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Generate impression based on findings. | 4-month-old male with omphalocele with bilious emesis; pulmonary hypoplasia, chronic lung disease, and ventilator associated changes. Rule out small bowel obstruction or volvulus. LUNGS AND PLEURA: Dependent opacities in the right upper lobe and left lower lobe are suggestive of atelectasis. Superimposed infection is d... | 1.Giant omphalocele containing liver, gallbladder, spleen, small bowel, and majority of the colon.2.Dilated bowel loops likely representing colon in the right aspect of the giant omphalocele, concerning for obstruction. Moderate to large amount of free fluid in the sac is additionally noted.3.Dependent opacities in the... |
Generate impression based on findings. | Female 62 years old Reason: rule out renal recurrence History: hx of renal cell carcinoma, sp partial nephrectomy ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Subcentimeter hypodense lesions in the inferior right hepatic lobe are nonspecific, but special attention at follow-up is recommende... | 1.Postsurgical findings related to partial left nephrectomy without evidence of locoregional disease recurrence or distant metastatic disease.2.Subcentimeter hepatic hypodensities are most likely benign in etiology, although special attention at follow-up is recommended. |
Generate impression based on findings. | 97-year-old female, assess prosthetic A dynamic right hip screw with distal sideplate and screws are noted in near-anatomic alignment transversing the right proximal femoral fracture. The left hip appears essentially within normal limits for the patient's age. | Dynamic hip screw in near-anatomic alignment without evidence of complication. |
Generate impression based on findings. | 30 year-old female with neck pain after MVC Cervical spine: Vertebral body alignment and heights are within normal limits. The neuroforamina appear patent. No fracture is evident. The pre-vertebral soft tissues are within normal limits.Elbow: Alignment is anatomic. No fracture or joint effusion is visualized. | No fracture or dislocation. |
Generate impression based on findings. | 32-year-old male. Reason: s/p urethroplasty on 12/19, check for extravasation of urine Scout film demonstrated no abnormal calcification.Cystografin was administered by gravity via the patient's suprapubic catheter and maximal distention was achieved at approximately 150 cc, at which point the examination was terminate... | 1. Findings suspicious for focal urine extravasation, located near the junction of the prostatic and bulbous portions of the urethra, as described.2. Segmental luminal irregularity in the mid-ureter at and distal to the expected region of the prostatic/bulbous urethra, may in part reflect postsurgical sequelae but supe... |
Generate impression based on findings. | Male 14 years old Reason: standing with TLSO when receives History: L1 chance fractureVIEWS: Thoracic and lumbar spine PA and lateral , upright and in brace 1/7/15 (two views) L1 vertebral body wedge fracture with minimal superior plate impaction is again noted. Alignment of the thoracic and lumbar spine is anatomic. | Anatomic alignment of the thoracic and lumbar spine after brace placement. |
Generate impression based on findings. | 70 year-old female with intermittent swelling of digits bilaterally Right hand: There is slight positive ulnar variance with a cyst in the ulnar side of the lunate. Minimal osteoarthritis affects the basilar joint. Alignment is anatomic. No erosions are evident.Left hand: Minimal osteoarthritis affects the basilar join... | Minimal osteoarthritis and right positive ulnar variance as described above. |
Generate impression based on findings. | Female 19 years old; Reason: Evaluate for evidence for Crohn's disease or anatomical abnormalities. History: Right abdominal quadrant pain and emesis in patient with Celiac disease in remission and normal EGD/ileocolonoscopies.EXAMINATION: MR enterography without and with IV contrast 1/7/15 ABDOMEN:LIVER, BILIARY TRACT... | 1. No evidence of active bowel inflammation. 2. Horseshoe kidney, without evidence of obstruction. |
Generate impression based on findings. | 65-year-old female with history of osteoporosis and thoracic compression fracture, now with low back pain The bones are diffusely demineralized. There is marked kyphosis of the thoracic spine with widespread loss of vertebral body height. Lumbar vertebral body heights and disk spaces are maintained. Multiple surgical c... | Diffuse demineralization with age indeterminate widespread loss of vertebral body height and associated kyphosis. |
Generate impression based on findings. | 67-year-old male with back pain and a history of prostate cancer. Evaluate for metastatic disease. No abnormal osseous foci are identified to indicate metastatic disease.There are degenerative changes in the cervical, thoracic, and lumbar spine, left knee and the acromioclavicular joints bilaterally. | No evidence of bone metastases. |
Generate impression based on findings. | 38-year-old male with right scrotal fullness and pain. Evaluate for hernia. RIGHT TESTIS: The right testis is normal in morphology, echogenicity, and size, measuring 2.2 x 1.9 x 3.7 cm without a discrete lesion. Spectral Doppler evaluation demonstrates arterial blood flow. There is a small hydrocele.LEFT TESTIS: The le... | Normal testicular ultrasound. No specific findings in the right inguinal region to account for the patient's right groin pain. |
Generate impression based on findings. | Baseline exam as required by IRB # 13-1294. Metastatic renal cell cancer. There are a few enhancing lesions at the grey-white junction in the supratentorial brain. The largest located within the right superior frontal gyrus adjacent to the falx measures approximately 11 x 9 mm with surrounding vasogenic edema. There is... | Multiple metastatic lesions in the brain, the largest of which measures up to 11 mm in the right frontal lobe.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 54-year-old female with pain Glenohumeral alignment is within normal limits. There is minimal acromioclavicular joint osteoarthritis. No fracture is visualized. | Minimal osteoarthritis. |
Generate impression based on findings. | 48 years old female with a history of breast cancer, status post chemotherapy which was completed on 2/19/14. This study was performed to evaluate response to chemotherapy.RADIOPHARMACEUTICAL: 12.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 105 mg/dL. Today's CT portion grossly demonstrates new left ple... | 1.Interval progression of metastatic breast cancer with new osseous metastasis in the L2 vertebral body and the left sacral ala and nodal metastasis in the left supraclavicular region.2.Interval worsening of the nodal metastasis in the right axilla and right chest wall at subpectoral regions.3.Probable stable metastati... |
Generate impression based on findings. | 44 years old, Female, Reason: patient is screening for clinical trial. please provide bidimentional measurements per RECIST v1.1 thank you History: sigmoid colon adenocarcinoma CHEST:LUNGS AND PLEURA: Multiple pulmonary nodules bilaterally concerning for metastasis, which are new since outside exam dated 12/10/13. For ... | 1.Multiple new bilateral pulmonary nodules consistent with metastasis.2.Numerous large hepatic metastasis. Metastasis within the hepatic parenchyma at the porta hepatis narrows and may invade the left portal vein. 3.Nodal metastasis within the porta hepatis appears inseparable from the IVC and vascular invasion cannot ... |
Generate impression based on findings. | Male 65 years old Reason: baseline exam prior to starting new systemic therapy History: hx of metastatic renal cell cancer CHEST:LUNGS AND PLEURA: Innumerable pulmonary nodules compatible with metastases. For reference purposes a right upper lobe nodule now measures 0.9 x 1.3 cm (image 39, series 4), previously 0.8 x 1... | 1.Right renal mass compatible with a reported history of renal cell carcinoma.2.Pulmonary, osseous and nodal metastases as detailed above.3.Osseous metastasis in the posterolateral L4 vertebral body invades the left L4 neural foramina and encroaches upon the spinal canal. Further evaluation with MRI can be considered a... |
Generate impression based on findings. | 66 year old female with breast cancer. Lymphoscintigraphy is needed for sentinel node biopsy.RADIOPHARMACEUTICAL: The left breast was prepared in a sterile manner. A total of 0.5 mCi Tc-99m filtered sulfur colloid was injected in four periareolar injections. Three foci of increased activity are noted representing senti... | Sentinel nodes identified in the intramammary region and the left axilla. |
Generate impression based on findings. | 67-year-old male with rectal mucosal mass Normal physiologic radiotracer distribution is seen in the spleen, kidneys, liver, bowel and bladder. A small focus on radiotracer uptake in the soft tissues in the midline abdomen posteriorly is nonspecific. Additional focus of radiotracer uptake overlying the scrotum likely r... | 1. Nonspecific focus in the soft tissues in the midline abdomen posteriorly. 2. No additional abnormal focus of activity to indicate an octreotide avid lesion. |
Generate impression based on findings. | 51 year-old female with hyperparathyroidism, evaluate for parathyroid adenoma There is physiologic distribution of the radiopharmaceutical. An abnormal focus of activity inferior to the left lobe of the thyroid consistent with an enlarged parathyroid gland is seen. | Focus of radiotracer activity inferior to the left lobe of the thyroid suspicious for a parathyroid adenoma. |
Generate impression based on findings. | 56-year-old female with right upper lobe cavitary lesion possibly aspergilloma. Please evaluate for possible lung resection. The comparison chest radiograph performed on 1/4/2015 demonstrates multiple right upper lobe cavities and findings consistent with COPD. The ventilation images show multiple areas of decreased ve... | Heterogeneously decreased bilateral ventilation and perfusion as described above. Quantification of relative ventilation and perfusion as above. |
Generate impression based on findings. | 51 year old with a hypoechoic right breast mass presents for ultrasound guided biopsy. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 7 x 3 mm at the 9 o’clock position without increased vascularity, 4 cm from the nipple. The lesion was readily visi... | Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Female, 67 years old. Reason: abdominal pain Air-filled loops of colon, with moderate to large stool burden in the ascending colon. Relative paucity of small bowel gas. No specific evidence of bowel obstruction. Degenerative disease of the symphysis pubis. | Moderate to large stool burden in the ascending colon, correlate clinically for constipation. |
Generate impression based on findings. | Ms. Makarenko is a 31 year old female presenting with bilateral "lumpy breasts" and breast pain. Per patient, she has no focal pain or any discrete mass. Family history of breast cancer in mother. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast paren... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram can be initiated at the age of 40. Clinical exams are recommended prior to that age. For any focal physical exam finding, a targeted ultrasound should be performed. Results and recommendat... |
Generate impression based on findings. | Left neck swelling, jaw pain, status post parathyroidectomy. The images are degraded by patient motion. There are postoperative findings related to parathyroidectomy. The parapharyngeal and retropharyngeal spaces are unremarkable. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy b... | 1. Postoperative findings related to parathyroidectomy without evidence of edema or mass lesions, although assessment is limited by the lack of intravenous contrast and patient motion.2. Degenerative changes in the left temporomandibular joint. |
Generate impression based on findings. | Male, 77 years old. Reason: evaluate for possible G tube by GI History: chronic aspiration, unable to leave floor for nonportable exam Dobbhoff tube with tip overlying the proximal gastric body.Air-filled loops of small and large bowel, less prominent compared to prior exam. No evidence of bowel obstruction. Moderate s... | No evidence of bowel obstruction. |
Generate impression based on findings. | History of dental abscess after tooth 3 extraction and questionable destructive process of right maxilla. Pain in the right V2 distribution. Please note that streak artifact from dental amalgam limits evaluation. There is a defect in the right maxillary alveolar ridge in the expected location of the #3 tooth, likely se... | An osteolytic process involving the right maxillary alveolar ridge likely represents osteomyelitis, although a neoplastic process is a differential consideration. Adjacent soft tissue thickening is present, which is likely inflammatory, although there is no definitive evidence of abscess. I personally reviewed the Imag... |
Generate impression based on findings. | Female, 49 years old. Reason: Assess for obstipation History: 49 y.o. with a history of constipation, endometriosis, now more severe with abdominal discomfort Multiple air-filled loops of small bowel. Evaluation of colon shows moderate to large stool burden. No specific evidence of bowel obstruction. | Moderate to large stool burden, compatible with a history of constipation. No bowel obstruction delineated. |
Generate impression based on findings. | 65-year-old male with abdominal pressure, discomfort. Evaluate for obstruction, history of stricturing at ileocolonic anastomosis. Paucity of gas in the abdomen without evidence of obstruction. Surgical clips are visualized in the lower abdomen and right pelvis. Mild thoracolumbar dextroscoliosis. | No evidence of bowel obstruction. |
Generate impression based on findings. | Pain Four views of the left knee are provided. Mild medial compartment narrowing on the skier's view, along with tiny osteophytes, indicate mild osteoarthritis. Round and tubular opacities in the soft tissues likely represent extensive venous varicosities.Mild osteoarthritis also affects the right knee as seen on the f... | Mild osteoarthritis. |
Generate impression based on findings. | 37 year-old female with pancreatitis and abdominal distention. Nonobstructive bowel gas pattern. Contrast is noted in the small bowel and residual biliary ductal contrast also present, sequela of same day cholangiogram. Right upper quadrant coil embolization material suggested. Interval removal of the right upper quadr... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female, 65 years old. Reason: ng tube Nasogastric tube with distal sideport overlying the gastric body. The lower pelvis is excluded from the field of view. Contrast seen in the colon from recent prior exam. No evidence of bowel obstruction. | Nasogastric tube with distal sideport overlying the gastric body. |
Generate impression based on findings. | Foot pain. Assess alignment. Lateral knee joint pain. Four views of the right foot are provided. Alignment is within normal limits. I see no specific findings to account for the patient's pain. A small density overlying the soft tissues of the second toe may either be artifactual on the patient's skin or conceivably a ... | No specific findings to account for the patient's pain. |
Generate impression based on findings. | 54-year-old male with Dobbhoff tube placement. Nonobstructive bowel gas pattern. The feeding tube tip is in the antrum of the stomach. Bilateral layering pleural effusions are noted. | Feeding tube tip in the antrum of the stomach. |
Generate impression based on findings. | 73-year-old with history of right mastectomy for breast cancer. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalcif... | 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. | Right elbow pain Again seen is a pin and tension wire device affixing a transverse fracture through the olecranon process in near anatomic alignment. I see no hardware complications. There has been progression of sclerosis along the fracture line indicating some interval healing. A small focus of heterotopic ossificati... | Orthopedic fixation of healing olecranon fracture. |
Generate impression based on findings. | cT2N3 base of tongue squamous cell carcinoma, p16 negative, status post CRT. There are post-treatment findings in the neck, include right lymph node dissection and radiation therapy effects. There is no residual significant lymphadenopathy in the neck. There is no measurable mass in the tongue base region. There is a p... | 1. Post-treatment changes in neck without measurable residual tumor in the right tongue base region and no evidence of significant residual lymphadenopathy in the neck.2. Unchanged partially calcified thyroid nodule. |
Generate impression based on findings. | 50 year-old male with point tenderness after fall There is a nondisplaced fracture of the right lateral T8 rib. No pneumothorax is visualized. | Nondisplaced right lateral thoracic rib fracture. |
Generate impression based on findings. | 79 years old, Male, Reason: Please assess for resolution of pelvic abscess History: pelvic abscess ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis without evidence of cholecystitis. There is no biliary dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: No sign... | 1.Near complete resolution of previously drained left pelvic wall abscess.2.Unchanged right pelvic wall loculated fluid collection favored to represent a lymphocele.3.Improvement in anterior abdominal wall fluid collection.4.Diffuse mesenteric haziness and small mesenteric lymph nodes. Although nonspecific, this could ... |
Generate impression based on findings. | Female 55 years old Reason: Evaluation of abdominal and perinephric fluid collection History: None ABDOMEN:LUNG BASES: Unchanged bibasilar atelectasis/scarring. Mild cardiomegaly.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADREN... | 1.Fluid collection anterior and inferior to the transplant kidney decreased in size with, the pigtail catheter unchanged in position.2.Fluid collection seen along the anterior psoas muscle with a soft tissue rim, without significant change in size; however, the soft tissue component appears slightly thicker. |
Generate impression based on findings. | 21-year-old female status post orthotopic liver transplant with portal vein stenosis status post stent and multiple angioplasties. Evaluate portal venous blood flow. LIMITED ABDOMENLIVER: The liver parenchyma is moderately coarsened, unchanged. No intrahepatic biliary dilatation or focal hepatic lesion is evident. It i... | 1. Patent vasculature. The main portal vein peak systolic velocity is slightly elevated but improved from the prior study. 2. Coarse liver parenchyma is compatible with parenchymal dysfunction, unchanged. 3. Splenomegaly. |
Generate impression based on findings. | Reason: ruling out PE History: sob, tachycardia, hypoxia PULMONARY ARTERIES: Technically adequate study without pulmonary embolus.LUNGS AND PLEURA: Previously noted right middle lobe mass now appears more flat and measures 3.7 x 2.4 cm (image 89, series 12) previously 4.5 x 2.4 cm. Scattered pulmonary micronodules, som... | 1.No pulmonary embolism. 2.Prominent mediastinal lymph nodes without significant interval change.3.Right middle lobe mass now appears more flat and may represent post infectious scarring/atelectasis.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV... |
Generate impression based on findings. | Female 11 years old; Constipation and enuresis.VIEW: Abdomen AP (one view) 1/7/15 Moderate amount of rectal stool is present, with a small amount of stool throughout the rest of the colon. The stomach is distended with luminal contents. No pneumatosis, portal venous gas, or pneumoperitoneum is evident. | Moderate amount of rectal stool. |
Generate impression based on findings. | Male 54 years old Reason: Does L iliacus abscess need further drainage? History: elevated WBC count, left pelvic pain, s/p drainage on IV ABX PROSTATE, SEMINAL VESICLES: The prostate is not definitely identified.BLADDER: There are a number of surgical clips around a non-opacified urinary bladder.LYMPH NODES: No signifi... | 1.Abscess in the soft tissues of the left hemipelvis extending into the retroperitoneal cavity via the iliacus muscle, as detailed above. 2.Cortical breakthrough and fracturing of the left iliac bone with possible sinus tract to the pelvic abscess, most consistent with acute on chronic osteomyelitis.3.Sacral decubitus ... |
Generate impression based on findings. | Female, 87 years old. Question of new brain metastases. Requires large volume tap, 4-5 ml within 4 tubes. The procedure, indications, benefits, risks/complications and alternatives were described to the patient and informed consent was obtained. The patient was placed in the prone position and the inferior back was pre... | Successful fluoroscopic guided lumbar puncture. |
Generate impression based on findings. | Female 7 months old Reason: evaluate for intra-abdominal pathology History: s/p liver transplant, abdominal distension, increased JP output ABDOMEN: Note is made that interpretation of the exam is diminished by lack of oral and or IV contrast.LUNG BASES: Bibasilar atelectasis with no effusions.LIVER, BILIARY TRACT: Tra... | Severe limitation in the evaluation of the abdomen and pelvis due to lack of oral and or IV contrast. Within these limitations no evidence of discrete loculated or free fluid collections noted. No evidence of obstruction or free air. |
Generate impression based on findings. | Cystic hygroma right neck. Assess for pathology. There is an infiltrative, largely hypoattenuating lesion involving the right floor of the mouth, sublingual space, submandibular space, pre-epiglottic space, and anterior right neck. Some components of this lesion are mildly hyperattenuating which may reflect proteinaceo... | Infiltrative multi-spatial right neck lesion compatible with patient's history of cystic hygroma which has not significantly changed in size or distribution given long interval since the prior study and differences in positioning and technique. |
Generate impression based on findings. | Brain. Foot injury. Tender to third metatarsal Three views of the left ankle reveal no evidence of ankle fractures. Note is made of the metatarsal fractures.Three views of the left foot reveal nondisplaced fractures of the third and fourth distal metatarsals. Note is made of a hallux valgus deformity with degenerative ... | Nondisplaced fractures of the third and fourth metatarsals. |
Generate impression based on findings. | 66 years old, Female, Reason: patient is screening for a clinical trial, please provide bidimensional measurments per RECIST v1.1 History: endometrial adenocarcinoma CHEST:LUNGS AND PLEURA: Right lower lobe pleural-based nodule measures 5 mm (series 5, image 73). Small scattered nodular groundglass opacities in the lef... | 1.Soft tissue mass in the posterior pelvis with extensive invasion and destruction of the sacrum and ilium.2.Multiple masses within the pelvis, one of which appears to be necrotic, as detailed above.3.Pelvic lymphadenopathy as measured above. 4.Pleural-based nodule in the right lung. Left lower lobe nodular groundglass... |
Generate impression based on findings. | 21-year-old male with history of metastatic osteosarcoma of rib, status post thoracotomies. Evaluate for pulmonary metastases/interval change. LUNGS AND PLEURA: Postsurgical changes/scarring in the left lower lobe are redemonstrated. Scattered bilateral micronodules are stable. No suspicious pulmonary nodules identifie... | Stable scattered bilateral pulmonary micronodules. No specific evidence of metastatic disease. |
Generate impression based on findings. | History of shoulder dislocation Four views of the left shoulder reveal a Hill-Sachs compression fracture from a previous anterior dislocation. This is unchanged from the previous exam of December 12, 2014. In addition there is what appears to small ossicle superimposed over the axillary recess that may represent a loos... | Hill-Sachs deformity. Possible loose body in the axillary recess |
Generate impression based on findings. | Metastatic breast cancer baseline scan before starting chemotherapy. Former smoker, stopped in distant past. CHEST:LUNGS AND PLEURA: Right upper lobe ground glass nodule measures 7 mm (series 5, image 23), unchanged.Numerous pulmonary micronodules ranging from groundglass to sub-solid in density within the upper lung z... | 1. Unchanged appearance of the thorax.2. Stable skeletal metastases.3. Slight increase in size of two of the larger hepatic lesions.4. Chronic wall thickening involving the pylorus unchanged. |
Generate impression based on findings. | Five day old male for assessment of left kidney function The posterior abdominal radionuclide angiogram demonstrates delayed, decreased perfusion of the left kidney and prompt, normal perfusion of the right kidney. Sequential renal images show the left kidney to be enlarged with a large photopenic area in the mid and l... | Abnormal left renal perfusion, function and morphology may represent obstruction. Follow-up renal scan is suggested to assess for interval change in renal function. |
Generate impression based on findings. | Feeding intolerance, anemia.VIEWS: Abdomen AP 1/7/15 (1 view/s) Bilateral coxa valga deformity and partial uncovering of both femoral heads. Disorganized, nonspecific abdominal gas pattern. No evince of obstruction or free air. No fecal impaction. | Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | History of shoulder dislocation Four views of the left shoulder reveal no evidence of any fractures or dislocations. Note is made of a partially fused growth plate. | Negative left shoulder exam. |
Generate impression based on findings. | 40 year-old female with pain Right foot: Again seen is a lucency partially traversing the base of the fifth metatarsal consistent with an incomplete stress fracture, with adjacent sclerosis centrally noted within the bone. A multipartite os peroneum is identified, a normal anatomic variant.Left foot: No fracture, malal... | Findings consistent with healing stress fracture of the base of the right fifth metatarsal, appearing similar to the prior study. |
Generate impression based on findings. | 51 year-old female with right knee pain for 3 months Tiny osteophytes indicate mild osteoarthritis, essentially within normal limits for the patient's age. A 7-mm focal round opacity overlying the lateral aspect of the joint seen on the AP view is not seen on other views and may be artifactual in etiology. Mild osteoar... | Mild osteoarthritis. |
Generate impression based on findings. | Cervical myelopathy. Preop evaluation. The cervicothoracic junction is not well visualized on the lateral view due to overlying anatomy. Mild degenerative disease affects C5/6 and C6/7, with small anterior vertebral body osteophytes also noted at C4. There is loss of the normal cervical lordosis but otherwise alignment... | Degenerative disk disease. |
Generate impression based on findings. | Restaging. Base of tongue squamous cell carcinoma,. There is a soft tissue mass at the base of tongue with exophytic component extending posteriorly on the right. There is some extension to the left of the midline. Mass measures approximately 3 cm in the transverse dimension (although transverse dimensions are not well... | 1. 2.1 x 3.0 x 2.8 cm (APxtrvxcraniocaudal) mass centered at the right base of tongue consistent with known neoplasm. There is effacement of the bilateral vallecula and mass effect on the epiglottis without clear evidence of epiglottic invasion. Please note the lateral margins/transverse dimension are not well defined ... |
Generate impression based on findings. | CMV positive, SGA. Question of sequelae of CMV. There is no evidence of acute intracranial hemorrhage. The grey-white matter differentiation appears to be intact with the white matter is appropriately immature. There are no definite areas of tissue loss. There is no periventricular or intraparenchymal calcification. Th... | No acute intracranial abnormality, hemorrhage, or calcification. |
Generate impression based on findings. | 38-year-old male with history of head and neck cancer (base of tongue), restaging for start of treatment. CHEST:LUNGS AND PLEURA: No pleural effusion, no consolidation and no suspicious nodules or masses.MEDIASTINUM AND HILA: Heart size within normal limits, and no pericardial effusion. No appreciable coronary artery c... | No significant abnormality, and no evidence of metastatic disease. |
Generate impression based on findings. | Male, 78 years old. Reason: new dht Dobbhoff tube with tip just below the gastroesophageal junction.Air-filled loops of small and large bowel, with moderate to large stool burden seen in the ascending colon and rectum.Decreased osseous mineralization. Degenerative disease of the spine. | Dobbhoff tube with tip just below the gastroesophageal junction, recommend advancing tube approximately 8 cm. |
Generate impression based on findings. | Male 9 years old; Reason: r/o abscess or other upper tract infection History: 9 y/o M with h/o ALL in remission w/ UTI BLADDER Wall Thickness: Normal Contents: Non-distended Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal M... | Mildly large kidneys, without focal lesions or perirenal collections.*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 paren... |
Generate impression based on findings. | Male, 39 years old. Reason: evaluating for stricture/ partial obstruction/constipation History: abdominal pain, epigastric and midabdominal, waxing/waning No evidence of bowel obstruction. Small to moderate stool burden in the ascending colon and rectum. | No evidence of obstruction. Small to moderate stool burden. |
Generate impression based on findings. | 36 year old female, infertility Scout AP film of the pelvis was normal. Opacification of the uterine cavity revealed a normally oriented uterine cavity without mucosal irregularity or filling defect in the uterine cavity, a previously visualized filling defect in the right uterine cavity is not seen on this exam.The le... | 1. Findings compatible with left fallopian tube patency. No peritoneal spillage of contrast delineated on the right side, concerning for right tubal occlusion. 2. Normal morphology of the uterine cavity. A previously visualized filling defect in the right uterine cavity is not seen on this exam. |
Generate impression based on findings. | 44-year-old male with history of persistent asthma. Evaluate for ABPA. LUNGS AND PLEURA: Linear opacities the underlying are most consistent with subsegmental atelectasis, although a component of scarring is possible.No bronchiectasis, no masses and no pleural effusion.MEDIASTINUM AND HILA: Heart size within normal lim... | Dependent atelectasis/scarring, without characteristics of ABPA. |
Generate impression based on findings. | 85 year-old female with history of fall. There is a lobulated hyperdensity in the right parietal scalp, presumably a subgaleal hematoma. No underlying skull fracture. There is no evidence of acute intracranial hemorrhage. There is mild periventricular and subcortical white matter hypoattenuation compatible with chronic... | 1. No evidence of acute intracranial hemorrhage. Hyperdensity in the right parietal scalp presumably a rounded hematoma; correlate with direct examination.2. Interval removal of left intraocular lens with new soft tissue nodule in the posterior aspect of the globe medially. Unclear if this is postsurgical material; cor... |
Generate impression based on findings. | 67-year-old female with a history of DVT and right ventricular dysfunction. Evaluate for venous thromboembolism. The comparison chest radiograph performed on 1/7/2015 demonstrates small bilateral persistent pleural effusions with borderline enlarged cardiac silhouette. The ventilation images show decreased ventilation ... | Low probability for pulmonary embolism. |
Generate impression based on findings. | Trauma. Follow-up fracture. Four views of the left shoulder reveal no acute fractures or dislocations. Note again is made of a comminuted fracture of the distal clavicle that has not changed from the previous. | Comminuted fracture distal clavicle unchanged |
Generate impression based on findings. | Ms. Hargrave is a 60 year old female with a personal history of benign right surgical excisional biopsy in 2010. Per patient, she has not had a mammogram since the biopsy in 2010. She was recalled from screening mammogram for an abnormal finding in the right breast. An ML view and two spot compression views of the righ... | Area of distortion on mammography along with vague shadowing on US are seen directly underneath the visible scar from prior benign excisional surgery. These findings are presumably all post-surgical in etiology. However, given the lack of other years mammograms since surgery to compare with, a short-term follow-up exam... |
Generate impression based on findings. | PICC placement. Gunshot wound. Lower extremity ulcers.VIEW: Chest AP (one view) 1/7/15, 1551 Left upper extremity PICC tip is in right atrium.Projectile fragments are again seen in the upper chest. Spinal fusion instrumentation remains in place.Cardiothymic silhouette is normal. No focal lung opacity is present. | PICC tip in right atrium. |
Generate impression based on findings. | Evaluate for TMJ dislocation versus pharyngeal abscess due to right facial pain and trismus. There is a lytic lesion in the right mandibular condyles, without evidence of pathologic fracture or temporomandibular joint dislocation. There is also a lytic lesion involving in the right petrous apex and clivus with dehiscen... | 1. A lytic lesion in the right mandibular condyles, without evidence of pathologic fracture is compatible with sarcoidosis, although other etiologies are not excluded. 2. Additional lytic lesions in the skull base are also compatible with sarcoidosis, although other etiologies are not excluded.3. Multiple enlarged cerv... |
Generate impression based on findings. | 58-year-old with left breast calcifications for which magnification views were requested. An ML view and two spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 54 year-old woman with history of pain, evaluate bunion formation. Right foot: There is a moderate hallux valgus deformity, progressed from the prior study. Mild osteoarthritis affects the first metatarsophalangeal joint. Also, there is mild pes planus deformity with small midfoot osteophytes appearing similar to the p... | Slight progression of hallux valgus deformities and arthritic changes as described above. |
Generate impression based on findings. | 56-year-old male status post right knee revision Status post revision of right total knee arthroplasty with long tibial and femoral stems in near-anatomic alignment. The proximal aspect of the femoral stem is not visualized. Drain and gas in the soft tissues reflects recent surgery. | TKA revision, as above. |
Generate impression based on findings. | 56-year-old female with pain Alignment is anatomic. There is a small plantar spur, but no fracture or other specific findings to account for the patient's pain. | Small plantar spur without other specific findings to account for the patient's pain. |
Generate impression based on findings. | 80 year-old female with left distal fibular fracture, assess medial joint space There is a spiral fracture of the distal fibula extending to the articular surface. Mild widening of the medial tibiotalar joint is also noted. Diffuse soft tissue swelling about the ankle. | Distal fibular fracture and medial tibiotalar joint space widening (SER type 4). |
Generate impression based on findings. | 38-year-old male with cancer of the base of the tongue. Evaluate for staging.RADIOPHARMACEUTICAL: 12.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 94 mg/dL. Today's CT portion of the pelvis grossly demonstrates no significant abnormality. A right inferior T11 vertebral body sclerotic focus is visualized ... | 1.FDG-avid lesion in the base of tongue consistent with known neoplasm with associated hypermetabolic right level 2 lesion compatible with nodal metastasis.2. No abnormal FDG-avid lesion in the chest, abdomen, or pelvis.Diagnostic CTs of the head and neck and chest/abdomen also performed at today's visit will be report... |
Generate impression based on findings. | 30 year-old female with knee pain for 4 years Alignment is anatomic. There is no fracture or other finding to explain the patient's symptoms. | Unremarkable knee without findings to explain the patient's symptoms. |
Generate impression based on findings. | 80 year-old female with distal fibular fracture There is increased medial joint space widening of 9 mm compared with 5 mm on the nonstress view. The spiral distal fibular fracture is also again visualized with mild lateral displacement of the distal fragment. There is soft tissue swelling about the ankle. | Increased medial joint space widening indicating deltoid ligament injury. |
Generate impression based on findings. | 61-year-old male with pancreatic cancer, treated with chemotherapy, SBRT and now with liver metastasesRADIOPHARMACEUTICAL: 13.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 99 mg/dL. Today's CT portion grossly demonstrates low attenuated lesions in the right lobe of the liver, pneumobilia, gastric stent, ... | 1.Multiple liver metastases with extension and probable involvement of the perihepatic peritoneum.2.Pancreatic lesion with increased activity in the distal pancreatic body suspicious for tumor.3.Several foci of increased activity in the peripancreatic region may represent regional lymph node metastases.4.Hypermetabolic... |
Generate impression based on findings. | 89-year-old female with history of fall. Evaluate for intracranial hemorrhage. There is no evidence of intracranial hemorrhage. There is hypoattenuation involving the periventricular white matter adjacent to the left frontal horn extending into the anterior limb of the internal capsule on the left, compatible with chro... | 1. No evidence of acute intracranial hemorrhage. 2. Chronic infarct in the left frontal lobe.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Ms. Rodgers is a 39 year old female presenting with bilateral self detected lumps. She denies any history of trauma, fever/chills, or focal pain. Three standard views of both breasts along with seven spot compression views (two left, five right) were performed digitally and reviewed with the aid of R2 CAD 9.3. The brea... | 1.No mammographic or sonographic abnormality to correlate with patient's bilateral palpable areas of concern. These areas should be followed up clinically.2.Two adjacent circumscribed ovoid masses in the right central breast with no discrete sonographic correlate. Given the benign appearance on the mammogram, a short t... |
Generate impression based on findings. | 88 years old, Male, Reason: hx of metatstatic colon ca on chemo- evaluate response to tx. History: none CHEST:LUNGS AND PLEURA: Changes of chronic lung disease. Trace bilateral pleural effusions right greater left.MEDIASTINUM AND HILA: The heart is enlarged. Coronary calcifications are present. Right chest wall port wi... | Decrease in size of hepatic metastases, lymphadenopathy, and previously noted mesenteric mass. |
Generate impression based on findings. | Male 70 years old Reason: right sided hydronephrosis seen on US, r/o stone or reason for obstruction History: AKI ABDOMEN:LUNG BASES: Pleural nodularity and calcifications again seen, likely related to prior asbestos exposure.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality noted... | 1.4-mm obstructing right ureteral stone with associated mild/moderate hydronephrosis. Additional 3-mm ureteral stone seen just proximal to the vesicoureteral junction.2.Nonspecific foci of gas within the aortobifemoral bypass graft with haziness of the surrounding mesentry, worrisome for an infected graft or possible e... |
Generate impression based on findings. | 74 year-old woman with history of humeral fracture, evaluate for dislocation. A single Velpeau view of the shoulder was obtained. A surgical neck fracture of the humerus is not well seen on this study. Glenohumeral alignment is within normal limits. | Glenohumeral alignment is within normal limits. Surgical neck fracture of the humerus not well seen on this study. |
Generate impression based on findings. | Neck swelling. There is diffuse enlargement and hyperenhancement of the left parotid gland with surrounding fat stranding. There is no evidence of radioattenuating calculi or ductal dilatation. The other salivary glands are unremarkable. There are mildly prominent cervical lymph nodes, particularly in the left suprahyo... | Diffuse enlargement and hyperenhancement of the left parotid gland with surrounding fat stranding is compatible with parotitis, without evidence of abscess. |
Generate impression based on findings. | Female 10 years old Reason: r/o fracture History: pain in right ankle, has been playing sportsVIEWS: Right ankle AP, lateral and oblique 1/7/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Female 50 years old Reason: history of gestational trophoblastic disease now for follow up CT aftter chemo History: cough CHEST:LUNGS AND PLEURA: Interval decrease in size of the pulmonary metastases. The reference right middle lobe index lesion now measures 3 mm (image 35, series 4), previously 8 mm. Additional non-in... | Treatment response: Decrease in size of the pulmonary metastases as well in the uterus with resolution of the previously seen enhancing intraparenchymal foci. |
Generate impression based on findings. | 23-year-old female with a history of AML. Evaluate GFR for pre-transplant evaluation. The patient’s weight of 67.1 kg and height of 162.5 cm were used for all calculations.Raw GFR = 89 mL/minBSA = 1.77 m2Estimated GFR/m2 = 51 mL/min/m2Estimated GFR/m2 * 1.73 m2 (average adult BSA) = 88 mL/min (adult GFR equivalent) | GFR measurements as above. |
Generate impression based on findings. | 67 years old female with a history of vaginal bleeding and rectal cancer with rectovaginal fistula. To assess for extent of primary disease, lymphadenopathy and metastases. Recent CT demonstrates questionable left inguinal lymphadenopathy and right middle lobe lung nodule. RADIOPHARMACEUTICAL: 8.7 mCi F-18 fluorodeoxyg... | 1.No evidence of FDG avid tumor.2.Extensive coronary artery calcifications which may suggest clinically significant coronary artery disease. |
Generate impression based on findings. | 10-year-old female with neuroblastoma now with left hip pain Normal physiologic radiotracer distribution is seen in the salivary glands, myocardium, liver, bowel and bladder. There is an abnormal focus of activity along the left paraspinal region that appears decreased in intensity when compared to the prior exam. No n... | Radiotracer uptake along the left paraspinal region is decreased in intensity when compared to the prior exam. No findings to account for the patient's left hip pain. |
Generate impression based on findings. | 86-year-old female with shortness of breath, evaluate for pulmonary embolus The comparison chest radiograph performed on 1/7/2015 demonstrates mild CHF.The ventilation images show small, nonsegmental decreased ventilation in the left lower lobe on single breath images with uniform distribution of activity on wash-in im... | No evidence of pulmonary embolism. |
Generate impression based on findings. | A patient submitted the following outside studies for review.1. Bilateral digital diagnostic mammogram 12/23/20142. Right breast ultrasound 12/23/2014 Submitted studies for review were performed at St. Anthony Hospital in Chicago IL. BILATERAL DIGITAL DIAGNOSTIC MAMMOGRAM (12/23/2014): Two standard views of both breast... | 1. Two 4 cm right breast masses with associated trabecular edema, skin thickening and axillary lymphadenopathy. The findings are highly suspicious for inflammatory breast cancer. Surgical consultation is recommended. If not already performed, tissue sampling of the right breast masses and abnormal right axillary lymph ... |
Generate impression based on findings. | Male, 50 years old. Reason: r/o retained products History: ingestion of bag of drugs Air filled loops of small bowel and colon, with moderate stool burden in the descending colon. No specific evidence of obstruction. No evidence of radiopaque foreign object within the abdomen to indicate a retained bag of drugs. | No evidence of radiopaque foreign object within the abdomen to indicate a retained bag of drugs. |
Generate impression based on findings. | Female, 68 years old. Reason: Assess stool burden History: see above Exam limited by patient body habitus. Nonobstructive bowel gas pattern. Moderate stool burden. | Moderate stool burden. |
Generate impression based on findings. | 67 years old, Female, Reason: abd pain c/f mesenteric ischemia History: abd pain Angiogram: No evidence of aortic aneurysm, dissection or other aortic pathology. There is focal narrowing at the portion of the celiac artery measuring approximately 3 mm (series 9, image 49). There is complete opacification of the branche... | 1.Atherosclerotic disease as detailed above. Complete opacification of the celiac axis, SMA, and IMA. 2.No evidence of bowel ischemia as clinically questioned. |
Generate impression based on findings. | Male 64 years old Reason: aortic arch and carotid pseudoaneurysm on MRA, p/w strokes History: aortic arch and carotid pseudoaneurysm on MRA, p/w strokes ANGIOGRAM: Small broad-based focal outpouching at the level of the aortic arch projecting inferolaterally (image 46, series 9) consistent with an ulcerated mural plaqu... | 1.Ulcerated mural plaque affecting the aortic arch without evidence of aortic dissection or aneurysmal dilatation.2.Lack of opacification of the infrarenal aorta is incompletely is worrisome for complete aortic occlusion; however, this fails reflect bolus timing. Full evaluation with abdomen and pelvis CTA can be consi... |
Generate impression based on findings. | Female, 99 years old. Reason: Dobbhoff History: Dobbhoff Dobbhoff tube with tip overlying the gastric body.Nonobstructive bowel gas pattern.Bilateral pleural effusions. Cardiomegaly. Degenerative disease of the spine and left hip. Partially visualized right hip prosthesis.Multifocal airspace opacity grossly unchanged c... | Dobbhoff tube tip overlying the gastric body. |
Generate impression based on findings. | Female, 24 years old. Reason: evaluate for degree of stool burden and gastric distension History: chronic, refractory nausea and vomiting, LLQ abdominal pain Nonobstructive bowel gas pattern. Moderate stool burden.Surgical clips in the right upper quadrant. Post-surgical material overlying the right lower quadrant. | Moderate stool burden. |
Generate impression based on findings. | Female, 44 years old. Reason: Evaluation of small bowel obstruction History: Small bowel obstruction Nasogastric tube coiled within the stomach, with distal side port below the level of the GE junction.Dilated small bowel loops seen centrally, compatible with small bowel obstruction as seen on recent CT exam. Enteric c... | Findings compatible with small bowel obstruction as seen on recent CT exam. |
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