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Generate impression based on findings. | Male, 12 years old, with Dandy-Walker malformation, VP shunt with revisions. Now with headache. The right parietal approach ventricular shunt catheter is in stable position with its tip situated approximately at the level of the left frontal horn. The visualized portions of the catheter system are intact. The size and ... | No change in the appearance of the shunted ventricular system and no evidence of any acute intracranial abnormality. |
Generate impression based on findings. | Pain at medial aspect of wrist. No fracture or malalignment. Mild degenerative changes are present at the basilar joint. No significant abnormality otherwise noted. | No specific findings to account for the patient's pain. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are scattered punctate areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with stable minimal chronic... | 1. No acute intracranial hemorrhage. 2. Chronic lacunar infarcts in the right caudate head and right basal ganglia. Stable minimal chronic small vessel ischemic changes. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. |
Generate impression based on findings. | 23-year-old female with abdominal pain. Evaluate for obstruction.VIEW: Abdomen AP (one view) 2/17/2015 10:31 Six coils are again seen in the right lower quadrant.Nonobstructive bowel gas pattern. Visualized lung bases are normal. | No evidence of obstruction. |
Generate impression based on findings. | Ms. Durtineeviciute is a 41 year old female with a strong family history of breast cancer in maternal cousin, ovarian cancer in mother and cervical cancer in maternal grandmother. Positive for BRCA 1. Three standard views of both breasts with two left spot compression views were performed digitally and reviewed with th... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Patients with BRCA positive gene mutations should also strongly consider annual MRI as an additional surveillance tool. Results and recommendation were discussed w... |
Generate impression based on findings. | Left arm/leg paresthesias and subtle left sided pronator drift. There is no appreciable change in the 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 siph... | No appreciable change in the small vessel ischemic disease and chronic left occipital lobe 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 and MRI is recommended for further evaluation. |
Generate impression based on findings. | right CCA stenosis slightly worse on USG comparing to 6 months ago. NONCONTRAST CT HEADNo evidence of acute ischemic or hemorrhagic lesion on this scan.Calcified and small eye globe on the left.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is ... | 1. About 44% luminal narrowing based on NASCET method with wall calcifications on the right extracranial ICA just above the bifurcation.2. About 4mm sized wide neck right A1-A2 junctional aneurysm.3. Atherosclerotic changes of intracranial and extracranial arterial system as described above.4. No evidence of acute isch... |
Generate impression based on findings. | Evaluation is limited by lack of intravenous contrast and by motion artifact.PHARYNX/LARYNX: The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass.GLANDS: The submandibular, sublingual, and parotid glands have an u... | 1. Evaluation is limited by lack of intravenous contrast and by motion artifact. Within these limitations, there is no significant abnormality of the neck soft tissues.2. Multiple dental caries and absent teeth. |
Generate impression based on findings. | 64 years, Male, Reason: pelvic GIST on gleevac - restaging History: re-staging. does ok w/ MRI contrast. PELVIS: MalePROSTATE, SEMINAL VESICLES: Posterior margin of the prostate is indistinguishable by adjacent tumor, unchangedBLADDER: No significant abnormality noted.LYMPH NODES: Small bilateral inguinal lymph nodes a... | Pelvic gastrointestinal stromal tumor is stable. No evidence of metastasis. |
Generate impression based on findings. | 56 year-old female. Shortness of breath, new oxygen requirement. History of lung cancer and laryngeal cancer. LUNGS AND PLEURA: Interval resolution of small right pleural effusion.Dense right paramediastinal consolidation with new small nodular opacities in the right upper lobe, consistent with post-radiation change an... | Bibasilar patchy opacities with associated bronchial wall thickening consistent with aspiration and/or infection. Dense right paramediastinal consolidation with new small nodular opacities in the right upper lobe, consistent with post-radiation change and obscuring the right lower lobe mass. |
Generate impression based on findings. | Clinical question: Evaluate for hemorrhage. Signs and symptoms: Status post ablation of hippocampus. Nonenhanced head CT:Cerebellar tonsillar herniation through the foramen magnum with resultant complete effacement of subarachnoid space remains similar to prior exams and consistent with Chiari malformation.Focus of low... | 1.A band of edema extending along the medial aspect of the right anterior, mid and posterior temporal lobe without hemorrhage or appreciable mass effect.2.Herniation of cerebellar tonsils through the foramen magnum and unremarkable exam otherwise.3.Right anterior temporal and right posterior parietal bur holes are note... |
Generate impression based on findings. | Hyperthyroidism, please evaluate for autonomous nodule versus thyroiditis. There is a dominant large warm to hyperfunctioning nodule within the right lower pole/isthmus without significant suppression of uptake throughout the remaining thyroid gland. There are multiple small to medium sized iso to warm and hypofunction... | 1. Multinodular thyroid with a predominant warm to hyperfunctioning right lower pole/isthmus nodule with overall normal thyroid uptake.2. Medium-sized left lower pole hypofunctioning nodule is indeterminate; correlate with ultrasound/biopsy as clinically indicated. |
Generate impression based on findings. | Follow-up fifth metatarsal stress fracture. Again seen is a fracture of the proximal diaphysis of the fifth metatarsal. The fracture fragments are in anatomic alignment. Callus formation along the fracture compatible with healing it is slightly progressed. | Healing fifth metatarsal stress fracture. |
Generate impression based on findings. | Female 67 years old Reason: hx Post cervical fusion, eval hardware placement, bony fusion and stability History: surveillance imaging. Again seen is an anterior plate with screws entering the C3 and C7 vertebrae, appearing similar to the prior study. There is fusion of the C3 through C6 vertebral bodies, appearing simi... | Postoperative changes of spinal fusion appearing similar to the prior study without frank instability. |
Generate impression based on findings. | Female 21 years old Reason: is there . a fracture of fibula? History: pain after injury We have 3 views of the right ankle which show mild soft tissue swelling of the right lateral ankle, as well as a small tibiotalar joint effusion. There is a subcentimeter ossicle distal to the fibular tip which appears corticated an... | Ossicle distal to the fibular tip, which we suspect is chronic in etiology. There is soft tissue swelling and a small tibiotalar effusion, but we see no acute fracture. |
Generate impression based on findings. | 69-year-old female with history of thoracic and abdominal aortic aneurysms. CT ANGIOGRAM: Postoperative changes are seen about the ascending aorta which maintains a stable diameter of approximately 3.5 cm (series 7, image 269). There are postoperative changes of the aortic arch which appear similar to the prior exam wi... | 1.Stable appearance of repaired aortic arch, distal aortic fusiform aneurysm, and proximal abdominal aortic aneurysm.2.Stable appearance of abdominal aortic aneurysm with aortobiiliac endovascular graft without evidence of endovascular leak.3.Stable bilateral saccular aneurysms at the origins bilateral renal arteries.4... |
Generate impression based on findings. | Limited upper GI examination was performed to evaluate for leak. Single contrast evaluation of the stomach was performed. The gastric body was decompressed and remained nondistended throughout the study. The examination was limited by patient's limited mobility which precluded the acquisition of lateral images. Within... | Limited study due to patient immobility. Within this limitation no evidence of gastric leak. |
Generate impression based on findings. | 14-year-old male with fracture.VIEWS: Right ankle AP, oblique, lateral (3 views) 2/17/2015 10:56 Stable positioning of distal tibial epiphyseal screws with no evidence of hardware complications. Healing triplane tibial fracture in anatomic alignment. | Healing fracture in anatomic alignment, with no evidence of hardware complications. |
Generate impression based on findings. | 59-year-old male. Five years out from RUL cancer. Pre-op CT. CHEST:LUNGS AND PLEURA: Stable postsurgical changes of right upper lobe wedge resection. Again seen is a 16 x 16 mm right upper lobe nodule adjacent to the suture line (series 4, image 44), unchanged and highly suspicious for recurrent tumor.Previously seen s... | Unchanged right upper lobe nodule adjacent to surgical suture highly suspicious for recurrent tumor. Prominent mediastinal lymph nodes, increased in size from prior, nonspecific. |
Generate impression based on findings. | 28 years, Male. Reason: kidney stone History: stone Lung bases are clear. Average stool burden. Nonobstructive bowel gas pattern. Radiodense opacity overlies the left kidney. | Radiodense opacity overlies the left kidney. |
Generate impression based on findings. | Bilateral knee pain Severe osteoarthritis affects the knees bilaterally, left greater than right, with tricompartmental joint space narrowing and osteophytes. There is bone on bone apposition at the medial compartments of the knees bilaterally. No joint effusion is evident in either knee. | Severe osteoarthritis, as above. |
Generate impression based on findings. | 69 year-old female with metastatic ovarian cancer CHEST:LUNGS AND PLEURA: Scattered and nonspecific micronodules in both lungs unchanged since 12/1/14. Largest nodule measures 5 mm (series 5, image 56).MEDIASTINUM AND HILA: No adenopathy. Cardiac wires unchanged and no pericardial effusion.CHEST WALL: Degenerative chan... | 1. Nonspecific pulmonary micronodules unchanged since/1/14 examination. 2. Moderately Extensive para-aortic and pelvic iliac adenopathy with slight increase in size since 12/1/14. 3. Probable posterior hepatic capsule surface soft tissue metastastic seeding. 4. Large right pelvic anterior wall hernia containing small b... |
Generate impression based on findings. | There is redemonstration of a masslike area of hyperdensity within the premedullary cistern, consistent with subarachnoid blood products. A minimal amount is noted dorsal to the caudal medulla, unchanged. There is associated mass-effect upon the caudal aspect of the medulla. There is a stable right frontal approach ve... | 1. Stable appearance of subarachnoid hemorrhage predominantly collecting in the premedullary cistern and minimally along the dorsal aspect of the medulla with mild mass-effect.2 Stable ventriculostomy catheter with unchanged ventriculomegaly.3. Stable scattered areas of encephalomalacia. |
Generate impression based on findings. | Male 58 years old Reason: restaging scans s/p 3 weeks of investigational immunotherapy; please assess extent of metastatic disease compared to previous scans History: hx of metastatic bladder cancer CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. No suspicious nodules or masses.MEDIASTINUM AND HILA:... | 1.Interval resolution of supraclavicular and mediastinal lymphadenopathy with decrease in size of the retroperitoneal lymphadenopathy.2.No new metastatic disease. |
Generate impression based on findings. | 70 year-old female history of soft palate clear-cell carcinoma status post resection. Extensive streak artifact from dental amalgam limits evaluation of the oral tongue and palate. There is no evidence of cervical lymphadenopathy by CT size criteria. The salivary glands are unremarkable. There is a new 4 mm hypoattenua... | 1. Limited study due to streak artifact limits evaluation of the palate.2. No evidence of cervical lymphadenopathy.3. New 4mm hypoattenuating lesion within the right thyroid lobe is nonspecific. If patient care warrants further imaging, a dedicated ultrasound may be obtained. |
Generate impression based on findings. | Female 35 years old Reason: instability? History: LBP. Small osteophytes project from the anterior aspect of the lumbar vertebrae. Vertebral body heights and intervertebral disk spaces appear normal. Alignment is within normal limits and we see no spondylolisthesis or instability between the flexion, neutral, and exten... | Minimal degenerative arthritic changes without evidence of instability. |
Generate impression based on findings. | PHARYNX/LARYNX: There are stable post-treatment changes in the left oropharyngeal region. The nasopharynx, oropharynx, hypopharynx, and larynx are otherwise unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The postcontrast appeara... | Stable post treatment changes without evidence of recurrent tumor or cervical lymphadenopathy. |
Generate impression based on findings. | Female 24 years old Reason: follow up History: follow up. Four views of the right foot again show two orthopedic screws affixing the first tarsometatarsal joint in near anatomic alignment. We see no hardware complications. The articulation remains visible at this time. There is also postoperative flattening of the medi... | Postoperative changes of a Lapidus procedure, appearing similar to the prior study. |
Generate impression based on findings. | Female 41 years old Reason: right hip pain History: pain. The bones appear demineralized. On the AP view, there is an irregular bandlike lucency traversing the medial cortex of the base of the femoral neck; this is highly suspicious for fracture, presumably a stress fracture. The possibility of a Looser zone is also co... | Incomplete fracture of the medial aspect of the femoral neck, perhaps a stress fracture. This can be further evaluated with MRI if clinically warranted.Dr. Wei Wei Lee was verbally notified of these findings at 1145 am on 2/17/2015. |
Generate impression based on findings. | Ms. Walsh is a 42 year old female with a personal history of benign left breast biopsy performed at an outside hospital in 2/2014 with pathology results demonstrating a fibroadenoma. She has no current breast related complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of ... | Benign morphology mass in the left superior breast, presumably representing the biopsied fibroadenoma. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.M... |
Generate impression based on findings. | 13-year-old female with toxic iron ingestionVIEW: Abdomen AP (one view) 2/17/15 10:34 No radiopaque foreign body. Nonobstructive bowel gas pattern. | Normal examination evidence of radiopaque foreign body. |
Generate impression based on findings. | Reason: evaluate follow-up for clear cell carcinoma of palate s/p resection History: follow-up imaging LUNGS AND PLEURA: Mild centrilobular emphysema.No evidence of pulmonary pleural metastases.Scattered focal scarring unchanged.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Moderate coronary artery calc... | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | 75-year-old male status post adjuvant chemotherapy for pancreatic cancer. Evaluate for disease progression. Compared to 11/11/14. CHEST:LUNGS AND PLEURA: Bilateral pleural effusions have not significantly changed with persistent loculations in the left pleural effusions. Compressive atelectasis again seen. No parenchym... | 1. Status post Whipple procedure/pancreatic resection with no significant change since most recent CT examination 11/11/14. 2. Soft tissue density adjacent to superior mesenteric artery is stable since July, 2014 and unlikely to represent metastatic disease, but since it is new since April, 2014, continued surveillance... |
Generate impression based on findings. | Again noted are small subdural collections along the bilateral cerebral hemispheres with low attenuation, but slightly above that of CSF, measuring up to 7 mm in thickness on the left and 4 mm on the right. There is no significant mass effect on the adjacent brain parenchyma. There are no definite areas of abnormal hy... | Small bilateral subdural collections with low attenuation, unchanged from CT head dated 2/15/2015. |
Generate impression based on findings. | 33 years, Female. Reason: post-op retained foreign object History: post-op An epidural catheter projects over the upper lumbar spine. Postsurgical pneumoperitoneum noted. Nonobstructive bowel gas pattern. No unexpected radiopaque foreign objects. | No unexpected radiopaque foreign objects.Findings discussed with Dr. Della Torre via telephone at 3:23 PM by Dr. McCann. |
Generate impression based on findings. | Urinary tract cancer. LUNGS AND PLEURA: No suspicious nodules and no pleural effusions.Filling defects in the right middle lobe and right lower lobe pulmonary arteries consistent with emboli, of uncertain chronicity but potentially acute. The findings were discussed with Dr. Steinberg at the time of reporting.MEDIASTIN... | 1. Small pulmonary emboli in the right middle lobe and right lower lobe arteries.2. No sign of metastatic disease in the thorax. |
Generate impression based on findings. | Neck pain. History of ACDF. There is fusion of the C3, C4, and C5 vertebral bodies. Severe degenerative disk disease affects C5/6 and C6/7. There are minimal retrolistheses of C5 and C6 which appear stable between the flexion, neutral, and extension views. There is loss of the normal cervical lordosis. There is a mild ... | Degenerative disk disease of the lower cervical spine and vertebral body fusion as described above. |
Generate impression based on findings. | 7-week-old female status post cardiac surgery stable on LFNC. Evaluate left lower lobe focality.VIEWS: Chest AP/lateral (two views) 2/17/2015 Surgical clips again noted in the superior mediastinum.Cardiothymic silhouette is unchanged with persistent cardiomegaly. Lingular opacity has resolved. Persistent streaky retroc... | Interval resolution of lingular opacity most consistent with atelectasis. Persistent left basilar atelectasis. Flattening of the hemidiaphragms suggestive of air trapping. |
Generate impression based on findings. | History of lumbar fusion. Evaluate stability of spine, hardware and bony fusion. Surveillance imaging. Evaluation of the lumbar spine is limited due to the patient's body habitus. The patient is status post multilevel laminectomy. Again seen are posterior rods with screws entering the L4 and L5 vertebrae. I see no hard... | Postoperative and degenerative changes of the spine appearing similar to those seen on the prior study. |
Generate impression based on findings. | 10-year-old male with neuroblastoma off therapy. Assess for progression of disease CHEST:LUNGS AND PLEURA: Bilateral subpleural pulmonary nodules as well as a left upper lobe subcentimeter nodule are unchanged. No new nodules are identified. No focal consolidations or pleural effusions.MEDIASTINUM AND HILA: No signific... | 1. No specific evidence of recurrent disease.2. Previously identified enhancing hepatic lesions are less conspicuous on today's exam and thought to be benign hemangiomas. |
Generate impression based on findings. | Male 52 years old; Reason: 52 y/o male with a history of urothelial cancer, status post adjuvant chemotherapy. please assess for disease progression: PLEASE NOTE:CT UROGRAM, DELAYED VIEWS, 3D RECONSTRUCTION History: hx of urothelial cancer CHEST:LUNGS AND PLEURA: No dominant lung lesion. No pulmonary infarction. No ple... | 1.Postsurgical changes from a cystoprostatectomy without evidence for metastatic disease.2.Right lower lobe pulmonary emboli.3.Findings discussed with Dawn Conway at the time of dictation |
Generate impression based on findings. | Female 58 years old Reason: rectal prolapse vs. intussusception History: possible prolapse of tissue There is prompt opacification of the rectum, sigmoid, and descending colon of normal static morphology.Trial straining showed markedly excessive descent of the perineal floor (series #10); voluntary anal sphincter contr... | Evacuation demonstrated an anterior rectocele measuring approximately 2.0 cm. Excessive mobility and descent of the pelvic floor when straining.No evidence of rectal prolapse or intussusception.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Three months status post PSF. Assess fusion. Again seen is an anterior plate with screws entering C4, C5, and C6. The C4 through C6 vertebral bodies are fused. There are also posterior rods entering C6 and C7, appearing similar to those seen on the prior study. I see no acute hardware complications. Severe degenerative... | Postoperative changes of cervical spine fusion and degenerative disk disease appearing similar to the prior study. |
Generate impression based on findings. | Neck pain, upper extremity weakness. History of cervical myelopathy. Evaluate stenosis and instability. Evaluation of the cervicothoracic junction is slightly limited by overlying anatomy. Severe degenerative disk disease affects C3/4, and there is a grade 1 retrolisthesis of C3 that appear stable between the flexion, ... | Degenerative disk disease and retrolistheses as described above. |
Generate impression based on findings. | 82-year-old male with bladder cancer status post cystectomy -- assess for recurrent disease. ABDOMEN:LUNG BASES: Calcified micronodules from prior granulomatous disease. No suspicious pulmonary nodules or masses seen. No pleural disease. Ventricular assist device unchanged.LIVER, BILIARY TRACT: Normal-appearing liver p... | 1. status post cystoprostatectomy with ileal conduit urinary diversion without evidence of recurrent or metastatic disease. 2. No change in right inguinal hernia containing bowel without complication. 3. Left inguinal hernia containing only mesenteric fat. |
Generate impression based on findings. | Confusion, abnormal gait, urinary incontinence No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are prominent consistent with patient's age. There is moderate degree of global p... | 1. No intracranial mass or mass-effect.2. Moderate chronic small vessel ischemic changes.3. Moderate degree of global parenchymal volume loss.4. There is prominence of the ventricular system which is likely related to advanced volume loss. However, a small component of communicating hydrocephalus cannot entirely be exc... |
Generate impression based on findings. | Pain and swelling medial knee. Effusion? Mild osteoarthritis affects the knee. There is a large joint effusion. I see no fracture or malalignment. | Large joint effusion, nonspecific. |
Generate impression based on findings. | Status post left total hip arthroplasty The AP view of the hip shows components of a total hip arthroplasty device situated in near-anatomic alignment without radiographic evidence of complication. A drain and foci of gas density within the soft tissues reflect recent surgery.The AP view of the pelvis reveals the afore... | Total hip arthroplasty as above. |
Generate impression based on findings. | Male 15 years old Reason: NG placement, s/p ex-lap History: increased NG outputVIEW: Abdomen AP (one view) 2/17/15 at 1147 hrs. NG tube terminates at the stomach. Almost complete paucity of abdominal gas. | NG tube terminates in the stomach. |
Generate impression based on findings. | Male, 74 years old, with history of squamous cell carcinoma of the skin and CLL, status post induction chemotherapy. Postsurgical findings are again seen in the right neck including scarring and infiltration particularly along the right sternocleidomastoid muscle. No discrete mass or pathologic adenopathy is detected a... | Postoperative findings in the right neck with no evidence to suggest recurrent mass or pathologic adenopathy. |
Generate impression based on findings. | Male 78 years old; Reason: patient with a history of renal cell cancer, please assess for disease progression History: RCC CHEST:LUNGS AND PLEURA: Small bilateral pleural effusions. No dominant lung lesion.MEDIASTINUM AND HILA: Heart size is normal. Severe coronary artery, thoracic aorta, and arch vessel calcification.... | 1.No significant size change in the reference lesions. |
Generate impression based on findings. | 90 year-old female glands abdominal aneurysm -- evaluate for stent graft placement and Endo leak. Status post EVAR. CHEST:LUNGS AND PLEURA: Emphysematous changes seen scattered left basilar punctate micronodules unchanged since 7/22/14.MEDIASTINUM AND HILA: Atherosclerotic calcification seen the aorta without aneurysma... | 1. Aortobiiliac endovascular stent unchanged in position and appearance. 2. Marked decrease in size of overlying sac size indicating no significant Endo leak. 3. Cholelithiasis without complication. |
Generate impression based on findings. | Female 40 years old; Reason: re-evaluate following additional systemic therapy; compare to previous scan and provide bi-dimensional measurements per RECIST 1.1; IRB 10-666 History: Stage IV melanoma CHEST:LUNGS AND PLEURA: No new lung lesions. The pleural spaces are clear. Subpleural reticulations along the anterolater... | 1.Stable exam. |
Generate impression based on findings. | 67-year-old male with history bladder cancer status post radical cystectomy with neobladder -- evaluate for metastatic disease. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Low Attenuation liver is seen indicating diffuse hepatic steatosis. No focal parenchymal liver lesions are seen, altho... | 1. Cystoprostatectomy with continent neobladder unchanged in appearance. 2. No evidence of recurrent or metastatic disease seen. 3. Resolution of prior noted left hydronephrosis. 4. Diffuse hepatic steatosis. |
Generate impression based on findings. | Male 72 years old; Reason: restaging scans s/p 24 weeks of oral tki therapy History: hx of metastatic renal cell cancer CHEST:LUNGS AND PLEURA: Lingular nodule measures 0.9 x 0.5 cm (image 79/series 5) previously, 0.8 x 0.5 cm.Right upper lobe pulmonary nodule measures 4mm image 52 series 5, unchanged.Remainder of the ... | 1.Near stable size measurements of the reference metastatic lesions.2.Slight size increase in the primary right renal neoplasm. |
Generate impression based on findings. | Acute versus acute-on-chronic knee pain Tricompartment osteophytes indicate mild to moderate osteoarthritis. I see no joint effusion. I see no fracture. Small ossicles are noted within the distal quadriceps and patellar tendons, which may not be of any current clinical significance. | Osteoarthritis without fracture evident. |
Generate impression based on findings. | 75-year-old female recurrent breast cancer to the left lung. Status post chemo and RT. LUNGS AND PLEURA: Increased left perihilar/upper lobe opacity with associated volume loss consistent with post-radiation reaction.Unchanged scattered calcified and noncalcified micronodules, most likely-postinflammatory.MEDIASTINUM A... | 1. Increased left perihilar/upper lobe opacity consistent with post radiation change although residual tumor is in the differential diagnosis. No new sites of disease are identified. 2. Contrast extravasation, as described above. |
Generate impression based on findings. | Female; 75 years old. History of HCV and remote liver transplant. Uncontrolled hypertension evaluate for renal artery stenosis. ULTRASOUND KIDNEYSRIGHT KIDNEY: The right kidney measures 10.0 cm in length. Renal cortex is mildly echogenic. There is no hydronephrosis or shadowing renal stone. Multiple simple cysts are se... | 1.Bilateral simple renal cysts.2.No evidence for renal artery stenosis.3.No worrisome hepatic mass. |
Generate impression based on findings. | Curvature to finger. There is a peculiar deformity of the middle phalanx of the fifth finger consisting of what appears to be a defect along the ulnar aspect of the bone which contains a 7 mm semicircular ossicle that is perhaps partially fused with the underlying phalanx. There is also slight ulnar inclination of the ... | Middle phalangeal deformity as described above. |
Generate impression based on findings. | 9-year-old female, postoperative evaluationVIEWS: Pelvis, AP (one view) 2/17/15 12:39 Plate and screws affix bilateral femoral osteotomies. The femoral heads are well directed into the acetabula with dysplasia of the left acetabulum again noted. No evidence of hardware complication. Moderate rectal stool collection. | Bilateral VDRO procedures without evidence of complication. |
Generate impression based on findings. | Paraneoplastic limbic encephalitis. Question of evidence of malignancy.RADIOPHARMACEUTICAL: 11.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 112 mg/dL. Today's CT portion grossly demonstrates a 7 mm pulmonary micronodule in the left upper lobe. There are mildly enlarged prevascular lymph nodes. There are... | 1. Markedly hypermetabolic prevascular lymph node and left upper lobe pulmonary micronodule are highly suspicious for malignancy. Mild activity in the right hilum is non-specific.2. Markedly hypermetabolic focus within the descending/sigmoid colon with corresponding soft tissue density on CT may represent a polyp and/o... |
Generate impression based on findings. | History of pancreatic cancer, restaging following neoadjuvant therapy CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Mild apical scarring.MEDIASTINUM AND HILA: Right central venous chest port with tip at the SVC atrial junction. Trace pericardial fluid (series 12, image 81) new from prior. Calcified... | 1.Pancreatic head/uncinate process mass compatible with patient's known adenocarcinoma, slightly increased in size from prior. The mass continues to abut approximately 180 degrees of the GDA and the porto-splenic confluence.2.Interval placement of common bile duct stent. 3.New trace pericardial fluid. |
Generate impression based on findings. | 15-year-old female with hip pain.VIEWS: Left hip AP, lateral, crosstable lateral (3 views) 2/17/2015 11:33 There are geographic areas of lucency throughout the proximal femur. No evidence of periosteal reaction. No fracture or dislocation. | Findings suggestive of osteomyelitis or osteonecrosis of the left proximal femur. |
Generate impression based on findings. | Left hip pain Three views of the left hip are provided. Severe osteoarthritis affects the hip, with bone on bone apposition superiorly.The AP view the pelvis shows the aforementioned severe osteoarthritis of the left hip. Moderate osteoarthritis affects the right hip. Overall, the bones appear demineralized, suggesting... | Severe osteoarthritis as above. |
Generate impression based on findings. | Female 84 years old; Reason: worsening SOB with COPD; increasing renal insufficiency in setting of history of rectal cancer, S/P ostomy; history of SBO;s History: as above CHEST:LUNGS AND PLEURA: Left lower lobe pulmonary nodule measures 5 mm on image 64/series 4 previously, 11 mm.MEDIASTINUM AND HILA: Heart size is mi... | 1.Atrophic kidneys without hydronephrosis.2.Left lower abdominal ostomy without evidence of obstruction.3.No specific evidence of metastatic disease. |
Generate impression based on findings. | 46-year-old female is history of hemangioendothelioma of vertebrae and liver; please compare target lesion measurements the 12th 3/13 in foci 2/14 examination. Bilateral pelvic pain. CHEST:LUNGS AND PLEURA: Segment right lower lobe groundglass is unchanged (series 6, image 44). A reticulonodular opacities in the anteri... | 1. Stable lung parenchymal findings with right lower lobe groundglass nodule, left upper lobe reticular nodular changes and. Left lower lobe confluent nodular opacities of uncertain significance. 2. Multiple peripheral based hepatic lesions typical of hemangioendothelioma with no significant change since 12/2/14 CT exa... |
Generate impression based on findings. | Male 76 years old Reason: hx of pancreas ca on watchful waiting, please compare size with previous ct History: previous weight loss, now gaining weight, slowly rising CA 19-9. CHEST:LUNGS AND PLEURA: Interval development of small bilateral pleural effusions. No suspicious nodules or masses.MEDIASTINUM AND HILA: Mild ca... | 1.Interval increase in size of the complex, multiseptated pancreatic lesion consistent with mucinous cystic neoplasm without vascular involvement or regional adenopathy. No evidence of distant metastases.2.New small bilateral pleural effusions. |
Generate impression based on findings. | Reason: Pleural mesothelioma. Please compare to prior exam per RECIST criteria. History: Pleural mesothelioma CHEST:LUNGS AND PLEURA: Postoperative changes of a right pleurectomy and decortication. Mild slightly nodular thickening of the right lung fissures remains similar in appearance to the prior exam. No significan... | 1.Stable postoperative changes of a right pleurectomy and decortication.2.Stable pleural disease, with reference measurements as given above.3.Right major fissure soft tissue density continues to decrease in size possibly loculated fluid. |
Generate impression based on findings. | 34 years old female. Reason: Medically refractory epilepsy. Unable to localize on scalp EEG. Brain CT portion of the study is not remarkable. FDG PET imaging demonstrates minimally decreased FDG uptake in the right hippocampus. Otherwise, there is symmetrical normal cerebral and cerebellar metabolic activity. | Minimally decreased metabolic activity in the right hippocampus. |
Generate impression based on findings. | The internal auditory canals are symmetrical and normal in size and signal intensity. The inner ears are normal, with normal T2 signal and no pathological enhancement. No abnormal mass or abnormal enhancement is seen within the cerebellopontine angle, cisterns bilaterally or within the internal auditory canals. The in... | 1. Multiple scattered foci of nonenhancing T2/FLAIR hyperintensity within the supratentorial white matter bilaterally. Differential diagnosis includes/inflammatory etiologies, demyelinating disease, chronic small vessel ischemic changes, or migraine headaches. Please correlate clinically.2. Unremarkable MR appearance o... |
Generate impression based on findings. | 56 years, Female. Reason: Dobbhoff placement History: Dobbhoff placement Note that the pelvis is excluded from the field-of-view. Nonobstructive bowel gas pattern. Enteric feeding tube tip projects over the gastric body. The lung bases are clear. | Enteric feeding tube tip projects over the gastric body. |
Generate impression based on findings. | Right elbow swelling. Low back pain. Hip pain RIGHT ELBOW: No fracture or malalignment is present. PELVIS: The bones appear demineralized. No fracture or malalignment is present. Mild degenerative changes affect the bilateral hip joints. LUMBAR SPINE: Severe degenerative disk disease is unchanged, with formation of lar... | Degenerative changes, as above. |
Generate impression based on findings. | 38-year-old male with history of hemorrhoids and sensation of incomplete evacuation of bowel No external hemorrhoids or rectal prolapse was noted on insertion of Foley catheter. There is prompt opacification of the rectum, sigmoid, and descending colon of normal static morphology.Trial straining showed appropriate desc... | Moderate anterior and small posterior rectocele. Perineal floor mechanics are within normal limits. Physical examination revealed rectal prolapse with hemorrhoids although acquired images did not demonstrate this finding. |
Generate impression based on findings. | Stage IB1 cervical cancer. Assess for metastatic disease. RADIOPHARMACEUTICAL: 14.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 88 mg/dL. Today's CT portion of the neck demonstrates no significant pathology. Please see diagnostic CT reports for details of the chest, abdomen, and pelvis.Today's PET examin... | 1. Increased FDG activity within the lower uterine segment/cervix correlating with provided history of malignancy.2. No evidence of FDG avid metastatic disease in the neck, chest, abdomen, and pelvis. Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | 83 years, Female. Reason: rule out mass vs. stool collection History: pain and tenderness with nausea Radiodensities compatible with gallstones project over the right upper quadrant. Nonobstructive bowel gas pattern. Average stool burden in the colon. Sternotomy hardware noted. The lung bases are clear. | Nonobstructive bowel gas pattern with average stool burden. |
Generate impression based on findings. | 12 year old boy with Dandy-Walker, headaches, rule out shunt malfunctionVIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 11/6/2014 The shunt catheter is seen with proximal tip in the right middle cranial fossa. The shunt catheter exits via a right occipital... | No kinking or discontinuity of the shunt catheter. |
Generate impression based on findings. | 69 years, Female. Reason: obstruction? History: constipation x 2 weeks No evidence of pneumoperitoneum on upright images. Nonobstructive bowel gas pattern. Slightly greater than average stool burden in the colon. | Nonobstructive bowel gas pattern with greater than average stool burden in the colon. |
Generate impression based on findings. | Female 62 years old Reason: RA pt, please obtain flex/extension C-spine films to compare to prior History: RA pt, please obtain flex/extension C-spine films to compare to prior C2/C3: There is 1 mm of retrolisthesis of C2 that corrects on flexion. C3/C4: There is 1 to 2 mm of anterolisthesis of C3 elicited on flexion.C... | Arthritic changes of the cervical spine as described above, appearing similar to those seen on the prior study. |
Generate impression based on findings. | 74 year old male. History of recurrent skin cancer and CLL. Status post induction chemo. Compare to previous. CHEST:LUNGS AND PLEURA: Stable scattered micronodules, likely post-inflammatory. Reference left upper lobe micronodule is 3 mm, previously 4 mm (series 7, image 37), not significantly changed.MEDIASTINUM AND HI... | Stable borderline enlarged chest and abdominal lymph nodes. No new sites of disease. |
Generate impression based on findings. | Ms. McMillian is a 63 year old female with a personal history of left breast lumpectomy in June 2012 for triple negative IDC followed by chemotherapy and radiation. 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 br... | 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 - Diagnos... |
Generate impression based on findings. | Redemonstrated is a soft tissue nodule within the left infratemporal fossa, just posterior to the zygoma, which measures 14 x 7 mm, previously 14 x 8 mm. Very subtle remodeling of the adjacent bone is again noted and unchanged.No new soft tissue lesions are demonstrated. No destructive osseous lesions are seen. The or... | Stable left infratemporal fossa soft tissue nodule. |
Generate impression based on findings. | RIGHT TEMPORAL BONE: The external auditory canal is clear. The tympanic membrane is faintly visualized. The scutum remains sharp.There is complete opacification of the middle ear cavity and the mastoid air cells. The right stapes is difficult to visualize. The remainder of the ossicular chain and tegmen tympani are in... | 1. Bilateral enlarged vestibular aqueducts, right greater than left.2. Somewhat amorphous bilateral cochlear apices, suggestive of mild likely associated bilateral cochlear dysplasia.3. Complete opacification of the right mastoid air cells and middle ear cavity, which is nonspecific and may be reactive. Please correlat... |
Generate impression based on findings. | 75-year-old male with history of renal cancer and chest mass. CHEST:LUNGS AND PLEURA: Left apical soft tissue attenuation mass (series 4, image 10) measures 1.8 x 2.7 cm and is nonspecific. Differential considerations include primary lung malignancy, metastasis, or inflammatory pleural process. Multiple additional subc... | 1.Status post left nephrectomy.2.Recurrent tumor in the left nephrectomy bed which invades the left psoas muscle. Additional metastatic lesions in the left paraspinal muscles, liver, and probably lung. 3.Moderate compression deformity of L1 which has progressed compared to the 2014 MRI and may be related to an addition... |
Generate impression based on findings. | The internal auditory canals are symmetrical and normal in size and signal intensity. The bilateral cochlear apices are somewhat amorphous and not well formed. The inner ears are otherwise intact, with normal T2 signal and no pathological enhancement. No abnormal mass or abnormal enhancement is seen within the cerebel... | 1. Bilateral enlarged vestibular aqueducts, right greater than left.2. Somewhat amorphous bilateral cochlear apices as seen on CT, suggestive of mild bilateral cochlear dysplasia.3. Complete opacification of the right mastoid air cells and middle ear cavity, which is nonspecific. Please correlate clinically |
Generate impression based on findings. | 9-day-old male status post PICC placementVIEW: Chest AP (one view) 2/17/15 NG tube side port in the distal thoracic esophagus. ETT tip is above the thoracic inlet. UVC catheter tip unchanged in position. A right sided catheter tip projects over the superior SVC.Extensive left predominant basilar airspace opacities incr... | ETT tip above the thoracic inlet. NG tube side-port in the distal thoracic esophagus. Interval increase in extensive patchy basilar air space opacities. |
Generate impression based on findings. | 67 years, Female. Reason: eval for ileus History: see above Multiple dilated loops of small bowel are seen in the midabdomen, measuring up to 3.5 cm in diameter. No pneumatosis or gross pneumoperitoneum seen.Findings compatible with prior right pneumonectomy and left lung airspace opacities are better evaluated on ches... | Multiple dilated loops of small bowel in the midabdomen. Cannot exclude a complete small bowel obstruction. If symptoms persist, a CT scan can be considered. |
Generate impression based on findings. | Ms. Shannon is a 56 year old female with a personal history of right breast lumpectomy in August 2012 for IDC followed by chemotherapy, radiation, and Arimidex. Personal history of bilateral benign breast biopsies. Family history of breast cancer in two paternal aunts. Three standard views of both breasts with two righ... | Stable postsurgical changes of the right 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 - Diagno... |
Generate impression based on findings. | Male 59 years old Reason: fracture History: fracture. We have 3 views of the left ankle which again show an oblique fracture of the distal fibula and a transverse fracture of the medial malleolus with the fracture fragments in near anatomic alignment. Fracture lines remain visible, appearing similar to those seen on th... | Distal fibular and medial malleolus fractures appearing similar to the prior study. |
Generate impression based on findings. | Male 67 years old Reason: Healed fx History: pain. We have 3 views of the right wrist showing sclerosis within the distal radius as well as callus formation along the dorsal radius, indicating a healing fracture. The fracture extends to the articular surface, with a minimally displaced fragment seen along the dorsal as... | Healing distal radius fracture. |
Generate impression based on findings. | 50 year-old male with concern for small bowel obstruction on x-ray. ABDOMEN:LUNG BASES: Is too numerous to count again seen at the lung bases similar to prior chest CT examination. Small amount loculated right pleural fluid again seen.LIVER, BILIARY TRACT: Hypodense lesion too small to characterize seen and segment 4 s... | 1. No change In appearance of innumerable lung nodules at the lung bases. 2. Several small hepatic parenchymal lesions, too small to characterize but metastatic disease cannot be excluded. Peripheral nature of the largest of these is very suggestive of metastatic disease. 3. No evidence of intestinal bowel obstruction.... |
Generate impression based on findings. | Female 62 years old Reason: fall on 2/14; right hand/wrist pain, swelling, bruising History: fall on 2/14; right hand/wrist pain, swelling, bruising. There is a spiral/oblique nondisplaced fracture of the fifth metacarpal diaphysis. The carpal bones and bones of the fingers appear intact. | Fifth metacarpal fracture as described above.These findings were verbally relayed to Dr. Diane Altkorn on 2/17/2015. |
Generate impression based on findings. | Status post left elbow fracture.VIEWS: Left elbow AP and lateral 2/17/15 (two views) Cast material obscures fine bone detail. Four K wires are affixing a healing supracondylar fracture to near anatomic alignment. | Healing fracture in near anatomic alignment after pinning and casting. |
Generate impression based on findings. | 68 years, Male, Reason: Abdominal pain History: Abdominal pain s/p liver bx. History of melanoma ABDOMEN:LUNG BASES: New small right pleural effusion. Right basilar atelectasis with patchy peripheral opacities which likely represent hemorrhage/infarction from patient's known pulmonary emboli. Mild to moderate coronary ... | 1.No hepatic hematoma status post biopsy.2.Increased small right pleural effusion with new right basilar opacities which likely represent hemorrhage/infarction related to patient's known pulmonary emboli.3.Single mildly enlarged retroperitoneal lymph node stable in size.. |
Generate impression based on findings. | Reason: hx of bladder cancer s/p cystectomy, on recent surveillance imaging 1cm nodule was noticed, please evaluate History: see above LUNGS AND PLEURA: Previously described left lower lobe pulmonary nodule measures 7 x 5 mm (series 4, image 61), previously measuring 10 mm, decreased in size and likely post inflammator... | 1. Previously described left lower lobe pulmonary nodule is decreased in size and likely post inflammatory in etiology.2. Multiple additional scattered micronodules, likely benign. Continued followup as per surveillance protocol. |
Generate impression based on findings. | History of LVAD, pulmonary fibrosis, repeat CT. LUNGS AND PLEURA: Interval decrease in groundglass opacities in the upper lung zones consistent with resolved edema.Moderate upper lobe predominant centrilobular and paraseptal emphysema. There remains basilar groundglass opacities that likely represent edema. This is on ... | Interval decreased pulmonary edema with some residual edema in the lower zones. This is superimposed on a background of basilar mild bronchiectasis and increased reticular opacities suggestive of a component of underlying interstitial fibrosis. |
Generate impression based on findings. | Ms. Goldberg is a 74 year old female with a personal history of left breast partial mastectomy March 2014 for DCIS with microinvasion status post radiation therapy. She has no current breast related complaints. Three standard views of both breasts, left, laterally exaggerated CC view, and two left spot magnification vi... | Expected 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 - Diagn... |
Generate impression based on findings. | Female 66 years old Reason: Evaluate for any changes in foci noted on last CT History: Cirrhosis/evaluate for any suspicious lesions CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: ... | Cirrhotic liver morphology with multiple, stable bilobar subcentimeter hypoattenuating foci which do not meet criteria for hepatocellular carcinoma. Hepatic vasculature is patent without ascites or varices. |
Generate impression based on findings. | Ovarian malignancy CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Stable spiculated left breast lesion best seen on image 44 series 3 measuring 1.4 x 1.1 cm.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant ... | Stable examination. |
Generate impression based on findings. | 36-year-old male with ileostomy and mucous fistula of distal bowel for evaluation of distal bowel prior to takedown. Contrast flowed freely from the rectum to the distal third of the transverse colon, emptying from the mucus fistula. Residual, mobile debris was noted in the colon without evidence of obstructing or cons... | Limited water soluble contrast exam. Grossly normal appearing colon up to level of mucous fistula/distal third of transverse colon. |
Generate impression based on findings. | 64 years, Male, Reason: DUODENAL CANCER WITH LIVER METS. EVALUATE FOR INTERVAL CHANGE History: Ampullary adenocarcinoma status post Whipple procedure. CHEST:LUNGS AND PLEURA: Nodule along the minor fissure measuring 1.7 x 1.5 cm ( 5/50) is new from the prior exam. There is an additional left lower lobe nodule which is ... | 1.Progression of disease with increased mediastinal and retroperitoneal lymphadenopathy as well as increased hepatic metastases and new pulmonary metastases.2.New small right pleural effusion and right basilar opacities which likely represent aspiration/infection. |
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