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Generate impression based on findings. | Male 20 years old; Reason: consult scan History: testicular pain/swelling. Patient reports an area of firmness within the scrotal sac. RIGHT TESTIS: Right testis measures 4.8 by 2.1 x 3.3 cm and is normal in appearance without focal mass.LEFT TESTIS: The left testis measures 4.3 x 1.9 x 3.1 cm and is normal in appearance without focal mass.RIGHT EPIDIDYMIS: The right epididymis measures 3.7 x 0.8 x 1.1 cm with a normal ultrasound appearance.LEFT EPIDIDYMIS: The left epididymis measures 4.1 x 0.6 x 1.1 cm and contains a 2.2 x 1.4 x 2.0 cm simple cyst, also seen on the prior outside ultrasound study. OTHER: Along the medial aspect of the left scrotum in the area of the palpable firmness felt by the patient are multiple scrotoliths, the largest measures 2 x 2 x 2 mm. Minimal left hydrocele. | 1.Normal ultrasound of the testicles. 2.2.2 cm left epididymal cyst, unchanged. 3.Multiple scrotoliths, a benign finding, along the medial aspect of the left scrotum in the area of the patient's palpable abnormality. |
Generate impression based on findings. | Female 46 years old Reason: recent CT with pulmonary nodules concerning for metastatic disease, evaluate for interval change and potential site of primary malignancy History: pulmonary nodules CHEST:LUNGS AND PLEURA: Multiple bilateral subcentimeter lung nodules, the largest in the right lower lobe measures 0.9 x 0.8 cm (series 5, image 69). MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion. Air-filled esophagus.CHEST WALL: Bilateral breast implants. No axillary lymphadenopathy.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Nonspecific sclerotic lesion in the T11 vertebral body.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Multiple bilateral, subcentimeter lung nodules without lymphadenopathy which may represent an infectious process or metastases. Consider biopsy of the nodule if clinically indicated.2.Single, nonspecific sclerotic lesion in the T11 vertebral body. |
Generate impression based on findings. | 63-year-old male with hematuria. ABDOMEN:LUNG BASES: Mild coronary artery calcifications.LIVER, BILIARY TRACT: Hepatic steatosis without focal lesions. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: The kidneys are normal in size and morphology. Bilateral subcentimeter low-attenuation lesions too small to completely characterize but likely benign cysts. No nephrolithiasis or hydroureteronephrosis.On delayed images, the kidneys excrete contrast symmetrically without filling defects in the renal collecting systems. The visualized portions of the ureters are normal in caliber without filling defects.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild atherosclerotic calcifications affect the abdominal aorta and its branches.BONES, SOFT TISSUES: Mild degenerative changes affect the visualized thoracolumber spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate. BLADDER: Small diverticulum. No bladder wall thickening is appreciated.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Mild degenerative changes affect the visualized thoracolumber spine.OTHER: No significant abnormality noted | 1.Hepatic steatosis.2.No nephrolithiasis, hydronephrosis, or suspicious renal masses.3.Prostatomegaly. |
Generate impression based on findings. | Prostate cancer, evaluation of disease after 12 cycles of investigational therapy. Please complete PCWG 2 form. There is a new posterior right 10th rib lesion, confirmed on CT, with a new pathologic fracture. There are also new areas of metastatic uptake within the left lateral 5th rib and the left anterior 8th rib. A right ischial lesion appears larger. Other previously identified areas of uptake within other ribs, the left AC joint, and spine appear unchanged; note given the lytic nature of these lesions on CT, bone scan is less sensitive for detection. Similarly, there may be additional new lytic lesions on the most recent CT not seen on this bone scan. The spine also appears more diffusely heterogeneous than previously which is also suspicious for additional lytic metastases, which is also suspected on the CT. | Progression of disease with multiple new and worsening osseous metastatic lesions; a majority of these lesions appear lytic on CT which limits sensitivity and detection on the bone scan. However, additional new lytic lesions are suspected when reviewing the most recent CT. |
Generate impression based on findings. | Female 26 years old Reason: evaluate for fracture History: Pain at 5th metatarsal, most severe pain along 3rd metatarsal, some pain along 2nd metatarsal. There is moderate soft tissue swelling along the dorsal aspect of the foot with a small joint effusion in the anterior tibiotalar joint. However, there is no underlying fracture or malalignment. | No acute fracture or malalignment. |
Generate impression based on findings. | Male 64 years old Reason: Unspecified mechanical complication of internal orthopedic device, implant, and graft History: Postsurgical changes in the right tibia/fibula. The external fixator device has been removed as has the distal syndesmotic screw.Three screws affix a the diaphyseal fracture and three distal metaphysis screws affix a distal tibial fracture in near-anatomic alignment.Two K wires affix the medial malleolus fracture. There is slight widening of the medial joint space about the ankle.Sideplate and screws affix a distal third fibular fracture. | Orthopedic fixation of the tibia and fibular fractures as detailed above. |
Generate impression based on findings. | Male 27 years old Reason: evaluate lymph nodes History: testicular cancer 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: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: Small amount of fluid in the pelvis, nonspecific. | No evidence of metastatic disease in the abdomen or pelvis. |
Generate impression based on findings. | The right uterine artery was embolized using 500-700 micron Embospheres until near stasis was achieved. The post-embolization angiogram confirmed these findings.LEFT UTERINE ARTERY EMBOLIZATION | Successful bilateral uterine artery embolization.PLAN: The patient is admitted to the gyn-onc service and will be further managed by this service. |
Generate impression based on findings. | Male; 57 years old. Reason: hydronephrosis History: hydronephrosis RIGHT KIDNEY: The right kidney measures 11.2 cm in length. The renal cortex is mildly echogenic. A nephroureteral stent is seen within the collecting system. There is moderate hydronephrosis which is new compared to the prior renal ultrasound. No shadowing renal stone.LEFT KIDNEY: The left kidney measures 10.7 cm in length. The renal cortex is mildly echogenic. A nephroureteral stent is seen within the collecting system. There is moderate hydronephrosis however progressed when compared to the prior ultrasound. Within the lower pole the kidney is a nonobstructing 1.3 x 1.2 x 0.8 cm renal stone which was likely present on the prior study.URINARY BLADDER: Nephroureteral stents terminate within the bladder. The bladder is nondistended. | 1.New moderate right hydronephrosis.2.Moderate left hydronephrosis has progressed compared to the prior ultrasound.3.Nonobstructing 1.2 cm left renal stone.4.Bilateral echogenic kidneys suggestive of medical renal disease. |
Generate impression based on findings. | Male 27 years old Reason: evaluate lymph nodes History: testicular cancer 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: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: Small amount of fluid in the pelvis, nonspecific. | No evidence of metastatic disease in the abdomen or pelvis. |
Generate impression based on findings. | Ms. Wallace is a 47 year old female with personal history of bilateral mastectomy status post reconstruction. In September 2014 she had drainage of a hematoma in the reconstructed right breast. She presents today with a palpable abnormality in the same location, concerning for reaccumulation of hematoma. The site of interest was marked by Dr. Chhablani. Upon physical exam of the reconstructed right breast, no discrete mass is appreciated in the site marked by Dr. Chhablani.A targeted right breast ultrasound was performed for the patient’s area of concern. In the right reconstructed breast 7 o'clock location, no suspicious cystic or solid mass was identified. | No sonographic evidence for malignancy or focal collection at the site marked. All results were relayed to Dr. Chhablani. Patient will follow-up with Dr. Chhablani in clinic.BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Hypercalcemia. There is physiologic distribution of the radiopharmaceutical. There is no focus of increased activity to suggest a parathyroid adenoma. There is equivocal slight prominence of the left upper parathyroid gland and possibly both lower parathyroid glands raising the question of possible parathyroid gland hyperplasia but this is equivocal. Incidental activity is noted within lymph nodes in the the left axilla from partial left-sided extravasation during radiotracer injection. | 1.No scintigraphic evidence for parathyroid adenoma.2.Additional findings are equivocal but are of some suspicion for possible parathyroid hyperplasia. |
Generate impression based on findings. | 16 year old female with history of mediastinal lymphoma, 6 months off therapy. LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No focal air space opacity or pleural effusion.MEDIASTINUM AND HILA: Mild interval decrease in size of left paramedian anterior mediastinal mass which measures 3.8 x 2.3 cm, previously 3.9 x 2.8 cm (series 3, image 24). Heterogeneous areas of low attenuation within the mass are again noted and suggestive of a necrotic component.Uniform soft tissue density with smooth margins in the right paramedian anterior mediastinum is compatible with rebound thymic hyperplasia, unchanged. Normal heart size without pericardial effusion.CHEST WALL: No axillary lymphadenopathy. No suspicious osseous lesions.UPPER ABDOMEN: No significant abnormality noted. | Mild interval decrease in size of left anterior mediastinal mass. No new sites of disease identified. |
Generate impression based on findings. | Male 84 years old Reason: left knee pain History: left knee pain. Severe osteoarthritic changes affect the left knee with near bone on bone apposition of the medial compartment and tricompartmental osteophytes. A moderate size joint effusion is seen in the suprapatellar pouch.Frontal views of the right knee demonstrate severe osteoarthritic changes with bone on bone apposition, tricompartmental osteophytes, and subchondral cyst formation. | Severe osteoarthritis of the left knee. |
Generate impression based on findings. | Female 42 years old Reason: ankle pain History: ankle pain. Oblique fracture of distal fibula is again seen with posterolateral displacement of the distal fracture fragment, which appears unchanged from the prior exam. There is widening of the lateral joint space. There is soft tissue swelling over the lateral malleolus. A well corticated ossicle adjacent to the medial malleolus, is unchanged from the prior exam, and most likely due to prior injury to the deltoid. | Distal fibular fracture with lateral joint space widening, unchanged from the prior exam. |
Generate impression based on findings. | 67-year-old male patient with questionable enterocutaneous fistula in the epigastric area. A 12 gauge catheter was inserted into a small cutaneous fistula and the patient was instructed to hold his index finger over the fistula. Omnipaque was injected and there was immediate opacification of a loop of small bowel. Upon retraction of the catheter tip towards the skin, there was only opacification of bowel and no significant length of fistula tract was seen.TOTAL FLUOROSCOPY TIME: 2:51 minutes | Enterocutaneous fistula in the epigastric region with direct communication to small bowel. No fistula tract was visualized. |
Generate impression based on findings. | History of of HL; day 100 post auto sct evaluation History: EvaluateRADIOPHARMACEUTICAL: 10.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 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 no suspicious FDG avid activity to indicate tumor currently. Extensive brown fat activity is seen in neck, thorax and upper abdomen | No suspicious FDG avid activity to indicate tumor currently. Please see the same day diagnostic CT report for details of the chest, abdomen, and pelvis. |
Generate impression based on findings. | 15-year-old female with lumbago.VIEWS: Lumbar spine left and right oblique views (two views) 2/19/2015 at 1405 No acute fracture or malalignment. No evidence of spondylolysis. Vertebral body heights are preserved. Nonobstructive bowel gas pattern. | Normal examination. |
Generate impression based on findings. | 63-year-old presents for annual follow-up. History of prior abnormal mammograms. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No new dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign morphology asymmetry in the right outer breast seen on the CC view is stable over multiple studies. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | ReintubationVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. NG tube removed in the interval. Cardiothymic silhouette normal. Minimal patchy atelectasis right lower lobe. No pleural effusion or pneumothorax. | Minimal patchy atelectasis right lower lobe. |
Generate impression based on findings. | 17 month old female with history of left humeral osteomyelitis.VIEWS: Left humerus AP and lateral (two views) 2/19/2015 at 1405 Bony remodeling and cortical thickening seen in the mid humeral diaphysis on prior exam have resolved, compatible with resolution of previous osteomyelitis. No bony erosive changes or foci of gas noted to suggest new acute osteomyelitis. No acute fracture or dislocation. | No specific radiographic evidence of acute osteomyelitis. |
Generate impression based on findings. | Male 63 years old Reason: shoulder History: shoulder pain Right shoulder: Bone mineralization is normal. Alignment is anatomic. Mild osteoarthritis affects the right shoulder with mild sclerosis of the glenoid and tiny osteophytes.Radiopaque foreign bodies are shown adjacent to the right base of neck. There is a lucency in the right upper lobe.Left shoulder: Bone mineralization is normal, alignment is anatomic. There are only tiny osteophytes in the left glenohumeral joint. There are healed left rib fractures.. | Mild right shoulder osteoarthritis. Left shoulder, appropriate for age. |
Generate impression based on findings. | Bilateral lower extremity pain. Lumbar spine: Severe degenerative disk disease affects the L5/S1 level. The disk spaces are otherwise preserved. The vertebral body heights are preserved. The alignment is anatomic. Moderate osteoarthritis affects the facet joints of the lower lumbar spine.Right hip: Mild osteoarthritis affects the right hip, appropriate for age. No fracture or malalignment.Left hip: Minimal osteoarthritis affects the left hip, appropriate for age. No fracture or malalignment.Right knee: Minimal osteoarthritis affects the right knee, appropriate for age. No fracture or malalignment. No joint effusion is evident. Left knee: Minimal osteoarthritis affects the left knee, appropriate for age. No fracture or malalignment. No joint effusion is evident. | Degenerative changes in the lower lumbar spine and other findings, as above. |
Generate impression based on findings. | History of ALL with osteonecrosis of the hip. Now with bilateral foot pain. The bones are diffusely demineralized. No specific evidence of osteonecrosis. Mild osteoarthritis affects the first MTP joints bilaterally. No fracture or malalignment. | No specific evidence of osteonecrosis. |
Generate impression based on findings. | The posterior fossa is normal in size. The cisterna magna measures approximately 12 mm on axial images. The cerebellar hemispheres and vermis are present and normally formed. The foramen of Magendie is normal. Evaluation of the fetal cerebral parenchyma demonstrates two distinct cerebral hemispheres and thalami. The corpus callosum is present. Evaluation of the ventricles demonstrates normal size of the lateral, third, and fourth ventricles. No focal area of hemorrhage is seen. There is no restricted diffusion. Limited imaging of the chest, abdomen and pelvis is obtained during localization sequences demonstrate mild dilation of the right renal collecting system. | 1. The cisterna magna measures up to 12 mm in diameter, which may represent very mild enlargement or a variation of normal. No other intracranial abnormalities are seen. 2. Mild dilation of the right renal collecting system. As this examination was tailored for the examination of the fetal brain, the remainder of the fetal anatomy is only partially seen. |
Generate impression based on findings. | 29 year old with bilateral milky nipple discharge for 10 years. Ultrasound for periareolar region was performed bilaterally. No dilated ducts, intraductal lesions or other suspicious findings are seen. | No sonographic evidence of malignancy. Clinical follow up is recommended. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Decreased ROM. No fracture or malalignment of the left shoulder. Normal appearance of the acromioclavicular and glenohumeral joints. No significant degenerative changes noted. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 59 years, Female. Reason: ngt readjustement History: please evaluate for NGT position Enteric feeding tube tip projects over the distal gastric body. Unchanged ileus bowel gas pattern, cholecystectomy staples, biliary stent and right lower quadrant suture material. The pelvis is excluded from the field-of-view. | Enteric feeding tube tip projects over the distal gastric body. |
Generate impression based on findings. | 25-year-old female with history of Ewing's sarcoma of the left tibia CHEST:LUNGS AND PLEURA: There is a new solid pulmonary mass in the left lung at the level of the aortic arch (series 4, image 31) measuring 4.5 x 5.2 cm highly suspicious for metastatic disease. The lesion abuts the posterior aspect of the aortic arch and proximal descending aorta as well as the posteromedial pleura without apparent invasion. No additional pulmonary nodules or masses. Scattered pulmonary micronodules are present.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: A homogenously enhancing lesion is present in hepatic segment 4 B (series 3, image 91) measuring approximately 4.2 x 4.3 cm corresponding to non-specific lesion described on 2012 MRI. An additional area of low attenuation in segment 4 A is thought to represent focal fat or perfusion phenomenon. Additional previously seen lesions are not appreciated seen on this examination.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Previously described lesion in the left kidney has resolved and may have represented focal pyelonephritis. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No suspicious osseous lesions are identified.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Intrauterine device within the uterus. 3 cm simple left adnexal cyst, likely physiologic.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small sclerotic lesion in right iliac wing likely bone island. No suspicious osseous lesions are identified.OTHER: No significant abnormality noted. | 1.New left lung mass measuring 4.5 x 5.2 cm highly suspicious for metastasis.2.Hepatic segment 4 B lesion may represent atypical focal nodular hyperplasia but is incompletely characterized, recommend MRI with and without contrast for further evaluation. |
Generate impression based on findings. | Head injury last night: reports blurred vision and nausea. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. However, the posterior fossa appears to be relatively small and the cerebellar tonsils up to 9 mm inferior to the foramen magnum. The ventricles are normal in size and configuration. There is no midline shift. The imaged paranasal sinuses and mastoid air cells are clear. There is no evidence of skull fracture. The scalp soft tissues are unremarkable. | 1. No evidence of acute intracranial hemorrhage or skull fracture.2. Small posterior fossa and low-lying cerebellar tonsils are suggestive of Chiari I malformation. FUrther evaluation via a brain and spine MRI may be useful. |
Generate impression based on findings. | Spinal cord stimulator lead confirmation There are 11 rib-containing thoracic vertebrae. The first non-rib containing vertebra will be designated L1. There are 6 non-rib-containing lumbar type vertebrae. Degenerative changes of the lower lumbar spine are present, with mild leftward curvature of the lumbar spine.A spinal stimulator device is noted in the left lateral posterior soft tissues of the back, with leads entering at the L1/L2 level, terminating at the T7 level, without kink or discontinuity. Atherosclerotic calcification of the abdominal aorta is noted. | Degenerative changes and spinal stimulator device, as above |
Generate impression based on findings. | Frontal sinus: The right frontal sinus is not pneumatized. The left frontal sinus is near completely opacified as is the left frontal ethmoidal recess.Anterior ethmoids: There is near complete opacification of the left anterior ethmoid air cells. The right anterior ethmoid air cells are clear.Maxillary sinuses: There is a moderate-sized air-fluid level in the left maxillary sinus with mild-moderate circumferential mucosal thickening. The right maxillary sinuses is clear. The right ostiomeatal unit is clear. The left is completely opacified.Posterior ethmoids: There is moderate mucosal thickening in the left posterior ethmoid air cells. The right posterior ethmoid air cells are clear.Sphenoid sinus: The right sphenoid sinus and sphenoethmoidal recess are clear. There is a small air-fluid the left sphenoid sinus, with mild circumferential mucosal thickening and opacification of the left sphenoethmoidal recess.There is minimal rightward nasal septal deviation. The nasal turbinate morphology is within normal limits although the left middle meatus is opacified. There is minimal debris in the left inferior meatus.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. There is a small incidental torus palatini. | Findings suggestive of left anterior greater than posterior paranasal sinus acute sinusitis. |
Generate impression based on findings. | Male 51 years old Reason: Newly dx HOP cancer with questionable nodal involvement and vessel involvement on poor quality OSH Scan. Needs Pancreas protocol CT Scan here. History: Painless jaundice ABDOMEN:LUNG BASES: No suspicious nodules or masses. No pleural effusion.LIVER, BILIARY TRACT: Common bile duct stent in place with mild to moderate intra/extrahepatic biliary ductal dilatation to the level of the stent. The portal vein, SMV, and splenic vein are patent. Left hepatic artery has an early takeoff from the common hepatic artery, very near the CHA origin. There is mild soft tissue stranding around the right hepatic artery beyond this point. The pancreatic lesion encases the GDA, which originates from the right hepatic artery, GDA remains patent (series 8, image 45). The remainder of the celiac axis and the SMA appear patent. No evidence of liver metastasis. No ascites.SPLEEN: No significant abnormality noted. PANCREAS: Ill-defined hypodense mass in the head of the pancreas measuring 4.0 cm x 3.3 cm (series 10, image 50). No significant pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Regional lymphadenopathy. For reference, a portocaval lymph node measures 1.6 x 1.5 cm (series 10, image 40). Scattered subcentimeter periceliac and retroperitoneal lymph nodes are present.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Punctate prostate calcifications..BLADDER: No significant abnormality notedLYMPH NODES: No pelvic lymphadenopathy.BONES, SOFT TISSUES: Age indeterminate compression deformity of the T12 vertebral body. Scattered nonspecific sclerotic lesions in the pelvis best visualized in the right ilium. The foci may represent bone islands, however, follow-up is recommended.1. | 2.Mass of the head of the pancreas without evidence of remote metastatic disease as described above. |
Generate impression based on findings. | Large laryngeal mass, assess extent. There are postoperative findings related to tracheostomy tube insertion with extensive multicompartment emphysema in the neck. There is a heterogenous infiltrative mass centered in the right supraglottic region with extension into the hypopharynx and base of tongue that measures up to at least 4 cm and extends across the midline. There is effacement of the laryngeal ventricles, although assessment for vocal cord involvement is limited. There is a heterogeneous appearance of the tracheal cartilages that may be due to tumor invasion, but the outer cortex appears to be intact, without discernible extension of tumor into strap muscles. There is right level 3 lymphadenopathy that appears to measure up to approximatively 2 cm, although assessment is limited due to the lack of fat planes. There are numerous sclerotic bone lesions throughout the imaged axial skeleton. There are secretions within the subglottic airway, but the airway inferior to the tracheostomy tube is clear. There is a midline thyroidotomy, but the thyroid tissue otherwise appears unremarkable. The major salivary glands are unremarkable. There is atherosclerotic plaque at the bilateral carotid bifurcations. There are multiple dental caries. The imaged intracranial structures are unremarkable. There are emphysematous changes in the partially imaged lungs. There is an enteric tube in position. | 1. Postoperative findings related to recent tracheostomy tube insertion with extensive multicompartment emphysema in the neck. 2. A necrotic infiltrative mass centered in the supraglottic region with extension into the tongue base that measures up to at least 4 cm and extends across the midline likely represents a squamous cell carcinoma. Further characterization of the mass is limited and MRI or PET may be useful for additional evaluation.3. Right level 3 lymphadenopathy, although assessment is limited due to the lack of fat planes related to cachexia. Further characterization of the mass is limited and MRI or PET may be useful for additional evaluation of this as well.4. Numerous sclerotic bone lesions throughout the imaged axial skeleton likely represent metastases.5. Multiple dental caries. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (12/1/14, 2/6/15), ultrasound images of right breast (2/6/15), images from ultrasound guided biopsy of right breast and post procedural mammographic images (2/6/15) performed at Northwestern Memorial Hospital. For comparison, digital mammographic images (11/1/13, 10/11/13, 9/17/12, 4/29/11, 9/16/08) are available. DIGITAL MAMMOGRAPHIC IMAGES (12/1/14, 2/6/15):The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A BB marker is placed at upper outer quadrant in the right breast on the images from 2/6/15, denoting the site of the palpable lump. There is an ill-defined focal asymmetry at the site of the palpable lump.No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in left breast. ULTRASOUND IMAGES OF RIGHT BREAST (2/6/15):And a very very shaped hypoechoic mass with angular margins, measuring 28 x 16 mm, is visualized at right 10 o'clock position, 6-cm from the nipple, corresponding to the focal asymmetry on mammogram.IMAGES FROM ULTRASOUND GUIDED BIOPSY OF RIGHT BREAST AND POST PROCEDURAL MAMMOGRAPHIC IMAGES (2/6/15):Ultrasound guided biopsy was performed for 10 o'clock mass in the right breast, with an appropriate needle placement. Postprocedural mammograms shows a coil-shaped marker clip within the focal asymmetry at upper outer quadrant.Per outside pathology report, the biopsy result was malignant; invasive ductal carcinoma grade 3 with focal mucinous features and ductal carcinoma in situ, grade 3. | Biopsy proven carcinoma in the right breast at 10 o'clock position.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Left breast cancer for left simple mastectomy, left axillary sentinel lymph node biopsy with possible CALND, left axillary reverse mapping, and removal of port. Surgery 2/20/2015 at 1000 am. RADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 1.03 mCi Tc-99m filtered sulfur colloid was injected in four left periareolar injections. Foci of increased activity are noted in the contralateral right axilla, representing the sentinel node(s). This region was marked with an indelible marker. No ipsilateral left axillary drainage is noted. This may reflect alteration of flow from previously identified left axillary tumor. | Contralateral right axillary lymph node drainage. No ipsilateral left axillary drainage is identified. |
Generate impression based on findings. | 83 year old female with abdominal pain and left hip 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: Moderate atherosclerotic calcifications of the abdominal aorta and its branches. BOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Moderate degenerative changes of the visualized thoracolumbar spine. Scattered bone islands.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Moderate degenerative changes of the visualized thoracolumbar spine. Mild-moderate degenerative changes of the bilateral hip joints without fracture.OTHER: No significant abnormality noted | 1.Colonic diverticulosis without evidence of diverticulitis.2.No evidence of fracture in the visualized portions of the pelvis and bilateral proximal femurs. |
Generate impression based on findings. | 60 year-old female with left big toe and foot pain, tender after binding toe this morningVIEWS: Left foot, AP, lateral, and oblique (3 views) 2/19/15 14:50 Alignment is anatomic. No fracture is evident. The osseous structures are normal for the patient's age. | Normal examination. Findings text paged to Dr. Shi (pager 5718) at the time of dictation. |
Generate impression based on findings. | Ms. Wheeler is a 54 year old female with a personal history of bilateral lumpectomies for IDC in 2009 treated with radiation, chemotherapy and tamoxifen. Patient now presents for a short term follow for a cluster of calcifications in the right breast. She has a family history of breast cancer in maternal grandmother and three maternal aunts. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Linear markers were placed on scars overlying both breasts. There are stable postsurgical changes including architectural distortion, increased density, and surgical clips present within the right lumpectomy site. There are stable postsurgical changes including architectural distortion, increased density, and skin retraction present within the left lumpectomy site. A small cluster of calcifications in the right upper inner breast is unchanged since 2011. In addition, several benign morphology masses are stable in both breasts. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Stable findings, including postsurgical changes in both breasts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is moderate right and mild left opacification of mastoid air cells. There is near complete opacification of both maxillary sinuses as well as near complete opacification of bilateral ethmoid and sphenoid sinuses. | 1. Unremarkable noncontrast MRI of brain.2. Bilateral paranasal sinus and mastoid air cell opacification which is nonspecific, for which clinical correlation is recommended. |
Generate impression based on findings. | 83-year-old with palpable area of concern in the left breast. Three standard views of both breasts and left spot compression views 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. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. This includes no suspicious finding under the triangular marker placed on the left inner breast. Bilateral benign calcifications are again noted. Biopsy clip in the left breast unchanged in position.ULTRASOUND | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 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. | Asymptomatic female presents for routine screening mammography. History of bilateral benign needle biopsies. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Metastatic cancer SCC versus non-SCC per path, prior skin lesions and left neck LAD. There are post-treatment findings in the neck related to left neck dissection and radiation, with diffuse edema in the hypopharyngeal region, denervation changes in the left hemitongue, and diffuse nonspecific stranding of the subcutaneous fat in the left neck. Otherwise, there is no evidence of discretely measurable locoregional mass lesions or significant cervical lymphadenopathy based on size criteria. However, there is a heterogeneous mass in the left upper mediastinum that measures 24 x 30 mm. The left submandibular gland is absent and a portion of the left parotid gland appears to have been resected. The thyroid and remaining salivary glands are unremarkable. The left internal jugular appears to have been sacrificed. The major cervical arteries are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. There are multiple tree-in-bud opacities in the partially-imaged lungs. | 1. Post-treatment findings in the neck without definite measurable tumor or significant lymphadenopathy.2. A mass in the left upper mediastinum that measures up to 30 mm likely represents metastatic disease. 3. Tree-in-bud opacities in the partially-imaged lungs may represent bronchiolitis. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Mother with history of breast cancer. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. 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. | Temporal lobe cavernoma resection. There are postoperative findings related to left occipital craniotomy for resection of a cavernous malformation. There is fluid and hemostatic material in the resection cavity, but no evidence of acute intracranial hemorrhage or discernible mass. There is a small amount of pneumocephalus as well. There is no evidence of hydrocephalus. There is no significant midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. | Expected recent postoperative findings related to left occipital craniotomy for resection of a cavernous malformation, without evidence of acute intracranial hemorrhage or discernible mass. |
Generate impression based on findings. | 33 year old who plans to have breast reduction surgery presents for pre-operative evaluation. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. Results were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: There is mild scattered mucosal thickening in the maxillary sinuses, with a couple small left maxillary sinus probable mucosal retention cysts. The ostiomeatal units are clear. There is no significant thickening or sclerosis of the sinus walls to suggest chronic findings.Posterior ethmoids: The posterior ethmoid air cells are clear.Sphenoid sinus: The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is no significant nasal septal deviation. The nasal turbinate morphology is within normal limits. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. The intercondylar processes are incidentally partially pneumatized. | No CT findings of chronic or acute sinusitis. Minimal scattered sinus inflammatory changes in the maxillary sinuses. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of mother and cousin with breast cancer. 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. | Frequent sinusitis, treated with antibiotics. There are postoperative findings related to endoscopic sinus surgery. There is a punctate left maxillary sinus rentention cyst. The other paranasal sinuses are clear and the neo-infundibula are patent. There are minimal secretions within the nasal cavity. The nasal septum is essentially midline. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. There is an incomplete posterior arch of C1, which is an anatomic variant. | Postoperative findings related to endoscopic sinus surgery with a punctate left maxillary sinus retention cyst, but no evidence of acute sinusitis. |
Generate impression based on findings. | RDSVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. NG tube tip at the GE junction. Umbilical catheters unchanged. Cardiothymic silhouette normal. Diffuse atelectasis bilaterally not significantly changed. No pleural effusion or pneumothorax. | Diffuse atelectasis not significantly changed. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of maternal aunt with breast cancer. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is 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. | Difficulty swallowing and breathing. Evaluation of anterior mediastinal probable thymoma.RADIOPHARMACEUTICAL: 11 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 100 mg/dL. Today's CT portion grossly demonstrates an ill-defined soft tissue infiltration of the anterior mediastinum appearing similar to the prior exam and without a discrete mass. There is also a 2 cm right thyroid nodule and bilateral adnexal cysts.Today's PET examination demonstrates no suspicious FDG avid focus. Specifically no FDG avid lesion is noted in the region of the thymus. Curvilinear bilateral adnexal activity is most likely physiologic. | No FDG avid lesion in the region of the thymus or elsewhere in the neck, chest, abdomen, or pelvis. |
Generate impression based on findings. | 38 year-old female. Hypoxia. Evaluate for PE. PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Focal streaky groundglass opacity in the lingula/left upper lobe consistent with infection.Small amount of intraluminal debris within the trachea.Mild lower lobe bronchiectasis and basilar linear scarring/atelectasis.Diffuse mosaic attenuation of the lungs likely relates to small airways disease.No pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Mild cardiomegaly without pericardial effusion.No visible coronary artery calcification.CHEST WALL: Minimal degenerative changes in the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Hepatomegaly. Atrophic spleen. Right upper pole renal cyst. | No evidence of pulmonary embolism. Lingular opacity consistent with pneumonia.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Reason: evidence of PE? Assess ILD History: hypercapnia, hypotension PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Redemonstration of diffuse reticulonodular opacities as well as traction bronchiectasis and subpleural cysts in a coarse honeycombing pattern. These findings are significantly progressed from the prior exam. Uniformly increased density commensurate with an interval decrease in lung volumes and additional increased areas of subpleural consolidation. New small bilateral effusions.Interval resolution of the previously visualized small right pneumothorax.MEDIASTINUM AND HILA: The heart is mildly enlarged, without pericardial effusion. No visible coronary artery calcification.Interval resolution of previously described pneumomediastinum.No mediastinal or hilar lymphadenopathy.ET tube in place. Nasogastric tube terminates in the stomach.CHEST WALL: Mild degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No evidence of pulmonary embolism.2. Marked progression of interstitial lung disease, possibly with superimposed acute exacerbation. The presence of pleural effusions raises the question of a component of CHF.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: There are scattered small probable mucosal retention cysts within the maxillary sinuses bilaterally. The ostiomeatal units are clear. There is a small left-sided Haller cell which minimally narrows the left infundibulum.Posterior ethmoids: The posterior ethmoid air cells are clear.Sphenoid sinus: The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is moderate rightward nasal septal deviation with a tiny rightward directed bony spur. The nasal turbinate morphology is within normal limits. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. | No CT evidence of acute or chronic sinusitis. Very minimal scattered probable mucosal retention cysts in the maxillary sinuses bilaterally. Patent bilateral ostiomeatal units. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of maternal grandmother with breast cancer. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Bilateral, benign appearing masses appear stable from 2010 and likely represent intramammary lymph nodes. 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. | Reason: Evaluate pneumothorax/chest tube, History: Worsening SOB, left sided chest pain LUNGS AND PLEURA: Moderate-sized left pneumothorax, with only a small amount of pleural fluid in the basilar region.A left chest tube extends to the apex.Surgical sutures from prior biopsy are seen in the left upper and lower lobe regions, and in the right upper lobe. Consolidation is present in the left lower lobe adjacent to the surgical suture line.Minimal dependent atelectasis affects the right lung. A 14 millimeter left upper lobe nodule is present likely in the anterior segment image 44 series 4.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Mild coronary artery calcifications are present.CHEST WALL: Left chest wall soft tissue emphysema is present, tracking from the chest tube site.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. A large left renal cyst is present. | 1. Moderate size left pneumothorax with a left chest tube in place.2. Multiple wedge resections bilaterally.3. Possible 14-mm nodule left upper lobe. |
Generate impression based on findings. | 10-year-old male with elbow swelling.VIEWS: Right elbow AP oblique lateral (3 views) 2/19/2015 at 1545 No acute fracture or dislocation. No evidence of elbow joint effusion. | Normal examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of BRCA positivity and strong family history of breast cancer. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is extremely dense, which lowers the sensitivity of mammography, 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: NSD - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral mastopexy. 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. Postoperative findings of mastopexy and benign calcifications compatible with oil cysts. 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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 49-year-old male. Metastatic cancer SCC versus non-CT per path. Prior skin lesions in left neck LAD. CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules highly suspicious metastases, including in the left upper lobe (series 5, image 35). The largest in the right lower lobe is 14 mm (series 5, image 56).Clustered tree in bud opacities in the left upper lobe consistent with bronchiolitis (series 5, image 49), possibly related to aspiration.Left basilar pleural metastasis, including a nodule that measures 15 mm in thickness (series 3, image 87).No pleural effusion.MEDIASTINUM AND HILA: Extensive mediastinal and bilateral hilar necrotic lymphadenopathy, including a left superior mediastinal node that is 23 mm (series 3, image 21) and a subcarinal node that is 37 mm (series 3, image 45).Left hilar lymphadenopathy encases the left main pulmonary artery and markedly attenuates/invades its lobar and segmental branches.Tumor encasement and invasion into the left mainstem bronchus, which is focally nearly completely occluded proximally (series 8024, image 38).The mid esophagus at the level of the pulmonary veins is encased and likely invaded by tumor, but without evidence of obstruction.Normal heart size without pericardial effusion. No visible coronary artery calcification.Right central line terminates in the right atrium.CHEST WALL: No axillary lymphadenopathy. Focal lucency in T4 with coarsened trabeculae is likely a hemangioma. Subtle nodule in the left scapula musculature suspicious for a metastasis (series 3, image 30).ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Markedly atrophic bilateral kidneys. 1 cm right renal lesion does not meet criteria for a simple cyst (series 3, image 113), incompletely characterized. Right iliac fossa transplant kidney.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Soft tissue nodule in the right lateral abdominal wall musculature (series 3, image 106) and subcutaneous fat (series 3, image 132) suspicious for distant body wall metastases.OTHER: No significant abnormality noted. | 1. Extensive metastatic disease in the chest with pulmonary/pleural metastases and bulky mediastinal and hilar lymphadenopathy invading the left mainstem bronchus and likely also the esophagus. 2. Cluster of tree-in-bud opacities in the left upper lobe consistent with bronchiolitis, likely related to aspiration.3. Soft tissue nodules in the right abdominal subcutaneous fat and musculature suspicious for distant body wall metastases. |
Generate impression based on findings. | Patient with elevated A-a gradient, hypoxia, tachycardia now on heparin gtt. Please evaluate for pulmonary embolus. The comparison chest radiograph performed on 02/18/2015 demonstrates small bilateral pleural effusions and mild basilar predominate interstitial opacities.The ventilation images show delayed activity on single-breath and wash-in images in the left lower lobe with mild retention during the wash-out phase. The perfusion images show a large matched perfusion defect of the left lower lobe. There are also scattered small, mostly matched, perfusion defects in the right lung. No significant moderate or large unmatched perfusion defect is identified. | Low probability for pulmonary embolus. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Maternal aunt and sister with history of breast cancer. Two standard digital views of both breasts with additional bilateral MLO and cleaveage view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Reason: 66 yo F with h.o dermatomyositis, evaluate for ILD History: "unresolving PNA" LUNGS AND PLEURA: Multiple focal subpleural reticular and nodular opacities with areas of mild linear scarring. Mild traction bronchiectasis. No evidence of honeycombing.Scattered benign appearing micronodules, some calcified. No suspicious pulmonary masses.No focal airspace consolidation. No pleural effusions.No air trapping seen on expiratory images.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Moderate coronary artery calcification.No mediastinal or hilar lymphadenopathy.CHEST WALL: Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Barium contrast material seen within the colon from recent prior examination. | Findings compatible with mild pulmonary fibrosis, possibly with small areas of organizing pneumonia. These findings may be secondary to the patient's known connective tissue disease. No evidence of active infection. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional bilateral MLO views were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Maternal aunt, paternal grandmother and aunt with history of breast cancer. 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. | Biopsy proven DLBCL. Staging.RADIOPHARMACEUTICAL: 15.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 77 mg/dL. Today's CT portion grossly demonstrates a large right jugular lymph node measuring 2 cm. There is a very large soft tissue mass surrounding the left scapula with associated destruction. Numerous large bulky left axillary and left supraclavicular lymph nodes are noted. A right chest port catheter terminates in the SVC. Today's PET examination demonstrates a very large extensively hypermetabolic soft tissue mass (max SUV = 31.6) centered in the left axilla extending to the left shoulder and left supraclavicular region consistent with lymphoma. Tumor activity destroys a significant portion of the adjacent scapula. Multiple adjacent hypermetabolic tumor foci surround the large tumor lesion. Additional hypermetabolic tumor surrounds the left proximal humerus and is seen in multiple intramuscular and subcutaneous regions more inferiorly in the left lateral chest wall.Multiple additional thoracic hypermetabolic lymph nodes are seen in the right axilla and left internal mammary lymph node stations as well as seeding of several nodules of the left inferoposterior pleural surface. In the right neck, there is a hypermetabolic right jugular chain lymph node (max SUV 29.4) consistent with tumor as well as a right parapharyngeal/right fossa of Rosenmueller nodule (max SUV of 23.7). No FDG avid lesion is identified in the abdomen and pelvis. | Extensive markedly hypermetabolic tumor in the right neck and bilateral thorax, most notably involving a large soft tissue mass in the left shoulder region causing significant destruction of the underlying scapula. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Maternal grandmother with history of breast cancer. 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 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. | There are scattered minimal somewhat globular areas of intrinsic T1 hyperintensity and T2 hypointensity with associated susceptibility along the right greater than left tentorium near the midline, as well as more subtle abnormal signal dependently along the posterior left parietal lobe as seen on 1101/10. Trace intrinsic T1 hyperintensity is also present along the left posterior falx on 401/11. There is a thin focal T1 hypointense and T2 hyperintense collection within the left parietal scalp, likely correlating with the site of cephalhematoma with evolving blood products. There is mild underlying flattening of the calvarium.The sulci are within normal limits. The left lateral ventricle is slightly larger than the right, likely normal variant. There is a cavum septum pellucidum et vergae. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal parenchymal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified. Myelination appears appropriate for the patient's stated age.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. | 1. Trace scattered left-sided subacute subdural blood products, likely redistributed since the initial outside exam which is not available.2. No definite structural abnormality identified.3. Very thin left parietal cephalhematoma with evolving blood products. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of prior left benign breast biopsies. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female 50 years old Reason: pain History: pain. Trace joint effusion is seen. Tiny osteophytes are seen in the medial compartment. No acute fracture or dislocation.Frontal views of the left knee are unremarkable. | Minimal arthritic changes affect the medial compartment of the right knee. |
Generate impression based on findings. | Female 60 years old Reason: Evaluate for osteomyelitis left hallux History: Non-healing ulcer plantar left hallux with new onset blister formation. Soft tissue defect on the plantar surface likely represents ulcer. Along the lateral surface of the tuft of the first distal phalanx there is a subcortical lucency; this is equivocal for osteomyelitis. There is thickening of the surrounding soft tissues. | Along the lateral surface of the tuft of the first distal phalanx there is a subtle subcortical lucency; this is equivocal for osteomyelitis. |
Generate impression based on findings. | Reason: 48 yo male with history of CMML; pre-allo SCT evaluation History: evaluate LUNGS AND PLEURA: An 8mm solid right middle lobe nodule along the minor fissure (series 4, image 148) is new from the prior exam dated 09/2014. Additional scattered benign appearing micronodules are stable from the prior exam.No other suspicious pulmonary nodules or masses.No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Moderate coronary artery calcification.No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Splenomegaly. | 1. An 8mm right middle lobe nodule is new from the prior exam dated 09/2014. Given the appearance and time course, a benign etiology is favored, such as granulomatous infection or an intrapulmonary lymph node. Recommend follow-up imaging in 3 to 6 months to confirm stability.2. No other evidence of infection. |
Generate impression based on findings. | Female 63 years old Reason: eval oa, with knee pain s/p fall 01/2015 History: eval oa, with knee pain s/p fall 01/2015. Four views of the right knee show mild arthritic changes and sharpening of the tibial spines, unchanged from the prior exam. No acute fracture or malalignment is seen. There is moderate prepatellar soft tissue swelling. 4 views of the left knee show mild arthritic changes and sharpening of the tibial spines unchanged from prior exam. No acute fracture malalignment is seen. There is mild prepatellar soft tissue swelling. | Mild osteoarthritis without evidence of acute fracture or malalignment. Prepatellar soft tissue swelling, right greater than left. |
Generate impression based on findings. | Male 68 years old Reason: s/p endoscopic repair of zenkers diverticulum today (2/19/2015), please evaluate for esophageal leak History: s/p endoscopic repair of zenkers diverticulum today (2/19/2015) No evidence of leak in the region of the cervical esophagus. Remainder of the esophagus demonstrates moderate motor abnormality. Moderate size sliding hiatal hernia and gastroesophageal reflux was demonstrated. Findings communicated to clinical service at time of examination.Fluoroscopy time: one minute 44 seconds | No evidence of leak. |
Generate impression based on findings. | There is inflammatory mucosal thickening in the sphenoid sinus with sclerotic appearance of the sphenoid sinus wall. There is also abnormal sclerotic appearance in the left pterygoid plates. There is an approximately 9 mm medial-lateral posterior right sphenoid sinus wall defect with a tiny (about 1 mm) defect along the anterior wall of the right carotid canal along the posterior wall defect of the right sphenoid sinus.There is extensive permeative destruction involving the skull base centered in the clivus extending inferiorly into the left opisthion, left occipital condyles, left C1 arch which is better appreciated on the accompanying MRI. There is involvement in the left jugular tubercle, left hypoglossal canal, and left jugular canal which is better depicted on accompanying MRI. Bulky appearance of the bilateral cavernous sinuses is better appreciated on accompanying MRI and the prior outside contrast enhanced CT. These findings are felt to be unchanged.There is subtle hypoattenuation in the left hemitongue which may be due to denervation, as clinically suspected. However, this is incompletely evaluated on the CT and on the accompanying MRI. There is mild soft tissue thickening involving the left tonsillar fossa nonspecific with suspected to be involved by the extensive regional infectious process.There are bilateral maxillary sinus mucus retention cysts. The mastoid air cells and middle ear cavities are clear. There is no proptosis or significant orbital abnormality.The brain parenchyma is grossly within normal limits. | 1.Extensive trans-spatial infection involving the central and posterior skull base with extensive permeative destruction. Please see details above and accompanying MRI report. Anteriorly infection appears to extend into the left pharyngeal soft tissues. Posteriorly infection extends in the left neck/paraspinous soft tissues and better evaluated on MRI.2.Most notably, there is a 9-mm defect along the posterior wall of the right sphenoid sinus, as well as a tiny osseous defect along the anterior aspect of the right carotid canal at the site of the posterior right sphenoid sinus wall defect. 3.Inflammatory mucosal thickening in the right sphenoid sinus.4.Infectious involvement of the bilateral cavernous sinuses is better appreciated on prior contrast enhanced CT, and accompanying MRI.5.Subtle hypoattenuation in the left hemitongue maybe due to denervation, as clinically suspected. However, this is incompletely evaluated on current exam and the accompanying MRI. |
Generate impression based on findings. | Ms. Jackson is a 44-year-old female presenting with a 3 week history of right retroareolar erythema, edema, and pain. She initially presented to an outside hospital where 10 to 12 cc of pus was aspirated from the retroareolar abscess. Patient says that she can still feel a residual abscess. She is currently on antibiotics. Upon physical exam at the patient's area of concern, a tender discrete mass is appreciated directly behind the nipple. There is no obvious skin erythema or edema.A targeted right breast ultrasound was performed for the patient’s area of concern. In the right retroareolar breast, there is a 5.0 x 1.5 cm complex fluid collection with thickened walls, compatible with an abscess. A limited right axillary ultrasound was performed demonstrating two mildly prominent right axillary lymph nodes, the largest of which measured 1.7-cm. These are compatible with reactive lymph nodes. | 5.2 x 1.5 cm right retroareolar abscess with two reactive lymph nodes in the right axilla. A surgical consultation is recommended. All results and recommendations were relayed to the patient and Dr. Chhablani.BIRADS: 2 - Benign finding.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 89 year old female with history of HTN, atrial fibrillation, pulmonary HTN, and aortic stenosis presenting for pre-procedural planning of aortic valve replacement. CPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with normal brachiocephalic branching pattern. No thoracic aortic dissection or aneurysm is noted. The thoracic aorta has mild tortuosity. No protruding aortic atheroma or thrombus is noted in the thoracic aorta. There is severe calcification of the aortic arch and mild calcification of the descending aorta. No aortic coarctation is noted. There is mild atherosclerosis of the proximal brachiocephalic vessels. Aortic Annulus: Dimension: 26mm x 21mm Perimeter: 8.3cm Area: 4.5cm2Sinus of Valsalva: Width: 27mm x 25mm x 29mm Height: 15mmSinotubular Junction: 28x27mmAscending Aorta (4cm from annulus): 34x33 mmDistal Aortic Arch: 27x27 mmDescending Aorta: 25x24mmAnnulus to LM Height: 11 mmAnnulus to RCA Height: 13 mmAortic Leaflet Length: 13 mmAortic Valve: The aortic valve is trileaflet. There is severe aortic valve calcification, which predominantly involves the right coronary and non-coronary cusps. Mitral Valve: Severe mitral annular calcification is noted. There is extension of the aortic valve calcification onto the anterior mitral leaflet.Left Ventricle: There is mild LVH. There is no thrombus noted in the left ventricle. There is a moderately sigmoid septum present. Right Ventricle: The right ventricle is severely dilated with basal diameter of 62 mm and mid diameter 58 mm. Left Atrium: The left atrium is severely dilated. There are four distinct pulmonary veins which drain normally into the left atrium. There is a filling defect in the left atrial appendage, which could represent either slow flow or a thrombus.Right atrium, vena cavae, and coronary sinus: The right atrium is severely dilated. The superior and inferior vena cavae are grossly normal. The coronary sinus is mildly dilated. Pulmonary Artery: The main pulmonary artery is mildly dilated (max diameter 34 mm), the left and right pulmonary arteries are dilated with diameter of 31 mm and 31 mm, respectively. Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary arteries: Because heart rate management was not attempted and nitroglycerine was not administered, this exam was not performed to optimally visualize the coronary arteries. However within the limitations of the study the following observations are made:LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. The LMCA is with mild calcification. LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There is severe calcification of the LAD. LCx: The left circumflex coronary artery courses normally in the the left AV groove and continues into the left posterior descending and postero-lateral branches making it the dominant vessel. It gives rise to the obtuse marginal branches and a small AV circumflex branch. There is mild calcification of the LCx.RCA: The right coronary artery arises normally from the right sinus of Valsalva. The RCA is small and non-dominant. There is minimal calcification in the RCA system. Coronary Bypass Grafts:None present. | 1. Severe aortic valve calcification with evidence of extension onto the anterior mitral leaflet. 2. Ascending aortic anatomy as above. 3. Left main height is low and less than the the aortic valve leaflet length. 4. Possible left atrial appendage thrombus. 5. Mild left ventricular hypertrophy with a moderately sigmoid septum. 6. Severe right ventricular dilation. This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report. The abdomen/ pelvis CTA is reported separately. |
Generate impression based on findings. | Female 32 years old Reason: s/p MVC, neck/shoulder pain with RUE radiation History: same. Four views of the right shoulder show no acute fracture or dislocation.6 views of the cervical spine show preservation of the vertebral body heights and intervertebral disk spaces. Neuroforamina appear patent bilaterally. | No specific radiographic evidence account for patient's pain. |
Generate impression based on findings. | Female 43 years old bilateral foot pain and bunions. There is a mild hallux valgus deformity of the left foot. No acute fracture.Three views of the right foot show a mild hallux valgus deformity. | Mild bilateral hallux valgus deformities. |
Generate impression based on findings. | Male 66 years old Reason: , eval for RA or cppd History: pain and swelling Right hand: Bone mineralization is normal . Alignment is anatomic. Mild osteoarthritis affect the third metacarpal phalangeal joint. No focal erosive changes. No acute fracture or malalignment.Left hand: Bone mineralization is normal. Alignment is anatomic. The joint spaces are appropriate for age. No focal erosive change. | Mild right hand osteoarthritis. No radiographic evidence of erosions or changes from CPPD. |
Generate impression based on findings. | Male 48 years old; Reason: Pre-op for L UKA History: same Moderate to severe degenerative changes are noted at the knee joint, with focal depression of the weight-bearing surface of the medial femoral condyle suggestive of an insufficiency fracture and similar to the prior MRI. The hip and ankle joints appear unremarkable. | Degenerative changes, as above. |
Generate impression based on findings. | Male 54 years old Reason: Right radius malunion History: Right radius malunion Postsurgical changes in the mid radius with plate and screw fixing a transverse radius fracture. There is sclerosis at the fracture margin with a lucency through the fracture. Other pin tracks are noted through the radius.Sideplate and screws affix a ulnar fracture in near-anatomic alignment. There is only subtle lucency at the fracture site. | Plate and screws affixing the radius and ulnar fractures with lucency through the radial fracture. Depending on the age of the fracture this could indicate malunion. |
Generate impression based on findings. | 25-year-old male with pelvic pain, evaluate for abscess. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: There is a left perirectal fluid collection (series 3, image 84) measuring 1.0 x 1.4 cm suspicious for a perirectal abscess. Enteric contrast does not enter this fluid collection. No additional abnormal fluid collections are identified in the pelvis.OTHER: No significant abnormality noted | 1.Left perirectal abscess measuring approximately 1.0 x 1.4 cm. In the appropriate clinical setting, MRI may be helpful for further evaluation. |
Generate impression based on findings. | 83 years, Male, Reason: Hx of GIST; evaluate for recurrence (original abdomen/gastrectomy); can do WITHOUT IV DYE if radiologist preference w/renal function History: See Above. Stomach GIST CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Scattered enlarged calcified mediastinal lymph nodes. Enlarged noncalcified subcarinal node measuring 2.4 x 1.3 cm (8/48). Mild cardiomegaly. Moderate coronary calcifications. Severe atherosclerotic calcifications of the aorta and its branches. CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Scattered hepatic hypodensities are too small to characterize.SPLEEN: Scattered splenic granulomas.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal hypodensities are too small to characterize.RETROPERITONEUM, LYMPH NODES: Ectatic aorta with atherosclerotic calcifications and mural thrombus.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: MalePROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality noted.LYMPH NODES: Enlarged left inguinal lymph node measuring 1.7 x 1.2 cm (8/195) is nonspecific.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Mild nonspecific left inguinal and mediastinal lymphadenopathy.2.No definite evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Female 48 years old Reason: 48 F w/ lupus and new right knee pain with effusion History: see above Bone mineralization is normal. Alignment is anatomic. The joint spaces are normal on these nonweightbearing views. No acute fracture or malalignment. Possible trace joint effusion. | Trace joint effusion; no acute fracture or malalignment. |
Generate impression based on findings. | Male 74 years old Reason: h/o gout with swollen DIP and PIP joints, eval for signs of chronic gout or osteoarthritis History: hand pain Bone mineralization is normal. Alignment is anatomic. There is severe joint space loss with osteophyte formation worst at the fifth proximal interphalangeal joint and second distal interphalangeal joint. There is bone-on-bone apposition in these areas.Remainder the interphalangeal joints shows moderate joint space narrowing and some osteophyte formation.No focal erosive change.Mild osteoarthritis affects the radiocarpal joint. | Osteoarthritis of the interphalangeal joints. |
Generate impression based on findings. | Female 50 years old Reason: right knee pain History: right knee pain Bone mineralization is normal. Alignment is anatomic. There is mild medial compartment joint space narrowing. No significant osteophyte formation.There is soft tissue swelling along the anterior aspect of the knee. No acute fracture or malalignment. | Soft tissue swelling without evident fracture. |
Generate impression based on findings. | There is redemonstration of a right thalamic and hemorrhage with further expected of motion since prior exams. The hematoma now measures 3.2-cm transverse by 2.5-cm AP, as compared to previous 4.2 x 2.2 cm. Midline shift has improved, now measuring 11 mm to the left as compared to previous 15 mm. Localized mass effect is similar, with partially effaced suprasellar and quadrigeminal plate cisterns. The hematoma itself is decreased in density, with decreased density also of the right greater than left intraventricular blood products. There is a stable left parietal approach ventriculostomy catheter, with its tip in the mid body of the left lateral ventricle. The sulci remain diffusely effaced. Lateral ventricular dilatation including involvement of temporal horns is similar in degree.There is no new intracranial hemorrhage. There is no extraaxial fluid collection. There is mild mucosal thickening in the right sphenoid sinus. Mastoid air cells are opacified bilaterally, with extension of opacification into the right middle ear. There is also fluid along the pneumatized right petrous apex. | 1. Interval expected evolution of right S1 parenchymal hematoma with intraventricular extension. No new intracranial hemorrhage. Slight decreased mass effect.2. Stable ventriculostomy catheter with stable lateral ventricular dilatation.3. Persistent diffuse sulcal effacement and partial basal cistern effacement.4. Progression of bilateral mastoid and right middle ear opacification, now extending into the pneumatized right petrous apex. Please correlate clinically. |
Generate impression based on findings. | Female 64 years old Reason: pre-op History: pain Moderate to severe osteoarthritis affects the medial compartment of the left knee where there is bone on bone apposition and subchondral sclerosis.There is a moderate joint effusion. There are small tricompartmental osteophytes. No acute fracture or malalignment.Mechanical axis of the left lower extremity is approximately 9 degrees of varus. | Left knee osteoarthritis as detailed above. |
Generate impression based on findings. | 64-year-old male with history of scrotal swelling and concern for rectal perforation versus traumatic Foley placement. PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedPENIS, TESTICLES: Complex fluid collection in the left scrotum with surrounding wall thickening and edema with inflammation from the scrotum extending into the perineum. New skin defect along the left scrotum and foci of gas within the scrotum thought to be related to interval incision and drainage.URETERS: Right hydroureter with incompletely imaged right ureteral stent. Left hydroureter is present without left ureteral stent.BLADDER: Thickened bladder wall which is unchanged from prior examination and may represent cystitis. Foley catheter in place with inflated balloon in bladder, which was previously in the prostatic urethra. Foci of gas within the bladder thought to be related to the Foley.LYMPH NODES: No inguinal lymphadenopathy.BOWEL, MESENTERY: Perirectal foci of gas have resolved. BONES, SOFT TISSUES: See above. OTHER: No significant abnormality noted | 1.Interval incision and drainage of left scrotal abscess. 2.Foley catheter has been repositioned with balloon now within bladder. 3.Peri-rectal foci of gas have resolved. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: There is trace mucosal thickening in the right maxillary sinus. The left maxillary The ostiomeatal units are clear.Posterior ethmoids: The posterior ethmoid air cells are clear.Sphenoid sinus: The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is minimal leftward nasal septal deviation, with a 3-mm leftward directed bony spur. There are bilateral concha bullosa. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. Multiple dental caries are present along with areas of periodontal and endodontal disease suspected. Filling defects within the external auditory canal likely. There is again opacification of a few right mastoid air cells. | 1. No significant sinus inflammatory changes.2. Multiple dental caries with suggestion of periodontal and endodontal disease, for which correlation with dental exam is recommended. |
Generate impression based on findings. | Female 33 years old Reason: s/p ERCP for retained stones post cholecystectomy. now with abdominal pain rule out perf History: same ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Small amount of fluid collection the gallbladder fossa is slightly smaller measuring 1.1 x 0.9 cm on image number 48, series number 3.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: 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 | Slight interval decrease in the size of the fluid in the gallbladder fossa, likely postsurgical. |
Generate impression based on findings. | Female 68 years old Reason: r knee pain History: pain in the knee There is a genu varus. Severe osteoarthritis affects the right knee with bone on bone apposition in the medial compartment. There are tricompartmental osteophytes. No joint effusion is evident.No acute fracture. | Severe right knee osteoarthritis. |
Generate impression based on findings. | Female 58 years old Reason: right hip pain History: right hip pain Right hip: Severe osteoarthritis affects the right hip joint with bone on bone apposition, subchondral cystic change and osteophyte formation. Bones are demineralized. There is a band of sclerosis in the right femoral neck that was present on the prior exam with an intervening CT scan which did not show a definite fracture.AP pelvis shows the aforementioned right hip osteoarthritis. Components of a total left hip arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication.Four views of the left knee shows mild joint space narrowing with tiny osteophytes | Severe osteoarthritis of the right hip with sclerosis at the femoral neck, unchangedMild left knee osteoarthritis. |
Generate impression based on findings. | Female 79 years old Reason: stability of l-spine History: back pain Bones are demineralized with compression fractures of the L3 and L5 vertebral bodies. There is also compression deformity of superior endplate of T11. There is mild levoconvex scoliosis of the lumbar spine. | Bone mineralization and height loss of the L3 and L5 vertebral bodies. |
Generate impression based on findings. | Male 47 years old Reason: SBO; diverticulitis History: epigastric pain; LLQ pain ABDOMEN:LUNG BASES: Cardiomegaly, unchanged.LIVER, BILIARY TRACT: Mild hepatomegaly, unchanged.SPLEEN: Moderate splenomegaly, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic kidneys. Vascular coils noted within the left kidney. Multiple bilateral hypodense lesions likely representing cysts. Some are too small to accurately characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Extensive diverticulosis involving the left colon and sigmoid colon. Mild fat stranding around the sigmoid colon may represent mild acute diverticulitis. No evidence of free air or peridiverticular abscess.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: Please see discussion aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Mild fat stranding around the diverticuli in the sigmoid colon may represent an early mild diverticulitis.Hepato- splenomegaly.Bilateral atrophic kidneys. |
Generate impression based on findings. | Female 70 years old Reason: r/o abd path History: woke up last night with sharp pain on the left side of the abd; feels achy now. No fever or chills or hematuria. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral large renal cysts are unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Focal fat stranding anterior to the distal descending colon containing a well-defined rim is consistent with epiploic appendigitis.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: No significant abnormality notedOTHER: No significant abnormality noted | Epiploic appendigitis of the distal descending colon explaining patient's acute abdominal pain. |
Generate impression based on findings. | Male 83 years old Reason: R/o appendicitis, colitis (associated with C. diff), obstruction, perforation History: Febrile This study is limited due to lack of intravenous contrast.ABDOMEN:LUNG BASES: Consultation in the lateral aspect of the right lower lobe, partially imaged may reflect sequela of prior radiation and/or pneumonia. Small right-sided pleural effusion. Left basilar air space opacity suspicious for aspiration or possibly infection. 7-mm nodule in the left base, image number 43, series number 3 of unknown etiology and significance. Metastatic disease cannot be excluded.Soft tissue thickening of the skin is noted in the lateral aspect of the chest wall in the area of prior disease.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Small hypodense lesion in the tail of the pancreas is unchanged measuring 1.5 x 1 cm image number 64, series number 3.ADRENAL 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:Artifact from the right hip prosthesis limits optimal evaluation of the pelvis.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: Diffuse atherosclerotic changes involving the abdominal aorta and its major vessels. | Limited study due to lack of intravenous contrast. Bilateral lower lobe lung findings as described above. Pneumonia cannot be excluded. |
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