instruction stringclasses 1 value | input stringlengths 6 8.98k | output stringlengths 5 3.11k |
|---|---|---|
Generate impression based on findings. | Female 36 years old Reason: low back pain with lower extremity pain History: see above AP view of the pelvis demonstrates no acute fracture or dislocation. Bilateral hip joints are unremarkable. The femoral head shapes are preserved.Two views of the lumber spine demonstrate degenerative changes at the L5/S1 joint including facet arthropathy. There is no acute fracture or malalignment. Body heights and intravertebral disk spaces are preserved above L5/S1. Note is made of right upper quadrant surgical clips and IVC filter. | Degenerative changes at the L5/S1 joint. However, given the patient's age, and incomplete segmentation abnormality or congenital variant cannot be excluded. |
Generate impression based on findings. | Reason: 70 Yr female here for follow-up of EGFR mutated NSCLC in need of restaging CT History: EGFR mutated NSCLC CHEST:LUNGS AND PLEURA: Redemonstration of postsurgical findings related to a right upper lobectomy. Multiple micronodules demonstrates progressive interval increase in size over the last two exams.Mild interval increase in size is noted in the following nodules:(Image 98, series 10234) now measuring 3 mm x 4 mm measuring 1 mm and exam dated 9/12/14.(Image 62, series 10234) measuring currently 5 mm x 4 mm and measured 2 mm x 2 mm on the exam dated 9/12/14.(Image 60, series 10234) now measuring 7 mm x 5 mm and measuring 5 mm x 2 mm on the exam dated 9/12/14.(Scattered other pulmonary micronodules also demonstrate mild progression in size.Right pleural thickening and calcification. No pleural effusions.MEDIASTINUM AND HILA: AP window lymph node (image 34 series 5) now measuring 10 mm x 10 mm previously measuring 8 mm x 10 mm.Cardiac size is normal without evidence of a pericardial effusion.Paraesophageal surgical clips redemonstrated. Small hiatal hernia.CHEST WALL: Status post right thoracotomy.Stable right subpectoral lymph node (image 25 series 5) measuring 7 mm.Sclerotic lesions and T1 T11 vertebra not significantly changed.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis.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: No significant abnormality noted.OTHER: No significant abnormality noted. | Gradually increasing size of scattered pulmonary micronodules over the last two exams and is suspicious of metastatic disease. No new suspicious pulmonary nodules or masses. No new sites of disease identified. |
Generate impression based on findings. | Female 61 years old Reason: Progression of endometrial cancer History: abdominal pain, palpable mass near rectum on exam ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: 1.5 x 0.5 cm cystic appearing lesion in the head of the pancreas is unchanged on image number 53, series number 3. This may represent a branch type by PMN. Further evaluation with M.R.C.P. in 6 months may be helpful.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left nephrolithiasis and scarring of the left kidney, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: The patient is status post hysterectomy. Previously measured asymmetric soft tissue density on the left side of the pelvis continuous with the vaginal cuff now measures 2.7 by 2.5 cm on image number 115, series number 3, not significantly changed from previous study. Again noted is the fullness in the vaginal cuff.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 significant change in the size of the referenced left-sided pelvic soft tissue density.Small cystic lesion in the head of the pancreas. Follow-up with M.R.C.P. in 6 months maybe helpful for further characterization. |
Generate impression based on findings. | History of MAI, now off medications since last CT. Evaluate for progression status post discontinuing medications. LUNGS AND PLEURA: New area of bronchiole mucus impaction in the right lower lobe (series 4, image 79) and interval resolution of mucus plugging in some of the left lower lobe bronchioles. Otherwise, the bilateral clusters of tree-in-bud opacities with associated mild bronchiectasis and bronchial wall thickening with scattered mucus impaction are unchanged.MEDIASTINUM AND HILA: Small mediastinal lymph nodes, unchanged. No new lymphadenopathy.Normal heart size without pericardial effusion.No visible coronary artery calcification.CHEST WALL: Mild degenerative changes of the thoracolumbar spine. Partially visualized anterior fusion hardware in the cervical spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Interval resolution of mucus plugging in some left lower lobe bronchioles and a newly impacted bronchiole in the right lower lobe. Otherwise, no significant interval change tree-in-bud opacities consistent with known MAI. |
Generate impression based on findings. | Reason: infection pre-induction chemo for new diagnosis of acute leukemia? (CT sinus also ordered) History: baseline pre-chemo LUNGS AND PLEURA: Probable accessory fissure in the right lower lobe, with an adjacent small solid nodule measuring up to 5 mm (series 6, image 181), with a triangular morphology suggestive of an intrapulmonary lymph node. Additional scattered benign appearing micronodules, some calcified.Mild basilar subsegmental atelectasis/scarring. No focal air space consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Moderate coronary artery calcification.Left subclavian central venous catheter, tip in the right atrium.No mediastinal or hilar lymphadenopathy.CHEST WALL: Right chest wall solid lesion with local destruction of the lateral right third rib, most likely related to a known history of myeloid sarcoma.Degenerative disease of the thoracic spine. Anterior wedging deformity of a low thoracic/upper lumbar vertebral body (sagittal image 53). No other focal osseous lesions.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No acute cardiopulmonary abnormality.2. Right chest wall solid lesion with local destruction of the lateral right third rib, most likely related to a known history of myeloid sarcoma. |
Generate impression based on findings. | hypothermiaVIEW: Chest AP 2/16/15 Tracheostomy tube in place. G-tube in place. Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Minimal perihilar atelectasis without pleural effusion or pneumothorax. | Minimal perihilar atelectasis without pneumonia. |
Generate impression based on findings. | Mild lobular mucosal thickening is present within the right maxillary sinus, unchanged. Mild mucosal thickening is present within the left maxillary sinus. Bilateral ostiomeatal units are patent.Minimal mucosal thickening is present within the anterior right sphenoid sinus. The left sphenoid sinus is clear and bilateral sphenoethmoidal recesses are clear.Bilateral ethmoid air cells are clear.Minimal mucosal thickening is present within the inferior bilateral frontal sinuses. Bilateral frontoethmoidal recesses are clear.Opacification is present within a few left mastoid air cells. The visualized right mastoid air cells and bilateral middle air cavities are clear.There are no air-fluid levels. The lamina papyracea are intact bilaterally. The floor of the anterior cranial fossa and cribriform plate region are unremarkable. The nasal septum is deviated leftward and there is a left sided septal spur. Bilateral orbits and the posterior nasopharynx appear unremarkable. Incidental note is made of bilateral retinal calcifications. | 1.Mucosal thickening within several paranasal sinuses without superimposed air-fluid levels.2.Opacification is present within a few left mastoid air cells.3.The nasal septum is deviated leftward and there is a left sided septal spur. |
Generate impression based on findings. | 55-year-old male with possible liver mass and gallstones ABDOMEN:LUNG BASES: Subsegmental atelectasis in the right lung base.LIVER, BILIARY TRACT: Multiple bilobar hepatic metastases. Index lesion in the left lobe measures 1.7 by 1.7-cm image number 30, series number 11. Pneumobilia. Metallic stent in the common bile duct. Mild intrahepatic biliary prominence persists. Cholelithiasis is unchanged.SPLEEN: Chronic thrombosis of the splenic vein secondary to invasion by the patient's known cancer.PANCREAS: There is an ill-defined infiltrative mass measuring 3.5 x 3.4 cm on image number 47, series number 11 likely arising from the pancreas and encasing SMA, SMV and extrahepatic main portal vein.There is air containing fluid in the lesser sac. Perforation cannot be excluded.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal likely metastatic borderline enlarged lymph nodes. An index node measures 10 x 7 mm on image number 59, series number 11.BOWEL, MESENTERY: Small amount of ascites.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 | Locally aggressive likely pancreatic origin cancer invading the retroperitoneal vessels and with multiple liver metastases.Air is noted within the fluid in the lesser sac. Perforation cannot be excluded.Mary Frech was not working today so Dr. Mangum from Friend Family Health Center was acknowledged and notified about the above findings at the time of the dictation. |
Generate impression based on findings. | FractureVIEWS: Right wrist AP and lateral Healing fracture involving the metaphysis of the distal radius again noted. The sclerosis is less evident reflecting interval healing. The distal ulna is normal. | Healing fracture distal radius as described above. |
Generate impression based on findings. | FractureVIEWS: Left femur AP and lateral Again noted fracture involving the proximal diaphysis of the left femur in near anatomic alignment. There is periosteal reaction and sclerosis reflecting interval healing. The overlying cast obscures fine bony detail. | Healing left femur fracture as described above. |
Generate impression based on findings. | Evaluate fractureVIEWS: Right middle finger AP, oblique and lateral There is a healing fracture involving the distal phalanx of the middle finger. The fracture line is less evident reflecting interval healing. The alignment is near anatomic. | Healing fracture distal phalanx of the middle finger. |
Generate impression based on findings. | 98 years, Female. Reason: assess stool burden or other cause of lower abd pain History: new lower abd pain Note that a portion of the left hemiabdomen is excluded from the field of view. Mildly dilated loops of bowel compatible with ileus. Slightly greater than average stool burden in the ascending colon. Skin staples project over the right hip.Bilateral pleural effusions noted. | Findings compatible with mild ileus. Slightly greater than average stool burden in the ascending colon |
Generate impression based on findings. | 51 year old male patient with history of achalasia s/p myotomy and Dor fundoplication in 2008 presents with worsening dysphagia. Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Double contrast evaluation of the esophagus and gastric cardia/fundus revealed a short portion of the esophagus beneath the level of the diaphragm, as well as the appearance of a distal esophageal pseudotumor which is consistent with the provided history of a Dor fundoplication. Fluoroscopic evaluation of esophageal peristalsis demonstrated cessation of the primary wave at the level of the thoracic inlet with proximal escape and tertiary waves in the distal esophagus (cine series 21).After ingestion of the 1.3 cm diameter barium pill, there was delayed transit of the pill past the gastroesophageal junction (series 31). The patient drank warm water for approximately 10 minutes until the barium pill was completely dissolved. The gastroesophageal junction was patent to 1 cm on prior examination. TOTAL FLUOROSCOPY TIME: 7:26 minutes | 1.Postsurgical changes from Dor fundoplication.2.Interval narrowing of the gastroesophageal junction with delayed passage of a 1.3 cm barium pill.3.Mild esophageal motility abnormality. |
Generate impression based on findings. | Reason: R ICA aneurysm coiling /shunt / follow up History: yearl follow up/clot, surveillance Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. The patient is status post clipping of a left posterior communicating artery aneurysm and embolic coil occlusion of a right posterior communicating artery aneurysm. The posterior communicating arteries are obscured by artifact . There is no obvious aneurysm recurrence appreciated though a small one may be obscured by artifactThe anterior communicating artery is identified and is intact.CT head:The patient is status post embolic coil occlusion of a right posterior communicating artery aneurysm.The patient is status post left-sided posterior communicating artery clip placementThe patient has undergone left-sided craniotomy for drainage of a left-sided subdural hematoma. A ventriculostomy tube course through the right parietal into the body of the right lateral ventricle across the midline and has its tip along the frontal horn of the left lateral ventricle. This is stable since the prior examHypodensity involving gray and white matter is present along the right parietal lobe, right temporal lobe and right occipital lobe as well as the posterior aspect of the right frontal lobe. This is associated with asymmetric enlargement of the trigone of the right lateral ventricle as well as the temporal horn of the right lateral ventricle. The ventriculostomy tube courses through the center of this focus of encephalomalacia.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.Status post coiling of a right posterior communicating artery and clipping of the left posterior communicating artery aneurysm. There is no obvious aneurysm recurrence appreciated though a small one may be obscured by artifact2.Encephalomalacia involving right frontal, occipital, parietal and temporal lobes.3.Status post ventriculostomy tube placement. The lateral ventricles are stable |
Generate impression based on findings. | Reason: h/o base of tongue ca and CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Previously new punctate micronodule left apex has resolved.MEDIASTINUM AND HILA: Scattered small subcentimeter lymph nodes are unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly 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: Stable renal cysts, some of which contain calcification.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Previously noted new left apex micronodule has resolved. Otherwise stable CT with no evidence of metastatic disease. |
Generate impression based on findings. | RIGHT: There are minimal appreciable changes related to canaloplasty and atticotomy.The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain is intact. The inner ear structures are unremarkable. The facial nerve describes a normal course.LEFT: The external auditory canal is patent. The middle ear and mastoid air cells are well-pneumatized and clear. The ossicular chain and scutum are intact. The inner ear structures are unremarkable. The facial nerve describes a normal course.MISCELLANEOUS: There is trace bilateral maxillary and right sphenoid sinus mucosal thickening. There is scattered ethmoid air cell opacification. There are staphylomatous deformities of both globes. | Postoperative findings in the right temporal bone without evidence of cholesteatoma.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography. 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.The sensitivity of mammography for detecting breast cancer is decreased in patients with dense breasts such as this patient. Physical exam assumes a more important role. Additional screening with automated whole breast ultrasound can also be considered based on her mammographically dense breasts.BIRADS: 1 - Negative.RECOMMENDATION: NSD - Screening Mammogram. |
Generate impression based on findings. | Multinodular goiter on outside CT. RIGHT LOBE MEASUREMENTS: 5.1 x 2.4 x 1.8 cmLEFT LOBE MEASUREMENTS: 5.8 x 2.4 x 2.4 cmISTHMUS MEASUREMENTS: 0.8 cm in thickness.RIGHT LOBE: A predominantly isoechoic solid nodule is noted in the right inferior thyroid lobe with a smaller internal more hypoechoic component and which measures 1.0 x 1.3 x 1 .8 cm. There is a thin faint hypoechoic rim surrounding the nodule.LEFT LOBE: Within the left inferior thyroid lobe is a 1.8 x 1.3 x 2.3 cm solid heterogeneous thyroid nodule.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.OTHER: No significant abnormality noted. | Bilateral solid inferior thyroid lobe nodules. Given the solid nature of the nodules, biopsy would provide further information. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: follow up for RCC History: hx of RCC LUNGS AND PLEURA: Bilateral pulmonary nodules consistent with metastatic disease are not significantly changed. The largest nodule is in the left lower lobe with an endobronchial component measuring 14 x 11 mm on image 65/117.MEDIASTINUM AND HILA: Scattered small subcentimeter nodes.CHEST WALL: Lucent lesion in posterior right eighth rib has increased in size with more cortical destruction (image 62/120).UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Post op change left nephrectomy. | 1. Stable pulmonary nodules, presumably metastases.2. Metastasis in posterior right eighth rib has increased in size with more cortical destruction |
Generate impression based on findings. | Male 48 years old Reason: preop for mitral valve repair History: palpitations CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCT Angiography: There is no evidence of thoracic aortic aneurysmal dilatation, dissection, significant stenosis, or tortuosity. The origins of the great vessels are normal in caliber. No evidence of atherosclerotic disease. CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Liver parenchyma is less dense than expected suggesting fatty infiltration. No cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple low density, nonenhancing well-defined lesions in the left kidney likely representing peripelvic cysts. Intrinsically high density, nonenhancing lesion in the left lateral kidney which likely represents a benign, complex cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.CT Angiography: There is no evidence of abdominal aortic aneurysm, dissection, significant stenosis, or tortuosity. The origins of the celiac axis, SMA, and renal arteries are patent. No evidence of atherosclerotic disease. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Moderately enlarged prostate with benign punctate calcifications.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Leftward curvature of the lumbar spine.OTHER: No significant abnormality noted | 1.Normal CT angiography of the chest, abdomen, and pelvis. There is no evidence of aortic aneurysm, dissection, significant stenosis, tortuosity or atherosclerotic disease. 2.Presumed benign renal cysts in the left kidney. |
Generate impression based on findings. | Reason: Please eval for masses, enlarged LNs elsewhere. History: Enlarged lymph nodes in inguinal area. UE and LE pitting edema. Pericardial fluid and ascites. CHEST:LUNGS AND PLEURA: Very small bilateral pleural effusions are present, left greater than right. Dependent atelectasis is seen throughout the left lung. No pulmonary nodule or mass.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy is seen. The heart is normal in size and there is a small pericardial effusion. Mildly enlarged cardiophrenic lymph node is noted.CHEST WALL: Bilateral prominent axillary lymph nodes are present.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Accessory spleen is seen anterior to the spleen.PANCREAS: 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 notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Mildly enlarged external iliac and inguinal lymph nodes are present.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Pelvic free fluid is present, likely physiologic. Mild body wall edema is seen in the lower abdomen. | 1.Mildly enlarged cardiophrenic, external iliac, and inguinal lymph nodes. Bilateral prominent axillary lymph nodes.2.Small pericardial effusion. Very small bilateral pleural effusions.3.Pelvic free fluid is likely physiologic. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in maternal great aunt. Two standard digital views and tomosynthesis of both breast were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 29 years, Female. Reason: eval bowel distension History: abd pain Rectal tube is coiled in the rectum with tip in the distal descending colon. Mildly increased colonic distention compared to prior study.Surgical clips in the bilateral upper quadrants. Suture material in the left upper abdomen. Incompletely imaged central venous catheter. | Mildly increased colonic distention compared to prior study. |
Generate impression based on findings. | Reason: infection? 68M pre-induction chemo for new diagnosis of CML myeloid blast crisis (CT sinus also ordered) (Protective isolation) History: baseline pre-chemo LUNGS AND PLEURA: Moderately large bilateral pleural effusions with basilar subsegmental atelectasis.No specific evidence of pneumonia.MEDIASTINUM AND HILA: Moderately enlarged mediastinal lymph nodes compatible with CML.Calcified lymph nodes in the left hilum compatible with previous infection.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Moderate pleural effusions with basilar atelectasis. |
Generate impression based on findings. | Ms. Martin is is a 57 year old female with a personal history of left breast mastectomy in December 2013 for triple negative IDC followed by chemotherapy and radiation. She has no current breast related complaints. Three standard views of the right breast 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. Scattered benign calcifications are noted in the right breast. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in the right breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 60 years old Reason: Elevated alk phos/ALT with h/o fatty liver, evaluation for progression of fatty liver vs gallstones History: see above LIVER: Liver measures 29 cm, enlarged. Increased echogenicity of the liver consistent with fatty infiltration. No focal liver lesions.BILIARY TRACT: Again noted multiple gallstones without sonographic evidence of acute cholecystitis or biliary dilatation.PANCREAS: Not well-visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 9 cm. ThereRIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Diffuse fatty infiltration of the liver and hepatomegaly. Cholelithiasis. |
Generate impression based on findings. | FlatfootVIEWS: Right foot weight-bearing AP/lateral (two views), left foot weight-bearing AP/lateral (two views) 2/16/2015 0956 Right foot: No acute fracture or dislocation. No soft tissue abnormalities seen. No evidence of pes planus.Left foot: No acute fracture or dislocation. No soft tissue abnormalities seen. No evidence of pes planus. | Normal examination. |
Generate impression based on findings. | 63 years, Male, Reason: neuroendocrine cancer compare to last CT \T\ measure 1) subcarinal node, 2) segment 8 liver leison \T\ 3) aortocaval node History: post 2 cycles of therapy. CHEST:LUNGS AND PLEURA: Right basilar subsegmental atelectasis. Scattered nonspecific micronodules. No suspicious nodules or masses.MEDIASTINUM AND HILA: Left thyroid nodule is unchanged. Mediastinal lymphadenopathy is unchanged with the reference subcarinal node measuring 1.4 x 1.0 cm (7/51). Right port catheter tip terminates in the SVC. Mild coronary artery calcifications.CHEST WALL: Right chest wall port.ABDOMEN:LIVER, BILIARY TRACT: Innumerable hepatic metastases have increased in size and number with increased hepatomegaly measuring 23.2 cm. Reference right hepatic lobe lesion measures 5.8 x 3.8 cm (7/99), previously 2.7 x 1.5 cm.Cholecystostomy tube with inflammatory changes with in the gallbladder fossa appearing similar to the prior exam. Prominent common bile duct is unchanged. Portal vein is patent.SPLEEN: Small splenule.PANCREAS: No significant abnormality notedNoneADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Reference right periaortic node is unchanged measuring 1.0 x 0.9 cm (7/130), previously 0.9 x 0.8 cm. mural thrombus within the mid aorta is unchanged.BOWEL, MESENTERY: Diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: MalePROSTATE, SEMINAL VESICLES: Enlarged prostate. Fat containing right inguinal hernia.BLADDER: Nonspecific bladder wall thickening is unchanged.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative changes of the visualized spine with disk bulge at L4-L5.OTHER: Increased pelvic ascites. | 1.Significantly increased hepatic metastases.2.Stable mediastinal and retroperitoneal lymphadenopathy.3.Cholecystostomy tube with adjacent inflammatory changes is stable. |
Generate impression based on findings. | Reason: syncope, headache, eval for ICH History: headache, dizziness The CSF spaces are appropriate for the patient's stated age with no midline shift. There is scalp normal thickening present adjacent to the parietal bones eccentric towards the left side. There is extension into the subcutaneous tissues. Additional nodules are also scattered in the subcutaneous and dermal tissues in the upper neck and occipital calvarium.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.There are skin-based lesions present along the parietal scalp bilaterally extending into subcutaneous fat. Additional smaller but similar appearing skin lesions are present in the upper neck posteriorly and also adjacent to the occipital calvarium. Please correlate with physical findings on clinical exam. These are not readily identified on a CT of the neck from 2006. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and bilateral additional MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Breast cancer. Evaluate for metastases. There is a focus of increased radiotracer uptake within the left aspect of the T11 vertebral body. Faint uptake is also seen within the breast soft tissues.Degenerative uptake is noted in the bilateral shoulders and sternoclavicular joints. | Non-specific focal uptake in the T11 vertebral body likely represents a hemangioma given CT findings; however, serial imaging would be helpful for confirmation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother, diagnosed in her 50s. Two standard digital views of both breasts with repeat right CC view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of mother with breast cancer. Two standard digital views with additional right MLO and CC views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSD - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt, diagnosed at the age of 34. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 47 years old female with a history of breast cancer.RADIOPHARMACEUTICAL: please refer to the report from the outside hospitalBLOOD GLUCOSE (FASTING): please refer to the report from the outside hospital. The CT portion grossly demonstrates extensive lymphadenopathy in the left lower neck, left supraclavicular region, left chest wall at subpectoral region and the left axilla. There is mucosal thickening of the bilateral maxillary sinuses. The uterus is enlarged.The PET examination demonstrates intense FDG uptake in the extensive lymphadenopathy in the left lower neck, left supraclavicular region, left chest wall at subpectoral region and left axilla. There is a central photopenic area in the left subpectoral mass, which is consistent with central necrosis. The SUVmax in the left supraclavicular lymph nodes is 17.6. There is no abnormal FDG uptake in the mucosal thickening of the maxillary sinuses, which is consistent with sinusitis. There is no evidence of abnormal FDG uptake in the enlarged uterus.Mild FDG uptake is seen in the degenerative changes in the thoracic and lumbar spine.The FDG uptake in the remaining portion of the body is physiological. Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Extensive left cervical, left supraclavicular, left upper chest wall and left axillary conglomerate lymphadenopathy, consistent with nodal metastasis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with an additional left CC view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Loosely clustered calcifications are present in both breasts, many of which have a lucent center and are compatible with dermal calcifications. Multiple focal asymmetries are identified in the right lateral breast, mid depth. No suspicious masses, microcalcifications or areas of architectural distortion are present in the left breast. | Focal asymmetries in the right lateral breast. Attempts to obtain prior mammogram should be made in order to confirm stability of these findings.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: chronic rhinitis, DNS History: cough, nasal obstruction. The ostiomeatal complex units are patent bilaterally. Within the nasal cavity no obstructive lesions are appreciated. Incidental note is made of concha bullosa bilaterally and very subtle right-sided deviation of the nasal septum.The frontal sinuses are clear.Maxillary sinuses are clear. Ethmoid air cells are clear . Sphenoid sinuses are clear. Visualized portions of the mastoid air cells and middle ears are clear. Visualized orbits are intact and the visualized intracranial structures are within normal limits. | CT of the paranasal sinuses is within normal limits. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with a repeat right MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Possible obscured mass in the left inferior breast is seen. No suspicious microcalcifications or areas of architectural distortion are present. Benign lymph nodes project over the axillae. | Potential left inferior breast mass for which spot compression and possible ultrasound are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Reason: Hx lung cancer compare to prior scans, measurements please History: none CHEST:LUNGS AND PLEURA: Postop right upper lobectomy. Emphysema.Stable scattered small pulmonary nodules including the reference nodule in the left lower lobe (image 71/110). No new pulmonary nodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Degenerative change involving in the spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: Diffuse pancreatic atrophy.RETROPERITONEUM, LYMPH NODES: Stable nonspecific node in the porta hepatis measuring 14 mm on image 106/159.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative change involving the spine.OTHER: No significant abnormality noted. | Stable CT demonstrating scattered micronodules which are stable and presumably benign. No new lesions to suggest recurrent or metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral benign biopsies in 1998, 2000, and 2002. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Biopsy clip in the left breast and small, bilateral benign-appearing masses are noted and unchanged. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Biopsy clip and benign-appearing masses, but no mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 86 year old female with severe aortic stenosis, evaluation for TAVR. ANGIOGRAM: Please see accompanying cardiac CT report for description of thoracic aorta. Mild-modeate atherosclerotic disease affects the abdominal aorta and its branches. No evidence of dissection. There is mild ectasia of the infrarenal abdominal aorta measuring up to 2.7 x 2.1 cm (series 10, image 208). There is moderate high grade stenosis at the origin of the celiac artery. The SMA is patent. There are atherosclerotic calcifications at the origins of the right and left renal arteries without significant stenosis. There is minimal deviation without significant tortuosity of the common and external iliac arteries which are without circumferential atherosclerotic calcifications.VESSELS:SUPRARENAL ABDOMINAL AORTA: 2.5 x 2.5 cmINFRARENAL ABDOMINAL AORTA: 1.9 x 2.2 cmRIGHT COMMON ILIAC ARTERY: 11.6 12.9 mmRIGHT EXTERNAL ILIAC ARTERY: 7.7 x 7.7 mmRIGHT COMMON FEMORAL ARTERY: 5.6 x 6.2 mmLEFT COMMON ILIAC ARTERY: 9.0 10.0 mmLEFT EXTERNAL ILIAC ARTERY: 7.5 x 8.0 mmLEFT COMMON FEMORAL ARTERY: 6.1 x 5.7 mmABDOMEN:LUNG BASES: Please see accompanying cardiac CT report for description of pulmonary findings. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The right kidney is mildly rotated. There is no hydronephrosis. A subcentimeter right renal lesion is too small to characterize.RETROPERITONEUM, LYMPH NODES: An infrarenal IVC filter is noted. Please see angiographic description of aorta. BOWEL, MESENTERY: Colonic diverticulosis without evidence of complicated diverticulitis.BONES, SOFT TISSUES: Thoracolumbar scoliosis and degenerative changes of the thoracolumbar spine causing multilevel spinal stenosis. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colonic diverticulosis without evidence of complicated diverticulitis.BONES, SOFT TISSUES: Thoracolumbar scoliosis and degenerative changes of the thoracolumbar spine causing multilevel spinal stenosis. OTHER: No significant abnormality noted | 1.Please see accompanying cardiac CT for full details regarding the thoracic aorta and chest.2.Mild-moderate atherosclerotic disease of the abdominal aorta and its branches. Moderate high grade stenosis of the celiac artery origin.3.Measurements of the iliac and femoral arteries as described above. Somewhat narrow femoral artery diameter. No significant tortuosity or circumferential atherosclerotic calcifications within the common/external iliac arteries.4.Colonic diverticulosis without evidence of complicated diverticulitis.5.Thoracolumbar scoliosis and degenerative changes of the thoracolumbar spine causing multilevel spinal stenosis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her maternal niece, diagnosed in her 30s. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Focal asymmetry identified in the right inferior breast, mid depth. Scattered benign calcifications are present bilaterally. No suspicious microcalcifications or areas of architectural distortion are present in the left breast. | Focal asymmetry in the right breast. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 65-year-old female with shortness of breath, mitral valve replacement preoperative evaluation. ANGIOGRAM: Please see accompanying cardiac CT report for description of thoracic aorta. Mild atherosclerotic disease affects the abdominal aorta and its branches. The origins of the celiac artery, SMA, bilateral renal arteries, and IMA are patent. No evidence of aortic dissection or aneurysm. The right hepatic artery arises from the SMA, a normal variant.Mild atherosclerotic disease affects the common/external iliac arteries without circumferential calcifications. No significant deviation or tortuosity of the common/external iliac arteries.VESSELS:SUPRARENAL ABDOMINAL AORTA: 1.5 X 2.0 cmINFRARENAL ABDOMINAL AORTA: 1.5 x 1.4 cmRIGHT COMMON ILIAC ARTERY: 8.4 x 8.8 mmRIGHT EXTERNAL ILIAC ARTERY: 8.2 x 7.6 mmRIGHT COMMON FEMORAL ARTERY: 5.7 x 5.4 mmLEFT COMMON ILIAC ARTERY: 8.4 x 8.2 mmLEFT EXTERNAL ILIAC ARTERY: 7.1 x 6.9 mmLEFT COMMON FEMORAL ARTERY: 5.6 x 5.8 mmABDOMEN:LUNG BASES: Please see accompanying cardiac CT report for description of pulmonary findings. Left posterior Bochdalek fat containing hernia.LIVER, BILIARY TRACT: Scattered subcentimeter low-attenuation hepatic lesions the larger of which are compatible with benign cysts and the smaller of which are incompletely characterized but are likely benign. Several scattered subcentimeter arterially enhancing lesions are incompletely characterized but most likely represents benign perfusion phenomenon. SPLEEN: No significant abnormality notedPANCREAS: Pancreatic duct is mildly prominent measuring up to 4 mm but is visualized in its entire length without signs of obstruction.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the visualized thoracolumbar spine. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the visualized thoracolumbar spine. OTHER: Degenerative changes of the visualized thoracolumbar spine including severe degenerative disk disease at L3-L4 and L5-S1. Orthopedic device affixing the left femur. Small sclerotic focus in left ileum likely benign bone island. Sacral nerve stimulator device. | 1.Mild atherosclerotic disease of the abdominal aorta and its branches. Somewhat narrow common femoral arteries (measurements above). No significant tortuosity or circumferential calcifications of the common/external iliac arteries.2.Mild prominence of the pancreatic duct. Though no obstructing lesion is identified, continued follow-up is recommended. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional MLO views of each breast were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Approximately 8mm asymmetry is seen in the right inner breast at approximately 11.5 cm depth. No additional suspicious masses, microcalcifications or areas of architectural distortion are present. | Asymmetry in the right inner breast which may represent a skin lesion. A repeat right CC view with skin lesions marked is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: R - Technical Repeat Views. |
Generate impression based on findings. | Female 81 years old Reason: assess for fracture, dislocation. Pls include right upper arm films too. History: right shoulder pain. There is no acute glenohumeral fracture or dislocation. There is no acute fracture or dislocation of the right humerus. Incompletely imaged right lung demonstrates patchy airspace opacities. Please refer to dedicated same day chest imaging for complete evaluation. | No acute fracture or dislocation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of Hodgkin's lymphoma. Two standard digital views of both breasts with repeat bilateral MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Scattered benign calcifications, including arterial calcifications, are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. An AICD obscures the left axilla. Normal size left axillary and left intramammary lymph nodes are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with repeat left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally. Stable right outer breast asymmetries. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bilateral benign breast biopsies. Family history of breast cancer in maternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign axillary lymph nodes project over the axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 66 years, Female, Reason: Patient with h/o abdominal aortic aneurysm and right common iliac artery aneuryism, plan for OR 1/20/15. History: none. CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. No suspicious nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Moderate coronary artery calcifications.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: Small bilateral renal cysts and minimal parenchymal scarring is unchanged.RETROPERITONEUM, LYMPH NODES:Interval placement of aortobiiliac stents. The excluded aneurysm sac measures 5.2 x 4.9 cm (5/127), previously 5.2 x 4.7 cm. Right iliac artery aneurysm measures 2.9 cm (5/150), previously 3.0 cm. Peripheral thrombus of the right common iliac artery extending into the internal iliac artery is slightly increased. High-grade stenosis at the celiac origin.BOWEL, MESENTERY: Umbilical hernia containing multiple bowel loops without evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: FemaleUTERUS, 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: Moderate degenerative changes of the lower lumbar spine.OTHER: Infiltration adjacent to the left femoral vessels is likely postprocedural. No focal fluid collections. | 1.Interval placement of aortobiiliac stent without evidence of endoleak.2.Slightly increased nonocclusive peripheral thrombus of the right common and internal iliac arteries |
Generate impression based on findings. | Female 56 years old Reason: cholecystitis? History: elevated enzymes LIVER: Moderately echogenic liver parenchyma an enlarged liver measuring 18-cm, unchanged.BILIARY TRACT: No evidence of cholelithiasis or biliary dilatation. Gallbladder wall is unremarkable.PANCREAS: Not well-visualized due to overlying bowel gas.SPLEEN: Spleen is not visualized.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Echogenic and enlarged liver, unchanged. |
Generate impression based on findings. | 64 years old male a lung nodule and station 10R lymphadenopathy. This study was performed for the diagnosis of solitary pulmonary nodule.RADIOPHARMACEUTICAL: 14.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 101 mg/dL. Today's CT portion grossly demonstrates two spiculated nodular densities in the right upper lobe, no significant change as compared with recent chest CT. Linear opacities seen in the right apex. There is a micronodule in the right lower lobe. There is diffuse emphysematous change in both lungs. Extensive calcifications are seen in the coronary arteries.Today's PET examination demonstrates intense FDG uptake in the two spiculated nodular densities in the right upper lobe with SUVmax of 8.8 and 8.0 in the superior and inferior nodular densities, respectively. There is also intense FDG uptake in the linear opacity in the right apex with SUVmax of 4.1.Multifocal symmetrical mild FDG uptake is seen in the bilateral lung hila, which is most likely due to inflammatory change. Linear areas of increased activity in the left shoulder joint are most likely due to arthritis.The FDG uptake in the remaining portion of the body is physiological. Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. There is no apparent abnormal FDG uptake in the micronodule in the right lower lobe. | 1. Spiculated nodular densities in the right upper lobe and linear density in the right apex, highly suspicious for lung cancer. However infection can have similar hypermetabolism.1.Symmetrical and mild multifocal FDG uptake in both lung hila is most likely due to inflammatory change. However nodal metastasis in the right lung hilum cannot be completely excluded.2.No definite PET evidence of regional nodal or distant metastasis.3.Non-FDG avid micronodule in the right lower lobe. |
Generate impression based on findings. | HCC. Question of metastatic disease. There is a focus of increased radiotracer uptake within the right aspect of the T9 vertebral body; this correlates with a bridging osteophyte on the CT study from the same date.No suspicious osseous lesion is identified. | No specific evidence of bone metastases. |
Generate impression based on findings. | 71 year old female with stage IV chronic kidney disease, prior history of kidney stones on the right. ABDOMEN: Within the limits of a non-IV contrast enhanced examination which limits the ability to evaluate solid organ parenchyma and vascular structures, the following observations can be made:LUNG BASES: Right postero-medial air space confluence disease seen adjacent to the diaphragm (series 3, images 7 through 11) with central air opacities and curvilinear vessels reaching this, most likely rounded atelectasis. However commonly associated pleura does not show significant thickening, usually associated with rounded atelectasis. Because of this, I would recommend further follow-up evaluation, perhaps with dedicated high resolution chest CT with prone positioning to insure that this is rounded atelectasis and to evaluate the remainder of the lung parenchyma..Calcified granuloma and approximate 3-mm left lower lobe noncalcified nodule (series 3, image 17) are unchanged. No new nodules are seen.LIVER, BILIARY TRACT: No significant abnormality noted in liver, within limits of non-IV contrast enhanced examination. Gallstones are again seen without other biliary tract abnormality.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left kidney is again seen atrophic similar in size and configuration. Right kidney shows similar lobular contour, unable to thyroid parenchyma due to lack of IV contrast. The punctate calcification burden has slightly increased in the lower pole calices when compared with previous but still remains subcentimeter nonobstructing. There are new calcifications in the upper pole calyces, again subcentimeter in size and nonobstructing. No hydronephrosis. No perinephric fluid collections are seen.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Prior right hemicolectomy of without other abnormality in the intestinal tract. No free mesenteric fluid.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: Prior right hemicolectomy without other significant abnormality seen.BONES, SOFT TISSUES: Extensive Sutures again seen in the anterior abdominal wall from prior surgery.OTHER: No significant abnormality noted | 1. Slight increase in nonobstructing right renal calyceal stone burden. 2. Atrophic left kidney. 3. Cholelithiasis without other complication. 4. Probable rounded atelectasis, although does not completely need imaging criteria for this. High resolution chest CT in the prone and supine position would be recommended to see if this can be further characterized.. |
Generate impression based on findings. | Female 30 years old Reason: Eval for erosive arthropathy History: Bilateral arthralgias MCP and PIP. There is some questionable juxtaarticular osteoporosis bilaterally without associated soft tissue swelling. A punctate fragment overlying the ulnar styloid may be a superimposed artifact. The remainder of the carpal bones are unremarkable bilaterally. | Questionable juxta-articular sclerosis without associated soft tissue swelling. Otherwise study of the bilateral hands. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Left upper lobe reference nodule measures 7 mm on image 35/112 (8 mm on previous).Previously noted apical fibrosis is unchanged. Patchy, peripheral, upper lobe predominance groundglass opacities and reticulation have slightly increased and may be due to XRT pneumonitis. Postinfectious/postinflammatory etiologies including aspiration remain possibilities as well.MEDIASTINUM AND HILA: Severe coronary artery calcifications. Postop change involving the neck. Reference pretracheal lymph node measures 8 mm on image 42/148 (11 mm on prior). Lipomatous hypertrophy of the intra-atrial septum.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: Left adrenal nodule is unchanged and likely benign.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: Degenerative disease affects the spine.OTHER: No significant abnormality noted. | 1.Slight decrease in size of reference left upper lobe nodule.2.Increased left lung opacities which may be to due radiation pneumonitis, chronic aspiration or infection. |
Generate impression based on findings. | Shortness of breath. Evaluate for PE. History of HIV. PULMONARY ARTERIES: No evidence of pulmonary embolism. Dilated main pulmonary artery measuring 3.9 cm consistent with pulmonary artery hypertension.LUNGS AND PLEURA: Diffuse bilateral groundglass opacities, similar in appearance to prior exam. Increased diffuse bronchial wall thickening. Very mild pulmonary edema.No pleural effusion.MEDIASTINUM AND HILA: Cardiomegaly without pericardial effusion. No visible coronary artery calcification.No mediastinal or hilar lymphadenopathy.CHEST WALL: No focal osseous lesion.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Atrophic kidneys. | 1. No evidence of pulmonary embolism.2. Diffuse bilateral ground glass opacities, suspicious for atypical infection (pneumocystic pneumonia). There may be superimposed pulmonary hemorrhage and edema.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Rheumatoid arthritis. Check for erosive changes Right hand: Marked asymmetry in abnormalities including ulnar subluxation largely observed involving the fifth right MCP with near bone on bone narrowing of the second, third and fourth MCP articulations. Scapholunate widening with moderate to marked degenerative changes involve the scapholunate also with pronounced ulnar subluxation. Ulnar styloid erosions with additional marginal erosions observed involving the base of the second proximal phalanx. Relative sparing of the distal articulations, however juxta articular osteoporosis is suggested Left hand: Mild osteoarthritic changes involving the MCPs and radiocarpal joint with relative sparing of the distal articulations. No evidence of alignment abnormality. Moderate juxta articular osteoporosis and the soft tissues are grossly intactFoot: Mild degenerative changes largely involving the first MTP with questionable soft tissue swelling overlying the fifth metatarsal head. No discrete underlying erosions or inflammatory osseous changes. Alignment preserved. | A constellation of findings consistent with the patient's carrying diagnosis of rheumatoid arthritis, most pronounced involving the right hand however asymmetry of findings is unusual. See detail provided |
Generate impression based on findings. | Female 33 years old Reason: RUQ U/S for Abnormal LFT's; Hx Excess Eton History: RUQ U/S for Abnormal LFT's; Hx Excess Eton LIVER: Infiltration of the liver. Liver measures 16 cm. No focal liver lesions.BILIARY TRACT: No evidence of gallstones or biliary dilatation.PANCREAS: Not well-visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 7 cm.RIGHT KIDNEY: No significant abnormalities noted. OTHER: No significant abnormalities noted. | Diffuse fatty infiltration of the liver, otherwise unremarkable study. |
Generate impression based on findings. | Ms. Singh is a 65 year old female returning for a short-term follow-up for a high probability benign focal asymmetry in the inferior left breast. Family history of breast cancer in two sisters, diagnosed at the age of 45 and 60. 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. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. Specifically, previously followed focal asymmetry in the inferior left breast is no longer present on today's exam, likely representing overlapping breast parenchymal tissue. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | blurry vision s/p fall CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Atherosclerotic calcifications are present along the distal internal carotid arteries.Incidental note is made of partial empty sella.CT maxillofacial bones:There are no fractures identified involving the maxillofacial bones.The skull base foramina are intact.The orbits are intact with no abnormal mass lesions in either orbit. The visualized eyeballs are intact lacrimal glands demonstrate enlargement of the AP dimension of the right connate with thinning of the right posterior sclera. Extraocular muscles are intact. The suprasellar cistern is unremarkable.Visualized portions of the mastoid air cells and middle ears are clear. The visualized portions of the paranasal sinuses are clear. Maxillary dentition is absent. Periapical lucencies along the remaining mandibular dentition.There are degenerative changes present in the visualized portions of the cervical spine with uncovertebral osteophytes and endplate osteophytes present at multiple levels. | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.No evidence for fracture in the maxillofacial bones3.Right eye staphyloma. |
Generate impression based on findings. | Known tissue in left thyroid bed. Please check for increase in thyroid tissue, suspicious features, suspicious lymph nodes. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomy.ISTHMUS MEASUREMENTS: Status post thyroidectomy.RIGHT LOBE: Status post thyroidectomy. No nodules or masses identified in the thyroid bed. No residual thyroid tissue identified. LEFT LOBE: Status post thyroidectomy. In the superior aspect of the thyroid bed, there is a nodule with the appearance of a lymph node measuring 0.9 x 0.4 x 0.3, previously measured 0.3 x 0.3 x 0.3 cm and is minimally larger. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: None identified. LYMPH NODES: Three right sided lymph nodes are present. For example, a right level 1 lymph node measures 1.5 x 0.7 x 0.3 cm. the right level 2 lymph node measures 0.9 x 0.4 x 1.8 cm, previously measured 1.2 x 0.4 x 2.1 cm. A right level 3 lymph node measures 1.0 x 0.3 x 1.7 cm, previously measured 1.0 x 0.3 by 2.1 cm. OTHER: No significant abnormality noted. | 1.The previously biopsied left thyroid bed lymph node is minimally larger but this is nonspecific.2.Multiple stable lymph nodes in the right neck. |
Generate impression based on findings. | Check metacarpal fracture Interval removal of the splint material. The comminuted fifth metacarpal neck fracture appears similar with an gross anatomic alignment other than mild volar angulation. Mild overlying soft tissue swelling. | Comminuted right fifth metacarpal neck fracture with angulation |
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. Gray/white interface are maintained. There are no extraaxial fluid collections or subdural hematomas. The mastoid air cells are clear. A nasogastric tube is in place via the right nares. | Negative unenhanced brain CT. |
Generate impression based on findings. | Reason: r/o acute process History: weakness, malaise and fatigue Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is no significant stenosis along the course of the vertebral arteries.Periapical lucencies are present along much of the patient's mandibular dentition and maxillary dentition.Atherosclerotic calcifications are present at the carotid bifurcations. Atherosclerotic calcifications are present at the vertebral artery origins.Degenerative changes present in the cervical spine without significant compromise of the spinal canal.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The left A1 segment is hypoplastic. The posterior communicating arteries are very small.The intracranial vertebral arteries are mildly narrowed just proximal the level of the origins of the posterior inferior cerebellar arteries or their associated atherosclerotic calcifications.CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.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.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries. | 1.No evidence for aneurysm.2.No evidence for cervicocerebral occlusive disease3.no evidence for acute intracranial hemorrhage, mass effect or edema. |
Generate impression based on findings. | Two months post knee operation. Please evaluate Moderate osteoarthritis, greater on the right with narrowing, sclerosis. Small effusion and osteophytes. Suspected potential loose body behind the knee, and followed serial imaging will help confirm if this is a fixed lesion. | Moderate osteoarthritis |
Generate impression based on findings. | Pain Mild soft tissue swelling overlying the lateral malleolus without discrete distinct definite underlying osseous abnormality. Minimal irregularity of the distal fibular tip may represent partial disruption of the ligaments, correlate with patient's specific site of pain | Mild osteoarthritic changes, see detail |
Generate impression based on findings. | Male 61 years old Reason: Assess for hx of metastatic rectal cancer; previously in liver s/p resection History: N/A CHEST:LUNGS AND PLEURA: Index left lower lobe nodule measures 14 by 12 mm on image number 33, series number 5, not significantly changed from previous study. Postsurgical changes in the right upper lobe, stable.MEDIASTINUM AND HILA: Index right hilar node measures 2.8 x 2.2 cm on image number 39, series number 3, slightly enlarged compared to previous study. Index right paratracheal node measures 2.9 by 3 cm on image number 35, series number 3, slightly enlarged compared to previous study.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: There are post ablation changes in the liver. One of the lesions in the right lobe likely represents a static disease and now is enlarged. This lesion now measures 4.1 by 3.7 cm on image number 77, series number 3. It was measuring 3 x 2.7 cm on image number 75, series number 3. There are also new lesions in the liver suspicious for metastatic disease. An index lesion measures 9-mm in diameter on image number 83, series number 3 adjacent to the IVC.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Previously measured paraesophageal index node is unchanged measuring 1.4 by 0.7-cm image number 66, series number 3. Small retroperitoneal lymph nodes are stable.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval progression of disease with interval increase in the size of the mediastinal adenopathy and liver metastases and interval development of new metastatic lesions in the liver. |
Generate impression based on findings. | Female 45 years old Reason: biliary pathology/obstruction History: elevated alk phos, bili, ast/alt LIVER: Liver measures measures 20.8 cm, enlarged. No focal liver lesions.BILIARY TRACT: Gallbladder is contracted. Therefore, cannot be optimally evaluated. No evidence of cholelithiasis.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 11 cm.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Trace amount of ascites. | Contracted gallbladder. Hepatomegaly. Trace amount of ascites. |
Generate impression based on findings. | 70 years old female. Reason: hoarseness, dysphagia, aspiration, left eye ptosis, left vocal cord paralysis. History: left neck sarcoma and left breast cancer. This study was performed for restaging.RADIOPHARMACEUTICAL: 12.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 105 mg/dL. Today's CT portion grossly demonstrates soft tissue thickening in the left and lower neck and left supraclavicular region as well as in the left upper chest wall. Surgical clips are also seen in the regions. Linear opacities are seen in the left lung base. There is a severe elevation of left hemidiaphragm.Today's PET examination demonstrates a focus of increased activity is seen in the left supraclavicular region at paratracheal region with SUVmax of 4.4. Another focus of increased activity with SUVmax of 2.8 is a soft tissue density seen in the left upper chest wall adjacent to distal portion the of the left clavicle. Additional focus of increased activity is seen in a lymph node in the mediastinal prevascular space with SUV Max of 4.7.A focus of mild FDG uptake is seen in the left iliac wing, corresponding to cortical sclerosis and irregularity.Diffuse FDG uptake is seen in the left low neck, left upper chest wall and left axilla, which is consistent with post posttherapy change. Multifocal mild FDG uptake is seen in the mediastinal and hilar regions, which is most likely due to inflammatory change.Physiological activity is seen in the liver, spleen, kidneys, intestines, uterus and bladder. | 1. Hypermetabolic soft tissue densities in the left lower neck at left paratracheal region and the left upper chest wall as well as small hypermetabolic lymph node in the mediastinal prevascular space. These findings may represent recurrent disease and nodal metastasis. However, given the history of post-radiation in the regions, posttherapy/inflammatory change can have a similar appearance.2. Severe elevation of left hemidiaphragm. |
Generate impression based on findings. | Follow-up examination, following unspecified surgery Since the prior exam, previously placement metallic implants/electrodes have been removed. There is no evidence for acute intracranial hemorrhage. There is some intracranial air present.A stereotactic frame is in place which creates artifact and may obscure more subtle a more abnormalities.The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | No evidence for acute intracranial hemorrhage mass effect or edema status post removal of intracranial electrodes. Please note that stereotactic frame create artifacts which may obscure more subtle abnormalities such as a small hemorrhage. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications and right lateral focal asymmetry are stable. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female, 12 months old, with abnormal head shape and ridging. Assess for craniosynostosis. The sagittal suture is largely fused with only a small portion at its anterior extent remaining patent. There is mild bony ridging along the fused portions of the suture. The coronal and lambdoid sutures are patent and normal. The metopic suture is partially fused which is likely normal for age. The skull is dolichocephalic.The shape of the brain conforms to the elongated skull morphology. The parenchyma, however, is otherwise normal with no evidence of edema, mass effect or loss of gray-white differentiation. No abnormal extra-axial fluid collections are seen. The ventricles are normal in size and morphology. | Dolichocephaly secondary to sagittal synostosis. |
Generate impression based on findings. | 52 year-old female with breast cancer. CHEST:LUNGS AND PLEURA: No significant abnormality noted.No worrisome nodules or parenchymal mass is seen to suggest metastatic disease.MEDIASTINUM AND HILA: No mediastinal adenopathy or masses seen.CHEST WALL: Left anterior chest wall Port-A-Cath with tip of the catheter in the proximal right atrium. This is unchanged since prior CT. clusters of small subcentimeter left axillary lymph nodes unchanged since prior CT. Approximately 5 mm sclerotic foci in the T8 for cable body unchanged since 5/14/14. This may represent a small bone island although metastatic disease cannot be excluded. Nuclear medicine bone scan is a more sensitive indicator of activity of bone disease.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted. No parenchymal mass lesion seen with normal-appearing vessels.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. No adenopathy seen.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mixed lytic/sclerotic lesion in the L5 vertebral body and posterior elements change since 5/14/14. No other focal skeletal abnormality seen to suggest metastatic disease. Nuclear medicine is more sensitive technique for evaluating activity of potential skeletal metastatic disease.OTHER: No significant abnormality noted. | 1. Stable L5 vertebral body mixed lytic/sclerotic lesion consistent with metastatic lesion, unchanged since 5/14/14. T8 subcentimeter sclerotic focus may represent bone island or small focus of metastatic disease -- this is stable as well. 2. No other evidence of metastatic disease in the chest, abdomen or pelvis. |
Generate impression based on findings. | As before, there is a left frontal approach ventriculostomy catheter with its tip unchanged in position. Redemonstrated is ventricular enlargement and stable intracranial abnormalities, better evaluated on prior MRI. There is no acute intracranial hemorrhage. A nasogastric tube is in place via the right nares. Fluid is present within bilateral mastoid air cells and middle air cavities. There is diffuse low density thickening of the extracalvarial soft tissues about the head and visualized neck suggestive of anasarca. | No acute intracranial hemorrhage. |
Generate impression based on findings. | T4N3M1 HPV+ squamous cell carcinoma of the right tonsil status post treatment. There are post-treatment findings in the neck with diffuse marked supraglottic edema with airway narrowing and superficial areas of hyperenhancement in the right oropharynx. Otherwise, there is no discretely measurable upper aerodigestive track mass. In addition, there is decrease in size of the right supraclavicular lymphadenopathy, which measures 19 x 22 mm, previously 33 x 47 mm. The salivary gland and thyroid appear unchanged. The airway inferior to the tracheostomy tube is patent. There is a left internal jugular venous catheter. The major vessels in the neck appear to be patent, although a portion of the right internal jugular vein remains somewhat narrowed. There is partial opacification of the maxillary sinuses and mastoid air cells bilaterally. The imaged intracranial structures are unremarkable. There is multilevel degenerative spondylosis of the cervical spine. There is unchanged lucency in the right glenoid, which is likely degenerative in nature. | 1. Post-treatment findings in the neck with diffuse marked supraglottic edema with airway narrowing and superficial areas of hyperenhancement in the right oropharynx, which may represent mucositis and/or treated tumor. 2. Continued interval decrease in size of the lymphadenopathy. |
Generate impression based on findings. | 77 years old Female. Reason: restaging. History: 76-year-old female with DLBC lymphoma receiving RCHOP. This study was performed for restaging.RADIOPHARMACEUTICAL: 11.0 MCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 97 mg/dL. Today's CT portion of the neck demonstrates no significant pathology. Please see diagnostic CT reports for details of the chest, abdomen, and pelvis.Today's PET examination demonstrates no evidence of FDG avid tumor in the neck, chest, abdomen and pelvis. Physiological activity is seen in the esophagus, liver, spleen, kidneys, intestines and bladder. There is a decreased FDG uptake in the cystic lesion in the right kidney. Previously identified tumor on the PET in the whole-body has resolved. | 1.No evidence of FDG avid tumor on current study.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | 91-year-old male with esophageal -- gastric junction cancer. Staging CT, evaluate for metastatic disease. Status post stent placement at outside hospital. CHEST:LUNGS AND PLEURA: Bilateral pleural effusions with a large right pleural effusion and moderate left pleural effusion. Scattered left nonspecific lung micronodules are seen, without sizable, measurable lung nodules seen. Basilar atelectasis/scarring is seen.MEDIASTINUM AND HILA: Postsurgical changes from sternotomy and presumed coronary artery surgery seen. Extensive dense coronary artery calcification seen. No adenopathy or other masses.Esophageal stent is in position in the mid to distal esophagus traversing the esophagogastric strict junction. Thickening about the stent is seen circumferentially at the distal EG junction and presumably represents the patient's known primary tumor.CHEST WALL: Degenerative changes are seen throughout the thoracic spine and skeletal structures without focal abnormality seen otherwise.ABDOMEN:LIVER, BILIARY TRACT: Scattered small well-defined hypodensities are seen throughout the liver in numerous locations. The largest of these are slightly greater than a centimeter and measure water density and are clearly benign cysts. The smaller of these are too small to characterize but most likely represent cysts. No definite evidence for metastatic disease to the liver is seen. Patient is status post cholecystectomy without other biliary tract abnormality.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Normal morphology kidneys are seen with bilateral simple benign cyst. No other significant abnormality seen.RETROPERITONEUM, LYMPH NODES: Scattered small subcentimeter lymph nodes seen in the gastrohepatic ligament and adjacent to the GE junction. The largest of these (series 3, image 82) measures 0.9 cm. BOWEL, MESENTERY: Stent is seen into the fundus of the stomach. Stomach is collapsed with slight thickening of the antrum seen -- this can be seen normally and is of nonspecific nature. Rapid passage of orally administered contrast is seen through normal-appearing small bowel to the right lower quadrant without obstruction or other abnormality seen. Colon is filled with fecal material moderate amount of ascites is seen scattered throughout the abdomen. No mesenteric masses are seen to suggest metastatic deposits.BONES, SOFT TISSUES: Diffuse subcutaneous edema seen in dependent positions predominantly. Diffuse degenerative changes seen about the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. New/distal esophageal stent with slight thickening about the stent, presumably representing known primary tumor. 2. Small gastrohepatic and peri-EG junction lymph nodes with maximum diameter of 9 mm. These do not meet imaging criteria for lymphadenopathy, but remain potential sites for metastatic disease. 3. Bilateral pleural effusions. 4. Scattered micronodules, greater in left lung and right lung. These are nonspecific. |
Generate impression based on findings. | Recurrent glioma, on Avastin, passed out and hit head yesterday with headache. There are post-treatment findings in the left frontal lobe with areas of gyriform hyperattenuation compatible with mineralization and patchy areas of nonspecific hypoattenuation. There is no evidence of acute intracranial hemorrhage. The ventricles are unchanged in size and configuration, with ex vacuo dilatation of the left lateral ventricle. There is no midline shift or herniation. The mastoid air cells are clear. There is a partially-imaged right maxillary sinus retention cyst. The skull and scalp soft tissues are unchanged. | 1. No evidence of acute intracranial hemorrhage.2. Post-treatment findings for a left frontal lobe glioma, which are otherwise better delineated on the recent prior brain MRI. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of ovarian cancer in mother, diagnosed at the age of 76. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal grandmother. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | The right uterine artery was embolized using 500-700 micron Embospheres until near stasis was achieved. The post-embolization angiogram confirmed these findings.LEFT UTERINE ARTERY EMBOLIZATION | Successful bilateral uterine artery embolization.PLAN: 1. The patient will be admitted overnight for pain control and observation.2. The patient was entered into the IR clinic follow-up system. A follow-up MRI pelvis will be performed in 3 months time, after which the patient should return to the interventional radiology clinic for post-procedural assessment. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal great aunt, diagnosed at the age of 70. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | ORIF Detail remains obscured by cast material. Gross anatomic alignment of the intra-articular distal radial fracture is again observed with resorption along the fracture edges compatible with partial interval healing | Persistent gross anatomic alignment of distal radial fracture |
Generate impression based on findings. | Spinal fusion, check arthrodesed. Interval posterior fixation and laminectomy of L5-S1 with interposed disk material. No bridging osteophytes and material is observed. No hardware complication. Alignment maintained with minimal anterolisthesis at this level . Upper lumber spine unremarkable | Posterior fixation of the lower lumbar spine, as described. No interval change in alignment |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of benign left breast biopsy. Family history of breast cancer in sister. Two standard digital views, tomosynthesis, and bilateral repeat CC views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. Motion artifact on 1 CC view is not present on the other CC view or tomosynthesis. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Two benign morphology masses are identified in the right central to inferior breast. Biopsy marker clip identified within the left central breast. No suspicious masses, microcalcifications or areas of architectural distortion are present in the left breast. | Two benign morphology masses in the right breast. Attempts to obtain prior mammogram should be made in order to confirm stability of these findings.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | 52 years old female. Reason: IIIC ovarian cancer s/p surgery and chemotherapy, now with rising CA 125. This study was performed for restaging. RADIOPHARMACEUTICAL: 12.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 90 mg/dL. Today's CT portion of the neck grossly is not remarkable.Today's PET examination demonstrates several foci increased activity in the mediastinum at right upper paratracheal region and subcarinal region, which may correlate with lymph nodes on CT. There are several foci of increased activity in the porta hepatis, portocaval region and gastrohepatic ligament with SUV Max of 7.0. Multiple foci of increased activity is seen in the abdominal retroperitoneal cavity, corresponding to the enlarged lymph nodes seen on CT. The SUVmax in the retrocaval lymph nodes at the level of the right kidney is 7.4. There is a focus of increased activity in the left hemipelvis at left external iliac region with SUVmax of 3.4.Symmetrical areas of FDG uptake are seen in the neck, bilateral supraclavicular regions and chest wall at paraspinal regions, which are consistent with brown fat activity.Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Multiple hypermetabolic lymph nodes in the mediastinum, upper abdomen and retroperitoneal cavity as well as in the left hemipelvis, which are consistent with metastasis.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | Acute pain. Rule-out abnormality. Two views of the right hip are provided. Mild osteoarthritis affects the hip. A small focus of mineralization along the greater trochanter may reflect calcification within the overlying bursa or tendon. Overall these findings appear similar to those seen on the prior study.Two views of the left hip show mild osteoarthritis.AP view of the pelvis shows mild bilateral hip joint osteoarthritis. Osteoarthritis also affects the pubic symphysis. | Osteoarthritis. |
Generate impression based on findings. | 53-year-old male with gross hematuria and tobacco history. Evaluate for mass. 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: Both kidneys show normal morphology without evidence of abnormal parenchymal mass. No hydronephrosis. No abnormal calcifications are seen in the kidneys or collecting systems. Prompt and symmetric excretion of contrast material is seen anterior and normal pyelocaliceal systems bilaterally. The ureters are well opacified throughout their entire lengths and show no intrinsic abnormalities.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: Mural nodularity is seen along the posterior dependent wall of the bladder. This can be seen at the bladder, prostate interface but appears slightly more lateral and superior and more prominent prominent than normally seen -- in light of hematuria history a mucosal surface lesion cannot be excluded there (see series 9, images 132 and 134).. LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative bony changes seen about the sacroiliac joints. No other significant abnormality seen.OTHER: No significant abnormality noted | 1. Slightly greater than expected mural nodularity to posterior bladder wall and a mucosal lesion there cannot be excluded.. 2. No other abnormality seen to account for hematuria. 3. No other significant abnormalities seen. |
Generate impression based on findings. | Reason: regionally advanced NSCLC History: follow up CHEST:LUNGS AND PLEURA: Right upper lobe mass measures 52 x 52 mm on image 47/113. It extends to the hilum and causes mild right upper lobe and bronchus intermedius airway narrowing.There is patchy nodular and airspace opacity in the right middle lobe (image 63/113) and anterior right upper lobe (image 52/113). Since these opacities were not present on recent PET/CT it is likely more acute such as aspirate or infection though continued follow-up is recommended to exclude additional malignancy.Emphysema. Calcified granulomas.MEDIASTINUM AND HILA: Severe coronary calcification. Atherosclerotic calcification of the aorta and its branches. Small hypodense right thyroid nodule, too small to characterize.CHEST WALL: Lobulated near water density subcutaneous nodule in the right posterior back (image 9 sagittal and 53) presumably a sebaceous cyst. It did not to increased activity at prior PET.Degenerative change involving the spine.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: Mild nonspecific nodularity involving both adrenal glandsKIDNEYS, URETERS: Complex renal lesions are seen bilaterally, with the largest on the right. The majority of the right-sided complex mass measures near water density though there is a area of calcification and slightly higher density along the posterior lateral margin (image 125/153). This cannot be adequately evaluated without IV contrast though did not show increased uptake on PET/CT. This likely represent a complex cyst though continued follow up is recommended as RCC cannot be excluded. The left kidney is atrophic.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 involving the spine.OTHER: No significant abnormality noted. | 1. 5 cm right upper lobe mass consistent with known lung cancer. It extends to the hilum and causes mild right upper lobe and bronchus intermedius airway narrowing.2. Patchy nodular and airspace opacity in the right middle lobe and anterior right upper lobe. Since these opacities were not present on recent PET/CT it is likely more acute such as aspirate or infection though continued follow-up is recommended to exclude additional sites of disease.3. Complex renal lesions are seen bilaterally, with the largest on the right. The majority of the right-sided complex mass measures near water density though there is a area of calcification and slightly higher density along the posterior lateral margin. This cannot be adequately evaluated without IV contrast though did not show increased uptake on PET/CT. This likely represent a complex cyst though continued follow up is recommended as RCC cannot be excluded. |
Generate impression based on findings. | 52 year-old female with ovarian cancer, rising CA -125. Clinically NED CHEST:LUNGS AND PLEURA: Scattered pulmonary parenchymal micronodules are unchanged. No new nodules or evidence of airspace disease is seen. No pleural disease.MEDIASTINUM AND HILA: No adenopathy or other right chest wall infusion port catheter terminates in the distal superior vena cava. significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Small subcentimeter hypodensities with a benign appearance are again seen unchanged. Liver parenchyma shows no suspicious mass lesions either parenchymal E. or along the surface. Hepatic vascularity appears normal. Gallbladder wall appears thickened with low density homogeneous appearance. No gallstones are seen. V. wall thickening is new since 10/10/14 -- this may indicate gallbladder inflammation, although occasionally other causes such as hypoalbuminemia or liver disease can cause gallbladder wall thickening. No intrahepatic or extrahepatic biliary duct dilatation is seen.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 enlarged lymph nodes are seen in the hepatoduodenal ligament measuring 1.7 x 2.5 cm (series 4, image 87) and 2.4 x 1.7 cm (series 4, image 89). These displace the left portal vein anteriorly. Surgical clips from prior retroperitoneal lymph node dissection is seen. Prior examinations noted clusters of small normal size lymph nodes, however one enlarged lymph node is now seen in the aorta caval space (series 4 on image 102 measuring 1.1 x 1.0 cm. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Prior hysterectomy without other abnormalities seen.BLADDER: Air in the bladder -- no evidence source is present on this examination. No other abnormalities.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. New enlarged lymph nodes in the hepatoduodenal ligament and in the aortocaval space as delineated/measured above. 2. Diffuse gallbladder wall thickening without gallstones of uncertain significance. CT can miss detecting gallstones and approximately 25% of patients with gallstones. 3. Air in the bladder -- no evidence source is seen and clinical correlation for possible recent instrumentation or Foley catheter placement. |
Generate impression based on findings. | Male, 32 years old, with mental status changes. No loss of gray-white distinction, parenchymal edema or mass effect. No evidence of intracranial hemorrhage or abnormal extra axial fluid collection is seen. The ventricles are normal in size and morphology.The osseous structures of the skull are intact. There is mucosal thickening within the left maxillary sinus and to a mild degree in the right maxillary sinus and ethmoid air cells.Phthisis bulbi of the right globe is seen. Hyperattenuating, presumably calcified vessels course through the soft tissues of the scalp. | 1.No acute intracranial abnormality or other specific findings to account for the patient's altered mental status.2.Phthisis bulbi on the right.3.Calcified subcutaneous vessels suggestive of diabetic vasculopathy. |
Generate impression based on findings. | Alcohol abuse, AML, gout, CKD 3-4, HTN, admitted with severe sepsis and anemia. There are bubbly secretions and mild mucosal thickening in the right sphenoid sinus. There is minimal mucosal thickening within the maxillary sinuses. The other paranasal sinuses are clear. The nasal cavity is clear. The nasal septum is deviated to the right with an associated spur that contacts the right inferior turbinate. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. There are opacities in the bilateral external auditory canals, which may represent cerumen. There is partial right mastoid air cell opacification. | 1. Possible right sphenoid acute sinusitis.2. Nonspecific partial right mastoid air cell opacification. |
Generate impression based on findings. | Reason: lung cancer History: history of RUL lobectomy for NSCLC. Following lung nodules LUNGS AND PLEURA: 7 mm irregular solid nodule in right lower lobe (series 4, image 49/109), unchanged.6 mm irregular subpleural solid nodule in the left upper lobe (series 4, image 34/109), unchanged.10 mm ground glass nodule in left lower lobe (series 4, image 77/109), stable to marginally increased.Other scattered micronodules are stable. Minimal apical scarring. Minimal bronchial wall thickening with some areas of mucus plugging. MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Mild coronary calcificationCHEST WALL: Degenerative change involving the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis. | Stable nonspecific solid and nonsolid nodules. |
Generate impression based on findings. | Reason: ho tongue ca, s/p CRT, compare to previous. measurements pls History: none CHEST:LUNGS AND PLEURA: Reference right upper lobe nodule no longer visible (0 mm). No new pulmonary nodules. Stable calcified granulomas.MEDIASTINUM AND HILA: Port tip in right atrium. Tracheostomy tube present. Scattered small subcentimeter nodes, some of which are calcified, show continued decrease in size.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: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Gastrostomy tube tip in stomach.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Resolved pulmonary nodules. Continued decrease in intrathoracic lymphadenopathy. |
Generate impression based on findings. | 87 year old with history of left lumpectomy in 2006 for invasive ductal carcinoma. Patient received adjuvant radiation therapy and Arimidex. No new breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Stable postsurgical architectural distortion, increased density and calcifications are present in the lumpectomy bed. Multiple surgical clips are again seen in the left axilla. Benign calcifications are scattered in both breasts including arterial calcifications. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female, 67 years old, history of myocardial infarction, type 2 diabetes, here with pre-syncope when looking to the left. Concern for vascular insufficiency in the neck arteries. Non angiographic findings:The cerebral and cerebellar hemispheres and brainstem are normal in attenuation and morphology. No intracranial hemorrhage or abnormal extra-axial fluid is seen. There is no evidence of mass effect or parenchymal edema. The ventricular system is normal in size and morphology. The sella is partially empty.The visualized paranasal sinuses and mastoid air cells are clear. The bones of the calvarium and skull base are intact. Scattered small cystic spaces are seen in the lung apices.Angiographic findings:Conventional aortic branching is seen. The right sided carotid vessels in the neck are unremarkable. The left common carotid artery appears to take a tortuous course, particularly at the level of the thyroid gland, where there seems to be an area of tortuosity and poor contrast opacification. It is difficult to follow the vessel continuously through this area. Assessment of this area is, however, substantially degraded by streak artifact and possibly some degree of motion (see series 9 images 141 through 155).The left vertebral artery origin is not well visualized. Elsewhere, the left vertebral artery is dominant and demonstrates normal caliber and morphology. The right vertebral artery is also unremarkable.Intracranially, the posterior circulation is intact with no evidence of stenosis, occlusion or aneurysm formation. Likewise, the anterior circulation is intact with no evidence of significant stenosis, occlusion or aneurysm. There may be a very small ACOM artery present but it is poorly seen. A small left PCOM artery is present. The right PCOM artery is not clearly visualized. | 1.Apparent tortuosity and poor opacification of the left common carotid artery at the level of the thyroid is of uncertain etiology. Given extensive streak artifact through this region, the possibility exists that this finding is itself artifactual. However, given the patient's symptoms, a true abnormality cannot be excluded. Additional imaging, either with a contrast-enhanced MRA or conventional angiography, may be helpful for better characterization.2.Elsewhere, no significant vascular abnormalities are detected in the neck. In particular, the vertebral arteries are patent.3.No significant intracranial vascular abnormalities are detected. |
Generate impression based on findings. | Male 35 years old Reason: 35yo male with Crohn's disease with pelvic abscess, iliopsoas abscess, and multiple fistulae. Also with tract to right testicle. History: abdominal abscesses ABDOMEN: Limited study secondary to lack of oral contrast making evaluation of bowel pathology suboptimal.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: Right hydronephrosis. No left hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Diffuse striated wall thickening and fat stranding of a large segment of distal ileum, involving the terminal ileum, in the right lower quadrant. The segment of affected bowel measures 20-30 cm and is best visualized on the coronal view (series 80292, image 77).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: Phlegmon in the right pelvis (series 3, image 113) measuring 2.4 x 1.5 cm with connection to multiple loops of small bowel. Posterior to the cecum there is a questionable fluid collection (series 3, image 91), which is likely a portion of the cecum, but cannot be definitively delineated secondary to lack of oral contrast. BONES, SOFT TISSUES: Percutaneous catheter drain is present with tip in the right iliopsoas muscle. No fluid collection is noted in the right iliopsoas muscle.OTHER: No significant abnormality noted | 1.Limited study secondary to lack of oral contrast making evaluation of bowel pathology suboptimal. Within these limitations, there is a large inflamed segment of the affected distal ileum measuring up to 30 cm in length. 2.Phlegmon in the right pelvis with connection to multiple loops of small bowel.3.Right hydronephrosis.4.Percutaneous catheter drain is present with tip in the right iliopsoas muscle without adjacent residual fluid collection. 5.Posterior to the cecum there is a questionable fluid collection, which cannot be delineated secondary to lack of oral contrast. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.