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Generate impression based on findings. | Reason: persistant sinus tachy, r/o PE History: sinus tachy PULMONARY ARTERIES: Demonstration of acute pulmonary emboli within the right descending pulmonary artery and segmental branches of the right lower lobe.There is no evidence of right heart strain.LUNGS AND PLEURA: Right posterior paramediastinal postsurgical ch... | Multiple acute pulmonary emboli within the right descending pulmonary artery and segmental branches the right lower lobe. No evidence of pulmonary infarction.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Lobar.RV Strain: Negative. |
Generate impression based on findings. | Right distal femur giant cell tumor. Evaluate for hardware failure/recurrence. Again seen is a plate and screw device affixing cement at the site of the distal femoral giant cell tumor curettage in near-anatomic alignment without evidence of hardware complication. Expansile remodeling of the medial aspect of the medial... | Postoperative changes of giant cell cell tumor curettage and distal femoral reconstruction as described above. Expansile remodeling of the medial aspect of medial femoral condyle appears similar to that seen on the prior study, although over the course of the last year appears to have increase slightly in width. While ... |
Generate impression based on findings. | History of left lumpectomy for invasive ductal carcinoma status post chemotherapy and radiation. No current breast related complaints. Three standard views of both breasts were performed along with 2 repeat right CC views, a repeat right MLO view, repeat left MLO view, repeat right mediolateral view, two CC spot mag vi... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign bilateral breast biopsies. 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. S-... | New group of calcifications in the left breast. Spot magnification imaging is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 55-year-old male with history of right upper lung nodule. Status post stem cell transplant. LUNGS AND PLEURA: Right upper lobe centrilobular nodular opacities have resolved over the interval, with minimal persistent centrilobular nodules/bronchial wall thickening in this area. Minimal right lower lobe centrilobular nod... | 1.Near complete interval resolution of right upper lung predominant centrilobular nodules, most consistent with infection.2.Diffuse skeletal sclerotic/lytic lesions, similar to prior.3.Unchanged severe splenomegaly. |
Generate impression based on findings. | Right shoulder pain. Evaluate for fracture. There is a transverse fracture through the surgical neck of the humerus with slight impaction and posterior angulation of the distal fracture fragment. The bones appear demineralized, suggesting osteopenia. Mild osteoarthritis affects the glenohumeral and acromioclavicular jo... | Proximal humerus fracture as above. |
Generate impression based on findings. | Seizures.VIEW: Chest AP (one view) 1/7/15 at 843 hours. ET tube tip is below the thoracic inlet. Feeding tube terminates at the antropyloric region. Central line tip is at the RA/SVC junction. Cardiac silhouette size is normal. Persistent bibasilar opacities likely atelectasis, with no effusions or pneumothorax. | Persistent bibasilar opacities. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in maternal cousin and paternal grandmother. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure sma... | 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. | Unknown 16 days old Reason: is there digitation of bowel? History: abdominal distentionVIEW: Abdomen AP (one view) 1/7/15 at 903 hours. Proximal side port of NG tube is above GE junction. A central line tip is at the right atrium. Generalized , nonspecific bowel distention. No evidence of pneumatosis intestinalis, port... | Misplaced NG tube.Generalized, nonspecific bowel distention. |
Generate impression based on findings. | Pain Three views of the left knee are provided. Mild osteoarthritis affects the knee. I see no fracture or joint effusion.Mild osteoarthritis also affects the right knee as seen on the frontal view. | Mild osteoarthritis. |
Generate impression based on findings. | Female 23 years old Reason: r/o colitis vs appendicitis History: abd pain 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, U... | Persistent inflammatory changes about the cecum, appearing similar to the prior examination. Although nonspecific, this could reflect focal colitis or possibly diverticulitis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast cyst aspiration. 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 su... | 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. | 58 year-old male with history of leukocytosis and concern for infection. CML. LUNGS AND PLEURA: Minimal bibasilar atelectasis/scarring. No consolidation or pleural effusion. Approximately 8mm well circumscribed left lower lobe solid nodule. An additional right middle lobe medial segment fat containing lenticular shaped... | 1.Minimal basilar atelectasis/scarring, without consolidation or other findings to suggest infection.2. 8mm left lower lobe solid nodule, of unclear etiology but possibly a noncalcified granuloma. Intrapulmonary chloromas have been reported in the literature but are extremely rare. Follow-up in 6 months with noncontras... |
Generate impression based on findings. | Female 4 years old Reason: increased WOB, tachypnea VIEW: Chest AP (one view) 1/7/15 at 949 hours Left upper extremity PICC terminates at the RA/SVC junction. Upper abdominal surgical clips unchanged. Bibasilar opacities again noted. No evidence of pleural effusions or pneumothorax. | Stable bibasilar opacities. |
Generate impression based on findings. | 16 year old female. Toe injury after ballet practice.EXAMINATION: Left second toe AP/oblique/lateral (3 views) 1/6/15 No fracture or malalignment is present. No soft tissue swelling is evident. | Normal examination of the left 2nd toe |
Generate impression based on findings. | Female 12 years old Reason: eval for healing fracture distal 4th mt History: foot pain 3 days s/p fall on gymnasticsVIEWS: Right foot AP, lateral and oblique 1/7/15 (3 views) Cast material obscures fine bone details. Salter-Harris 3 healing fracture of the distal fourth metatarsal is in near anatomic alignment. | Healing fracture in near-anatomic alignment. |
Generate impression based on findings. | Fecal impactionEXAMINATION: Abdomen AP (one view) 1/6/15 Large rectosigmoid stool burden, with a moderate amount of stool throughout the rest of the colon. The rectum measures at least 10 cm in width. No pneumatosis, portal venous gas, or pneumoperitoneum. | Large rectosigmoid stool burden. |
Generate impression based on findings. | esoph ca, s/p chemo and RT and esophagectomy. Pls c/w previous study and evaluate dz status. CHEST:LUNGS AND PLEURA: No change in scattered nonspecific pulmonary micronodules. No suspicious pulmonary nodule or mass is seen. No pleural effusion or consolidation is present.MEDIASTINUM AND HILA: Status post total esophage... | No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 44-year-old male with history of tachycardia and shortness of breath. Evaluate for PE. Motion artifact slightly limits this exam.PULMONARY ARTERIES: No pulmonary embolus.LUNGS AND PLEURA: Patchy consolidation in the left lower lobe, most consistent with infection. Minimal patchy opacities in the right lower lobe are al... | No pulmonary embolus. Predominantly left lower lobe patchy consolidation most consistent with infection. Follow-up PA and lateral chest radiographs in 6 weeks recommended to ensure resolution.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain... |
Generate impression based on findings. | Reason: mets lung cancer. s/p chemo. Pls c/w previous study and evaluate dz status. History: lung cancer CHEST:LUNGS AND PLEURA: Status post bilateral upper lobectomies. Fibrosis is again seen along the right superior hilum. The previously right lower lobe micronodule again measures 4 mm (image 77, series 4). Ground gl... | 1.No evidence of recurrent or metastatic disease.2.No change in indeterminate pulmonary nodules, however continued follow-up is recommended to exclude indolent primary adenocarcinoma. |
Generate impression based on findings. | Male 47 years old; Reason: rectal cancer restaging History: rectal cancer restaging CHEST:LUNGS AND PLEURA: 5-mm nodule along the minor fissure (image 51; series 5) is unchanged. The pleural spaces are clear.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER,... | Stable exam with reference measurements given above. |
Generate impression based on findings. | 33-year-old female with a history of roux-en-y gastric bypass c/b anastomotic strictures s/p dilatation at OSH now with persistent abdominal pain and intermittent vomiting/intolerance to po intake. Scout radiograph showed a nonobstructive bowel gas pattern. Surgical clips are visualized in the right upper quadrant from... | 1.Post-surgical changes related to a Roux-en Y gastric bypass procedure. 2.Findings suspicious for partial small bowel obstruction at the jejunojejunal anastomosis.3.Patent gastrojejunal anastomosis. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage or mass. 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 unremarka... | No evidence of acute intracranial hemorrhage or depressed calvarial fracture.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 44 years old Reason: r/o obstruction History: metastatic colon cancer, not tolerating PO, emesis, no BM since yesterday ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Multiple hepatic metastases again seen without significant interval change in size. Hepatic segment 8 lesion now measur... | 1.Physiologically significant right-sided renal obstruction, with the associated nephroureteral stent likely malfunctioning.2.Small bowel obstruction with multifocal transition points seen in the left hemipelvis, secondary to tumoral infiltration.3.Peritoneal carcinomatosis and liver metastases without significant inte... |
Generate impression based on findings. | 53-year-old with atypical lobular hyperplasia in the left breast status post lumpectomy and follow-up biopsy with additional foci of ALH. No family history of breast cancer. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously de... | 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. | Male 79 years old Reason: 79 yo male with recently diagnosed colon cancer by colonoscopy History: colon cancer CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses are identified.MEDIASTINUM AND HILA: The heart size is enlarged. There is no evidence of pleural or pericardial effusion. The trachea and mains... | Cecal mass compatible with the reported history of colon cancer, with findings worrisome for regional lymph node metastasis and possible adjacent peritoneal carcinomatosis. |
Generate impression based on findings. | Reason: postoperative scans for right cheek SCC with parotid invasion and positive margins History: s/p resection for SCC of right cheek. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodule or mass. No pleural effusion or consolidation.MEDIASTINUM AND HILA: Several mildly enlarged lower cervical lymph nodes are part... | 1.Splenomegaly and mild mediastinal, axillary, and retroperitoneal lymphadenopathy is likely related to the patient's leukemia.2.No evidence of metastatic disease from the patient's right cheek SCC.3.Please see CT neck report for further details. |
Generate impression based on findings. | 78-year-old male with swelling and tenderness to palpation over the fourth metacarpal after fall There is swelling along the dorsal aspect of the hand. No fracture is evident. Mild osteoarthritis affects the interphalangeal joints. We also see narrowing of the metacarpophalangeal joints with osteophyte formation and fa... | Arthritic changes likely representing a combination of osteoarthritis and perhaps CPPD arthropathy. |
Generate impression based on findings. | 50 year-old female with pain, evaluate for fracture There is mild soft tissue swelling about the PIP joint as well as a cortical step off seen on the PA and lateral views along the radial and dorsal aspects (respectively) of the base of the middle phalanx consistent with a nondisplaced fracture. | Nondisplaced fracture of the middle phalanx. |
Generate impression based on findings. | 54-year-old female with radiculopathy Moderate to severe degenerative disk disease affects C4/5 with moderate degenerative disk disease affecting C5/6 and C6/7. There are anterior and posterior vertebral body osteophytes at these levels. The cervical spine is kyphotic. There is narrowing of bilateral neuroforamina at C... | Degenerative disk disease and other findings as described above. |
Generate impression based on findings. | 67-year-old female with pain, evaluate for progression of AVN Left hip: Again seen is bandlike sclerosis consistent with AVN. Best seen on the frog leg view is curvilinear subchondral lucency indicating subchondral fracture with collapse of the overlying superior and medial articular surface, progressed from the prior ... | Progression of avascular necrosis involving the left femoral head. |
Generate impression based on findings. | 64 year old woman with history of multiple myeloma. SKULL: Multiple lucent lesions are seen in the cranial apex, although with poorly defined margins.CERVICAL SPINE: Cervical spine alignment is within normal limits and the vertebral body and intervertebral disc heights are preserved. No myelomatous lesions are identifi... | Questionable lucent lesions of the calvaria, otherwise no myelomatous lesions identified. |
Generate impression based on findings. | 62 year-old female status post right total hip arthroplasty Hip: Hardware components of a total hip arthroplasty are situated in near-anatomic alignment without evidence of complication.Pelvis: The bones are demineralized, suggesting osteopenia. Mild osteoarthritis affects the left hip. | Total hip arthoplasty in near-anatomic alignment. |
Generate impression based on findings. | 10-year-old female with PICC manipulated/moved.VIEW: Chest AP (one view) 1/7/2015, 0832 hours. Right upper extremity PICC tip in the right axilla and does appear slightly retracted from the previous exam accounting for differences in technique. NG tube tip is beyond the field of view.No focal pulmonary opacity, pleural... | PICC tip in the right axilla. |
Generate impression based on findings. | 77-year-old female with sickle crisis, evaluate for erosive OA or rheumatoid arthritis Right hand: Moderate osteoarthritis affects the basilar joint. Mild osteoarthritis affects the interphalangeal joints of the fingers. There is also mild narrowing of the metacarpophalangeal joints with tiny osteophytes, but no erosio... | Osteoarthritis of both hands. Mild degenerative osteoarthritic changes of the metacarpophalangeal joints may reflect an extension of the patient's primary osteoarthritis or perhaps CPPD arthropathy, although we see no definite chondrocalcinosis to support this. There is slight narrowing of the left radiocarpal joint, b... |
Generate impression based on findings. | 78-year-old male with history of altered mental status. Evaluate for subdural hematoma. There is no evidence of acute intracranial hemorrhage. There is unchanged extensive cerebral white matter hypoattenuation. There is no midline shift or mass-effect. There is diffuse cerebral volume loss. There is unchanged tortuosit... | 1. No evidence of subdural hematoma. 2. Unchanged extensive chronic small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 48-year-old female status post fourth ray resection with transposition of the fifth to fourth ray A plate and screw device affixes the transplanted bones of the fifth ray to the fourth metacarpal. The lateral aspect of the osteotomy remains visible, but there is perhaps some bony bridging across the center of the osteo... | Postoperative changes of fourth ray resection and fifth ray transposition as described above. |
Generate impression based on findings. | h/o met ACC, s/p chemo and palliative RT, compare to previous, measurements pls CHEST:LUNGS AND PLEURA: Innumerable pulmonary and pleural nodules are again seen, increased in size and number from the prior study. Reference measurements are as follows:1.Left lower lobe nodule now measures 15 mm (image 55, series 6), pre... | 1.Increase in size and number of pulmonary and pleural metastases. Increase in bilateral pleural effusions.2.Increase in size and number of hepatic metastases.3.New bilateral renal metastases.4.New subtle lytic lesions in the left iliac wing and may represent additional osseous metastases.5.No change in mediastinal/hil... |
Generate impression based on findings. | 74 year-old woman with history of pain. Left knee: Hardware components of a left total knee arthroplasty device are seen in near anatomic alignment. There is no evidence of hardware complication.Right hip: Hardware components of a right total hip arthroplasty device are seen in near anatomic alignment. There is no evid... | Hip and knee arthroplasties as described above without evidence of complication. |
Generate impression based on findings. | There are post-treatment findings in the right frontal lobe related to tumor resection. There is minimal curvilinear enhancement along the posterior margin of the right frontal surgical cavity best seen on the sagittal sequence. The T2/FLAIR hyperintense nodular components of tumor along the anterior margin and poster... | 1. Interval increase in size of an enhancing ependymal lesion along the lateral aspect of the right frontal horn, suspicious for a growing tumor deposit.2. Gradual increase in size of abnormal T2/FLAIR hyperintense signal along the right aspect of the fourth ventricle, of uncertain significance.3. Otherwise, no signifi... |
Generate impression based on findings. | 49-year-old woman with history of pain. The hand is normal in appearance without acute fracture, malalignment, or significant degenerative changes. | No finding to explain the patient's pain. |
Generate impression based on findings. | 62 year-old woman with history of shooting pains along the talocalcaneal joint. There are small osteophytes at the navicular cuneiform articulation indicating mild to moderate osteoarthritis. The subtalar joint appears normal. There is no acute fracture or malalignment. | Degenerative changes of the navicular cuneiform articulation. |
Generate impression based on findings. | 77-year-old woman with history of bilateral knee pain and locking of the left knee. Left knee: Moderate to severe osteoarthritis affects the left knee with predominately lateral joint space narrowing to near bone-on-bone apposition and tricompartmental osteophyte formation. Multiple surgical clips are noted in the medi... | Degenerative changes of the knees bilaterally with loose body in the right knee joint. |
Generate impression based on findings. | 57 year-old female with elbow pain and hand paresthesias Wrist: No fracture or other specific findings are identified to account for the patient's pain.Elbow: No fracture, effusion, or malalignment evident.Lumbar spine: There is slight straightening of the lumbar spine. Vertebral body heights and disk spaces are mainta... | No fracture or other specific findings to account for the patient's pain. |
Generate impression based on findings. | Trauma. Evaluate for clavicular fracture.VIEWS: Left clavicle AP and axial 1/7/15 (two views) There is a transverse fracture with inferior angulation of the mid shaft of the left clavicle. | Transverse fracture of the left clavicle as described. |
Generate impression based on findings. | Male 4 months old Reason: bilious emesis, eval obstruction VIEW: Abdomen AP (one view) 1/7/15 at 943 hours. Giant of velocities again noted. A second NG tube has been placed into the stomach. A single dilated loop in the right upper abdominal quadrant is again noted. Obstruction cannot be excluded. | Interval placement of a second NG tube.The bowel distention concerning for obstruction. |
Generate impression based on findings. | 62-year-old with history of IDC in the right breast status post lumpectomy, radiation, and hormonal therapy. Patient states the right breast is still tender, but otherwise has no complaints. No family history of breast cancer. Three standard views of the right breast along with two CC mag views and one mediolateral spo... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in July 2015 (to get back on a bilateral annual schedule). Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagno... |
Generate impression based on findings. | Reason: vocal cord paralysis, recurrent laryngeal nerve involvement History: hoarse Motion artifact limits evaluation of the lower lobes.LUNGS AND PLEURA: Small left pleural effusion is noted. No consolidation, pulmonary nodule, or mass.MEDIASTINUM AND HILA: Right central venous catheter tip is seen in place with its t... | No mass lesion is seen along the course of the recurrent laryngeal nerves.Small left pleural effusion. |
Generate impression based on findings. | 4-month-old male with a bradycardic episodes associated with feeding.EXAMINATION: Oropharyngeal motility study 1/7/2015, 1015 hrs. Beth Harrison, speech and language therapist, supervised the examination.99 seconds of fluoroscopy was used.Thin liquids and half strength nectar were administered via a slow flow nipple. F... | Penetration and aspiration, as above.Please see the speech and language therapist's report for feeding recommendations. |
Generate impression based on findings. | Recto-urinary fistula KIDNEYS Cortical Echogenicity: Normal. The cortex is minimally thinned in the left kidney due to hydronephrosis. Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Left: 3/4 Length*** Right: 4.3 cm Left: 4.4 cm Mean for age: 4 cm Range for age: 3.5 - 5.5 cmADDITION... | 1. Grade 3/4 left hydronephrosis2. Palpable perineal/anal bulge likely representing anorectum with meconium. *SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the cali... |
Generate impression based on findings. | Female 11 years old. Reason: follow-up scan. History: neurogenic bladder with history of renal stones. BLADDER Wall Thickness: Slightly thickened. Contents: Fluid distended with a small amount of layering debris. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKI... | Non-obstructing right renal stone.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading syst... |
Generate impression based on findings. | Prostate carcinoma CHEST:LUNGS AND PLEURA: Interval increase in size of small bilateral pleural effusions.MEDIASTINUM AND HILA: Stable thyroid nodules. Stable reference right paratracheal lymph node best seen on image 40 of series 3 measuring 1.1 x 2 cm. Stable bilateral hilar adenopathy.CHEST WALL: No significant chan... | Subcentimeter low attenuation focus within the right lobe of liver not appreciated on prior studies; would pay special attention to this lesion on future surveillance scans.Widespread sclerotic bony metastasis again noted and unchanged.Interval increase in small bilateral pleural effusions and new trace ascites. |
Generate impression based on findings. | Female 77 years old Reason: hx of urothelial cancer of the left kidney s/p left nephroureterectomy and bladder cancer, evaluate for metastatic disease History: see above ABDOMEN: Within the limits of a non IV contrast enhanced examination which limits ability to evaluate solid parenchymal organs and vascular structures... | 1.Post surgical changes related to left nephrectomy without evidence of locoregional disease recurrence or metastatic disease.2.Unchanged from the gastric hepatic ligament lymph nodes. Although nonspecific, attention at follow-up is recommended.3.Resolution of the previous seen fat stranding about the umbilicus. |
Generate impression based on findings. | There is an unchanged left posterior parafalcine extra-axial partially calcified mass with mildly worsened vasogenic edema in the adjacent left frontal and parietal lobes. There is unchanged erosion of the left parietal calvarium inner table with heterogeneous appearance. There is mild mass effect on the left lateral ... | No acute intracranial hemorrhage. Mild interval worsening of vasogenic edema associated with the unchanged left posterior parafalcine meningioma. |
Generate impression based on findings. | Twisted knee. Pain.VIEWS: Left knee AP/lateral/oblique (3 views) 01/07/15 A joint effusion is not present. No fracture is seen. The bones are normal in appearance. | Normal examination. |
Generate impression based on findings. | 6-year-old female with fever, hypoxia, work of breathing.VIEW: Chest AP (one view) 1/7/2015, 1115 hrs. Low lung volumes.Retrocardiac opacity suggestive of atelectasis, less likely consolidation. No evidence of pleural effusion or pneumothorax. Normal cardiothymic silhouette.Dilated colon seen in the upper abdomen. Dedi... | Retrocardiac opacity may represent atelectasis, less likely consolidation. |
Generate impression based on findings. | 65-year-old male status post orogastric tube placement. Paucity of bowel gas in the abdomen without evidence of obstruction. The orogastric enteric tube loops in the body of the stomach with the tip in the fundus. Note that the lower pelvis was not included in the exam. | Orogastric tube with the tip in the fundus. |
Generate impression based on findings. | 74 years old, Male, Reason: 73M with h/o acute pancreatitis c/b pancreatic necrosis and pancreatic pseudocsyst s/p drainage. 1 drain recently pulled. History: Pancreatic pseudocyst ABDOMEN:LUNG BASES: Moderate calcifications of the coronary arteries.LIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis... | 1.Interval decrease in size of perigastric fluid collection with drain in place.2.Interval removal of cyst gastrostomy drain without residual fluid collection in the area of the pancreatic head.3.Splenic vein and SMV well opacified and appear patent on this study. 4.Stable abdominal aortic and iliac aneurysms. |
Generate impression based on findings. | 65-year-old male with increasing abdominal distention and postoperative day one from an LVAD. Note that the pelvis was not included in the exam. Post-surgical changes, support devices, and tubes are again seen and appear similar to same day thoracoabdominal radiography. Nonobstructive bowel gas pattern. Surgical clips ... | Nonobstructive bowel gas pattern, essentially stable exam. |
Generate impression based on findings. | 53-year-old female with defecatory dysfunction. On exam seems to have rectocele that extends to right ischiorectal fossa in area of prior episiotomy. History: Describes bulge that tracks R laterally with associated symptoms, chronic constipation. There was prompt opacification of the rectum and sigmoid of normal static... | 1. Small right-sided lateral rectocele and possible smaller left-sided lateral rectocele. 2. Rectal prolapse present. |
Generate impression based on findings. | Female 69 years old Reason: mets lung cancer. s/p 12 cycles of MPDL3280A. pls c/w previous study to evaluate tx response. History: lung ca ABDOMEN:LUNG BASES: Please see chest CT report from the same day for full evaluation of the thoracic findings.LIVER, BILIARY TRACT: Multiple hepatic hypodensities unchanged.SPLEEN: ... | 1.Stable examination, no evidence of metastatic disease as clinically indicated.2.Please see chest CT report from the same day for full evaluation of the thoracic findings. |
Generate impression based on findings. | Pain. Evaluate fracture. The nondisplaced medial malleolar fracture seen on the prior study is barely visible on the current study, likely due to some interval healing combined with slight differences in patient positioning between two examinations. | Medial malleolar fracture as described above. |
Generate impression based on findings. | Chronic back pain with paresthesias in left leg. Pain in right leg with radiation to foot. Severe degenerative disk disease affects L5/S1. Mild to moderate facet joint osteoarthritis affects the lower lumbar spine. There are minimal anterolistheses of L3 and L4 with slight posterior bulging of the calcified periphery o... | Degenerative disk disease/osteoarthritis as described above. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild periventricular and subcortical white matter hypoattenuation, especially adjacent to the left frontal horn and atrium of the left lateral ventricle which is nonspecific in this age group. The ventricles and basal cisterns are norma... | 1.No acute intracranial hemorrhage or mass effect. CT is insensitive for detection of early nonhemorrhagic stroke.2.Mild periventricular and subcortical white matter hypoattenuation, especially focally adjacent to the left frontal horn and atrium of the left lateral ventricle, nonspecific in this age group. Differentia... |
Generate impression based on findings. | Rule out shoulder dislocation. Shoulder pain. Hip pain. History of hip replacement. Rule out fracture. The Velpeau view of the shoulder again shows the fracture through the surgical neck of the humerus with fracture fragments in near-anatomic alignment. Glenohumeral joint alignment is within normal limits.Two views of ... | Right humeral neck fracture, right total hip arthroplasty, and other findings as above. |
Generate impression based on findings. | Cough and S.O.B.. Evaluate ILD for changes. Pain in joint, shortness of breath, anemia, muscle weakness. LUNGS AND PLEURA: Significant interval improvement in pulmonary opacity since the previous examination, now with fairly symmetric residual areas of anterior and upper lung linear scarring. Mild cylindrical bronchiec... | Near complete resolution of pulmonary opacities with residual scarring and mild bronchiectasis. Interval development of anterior mediastinal fat stranding with numerous small lymph nodes; correlate for inflammatory process as it is more nodular than typically seen with reactive thymic hyperplasia. |
Generate impression based on findings. | 46 year old with left breast mass at the two o'clock position presents for ultrasound guided biopsy. Left ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 6 x 4 mm at the 2 o’clock position without increased vascularity, 6 cm from the nipple. The lesion was... | Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Pain Again seen is a large osteochondroma projecting from the posterolateral aspect of the proximal humeral diaphysis. This appears similar to that seen on prior studies. I see no fracture or specific findings to suggest malignancy. | Osteochondroma as above. |
Generate impression based on findings. | Occasional dyspnea. Follow-up of metastatic breast cancer. CHEST:LUNGS AND PLEURA: Diffuse pleural metastases on the right are now near-circumferential. Reference nodular focus near the right apex measures 12 mm, previously 9-mm (3/17). Second reference pleural lesion abutting the right heart border (3/49) measures 8 m... | 1. IVC filter strut penetration into the transverse portion of the duodenum noted. If patient is asymptomatic, may be inconsequential. Dr.Fleming notified via e-mail.2. Pleural metastases on the right with reference measurements provided in the body of the report.3. Interval development of bilateral mediastinal and ips... |
Generate impression based on findings. | 21 year-old male with right ankle pain to medial, posterior malleolus and decreased range of motion status post injury 1 1/2 months ago. Evaluate for fracture. I see no fracture, malalignment, or other specific findings to account for patient's pain. | No fracture or other findings to account for patient's pain. |
Generate impression based on findings. | HEAD: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. MAXILLOFACIAL: No acute facial bone fracture is identified. The temp... | 1.No acute intracranial hemorrhage or skull fracture.2.No acute facial bone fracture. |
Generate impression based on findings. | Knee pain status-post sports injury. Evaluate for fracture. Four views of the left knee are provided. I see no fracture, malalignment, or other specific findings to account for the patient's knee pain. The right knee likewise appears normal as seen on the frontal views. | No fracture or other findings to account for patient's pain. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Giant cell tumor of left proximal tibia status post curettage x 2. Evaluate for recurrence. Again seen is a plate and screw device affixing cement within the proximal tibia at the site of giant cell tumor curettage. I see no hardware complications. I see no radiographic evidence of tumor recurrence. | Postoperative changes of giant cell tumor curettage appearing similar to the prior study. |
Generate impression based on findings. | Right femur diaphyseal cortically based lesion. Evaluate for interval change. Again seen is an elongated lucency within the cortex of the lateral aspect of the mid femoral diaphysis appearing similar to that seen on the prior study. The lesion appears slightly smaller than that seen on a study from January 2013. I see ... | Cortically based lesion as described above without evidence of progression. I suspect that this is benign. |
Generate impression based on findings. | Fracture Again seen is a side plate and screws affixing a fracture of the distal fibula in near anatomic alignment. I see no hardware complications. The fracture is perhaps slightly less distinct on the current study on the prior study, suggesting some interval healing. Plates and screws also affix an intra-articular f... | Orthopedic fixation of fractures as above. |
Generate impression based on findings. | There is an unchanged 11 x 9 mm in hyperattenuating lesion in the roof of the third ventricle. The ventricles and basal cisterns are normal in size and unchanged. There is patchy periventricular and subcortical white matter hypoattenuation without significant change representing small vessel ischemic disease. There is... | No significant change in third ventricular colloid cyst. No hydrocephalus or significant change in ventricular caliber. |
Generate impression based on findings. | Metastatic lung cancer to the right neck with vocal cord paralysis, status post Radiesse paste injection into right vocal cord. There is interval decrease in size of an ill-defined conglomerate of right level 4 lymph nodes, which measures up to 12 x 16 mm, previously 14 x 20 mm. However, there is no significant interva... | 1.Interval decrease in size of an ill-defined conglomerate of right level 4 lymph nodes, but other cervical and upper mediastinal lymphadenopathy are not significantly changed.2.Partially imaged right lung mass. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Severe headache, evaluate for hemorrhage No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial coll... | No evidence of intracranial hemorrhage or mass effect. |
Generate impression based on findings. | Status post total knee arthroplasty. Evaluate alignment. Components of a total knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. Skin staples, a drain, and foci of gas density within the soft tissues reflect recent surgery. | Total knee arthroplasty in near-anatomic alignment. |
Generate impression based on findings. | Cough and follow-up lung cancer CHEST:LUNGS AND PLEURA: Postsurgical changes and left upper lobe excision without new acute abnormality. Mild volume loss and associated stable appearing pleural thickening/scarring. Mild basilar atelectasis and multiple unchanged peripheral subpleural nodules in the right upper lobe (im... | Postsurgical changes following excision of the left upper lobe. Otherwise stability in overall appearance and no new suspicious abnormalities. The scattered subcentimeter subpleural nodules the right upper lobe and reference measurements are provided |
Generate impression based on findings. | Metastatic lung cancer status post 12 cycles of MPDL3280A. LUNGS AND PLEURA: Right upper lobe mass (5/38) measures 4.6 x 1.3 cm, previously 4.6 x 1.6 cm; differences in transverse dimension may be the result of the obliquity of the lesion with scan plain as subjectively it appears similar to the prior study.Right middl... | No significant change in right upper lobe mass however the right middle lobe lesion has decreased in density. Mixed response and lymphadenopathy with regression of previously seen enlarged mediastinal and hilar lymph nodes with the exception of an enlarging conglomerate of necrotic prevascular lymph nodes. |
Generate impression based on findings. | 66 year old with biopsy proven left breast malignancy present for needle localization prior to surgery. On review of the prior studies, the left breast mass at 5:00 is well seen sonographically. The procedure, risks including bleeding, mistargeting and infection, and benefits of needle-wire localization were discussed ... | Successful needle localization of the left breast malignancy.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Esophageal cancer CHEST:LUNGS AND PLEURA: Unchanged stable mild paramediastinal fibrotic changes consistent with known prior radiation therapy. A small focal ground glass opacity in the right upper lobe has since resolved it has been replaced with a similar abnormality now observed in the mid left lung. No suspicious s... | 1. Stable unchanged distal esophageal circumferential wall thickening with post radiation changes observed throughout the midline.2. Evidence of aspiration, currently observed on the left and resolved on the right |
Generate impression based on findings. | Reason: lung nodule. missed bx at OSH History: cough LUNGS AND PLEURA: No suspicious: None masses.Minimal scarring/discoid atelectasis at the right lung base. No focal or consolidation.No pleural effusions.MEDIASTINUM AND HILA: Mild amount of residual thymic tissue in the anterior mediastinum.Several small nonenlarged ... | No suspicious pulmonary nodule or mass can be identified. |
Generate impression based on findings. | Non-small cell lung cancer CHEST:LUNGS AND PLEURA: Right lower lobe postoperative changes with an unchanged reference right upper lobe nodule (image 25 series 4) continuing to measure 8 x 7 mm. Similar unchanged reference left lower lobe nodule (image 67 series 4) again remaining 10 x 10 mm. Nodules remain suspicious f... | Stable reference measurements and exam is without additional new abnormalities. |
Generate impression based on findings. | Reason: esophgeal cancer History: evaluate disease/check for progression CHEST:LUNGS AND PLEURA: New moderate sized right pleural effusion.No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Esophageal stent identified in the distal esophagus with considerable amount of debris and fluid noted within the ste... | 1.Esophageal stent placement with a considerable amount of fluid/debris within the stent and esophageal lumen proximal to the stent.2.Moderate-sized right pleural effusion new from the prior exam, however unchanged from abdominal/pelvic CT dated 12/22/14. However, there has been clearing of the left-sided pleural effus... |
Generate impression based on findings. | Shortness of breath rule-out underlying lung disease. COPD, pulmonary hypertension, CREST variant of scleroderma and history of lung cancer. LUNGS AND PLEURA: Left hemithorax volume loss with post surgical changes suggestive of lingulectomy. Moderate to severe centrilobular emphysema. 7-mm noncalcified indeterminate no... | 1. Emphysema with subtle increase in density of the background lung parenchyma, too mild to accurately characterize but potentially could be sequela of hemosiderin deposition from previous episodes of autoimmune-related alveolar hemorrhage given proximity to the bronchovascular bundles. No evidence of acute alveolar he... |
Generate impression based on findings. | 67 years old, Male, Reason: 67M w/ hx cholangiocarcinoma, s/p whipple, w/ PTC and IR drain in place, requires drian revision (discussed with IR) History: 67 M w/ hx cholangiocarcinoma, s/p whipple, w/ PTC and IR drain in place, requires drian revision (discussed with IR) Progression of collections, abscess ABDOMEN:LUNG... | 1.Stable right hepatic lobe biloma with drain in place. Unchanged percutaneous biliary drainage catheter.2.Narrowing of the main portal vein near the head of the pancreas.3.Mild to moderate intrahepatic biliary ductal dilatation.4.Moderate amount of ascites, unchanged from prior exam.5.Evolving splenic infarctions.6.Bi... |
Generate impression based on findings. | Squamous cell carcinoma, status post radiation therapy and amputation LUNGS AND PLEURA: Unchanged large calcified granuloma in the apical segment of the right lower lobe. Right basilar scarring and along the major fissure, without additional suspicious new nodules or masses bilaterally. No effusions. Minimal centrilobu... | No evidence of metastatic disease and interval clearance of previously described infectious or inflammatory pulmonary changes |
Generate impression based on findings. | Female, 89 years old, with altered mental status. No evidence of parenchymal edema or mass-effect is seen. No loss of gray-white distinction is evident. Mild periventricular hypoattenuation is a nonspecific finding which may reflect age indeterminate microvascular ischemic disease. A focal lucency within the left thala... | 1.No acute intracranial abnormality.2.Mild age indeterminate small vessel ischemic disease. |
Generate impression based on findings. | Male 80 years old; Reason: monitor for abscess enlargement vs resolution History: see above ABDOMEN:LUNG BASES: Stable reticular opacities in the lung bases and in the right middle lobe, likely atelectasis or scarring.LIVER, BILIARY TRACT: Stable subcentimeter hypodensity in the inferior right hepatic lobe.SPLEEN: No s... | 1.Redemonstrated 2.9 x 2.1 cm loculated fluid collection in the pelvis also contains gas, and apparently tracks towards an anterior loop of small bowel. Underlying fistula not excluded. Not significantly changed since prior exam. Other presacral fluid and induration is also seen, grossly unchanged in appearance.2.Redem... |
Generate impression based on findings. | 58-year-old with history of cyst aspiration in 2013. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No new dominant mass, suspicious microcalcifications or areas of architectura... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Pain. Rule out fracture. The bones are demineralized, suggesting osteopenia/osteoporosis. There is a transverse fracture through the surgical neck of the humerus with slight posterior displacement of the diaphyseal fracture fragment. Several old healed right rib fractures are also noted. | Proximal humerus fracture as above. |
Generate impression based on findings. | 77 years old, Male, Reason: atypical renal cyst History: atypical renal cyst ABDOMEN:LUNG BASES: Trace right pleural effusion with bibasilar dependent atelectasis. LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenic granuloma.PANCREAS: There is a small cyst in the pancreatic head.ADRENAL GLANDS: No si... | 1.Multiple benign renal cysts bilaterally.2.Incidental note is made of uncomplicated malrotation of the bowel.3.Asymmetric bladder wall thickening in the trigonum of the bladder; neoplasm cannot be excluded. Recommend correlation with cystoscopy. |
Generate impression based on findings. | 48-year-old male with history of head and neck squamous cell carcinoma of the base of tongue. Chemoradiation therapy. 10-069 protocol. CHEST:LUNGS AND PLEURA: Stable scattered pulmonary micronodules, some of which are calcified. No pleural effusion, consolidation or new nodules or masses.MEDIASTINUM AND HILA: Left thyr... | No significant abnormality, and no evidence of metastatic disease. |
Generate impression based on findings. | Renal cell carcinoma CHEST:LUNGS AND PLEURA: Stable micronodules. Reference left cardiophrenic angle nodular focus as seen on image 91 of series 5 measures 0.6 x 0.4 cm.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Status post cholecystec... | Slight interval decrease in size of reference pancreatic lesions as well as resolution of left periaortic enlarged lymph node. No new metastatic focus. |
Generate impression based on findings. | Female 40 years old Reason: 40 yr old patient with hx of peritoneal cancer. Ex-lap, TAH/BSO, sigmoid coln resection, ileocecal resection with side to side anastomosis, appy chole on 8-14-14 History: none CHEST:LUNGS AND PLEURA: No suspicious pleural nodules or masses identified.MEDIASTINUM AND HILA: The heart size is n... | 1.Interval decrease in size of the upper abdominal soft tissue mass.2.Additional peritoneal nodularity and thickening without significant interval change.3.Asymmetric low-density thickening of the lateral cecal wall, may represent serosal infiltration, although this is equivocal and attention at follow-up is recommende... |
Generate impression based on findings. | Lung cancer and dyspnea CHEST:LUNGS AND PLEURA: The left upper lobe spiculated lobulated mass appears only minimally larger with increased confluence with the proximal descending aorta. Although similar when measured axially (image 48 series 5) measuring 4.3 x 2.3 cm, the craniocaudal measurement (image 28 series 8021 ... | Overall stability in all reference measurements other than a mild craniocaudal increase in the left lower lobe pulmonary mass; see detail reference measurements provided. This change could be partially due to differences in technique and it is unclear as to whether represents definite interval change. |
Generate impression based on findings. | Assessment of alignment. Status-post ORIF. Since the prior study, there has been development of a fracture through the sideplate and screw device affixing the distal fibula. The fracture is at the level of the tibiotalar joint and there is now approximately 20 degrees of medial angulation of the distal fragment sidepla... | Fractured fibular plate with new ankle fracture/subluxation as described above. While this could be due to a distinct traumatic episode that occurred since the prior exam, the additional destruction of the tibial plafond as well as the extensive heterotopic bone formation suggest the possibility of an underlying neurop... |
Generate impression based on findings. | 51 year old male. Stroke in 2010, now with chronic cough. Evaluate for aspiration. Scout radiograph of the chest was unremarkable.Single contrast evaluation of the esophagus and gastric cardia/fundus revealed no definite morphologic abnormalities. No hiatal hernia was seen.Fluoroscopic evaluation of oropharyngeal and p... | Moderate esophageal dysmotility with proximal escape of the primary peristaltic wave. Significant gastroesophageal reflux.No tracheal aspiration was seen. |
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