instruction stringclasses 1 value | input stringlengths 6 8.98k | output stringlengths 5 3.11k |
|---|---|---|
Generate impression based on findings. | Malignant bronchial neoplasm LUNGS AND PLEURA: Stable mixed interstitial and patchy focal air space opacities largely observed in the right upper lobe, all unchanged. No associated effusion or additional intrapulmonary abnormalitiesMEDIASTINUM AND HILA: Right paratracheal lymph node remains 2.4 cm in short axis (image 24 series 80214). Subcarinal node or conglomerate lymph node also remains unchanged at 3.1 cm (image 39 see series 80214). Necrotic centers are observed. Associated compression of the right main stem bronchus is also identified and similar, however minimally improved when compared to the older prior 11/17/14. Invasion cannot entirely be excluded.Small a moderate pericardial effusion, mildly larger. No additional cardiac or pericardial abnormalitySmall hiatal hernia.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Mildly nodular left adrenal gland similar to prior study, otherwise no additional abnormalities observed in this limited view of the upper abdomen | Stable right apical suspected scarring or chronic change without new superimposed acute pulmonary abnormality. Specifically no findings to support intrapulmonary recurrent disease or metastatic disease. See reference measurements provided |
Generate impression based on findings. | 37 years, Female. Reason: Pre-Kidney Transplant Evaluation, two view supine and upright History: Potential Living Donor kidney transplant patient, with hx of umbilical abdominal pain r/o incarcerated hernia Severe levoscoliosis of the lumbar spine with lateral listhesis of L3 over L4. Compression deformity of the L2 and L3 vertebral bodies. Cholecystectomy clips project over the right upper quadrant. Lung bases are clear.Nonobstructive bowel gas pattern. No pneumoperitoneum. Peritoneal dialysis catheter projects over the midpelvis. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 72 years old Reason: HIP TOTAL ARTHROPLASTY PRIMARY UNCEMENTED (Left HIP). Components of a left total hip arthroplasty device with preliminary femoral component are situated in near anatomic alignment, although the distal extent of the device is not included on the field of vision of the study. Gas density over the left hip presumably reflects a surgical wound. Severe osteoarthritis affects the right hip. The superior aspect of the pelvis is not included on the field of view of this study. | Total hip arthroplasty in near-anatomic alignment. |
Generate impression based on findings. | 35 years, Male. Reason: eval stool burden vs SBO History: abd distension, abd pain Partially visualized central venous catheter tip projects over the left atrium. Lung bases are clear.Dilated loops of small bowel in the left upper quadrant with relative paucity of distal colonic bowel gas. | Partial small bowel obstruction versus ileus pattern. |
Generate impression based on findings. | Female 68 years old Reason: History of lytic lesion right radius. Please evaluate for resolution. History: As above. We have two views of the right forearm. There is an ovoid lucent lesion within the dorsal aspect of the mid radial diaphysis associated with endosteal scalloping. The lesion is approximately 2 cm in longitudinal dimension. | Lucent lesion of the mid radial diaphysis as described above. Although nonspecific, this may represent a benign focus of cortical thinning considering that it was evidently present since at least 2008, based on clinical information supplied in a bone scan report. If further evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Left chest tube, check pneumothorax LUNGS AND PLEURA: Small pleural effusions persist without significant interval change yet demonstrate underlying consolidation and/or atelectasis. Persistent focal gas collections are also observed again thought to represent cysts. Minimal new patchy airspace opacities in the left upper lobe, appearance suggesting probable aspirationLeft chest tube is observed traversing the lung base laterally and kinked with the tip projected towards the diaphragmatic dome. Small anterior and significant pneumothorax..MEDIASTINUM AND HILA: No lymphadenopathy Persistent moderate pericardial effusion. No significant pericardial or cardiac abnormality, specifically no definite coronary calcifications. SVC catheterCHEST WALL: No abnormalityUPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Limited evaluation of the upper abdomen. Dobbhoff tube is observed extending into the mid gastric lumen. No discrete focal lesion in this limited evaluation | Chest tube unchanged the small and significant associated pneumothorax. Minimal suspected aspiration without significant additional new abnormalities. Moderate pericardial effusion. See detail provided |
Generate impression based on findings. | 60 year-old woman with history of left breast mass seen on mammogram and ultrasound July 2014. Now with left axillary drainage. Three standard views of the left breast and a spot compression left MLO view were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A small, benign-appearing mass in the left upper inner quadrant is again seen and unchanged from the prior examination. No dominant mass, suspicious microcalcifications or areas of architectural distortion is seen in the left breast. SONOGRAPHIC | No mammographic evidence of malignancy. Sebaceous cyst in the left axilla. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Theodore Ford is a 61Yrs old male with history of IDDM, AAA (5.9 cm), CAD (s/p PCI x 7), CVA w/ residual slurred speech, and ischemic cardiomyopathy who is status post LVAD (HMII) insertion on 2/6/15CPT Code: 75572 Left Ventricle: The left ventricle is severely dilated without evidence of thrombus. There is an LVAD (Heart Mate II) cannula present in the LV apex. The LVAD cannula appears to be well positioned. There is no obvious obstruction of the inflow cannula. The interventricular septum is mid-line. Right Ventricle: The right ventricle is moderately dilated. An ICD lead is noted in the RV.Left Atrium: The left atrium is severely dilated. There are at least four distinct pulmonary veins which drain normally into the left atrium. There is no evidence of left atrial appendage thrombus.Right atrium, vena cavae, and coronary sinus: The right atrial volume appears to be normal in size. The superior and inferior vena cavae are grossly normal. The coronary sinus is normal in size. Pacemaker leads are noted in the right atrial appendage and in the coronary sinus.Valves: There is no calcification on the aortic or mitral valves.Great vessels: There is no thoracic aortic aneurysm or dissection noted. The LVAD outflow cannula is anastomosed to the ascending aorta. There is no obstruction or "kinking" noted in the outflow cannula. The main pulmonary artery is moderately dilated.Pericardium: The pericardium is normal in thickness. Post-surgical changes are noted on the anterior pericardium. Coronary arteries: LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There are no significant stenoses present in the left main; however, the vessel is ectatic. LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There is diffuse atherosclerosis of the proximal LAD. There is a stent in the mid LAD; its lumen is non-diagnostic due to blooming artifact. There is a stent in the major diagonal artery. The diagonal artery is occluded proximal to the stent. LCx: The left circumflex coronary artery is dominant. It courses normally in the left AV groove. It gives rise to the obtuse marginal, posterior descending, and posterolateral branches. There are no significant stenoses in the proximal and mid LCx. The distal LCx is not well visualized. There is a stent in the major obtuse marginal branch but its lumen is not well visualized due to blooming artifact.RCA: The right coronary artery arises normally from the right sinus of Valsalva. There is a 50% stenosis in the proximal RCA. The mid RCA is occluded. | 1. No evidence of obstruction or "kinking" involving the inflow or outflow LVAD cannulas, which appear to be well positioned. 2. The LV is severely dilated but the interventricular septum is mid-line. 3. Moderate RV dilation. 4. Severe left atrial dilation. 5. Severe coronary artery disease as described above.This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report. |
Generate impression based on findings. | Pain. Preoperative assessment. Three views of the left knee show severe osteoarthritis. Components of a right total knee arthroplasty device are situated in anatomic alignment and without complication.There is 7 degrees of valgus alignment of the knee with respect to the mechanical neutral axis. Severe degenerative disc disease affects the lower lumbar spine. | Osteoarthritis and valgus deformity. |
Generate impression based on findings. | Female 66 years old Reason: r/o worsening DJD History: fell one month ago and hurt the right knee. effusion present. There is severe osteoarthritis of the right knee, particularly affecting the lateral compartment. There is also a moderate sized joint effusion. Overall, this appears similar compared to the prior study. We see no fracture.Mild osteoarthritis affects the left knee as seen on the frontal view. | Osteoarthritis. |
Generate impression based on findings. | 9-year-old male with two chest tubes placed to drain pleural effusion. Evaluate right chest tube placement.VIEW: Chest AP (one view) 2/18/2015 14:33 Placement of two right-sided pigtail catheters, one terminating in the medial aspect of the right hemidiaphragm and the second in the right lower lobe. ET tube below the thoracic inlet and above the carina. Left central venous catheter tip in the SVC. Feeding tube with side-port in the stomach.Cardiothymic silhouette is obscured. Persistent opacity shows left hemithorax likely a combination of atelectasis and effusion unchanged. Improved aeration of the right lung with decrease in size of the right pleural effusion. | Placement of two right-sided chest tubes with improved aeration of the right lung as well as right pleural effusion. Persistent opacification of the left hemithorax unchanged. |
Generate impression based on findings. | Female 59 years old Reason: r/o oa vs ra History: bilat hand pain. We have 3 views of the right hand. Minimal osteoarthritic changes affect the hand. We see no erosions or other specific radiographic features of inflammatory arthritis.We have 3 views of the left hand. Minimal osteoarthritic changes affect the hand. We see no erosions or other specific radiographic features of inflammatory arthritis. | Minimal osteoarthritis. |
Generate impression based on findings. | Male 67 years old Reason: s/p orif of ankle History: ankle pain. Three views of the left ankle show a side plate, screws, and pin affixing an oblique fracture of the distal fibula in near anatomic alignment. We see no hardware complications. Two screws affix a fracture of the medial malleolus in near anatomic alignment. There is also a minimally displaced fracture of the "posterior malleolus" of the tibia. | Orthopedic fixation of distal tibial and fibular fractures |
Generate impression based on findings. | Male 84 years old Reason: pain History: above. Four views of the right shoulder show mild osteoarthritis of the glenohumeral and acromioclavicular joints. There is spurring of the anterior aspect of the acromion as well as an adjacent ossicle. The glenohumeral joint alignment is within normal limits. | Osteoarthritis of the shoulder and other findings as above. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Male 56 years old Reason: Evaluation of pancreatic allograft History: Elevated amylase and lipase look for pancreatic abnormality The lack of intravenous contrast limits evaluation of solid organ pathology and lymphadenopathy.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis without acute cholecystitis or biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: Redemonstrated is severe fatty infiltration of the right lower quadrant transplant pancreas, which is partially located within the right body wall hernia. No adjacent fluid collection or CT evidence of pancreatitis.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic native kidneys with stable thickening at the left lower pole. Left iliac fossa renal transplant without hydronephrosis or perinephric fluid collection. There is a small hyperdense lesion in the midpole of the transplant kidney (series 3, image 120).RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Redemonstrated is a right abdominal wall hernia containing small bowel and a portion of transplant pancreas. There is no evidence of bowel obstruction. Healed fractures of the seventh and eighth posterior ribs.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: The anterior aspect of the bladder is seen within the right inguinal hernia.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No CT evidence of pancreatitis or its complications in the right lower quadrant transplant pancreas.2.No hydronephrosis or perinephric fluid collection in the left iliac fossa transplant kidney. |
Generate impression based on findings. | 29-year-old female patient with infertility. Scout AP film of the pelvis was normal. Opacification of the uterine cavity revealed a normally oriented uterine cavity without mucosal irregularity or filling defects in the uterine cavity. The left tube freely opacified with free spillage into the pelvis, indicating tubal patency. The right tube was dilated and there was no spillage into the pelvis.TOTAL FLUOROSCOPY TIME: 1:11 minutes | Normal uterine cavity with patent left fallopian tube. The right fallopian tube was dilated and there was no free spillage into the pelvis. |
Generate impression based on findings. | Call back from screening mammogram for calcifications in the right breast. Three standard views with two spot magnification views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. Loosely clustered coarse round calcifications are seen in the central aspect of the right breast. These calcifications appear highly likely benign. | High probability benign calcifications in the right breast. Short term follow-up of the right diagnostic mammogram in 6 months is recommended.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Clinical stage IIIB cervical cancer. Complete staging exam.RADIOPHARMACEUTICAL: 8.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's CT portion grossly demonstrates several calcified splenic granulomata. Dilation of the left upper renal collecting system is noted. Several enlarged bilateral iliac lymph nodes are seen. Mass-like enlargement of the cervix/uterus is noted. Pelvic ascites is seen. Foley catheter with air in the bladder is also noted.Today's PET examination demonstrates a large markedly hypermetabolic cervical/uterine mass (SUV max = 11.3), compatible the patient's diagnosis of cervical cancer.Several enlarged moderately hypermetabolic bilateral external and internal iliac pelvic lymph nodes (SUV max = 5.7), are compatible with regional lymph node metastases. Significantly more superiorly within the left periaortic abdominal retroperitoneum at the level of the lower portion of the left kidney, there is a borderline enlarged more mildly FDG avid lymph node (SUV max = 3.1). This is of some suspicion for additional lymph node metastatic disease although given the lower level of uptake and somewhat more distant location, this could also represent an inflammatory lymph node.No additional suspicious FDG avid lesion to indicate tumor elsewhere. There is significant abnormality of the left kidney with delayed excretion of radiotracer with a dilated left collecting system which likely represents more distal ureteral obstruction from the pelvic mass with resultant left renal parenchymal dysfunction. | 1.Large markedly hypermetabolic cervical/uterine mass, compatible with the patient's diagnosis of cervical cancer.2.Several hypermetabolic bilateral iliac lymph node metastases within the pelvis.3.Borderline enlarged more mildly FDG avid lymph node more superiorly within the abdominal retroperitoneum is of some suspicion for additional lymph node metastasis although could also represent inflammation.4.Apparent left ureteral obstruction causing hydronephrosis and left renal parenchymal dysfunction. |
Generate impression based on findings. | Male, 78 years old, with severe neck pain at the base of the skull. Anterior instrumented fusion has been performed from C4 to C5 with placement of intervertebral device. The surgical plate and screws seem well positioned with no evidence of complication. A grade 2 anterolisthesis of C4 relative to C5 is demonstrated. A mild retrolisthesis of C6 relative to C7 is also demonstrated. There is a reversal of the normal cervical lordosis.Prominent panus formation is seen at the atlando-dental articulation. The soft tissue process protrudes posteriorly causing effacement of the thecal sac and but minimal if any mass effect upon the spinal cord. The odontoid process is intact. However, the anterior arch of C1 is severely thinned. Up to 7 mm of anterior subluxation of C2 relative to the basion is seen.Vertebral bodies are grossly intact. However, there is mild vertebral body deformation and sclerosis secondary to severe degenerative disk disease from C5 through C7. Level specific findings are as follows:C2-3: Right greater than left facet hypertrophy. Posterior disk osteophyte formation. Minimal spinal canal narrowing. No significant foraminal narrowing. C3-4: Marked right and mild left facet hypertrophy. Bulky posterior disk osteophyte formation. Mild/moderate spinal canal stenosis. Mild left and moderate right foraminal narrowing. C4-5: Marked bilateral facet hypertrophy. Grade 2 anterolisthesis as above. Mild/moderate spinal canal stenosis. Moderate bilateral foraminal narrowing.C5-6: Bulky posterior disk osteophyte formation asymmetric to the right. Moderate generalized spinal canal stenosis particularly affecting the right ventral aspect of the canal. Moderate bilateral foraminal narrowing. C6-7: Bulky posterior disk osteophyte formation. Moderate generalized spinal canal stenosis. Moderate bilateral foraminal narrowing. C7-T1: Posterior disk osteophyte formation. Mild to moderate spinal canal stenosis. Moderate left and mild right foraminal narrowing.Cystic changes are seen in the lung apices. | 1. Findings related to anterior instrumented spinal fusion at C4-5. No instrument complications are suspected. There is a grade 2 anterolisthesis of C4 relative to C5.2. Marked pannus formation at the atlanto-dental articulation resulting in effacement of the ventral thecal sac but minimal if any spinal cord deformation. The odontoid process is intact, however the anterior arch of C1 is severely thinned and deformed. Up to 7 mm of anterior subluxation of the odontoid process is seen relative to the basion.3. Multilevel cervical spondylosis with disk osteophyte formation at every level and mild/moderate spinal canal stenoses as above. |
Generate impression based on findings. | History of DVT not on anticoagulation, worsening HF. Assess for PE. The comparison chest radiograph performed on 2/18/2015 demonstrates no focal pulmonary opacities or pleural fluid. The ventilation images show decreased ventilation within the left lower lobe on single-breath and wash-in images with eventual mild retention in the left lower lobe and to a lesser degree the right lower lobe. The perfusion images show a large matched perfusion defect of the left lower lobe. There are also multiple small unmatched peripheral perfusion defects of both lungs. | Intermediate probability for pulmonary embolus. Findings discussed by Dr. Appelbaum with the ICU resident in person prior to the stat dictation. |
Generate impression based on findings. | 10-year-old male with left mid abdominal pain, question of constipationVIEW: Abdomen AP (one view) 2/18/15 14:55 The bowel gas pattern is nonobstructive. There is only a mild stool burden. | Normal examination. |
Generate impression based on findings. | 11 year old female with knee pain with sportsVIEWS: Right and left knees, AP, lateral, sunrise and skiers (4 views) 2/18/15 14:04 Alignment is anatomic. There is no joint effusion or fracture evident. The osseous structures of both knees appear normal for the patient's age. | Normal examination. |
Generate impression based on findings. | Cough, SOB, fibrosis. LUNGS AND PLEURA: Moderate upper lobe paraseptal and mild centrilobular emphysema.Basilar subpleural honeycombing, architectural distortion, and mild traction bronchiectasis, consistent with UIP pattern.Calcified nodules consistent with healed granulomatous disease. Noncalcified scattered micronodules are likely also post-inflammatory.No groundglass opacities. No suspicious pulmonary nodules. No air trapping observed.MEDIASTINUM AND HILA: Scattered small mediastinal lymph nodes.Dilated main pulmonary artery to 3.4 cm, suggestive of pulmonary artery hypertension.Post-surgical findings of CABG. Severe coronary artery calcification. No pericardial effusion.Small hiatal hernia.CHEST WALL: Median sternotomy. Mild to moderate degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Calcified atherosclerotic disease of the abdominal aorta and its branches. Renovascular calcification. | Findings consistent with combined pulmonary fibrosis and emphysema (CPFE). |
Generate impression based on findings. | Female; 44 years old. Reason: secondary HTN History: High BP uncontrolled for last 2 months RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No perinephric fluid collections.KIDNEY: The transplanted kidney measures 11.1 cm in length. The cortex is normal in echogenicity. There is no shadowing stone or worrisome renal mass identified.COLLECTING SYSTEM/URETER: No evidence of hydronephrosis hydroureter.URINARY BLADDER: Bladder is nondistended.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels The peak systolic velocity of the iliac artery is 1.45 m/sec. The peak systolic velocity at the anastomosis is 1.59 m/sec with a resistive index of 0.74. The renal artery is patent with a Doppler waveform which shows prompt systolic upstroke. The peak systolic velocity of the renal artery is 1.61 m/sec at the origin, 1.18 m/sec in the midportion and 1.36 m/sec distally with resistive indices of .76, .60, and .59 respectively. Resistive indices within the arcuate arteries vary between .54 and .60. The renal vein is patent.OTHER: No significant abnormality noted | Normal ultrasound appearance of the transplanted kidney with patent vasculature. |
Generate impression based on findings. | Marginal zone lymphoma CHEST:LUNGS AND PLEURA: Right lower lobe nodule significant less conspicuous on the current examination but still measuring approximately 0.6 cm.MEDIASTINUM AND HILA: Interval decrease in size of posterior tracheal wall soft tissue mass as seen on image 23 now measuring 2.3 x 0.9 cm; this is in comparison 2.5 x 1.5 cm on 1/19/2015. Interval decrease in right bronchus wall mass as seen on image 41 now measuring 1.5 x 0.6 cm; this is in comparison to 1.7 x 1.1 cm on 1/19/2015.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: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: No significant abnormality noted | Interval decrease in size of tracheal wall and right bronchial wall soft tissue masses. No new adenopathy. |
Generate impression based on findings. | Congestive heart failure, question LVAD. LUNGS AND PLEURA: Areas of linear scarring in the left upper lobe and lower lobes bilaterally. No evidence of CHF. Mild mosaic attenuation of the lung parenchyma, best appreciated on the coronal MINIP sequence; this may be the result of small airways disease and was present previously..MEDIASTINUM AND HILA: The left ventricular assist device is unchanged in position and without abnormal surrounding fluid collections. Chronic mild mediastinal lymphadenopathy is unchanged, with lymph nodes measuring up to 18-mm in short axis (5/30). Left subclavian AICD is present with leads in in the right ventricular apex, the right atrial appendage and a coronary sinus branch, unchanged. The native coronary arteries are heavily calcified. Bypass grafts are poorly visualized without the benefit of IV contrast.Cardiomegaly is unchanged. Hypoattenuation in the subendocardial area of the free wall of the left ventricle is unchanged. No pericardial fluid.CHEST WALL: Sternotomy hardware is intact, and there are no abnormal peristernal fluid collections or signs of sternal dehiscence. Unchanged mild superior endplate compression deformity at approximately T11.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Limited scanning range. The drive line is incompletely included within the range of the scan, but no fluid collections are appreciated along its visualized length.Cholecystectomy. Vascular calcifications. Cirrhotic morphology of the liver. | LVAD in expected position and without radiographic signs of complication. Chronic mild mediastinal lymphadenopathy is unchanged. No acute pulmonary abnormality; chronic mosaic attenuation of the lung parenchyma suggests the presence of small airways disease. |
Generate impression based on findings. | Cough, shortness of breath, fibrosis. Evaluate ILD. LUNGS AND PLEURA: Small bilateral pleural effusions.Patchy nodular groundglass and solid opacities bilaterally with more confluent faint groundglass in the lower lobes. Largest solid nodule is in the right middle lobe at 19 x 17 mm (series 4, image 54).No interlobular septal thickening.No honeycombing or reliable evidence of interstitial lung disease.No significant air trapping on expiratory phase images.MEDIASTINUM AND HILA: Moderately enlarged mediastinal lymph nodes, including a right paratracheal node that is 13 mm (series 3, image 35).Moderately large pericardial effusion. Normal heart size.No coronary artery calcification.CHEST WALL: Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Splenomegaly. | 1. Multifocal groundglass and solid nodules, suspicious for an atypical infection in the appropriate clinical setting. For the solid nodules, the largest in the right middle lobe, lung malignancy is also in the differential though considered less likely. Pulmonary edema is also in the differential for the groundglass opacities.2. No reliable evidence of interstitial lung disease.3. Moderate pericardial effusion. Moderately large mediastinal lymphadenopathy.4. Small bilateral pleural effusions. |
Generate impression based on findings. | No acute intracranial hemorrhage. No CT evidence of acute large territorial ischemia. Small hypoattenuating lesion in the left frontal lobe may be slightly more prominent compared to the previous examination and may be related to evolution of the previous small stroke in this location. There is a small region of hypoattenuation in the left caudate head, corresponding to a prior stroke. Additional scattered regions of hypoattenuation are nonspecific. There are no masses, mass effect or midline shift. The ventricles and sulci are normal in size. There are no extraaxial fluid collections or subdural hematomas. Moderate to near complete opacification the ethmoid air cells, specifically on the left; otherwise, paranasal sinuses and mastoid air cells are clear. | 1.No CT evidence of acute large territorial ischemia. If there is high clinical concern for acute ischemia, further evaluation with MRI is recommended.2.Scattered small hypoattenuating lesions, most of which were seen on the previous exam, are compatible with age indeterminate ischemic changes. |
Generate impression based on findings. | There is evidence of surgery/dissection in the left neck with volume loss and infiltration of the fascial planes as well as numerous scattered surgical clips. Since the prior examination, a large cystic lesion in the left supraclavicular fossa has been resected with new surgical findings correlating to that procedure. Medial to the operative bed, there is a new apparently thick-walled cystic lesion measuring 44 x 31 mm (series 6, image 59) which abuts the paraspinal musculature. No osseous erosion or evidence of encroachment on the neural foramina or spinal canal within the limitation of a CT examination. Just inferior to the resection bed, there is a discrete nodule which measures 15 mm (series 6, image 63). Additionally, there is a subcentimeter calcified node anterior to the sternocleidomastoid muscle at the level of the parotid gland on the left which shows increasing calcification and may represent a a treated node. A nodule in the right aspect of the mediastinum measures 11 mm (series 6, image 73), previously measuring 3 to 4 mm.The parotid glands, submandibular glands and thyroid lobes are symmetric bilaterally. No thyroid masses are identified bilaterally. There are no nasopharyngeal, oropharyngeal, hypopharyngeal or laryngeal masses identified. There is no airway compromise. Prominent retrocerebellar fluid on the right is unchanged. Multilevel cervical spondylosis. | 1.Findings related to remote surgery in the left neck. 2.Interval resection of a cystic mass in the left supraclavicular region. Medial to the resection bed, there is a new thick walled cystic lesion and immediately inferior to the resection bed, there is a soft tissue nodule. While it is possible that both findings are postoperative in etiology, they are also concerning for residual or recurrent tumor. 3.Interval increase in size of a mediastinal nodule. |
Generate impression based on findings. | Right lower quadrant pain This study is compromised due to lack of intravenous contrast and poor bowel opacificationABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Stable splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable renal atrophyRETROPERITONEUM, 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: Bilateral adnexal cysts unchangedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Given the technical limitations of poor bowel opacification and lack of intravenous contrast, stable examination without acute, inflammatory, or neoplastic process. |
Generate impression based on findings. | Cardiac surgeryVIEW: Chest AP ET tube and NG tube have been removed in the interval. Right central line, right chest tube and epicardial pacing leads again noted. Cardiomegaly unchanged. Patchy atelectasis in the right middle lobe and left lower lobe unchanged. No pleural effusion or pneumothorax. | Bilateral patchy atelectasis unchanged. |
Generate impression based on findings. | Right upper lung cancer initial staging.RADIOPHARMACEUTICAL: 12.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 93 mg/dL. Today's CT portion grossly demonstrates an approximately 2.5 cm right upper lobe spiculated mass, similar to previous CT. Several hypodense bilateral renal lesions are likely cysts. Extensive atherosclerotic including coronary arterial calcifications are noted. Several bilateral thyroid nodules are seen some of which are calcified. A large calcified mass in the pelvis is most likely a fibroid.Today's PET examination demonstrates a medium-sized markedly hypermetabolic right upper lobe mass (SUV max = 10.8), compatible with the patient's diagnosis of lung cancer.A punctate slightly FDG avid lymph node in the right superior hilar/interlobar location is present (SUV max = 2.2) and given the location could represent a regional lymph node metastasis although is equivocal.No additional suspicious FDG avid lesion is identified elsewhere. A punctate hypermetabolic focus in the soft tissues about the right hip is compatible with benign inflammation at the joint. | 1.Markedly hypermetabolic right upper lobe mass, compatible with the patient's diagnosis of lung cancer.2.Punctate slightly FDG avid right superior hilar/interlobar lymph node of some suspicion for a single ipsilateral metastasis although this is equivocal.3.No contralateral thoracic or extrathoracic FDG avid tumor. |
Generate impression based on findings. | 16-year-old male with history of pancreatitis now with bilious output. Evaluate pancreas and rule out pancreatic pseudocyst ABDOMEN:LUNG BASES: No suspicious pulmonary nodules or masses. Bilateral pleural effusions, left greater than right, increased from prior study with adjacent compressive atelectasis. LIVER, BILIARY TRACT: Hepatomegaly and hepatic steatosis unchanged. SPLEEN: Splenomegaly unchanged.PANCREAS: The pancreas is slightly decreased in size compared to prior study reflecting improving pancreatitis. Normal enhancement of the pancreatic parenchyma is again seen. Extensive peripancreatic soft tissue stranding as well as mild abdominal ascites are unchanged. No evidence of enhancing fluid collection, phlegmon or pseudocyst is seen.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mildly prominent mesenteric lymph nodes in the upper abdomen are unchanged..BOWEL, MESENTERY: Feeding tube tip in the stomach. No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Slight interval decrease in size of the pancreas reflecting improving pancreatitis. Extensive inflammatory changes surrounding the pancreas are unchanged however with no evidence of loculated fluid collection, abscess or pseudocyst.2. Bilateral pleural effusions, left greater than right, are increased from prior study. |
Generate impression based on findings. | 77 year-old male with history of gastric cancer on chemotherapy, compare to prior. CHEST:LUNGS AND PLEURA: Reference right lower lobe solid pulmonary nodule (series 4, image 55) measures 7 mm, unchanged. Reference left lower lobe pulmonary nodule (series 4, image 68) poorly visualized but it is stable to decreased in size. Additional pulmonary micronodules unchanged.MEDIASTINUM AND HILA: Right-sided central venous chest port with tip at the SVC atrial junction. Mild coronary artery calcifications. Small mediastinal lymph nodes appear similar to prior. Moderate hiatal hernia.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Segment 7 low attenuation hepatic lesion (series 703, image 98) measures 1.0 x 1.0 cm, unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Stable thickening of the lateral limb of the left adrenal gland with Hounsfield units of 0.5, suggestive of adenoma.KIDNEYS, URETERS: Unchanged right upper pole simple cyst. Subcentimeter right lower pole and left lower pole hypoattenuating lesions which are too small to characterize. No hydronephrosis. Post surgical changes relating to prior cystectomy with ileo-conduit formation. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Abnormal circumferential thickening of the gastric antrum (series 703, image 105) measures 3.8 x 5.3 cm, previously 5.0 x 6.0 cm (previously reported "5.6 x 1.3 cm" is thought to represent typographical error). Adjacent enlarged gastrohepatic lymph node (series 703, image 116) measures 1.6 x 2.1 cm, previously 2.9 x 2.1 cm.Interval placement of embolic coils in distribution of gastroduodenal artery. BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine. OTHER: No significant abnormality notedPELVIS:PROSTATE/SEMINAL VESICLES: Status post prostatectomyBLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Unremarkable appearance of the bowel anastomosis.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine. OTHER: No significant abnormality noted | 1.Abnormal thickening of the gastric antrum suspicious for gastric malignancy with nodal involvement, decreased in size from prior. 2.Status post cystectomy with ileal conduit formation. No evidence of local recurrence. |
Generate impression based on findings. | Squamous cell carcinoma of the scalp and scan of neck. Status post RT. LUNGS AND PLEURA: New 9-mm nodule with epicenter along the mediastinal pleural surface (4/16).14-mm nodule right upper lobe (6/37), new from previous.23 x 21 mm soft tissue nodule surrounding the left inferior pulmonary vein and occluding the left lower lobe lateral segmental airway, possibly present but smaller on the previous study, likely visible only in retrospect and is it occurs along the bronchovascular bundle.Newly enlarged subpleural lymph node along the medial aspect of the right major fissure (6/61).MEDIASTINUM AND HILA: Physiologic volume of pericardial fluid. Severe coronary artery calcifications.CHEST WALL: Loculated fluid collection in the left thoracic inlet was present on the prior study and is incompletely included within the scanning range, please refer to separately reported CT neck.A mildly enlarged left subclavicular region lymph node is new (4/7, coronal image 52).UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Limited scanning range. No visible abnormalities. | Left thoracic inlet mass with ipsilateral chest wall lymphadenopathy, bilateral pulmonary nodules suspicious for metastases and a right sided pleural metastases. |
Generate impression based on findings. | NG placementVIEW: Abdomen AP NG tube tip in the fundus of the stomach. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | NG tube tip in the fundus of the stomach. |
Generate impression based on findings. | NG placementVIEW: Abdomen AP NG tube tip in the fundus of the stomach. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | NG tube tip in the fundus of the stomach. |
Generate impression based on findings. | 13-year-old male right thumb pain status post injuryVIEWS: Right hand, AP, oblique, and lateral (3 views) 2/18/1515:40 A fracture is noted through the volar aspect of the base of the distal phalanx of the thumb extending to the physis with overlying soft tissue swelling. | Salter-Harris type II fracture of the base of the distal phalanx of the thumb. |
Generate impression based on findings. | Female; 35 years old. Reason: cervical cancer History: cervical cancer CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodule.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypodensity in segment 7 of the liver (series 4/87) is too small to characterize but unchanged since February 2014.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right nephroureteral stent is again seen. There is no hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: A bone island is noted in the right humeral head.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: A brachytherapy clip is redemonstrated within the cervix. The cervix is bulky and heterogeneous with a similar size and appearance when compared to the most recent prior CT.BLADDER: Right nephroureteral stent terminates in the bladder.LYMPH NODES: Redemonstrated left pelvic sidewall lymphadenopathy. The reference lymph node measures 1.4 x 2.1 cm (series 4/179), unchanged. The reference ill-defined soft tissue mass more inferiorly measures 1.6 x 2.4 cm (series 4/185), not significantly changed.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable size and appearance of bulky cervical tumor and pelvic sidewall adenopathy.2.No evidence of metastatic disease.3.Subcentimeter hypodensity in the right lobe of the liver is too small to characterize but its stability favors a benign process. This can be followed on subsequent studies. |
Generate impression based on findings. | Female 34 years old Reason: hx of metastatic neuroblastoma, now s/p chemotherapy and resection History: hx of metastatic neuroblastoma, now s/p chemotherapy and resection. Status post retroperitoneal mass resection, IVC tumor thrombus resection, IVC resection with Gore-Tex graft reconstruction CHEST:LUNGS AND PLEURA: Interval resolution of small bilateral pleural effusions.MEDIASTINUM AND HILA: Central venous catheter with tip in the right atrium.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Nonobstructing right renal calculus, unchanged.RETROPERITONEUM, LYMPH NODES: Tubular fluid collection surrounding the IVC graft measuring up to 4.4 x 3.9 cm (series 5, image 99). The fluid collection has mass effect on the graft however the graft remains patent. There is a small nonocclusive thrombus within the graft best seen on series 5, image 115. No evidence of disease recurrence.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Anterior soft tissue infiltration likely postoperative in nature.OTHER: No significant abnormality notedPELVIS: UTERUS, ADNEXA: Intrauterine device in place.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OfOTHER: No significant abnormality noted. | 1.Postoperative fluid collection surrounds and exerts mass effect on a patent IVC graft. Favor hematoma or benign seroma over abscess. 2.The IVC graft is patent with a small nonocclusive thrombus. 3.No evidence of disease recurrence. |
Generate impression based on findings. | Status post left TKA. Two portable radiographic views of the left knee were obtained in the recovery room and time stamped 1333 and 1337 respectively. There are components of a total knee arthroplasty device situated in anatomic alignment and without complication. Foci of gas in the soft tissues and a drain reflect recent surgery | Total knee arthroplasty device as above. |
Generate impression based on findings. | Patient with breast cancer with mets to the liver is here for a Y90 mapping along with a nuclear medicine MAA. There is mild to moderate shunting to the lungs (lung fraction = 14.6%). There is heterogeneous activity in the right liver consistent with perfusion to tumor. Note however, a vast majority of activity goes to the right inferior hepatic lobe with sparing of the largest hepatic dome lesion.Mild salivary gland, bilateral renal, and diffuse stomach activity is consistent with mild free pertechnetate. There is no abnormal extrahepatic intraabdominal activity. | 1. Mild to moderate lung shunting.2. Note the largest hepatic dome lesion does not receive a significant amount of perfusion from the injection of radiotracer with the catheter in this location. |
Generate impression based on findings. | Back pain and tenderness as well as left hip pain for 2 months following fall. Five views of the lumbar spine show sever degenerative disc disease of L5-S1. Moderate degenerative disc disease is noted at L4-5. Alignment is within normal limits. Two views of the left hip show mild to moderate osteoarthritis affecting the left hip but we see no evidence of avascular necrosis. | Osteoarthritis and degenerative disc disease as described above. |
Generate impression based on findings. | 15 year-old female with scoliosisVIEWS: Thoracic and lumbar spine, AP (1 view) 2/18/15 15:28 14 degrees thoracic dextroscoliosis from the superior endplate of T3 through the inferior endplate of T10 and 32 degrees thoracolumbar levoscoliosis from the superior endplate of T11 to the inferior endplate of L4. No segmentation or fusion defects. The cardiothymic silhouette is normal. | Thoracic dextroscoliosis and thoracolumbar levoscoliosis as described above appearing similar to the prior exam. |
Generate impression based on findings. | Malignant neoplasm of the adrenal gland. Repeat evaluation. Normal physiologic radiotracer distribution is seen in the salivary glands, myocardium, liver, bowel and bladder. A left sacral lesion has significantly decreased in activity, although remains mildly MIBG avid suggesting some persistent activity. Previously seen abdominal soft tissue as well as vertebral activity has entirely resolved. Prominent uptake corresponding to the left adrenal gland is more likely felt to represent benign activity. | 1. Near complete resolution of the previously seen MIBG avid tumor with mild residual activity of the left sacral metastatic lesion. No new MIBG avid lesion is identified.2. Prominent left adrenal uptake is considered more likely benign in etiology. |
Generate impression based on findings. | Small cell lung cancer pre-chemotherapy. CHEST:LUNGS AND PLEURA: There is significant dependent and compressive atelectasis due to scanning during supine patient positioning. Dominant nodule in the right upper lobe with incomplete occlusion of the apical segmental bronchus measures 2.5 x 1.7 cm and is inseparable from the adjacent mediastinal pleural surface (6/26). This lesion extends centrally in a contiguous fashion to be right hilum where a soft tissue mass occurs over a 3.6-cm transverse of this length, inseparable from adjacent lymphadenopathy (axial series, image 30) as well as the distal trachea and right main bronchus. Multiple pulmonary nodules are noted on the right measuring up to 2.3 cm in length (6/30, subpleural). Tumor medial to be right upper lobe anterior bronchus is inseparable from the pericardium (axial series, image 35).Enlarged subpleural lymph nodes along the right minor fissure (6/38).MEDIASTINUM AND HILA: Normal heart size. Mitral annulus calcification. Poorly defined soft tissue containing calcifications extends from the right paratracheal chain at the level of the aortic arch (axial image 24) to the low right paratracheal chain, crossing the midline to the left at the level of the carina; For reference this measures at least 4.1-cm in craniocaudal length by at least 3-cm transversely. Heterogeneously enhancing and centrally necrotic soft tissue adjacent to branches of the right lower lobe bronchus (axial image 47) may reflect lymphadenopathy or a parenchymal metastasis; this is inseparable from the mediastinal pleural surface and adjacent bronchovascular bundles.Right chest port with tip at the SVC/RA junction.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesion in the right hepatic lobe too small to accurately characterize, nonspecific.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 aorta and its branches.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. | Examination is limited by severe underinflation and compressive atelectasis due to scanning of the patient in the prone position. In addition, motion artifact is present. Within this limitation, the following observations were made:1. Right upper lobe anterior segment lesion extends centrally, inseparable from the right hilum. There is subsegmental collapse within the anterior and medial segments due to soft tissue lesions and multiple subpleural and parenchymal nodules within the right upper lobe are suspicious for metastatic lesions.2. Enlarged subpleural lymph nodes along the right minor fissure suspicious for pleural metastatic lesions. 3. It is unclear whether the right lower lobe lesion is a metastatic lymph node or a parenchymal lung lesion with extension to the adjacent bronchovascular bundle.4. No visible skeletal, adrenal gland or hepatic metastases.5. It is strongly recommended the due to limitations of this study correlation be made with accompanying PET scan which will be reported separately. |
Generate impression based on findings. | Lung cancer staging.RADIOPHARMACEUTICAL: 7.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's CT portion grossly demonstrates an approximately 7-cm left upper lobe pulmonary mass with some adjacent interstitial and groundglass opacities. A medium-sized left pleural effusion is present. Scattered enlarged mediastinal lymph nodes are noted. Extensive atherosclerotic including coronary arterial calcifications are seen.Today's PET examination demonstrates large markedly hypermetabolic left upper lobe mass (SUV max = 24.3), compatible with the diagnosis of lung cancer.In the adjacent left AP window, a slightly enlarged but markedly hypermetabolic mediastinal lymph node (SUV max = 12.5), is a very suspicious for regional lymph node metastasis.Elsewhere in the mediastinum there are multiple smaller significantly more mildly hypermetabolic lymph nodes seen symmetrically in both hilar regions as well as paratracheal and anterior mediastinal stations. Given the significantly lower level of activity and their locations including symmetry, these are felt to represent superimposed granulomatous inflammation rather than additional lymph node metastases.No suspicious FDG avid lesion is seen within the abdomen, pelvis, or visualized skeleton. | 1.Markedly hypermetabolic left upper lobe mass, compatible with the history of lung cancer.2.Single markedly hypermetabolic left AP window lymph node likely represents ipsilateral lymph node metastasis.3.Multiple additional fairly symmetric bilateral hilar and mediastinal lymph nodes which are only mildly FDG avid and considered more likely superimposed inflammation although additional metastatic disease cannot be entirely excluded.4.No suspicious FDG avid lesion in the abdomen, pelvis, or skeleton. |
Generate impression based on findings. | Staging newly diagnosed gastric cancer. Evaluate extent of disease. RADIOPHARMACEUTICAL: 10.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 98 mg/dL. Today's CT portion of the neck demonstrates no significant pathology. Please see diagnostic CT reports for details of the chest, abdomen, and pelvis.Today's PET examination demonstrates a subcentimeter but significantly hypermetabolic focus corresponding to the superior right thyroid lobe (SUV max = 6.4). This is compatible with a primary thyroid nodule which may be benign or malignant.Multiple small symmetric mild to moderately hypermetabolic bilateral hilar, paratracheal, and subcarinal lymph nodes have a typical distribution for granulomatous inflammation although metastatic disease cannot be entirely excluded.A large markedly hypermetabolic mass in the gastric antrum is noted (SUV max = 28.0), compatible with the history of gastric cancer.Several adjacent small but significantly hypermetabolic gastrohepatic lymph nodes (SUV max = 10.3) are compatible with adjacent lymph node metastases.Small linear mild to moderately hypermetabolic activity involving the left adrenal gland (SUV max = 5.0) has features on PET as well as the diagnostic CT more suggestive of a benign lesion than metastatic.No additional suspicious FDG avid lesion elsewhere. Physiologic excreted activity in ileo-conduit is noted. | 1.Large markedly hypermetabolic gastric antral mass, compatible with the history of gastric carcinoma.2.Several adjacent hypermetabolic gastrohepatic lymph nodes, consistent with regional lymph node metastases.3.No convincing FDG avid metastatic disease elsewhere. Symmetric mediastinal/hilar lymph node activity is considered probably benign granulomatous rather than the less likely possibility of metastatic. Left adrenal focus is also considered most likely benign.4.Subcentimeter markedly hypermetabolic right superior thyroid nodule may be a benign or malignant primary thyroid nodule. Further evaluation with thyroid ultrasound can be made as clinically warranted.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Patient metastatic lung cancer. Status post MPDL LUNGS AND PLEURA: The left lower lobe peripheral nodule remains unchanged measuring 2.3 x 1.3 cm (image 68 series 4) with associated mild pleural adjacent thickening. Numerous pleural calcifications are also observed all unchanged.Mild centrilobular emphysema is unchanged. Decreased yet persistent minimal basilar shifting atelectasis. No suspicious new pulmonary nodules or masses. No effusions.MEDIASTINUM AND HILA: No lymphadenopathy. The reference anterior mediastinal focal density described is a 7-mm lymph node (image 26 series 3) appears unchanged and been measured for consistency purposes only. Heavy severe coronary calcifications and suspected stents involving both the left and right systems.Small hiatal herniaCHEST WALL: Unchanged sclerotic left 11th rib, possibly Paget'sUPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Incompletely visualized bulky heavy aortic calcifications without additional abnormalities observed in this limited view of the upper abdomen | Unchanged left lower lobe focal pleural based nodule without additional abnormality. Reference measurements provided |
Generate impression based on findings. | Mesothelioma pre-clinical trial.RADIOPHARMACEUTICAL: 9.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's CT portion grossly demonstrates diffuse left pleural thickening involving nearly all of the left pleural surface with left basilar consolidation and diffuse left interstitial opacities. There are bilateral pleural effusions and a moderate pericardial effusion. There are bilateral mastectomies and a left breast prosthesis. There are numerous enlarged mediastinal and left axillary lymph nodes. There are enlarged lymph nodes in the upper abdomen including the paraesophageal, gastrohepatic, and retroperitoneal stations. The left kidney is markedly atrophic. There is a small amount of ascites.Today's PET examination demonstrates very extensive markedly hypermetabolic left pleural thickening involving nearly the entire left pleural surface. Although there is slightly decreased activity compared to the prior examination, there is significantly increased extent of disease consistent with tumor progression. There is also progression of hypermetabolic activity within the pulmonary parenchyma of the left lung base which may represent tumor progression or inflammation. Additionally within the thorax, there are numerous markedly hypermetabolic bilateral supraclavicular, left axillary, mediastinal, and left chest wall lymph nodes which have significantly progressed in size, number, and hypermetabolic activity compared to the previous examination (max SUV of 7.5). In the upper abdomen, there are multiple markedly hypermetabolic abdominal, retroperitoneal, and gastrohepatic lymph nodes compatible with metastatic disease. Although, one of these nodes has decreased in size and activity, there are multiple others which are new, which is consistent with progression of tumor (max SUV of 5.8). | 1.Markedly hypermetabolic left pleural thickening involving nearly the entire left pleural surface has significantly increased in extent compatible with tumor progression. Additionally, increased activity within the left lung parenchyma may reflect additional tumor progression or inflammation. 2.Numerous new hypermetabolic lymph nodes in the thorax and upper abdomen are consistent with tumor progression.3.Bilateral pleural effusions and a moderate pericardial effusion. |
Generate impression based on findings. | Male 13 years old Reason: hx of ORIF History: above. Previously seen intramedullary rod affixing a fracture of the left clavicle has been removed. There is mild deformity of the distal clavicular diaphysis indicating a healing/healed fracture. | Healing clavicle fracture following removal of intramedullary rod. |
Generate impression based on findings. | Lung carcinoma ABDOMEN:LUNG BASES: Please see separate chest CT reportLIVER, BILIARY TRACT: No significant change in bilobar subcentimeter low-attenuation foci.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: Stable abdominal aortic ectasia.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: No significant abnormality noted | Stable examination |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Linear and nodular apical pleural scarring, unchanged from the prior exam. Mild to moderate centrilobular and paraseptal emphysema.Right middle lobe scarring, stable, likely from prior infection. Calcified pleural plaques, consistent with a known history of asbestos exposure.Scattered benign appearing micronodules, some calcified. No new suspicious pulmonary nodules or masses. No focal air space consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Severe coronary artery calcification.Scattered small mediastinal and hilar lymph nodes unchanged. No mediastinal or hilar lymphadenopathy.CHEST WALL: 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: Stable left adrenal nodule, presumed adenoma.KIDNEYS, URETERS: Scattered punctate nonobstructing renal calcifications. Subcentimeter renal hypodensities are stable, likely cysts.PANCREAS: Mild pancreatic ductal dilatation, unchanged.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. | No evidence of metastatic disease. |
Generate impression based on findings. | 66 year old female with multiple recent abdominal surgeries and persistent abdominal pain, nausea, leukocytosis with recent low grade fever. ABDOMEN:LUNG BASES: Small bilateral pleural effusions with associated basilar atelectasis appearing similar to recent CT. Borderline cardiomegaly. Small hiatal hernia. LIVER, BILIARY TRACT: Contracted gallbladder. Cholelithiasis. SPLEEN: Splenic calcifications likely from prior granulomatous disease.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal low attenuation lesion (series 3, image 27) incompletely characterized. Additional bilateral subcentimeter low-attenuation renal lesions too small to characterize. No hydronephrosis or obstructing stones.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic disease of the abdominal aorta and its branches with mild ectasia of the infrarenal aorta.BOWEL, MESENTERY: Extensive post surgical changes. Percutaneous jejunostomy tube and right lower quadrant end ileostomy. Residual small bowel is nondilated and is without evidence of obstruction. Several small bowel loops are tethered in the pelvis compatible with nonobstructive postsurgical adhesions. Postsurgical changes of Hartmann's pouch creation and partial colectomy.BONES, SOFT TISSUES: Midline postsurgical abdominal wall defect. Scoliosis and severe degenerative changes of the visualized thoracolumbar spine.OTHER: No free intraperitoneal air or fluid.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Foley catheter in collapsed bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Extensive post surgical changes. Percutaneous jejunostomy tube and right lower quadrant end ileostomy. Residual small bowel is nondilated and is without evidence of obstruction. Several small bowel loops are tethered in the pelvis compatible with nonobstructive postsurgical adhesions. Postsurgical changes of Hartmann's pouch creation and partial colectomy.BONES, SOFT TISSUES: Scoliosis and severe degenerative changes of the visualized thoracolumbar spine.OTHER: No free intraperitoneal air or fluid. | 1.Extensive postsurgical changes without evidence of small bowel obstruction. Non-obstructive small bowel adhesions in the pelvis.2.No intraperitoneal abscess.3.Left renal low attenuation lesion does not meet all requirements for benignity and is incompletely characterized. In the appropriate clinical setting, recommend dedicated cross-sectional imaging for further evaluation.4.Cholelithiasis. 5.Small bilateral pleural effusions. |
Generate impression based on findings. | Female; 34 years old. Reason: 34 F with metastatic neuroendocrine tumor, please eval for interval progression since prior CT. History: none CHEST:LUNGS AND PLEURA: Again seen is a 3-mm nodule along the right minor fissure. This is unchanged. Right upper lobe pulmonary micronodules are unchanged.No suspicious pulmonary nodule is seen.No consolidation or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Heart is normal in size, there is no pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Again seen are innumerable, bilobar, arterially enhancing liver lesions which have not significantly changed in size or number compared to the most recent prior CT. The reference lesion in the dome of the liver measures 6.0 x 5.2 cm (series 6/20), unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple prominent retroperitoneal lymph nodes are again seen and are not significantly changed compared to the most recent prior CT. The reference lymph node posterior to the IVC measures 1.6 x 0.7 cm (series 7/113), unchanged. There is no new lymphadenopathy.BOWEL, MESENTERY: A soft tissue nodule anterior to the head of the pancreas likely represents a lymph node and is unchanged (series 7/108).BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Stable appearance of innumerable liver lesions compatible with metastatic neuroendocrine tumor. |
Generate impression based on findings. | Right shoulder pain. Rule-out osteoarthritis. Mild osteoarthritis affects the glenohumeral joint. There is cyst formation in the greater tuberosity at the expected site of insertion of the rotator cuff. The acromiohumeral interval is within normal limits. Degenerative arthritic changes also affect the visualized spine. Leads of a cardiac conduction device are incompletely imaged on this study. | Mild osteoarthritis of the shoulder. |
Generate impression based on findings. | Female, 88 years old, with altered mental status. Assess for intracranial mass or bleed. Patchy periventricular hypoattenuation is again seen, a nonspecific finding. No loss of gray-white distinction, parenchymal edema or mass effect is detected. No evidence of intra-cranial hemorrhage or any abnormal extra-axial fluid collection is seen. The ventricular system is stable and normal in size. The osseous structures of the skull are intact. The visualized paranasal sinuses and mastoid air cells are clear. | Redemonstration of nonspecific periventricular hypoattenuation which may represent age indeterminate microvascular ischemic disease.No CT evidence of acute territorial ischemia is seen. However, if clinical concern persists, further evaluation with MRI would be appropriate. |
Generate impression based on findings. | Male 72 years old Reason: Evaluate s/p Left THA History: Evaluate s/p surgery . Hardware components of a left total hip arthroplasty device are situated in near anatomic alignment with no radiographic evidence of hardware complication. Skin staples, a drain, and foci of gas density in the soft tissues reflect recent surgery. Severe osteoarthritis affects the left hip. | Total hip arthroplasty in near-anatomic alignment. |
Generate impression based on findings. | Follow-up A plate and screws are again seen affixing an oblique fracture of the distal fibula in near anatomic alignment. Callus along the posterior aspect of the fracture appears to have progressed compared with the prior study, suggesting some interval healing. There is mild diffuse soft tissue swelling. There is thickening of the distal Achilles' tendon suggesting tendinopathy that appears similar to that seen on the prior study. | Orthopedic fixation of healing distal fibular fracture. |
Generate impression based on findings. | LEFT LOWER EXTREMITY: Flow in the external iliac artery terminates abruptly in the midportion of the external iliac and common femoral artery stent. The distal common femoral artery bypass graft and profunda reconstitute via collaterals. After angioplasty with a 6-mm balloon, there is only a moderate amount of flow through the stent and filling defects are noted in the common femoral artery consistent with thrombosis. The bypass graft is patent, there is no evidence of twisting or kinking. The bypass terminates on the below knee popliteal artery. There is a stenosis of the distal popliteal artery just proximal to the takeoff of the anterior tibial artery. The intertubular is not well visualized. The visualized portions of the posterior tibial artery and peroneal artery are robust.CONTRAST: 60 mLFLUOROSCOPY TIME: Six minutesAIR KERMA: 175 mGrESTIMATED BLOOD LOSS: Less than 5cc. | Acute thrombosis of the left common femoral artery. Minimal improvement status post angioplasty.PLAN: The patient will be taken emergently to the operating room for surgical repair. |
Generate impression based on findings. | Female 41 years old Reason: eval for fracture History: hip pain. The bones appear demineralized. There is a poorly defined bandlike lucency traversing the left femoral neck consistent with a fracture or Looser's zone if the patient has a history of osteomalacia. There is poor definition of the superolateral cortex of the femoral neck, suggesting bone resorption.There is a T-shaped contraceptive device in the pelvis. | Nondisplaced left femoral neck fracture/Looser's zone as described above. Workup for osteomalacia is recommended |
Generate impression based on findings. | Female 29 years old Reason: right thumb MCP injury History: swelling and pain, after bending thumb backwards accidentally. No fracture or malalignment. Specifically, the right thumb metacarpophalangeal joint appears normal. | No specific findings to account for patient's pain. If further imaging evaluation is clinically warranted, dedicated thumb radiographs are recommended. |
Generate impression based on findings. | Rectal 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, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Complex loculated perianal fluid collection best seen on image 99 of series 3 measuring 3.6 x 4.7 cm. This collection extends into the right ischial-rectal fossa.OTHER: No significant abnormality noted | Complex loculated perianal fluid collection with extension into the right ischiorectal fossa. Findings consistent with peri-anal abscess. Since CT lacks sensitivity in assessing for fistulous communication to the anus, would recommend correlation with MR. |
Generate impression based on findings. | Female, 96 years old, with lethargy and decreased mentation, prior posttraumatic intracranial hemorrhage. Please compare to previous. Hyperattenuating blood product seen on the prior examination in the right parietal lobe and along the right occipital and temporal lobes has resolved. Hypoattenuation and encephalomalacia are now seen in these locations.No evidence of any new or acute intracranial hemorrhage is seen. No new abnormal extra axial fluid collections are detected. Periventricular hypoattenuation is demonstrated, a nonspecific finding.The ventricles and sulci are generally prominent compatible with volume loss, though the caliber of the lateral ventricles has increased mildly but diffusely. Along the right lateral ventricle, this may reflect some degree of ex vacuo dilatation from evolution of hemorrhage, but the other components of the lateral ventricles are also slightly larger. The osseous structures of the skull are intact. The visualized paranasal sinuses and mastoid air cells are clear. A small hematoma is present in the midline posterior scalp. | 1.Resolution of previously seen hyperdense hemorrhage with encephalomalacia now seen in those locations.2.Mild interval increase in caliber of the lateral ventricles is seen which cannot be entirely attributed to ex vacuo dilatation. The etiology and significance of this finding are uncertain.3.Redemonstration of periventricular hypoattenuation which likely reflects age indeterminate microvascular disease.4.Small hematoma in the posterior midline scalp. |
Generate impression based on findings. | Restaging small cell lung cancer prior to clinical trial.RADIOPHARMACEUTICAL: 9.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 106 mg/dL. Today's CT portion of the neck and pelvis demonstrates a right hip prosthesis but otherwise no significant pathology. Please see diagnostic CT reports for details of the chest and upper abdomen.Today's PET examination demonstrates a small but significantly hypermetabolic nodule in the right lung apex (SUV max = 5.2), compatible with recurrent lung cancer. A moderately enlarged markedly hypermetabolic right hilar lymph node (SUV max = 7.6), indicates mediastinal metastases. Several additional small but significantly hypermetabolic right thoracic foci seen along the right anterior mediastinum, the right infrahilar region as well as a punctate focus at the medial right lung base are compatible with additional foci of right thoracic tumor activity.No convincing contralateral thoracic FDG avid tumor identified. Curvilinear region of left mediastinal activity superior to the left ventricle is considered most likely to represent unusually prominent but benign atrial appendage.No suspicious FDG avid lesion identified within the abdomen, pelvis, or visualized skeleton. | 1.Multiple hypermetabolic tumor foci in the right chest.2.No suspicious FDG avid lesion in the contralateral left chest, abdomen, pelvis, or visualized skeleton.Diagnostic CTs of the chest and upper abdomen and also performed at today's visit will be reported separately. |
Generate impression based on findings. | 44 year-old female. Patient status post anterior pelvic exenteration for recurrent cervical cancer. Now with persistent tachycardia. PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Calcified nodules consistent with healed granulomatous disease. Scattered noncalcified micronodules are likely also postinflammatory. Left pleural calcification.No focal airspace consolidation or pleural effusion.MEDIASTINUM AND HILA: Calcified mediastinal lymph nodes consistent with healed granulomatous disease. No intrathoracic lymphadenopathy.Right chest wall port tip in the right atrium.Normal heart size. Small amount of pericardial fluid anteriorly, unchanged.CHEST WALL: Minimal degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Calcified hepatic and splenic granulomas. Bilateral hydronephrosis, incompletely imaged. | No evidence of pulmonary embolism or significant acute abnormality. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male 72 years old; Reason: ankle fracture? History: s/p fall, TTP at lateral malleolus and midfoot Three views of the right ankle show an oblique fracture of the distal fibula with fracture fragments in near-anatomic alignment. There is soft tissue swelling about the ankle. Three views of the right foot show slightly demineralized bones. Osteoarthritic changes affect the foot but we see no fracture. There is soft tissue swelling along the dorsum of the foot. Four views of the right knee show no fracture. Mild osteoarthritis affects the knee. There is no joint effusion. | Distal fibular fracture as above. Findings were discussed with Dr. Frogge (pager 3326) at the time of this finding by Dr. Veronesi of the radiology service on 2/18/2015 at approximately 1630. |
Generate impression based on findings. | History of psoriatic arthritis. ANA positive and inflammatory back pain. Evaluate for spondylitis. There is a bilateral spondylolysis of L5 without significant spondylolisthesis. There is perhaps minimal narrowing of the L5-S1 intervertebral disk space, but this is equivocal. Vertebral body heights are preserved. Alignment is within normal limits. There is a fusion anomaly of the posterior elements of L5, a normal variant. The sacroiliac joints appear normal. Mild degenerative disk disease affects T10/11. | L5 spondylolysis. |
Generate impression based on findings. | Neck instability. Some dysphagia. Moderate degenerative disk disease affects C5/6. The C5/6 neural foramina appear slightly narrowed bilaterally. Alignment of the cervical spine is within normal limits. The atlantal-axial articulation is within normal limits. Note is made of an impacted mandibular molar. A right upper lung nodule has been described in a previous CT scan report. | Degenerative disk disease and other findings as above. |
Generate impression based on findings. | Neuroblastoma on ANBL09P1 status post MIBG therapy. Normal physiologic radiotracer distribution is seen in the salivary glands, myocardium, liver, bowel and bladder. Previous activity within the right adrenal gland has resolved. There is no abnormal focus of activity to indicate current MIBG avid tumor. A focus of apparent uptake within the mid-abdomen resolved on subsequent imaging with movement and corresponded to the patient's external catheter. | No MIBG avid tumor currently. |
Generate impression based on findings. | Clinical question: Rule out mass lesion. Signs and symptoms: Seizure. Unenhanced head CT:There is no detectable acute intracranial hemorrhage, edema, mass effect, midline shift or hydrocephalus.There is no detectable abnormal enhancement the brain parenchymal or the leptomeninges to suggest presence of a mass.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation. Rightunremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses and mastoid air cells. | Negative enhanced head CT. |
Generate impression based on findings. | Clinical question; Rule out bleed. Signs and symptoms: AMS. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes.There are patchy bilateral subcortical and periventricular low attenuation white matter which are nonspecific however considering patient's stated age of 84 likely the presenting microvascular ischemic changes of indeterminate age.Slight prominence of cortical sulci and the ventricular system is within normal range for age.Mild bilateral internal carotid vascular calcification is noted.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells. | 1.No acute intracranial process.2.Moderate age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Clinical question: AMS. Signs and symptoms: AMS. Nonenhanced head CT:There is no evidence of acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic stroke. Examination demonstrate moderate periventricular and subcortical low attenuation white matter which considering patient's stated age of 88 likely representing age indeterminate microvascular ischemic changes. Subtle prominence of cortical sulci and ventricular system is within normal range for stated age.Moderate bilateral cavernous and supraclinoid internal carotid vascular calcification is present inunremarkable calvarium, soft tissues of the scalp, orbits, paranasal sinuses and mastoid air cells | 1.No acute findings.2.Moderate age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | altered mental status No evidence of acute ischemic or hemorrhagic lesion.Moderate degree non specific small vessel ischemic changes, no change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion.Small vessel ischemic disease, no change since prior exam. |
Generate impression based on findings. | 57 years, Female. Reason: evaluate for free air History: septic shock with unknown source Note that the examination is limited by patient instability and positioning. The pelvis is excluded from the field-of-view. Enteric feeding tube tip projects over the gastric body. Nonobstructive bowel gas pattern. No pneumoperitoneum seen. Bilateral interstitial opacities appear similar compared to prior chest radiograph. | Enteric feeding tube tip projects over the gastric body. No pneumoperitoneum seen. |
Generate impression based on findings. | Clinical question: Concern for bleed or edema. Signs and symptoms: Alteration of mental status. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable images through the orbits, paranasal sinuses, mastoid air cells. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | 49 years, Male. Reason: dht placement History: DHT PLACEMENT Enteric feeding tube tip projects over the pyloric region. Mildly dilated loops of small bowel are consistent with an ileus pattern. Left lower lobe opacities appear similar compared to prior chest radiograph.The lower pelvis is excluded from the field-of-view. | Enteric feeding tube tip projects over the pyloric region. |
Generate impression based on findings. | cerebrovascular accident Multifocal low attenuation areas on the left parietal lobe superior lobule, right side putamen and external capsule, and right cerebellar hemisphere indicating possible acute/subacute ischemic infarctions. Underlying brain shows moderate to severe non specific small vessel ischemic disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | Multifocal low attenuation lesions indicating possible acute/subacute ischemic lesions as described above.Brain MRI can be considered if further imaging investigation is needed.Extensive non specific small vessel ischemic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Skin lesion again marked on the left inner breast. | 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. | Clinical question: 55 year old female with history of head and neck cancer ACC with metastases to tongue, lung and liver. Signs and symptoms: On deviation to the left, rule out brain metastases. Nonenhanced head CT:Examination demonstrate a focus of vasogenic pattern edema in the left superior frontal gyrus with resultant very subtle regional mass-effect. Considering provided clinical information this finding is highly suspicious for a focus of metastatic disease and follow-up with an MRI or post enhanced head CT is recommended. The cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation is otherwise unremarkable for patient's age.Calvarium and soft tissues of the scalp are unremarkable.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells | 1.Small focus of vasogenic edema in the left superior frontal gyrus (12 x 22 mm) highly suspected of peritumoral vasogenic edema. Follow up with enhanced CT or MRI is recommended.2.Unremarkable exam otherwise. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral benign 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. No significant change in bilateral asymmetries, including those under the linear scar markers noting the sites of prior benign biopsies. | 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. | 47 years, Male. Reason: dobhoff placement History: same Dobbhoff tube tip projects over the gastric body. Support devices are unchanged. Mildly dilated loops of small bowel are again noted. Right pleural effusion.The pelvis is excluded from the field of view. | Dobbhoff tube tip projects over the gastric body. |
Generate impression based on findings. | 63 years, Female. Reason: NGT position History: pulled out 6 inches Enteric feeding tube tip projects over the gastric fundus. Persistently dilated loops of small bowel, consistent with postsurgical ileus. Surgical drain and skin staples project over the lower abdomen and pelvis.The pelvis is excluded from the field-of-view. | Enteric feeding tube tip projects over the gastric fundus. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history breast cancer in her grandmother. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable focal asymmetry in the left upper outer breast. Benign intramammary lymph node in the right upper outer breast also unchanged. | 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. | 58 years, Female. Reason: 58 yo with abd pain History: abd pain Nonobstructive gas pattern. No pneumoperitoneum. Average stool burden in the colon. | No acute intra-abdominal abnormalities. |
Generate impression based on findings. | 55-year-old male with chest pain and hypotension, rule out abdominal aortic aneurysm. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: The ascending aorta is ectatic measuring up to 4.5 cm (series 3, image 41). Though evaluation for dissection is limited due to lack of intravenous contrast, the morphology of the thoracic aorta is similar to the prior study. No pericardial effusion.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver. Mild hepatomegaly.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Previously seen peripancreatic lymph node (series 3, image 102) has decreased in size. BOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Colonic diverticulosis without diverticulitis.BONES, SOFT TISSUES: Degenerative changes affect the visualized thoracolumbar spine. 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 diverticulitis.BONES, SOFT TISSUES: Degenerative changes affect the visualized thoracolumbar spine. OTHER: No significant abnormality noted | 1.Evaluation for dissection limited by lack of intravenous contrast. Ectatic ascending aorta similar in morphology to prior.2.Normal caliber abdominal aorta. 3.Colonic diverticulosis without diverticulitis.4.Hepatic steatosis. |
Generate impression based on findings. | 53-year-old female with history of low-grade endometrial stromal sarcoma resected in anterior vaginal wall, evaluate for metastasis. CHEST:LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules. No suspicious nodules or masses. No consolidation or pleural effusions. MEDIASTINUM AND HILA: No hilar or mediastinal adenopathy. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Area of low attenuation along the interlobar fissure compatible with focal fat. No suspicious hepatic lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No lymphadenopathy by size criteria. BOWEL, MESENTERY: Scattered small nonspecific mesenteric lymph nodes. BONES, SOFT TISSUES: Foci of gas within the anterior abdominal wall likely related to injections.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Scattered small internal iliac lymph nodes are present on the right.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Interval resection of vaginal cuff mass seen on recent MRI. There is a focus of ill-defined asymmetric soft tissue density in the right pelvis (series 3, image 157) which is nonspecific but could represent metastatic disease.There is new ill-defined soft tissue attenuation (series 3, image 171) measuring 3.7 x 3.1 cm encasing a thrombosed right common femoral vein. | 1.Interval resection of vaginal cuff mass seen on recent MRI.2.Ill-defined soft tissue attenuation in the right pelvis nonspecific but cannot exclude metastatic disease.3.New ill-defined soft tissue encasing thrombosed right common femoral vein, cannot exclude metastatic disease. In the apppropriate clinical setting, may be evaluated further with MRI. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in her aunt. Bilateral breast pain for a week. 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 composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. Areas of parenchymal asymmetry in the left outer breast disperse on tomosynthesis with no underlying persistent mass. Normal-sized lymph nodes project in each axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Suggest clinical correlation given the patient's breast pain.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 66 years old Reason: rule out tifflitis, SBO in 66yo neutropenic pt w abd pain and distention History: abdominal distention s/p colectomy ABDOMEN:LUNG BASES: Subpleural nodule in the right upper lobe which has slightly decreased in size now measuring up to 8 mm (series 4, image 3). Additional nonspecific micronodules are unchanged. Right basilar pleural calcification again noted. Pleural thickening without pleural effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Markedly dilated colon with air-fluid levels, measuring up to 6.5 cm in the transverse colon. There is fecal material and air within the rectum. No evidence of bowel obstruction. No pneumatosis or pneumoperitoneum.The anus is not well visualized and an obstructing mass cannot be excluded.There is an ill-defined 2.7 x 2.6 cm soft tissue mass located within the mesentery in the left midabdomen (series 3, image 99).Small ventral hernia without evidence of obstruction. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality noted LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Markedly dilated colon consistent with colonic ileus.2.Ill-defined soft tissue mesenteric mass in the left midabdomen which likely represents metastatic lymphadenopathy or carcinoid tumor. |
Generate impression based on findings. | 70 year-old female with abdominal pain. Exam somewhat limited by motion. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: Subsegmental basilar opacities, probably atelectasis. Small pericardial effusion. LIVER, BILIARY TRACT: Cholelithiasis without evidence of acute cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Above average stool burden in the colon and rectum. No intraperitoneal free air or free fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Distended bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Above average stool burden in the colon and rectum. No intraperitoneal free air or free fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No acute intraabdominal process.2.Cholelithiasis without evidence of acute cholecystitis.3.Distended bladder. 4.Above average stool burden. |
Generate impression based on findings. | 26-year-old male with history of renal transplant, evaluate for fluid collection. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic native kidneys.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. No intraperitoneal free air. Colonic diverticulosis without diverticulitis.BONES, SOFT TISSUES: Postsurgical changes to right lower quadrant abdominal wall.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. No intraperitoneal free air. Colonic diverticulosis without diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Status post renal transplant in the right iliac fossa. There is a 2.3 x 7 cm fluid collection located posterior to the renal transplant (series 3, image 73). Mild fat stranding adjacent to the transplant kidney is likely postoperative in etiology. Transplant kidney with nephroureteral stent with distal tip in the bladder. No hydronephrosis. A JP drain has its tip located in the midline soft tissues of the anterior abdominal wall. | 1.Right iliac fossa transplant kidney without hydronephrosis. Nonspecific 2.3 x 7 cm fluid collection posterior to the transplant kidney, favor postoperative seroma or urinoma. JP drain with tip in the midline soft tissues of the anterior abdominal wall without associated fluid collection.2.Colonic diverticulosis without evidence of diverticulitis. |
Generate impression based on findings. | 73 year old female with history of metastatic breast cancer needs re-evaluation and compare to prior scans using RECIST. CHEST:LUNGS AND PLEURA: Bilateral upper lobe pleural thickening/scarring, right greater the left, with areas of calcification. Mild apical predominant centrilobular emphysema. Bibasilar dependent scarring/atelectasis.Scattered nonspecific micronodules similar to prior without suspicious nodules or masses.MEDIASTINUM AND HILA: The previously described prevascular and AP window lymph nodes have decreased in size. Reference lymph node (series 3, image 28) measures 4 x 7 millimeters, previously 6 x 11 mm. Mild coronary artery calcifications. CHEST WALL: Multiple prominent bilateral axillary lymph nodes, overall decreased in size from prior. Previously described 13-mm left axillary lymph node seen on coronal image 70 is thought to actually be a right axillary lymph node (typographical error). In retrospect, this lymph node measures 11 x 17 mm (series 10247, image 25) on the previous exam and measures 8 x 13 mm currently (series 3, image 28). Multiple lytic/sclerotic lesions throughout the visualized osseous structures compatible with metastases, grossly similar to prior. Right clavicular fracture and bilateral posterior rib fractures, possibly pathologic appearing similar to prior. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Left adrenal nodule previously shown to be hypermetabolic on PET (series 3, image 89) measures 0.7 x 1.6 cm, previously 0.7 x 1.8 cm.KIDNEYS, URETERS: Unchanged appearance of exophytic right renal hypodensity, likely cyst.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic disease of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small fat-containing umbilical hernia. Lytic/sclerotic lesions throughout the visualized osseous structures compatible with metastases.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Lytic/sclerotic lesions throughout the visualized osseous structures compatible with metastases. Chronic appearing deformity of the right superior pubic ramus and minimally displaced fracture of the right inferior pubic ramus which may be pathologic.OTHER: No significant abnormality noted. | 1.Interval decrease in size of reference anterior mediastinal and axillary lymph nodes.2.Interval decrease in size of left adrenal nodule which previously demonstrated increased metabolic activity on PET.3.Widespread osseous metastases appearing grossly similar to prior. Possibly pathologic fractures of the right clavicle, posterior ribs, and right pubic rami. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 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. | Right sided hydronephrosis. Duplex right kidney. There is prompt perfusion, uptake and excretion of the left kidney. No evidence of left collecting system dilation or obstruction. The right kidney demonstrates somewhat delayed perfusion. The right upper moiety demonstrates prompt uptake and excretion without evidence of collecting system dilation or obstruction. The right lower moiety demonstrates delayed and diminished uptake and excretion into a moderately dilated right lower pelvocaliceal system. There is slow washout from the right lower moiety collecting system. This could be due to obstruction or poor right lower moiety parenchymal function.The estimated contribution of the right kidney to total renal function is 64% and that of the left kidney is 36%.When comparing the right upper moiety versus the right lower moiety, the relative function of the right upper moiety was 83% versus 17% for the right lower moiety. The T1/2 washout of the right upper moiety was 3 minutes whereas that of the right lower moiety was not reached. | 1.Normal appearing left kidney and its collecting system.2.Normal upper moiety of the right kidney and its collecting system. 3.Significantly diminished parenchymal function of the right lower moiety as well as moderately dilated right lower collecting system with poor washout which could be due to lower moeity obstruction or manifestation of poor lower parenchymal function. This leads to significantly diminished function of the right lower moiety compared to the right upper moiety (and hence decreased total right kidney compared to the left kidney, as quantified above). |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of ovarian cancer in her mother. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign calcifications are again noted bilaterally. Bilateral asymmetries are also stable. Stable normal sized lymph nodes in each axilla. | 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. | Reason: evaluate R middle lobe opacity, ? PNA, infarct vs. neoplasm History: R middle lobe infarct, recurrent fevers LUNGS AND PLEURA: Right perihilar solid, nodular area of consolidation ( new from prior CT imaging dated 01/2004) with extension anteriorly and inferiorly, and scattered surrounding ground glass and nodularity. This measures up to 28 x 23 mm (series 7, image 34). This finding corresponds with the opacity seen on recent prior chest radiographs, and is likely new from the prior radiograph dated 12/16/2014. The associated bronchus is mildly narrowed.Basilar subsegmental atelectasis/scarring. Scattered groundglass and small areas of consolidation in the left lower lobe, may relate to aspiration/infection.MEDIASTINUM AND HILA: The heart is mildly enlarged, without pericardial effusion. No visible coronary artery calcification.Right IJ central venous catheter, tip at the cavoatrial junction.Scattered prominent mediastinal lymph nodes. A precarinal lymph node measures 10 mm (series 5, image 27).Small hiatal hernia.CHEST WALL: Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Rounded dense calcification at the splenic hilum may represent a splenic artery aneurysm, unchanged from 01/2004 | Right perihilar solid, nodular area of consolidation corresponds with the opacity seen on recent prior chest radiographs. Given the relatively short time course of this abnormality on recent radiographs, infectious process is more likely, but the appearance is worrisome for tumor, and rapidly growing neoplasm cannot be excluded. Recommend followup CT exam with IV contrast in 6-8 weeks. |
Generate impression based on findings. | 45 years, Female. Reason: obstipated without bowel sounds. Rule out mechanical obstruction vs ileus History: pain, constipation Diffuse dilation of predominately large bowel loops. Moderate stool burden with amorphous stool in the rectum. Bilateral tubal ligations clips noted. | Diffuse dilation of predominately large bowel loops suggestive of large bowel ileus. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History breast cancer in her grandmother. 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable subareolar left breast mass. Benign calcifications are again noted 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. | 81 years, Male. Reason: Patient with suspected CBD injury, direct transfer from OSH History: Abdominal pain Cardiomediastinal silhouette is normal. No pleural effusion or pneumothorax. Right greater than left bibasilar interstitial and airspace opacities. Discoid atelectasis bilaterally at the bases.Surgical clips in the right upper quadrant. Dilated loops of small bowel with thickened folds measuring up to 3.5 cm with air-fluid levels. Average stool burden throughout the colon. No pneumoperitoneum. | 1.Right lung base opacity may represent aspiration.2.Ileus versus partial small bowel obstruction.3.Thickened jejunal folds. Correlate for causes of mucosal edema such as ischemia. |
Generate impression based on findings. | Female 77 years old; Reason: Merkel cell with mets to pancreas. please measure using recist criteria and assess for any other sites of disease History: pre chemo CHEST:LUNGS AND PLEURA: Apical pleural nodularity/scarring. Punctate 2 mm right middle lobe lung nodule, image 58 series 8, nonspecific. No pleural effusion. Small right base and lingular atelectasis. MEDIASTINUM AND HILA: Subcentimeter mediastinal lymph nodes. Thrombosed portal vein. Nonvisualization of splenic vein and SMV not definitely seen, likely related to thrombosis. 3.7 cm ascending thoracic aorta. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Mild to moderate biliary duct dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Large dominant heterogeneous enhancing soft tissue mass with lobular margins involving majority of pancreas, centered in region of pancreatic body, mass extends inferiorly and into retroperitoneal/left paraaortic area. Mass measures 14.5 cm in transverse dimension by 13.7 cm in craniocaudal dimension by 14.3 cm in AP dimension. Image 50 series 7.Displacement of adjacent anatomic structures seen with abdominal aorta deviated towards the right. Associated encasement of celiac axis and its branches as well as superior mesenteric artery seen. ADRENAL GLANDS: Aforementioned mass inseparable from portion of left adrenal gland, appearance suspicious for invasion, image 87 series 8. Diffusely thickened right adrenal gland, nonspecific. KIDNEYS, URETERS: Symmetric renal enhancement. No hydronephrosis. RETROPERITONEUM, LYMPH NODES: Adenopathy, including periceliac/gastrohepatic and pelvic adenopathy. Reference lymph node measuring 1.7 x 1.6 cm, image 89 series 8/coronal image 62 series 80588. Reference right common iliac lymph node, measuring 1.4 x 1.1 cm, image 132 series 8. Small inguinal nodes. Aortobiiliac atherosclerotic calcifications. Mild luminal heterogeneity in right superficial femoral vein, nonspecific. BOWEL, MESENTERY: Bowel including stomach deviated peripherally. Gastric lumen markedly narrowed as a result of mass effect from large pancreatic mass. Underlying neoplastic invasion of adjacent bowel not entirely excluded but no bowel dilatation seen to suggest obstruction at this time. No ascites.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes of spine. Diffuse decreased osseous mineralization. Dextroscoliosis of spine. | 1. Large heterogeneous soft tissue mass involving majority of pancreas, compatible with patient's history of metastatic disease. 2. Periceliac and pelvic adenopathy, reference nodes as above. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.