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Generate impression based on findings. | Ms. Digby-Lucas is a 40 year old female with palpable left axillary mass for the past 3 months. Dr. Jaskowiak has marked the site with palpable area of abnormality. Family history of breast cancer in sister, diagnosed at the age of 34. Upon physical exam at the palpable area of abnormality, a vague soft abnormality is palpated at the marked site.A targeted left axillary ultrasound was performed for the palpable area of concern. No suspicious cystic or solid mass is identified at this site. However, a prominent fat lobule is located directly underneath the skin marking, likely corresponding to the palpable abnormality. | Prominent fat lobule with no sonographic evidence for malignancy. Patient should return to normal screening mammogram annually, due next in Jan 2016. All results and recommendations were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Follicular lymphoma; pre-allo sct evaluation. The moderate right and mild left maxillary sinus mucosal thickening. There is minimal opacification of the ethmoid sinuses. The frontal and sphenoid sinuses are clear. There is partial opacification of the right concha bullosa. The nasal septum is deviated to the left posteriorly with an associated spur that contacts the left nasoantral wall and deviated to the right anteriorly. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, and orbits appear to be unremarkable. There is an embolization coil mass and stent in the circle of Willis region. There are degenerative changes involving the right temporomandibular joint. | 1. Nonspecific scattered sinonasal opacification. 2. Degenerative changes involving the right temporomandibular joint. |
Generate impression based on findings. | Right upper quadrant pain. LIVER: The liver is mildly enlarged measuring 18.2 cm in length. There is normal echotexture and there are no focal mass lesions.GALLBLADDER, BILIARY TRACT: Normal appearing gallbladder without biliary ductal dilatation. Normal hepatopetal flow of the main portal vein.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Right kidney is normal in appearance and measures 11 cm in length.OTHER: Left kidney is normal in appearance and measures 12 cm in length. The spleen is normal in appearance and measures 8.3 cm. | 1.Mild liver enlargement without focal mass-lesion. 2.Normal gallbladder. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of left benign biopsy. Two standard digital views of both breasts and additional bilateral MLO views, left CC view, and cleavage 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-appearing calcifications and masses are seen in both breasts. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 63 years old; Reason: R testicle torsion? History: right testicular swelling RIGHT TESTIS: Right testis measures 4.4 x 2.7 x 2.5 cm. no focal lesions. Normal vascularity.LEFT TESTIS: Left testis measures 4.5 by 3 x 2 cm. No focal lesions. Normal vascularity.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: Bilateral small hydroceles. Significantly thickened scrotal wall. | Normal vasculature of bilateral testis without any focal lesions. Small bilateral hydrocele. Significant thickened scrotal wall. |
Generate impression based on findings. | Female, 67 years old.Evaluate for RFO. Prolonged surgery. Surgical clips are noted projecting over the right upper quadrant. Surgical drain projects over the mid abdomen with tip projecting over the stomach. No unexpected radiopaque foreign objects.Note that the lower portion of the pelvis is excluded from the field-of-view. | No unexpected radiopaque foreign objects.Findings communicated to Dr. Alverdy at 2:45 PM on 2/16/2015 via text message and confirmed receipt of message. |
Generate impression based on findings. | Back painVIEWS: Lumbar spine three views No acute fracture or subluxation. No evidence of spondylolyses or spondylolisthesis. The disk spaces are maintained. | Normal examination. |
Generate impression based on findings. | Right upper quadrant pain status post meals. Question of biliary dyskinesia. Angiographic images are unremarkable. Prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is normal excretion of tracer into the intrahepatic ducts, common bile duct, gallbladder and duodenum, indicating patent common bile and cystic ducts.Following CCK administration, there was visually gall bladder emptying with the GB ejection fraction calculated to be 48% (normal >40%).The patient experienced no symptoms during CCK administration. | 1. Normal hepatobiliary imaging. No evidence of acute or chronic cholecystitis.2. Lower limits of normal gall bladder contractile response to CCK. The patient was asymptomatic with CCK administration. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with additional bilateral MLO and CC 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. Benign appearing lymph node is unchanged in the left upper outer quadrant. 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. | Female 22 years old Reason: r/o hydro (hx stones) History: flank pain, recent dx stones RIGHT KIDNEY: Right kidney measures 12.6 cm. no focal lesions. No hydronephrosis.LEFT KIDNEY: Left kidney measures 12.4 cm. No focal lesions. Mild left-sided caliectasis. Punctate stone in the left kidney is unchanged.OTHER: No significant abnormalities noted. | Mild left caliectasis and left nephrolithiasis. |
Generate impression based on findings. | Female 33 years old Reason: pls assess hepatomegaly, pls include DOPPLER STUDY to assess for chronic budd chiari History: chronic abdominal pain LIMITED ABDOMENLIVER: Liver measures 24 cm, enlarged. Patient's known liver mass is again noted in the right lobe of the liver. This cannot be optimally characterized by ultrasound.BILIARY TRACT: Gallbladder is contracted. No evidence of intra-or extrahepatic biliary dilatation.PANCREAS: Not well-visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted. Spleen measures 8 cm. RIGHT KIDNEY: No significant abnormalities noted.OTHER: Small bilateral pleural effusions. | Hepatomegaly. Dilated hepatic veins and IVC likely secondary to congestive heart failure. |
Generate impression based on findings. | History of RCC. Follow up. There is a focus of increased radiotracer uptake within the posterior right 8th rib, which correlates to a lytic lesion on CT. There is a large area of uptake within the distal right humerus and increased uptake within the lower lumbar spine. There is relative faint increased uptake in the right proximal femur of uncertain clinical significance. The left kidney is not visualized and presumably surgically absent. | Multiple osseous metastatic lesions with a large distal right humeral lesion; correlate with focal tenderness and consider dedicated radiographs if clinically indicated. |
Generate impression based on findings. | Elevated liver enzymes. LIVER: Normal appearance of the liver which measures 16.7 cm in length. No focal mass lesions are noted.GALLBLADDER, BILIARY TRACT: The gallbladder is not visualized consistent prior cholecystectomy. The common bile duct diameter measures 6 mm.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney is normal in appearance and measures 9.6 cm in length.OTHER: The left kidney is normal in appearance and measures 9.2 cm in length. The spleen is normal in appearance and measures 12.8 cm in length. | Normal appearance to the liver without focal mass lesion. |
Generate impression based on findings. | Drop in hematocrit, evaluate for intra-abdominal bleed. ABDOMEN:LUNG BASES: Streaky atelectasis is seen in the lung bases. Hypodense blood pool is compatible with anemia.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Nasogastric tube tip projects over the gastric body. High density material is seen throughout the small bowels. If no oral contrast has been recently administered, this raises concern for gastrointestinal hemorrhage.BONES, SOFT TISSUES: A small amount of ascites is present. Multiple enlarged mesenteric lymph nodes are noted. Open abdominal defect containing multiple bowel loops and a portion of the liver is present with silo in place. Right femoral venous catheter tip lies in the suprahepatic IVC.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Multiple enlarged mesenteric lymph nodes are again noted. Open abdominal defect as described above.BONES, SOFT TISSUES: Bilateral hydroceles are partially visualized, left greater than right. | 1.High-density material the small bowels raises concern for gastrointestinal hemorrhage if no oral contrast has been recently administered.2.Multiple enlarged mesenteric lymph nodes are present.3.Status post exploratory laparotomy with silo placement. |
Generate impression based on findings. | 76-year-old female with metastatic lung cancer status post 6 cycles of treatment. Please evaluate treatment response. ABDOMEN:LUNG BASES: See chest CT report from today's examination.LIVER, BILIARY TRACT: No significant abnormality noted in the liver or biliary tract.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination with no evidence for metastatic disease in abdomen or pelvis. |
Generate impression based on findings. | Male 39 years old; Reason: history of ALL s/p bone marrow transplant with testicular pain. F/u ultrasound after ibuprofen therapy. Bilateral as he know has left pain . Initially right sided pain History: right testicular mass RIGHT TESTIS: Right testis measures 4.6 x 2.2 x 2.9 cm. Again noted a hypoechoic lesion in the right testis measuring 8 x 5 mm, not significantly changed from previous study.LEFT TESTIS: Left this is measures 3.5 x 2 x 2.8 cm. There is a new hypoechoic lesion in the left testis measuring 4 by 6 mm.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: No significant abnormalities noted. | Unchanged right testicular lesion with interval development of small left testicular lesion. These are suspicious for leukemia involvement versus less likely testicular cancer. |
Generate impression based on findings. | Ms. Fitzgerald is a 65 year old female with high probability benign clustered cysts and a benign hyalinized fibroadenoma in the right breast. She has a personal history of cutaneous B cell lymphoma. 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. Previously characterized cluster of cysts in the right upper inner breast is no longer visualized on today's mammogram. A cluster of popcorn calcifications with associated mass in the right lower inner breast is compatible with hyalinized fibroadenoma. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Benign hyalinizing fibroadenoma. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 55-year-old female patient with history of small bowel obstruction and intermittent abdominal pain, nausea and vomiting. UPPER GI:Double contrast visualization of the esophagus showed a small hiatal hernia. During the exam, spontaneous gastroesophageal reflux was observed. Fluoroscopic evaluation of esophageal peristalsis demonstrated cessation of the primary wave at the level of the thoracic inlet with proximal escape.The stomach was normal in size, shape, and position. Spontaneous emptying of contrast into the duodenal sweep was observed. The gastric mucosal surface was normal.The duodenal bulb and sweep were within normal limits. SMALL BOWEL FOLLOW THROUGH:Scout radiograph showed a nonobstructive bowel gas pattern and cholecystectomy clips in the right upper quadrant. Transit time to the colon was thirty minutes. There was a long segment of bowel (approximately 10 cm in length) in the right upper quadrant near the jejunoileal junction that had numerous areas of dilatation. There was a persistent stricture seen (series 48) that measures approximately 0.7 cm in length and distends to a maximum of 1 cm. The examination was augmented with administration of room air per rectum, however, the ileocecal valve was patent and air could not be insufflated into the small bowel. No separation of bowel loops was present to suggest fibrofatty proliferation. The terminal ileum and ileocecal valve were normal in appearance. No internal hernias or ventral hernias were evident. The ascending colon was grossly normal. TOTAL FLUOROSCOPY TIME: 17:29 minutes | 1.Small bowel stricture with associated dilatation in the right upper quadrant as described above.2.Minor esophageal motor abnormality.3.Small hiatal hernia. |
Generate impression based on findings. | Right sided heart failure on echo. Concern for PE. Examination limited by suboptimal positioning secondary to patient mobility issues. The comparison chest radiograph performed on 2/12/2015 demonstrates no focal pulmonary opacities or pleural fluid. The ventilation images show a uniform distribution of activity on single-breath and wash-in images, though uniformly diminished within the right greater than left lung. There is no abnormal Xe-133 retention during the wash-out phase. The perfusion images show matched decreased perfusion in the right lung with multiple small punctate peripheral defects though none of moderate/large size or distinctly subsegmental. | Low probability for pulmonary embolus. |
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 left with an associated spur that contacts the left 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. | Numerous intra-axial metastases are better demonstrated on prior MRI. Hypodensity representing associated vasogenic edema is noted, and a couple of lesions demonstrate increased central density. The ventricles and sulci are normal in size. There is no midline shift. There is no acute intracranial hemorrhage or evidence for acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | Numerous intra-axial metastases are better demonstrated on prior MRI. Hypodensity representing associated vasogenic edema is noted, and a couple of lesions demonstrate increased central density. There is no midline shift. There is no acute intracranial hemorrhage. |
Generate impression based on findings. | Female 3 years old Reason: eval fracture healing History: s/p ORIF. Evaluation is limited by overlying cast material. We have 4 views of the left elbow. Orthopedic pins are again seen affixing the radial head as well as a fracture of the capitellum in gross anatomic alignment; appearing similar to the prior study, accounting for slight positional differences. | Orthopedic fixation of capitellum and radial head. Appearance is similar to the prior study. |
Generate impression based on findings. | Female 75 years old Reason: Rule out fx History: pain s/p fall. The bones are demineralized, suggesting osteopenia. Mild osteoarthritis affects the interphalangeal joints, but we see no fracture. There is slight widening of the scapholunate interval which may reflect ligamentous laxity or disruption, which is of questionable current clinical significance. | Mild osteoarthritis and other findings as above, but no fracture evident. |
Generate impression based on findings. | Reason: evaluate for changes in ILD History: increased oxygen requirements, worsened DOE LUNGS AND PLEURA: Diffuse reticulonodular interstitial disease with predominantly subpleural and basilar distribution, markedly increased compared to the previous scan. Diffuse traction bronchiectasis is present consistent with fibrosis with some areas of subpleural honeycombing.Several small discrete pulmonary nodules, some of which are calcified are unchanged.Small areas of air trapping in the lung bases on the expiration series.MEDIASTINUM AND HILA:Marked diffuse thickening of the esophageal wall, up to 12 mm in thickness in the lower esophagus. However this is not significantly changed since the previous scan in 2012. The differential diagnosis includes infiltrative diseases such as lymphoma and esophagitis.Multiple moderately enlarged mediastinal lymph nodes, increased in size ranging up to 12 mm in short axis diameter.Main pulmonary artery in diameter 29 mm, about upper normal.Mild coronary artery calcification.No pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Limited evaluation showing a nonobstructive calculus in the right renal collecting system and calcified granulomas in the spleen consistent with previous infection. | Diffuse basilar predominant pulmonary fibrosis compatible with UIP, with marked interval progression and loss of lung volumes since 2012. Focal areas of air trapping at the lung bases raise the question of hypersensitivity pneumonitis as an underlying etiology. |
Generate impression based on findings. | left hand caught in elevator door and is swollen but no bruisingVIEWS: Left hand AP, oblique and lateral No acute fracture or dislocation. | Normal examination. |
Generate impression based on findings. | Reason: mets lung cancer, s/p 6 cycles of MPDL3280A. Pls c/w previous study and evalaute tx response. History: lung ca LUNGS AND PLEURA: Left apical nodule (image 15 series 7) measures 9 x 6 mm (9 mm x 8 mm previously).Additional left upper lobe lesion (image 17 series 7) stable at 10 x 6 mm. Left superior segment nodule (image 24 series 7) stable at 8 mm x 7 mm.Other punctate nodules are stable.Stable right upper lobe paramediastinal and right perihilar post radiation fibrotic changes.MEDIASTINUM AND HILA: Left chest port tip in SVC. Small pericardial effusion unchanged.Reference prevascular lymph node measures 4 mm on image 29/102 (5 mm on prior).CHEST WALL: Postop change involving right breast and axilla. | No significant change small pulmonary nodules and mediastinal nodes. |
Generate impression based on findings. | Renal failure, evaluate line placementVIEW: Chest AP (one view) 2/16/2015 1317 Right internal jugular catheter tip lies within the right atrium. Nasogastric tube extends into the stomach. One of the previously seen nasogastric tubes has been removed. Endotracheal tube tip is just below the thoracic inlet.Left lower lobe atelectasis is unchanged from the prior study. No new air space opacity is identified. No pleural effusion or pneumothorax is seen.The cardiothymic silhouette is normal. | Right internal jugular catheter tip lies within the right atrium. No new tubes or catheters identified. |
Generate impression based on findings. | Redemonstrated is a stable 9 x 6 mm hyperattenuating focus in the right frontal corona radiata without significant change. There is mild advanced diffuse volume loss with diffusely prominent sulci which may be treatment related given the patient's underlying breast cancer. Additionally, the morphology of the cerebellar tonsils are mildly bulky, rounded and somewhat masslike, perhaps with adjacent subtle associated hypodensity, but unchanged from prior exam. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. A nasogastric tube is now present via the right nares. | 1.Stable 9 x 6 mm hyperattenuating focus in the right frontal corona radiata.2.Stable bulky morphology of the cerebellar tonsils.3.Differential diagnosis list includes small focal parenchymal hemorrhage, cavernoma, or infectious/inflammatory etiology (possibly even chronic) with focal area of mineralization, or possibly a hemorrhagic/non-hemorrhagic metastases given history of breast cancer. Further evaluation with MRI without and with IV contrast is recommended. |
Generate impression based on findings. | Term infant with tachypneaVIEW: Chest AP 2/16/15 Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Diffuse patchy atelectasis bilaterally. No pleural effusion or pneumothorax. | Diffuse patchy atelectasis bilaterally. |
Generate impression based on findings. | 53 year old male with history of Crohn's disease. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal lower pole lesion measuring 8 mm (series 3, image 40) with an attenuation of approximately 75 HU is incompletely characterized. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Post surgical changes of resection of small and large bowel. The proximal small bowel is unremarkable. The distal small bowel is significantly dilated up to approximately 5 cm which is new compared to the prior small bowel follow through. Enteric contrast does not reach the colon. The enterocolic anastomosis is not visualized, and high-grade stenosis cannot be excluded. No bowel wall thickening or evidence of fistulae. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Trace amount of free fluid is present in the abdomen and pelvis. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Post surgical changes of resection of small and large bowel. The proximal small bowel is unremarkable. The distal small bowel is significantly dilated up to approximately 5 cm which is new compared to the prior small bowel follow through. Enteric contrast does not reach the colon. The enterocolic anastomosis is not visualized, and very short segment, high-grade stenosis cannot be excluded. No bowel wall thickening or evidence of fistulae. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Trace amount of free fluid is present in the abdomen and pelvis. | 1.Postsurgical changes of prior small and large bowel resection. 2.New significant dilation of the distal small bowel. The enterocolic anastomosis is not visualized, and high-grade short segment stenosis at the anastomosis cannot be excluded. No specific evidence of active Crohn's disease. Barium fluoroscopic examination could evaluate this further if clinically indicated. 3.8mm right renal lower pole lesion incompletely characterized with only one phase of iv contrast and no precontrast imaging. Small neoplasm cannot be excluded, and further follow-up is recommended.Findings communicated with WICHMANN, ALANA at 4:00 p.m. on 2/16/2015. |
Generate impression based on findings. | Abdominal pain with urination, history of hernia surgery ABDOMEN:LUNG BASES: No consolidation or pleural effusion is seen in the visualized portion of the lung bases.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: 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 noted | No findings to explain the patient's symptoms. |
Generate impression based on findings. | Breast cancer There is increased radiotracer uptake at the left aspect of the L5/S1 level which corresponds to a sclerotic/lytic lesion on recent CT. No additional area of abnormal tracer uptake is identified. | L5/S1 lesion which is highly suspicious for metastatic disease. |
Generate impression based on findings. | 61-year-old female presents for annual mammogram. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Mildly ectatic duct in the left retroareolar region is unchanged. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Ms. Griffith is a 71 year old female presenting with a large pelvic mass suspicious for malignancy. Evaluate for breast cancer primary. Three standard views of both breasts with a left spot compression view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. A focal asymmetry in the left inferior breast disperses into normal breast parenchyma on spot compression views. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Metastatic lung cancer status post neck radiation therapy and chemotherapy. There is no evidence of recurrent significant residual lymphadenopathy in the neck. For example, a left level 2A lymph node measures 4 mm in short axis, previously also 4 mm. Likewise, subcutaneous mass in the right supraclavicular region remains indiscernible. The thyroid and major salivary glands are unchanged. There is an unchanged 5 mm wide cystic structure near the midline anterior to the thyroid cartilage, which likely represents a thyroglossal duct cyst. There is a left internal jugular venous catheter. There is mild atherosclerotic plaque at the carotid bifurcations. The imaged paranasal sinuses and mastoid air cells are clear. There are multiple left upper lobe pulmonary nodules, which appear to have further decreased in size, but there is a persistent right upper lobe consolidation with traction bronchiectasis. There are bilateral lens implants. The imaged intracranial structures are unremarkable. There are multilevel degenerative changes in the cervical spine. | 1. No evidence of recurrent significant residual lymphadenopathy in the neck. 2. Continued interval decrease in size of metastases in the imaged portions of the lungs, but persistent right lung consolidation. Please refer to the separate CT chest report for additional details. |
Generate impression based on findings. | Evaluate pleural effusionVIEW: Chest AP 2/16/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Left chest tube in place. Right central line in place. Cardiothymic silhouette normal. Bilateral atelectasis improved in the interval. Left pleural effusion decreased in the interval. | Placement of left chest tube with interval decrease in the pleural effusion. |
Generate impression based on findings. | 54-year-old male. History of of follicular lymphoma. Pre allo SCT evaluation. LUNGS AND PLEURA: Calcified lung nodules consistent with healed granulomatous disease. Additional scattered noncalcified micronodules are most likely also post inflammatory.Mild basilar scarring.No evidence of active infection. No pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Mild coronary artery calcification. Post-surgical finding of a CABG.Normal heart size without pericardial effusion.CHEST WALL: No axillary lymphadenopathy.Median sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Cholelithiasis. Splenic artery calcification. | No evidence of active infection or significant acute abnormality. |
Generate impression based on findings. | Female 35 years old Reason: eval for joint derangement History: wrist pain. We have 3 views of the left wrist. The sclerotic band in the distal radius seen on the prior study, presumably representing a healing fracture, is no longer evident, suggesting that the fracture has healed. We see no specific findings to account for the patient's wrist pain. | Healed distal radius fracture. |
Generate impression based on findings. | 62 years old Male. Reason: 62 years old male with HIV and metastatic anal squamous cell carcinoma, off therapy for 3 months. Please evaluate for evidence of disease progression. Please evaluate for evidence of disease progression. RADIOPHARMACEUTICAL: 12.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 86 mg/dL. Today's CT portion grossly demonstrates mucosal thickening of the right maxillary. An enlarged lymph node is seen in the left inguinal region. A right chest Port-A-Cath with tip is seen in the right atrium. A biliary stent is also noted.Today's PET examination demonstrates intense FDG uptake in the left inguinal lymph node with SUVmax of 5.2, which is new as compared with prior study. There are several new foci of increased activity in the posterior pelvis at presacral and perirectal regions with SUV Max of 10.5. Several new foci of increased activity are seen in the bilateral inguinal iliac lymphatic chains and left external iliac chain. There is a new large mass with intense FDG uptake in the lower pelvis at rectum, prostate and perirectal regions. The mass may extend to the floor of the pelvis. The SUVmax in the mass is 9.5.There is a prominence of bilateral renal collecting systems including bilateral renal pelvis and ureters.Physiologic activity is seen in the liver, spleen, kidneys, intestines, ureters. There is no FDG containing urine in the bladder suggesting obstruction of the bilateral ureters. | 1.New hypermetabolic masses and lymphadenopathy in the pelvis and in the left inguinal region, consistent with recurrent and metastatic disease.2.Probable bilateral ureteral obstruction. |
Generate impression based on findings. | Reason: 42M with CD s/p ex lap with ileocolonic resection/anastomosis. Persistently tachycardic post op requiring O2. History: O2 requirements, persistent tachycardic PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Debris in the right main stem bronchus and lower lobe bronchi.Bilateral basilar segmental atelectasis, right greater than left. Small pleural effusions, left greater than right. Mild basilar subsegmental atelectasis/scarring. Findings compatible with aspiration/mucus plugging.Scattered benign appearing micronodules. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. No visible coronary artery calcification.No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. Pneumoperitoneum and intra-abdominal fluid likely related to recent abdominal surgery. | 1. No evidence of pulmonary embolism.2. Findings compatible with aspiration/mucus plugging and subsequent basilar atelectasis, with small pleural effusions.3. Free peritoneal air and ascites likely related to recent abdominal surgery.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 32 years old Reason: hx skiing accident with C7 fracture. eval healing History: neck pain. There is a curvilinear lucency through the left articular pillar of C7 which presumably represents the patient's known C7 fracture; fracture fragments are in near-anatomic alignment. There is perhaps 1 mm anterolisthesis of C6 on C7, but the clinical significance of this is uncertain. | Fracture of the left articular pillar of C7 in near anatomic alignment. |
Generate impression based on findings. | Reason: Pleural mesothelioma. Please compare to prior exam per RECIST criteria. History: Pleural mesothelioma CHEST:LUNGS AND PLEURA: Postoperative changes of left pleurectomy/decortication. Reference small focus of residual pleural thickening is stable measuring 5 mm in the left apex at the 11 o'clock position (image 21/156).Multiple pulmonary nodules are grossly stable. The reference left lower lobe nodule again measures 7 mm (image 9/113).MEDIASTINUM AND HILA: Small lymph nodes in the anterior mediastinum are similar to previous.CHEST WALL: Reference left axillary lymph node stable at 12-mm (image 30/156). Very small left internal mammary nodes are again 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: 18-mm gastrohepatic ligament lymph node (3image 88/156), stable. Other smaller nodes are also unchanged. BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Nonspecific mild mesenteric fat stranding is unchanged.BONES, SOFT TISSUES: No significant abnormality noted.. | 1. Stable pulmonary nodules in the left lung.2. Stable left axillary and intraabdominal lymphadenopathy.3. Stable very small focus of pleural thickening. |
Generate impression based on findings. | Female 86 years old Reason: cause of dysphagia History: dysphagia Double contrast evaluation of the esophagus revealed no mucosal or mural abnormalities. No hiatal hernia was identified. Mass effect posterolateral to the inferior esophagus best seen in the steep LAO position is likely due to an uncoiled aorta and is accentuated by a thoracic scoliosis. Fluoroscopic examination of esophageal motility revealed no motility abnormality (cine images; series 16, series 9). No gastroesophageal reflux was identified. Double contrast images of the stomach demonstrate a prominent areae gastricae within the proximal stomach. Correlation for gastritis/H. pylori infection recommended. | Prominent areae gastricae within the proximal stomach. Correlation for gastritis/H. pylori infection recommended. |
Generate impression based on findings. | ABPA, evaluate for airflow obstruction LUNGS AND PLEURA: Flat subpleural lesion in the right upper lobe (image 20, series 4) likely represents an intrapulmonary lymph node. No suspicious pulmonary nodule or mass is seen. No bronchiectasis, bronchial wall thickening, or consolidation is seen. No pleural effusion.MEDIASTINUM AND HILA: No mediastinal lymphadenopathy is seen. The heart is normal size and there is no pericardial effusion.CHEST WALL: Mild dextroscoliosis of the thoracic spine is noted. No axillary lymphadenopathy.UPPER ABDOMEN: The visualized upper abdominal organs are within normal limits. | No bronchiectasis, bronchial wall thickening, or consolidation. |
Generate impression based on findings. | 32-year-old female with history altered mental status. No evidence of acute intracranial hemorrhage. No midline shift or mass effect. The gray-white differentiation is preserved. The ventricles and sulci are symmetric. The basal cisterns are intact. There is no significant edema. The calvarium and soft tissues of the scalp are normal. The imaged paranasal sinuses, mastoid air cells, and orbits are unremarkable. | No acute intracranial abnormality. |
Generate impression based on findings. | Female 70 years old Reason: s/p TEVAR History: s/p TEVAR CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: CT Angiography: Tortuous thoracic aorta with aortic aneurysmal dilatation extending from the descending aorta to the proximal abdominal aorta measuring up to 7.6 cm (series 12, image 43). Status post TEVAR which extends from the ascending aorta to the proximal abdominal aorta just proximal to the celiac axis. There is peripheral filling of the aneurysmal sac by medial branch vessels (series 9, image 35) consistent with a type II endoleak. The origins of the great vessels are patent.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Extrarenal pelvis noted bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.CT Angiography: The origins of the celiac axis, SMA, and renal arteries are patent. Mild evidence of atherosclerotic disease. BOWEL, MESENTERY: Ill-defined cystic lesion in the lesser sac of uncertain etiology (series 9, image 90) measuring 2.3 x 1.4 cm in.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: Multiple lower extremity soft tissue granulomas.OTHER: No significant abnormality noted. | 1. Thoracic aortic aneurysm measuring up to 7.6 cm status post TEVAR with peripheral filling of the aneurysmal sac by medial branch vessels consistent with a type II endoleak. 2. Ill-defined cystic lesion of uncertain etiology in the peri-pancreatic soft tissue within the lesser sac. Recommend MR imaging to better characterize.Findings were discussed by telephone with the clinical service, Amanda Hasseltine, pager 9650 at 4:15 pm. on 2/16/2015. |
Generate impression based on findings. | 76 y/o female with history of DLBCL on treatment, re-staging. CHEST:LUNGS AND PLEURA: Nonspecific scattered micronodules, similar to prior. Calcific pleural plaques suggestive of asbestos exposure. No new suspicious nodules or masses. MEDIASTINUM AND HILA: Left-sided central venous chest port with tip at the SVC atrial junction. There is redemonstration of nonocclusive fibrin thrombus in the left brachiocephalic vein (series 7, image 24). CHEST WALL: Possible vertebral body hemangioma in T9, unchanged. Right chest wall mass seen on 8/28/2014 CT is again no longer present. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right lower pole renal cyst, unchanged. RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic disease of the abdominal aorta and its branches. No retroperitoneal lymphadenopathy by size criteria.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: Soft tissue mass in the left iliac fossa has resolved.OTHER: No significant abnormality noted. | 1.No significant lymphadenopathy to suggest disease recurrence. 2.Resolved right chest wall mass and left iliac fossa mass. 3.Chest wall port with fibrin thrombus adjacent to its catheter in the left brachiocephalic vein, similar to prior. |
Generate impression based on findings. | direct hyperbilirubinemia. Evaluate for cyst, biliary tree LIVER: Normal echogenicity measuring up to 6.0 cm in length. No intra-or extra hepatic biliary dilatation. Normal direction and flow of the portal vein. There is a small amount of perihepatic ascites.GALLBLADDER, BILIARY TRACT: There is sludge in the gallbladder. There is no cholelithiasis, gallbladder wall thickening or pericholecystic fluid. The common bile duct is normal in diameter measuring up to 2 mm.PANCREAS: Normal echogenicity.SPLEEN: Normal echogenicity measuring up to 3.5 cm in length. KIDNEYS: Normal echogenicity with no evidence of hydronephrosis. The right kidney measures up to 4.5 cm in length. The left kidney measures up to 4.7 cm in length.OTHER: No significant abnormality noted. | Small amount of perihepatic ascites. Gallbladder sludge with no evidence of cholecystitis. |
Generate impression based on findings. | Female 36 years old Reason: post reduction History: above. Two views of the left ankle were obtained post reduction. Evaluation of fine bone detail is limited by overlying cast material. Again seen is a comminuted oblique fracture of the distal fibula with approximately 5 mm of lateral displacement of the distal fracture fragment. There is also a slight lateral displacement of the talus and medial malleolus fracture fragments along with the distal fibular fragment. There is a minimally displaced fracture of the "posterior malleolus" of the distal tibia. | Trimalleolar fracture as described above. |
Generate impression based on findings. | 14-year-old male with right lower pole kidney stone status post ESWL. BLADDER Wall Thickness: Unable to assess Contents: Collapsed Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Continued increase in cortical echogenicity of the right kidney. Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Left: 0 Length*** Right: 6.5 cm Left: 7.2 cm Mean for age: 10.0 cm Range for age: 8.5 - 11.1 cmADDITIONAL OBSERVATIONS: A 4 mm shadowing echogenic focus in the inferior pole of the right kidney is again seen and unchanged consistent with a non-obstructing renal stone. | 1. Increased right renal cortical echogenicity suggestive of medical renal disease. 2. Nonobstructing 4 mm stone in the inferior pole of the right kidney.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
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 mother, maternal aunt, and maternal grandmother. She currently presents today with right arm pain. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Benign morphology mass in the left upper outer breast is stable when compared to multiple prior exams, being previously characterized as a fibroadenoma on prior ultrasound exam. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable benign morphology mass in the left breast. Patient's right arm pain should be managed clinically. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 47-year-old female patient with history of colectomy and multiple resections presents with intermittent obstructive symptoms. Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the J pouch was 15 minutes. Fluoroscopic evaluation showed normal mucosa throughout the small bowel, with no ulcers, sinus tracts, fistulae, or adhesions. There was expected dilatation of a long segment of small bowel consistent with a small bowel reservoir. No areas of stricture or focal bowel obstruction. The examination was augmented with administration of room air per anus and a normal appearing J pouch was seen. No separation of bowel loops was present to suggest fibrofatty proliferation. No internal hernias or ventral hernias were evident. TOTAL FLUOROSCOPY TIME: 5:42 minutes | Expected postsurgical changes in the small bowel without evidence of focal stricture or bowel obstruction. |
Generate impression based on findings. | History of right submandibular gland malignancy (intracapsular carcinosarcoma). There are postoperative findings related to right submandibular gland resection. There is no definite evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid appear unremarkable. There are bilateral punctate tonsilloliths. There is a defect in the left lateral aspect of the C5 vertebral body, which may be due to a tortuous vertebral artery. The osseous structures are otherwise unremarkable. The airways are patent. The paranasal sinuses are clear. The imaged intracranial structures are grossly unremarkable. The imaged portions of the lungs are clear. | Postoperative findings related to right submandibular gland resection definite evidence of recurrent tumor or significant lymphadenopathy in the neck, although assessment is limited by the lack of intravenous contrast. |
Generate impression based on findings. | Reason: hx NSIP-like ILD, has underlying scleroderma with possible overlap CTD; evaluate for change in CT compared to 2010 History: hx NSIP-like ILD, has underlying scleroderma with possible overlap CTD; evaluate for change in CT compared to 2010 LUNGS AND PLEURA: Stable basilar and peripheral predominant interstitial abnormality with scattered areas of groundglass opacity, nodularity, and traction bronchiectasis, especially in the periphery of the right middle lobe. No evidence of pleural effusion.MEDIASTINUM AND HILA: New 12-mm nodule in the anterior mediastinum abutting the ascending aorta (image 45/27) which may represent a lymph node or be related to the thymus. Severe coronary calcification.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Stable interstitial lung disease which may be related to NSIP.2. New 12-mm nodule in the anterior mediastinum abutting the ascending aorta which may represent lymphadenopathy or be related to the thymus (likely a thymoma though malignancy cannot be excluded, continued follow up is recommended). |
Generate impression based on findings. | Male 53 years old Reason: eval wrist for fracture History: wrist injury. We have 3 views of the right wrist. We see no fracture or malalignment. | No fracture evident. |
Generate impression based on findings. | Female 15 years old Reason: eval alignment History: elbow GSW. Again seen is posttraumatic deformity of the elbow, appearing similar to that seen on the prior study with numerous bullet fragments in the adjacent soft tissues. A plate and screw device affixing the proximal radius and a suture anchor in the distal humerus appear similar to those on the prior study. Alignment is grossly anatomic.Defects in the proximal and mid ulnar diaphysis from prior orthopedic fixation are again noted with maturation of callus along the proximal defect. | Posttraumatic deformity and postoperative changes as described above, with alignment appearing similar to the prior study. |
Generate impression based on findings. | 72 years, Female. Reason: Assess dobhoff placement History: dobhoff placement Dobbhoff tube tip projects the expected location of the gastric body. Nonobstructive bowel gas pattern. Support devices are unchanged in position. | Dobbhoff tube tip projects over the gastric body. |
Generate impression based on findings. | Female 50 years old Reason: Left proximal tibia lesion, evaluate on xray History: above. Two views of the left knee are provided. There is a mixed lucent and sclerotic lesion within the lateral aspect of the proximal tibial meta-epiphysis. It measures approximately 4 cm in the craniocaudal dimension and approximately 3 cm in the transverse dimension. Its margins are poorly defined, particularly on the lateral view. We see no frank cortical destruction. The knee otherwise appears normal.The right knee, seen on the frontal view, also appears normal. | Mixed lucent and sclerotic lesion in the proximal tibia as described above. We suspect that the lesion is benign, perhaps representing a peculiar area of bone infarction, fibrous dysplasia, or possibly a benign cartilage neoplasm or intraosseous venous malformation. If the patient has a known primary malignancy, then the possibility of metastasis is raised, although this is considered less likely. |
Generate impression based on findings. | Male 63 years old Reason: 63yo M with worsening epigastric/RUQ pain and LFT changes. Please assess former LVAD pocket and driveline. History: epigastric/RUQ pain LIVER: Coarse echotexture of the liver. Liver measures 20 cm, enlarged. Small amount of perihepatic ascites.BILIARY TRACT: No evidence of biliary dilatation. Again noted echogenic material layering in the dependent portion of the gallbladder consistent with sludge or non-shadowing stones.PANCREAS: Not well visualized due to overlying bowel gas.SPLEEN: No significant abnormalities noted.RIGHT KIDNEY: No significant abnormalities noted. OTHER: Small amount of fluid is noted in the subcutaneous tissues of the right lower quadrant at the previous drainage site. Trace left-sided pleural effusion. | Slightly coarse echotexture of the liver. Hepatomegaly.. Small amount of sludge versus non-shadowing stones in the gallbladder. Small amount of ascites and left-sided pleural effusion.Small amount of subcutaneous fluid in the right lower quadrant at the previous drainage site. |
Generate impression based on findings. | Reason: Lung cancer s/p chemo, re-staging exam History: Lung cancer s/p chemo, re-staging exam CHEST:LUNGS AND PLEURA: Biapical nodular pleural thickening suggestive of scarring.Moderate left pleural effusion.Volume loss some surgical staples in the area of the left lower lobe suggestive of previous lower lobectomy.Markedly enlarged descending left pulmonary artery suggestive of aneurysm formation. However this cannot be adequately evaluated in the absence of intravascular contrast material. For the same reason it is difficult to exclude a mass in this area. However this region was not FDG avid on the previous scan.MEDIASTINUM AND HILA: Moderately enlarged mediastinal lymph nodes in the AP window area ranging up to 12 mm in diameter. The previous scan was not of diagnostic quality and these nodes may have been present previously.No visible coronary artery calcification.No pericardial effusion.Calcification and surgical clips in the area of the pulmonary artery.CHEST WALL: Degenerative disease in the spine.Status post median sternotomy.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild aortic atherosclerosis.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disease in the spine..OTHER: No significant abnormality noted. | Limited examination due to absence of contrast material, showing a left pleural effusion and presumed to previous left lower lobectomy. Masslike opacity in the area of the left descending pulmonary artery is suggestive of an aneurysm, which could be confirmed by CT scan with contrast material. Moderate mediastinal lymphadenopathy and no other specific evidence of tumor recurrence. |
Generate impression based on findings. | Reason: Intra-Abdominal Injury, GSW to the right flank History: Pediatric Trauma ABDOMEN:LUNG BASES: No consolidation or pleural effusion.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: The kidneys are intact without evidence of injury.RETROPERITONEUM, LYMPH NODES: Hyperdense material compatible with blood products and air is seen along the right paracolic gutter and right retroperitoneum surrounding the right psoas muscle. The largest bullet fragment is seen just to the left of the aorta. Streak artifact from the bullet fragment limits evaluation of adjacent structures and aortic injury at this level cannot be entirely excluded (image 91, series 3). No periaortic inflammation is identified.BOWEL, MESENTERY: No evidence of colonic injury. No free intraperitoneal air.BONES, SOFT TISSUES: Fracture of the superolateral aspect of the L4 vertebral body is present. The posterior superior aspect of the right iliac is fractured. Air, fluid, and bullet fragments are seen along the bullet tract extending from the right back at the level of L4-L5 extending through the right paraspinal and right psoas muscles.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Rectal catheter is seen in place.BONES, SOFT TISSUES: Fractures of the right iliac crest and L4 vertebral body. Right retroperitoneal hemorrhage and injury to the right paraspinal and right psoas muscles. | 1.Gunshot wound injury resulting in L4 and right iliac crest fractures, right retroperitoneal and paracolic gutter hemorrhage, and injury to the right psoas and paraspinal musculature.2.The largest bullet fragment is immediately adjacent to the aorta at the level of L3-L4. While no periaortic inflammation is seen, injury to the aorta at the level of the bullet fragment cannot be entirely excluded. If there is concern for aortic injury, angiogram is recommended for further evaluation.3.No evidence of colonic injury. |
Generate impression based on findings. | TraumaVIEWS: Abdomen AP There is a metallic bullet at the level of L4 on the left of midline. Additionally there is a small punctate metallic fragment on the right of L4. There are fractures involving the L4 vertebral body and right iliac crest. Disorganized nonobstructive bowel gas pattern. | Acute fractures involving L4 and right iliac crest. |
Generate impression based on findings. | Female, 59 years old, history of right tonsil squamous cell carcinoma. An 11 x 9 mm enhancing mass is present in the left temporal lobe with moderate surrounding parenchymal edema. In retrospect, this lesion is first detectable on the 9/25/14 examination, and it has increased in size from that time.A 13 x 9 mm region of apparent enhancement is seen along the right posterior lateral tongue (image 34 series 6). This area, and the oral cavity in general, are somewhat affected by dental amalgam streak artifact, but no findings similar to this were seen on review of multiple prior exams.Evidence of right neck dissection is seen with volume loss and effacement of fascial planes appearing similar to prior. No pathologic adenopathy is detected on either side of the neck by size criteria. The salivary glands and the thyroid or free of focal lesions. The right IJ vein has been resected. Extensive scarlike opacity in the lung apices, left greater than right, is redemonstrated.No concerning or destructive osseous lesions are suspected. Multilevel cervical spondylosis is demonstrated with disk osteophyte complexes at several levels. This is most severe at the C4-5 level where at least moderate spinal canal stenosis is noted with some impingement of the spinal cord. These findings are unchanged. | 1. A parenchymal mass with moderate associated edema is seen in the left temporal lobe which has increased in size from September 2014, but which was not clearly evident on earlier studies. Further assessment with contrast enhanced MRI is recommended.2. An apparent enhancing nodule is seen along the right postero-lateral tongue. It is possible that this finding may be artifactual and related to streaking from dental amalgam. However, direct visual inspection is recommended.3. Elsewhere in the neck, no concerning lesions are seen. No evidence of pathologic adenopathy is detected. |
Generate impression based on findings. | 72 years old male presents with dysphagia. Reason: Patient with a history of esophageal and gastric cancer needs surveillance imaging. This study was performed for restaging.RADIOPHARMACEUTICAL: 14.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 79 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 interval increased metabolic activity in the multifocal mildly abnormal FDG uptake in the mediastinal subcarinal region and perihilar regions without definite CT correlation. The SUVmax in the right main bronchus is 3.6 (it was 2.6 on prior study).There is a new focus of FDG uptake in the right anterior proximal thigh without definite CT correlation. Stable focus increased activity is seen in the right hip which is most likely due to bursitis/tendinopathy.Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Interval increased metabolic activity in the multifocal mildly abnormal FDG uptake in the mediastinum and lung hila, which which remain nonspecific. Suggest follow-up.2.No new FDG avid tumor identified.3.Nonspecific new focal FDG uptake in the right thigh muscle.4.Stable FDG uptake in the right hip is most likely due to bursitis/tendinopathy.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | History of AML, s/p SCT. Persistently febrile, tachycardic despite broad spectrum abx LUNGS AND PLEURA: Near the right lung apex, there is a focal, approximately 6mm nodular density (series 4, image 22), with apparent internal air-bronchogram, which may represent mucus plugging. Additional scattered benign-appearing pulmonary micronodules.No focal airspace consolidation. Mild basilar subsegmental scarring/atelectasis. Small bilateral pleural effusions with mild associated compressive atelectasis.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Moderate coronary artery calcification. Hypoattenuation of the blood pool, compatible with anemia.Mildly prominent mediastinal lymph nodes. A right paratracheal lymph node measures approximately 12 mm in short axis, similar in appearance the prior CT exam dated 06/2005.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Small bilateral pleural effusions. No evidence of edema or infection. |
Generate impression based on findings. | ConstipationVIEW: Abdomen AP 2/16/15 Moderate amount of fecal burden. Nonobstructive bowel gas pattern. There are segmentation anomalies at the thoracolumbar junction. No pneumatosis or pneumoperitoneum. | Moderate amount of fecal burden. |
Generate impression based on findings. | Evaluate NG placementVIEW: Abdomen AP 2/16/15 NG tube tip in the fundus of the stomach. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. Patchy atelectasis left lower lobe. | NG tube tip in the fundus of the stomach. |
Generate impression based on findings. | Right inferior pelvic transplant kidney. Evaluate for obstruction. RENAL TRANSPLANT: Normal appearing transplant kidney measuring 10.1 cm in length. No hydronephrosis or nephrolithiasis. LOCATION: Right inferior pelvisPERITRANSPLANT TISSUES: Very minimal perinephric fluid which is nonspecific.KIDNEY: Echogenic kidneys with multiple cysts again seen and grossly unchanged. No evidence of obstruction or hydronephrosis.COLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: The bladder is collapsed.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels No significant abnormality notedOTHER: No significant abnormality noted | 1.Normal size and echogenicity of the right inferior pelvis transplant kidney without evidence of obstruction or hydronephrosis.2.Trace perinephric fluid adjacent to the transplant kidney which is nonspecific.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | There is a small portion of intrathecal contrast at the level of the lumbar spine. More cephalad the contrast pattern appears to shift from the subarachnoid compartment to a subdural location at approximately L3, and above the T10/11 level resides entirely within a subdural location. There are no osseous dysplasias. | 1.There is a small portion of intrathecal contrast at the level of the lumbar spine. More cephalad the contrast pattern appears to shift from the subarachnoid compartment to a subdural location at approximately L3, and above the T10/11 level resides entirely within a subdural location.2.Findings were discussed with Dr. Frim on 2/16/2015 at approximately 3:20 p.m. |
Generate impression based on findings. | Male 55 years old Reason: s/p temporary pancreatic stent placement, eval for passage History: pancreatic cancer, s/p CBD stent placement, with liver mets Intravenous contrast material opacifies the collecting system bilaterally and the bladder. Biliary stent in situ. Pancreatic stent in situ. The pigtail component of the pancreatic stent is projected over the expected location of the second part of duodenum. Nonobstructive bowel gas pattern. | Temporary pancreatic stent in situ. The pigtail component is projected over the expected location of the second part of duodenum. |
Generate impression based on findings. | 72-year-old female with abdominal pain. Assess etiology. ABDOMEN:LUNG BASES: Calcified lung nodules from prior granulomatous disease. Mitral valve annular calcification. No other significant abnormalities seen.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Benign left renal cysts seen. Renal morphology otherwise appears normal. Slight prominence of the renal pelves are seen bilaterally with slight prominence of the ureters. Bilateral ureteral stents are seen extending into the right lower quadrant urinary diversion conduit with ileal conduit exiting the slight right abdomen centrally.RETROPERITONEUM, LYMPH NODES: No lymphadenopathy seen. Extensive aortic atherosclerotic calcifications are seen and small less than 3 cm distal lumbar aortic aneurysm. An internal stent is seen in the distal aorta. Extensive atherosclerotic calcifications are seen in the proximal common iliac arteries bilaterally.BOWEL, MESENTERY: Small hiatal hernia with small residual gastric pouch from prior gastric bypass surgery. Orally administered contrast rapidly progresses through the gastric pouch to jejunum and distal small bowel to the right colon without evidence of obstruction -- postoperative changes and anastomoses are visualized without complication. Small amounts of free mesenteric fluid is seen collecting in the lateral flanks dependent position..BONES, SOFT TISSUES: Postoperative changes are seen with open wound in the left anterior subcutaneous tissues at the abdominal/pelvic junction without abnormal fluid accumulation.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Prior hysterectomy.BLADDER: Recent cystectomy with surgical drain in bladder bed with residual pockets of air most likely representing recent postoperative changes.LYMPH NODES: No lymphadenopathy. In the expected region of the left external iliac lymph node chain are fluid collections which may represent postoperative seroma or lymphoceles which extend into the mid pelvis.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Recent cystectomy/hysterectomy with postoperative changes. Surgical drains with expected appearance. 2. Ileal conduit urinary diversion with expected appearance. 3. Fluid collections in the left pelvis and central pelvis most likely lymphoceles or seromas. While CT cannot characterize fluid collections, and no abnormal mural enhancement or associated adjacent inflammatory changes are seen to suggest infection. 4. Small hiatal hernia with gastric bypass postsurgical changes as expected. |
Generate impression based on findings. | The patient was not cognitively intact, and therefore, the procedure, indications, benefits, risks/complications and alternatives were described to the patient's caretaker (Dawn Hinton - at phone number 773-230-7744) and informed consent was obtained over the telephone by Dr. Uppuluri, and witnessed by Dr. Katzman.The patient was placed in the prone position and the lumbar region was prepped with Betadine, draped and anesthetized with 1% lidocaine.Using fluoroscopic guidance, a 22 gauge x 5 inch spinal needle was localized into the thecal sac at the L3-4 level. Clear cerebral spinal fluid (11 cc) was obtained and the sample was sent to cytopathology for diagnostic analysis. The needle was removed and hemostasis was achieved.The patient tolerated the procedure well with no immediate complications. | Status-post lumbar puncture as above. |
Generate impression based on findings. | Male 65 years old Reason: mets lung cancer, on MPDL3280A, s/p 12 cycles. pls c/w previous study and evaluate tx response. History: lung ca ABDOMEN:LUNG BASES: Small left-sided pleural effusion.LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver. Hypodense lesion in the left lobe is unchanged and likely represents a cyst.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Right adrenal nodule is unchanged measuring 2.1 x 2.2 cm on image number 36 of series number 7. Diffuse left adrenal gland thickening.KIDNEYS, URETERS: Simple appearing right renal cyst.RETROPERITONEUM, LYMPH NODES: Shotty retroperitoneal lymph nodes are unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No significant change from previous study. Right adrenal nodule is unchanged. |
Generate impression based on findings. | HLH, pre-transplant evaluation. The patient’s weight of 5.12 kg and height of 39 cm were used for all calculations.Raw GFR = 20 mL/minBSA = 0.26364 m2Estimated GFR/m2 = 75 mL/min/m2Estimated GFR/m2 * 1.73 m2 (average adult BSA) = 130 mL/min (adult GFR equivalent) | GFR measurements as above. |
Generate impression based on findings. | There is an evolving recent right MCA territory infarct with no hemorrhagic conversion involving portions of the right temporal, parietal and frontal lobes, right insula with relative sparing of the right basal ganglia. There is mildly increased regional mass effect with sulcal effacement and partial effacement of the atrium of the right lateral ventricle. There is no acute intracranial hemorrhage, midline shift or herniation. There is a background of periventricular and subcortical white matter hypoattenuation without significant change. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | 1.Evolving recent right MCA territory infarct with no hemorrhagic conversion. 2.Mildly increased mass effect which is felt to be expected from interval infarct evolution. No midline shift or herniation.3.Chronic microvascular ischemic changes. |
Generate impression based on findings. | Ms. Dennis is a 44 year old female recalled from screening mammogram for a focal left breast asymmetry. No current breast related complaints. An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Focal asymmetry in the central left breast disperses on spot compression views. There are no suspicious microcalcifications or areas of architectural distortion identified in the left breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient. No noBIRADS: 1 - Negative. RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Reason: hx;SAH, multiple aneuysms, s/pemoblic coiling History: morning confusion MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.The patient is status post embolic coil occlusion of a left posterior communicating artery aneurysm, a left superior hypophyseal aneurysm and a right ophthalmic segment aneurysm. Artifact is present in the expected locations of the left posterior communicating artery aneurysm, the left superior hypophyseal aneurysm and the right ophthalmic segment aneurysm due to embolization coils. Since the previous examination. There is no interval change in the appearance of these aneurysms.The anterior communicating artery is identified and is medium size. The right posterior cerebral artery has fetal origin. There is a 1.5 mm size aneurysm present at the origin of the right posterior communicating artery. On the prior exam it measured approximately 1 mm.The vertebral arteries are asymmetric in size right larger than left. There is no evidence for intracranial aneurysm or cerebrovascular occlusion. | 1. Status embolic coil occlusion of a left posterior communicating artery aneurysm, a left superior hypophyseal aneurysm and a right ophthalmic segment aneurysm. There is no interval change in the appearance of these aneurysms. There is a 1.5mm residual component of the aneurysm at the base of the left posterior communicating artery aneurysm which has been stable. It is possible that the left posterior communicating artery aneurysm residual component is not seen on conventional angiography as a result of "helmet effect". 2.There is a 1.5-mm aneurysm present at the origin of the right posterior communicating artery which is suspected to have slightly increased in size when compared to prior exams. However, this suspected change in size is probably within the range of error. Continued follow-up MRAs would be helpful.3.Findings were discussed with Dr Awad at the time of this interpretation. |
Generate impression based on findings. | History of Crohn's disease and decreasing hemoglobin. Evaluate for hepatic thrombus. LIMITED ABDOMENLIVER: The liver is normal in appearance and echogenicity measuring 15.4 cm in length. No focal mass lesions.BILIARY TRACT: Normal appearing gallbladder. No intra-or extrahepatic biliary ductal dilatation. PANCREAS: No significant abnormalities noted.SPLEEN: The spleen is normal in appearance and measures 10.9 cm in length. RIGHT KIDNEY: The right kidney is normal in echogenicity and size measuring 10.7 cm in length.OTHER: There is hydronephrosis of the left kidney which measures 11.9 cm in. | 1.Left renal hydronephrosis.2.No evidence of hepatic vascular thrombus. |
Generate impression based on findings. | Male 72 years old Reason: pt with a hx of esophageal and gastric cancer needs surveillance imaging History: dysphagia CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Postsurgical changes secondary to esophagectomy and gastric pull-through.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: Bilateral punctate renal stones.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: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No significant change from previous study. |
Generate impression based on findings. | Ms. Cammon is a 50 year old female with a personal history of benign left breast biopsy in 2012. No current breast related complaints pain Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally. Two percutaneously placed biopsy clips are identified in the left breast. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Bilateral benign calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male 64 years old Reason: eval for degenerative disease, disc disease History: neck pain. We have 3 views of the shoulder. The bones appear slightly demineralized. Mild osteoarthritis affects the glenohumeral and acromioclavicular joints. Small densities along the greater tuberosity may reflect a foci of calcification within the rotator cuff at its insertion.We have two views of the cervical spine. There is severe degenerative disk disease at C5/6 and C6/7. There is grade 1 retrolisthesis of C5. There is moderate degenerative disk disease at C4/5 and mild degenerative disk disease at C3/4 with a grade 1 anterolisthesis of C3. There is moderate multilevel facet joint osteoarthritis.We have 3 views of the sacroiliac joints. Slight narrowing of the sacroiliac joints suggest mild osteoarthritis, which is essentially within normal limits for the patient's age. Degenerative disk disease affects L5/S1. Mild osteoarthritis affects both hips. | Degenerative arthritic changes of the cervical spine, sacroiliac joints, and shoulder as described above. |
Generate impression based on findings. | 59 years, Female. Reason: NGT placement History: NGT placement Enteric feeding tube tip projects over the gastric body. Cholecystectomy clips and biliary stent project over the right upper quadrant. Surgical suture material projects over the right lower quadrant and pelvis. Thickened jejunal folds and findings compatible with generalized ileus. Note that the lower portion of the pelvis is excluded from the field-of-view. | Enteric feeding tube tip projects over the gastric body. |
Generate impression based on findings. | Reason: acute stroke activation History: right face droop The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present. Atherosclerotic calcifications are present along the distal internal carotid arteries. There are calcifications present at the the globus pallidi bilaterally. Atherosclerotic calcifications are present along the distal vertebral arteries.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.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.3.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | Ms. Herron submitted outside mammograms dated: 12/10/2012 and 11/26/2012 from Mercy Hospital. Submitted outside studies were compared to the current mammogram dated 01/22/2015. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is no significant change between these studies. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 65 years old Reason: s/p RTSA History: above. Evaluation of fine bone detail is limited by overlying splint material. Components of a reverse total shoulder arthroplasty are seen in near anatomic alignment. A surgical drain and foci of gas density in the soft tissues reflect recent surgery. | Postoperative changes of left reverse total shoulder arthroplasty. |
Generate impression based on findings. | Ms. Herron submitted outside mammograms dated: 12/10/2012 and 11/26/2012 from Mercy Hospital. Submitted outside studies were compared to the current mammogram dated 01/22/2015. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is no significant change between these studies. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 49 years old Reason: eval for source for hip pain, eval for DJD History: hip pain. Severe degenerative disk disease is seen at L5/S1. The remaining lumbar intervertebral disk spaces are within normal limits. There is mild deformity of the right transverse process of L5, which may reflect prior trauma. There is also an orthopedic screw affixing the right sacroiliac joint in near anatomic alignment. | Severe degenerative disk disease at L5/S1 and posttraumatic/postoperative changes as described above. |
Generate impression based on findings. | 20 year old male with left neck swelling. Assess for left cervical abscess. In the left submandibular region there are two enlarged lymph nodes. One measures 3.0 cm x 2.0 cm x 2.9 cm and the other measures 2.6 cm x 1.5 cm. No evidence of loculated fluid collection or abscess.The visualized thyroid gland appears normal. | Two enlarged lymph nodes in the left submandibular region. No evidence of abscess. |
Generate impression based on findings. | Male 40 years old Reason: eval LBP w/o LE radiation History: same. We have 5 views of the lumbar spine which show perhaps mild facet joint osteoarthritis affecting the lower lumbar spine. Vertebral body heights and intervertebral disk spaces are within normal limits for the patient's age. Small osteophytes project from the anterior aspects of the lumbar vertebrae. Alignment is within normal limits. | Mild degenerative arthritis. If further imaging is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Female 7 years old Reason: s/p curettage/bone grafting of left distal tibia pathologic fracture through UBC, evaluate for healing/recurrence History: above. We have 3 views of the left ankle again showing mild expansile remodeling of the distal tibia with intramedullary density compatible with grafting of a unicameral bone cyst. The graft margins are slightly less distinct on the current study, suggesting some interval healing. We see no findings to suggest tumor recurrence. Overall the bones appear demineralized, perhaps from disuse. | Findings consistent with healing unicameral bone cyst. |
Generate impression based on findings. | Female 77 years old Reason: severe pain with palpation via rectal exam s/p fall History: rectal/sacral pain eval for fx. Evaluation of the sacrum is slightly limited by overlying bowel contents, but we see no fracture. Mild osteoarthritis affects the sacroiliac joints. Severe degenerative disk disease affects the visualized lower lumbar spine. Note is made of bilateral total hip arthroplasties, incompletely imaged on this study. | Osteoarthritis and degenerative disk disease without fracture. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her sister. 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. Bilateral areas of asymmetry are stable. Normal lymph nodes in each axilla are again seen and symmetric. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 30 years old Reason: Is there liver disease? And is there portal hypertension? History: Transaminitis LIVER: Liver measures 18 cm. Slightly coarse echotexture. No focal liver lesions.GALLBLADDER, BILIARY TRACT: No significant abnormality noted.PANCREAS: Not well-visualized due to overlying bowel gas.SPLEEN: No significant abnormality noted. Spleen measures 10 cm.KIDNEYS: Slight echogenic kidneys. No hydronephrosis. Right kidney measures 13 cm. Left kidney measures 12.4 cm.ABDOMINAL AORTA: No evidence of aneurysm in the visualized abdominal aorta.INFERIOR VENA CAVA: No significant abnormality noted.OTHER: Small amount of ascites. Diffuse wall thickening of the bladder. Small amount of debris is present within the bladder. | Coarse echotexture of the liver and hepatomegaly. Bilateral slightly echogenic kidneys.Diffuse wall thickening of the bladder. Small amount of debris is present within the bladder. |
Generate impression based on findings. | Pls evaluate L thumb for fracture History: "hairline fracture" diagnosed at OSH ER after fall in a snowbank, was splinted for 1 week.VIEWS: Left hand PA/oblique/lateral (3 views) 2/16/2015 1557 Buckle fracture of the proximal first metacarpal is present. No dislocation is present. | First proximal metacarpal buckle fracture. |
Generate impression based on findings. | Status post intramedullary rod of left tibia fracture. Evaluate for healing. Again seen is an intramedullary rod and screw device affixing a transverse fracture of the distal tibial diaphysis in anatomic alignment. I see no hardware complication. The fracture line is less distinct on the current study than on the prior study, suggesting some interval healing. Note is also made of a healing fracture of the distal fibular diaphysis, with fracture fragments in near anatomic alignment. | Healing distal tibial and fibular fractures as above. |
Generate impression based on findings. | Reason: thymic carcinoma History: thymic carcinoma s/p chemo/radiation LUNGS AND PLEURA: Linear scarring and atelectasis, especially at the bases, but no definitive pulmonary metastases. Scattered punctate micronodules are present though these are most likely post inflammatory.MEDIASTINUM AND HILA: Heterogeneous anterior mediastinal mass measuring 55 x 55 mm on image 40/88 abuts the aortic root, SVC, and right atrial appendage. There is likely pericardial invasion though no pericardial effusion is present. Scattered small subcentimeter mediastinal nodes. Punctate hypodense right thyroid nodule.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Cholelithiasis. | Heterogeneous 5 cm anterior mediastinal mass abuts the aortic root, SVC, and right atrial appendage. There is likely pericardial invasion though no pericardial effusion is present. Scattered small subcentimeter mediastinal nodes. No definitive pulmonary metastases. |
Generate impression based on findings. | Back and hip pain. Osteoarthritis? Two views of the left hip are provided. Tiny acetabular osteophytes suggest minimal osteoarthritis. A round lucency with thin sclerotic margins in the femoral head/neck likely represents a benign synovial herniation pit. Small foci of mineralization along the superior aspect of the greater trochanter likely represent calcifications within the gluteus medius tendon, of questionable current clinical significance.Five views of the lumbar spine are provided. Mild degenerative disk disease affects L5/S1, with sclerosis of the anteroinferior aspect of L5 that I suspect is discogenic in etiology. Vertebral body heights are preserved and alignment is within normal limits. | Mild degenerative arthritic changes of the hip and lumbar spine as described above. |
Generate impression based on findings. | Pain status post MVA. The alignment is anatomic. Mild scattered degenerative changes are noted. The vertebral body heights and disk spaces are preserved. No fracture is evident. The prevertebral soft tissues are unremarkable. | Degenerative changes, without fracture or malalignment. |
Generate impression based on findings. | Pain over left anterior tibia No fracture or malalignment is present. No osseous lesion is noted. No significant abnormality is otherwise evident. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Male 50 years old; Reason: evaluate wrist alignment History: s/p repair of scapholunate ligament Again seen is an orthopedic screw affixing a fracture of the radial styloid in near-anatomic alignment. The fracture line is indistinct suggesting healing, similar to the prior study. Two orthopedic pins also affix the scapholunate and scaphocapitate articulations in near-anatomic alignment, unchanged. The fracture through the base of the fifth metacarpal is less distinct than on 1/12/15 suggestive of healing, similar to prior.Mild osteoarthritis affects the basilar joint. | Stable postoperative findings, as above. |
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