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Generate impression based on findings. | HypotensionVIEW: Chest AP and abdomen AP 2/20/15 ET tube tip below thoracic inlet and above the carina. NG tube tip at the GE junction. The umbilical venous catheter tip likely in the umbilical vein. The umbilical arterial catheter tip at T8. Cardiothymic silhouette normal. Diffuse atelectasis bilaterally unchanged. No pleural effusion or pneumothorax. Absent bowel gas without pneumoperitoneum. | Diffuse atelectasis bilaterally unchanged. |
Generate impression based on findings. | 9-year-old male with right pleural effusion/empyema.VIEWS: Chest PA/lateral (two views) 2/20/2015 at 0524 ET tube tip between the thoracic inlet and carina. Feeding tube has been advanced with tip and sidehole now in the stomach. Left upper extremity PICC tip in right atrium. Right pigtail catheter unchanged. Right chest tube tip in the right lung apex. Unchanged cardiothymic silhouette. Bilateral pleural effusions with overlying patchy atelectasis, right greater than left and not significantly changed. No pneumothorax. | No significant interval change in bilateral pleural effusions and overlying patchy atelectasis. |
Generate impression based on findings. | 9-year-old male with right-sided pleural effusion.VIEW: Chest AP (one view) 2/19/2015 at 1857 ET tube tip between the thoracic inlet and carina. Feeding tube has been advanced with tip and sidehole now in the stomach. Left upper extremity PICC tip in right atrium. Right pigtail catheter unchanged. Right chest tube tip in the right lung apex. Unchanged cardiothymic silhouette. Bilateral pleural effusions with overlying patchy atelectasis, right greater than left and not significantly changed. No pneumothorax. | No significant interval change in bilateral pleural effusions and overlying patchy atelectasis. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense. 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - 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, version 9.3. The breast parenchyma is mostly fatty replaced, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - 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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense. 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | There is extensive artifact related to dental amalgam limiting evaluation of the oral cavity. Mild thickening of the right-sided cervical esophageal wall along the posterior aspect of the trachea at the level of the thyroid gland is unchanged measuring 1.0 x 1.4 cm. No significant cervical lymphadenopathy is seen. Bilateral thyroid lobe hypoattenuating nodules are unchanged. The right submandibular gland remains slightly smaller than the left. The major salivary glands are otherwise unremarkable. There are unchanged calcific atherosclerosis at the bilateral carotid bifurcations. The major cervical vessels are otherwise patent. There are unchanged small left retropharyngeal calcifications at the level of the oropharynx. The osseous structures are unchanged and show no focal lesions. Multilevel cervical spondyloarthropathy and facet arthropathy is seen predominantly on the right. There is a chronic T1 spinous process fracture. There is unchanged mild periapical lucency involving left maxillary premolar tooth. The airways are patent. The imaged intracranial structures are unremarkable. There is persistent mucosal thickening in the left maxillary sinus. There are unchanged mild fibrotic changes in the lung apices. Please refer to dedicated accompanying chest CT for further details. | 1.Unchanged nonspecific soft tissue thickening along the cervical esophagus at the level of the thyroid gland along the posterior margin of the trachea.2.No significant cervical lymphadenopathy.3.Unchanged subcentimeter thyroid nodules. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Stable benign mass is present in the posterior lateral right breast. Scattered benign calcifications bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 2-year-old male with bilious emesis.VIEW: Abdomen AP (one view) 2/19/2015 at 1914 Feeding tube tip in the stomach. Disorganized but nonobstructive bowel gas pattern. No pneumatosis, free air, or portal venous gas. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Four month old male with a ventriculoperitoneal shunt and lethargy.VIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 2/19/2015 at 1948 Ventricular catheter tip terminates at the cranial midline and exits the skull via a right parietal burr hole. The catheter courses within the soft tissues of the right neck and midline anterior chest before entering and coiling in the abdomen and terminating in the mid pelvis. No kinking or discontinuity within the visualized radiopaque portions of the shunt. The Strata valve measures P/L 2.0. The bones of the skull and cervical spine are unremarkable. Normal cardiothymic silhouette. No focal air space opacity, pleural effusion, or pneumothorax. Nonobstructive bowel gas pattern. | No evidence of VP shunt malfunction. |
Generate impression based on findings. | Male 66 years old ABDOMEN:LUNGS BASES: Scattered lung parenchymal calcifications and subcentimeter right hilar calcification, likely sequela from prior granulomatous disease. Dystrophic calcification seen in region of aortic valve. Relatively hypoattenuated appearance of intracardiac blood pool, suggesting underlying anemia.LIVER, BILIARY TRACT: Scattered hepatic parenchymal calcifications, likely related to prior granulomatous disease. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable simple appearing bilateral renal cysts, bilateral extrarenal pelvises.RETROPERITONEUM, LYMPH NODES: Subcentimeter retroperitoneal and pelvic lymph nodes. Aortobiiliac atherosclerotic disease. BOWEL, MESENTERY: Normal appendix. Left-sided colonic diverticulosis with focal area seen at junction of descending and sigmoid colon demonstrating moderate to marked circumferential wall thickening, area measures 4.4 cm in length, image 69 series 2. Surrounding paracolic fat stranding and minimal adjacent fluid seen. No extraluminal air or fluid collection seen to suggest perforation/pneumoperitoneum or abscess formation.PELVIS:PROSTATE/SEMINAL VESICLES: Prostate measures up to 4.5 cm in transverse dimension.BLADDER: Underdistended, making assessment suboptimal. BONES, SOFT TISSUES: Visualized osseous structures stable in appearance. Scattered small sclerotic foci, most likely bone islands, as well as sclerotic rimmed lesions in left iliac bone, image 70 series 2, stable and of uncertain clinical significance. Decreased osseous mineralization and degenerative changes of spine. Incompletely imaged mild subaxillary subcutaneous soft tissue induration with subcentimeter lymph node containing fatty hilum seen, image 4 series 2. OTHER: Small pelvic free fluid, likely reactive/related to patient's acute diverticulitis. | Outside exam read:1. Findings compatible with acute diverticulitis as described, no associated bowel perforation or abscess formation seen. Small adjacent fluid and pelvic ascites seen, likely reactive. Follow up to resolution suggested to exclude possibility of underlying neoplasm. |
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, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. Stable benign masses are unchanged in both breasts.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, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 4-year-old female with new wheezing and feverVIEWS: Chest AP/lateral (two views) 2/19/15 20:04 The cardiac apex, aortic arch and stomach are left-sided. The cardiothymic silhouette is normal.Bronchial wall thickening and large lung volumes compatible with bronchiolitis or reactive airway disease. No evidence of pneumonia. | Bronchiolitis or reactive airway disease without evidence of pneumonia. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense. Architectural distortion is present at posterior upper quadrant in the left breast.No suspicious masses or microcalcifications are present. | Architectural distortion at posterior upper quadrant in the left breast. Spot compression views and possible ultrasound study are recommended. Submission of old mammogram is also recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 42 years, Female, Reason: cholangiocarcinoma with peritoneal/adnexal mets, on palliative chemotherapy. Evaluate interval change CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. Scattered small micronodules in the right middle lobe are new but nonspecific. No suspicious nodule.MEDIASTINUM AND HILA: Large thyroid isthmus nodule is unchanged. Right chest port tip in the right atrium. Scattered calcified mediastinal nodes, unchanged and likely reflect prior granulomatous disease. Small prevascular node is stable. Mild cardiomegaly. Mildly enlarged main pulmonary diameter which raises the suspicion for pulmonary hypertension.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Hepatic dome lesion is decreased in size measuring 4.1 x 2.8 cm (3/52), previously 5.1 x 4.3 cm. Additional hepatic lesions are decreased in size. Portal vein is patent. Gallbladder is collapsed.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left striated nephrogram has resolved. Left-sided hydronephrosis has resolved.RETROPERITONEUM, LYMPH NODES: Mild retroperitoneal lymphadenopathy is unchanged.BOWEL, MESENTERY: Extensive peritoneal and omental carcinomatosis has decreased in size with a left sided reference nodule measuring 2.7 x 1.5 cm (3/104), previously 2.6 x 1.8 cm. A right upper quadrant mesenteric mass is decreased in size measuring 3.4 x 2.6 cm (3/120), previously 3.2 x 2.3 cm.There is a left lower quadrant ostomy with centralization of bowel loops, some of which are mildly dilated up to 3.2 cm, however contrast is seen within the colon and this may reflect an element of mild partial obstruction, similar to the prior exam.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Large amount of ascites is increased with a surgical drain terminating in the pelvis.PELVIS: FemaleUTERUS, ADNEXA: Large pelvic masses have decreased in size. For example, a right component of the mass measures 7.2 x 6.8 cm (3/153), previously 7.7 x 7.5 cm. A left more inferior component of the mass measures 5.8 x 5.3 cm (3/166), previously 5.7 x 6.5 cm. This mass invades the sigmoid colon, unchanged.BLADDER: No significant abnormality noted.LYMPH NODES: Right external iliac node is decreased in size measuring 1.4 x 1.3 cm (3/165), previously 1.9 x 1.4 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild right sacroiliitis. | 1.Interval decrease in size of liver lesions, pelvic masses and extensive peritoneal and omental carcinomatosis.2.Increased abdominal ascites.3.Resolution of left-sided hydronephrosis.4.Slightly dilated bowel loops may represent partial obstruction, unchanged. |
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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A percutaneously placed clip within the left upper outer quadrant is unchanged in position. 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - 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, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. There are developing amorphic calcifications at upper outer quadrant in the left breast. No suspicious masses or areas of architectural distortion are present. | Developing amorphic calcifications at upper outer quadrant in the left breast. A spot magnification views are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 12-year-old male with history of megaureter status post left ureteral reimplantation. Nephroureteral stent has been removed. BLADDER Wall Thickness: Normal Contents: Distended with scattered debris. Distal Ureter -- SFU Grade** Right: 0 Left: 2 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Left: 0 Length*** Right: 9.2 cm Left: 9.9 cm Mean for age: 10 cm Range for age: 8.4 - 11.3 cmADDITIONAL OBSERVATIONS: Previously described nephroureteral stent in the left renal collecting system has been removed as per discussion with the clinical service. | 1.Grade 2 dilatation of the distal left ureter, which may represent postsurgical change status post left ureteral implantation and stent removal.2.No hydronephrosis. *SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
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, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. A few coarse benign calcifications are seen in the left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. The patient has lost 110 pounds since the last examination. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is extremely dense, limiting the sensitivity of mammography and increasing the importance of physical examination. 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSD - Screening Mammogram. |
Generate impression based on findings. | Female, 30 years old, with AML, neutropenia, and sinus pressure. Also with bilateral neck pain and swelling. The aerodigestive mucosa is unremarkable. Scattered small lymph nodes are identified on both sides of the neck, but none with pathologic or aggressive features. No evidence of any discrete fluid collection or any significant soft tissue inflammation is seen. The salivary glands and thyroid are normal. The osseous structures are free of suspicious lesions.The right frontal sinus is hypoplastic and both frontal sinuses and the frontal ethmoidal recesses are clear. Mild patchy opacification is seen in the ethmoid air cells slight progressed from prior. Mucosal thickening and opacification of the left sphenoid sinus is worsened. The left sphenoid sinus is smaller than the right. Mucosal thickening and opacification of the small left maxillary sinus is improved. Mild peripheral mucosal thickening in the right maxillary sinus is minimally more prominent. The maxillary outflow pathways are obscured by mucosal thickening. The nasal septum deviates towards the right. The turbinates are unremarkable. The nasal cavity is otherwise clear. The mastoid air cells and middle ear cavities are clear. | 1.No specific findings are seen to account for patient's neck pain.2.Mild scattered patchy areas of mucosal thickening and opacification are seen in the paranasal sinuses, slightly progressed in some areas and slightly improved in others. |
Generate impression based on findings. | 77 year old female with with metastatic colorectal cancer; needs surveillance CT scans. CHEST:LUNGS AND PLEURA: Reference right lower lobe pulmonary nodule (series 5, image 50) measures 0.8 x 1.1 cm, measured 0.8 x 1.1 cm previously. Non-reference small pulmonary (series 5, image 66) has slightly increased in size. Additional small pulmonary nodules are similar to prior without definite new nodule seen. Moderate right pleural effusion has increased in size from the prior exam. MEDIASTINUM AND HILA: Cardiomegaly. Right-sided chest port with catheter tip in the proximal right atrium. Reference pretracheal lymph node (series 3, image 30) measures 0.7 x 1.1 cm, previously 0.7 x 1.1 cm. Additional non-reference pretracheal lymph nodes (for example, series 3, image 32) have slightly increased in size.Enlarged thyroid containing low-attenuation nodules appears similar to prior. CHEST WALL: Relative paucity of trabeculae in the right humeral head is thought to represent degenerative/osteopenic change and appears similar to 2007 examABDOMEN:LIVER, BILIARY TRACT: Postsurgical changes from right hepatic lobe resection with associated hypertrophy of the left lobe. The residual hepatic and portal veins are patent. Fluid collection to the right of the liver with areas of internal higher attenuation which may represent blood products, similar to prior.Several low attenuation hepatic lesions are present which have overall increased in size compared to the prior exam. The reference lesion (series 3, image 94) measures 1.7 x 2.6 cm, previously 1.2 x 1.9 cm. No definite new lesion noted.Stable dilation of the common bile duct without obstructing lesion evident. 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: Moderate atherosclerotic disease affects the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine without suspicious osseous lesions.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine without suspicious osseous lesions. | 1.Stable reference pulmonary nodule and mediastinal lymph nodes. Slight interval increase in size of non-reference mediastinal lymph nodes and right lower lobe pulmonary nodule. 2.Interval increase in size of hepatic lesions.3.Moderate right pleural effusion, increased in size from prior. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. End-stage renal disease. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Trabecular thickening is again seen throughout both breasts. Multiple engorged veins are seen bilaterally, but left greater than right.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, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: eval for acute intracranial abnormality History: altered mental status, DKA, diabetes. Chronic hepatitis c without mention of hepatic coma The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses demonstrate hyper dense opacification of the right maxillary sinus and to a lesser degree left maxillary sinus. There is medial expansion of the right maxillary sinus The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin. Findings are compatible folder right-sided medial wall fracture.Atherosclerotic calcifications are present along the distal internal carotid arteries. | 1.No evidence for acute intracranial hemorrhage, mass effect or edema.2.There is incompletely included hyperdense opacification of the right maxillary expanding into the nasal cavity. Based on comparison to an MRI from 6/6/2003 this most likely represents inspissated secretions and is chronic. A fungal infection in a patient with DKA would may have a similar appearance. Please correlate with patient's clinical history and symptoms.3.Findings were reported to Mohammad Subeh at the time of this report. |
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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. A circumscribed mass is present at upper outer quadrant in the right breast, likely an intramammary lymph node. Scattered benign calcifications and mild arterial calcifications are noted in both breasts.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, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 63 year old woman with history of DCIS s/p left lumpectomy 2002. 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. Post-surgical findings of left lumpectomy with scar marker and slight volume loss are noted. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over both axillae. | 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: 1 - Negative.RECOMMENDATION: ND - Diagnostic 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, version 9.3. The breast parenchyma is heterogeneously dense. Scattered benign calcifications are present in both breasts.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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female 41 years old Reason: follow up History: follow up. 4 views of the right foot again show transverse fractures through the bases of the second, third, and fourth metatarsals. The fracture lines appear slightly less distinct on the current study than on the prior study suggesting some interval healing. | Healing fractures of the second, third, and fourth metatarsals. |
Generate impression based on findings. | Reason: status of lung transplant History: dyspnea LUNGS AND PLEURA: Redemonstration of postsurgical findings of a right lung transplant.Severe apical predominant centrilobular and paraseptal emphysema in the left lung, similar in appearance to the prior exam.Scattered benign appearing micronodules in both lungs, stable, without suspicious pulmonary nodules or masses.No focal airspace consolidation.Moderate right pleural effusion is stable to slightly decreased from the prior exam, with very mild associated subpleural edema.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion. Mild 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. Status post cholecystectomy. Probable right renal cyst. | Status post right lung transplant. Stable moderate right pleural effusion, without additional evidence of complication or other acute abnormality. |
Generate impression based on findings. | Ms. Hayducak is a 64 year old female with a personal history of left breast lumpectomy in February 2010 for IDC/DCIS followed by radiation and hormonal therapy. She has a family history of breast cancer in mother and two maternal aunts. No current breast related complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the left breast. There are stable postsurgical changes including architectural distortion, increased density, and benign dystrophic calcifications present within the left lumpectomy site. Focal asymmetry in the superior right breast is stable. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Stable postsurgical changes of the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic 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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: GE Junction esophageal cancer. Please compare to prior exam per RECIST criteria. History: Esophageal cancer CHEST:LUNGS AND PLEURA: Interval partial clearing of multiple areas of groundglass opacity which may have been secondary to aspiration.Slightly increased focal airspace opacity in the posterior basal segment of the left lower lobe, with some nodular components, also suggestive of aspiration.No suspicious nodules.MEDIASTINUM AND HILA: No significant lymphadenopathy.Moderate coronary artery calcification.Catheter extending to the SVC/RA junction.Thickening of the distal esophagus with considerable motion artifact in this area.A previously measured paraesophageal lymph node is not visible, but likely obscured by motion.CHEST WALL: Degenerative disease in the spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Large bilateral renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small amount of residual soft tissue in the celiac axis region measuring about 14 x 17 mm (series 3/85) not significantly changed.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Pulmonary abnormalities suggestive of aspiration, mainly in the left lower lobe.2. Distal esophageal thickening, not significantly changed. 3. Stable residual celiac lymphadenopathy. |
Generate impression based on findings. | Two years after lung resection for Stage I NSCLC. LUNGS AND PLEURA: Stable post surgical findings of a right upper lobectomy without evidence of recurrence.Small peripheral groundglass opacity subjacent to the right major fissure (series 5, image 59), unchanged and likely represents scarring.Mild centrilobular emphysema.Unchanged calcified and noncalcified micronodules, most likely benign.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Calcified mediastinal lymph nodes consistent with healed granulomatous disease.Moderate coronary artery calcification.Normal heart size without pericardial effusion.CHEST WALL: Degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Stable hepatic hypodensities, likely cysts. Calcified splenic granulomata. | No specific evidence of recurrent disease or metastases. |
Generate impression based on findings. | 7-year-old male with history of Beckwith Weidman syndrome, assess for tumor LIVER: The liver measures 12.9 cm. No focal hepatic lesion.GALLBLADDER, BILIARY TRACT: The gallbladder is distended and otherwise normal. No biliary ductal dilatation. The common bile duct measures 3 mm. Limited color and spectral Doppler evaluation demonstrates patent hepatopetal portal flow.PANCREAS: The pancreatic head and body appear normal. The tail is obscured by bowel gas.SPLEEN: The spleen measures 9.8 cm.KIDNEYS: The right kidney measures 11.2 cm. The left kidney measures 10.1 cm. No focal lesion or hydronephrosisABDOMINAL AORTA: The proximal aorta measures 1.3 x 1.2 cm. The mid aorta measures 1.0 x 1.0 cm. The distal aorta measures 0.5 x 0.6 cm.INFERIOR VENA CAVA: Patent with normal flow.OTHER: No significant abnormality noted. | Normal examination. |
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, version 9.3. The breast parenchyma is heterogeneously dense. 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - 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, version 9.3. The breast parenchyma is extremely dense, limiting the sensitivity of mammography and increasing the importance of physical examination, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSD - 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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A metallic clip in the right breast is in stable position. 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A circumscribed mass at 6 o'clock position in the left breast is unchanged. 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, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 82 years, Male. Reason: evaluate bowel gas pattern History: abdominal distension and pain Dilated loops of small and large bowel with air fluid levels are compatible with early small bowel obstruction. High-grade ileus is considered less likely. Chronic elevation of the left hemidiaphragm. Note that the pelvis is excluded from the field-of-view. | Findings compatible with early small bowel obstruction. High-grade ileus is considered less likely. |
Generate impression based on findings. | 45-year-old male with metastatic rectal cancer. CHEST:LUNGS AND PLEURA: No suspicious nodules or masses.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Left-sided chest port with catheter tip in the inferior SVC.ABDOMEN:LIVER, BILIARY TRACT: Hypoattenuating lesion within segment 8 consistent with patient's known hepatic metastasis measures 1.5 x 2.0 cm (series 3, image 84), previously 1.3 x 1.7 cm. No new focal hepatic lesion.SPLEEN: Hypoattenuating lesions inferiorly within the spleen which are indeterminate but are unchanged. Given the absence of activity on FDG PET study, favor benign etiology.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypoattenuating left renal lesion this too small characterize but may represent a renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Enlarged left perirectal node measures 1.6 x 1.5 cm (series 3, image 167), previously 1.6 x 1.5 cm.BOWEL, MESENTERY: Persistent left rectal wall thickening is identified, similar to prior. BONES, SOFT TISSUES: No significant abnormality noted | 1.Slight interval increase in size of hepatic metastasis. 2.Stable left rectal wall thickening and perirectal lymph node. 3.No new sites of metastatic disease are identified. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements. 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male; 70 years old. Reason: assess L renal cyst History: dysuria, wt loss RIGHT KIDNEY: The right kidney measures 9.7 cm in length. There is no hydronephrosis or shadowing renal stone.LEFT KIDNEY: The left kidney measures 11.3 cm in length. There is no hydronephrosis or shadowing renal stone. Within the upper pole of the kidney, correlating with the lesion seen on CT, is a 2.3 x 1.7 x 1.9 cm predominantly solid lesion with some cystic components. There is no internal vascularity on color Doppler.URINARY BLADDER: The bladder is nondistended. | 2.3 cm predominantly solid left upper pole renal lesion is indeterminate but concerning for neoplasm. |
Generate impression based on findings. | Soft palate cancer status post CRT. Compare to previous measurements. CHEST:LUNGS AND PLEURA: Mild paraseptal and centrilobular emphysema.Intraluminal debris in multiple right lower lobe bronchi (series 5, image 61). No focal airspace consolidation or pleural effusion.Stable left upper lobe micronodule, most likely benign. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Normal heart size without pericardial effusion.No visible coronary artery calcification.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Calcification of the abdomen aorta without aneurysm. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of metastatic disease. Right lower lobe bronchi aspirated debris without evidence of pneumonia. |
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, version 9.3. The breast parenchyma is heterogeneously dense. Focal asymmetry is present at upper inner quadrant in the left breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Focal asymmetry at upper inner quadrant in the left breast. Comparison to old mammograms is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: O - Old Study For Comparison. |
Generate impression based on findings. | 71 year-old woman history of left DCIS with microinvasion status post lumpectomy in 2009. 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. Post-surgical changes in the left breast are noted including architectural distortion, density, and surgical clips. Scattered, benign-appearing calcifications are seen in the breasts bilaterally. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Benign calcifications are again present appreciated in the right breast No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Reason: Hisotry of left breast triple negative breast cancer in 2012. Now with left prominence of medial infraclavicular area, around ribs 1-2, r/o internal mammary nodes. History: Hisotry of left breast triple negative breast cancer in 2012. Now with left prominence of medial infraclavicular area, around ribs 1-2, r/o internal mammary nodes LUNGS AND PLEURA: Right lower lobe calcified granuloma. No suspicious pulmonary nodules or masses. Mild dependent atelectasis. No focal air space consolidations. No pleural effusion.MEDIASTINUM AND HILA: The heart is normal in size, without pericardial effusion. No visible coronary artery calcifications.No mediastinal or hilar lymphadenopathyCHEST WALL: Surgical changes in the left breast. Status post axillary lymph node dissection.No axillary, supraclavicular, or internal mammary lymphadenopathy.Degenerative disease of the visualized cervical spineUPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Bilateral renal hypodensities, likely benign cysts. | No chest wall lymphadenopathy or other evidence of metastatic disease. |
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, version 9.3. The breast parenchyma is mostly fatty replaced, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Female 79 years old Reason: fx, eval healing History: above. Again seen is a fracture of the proximal humerus involving the surgical neck and greater tuberosity with mild impaction. There is, perhaps, a small amount of callus adjacent to the fracture suggesting early healing. Glenohumeral alignment is within normal limits. The bones appear to be slightly demineralized. | Proximal humerus fracture as above. |
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, version 9.3. The breast parenchyma is extremely dense, limiting the sensitivity of mammography and increasing the importance of physical examination, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSD - Screening Mammogram. |
Generate impression based on findings. | 69 years, Female. Reason: please assess capsule position History: gib, vce study LVAD, median sternotomy wires/plates, and pacer leads are noted. Metallic radiodensities in the right lower quadrant, presumed to represent the capsule, is likely in the terminal ileum/cecum. Nonobstructive bowel gas pattern. | Presumed capsule in the right lower quadrant as described above. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. There are two new benign circumscribed masses in the lower inner quadrant of the left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: weight loss 25 lbs. lung nodule noticed on recent ct a/p. evaluate for change/progression History: lung nodule LUNGS AND PLEURA: Focal reticulonodular opacities at the left apex anteriorly, unchanged since 2010, likely secondary to previous infection.Subpleural nodular opacity in the superior segment of the left lower lobe, also unchanged since 2010 compatible with a scar.New focal scarlike opacity anteriorly in the right middle lobe and unchanged scar anteriorly in the left lower lobe at the cardiophrenic angle.Additional micronodules and left lower lobe cyst, unchanged.MEDIASTINUM AND HILA: Moderately enlarged high right paraesophageal lymph node (series 3/12) increased from previous.No other significant lymphadenopathy.Moderate coronary artery calcification.No pericardial effusion.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No suspicious pulmonary nodules.2. Single moderately enlarged nonspecific high right paraesophageal lymph node, most likely reactive. |
Generate impression based on findings. | Pain Moderate to severe osteoarthritis affects the left hip, which appears to have progressed slightly when compared to the prior study.Relatively mild osteoarthritis affects the right hip as seen on the single frontal view.Degenerative disk disease affects the visualized lower lumbar spine. | Osteoarthritis. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 60 years, Female. Reason: r/o air fluid levels or thumbprinting History: elevated lactate to 20, ?abdominal pain NG tube tip projects over the gastric antrum. Cholecystectomy clips, IVC filter, and lower lumbar spinal fixation hardware are noted. Vascular calcifications are noted. Catheter projects over the left inguinal area.Centralized loops of gas distended bowel. | Nonspecific bowel gas pattern. |
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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - 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, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense. 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - 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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. There are several masses in both breasts. Most of them are circumscribed and benign appearing, however, the mass at right retroareolar region is indeterminate.No suspicious microcalcifications or areas of architectural distortion are present. | Mass in the right retroareolar region. Comparison to old mammogram is recommended. If old mammograms are not available, patient will be called back and spot compression views and possible ultrasound study will be performed. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: O - Old Study For Comparison. |
Generate impression based on findings. | Ms. Swift is a 49 year old female with a personal history of right breast mastectomy in December 2014 for locally advanced IDC/DCIS treated with chemotherapy. She has no current breast-related complaints. Three standard views of the left breast, additional left MLO view and one left spot compression view 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. A focal asymmetry in the lateral left breast, posterior depth, disperses on spot compression views. Scattered benign calcifications are stable. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in the left breast. A vascular port overlies the left axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Reason: s/p bronch, left extended pleurectomy decortication (1/14/2015) for epithelioid mesothelioma History: follow up LUNGS AND PLEURA: Interval changes of a recent left pleurectomy and decortication.Left basilar atelectasis and consolidation consistent with postoperative status.A new loculated fluid collection within the left major fissure (series 7, image 55). Very small left pleural effusion.Mild residual pleural and subpleural nodularity. Pleural thickening along the anterior aspect of the left upper lobe at the 12 o'clock position measures 4 mm (series 5, image 24), previously 6 mm. Focal pleural thickening along the posterior lateral aspect of the left lung base at the 5 o'clock position measures 9 mm (series 5, image 86).The previously described 12-mm right upper lobe ground glass nodule with a small solid component (series 7, image 42) is unchanged from the prior exam dated 1/2/2015.Two additional more solid right lower lobe nodules measuring up to 10 mm (series 7, image 72) appear not significantly changed from the prior exam.MEDIASTINUM AND HILA: The heart is normal in size, without significant pericardial effusion. No visible coronary artery calcification.A previously described prominent left cardiophrenic lymph node is not clearly seen on this exam.A left interlobar lymph node is mildly enlarged, measuring up to 10 mm, possibly related to recent surgery, but appears centrally necrotic.CHEST WALL: Degenerative disease of the thoracic spine.Surgical changes are the right glenohumeral joint.Small left internal mammary lymph node (series 5, image 45).UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Subcentimeter right hepatic lobe hypodensity, stable, likely a benign cyst. | 1. Mild residual pleural nodularity and left interlobar adenopathy as detailed above are nonspecific in the immediate postoperative setting. Continued close follow up is recommended to evaluate for changes in these findings.2. A 12-mm subsolid right upper lobe nodule, suspicious for adenocarcinoma in situ or minimally invasive adenocarcinoma, appears similar to the prior exam dated 01/2015. Additional irregularly marginated right lower lobe nodules are nonspecific, somewhat suspicious for synchronous primary carcinomas. Continued short interval follow up imaging (in 3 months) is recommended. |
Generate impression based on findings. | Cervical esophageal cancer. Compare to previous. CHEST:LUNGS AND PLEURA: Stable superior paramediastinal reticular opacities, likely post-radiation change.Calcified and noncalcified micronodules are unchanged, most likely post-inflammatory. New small nodular opacity in the left lower lobe likely represents atelectasis or aspiration (series 4, image 66), special attention on follow-up scans to confirm resolution.No new suspicious pulmonary nodules.MEDIASTINUM AND HILA: Calcified mediastinal nodes consistent with healed granulomatous disease. No intrathoracic lymphadenopathy.Mild coronary artery calcification.Small nonspecific thyroid nodules, unchanged.Small hiatal hernia.CHEST WALL: No axillary lymphadenopathy. Degenerative changes of the thoracolumbar spine. Heterogeneous appearance of the cervical spine is likely post-treatment related, unchanged.Small left fat containing Bochdalek hernia.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: Unchanged right renal hypodense foci, likely cysts.Status post left nephrectomy.PANCREAS: Cystic pancreatic head mass is 2.8 x 2.1 cm, previously 2.5 x 2.2 cm, not significantly changed, previously characterized on CT abdomen to likely be an IPMN.RETROPERITONEUM, LYMPH NODES: Calcified atherosclerotic disease of the abdomen aorta without aneurysm. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted. | No evidence of metastasis. Stable pancreatic cystic lesion, likely an IPMN. |
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, version 9.3. The breast parenchyma is heterogeneously dense. 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, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female 58 years old Reason: pt with hx of gastric cancer s/p CRT needs surveillance scans History: lower abdominal pain CHEST:LUNGS AND PLEURA: Stable emphysematous disease. Left lower lobe nodule along the fissure is unchanged (series 4, image 74) and likely represents an intrapulmonary lymph node. Small area of ground glass opacity at RML base, unchanged. No pleural effusion. No suspicious pulmonary nodule.MEDIASTINUM AND HILA: There is a left paraesophageal focus with attenuation measuring simple fluid now measuring 2.2 x 1.1 cm (series 3, image 26), previously 1.9 x 1.0 cm. The focus has been present since CT study from 7/10/2014 with slight interval increase in size. No additional hilar or mediastinal lymphadenopathy. Heart size normal without pericardial effusion. Mild atherosclerotic calcifications of the thoracic aorta. No coronary artery calcifications. Heterogeneous thyroid.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multiple stable hypoattenuating lesions, too small to characterize. The segment 3 hypoattenuating focus seen on prior exam is not well visualized on the current exam, which may be due in part to contrast timing, nonspecific.SPLEEN: No significant abnormality noted.PANCREAS: Trace fluid anterior to the pancreas which may be postoperative in etiology. Correlate with patient's history and clinical symptoms to exclude pancreatitis.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Stable bilateral renal hypoattenuating lesions. Dominant 2 cm left lower pole renal cyst (series 3, image 125) is unchanged. Additional subcentimeter hypoattenuating foci seen in both kidneys, too small to characterize. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta and its branches, including the bilateral renal arteries which remain patent. Reference para-aortic lymph node measures 1.1 x 0.9 cm (series 3, image 115), without significant change from prior study. There is luminal heterogenicity of the IVC which is unchanged and may be secondary to flow or mixing artifact.BOWEL, MESENTERY: Status post partial gastrectomy with gastrojejunostomyBONES, SOFT TISSUES: Osteopenia. Mild right curvature of the thoracolumbar spine.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Loss of height of the L4 vertebral body, unchanged. | 1.Left paraesophageal cystic focus, which has been present since CT examination from July 2014, but has slowly increased in size. This could be due to a benign etiology such as a duplication cyst, however with the slight interval increase in size, metastatic disease cannot be excluded. Recommend PET study for further characterization.2.No additional evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Male, 63 years old, status post cervical decompression. Findings is seen compatible with recent cervical laminoplasty. Laminectomy/laminotomy has been performed from C3 through C7 with spinous process resection. The posterior bony arches have been canted posteriorly and to the right, and reinforced with bone graft material placed in the laminectomy defects at C4 and C6 on the left. A surgical drain is in place. No evidence of any concerning soft tissue or paraspinal fluid collections are seen.Trace retrolisthesis of C4 relative to C5 and C5 relative to C6 is noted. Vertebral body height is largely preserved. Degenerative endplate irregularity is noted most severely affecting C4-5, C5-6 and C6-7. There are also numerous small lucent spaces within the bone, adjacent to the endplates, at these levels which are likely degenerative as well.C2-3: Minimal posterior disk osteophyte formation. No significant spinal canal stenosis. At most, mild left foraminal narrowing.C3-4: Posterior disk osteophyte formation. Posterior spinal canal decompression. Moderate left and mild right foraminal narrowing. C4-5: Disk degeneration with loss of disk height and posterior disk osteophyte formation. Posterior spinal canal decompression. Severe bilateral foraminal narrowing.C5-6: Disk degeneration with loss of disk height and posterior disk osteophyte formation. Posterior spinal canal decompression. Severe bilateral foraminal narrowing.C6-7: Disk degeneration with loss of disk height and posterior disk osteophyte formation. Posterior spinal canal decompression. On some cuts, the spinal canal does remain narrow in the AP dimension, but it is improved relative to the pre-operative study. Severe bilateral foraminal narrowing. C7-T1: No significant spinal canal or neuroforaminal stenosis. | Expected findings status post recent cervical laminoplasty. No complications are suspected. Multilevel spinal canal stenoses seen on the preoperative examination have been relieved. |
Generate impression based on findings. | 62-year-old male patient with history of familial adenomatous polyposis status post colectomy and ileal anal pouch. Concern for small bowel polyps. Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the anal verge was 45 minutes. There is a 1 cm filling defect seen in the third segment of the duodenum, compatible with a polyp. Fluoroscopic evaluation showed normal mucosa throughout the small bowel, with no additional polyps, ulcers, sinus tracts, fistulae, or adhesions. There is expected postoperative dilatation and decreased peristalsis of a long segment of ileum proximal to the J-pouch. TOTAL FLUOROSCOPY TIME: 7:48 minutes | 1 cm filling defect compatible with a polyp in the third portion of the duodenum. |
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, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. A small asymmetry is present at central right breast on CC view.No suspicious microcalcifications or areas of architectural distortion are present. | Small asymmetry is present at central right breast on CC view. Comparison to old mammogram is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: O - Old Study For Comparison. |
Generate impression based on findings. | Reason: please compare to PACS. LLL with questionable AVM and cysts. History: cough PULMONARY ARTERIES AND VEINS: Complex abnormality in the left lower lobe with multiple large cysts measuring up to 3 cm in diameter and multiple tortuous and dilated pulmonary veins, draining into the left inferior pulmonary vein which is markedly enlarged, and also into the lower mediastinum, likely connecting with the hemiazygos vein.The main and left descending pulmonary artery are normal in caliber and no connection between the left lower lobe pulmonary artery and veins is identified, though there may be multiple small distal AVMs. There is no evidence of a systemic arterial supply to support a diagnosis of sequestration.There is a small amount of abnormal soft tissue laterally in the left lower lobe that could represent scarring or focal atelectasis.The caliber of the pulmonary arteries and veins in the right lower lobe is unusually large relative to the bronchi, and this is of uncertain significance.LUNGS AND PLEURA: Mild subpleural scarring in the apical areas and no acute abnormalities.Multiple cysts and scarlike opacities with architectural distortion in the left lower lobe as detailed above.MEDIASTINUM AND HILA: No significant lymphadenopathy.No visible coronary artery calcification.Minimal amount of pericardial fluid.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Markedly enlarged left lower lobe pulmonary veins with partial anomalous pulmonary venous drainage and a markedly enlarged left inferior pulmonary vein, but without direct evidence of arteriovenous fistula. However enlarged subpleural vessels in the costophrenic angle may represent multiple small AV fistulae. Multiple large cysts in the left lower lobe suggest a congenital or childhood infection related etiology. Pulmonary angiography may be considered to determine the presence of AV fistulae in this area.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | There is mild reversal of cervical lordosis. The craniocervical junction alignment is normal. There is no acute fracture, subluxation, or prevertebral soft tissue swelling. There are mild cervical degenerative changes including small disk osteophyte complexes at C4-5, C5-6 and C6-7 without significant spinal canal stenosis. There is bilateral neural foraminal stenosis at C6-7. | No acute fracture. Mild cervical degenerative changes. |
Generate impression based on findings. | Unchanged right calvarial postoperative changes and encephalomalacia involving the right temporal, occipital, and posterior parietal lobe with ex vacuo dilatation of the right lateral ventricle atrium. No acute intracranial hemorrhage. No evidence of mass, mass-effect, or midline shift. There are no extraaxial fluid collections or subdural hematomas. Patchy periventricular and subcortical white matter hypoattenuation consistent with age indeterminate small vessel ischemic disease. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | 1.No acute intracranial hemorrhage or mass effect.2.Unchanged encephalomalacia in the right cerebral hemisphere. |
Generate impression based on findings. | 19 year-old male with abdominal pain status post esophageal dilation. Evaluate for free air.VIEWS: Abdomen supine and erect (two views) 2/19/2015 at 2131 Nonobstructive bowel gas pattern. No pneumatosis or free air. Average fecal burden. Gastrostomy tube in expected position. | Normal examination. No specific findings to account for the patient's pain. |
Generate impression based on findings. | History of right submandibular gland malignancy (intracapsular carcinosarcoma). There are postoperative findings related to right submandibular gland resection. There is no definite evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid appear unremarkable. There are bilateral punctate tonsilloliths. There is a defect in the left lateral aspect of the C5 vertebral body, which may be due to a tortuous vertebral artery. The osseous structures are otherwise unremarkable. The airways are patent. The paranasal sinuses are clear. The imaged intracranial structures are grossly unremarkable. The imaged portions of the lungs are clear. | Postoperative findings related to right submandibular gland resection without definite evidence of recurrent tumor or significant lymphadenopathy in the neck, although assessment is limited by the lack of intravenous contrast. |
Generate impression based on findings. | There has been mild to moderate improvement in the supraglottic laryngeal edema. Again noted is irregular contour of the aryepiglottic folds, which is nonspecific. No obvious residual tumor/mass in the supraglottic region. The airway is patent.The parotid and submandibular glands are normal in size and symmetric bilaterally without masses. There are no thyroid masses. Partially visualized emphysema in the lung apices without opacities. There is no clinically significant adenopathy. Near complete opacification of the left sphenoid sinus.Atherosclerotic plaque at bilateral carotid bifurcations with moderate stenosis at the proximal left internal carotid artery. Multilevel degenerative spondylosis. Encephalomalacia in the left temporal lobe. | 1.Posttreatment changes as above without measurable recurrent tumor.2.Moderate stenosis at the left proximal internal carotid artery. |
Generate impression based on findings. | 74-year-old male with history of gallbladder carcinoma with known right pelvic bone metastasis status post radiotherapy. Evaluate for interval change. CHEST:LUNGS AND PLEURA: Right lower lobe micronodule with irregular margins (series 6, image 91) appears to have slightly increased in size. Additional multiple scattered micronodules are again noted appearing similar to prior.MEDIASTINUM AND HILA: Severe coronary artery calcifications are present. No mediastinal or hilar lymphadenopathy.CHEST WALL: Right chest port with catheter tip in the SVC.ABDOMEN:LIVER, BILIARY TRACT: Soft tissue mass in the gallbladder fossa with direct invasion into the liver. Reference segment IVa lesion measures 5.9 x 6.3 cm (series 4, image 107), previously measuring 3.8 x 4.8 cm. Reference segment IVb lesion measures 5.1 x 5.7 cm (series 3, image 107), previously measuring 4.4 x 5.4 cm. Nonreference lesions have also increased in size. Right and left intrahepatic biliary ductal dilatation appearing similar to prior. The main portal vein is patent, but there is increased attenuation of right portal vein branches by the mass.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: There is mild asymmetric thickening of left adrenal gland appearing similar to prior.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Moderate calcifications affect the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Gaseous foci in the anterior abdominal are likely related to injection sites. OTHER: 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: Redemonstration of lytic lesion involving the right inferior pubic ramus with cortical destruction not significantly changed compared to the prior exam. | 1.Findings compatible with primary gallbladder malignancy with interval increase in hepatic metastatic disease.2.Right inferior pubic ramus destructive metastatic osseous lesion appearing similar to prior.3.Slight increase in size of right lower lobe micronodule, suspicious for metastatic disease. Attention on subsequent follow-up exams is recommended. |
Generate impression based on findings. | History of left parotidectomy for carcinoma ex pleomorphic adenoma. Evaluate for recurrence. Redemonstrated are postoperative findings related to a partial left parotidectomy for resection of parotid mass. There is unchanged patchy soft tissue and clips in the surgical bed. There is no evidence of significant cervical lymphadenopathy. However, several subpectoral lymph nodes have increased in size, the largest of which measures 11 x 17 mm, previously 5 x 10 mm. The thyroid and remaining salivary glands are unchanged. The major cervical vessels are patent. The osseous structures are unchanged. There is degenerative spondylosis of the cervical spine with mild retrolisthesis of C4 on C5. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | 1. Postoperative findings related to a partial left parotidectomy with unchanged soft tissue in the surgical bed that likely represents postsurgical granulation tissues and/or scarring, but otherwise no evidence of measurable mass lesion in this region. 2. No significant cervical lymphadenopathy, although several left subpectoral lymph nodes have increased in size and are perhaps reactive in nature, but otherwise nonspecific. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Ms. Davis is a 56 year old female with a personal history of left breast lumpectomy in 2008 for IDC/DCIS followed by radiation, chemotherapy, and hormonal therapy. Personal history of benign right breast biopsy in 2006. Family history of breast cancer in second maternal cousin. She presents today for short term follow-up of high probability benign calcifications in the left breast. Three standard views of both breasts, a left laterally exaggerated CC view, and two left spot magnification 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. A linear marker was placed on the scar overlying the left breast. There are stable postsurgical changes including architectural distortion, increased density, and surgical clips present within the left lumpectomy site. Dystrophic calcifications have developed in a benign fashion within the left lumpectomy bed. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Benign dystrophic calcifications in the left lumpectomy bed. 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. | Increased oxygen requirementVIEW: Chest AP and abdomen AP ET tube tip below thoracic inlet and above the carina. The umbilical venous catheter tip in the IVC. The umbilical arterial catheter tip at T8. Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. No focal lung opacity. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | No focal lung opacity. |
Generate impression based on findings. | PainVIEWS: Left forearm AP and lateral No acute fracture or dislocation. | Normal examination. |
Generate impression based on findings. | Reason: r/o acute abnormalities History: abdominal mass c/ for adenocarcinoma LUNGS AND PLEURA: Scattered benign appearing micronodules and calcified granulomas. No suspicious pulmonary nodules or masses.No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size, without significant pericardial effusion. Mild coronary artery calcification.Scattered calcified mediastinal and hilar lymph nodes likely from prior granulomatous disease, without lymphadenopathy.CHEST WALL: Mild degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Pneumobilia. Partially visualized conglomerate mass in the upper abdomen. See recent prior CT abdomen and pelvis for additional findings. | No evidence of pulmonary metastases. |
Generate impression based on findings. | FractureVIEWS: Left shoulder three views There is a transverse fracture of the proximal metadiaphysis of the left humerus with lateral and posterior angulation not significantly change. No evidence of shoulder dislocation | Fracture of the left proximal humerus with lateral and posterior angulation not significantly changed. |
Generate impression based on findings. | 2-year-old male with history of hemihypertrophy. Evaluate for hepatic and renal tumors. LIVER: The liver measures 9.2 cm in length. No focal hepatic lesions or biliary ductal dilatation. The main portal vein is patent and exhibits normal directional flow. GALLBLADDER, BILIARY TRACT: No shadowing gallstones, gallbladder wall thickening, or pericholecystic fluid. The CBD measures 1 mm. PANCREAS: Obscured by overlying bowel gas.SPLEEN: The spleen measures 6.7 cm in length with normal echotexture.KIDNEYS: The right kidney measures 7.6 cm in length. The left kidney measures 7.5 cm in length. No hydronephrosis or focal renal lesions. ABDOMINAL AORTA: The abdominal aorta demonstrates normal caliber.INFERIOR VENA CAVA: The IVC is patent.OTHER: No ascites. The bladder appears normal. | Normal examination. |
Generate impression based on findings. | Male 74 years old Reason: Esophageal cancer post chemo/rt prior to surgery History: Esophageal cancer Scout radiograph shows no mediastinal widening however, there is a palmar opacity in the left lower lobe.The right chest wall port terminates at the cavoatrial junction..Double contrast evaluation of the esophagus and gastric cardia/fundus revealed mild narrowing of the mid to distal esophagus for approximately a 4.6-cm length with some mucosal irregularity. There is a smaller raised lesion in this area measuring approximately 6 mm. The maximum distention achieved in this area is 1 cm. There is also slight mucosal irregularity in the distal esophagus near the EG junction.There is mild proximal escape. No reflux was elicited.TOTAL FLUOROSCOPY TIME: 2.49 minutes | Mid esophageal narrowing possibly the area of radiation with small raised lesion. |
Generate impression based on findings. | Male 63 years old Reason: left upper tract transitional cell carcinoma ( hx of) - s/p left nephro-u History: left upper tract transitional cell carcinoma ( hx of) - s/p left nephro-u Examination is limited by lack of oral and intravenous contrast. Evaluation of visceral, vascular, and bowel pathology is suboptimal. Within these limitations, these observations were made: CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Mild atherosclerotic calcifications of the thoracic aorta.ABDOMEN:LIVER, BILIARY TRACT: Hepatic steatosis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Postsurgical changes from prior right nephrectomy and ureterectomy. The contour of the left kidney is normal. There is no evidence of recurrence in the right renal fossa. There is a remnant of the right kidney at the location of the prior horseshoe connection, which appears unchanged compared to prior outside CT exam. RETROPERITONEUM, LYMPH NODES: Status post endograft placement for infrarenal abdominal aortic aneurysm. The endograft extends from the level of the left renal artery to the common iliac arteries. The aortic aneurysm appears slightly decreased in size measuring up to 4.4 cm in greatest diameter (series 4, image 83). There is also an endovascular stent in the IMA.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Status post right nephroureterectomy. 2.Ability to assess for visceral pathology is limited by lack of intravenous contrast. Within the limitations, the contour of the left kidney is normal and there is no evidence of disease recurrence in the right renal fossa.3.Stable size of the infrarenal abdominal aortic aneurysm status post remote endovascular stenting. |
Generate impression based on findings. | 65-year-old man with history of laryngeal cancer and appendiceal lesion, compare to previous. CHEST:LUNGS AND PLEURA: Mild apical predominant emphysema. Scattered nonspecific pulmonary micronodules appearing similar to prior. No new suspicious nodules or masses.MEDIASTINUM AND HILA: Postsurgical changes along the right mediastinum and hilum. Mild coronary artery calcifications.CHEST WALL: Postsurgical changes to the posterior ribs. Healed left inferior rib fracture.ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions. Cholelithiasis without CT evidence of cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic disease of the abdominal aorta and its branches.BOWEL, MESENTERY: The appendix is partially filled with contrast and is no longer dilated. There is a small focus of soft tissue attenuation/stranding surrounding the distal tip of the appendix, decreased from prior. Previously seen presumed periappendiceal lymph nodes have decreased in size. No visible fluid or mucinous intraperitoneal collections are identified elsewhere. Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Post surgical changes to the prostate and pelvis. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The appendix is partially filled with contrast and is no longer dilated. There is a small focus of soft tissue attenuation/stranding surrounding the distal tip of the appendix, decreased from prior. Previously seen presumed periappendiceal lymph nodes have decreased in size. No visible fluid or mucinous intraperitoneal collections are identified elsewhere. Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine most prominent at L5-S1. | 1.No specific evidence of metastatic disease.2.Continued decrease in size of appendix and periappendiceal soft tissue, thus favor improving indolent/chronic appendicitis as opposed to mucocele/metastatic disease. 3.Cholelithiasis.4.Diverticulosis. |
Generate impression based on findings. | Female 48 years old Reason: LUMBAR PAIN History: LUMBAR PAIN. There is a slight rightward curvature of the lumbar spine. There are small anterior vertebral body osteophytes, but the intervertebral disk spaces and vertebral body heights are preserved. A pump device overlying the right hemiabdomen is incompletely imaged on this study. The catheter appears to enter the spinal canal at L1/L2 and courses cranially within the spinal canal; we suspect that its tip is at the level of T10. | Intrathecal catheter and other findings as described above. |
Generate impression based on findings. | Female 50 years old; Reason: 50F with MM s/p auto-SCT x 2 with relapsed disease SKULL: No significant abnormality noted. No discrete myelomatous lesions are seen.CERVICAL SPINE: A nonspecific small lucency in the spinous process of C4 may possibly represent a myelomatous lesion or cyst. Moderate degenerative disk disease affects C5/C6 and C6/C7.THORACIC SPINE: The bones appear demineralized. There is mild scoliosis and degenerative disk disease of the upper thoracic spine. No discrete myelomatous lesions are seen.LUMBAR SPINE: The bones appear demineralized. There is degenerative disk disease, severe at L5/S1 and relatively mild at L4/L5. No discrete myelomatous lesions are seen.RIBS: The bones appear demineralized. No discrete myelomatous lesions are seen.PELVIS: Mild osteoarthritis affects the hips bilaterally. No discrete myelomatous lesions are seen.UPPER EXTREMITY: Mixed lucency and sclerosis in the right lunate and triquetrum may be secondary to ulnocarpal abutment. Lucent foci with sclerotic margins in the left scaphoid and capitate likely represent cysts or ganglia. These lesions do not have the typical appearance for myeloma. LOWER EXTREMITY: No significant abnormality noted. No discrete myelomatous lesions are seen. | Small lucency in the spinous process of C4 which is nonspecific and may represent a myelomatous lesion or simply a cyst. Otherwise, no discrete myelomatous lesions are seen. |
Generate impression based on findings. | Female 55 years old Reason: shoulder pain History: same. There is a small lucency within the glenoid that may either represent a degenerative cyst or a postoperative defect. Shoulder otherwise appears normal for age. Leads of a cardiac conduction device are incompletely imaged on this study. | Small lucency in the glenoid may represent a cyst or a postoperative defect. Shoulder otherwise appears normal. |
Generate impression based on findings. | 5-year-old female, thumb fractureVIEWS: Left thumb, AP, oblique, and lateral (3 views) 2/20/15 8:55 Interval removal of cast. Fracture through the base of the proximal phalanx of the thumb with dorsal angulation of the distal fracture fragment is again visualized with mild adjacent callus formation | Fracture of the proximal phalanx of the thumb as described above. |
Generate impression based on findings. | 9-month-old male, evaluate for deformityVIEWS: Right and left hands, AP, lateral, and oblique (3 views) 2/20/15 9:09 Right hand: Flexion deformity is noted at the PIP joint of the ring finger of the right hand. The osseous structures appear normal for the patient's age.Left hand: Alignment is anatomic. The osseous structures appear normal for the patient's age. | Flexion deformity of the ring finger of the right hand with otherwise normal osseous structures. |
Generate impression based on findings. | Male 83 years old Reason: eval for fx or gout, pain with weight-bearing x 1 day History: pain and swelling. The bones appear slightly demineralized. Severe osteoarthritis affects the first metatarsophalangeal joint. Mild osteoarthritis affects the interphalangeal joints and the midfoot articulations. A defect along the medial aspect of the first metatarsal head probably represents a degenerative cyst, with a gouty erosion considered less likely. We see no fracture. Mild diffuse soft tissue swelling with mild thickening of the Achilles' tendon is suggestive of tendinopathy. There are mild enthesopathic changes at the Achilles' tendon insertion on the calcaneus. There are arterial calcifications in the soft tissues. | Osteoarthritis and other findings as described above. |
Generate impression based on findings. | 68 years, Male, Reason: 68 yo M with HCV cirrhosis c/b HCC s/p TACE/RFA 2/17-2/18 now with fever and tachycardia, evaluate for liver abscess formation, eval biliary dilatation History: hepatocellular carcinoma s/p chemo-embo and ablation, now with fever, tachycardia. LIVER: Liver is normal in size measuring 16.7 cm in length. Cirrhotic contour. Hypoechoic segment 8 lesion measures 2.3 x 2.0 x 2.2 cm, previously 1.5 x 1.3 x 1.3 cm on prior ultrasound, compatible with known HCC. No new lesions identified, specifically no evidence of abscess otherwise. No intrahepatic biliary ductal dilatation. Portal venous flow is hepatopetal with a peak velocity of 0.2 m/sec.GALLBLADDER, BILIARY TRACT: The gallbladder is normal in appearance. No evidence of cholelithiasis, gallbladder wall thickening or pericholecystic fluid. The common bile duct measures 3 mm in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: The right kidney measures 9.0 cm in length. Mildly increased renal parenchymal echogenicity is compatible with medical renal disease. Echogenic focus in the right upper pole measuring 7 mm with twinkle artifact is compatible with a stone seen on prior CT.LEFT KIDNEY: The left kidney measures 9.8 cm in length. Mildly increased renal parenchymal echogenicity is compatible with medical renal disease.SPLEEN: The spleen measures 12.8 cm in length.OTHER: No evidence of ascites. Small right pleural effusion | 1.No evidence of abscess or biliary ductal dilatation.2.Segment 8 lesion compatible with known HCC, increased from prior ultrasound.3.Small right pleural effusion.4.Bilateral medical renal disease with small right upper pole stone. |
Generate impression based on findings. | Male 19 years old Reason: evaluating for fracture History: s/p fall on ice 11pm last night landing on left wrist. +swelling, limited ROM due to pain, diffuse ttp, ttp over both radial, ulnar, and also 5th metacarpal, no snuff box ttp. There is a poorly defined linear lucency traversing the waist of the scaphoid concerning for a fracture. We see no fracture the distal radius or ulna or visualized portions of the fifth metacarpal bone. There is soft tissue swelling along the dorsal aspect of the wrist. | Findings concerning for a scaphoid fracture as described above.These findings were verbally relayed to Dr. Kristen Lipstreuer at 1120 am on 2/20/2015. |
Generate impression based on findings. | 54 year old woman with history of multiple breast cysts. No current breast complaints. 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. Multiple round, circumscribed masses including two in the right anterior upper outer breast and one in the left upper outer breast are unchanged and consistent with cysts. Scattered, benign-appearing calcifications are noted. No suspicious mass, microcalcifications, or areas of architectural distortion in either breast. | Stable cysts bilaterally, but 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. | Reason: Head and neck cancer. Post CRT evaluation please compare to previous and provide measurements History: as above CHEST:LUNGS AND PLEURA: No evidence of pulmonary pleural metastases, or other pulmonary abnormality. MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Mild coronary artery calcifications are present, with apparent left ventricular wall hypertrophy.Left subclavian dual chamber ICD leads are unchanged and appropriately positioned.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable benign appearing subcentimeter hepatic cyst image 127 series 3.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Nonobstructing renal calculi, unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of metastases, or other significant abnormality. |
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