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Generate impression based on findings. | Nausea and vomiting No acute intrathoracic findings. No bowel obstruction or free air. | No acute intrathoracic findings. No bowel obstruction or free air. |
Generate impression based on findings. | NG tube placement Distal end of the NG tube within stomach. Dilated small bowel loops again noted | Distal end of NG tube within stomach. Small bowel obstruction again noted. |
Generate impression based on findings. | NG tube placement Distal end of the NG tube within stomach. No bowel obstruction | Distal end of NG tube within stomach. No bowel obstruction |
Generate impression based on findings. | NG tube placement Distal end of ET tube at thoracic inlet. Distal end of the NG tube at GE junction with distal side port within distal esophagus. No bowel obstruction. | Distal end of NG tube at GE junction with distal side port within distal esophagus. No bowel obstruction. |
Generate impression based on findings. | Dysphagia Distal end of feeding tube within stomach. No bowel obstruction | Distal end of feeding tube within stomach. No bowel obstruction |
Generate impression based on findings. | Feeding tube Distal end of feeding tube coiled within stomach. No bowel obstruction | Distal end of feeding tube coiled within stomach. No bowel obstruction |
Generate impression based on findings. | Feeding tube placement Distal end of the feeding tube coiled within stomach. No bowel obstruction | Distal end of the feeding tube coiled within stomach. No bowel obstruction |
Generate impression based on findings. | Right lower quadrant and CVA tenderness ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis with subtle pericholecystic infiltration and possible wall thickening.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: 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 | Cholelithiasis associated with subtle pericholecystic soft tissue infiltration with possible gallbladder wall thickening. The findings raise the possibility of acute cholecystitis. Would recommend correlation with ultrasound. Otherwise negative examination. |
Generate impression based on findings. | HEAD: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. Prominence of the CSF space is seen along the posterior midline cerebellum likely representing either a mega cisterna magna or an arachnoid cyst. The calvarium is intact.MAXILLOFACIAL: There is no acute facial bone fracture. The mandible, orbits, and globes are intact. There is no retrobulbar hematoma. There is mild mucosal thickening in the right maxillary sinus. The visualized paranasal sinuses are otherwise clear. There is no significant facial soft tissue swelling. | No evidence of acute traumatic injury to the head or face.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Metastatic breast carcinoma CHEST:LUNGS AND PLEURA: Emphysema again noted. Subcentimeter left upper lobe micronodule stable best seen on image 22 of series 5 measuring 0.4 cm in diameter.Loculated right pleural effusion unchanged. Interval increase in size of right pleural-based enhancing nodule best seen on image 79 of series 3 measuring 1.7 x 0.7 cm; this is in comparison to 1.1 x 0.5 cm on 11/14/2014.MEDIASTINUM AND HILA: Small thrombus associated with the central line within the right jugular vein unchanged. Distal end of the central line within the right atrium.CHEST WALL: No change in bony metastatic fociABDOMEN: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: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No change in bony metastatic fociOTHER: 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 change in bony metastatic fociOTHER: No significant abnormality noted. | Interval increase in size of enhancing right pleural-based nodule worrisome for metastatic focus. No change in bony metastases. |
Generate impression based on findings. | Pain, patient fell check for fracture Knee: Diffuse demineralization mildly limits sensitivity. Deformity and a suspected transverse patellar fracture is observed, please correlate with patient's site of symptoms. No distinct overlying soft tissue swelling, this may represent an old deformity difficult to confirm on alternate views due to extensive overlapping structures. Specifically if confirmation is needed, a CT may be indicated. Old deformity is identified extending to the metaphysis of the distal femur without additional acute abnormality of the knee. Surrounding soft tissues are unremarkable and the distal osteotomy margin is sharp.Femur: Moderate hip osteoarthritis without additional more proximal femoral abnormality. Vascular stenting is observed within the thigh with graft material | Questionable patellar deformity and suspected fracture. Pager 2567 contacted |
Generate impression based on findings. | There is no acute intracranial hemorrhage, mass effect, or midline shift. The ventricles, sulci, and cisterns are normal in size and configuration with preserved gray-white differentiation. On the most inferior image, an apparent lucency involving the left anterior arch of C1 likely represents partial volume averaging. Otherwise, the calvarium is unremarkable without fracture. The imaged portions of the orbits, paranasal sinuses, and mastoid air cells are unremarkable. | 1. No acute intracranial hemorrhage or mass effect.2. Apparent lucency involving the left anterior arch of C1 on the most inferior image most likely represents artifactual partial volume averaging. However, if there is clinical suspicion for acute cervical spine pathology, a cervical spine CT should be considered. |
Generate impression based on findings. | CT neck soft tissues: There is no evidence of a mass lesion or significant cervical lymphadenopathy. There is suspected mild bilateral orbital exophthalmos. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is complete osseous fusion of C7-T1 and partial fusion of C3-4, 4-5, and 5-6, with relative sparing of the cervical intervertebral disk spaces. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.CT orbits: There is suspected bilateral exophthalmos with symmetric prominence of both lacrimal glands. The globes, extraocular muscles, and optic nerves appear unremarkable. The intraconal fat is preserved. There is mild opacification of the right ethmoids, otherwise the sinuses appear unremarkable. There is no fracture. | 1. No evidence of neck mass, thyroid abnormality, or orbital cellulitis as clinically questioned. 2. Symmetric bilateral prominence of the lacrimal glands without evidence of malignancy or infection. This finding is nonspecific but could reflect a systemic inflammatory or autoimmune process. 3. Multilevel cervical spinal fusion with relative sparing of the intervertebral disk spaces may likewise reflect a systemic inflammatory or autoimmune process, with the differential including seronegative spondyloarthropathies. 4. Suspected orbital exophthalmos which can be a normal variation. |
Generate impression based on findings. | Shoulder pain. ROMVIEWS: Left shoulder in internal and external rotation 2/14/15 (two views) Fragmentation of the distal acromion may represent avulsion fracture versus normal variant. Please correspond with a maximal point of tenderness. No malalignment or additional fractures noted. | Skeletal solution of fracture versus normal variant of the distal acromion as described. |
Generate impression based on findings. | 50-year-old male. CT to evaluate lung cancer. CHEST:LUNGS AND PLEURA: Right paratracheal mass in the upper lobe is 55 x 42 mm (series 3, image 25), previously 35 x 29 mm.Mild paraseptal emphysema with apical bullae.Calcified lung nodules consistent with healed granulomatous disease. No new suspicious pulmonary nodules or masses.Very mild lower lobe bronchiectasis.MEDIASTINUM AND HILA: Aforementioned right upper lobe mass invades into the mediastinum and is contiguous with the right half of the trachea. The right brachiocephalic artery and vein are inseparable from this mass.No mediastinal or hilar lymphadenopathy. Calcified left hilar nodes consistent with healed granulomatous disease.Normal heart size without pericardial effusion. Low-density cardiac blood pool consistent with anemia.Mild coronary artery calcification.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Small sclerotic focus in the right sacrum is likely benign bone island.OTHER: No significant abnormality noted. | Increased size of right paratracheal mass consistent with known primary lung cancer. No new sites of disease. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild periventricular white matter hypoattenuation which is nonspecific, likely representing age indeterminate microvascular ischemic changes. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are mild atherosclerotic calcifications in the left V4 vertebral artery segment and bilateral cavernous carotid arteries. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or skull fracture. Mild age indeterminate microvascular ischemic changes. CT is insensitive for detection of early nonhemorrhagic stroke. |
Generate impression based on findings. | TxN2cM0 squamous cell carcinoma status post chemo/RT followed by right neck dissection with right vocal cord paralysis. Neck: There are post-treatment findings in the neck, including prior right neck dissection and persistent marked supraglottic mucosal edema with associated airway narrowing. There are also a few punctate calcific foci along the epiglottis and diffuse stranding of the subcutaneous fat in the anterior neck related to treatment effects. However, there is no evidence of measurable residual mass lesions or significant lymphadenopathy in the neck. For example, a left supraclavicular lymph node measures 6 mm in short axis. There is unchanged mild narrowing of the right carotid artery associated with a small amount of residual ill-defined soft tissue, which is otherwise not readily measurable. There is a central venous catheter, but the inferior left jugular vein and much of the right internal jugular vein are inapparent. The parotid and submandibular glands are heterogeneously hyperattenuating, likely due to treatment effects. The thyroid appears unremarkable. The osseous structures are unchanged. There is pulmonary emphysema and micronodules.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 mastoid air cells are clear. There is mild scattered paranasal sinus opacification. The skull and scalp soft tissues are unremarkable. | 1. No definite evidence of measurable residual mass lesions or significant lymphadenopathy in the neck amidst extensive post-treatment effects with persistent markedly edematous tissue in the supraglottic region associated with airway narrowing, as well as a small amount of residual ill-defined soft tissue associated with mild narrowing of the carotid artery. 2. No evidence of intracranial metastases.3. Pulmonary emphysema and micronodules. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | History of thyroid cancer metastatic to the skull s/p thyroidectomy and resection of the skull lesion. Neck: The thyroidectomy bed appears unchanged. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The salivary glands are unremarkable. The major cervical vessels are patent. There is a retropharyngeal course of the right carotid artery. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. There are bilateral pulmonary nodules. There is an unchanged nonspecific subcentimeter subcutaneous nodule in the left cheek. There is unchanged curvilinear metallic structure in the posterior left neck subcutaneous tissues. Head: There are stable postoperative findings related to cranioplasty and debulking of the large calvarial lesions. There is no significant interval change in the expansile calvarial metastases with associated mass effect upon the underlying the brain parenchyma. For example, the left frontal lesion measures 34 x 59 mm, previously 35 x 59 mm, the left occipital lesion measures 37 x 68 mm, previously 38 x 66 mm, and the left occipital condyle lesion measures 12 x 16 mm. Otherwise, there is no evidence of abnormal intraparenchymal enhancement. The ventricles are unchanged in size and configuration. There is a partially empty sella. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. | 1. No evidence of measurable tumor recurrence in the neck.2. No significant interval change in the skull metastases.3. Lung metastases. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Male, 18 years old, with severe upper airway obstruction. The osseous structures of the skull are intact. The calvarium is symmetric and normal in size. The major calvarial sutures are identified and are normal.Mild malocclusion is seen with an apparent slight mandibular underbite. This may reflect abnormalities of dentition in the anterior maxilla where the incisors and canines demonstrate a jumbled, malaligned and malpositioned distribution. The anterior mandibular teeth are also somewhat malaligned and disorganized but to a lesser degree. The mandible is intact and seems to be normally formed. The skin of the face is diffusely and uniformly thickened. The skin of the scalp is very irregular with areas of volume loss, possibly surgical, involving the right temporal region and to a lesser extent the left parietal region. A region of significantly thickened skin is seen along the right parietal bone with a less severely thickened region along the left parietal bone.Views of the intracranial structures and the soft tissues of the neck reveal no significant abnormalities. The adenoidal tissues are mildly prominent but not out of proportion to typical findings in this age group. | 1.Diffuse facial skin thickening with regions of more significant thickening seen along the scalp bilaterally. Scalp soft tissue defects may reflect prior surgical intervention.2.Mild malocclusion which may be secondary to malalignment and disorganization of the incisors and canines affecting the maxillary more than the mandibular teeth. |
Generate impression based on findings. | There is generalized parenchymal volume loss and periventricular hypoattenuation consistent with age-indeterminant small vessel ischemic disease. There is no acute intracranial hemorrhage, mass effect, or midline shift. There is a hematoma of the frontal calvarial soft tissues without underlying fracture. Extensive degenerative changes of C1 and C2 are partially imaged. | 1. Frontal scalp hematoma without underlying fracture. 2. No acute intracranial hemorrhage or edema. |
Generate impression based on findings. | There is pointed morphology with inferior herniation of the right cerebellar tonsil measuring up to 12-mm below the foramen magnum (soft tissue sagittal series 80269 image 32) suggesting Chiari I malformation. However, this can be confirmed with MRI.There is trace right maxillary sinus mucosal thickening. The remaining paranasal sinuses are clear. The ostiomeatal complexes and sphenoethmoidal recesses are patent. There are hypoplastic bilateral mastoid air cells, which are otherwise clear. The marked nasal septum is deviated to the right with effacement of the right middle meatus. The orbits and imaged intracranial structures are otherwise within normal limits. | 1.Findings suggesting Chiari I malformation, however confirmation is recommended with MRI brain and cervical spine.2.Trace right mastoid sinus mucosal thickening. No evidence of acute sinusitis.3.Marked rightward nasal septal deviation with effacement of the right middle meatus. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is a tiny calcification in the right frontal high convexity probably representing dural calcification. There is scattered mild ethmoid sinus mucosal thickening. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or mass-effect.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | There is no evidence of mass lesions or significant cervical lymphadenopathy. There are scattered small cervical lymph nodes which are unchanged in size and morphology. There are bilateral palatine tonsilloliths again seen. The left submandibular gland is atrophic but unchanged. The thyroid and remaining major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures show no discrete lesions. There is mild cervical spondylosis. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | Posttreatment findings with no evidence of recurrent tumor or significant cervical lymphadenopathy. Scattered small cervical lymph nodes without an acute change. |
Generate impression based on findings. | Female, 73 years old, with history of left cavernous sinus aneurysm, yearly surveillance scan. History of acoustic tumor status post removal in 1989. An aneurysm arising from the left cavernous ICA, just past the second genu, shows no significant interval change in size or morphology. The lesion is directed superiorly and laterally and continues to measure approximately 4 mm from base to apex with a neck of approximately 5 mm.No new aneurysms are detected. There may be a focal stenosis within the right A2 segment of the ACA just as the vessel rounds the genu of the corpus callosum. No other significant vascular abnormality is detected. Anomalous fenestration of the basilar artery is redemonstrated. | Stable left ICA aneurysm. |
Generate impression based on findings. | Male, 68 years old, with confusion, status post subdural hematoma and hygroma. Fairly symmetric bilateral subdural hygromas along the cerebral hemispheres have not significantly changed in size. For reference, the hygroma on the left measures up to 13 mm in reference, previously 13 mm. Mild prominence of the subdural space also persists along the left cerebellar hemisphere unchanged.A small hyperattenuating focus in the left superior frontal gyrus is unchanged. Hyperattenuating foci reported on prior examination in the left centrum semiovale and left temporal lobe are not clearly identified. Minimal sulcal hyperattenuation along the right temporal lobe is also unchanged. Patchy scattered foci of hypoattenuation are demonstrated particularly within the bilateral thalami, again stable. No new fluid collections are detected. The ventricles are normal in size morphology. | 1.Stable bilateral subdural hygromas.2.Stable trace subarachnoid blood product along the right temporal lobe.3.Stable small focal hemorrhages in the left superior frontal gyrus.4.Scattered areas of hypoattenuation are unchanged, nonspecific finding which may reflect age indeterminate microvascular ischemic disease. |
Generate impression based on findings. | Male, 89 years old, stroke. Assess status of petechial hemorrhage. Hypoattenuation involving the right basal ganglia is unchanged in extent but slightly better defined than on the prior examination compatible with expected evolution of stroke. Central to this region there is very subtle increased attenuation similar to the prior examination which could represent petechial blood. No frank hemorrhagic conversion is seen.No new loss of gray-white distinction is detected. No significant generalized mass effect is seen. The right frontal horn is partially effaced by the adjacent ischemic lesion similar to the prior examination. No large extra-axial fluid collections are detected. The ventricular system is stable in size and morphology. | 1. Expected evolution of the appearance of a right basal ganglia stroke with no interval expansion in geographic extent.2. Minimal petechial blood product internal to the stroke is unchanged.3. No new intracranial lesions are seen. |
Generate impression based on findings. | Male 56 years old Reason: RLQ pain, hernia, appendicitis, less likely renal stones History: as above ABDOMEN:LUNG BASES: Dilated distal esophagus secondary to patient's known history of achalasiaLIVER, BILIARY TRACT: Nonspecific subcentimeter hypodensities within the liver, too small to accurately characterize but are most likely benignSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral small cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Periumbilical hernia containing nonobstructed small bowel segments.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No CT findings to explain patient's right lower quadrant pain. |
Generate impression based on findings. | Female 18 years old Reason: r/o hematoma, intraabdominal pathology History: was shoved in stomach, domestic dispute, epigastic and RLQ abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes in the thoracic spineOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No CT findings of acute traumatic injury |
Generate impression based on findings. | Female 21 years old Reason: New fever, crohns disease with prior tuboovarian abscess History: new fever, rising CRP ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Significant diffuse wall thickening and increased enhancement of the entire colon segments consistent with pancolitis. This has progressed from previous CT and also now extends to the cecum. Interval development of a fluid collection adjacent to the cecum suspicious for an abscess. This collection measures 2.8 by 2 cm on image number 74, series number 3. More inferiorly near the base of the cecum, there is another collection which also represent another abscess.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: Please see discussion aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval worsening of pancolitis and interval development of fluid collections in the cecum suspicious for abscess |
Generate impression based on findings. | Female 45 years old Reason: resolution of pelvic abscesses History: abdomninal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild small bowel dilatation likely secondary to focal ileus caused by pelvic abscesses as slightly improved.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: Interval removal of pigtail catheter. Multiloculated pelvic collections are slightly smaller on today's study. A right-sided localized collection now measures 1.7 x 1.9 cm. Small amount of free fluid in the pelvis and fat stranding persists. | Interval decrease in the size of the pelvic multiloculated abscesses. Mild ileus as described above. |
Generate impression based on findings. | Female 38 years old Reason: 38 y/o F w/ Hx of endometriosis 1 week post op total lap colectomy w/ ileostomy who presents w/ diffuse abdominal pain and rectal pain would like to evaluate ileum and rectum specifically (IV and PO contrast) History: Abdominal pain radiation from RLQ to L back, rectal pain, failure to pass flatus ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: There is a focal increase in enhancing area in the tail of the pancreas measuring 8 x 7 mm on image number 35, series number 3. Compared to MRI dated 10/20/2014 this area of abnormality is smaller. Further evaluation with a repeat MR is recommended.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant ileostomy. Postsurgical changes in the anterior abdominal wall.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: The wall of the pouch is slightly thickened and edematousBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of free fluid in the pelvis. | Postsurgical changes secondary to colectomy. Subcentimeter hyperdense lesion in the pancreatic tail. Further evaluation with a repeat pancreas MRI is recommended.Wall thickening of the pouch may represent pouchitis. |
Generate impression based on findings. | Female 40 years old Reason: eval for small bowel mass, ?abscess, ?obstruction, cause of ab pain, N/V History: N/V, ab pain, weight loss ABDOMEN:LUNG BASES: Bilateral moderate pleural effusions and atelectasisLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Streaky artifacts due to residual barium in the descending colon limit optimal evaluation of the left side of the abdomenBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterine fibroidsBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of free fluid in the pelvis | Bilateral moderate sized pleural effusions and dependent atelectasis |
Generate impression based on findings. | Female 71 years old Reason: 71 y/o F p/w abdominal bleeding x2 weeks was told in Belize she had a large cervical pelvic mass History: Vaginal bleeding, LLQ abdominal mass on exam ABDOMEN:LUNG BASES: Small right-sided pleural effusionLIVER, BILIARY TRACT: Mild periportal edema. A small amount of perihepatic ascites.There is a 2.5 by 2.8-cm ill-defined hypodense lesion in the right lobe liver, adjacent to the gallbladder. Adjacent gallbladder wall is slightly thickened. Given the presence of a large malignant ovarian mass and metastatic retroperitoneal adenopathy, this lesion may represent metastatic disease, however, because of its ill-defined borders and focal wall thickening of the adjacent gallbladder, possibility of an abscess cannot be entirely excluded. No evidence of intra-or extrahepatic biliary dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Extensive retroperitoneal metastatic disease. An index portacaval partially necrotic node measures 2.4 x 3.8 cm on image number 32, series number 4.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of ascites. Fat containing periumbilical hernia.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Complex cystic right ovarian mass with solid components measuring 14.4 x 13 cm suspicious for an ovarian neoplasm. This mass invades the uterus. There are multiple fibroids arising from the uterus. Left ovary is likely posterior to the uterus and appears unremarkable and normal in size. Small amount of fluid in the pelvis.BLADDER: No significant abnormality notedLYMPH NODES: Pelvic adenopathy. Index left iliac node measures 1.9 x 1.7 cm on image number 61, series number 4.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Right ovarian complex cystic mass with solid component suspicious for ovarian malignancy. Retroperitoneal and pelvic metastatic adenopathy.Ill-defined hypodense lesion in the liver suspicious for metastatic disease, however, an abscess cannot be excluded. Focal gallbladder wall thickening involving the fundus of the gallbladder. Clinical correlation of these findings and further evaluation with right upper quadrant ultrasound is recommended.Small right-sided pleural effusion. |
Generate impression based on findings. | Female 60 years old Reason: evaluate for acute intra abdominal process History: abdomoinal pain and vomiting ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Significant into and extrahepatic biliary dilatation throughout the common bile duct is unchanged compared to previous study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: 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: Small amount of fluid in the pelvis. | Persistent intra-and extrahepatic biliary dilatation. No significant change from previous study. |
Generate impression based on findings. | Male 78 years old Reason: metastatic work up for brain mass History: seizure CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Diffusely dilated esophagus which may be secondary to reflux. Exact etiology is unknown.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver. There are small hypodense lesions in the liver, some of it are too small to accurately characterize but are most likely cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal nodule measuring 2 x 2.6 cm. metastatic disease cannot be excluded. MRI may be helpful for further evaluation of this lesion.KIDNEYS, URETERS: Bilateral renal cysts.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: Status post prostatectomy. Surgical changes secondary to prostatectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Left adrenal mass of uncertain etiology area MRI may be helpful for further evaluation.Diffusely dilated esophagus of uncertain etiology and significance. Endoscopy helpful for further evaluation of the distal esophagus.Diffuse fatty infiltration of the liver and small hypodense lesions of uncertain etiology. MR may be helpful for further characterization of these lesions. |
Generate impression based on findings. | Male 51 years old Reason: Re-evaluate disease status following completion of maintenance immunotherapy; compare to previous scan History: Stage III melanoma CHEST:LUNGS AND PLEURA: Stable subcentimeter micronodular image number 39, series number 9 in the right upper lobe. No new nodules.MEDIASTINUM AND HILA: Ortolani enlarged mediastinal and bilateral axillary lymph nodes are stable.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Cluster of nonenlarged mesenteric lymph nodes are stable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No significant change from previous study. |
Generate impression based on findings. | Female 65 years old Reason: Ovarian cancer History: progressive leg edema right more than left CHEST:LUNGS AND PLEURA: Peripheral groundglass tree in bud opacities are again seen. Fat long-standing right-sided diaphragmatic hernia, unchanged.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: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Index left common iliac lymph node is unchanged measuring 6 in diameter on image number 124, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: Index right external iliac lymph node now measures 4 mm in diameter on image number 150, series number 3.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant change from previous study. |
Generate impression based on findings. | Female 41 years old Reason: 41 female with history of umbilical hernia and ? inguinal hernia, please eval History: hernia as above ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Bilobar numerous cystic lesions compatible with biliary hamartomasSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small periumbilical hernia containing nonobstructed bowel segments.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: Small amount of fluid in the right inguinal canal. This measures secondary to a right inguinal hernia. | Small periumbilical hernia containing unobstructed bowel segments. Small amount of fluid in the right inguinal canal which measures secondary to inguinal hernia. |
Generate impression based on findings. | Male 56 years old Reason: history of met castrate resistant prostate ca; staging History: staging CT CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged. Bilateral moderate pleural effusions and dependent atelectasis, new from previous study.MEDIASTINUM AND HILA: Diffuse wall thickening of the esophagus and stomach. Etiology is unknown.CHEST WALL: Sclerotic bone lesions consistent with metastatic disease have slightly progressed and now also involve the vertebral bodies and posterior rib lesions.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Index portacaval lymph node measures 2.1 by 2 cm on image number 107, series number 5. Other retroperitoneal lymph nodes are also grossly unchanged. Double IVC is unchanged. Index paracaval node measures 5 mm in diameter on image number 156, series number 5, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: New, sclerotic vertebral body lesions suspicious for metastatic disease.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: New, sclerotic, vertebral body and pelvic bone lesions suspicious for metastatic disease.OTHER: No significant abnormality noted | New bone lesions suspicious for metastatic disease.New bilateral moderate pleural effusions and diffuse wall thickening of the esophagus and stomach. Etiology of this is unknown. |
Generate impression based on findings. | Female 44 years old Reason: abdominal pain r/o colitis History: left upper and lower abd pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: 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 | Normal study. |
Generate impression based on findings. | 64 years old, Female, Reason: r/o acute abnormality History: sob PULMONARY ARTERIES: Pulmonary artery opacification adequate to a subsegmental level. No evidence of pulmonary embolism.LUNGS AND PLEURA: Bibasilar bronchiectasis is present. There is mucous plugging in the left lower lobe. Mild left basilar atelectasis is present. The trachea and main bronchi are patent. There is a new ground glass opacity in the left upper lobe (series 8 image 35), which may be infectious or inflammatory in etiology. There is mild atelectasis in the lingula. Previously seen cluster micronodules appear somewhat smaller on this exam (series 8 come image 69). Ground glass opacity in the right middle lobe which may be infectious or inflammatory in etiology. No pleural effusion.MEDIASTINUM AND HILA: Moderate atherosclerotic calcifications of the coronary arteries are present. The great vessels are normal in caliber. Right hilar lymph node measures 10 mm (series 7, image 126), and may be reactive in etiology. There is no significant internal mammary and cardiophrenic, or retrocrural lymphadenopathy by CT size criteria. Air filled esophagus.CHEST WALL: No significant axillary lymphadenopathy CT size criteria. Healing sixth and seventh rib fractures. Mild degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of pulmonary embolism. 2.Bibasilar bronchiectasis with mucous plugging in the left lower lobe.3.Groundglass opacity in left upper lobe is nonspecific but may be infectious or inflammatory etiology.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male 66 years old Reason: recurrent urothelial cancer in the bowel wall by biopsy, evaluate for measurable disease History: recurrent urothelial cancer in the bowel wall by biopsy, evaluate for measurable disease ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic right kidney. Right lower quadrant ileostomy. Cholelithiasis.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: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of free fluid in the pelvis. | No MR evidence of recurrent or metastatic disease. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is partial opacification of the left maxillary sinus. The imaged paranasal sinuses and mastoid air cells are otherwise clear. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or skull fracture. |
Generate impression based on findings. | Male 5 months old Reason: evaluate for intrapulmonary process, pneumonia, trach placement History: hypoxia, persistent pulmonary hypertension.VIEW: Chest AP (one view) 2/14/15 at 1132 hrs. Tracheostomy tube terminates at the thoracic inlet. NG tube is noted. Cardiac silhouette size is normal. No effusions or pneumothorax. Right lower lobe opacity, likely atelectasis on a background of chronic lung disease. | Right lower lobe opacity, likely to the testes on a background of chronic lung disease. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. An apparent focal small area of hyperattenuation in the right anterior aspect of the medulla (described on the preliminary report) is likely artifactual. There is minimal periventricular and subcortical white matter hypoattenuation which is nonspecific, likely representing chronic microvascular ischemic changes. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is an old left lamina papyracea fracture. The skull and extracranial soft tissues are otherwise unremarkable. | No acute intracranial hemorrhage or mass effect. |
Generate impression based on findings. | Female 2 months old Reason: evaluate for NEC History: abdominal distention > 3cmVIEW: Chest and abdomen AP (two views) 2/14/15 at 1306 hrs. NG tube terminates at the antral pyloric region. Cardiac silhouette size is normal. Persistent bilateral diffuse haziness with no focal opacities, effusions or pneumothorax.Generalized, nonspecific bowel distention. No evidence of obstruction or free air. No pneumatosis intestinalis or portal venous gas. No ascites. | Persistent bilateral diffuse lung haziness.Nonspecific and generalized bowel distention |
Generate impression based on findings. | 85 years old, Female, Reason: r/o PE History: Tachy and hypoxic PULMONARY ARTERIES: Large right main pulmonary artery embolism extending into the lobar and segmental levels. There straightening of intraventricular septum suggestive of right heart strain. The main pulmonary artery measures 2.7 cm, within normal limits.LUNGS AND PLEURA: Right lower lobe pulmonary opacity has a geographic appearance and is favored to represent evolving infarct. Bilateral pleural effusions are present left greater than right. There is severe atelectasis of the left lower lobe. Previously noted spiculated mass in the area of the lingula appears similar to prior study measuring 2.0 x 1.7 cm (series 13, image 43).MEDIASTINUM AND HILA: An AP window lymph node measures 10 mm (series 10 come image 81). There is no hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Large right main pulmonary artery embolism extending into the lobar and segmental levels with associated right lower lobe infarct.2.Bilateral pleural effusions.3.Spiculated subpleural mass is highly suspicious for neoplasm.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Single.Most Proximal: Main.RV Strain: Positive. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is a small ill-defined right middle frontal gyrus hypoattenuation which is new from prior exam, and nonspecific, and may possibly even be artifactual. Right precentral gyrus hypoattenuation seen on prior exam is not definitely seen on prior exam. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is near complete opacification of the imaged maxillary sinuses, right nasal cavity, and moderate opacification of the bilateral ethmoid air cells, similar to the prior examination. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or mass effect. |
Generate impression based on findings. | Male 12 years old Reason: eval for fx, able to move all joints History: pain after slamming in door frame injury to 3rd and 4th fingerVIEWS: Right hand AP, lateral and oblique 2/14/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Male 16 months old Reason: Concern for obstruction History: Frequent emesis and loose stools.VIEWS: Abdomen AP supine and left lateral decubitus (two views) 2/14/15 Normal abdominal gas pattern. No evidence of obstruction or free air. | Normal examination. |
Generate impression based on findings. | Male 10 months old Reason: signs of obstruction, other abnormalities History: Acute on chronic vomiting in child with failure to thriveVIEWS: Abdomen AP supine and left lateral decubitus (two views) 2/14/15 at 1639 hrs. Umbilical line has been removed. Not obstructive abdominal gas pattern. Mild to moderate fecal accumulation. No free air or pneumatosis intestinalis. | Mild to moderate fecal accumulation with no evidence of obstruction. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is small region of ill-defined hypoattenuation in the left subinsular region which was present on the prior examination, along with subtle hypoattenuation in the anterior temporal lobes. Few scattered brain parenchymal calcifications seen on prior examination are grossly unchanged, for example in the left temporal lobe. The ventricles and basal cisterns are slight more prominent from prior exam, consistent with progressive mild volume loss. There is no midline shift or herniation. There is mild bilateral maxillary and left frontal, moderate bilateral ethmoid and sphenoid sinus mucosal thickening. There is moderate opacification of the left mastoid air cells and middle ear cavity. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or mass effect. |
Generate impression based on findings. | Female 12 years old Reason: eval for interval reduction L proximal humerus fx History: see aboveVIEWS: Left shoulder AP and transthoracic 2/14/15 at 2012 hrs. (Two views) Unchanged posterior angulation of the transverse fracture of the left humerus. | Left humerus transverse fracture, unchanged in alignment. |
Generate impression based on findings. | Female 12 years old Reason: r/o dislocation History: shoulder swellingVIEWS: Left shoulder AP and transthoracic at 2/14/15 at 1832 hrs. (Two views) Unchanged dorsal angulation of the transverse fracture of the left humerus with no evidence of dislocation. | Transverse fracture of the left humerus with no evidence of shoulder dislocation. |
Generate impression based on findings. | Female, 37 years old, subarachnoid hemorrhage, status-post EVD, assess ventricular size. Redemonstration of extensive subarachnoid hemorrhage located predominantly along the ventral brainstem in the posterior fossa. Evidence of intraventricular blood product persists with layering hyperdense blood in the occipital horns. The relative height of these blood fluid levels has increased since the prior examination, but this could simply reflect interval redistribution. Scattered subarachnoid blood product is also seen along the cerebral sulci, particularly the right sylvian fissure, unchanged.A right frontal approach ventriculostomy catheter remains in stable position. The ventricles remain dilated but the caliber has improved by several millimeters since the prior examination.Redemonstration of proximal hypoattenuation in the bilateral paramedian frontal lobes in the left opercular regions. | 1. Redemonstration of extensive subarachnoid blood along the brainstem, in the ventricular system, and scattered along the cerebral sulci. There may be some redistribution of blood products as evidenced by the changing blood fluid levels in the ventricles, but no substantial overall change in quantity of blood is suspected.2. The right frontal approach ventricular shunt catheter is stably positioned. There has been some interval improvement in ventriculomegaly. |
Generate impression based on findings. | Female 12 years old Reason: r/o dislocation, fracture History: pain, swellingVIEWS: Left shoulder AP in internal and external rotation 2/14/15 (two views) There is a transverse fracture of the proximal metadiaphysis of the left humerus with lateral and posterior angulation. No evidence of shoulder dislocation | Transverse fracture of the left humerus as described with no evidence of shoulder dislocation. |
Generate impression based on findings. | Male 14 days old Reason: 2 week old, intubated, reevaluation of left lung fields History: left lung opacificationVIEW: Chest AP (one view) 2/15/15 at 604 hours. ET tube terminates below thoracic inlet. NG tube tip is in the stomach. Right upper extremity PCVC terminates at the right innominate vein. Cardiac silhouette size is not visible due to a bi-basilar and left upper lobe opacities. Improvement in right upper lobe atelectasis. Mild soft tissue edema. | Multifocal opacities as described. |
Generate impression based on findings. | BRAIN: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is mild mucosal thickening of the ethmoid air cells. The imaged paranasal sinuses and mastoid air cells are otherwise clear. The skull and extracranial soft tissues are unremarkable. CERVICAL: There is severe beam hardening artifact at C6, C7 and T1 levels essentially rendering these levels nondiagnostic. Within this limitation, there is no acute fracture, subluxation, or prevertebral soft tissue swelling at other levels. There are degenerative changes in the cervical spine including uncovertebral hypertrophy causing moderate to severe left neural foraminal stenosis at C4-5. | 1.No acute intracranial hemorrhage or skull fracture.2.Very limited evaluation at C6 through the T1 levels due to beam hardening artifact. No definite acute fracture or subluxation at other levels, although examination at C6 through T1 is nondiagnostic due to artifact.3.Moderate to severe left neural foraminal stenosis at C4-5. |
Generate impression based on findings. | Male 14 days old Reason: ex-37 week NICU infant, s/p congenital diaphragmatic hernia repair, intubated with increased O2 requirement, please assess for new infiltrate History: Increasing O2 requirement, intubatedVIEW: Chest AP (one view) 2/14/15 at 1837 hrs. ET tube terminates below the thoracic inlet. NG tube tip is in the stomach. Right upper extremity PCVC terminates at the right innominate vein. Cardiac silhouette is not sizable note to wait complete opacification of the left and. Right upper and lower lobe atelectasis are noted as well. Interval improvement in right-sided pleural effusion. | Multifocal opacities as described. Possible left lung mucus plugging. Improvement in right-sided pleural effusion. |
Generate impression based on findings. | Male 3 years old Reason: R/O obstruction History: Patient with emesis and diarrhea. Mother concerned that the emesis looks and smells feculent.VIEWS: Abdomen AP supine and left lateral decubitus 2/14/15 (two views) Normal abdominal gas pattern. No evidence of obstruction or free air. | No obstruction or free air. |
Generate impression based on findings. | 35 years old, Male, Reason: r/ o PE History: chest pain, hypoxia PULMONARY ARTERIES: Adequate pulmonary opacification to the subsegmental level. No evidence of pulmonary embolism.LUNGS AND PLEURA: Mild bibasilar dependent atelectasis. Minimal centrilobular and paraseptal emphysema is present. No pneumothorax or effusion. No consolidation to suggest infection. Stable 3-mm right upper lobe nodule (series 6, image 38). Right middle lobe pleural-based nodule (series 6, image 80), is unchanged from prior study.MEDIASTINUM AND HILA: The heart is within normal limits without evidence of pericardial effusion. No significant mediastinal lymphadenopathy by CT size criteria. No hilar lymphadenopathy. No evidence of internal mammary cardiophrenic and retrocrural lymphadenopathy. No evidence of coronary artery calcifications are presentCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence pulmonary embolism. 2.Stable pulmonary nodules.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 15 years old Reason: ETT placement, new infiltrate History: desaturations in pt with respiratory failureVIEW: Chest AP (one view) 2/15/15 at 310 hours. Spinal rods again noted. ET tube terminates thoracic inlet. NG tube since. Right upper extremity central line tip is at the RA/SVC junction. Cardiac silhouette size is normal. Interval worsening in right lower lobe opacity either atelectasis or pneumonia and right-sided pleural effusion. | Interval worsening in right lung base opacity and pleural effusion. |
Generate impression based on findings. | Male 9 years old Reason: check ETT placement History: respiratory failureVIEW: Chest AP (one view) 2/15/15 at 539 hours. Central line terminates at the SVC. ET tube terminates below thoracic inlet. NG tube tip is in the stomach Cardiac silhouette size is normal. Interval complete atelectasis of the right flank, a mucous plugging is a consideration. Small left-sided pleural effusion unchanged. | Interval complete atelectasis of the right hand as described. |
Generate impression based on findings. | There is extensive soft tissue gas extending from the frontal scalp the bilateral preseptal soft tissues, pre-nasal soft tissues, dissecting inferiorly into the pre-maxillary soft tissues, the left masticator space and buccal space as well as the right buccal space. Soft tissue air also dissects along the left superior extraconal orbit towards the orbital apex. There is no intraconal air within the orbits. The globes are intact.There are bilateral comminuted nasal bone fractures with mild displacement. There is a comminuted fracture with mild displacement involving the posterior nasal osseous septum/vomer. The orbits, zygomas, pterygoid plates, lamina papyracea, the mandibles and imaged calvarium are intact.There is extensive dental disease. There are periapical lucencies involving the mandibular incisors, the left maxillary premolars and molars. There is also carious disease involving a left maxillary molar. | 1.Comminuted and mildly displaced bilateral nasal bone fractures and vomer. 2.Extensive facial superficial soft tissue gas extending from the frontal scalp, preseptal, pre-nasal and premaxillary soft tissues. Soft tissue air dissects the bilateral buccal spaces and into the left masticator space as well.3.Additionally, soft tissue gas dissecting along the superior extraconal left orbit without orbital fracture or retrobulbar hematoma. Globes are intact.4.Extensive dental disease as described above. |
Generate impression based on findings. | Male 4 months old Reason: ETT placement History: respiratory failureVIEW: Chest AP (one view) 2/15/15 at 550 hours. ET tube terminates at the carina. NG tube tip is in the stomach. Cardiac silhouette size is enlarged. Bibasilar streaky opacities, likely subsegmental atelectasis. No effusions or pneumothorax. | Cardiomegaly and multifocal opacities as described. |
Generate impression based on findings. | 48 years old, Female, Reason: r/o pe History: syncope, chest pain PULMONARY ARTERIES: There is adequate pulmonary artery opacification of the subsegmental level. There is no evidence of pulmonary embolism. The pulmonary arteries normal in caliber.LUNGS AND PLEURA: There is a 6-mm pulmonary nodule in the left lower lobe (series 10, image 83). There is a 5-mm pulmonary nodule no right lower lobe (series 10, image 81). There are two additional 4-mm nodules in the right upper lobe (series 10, image 38 and 39). There are scattered micronodules.MEDIASTINUM AND HILA: There is no significant mediastinal adenopathy by CT size criteria. The heart is at the upper limits of normal without evidence of pericardial effusion. There is no significant internal mammary cardiophrenic or retrocrural lymphadenopathy by CT size criteria.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No pulmonary embolism.2.Multiple pulmonary nodules the largest of which measures 6 mm. Recent guidelines by the Fleischner society (Radiology 2005: 237:395-400) suggest that patients with low risk for lung cancer and nodules greater than 4 mm and less than or equal to 6 mm in diameter should have follow up in 12 months. In patients with a higher risk, such as smokers, follow-up is recommended in 6 months. Patients with a known malignancy are at increased risk for metastasis and should receive a three month follow-up.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 15 years old Reason: f/u pleural effusion History: known pleural effusion, CT to water sealVIEW: Chest AP (one view) 2/15/15 at 534 hours. Central line terminates at the RA/SVC junction. Interval removal of epicardial drain. Left-sided chest tube is again noted. Cardiac silhouette size is top normal or mildly enlarged but stable. Persistent left retrocardiac opacity and bilateral pleural effusions. | No change in left lower lobe opacity and bilateral pleural effusions. |
Generate impression based on findings. | Male 12 years old Reason: ETT placement History: respiratory failureVIEW: Chest AP (one view) 2/15/15 at 611 hours. ET tube terminates below thoracic inlet. A likely venous access is overlying the medial aspect of the right arm. Thoracolumbar dextroscoliosis unchanged. Cardiac silhouette size is normal. Streaky opacities of the left upper and lower lobe noted. Atelectasis is a consideration. No effusions or pneumothorax. | Multifocal opacities as described. |
Generate impression based on findings. | Female 2 years old Reason: Fracture, AVN, bony lesion History: Acute refusal to bear weight on right leg.VIEWS: Pelvis AP and frog leg 2/15/15 (two views) Both round, smooth and normally formed femoral heads are well directed to a normally developed acetabulum. | Normal examination. |
Generate impression based on findings. | Female 50 days old Reason: follow up History: post operativeVIEW: Chest AP (one view) 2/15/15 at 713 hours. NG tube terminates above GE junction. Mediastinal clips unchanged. Interval epicardial pacer lead removal. Cardiac silhouette size is top normal. Streaky opacities of both lung bases and mild lung vascular engorgement. No effusions or pneumothorax. | Multifocal opacities and mild lung vascular engorgement. |
Generate impression based on findings. | Female 8 months old Reason: r/o new infiltrate History: desaturations despite increasing HFVIEW: Chest AP (one view) 2/15/15 at 719 hours. Cardiac silhouette size is top normal. Slight improvement in right upper lobe aeration with interval development of left upper lobe subsegmental atelectases. Left retrocardiac opacity is unchanged. | Multifocal opacities as described , on a background of chronic lung disease.. |
Generate impression based on findings. | Female 12 years old Reason: r/o fracture History: tender to MT/PIP jointVIEWS: Right foot AP, lateral and oblique 2/14/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 19 years old, Male, Reason: evaluate for mediastinal air History: injury w/concern for air on ct neck LUNGS AND PLEURA: No evidence of pneumothorax or pleural effusion. No focal consolidation to suggest infection. There is a 5-mm pulmonary nodule in the right lower lobe (series 4, image 56).MEDIASTINUM AND HILA: There is air tracking along the trachea down into the posterior mediastinum. There is no significant mediastinal lymphadenopathy by CT size criteria. Heart size within normal limits without pericardial effusion. No significant hilar, internal mammary, cardiophrenic or retrocrural lymphadenopathy.CHEST WALL: No significant axillary lymphadenopathy. Osseous structures are within normal limits.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. There is a nonspecific 6-mm hypodensity in the left hepatic lobe (series 3, image 92) which is too small to characterize on this noncontrast exam. | Pneumomediastinum without evidence of pneumothorax. |
Generate impression based on findings. | Female 2 months old Reason: NG tube placement History: confirm ng tube in proper placement, necrotizing enterocolitis.VIEW: Abdomen AP (one view) 2/14/15 at 1358 hrs. NG tube terminates in the stomach. Central line tip is at the right atrium. Changes of chronic lung disease note that. Left lower lobe opacity is present as well. Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | NG tube positioning as described. |
Generate impression based on findings. | Male 1 day old Reason: evaluate for esophageal probe placement History: part of cooling protocolVIEW: Chest AP (one view) 2/14/15 at 1437 hrs. Esophageal temperature probe terminates at the need esophagus. NG tube tip is at the stomach. UVC terminates at the IVC/right atrium junction. UAC tip is at T6. The aortic arch, cardiac apex and stomach and left-sided. Cardiac silhouette size is normal. No focal opacities, effusions or pneumothorax. | Esophageal temperature probe an umbilical lines positioning as described.No focal lung opacities. |
Generate impression based on findings. | Male 16 days old Reason: is there pneumatosis History: abdominal distention and emesisVIEW: Abdomen AP (one view) 2/14/15 at 1431 hrs. NG tube terminates in the stomach. Generalized, nonspecific bowel distention. No obstruction or free air. No pneumatosis intestinalis or portal venous gas. No ascites. | Generalized, nonspecific bowel distention. |
Generate impression based on findings. | 43 years old, Female, Reason: h/o klebsiella pneumonia, possible RLL infiltrate, fever - assess for PNA History: h/o klebsiella pneumonia, possible RLL infiltrate, fever - assess for PNA LUNGS AND PLEURA: Bibasilar groundglass opacities, possibly related to infection/aspiration are not significant change from prior study. Bibasilar compressive atelectasis. Calcified and noncalcified pulmonary micronodules are present bilaterally. New 9 x 9 mm focal opacity in the right upper lobe (series 7, image 19) may represent a focus of infection. Previously noted irregular left apical opacity has decreased in size since the prior exam now measuring 1.9 x 0.8 cm (series 7 comment which 20), previously measuring 2.7 x 1.8 cm.MEDIASTINUM AND HILA: Moderate cardiomegaly and moderate pericardial effusion.No coronary artery calcifications on this targeted study. Pulmonary catheter is present with tip in the main pulmonary artery. Persistent mediastinal lymphadenopathy with prevascular lymph node measuring 10 mm (series 5 comment which may 6). IABP pump is noted within the aorta.CHEST WALL: Soft tissue focus in the right breast measuring 1.2 x 1.2 cm may be better evaluated by mammography or ultrasound.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.New focal opacity in the right upper lobe may be related to atelectasis or infection.2.Persistent bibasilar groundglass opacities with scattered nodular opacities likely related to infection.3.Unchanged moderate pericardial effusion.4.Soft tissue density in the right breast may be better evaluated by mammography or ultrasound. |
Generate impression based on findings. | Male 4 days old Reason: Preterm infant on oscillator, please assess expansion and tube placement History: Preterm infant on oscillator , respiratory distress syndrome.VIEW: Chest AP (one view) 2/15/15 600 hours. UVC unchanged. A second catheter is overlying the right mid abdomen. ET tube terminates below thoracic inlet. Proximal side port of NG tube is above GE junction. Cardiac silhouette size is normal. Large lung volumes and diffuse lung haziness unchanged. No focal opacities, effusions or pneumothorax. | Misplaced NG tube.Large lung volumes and bilateral diffuse lung haziness, likely due to RDS. |
Generate impression based on findings. | Male 51 years old Reason: s/p OLT with increased jp output. concern for portal vein compromise History: as above LIMITED ABDOMENLIVER: Liver measures 17 cm. small amount of perihepatic fluid.BILIARY TRACT: No evidence of biliary dilatation.PANCREAS: Not visualized.SPLEEN: Splenomegaly. | Small amount of perihepatic ascites, mild hepato- splenomegaly, otherwise unremarkable study. Trace ascites. Patent hepatic vasculature. |
Generate impression based on findings. | Female 37 years old Reason: RUQ r/o cholecystitis History: Abdominal pain LIVER: Liver measures 16.3 cm. increased echogenicity compatible with fatty infiltration. No focal liver lesions.BILIARY TRACT: No evidence of intrarectally pedicle there dilatations. Gallbladder is distended with stones. Due to the extensive shadowing from the stones gallbladder cannot be optimally evaluated. Gallbladder wall is slightly thickened. Small amount of pericholecystic fluid is present. Sonographic Murphy sign could not be evaluated due to patient's medication. These findings may be compatible with herniated cholecystitis.PANCREAS: No significant abnormalities noted.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Fat infiltration of the liver. Numerous gallstones. Due to the shadowing from the gallstones, gallbladder cannot be optimally evaluated. Mild acute cholecystitis cannot be excluded. |
Generate impression based on findings. | Female 23 years old Reason: right upper quadrant pain, eval for pathology; hepatobiliart system and right kidney History: RUQ pain, fever LIVER: Liver measures 17 cm, slightly enlarged. No focal liver lesions.BILIARY TRACT: Gallbladder is unremarkable. No evidence of gallstones or biliary dilatation.PANCREAS: Not visualized to to overlying bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Unremarkable study. |
Generate impression based on findings. | Female 35 years old Reason: RUQ US for GB distention History: RUQ pain LIVER: Liver measures 15 cm. no focal liver lesions.BILIARY TRACT: There is significant intra-axial peribiliary dilatation secondary to patient's known history of pancreatic head cancer. Gallbladder is also significant distended with significant wall thickening. Small amount of ascites in acoustic fluid is present. These findings may be compatible with acute cholecystitis.PANCREAS: Pancreatic mass in the head of the pancreas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Ascites. | Significant intra-extra hepatic biliary dilatation and gallbladder distention caused by patient's pancreatic cancer. Gallbladder wall thickening associated with gallbladder distention. Acute cholecystitis cannot be excluded. |
Generate impression based on findings. | Male, 69 years old, subdural hemorrhage follow up. Evidence of craniotomy is seen involving the right frontal, parietal and temporal bones. Encephalomalacia of the anterior right temporal lobe is similar to that seen on the prior examination.A hyperdense collection is seen along the right aspect of the interhemispheric falx which measures up to 12 mm in thickness with mild displacement of the adjacent cingulate and superior frontal gyri.Additional patchy areas of hypoattenuation are seen including in the left frontal lobe and scattered through the cerebellum. Ventricular size and morphology show no significant change from the prior exam.Subcutaneous swelling and hematoma formation is seen extracranially at the high left vertex. No skull fractures are identified. | Acute subdural hemorrhage is seen along the right aspect of the interhemispheric falx resulting in mild mass effect on the adjacent right cingulate and superior frontal gyri.Evidence of scalp injury is seen with swelling and hematoma formation at the high left vertex.Sequelae of prior right-sided surgery are demonstrated with stable encephalomalacia of the right anterior temporal lobe.Scattered small additional areas of encephalomalacia in the cerebellum may represent prior ischemic insults. |
Generate impression based on findings. | 41 years old, Male, Reason: h/o endocarditis, assess for septic emboli History: h/o endocarditis, assess for septic emboli LUNGS AND PLEURA: There are bilateral confluent groundglass patchy opacities which is favored to represent pulmonary edema, septic emboli are felt to be less likely. No large cavitary lesions are identified. There is a right lower lobe pulmonary nodule measuring 9 mm (series 7, image 83). There is a peripherally based right lower lobe nodular opacity measuring 7 mm (series 7, image 97) which may represent rounded atelectasis or a pleural based nodule. Left basilar atelectasis is present.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy is present with AP window lymph node measuring 10 mm (series 5 image 43). No significant internal mammary, cardiophrenic, or retrocrural lymphadenopathy.CHEST WALL: Lucent foci with sclerotic well-defined borders are present in the right sixth and eighth ribs as well the 10th rib on the left which appear benign in etiology.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Bilateral confluent ground glass patchy opacities which are favored to represent pulmonary edema. Septic emboli are also considered although are felt to be less likely. |
Generate impression based on findings. | Male 77 years old Reason: 77M CKD with acute renal failure History: uptrending Cr RIGHT KIDNEY: Significant echogenic kidney. Right kidney measures 9.8 cm. no hydronephrosis. 2.2 x 1 .7-cm simple appearing cyst within the right kidney.LEFT KIDNEY: Left kidney measures 13.3 cm. Significant echogenic kidney. There is a large cyst at the inferior aspect of the left kidney. The cyst measures 6 x 5 cm. Possible punctate stone without evidence of hydronephrosis in the lower pole of the left kidney.URINARY BLADDER: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Bilateral significant echogenic kidneys without evidence of hydronephrosis. Possible left renal stone. |
Generate impression based on findings. | Male, 65 years old, altered mental status. No evidence of intracranial hemorrhage or any abnormal extra-axial fluid collection is detected. The gray white differentiation is preserved. No parenchymal edema or mass effect seen. Ventricles are normal in size and morphology. There may be minimal periventricular hypoattenuation which is a nonspecific finding.The osseous structures of the skull are intact. The visualized paranasal sinuses and mastoid air cells are clear. | No evidence of any acute intracranial abnormality. |
Generate impression based on findings. | There is a large predominately hypoattenuating complex mass in the right frontal region measuring at least 4.3 x 4.6 cm causing leftward midline shift of 8 mm, partial effacement of the right lateral ventricle and dilatation of the left lateral ventricle suggesting possible entrapment. There is extensive surrounding vasogenic low attenuation. There is high attenuation in the periphery of the mass may represent areas of calcification and/or blood products, although there are no layering fluid-fluid levels. There are no separate areas of acute intracranial hemorrhage. The paranasal sinuses and imaged mastoid air cells are clear. The calvarium is intact. | Large complex cystic/solid mass in the right frontal region with extensive mass effect, and midline shift with possible entrapment of the left lateral ventricle. Foci of high attenuation in the periphery of the mass may represent calcification and/or blood products, although there are no layering fluid-fluid levels. Further evaluation with contrast enhanced MRI is warranted.Findings were electronically communicated with the emergency department, and acknowledged, at the time of initial interpretation by the radiology resident on call. |
Generate impression based on findings. | Female 85 years old Reason: assess for toxic megacolon, ileus, distention History: active recurrent c diff, sepsis Interval increase in the size of centralized gas distended loops of bowel measuring up to 6 cm. there is thumbprinting in portions of the colon suggestive of colitis. NG tube tip projects over the distal portion of the stomach. Chest findings are unchanged. | Interval increase in the size of centralized gas distended loops of bowel measuring up to 6 cm. there is thumbprinting in portions of the colon suggestive of colitis. |
Generate impression based on findings. | Male 59 years old Reason: Assess location of IABP History: location of IABP Motion degrades the quality of the examination. Nonobstructive bowel gas pattern. Enteric tube projects over the second/third portion of the duodenum. Remainder of support devices are unchanged. | No free air. |
Generate impression based on findings. | Female 30 years old Reason: r/o obstruction History: bilious emesis Enteric tube projects over the third/fourth portion of the duodenum. Nonspecific bowel gas pattern. No free air. Residual barium in the colon. | No free air. |
Generate impression based on findings. | Female 72 years old Reason: dobhoff advanced History: same Enteric tube is obscured by LVAD. Its tip presumably projects over the gastric body. Otherwise, spot support tubes, lines, devices are grossly unchanged. Retrocardiac opacity which can be further evaluated with chest x-ray. | The tip of the enteric tube projects over the gastric body. |
Generate impression based on findings. | There is a stable large predominately hypoattenuating complex mass in the right frontal region measuring at least 4.3 x 4.6 cm causing leftward midline shift of 8 mm, partial effacement of the right lateral ventricle and dilatation of the left lateral ventricle suggesting possible entrapment, unchanged. There is unchanged extensive surrounding vasogenic low attenuation. There is unchanged high attenuation in the periphery of the mass may represent areas of calcification and/or blood products, although there are no layering fluid-fluid levels. There are no new/separate areas of acute intracranial hemorrhage. The paranasal sinuses and imaged mastoid air cells are clear. The calvarium is intact. | No significant change in large complex cystic/solid mass in the right frontal region with extensive mass effect, and midline shift with possible entrapment of the left lateral ventricle. |
Generate impression based on findings. | Male 39 years old Reason: GSW History: GSW Dense oval-shaped radiodensities overlie the patient's chest and abdomen. They can be external to the patient. Their etiology is unknown. Nonobstructive bowel gas pattern with no free air. | No free air. |
Generate impression based on findings. | Male 88 years old Reason: s/p DHT placement History: as above The tip of the enteric tube is in the right mainstem bronchus. Nonobstructive bowel gas pattern. No free air. | The tip of the enteric tube is in the right mainstem bronchus.Dr. Thompson was notified and acknowledged about the above findings at the time of the dictation. |
Generate impression based on findings. | Male 89 years old Reason: replace DHT History: replace DHT Enteric tube projects over the gastric body. Nonobstructive bowel gas pattern. No free air. | Enteric tube projects over the gastric body. |
Generate impression based on findings. | BRAIN: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is minimal periventricular white matter hypoattenuation which is nonspecific, likely representing age indeterminate small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is slight right nasal bone deformity of indeterminate age; please correlate with physical examination findings. There is carious disease involving a left maxillary molar. The skull and extracranial soft tissues are otherwise unremarkable. CERVICAL: Evaluation is limited due to beam hardening artifact at C7 level and below. There is age indeterminate mild loss of height of C7 and moderate loss of height of T1 vertebral bodies without retropulsion of osseous fragments into the spinal canal; there is no paravertebral/prevertebral soft tissue swelling at these sites. There is no other acute fracture, subluxation or prevertebral soft tissue swelling. There is a prominent ligamenta flava calcification at C6 which maybe contributing to mild spinal canal stenosis. There is a 21 x 13 mm hypodense right thyroid lobe nodule with coarse calcification. | 1.Very limited evaluation due to beam hardening artifact at C7 level and below. Age indeterminate compression fractures of C7 and T1 vertebral bodies without osseous retropulsion into the spinal canal. There is no paravertebral soft tissue swelling at these sites. Further evaluation with MRI can be obtained if clinically indicated.2.No acute intracranial hemorrhage. 3.Age indeterminate right nasal bone fracture without significant displacement. Please correlate with physical exam findings.4.21 x 13 mm right thyroid lobe hypoattenuating nodule with coarse calcification. Further evaluation with thyroid sonogram can be performed if clinically indicated.Findings were discussed with resident Dr. Turner from the ED on a telephone at 12:36 p.m. today. |
Generate impression based on findings. | Male 47 years old Reason: dobhoff placement History: same Enteric tube is obscured by the LVAD. The tip presumably projects over the proximal stomach. Chest findings are unchanged from 2/13/2014. | No free air. |
Generate impression based on findings. | Female 34 years old Reason: abd pain, diarrhea History: abd pain, diarrhea Surgical sutures projects over the left midabdomen. Nonobstructive bowel gas pattern. No free air. | No free air. |
Generate impression based on findings. | Female 81 years old Reason: R/O Obstruction History: 81 yo with partial SBO, now persistent n/v Nonobstructive bowel gas pattern. No free air. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 56 years old Reason: Free air? History: Distension, vomiting Distention of the small bowel loops suggestive of bowel obstruction without evidence of free air. | No free air. |
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