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Generate impression based on findings. | Female 58 years old Reason: hx of bladder cancer s/p cystectomy, evaluate for metastatic disease with delayed imaging History: see above ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality ... | No CT evidence of metastatic disease. |
Generate impression based on findings. | Female 64 years old Reason: 64yo female with stage 1 vaginal cancer s/p ex-lap and LOA for SBO on 1/21, with bowel perforation and enterocutnaeous fistula on 2/4, s/p IR drains 2/5, for re-evaluation of abdomina fluid collections History: abdominal incision wound drainage, abdominal pain ABDOMEN:LUNG BASES: Bilateral s... | Stable or minimally decreased intra-abdominal fluid collections. There is a small midline collection which made communicating with the small bowel loops. Clinical correlation is recommended. |
Generate impression based on findings. | Male 70 years old Reason: Evaluate for progression of disease; triple scan liver to evaluate metastatic disease; compare to previous scan History: none CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Small mediastinal lymph nodes are unchanged.CHEST WALL: No significant abnormality notedAB... | Suboptimal study to evaluate the liver. Left lobe of the liver appears more heterogeneous on today's study suggestive of new focal liver lesions. MRI of the liver is recommended for further evaluation. |
Generate impression based on findings. | The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormaliti... | Negative noncontrast brain MRI. Specifically, there are no MRI findings to explain the patient's staring spells. |
Generate impression based on findings. | Reason: Evaluate for progression of metastatic disease; compare to previous scan History: none LUNGS AND PLEURA: Minimal dependent edema or atelectasis.MEDIASTINUM AND HILA: Right chest port tip at RA/SVC junction. Severe coronary calcification.CHEST WALL: Severe degenerative change involving the thoracic spine. | No evidence of pulmonary metastases. |
Generate impression based on findings. | Female 55 years old Reason: Crohn's disease with surgery for previous enterovesical and enterorectal fistula in 2006. ? recurrence of fistula History: Abdominal pain and previous CT with collection ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hepatomegaly. Liver measures 21 cm in vertical d... | Short segment mild wall thickening of the ileocolonic anastomosis which may indicate mild active inflammation at the level of the anastomosis. |
Generate impression based on findings. | Female 70 years old Reason: severe abdominal pain, known ho adhesions, CT w/ evidence partial SBO- want to know extent History: abd pain.Additional history from CT report: History provided indicated "colectomy". Transit time to the terminal ileum was no more than one hour and 45 minutes contrast at which time contrast ... | Multiple prominent loops of distal small bowel as identified on recent CT however contrast passed to the rectum with transit time within normal limits. No evidence of adhesions.Fluoroscopy time: Three minutes and 13 seconds. |
Generate impression based on findings. | Bilateral knee pain Bilateral near severe tricompartmental osteoarthritis mildly greater on the right with near bone-on-bone narrowing. No definite effusions, however small fluid collections cannot be excluded. Mild atherosclerotic changes. | Near severe osteoarthritic changes of both knees, greater on the right |
Generate impression based on findings. | Total hip arthroplasty follow-up Hip: Interval removal of surgical drain. The right total hip arthroplasty remains otherwise unchanged without evidence of new complication. Alignment preserved. Small focal bone chip fracture or possibly heterotopic bone adjacent to the superior acetabulum is unchanged and fixed.Pelvis:... | Unchanged and uncomplicated right total hip arthroplasty |
Generate impression based on findings. | Male 62 years old Reason: 62 Yrs old man with a history of lymphoplasmacytic lymphoma transformed to DLBCL s/p R-CHOP x6 with near CR, who recently suffered loss of L-sided vision and was found to have leptomeningeal disease treated with MTR x4 History: NHL CHEST:LUNGS AND PLEURA: Emphysema. Bronchiectasis at the lung ... | No evidence of enlarged lymph nodes.Bronchiectasis in the bilateral lower lobes, more prominent on the left side and emphysema. |
Generate impression based on findings. | Cast revision Detail obscured by overlying splint material. Gross anatomic alignment with mild volar angulation remains observed involving the fifth metacarpal neck fracture. | Mild persistent volar angulation involving the fifth metacarpal fracture |
Generate impression based on findings. | Male 82 years old Reason: diverticulitis vs. appendicitis History: lower abdominal pain, ABDOMEN:LUNG BASES: Bilateral pleural effusions and atelectasis, new from previous study.LIVER, BILIARY TRACT: Stable hepatic cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: N... | Interval development of bilateral pleural effusions and small amount of ascites.Diffuse wall thickening of a long segment of sigmoid colon suspicious for colitis. |
Generate impression based on findings. | Ankle fracture.VIEWS: Right ankle AP/lateral/oblique (3 views) 02/23/15 Two screws remain in place in the tibial epiphysis. Alignment is anatomic. The fracture has healed. | Postoperative changes. |
Generate impression based on findings. | Lumbago Mild scoliosis without evidence of discrete superimposed focal lumbar abnormality. Specifically lumbar bodies, disk spaces and alignment are preserved. SI joints are intact. Questionable minimal degenerative changes with facet sclerosis involving the lower levels | Questionable minimal osteoarthritic changes of the lower lumbar levels without associated additional focal abnormality |
Generate impression based on findings. | Cannot bear weight. Check for fracture. Pain and swelling Minimal diffuse soft tissue swelling without underlying osseous abnormality. Specifically no acute fractures or malalignment. Os trigone observed, a normal variant | Minimal soft tissue swelling without acute abnormality |
Generate impression based on findings. | Hypodensity is present within the white matter without associated mass effect. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections ... | Small vessel ischemic disease of indeterminate ages. If there is continued clinical concern for acute ischemia, MRI would be recommended. |
Generate impression based on findings. | Cervical stenosis. Planning cervical fusion. Pain Anterior fixation of C5-6 is observed with associated fusion at this level. Alignment otherwise preserved. No evidence of instability with only minimal degenerative changes observed proximally. Lower cervical spine is also less well visualized due to overlapping structu... | Fusion of C5-6 with anterior fixation |
Generate impression based on findings. | Female 63 years old Reason: +FOB, incomplete initial colonoscopy due to stricture; chronic inactive Hep B with viral load <100 History: source of positive stool for occult blood; colonoscopy done 4/7, unable to advance colonoscope past hepatic flexure due to resistance; incomplete colonoscopy. Hx Hep B, viral load <100... | Marked tortuosity and redundancy of the colon with scattered small ascending colon diverticulae. No significant sized polyps seen.Fluoroscopy time: Six minutes and 12 seconds. |
Generate impression based on findings. | Male 86 years old; Reason: 86 M with HCC s/p TACE, please evaluate for response to TACE. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: On noncontrast portion of the exam, amorphous radiodensity seen in right hepatic lobe, within patient's dominant hepatic segment 7/6 mass. Again seen are m... | 1. Multifocal hepatocellular carcinoma with posttreatment sequela as above. 2. Endovascular aortic repair with type II endoleak. |
Generate impression based on findings. | Female 81 years old Reason: eval esophageal motility History: reflux Scout radiograph of the chest showed no mediastinal widening, or pleural effusions. Stable appearance of a 2.2-cm well-defined right upper lobe opacity.Double contrast evaluation of the esophagus and gastric cardia/fundus revealed no morphologic abnor... | 1. Mild esophageal motility disorder. 2. Small hiatal hernia with mild gastroesophageal reflux demonstrated. |
Generate impression based on findings. | 36 year old with newly diagnosed right breast cancer presents for bilateral mammogram. Three standard views of both breasts and bilateral spot views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Biopsy proven cancer in t... | Biopsy proven malignancy in the right breast and biopsy proven metastatic right axillary lymph node. No additional suspicious mammographic or sonographic findings. The patient is seeing Dr. Jaskowiak today. Breast MRI is suggested based on her breast density and young age at cancer diagnosis. BIRADS: 6 - Known cancer.R... |
Generate impression based on findings. | Pain, follow-up questionable tibial plateau fracture No acute or subacute fracture abnormality observed in follow-up imaging. No effusion. Alignment preserved. Minimal degenerative changes similar to prior studies | Minimal osteoarthritis without additional new acute or subacute fractures |
Generate impression based on findings. | HTN and cognitive impairment with memory loss. There is no evidence of acute intracranial hemorrhage or mass. The ventricles are normal in size and configuration. There are right vertebral artery calcifications. There is no midline shift or herniation. The mastoid air cells are clear. There is minimal mucosal thickenin... | No evidence of acute intracranial hemorrhage or mass. |
Generate impression based on findings. | Bilateral severe-profound hearing loss. Left: There is marked stenosis of the cochlear aperture, which measures less than 1 mm in width. The internal auditory canal is otherwise not particularly narrow, measuring approximately 4 mm in diameter. There is focal paucity of bone overlying the superior semicircular canal. T... | 1. Bilateral severe cochlear aperture stenosis is compatible with cochlear nerve deficiency. Please refer to the separate MRI for additional details.2. Suggestion of focal left superior semicircular canal dehiscence.3. Bilateral nonspecific otomastoid opacification.4. Scattered paranasal sinus opacification. |
Generate impression based on findings. | Swelling and pain There is an oblique fracture of the distal fibula extending to the level of the tibiotalar joint, with ~2 mm of lateral displacement of the distal fracture fragment. There is also a transverse fracture through the medial malleolus with fracture fragments in near anatomic alignment. A small linear dens... | Distal fibular and tibial fractures. |
Generate impression based on findings. | Status post hardware removal and replacement. Evaluate bone fusion to lumbar spine, evaluate sagittal balance. Surveillance imaging. The previously seen posterior lumbosacral fixation device has been removed and replaced with new posterior rods and screws that enter the L2 through S1 vertebrae, with additional screws e... | Postoperative changes of lumbosacral fusion as described above; sagittal balance is within normal limits. |
Generate impression based on findings. | Reason: Assess for SVC syndrome or proximal clot History: RUE swelling LUNGS AND PLEURA: Mild left lower lobe atelectasis with a small pleural effusion. Stable scattered calcified and noncalcified micronodules,unchanged. Chronic atelectasis of the anterior segment of the right upper lobe; the aerated segment of the bro... | Right brachiocephalic vein and SVC are widely patent. Central aspect of left brachiocephalic vein is widely patent though there there is severe chronic narrowing at the left jugular/subclavian vein confluence possibly secondary to previous central venous catheters, not significantly changed from multiple previous. |
Generate impression based on findings. | 33 years, Female, Reason: kidney stones? History: urethral pain. RIGHT KIDNEY: The right kidney measures 11.7 cm in length. Mild right sided hydronephrosis. No definite stone.LEFT KIDNEY: The left kidney measures 11.9 cm in length. No evidence of hydronephrosis or hydroureter. There is a nonobstructing stone in the lef... | 1.Mild right-sided hydronephrosis and stone within the bladder, which may be recently passed. However mild hydronephrosis may be seen at this stage in pregnancy.2.Nonobstructing stone in the left lower pole there |
Generate impression based on findings. | Female 61 years old; Reason: LUQ abdominal pain History: as above ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URET... | 1.No definite CT findings to account for patient's left upper quadrant pain.2.Fibroid uterus. |
Generate impression based on findings. | Prostate cancer and rising PSA. Please compare to previous exam. No abnormal osseous foci are identified to indicate metastatic disease.Foci of increased uptake are noted in the cervical spine, acromioclavicular joints, and lower lumbar spine, which is similar to the prior examination and likely represents degenerative... | No evidence of bone metastases. |
Generate impression based on findings. | Female; 58 years old. Reason: follow up lung cancer. CHEST:LUNGS AND PLEURA: Postoperative changes again noted in the right upper lobe. Soft tissue thickening around the suture line is stable and likely reflects scarring. Moderate upper lobe predominant centrilobular emphysema. No suspicious pulmonary nodules or masses... | Postoperative changes and likely scarring in the right upper lobe without suspicious pulmonary nodules or evidence of metastatic disease. |
Generate impression based on findings. | 65 year old woman with history of metastatic carcinosarcoma of the uterus, s/p debulking, evaluate for metastatic disease. CHEST:LUNGS AND PLEURA: Scattered nonspecific calcified and uncalcified pulmonary micronodules, not significantly changed. No new suspicious nodules or masses. Multiple thin-walled pneumatoceles ap... | 1.Post surgical changes of interval hysterectomy.2.Widespread metastatic disease in the abdomen and pelvis increased from prior including hepatic capsular implants, peritoneal implants, pelvic soft tissue nodules and pelvic lymphadenopathy. |
Generate impression based on findings. | 57-year-old female with metastatic breast cancer post 8 cycles of Taxol. Restaging. CHEST:LUNGS AND PLEURA: Previously noted subpleural nodules in the right middle and right lower lobe are no longer identified. There is minimal scarring in the location of prior nodules. There is mild and somewhat linear pleural thicken... | Resolution of previously noted subpleural lung nodules.Mild, focal pleural thickening right lung base.Severe pancreatic atrophy with findings of chronic pancreatitis. There is likely a separate cystic lesion in pancreatic tail. If further clinical information is needed, M.R.C.P. may be helpful.Calcified uterine fibroid... |
Generate impression based on findings. | 59 years, Male. Reason: Dobbhoff and OG tube placement History: Dobbhoff and OG tube placement Motion degrades the study. Multiple chest tubes, drains, surgical staples and clips are noted. OG tube is noted with tip projecting over the gastric antrum. Dobbhoff tube is looped with tip projecting over the fundus although... | Limited examination due to motion. OG tube projects over over the gastric antrum. Dobbhoff tube projects over the gastric fundus although tip is not clearly visualized. |
Generate impression based on findings. | Male 80 years old Reason: s/p IM rod left proximal femur pathologic fx History: above An intramedullary rod and screw device is again seen affixing a femoral neck fracture in near-anatomic alignment. The fracture remains visible, although portions are slightly less distinct on the current study than on the prior study ... | Orthopedic fixation of proximal femoral fracture with proximal screw retraction and distal screw fracture as described above. |
Generate impression based on findings. | There is encephalomalacia and gliosis within the left MCA territory distribution associated with ex vacuo dilatation of the adjacent left lateral ventricle, evidence for evolving old left MCA infarct. Elsewhere there is confluent hypodense abnormality throughout the white matter without associated mass effect. Inciden... | 1.Evolving old left MCA infarct.2.Advanced small vessel ischemic disease of indeterminate ages. If there is continued clinical concern for acute ischemia, MRI would be recommended.3.Incidental note is made of a focal osseous structure along endosteum of the left frontal bone which most likely reflects a small meningiom... |
Generate impression based on findings. | History of breast cancer with metastatic disease in supraclavicular node. Evaluate extent of disease. No abnormal osseous foci are identified to indicate metastatic disease.There are foci of increased uptake within the right lateral 6th and 7th ribs, which correspond to healing fractures on a recent CT. Additional foci... | No evidence of bone metastases. |
Generate impression based on findings. | Reason: LUL nodule. Navigation protocol please History: dyspnea LUNGS AND PLEURA: A spiculated left upper lobe nodule measures 1.3 x 1.3 cm (series 6, image 61), slightly increased from the prior CT exam dated 11/2014, and hypermetabolic on recent PET imaging. Adjacent scarring and an adjacent additional punctate solid... | Left upper lobe 1.3 cm nodule is highly suspicious for malignancy, including primary lung neoplasm vs metastasis. |
Generate impression based on findings. | Female 30 years old Reason: eval LT wrist IN CAST History: pain. Evaluation of fine bone detail is limited by overlying cast. Again seen is a transverse fracture of the distal radius with fracture fragments in near anatomic alignment. The fracture line remains visible, but there is callus formation dorsally suggesting ... | Healing distal radius fracture as above. |
Generate impression based on findings. | Female 30 years old Reason: eval fracture History: pain. Three views of the right wrist show a comminuted intra-articular fracture of the distal radius with fracture fragments in near anatomic alignment. | Comminuted intra-articular fracture of the distal radius with fracture fragments in near-anatomic alignment. |
Generate impression based on findings. | Reason: hypoxemia, dyspnea History: hypoxemia, dyspnea LUNGS AND PLEURA: Punctate micronodule in right upper lobe is stable and consistent with a postinflammatory nodule (image 49/92)MEDIASTINUM AND HILA: Right chest port at RA/SVC junction. Scattered small nodes are unchanged.CHEST WALL: Spinal stimulation device. Sma... | No acute cardiopulmonary abnormality. |
Generate impression based on findings. | Male 81 years old; Reason: 81 y/o M with marginal zone lymphoma in the setting of active mycobacterial infection. please evaluate for progression. CHEST:LUNGS AND PLEURA: Trace left pleural effusion. Again seen is left upper lobe consolidation, area measures approximately 8.8 x 5.4 cm. Multiple cystic areas seen within... | 1. Stable left upper lobe consolidation, right lower lobe cavitary lesion and trace left pleural effusion. Multiple cystic areas seen within left upper lobe consolidation, likely due in part to air bronchograms but appearance worrisome for superimposed infection/underlying pulmonary parenchymal necrosis. 2. Mildly prom... |
Generate impression based on findings. | Female; 54 years old. Reason: met breast cancer History: on anastrazole CHEST:LUNGS AND PLEURA: Moderate dependent scarring and scattered subpleural and parenchymal cysts. No pleural effusions or focal areas of consolidation. No suspicious pulmonary nodules or masses. Punctate left upper lobe granuloma.MEDIASTINUM AND ... | 1.Partially visualized expansile soft tissue mass involving the L5 vertebral body and sclerotic lesion in the T3 vertebral body are compatible with osseous metastases. Please see prior bone scan and today's bone scan reports for additional details.2.Postsurgical changes as described above without evidence of new metast... |
Generate impression based on findings. | History of metastatic breast cancer on treatment. There is faint increased uptake in the left acetabulum appearing similar in size and intensity as the prior examination. No new areas of abnormal uptake are identified. | Stable left acetabular osseous lesion which in combination with a prior CT remains suspicious for metastatic disease. |
Generate impression based on findings. | ConstipationVIEW: Abdomen AP Minimal amount of fecal burden without evidence of obstruction. No abnormal bowel dilation. No pneumatosis or pneumoperitoneum. | Minimal amount of fecal burden without evidence of obstruction. |
Generate impression based on findings. | Ms. Gerling is a 48 year old female with history of bilateral benign calcifications. Personal history of cervical cancer diagnosed at the age of 28. Family history of breast cancer in mother. Three standard views of both breasts, a right laterally exaggerated CC view, and two spot compression views of the right breast ... | Bilateral benign calcifications. 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: 79 F w/ apical nodule, please assess for growth LUNGS AND PLEURA: A left apical pleural nodular thickening is stable from the prior exam dated 11/2014. This is difficult to accurately measure on axial imaging, measuring approximately 28 x 19 mm (series 4, image 8). On coronal images it measures 17 x 9 mm (coron... | Stable appearance of a left apical pleural-based nodular opacity. Recommend continued followup imaging in 6 months to 1 year. No other acute abnormality. |
Generate impression based on findings. | Reason: bleed/abnormality History: right sided ha and pressure post mvc yesterday There is a 59 x 54 mm sagittal dimension CSF density lesion in the posterior fossa associated with adjacent bone remodeling. The cerebellum is displaced anteriorly.No abnormal mass lesions are appreciated intracranially. No intracranial h... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.A large cystic lesion in the posterior fossa with associated displacement of the cerebellum and bone remodeling most likely represents a large arachnoid cyst. This can be confirmed with MRI if clinically appropriate. |
Generate impression based on findings. | 49 year old male with dysphagia. Reports food gets stuck in the throat. Scout radiograph of the chest showed no mediastinal widening, abnormal pulmonary opacities, or pleural effusions.Double contrast evaluation of the esophagus and gastric cardia/fundus revealed a moderate hiatal hernia measuring up to 3.3 cm and a Sc... | 1.Schatzki's ring obstructive to a barium pill. 2.Moderate hiatal hernia. 3.New grade 1-2 anterolisthesis of C4 over C4. |
Generate impression based on findings. | 13 year-old male with worsening abdominal pain, nausea/vomiting. Evaluate for free air, obstruction.VIEWS: Abdomen AP supine and upright (two views) 2/23/2015 Multiple dilated small bowel loops with air-fluid levels compatible with small bowel obstruction. No evidence of pneumatosis intestinalis, pneumoperitoneum, port... | Findings compatible with small bowel obstruction. Findings were discussed with Dr. Theodore De Beritto by phone on 2/23/2015 at 2:35 PM. |
Generate impression based on findings. | Female 46 years old Reason: 46 F with metastatic anal cancer s/p RFA with perihepatic hematoma, please evaluate for interval change since prior CT. ABDOMEN:LUNG BASES: No significant abnormality noted LIVER, BILIARY TRACT: Postprocedural changes of radiofrequency ablation of the previously described segment 6/7 hypoatt... | Postprocedural changes of radiofrequency ablation with small perihepatic fluid collection, favor resolving hematoma. Decreased size of postablation cavity. Remainder of study without significant change. |
Generate impression based on findings. | 73-year-old male with history of seizures and lymphoma. Evaluate for malignancy. There is no evidence of acute intracranial hemorrhage. The gray-white differentiation is preserved. No midline shift or mass effect. The basal cisterns are intact. The ventricles and sulci are symmetric. The imaged paranasal sinuses and ma... | No acute intracranial abnormality or malignancy as clinically queried. |
Generate impression based on findings. | Reason: primary hyperparathyroidism History: hypercalcemia There are several nodules present in the soft tissues of the lower neck . Their locations and serial Hounsfield units on dynamic CT or listed below along with some density units of normal structures:Houndsfield units through nodules (0seconds, 25 seconds, 55 se... | 1.There is a 9mm anterior mediastinal nodule located behind the sternum and towards the left, anterior to the pulmonary trunk which is suspicious for a parathyroid adenoma based on contrast uptake on dynamic CT.2.Parathyroid venous sampling.3.Degenerative changes of the cervical spine are worse at C5-6 as detailed abov... |
Generate impression based on findings. | 4-month-old male with placement of NJ tube.VIEW: Abdomen AP (one view) 2/23/2015 14:01 Feeding tube tip coiled in the left upper quadrant likely in the stomach.Disorganized bowel gas pattern with no evidence of obstruction. | Feeding tube tip coiled and likely in the stomach. |
Generate impression based on findings. | Reason: evaluate ILD History: cough soboe fibrosis LUNGS AND PLEURA: There are low lung volumes.Basilar predominant subpleural reticulation with mild architectural distortion, traction bronchiectasis, and groundglass opacities . No honeycombing identified.Postsurgical changes are noted in the left lower lobe related to... | 1.Basilar predominant interstitial fibrosis compatible with possible fibrosing NSIP. This may be idiopathic in origin. However, the differential diagnosis would include mixed connective tissue disease as well as possible drug toxicity.2.Cardiac enlargement with small loculated pleural effusion.3.Multiple thoracic verte... |
Generate impression based on findings. | 75 years, Female, Reason: severe post procedure pancreatitis History: recent admission at OSH with CT w/o contrast. ABDOMEN:LUNG BASES: Small left pleural effusion, decreased from the prior exam. Resolution of right pleural effusion.LIVER, BILIARY TRACT: Borderline enlarged liver. Left hepatic dome lesion is stable.SPL... | 1.Findings compatible with resolving acute pancreatitis and new organizing peripancreatic fluid collections. Ascites overall is decreased and there is no evidence of necrosis.2.Complex left ovarian cyst measuring up to 4.2 cm. Further evaluation with ultrasound is recommended.3.Omental and mesenteric nodularity is most... |
Generate impression based on findings. | 64 year old female with endometrial cancer and metastatic disease to left chest wall. Comparison with prior CT.History nephrectomy. CHEST:LUNGS AND PLEURA: Reference left lower lobe nodule measures 1.0 x 1.3 cm on image 63/105 without interval change. Reference lingula nodule measures 0.7 x 0.7 cm on image 49/105 witho... | No change in lung nodules.No significant change in mediastinal/hilar adenopathy.Improved retroperitoneal adenopathy.New, abnormal right axillary lymph node.New, left breast nodule.The enhancing component of the left anterior chest wall mass has decreased.Progression of mass involving left ribs, vertebrae and neural can... |
Generate impression based on findings. | Eructation. Question of delayed gastric emptying. Visually there was significant and progressive gastric emptying up to the early termination point of the exam. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 78 % of peak... | No specific evidence of gastroparesis though the is study limited due to early termination of exam secondary to patient intolerance. |
Generate impression based on findings. | Osteosarcoma metastatic to the lungs. Staging exam prior to possible metastestectomy.RADIOPHARMACEUTICAL: 14.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 124 mg/dL. Today's CT portion grossly demonstrates a left chest tube with residual left pneumothorax and subcutaneous left anterior emphysema. Diffuse... | 1.No evidence of significantly FDG avid tumor.2.Left upper lobe pulmonary nodule demonstrates only minimal activity. This may represent a benign nodule although weakly FDG avid tumor cannot be entirely excluded.3.Fairly diffuse mild to moderate activity involving the left pleural surfaces considered more likely inflamm... |
Generate impression based on findings. | Pain in back and shoulders. Metastatic breast cancer. There is marked interval progression of a left proximal humerus lesion. Foci of increased uptake within the T4 vertebral body appear less intense on this examination. There is either increased uptake or a new adjacent focus of uptake in the left L5/S1 region. Otherw... | Mixed response with worsening left proximal humerus and left L5/S1 lesions. No definite new areas of uptake are identified. |
Generate impression based on findings. | Female; 61 years old. Reason: Cough and dyspnea, smoker, restriction on PFT, history of SLE/Sjogrens. LUNGS AND PLEURA: Scattered calcified and noncalcified pulmonary micronodules, measuring up to 4 mm. No suspicious pulmonary nodules or masses. No pleural effusions or focal areas of consolidation. Scattered areas of n... | 1.Scattered areas of mild pulmonary parenchymal and pleural scarring . No specific evidence of pulmonary fibrosis/ILD consistent with connective tissue disorders.2.Findings compatible with prior granulomatous infection as described above. |
Generate impression based on findings. | 37-year-old male status post bilateral mandibular fracture open reduction internal fixation repair with residual anterior open bite, malocclusion As demonstrated on previous Panorex, there has been interval open reduction internal fixation of bilateral mandibular angle fractures. Hardware is intact. The posterior-most ... | There has been interval open reduction internal fixation of bilateral mandibular angle fractures. Hardware is intact. The posterior-most screw on the right appears subjacent to osseous cortex. Fracture fragments are now in near-anatomic alignment. Bony trabecular bridging with periosteal new bone is evident on the left... |
Generate impression based on findings. | Hyperparathyroidism. Question of parathyroid adenoma. There is physiologic distribution of the radiopharmaceutical. No abnormal focus of activity consistent with an enlarged parathyroid gland is seen. The right thyroid lobe appears to measure 4.1 cm and the left lobe 4.2 cm in length.There is a focus of air posterolate... | 1. No scintigraphic evidence for parathyroid adenoma.2. Focus of air posterolateral to the trachea. While there is no definitive communication to the trachea or esophagus, this may represent an esophageal diverticulum. If clinically warranted, this may be further evaluated with dedicated imaging. |
Generate impression based on findings. | 72-year-old male with history of metastatic RCC. There is no evidence of acute intracranial hemorrhage. There is mild periventricular and subcortical white matter hypoattenuation compatible with age-indeterminate small vessel ischemic disease. The gray-white differentiation is preserved. There is no midline shift or ma... | 1. No evidence of significant mass effect, although we cannot entirely exclude metastatic disease on a noncontrast exam.2. Mild age-indeterminate small vessel ischemic disease.3. No acute intracranial abnormality. |
Generate impression based on findings. | 60 years, Female. Reason: 60F with severe COPD s/p EMR of large cecal lesion (4cm), now with abdominal pain, need to eval for air under diaphragm to r/o microperf History: abdominal pain No evidence of pneumoperitoneum. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. Rightward... | No evidence of pneumoperitoneum. |
Generate impression based on findings. | 7-year-old female with difficulty breathing, feverVIEWS: Chest PA/lateral (two views) 2/23/2015 Left sided aortic arch, cardiac apex and stomach. Narrowing of the subglottic trachea is noted. Peribronchial thickening with no focal pulmonary opacity. Linear streaky opacities in the left lung base likely atelectasis. | Croup with reactive airway disease or bronchiolitis pattern. Likely atelectasis in the lung base. |
Generate impression based on findings. | 57 year old female, evaluate for neoplasm. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Scattered subcentimeter low attenuation hepatic lesions too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormal... | 1.No specific evidence for metastatic disease.2.Hepatic and liver subcentimeter lesions too small to characterize.3.Low-attenuation lesion within the right adductor musculature, indeterminate and may represent a myxoma but should be further evaluated with dedicated contrast enhanced MRI. |
Generate impression based on findings. | 76 year old woman with history of left lumpectomy for invasive mucinous carcinoma in 2012. 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-operative f... | Post-operative changes of left lumpectomy 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 - Diagnosti... |
Generate impression based on findings. | Male 26 years old Reason: hx recurrent dislocations, Bankart, Laterjet History: same, apprehension. Two screws are seen affixing bone graft to the anterior aspect of the glenoid, compatible with stated history of Laterjet procedure. The bone graft appears fused to the underlying glenoid in the axillary view. There may ... | Postoperative imaging of Laterjet procedure and other findings as described above. |
Generate impression based on findings. | Fell on hip Two views of the right hip and one view of the pelvis demonstrate no fracture. Mild osteoarthritis affects the hips. Chondrocalcinosis is noted at the pubic symphysis. Heterotopic bone formation is seen in the proximal left thigh, appearing similar to prior. | Mild osteoarthritis, with no fracture. |
Generate impression based on findings. | Male 50 years old; Reason: 50Yrs old male patient with marginal zone lymphoma and peripheral neuropathy s/p 6 cycles of bendamustine/rituxan, in need of end of treatment staging History: marginal zone lymphoma CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Small mediastinal lymph nodes, ... | 1. Postsurgical sequela, minimal illdefined soft tissue attenuation seen in right retroperitoneal/hemipelvic area as above, no measurable disease. Please refer to concomitant PET portion of exam for additional findings. |
Generate impression based on findings. | Male 63 years old Reason: evaluate extent of incisional hernia History: upper midline incisional hernia ABDOMEN:LUNG BASES: Paraseptal emphysema with lingular scarring, unchanged. LIVER, BILIARY TRACT: Hypodense lesions within the liver which are too small to characterize.SPLEEN: No significant abnormality notedPANCREA... | 1.Two discrete fat containing abdominal ventral hernias as detailed above.2.Infrarenal abdominal aortic aneurysm status post stent graft repair. |
Generate impression based on findings. | 56 years, Female, Reason: eval for cirrhosis, f/u liver lesion History: hepatitis c. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There is a lesion within segment 5 again identified measuring 1.1 x 0.8 centimeters (11/53), previously 0.9 x 0.9 cm. This lesion is stable in size since 2009, h... | Segment 5 lesion has new arterial phase enhancement but is stable in size since 2009. Given this lesions long-term stability, a malignancy would be considered highly unlikely. No suspicious abnormalities in the liver. |
Generate impression based on findings. | 20 year-old male with scoliosis undergoing posterior spinal fixation.VIEWS: Lumbosacral spine AP (one views) 2/23/2015 11:13 Interval placement of pedicle screws from L1 to L3 vertebral bodies bilaterally. Feeding tube tip in the GE junction, side port in the distal esophagus. Curvilinear structure projected in the reg... | 1. Interval placement of pedicle screws from L1 to L3 vertebral body bilaterally.2. Feeding tube tip at the GE junction, side port in the distal esophagus. |
Generate impression based on findings. | Reason: hyperparathyroidism History: hypercalcemia, Selective Venous sampling for Parathyroid hormone levels. There are several nodules present in the soft tissues of the lower neck . Their locations and serial Hounsfield units on dynamic CT or listed below along with some density units of normal structures:Houndsfield... | 1.There is a 9mm anterior mediastinal nodule located behind the sternum and towards the left, anterior to the pulmonary trunk which is suspicious for a parathyroid adenoma based on contrast uptake on dynamic CT.2.Parathyroid venous sampling suggest highest level at the innominate vein junction which corresponds with th... |
Generate impression based on findings. | Follicular lymphoma of the small intestines following resection. Staging exam.RADIOPHARMACEUTICAL: 10.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 88 mg/dL. Today's CT portion grossly demonstrates a postsurgical appearance to the upper abdomen. Hypodense left adnexal lesion is likely a cyst.Today's PET ... | No FDG avid tumor currently identified in the neck, chest, abdomen or pelvis. |
Generate impression based on findings. | Female 69 years old; Reason: Severe DJD noted in hip x-rays done 12/2014. Evaluate interval change. History: severe L hip pain, known OA L-SPINE: The bones are demineralized. Severe facet osteoarthropathy affects the lower lumbar spine, with grade 1 anterolisthesis of L5 on S1. There is hypertrophy of the spinous proce... | 1. Mild degenerative changes of the hips. 2. Severe facet osteoarthropathy of the lower lumbar spine. |
Generate impression based on findings. | Male 73 years old Reason: pain - evaluate for bone spurs History: pain. Two views of the left elbow show small enthesophytes along the posterior aspect of the olecranon at the triceps insertion of questionable significance. Alignment is within normal limits. We see no joint effusion.We have two views of the right elbow... | Small enthesophytes of the left olecranon of questionable significance. The elbows otherwise appear normal for age. |
Generate impression based on findings. | Male 64 years old Reason: "eval fx RF" History: same. There is a spiral/oblique fracture of the proximal mid-diaphysis of the fourth metacarpal with mild volar angulation of the distal fracture fragment. Mild osteoarthritic changes affect the hand. There is an ossicle adjacent to the radial styloid which may reflect ol... | Fourth metacarpal fracture as above. |
Generate impression based on findings. | Lymphoplasmacytic lymphoma transformed to diffuse large B cell status post 6 cycles of chemotherapy with near complete remission subsequently suffered left-sided vision loss and found to have leptomeningeal recurrence. Restaging exam.RADIOPHARMACEUTICAL: 10.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 8... | 1.No FDG avid tumor currently identified in the neck, chest, abdomen or pelvis.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | Male 46 years old Reason: right foot pain History: x-ray with attention to dorsal surface to arch . There may be mild soft tissue swelling along the dorsal aspect of the foot, but this is equivocal. We see no fracture or malalignment. Note is made of an os peroneum, a normal variant. | Possible mild soft tissue swelling. Otherwise, no specific findings to account for patient's pain. |
Generate impression based on findings. | 20 old male with scoliosis undergoing post posterior spinal fusion. VIEWS: Lumbosacral spine AP and lateral (two views) 2/23/2015 12:40 Redemonstration of pedicle screws from L1 to L3 vertebral bodies bilaterally with interval placement of additional pedicle screws in T11, T12 and L4 vertebral bodies bilaterally. Feedi... | 1. Pedicle screws from T11-L4 vertebral bodies bilaterally.2. Feeding tube tip at the GE junction, side port in the distal esophagus. |
Generate impression based on findings. | 14-year-old female with concern for aspirationEXAMINATION: Oropharyngeal motility study 2/23/1514:57 Julie Ecclestone (pager 8293), speech and language therapist, supervised the examination.1 minute 30 seconds of fluoroscopy was used.Delayed swallow without penetration or aspiration with solids, purée and nectar admini... | Shallow penetration with thin liquids. No evidence of aspiration. Please see the speech and language therapist's report for feeding recommendations. |
Generate impression based on findings. | Male 20 years old; Reason: evaluating for fracture History: pt with acute injury yesterday playing soccer, now unable to bear wt w/o pain, pain is greatest along the medial aspect of foot, instep, metatarsal area. Three views of the right foot demonstrate no fracture or dislocation. No specific findings are identified ... | No specific findings to account for the patient's pain. |
Generate impression based on findings. | Metastatic adenocarcinoma of the gastroesophageal junction status post chemotherapy, last February 2015. Restaging exam.RADIOPHARMACEUTICAL: 7.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 101 mg/dL. Today's CT portion grossly demonstrates left subpleural scattered pulmonary parenchymal foci. Several bor... | 1.Multiple small mild to moderately hypermetabolic abdominal lymph nodes have progressed from previous and are of some suspicion for disease progression although somewhat equivocal. Attention to these regions on follow-up exam can be made.2.Possible new right cerebellar lesion could represent metastasis or infarct alth... |
Generate impression based on findings. | Elbow pain Four views of the left elbow demonstrate a silastic radial head, which appears to be undergoing mild fragmentation. Mild osteoarthritis affects the elbow. | Silastic radial head and mild osteoarthritis, as described above. |
Generate impression based on findings. | Female 78 years old. Pain to anterior upper tibia right after a fall 4 months ago ANKLE: The bones are demineralized. We see no fracture. Arterial calcifications are noted in the soft tissues. Small plantar and posterior calcaneal spurs are noted and may be of no clinical significance.TIBIA/FIBULA: The bones are demine... | No fracture evident. |
Generate impression based on findings. | Male 47 years old Reason: post-op alignment History: post-op ORIF. Orthopedic pins affix a comminuted fracture of the proximal phalanx of the ring finger in near anatomic alignment. Slight radial angulation of the distal fracture fragment appearing similar to that seen on the prior study. The fracture remains visible a... | Orthopedic fixation of fourth and fifth finger fractures appearing similar to the prior study. |
Generate impression based on findings. | Male 35 years old; Reason: Evaluate right metacarpal, out of cast Two views of the right hand demonstrate a plate and screw device affixing the fracture through the distal diaphysis of the fifth metacarpal in near-anatomic alignment. We see no radiographic evidence of hardware complication. The fracture line remains vi... | Fixation of healing fifth metacarpal fracture. |
Generate impression based on findings. | 38-year-old male with abdominal tenderness and distention, evaluate for intra-abdominal infection. ABDOMEN:LUNG BASES: Bilateral small pleural effusions with associated basilar compressive atelectasis, increased from prior. Multiple ill-defined solid nodules with surrounding groundglass opacities bilaterally which are ... | 1.Ill-defined pulmonary nodules suspicious for fungal infection, increased from prior. Bilateral small pleural effusions, increased from prior. Please see chest CT from same day for full details regarding chest.2.New abdominopelvic ascites and anasarca.3.Fluid surrounding gallbladder, cannot exclude acute cholecystitis... |
Generate impression based on findings. | 84 years, Female. Reason: assess stool burden, assess for bowel dilation History: abd distension, diarrhea Scattered loops of air distended small and large bowel in a nonobstructive bowel gas pattern. Less than average stool burden. | Nonobstructive bowel gas pattern. Less than average stool burden. |
Generate impression based on findings. | Four month old male with NJ tube. Evaluate placement.VIEW: Abdomen AP (one view) 2/23/2015 15:21 NJ tube coursing to the proximal portion of the second duodenum with tip coiled likely in the duodenal bulb. Dilated bowel loops with no definite evidence of obstruction. | 1. NJ tube tip coiled likely in the duodenal bulb.2. Dilated bowel loops with no definite evidence of obstruction. |
Generate impression based on findings. | Severe ILD pattern consistent with langerhans cell histiocytosis. Evaluate for myeloma or langerhans cell histiocytosis. No abnormal osseous foci are identified to indicate metastatic disease.Foci of uptake within the cervical spine likely represents degenerative change. Increased uptake within the sternum and manubriu... | No evidence of bone metastases. |
Generate impression based on findings. | Female 79 years old Reason: fracture History: pain. We have 3 views of the left hand. The bones appear demineralized. We see no fracture. There is osteoarthritis of the first carpometacarpal joint and mild osteoarthritis of the interphalangeal joints. | Osteoarthritis without fracture evident. |
Generate impression based on findings. | 55 years, Female. Midline surgical suture material is noted many of which appear fractured. No herniation of bowel loops are noted on the lateral view. Metallic radiodensity projects over the anterior pelvis only seen on lateral view. On previous CT scout radiograph, the same density is noted in the soft tissues of the... | Greater than average stool burden. Bullet in the soft tissues of the left upper thigh. |
Generate impression based on findings. | 78 years, Female, Reason: Gallbladder/cholangiocarcinoma - restaging prior to starting therapy. History: back pain. CHEST:LUNGS AND PLEURA: Scattered nonspecific micronodules. No suspicious nodules or masses.MEDIASTINUM AND HILA: Left thyroid nodule. Right chest port tip terminates at the cavoatrial junction. Severe at... | 1.Gallbladder neoplasm with invasion of liver, hepatic hilum and adjacent colon. There is invasion and obstruction of the common bile duct with moderate intrahepatic biliary ductal dilatation.2.Mild retroperitoneal lymphadenopathy.3.Obstructing left proximal ureteral stone.4.Left breast soft tissue lesion with calcific... |
Generate impression based on findings. | New pain in thoracic spine and left posterior ribs. History of breast cancer. THORACIC SPINE: The bones appear demineralized. Mild multi-level degenerative disk disease affects the thoracic spine. No focal lesions are seen to suggest metastatic disease.RIBS: No specific findings are identified to account for the patien... | Mild degenerative disk disease of the thoracic spine. No specific findings to account for the patient's pain. |
Generate impression based on findings. | 16 year-old female with tenderness to palpation along the distal radiusVIEWS: Left wrist PA, oblique, and lateral (3 views), right hand PA, right ring finger oblique, lateral (3 views) 2/23/15 15:12 Wrist: Alignment is anatomic. The distal radius, ulna and carpal bones are intact without fracture or malalignment.Hand/f... | No fracture or dislocation. Apparent soft tissue defect dorsal to the PIP joint. |
Generate impression based on findings. | Female 71 years old Reason: Evaluate for possible fracture History: Pain distal left fibula s/p fall 3 months ago. Three views of the ankle show no fracture or malalignment.Two views of the left fibula and tibia show no fracture or malalignment. Calcific foci within the distal tibial metadiaphysis may represent an ench... | No fracture evident. Other findings as described above. |
Generate impression based on findings. | Male 38 years old Reason: eval fracture healing History: s/p ORIF. Three views of the left middle finger show 3 screws affixing an oblique fracture of the proximal phalanx in near anatomic alignment. The fracture line is less distinct on the current study than on the prior study indicating some interval healing.Three v... | Orthopedic fixation of healing left middle and ring finger fractures. |
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