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Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign lymph nodes project axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of benign right breast biopsy in 1984. Family history of breast cancer in maternal niece diagnosed at the age of 20. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Multiple benign morphology circumscribed masses are stable in both breasts. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Bilateral benign morphology masses. 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: NSA - Screening Mammogram. |
Generate impression based on findings. | 1-year-old male, evaluate for fractureVIEWS: Right elbow, AP and lateral (two views) right humerus, AP and lateral (two views), right shoulder, AP, Grashey and Y view (3 views). Alignment is anatomic. The humerus is intact. No elbow fracture is visualized. The humeral head is well directed with respect to the glenoid. | Normal examination. |
Generate impression based on findings. | Postop prosthetic assessment Two views of the right hip show components of a total hip arthroplasty device situated in near-anatomic alignment without radiographic evidence of complication.AP view of the pelvis reveals the aforementioned right total hip arthroplasty. Minimal osteoarthritis affects the left hip, essentially within normal limits for age. Mild degenerative arthritis also affects the pubic symphysis. | Right total hip arthroplasty as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of benign left breast biopsy. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Metallic clip seen in the left superior breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 90 years, Female. Reason: ng History: ng Dilated loops of small bowel with relative under distention of contrast filled large bowel. Please note that the upper abdomen is excluded from the field-of-view. NG tube tip projects over the gastric pyloric area. | Small bowel obstruction. NG tube tip projects over the gastric pyloric area. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of ovarian cancer, diagnosed at the age of 31. Family history of breast cancer in mother, diagnosed at the age of 44. Two standard digital views and tomosynthesis of both breasts along with an additional left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 56-year-old male with history of NHL. Pre allo SCT evaluation. LUNGS AND PLEURA: Calcified micronodules consistent with healed granulomatous disease. Scattered noncalcified micronodules, likely also post-inflammatory.No evidence of active infection.Scar-likely opacity in the lingula.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Normal heart size without pericardial effusion. Low density blood pool consistent with anemia.Mild coronary artery calcification.Right chest wall port tip terminates in the SVC.CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Bilateral adrenal masses; for reference the right mass is 5.5 x 3.2 cm (series 3, image 105). Incompletely imaged left upper quadrant mass posterior to the pancreas and contiguous with the left hemidiaphragm, likely representing conglomerate lymphadenopathy given lymphoma history. | No evidence of active infection. Bilateral adrenal masses and conglomerate lymph node mass in the left upper quadrant consistent with known lymphoma. |
Generate impression based on findings. | T1N3 base of tongue squamous cell carcinoma with completion of CRT on 3/9/12 and posttreatment salvage neck dissection. There are post-treatment findings in the neck, including persistent diffuse supraglottic edema and stranding of the right neck subcutaneous tissues. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands appear unchanged. There is mild plaque at the bifurcations bilaterally. The osseous structures are unchanged. The airways are patent. The imaged intracranial structures are unremarkable. There is mild mucosal thickening within the maxillary sinuses. There are bilateral lens implants. There is an unchanged subcentimeter low attenuation (20 HU) lesion along the inferior pinna, which may represent an inclusion cyst. There is also a nonspecific subcentimeter skin excrescence along the right inferior eyelid. The imaged portions of the lungs are clear. | Post-treatment findings in the neck without evidence of measurable mass lesions or significant cervical lymphadenopathy. |
Generate impression based on findings. | History of right ankle post-traumatic arthritis, status post recent fall and twisting injury to same ankle with pain. Evaluate for new injury/fracture. Again seen is a side plate and radiolucent cable device affixing the distal tibiofibular syndesmosis in gross anatomic alignment. I see no new fracture. Periosteal new bone formation along the distal tibia appears similar to that seen on the prior study, as do foci of ossification distal to the medial malleolus. Moderate to severe osteoarthritis affects the tibiotalar joint, appearing similar to the prior study. Osteoarthritis also affects the midfoot articulations. There is soft tissue swelling about the ankle. Opacity anterior to the tibiotalar joint may represent synovitis or effusion. There is a flatfoot deformity. | Postoperative changes, osteoarthritis and soft tissue swelling as described above, without acute fracture evident. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts (total of 8 images) were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Bilateral circumscribed masses are present. There are no suspicious microcalcifications or areas of architectural distortion present. | Bilateral circumscribed masses. Attempts to obtain patient's prior mammograms should be made in order to confirm stability of these findings.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breat cancer in sister. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Bilateral circumscribed masses are present. There are no suspicious microcalcifications or areas of architectural distortion present. | Bilateral circumscribed masses. Attempts to obtain patient's prior mammograms should be made in order to confirm stability of these findings.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | 53-year-old female with difficulty of swallowing liquids. Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Double contrast evaluation of the esophagus and gastric cardia/fundus revealed no morphologic abnormalities of the mucosal surfaces or mural contours. Anteroposterior and lateral images of the hypopharynx demonstrate tracheal aspiration without cough reflex. Instruction to cough resulted in clearance of aspirate. A small sliding hiatal hernia was present. Fluoroscopic evaluation of esophageal peristalsis demonstrated a normal primary peristaltic wave. In the supine position, there is tortuosity of the esophagus due to mass effect from the heart border. A slightly delay in transit of contrast from the esophagus into the stomach was noted in the supine position. During the exam, no spontaneous or provoked gastroesophageal reflux was observed.TOTAL FLUOROSCOPY TIME: 5:43 minutes | 1.Tracheal aspiration with absent cough reflex. Dedicated OPM study may be considered for further evaluation.2.Small sliding hiatal hernia. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with repeat bilateral MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications, including arterial calcifications, are 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, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 16-week-old female with worsening cough and sweatsVIEWS: Chest, AP and cross table lateral (two views), soft tissue neck, AP and lateral (two views). 2/18/15 0:37 Chest: The cardiothymic silhouette is normal. The cardiac apex and stomach are left-sided. Bronchial wall thickening without consolidation or pleural effusion.Neck: Limited exam due to positioning. The patient was inconsolable and an earring overlies the airway. Within these limitations, the airway appears grossly patent and the prevertebral soft tissues are unremarkable. No unexpected radiopaque foreign body is visualized. | Bronchial wall thickening indicating bronchiolitis without evidence of pneumonia. |
Generate impression based on findings. | Follow-up of T1N2B left tonsil cancer, status post induction with TPF then TFHX completed on 8/17/2011. The images are partly degraded by patient motion. There are post-treatment findings in the neck, but no evidence of measurable mass lesions or significant cervical lymphadenopathy. For example, a right level 2 lymph node measures 4 mm in short axis, previously also 4 mm. The thyroid and salivary glands appear unchanged. There is mild to moderate atherosclerotic plaque at the bilateral carotid bifurcations. The osseous structures are unchanged, with multilevel degenerative cervical spondylosis and partial fusion of C6 and C7. The airways are patent. There is a retention cyst within the right maxillary sinus. There is partial opacification of the bilateral mastoid air cells. The imaged intracranial structures are unremarkable. There is extensive emphysema in the partially imaged lungs and an unchanged right apical micronodule. | 1. Post-treatment findings in the neck without evidence of measurable locoregional tumor recurrence or significant lymphadenopathy.2. Mild to moderate atherosclerotic plaque at the bilateral carotid bifurcations. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in two paternal aunts (diagnosed at the ages of 60 and 70). Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Acute myeloid leukemia. Baseline, starting chemotherapy. LUNGS AND PLEURA: Very mild centrilobular emphysema.Calcified lung nodules consistent with healed granulomatous disease. No evidence of an active infection.Scattered flat nodules along pleural surfaces, including in the periphery of the left upper lobe (series 5, image 31), likely intrapulmonary lymph nodes.MEDIASTINUM AND HILA: Calcified mediastinal and right hilar lymph nodes consistent with healed granulomatous disease.Normal heart size without pericardial effusion. Mild coronary artery calcification.CHEST WALL: Mild degenerative changes of the thoracic spine. Cervical plate and screws in the lower cervical spine, incompletely imaged.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Calcified hepatic and splenic granulomas. Debris filled stomach. | No evidence of active infection. Very mild emphysema. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts along with an additional right MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable benign intramammary lymph nodes are present in the right breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 7-day-old male with hypoxia, hypercapnia. Evaluate interval change of the lung fields.VIEW: Chest and abdomen AP (two view) 2/17/2015 Umbilical arterial catheter at T8 vertebral body. NG tube side-port below the GE junction. ET tube below the thoracic inlet and above the carina. Cardiothymic silhouette normal. Diffuse atelectasis bilaterally not significantly changed. No pleural effusion or pneumothorax. The umbilical venous catheter tip in the umbilical vein. Absent bowel gas within the abdomen. | Diffuse atelectasis bilaterally not significantly changed. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bilateral benign breast biopsies. Family history of breast cancer in mother (diagnosed at the age of 50) and maternal aunt (diagnosed at the age of 66). Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Redundant fatty tissue and mild accessory tissue overlying both axillae are stable. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 3-year-old male with painVIEWS: Left foot, AP, oblique and lateral (3 views) 2/18/15 Lucency and cortical angulation along the bases of the first, second, third, and fourth metatarsals consistent with fractures. There is overlying soft tissue swelling along the dorsum of the foot. Alignment is otherwise anatomic. | Fractures of the bases of the first, second, third, and fourth metatarsals as described above. |
Generate impression based on findings. | 6-year-old male with snoringVIEWS: Soft tissue neck, lateral (one views) 2/18/15 There is mild enlargement of the adenoid tonsils without significant obstruction of the airway. The prevertebral soft tissues are normal. Straightening of the cervical spine is likely due to patient positioning. | Mild adenoid tonsil enlargement without airway obstruction. |
Generate impression based on findings. | Nausea and vomitingVIEW: Abdomen AP Disorganized nonobstructive bowel gas pattern. Paucity of bowel gas within the abdomen. Punctate radiopaque densities at the right lower quadrant may represent ingested material or retained barium. No pneumatosis or pneumoperitoneum. | Paucity of bowel gas within the abdomen. |
Generate impression based on findings. | New pancreatic adenocarcinoma with liver mets. Pre-therapy. Malignancy workup. LUNGS AND PLEURA: Small bilateral pleural effusions and basilar subsegmental atelectasis and/or aspiration. Linear scarring in left lower lobe.Very mild centrilobular emphysema.Intraluminal debris in the upper trachea.No suspicious pulmonary nodules are identified.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Normal heart size without pericardial effusion.No visible coronary artery calcification. Mild thoracic aorta calcification.CHEST WALL: Anasarca. No suspicious osseous lesion.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Bilobar hypodense hepatic lesions consistent with metastases. CBD stent with expected pneumobilia. Ascites. Air in the lesser sac, concerning for perforation, unchanged. Refer to recent CT abd/pelvis report for further details. | 1. No specific evidence of metastatic disease in the chest. Small bilateral pleural effusions with adjacent atelectasis and/or aspiration. 2. Liver metastases, abdominal ascites, and lesser sac air concerning for perforation, unchanged and previously described on 2/16/2015 CT abd/pelvis report. |
Generate impression based on findings. | 12-year-old male with history of pain in left knee, rule out fractureVIEWS: Left knee, AP, oblique, and lateral (3 views) 2/18/15 9:04 There is mild soft tissue swelling overlying the tibial tubercle. The quadriceps tendon and patellar tendon appear otherwise normal. Alignment is anatomic. No fracture or joint effusion is noted. | Minimal soft tissue swelling overlying the tibial tubercle may represent early Osgood-Schlatter's disease, but MRI may be considered for further evaluation if clinically warranted. |
Generate impression based on findings. | PICC placementVIEW: Chest AP 2/18/15 Cardiothymic silhouette normal. Right lung atelectasis has improved in the interval. Placement of a left upper extremity PICC with tip in the right atrium. Minimal atelectasis left lung. | Left PICC tip in the right atrium. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 82-year-old female with history of diabetes mellitus with right big toe ulcer. Rule-out "osteo". There is ulceration of the soft tissues along the distal and dorsal aspects of the great toe. There is destruction of the underlying tuft of the distal phalanx indicating osteomyelitis. | Osteomyelitis of the distal phalanx of the great toe. This was relayed to Dr. Dia over the phone at the time of dictation. |
Generate impression based on findings. | Evaluate bowel gas patternVIEW: Chest AP and abdomen AP ET tube tip at the level of the thoracic inlet. NG tube tip in the stomach. Right central line in place. Left chest tube in place. The side hole of the left chest tube is within the subcutaneous tissue. There is a small left basal pneumothorax. Patchy atelectasis bilaterally without pleural effusion. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Disorganized nonobstructive bowel gas pattern. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bilateral benign breast biopsies. She currently complains of right breast tenderness for 1 month. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Diffuse benign punctate and popcorn-like calcifications are seen bilaterally, several of which may represent hyalinized fibroadenomas. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable benign calcifications seen bilaterally. 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. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in sister diagnosed at the age of 50. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign punctate calcifications are seen bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in two sisters. Two standard digital views of both breasts with repeat right MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Ovoid circumscribed mass present in the left upper outer breast. This may have a fat density component. No suspicious masses, microcalcifications or areas of architectural distortion are present in the right breast. | Ovoid mass in the left breast may represent an area of fat necrosis or a lymph node. However, to ensure a benign etiology, 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. | Head and neck cancer. LUNGS AND PLEURA: Moderate paraseptal and centrilobular emphysema.Stable left lower lobe subpleural nodule, unchanged from 2012 and most likely benign. No suspicious pulmonary nodules or masses.Small area of groundglass opacity adjacent to the aorta in the left lower lobe, which is probably atelectasis.MEDIASTINUM AND HILA: Small mediastinal lymph nodes, unchanged. No mediastinal or hilar lymphadenopathy.Cardiomegaly with severe left ventricular enlargement, unchanged. Severe coronary artery calcification.CHEST WALL: Mild degenerative changes of the thoracic spine. Focal sclerosis in T11 is unchanged from 2012.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of metastatic disease in the chest. |
Generate impression based on findings. | Large goiter with substernal extension and hyperthyroidism. Question of distribution of activity and uptake. There is a large dominant hypofunctioning nodule occupying much of the right mid to lower thyroid lobe. There is also the suggestion of two other hypofunctioning nodules in the left mid to lower lobe. The remaining uptake in the gland is uniform. No hyperfunctioning nodules are identified. The 4-hour radioactive iodine uptake is 22% and the 23-hour uptake is 39% (normal range 10-30% at 24-hours). | 1. Bilateral hypofunctioning nodules, with a large dominant nodule on the right, are indeterminate for malignancy.2. Otherwise, fairly uniform uptake which is inappropriately elevated given a suppressed TSH; Grave's disease is favored over toxic multinodular goiter. |
Generate impression based on findings. | Gastric cancer on chemotherapy with daily headaches. There is no evidence of intracranial mass or abnormal enhancement. The grey-white matter differentiation appears to be intact. The ventricles are normal 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. | No evidence of intracranial metastases. However, CT is less sensitive than MRI for the detection of intracranial metastases. |
Generate impression based on findings. | 42 year-old woman with history of right DCIS status post mastectomy in 2011. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Reason: is there evidence of disease in the left neck, supraclavicular region, or at the site of prior left neck dissection History: history of pT3N2b SCC of L tonsil s/p CRT 2013, then developed L neck soft tissue recurrence in 11/2014 treated with surgical resection on 12/26/14 (margins uncertain). Had a PET with + JGD LN and SCV LN on L but non contrast. CHEST:LUNGS AND PLEURA: Scattered calcified and noncalcified micronodules.No suspicious pulmonary nodules or masses.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Cardiac size is normal without evidence of a pericardial effusion.Mild coronary artery calcification.CHEST WALL: Hemangiomas in the T12 and L1 vertebrae.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Focal hypodensity in the left lobe incompletely characterized.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Nonspecific small sclerotic foci within the bony pelvis most likely representing bone islands.OTHER: No significant abnormality noted. | No evidence of metastatic disease within the thorax and visualized abdomen. |
Generate impression based on findings. | 2-day-old female with increased work of breathing. Evaluate for pneumothorax or atelectasis or RDS.VIEW: Chest AP (one view) 2/17/2015 17:46. Increased atelectasis in the left lung. Small right-sided pneumothorax. Left heart border is obscured by overlying pulmonary density. | Small right pneumothorax. Increased atelectasis in the left lung. |
Generate impression based on findings. | 74 year-old male with history of aortic stenosis, pre-operative TAVR evaluation. Patient also with history of cirrhosis, evaluate portal vein for thrombosis. ANGIOGRAM: Please see accompanying cardiac CT report for description of thoracic aorta. Moderate atherosclerotic disease affects the abdominal aorta and its branches. No evidence of dissection or aneurysm. The origins of the celiac axis, SMA, and IMA are widely patent. Atherosclerotic calcifications at the origins of the bilateral renal arteries cause mild stenosis.There is moderate tortuosity of the bilateral common/external iliac arteries without circumferential atherosclerotic calcifications or significant stenoses.VESSELS:SUPRARENAL ABDOMINAL AORTA: 2.1 x 2.1 cmINFRARENAL ABDOMINAL AORTA: 1.7 x 1.7 cmRIGHT COMMON ILIAC ARTERY: 13.1 x 12.8 mmRIGHT EXTERNAL ILIAC ARTERY: 9.1 x 9.8 mmRIGHT COMMON FEMORAL ARTERY: 10.4 x 9.8 mmLEFT COMMON ILIAC ARTERY: 12.2 x 10.3 mmLEFT EXTERNAL ILIAC ARTERY: 10.0 x 9.7 mmLEFT COMMON FEMORAL ARTERY: 8.8 x 8.8 mmABDOMEN:LUNG BASES: Please see accompanying cardiac CT report for description of pulmonary findings. LIVER, BILIARY TRACT: The liver demonstrates a nodular surface contour, relative hypertrophy of the left lateral segment and caudate lobe as well as fissural widening, compatible with cirrhosis. No focal hepatic lesions. Mild focal dilation of right portal vein compatible with varix. Sub-occlusive thrombus is present at the portal venous confluence involving the proximal main portal vein, proximal splenic vein, and proximal to mid superior mesenteric vein. The hepatic artery is patent. Status post cholecystectomy.SPLEEN: The splenic artery is tortuous but patent. The spleen is markedly enlarged. Perisplenic varices are present. Small low attenuation lesion in the spleen (series 16, image 62) is nonspecific.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic kidneys.RETROPERITONEUM, LYMPH NODES: Please see angiographic description of aorta and its branches above. Infrarenal IVC filter with tines protruding into adjacent lumbar vertebral body. BOWEL, MESENTERY: Esophageal varices. Normal caliber bowel without evidence of obstruction. Colonic diverticulosis without specific evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes of the visualized thoracolumbar spine including severe degenerative disk disease at several levels.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Colonic diverticulosis without specific evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes of the visualized thoracolumbar spine including severe degenerative disk disease at several levels. Severe degenerative arthritic changes of the bilateral hip joints. OTHER: No significant abnormality noted | 1.Please see accompanying cardiac CT for details regarding the thoracic aorta and chest.2.Vascular measurements as above. Moderate tortuosity of the bilateral common/external iliac arteries without circumferential atherosclerotic calcifications or significant stenoses.3.Cirrhotic liver morphology with associated splenomegaly and portosystemic varices. 4.Sub-occlusive thrombosis of the main portal vein, splenic vein, and superior mesenteric vein.5.Colonic diverticulosis without specific evidence of diverticulitis. |
Generate impression based on findings. | Right hip FAI. MEASUREMENTS: CAM location : Three o'clock position.Alpha angle : 65 degreesCoronal center-edge angle : Approximately 31 degreesSagittal center-edge angle : 56 degrees as measured on direct sagittal images to the anterior edge of the acetabulum.Femoral neck-shaft angle : 133 degreesAcetabular version (1 o’clock) : 0 degrees Acetabular version (2 o’clock) : 12 degrees anteversionAcetabular version (3 o’clock) : 13 degrees anteversionFemoral version angle (+anteverted, -retroverted) : Approximately 8 degrees of femoral anteversionMcKibbin index : 21 degreesAIIS width : Approximately 11 mmDistal base of AIIS to acetabular rim : Approximately 7 mm | Cam deformity of the anterior femoral head-neck junction and other measurements as above |
Generate impression based on findings. | The scout lateral view and the sagittal reformatted images demonstrate normal alignment of the cervical spine, with trace reversal of the normal cervical lordosis. The vertebral body and disk space heights are well-maintained.There is no acute fracture.At C1-C2, there is a normal relationship of the dens with the arch of C1.The axial images do not demonstrate any significant disk bulge, disk herniation, significant bony spinal canal or foraminal stenosis.There is mild interlobular septal thickening at the lung apices with mild pleural based nodularity especially on the left which may relate to scarring. | No acute fracture or subluxation. |
Generate impression based on findings. | Reason: h/o tonsil ca, s/p CRT, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Moderate upper lobe predominant centrilobular emphysema.Scattered stable calcified and noncalcified micronodules.No suspicious pulmonologist masses.No pleural effusions.Mild basilar scarring/discoid atelectasis with evidence of postoperative changes in the left lower lobe.MEDIASTINUM AND HILA: There lymph nodes with reference right hilar lymph node measuring 19 mm unchanged from the prior exam (image 58 series 3).Subcarinal lymphadenopathy measuring 12 mm in short axis previously measuring 13 mm (image 58 series 3).Cardiac size is normal without evidence of a pericardial effusion.Moderate coronary artery calcification.CHEST WALL: Mildly large left extra lymph node unchanged.Degenerative changes in the thoracic spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: CholelithiasisSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative changes in the spine.OTHER: No significant abnormality noted. | Stable hilar and mediastinal lymphadenopathy. No new sites of disease identified. |
Generate impression based on findings. | Following a discussion of the procedure with the patient and/or family, including its risks, benefits, alternatives and steps to prevent infection, informed written consent was obtained and documented in the patient's chart. The time-out form was completed to confirm patient identity and side/type of procedure. All operators present for the case performed standard preprocedural prep including hand washing, sterile gloves, mask and cap. The patient was prepped and draped in the usual aseptic fashion. Local anesthesia over the target area was obtained by 1% lidocaine. Midazolam and fentanyl were administered IV by the nurses during continuous hemodynamic monitoring. Using CT guidance, the needle was advanced to the intramedullary space of the right proximal femur just below the lesser trochanter using a sterile hand operated drill. Three core specimens were taken at 1,2, and 3 cm within the medullary bone. The core biopsy specimens were hand carried to the Surgical Pathology labThe patient tolerated the procedure well without immediate complication. Routine post procedure instructions were communicated to the patient.ESTIMATED BLOOD LOSS: Less than 5cc. An adhesive bandage was placed on the patient’s skin. | Successful CT guided right femoral bone biopsy.PLAN: |
Generate impression based on findings. | Reason: esophageal cancer, sp chemoradiation, ck response History: dysphagia CHEST:A pulmonary arterial filling defect in the right upper lobe pulmonary artery (series 3, image 38) is new from the prior exam. Additional segmental branch right lower lobe pulmonary arterial filling defects are new (series 3, image 59). The main pulmonary artery is normal in caliber. No evidence of right heart strain.LUNGS AND PLEURA: Stable minimal paramediastinal scarring, related to radiation reaction.Small tubular density in the lingula to represent bronchial mucous plugging is unchanged (series 5, image 55). Additional scattered micronodules are unchanged. No new suspicious pulmonary nodules or masses.Minimal dependent atelectasis and basilar subsegmental atelectasis. No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Mild coronary artery calcification.No mediastinal or hilar lymphadenopathy. A reference right paratracheal lymph node measures 6 mm (series 3, image 17), slightly less prominent compared to the prior exam.Interval removal of esophageal stent.CHEST WALL: The previously described left lower neck lymph node appears stable.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Pulmonary emboli in the right upper lobe and right lower lobe pulmonary arteries. No evidence of right heart strain.2. No evidence of metastatic disease.Findings discussed with Dr Villaflor at 11:10 AM |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There are moderate foci of periventricular and subcortical white matter hypoattenuation which are nonspecific, likely representing chronic small vessel ischemic changes. There are more focal small areas of hypoattenuation in the left subinsular region, and right basal ganglia which are grossly stable from prior exam, accounting for differences in technique. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are dense atherosclerotic calcifications in the bilateral intracranial internal carotid arteries and vertebral arteries. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or mass effect. Grossly stable chronic microvascular ischemic changes. |
Generate impression based on findings. | Mesothelioma status post pleurectomy decortication status post chemotherapy. On observation, evaluate for EOD. Compared to previous. CHEST:LUNGS AND PLEURA: Postoperative changes in the right hemithorax with a diaphragmatic mesh. No evidence of residual or recurrent disease.Scattered stable micronodules, most likely postinflammatory.MEDIASTINUM AND HILA: Reference right paratracheal it is 7 mm (series 3, image 22), unchanged.Eccentric nonocclusive mural thrombus in the proximal left subclavian artery, unchanged.CHEST WALL: Right internal mammary chain lymph node is 4 mm, unchanged (series 3, image 30).ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No focal suspicious hepatic mass is identified. Cholecystectomy clips. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Interval right upper pole partial nephrectomy for resection of the previously seen renal mass. Nonspecific soft tissue density and stranding in the operative bed, presumably post-surgical. No enhancing discrete mass to suggest residual tumor.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of recurrent or residual disease relating to mesothelioma. Interval right upper pole partial nephrectomy with no definite evidence of residual tumor. Right suprarenal soft tissue is presumably postsurgical, continued follow up recommended |
Generate impression based on findings. | Male 66 years old Reason: bladder cancer History: bladder cancer ABDOMEN:LUNG BASES: Atelectasis of the right lung base with persistent elevation of the right hemidiaphragm.LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver with nodular contour and widened fissures suggestive of chronic liver disease. Redemonstrated is a hypodense, nonenhancing lesion in the right lobe of the liver measuring 1.6 x 1.7 cm (series 7, image 52), previously 1.6 x 1.9 cm, unchanged.Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal nodule which is slightly increased in size now measuring 1.3 x 2.0 cm (series 7, image 65), previously 1.4 x 1.6 cm. The imaging features of the nodule likely represent an adenoma.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Cystic lesion posterior to the cecum, unchanged, best visualized on series 7, image 94.BONES, SOFT TISSUES: Moderate degenerative changes of the thoracic spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Few scattered retroperitoneal lymph nodes. Reference left external iliac lymph node is unchanged, measuring 1.5 x 1.1 cm (series 7, image 107), previously 1.6 x 1.4 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Moderate degenerative changes of the lumbar spine, unchanged.OTHER: No significant abnormality noted | 1.Stable examination with no evidence of metastatic disease. 2.Fatty infiltration of the liver with features suggestive of chronic liver disease. |
Generate impression based on findings. | 35-year-old woman with history of DCIS left breast status post lumpectomy in 2012. Three standard views of both breasts along with spot compression CC and LM views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. There is a linear scar marker over the left breast along with stable postoperative changes including architectural distortion and surgical clips in the left lumpectomy bed. A biopsy clip in the central right breast at the posterior depth is unchanged. | 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. | 43 year-old woman with history of left breast IDC status post mastectomy in 2013. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | No evidence of intracranial hemorrhage, extra-axial fluid collections or subdural hematomas. No CT evidence of acute large territorial ischemia. Mild prominence of the ventricles and sulci, likely age related volume loss. No evidence of midline shift. Mild periventricular hypoattenuation consistent with age indeterminate small vessel ischemic disease. The mastoid air cells are clear. Mild opacification of the left maxillary sinus with possible air-fluid levels. | 1.No evidence of intracranial hemorrhage as clinically questioned.2.Partial opacification of the left maxillary sinus with possible air-fluid level. Correlate for acute sinusitis. |
Generate impression based on findings. | Reason: metastatic lung cancer on treatment, evaluate disease History: cough, hemoptysis CHEST:LUNGS AND PLEURA: Interval increase in size and number of numerous pulmonary nodules and increasing loculated left pleural effusion.Reference measurements are as follows:Left upper lobe (image 44 series 4) lingular nodule now measuring 2.8 cm x 3.9 cm previously measuring 2.6 cm x 3.8 cm.Right upper (image 43 series 4) measuring 3 cm x 1.8 cm previously measuring 2.3 cm x 1.7 cm. lobe nodule.Bilateral basilar consolidation redemonstrated with interval increase on the right.MEDIASTINUM AND HILA: Stable right paratracheal soft tissue thickening measuring 10 mm (image 27 series 3).No hilar mediastinal adenopathy identified.Cardiac enlargement with stable pericardial effusion.Mild coronary calcifications.Enlarged pulmonary artery compatible with pulmonary arterial hypertension.Stable enlarged left lobe of thyroid gland with evidence of calcification and hypodensities.CHEST WALL: No axillary lymphadenopathy.Degenerative changes in the thoracic spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable small hypodensities. Calcification again noted along the falciform ligament.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Small left adrenal nodule unchanged.KIDNEYS, URETERS: High density well-defined right renal mass most likely representing a complex cyst and is unchanged there is a gasPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Interval progression in size and number of multiple pulmonary metastases.2.Increasing bilateral basilar consolidation/atelectasis particularly on the right.3.Interval increase in loculated left sided pleural effusion with development of small right-sided pleural effusion. |
Generate impression based on findings. | Male 44 years old Reason: fall History: pain. We have 3 views of the left wrist. There is soft tissue swelling of the wrist. Seen only on the PA view is a step-off along the cortex on the medial aspect of the ulna at the base of the ulnar styloid which may represent a nondisplaced fracture. We see no fracture of the distal radius or any of the carpal bones.We have two views of the left forearm showing soft tissue swelling about the wrist. We see no fracture on these forearm radiographs. | Possible nondisplaced fracture through the base of the ulnar styloid. |
Generate impression based on findings. | 54 year-old female. Mantle cell lymphoma on observation. Bilateral cervical lymphadenopathy is redemonstrated and not significantly changed. For example right level 1B lymph node measures 25 x 19 mm (series 8, image 50), unchanged. Right level 2A lymph node measures 16X14 mm previously 15x13 mm (series 8, image 47) and not significantly changed. Large ovoid right level 3/4 lymph node measuring 17 mm in the short axis, sagittal image 30, also not significantly changed.The thyroid and salivary glands are unremarkable. Major cervical vessels are patent. Osseous structures are unremarkable. Right maxillary sinus mucus retention cyst. Please refer to separate report for findings in the chest. | No significant change in extensive cervical lymphadenopathy compared to 7/16/2014. |
Generate impression based on findings. | 55 year old status post right stereotactic biopsies for calcifications, with pathology results including focal ADH. On review of the prior studies, a marker clip is present at 12 o'clock position in the right breast. There are multiple calcifications near this clip, extending posteriorly. The target of this procedure is the marker clip.The procedure, risks including bleeding and infection, and benefits of needle-wire localization were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed to confirm patient identity and site of procedure. The right breast was placed in an alphanumeric grid using superior to inferior approach. When the target was positioned in the aperture of the grid, the skin was cleansed with chlorhexidine. Local anesthesia was obtained using 2% Lidocaine. Using coordinates from the grid, a 5 cm Kopans needle was placed adjacent to the clip. On orthogonal digital mammography, adequate positioning of the needle was confirmed after adjusting depth so the needle tip was approximately 1 cm deep to the center of the target. A spring wire was then deployed. Repeat two view orthogonal digital mammograms reveal the spring wire to be in adequate position. The digital mammogram was annotated and reviewed with Dr. Jaskowiak prior to the patient's procedure. Patient tolerated the procedure well and was sent to the holding area in stable condition. Dr. Abe performed the procedure.Orthogonal digital specimen radiographs revealed the calcifications and clip and spring wire to be within the specimen. | Successful needle localization of the right breast clip.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | No evidence of acute intracranial hemorrhage. No CT evidence of acute large territorial ischemia. The ventricles and sulci are normal in size. There are no extraaxial fluid collections or subdural hematomas. Mild to moderate periventricular hypoattenuation, likely small vessel ischemic disease of indeterminate age. Mastoid air cells are under-pneumatized. Otherwise, the paranasal sinuses are clear. | No acute intracranial hemorrhage or CT evidence of large territorial ischemia. If there is high clinical suspicion for acute ischemia, further evaluation with MRI is recommended. |
Generate impression based on findings. | Basal cell cancer metastases to the lung. CK response to chemo. CHEST:LUNGS AND PLEURA:Necrotic right suprahilar mass is 34 x 27 mm, previously 33 x 20 mm (series 5, image 48) and now with fluid filling the necrotic central cavity.Left inferior hilar mass is 34 x 30 mm (series 20212, image 60), previously 34 x 28 mm. New clustered perihilar micronodules in the left upper lobe are most likely infectious/inflammatory, though special attention to this on follow-up exams to exclude metastases.Soft tissue encasement and narrowing of the left hilar and lower lobe bronchi with associated distal subsegmental atelectasis as well as tree-in-bud opacities representing retained secretions, unchanged.MEDIASTINUM AND HILA: Prominent mediastinal lymph nodes, including the reference prevascular lymph node measuring 11 x 7 mm (series 20212, image 27), unchanged.Soft tissue nodule posterior to the right mainstem bronchus (series 20212, image 46), unchanged from immediate prior study and larger compared to remote exams, consistent with tumor.Normal heart size without pericardial effusion.No visible corner artery calcification.Right internal jugular vein is chronically occluded with collateral vessels in the right neck.Small hiatal hernia.CHEST WALL: Calcified left axillary lymph node, unchanged. Moderate degenerative changes of the thoracolumbar spine, unchanged. ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Calcified atherosclerotic disease of the abdominal aorta. BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Moderate degenerative changes of the thoracolumbar spine, unchanged. OTHER: No significant abnormality noted. | 1. Previously necrotic right suprahilar mass is mildly increased in size. Remainder of reference lesions are not significantly changed.2. New clustered left perihilar micronodules in the upper lobe are likely infectious/inflammatory though special attention to this area on follow-up scan to exclude metastases. |
Generate impression based on findings. | 63-year-old female with history of ovarian cancer, compare to previous. CHEST:LUNGS AND PLEURA: Reference right upper lobe pulmonary nodule (series 4, image 24) measures 3 x 7 mm, previously measuring 7 x 3 mm. Additional scattered pulmonary micronodules not significantly changed.MEDIASTINUM AND HILA: Reference pretracheal lymph node (series 3, image 32) measures 1.1 x 1.6 cm, measured 1.1 x 1.6 cm previously. Additional non-reference pretracheal lymph node (series 3, image 39) is increased in size. Left sided central venous chest port with catheter tip at the SVC atrial junction.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: The patient is status post left hepatectomy and cholecystectomy. No suspicious focal lesions are identified within the hepatic parenchyma.SPLEEN: Status post splenectomy.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Numerous surgical clips without lymphadenopathy. BOWEL, MESENTERY: There are extensive postsurgical changes including partial gastrectomy and gastrojejunostomy. There is no evidence of bowel obstruction. Reference mesenteric lymph node (series 3, image 139) measures 0.6 x 1.2 cm, measured 0.6 x 1.3 cm previously.BONES, SOFT TISSUES: No suspicious osseus lesions. OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No pelvic lymphadenopathy. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No suspicious osseus lesions. OTHER: No significant abnormality noted. | 1.Reference mediastinal and mesenteric lymph nodes are stable.2.Interval increase in size of single non-reference pretracheal lymph node.3.No additional new lymphadenopathy or new evidence of metastatic disease. |
Generate impression based on findings. | Male 67 years old Reason: BL chronic wrist pain History: as above. We have 3 views of the right wrist. There is slight widening of the scapholunate interval suggesting ligamentous laxity or disruption. There is narrowing of the radioscaphoid articulation with osteophyte formation. There is also dorsal tilting of the lunate with narrowing of the capitolunate articulation. These findings are suggestive of a SLAC wrist deformity. There are small ossicles adjacent to the radial and ulnar styloids. There is also a small ossicle dorsal to the carpus. There is soft tissue swelling about the wrist and arterial calcifications in the soft tissues.We have 3 views of the left wrist. There is mild widening of the scapholunate interval suggesting ligamentous laxity or disruption. Mild osteoarthritis affects the radioscaphoid articulation. There is narrowing of the capitolunate articulation as well. These findings suggest a SLAC wrist deformity. There is soft tissue swelling about the wrist and arterial calcifications in the soft tissues. | Arthritic changes of both wrists as described above suggesting SLAC wrist deformities. |
Generate impression based on findings. | 40 year-old female with history of appendectomy, two adhesion lysis surgeries, the most recent in 2010, with 3 episodes of ileocolonic intussusceptions since. Presents with chronic baseline pain in left hemiabdomen. The scout film shows a nonobstructive bowel gas pattern. Fluoroscopic evaluation showed thickening of folds with somewhat nodular appearance in the jejunum correlating with pain upon palpation over this area. Multiple nonobstructive adhesions with fixation of small bowel loops were noted in the left hemiabdomen. No evidence of superior mesenteric artery syndrome. No separation of bowel loops was present to suggest fibrofatty proliferation. A duodenal diverticulum was incidentally noted.Transit time to the terminal ileum was 40 minutes. Spot films of the terminal ileum were within normal limits. The terminal ileum and ileocecal valve were normal in appearance. No incisional or ventral hernias were evident. The ascending colon was grossly normal. TOTAL FLUOROSCOPY TIME: 9:30 minutes | 1.Nonspecific thickening of the jejunal folds with nodular appearance. 2.Multiple nonobstructive adhesions in the left hemiabdomen as described above. |
Generate impression based on findings. | Call back from screening mammogram for a benign appearing mass in the left breast. Focused ultrasound was performed for the left breast. Detected is a circumscribed 5 mm oval mass with internal hyperechoic area with blood flow, consistent with intramammary lymph node at 11 o;clock position in the left breast, corresponding to the mammographic findings. | No sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There is abnormal low density which is noted in the white matter of the right superior frontal gyrus near the apex, as seen on 4/26-27 and 80236/40-42. There is additional questionable low-density in the left superior frontal gyrus in a similar location. There are no areas of pathological enhancement. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.The intracranial internal carotid arteries are normal in course and caliber. The middle and anterior cerebral arteries are unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries are normal in course and caliber. The vertebral arteries are co-dominant. There is no evidence of flow-limiting stenosis or aneurysm. | Area of abnormal low density in the right superior frontal gyrus white matter as well as questioned on the left. Given the bilaterality of findings and location, these could represent prominent perivascular spaces in patient of this age although more commonly seen in the pediatric population. No associated abnormal vasculature to suggest vascular malformation. No intracranial aneurysm. MRI brain with and without contrast recommended for further evaluation, to exclude underlying abnormality. |
Generate impression based on findings. | Pre-renal transplant evaluation ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal atrophy again noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcification involving the abdominal aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Mild atherosclerotic calcification involving common iliac arteries bilaterally. Moderate right external iliac atherosclerotic calcification. Moderate left external iliac atherosclerotic calcification. Extensive internal iliac calcification bilaterally. | Mild atherosclerotic calcification involving the abdominal aorta. Mild atherosclerotic calcification involving common iliac arteries bilaterally. Moderate external iliac atherosclerotic calcification bilaterally. |
Generate impression based on findings. | Reason: mesothelioma History: s/p extended pleurectomy decortication CHEST:LUNGS AND PLEURA: Surgical changes of a recent right pleurectomy and decortication, with moderate right pneumothorax, focal consolidation, and right-sided subcutaneous emphysema. Nodular wall thickening throughout the right hemithorax. For reference, this nodularity was measured, although difficult to fully assess without prior imaging.At the level of the aortic arch (series 3, image 36): The lesion at the 3 o'clock position measures 5 mm. The lesion at the 4 o'clock position measures 9 mm.At the level of the main pulmonary artery (series 3, image 49): The lesion at the 5 o'clock position measures 9 mm. the lesion at the 7 o'clock position measures 10 mm.At the level of the mitral valve (series 3, image 68): Lesion of the 7 o'clock position measures 11 mm. the lesion in the 5 o'clock position measures 6 mm.Extensive left-sided pleural calcification. Scattered pulmonary micronodules on the left. A solid nodule in the left lower lobe measures 7 mm.No focal air space consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Severe coronary artery calcification.Enlarged mediastinal and hilar lymph nodes, including a right hilar lymph node measuring 17 mm (series 3, image 52) and an AP window lymph node measuring 13 mm (series 3, image 40).CHEST WALL: Status post median sternotomy. Right-sided subcutaneous emphysema from recent surgical procedure. Soft tissue thickening/infiltration in the right chest wall may be post procedural. Degenerative disease of the thoracic spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disease of the lumbar spine.OTHER: No significant abnormality noted. | Post surgical changes in the right hemithorax of a pleurectomy decortication, with residual nodular pleural thickening and right hilar/mediastinal lymphadenopathy. Reference measurements as above. No definite evidence of disease in the left chest or in the abdomen. Presumably postprocedural changes in the right chest wall, for which close monitoring will be needed on future imaging. |
Generate impression based on findings. | 19 years, Female. Reason: Assess for obstipation, ileus History: 19 y.o. woman with history of constipation on narcotics for ankle surgery. Severe gas/bloating, abd distension No free intraperitoneal air. Greater than average stool burden with desiccated stool in the distal colon. Nonobstructive bowel gas pattern. Lung bases are clear. | Greater than average stool burden with desiccated stool in the distal colon. |
Generate impression based on findings. | Female 88 years old Reason: fracture History: known hip fracture; need pelvis through distal femur. The bones are demineralized suggestive of osteopenia/osteoporosis. There is a complete fracture of the femoral neck with approximately 1 cm superior displacement of the diaphyseal fragment. There is bone on bone apposition of the fracture fragments and relatively little adjacent soft tissue swelling, while this may represent an acute fracture, the possibility of a subacute fracture is also considered. The remainder of the proximal femoral diaphysis is intact, although the distal femur is not included on the study.There is also a mildly displaced fracture of the left ischiopubic junction; the fracture remains visible although there is a small amount of adjacent callus indicating an attempt at healing. There is a mildly displaced fracture of the body/superior ramus of the left pubic bone; the fracture remains visible, although there is a small amount of adjacent callus indicating an attempt at healing. There is also bandlike sclerosis within the right sacral wing consistent with a healing, nondisplaced fracture.Mild osteoarthritis affects the hips, pubic symphysis and sacroiliac joints. Severe degenerative disk disease affects L5/S1, although this is incompletely imaged on this study. Globular calcifications in the pelvis represent a uterine fibroid. There are also scattered arterial calcifications the pelvis and proximal thighs. The bladder is distended with urine. | Limited study due to inability to optimally position patient within the CT scanner.1.Complete fracture of the femoral neck with mild displacement as described above.2.Additional pelvic fractures and other findings as described above. |
Generate impression based on findings. | 84 years, Female. Reason: check NG tube placement to begin trickle feeds History: check NG tube placement to begin trickle feeds Nasogastric tube tip projects over the gastric body. ET tube noted. Right pleural effusion with adjacent atelectasis. Significant interval decrease in gaseous dilation of small and large bowel. Relative paucity of bowel gas. Note that the pelvis is excluded from the field-of-view. | Nasogastric tube tip projects over the gastric body. |
Generate impression based on findings. | Status post dedifferentiated chondrosarcoma Two views of the right humerus reveal a hemiarthroplasty with a long humeral stem and resection of the proximal one third of the humerus. No change is seen from the previous exam. No evidence of hardware loosening or complications. No evidence for tumor recurrence. There is a small amount of heterotopic bone formation unchanged from the previous | Stable examination |
Generate impression based on findings. | T3N2c supraglottic squamous cell carcinoma receiving induction chemotherapy with carbo/taxol. Here for C2D8. There has been interval decrease in size of the supraglottic mass, which now measures up to approximately 10 mm, previously approximately 15 mm. There is slight interval decrease in size of the right level 3 lymph node, which measures 9 mm in short axis, previously 11 mm. A reference left level 2 lymph node measures 7 mm in short axis, previously 9 mm. There are bilateral tonsilloliths. The thyroid and major salivary glands are unchanged. The major cervical vessels are patent. The osseous structures are unremarkable. The imaged intracranial structures and orbits are unremarkable. There is extensive pulmonary emphysema. | Interval decrease in size of the laryngeal squamous cell carcinoma and cervical lymphadenopathy. |
Generate impression based on findings. | Note that the cervical spine is only viewed to the C6 level on the lateral view. Postsurgical changes of a multilevel laminectomy are again noted from C3 to C6. Severe degenerative changes are noted of the cervical spine with near complete loss of height of the C3-4 disk space and with degenerative fusion of the C4-5 disk space. There is severe loss of height of the C3 vertebral body and moderate loss of the height of the C4 vertebral body. Severe degenerative changes are also noted of the C5-6 and C6-7 levels. Again seen is retrolisthesis of C3 on C4 by 4 mm which is slightly increased compared to the previous exam where it was 3 mm. there is 4 mm of anterior listhesis of C4 on C5.There is severe degenerative disease of the lumbosacral spine with complete loss of height of the intravertebral disk spaces with vacuum phenomenon especially noted at the L4-5 level. Vascular calcifications are noted in the abdominal aorta. There is also levoscoliosis of the thoracolumbar spine.And | Severe degenerative disease of the cervical and lumbar spine as described above. |
Generate impression based on findings. | left ankle pain after binding the floor two days beforeVIEWS: Left ankle AP, oblique, lateral Soft tissue swelling and joint effusion about the ankle. Linear oblique lucency along the distal fibular metaphysis may represent a nondisplaced fracture. The ankle mortise joint is normal. | Probable nondisplaced fracture of the distal fibular metaphysis with soft tissue swelling and joint effusion. Text page was sent to Dr. Yingshan, Shi at 2/18/2015 at 11:50 AM. |
Generate impression based on findings. | PHARYNX/LARYNX: The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The right parotid and submandibular glands are slightly larger than the left. The right submandibular gland may also be slightly more heterogeneous. Sublingual glandular tissue also appears slightly prominent in size, greater on the left. The thyroid isthmus is mildly thickened at 8 mm, with partially exophytic nodule off its inferior margin, measuring 1.8 x 2.3 cm. There is central heterogeneous hypoenhancement. In addition, there are scattered foci of hypoenhancement within the right lobe of the thyroid gland.ORAL CAVITY: The oral tongue and floor of mouth are unremarkable, within the limitations of this exam as there is artifact from dental amalgam.CERVICAL SOFT TISSUES: There are no pathologically enlarged cervical lymph nodes.OTHER: Right mastoid air cells are underpneumatized. There are minimal cervical spondylotic changes with left facet arthropathy along the mid to lower cervical spine. | 1. Subtle asymmetric enlargement of the right parotid and cerebellar glands with increased heterogeneity of the right submandibular gland. No associated inflammatory changes identified. Left slightly greater than right prominence of the sublingual glands. No focal mass is identified. Findings may relate to an inflammatory/autoimmune process such as Sjogren's, with the differential including sialadenitis and sarcoid, with lymphoma felt to be unlikely. Please correlate clinically.2. No cervical lymphadenopathy.3. Dominant thyroid isthmic mass with punctate hypoenhancing lesions in the right lobe as well. Correlation with thyroid function tests is recommended and thyroid ultrasound may be obtained as clinically indicated. . |
Generate impression based on findings. | Right femoral neck fracture. Evaluate. The bones appear demineralized, suggesting osteopenia. There is a complete fracture through the femoral neck with mild superior displacement of the diaphyseal fracture fragment, as seen on the recent CT scan. The distal femur appears intact. There are subacute fractures of the left obturator ring as seen on the prior CT scan. Faint sclerosis of the right sacral wing represents an additional healing fracture better seen on CT. Mild osteoarthritis affects both hip joints as well as the right knee and right sacroiliac joint. Degenerative arthritic changes also affect the visualized lower lumbar spine. Calcifications in the pelvis likely reside in uterine fibroids. | Right femoral neck fracture and other findings as above. |
Generate impression based on findings. | There is no intracranial hemorrhage. The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no midline shift or mass effect. There are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with mild age-indeterminate small vessel ischemic changes. There is no pathological enhancement. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. | 1. No acute intracranial hemorrhage, mass, or mass effect. No intracranial abscess or empyema. No CT evidence of PRES. Please note MRI would be more sensitive and can be considered as clinically indicated.2. Mild age-indeterminate small vessel ischemic changes. 3. Mild contrast extravasation as noted in technique section above. |
Generate impression based on findings. | Clinical question: Evaluate for stroke, rule out hemorrhagic conversion. Signs and symptoms: Status post stroke. Nonenhanced head CT:There is a new small foci of cortical attenuation in high convexity right posterior frontal (axial image 26 and 27) measuring approximately 15 mm in size and highly suspected a small focus of ischemic stroke. This finding was not present on prior study and highly suggestive of a new focus of ischemic stroke.A left posterior temporal -- parietal hemorrhagic ischemic stroke demonstrate interval decreased density and size of hemorrhagic component and with subtle interval decreased regional mass effect.Focus of left inferior frontal edema and hemorrhage demonstrate decreased density of hemorrhage and subtle decreased in extent of edema.Bilateral occipital regions of low-attenuation consistent ischemic strokes demonstrate no change.Ventricular system remains within normal size and stable since prior exam.Small focus of low attenuation in the right cerebellum consistent with a small chronic stroke similar to prior study. | 1.New since prior exam is a 15-mm focus of cortical low attenuation suggestive of an acute ischemic stroke in high convexity right posterior frontal as detailed.2.Interval decrease density of hemorrhage of left hemispheric stroke and with mild decreased regional mass-effect. 3.Interval subtle decreased size of left inferior frontal edema and hemorrhage.4.Stable exam otherwise as detailed. |
Generate impression based on findings. | Male 68 years old; Reason: staging exam History: prostate cancer CT of pelvis for research purposes | 1.CT of pelvis for research purposes |
Generate impression based on findings. | Mantle cell lymphoma CHEST:LUNGS AND PLEURA: Stable micronodulesMEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable bilateral renal cystsRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Stable reference right obturator lymph node best seen on image 183 of series 3 measuring 2.1 x 1 cm. Stable bilateral inguinal lymph nodes. Reference right inguinal lymph node best seen on image to 13 of series 3 measures 3.1 x 1.6 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable examination. No new adenopathy. |
Generate impression based on findings. | There is a moderate area of low attenuation in the posterior right frontal/parietal lobe subcortical white matter, right centrum semiovale, and corona radiata favored to represent vasogenic edema with concern for underlying mass, which results in cortical low density. Although axial images appear to suggest an area of mass-like isodensity, reformats do not delineate such a mass, and the finding may relate to displaced cortex. There is a punctate focus of calcification in the region of low density on series 3 image 21. There is regional mass effect with effacement of the sulci.There is mild confluent periventricular white matter hypoattenuation elsewhere which is nonspecific. The ventricles and basal cisterns are patent without evidence of hydrocephalus. There is no midline shift or herniation. There are prominent areas of hyperattenuation in the bilateral dentate nuclei, and the basal ganglia. The imaged paranasal sinuses and mastoid air cells are clear. There is hyperostosis frontalis. The skull and extracranial soft tissues are otherwise unremarkable. | 1.Finding representing vasogenic edema in the right posterior frontal/parietal lobe as described above with mild regional mass effect with underlying mass suspected. Further evaluation with contrast enhanced MRI is recommended, if there are no contraindications.2.Extensive symmetric bilateral basal ganglia and dentate nuclei calcifications. Differential diagnosis includes endocrine, metabolic, toxic etiologies, and Fahr disease.3.Probably underlying age-indeterminate small vessel ischemic changes. |
Generate impression based on findings. | Mesothelioma on observation. CHEST: TheLUNGS AND PLEURA: Left pleural thickening consistent with provided history of mesothelioma, reference measurements on the left as follows:1. Level of the diaphragm at the 4 o'clock position (4/90) 2.3 x 4.2-cm previously 2.8 x 4.4 cm differences in first dimension likely reflects obliquity of the diaphragm with the scanning plane. 5 o'clock position (4/93) 10 mm, unchanged. 2. Level of the main pulmonary artery 10 o'clock position 5 mm, previously 6-mm (4/46). 0 mm at the 3 o'clock position.3. Level of the GE junction (4/85) 12 o'clock position 14 mm, unchanged. 8 o'clock position 4 mm, unchanged.Moderate volume of left pleural fluid minimally decreased.Calcified pleural plaques noted on the left which appear lobular, correlate for prior pleurodesis. Calcified nodules consistent with granulomas. No contralateral pleural disease.MEDIASTINUM AND HILA: Small mediastinal lymph nodes are unchanged. Mild coronary artery calcifications. Left cardiophrenic angle lymphadenopathy unchanged (3/86). A left-sided catheter terminates in the SVC.CHEST WALL: Very small left internal mammary chain and left low cervical lymph nodes are unchanged.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Probable cortical cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Tumor infiltrating the left diaphragmatic crus measures 3.5 x 2 cm, previously 3.6 x 2.3 cm (4/99).Enlarged lymph node in the gastrohepatic ligament measures 15 mm, previously 16mm (4/95).Soft tissue stranding and small lymph nodes about the celiac axis are similar to recent previous.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted. | No significant change in reference level measurements. No new sites of disease. |
Generate impression based on findings. | Total shoulder arthroplasty Three views of the right shoulder show components of a reverse total shoulder arthroplasty device situated in near-anatomic alignment without radiographic evidence of hardware complication. Overall the shoulder appears similar to that seen on the prior study. Degenerative arthritic changes affect the visualized spine. | Total shoulder arthroplasty appearing similar to prior study. |
Generate impression based on findings. | Status post left total knee arthroplasty 3 views of the left knee show components of a total knee arthroplasty device situated in near-anatomic alignment without radiographic evidence of hardware complication. Swelling of the anterior soft tissues limits evaluation of the extensor mechanism.Severe osteoarthritis affects the right knee as seen on the frontal view. | Total knee arthroplasty as above. |
Generate impression based on findings. | 7-year-old female with acute left lower leg painVIEWS: Tibia and fibula, AP and lateral (two views) 2/18/15 11:22 The bones are gracile and diffusely demineralized. There is an oblique fracture of the distal tibial diaphysis with mild lateral displacement of distal fragment. Bowing deformity of the fibula is also noted. | Oblique distal tibia fracture and additional findings as described above. |
Generate impression based on findings. | Status post total shoulder arthroplasty. Assess prosthesis. Components of a reverse total shoulder arthroplasty device are situated in near-anatomic alignment without specific radiographic findings to suggest hardware complication. A plate and screw device affixing the humeral diaphysis is incompletely imaged on this study, but appears similar to that seen on the prior study. The bones appear slightly demineralized. Mild left rib deformities represent old healed fractures. | Left total shoulder arthroplasty and other findings as described above appearing similar to the prior study. |
Generate impression based on findings. | Pain. Prosthetic assessment. Three views of the right knee are provided. Severe tricompartment osteoarthritis affects the knee, appearing similar to that seen on the prior study. I see no joint effusion.Three views of the left knee are provided. Components of a longstem total knee arthroplasty device are situated in near anatomic alignment. Thin lucency at the cement bone interface of the tibial component and along the stem of the femoral component is within normal radiographic limits, although I cannot entirely exclude the possibility of loosening. | Total knee arthroplasty and osteoarthritis as described above. |
Generate impression based on findings. | Microscopic hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 0.6-cm obstructing right renal stone. No hydronephrosis. No worrisome renal mass or acute inflammatory process. Unremarkable collecting systems bilaterally.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: 2.6 x 3.7 cm right adnexal cysts.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 0.6-cm nonobstructing right renal stone. Otherwise unremarkable examination without evidence for worrisome renal mass, hydronephrosis, or acute inflammatory process. Unremarkable collecting systems bilaterally.Right adnexal cyst. |
Generate impression based on findings. | Male 68 years old Reason: 67M with history of renal stones now with positive urine cytology, please perform CT urogram History: gross hematuria, positive urine cytology ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple bilateral nonobstructing renal calculi. No hydronephrosis bilaterally. Multiple bilateral hypodense renal lesions, the larger ones likely represent simple cysts. Many of of the smaller lesions are too small to characterize. There is a minimally complex cyst in the left lower pole with adjacent calcification (series 9, image 64).Abnormal mucosal enhancement and mild thickening of the urothelium of a left lower pole calyx (series 7, image 63). No polypoid filling defects.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications of the abdominal aorta. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Abnormal mucosal enhancement and mild thickening of the urothelium in a left lower pole calyx. Given the small size of lesion, it is difficult to characterize with CT and recommend retrograde evaluation. 2.Multiple bilateral nonobstructing renal stones. |
Generate impression based on findings. | 53 year old with benign appearing calcifications in right breast, presents for follow up study. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Small cluster of amorphic calcifications is again seen at anterior 6 o'clock position without significant changes. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Cough feverVIEW: Chest AP Cardiothymic silhouette normal. Peribronchial wall thickening with subsegmental atelectasis left lower lobe. No pleural effusion or pneumothorax. | Reactive airway disease without pneumonia. |
Generate impression based on findings. | Patient with neuroendocrine tumor. Benign carcinoid, follow-up LUNGS AND PLEURA: the. described mild to moderate compression atelectasis related to the anterior mediastinal mass essentially unchanged. No suspicious superimposed pulmonary nodules or new masses. No effusionsMEDIASTINUM AND HILA: The large anteromediastinal mass demonstrates heterogeneity and no apparent interval change. Axial measurements remain 13.1 cm by 8.9 cm (image 38 series 6). The reference corresponding mediastinal lymph nodes are also similar measuring 1.6 cm (image 28 series 6) for a reference prevascular lymph node. There continues the no evidence of inferior lymphadenopathy, specifically the hilar regions are clear.The cardiac and pericardial appearance are otherwise unremarkableCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Unchanged size and measurements of the mediastinal mass and lymph nodes, reference measurements provided. Appearance remains consistent with known carcinoid |
Generate impression based on findings. | Fracture healing? The bones appear demineralized with gracile diaphyses and mild chronic deformity of the carpus appearing similar to the prior study. There is a side plate and screw device affixing a fracture of the distal radial diaphysis in anatomic alignment. The portion of the fracture not obscured by overlying hardware remains visible at this time. Surgical clips are noted within the soft tissues. | Orthopedic fixation of distal radius fracture as above. |
Generate impression based on findings. | Lumbar pain There are posterior rods with screws entering the L4 and L5 vertebrae. I see no hardware complications. There is a spacer device between the L4 and L5 vertebral bodies with associated bone graft material that appears similar to that seen on the prior study. Small osteophytes project from the anterior aspects of the lumbar vertebrae. Mild degenerative disk disease affects L5/S1. Surgical suture material is noted in the pelvis. | Postoperative changes of lower lumbar spine fusion appearing similar to those seen on the prior study. |
Generate impression based on findings. | Evaluation of the craniocervical junction demonstrate borderline low cerebellar tonsils with preserved rounded morphology. Right cerebellar tonsil measures up to 6 mm below the foramen magnum. There is retroflexion of the dens which partially effaces the ventral thecal sac. CSF spaces at the craniocervical junction are otherwise preserved. CSF flow sequences are slightly motion degraded but demonstrate preserved biphasic flow anteriorly and posteriorly at the foramen magnum.The cervical spine is in normal alignment, with a normal cervical lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal. There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the cervical spine. THORACIC SPINE | 1. Low-lying cerebellar tonsils measuring up to 6 mm on the right and 4-5 mm in the midline. There is mildly diminished CSF space at the foramen magnum related to retroflexed dens and the borderline low cerebellar tonsils. There is preserved biphasic flow.2. No evidence of syrinx or cord signal abnormality.3. No evidence of tethered cord. Conus terminates normally at the lower L1 level. No lipoma or other masses are seen involving the filum or cauda equina nerve roots. |
Generate impression based on findings. | Fall 8 days ago. Severe pain over radius with movement. There is perhaps mild soft tissue swelling along the dorsal and radial aspects of the wrist, but I see no underlying fracture. There is slight widening of the scapholunate interval which appears similar to that seen on the prior study. Minimal degenerative arthritic changes affect the wrist. | Soft tissue swelling and other findings as above without fracture evident. If there is clinical concern for an occult scaphoid or radius fracture, MRI may be considered for further evaluation. |
Generate impression based on findings. | Bladder carcinoma ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomySPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable bilateral nonobstructing subcentimeter renal stones. Stable bilateral renal cysts. No worrisome mass. Unremarkable collecting systems bilaterally. Previously noted ureteral stents removed.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomyBLADDER: Unremarkable ileal conduitLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Left pre-psoas retroperitoneal bland appearing fluid collection best seen on image 98 of series 7 again noted measuring 5.4 x 4.1 cm. | Stable nonobstructing bilateral nephrolithiasis. Stable left retroperitoneal pre-psoas bland fluid collection; favor benign postoperative collection such as lymphocele. No evidence for acute, inflammatory, or metastatic process. |
Generate impression based on findings. | Left foot, ankle and leg pain and swelling. New onset. History of stem cell transplant on steroids for 10 months. Three views of the left foot are provided. Mild osteoarthritis affects the first metatarsophalangeal joint and midfoot. There is soft tissue swelling, particularly along the dorsum of the foot, but I see no underlying fracture. Three views of the left ankle are provided. There is diffuse soft tissue swelling, but I see no acute fracture. There is thickening of the distal Achilles' tendon suggesting tendinopathy although this may in part be exaggerated by the aforementioned diffuse soft tissue swelling. There are arterial calcifications in the soft tissues. Small densities overlying the anterior aspect of the tibiotalar joint may represent small loose bodies in the joint or capsular calcifications.Two views of the left leg show diffuse soft tissue swelling. I see no fracture. Moderate osteoarthritis affects the knee, although this is incompletely imaged on this study. The bones are perhaps slightly demineralized. Chronic appearing periosteal reaction along the tibia and fibula is nonspecific, but I see no osteolysis or findings to suggest osteomyelitis. | Nonspecific soft tissue swelling and other findings as described above. |
Generate impression based on findings. | There is beam hardening artifact at C7 level and below, limiting evaluation. There is straightening of the cervical lordosis. There is mild narrowing of the C2-3 disk suspected to be at least partly developmental, with small posterior bridging osteophyte formation. There is developmental fusion of the right C2-3 facet, and narrowed facet joints space on the left with partial fusion. The vertebral body and disk space heights are well-maintained elsewhere.There is no acute fracture.At C1-C2, there is a normal relationship of the dens with the arch of C1. There is a disk extrusion suspected at C3-4 with superior migration with underlying CSF space effacement. There are also small disk protrusions at C5-6 and C6-7.There is mild-moderate bilateral neural foraminal stenosis at C4-5. There is mild multilevel facet arthropathy. There are mild atherosclerotic calcifications in the carotid bifurcations.The visualized intracranial structures and lung apices appear normal. | 1.No acute fracture or traumatic subluxation. 2.Multilevel disk/endplate and facet degenerative changes, worst at C3-4 where there is a suspected disk extrusion.3.Mild-moderate bilateral bony foraminal narrowing at C4-5. |
Generate impression based on findings. | Pain, swelling. There is soft tissue swelling, particularly along the medial aspect of the ankle. I see no underlying fracture or malalignment. I see no joint effusion. | Soft tissue swelling, nonspecific. |
Generate impression based on findings. | Status post shoulder scope Mild osteoarthritis affects the glenohumeral joint. There is new widening of the acromioclavicular joint that is presumably postoperative in etiology. Streaky calcification between the humeral head and acromion process suggests calcific tendinopathy of the rotator cuff. | Postoperative and degenerative arthritic changes as described above. |
Generate impression based on findings. | Low back pain. Fall on icy stairs. Moderate to severe degenerative disk disease affects L5/S1. The remaining intervertebral disk spaces are preserved. I see no frank compression fracture. Tiny osteophytes project from the anterior aspects of the lumbar vertebrae. Alignment is within normal limits. Calcifications of the distal aorta and common iliac arteries. | Degenerative disk disease. |
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