of fracture. There is a punctate midline posterior epidural calcification at L3-4. There is a slight disc bulge at L4-5 as well as mild bilateral facet hypertrophy and ligamentum flavum thickening with mild spinal canal stenosis. There are postoperative findings at L5-S1, including left partial facetectomy and hemilaminotomy. There is moderate disc space narrowing at L5-S1, where there is also right facet arthropathy and left uncovertebral hypertrophy with moderate left neural foramen stenosis and mild right neural foramen stenosis, but no significant spinal canal stenosis. The vertebral column alignment is within normal limits. The vertebral body heights are preserved. The paravertebral soft tissues are unremarkable. | Postoperative findings and degenerative spondylosis in the lower lumbar spine, but no evidence of lumbar spine fracture. |
Generate impression based on findings. | 56-year-old female with history of benign ultrasound guided core biopsy of the left breast. 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 heterogeneously dense, unchanged in pattern and distribution. A ribbon-shaped metallic clip is unchanged in location in the left breast at 6 o'clock position. A circumscribed density is partially visualized in the posterior medial aspect in the left breast on CC view. No suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. Focused ultrasound for left medial breast was performed. A small cyst is detected at 9 o'clock position measuring 4 mm, which might correspond to the mammographic findings. No solid lesions or suspicious findings are detected. | No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. In view of her dense breasts, whole breast ultrasound may be useful for the supplemental screening. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male 63 years old Reason: AKI History: AKI RIGHT KIDNEY: 11.4 cm in length. Increased echogenicity consistent with medical renal disease. Several small cysts.LEFT KIDNEY: Atrophic, 7.7 cm in length. Echogenic. Several small cyst.URINARY BLADDER: : No significant abnormality noted.OTHER: Limited color Doppler imaging shows blood flow to both kidneys. | Echogenic right kidney consistent with medical renal disease. Atrophic left kidney. Several small cysts bilaterally. No hydronephrosis. |
Generate impression based on findings. | Female 65 years old Reason: eval for esophageal injury, esophageo-jejunal anastomosis integrity History: C-spine repair now s/p esophago-jejunostomy Scout radiograph shows a left lower lobe opacity. Postsurgical changes are noted in the lower cervical spine and upper abdomen. There is skin suture staples and multiple staple margins in the left upper abdomen.Ingested contrast freely flowed through the esophageal jejunal anastomosis without evidence for leak. No stricturing is identified. There was severe reflux to the level of the thoracic over multiple times.TOTAL FLUOROSCOPY TIME: 1:46 minutes. | 1.No evidence of leak at the esophageal jejunal anastomosis.2.Severe jejunal esophageal reflux. |
Generate impression based on findings. | 62 years, Male. Reason: ngt placement History: ngt placement NG tube side-port projects over the gastroesophageal junction with tip over the gastric body. Gastrostomy tube is noted. Rectal temperature probe is partially visualized. Nonobstructive bowel gas pattern. | NG tube side-port projects over the gastroesophageal junction, recommend advancement. |
Generate impression based on findings. | 58 years, Female, Reason: f/u ovarian cancer History: shooting pain starting at navel and going down. CHEST:LUNGS AND PLEURA: No consolidation or pleural effusion. Scattered nonspecific micronodules are unchanged. No suspicious nodules or masses.MEDIASTINUM AND HILA: Left chest port tip terminates in the SVC. Aneurysmal dilatation of the ascending aorta is unchanged measuring 4.2 cm. No mediastinal lymphadenopathy. Mild coronary artery calcifications. Trace pericardial effusion, unchanged.CHEST WALL: Right chest portABDOMEN:LIVER, BILIARY TRACT: Status-post cholecystectomy. Enhancing lesion in the right hepatic lobe measuring 1.7 x 0.9 cm (3/70) is unchanged from prior study of 11/28/2012.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: 1.1 x 1.1 left adrenal adenoma is unchanged.KIDNEYS, URETERS: Bilateral nephroureteral stents. Mild left-sided hydronephrosis. Enhancement of the ureters is likely the result of chronic inflammation.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy is unchanged with a right para-aortic node measured 1.4 x 1.1 cm (3/126), previously 1.3 x 1.1 cm. Omental nodularity is minimally increased. For example, a calcified omental nodule measures 8 mm (3/104), previously 6 mm. additional No jewels are present within the left rectus abdominous which are more apparent on this study due to intravenous contrast. Pararectal thickening and nodularity is unchanged.BOWEL, MESENTERY: Status post omentectomy. A lipoma is present within the transverse colon at the hepatic flexure.BONES, SOFT TISSUES: Sclerotic focus in T11 is unchanged.OTHER: No significant abnormality notedPELVIS: FemaleUTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: See above.BONES, SOFT TISSUES: Sclerotic focus in the right iliac wing is unchanged.OTHER: No significant abnormality noted. | 1.Omental nodularity is minimally increased.2.Subcentimeter enhancing right hepatic lobe lesion is unchanged from 2012 and may represent a hemangioma, although metastasis cannot be excluded.3.Stable retroperitoneal lymphadenopathy. |
Generate impression based on findings. | 43 year old female with pain with eating, evaluate for SMA syndrome There is prompt emptying of contrast from the esophagus into the stomach. The stomach was normal in size, shape, and position. There was delayed emptying of contrast into the duodenum. After approximately 8 minutes, contrast emptied into the duodenum and promptly traversed the 3rd portion of the duodenum. No notable dilation of the proximal duodenum to suggest compression by the SMA. The duodenal bulb and sweep were within normal limits. TOTAL FLUOROSCOPY TIME: 6:02 minutes | Delayed emptying of contrast into the duodenum. No evidence of SMA syndrome. Formal nuclear medicine gastric emptying study may be considered. |
Generate impression based on findings. | Chronic DOE. Abnormal CXR suggesting possible chronic indolent infection. LUNGS AND PLEURA: Right lower lobe opacity with volume loss and linear margins, increased in size from prior and likely representing atelectasis. Patent bronchi without evidence of an obstructing lesion in this area of atelectasis. No evidence of active infection or lung malignancy.Subsegmental right middle lobe atelectasis. Small amount of endoluminal debris in the distal left trachea.No pleural effusion. Stable calcified and noncalcified micronodules consistent with healed granulomatous disease.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Cardiomegaly and post surgical changes of CABG. Severe coronary artery calcification and cardiac stents.No pericardial effusion.CHEST WALL: Median sternotomy. Elevated right hemidiaphragm, unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Increased size of right lower lobe opacity, most likely representing atelectasis. This may partially be attributed to a chronically elevated hemidiaphragm. No evidence of active infection or lung malignancy. |
Generate impression based on findings. | 8-month-old female with emesis. Assess NJ tube placement.VIEW: Abdomen AP (one view) 2/13/2015 10:30 NJ tube tip unchanged in the distal duodenum. Partially visualized central venous catheter in the cavoatrial junction. IVC stent and suture material in the right upper quadrant are again seen.Disorganized bowel gas pattern with no evidence of obstruction. | NJ tube tip in the distal duodenum. |
Generate impression based on findings. | Reason: localize SAH lesion History: posterior headache 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.The left common card artery originates from the innominate artery.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.There is an intracranial stent at the distal cavernous segment, clinoidal segment, ophthalmic segment and communicating segment of the left internal carotid arteryThe anterior communicating artery and the posterior communicating arteries are identified and are intact. There is fenestration of the anterior communicating artery presentCT head:There are foci of encephalomalacia present involving the left inferior frontal gyrus and part of the left superior temporal gyrus extending into the left supramarginal gyrus. There is associated enlargement of the left lateral ventricle. Foci of encephalomalacia is also present along the inferior medial aspects of the frontal lobes bilaterally.There is redemonstration of ventriculomegaly. Biventricular diameter at the level of the foramen of Monroe on coronal imaging is approximately 46 mm on the current exam and previously was the same.There is a radiopaque stent present along the distal left internal carotid artery.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for aneurysm. If clinically appropriate, conventional angiogram would help further evaluate for aneurysm not readily identified on this exam.2.Subarachnoid hemorrhage is collected predominantly in the posterior fossa in the pre-medullary cistern and surrounding the medulla. This suggests possible source from the distal vertebral vascular distribution. 3.No evidence for cervicocerebral occlusive disease4.Ventriculomegaly is stable compared to previous day's exam.5.Multiple foci of encephalomalacia are present in the left frontal lobes and to a lesser degree left temporal lobe, left parietal lobe and right frontal lobe as detailed above. Most likely these are related to prior ischemic cerebral infarctions.6.Status post distal left internal carotid artery stent placement.7.Findings were discussed with the neuroICU fellows. |
Generate impression based on findings. | Reason: HNSCC. Compare to previous. History: as above CHEST:LUNGS AND PLEURA: Mild centrilobular emphysema.Multiple bilateral lung nodules appear to have gradually increased in size, especially compared to the prior exam dated 09/2014.Reference anterior right upper lobe subpleural nodule measures 7 x 5 mm (series 7, image 62), unchanged.Reference left upper lobe nodule measures 11 x 8 mm (series 7, image 40), previously measuring approximately 10 x 6 mm.A new solid nodule in the right lower lobe me measures 21 x 12 mm (series 7, image 63).Scattered right lower lobe ground glass opacity is increased from the prior exam.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Mild coronary artery calcifications. Aberrant right subclavian artery, normal variant.Enlarged necrotic mediastinal and hilar lymphadenopathy is seen, increased in size, especially compared to the prior exam dated 08/2014.Reference AP window lymph node measures 18 mm (series 5, image 35), previously measuring 12 mm.Reference right hilar lymph node measures 16 mm in long axis (series 5, image 53), unchanged.A subcarinal lymph node measures 20 mm (series 5, image 43), previously measuring approximately 13 mm on 08/2014.CHEST WALL: Right chest wall port, tip at the cavoatrial junction.Degenerative disease of the thoracic spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable appearance of innumerable round, sharply marginated hepatic hypodensities of varying sizes, likely benign cysts.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: Atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disease of the lumbar spine.OTHER: No significant abnormality noted. | 1. Gradually enlarging bilateral pulmonary nodules, including a new right lower lobe nodule, and gradually enlarging necrotic mediastinal/hilar lymphadenopathy, most likely representing progressive metastatic disease.2. Right lower lobe scattered groundglass opacity may be related to inflammatory process, including aspiration. |
Generate impression based on findings. | Lung Transplant Evaluation. Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 47.9 % of peak activity (normal >70 %)1 hour: 32.8 % of peak activity (normal 30-90 %) 2 hours: 0.5 % of peak activity (normal <10 % by 4 hours) | Gastric emptying within normal limits. |
Generate impression based on findings. | Male 15 years old Reason: follow up History: follow up. There is a deformity of the head of the fifth metacarpal bone compatible with a prior fracture. Fracture line is somewhat indistinct with bony bridging compatible with partial healing and callus formation. | Partial healing of the fracture of the fifth metacarpal head. |
Generate impression based on findings. | Six year old male status post fractureVIEWS: Right wrist PA, oblique, lateral (3 views) 2/13/2015 10:40 Interval removal of cast material. Healing distal radial and ulnar fractures with periosteal reaction and callus formation again seen. Radius and ulna are in near anatomic alignment. | Healing fractures with the radius and ulna in near anatomic alignment. |
Generate impression based on findings. | Male 18 years old Reason: left leg pain History: pain. Again seen is a intramedullary rod of the left femur with a single orthopedic screw at the distal diaphysis of the femur. A distinct fracture line is seen at the mid diaphysis of the femur with minimal medial displacement of the distal fracture fragment and surrounding callus formation. There is no radiographic evidence of hardware complication. | Orthopedic fixation of partially healed mid diaphyseal femoral fracture as described above. |
Generate impression based on findings. | Female 79 years old Reason: eval parastomal hernia - ?incarceration History: pain at hernia, N/V, inc firmness ABDOMEN:LUNG BASES: New incompletely imaged, nonspecific tree in bud opacities in the right upper lobe. Early infectious process cannot be excluded. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenic hypodensity is unchanged in size from the prior exam and likely benign in etiology. PANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal nodularity is unchanged.KIDNEYS, URETERS: Renal hypodensities are too small to characterize. Right extrarenal pelvis is noted.RETROPERITONEUM, LYMPH NODES: Bulky large para-aortic lymph nodes are not significantly changed. New bulky lymph nodes along the hepatic artery measuring 2.3 x 1.0 cm (series 3, image 50). Extensive vascular calcifications of the abdominal aorta with stable mild ectasia.BOWEL, MESENTERY: New small amount of ascites.Dilated small bowel loops within and proximal to the parastomal hernia with collapsed small bowel loop exiting the parastomal hernia. Findings are worrisome for high grade partial bowel obstruction with transition point in the area of the parastomal hernia.No evidence of portal venous gas or pneumoperitoneum. BONES, SOFT TISSUES: New enlarged lymph node in the abdominal soft tissue left of the parastomal hernia, measuring 1.3 x 1.2 cm (series 3, image 87). OTHER: No significant abnormality noteddPELVIS:UTERUS, ADNEXA: No significant abnormality noteddBLADDERStatus post cystectomy. LYMPH NODES: Interval increase in size of the reference right inguinal lymph node, measuring 2.9 x 2.2 cm, previously 2.1 x 1.9 cm (series 3, image 125). BOWEL, MESENTERY: No significant abnormality noteddBONES, SOFT TISSUES: Degenerative changes of the lumbar spine..OTHER: No significant abnormality notedd | 1.High-grade partial small bowel obstruction with transition point in the area of the parastomal hernia. 2.New and increasing size of several inguinal and abdominal lymph nodes worrisome for progression of metastatic disease. |
Generate impression based on findings. | Evaluate for toxic multinodular goiter. The thyroid images demonstrate a single or two adjacent hypofunctioning nodules in the right mid to lower pole. There is also a small to medium warm functioning nodule within the left midpole. However, there is no suppression throughout the remaining gland which demonstrates uniform uptake. The pyramidal lobe also shows uniform uptake. The 6-hour radioactive iodine uptake is 18% and the 25-hour uptake is 27% (normal range 10-30% at 24-hours). | 1. Dominant hypofunctioning right mid to lower pole nodule(s) which are indeterminate for malignancy; this may be further evaluated with ultrasound/biopsy as clinically indicated.2. Otherwise, fairly uniform uptake of tracer throughout the thyroid gland, including the pyramidal lobe, which is at the upper limits of normal. In the setting of a low TSH, these findings likely represent mild Grave's disease. |
Generate impression based on findings. | Male 78 years old Reason: assess fracture History: right leg pain. Two views of the right femur show an intramedullary rod with two screws affixing a comminuted fracture of the proximal femur in near anatomic alignment. The fracture lines appear less distinct with surrounding callus formation indicating interval healing. There is no radiographic evidence of hardware complication. Again seen are moderate degenerative arthritic changes affecting the right hip. | Orthopedic fixation of healing right proximal femoral fracture as described above. |
Generate impression based on findings. | 83-year-old female. Hemoptysis. Lung nodule. LUNGS AND PLEURA: Left lower lobe 7-mm nodule (series 4, image 69), unchanged from 7/2014.Calcified nodules consistent with healed granulomatous disease.MEDIASTINUM AND HILA: Normal heart size without pericardial effusion.Calcified mediastinal nodes consistent with healed granulomatous disease.Stable prominent prevascular lymph node. No other mediastinal or hilar lymphadenopathy.Mild coronary artery calcification. Mild thoracic aorta calcification.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Abdominal aorta atherosclerotic calcification. | Stable 7 mm left lower lobe nodule, very likely benign; however, one additional follow-up scan in 1 year is recommended is confirm stability. |
Generate impression based on findings. | Ms. Davis is a 57 year old female with a personal history of benign right breast biopsy. No current breast related 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 density, unchanged in pattern and distribution. Linear markers were placed on scars overlying both breasts. Scattered benign calcifications are present bilaterally, some of which have progressed in a benign fashion in the left breast. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Bilateral benign calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 14-year-old male with sickle cellVIEWS: Chest AP/lateral (two views) 2/13/15 10:38 The cardiothymic silhouette is normal. Subsegmental atelectasis of the anterior right upper lobe. No pleural effusions. | Subsegmental right upper lobe atelectasis. |
Generate impression based on findings. | Reason: s/p VATS LUL for T1N0 carcinoid History: follow up LUNGS AND PLEURA: Small micronodules and an intrapulmonary lymph node in the right upper lung zone unchanged.There is no evidence of tumor recurrence following left upper lobectomy.Mild centrilobular emphysema is most pronounced in the right upper lobe. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.There are no visible coronary calcifications, the heart and pericardium unremarkable in appearance.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Unchanged left adrenal nodule probably benign. Stable renal cysts. | No evidence of tumor recurrence following left upper lobectomy. No other significant abnormality. |
Generate impression based on findings. | Colon carcinoma 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: Stable reference aortal caval lymph node best seen on image 73 of series 3 measuring 1.1 x 0.6 cmBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination without acute, inflammatory, or metastatic process. |
Generate impression based on findings. | 70 years, Female, Reason: 70 y.o F iwth FL on BR regimen, please restage and assess response. History: none. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Left supraclavicular lymph node measures 2.3 x 1.5 cm (3/4), previously 3.5 x 2.5 cm. Thyroid nodules are unchanged. Precarinal node is significantly decreased measuring 1.0 x 0.5 cm (3/36), previously 1.9 x 1.4 cm. Retrocrural lymphadenopathy is also significantly improved.CHEST WALL: Bilateral axillary lymphadenopathy is significantly decreased with reference left axillary node measuring 1.9 cm (3/22), previously 3.7 cm.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: Splenomegaly is decreased measuring 14.0 centimeters (80280/40), previously 18.9 cm.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Retroperitoneal and mesenteric lymphadenopathy is improved with scattered residual mildly enlarged nodes. A reference mesenteric node measures 07 x 0.5 cm (3/112), previously 3.4 x 2.6 cm. An index left para-aortic node measures 1.7 by 1.6 cm (3/117), previously 3.0 x 2.5 cmBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: FemaleUTERUS, ADNEXA: Necrotic uterine fibroid is unchanged. BLADDER: No significant abnormality noted.LYMPH NODES: Improved inguinal lymphadenopathy with the reference left inguinal node measuring 2.9 x 1.8 cm (3/25), previously 4.1 x 5.8 cm. Pelvic lymphadenopathy is also significantly improvedBOWEL, MESENTERY: Postsurgical findings of ileocecectomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Improved lymphadenopathy and splenomegaly |
Generate impression based on findings. | Ms. Amshoff is a 40 year old female with a personal history of bilateral benign breast biopsies and recent right cyst aspiration. Family history of breast cancer in mother and grandmother. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Two percutaneously placed biopsy marker clips identified in the right lateral breast. Focal asymmetries in both breasts are stable when compared to prior exam. 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. Tomosynthesis may also be useful for this patient. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 53 year old male with history of rectal cancer, restaging after neoajuvant therapy. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Mild mesenteric haziness adjacent to the pancreas is nonspecific but may represent sequela of prior inflammation.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy. Mild atherosclerotic calcifications of the abdominal aorta and its branches. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No pelvic lymphadenopathy. BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative disk disease of the spine most prominent at L5-S1.OTHER: No significant abnormality noted | No pelvic lymphadenopathy or other specific evidence of metastatic disease. |
Generate impression based on findings. | Prostate carcinoma CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Stable gynecomastia.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable right renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Interval increase in size of sclerotic lesions involving T7, T12, and L2 vertebral bodies. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post prostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Interval increase in size of sclerosis involving left iliac wing.OTHER: No significant abnormality noted | Interval increase in size of sclerotic bony lesions; correlation with nuclear medicine scan recommended. No new metastatic foci. |
Generate impression based on findings. | 53 years, Male, Reason: 53 yo male with history of necrotizing pancreatitis with peripancreatic fluid collections, s/p ERCP with transduodenal stent exchange, panceratic duct stent placement for pancreatic duct fistula. CT to asssess fistula History: history of pancreatitis with pancreatic duct disruption. ABDOMEN:LUNG BASES: Right lower lobe cysts are new from the prior exam. Improved left pleural effusion.LIVER, BILIARY TRACT: Moderate intrahepatic biliary ductal dilatation is unchanged. New gallbladder wall thickening with hyperdense material within the gallbladder, possibly a developing stone. Attenuation of the main portal vein is unchanged with thrombosis of multiple branches on the right.SPLEEN: Peripheral linear hypodense foci are unchanged and likely represent small infarcts.PANCREAS: Interval removal of percutaneous drain with persistent pancreatic stent. A few small foci of air surrounding the pigtail catheter. There is enhancement of the pancreatic head and neck with necrosis of the body which appears similar to the prior exam. Peripancreatic fat stranding consistent with acute pancreatitis is similar to the prior exam with unchanged peripancreatic lymph nodes. No new pancreatic fluid collections. For evaluation of a fistulous communication, a fluoroscopic study would be more sensitive.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple renal cysts are unchanged.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy is unchanged. Atherosclerotic calcifications of the aorta and its branches.BOWEL, MESENTERY: Removal of enteric tube.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Ascites is decreased with a small amount of perihepatic ascitesPELVIS: MalePROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Pelvic ascites has improved. | 1.Improved abdominal ascites.2.New gallbladder wall thickening and possible developing stones. Recommend further evaluation with ultrasound.3.Necrotic pancreatitis appearing similar to the prior exam. No new fluid collections. For evaluation of a fistulous communication, a fluoroscopic study would be more sensitive. |
Generate impression based on findings. | History renal cell carcinoma, follow-up. CHEST:LUNGS AND PLEURA: No suspicious nodules masses. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Pacemaker leads terminate in the right atrium and right ventricle. Mild coronary artery calcifications. Nonspecific small hypoattenuating nodule in the right thyroid lobe.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. SPLEEN: Heavily calcified 6 mm splenic artery aneurysm (series 3, image 85), unchanged. PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy. No soft tissue mass is seen in the surgical bed to indicate local recurrence. Subcentimeter hypodensities in the left kidney are too small to characterize, likely cysts, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis. BONES, SOFT TISSUES: Degenerative changes of the lumbar spine. No focal lytic lesion is identified. OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Uterus surgically absent. BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis. BONES, SOFT TISSUES: Degenerative changes of the lumbar spine. No focal lytic lesion is identified. OTHER: No significant abnormality noted. | No specific evidence of local recurrence or metastatic disease. |
Generate impression based on findings. | 12-year-old female with abdominal pain, evaluate for SMA syndrome ABDOMEN:LUNG BASES: Lung bases are clear.LIVER, BILIARY TRACT: Normal hepatic morphology without focal lesion.SPLEEN: No significant abnormality noted.PANCREAS: Normal pancreatic enhancement.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Symmetric renal cortical enhancement without hydronephrosis.RETROPERITONEUM, LYMPH NODES: The celiac artery and SMA are patent without evidence of stenosis. The aortomesenteric angle measures approximately 32 degrees. The aortomesenteric distance measures 4 mm. There is no compression of the left renal vein. BOWEL, MESENTERY: There is no significant distention of the stomach or duodenum. The visualized small bowel is normal in caliber.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Normal exam without evidence of SMA syndrome with measurements provided above. |
Generate impression based on findings. | Family history colon cancer with right-sided abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty infiltration the liver.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Minimal right hydronephrosis and hydroureter due to the presence of a 0.5 x 0.3 cm distal right ureteral stone. Additional nonobstructing punctate right renal stone.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: Subcentimeter distal right ureteral stone as described.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Subcentimeter distal right ureteral stone associated with mild right hydronephrosis and hydroureter. Additional nonobstructing punctate right renal stone. |
Generate impression based on findings. | History of HCC please assess and compare to previous imaging and provide index lesion measurements for RECIST. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. MEDIASTINUM AND HILA: Moderate atherosclerotic calcifications of the coronary arteries.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver morphology. Dominant segment 6 right hepatic lobe mass (series 9, image 36) measures 5.9 x 5.3 cm, previously 5.9 x 5.3 cm. This lesion again demonstrates central necrosis with mildly enhancing periphery suggesting viable tumor.Second arterially enhancing mass in the hepatic dome (series 9, image 12) measures 2.6 x 4.5 cm, increased from 1.6 x 4.0 cm previously when similar measurement on arterial phase used (mass measured 4.6 x 2.7 cm on portal venous phase previously). The adjacent conglomerate of additional arterially enhancing satellite nodules also appears to have slightly increased. A third nodule in the right hepatic lobe (series 9, image 24) measures 1.4 x 1.7 cm, previously 1.4 x 1.7 when similar measurement technique used. Replaced hepatic artery arises from the SMA. Patent portal and hepatic veins. Cholelithiasis.SPLEEN: There are unchanged splenic varices, likely secondary to portal hypertension. There is an unchanged peripherally calcified splenic artery aneurysm (series 10, image 73).PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypodensities within the renal parenchyma are incomplete characterized, but likely benign in etiologyRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No focal osseous lesions to suggest metastasis. OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Patient status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No focal osseous lesions to suggest metastasis. OTHER: No significant abnormality noted. | 1.Stable segment 6 partially necrotic dominant hepatic mass with mildly enhancing periphery suggesting viable tumor. 2.Interval increase in size of the hepatic dome lesion and conglomerate of surrounding satellite lesions. 3.No specific evidence of distant metastatic disease. 4.Stable splenic artery aneurysm. |
Generate impression based on findings. | Sinusitis and intermittent crusty nasal drainage, status post repair of bilateral choanal atresia. There is near-complete opacification of the bilateral maxillary and ethmoid sinuses with suggestion of fluid. The sphenoid and frontal sinuses have not yet pneumatized. There are postoperative findings related to choanal atresia repair. There are stand-like secretions in the bilateral nasal cavities and more confluent opacification in the posterior right nasal cavity, where there is suggestion of a possible membranous barrier posteriorly. The left posterior choana is grossly patent. There is opacification of the left middle ear and mastoid air cells. There is also opacification of the right middle ear. The imaged intracranial structures and orbits are unremarkable. | 1. Findings suggestive of acute rhinosinusitis. 2. Postoperative findings related to choanal atresia repair with possible restenosis of the right posterior choana, although assessment is limited in the presence of superimposed secretions.3. Findings suggestive of left otomastoiditis and right otitis media. |
Generate impression based on findings. | Male 30 years old; Reason: evaluate for torsion, clot History: acute scrotal pain/swelling RIGHT TESTIS: The right testis measures 4.5 x 2.8 x 2.4 cm and is of normal echotexture. Small right hydrocele noted.LEFT TESTIS: The left testis measures 3.9 x 2.6 x 2.1 cm and is of normal echotexture.RIGHT EPIDIDYMIS: The right epididymis measures 0.8 x 0.9 x 1.4 cm and is unremarkable.LEFT EPIDIDYMIS: The left epididymis is not clearly seen.OTHER: Bilateral scrotal skin thickening, felt likely to reflect edema. Bilateral varicoceles noted. | No evidence of testicular torsion. Bilateral varicoceles noted. Scrotal skin thickening, likely reflects edema. |
Generate impression based on findings. | Neck: There is overall slight interval increase in size of multiple necrotic cervical lymph nodes with evidence of extracapsular extension. For, example, a heterogeneous right level Ia lymph node measures 14 mm in short axis, previously 13 mm in short axis, a right level Ib lymph node measures 27 mm in short axis, and right level II lymph nodes measuring up to 25 mm in short axis, a right level II lymph node that encases and markedly narrows the right internal carotid artery and the right internal jugular vein measures 27 mm, previously 25 mm. There is associated invasion of the right parotid and submandibular glands, as well as the adjacent muscles. There has been interval increase in size of right lower face dermal nodules. For example, a lesion in the subcutaneous tissues overlying the inferior margin of the right body of the mandible measures up to 11 mm, previously 6 mm. There is an aberrant right subclavian artery. There is a right internal jugular venous cathter. There is ill-defined heterogeneity within the right tonsillar fossa region. The thyroid gland appears unchanged, with a nodule in the left tracheoesophageal groove that measures up to 12 mm. The airways are patent. The osseous structures are unchanged. The imaged portions of the upper lungs are essentially clear.Head: There is no evidence of intracranial mass or abnormal enhancement. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | 1. Slight interval progression of extensive right cervical lymphadenopathy with signs of extracapsular extension and increase in size of right face dermal metastases, but unchanged appearance of the treated right tonsillar fossa.2. No evidence of intracranial metastases.3. A nodule in the left tracheoesophageal groove that measures up to 12 mm may represent a thyroid nodule or less likely a parathyroid adenoma. |
Generate impression based on findings. | 8 month old female with elevation of LFTs following transplant. Evaluate for signs of acute rejection, changes in blood flow. Grayscale, spectral and color Doppler images were obtained on inflow and outflow images.LIVER: Normal echogenicity with no evidence intra-or extrahepatic biliary ductal dilatation.There is normal direction and flow of the main portal vein with velocity of 27.7 cm/s.There is normal direction and flow of the left portal vein with velocity of 37.3 cm/s. There is normal direction and flow of the right portal vein with velocity of 22.8 cm/s.There is normal direction and flow of the common hepatic artery with peak systolic velocity of 57.7 cm/s, end diastolic velocity of 15.8 cm/s and RI of 0.73.There is normal direction and flow of the left hepatic artery with peak systolic velocity of 79.9 cm/s, end diastolic velocity of 35.4 cm/s and RI of 0.56.There is normal direction and flow of the right hepatic artery with peak systolic velocity of 47.4 cm/s, end diastolic velocity of 20.3 cm/s and RI of 0.57. There is normal direction and flow of the left, right and middle hepatic veins. GALLBLADDER, BILIARY TRACT: Not visualized.PANCREAS: Partially visualized pancreas is normal in echogenicity. SPLEEN: Enlarged measuring up to 8.0 cm in length. Normal echogenicity with normal flow and direction of the splenic artery with peak systolic velocity of 42.8 cm/s, end diastolic velocity of 17.2 cm/s and RI of 0.60. There normal flow and direction of flow of the splenic vein with velocity of 29.7 cm/s.KIDNEYS: Not visualized on this exam. ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Moderate ascites. | 1. Normal direction, velocity and flow of the portal veins, hepatic arteries and hepatic veins. 2. Moderate ascites in the abdomen. 3. Splenomegaly. |
Generate impression based on findings. | 47 years, Male. Reason: Dobbhoff placement History: same LVAD, pacer leads, median sternotomy wires and fixation plates are all unchanged. Dobbhoff tube tip is obscured by LVAD device and presumably projects over the gastric body. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Obscured Dobbhoff tube tip presumably projects over the gastric body. |
Generate impression based on findings. | Tenderness and swelling at the left maxillary area. Right ring finger pain. FACIAL BONES: No fracture or malalignment evident. Dental amalgam noted.RIGHT FOURTH DIGIT: Minimally displaced oblique fracture through the middle phalanx, without intra-articular extension. There is mild overlap of the fracture fragments. | 1. Right ring finger middle phalangeal fracture, as above. 2. No maxillofacial fracture evident. |
Generate impression based on findings. | 37 years, Female. Reason: eval for acute process History: abdominal pain, distention, hepatic failure, lactulose Intrauterine device projects over the midpelvis. Nonobstructive bowel gas pattern. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Lung carcinoma ABDOMEN:LUNG BASES: Please see separate report for chest findingsLIVER, BILIARY TRACT: Stable cholelithiasisSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Stable right adrenal nodule best seen on image 41 of series 7 measuring 1.2 x 0.8 cm.KIDNEYS, URETERS: Stable bilateral renal cysts. Stable nonobstructing subcentimeter left renal stone.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 | Stable examination. |
Generate impression based on findings. | 65 years, Male. Reason: Dobbhoff placement History: Dobbhoff placement Dobbhoff tube tip projects over the first portion of the duodenum. Bilateral chest tubes, median fixation plate and wires, and mediastinal clips are unchanged. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip projects over the first portion of the duodenum. |
Generate impression based on findings. | 3-year-old male with pain and right third ribVIEWS: Chest AP/lateral (two views) 2/13/15 11:24 The cardiothymic silhouette is normal. Bronchial wall thickening and large lung volumes indicate bronchiolitis or reactive airway disease. No pleural effusions. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Reason: Evaluate for progression of metastatic disease; compare to previous scan History: None CHEST:LUNGS AND PLEURA: Marked interval increase in the left pleural effusion with a persistent small right pleural effusion.Complete atelectasis of the left upper lobe with a centrally obstructing mass. Previous measurements were made of the collapsed upper lobe, and do not reflect tumor size.Endobronchial tumor is apparent at the origin of the left upper lobe bronchus.Multiple groundglass and solid nodules are present throughout the right lung with septal thickening. Some of the ground glass nodules have slightly increased in size but several solid nodules have decreased.MEDIASTINUM AND HILA: Large pericardial effusion, increased compared to previous.Extensive bilateral mediastinal lymphadenopathy, not significantly changed.Reference left hilar node (series 3/55) measures 15 mm, unchanged.Reference conglomerate mass of subcarinal lymph nodes measures 27 mm, also unchanged.Moderate to severe coronary artery calcification.CHEST WALL: Bilateral supraclavicular, axillary and subpectoral lymphadenopathy, not significantly changed.Small cardiophrenic lymph nodes, also unchanged.Port catheter in the right chest wall with its tip at the SVC/RA junction.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Focal hypodensity in the left lobe adjacent to the falciform ligament which may represent focal fat, unchanged. Small cysts. No reliable evidence of hepatic metastases.Thickened gallbladder wall with a small amount of pericolic fluid, suggestive of cholecystitis but not significantly changed.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Left adrenal enlargement measuring 20 x 27 mm, increased from previous, consistent with a metastasis.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Retrocrural and para-aortic lymphadenopathy, unchanged.Abnormal soft tissue in the celiac axis region consistent with confluent lymphadenopathy, not significantly change.Small amounts of ascites adjacent to the liver and spleen, increased from previous.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Fat stranding and small mesenteric nodules suspicious for metastatic disease.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Markedly increased left pleural effusion and moderately increased pericardial effusion. 2. Extensive hematogenous and possibly lymphogenous metastatic disease in the lungs, slightly overall stable or slightly improved.3. Extensive metastatic lymphadenopathy in the thorax, chest wall and abdomen, without significant change. |
Generate impression based on findings. | LIVER: Normal echogenicity with no intra-or extrahepatic biliary ductal dilatation.GALLBLADDER, BILIARY TRACT: Visualized gallbladder appears normal in echogenicity.PANCREAS: Partially visualized pancreas appears normal in echogenicity.SPLEEN: Partially visualized spleen appears normal in echogenicity. KIDNEYS: The visualized kidneys are normal in echogenicity. ABDOMINAL AORTA: No significant abnormality noted.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: The appendix is seen and is compressible, appears normal in echogenicity and caliber measuring up to 3 mm in diameter. The appendix is compressible. Mildly prominent lymph nodes in the right lower quadrant. No bowel wall thickening. No free fluid. | No evidence of appendicitis. Mildly prominent lymph nodes in the right lower quadrant. |
Generate impression based on findings. | 28 years, Female. Reason: eval stool burden History: abd pain Above average stool burden. Nonobstructive bowel gas pattern. Lung bases are clear. Probable urinary or rectal catheter overlies the midpelvis. | Above average stool burden. |
Generate impression based on findings. | Male 2 years old Reason: R/O Fracture History: Pediatric TraumaVIEWS: Chest AP (one view), cervical spine AP and lateral (two views), pelvis AP (one view), 2/13/50. The aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal. No focal lung opacity, pleural effusion or pneumothorax is seen. Vertebral body heights and disk spaces are normal. No fracture is seen. No prevertebral soft tissue swelling is identified.The femoral heads are directed into the acetabula. No pelvic fracture is seen. | Normal chest, cervical spine and pelvis. |
Generate impression based on findings. | Age: 65 years. Sex : Male. Reason for study: Reason: 65 y/o male with head/neck CA; please eval for aspiration; completing chemo/RT this week History: Coughing when swallowing thin liquids. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. No static or hard copy films were obtained. The exam was positive for vestibular penetration and negative for aspiration. FLUOROSCOPY TIME: Three minutes and 35 seconds | Exam positive for penetration but negative for aspiration. Please refer to dedicated speech pathology report for additional findings and feeding recommendations. |
Generate impression based on findings. | Male 45 years old Reason: METASTATIC PANCREATIC NEUROENDOCRINE CANCER. STATUS POST CHEMOTHERAPY WITH CAPECITABINE AND TEMODAR. EVALAUTE FOR DISEASE RESPONSE History: PANCREATIC NEUROENDOCRNIE TUMOR CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple bilobar hepatic metastases. An index lesion in the right lobe measures 5.1 x 6.6 cm on image number 91, series number 11. There is thrombus in the extrahepatic and part of the intrahepatic main portal vein with cavernous transformation. Thrombus also extends into the superior SMV. This thrombus maybe secondary to tumor invasion. Splenic vein is also chronically thrombosed. Numerous collaterals are noted throughout the peritoneum and around the spleen.SPLEEN: Chronic thrombosis of the splenic vein with extensive collaterals.PANCREAS: Patient's known pancreatic mass measures 3.1 x 4.2 cm on image number 108, series number 11.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of ascites. | Large pancreatic mass invading the main portal vein, SMV and splenic vein and causing tumor thrombus in the main portal vein.Numerous hepatic metastases. |
Generate impression based on findings. | Age: 79 years. Sex : Male. Reason for study: Reason: stroke, concerns for aspiration History: as above. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. No static or hard copy films were obtained. The exam was negative for penetration and negative for aspiration. FLUOROSCOPY TIME: Two minutes and 49 seconds. | The examination was negative for vestibular penetration and negative for aspiration. Please refer to speech pathology report for additional findings and feeding recommendations. |
Generate impression based on findings. | Age: 45 years. Sex : Female. Reason for study: Reason: previous OPM, hx of scleroderma, microaspirations leading to pneumonia History: scleroderma, pneumonia. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. No static or hard copy films were obtained. The exam was positive for penetration and negative for aspiration. FLUOROSCOPY TIME: One minute and 43 seconds. | The examination was positive for vestibular penetration and negative for aspiration. Please see speech pathology report for additional findings and feeding recommendations. |
Generate impression based on findings. | Female 47 years old Reason: renal cancer and SOB History: as above CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Postsurgical changes involving the right kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes in the stomach secondary to gastric band surgery. Fat containing peri-umbilical hernias.BONES, SOFT TISSUES: Sclerotic lesion in T7 vertebral body of uncertain etiology and significance.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Nonspecific, sclerotic lesion involving the T7 vertebral body. Postsurgical changes involving the right upper renal pole. |
Generate impression based on findings. | Status post fall 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. | No evidence of intracranial hemorrhage or skull fracture |
Generate impression based on findings. | Male 70 years old Reason: Pt s/p subtotal colectomy for stage IIA colon cancer in 2011 - please eval for any recurrent or metastatic disease (note: bx of Right pericolic gutter mass on 11/26/13 negative for cancer) History: colon cancer ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Pancreatic parenchymal calcifications suggestive of chronic pancreatitis.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Index soft tissue nodule in the right paracolic gutter is now smaller measuring 8 mm in diameter image number 88, series number 3.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Index left common iliac lymph node measures 1 cm in diameter on image number 91, series number 3, not significantly changed in size compared to previous study.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Slight interval decrease in the right peritoneal pericolic implant, otherwise no significant change from previous study. |
Generate impression based on findings. | Reason: NSCLC restaging History: NSCLC CHEST:LUNGS AND PLEURA: Right upper lobe a large necrotic mass abutting and probably invading the pleura (series 3/29) 6.5 by 5.6 cm, decreased from previous.Small right upper lobe nodule (series 4/46) now 5 mm, decreased from 7 mm previously.New small right pleural effusion.Decreased left upper lobe nodule (series 4/68) 4 mm, decreased from 7 mm previously.Left upper lobe ground glass nodule (series 4/25) measuring 9 mm, unchanged, suspicious for adenocarcinoma in situ.Moderate centrilobular emphysema.MEDIASTINUM AND HILA: Decreased lower right paratracheal lymph node, now 13 mm, decreased from 16 mm previously.Right hilar lymphadenopathy unchanged.Moderate coronary artery calcification.No significant pericardial effusion.CHEST WALL: Left humeral rod placed for known osseous metastases.No other visible skeletal metastases on the current scan.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Large hepatic metastasis (series 3/113) 3.7 x 2 .3 cm, markedly decreased from 6.6 x 4.5 cm previously. Mild central intrahepatic and extrahepatic biliary ductal dilatation, unchanged.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Mildly enlarged left adrenal gland, not significantly changed.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Dilated pancreatic duct, unchanged.RETROPERITONEUM, LYMPH NODES: Atherosclerosis in the abdominal aorta.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Congenital fusion abnormality in the lower lumbar spine.OTHER: No significant abnormality noted. | Interval decrease in right upper lobe mass, pulmonary nodules, mediastinal lymphadenopathy and hepatic metastasis. |
Generate impression based on findings. | Reason: Right v/c paralysis, Please evaluate. History: Right v/c paralysis, Please evaluate. LUNGS AND PLEURA: Calcified granuloma left lower lobe.MEDIASTINUM AND HILA: Mild coronary artery calcification.calcified nodes consistent with healed granulomatous disease.There is a short segment subglottic stenosis causing narrowing of the trachea to an AP diameter of 7 mm (series 3/97). Asymmetric nonspecific soft tissue causing the narrowing of the airway is predominantly left-sided. This is fixed on dynamic expiration phases. A small amount of dependent debris is noted within the trachea distal to the stenosis. The lower trachea is normal.CHEST WALL: Degenerative changes affect the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. There are multiple splenic granulomas. A hypodense lesion in the right mid kidney is incompletely imaged. The imaged portion has the CT appearance of a simple cyst with a diameter of 3.3 cm. | Subglottic stenosis seen secondary to soft tissue thickening along the posterior and left lateral aspects of the airway. Is relatively fixed on dynamic phases. Please see dedicated neck CT report for further details regarding the upper airway. The lower trachea is normal.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Again seen is a large enhancing mass extending from the left T1-T2 level to the left T3-T4 level. Mass measures up to approximately 6.2 x 7 .6 cm in the axial and transverse dimensions (axial image 21 of 20, including right vertebral involvement) and up to 5.9 cm in the craniocaudal dimension (coronal image 20 to 53). There is extensive lytic destruction of the T2 and T3 vertebral bodies on the left as well as the pedicle, lamina, and transverse processes. There is relatively smaller component involving the right aspect of the T2, T3, and T4 vertebral bodies and posterior elements. There is evidence of spinal decompression with laminectomy from T2 to T4 levels. Mass extends to involve the ventral and lateral aspects of the spinal canal include just superior to the level of the laminectomy. There is also left neural foraminal stenosis at T1-T2, T2-T3, and T3-T4 related to tumor. There is small fluid collection involving the posterior paraspinous soft tissues which may represent a seroma or pseudomeningocele. Destruction of the left third rib and milder involvement of the left fourth rib are noted. Evidence of diffuse idiopathic skeletal hyperostosis. Left renal mass and left adrenal nodule again seen. | 1. Compared to 1/28/2015, there is no significant change in size of large destructive upper thoracic spinous and paraspinous mass extending from T1-T2 to the T3-T4 levels and consistent with known metastatic disease. 2. Tumor extends into the spinal canal with mild narrowing superior to the level of the laminectomies from T2 to T4. |
Generate impression based on findings. | There is streak artifact from dental amalgam limiting evaluation. There are postoperative and posttreatment findings in the neck with no discrete recurrent tongue mass. There is hyperenhancement and edema of the oropharyngeal mucosa compatible with posttreatment mucositis. There is also new thickening and hyperenhancement of the aryepiglottic folds, worse on the left, likely representing posttreatment mucositis and edema. Likewise, there is diffuse stranding of the subcutaneous tissues in the anterior neck, which may represent radiation dermatitis. There is slight interval enlargement of the hyperenhancing bilateral level Ib lymph nodes measuring 9 mm each, previously measuring up to 7 mm each. However, there is no evidence of significant lymphadenopathy in the neck based on size criteria. The thyroid is unremarkable. The major cervical vessels are patent. There is no discrete osseous lesion. There are mild degenerative changes in cervical spine with mild spinal canal and neural foramen narrowing at C5-6 and C6-7. The airways are patent. The imaged intracranial structures are unremarkable. There is minimal left maxillary sinus mucosal thickening. There is a new right chest wall Mediport catheter. | Post-treatment findings in the neck with slight interval enlargement of hyperenhancing bilateral level Ib lymph nodes, which are likely reactive, and no evidence of recurrent measurable tumor in the neck otherwise, although assessment I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts with 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. Scattered coarse benign calcifications are present in the left breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Scattered benign calcifications are present in both breasts. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, 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 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. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother (diagnosed at the age of 76) and maternal aunt (diagnosed at the age of 50). Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: active smoking 1/2 PPD x 57 yrs History: none LUNGS AND PLEURA: Sharply marginated 10 x 9 mm right upper lobe nodule image 54 series 5 has not significantly changed as far back as at least 9/16/2008.Scattered scarlike opacities, minimal bronchial wall thickening, and mild emphysema are unchanged.No evidence of lung cancer. MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Severe coronary artery calcification is present, and the heart is mildly enlarged.Dense aortic calcifications are noted.Small hiatal hernia noted.Calcified right hilar lymph node.CORONARY ARTERIES: Severe calcification.CHEST WALL: Degenerative changes affect the thoracic spine.UPPER ABDOMEN: Low dose technique markedly limits sensitivity for abdominal pathology. Extensive vascular calcification involving the aorta and its branches. | 1. No evidence of lung cancer.2. Long-term stability of the known right upper lobe nodule which is likely benign.3. Severe coronary artery calcification.Lung-RADS: Category: 2/S (Benign Appearance or Behavior: Nodules with a very low likelihood of becoming a clinically active cancer due to size or lack of growth/Significant - other)RECOMMENDATION: Continue annual screening with LDCT in 12 months. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of benign right breast biopsy. Family history of cervical cancer in mother, diagnosed at the age of 77. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. There is a loose cluster of incompletely characterized calcifications identified in the right central breast, posterior depth. Biopsy marker clip present within the right upper outer breast. No suspicious masses, microcalcifications or areas of architectural distortion are present in the left breast. | Incompletely characterized calcifications in the right breast. Additional imaging, including spot magnification views, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of colon cancer. 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. Scattered benign calcifications, including arterial 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. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | The patient submitted outside mammogram dated 12/13/2012, from Metro South Hospital. Submitted outside study was compared to the current mammogram dated 2/5/2015. The breast parenchyma is composed of scattered fibroglandular elements. Previously identified benign morphology masses in the left breast have resolved on the recent mammogram, presumably representing involuting cysts. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Involuting left breast cysts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: h/o tonsil ca and CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy noted.Severe coronary artery calcifications are present.A sliding hiatal hernia is noted. CHEST WALL: Mild degenerative abnormalities affect the lower thoracic spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Incidental note made of focal fat adjacent to the falciform ligament.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: Focal aneurysmal dilatation of the infrarenal abdominal aorta, with eccentric thrombus formation, previously 4.3 x 3 .7 cm, but now 4.2 x 4.9 cm.Vascular calcifications are present throughout the aorta and its branches. BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. No evidence of metastatic disease.2. Enlarging infrarenal abdominal aortic aneurysm. |
Generate impression based on findings. | Female 51 years old Reason: evaluate for gall stones, s/p gastric bypass 2009 History: epigastric and LUQ 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: Simple right renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes in the stomach secondary to bariatric surgery.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 | Postsurgical changes in the stomach secondary to bariatric surgery, otherwise unremarkable CT. |
Generate impression based on findings. | The patient submitted outside mammogram dated 12/13/2012, from Metro South Hospital. Submitted outside study was compared to the current mammogram dated 2/5/2015. The breast parenchyma is composed of scattered fibroglandular elements. Previously identified benign morphology masses in the left breast have resolved on the recent mammogram, presumably representing involuting cysts. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Involuting left breast cysts. 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. | The patient submitted outside mammogram dated 11/8/2014, from Advocate Trinity Hospital. Submitted outside study was compared to mammograms dated 11/15/2013 and 11/09/2012. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Benign morphology mass in the left lateral breast has previously been documented as a cyst on prior ultrasound exam dated 12/10/2013. An additional benign morphology mass in the left lateral breast has resolved on the most recent exam. These findings are compatible with waxing and waning cysts. There are no suspicious microcalcifications or areas of architectural distortion present in the left breast. | Waxing and waning cysts in the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine diagnostic mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is hypoattenuation involving the left frontal lobe including the precentral gyrus compatible with recent infarct, which is unchanged since 2/10/2015, but not present on the prior study from 1/16/2015. There are chronic lacunar infarcts involving the right frontal corona radiata as well as probably also involving the right superior cerebellar hemisphere. There is a small extra-axial collection in the posterior fossa on the right which remains unchanged dating back to CT dated 9/18/2014. There is no hydrocephalus. There is no midline shift or herniation. There is mild chronic pansinusitis and postoperative sinonasal findings and opacification of the bilateral mastoid air cells, similar to prior exam. The skull and extracranial soft tissues are unremarkable. | 1. No acute intracranial hemorrhage or mass-effect. Please note CT is insensitive for detection of early nonhemorrhagic stroke.2. Multiple small bilateral infarcts including in the left frontal lobe which is present on 2/10/2015 but new since 1/16/2015. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Scattered benign appearing micronodules, but no evidence of metastases.New reticular opacities in the left lung base, with mild bronchiectasis, is suggestive of aspiration.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Mild corner calcifications are present, the heart and pericardium otherwise unremarkable in appearance.A right jugular catheter terminates at the RA level.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: New intra-and extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Significant decrease in subcutaneous fat since the prior study with increased attenuation which can sometimes be seen in soft tissue edema/anasarca.OTHER: No significant abnormality noted. | 1. No evidence of metastatic disease.2. New intra-and extrahepatic biliary ductal dilatation, cause not identifiable, but could be better evaluated by MRCP. |
Generate impression based on findings. | Male 58 years old Reason: staging exam-Research History: prostate cancer This study is performed for research purposes. | This study is performed for research purposes. |
Generate impression based on findings. | Age: 63 years. Sex : Male. Reason for study: Reason: r/o aspiration History: coughing with oral intake, signs of aspiration on CT chest. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. No static or hard copy films were obtained. The exam was negative for penetration and negative for aspiration. FLUOROSCOPY TIME: 2:07 | The examination was negative for vestibular penetration and negative for aspiration. Please see speech pathologist report for additional findings and feeding recommendations. |
Generate impression based on findings. | Left ankle injury playing soccer. Point tenderness overlying medial and lateral malleoli Moderate soft tissue swelling mildly greater medially without underlying osseous abnormality. Specifically no evidence of a fracture. Ankle mortise intact and symmetric.Note is made of an minimal well corticated ossicles including an os trigone and small calcific changes in the soft tissues underlying the anterior calcaneus and cuboid. Presumably old trauma | Diffuse soft tissue swelling without distinct acute abnormality. |
Generate impression based on findings. | Metastatic lung cancer. Status post 6 cycles of Docetaxel. Compare with previous study and evaluate tx response. LUNGS AND PLEURA: Right perihilar mass is 36 x 46 mm (series 6, image 38), previously 35 x 42 mm, but not significantly changed on the coronal series.Left upper lobe fat-containing nodule consistent with a hamartoma is unchanged.No new suspicious pulmonary nodules. Mild to moderate emphysema.MEDIASTINUM AND HILA: Reference 9 mm subcarinal lymph node, unchanged. Right hilar lymphadenopathy inseparable from the perihilar mass, similar to prior.Mild coronary artery calcification.Small right thyroid lobe nonspecific hypodensities, unchanged.CHEST WALL: Stable lower thoracic vertebrae compression deformities. Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. See separately dictated same day CT abdomen/pelvis report. | Stable right perihilar mass. No new sites of disease. |
Generate impression based on findings. | Reason: evaluate for response to chemotherapy; angiosarcoma of vocal cords. History: evaluate for response to chemotherapy; angiosarcoma of vocal cords. LUNGS AND PLEURA: Scattered benign-appearing pulmonary micronodules, unchanged. No new suspicious pulmonary nodules or masses.No focal airspace consolidation.No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Moderate coronary artery calcification.No mediastinal or hilar lymphadenopathy.CHEST WALL: Right chest port, tip in the SVC.Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of metastatic disease or other significant abnormality. |
Generate impression based on findings. | Shoulder pain, lymphoma on CT guided biopsy Marked distraction and loss of the glenoid and a large lytic lesion extending into the scapular with minimal scattered osseous nonspecific fragments. Diffuse demineralization with a downward projected humeral head, representing possible large shoulder effusion. | Large scapular lytic lesion with marked destruction and loss of the glenoid. Appearance similar to recent CT 1/29/15 |
Generate impression based on findings. | The patient submitted outside mammogram dated 11/8/2014, from Advocate Trinity Hospital. Submitted outside study was compared to mammograms dated 11/15/2013 and 11/09/2012. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Benign morphology mass in the left lateral breast has previously been documented as a cyst on prior ultrasound exam dated 12/10/2013. An additional benign morphology mass in the left lateral breast has resolved on the most recent exam. These findings are compatible with waxing and waning cysts. There are no suspicious microcalcifications or areas of architectural distortion present in the left breast. | Waxing and waning cysts in the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine diagnostic mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Prostate cancer. Foci of activity in the T7 and T12 vertebrate, right posterior elements of L2 and within the left inferior medial iliac wing have significantly increased in size and/or osteoblastic activity compared to the previous exam, which is very suspicious for progression. Again seen is a faint right ninth rib lesion which is stable and may represent either a metastasis or a benign osseous lesion. Foci of increased activity in the cervical spine are likely degenerative. Activity from degenerative changes are seen in the bilateral knees, ankles, and feet. | Increased size and activity of four active bone metastases without new lesions, very suspicious for osseous metastatic progression. However, in there has been recent therapy, flare phenomenon may also be considered. |
Generate impression based on findings. | The patient submitted outside mammogram dated 12/5/2012, from HealthEast Health Care System. Submitted outside study was compared to the current mammogram dated 1/19/2015. The breast parenchyma is almost entirely fatty. Previously identified focal asymmetry in the right superior breast is stable when compared to the prior exam. Postsurgical changes, including coarse dystrophic calcifications in the right breast, are compatible with bilateral breast reduction. There are no new suspicious microcalcifications or areas of architectural distortion.There is no significant change between these two studies. | Stable focal asymmetry in the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually, due next in Jan 2016.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Pain A right total reverse shoulder arthroplasty remains in alignment with a questionable small effusion. Specifically the glenoid and humeral stem components appear intact without evidence of loosening or superimposed new complication. Minimal polygonal soft tissue lucency representing suspected gas is observed overlying the shoulder joint and just proximal to the tuberosity. This may represent a skin defect and related to patient's recent surgery, please correlate physical exam. Specifically however if there is concern for infection, follow-up imaging may be indicated | Nonspecific focal lucency suggesting gas and probable skin ulceration/incision, however see recommendation provided above |
Generate impression based on findings. | There is moderate motion degradation limiting evaluation. Within this limitation, there is no gross evidence of intracranial hemorrhage or significant mass effect. There is unchanged periventricular white matter hypoattenuation which is more focal in the posterior limb of the right internal capsule and adjacent to the right frontal horn, nonspecific, likely representing chronic microvascular ischemic changes. The ventricles and basal cisterns are unchanged with no hydrocephalus. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. A nasogastric tube is partly imaged. | Motion degraded exam with no gross intracranial hemorrhage or mass-effect. |
Generate impression based on findings. | Metastatic prostate cancer. Assess for progression. There are two new areas of significantly increased radiotracer uptake within the left iliac bone/acetabulum and the left proximal femur indicating progression of osseous metastases. Mild degenerative uptake is noted at the AC joints and the lower lumbar spine. | Progression of osseous metastases with two new significant osteoblastic lesions. |
Generate impression based on findings. | History of renal mass. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Subcentimeter low attenuation hepatic lesions in the dome and in segment 6 too small to characterize but probably benign cysts, unchanged. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple bilateral renal lesions which enhance, have increased in size compared to the 2012 exam, and are suspicious for malignancy, most likely papillary renal cell carcinoma. There are at 6 lesions in the right kidney which demonstrate enhancement. The largest enhancing lesion in the right midpole (series 7, image 44) measures 2.2 x 2.1 cm, measured 1.0 x 1.1 cm on 2012 outside CT.There are at 5 lesions in the left kidney which demonstrate enhancement. A reference enhancing lesion in the left lower pole (series 7, image 60) measures 1.9 x 1.5 cm, measured 0.8 x 0.9 cm on 2012 outside CT.A left lower pole exophytic cyst has slightly increased in size but does not enhance. The kidney excrete symmetrically. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Multiple bilateral renal lesions which enhance, have increased in size compared to the 2012 exam, and are suspicious for malignancy, most likely papillary renal cell carcinoma. Discussed findings with Dr. Zeytinoglu at 2:12 p.m on 2/13/2015. |
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