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Generate impression based on findings. | Male 84 years old Reason: Ng tube placement History: ng tube placement The tip of the enteric tube is in the antrum. Nonobstructive bowel gas pattern. No free air. | The tip of the enteric tube is in the antrum. |
Generate impression based on findings. | Female 29 years old Reason: eval stool burden, ileus History: abd pain, obstipation Rectal tube is coiled in the rectum with its tip in the distal descending colon. Mild to moderate interval distention of the small bowel loops within the interval. This may be secondary to ileus, however, bowel obstruction cannot be excluded. | Interval increase in the distention of small bowel loops. CT may be helpful to exclude bowel obstruction. |
Generate impression based on findings. | 57 years old, Male, Reason: Progressive right arm swelling, evaluate for fasciatis History: Right arm swelling Interval increase in subcutaneous edema throughout the right forearm. There is fluid tracking within the subcutaneous tissues extending from the level of the elbow to the wrist. There are no foci of subcutaneous gas. There is no bone destruction to suggest osteomyelitis. No loculated fluid collections to suggest an abscess. | Significant interval increase in subcutaneous edema with fluid tracking along the fascial planes of the forearm. No CT evidence of osteomyelitis. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild nonspecific periventricular and subcortical white matter hypoattenuation with an old small infarct in the right basal ganglia again seen. The ventricles and basal cisterns are unchanged. There is no midline shift or herniation. There are extensive cavernous carotid and intracranial vertebral artery atherosclerotic calcifications again seen. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or mass effect. CT is insensitive for detection of early nonhemorrhagic stroke. |
Generate impression based on findings. | Female 54 years old Reason: placemennt of NGT History: NGT placement The tip of the enteric tube is in the antrum. Nonobstructive bowel gas pattern. No free air. Calcification in the midline pelvis may represent a calcified fibroid. | No free air. |
Generate impression based on findings. | Female 22 years old Reason: abdominal pain, decreased bowel sounds History: abdominal pain Nonobstructive bowel gas pattern. No free air. The tip of the enteric tube is in the jejunal segments. Ventriculoperitoneal shunt with its tip in the pelvis. A pacemaker is superimposed over the right lower quadrant. G-tube in the left upper quadrant. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | There is a 22 x 27-mm homogeneously hypoattenuating structure centered in the left sublingual space/floor of the mouth with extension to the right paramedian aspect of the floor of the mouth. However, it does not extend to involve the left lingual tonsil as was seen on prior exam. There is an asymmetrically prominent left palatine tonsil which may be reactive. There is no significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | 22 x 27 mm homogeneously hypoattenuating cystic lesion in the left sublingual space/floor of the mouth crossing the midline, showing smaller size and a different morphology than on the prior examination. Differential considerations include cystic hygroma, atypical thyroglossal duct cyst, or even ranula. Please correlate clinically for possibility of superinfection. |
Generate impression based on findings. | Male 63 years old Reason: evaluation for NGT History: NGT placement The tip of the NG tube is in the antrum. Nonobstructive bowel gas pattern. No free air. | The tip of the NG tube is in the gastric antrum. |
Generate impression based on findings. | Female 96 years old Reason: check ngt History: see above The tip of the NG tube is in the antrum. No free air. Nonobstructive bowel gas pattern. | No free air. |
Generate impression based on findings. | 50 years old, Female, Reason: is there a fracture History: fall onto knee, +pain anterior, small abrasion below knee area No acute fracture or malalignment is evident. No evidence of joint effusion. Extensor mechanism is intact. | No fracture or malalignment. |
Generate impression based on findings. | Male 69 years old Reason: Follow up Feeding Tube Placement 2/14/15 History: Follow up Feeding Tube Placement 2/14/15 Distal end of the feeding tube is coiled in the stomach. No bowel obstruction. | Distal end of feeding tube within stomach. No bowel obstruction. |
Generate impression based on findings. | 77 years old, Male, Reason: r/o fx History: very ttp along 1st metacarpal. Basilar joint osteoarthritis without evidence of acute fracture or malalignment. Osteoarthritis of the distal interphalangeal joints. | Osteoarthritis without evidence of acute fracture or malalignment. |
Generate impression based on findings. | 77 years old, Male, Reason: assess for fracture History: fall Single view of the forearm shows no evidence of acute fracture or malalignment. Degenerative changes of the carpal joints, specifically the basilar joint is noted.Shoulder and humerus: No acute fracture is present. Chronic degenerative changes of left shoulder are present. High riding humeral head is suggestive of chronic rotator cuff pathology. | No acute fracture or dislocation. |
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 are air-fluid levels in the bilateral maxillary sinuses and in the right sphenoid sinus suggesting acute sinusitis. The skull and extracranial soft tissues are unremarkable. | 1.No acute intracranial hemorrhage or mass-effect. 2.Bilateral maxillary and right sphenoid sinus air-fluid levels suggest acute sinusitis in the proper clinical setting. |
Generate impression based on findings. | There is encephalomalacia along the left superior paramedian cerebellar hemisphere/vermis. There is widened right cerebellopontine angle cistern consistent with arachnoid cyst seen on prior MRI. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are otherwise normal. There is no midline shift or herniation. There is minimal left maxillary sinus mucosal thickening. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or mass-effect. |
Generate impression based on findings. | 38 years old, Male, Reason: is there a rib fracture History: left lower rib pain sp fall No displaced rib fractures are seen. No evidence of pneumothorax. | No displaced rib fractures. |
Generate impression based on findings. | There is streak artifact from dental amalgam limiting evaluation. There is significant soft tissue edema surrounding the left orbit and left face with hematoma along the lateral aspect of the left orbit measuring 1.8 cm. The globes are intact. There is a chronic right nasal bone fracture again seen. There are no other acute fractures identified.There is an extra-axial calcified mass in the region of the foramen magnum, posterior to the clivus exerting mass effect with posterior displacement and leftward deviation of the medulla. This is similar to prior examination. There are degenerative changes in cervical spine with mild to moderate neural foraminal stenosis at C3-4 on the right and C4-5 on the left. There is dense atherosclerotic calcification in the left carotid artery bifurcation.There are extensive sinonasal postoperative findings as noted before with resection/obliteration of the right maxillary sinus with markedly thickened residual lateral right maxillary sinus wall. There is a plate and screw traversing the right maxilla. The right ostiomeatal unit has been resected along with the right inferior turbinate and some of the ethmoid air cells. The inferior posterior aspect of the nasal septum is also absent. There is evidence of left maxillary antrectomy with resection of the uncinate process again seen. A portion of the right sphenoid sinus has also been resected with thickening and sclerosis of the residual sphenoid sinus walls. There is mild scattered ethmoid, and right sphenoid sinus mucosal thickening. | 1.No definite acute facial bone fracture.2.Extensive superficial left facial and periorbital soft tissue swelling with discrete superficial soft tissue hematoma along the lateral aspect of the orbit. 3.Extra-axial calcified lesion posterior to the clivus at the level of the foramen magnum with mass effect on the medulla without significant change.4.Extensive postoperative sinonasal findings without significant change. |
Generate impression based on findings. | 23 years old, Female, Reason: reduction of R 5th digit dislocation History: R 5th digit dislocation, now reduced Interval reduction of fifth PIP joint dislocation without evidence of fracture. The finger is now in anatomic alignment. | Interval reduction of the PIP joint dislocation without evidence of fracture. |
Generate impression based on findings. | 23 years old, Female, Reason: r/o fracture History: deformity Volar dislocation of the middle phalanx of the fifth digit without evidence of acute fracture. | Volar dislocation of the middle phalanx of the fifth digit without evidence of acute fracture. |
Generate impression based on findings. | There is a small amount of hyperattenuating subarachnoid hemorrhage in the right sylvian fissure. There is minimal intra-ventricular hemorrhage layering in the right occipital horn on series 80476 image 23. There is mild asymmetric effacement of the right temporal/parietal sulci which may reflect isodense subarachnoid hemorrhage or secondary to mild mass effect. Encephalomalacia of the pons is seen. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is a mucus retention cyst in the right maxillary sinus. There is a soft tissue nodule measuring 19 x 6 mm on the right parietal scalp laterally, nonspecific and may represent a sebaceous cyst. The skull and extracranial soft tissues are otherwise unremarkable. There is evidence of dental disease. | Small focus of acute subarachnoid hemorrhage in the right sylvian fissure with minimal interventricular hemorrhage layering in the right occipital horn. No significant mass effect or midline shift. |
Generate impression based on findings. | Small focus of subarachnoid hemorrhage in the right sylvian fissure is unchanged. There is persistent effacement of the right temporal and parietal sulci which is asymmetric to the left. There is persistent small focus of intraventricular hemorrhage suspected layering in the right occipital horn. There are no definite new areas of acute intracranial hemorrhage. There is no mass effect or midline shift. The ventricles and sulci are unchanged. There is no calvarial fracture. | Stable small focus of subarachnoid hemorrhage in the right sylvian fissure with persistent effacement of the right temporal and parietal sulci, asymmetric to the left. |
Generate impression based on findings. | Left-sided pneumothoraxVIEW: Chest AP (one view) 2/15/15 at 957 hours. ET tube tip is above the thoracic inlet. NG tube is present. Cardiac silhouette size is normal. Bibasilar streaky opacities likely subsegmental atelectases on a background of diffuse lung haziness. Slight improvement in left-sided pneumothorax. No effusions. | Interval improvement in left sided pneumothorax with development of bibasilar streaky opacity. |
Generate impression based on findings. | 51 years old, Female, Reason: r/o fracture, loosened hardware History: s/p fall, unable to flex or stand on knee Evidence of a right knee arthroplasty device in anatomic alignment without evidence of fracture or loosening. No malalignment. There is a small joint effusion present. | No evidence of fracture, malalignment or loosening. |
Generate impression based on findings. | There are unchanged postoperative findings related to right parietal craniotomy with encephalomalacia in the right temporal, occipital and posterior parietal lobes with ex vacuo dilatation of the right lateral ventricle atrium, unchanged. The ventricles and sulci are unchanged. There is no acute intracranial hemorrhage, mass effect or herniation. There is patchy low attenuation in the bilateral periventricular white matter likely representing small vessel ischemic changes, stable from prior exam. | No acute intracranial hemorrhage or mass-effect. Encephalomalacia in the right cerebral hemisphere and postoperative findings without change. |
Generate impression based on findings. | 65 years old, Female, Reason: evaluate for fracture or dislocation History: s/p injury Right hip: No acute fracture or malalignment. Pelvis: No acute fracture or malalignment.Right knee: Hardware components of total knee arthroplasty device is situated in near-anatomic alignment without evidence of hardware complication. No acute fracture or malalignment. There is a 7-mm ossicle in the posterolateral aspect of the tibia that appears similar to that seen on the prior studies. No joint effusion.Right tibia-fibula: No evidence of acute fracture or malalignment.Right elbow: No evidence of acute fracture or malalignment.Right hand: Well corticated ossicle in the dorsal aspect of the index finger DIP joint without associated soft tissue swelling likely represents old injury. Recommend correlation with point tenderness. | No evidence of acute fracture or malalignment. Ossicle the dorsal aspect of the DIP joint likely represents old injury. |
Generate impression based on findings. | 47 years old, Male, Reason: fx History: swelling Comminuted fracture through the level of the neck of the fifth metacarpal with volar angulation. The fracture does not appear to involve the joint space. No other fractures are noted. | Comminuted fracture of the neck of the fifth metacarpal with volar angulation. |
Generate impression based on findings. | 63 years old, Female, Reason: fracture History: knee pain Right Knee: Significant vascular calcifications are present within the soft tissues. No evidence of fracture or malalignment. There is no evidence joint effusion. Extensor mechanism appears intact.Right foot: Patient status post amputation through the mid metatarsals. Vascular calcifications are present within the soft tissues. Soft tissue irregularity around the stump and plantar surface suggests possible ulcerations. No osseous cortical irregularity to suggest osteomyelitis. No evidence of fracture or malalignment. | 1.No evidence of fracture or malalignment.2.Vascular calcifications within the soft tissues suggests vasculopathy.3.Soft tissue irregularity of the right foot suggest possible ulcerations without definite evidence of osteomyelitis. If there is clinical concern for osteomyelitis MRI may be considered. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There are multiple areas of nonspecific white matter periventricular and subcortical hypoattenuation better visualized on the MRI dated 2/8/2015, which may be slightly less prominent as compared to the prior exam. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is mild right maxillary and near complete left sphenoid sinus mucosal thickening as noted before. 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.Scattered areas of nonspecific white matter hypoattenuation again seen, appearing slightly less prominent as compared to prior exam. |
Generate impression based on findings. | Male, 55 years old, left lower extremity radicular symptoms. Unilateral left pedicle screws are in place at L5 and S1 affixed to a posterior stabilization rod. Up to 6 mm of lucency is seen along the anterior aspect of the S1 screw. Laminectomy has been performed at L5 and probably at S1 as well.A grade 2 anterolisthesis of L5 relative to S1 is seen. The endplates are severely sclerotic and irregular. The intervening disk space shows loss of height and vacuum disk phenomenon.Remaining vertebral bodies are normally aligned and demonstrate normal height and morphology. A chronic appearing cortical defect is seen within the left posterior iliac bone. No other destructive osseous lesions are seen.L1-2: No significant spinal canal stenosis or neuroforaminal narrowing. L2-3: No significant spinal canal or neuroforaminal stenosis. L3-4: Facet hypertrophy. Minimal bulging disk. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L4-5: Postop findings and advanced facet hypertrophy. Bulging disk. Some narrowing of the spinal canal is suspected at least in the transverse dimension. Moderate bilateral foraminal narrowing is seen. L5-S1: Disk uncovering and disk bulging. The spinal canal is decompressed posteriorly. Severe bilateral foraminal narrowing is seen due to both bony and soft tissue material. | 1. Postoperative findings compatible with unilateral left posterior spinal fusion at L5 and S1. Lucency of up to 6 mm is seen along the anterior aspect of the S1 screw which suggests the possibility of hardware loosening.2. Severe disk and endplate degeneration is seen at L5-S1 with a grade 2 anterolisthesis. The spinal canal has been decompressed posteriorly at this level. However, the L5-S1 neural foramina are severely narrowed.3. Much less severe degenerative findings are seen at other levels with moderate foraminal narrowing at L4-5 and mild foraminal narrowing at L3-4.4. A chronic-appearing cortical defect of the posterior left iliac bone is of uncertain etiology but may be postoperative in nature. |
Generate impression based on findings. | Male, 64 years old, with altered mental status, thrombocytopenic, confused and hypertensive. Assess for hemorrhage. Small areas of encephalomalacia are again seen within the right middle frontal gyrus and the left parietal lobe without significant interval change. Patchy periventricular hypoattenuation is nonspecific but likely indicative of age indeterminate microvascular ischemic disease.Small subdural collections are suspected along both cerebral hemispheres with attenuation which is low but slightly above that of CSF. These collections measure up to 7 mm in thickness on the left and 4 mm on the right. They exert no significant mass effect on the adjacent brain parenchyma. They are new when compared to the prior CT examination, and may have been present to some degree on the recent prior MRI but they were not as well seen on that exam.No clear evidence of hyper attenuating hemorrhage is seen intracranially. Ventricular size and morphology are not significantly change.The osseous structures of the skull are intact. The paranasal sinuses and mastoid air cells are clear. | Small bilateral subdural collections are seen, questionably present on the prior recent MRI but definitely new when compared to older studies. The attenuation of these collections is low, but in the setting of coagulopathy, low-attenuation is unreliable as a distinguishing feature between new hemorrhage, old hemorrhage or nonhemorrhagic hygroma. These findings were discussed with Dr. Dellaria at 2:00 PM on 2/15/15. |
Generate impression based on findings. | Male, 60 years old, history of atrial fibrillation with weakness. Assess for stroke. Mild nonspecific periventricular hypoattenuation is seen. The gray-white differentiation is preserved. No evidence of parenchymal edema or mass effect is detected. No acute intracranial hemorrhage or any abnormal extra axial fluid collection is seen. The ventricular system is normal in size and shape.The osseous structures of the skull are intact. The paranasal sinuses and mastoid air cells are clear. | Nonspecific periventricular hypoattenuation may reflect age indeterminate microvascular ischemic disease. No definite acute intracranial abnormality is seen including no evidence of intracranial hemorrhage or acute ischemia. Please note, however, that CT is insensitive for the detection of small or early ischemic lesions. If clinical concern persists, further evaluation with MRI would be appropriate. |
Generate impression based on findings. | Male, 51 years old, history of laryngeal cancer. The supraglottic mucosa is diffusely thickened similar to prior. However, superimposed upon this thickening is new patchy ill-defined enhancement affecting the base of the epiglottis, aryepiglottic folds, the left greater than right piriform sinuses and the mucosa of the false vocal folds.Mild diffuse thickening along the anterior strap muscles of the neck is unchanged. Sclerosis of the right posterior thyroid cartilage is also a stable finding.Diffuse infiltration of the fascial planes of the neck persists and is likely therapy related. No new or progressing adenopathy is detected in the neck. A reference cluster of left supraclavicular nodes measures 10 x 7 mm, previously 12 x 6 mm.The salivary glands and thyroid are free of focal lesions. The right IJ vein is diminutive at its inferior aspect. No concerning osseous lesions are detected. | On a background of stable thickened supraglottic mucosa, there is new superimposed ill-defined and patchy enhancement. This could be reactive or inflammatory in nature, however it is somewhat more striking than what is typically seen in the post therapy period. Direct visual inspection and/or close interval follow-up is recommended to exclude infiltrative tumor. |
Generate impression based on findings. | Female, 46 years old, struck with iron rod in the right temporal and zygomatic region. No acute intra-cranial hemorrhage, loss of gray-white distinction, parenchymal edema or mass effect is detected. No abnormal extra-axial collections are seen. The ventricles are normal in size and morphology.No clear fracture of the skull or facial bones is seen. There is a network of grooves running along the right posterior lateral orbital roof which, which on close inspection of coronal and sagittal reformatted images, do not traverse the full thickness of the bone and are therefore unlikely to be fractures. The bone in this region is somewhat sclerotic relative the same area on the left, and there is mild irregularity of the contour of the adjacent lateral orbital wall which raises the question of prior healed trauma. A small ossific structure seen adjacent to the left zygoma without a clear donor site may represent sequelae of old trauma or anatomic variation. | 1. No acute intracranial abnormality.2. No clear acute fracture of the skull or facial bones. |
Generate impression based on findings. | 81 years, Female, Reason: r/o abdominal obstruction History: persistent n/v, bilious. Ovarian cancer. ABDOMEN:LUNG BASES: Moderate bilateral pleural effusions, increased from the prior exam. Associated compressive atelectasis.LIVER, BILIARY TRACT: Multiple hepatic metastases are increased in size. Right hepatic lobe lesion measures 5.0 x 2.3 cm (3/38), previously 2.7 x 1.7 cm. An adjacent right hepatic lobe lesion is also increased in size measuring 2.9 x 2.3 cm (3/33), previously 2.7 x 1.7 cm. The portal vein is compressed but appears patent.There is increased scalloping with a pseudomyxoma peritonei appearance.SPLEEN: Hypodense lesion at the hepatic hilum likely represents a cystic metastases and is unchanged from the prior exam. Additional splenic hypodensities are unchanged.PANCREAS: Prominent pancreatic duct is unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cyst is unchanged.RETROPERITONEUM, LYMPH NODES: Index left para-aortic node measures 1.4 x 1.5 cm (3/62), previously 1.5 x 1.4 cm. Additional retroperitoneal lymphadenopathy, include bulky tumor encasing the hepatic hilum, appear similar to the prior exam.IVC and iliac veins are compressed, thrombosis cannot be excluded.BOWEL, MESENTERY: The stomach is decompressed compared to the prior exam, however there is persistent wall thickening within the antrum which may represent invasion of right tumor. There is a moderate hiatal hernia with upward herniation of ascites filled peritoneum through the esophageal hiatus.Multiple cystic peritoneal metastases within the abdomen and pelvis are slightly increased from the prior exam. Multiple enlarged mesenteric masses.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Increased large amount abdominal ascites.PELVIS: FemaleUTERUS, ADNEXA: Multiple cystic metastases there seen within the right inguinal canal.BLADDER: No significant abnormality notedLYMPH NODES: Multiple enlarged peritoneal based lesions may represent nodes or peritoneal implants are slightly increased since the prior examBOWEL, MESENTERY: Right hemipelvis soft tissue mass measures 4.6 x 5.2 cm (3/117), previously 4.6 x 3.8 cm.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Increased hepatic metastases.2.Slightly increased peritoneal metastases with increased abdominal ascites and a pseudomyxoma peritonei appearance.3.Stable tumor encasing the gastric antrum with resolution of gastric outlet obstruction. No evidence of abdominal obstruction.4.Increased moderate pleural effusions. |
Generate impression based on findings. | Reason: SDH stability History: sdh stabilty There is redemonstration of a right parafalcine hematoma measuring 14 mm in width on the current exam and measuring the same on the prior exam. Sagittal dimensions are currently 47 x 26 mm and previously were approximately the same. There is redemonstration of a subgaleal hematoma adjacent to the left parietal bone which is also stable compared with prior exam.The patient is status post right frontal craniotomy.There is redemonstration of encephalomalacia along the right anterior temporal lobe and left cerebellar hemisphere.Periventricular and subcortical white matter hypodensities of a moderate degree are present.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Since the prior exam a right parafalcine hematoma has not changed 2.Foci of encephalomalacia in the right temporal lobe and left cerebellar hemisphere . |
Generate impression based on findings. | The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | Negative unenhanced brain CT. |
Generate impression based on findings. | Reason: F/u compared to previous History: F/u compared to previous. Subarachnoid hemorrhage The patient is status post right-sided craniotomy for anterior communicating artery aneurysm clip placement. In addition, a ventriculostomy tube has been placed which courses to the right frontal lobe into the frontal horn of the right lateral ventricle with tip in the body of the left lateral ventricle. There is some intraventricular blood present. There is no evidence for ventriculomegaly.There is hypodensity present along the anterior aspect of the right temporal lobe as well as the gyrus rectus bilaterally and the a small portion of the medial aspect of the left frontal lobe extending to the cingulate gyrus and superior frontal gyrus. Another hypodense focus is present along the right caudate nucleus.The visualized portions of the paranasal sinuses demonstrate mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Status post ventriculostomy tube placement. The lateral ventricles are stable.2.Status-post a recent craniotomy for anterior communicating artery aneurysm clip placement.3.Hypodensities along the anterior aspect of the right temporal lobe as well as the inferomedial aspects of the frontal lobes, right caudate nucleus and the medial left frontal lobe are present. One possibility includes that this reflects ischemic insult. This is stable since the prior exam. |
Generate impression based on findings. | 46 year old female with firm, tender mass along periumbilical left upper quadrant,rule out strangulated periumbilical hernia. ABDOMEN:LUNG BASES: No consolidation or pleural effusions.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small right upper pole renal cyst. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a small midline ventral abdominal hernia immediately superior to the umbilicus with a single loop of herniated small bowel. The hernia neck measures 2.7 cm. There is mild wall thickening and increased enhancement of the herniated segment of bowel as well is a small amount of surrounding fluid. These findings raise the question of ischemia in the proper clinical setting. Several small bowel loops proximal to the hernia are mildly dilated up to 3.2 cm with small bowel collapsed distally compatible with small bowel obstruction. No intraperitoneal free air or additional free fluid. BONES, SOFT TISSUES: There is a separate subcutaneous fluid collection (series 80282, image 81) immediately inferior to the ventral hernia which may reside in an umbilical hernia which measures 3.0 X 2.5 cm of uncertain etiology, abscess not excluded. Mild degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Enlarged uterus with multiple heterogenous lesions which are incompletely characterized on CT but often represent leiomyomas. There is a small amount of endometrial fluid which may be physiologic. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is a small midline ventral abdominal hernia immediately superior to the umbilicus with a single loop of herniated small bowel. The hernia neck measures 2.7 cm. There is mild wall thickening and increased enhancement of the herniated segment of bowel as well is a small amount of surrounding fluid. These findings raise the question of ischemia in the proper clinical setting. Several small bowel loops proximal to the hernia are mildly dilated up to 3.2 cm with small bowel collapsed distally compatible with small bowel obstruction. No intraperitoneal free air or additional free fluid. BONES, SOFT TISSUES: Mild degenerative changes of the thoracolumbar spine. There is bilateral sclerosis of the sacroiliac joints compatible with sacroiliitis.OTHER: No significant abnormality noted | 1.Periumbilical small bowel containing ventral hernia causing small bowel obstruction. Herniated bowel with findings raising the question of ischemia. 2.Separate small abdominal wall fluid collection inferior to the hernia sac of uncertain etiology, abscess not excluded.3.Enlarged uterus with multiple heterogenous lesions which are incompletely characterized on CT but often represent leiomyomas.4.Bilateral sacroiliitis. Findings communicated by the radiology resident on-call to the emergency department at 10:55 a.m. on 2/15/2015. |
Generate impression based on findings. | 58-year-old male with altered mental status and lethargy There is no acute intracranial hemorrhage, edema, mass-effect, midline shift or hydrocephalus. CT however it is insensitive for early detection of acute nonhemorrhagic ischemic strokes. Mild ex-vacuo dilatation of left frontal horn of lateral ventricle secondary to a left caudate chronic lacunar infarct, unchanged. Small focus of low-attenuation in the left basal ganglia most like representing a chronic lacunar infarct, also unchanged. Stable normal appearing cortical sulci and CSF spaces. Very mild bilateral cavernous and supraclinoid internal carotid vascular calcification similar to prior study. Unremarkable calvarium, paranasal sinuses, mastoid air cells, and orbits and all paranasal sinuses. | No acute intracranial abnormality. CT is insensitive for early detection of acute nonhemorrhagic ischemic stroke. |
Generate impression based on findings. | 29 years, Female. Reason: eval ileus, colonic distension History: colonic distension Rectal tube is unchanged in position, coiled in the rectum with tip in the distal descending colon. Persistent colonic dilatation, proximal to the surgical anastomosis diminished compared to prior . Central venous catheter is incompletely evaluated. Surgical clips and again noted in the right and left upper quadrants. Suture material in the left upper quadrant. Lung bases clear. | Persistent colonic distention, proximal to the anastomosis, diminished compared to prior. |
Generate impression based on findings. | 19 year old man with sudden onset left flank pain with associated nausea, vomiting, and microscopic hematuria. 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: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Kidneys are normal in size and morphology. No hydronephrosis, nephrolithiasis, or perinephric stranding. No hydroureter or ureteral calculi.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: A 4-mm calculus is present within the posterior aspect of the bladder which probably represents a recently passed calculus.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.4 millimeter calculus in the bladder -- if recently passed into bladder may explain patient's current clinical symptoms..2.Currently, no hydronephrosis or nephrolithiasis, and no other significant abnormalities. |
Generate impression based on findings. | 34 year old female with abdominal pain, assess for acute process. 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: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy. No evidence of focal hepatic lesions. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: There is nodular thickening of the bilateral adrenal glands with homogenous attenuation less than 10 Hounsfield units compatible with benign adenomas, similar to prior.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis. There is circumferential mesenteric fat stranding about the distal descending colon in a similar location to the prior exam, again compatible with acute diverticulitis. The amount of inflammation, however, has increased compared to the prior exam. There is no evidence of drainable fluid collection, micro or macro perforation, or pneumoperitoneum.BONES, SOFT TISSUES: Small fat-containing umbilical hernia. Orthopedic rod and screw fixation hardware present in the lower thoracic spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colonic diverticulosis. There is circumferential mesenteric fat stranding about the distal descending colon in a similar location to the prior exam, again compatible with acute diverticulitis. The amount of inflammation, however, has increased compared to the prior exam. There is no evidence of drainable fluid collection, micro or macro perforation, or pneumoperitoneum.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Uncomplicated diverticulitis of the descending colon in similar location to prior exam without perforation or abscess. Amount of inflammation is greater than on prior exam which may represent an acute worsening, although without interval imaging it is not possible to exclude the possiblity that these changes are residual from prior episode..2.Bilateral benign adrenal adenomas. |
Generate impression based on findings. | Reason: F/u to previous, ventriculomegaly History: ventriculomegaly 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. A small amount of blood is present in lateral ventriclesThere is redemonstration of the ventriculostomy tube coursing through the right frontal lobe into the right lateral ventricle with tip in the region of foramen of Monro there biventricular diameter on coronal imaging at the level of the entry point of the ventriculostomy tube is currently 44 mm and previously was the same.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.Subarachnoid hemorrhage is collected predominantly in the posterior fossa in the pre-medullary cistern and surrounding the medulla. 2.Status post ventriculostomy tube placement. Ventriculomegaly is stable compared to previous day's exam.3.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.4.Status post distal left internal carotid artery stent placement. |
Generate impression based on findings. | 9 year old male intubated. Follow up examVIEW: Chest AP (one view) 2/16/2015 4:05 Central venous catheter tip in the SVC. ET tube tip below the thoracic inlet and above the carina. NG tube tip in the stomach. Cardiac silhouette is normal. Interval near complete collapse of the right lung with mediastinal shift to the right likely a combination of atelectasis and a small pleural effusion. Interval improvement in aeration of the left lung. Small left pleural effusion. No pneumothorax. | Interval near complete collapse of the right lung likely a combination of atelectasis and a small pleural effusion. Interval improved aeration of the left lung with a small left pleural effusion. |
Generate impression based on findings. | 56 years, Female. Reason: eval for stool impaction History: malaise, appears to be excess stool in CXR Nonobstructive bowel gas pattern. Less than average stool burden. Left lower lung opacity is better evaluated on prior chest radiograph. | Nonobstructive bowel gas pattern with less than average stool burden. |
Generate impression based on findings. | Male 26 years old Reason: Appendicitis vs. diverticulitis History: abdominal pain The exam is limited secondary to motion artifact.ABDOMEN:LUNG BASES: No significant abnormality noted.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: Mildly dilated esophagus.BOWEL, MESENTERY: Normal appendix, except for the base of the appendix which is not clearly visualized.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 | Limited examination due to patient's inability to hold his breath. No CT findings to explain patient's acute abdominal pain. |
Generate impression based on findings. | Foci of encephalomalacia with gliosis are noted involving the left frontal, left frontotemporal and left parieto-occipital regions most likely representing chronic infarcts given morphology and locations. The ventricles are normal in size. There are no masses, mass effect or midline shift. There is no evidence for acute intracranial hemorrhage. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. Note is made of chronic nasal deformity from old fractures. | Foci of encephalomalacia with gliosis are noted involving the left frontal, left frontotemporal and left parieto-occipital regions most likely representing chronic infarcts given morphology and locations. If there is continued clinical concern for acute ischemia, MRI would be recommended. |
Generate impression based on findings. | 78 year-old female with left lower quadrant pain and rectal bleeding, evaluate for diverticulitis vs other abdominal pathology. ABDOMEN:LUNG BASES: Mild basilar atelectasis. Partially visualized coronary artery calcifications. Cardiomegaly. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Thre is mild fullness of the left renal collecting system and left proximal ureter consistent with mild hydroureteronephrosis, slightly more prominent than on the prior exam. The left ureter is mildly dilated until the region of the abdominal aortic aneurysm which may be compressing the ureter. There is a 2-mm hyperdense focus in the expected location of the right mid ureter, which is unchanged dating back 2009 and may represent a wall calcification or non-obstructing ureteral calculus. No hydronephrosis or hydroureter on the right. No definite obstructing calculi. Left renal upper pole simple cyst.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications affect the aorta and its branches. Again identified is a large abdominal aortic aneurysm which measures up to 6.1 cm in diameter (series 4, image 64), unchanged. Patient is status post endovascular repair of infrarenal abdominal aortic aneurysm and iliac arteries. Again identified is atherosclerotic narrowing of the celiac axis. BOWEL, MESENTERY: Normal caliber small bowel without obstruction. No evidence of diverticulitis. Large colonic stool burden. BONES, SOFT TISSUES: Degenerative changes of the visualized thoracolumber spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Atrophic uterus.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber small bowel without obstruction. No evidence of diverticulitis. Large colonic stool burden. The rectum is distended with stool up to 8 centimeters edema/soft tissue infiltration in the presacral space raising the question of stercoral colitis. BONES, SOFT TISSUES: Degenerative changes of the visualized thoracolumber spine.OTHER: No significant abnormality noted | 1.Postoperative changes of abdominal aortic aneurysm repair, unchanged.2.Mild left hydroureteronephrosis which may be related to compression by abdominal aortic aneurysm. No obstructing calculi on the left.3.Findings compatible with right mid ureteral stone versus wall calcification, unchanged since 2009, and without proximal right hydroureteronephrosis.4.Large colonic stool burden and findings raising the question of stercoral colitis, recommend clinical correlation. |
Generate impression based on findings. | 58 year old female with history of HTN, DM, HLD, OSA, DVT, SLE, RA, COPD presenting with new onset abdominal pain, evaluate for obstruction. Evaluation of the solid organs is somewhat limited due to contrast bolus timing (exam was combined with a chest CT PE protocol). ABDOMEN:LUNG BASES: Mild basilar atelectasis. Partially visualized coronary artery calcifications. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: There is a small to moderate amount of pneumoperitoneum without clear source. No evidence of bowel obstruction, bowel wall thickening, or mesenteric inflammatory changes. The cecum is displaced toward the midline suggesting that it is freely mobile.BONES, SOFT TISSUES: A small fat and peritoneal free air containing hernia is present. Mild degenerative changes affect the visualized thoracolumber spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is a small to moderate amount of pneumoperitoneum without clear source. No evidence of bowel obstruction, bowel wall thickening, or mesenteric inflammatory changes. The cecum is displaced toward the midline suggesting that it is freely mobile.BONES, SOFT TISSUES: Mild degenerative changes affect the visualized thoracolumber spine.OTHER: No significant abnormality noted | 1.Pneumoperitoneum suggesting perforation of a hollow viscus, however, no clear source is identified on this examination.2.No evidence of bowel obstruction.3.The cecum is displaced toward the midline suggesting that it is freely mobile. Findings discussed by on call resident with Dr. Patel at 10:58 p.m. on 2/15/2015. |
Generate impression based on findings. | 51 years, Female. Reason: eval for megacolon History: cdiff, continued fevers, abd pain The lung bases are clear.Nonobstructive bowel gas pattern. No intramural or free intraperitoneal free air. No evidence of bowel wall thickening. Average stool burden. No evidence of toxic megacolon. | No evidence of bowel wall thickening or colonic dilatation to suggest toxic megacolon. |
Generate impression based on findings. | Reason: PE or infection? History: low O2 sats Respiratory motion artifact and expiratory phase imaging moderately limit evaluation of the lungs.PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: New bilateral small pleural effusions, right slightly greater than left, with moderate associated compressive atelectasis. Additional mild septal wall thickening likely related to edema. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: The heart is mildly enlarged, without pericardial effusion. No visible coronary artery calcification.No mediastinal or hilar lymphadenopathy.Small hiatal hernia.CHEST WALL: Status post left mastectomy, left axillary lymph node dissection. Degenerative change involving spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Mild prominence of the left adrenal gland is only partially visualized. Distended gallbladder with multiple stones only partially visualized. See prior 1/21/2015 report for further details as it was imaged in its entirety at that time. | 1. No pulmonary embolism.2. Bilateral pleural effusions and mild pulmonary edema, likely related to CHF.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 47 years, Male. Reason: DHT placement History: DHT pulled and readvanced Note that the pelvis is excluded from the field of view and patient motion artifact limits evaluation. LVAD and AICD unchanged. Enteric feeding tube tip appears to project over the proximal stomach. | Enteric feeding tube tip appears to project over the proximal stomach. |
Generate impression based on findings. | 74 year old female with abdominal pain, evaluate for small bowel obstruction or fluid collection. 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: Mild basilar atelectasis. Coronary artery calcifications. Mitral valve calcifications.LIVER, BILIARY TRACT: No focal hepatic lesions. Status post cholecystectomy. The common bile duct is dilated up to approximately 10 mm, similar to prior.SPLEEN: No significant abnormality notedPANCREAS: Previously seen 9 mm hypodense nodule in the body of the pancreas is poorly visualized but does not appear to have grossly changed. The pancreatic duct is again dilated to approximately 7 mm, similar to prior. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Post-surgical changes to the stomach. A small duodenal diverticulum is present. No evidence of bowel obstruction. Interval repair of large ventral hernia. Colonic diverticulosis.BONES, SOFT TISSUES: There is diffuse fluid/edema in the anterior abdominal wall surrounding the surgical mesh which does not extend into the peritoneal cavity. No associated loculations or foci of air. Severe degenerative changes and multiple compression fractures throughout the thoracolumbar spine, similar to prior. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomy. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Post-surgical changes to the stomach. A small duodenal diverticulum is present. No evidence of bowel obstruction. Interval repair of large ventral hernia. Colonic diverticulosis.BONES, SOFT TISSUES: Bilateral hip orthopedic devices. Severe degenerative changes and multiple compression fractures throughout the thoracolumbar spine, similar to prior. OTHER: No significant abnormality noted | 1.Interval ventral hernia repair with diffuse fluid/edema in the anterior abdominal wall surrounding the surgical mesh. Though the fluid is incompletely characterized on CT and infection cannot be excluded, there are no specific signs of infection such as air or loculation. 2.No evidence of bowel obstruction. 3.Mild to moderate dilation of the common bile duct and pancreatic duct of uncertain etiology but which appears similar to prior. 4.Previously seen 9 mm pancreatic body lesion poorly visualized but grossly unchanged.5.Severe degenerative changes and multiple compression fractures throughout the thoracolumbar spine, similar to prior. |
Generate impression based on findings. | The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | Negative unenhanced brain CT. |
Generate impression based on findings. | 56 year old male with acute onset right flank pain, evaluate for renal stone. 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: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral punctate renal stones. Right ureter is minimally dilated. No evidence of ureteral stones. Mild right pelviectasis.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: There is a punctate stone bladderLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Bilateral punctate renal stones with mild right caliectasis and dilated right ureter of uncertain etiology. This may be secondary to a recently passed stone. No evidence of ureteral stones.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 47 years, Male. Reason: eval dobhoff placement History: above Enteric feeding tube tip projects over the gastric fundus.Support devices unchanged. Pelvis excluded from the field of view. | Enteric feeding tube tip projects over the gastric fundus. |
Generate impression based on findings. | For purposes of numbering, the lowermost level containing a well formed disc is presumed to be L5/S1. Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.T11/12: Mild disc bulge versus small protrusion without cord abutment, no associated mass effect, and no resulting stenosis, unchanged.T12/L1: There is a small left paracentral disc protrusion causing mild left lateral recess stenosis, unchanged.L1/2: Mild disc bulge without stenosis, unchanged.L2/3: A previously demonstrated tiny right paramedian annular fissure of diffuse disc bulge now has an appearance of a right paracentral shallow disc protrusion causing new mild right lateral recess stenosis. Mild bilateral facet hypertrophy and mild bilateral neural foraminal stenosis are unchanged.L3/4: Slight interval progression of diffuse annular disc bulge containing a posterior annular fissure, ligamentum flavum thickening, and mild bilateral facet hypertrophy. There is is now mild to moderate central stenosis (previously mild), new mild bilateral lateral recess stenosis, and mild to moderate bilateral neural foraminal stenosis (previously mild).L4/5: A previously demonstrated large left paracentral disc extrusion has nearly resolved leaving a shallow left paracentral disc protrusion with improved mild left lateral recess stenosis. There remains diffuse annular disc bulge, slight ligamentum flavum thickening, and mild bilateral facet hypertrophy. Central stenosis is now mild (previously moderate rightward) and mild bilateral neural foraminal stenosis is stable.L5/S1: There is a small left paracentral disc protrusion which abuts the left S1 nerve root sheath origin, unchanged. | 1.T12/L1: There is a small left paracentral disc protrusion causing mild left lateral recess stenosis, unchanged.2.L2/3: A previously demonstrated tiny right paramedian annular fissure of diffuse disc bulge now has an appearance of a right paracentral shallow disc protrusion causing new mild right lateral recess stenosis. Mild bilateral neural foraminal stenosis are unchanged.3.L3/4: Slight interval progression of diffuse annular disc bulge containing a posterior annular fissure, ligamentum flavum thickening, and mild bilateral facet hypertrophy. There is is now mild to moderate central stenosis (previously mild), new mild bilateral lateral recess stenosis, and mild to moderate bilateral neural foraminal stenosis (previously mild).4.L4/5: A previously demonstrated large left paracentral disc extrusion has nearly resolved leaving a shallow left paracentral disc protrusion with improved mild left lateral recess stenosis. Central stenosis is now mild (previously moderate rightward) and mild bilateral neural foraminal stenosis is stable.5.L5/S1: There is a small left paracentral disc protrusion which abuts the left S1 nerve root sheath origin, unchanged. |
Generate impression based on findings. | 33 -year-old female with history of diabetes now with epigastric pain and abdominal distention. ABDOMEN:LUNG BASES: Small right pleural effusion with associated atelectasis, similar to prior. Trace left pleural effusion with associated atelectasis, improved from prior. Cardiomegaly. LIVER, BILIARY TRACT: The liver is enlarged, increased in size from prior. The liver demonstrates heterogenous, organized, reticular, peripheral greater than central enhancement. There is marked dilation of the IVC with probable reflux of contrast. The hepatic veins appear patent. The portal vein is attenuated but appears patent.In segment 7, there is a predominantly homogenously enhancing lesion with a nonenhancing central component (series 3, image 25) which overall measures 4.9 x 4.6 cm, not significantly changed. This lesion may represent a focal nodular hyperplasia or a benign regenerative nodule. Additional smaller avidly enhancing nodules are unchanged. The overall pattern is most consistent with benign regenerative nodules in the setting of passive hepatic congestion. Persistent periportal and pericholecystic fluid likely related to chronic liver disease. Gallbladder wall thickening similar to prior and non-specific. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral kidneys again display delayed diminished enhancement.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate abdominopelvic ascites.PELVIS: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: Moderate abdominopelvic ascites. | 1.Increasing hepatomegaly.2.Heterogenous hepatic enhancement and multiple small avidly enhancing nodules in pattern most consistent with benign regenerative nodules in setting of chronic passive hepatic congestion.3.Approximately 5 cm mass in the right lobe of the liver most likely represents an FNH or a additional benign regenerative nodule, similar to prior.4.Moderate abdominopelvic ascites, similar to prior.5.Small right pleural effusion, unchanged. Trace left pleural effusion, improved. |
Generate impression based on findings. | 47 years, Male. Reason: re eval dobhoff reposition History: above Enteric feeding tube tip projects over the gastric body.Support devices unchanged. Pelvis is excluded from the field of view. | Enteric feeding tube tip projects over the gastric body. |
Generate impression based on findings. | cerebrovascular accident No evidence of acute ischemic or hemorrhagic lesion.Underlying brain shows non specific small vessel disease, no change since prior exam.Diffuse minimal brain atrophy which is age appropriate.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion.Non specific small vessel disease, mild. |
Generate impression based on findings. | Sternal wound drainage and minor instability after MV repair. Evaluate for sternal dehiscence. LUNGS AND PLEURA: Very small bilateral pleural effusions.Dependent subsegmental atelectasis and/or basilar scarring.MEDIASTINUM AND HILA: Cardiomegaly with a mitral valve prosthesis. Epicardial pacer wire terminates along the right ventricle. No visible coronary artery calcification.Small pericardial effusion, decreased from prior.CHEST WALL: Post-surgical findings of recent median sternotomy with intact hardware. Overlying skin staples.No drainable fluid collection in the anterior chest wall.Prominent bilateral axillary lymph nodes, unchanged.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Cholelithiasis. Left upper pole renal cysts. | 1. Postsurgical findings of recent median sternotomy for mitral valve replacement without evidence of dehiscence. 2. Very small bilateral pleural effusions and bibasilar subsegmental atelectasis/scarring. |
Generate impression based on findings. | 65 years, Female. Reason: eval abdominal pain History: RLQ abd pain, Lung bases clear.Nonobstructive bowel gas pattern. Average stool burden. No intramural or free intraperitoneal air. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 69 years, Male. Reason: Repeat Abdominal Xray per Radiology to assess Dobhoff line placement History: Dysphagia Enteric feeding tube tip projects over the gastric body and is questionably kinked distally. Mildly dilated loops of small bowel in the left hemi abdomen. Right sided pulmonary opacities are better evaluated on prior chest radiograph.Note that the pelvis is excluded from the field of view. | Enteric feeding tube tip projects over the gastric body. |
Generate impression based on findings. | altered mental status No evidence of acute ischemic or hemorrhagic lesion.Minimal non specific small vessel disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | 9-year-old male with worsening desaturation. Evaluate for interval change.VIEW: Chest AP (one view) 2/15/2015 15:07 Central venous catheter tip in the SVC. ET tube tip below the thoracic inlet and above the carina. NG tube tip in the stomach. Interval near complete collapse of the left lung likely a combination of atelectasis and small pleural effusion. Interval improvement in aeration of the right lung. Small right pleural effusion. Cardiac silhouette obscured by overlying opacification of the left lung. | Interval near complete collapse of the left lung likely a combination of atelectasis and small pleural effusion. Interval improved aeration of the right lung with a small pleural effusion. |
Generate impression based on findings. | Male 77 years old Reason: r/op acute fracture/abnormalities History: pain, swelling s/p fall. There is no acute fracture or dislocation. There is demineralization of bones. There are osteophytes and severe joint space narrowing of the basilar joint. | Severe osteoarthritis of the basilar joint without evidence of acute fracture or dislocation. |
Generate impression based on findings. | Pain and swelling of the left upper jaw No fracture or malalignment. No temporomandibular joint subluxation. The paranasal sinuses are unopacified. Dental amalgam noted. | No fracture or malalignment. |
Generate impression based on findings. | Female 33 years old Reason: r/o bile leak, retained cbd stone History: s.p lap chole on 2/3, epigastric and RUQ persistent pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy with surgical clips in the gallbladder fossa.Hypodense, nonenhancing fluid collection in the gallbladder fossa measuring 2.1 x 1.6 cm (series 4, image 37) which is likely postsurgical in etiology. Common bile duct is normal in caliber.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 | Small fluid collection in the gallbladder fossa which is likely postsurgical in nature. |
Generate impression based on findings. | Assess for cholecystitis. Abdominal pain. Angiographic images are unremarkable. Prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is normal excretion of tracer into the intrahepatic ducts, common bile duct, and duodenum, indicating patent common bile ducts. The gallbladder was not observed to fill throughout this period, however, there were no specific secondary signs of inflammation. | Non-filling of the gallbladder without specific secondary signs of inflammation is non-specific. Findings discussed with the surgery resident at pager 1616 prior to dictation. |
Generate impression based on findings. | Right ankle fracture The medial gutter of the tibiotalar joint is minimally prominent, though within normal limits. Moderate soft tissue swelling is present at the lateral aspect of the ankle. The distal fibular fracture is again noted, in anatomic alignment. | Fibular fracture, as above. |
Generate impression based on findings. | Male 52 years old Reason: r/o fx History: decreased ROM, injury, pain, swelling. There is no soft tissue swelling surrounding the fifth digit. No acute fracture or dislocation. | No acute fracture or dislocation. |
Generate impression based on findings. | Ileus and collapse, intubatedVIEW: Chest AP (one view) 2/16/2015 0647 Thoracolumbar dextroscoliosis is again noted. Cholecystectomy clips are seen. Patchy opacities throughout the left lung are unchanged. No pneumothorax or new air space opacity is identified. The cardiothymic silhouette is within normal limits.Bilateral upper extremity venous accesses are again seen. Right supraclavicular wires are likely external to the patient. Gastrostomy tube is partially visualized. | No change in patchy left lung opacities. |
Generate impression based on findings. | Female 22 years old Reason: r/o fracture History: pain, swelling. There is a nondisplaced fracture of the radial head with a large elbow joint effusion. | Radial head fracture as described above. |
Generate impression based on findings. | Ms. Costella is a 46 year old female with a personal history of left breast lumpectomy in 2005 for IDC/DCIS followed by chemotherapy, radiation and hormonal therapy. Family history of breast cancer in maternal grandmother, diagnosed at the age of 40. 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 heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A linear marker is placed on a scar overlying the left breast. There are stable postsurgical changes including architectural distortion, increased density, and skin retraction present within the left lumpectomy site. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Stable postsurgical changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 25 years old Reason: dislocation History: pain. There is no acute fracture or dislocation of the elbow. No joint effusion is identified. | No acute fracture or dislocation of the right elbow. |
Generate impression based on findings. | Reason: eval for PE History: chest pain, elevated ddimer PULMONARY ARTERIES: No evidence of pulmonary embolism. Main pulmonary artery is normal in caliber.LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.Mild basilar subsegmental atelectasis/scarring. Scattered subtle groundglass likely related to expiratory phase imaging. No focal air space consolidations. No pleural effusions.MEDIASTINUM AND HILA: The heart is upper normal in size, without pericardial effusion. No visible coronary artery calcification.No mediastinal hilar lymphadenopathy.CHEST WALL: Solid, ovoid left breast nodule measuring up to 22 m x 17 mm (Series 7, image 82).No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No evidence of pulmonary embolism. Mild basilar subsegmental atelectasis/scarring. Scattered subtle groundglass likely related to expiratory phase imaging. No focal air space consolidations. No pleural effusions.2. Approximately 2-cm solid left breast nodule. Correlate with physical exam.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 61-year-old male. Relapsed AML. E coli bacteremia, cough with blood-tinged mucous. Evaluate for infection. LUNGS AND PLEURA: Significant motion artifact, most severe in the bases. Patchy ground-glass opacities bilaterally suggestive of atelectasis and mild pulmonary edema. No reliable evidence of infection.Right apical scarring with additional scattered scar-like opacities in the right lung. Small bilateral pleural effusions. MEDIASTINUM AND HILA: Moderately enlarged mediastinal lymph nodes, including a right paratracheal node that is 12 mm in short axis.Normal heart size without pericardial effusion. Mild coronary artery calcification. Low-density blood pool consistent with anemia.Left chest wall port tip terminates at the cavoatrial junction.CHEST WALL: Mild degenerative changes of the thoracic spine. Left chest wall port.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Small amount of perihepatic ascites. Calcified hepatic granuloma. Cholelithiasis. Splenomegaly. | 1. Mild groundglass opacities suggestive of pulmonary edema with small pleural effusions.2. No reliable evidence of infection.3. Nonspecific moderately enlarged mediastinal lymph nodes. Small amount of perihepatic ascites.Findings communicated to Dr. Rich over the phone at time of dictation. |
Generate impression based on findings. | Pain and swelling status post fall Moderate soft tissue swelling is present at the lateral aspect of the ankle. An oblique nondisplaced fracture is seen in the distal fibula, at the level of the tibiotalar joint. | Fibular fracture, as above. |
Generate impression based on findings. | 8-year-old male with intermittent severe abdominal pain and emesis. Rule out obstruction.VIEWS: Abdomen AP upright and supine (two views) 2/15/2015 Large colonic stool burden. Nonobstructive bowel gas pattern. No focal pulmonary opacities in the visualized lung bases. | Large colonic stool burden with no evidence of obstruction. |
Generate impression based on findings. | Pleural effusion status post chest tubeVIEW: Chest AP (one view) 2/16/2015 0355 Bilateral pleural effusions, left greater than right, are again seen. A pigtail catheter projects over the left lower hemithorax. No pneumothorax is present. Nonspecific retrocardiac consolidation/atelectasis is unchanged.Right upper extremity PICC tip projects over the cavoatrial junction. | No change in bilateral pleural effusions with left chest tube in place. |
Generate impression based on findings. | Male 62 years old Reason: fx History: pain, swelling. Limited study of the ribs is unremarkable for left rib fracture. Visualized thoracic vertebral bodies heights and intervertebral spaces are preserved. | No definite left rib fracture, however the study is limited. |
Generate impression based on findings. | Podagra Chronic deformities of the 1st, 2nd, and 4th metatarsals likely reflect prior injury. No acute fracture evident. No specific evidence of gout. Scattered degenerative changes are noted, particularly at the 1st MTP joint. | No specific evidence of gout. |
Generate impression based on findings. | 76-year-old female with history of fall. Head: No evidence of acute intracranial hemorrhage. There is minimal confluent periventricular white matter hypoattenuation. The gray-white differentiation is preserved. There is an empty sella with expanded margins likely secondary to CSF pulsation. The basal cisterns are intact. The ventricles and sulci are symmetric. There is mild cerebral volume loss likely secondary to age. Opacity along the inferior aspect of the left maxillary sinus compatible with mucous retention cyst. The remaining visualized paranasal sinuses are clear. There is asymmetric opacification of the right mastoid air cells and right middle ear.Cervical spine: There is no evidence of acute cervical spine fracture or subluxation. The prevertebral soft tissues are within normal limits. The airways is intact. There is minimal anterolisthesis of C4 on C5. There is straightening of the normal cervical lordosis. There is fusion of the cervical spine facets on the left from C2 - C4. There is atherosclerotic calcifications at the carotid artery bifurcations.Moderate multilevel degenerative disc disease affects the cervical spine as follows: At C1-2 there is no significant compromise to the spinal canal or neural foramina.At C2-3 there is no significant compromise to the spinal canal or neural foramina. There is bilateral facet fusion present at this level.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is left sided facet fusion present at this level.At C4-5 there is bilateral facet hypertrophy associated with mild anterior subluxation of C4 on C5.At C5-6 there is loss of disk space height, endplate and uncovertebral osteophytes associated with narrowing of the neural foramina bilaterally. There is narrowing of the facet joints and facet hypertrophy present at this level. There is encroachment of the right-sided exiting nerve roots as a result of osteophytes at this level.At C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina. | 1. No evidence of acute intracranial hemorrhage or cervical spine fracture. There is mild subluxation at C4-5 which is suspected to be a result of degenerative change.2. Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 3. Asymmetric opacification of the right mastoid air cells and right middle ear. No obvious cause can be appreciated on this exam. Please correlate clinical symptoms and evaluation4. There are multilevel degenerative changes present in the cervical spine worse at C5-6 were there is encroachment of right-sided exiting nerve roots within the neural foramen. |
Generate impression based on findings. | Female 76 years old Reason: r/o fx History: fall, pain. There is no acute fracture or dislocation. Osteophytes affect the glenohumeral joint. There is a high riding humeral head consistent with a chronic rotator cuff tear. Humeral head deformities consistent with prior trauma. A well corticated ossicle in the axillary recess likely represents a loose body in the axillary joint. | 1.No acute fracture or dislocation of the left shoulder joint.2.High riding humeral head consistent with chronic rotator cuff tear and deformity of the humeral head consistent with prior trauma. |
Generate impression based on findings. | Female, 48 years old, with mucoepidermoid cancer of the buccal and parotid area. Compared to last CT and measured the left infratemporal fossa mass in the coronal and axial plane, and the nodule deep to the left zygomatic arch. Head:No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. Neck:Extensive surgical alterations are redemonstrated including partial left maxillectomy and palatectomy as well as partial resection of the left mastoid air cells. The left parotid gland is absent. The left submandibular gland is present but is small.A bulky mass centered in the left infratemporal fossa/masticator space is not significantly changed in size or morphology when accounting for differences in scan technique. This lesion measures approximately 52 x 23 mm in the axial plane (image 11 series 7) when measured similarly to the prior examination where it measured approximately 52 x 22 mm. This lesion measures approximately 21 x 20 mm in the coronal plane (image 32 series 80330) compared to 20 x 20 mm previously. An additional reference nodule deep to the left zygomatic arch measures 10 x 10 mm (image 6 series 7) and is unchanged as well. A similar sized nodule along the left masseter muscle is also unchanged.Erosion of the skull base adjacent to the tumor is a stable finding. The left pterygopalatine fossa and foramen rotundum remain significantly enlarged likely reflecting tumor involvement but there has been no significant change from prior. Sclerosis of the left mandible, zygomatic arch, sphenoid wing and left temporal bone are stable findings. The partially resected left mastoid air cells are partly opacified with soft tissue as is the external auditory canal, similar to prior.A left submental reference node measures 5 mm short axis (image 35 series 7) previously 8 mm. A right level 2a node measures 6 mm short axis (image 26 series 7), not significantly changed accounting for differences in technique. No new or progressive adenopathy is detected anywhere in the neck.The residual salivary glands and the thyroid are free of focal lesions. The cervical vessels enhance normally. A micronodule in the right lung apex is unchanged. No new concerning osseous lesions are detected. | 1.Stable bulky mass in the left infratemporal fossa with stable additional nodules deep to the zygomatic arch and along the anterior aspect of the masseter muscle.2.No pathologic adenopathy is detected in the neck and no significant change of any reference nodes is seen.3.Erosion of the skull base and infiltration of the pterygopalatine fossa and foramen rotundum are stable.4.No CT evidence of brain parenchymal metastases. |
Generate impression based on findings. | Term infant status post congenital diaphragmatic hernia repair. Please assess right pleural effusion and multiple opacities noted on previous chest radiographVIEW: Chest AP (one view) 2/16/2015 0430 Right pleural effusion has increased in size and now appears moderate to large in size. Diffuse haziness of the right lung is likely due to layering effusion/atelectasis. No pneumothorax. Patchy left lung opacities are again noted. Mild chest wall edema is again noted.Endotracheal tube tip terminates just above the carina. Nasogastric tube extends into the stomach. Right upper extremity PICC tip lies at the confluence of the brachiocephalic veins | Increase in right pleural effusion. No change in patchy left lung opacities. |
Generate impression based on findings. | Swelling and ecchymosis, particularly at the medial right knee status post fall RIGHT KNEE: No fracture or malalignment. No joint effusion. Vascular calcifications noted.LEFT FOOT: No fracture or malalignment. Mild hallux valgus deformity noted. Extensive vascular calcifications. | No fracture or malalignment. |
Generate impression based on findings. | 3 day old female status post line adjustment. Evaluate tip of PCVC.VIEW: Chest AP (one view) 2/15/2015 16:23 Left upper extremity PICC tip has been retracted and now terminates at the confluence of the brachiocephalic veins. NG tube tip in the gastric body.Cardiothymic silhouette is normal. No focal pulmonary opacities. No pleural effusion or pneumothorax. | Left upper extremity PICC tip terminates at the confluence of the brachiocephalic veins. |
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. No suspicious masses, microcalcifications or areas of architectural distortion are present. Scattered benign calcifications, including arterial calcifications, are present in both breasts. | No mammographic evidence of malignancy. Early arterial calcifications can be an indicator of cardiovascular disease. Recommend correlation with clinical history. 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: NSD - Screening Mammogram. |
Generate impression based on findings. | Status post left varus derotational osteotomy and Spica placementVIEWS: Pelvis AP (one view) 2/16/2015 0755 Overlying spica cast obscures fine bone detail.Status post left varus derotational osteotomy. Left proximal femur plate and screw device is seen in place without complication. The osteotomy margins are indistinct compatible with interval healing. Right femoral head deformity is again noted with right hip joint space narrowing. Screw tracks from prior right varus derotational osteotomy hardware is present. Heterotopic ossification along the medial proximal femur is unchanged. The femoral heads are well directed into the acetabula. | Postoperative changes. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally, including stable right outer breast calcifications. 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. | L4-5 fusion Spinal fusion of L4-5 with bipedicular screws and bone graft. No radiographic evidence of hardware complication. Grade 1 anterolisthesis of L4 on L5, unchanged. Vertebral body heights are preserved. | Postoperative changes, as above. |
Generate impression based on findings. | SOB, palpitations. Evaluate for PE, history of PE in 2012. PULMONARY ARTERIES: Suboptimal examination due to poor opacification of the pulmonary arteries. No evidence of pulmonary embolism to the lobar level.LUNGS AND PLEURA: Scattered micronodules, most-likely postinflammatory.No pleural effusion or focal airspace consolidation.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Normal heart size without pericardial effusion.No visible coronary artery calcification.CHEST WALL: Minimal degenerative changes of the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholecystectomy clips. | No evidence of pulmonary embolism to the lobar level or other significant abnormality.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Ms. King is a 52 year old female with a history of bilateral breast calcifications. She has 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. Scattered benign punctate calcifications are present bilaterally, remaining unchanged in distribution and appearance when comparing back to examinations from 2011. 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. | Reason: r/o PE History: oxygen desaturations PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Basilar subsegmental atelectasis, increased from the prior exam. No new focal air space consolidation. No pleural effusions.Left upper lobe round, heterogeneous, subpleural nodule measures 13 x 11 millimeters (series 8, image 103), mildly increased from the prior exam.Additional scattered small nodules, some calcified, are unchanged.Moderate centrilobular emphysema.MEDIASTINUM AND HILA: The heart is normal in size, without pericardial effusion. Mild coronary artery calcification. Ectatic ascending aorta.No mediastinal or hilar lymphadenopathy.Tracheostomy. Extensive post op change involving neck.CHEST WALL: Left upper chest staple line, subcutaneous gas compatible with recent surgical procedure.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Nasogastric tube terminates in the stomach. Gastrostomy tube in place. | 1. No evidence of pulmonary embolism.2. Mildly increased size of a left upper lobe subpleural nodule. Indolent primary cancer and hamartoma remain on the differential. PET imaging may be useful for further evaluation. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. There are microcalcifications in the right upper inner breast at approximately 14 cm depth. No suspicious masses or areas of architectural distortion are present. | Microcalcifications in the right upper inner breast for which comparison with prior examinations is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Reason: concern for subacute stroke History: aphasia, ataxia The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a 15 x 10 millimeter extra-axial calcified lesion adjacent to the right parietal bone. There is a 11 x 23 mm coronal dimension calcified extra-axial lesion adjacent to the left parietal bone. These two lesions most likely represent calcified meningiomas.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits demonstrate medial deviation of the left lamina papyracea most like to represent an old left medial orbital blowout fracture. The eyeball lenses are thin.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.3.Findings suggest calcified meningiomas at adjacent to the right and left parietal bones |
Generate impression based on findings. | 14-year-old female with abdominal pain. Evaluate stool burden.VIEW: Abdomen supine AP (one view) 2/15/2015 Average stool burden. Nonobstructive bowel gas pattern. | Average stool burden. |
Generate impression based on findings. | 13-month-old male with cough and streaks of blood. Evaluate for pneumonia.VIEWS: Chest AP/lateral (two views) 2/15/2015 Left-sided aortic arch, cardiac apex and stomach. Cardiothymic silhouette is normal. Mild peribronchial thickening and subsegmental atelectasis in the right lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurments History: none CHEST:LUNGS AND PLEURA: Emphysema. Scattered punctate micronodules, including the previously reference subpleural nodule in the left lower lobe (image 69/123) are stable and presumably benign. No new pulmonary nodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Postop left nephrectomy.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: Degenerative change in lower lumbar spine.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
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