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Generate impression based on findings. | Metacarpal neck fracture Again seen is an oblique fracture through the distal diaphysis of the fifth metacarpal, with slight volar and radial angulation of the distal fracture fragment. There is associated callous formation, indicating healing. | Healing fifth metacarpal fracture, as above. |
Generate impression based on findings. | Female 12 years old; Reason: Left distal radius pathologic fracture, evaluate for healing Again seen is the pathologic fracture through a lucent lesion of the distal radial metadiaphysis. The fracture fragments remain in near anatomic alignment. Indistinctness of the fracture line and periosteal reaction along the distal radius reflects healing. | Healing distal radial fracture, as above. |
Generate impression based on findings. | SOB, unexplained weight loss. ESRD. Evaluate for malignancy. LUNGS AND PLEURA: Very mild paraseptal emphysema. Mosaic attenuation, most pronounced in the lung bases, likely due to small airways disease.No evidence of lung malignancy or infection.Mild basilar scarring/atelectasis. Scattered micronodules, some calcified, most likely post-inflammatory. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion.No visible coronary calcification. Mitral annulus calcification.Moderately enlarged mediastinal lymph nodes, nonspecific.CHEST WALL: Mild degenerative changes of the thoracic spine. Mild asymmetry in chest wall musculature just inferior to the right scapula (image 58/116) is presumably related to patient positioning. This could be further evaluated with MR or US if clinically warranted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of lung malignancy. Very mild emphysema and lower zone predominant mosaic attenuation, likely due to small airways disease. Small intrathoracic nodes.Mild asymmetry in chest wall musculature just inferior to the right scapula (image 58/116) is presumably related to patient positioning. This could be further evaluated with MR or US if clinically warranted. |
Generate impression based on findings. | Reason: mets lung cancer, on MPDL3280A, s/p 12 cycles. pls c/w previous study and evaluate tx response. History: lung ca LUNGS AND PLEURA: Emphysema. Extensive postop and post XRT changes on the left. Multiple small calcified nodules are presumably granulomas. No new pulmonary nodules. No evidence of pleural effusion.MEDIASTINUM AND HILA: Severe coronary calcification. Calcified nodes suggestive of healed granulomatous disease. Dilation of the main pulmonary artery is nonspecific but can be seen in pulmonary artery hypertension.CHEST WALL: Excessive degenerative change involving the thoracic spine.The reference left lateral chest wall mass measures 34 x 20 mm on image 69/98 (37 x 23 mm on prior). UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Reported separately. Please see separate report. | Stable to slightly decreased left chest wall mass. Other findings stable. |
Generate impression based on findings. | Pain and swelling of the second metacarpal phalangeal joint of the left hand No fracture or malalignment. No significant abnormality is otherwise evident. | No specific findings to account for the patient's pain. |
Generate impression based on findings. | 54-year-old female with worsening history of lower abdominal pain into her pelvis a goes into her legs. No current neurological symptoms. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality noted in the liver parenchyma. Gallbladder and biliary tract appear normal.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: Bulbous fundus and posterior uterus most likely representing large fibroid tumor. No other abnormalities.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes about the posterior facet joints of the lumbar spine - at L5 -- S1 this does narrow the spinal canal and raises question of spinal stenosis (see series 5, image 92).OTHER: No significant abnormality noted | 1. Probable large fibroid tumor in the uterus. 2. Marked hypertrophic degenerative changes at the posterior facet joints greatest at L5 -- S1 which narrows the spinal canal. See above discussion. 3. No other abnormalities seen. |
Generate impression based on findings. | Pain. Mallet finger. Again seen is the intra-articular fracture through the dorsal aspect of the base of the distal phalanx of the ring finger (mallet fracture). Alignment remains near-anatomic. No significant callus formation is evident. | Ring finger mallet fracture, unchanged. |
Generate impression based on findings. | Oral SQCC staging. Evaluate for distant mets or regional spread. LUNGS AND PLEURA: Scattered micronodules, which are most-likely post-inflammatory.No suspicious pulmonary nodules or masses are identified.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Normal heart size without pericardial effusion. No visible coronary calcification. Mild thoracic aorta calcification.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Subcentimeter hepatic hypodensities to small to characterize, likely cysts. Calcified hepatic granulomas.Lobulated contour of both kidneys, likely due to cortical scarring. | No definite evidence of metastatic disease in the chest. Scattered punctate pulmonary micronodules are nonspecific but far more typical of postinflammatory nodules than metastases. Continued follow up is recommended. |
Generate impression based on findings. | Left arm/leg paresthesias and subtle left sided pronator drift. There is unchanged patchy cerebral white matter hypoattenuation and more focal encephalomalacia in the left occipital lobe and basal ganglia. There is no evidence of acute intracranial hemorrhage or mass. There are bilateral carotid siphon vascular calcifications. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | Unchanged small vessel ischemic disease and chronic left occipital lobe and and basal ganglia infarcts, but no evidence of acute intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | 56 year-old female with right-sided abdominal pain. ABDOMEN:LUNG BASES: Left Bassler parenchymal calcification most likely from prior scarring. Associated atelectasis or scarring in the adjacent region at left lung base. No pleural disease seen.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: Scattered subcentimeter periaortic lymph nodes but no enlarged nodes meeting criteria for lymphadenopathy. No other abnormalities.BOWEL, MESENTERY: Small hiatal hernia. Stomach otherwise appears normal. Small bowel is well opacified with orally administered contrast and appears normal with no evidence of obstruction. Colon is opacified with oral contrast material and contains feces without other significant abnormality. No free mesenteric fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Prior hysterectomy without other abnormality.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small bowel is well opacified with orally administered contrast and appears normal with no evidence of obstruction. Colon is opacified with oral contrast material and contains feces without other significant abnormality. No free mesenteric fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Small hiatal hernia. 2. No other significant abnormality seen and no findings seen to account for patient's symptomatology. |
Generate impression based on findings. | Hypercalcemia There are multiple areas of increased radiotracer uptake within the distal right humerus, skull, ribs, spine, and left iliac wing. Some of these lesions have a lytic component. | Multiple osseous metastatic lesions, some of which have a lytic appearance; correlate with recent CT imaging. |
Generate impression based on findings. | 44 year old male with chronic kidney disease now with RLQ pain at site of transplanted kidney. ABDOMEN:LUNG BASES: Mild basilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral atrophic native kidneys. 1.3 cm right lower pole renal lesion incompletely characterized. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal caliber small bowel without evidence of small bowel obstruction. The appendix is well-visualized and is unremarkable. There is diffuse colonic wall thickening compatible with pancolitis.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: Normal caliber small bowel without evidence of small bowel obstruction. The appendix is well-visualized and is unremarkable. There is diffuse colonic wall thickening compatible with pancolitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Transplant kidney in right iliac fossa appears swollen, has moderate perinephric stranding, and demonstrates poor enhancement. These findings together are concerning for rejection. A stent is present in the renal hilum. No hydronephrosis. No adjacent drainable fluid collections. Several prominent adjacent lymph nodes are present. | 1.Swollen, poorly enhancing transplant kidney which may be due to rejection.2.Nonspecific pancolitis which may be secondary to infectious, inflammatory, or less likely ischemic etiology. |
Generate impression based on findings. | Metastatic prostate cancer, known mets to right humerus, multiple ribs. Shoulder pain, staging. There is worsening existing and multiple new areas of radiotracer uptake involving the bilateral ribs, spine, proximal humeri, pelvis, and proximal femurs. | Worsening existing and new metastatic osseous lesions. |
Generate impression based on findings. | 10-year-old female with NG tube. Check NG placementVIEW: Abdomen AP (one view) 2/15/2015 13:04 NG tube tip at the GE junction. Nonobstructive bowel gas pattern. | NG tube tip at the GE junction. |
Generate impression based on findings. | Coronary artery disease, shortness of breath, left breast cancer. LUNGS AND PLEURA: Background emphysema with linear interstitial abnormality, upper lobe predominant, with subpleural reticulation especially in the upper lobes. Equivocal honeycombing in some locations. No evidence of pulmonary metastases. Mild bronchial wall thickening.MEDIASTINUM AND HILA: Multiple hypodense thyroid nodules, nonspecific. Mediastinal and bilateral hilar lymphadenopathy, some of the nodes are calcified. Severe coronary calcification. Left vertebral artery arises directly from aorta, normal variant.CHEST WALL: 16 x 11 mm left breast nodule, partially calcified (image 44/95) consistent with known carcinoma. UPPER ABDOMEN: Calcified granulomas in the spleen. Scattered subcentimeter hepatic and splenic hypodensities, too small to characterize. Scattered subcentimeter upper abdominal nodes. | 1. Background emphysema with linear interstitial abnormality as above. Intrathoracic lymphadenopathy, partially calcified. The findings are nonspecific but more likely related to sarcoidosis or healed granulomatous disease than metastases. Metastases, however, cannot be excluded and continued follow up is recommended. A PET/CT may help with further characterization. 2. Left breast nodule consistent with known breast cancer.3. Other findings as above. |
Generate impression based on findings. | 14-month-old male with vent change. Evaluate lung volumes following vent changeVIEW: Chest AP (one view) 2/15/2015 13:29 Tracheostomy tube is seen.Cardiothymic silhouette is normal. Bilateral atelectasis with no focal pulmonary opacities. No pleural effusion or pneumothorax. | Bilateral atelectasis with no focal pulmonary opacities. |
Generate impression based on findings. | Right facial droop. There is encephalomalacia in the left posterior cerebral artery territory and left posterior inferior cerebellar artery terrotiroy. There is also unchanged patchy cerebral white matter hypoattenuation. There is no evidence of acute intracranial hemorrhage or mass. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are grossly clear. The skull is intact. There is a small left occipital scalp lipoma. There are bilateral lens implants. | Chronic left posterior cerebral artery and left posterior inferior cerebellar artery territory infarcts and small vessel ischemic disease, but no evidence of acute intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | Back pain after fall. Fracture? The bones appear demineralized suggesting osteopenia/osteoporosis. There is mild loss of height of the L3 and L5 vertebral bodies representing compression fractures of indeterminate age. Moderate to severe facet joint osteoarthritis affects the lower lumbar spine, and there are minimal anterolistheses of L4 and L5. Osteoarthritis affects the left sacroiliac joint and left hip joint. There is a slight leftward curvature of the thoracolumbar spine. There is atherosclerotic calcification of the distal abdominal aorta. A curvilinear metallic density within the pelvis presumably represents a contraceptive device. | Demineralized bones with mild loss of height of L3 and L5 representing compression fractures of indeterminate age. Facet joint osteoarthritis and other findings as above. |
Generate impression based on findings. | 56-year-old male -- preop evaluation for mitral valve repair -- robotic. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality in the liver, although parenchymal evaluation is limited due to arterial phase only images. Gallbladder and biliary tract appears normal.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No lymphadenopathy or other retroperitoneal masses or abnormal fluid collections.CT ANGIOGRAM: A ureter shows normal caliber throughout with a normal bifurcation into normal diameter common iliac and external iliac arteries without significant tortuosity. No luminal narrowing in any of these major vessels are seen. No aneurysmal dilatation is seen. Mild atherosclerotic calcifications are seen scattered throughout the aortic wall and along the bilateral internal iliac arteries proximally.Origins of the celiac axis, superior mesenteric artery, bilateral renal arteries and the inferior mesenteric artery are widely patent without narrowing or other abnormality. BOWEL, MESENTERY: No significant abnormality noted..BONES, SOFT TISSUES: No significant abnormality noteddOTHER: No significant abnormality noteddPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noteddBLADDER: No significant abnormality noteddLYMPH NODES: No significant abnormality noteddBOWEL, MESENTERY: No significant abnormality noteddBONES, SOFT TISSUES: No significant abnormality noteddOTHER: No significant abnormality notedd | 1. Aortic mild peripheral atherosclerotic calcification without significant narrowing or aneurysmal dilatation. 2. Iliac arteries and femoral arteries show no significant tortuosity and are widely patent without significant narrowing. 3. No other significant abnormality seen. |
Generate impression based on findings. | 2-year-old female, hip subluxation.VIEW: Pelvis AP and frog leg views (two view) 2/16/2015 11:25 Bilateral coxa valgus. Lateral uncovering of the right femoral head of approximately 10%. The left hip is normal. No evidence of fracture bilaterally. | 1. Bilateral coxa valgus. 2. Lateral uncovering of the right femoral head of approximately 10%. Left hip is normal. |
Generate impression based on findings. | 3-year-old male with left knee painVIEW: Left knee AP, oblique and lateral, left hip AP and lateral (5 views) 2/16/2015 15:08 No soft tissue swelling or joint effusion. No evidence of fracture or dislocation. Alignment is normal. | Normal examination. |
Generate impression based on findings. | Pain. Injury? I see no fracture or malalignment. There is mild soft tissue swelling. | Mild soft tissue swelling, but otherwise no specific findings to account for the patient's pain. |
Generate impression based on findings. | 63-year-old male with abdominal pain, nausea and vomiting. Evaluate for acute intra-abdominal process. ABDOMEN:LUNG BASES: Emphysematous changes again seen. No pleural disease seen. No other abnormalities.LIVER, BILIARY TRACT: Several small subcentimeter hypodensity seen -- although these are nonspecific they have an appearance most likely of a benign nature -- these are unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No lymphadenopathy identified. What appear to be lymphadenopathy on a 1/24/15 CT examination and reference as measuring 2.7 x 1 .4 cm, can now be seen as the duodenum, which was unopacified in that portion on the prior examination. Scattered small subcentimeter lymph nodes are seen but none meeting criteria for lymphadenopathy.BOWEL, MESENTERY: Orally administered contrast rapidly progresses through stomach and small bowel to the right lower quadrant without evidence of obstruction and no intrinsic bowel abnormality. Colon is filled with fecal material. Peripheral nodular debris is seen along the proximal jejunum with a similar appearance to that seen the stomach and is felt to represent intraluminal debris passing from the stomach.BONES, SOFT TISSUES: Diffuse sclerotic/lytic disease throughout the entire skeleton unchanged.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: Diffuse sclerotic/lytic lesions throughout the bony skeleton, unchanged.OTHER: No significant abnormality noted | 1. Diffuse skeletal metastatic disease similar in appearance to 1/24/15 CT examination. 2. No evidence for lymphadenopathy (prior described questionable lymph node today is confirmed as duodenum.). 3. No abnormalities otherwise seen and no cause for patient's symptomatology identified. |
Generate impression based on findings. | Reason: history of soft tissue of head/neck s/p multiple resections and adjuvant radiation. Interval CT for evaluation History: history of soft tissue of head/neck s/p multiple resections and adjuvant radiation. Interval CT for evaluation LUNGS AND PLEURA: Scattered benign-appearing pulmonary micronodules, unchanged. No suspicious pulmonary nodules or masses. No focal air space consolidations. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. No visible coronary artery calcifications.No mediastinal or hilar lymphadenopathy. Calcified mediastinal and hilar lymph nodes from prior granulomatous disease.CHEST WALL: Right axillary lymph node dissection.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | 56-year-old female with metastatic cholangiocarcinoma and chemotherapy. Evaluate for interval progression. CHEST:LUNGS AND PLEURA: Solitary right lower lobe pulmonary nodule again seen (series 5 on image 60) measuring 0.6 x 0 .5 cm, previously 0.6 x 0.6 cm. No other nodules or air space disease is seen. Resolution of the prior noted tree in bud opacities in the right middle lobe. No pleural disease.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right anterior chest wall Port-A-Cath again seen with catheter tip terminating at the cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Multiple liver masses are seen throughout the liver, again most concentrated in the left hepatic lobe. The aggregate left hepatic lobe masses (series 4, image 88) measured 14.0 x 6.8-cm, previously 1.5 x 7.1-cm. The scattered right lobe tumor foci are unchanged. Again seen is extensive tumor thrombus throughout the left, right and main portal vein, and expanding the portal vein and representing tumor thrombus. Lateral portal vessels are seen throughout the porta hepatis. SPLEEN: Splenomegaly without focal lesion.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered enlarged periaortic lymph nodes are again seen unchanged. The lymph node on 9/15/14 in the portacaval space cannot be adequately differentiated on today's examination due to the lower IV contrast load administered. Subjectively the other para-aortic lymph nodes as mentioned are unchanged in size.BOWEL, MESENTERY: No intrinsic abnormality is seen in knee stomach or small bowel that are well opacified. Colon is fecal filled without other abnormality. No free mesenteric fluid is seen.There is however nodular infiltration to a mild degree but new since prior examination in the anterior omentum (see series 4, image 138) which is suspicious for early omental/mesenteric disease. Further follow-up may clarify this.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: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. 1. Diffuse intrahepatic mass lesions consistent with diagnosis of cholangiocarcinoma, minimally changed since 12/16/14. 2. Extensive portal vein thrombus, presumably tumor thrombus. 3. Stable solitary right lower lobe pulmonary nodule. 4. Subtle anterior abdominal omental nodularity which is suspicious for omental metastatic disease but requires follow-up for confirmation. |
Generate impression based on findings. | Ankle fracture Evaluation of fine detail is limited by overlying cast material. Again seen is a comminuted, predominantly oblique fracture of the distal fibula. The proximal and distal fracture fragments appear to have been reduced to near-anatomic alignment, with a butterfly-type fragment displaced laterally by approximately 5 mm. The talus and medial malleolar fracture fragment also appear to have been reduced to near-anatomic alignment. There is a mildly displaced fracture of the posterior malleolus of the distal tibia. | Trimalleolar fracture status-post reduction as described above. |
Generate impression based on findings. | 24 year old male status post total abdominal colectomy with end ileostomy for UC toxic megacolon 6 weeks ago, evaluate for small bowel obstruction. ABDOMEN:LUNG BASES: Previously seen bilateral pleural effusions and atelectasis have resolved.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: Post surgical changes of total colectomy with right lower quadrant ostomy and Hartman pouch formation. An enteric tube is present with the tip in the gastric body. The proximal small bowel is relatively non-distended. The distal small bowel is dilated up to 3.6 cm and remains dilated up until near the right lower quadrant ostomy without definite discrete transition point. There is a long segment of circumferential bowel wall edema in the distal small bowel which is nonspecific but raises the possibility of infection or ischemia. A catheter is present within the ostomy. The catheter tip is located in the right lower quadrant abdomen, however, without enteric contrast it is unclear if the tip is intraluminal or extraluminal. There is associated moderate abdominal pelvic ascites, similar to prior, without discrete loculated collections to suggest abscess. No intraperitoneal free air.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: Post surgical changes of total colectomy with right lower quadrant ostomy and Hartman pouch formation. An enteric tube is present with the tip in the gastric body. The proximal small bowel is relatively non-distended. The distal small bowel is dilated up to 3.6 cm and remains dilated up until near the right lower quadrant ostomy without definite discrete transition point. There is a long segment of circumferential bowel wall edema in the distal small bowel which is nonspecific but raises the possibility of infection or ischemia. A catheter is present within the ostomy. The catheter tip is located in the right lower quadrant abdomen, however, without enteric contrast it is unclear if the tip is intraluminal or extraluminal. There is associated moderate abdominal pelvic ascites, similar to prior, without discrete loculated collections to suggest abscess. No intraperitoneal free air.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Dilated distal small bowel until near right lower quadrant ostomy without definite transition point.2.Interval development of a long segment of circumferential bowel wall edema in the distal small bowel concerning for infection or ischemia.3.Right lower quadrant ostomy catheter with tip in the right lower quadrant abdomen, unclear whether tip is intraluminal or extraluminal. No intraperitoneal free air. 4.Interval resolution of previously seen bilateral pleural effusions.Discussed with Dr. Kempton at 05:31 p.m. on 2/16/2015. |
Generate impression based on findings. | Bilateral wrist swelling and tenderness. Bilateral ankle swelling and tenderness. Right rib pain. Joint erosions? Bony involvement? Evaluate for arthritis/fracture. Three views of the left wrist are provided. I see no erosions or other specific radiographic features of inflammatory arthritis. The bones appear normal, and I see no specific findings to account for the patient's tenderness.Three views of the right wrist are provided. I see no erosions or other specific features of inflammatory arthritis. The bones appear normal, and I see no specific findings to account for the patient's tenderness.Three views of the right foot are provided. I see no erosions or other specific radiographic features of rheumatoid arthritis. The bones appear normal.Three views of the ribs are provided. Markers were placed along the lower right rib cage. I see no underlying fracture or other specific findings to account for the patient's rib pain. There is a posterior stabilization device with the screws affixing the thoracolumbar spine, with portions of the spine appearing fused.. There is a mild dextroscoliosis of the thoracolumbar spine. There is blunting of the right costophrenic angle which may represent scarring or effusion. | Postoperative changes of the spine and right pleural effusion or scarring; I see no fracture or frank arthritic changes. |
Generate impression based on findings. | 46 years old male with a history of head and neck cancer status post chemoradiation on April 2014. This study was performed for restaging.RADIOPHARMACEUTICAL: 10.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 96 mg/dL. Today's CT portion grossly demonstrates multiple scattered lung nodules in both lungs. The dominant lung nodules are located in the left lower lobe.Today's PET examination demonstrates intense FDG uptake in the scattered lung nodules in both lungs. For reference, the SUVmax of in the two lung nodules in the right upper and lower perihilar regions are 7.5 and 7.3, respectively. The SUVmax in the left lower lobe nodules is 6.5.Diffuse FDG uptake is seen in the left neck, which is consistent with muscle activity and post-therapy change.Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Multiple scattered lung nodules in both lungs, consistent with the metastasis. |
Generate impression based on findings. | Focal lower back pain, pain radiation to left leg. Compression fracture? The bones appear demineralized suggesting osteopenia/osteoporosis. Vertebral body heights are preserved; I see no frank compression fracture. There is an intervertebral spacer device at L4/5, with the anterior radiopaque marker projecting just anterior to the inferior endplate of L4. Severe degenerative disk disease affects L3/4 and L5/S1. Moderate to severe facet joint osteoarthritis affects the lower lumbar spine. Alignment is within normal limits. A small linear metallic density projecting just above the right iliac crest probably represents a surgical clip. There is atherosclerotic calcification of the distal aorta and common iliac arteries. | Degenerative disk disease and other findings as described above without fracture evident. |
Generate impression based on findings. | 56 year old man being considered for robotic mitral valve repair and is referred for evaluation of cardiovascular anatomy prior to surgery. CPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with a pseudo-bovine brachiocephalic branching pattern with only mild calcification of the aortic arch. No thoracic aortic dissection is noted. The ascending aorta is mild to moderately dilated with a maximum dimension of 4.7cm. No protruding aortic atheroma or thrombus is noted in the thoracic aorta. No aortic coarctation is noted. Aortic Valve: The aortic valve is trileaflet. There is no aortic valve calcification noted.Mitral Valve: There is mild thickening of the mitral leaflets and evidence of posterior mitral valve leaflet prolapse.Left Ventricle: The left ventricular end-diastolic dimension is normal. There is no thrombus noted in the left ventricle. There is a sigmoid septum. Right Ventricle: Visually the right ventricle is within normal limits.Left Atrium: The left atrium is severely dilated. There are four distinct pulmonary veins which drain normally into the left atrium. There is no evidence of left atrial appendage thrombus.Right atrium, vena cavae, and coronary sinus: The right atrium is normal in size. The superior and inferior vena cavae are grossly normal. The coronary sinus is normal in size. Pulmonary Artery: Normal in size.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary arteries: Because heart rate management was not attempted and nitroglycerin was not administered, this exam was not performed to optimally visualize the coronary arteries. However within the limitations of the study the following observations are made:LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There is mild atherosclerosis of the left main coronary artery. LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There is moderate calcification of the LAD. LCx: The left circumflex coronary artery courses normally in the the left AV groove. It gives rise to the obtuse marginal branches and a small AV circumflex branch. There is mild calcification of the LCx.RCA: The right coronary artery arises normally from the right sinus of Valsalva. It is the dominant coronary artery supplying a posterior descending artery and a posterolateral branch. There is moderate calcification of the RCA. Coronary Bypass Grafts:None present. | 1. Mildly dilated ascending aorta. 2. Evidence of mitral valve leaflet thickening and posterior leaflet prolapse. 3. Severe left atrial dilation. 4. Moderate burden of coronary calcium, which is advanced for a 56 year old man. This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report. The abdomen/ pelvis CTA is reported separately. |
Generate impression based on findings. | Draining ankle ulcer. Rule out osteomyelitis. There is diffuse soft tissue swelling, with a defect superficial to the medial malleolus presumably representing the ulcer. There is mild chronic-appearing periosteal reaction along the medial malleolus that may reflect a long-standing reactive osteitis or perhaps sequela of chronic osteomyelitis, but I see no frank osteolysis to confirm acute osteomyelitis. Irregularity of the soft tissues along the lateral aspect of the ankle may reflect additional ulceration. | Soft tissue swelling and ulceration as described above. Chronic-appearing periosteal reaction along the medial malleolus is nonspecific and may reflect sequela of prior infection, but I see no frank osteolysis to confirm acute osteomyelitis. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | LUNG APICES: The visualized lung apices are clear.PROXIMAL VASCULATURE: The aortic arch and great vessels are widely patent. The brachiocephalic veins are also widely patent. LEFT ARM: The subclavian, axillary, brachial, radial, ulnar and interosseous arteries are all widely patent. The patient's known infiltrative hemangiomata are again seen, with fatty elements and numerous phleboliths extending from the level of the left proximal humerus peripherally to the hand. There has been interval surgical resection of hemangiomas at the left posterior upper arm/mid humerus, lateral forearm at the level of the proximal radius, and at the dorsum of the left hand. Surgical clips are seen in the hemangioma resection sites. The bones are within normal limits. | Hemangiomata of the left upper extremity, with interval resection at three sites as above. No acute abnormalities, and the arteries of the upper extremity are patent. |
Generate impression based on findings. | Right facial droop. There is encephalomalacia in the left posterior cerebral artery territory and left posterior inferior cerebellar artery territory. There is also unchanged patchy cerebral white matter hypoattenuation. There is no evidence of acute intracranial hemorrhage or mass. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are grossly clear. The skull is intact. There is a small left occipital scalp lipoma. There are bilateral lens implants. | Chronic left posterior cerebral artery and left posterior inferior cerebellar artery territory infarcts and small vessel ischemic disease, but no evidence of acute intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct, particularly in the posterior fossa. |
Generate impression based on findings. | Female 13 years old Reason: right hip pain, concern AVN History: right hip painVIEWS: Pelvis AP and frog leg 2/16/15 (two views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. Specifically no evidence of AVN. | Normal examination. |
Generate impression based on findings. | Reason: r/o acute event History: impulsive self destructive behavior. Doesn't recall self destructive behavior The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a hypodense focus present in the right inferior parietal lobule measuring 16 x 18 mm axial dimensions associated with some adjacent volume loss.Atherosclerotic calcifications are present along the distal internal carotid arteries.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.Small focus of encephalomalacia in the right inferior parietal lobule. Most likely this is vascular related injury based on its location. |
Generate impression based on findings. | Female 22 months old Reason: increasing lactate, r/o pneumonosis intestinalis History: increasing lactateVIEW: Abdomen AP (one view) 2/16/15 at 1831 hrs. Gastrostomy and ileostomy tubes are noted. Interval removal of feeding tube. Partial uncovering of the right femoral head and dislocation of the left hip as well as bilateral coxa valga deformity is again noted. Two central lines terminates at the right atrium. Small amount of residual contrast material is noted in bowel loops. Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | acute change in mental status No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | 64 years, Male, Reason: assessment of PFC drain History: abdominal distension. ABDOMEN:LUNG BASES: Large left pleural effusion is unchanged. Right basilar atelectasis. Patchy ground-glass opacities in the lingula and right lower lobes are new.LIVER, BILIARY TRACT: CholelithiasisSPLEEN: No significant abnormality notedPANCREAS: There are findings of necrotizing pancreatitis with peripancreatic fat stranding and lymphadenopathy. A large fluid filled collection within the lesser sac has decreased in size and is now mostly air-filled measuring 7.8 x 5.8 cm (80212/91), previously 12.6 x 13.4 cm. A percutaneous catheter which previously resided in this collection is now positioned more posteriorly with its tip in the region of a large necrotic air and fluid filled collection in the region of the pancreatic body and tail that is unchanged in size measuring 13.1 x 5.9 cm (3/70), previously 15.6 x 5.2 cm, and courses down the left paracolic gutter. There is been interval placement of two drains extending from the gastric body to the posterior aspect of this collection and from the gastric fundus to the junction of the anterior aspect of this collection in the aforementioned collection which had decreased in size. A pancreatic stent is unchanged in position. A small amount of pneumoperitoneum is new from the prior exam. Evaluation of the vasculature and pancreatic enhancement is limited due to lack of intravenous contrast. No new fluid collections are evident.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: IVC filter. IVC is collapsed.BOWEL, MESENTERY: Enteric tube tip at the ligament of Treitz. Bowel wall thickening of adjacent bowel loops is likely reactive.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate abdominopelvic ascites is slightly increased.PELVIS: MalePROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Rectal tube. There is cecal pneumatosis with a small amount of pericecal free air which is new.BONES, SOFT TISSUES: Mild degenerative changes are unchanged.OTHER: No significant abnormality noted | 1.Necrotizing pancreatitis with interval drain placement and decrease in size of large anterior fluid collection with persistent large necrotic air and fluid-filled posterior collection in the region of the pancreatic body and tail.2.Cecal pneumatosis with adjacent free air is suspicious for colonic ischemia and perforation.3.Slightly increased moderate abdominopelvic ascites.4.Large left pleural effusion with new ground-glass opacities which may represent infection or infarction. |
Generate impression based on findings. | Female, 36 years old. There was no needle miscount. Two metallic densities projected over the right upper quadrant. The superior density has the appearance of a cholecystectomy clip. A curvilinear density within the right upper quadrant was confirmed to be a surgical clip by the attending surgeon. A nasogastric tube coils in the gastric fundus and the tip is projected over the distal gastric body.A right-sided surgical catheter tip is projected over the right upper quadrant. No other radiopaque foreign object. | No unexpected radiopaque foreign object.These findings were discussed by telephone with Dr. Hussain (#3605), the surgical fellow, who relayed the interpretation to Dr. Renz (# 4214) on 02/16/15 at 5:19 p.m.. |
Generate impression based on findings. | Clinical question : Evaluate for subacute stroke. Signs and symptoms : facial droop. Unenhanced head CT:No detectable acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Similar to prior exam there are periventricular and subcortical low attenuation of white matter consistent with age indeterminate small vessel ischemic strokes of mild to moderate degree. Ventricular system remains within normal size and maintained midline. At calvarium, paranasal sinuses and orbits are unremarkable. | 1.No acute intracranial process.2.Mild to moderate age indeterminate small vessel ischemic strokes |
Generate impression based on findings. | Reason: possible bleed History: 5x falls 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.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.There is asymmetric volume loss in the left versus the right cerebellar hemisphere.The visualized portions of the paranasal sinuses demonstrate minor mucosal thickening and small mucous retention cysts in the maxillary sinuses. 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. | seizure No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | headache, dizziness after head injury No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. There is small scar on the right forehead without associated swelling indicating chronic nature (series 2, image 36/58). | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Female 12 years old Reason: fracture History: pain, swelling after blunt traumaVIEWS: Left hand AP and left third digit lateral and oblique 2/16/15 (3 views) Soft tissue swelling of the distal phalanx of the left third finger with no fracture or malalignment. | Soft tissue swelling with no fracture. |
Generate impression based on findings. | Clinical question: Rule out ICH. Signs and symptoms Cone ASA/Plavix with recent occipital CVA and left-sided headache. Unenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes.The small focus of low attenuation of right occipital lobe without associated mass effect or hemorrhage or evidence of parenchymal volume loss is suggestive of an age indeterminate small cortical stroke. There are no prior exams for comparison.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and with preservation of gray -- white matter.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells. | 1.No acute intracranial process. 2.Small focus of low-attenuation in the right occipital lobe without evidence of mass effect or volume loss is suggestive of an age indeterminate ischemic stroke. |
Generate impression based on findings. | Ms. Hubbard submitted outside mammogram dated 09/13/2012, from Mercy Hospital. Submitted outside study was compared to the current mammogram dated 12/24/2014. The breast parenchyma is mostly fatty replaced, unchanged in appearance. There has been interval development of a circumscribed fat-containing mass in the upper outer quadrant of the right breast, which most likely represents an area of fat necrosis. No suspicious microcalcifications or areas of architectural distortion are present. | Interval development of a circumscribed fat-containing mass in the right upper outer breast, most likely representing an area of fat necrosis. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EA - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 77 years, Male. Reason: 77 year male, hx DM on insulin, abscess at injection sight, please evaluate for any abnormalities History: swelling Nonobstructive bowel gas pattern. Slightly greater than average stool burden in the colon. Degenerative changes and osteophytes noted in the thoracolumbar spine. Posterior fusion hardware projects over the lower lumbar spine. | Nonobstructive bowel gas pattern with slightly greater than average stool burden in the colon. |
Generate impression based on findings. | headache No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Clinical question: CVA. Sudden loss of vision. Signs and symptoms: As above. Unenhanced head CT:Large focus of low attenuation involving the cortex and subcortical white matter of left hemisphere along the distribution of left posterior cerebral artery. The findings extends along the medial aspect left temporal lobe and extensive involvement of the left occipital lobe. There is resultant effacement of adjacent cortical sulci and subtle mass effect on the occipital horn of left lateral ventricle. Findings consistent with a subacute nonhemorrhagic ischemic stroke.Ventricular system are otherwise unremarkable and maintained midline.Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces otherwise.Unremarkable calvarium, paranasal sinuses, orbits and mastoid air cells are | 1.Subacute nonhemorrhagic ischemic stroke in the left PCA territory involving the left temporal and occipital lobes.2.Unremarkable exam otherwise. |
Generate impression based on findings. | Female 11 years old Reason: evaluate for fracture History: pain, swelling, visible deformityVIEWS: Right ankle AP, lateral and oblique on 2/16/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Female 3 years old Reason: r/o PNA History: prolonged fever, coughVIEWS: Chest AP/lateral (two views) 2/16/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Peribronchial thickening retrocardiac opacity either atelectasis or pneumonia . No effusions or pneumothorax. | Peribronchial thickening and retrocardiac opacity as described. Findings were communicated to acknowledged by Dr. PAIK, SANGHYUN MARGARET on 2/17/15 at 749 hours. |
Generate impression based on findings. | Ms. Hubbard submitted outside mammogram dated 09/13/2012, from Mercy Hospital. Submitted outside study was compared to the current mammogram dated 12/24/2014. The breast parenchyma is mostly fatty replaced, unchanged in appearance. There has been interval development of a circumscribed fat-containing mass in the upper outer quadrant of the right breast, which most likely represents an area of fat necrosis. No suspicious microcalcifications or areas of architectural distortion are present. | Interval development of a circumscribed fat-containing mass in the right upper outer breast, most likely representing an area of fat necrosis. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EA - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Ms. Jefferson submitted outside mammograms dated 03/06/2012 and 03/11/2011, from Mercy Hospital. Submitted outside studies were compared to the current mammogram dated 12/24/2014. The breast parenchyma is mostly fatty replaced. Scattered coarse benign calcifications are seen in both breasts. 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, due next in Dec 2015.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 59 years, Male. Reason: NGT placement History: NGT placement Patchy opacities in the left base.Nasogastric tube with tip projected over the mid gastric body. Interval removal of left-sided chest tube. The pelvis is not included on this radiograph. | Nasogastric tube with tip projected over the gastric body. |
Generate impression based on findings. | Ms. Jefferson submitted outside mammograms dated 03/06/2012 and 03/11/2011, from Mercy Hospital. Submitted outside studies were compared to the current mammogram dated 12/24/2014. The breast parenchyma is mostly fatty replaced. Scattered coarse benign calcifications are seen in both breasts. 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, due next in Dec 2015.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Reason: dissection History: new vision loss 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 60% stenosis at the proximal right internal carotid artery associated with irregular hypodense plaque and 45% stenosis at the origin of the left internal carotid artery associated with hypodense plaque.. Approximately 14 mm from its origin the left subclavian and agree is narrowed by 50%.There is no significant stenosis along the course of the vertebral arteries.Are multilevel degenerative changes present in the cervical spine worse at C5-6 and C6-7 where there endplate and uncovertebral osteophytes narrowing the spinal canal and neural foramina. This appears to be worse at C6-7Brain 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.Atherosclerotic calcifications are present along the distal internal carotid arteries.There is a 75% stenosis present along the clinoidal segment of the right internal carotid artery.The anterior communicating artery is small to medium size. The posterior communicating arteries are barely perceptible.The left common carotid artery originates from the innominate arteryCT head: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.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 demonstrate mucus retention cyst in the left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.There is 75% stenosis of the right ICA at the clinoidal segment. Please note that the posterior communicating arteries are very tiny in the anterior communicating artery is small to medium size.2.On the basis of NASCET criteria there is 60% stenosis at the proximal right internal carotid artery associated with irregular narrowing and hypodense plaque. 3.45% stenosis at the origin of the left internal carotid artery associated with hypodense plaque.4.50% stenosis of the proximal left subclavian artery.5.Degenerative changes are present in the cervical spine. |
Generate impression based on findings. | Male 64 years old Reason: L testicular Swelling History: above PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedPENIS, TESTICLES: Complex fluid collection in the region of the expected location of left testicle measuring 9.0 x 6.3 cm (series 2, image 124), corresponding to lesion seen on ultrasound from the same day. There is surrounded wall thickening and edema with inflammation from the scrotum extending into the perineum. The left testicle is not clearly visualized. URETERS: Right hydroureter with incompletely imaged right ureteral stent. Left hydroureter is present without left ureteral stent.BLADDER: Thickened bladder wall which is unchanged from prior examination and may represent cystitis. Foley catheter in place with inflated balloon within the prostatic urethra.LYMPH NODES: No inguinal lymphadenopathy.BOWEL, MESENTERY: Thickened rectal wall with foci of gas within the anterior rectal wall (series 2, image 65). This foci of gas could represent either extension of the scrotal infection into the rectal wall or perforation of the rectum. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Large left scrotal collection which is suspicious for an abscess.2.Rectal wall thickening with foci of gas within the wall which could represent extension of the scrotal infection (Fournier's gangrene) or perforation of the rectum. 3.Foley catheter with inflated balloon and tip within the prostatic urethra. Repositioning is recommended. |
Generate impression based on findings. | 42 year-old female status post cholecystectomy and colon resection complicated by GI bleed at anastomosis, colonoscopy showed loose sutures at anastomotic site, evaluate for anastomotic leak or fluid collection. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy with expected small amount of pneumobilia. 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: Postsurgical changes of partial colectomy with anastomotic suture line near hepatic flexure. There is bowel wall thickening about the anastomotic site with adjacent mesenteric fat stranding indicating ongoing inflammation. The stranding extends to a small area of anterior perihepatic fluid (series 3, image 60) with an attenuation of 23 HU indicating complex fluid, but no drainable fluid collections are present. Multiple adjacent lymph nodes are noted in the right upper quadrant compatible with an ongoing inflammatory process. No evidence of bowel obstruction or free air. BONES, SOFT TISSUES: Postsurgical changes in the anterior abdominal wall including midline incision with a small amount of residual fluid and fat stranding without large drainable fluid collections.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical changes of partial colectomy with anastomotic suture line near hepatic flexure. There is bowel wall thickening about the anastomotic site with adjacent mesenteric fat stranding indicating ongoing inflammation. The stranding extends to a small area of anterior perihepatic fluid (series 3, image 60) with an attenuation of 23 HU indicating complex fluid, but no drainable fluid collections are present. Multiple adjacent lymph nodes are noted in the right upper quadrant compatible with an ongoing inflammatory process. No evidence of bowel obstruction or free air. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Trace amount of free fluid in the pelvis. | 1.Postsurgical changes from recent cholecystectomy and partial colectomy.2.Extensive inflammatory changes at right upper quadrant colonic anastomosis without large drainable peritoneal fluid collections or free intraperitoneal air. |
Generate impression based on findings. | Male 10 years old Reason: hx of distal radius fx, eval healing VIEWS: Right wrist AP, lateral and oblique 2/16/15 (3 views) There is no evidence of fracture, malalignment or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Ms. Black submitted outside mammograms dated 12/17/2013 and 06/16/2009, from Mercy/Provident Hospital. Submitted outside studies were compared to the current mammogram dated 12/18/2014. The breast parenchyma is composed of scattered fibroglandular density. A benign-morphology partially obscured mass in the right upper quadrant is stable when compared to 2013. Additional focal asymmetries seen in 2009 have resolved, compatible with involuting cysts. Benign arterial calcifications are present. No suspicious microcalcifications or areas of architectural distortion are present. There is no significant change between the last two studies. | Stable benign morphology mass in the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 59-year-old male with scrotal swelling, evaluate for Fournier's gangrene. ABDOMEN:LUNG BASES: Bilateral small pleural effusions. Basilar subsegmental consolidation which may be due to aspiration. Severe emphysema. Calcified pulmonary micronodules and hilar lymph nodes likely from prior granulomatous disease. LIVER, BILIARY TRACT: The liver demonstrates a nodular surface contour, hypertrophy of the left lateral segment and caudate lobe as well as fissural widening, compatible with cirrhotic morphology. The portal vein appears grossly patent. Cholelithiasis.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: There is circumferential wall thickening involving much of the colon especially the proximal colon. No evidence of bowel obstruction. BONES, SOFT TISSUES: Diffuse anasarca. OTHER: Small amount of abdominopelvic ascites. Foci of gas within the right lower abdominal wall may be related to recent injection.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: There is circumferential wall thickening involving much of the colon especially the proximal colon. No evidence of bowel obstruction. BONES, SOFT TISSUES: Diffuse anasarca. OTHER: Small amount of abdominopelvic ascites. There is extensive skin thickening and fluid within the scrotum without foci of gas to indicate gangrene. | 1.Cirrhotic liver morphology.2.Small pleural effusion, ascites, and anasarca which may be related to cirrhosis.3.Diffuse colonic wall thickening which may be related to hypoalbuminemia or colitis from infectious, inflammatory, or less likely ischemic etiology.4.Marked scrotal swelling which may be related to hypoalbuminemia. Though no associated foci of gas to indicate gangrene, infection is not excluded. 5.Severe emphysema. Basilar pulmonary opacities which may be related to aspiration.6.Cholelithiasis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Maternal cousin with breast cancer. 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. | Ms. Black submitted outside mammograms dated 12/17/2013 and 06/16/2009, from Mercy Hospital. Submitted outside studies were compared to the current mammogram dated 12/18/2014. The breast parenchyma is composed of scattered fibroglandular density. A benign-morphology partially obscured mass in the right upper quadrant is stable when compared to 2013. Additional focal asymmetries seen in 2009 have resolved, compatible with involuting cysts. Benign arterial calcifications are present. No suspicious microcalcifications or areas of architectural distortion are present. There is no significant change between these two studies. | Stable benign morphology mass in the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 12 years old Reason: eval for interval change History: increased WOBVIEW: Chest AP (one view) 2/17/15 at 219 hours. Thoracolumbar kyphoscoliosis and cholecystectomy cleats as well as gastrostomy tube unchanged. Cardiac silhouette size is normal. Streaky opacities of the left upper and lower lobe are again noted. No effusions or pneumothorax. | Persistent streaky multifocal opacities as described. |
Generate impression based on findings. | 72-year-old male with hemoglobin drop, evaluate for hematoma. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: Partially visualized ICD device. Severe coronary artery calcifications. Multiple solid pulmonary nodules in the bilateral lung bases are suspicious for malignancy. The largest is in the left lower lobe (series 4, image 16) measuring 1.5 x 1.4 cm.LIVER, BILIARY TRACT: Hepatomegaly. Nodular hepatic contour may represent cirrhosis or pseudocirrhotic appearance from diffuse neoplastic process. Multiple incompletely characterized lesions are present in the liver, for example high attenuation lesion in segment 6 (series 3, image 70). There is suggestion of high attenuation within the left lateral segment of the portal vein which may represent thrombosis. Small amount of perihepatic ascites is present which measures attenuation of simple fluid.Cholelithiasis without specific evidence of cholecystitis. No biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Non-specific subcentimeter nodular thickening of the right adrenal gland (series 3, image 35).KIDNEYS, URETERS: Atrophic kidneys.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications of the abdominal aorta and its branches. BOWEL, MESENTERY: Normal caliber small bowel without evidence of obstruction. Appendix well visualized and unremarkable. Wall thickening in a portion of the sigmoid colon (series 3, image 113) may represent a primary adenocarcinoma. Adjacent mildly prominent lymph nodes are present.BONES, SOFT TISSUES: Small fat and fluid containing umbilical hernia. Moderate-severe degenerative changes of the visualized thoracolumbar spine. No focal suspicious lesions identified. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber small bowel without evidence of obstruction. Appendix well visualized and unremarkable. Wall thickening in a portion of the sigmoid colon (series 3, image 113) may represent a primary adenocarcinoma. Adjacent mildly prominent lymph nodes are present.BONES, SOFT TISSUES: Moderate-severe degenerative changes of the visualized thoracolumbar spine. No focal suspicious lesions identified. OTHER: No significant abnormality noted | 1.Widespread metastatic disease to the lung and liver likely from a sigmoid colon adenocarcinoma. Recommend endoscopy for further evaluation.2.No evidence of hemorrhage or loculated fluid collections in the abdomen or pelvis.3.Cholelithiasis.4.Severe coronary artery calcifications.Findings discussed with P.A. Anderson at 09:23 a.m. on 2/17/2015. |
Generate impression based on findings. | 15-year-old female with T8 - T10 pain. Evaluate for fracture and spondylolisthesis.VIEWS: Swimmers, L5/S1 Lateral, Thoracic and lumbar spine AP, lateral (6 views) 2/16/2015 No evidence of fracture or dislocation. Alignment is normal. | Normal examination. |
Generate impression based on findings. | Clinical question: Evaluate for cause of right leg weakness. Signs and symptoms: Right leg weakness for 3 days. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There are very subtle periventricular and subcortical low attenuation white matter which considering patient's stated age likely representing age indeterminate small vessel ischemic strokes. The findings were present on prior MRI exam from 2014 although precise comparison is accurate.Ventricular system are slightly prominent however stable since prior exam from 2014 and midline is maintained.Cortical sulci and CSF spaces are unremarkable.Similar to prior MRI exam there is a well-demarcated round focus of high density in the anterior -- superior aspect of the third ventricle measuring at 4 times 6-mm size and consistent with a small colloid cyst of the third ventricle.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells. | 1.No acute intracranial process.2.Findings suggestive of mild age indeterminate small vessel ischemic strokes.3.Stable colloid cyst of the third ventricle measuring at 4 x 6-mm in size and stable mildly prominent supratentorial ventricular system since prior MRI exam from 2014. |
Generate impression based on findings. | Ms. Trujillo is a 54 year old female presents for short-term follow-up of a benign mass in the left breast. She has no current breast related complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Multiple partially obscured masses are identified in both breasts, all of which are stable in size and appearance when compared to the prior exam. These have previously been characterized as cysts on the prior ultrasound exam. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Bilateral benign masses, previously characterized as cysts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements. Low lying right axillary lymph node is present. 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 9-year-old female with increased oxygen requirement, rule out pneumoniaVIEW: Chest AP (one view) 2/17/15 7:03 Marked interval increase in opacity involving the right hemithorax with sparing of the apex. Retrocardiac atelectasis is also noted. The cardiothymic silhouette is partially obscured. | Marked increase in right pulmonary opacity sparing the apex compatible with acute chest. |
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, version 9.3. The breast parenchyma is heterogeneously dense, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 16-year-old female with back pain. Evaluate for bony problem.VIEWS: Swimmers, thoracic and Lumbar spine AP and lateral, L5/S1 lateral (6 views) 2/16/2015 No evidence of fracture or dislocation. Alignment is normal. | Normal examination. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 33 year old male with history of DLBCL. Pre-allo SCT transplant. LUNGS AND PLEURA: Significant left hemidiaphragm elevation. Lingula and left lower lobe subsegmental atelectasis with associated patent air bronchograms. No suspicious nodules or masses. No evidence of active infection.Calcified and noncalcified micronodules, most likely post-inflammatory. No pleural effusion.MEDIASTINUM AND HILA: Left superior mediastinal conglomerate mass extending into the apex is consistent with known lymphoma. For reference, it measures 7.1 x 4.6 cm (series 3, image 16).Normal heart size. Very small pericardial effusion. No visible coronary artery calcification.Lower left neck ill-defined soft tissue (series 3, image 2), which is incompletely imaged, likely represents additional lymphadenopathy. CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of active infection. Left superior mediastinal conglomerate mass extending into the apex and left lower neck lymphadenopathy consistent with known lymphoma. |
Generate impression based on findings. | 2-year-old male with history desaturationsVIEW: Chest AP (one view) 2/17/15 5:23 Interval removal of right IJ catheter. Left central catheter tip in the SVC. NG tube tip and side-port in the stomach. ETT tip below the thoracic inlet. The cardiothymic silhouette is normal. Improved right upper lobe atelectasis and persistent left lower lobe subsegmental atelectasis. No pneumothorax. | Left central venous catheter tip in the SVC. No pneumothorax. |
Generate impression based on findings. | Male 64 years old; Reason: Testicular Swelling History: Above RIGHT TESTIS: 3.4 x 2.7 x 3.1 cm, normal echotexture. Adjacent 2 cm complex fluid collection distorts the right testicle. There is diffuse scrotal wall thickening and edema with hyperemiaLEFT TESTIS: No normal left testicle is identified. Within the region of the left testicle is a complex appearing mass/fluid collection. There also appears to be complex fluid throughout the scrotal sac. There is diffuse scrotal wall thickening and edema with hyperemia.RIGHT EPIDIDYMIS: 0.9 x 1.5 x 1.3 cm with normal echotexture.LEFT EPIDIDYMIS: No normal left epididymis is identified.OTHER: No significant abnormalities noted. | 1.The left testicle is replaced by a large, complex fluid collection. An aggressive infectious/inflammatory process is favored. These findings could also be secondary to infection of a neoplastic process, however this is felt to be less likely. Please refer to the report for the subsequent CT of the pelvis for additional details; early Fournier's cannot be excluded.2.Bilateral scrotal wall thickening and edema with hyperemia. |
Generate impression based on findings. | Female 1 day old Reason: is there atelectasis History: previous film with atelectasis, respiratory distress of the newborn.VIEW: Chest AP (one view) 2/16/15 1848 hrs. Cardiac silhouette size is normal. In the fine right middle lobe opacity, likely atelectasis on a background of diffuse lung haziness due to surfactant deficiency. Interval improvement in left lung aeration. | Interval improvement in left lung aeration with persistent right middle lobe atelectasis on a background of diffuse lung haziness. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Multiple circumscribed mass in both breast, including biopsy proven fibroadenoma with clip in lower inner left breast, are unchanged.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, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 15-year-old male post reductionVIEWS: Hand PA and lateral, Wrist AP and lateral (4 views) 2/17/2015 Interval reduction of distal fifth metacarpal metaphyseal fracture with improvement in degree of lateral and palmar angulation now in near anatomic alignment. Cast material overlying fifth digit and medial aspect of the forearm. No evidence of fracture or dislocation in the remaining digits and wrist. | Post reduction of distal fifth metacarpal metaphyseal fracture with improvement in degree of lateral and palmar angulation. |
Generate impression based on findings. | Male 6 days old Reason: lines \T\ tubes; lung expansion History: 25 weeks premature.VIEW: Chest and abdomen AP (two views) 2/17/15 at 603 hours. ET tube terminates below thoracic inlet. Proximal side port of the NG tube is above the GE junction. UAC tip is at T7. UVC terminates in an uncertain position, either in the proximal umbilical vein or the peritoneum.Cardiac silhouette size is normal. Increasing in diffuse granular lung haziness, no effusions or pneumothorax.Complete paucity of abdominal gas. | Misplaced NG tube and UVC as described.Bilateral diffuse lung haziness, likely due to surfactant deficiency.Complete paucity of abdominal gas. |
Generate impression based on findings. | Pain after fall. Pain over the anterior knee. No fracture or malalignment. No joint effusion is evident. No significant abnormality otherwise noted. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Reason: Traumatic removal of Hickman catheter, now with new onset tachycardia, concern for PE History: Tachycardia PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Scattered pulmonary micronodules are stable from the prior exam and decreased from the previous exam dated 09/2014, likely postinflammatory in etiology. No new suspicious pulmonary nodules or masses.No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: Heart is normal in size, without significant pericardial effusion.No mediastinal or hilar lymphadenopathy.Left vertebral artery arises from the aortic arch, normal variant.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Subcentimeter hypoattenuating lesions in the liver and right kidney, likely benign cysts. | No evidence of pulmonary embolism or other acute cardiopulmonary abnormality.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Stable benign mass is present within the right 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, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Pain after bricks fell on forearm. No fracture or malalignment. No significant abnormality otherwise noted. | No fracture or malalignment. |
Generate impression based on findings. | 66 years, Male, Reason: Pt w/ borderline resectable pancreatic cancer on a non infused CT scan - also s/p IR PCT 2/10 for acute cholecystitis - please evaluate for resectability (pancreatic protocol CT scan) History: Pancreatic cancer. ABDOMEN:LUNG BASES: Small right pleural effusion with associated atelectasis is new from the prior exam. Mild cardiomegaly. Enlarged subcarinal node measuring 2.1 x 1.6 cm (10/1).LIVER, BILIARY TRACT: There is cholelithiasis with gallbladder wall thickening and adjacent inflammatory changes, likely representing acute cholecystitis. There has been interval placement of cholecystostomy tube and common bile duct stent with pneumobilia. Enhancement adjacent to the gallbladder fossa is likely related to adjacent inflammationNo suspicious hepatic lesions.SPLEEN: No significant abnormality notedPANCREAS: Primary tumor: 2.0 x 2.7 x 2.1 cm mass in the the head of the pancreas (10/54 and 80796/66).Pancreatic duct: 4 mm.Mesenteric Arteries:Arterial anatomy: Right hepatic artery replaced to SMAArterial tumor abutment or encasement: (1) Proximal celiac artery, SMA, and hepatic artery: Tumor abutment (less than or equal to 180 degrees) of the right hepatic artery (10/49). Proximal celiac and SMA are uninvolved.(2) Tumor abutment or encasement of additional arteries: i.e. IPDA, GDA, jejunal, middle colic, or ileocolic branches): Encasement of the GDA.Mesenteric Veins:Venous anatomy: (1) Superior mesenteric vein (SMV) first jejunal branch: posterior to SMA. SMV terminates as the vein. (2) Inferior mesenteric vein (IMV) drains into the central splenic vein at the SMV.Venous tumor abutment or encasement: SMV-PV-splenic vein confluence: Tumor abutment (less than or equal to 180 degrees)First jejunal vein branch: Not involvedSMV, PV, or segmental SMV-PV occlusion: No occlusion. Other: NonePortal venous system: PatentInferior vena cava (IVC): PatentADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Enlarged periportal node measured 1.5 x 1.0 cm (10/44).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of ascites.PELVIS: MalePROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Pancreatic head mass with abutment of the hepatic and portal veins and encasement of the GDA.2.Mildly enlarged retroperitoneal and subcarinal nodes.3.Findings of acute cholecystitis with interval placement of cholecystostomy tube. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in maternal aunt. 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. | Swelling and pain. Mild soft tissue swelling about the ankle. No fracture or malalignment. No knee joint or ankle joint effusion evident. | Mild ankle soft tissue swelling, without fracture or malalignment. |
Generate impression based on findings. | Male 72 years old Reason: fracture History: R ankle, foot, knee pan s/p fall. We have 3 views of the right foot. The bones appear demineralized, suggestive of osteopenia. There is diffuse soft tissue swelling. There is an oblique fracture of the distal diaphysis of the third metatarsal, best seen on the oblique view, with the fracture fragments in near anatomic alignment. There is also an oblique fracture of the distal diaphysis of the fourth metatarsal with minimal lateral displacement of the distal fracture fragment. Mild degenerative arthritic changes affect the foot.Three views of the right ankle show diffuse soft tissue swelling. Mild degenerative arthritic changes affect the midfoot and hindfoot, but we see no acute fracture.Three views of the right knee show diffuse soft tissue swelling. We see no acute fracture or malalignment. | Fractures of the third and fourth metatarsals, and other findings as described above. |
Generate impression based on findings. | 7-week-old female, reevaluate lung fields status post cardiac surgeryVIEW: Chest AP (one view) 2/17/15 5:12 Interval removal of NG tube. Surgical clips again noted in the superior mediastinum. The cardiothymic silhouette is unchanged with persistent cardiomegaly.Streaky lingular and retrocardiac subsegmental atelectasis, mildly increase from the prior exam. No pneumothorax. | Lingular and retrocardiac subsegmental atelectasis. No pneumothorax. |
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, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. Stable asymmetry in the right lateral breast is present. 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, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Ms. Rykal is a 75 year old female with a personal history of left breast lumpectomy in 2005 for IDC followed by chemotherapy and radiation. She is currently on tamoxifen. Family history of breast cancer in mother (diagnosed at the age of 65) and sister (diagnosed at the age of 63). She has no current breast related complaints. Three standard views of both breasts and an additional laterally exaggerated left CC view 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. A linear marker was placed on the scar overlying the left breast. There are stable postsurgical changes including architectural distortion, increased density, and skin retraction present within the left lumpectomy site. Scattered benign calcifications are present bilaterally. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Stable postsurgical changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Reason: status hemorrhage before starting heparin History: status hemorrhage before starting heparin There is a redemonstration of a hematoma centered in the left thalamus associated with intraventricular blood. Since the prior exam the density of the intraparenchymal hematoma has decreased as has the density of the intraventricular blood. Overall there is less blood in the lateral ventricles on the current exam versus the prior.The temporal horns of the lateral ventricles are dilated but not substantially changed since the prior.There are periventricular white matter hypodensities present.A right-sided subdural effusion which is up to 8 mm in thickness is stable since the prior exam.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. | 1.There is a right-sided subdural effusion which is stable since the prior exam .2.Continued evolution of a left thalamic and brainstem hematoma associated with intraventricular blood. |
Generate impression based on findings. | Female 78 years old Reason: post-reduction film History: post-reduction. Three views of the left wrist were obtained post reduction and time stamped 0553 through 0555. Evaluation of fine detail is limited by the overlying cast material. A curvilinear lucency traversing the radial styloid may represent overlying artifact or a nondisplaced fracture, and was not evident on the prior study. A similar curvilinear lucency is seen traversing the ulnar styloid; we suspect that this is artifactual. The distal radioulnar joint alignment is within normal limits. | Equivocal radial styloid fracture. If further imaging evaluation is clinically warranted, CT may be considered. |
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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. There is a new focal asymmetry at lower inner left breast.No suspicious microcalcifications or areas of architectural distortion are present. | New focal asymmetry at lower inner left breast, for which spot compression views and possible ultrasound study is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 16 day old male with history of pleural effusionsVIEW: Chest AP (one view) 2/17/15 6:06 ETT tip below thoracic inlet. Right PIC catheter extends into the right innominate vein. NG tube tip in the stomach.Large bilateral pleural effusions and associated atelectasis as well as patchy left pulmonary opacities appear similar to the prior exam. The cardiothymic silhouette is obscured. No pneumothorax. | Large bilateral pleural effusions and pulmonary opacities without significant interval change. No pneumothorax. |
Generate impression based on findings. | Right upper extremity swelling. Evaluate for compartment syndrome. There is diffuse subcutaneous soft tissue edema throughout the right upper extremity from the shoulder to fingertips. No soft tissue mass or loculated fluid collection is seen. No soft tissue gas is evident.Emphysematous changes are visualized in the partially imaged right lung apex. No underlying osseous abnormality is evident. | Diffuse soft tissue edema, without soft tissue mass or abscess. Please note that compartment syndrome cannot be excluded by CT. |
Generate impression based on findings. | Female 78 years old Reason: eval for fx, dislocation; FOOSH History: distal ulnar and radial TTP. We have 3 views of the left wrist. We see no fracture. There is mild soft tissue swelling along the radial aspect of the left wrist. Mild osteoarthritis affects the basilar joint. Although the distal ulna appears slightly dorsally displaced on the lateral view, this may simply be an artifact of suboptimal positioning. | No definite fracture. Apparent slight dorsal displacement of the ulna may simply be due to suboptimal positioning rather than subluxation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and cleavage view of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. There is a 1 cm mass in the left upper outer breast at approximately 17 cm depth. No microcalcifications or areas of architectural distortion are present. | Mass in the left upper outer breast for which spot compression views and possible ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Reason: recurrent epidural hematoma? 30F thrombocytopenic with LVAD, relapsed AML s/p 2 stem cell transplants. c/o L leg sciatica similar to 8/2014 when she had epidural hematoma that got smaller off coumadin. Now platelets are only 4K. History: worsening L leg sciatica over past few days similar to pain from epidural hematoma Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. At L5-S1 there is no significant compromise to spinal canal or neural foramina.At L4-5 there is no significant compromise to spinal canal or neural foramina.At L3-4 there is no significant compromise to spinal canal or neural foramina. Since the prior exam and epidural the lesion has regressed and is no longer perceptible on the current examAt L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina. There is redemonstration of a hyperdense lesion similar in CSF in density probably representing perineural cyst in the right neural foramen at this level. | 1.There is no evidence for epidural hematoma current exam. Since the prior exam previously noted epidural hematoma at L3-4 has regressed. |
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