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Generate impression based on findings. | Female 46 years old Reason: eval for arthritis, pes planovalgus History: L dorsal midfoot pain. We have 3 views of the left ankle. Small osteophytes along the tibiotalar joint indicate mild osteoarthritis. A poorly defined lucency in the medial aspect of the talar dome may represent a degenerative cyst or old osteochon... | Mild pes planovalgus deformity and osteoarthritic changes as described above. |
Generate impression based on findings. | Distal femoral osteosarcoma. End of therapy evaluation.VIEWS: Left femur AP/lateral (two views) 02/24/15 Longstem total knee endoprosthesis device is again visualized. No loosening is identified. The proximal femur is normal in appearance.Soft tissue fullness is present in the popliteal region and unchanged from 08/19/... | No definite evidence of tumor recurrence. A lateral knee radiograph in extension is recommended for evaluation of the popliteal soft tissue fullness. |
Generate impression based on findings. | Reason: Abscess, signs of ludwig's? History: neck swelling, edema The right submandibular gland is asymmetrically enlarged when compared to the left. There is mild infiltration of surrounding fat planes in the right submandibular space. There is no evidence for radiopaque sialolith. The right jugulodigastric node that ... | 1.Findings suggest sialadenitis involving the right submandibular gland associated with some reactive adenopathy. Please correlate with patient's clinical history and symptoms. If the patient does not have corresponding clinical symptoms suggestive of inflammatory change, alternates considerations may include lymphaden... |
Generate impression based on findings. | Weight loss, diarrhea. Question of carcinoid tumor recurrence. Normal physiologic radiotracer distribution is seen in the salivary glands, myocardium, liver, bowel and bladder. There is no abnormal focus of activity to indicate current MIBG avid tumor.A sclerotic focus within the right ilium adjacent to the SI joint is... | No evidence of a somatostatin receptor avid tumor; the questionable subcentimeter liver lesions seen on recent CT are beyond the resolution of SPECT/CT. |
Generate impression based on findings. | 72-year-old male with shortness of breath and fatigue, preoperative evaluation for MVR/TVR. ANGIOGRAM: Please see accompanying cardiac CT report for description of thoracic aorta. There is no evidence of abdominal aortic aneurysm, dissection, or significant stenosis. The origins of the great vessels, celiac axis, SMA, ... | 1.Vascular measurements of the abdominal aorta and its branches as above. Please see dedicated cardiac CT for details regarding the chest and thoracic aorta.2.Mild-moderate atherosclerotic disease of the abdominal aorta and its branches including mural thrombus which narrows proximal right common iliac artery to approx... |
Generate impression based on findings. | 49 year-old female with history of DCIS status post left mastectomy in 2008, chemotherapy, and radiation therapy, and history of benign right axillary lymph node biopsy in 2009. . No current breast complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. Th... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Age: 80 years. Sex : Male. Reason for study: Reason: 80 male with AML, prior CVA. Concern for clinical aspiration History: Coughing. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. No static o... | The exam was positive for penetration and positive for aspiration. Please see speech pathology report for additional findings and feeding recommendations. |
Generate impression based on findings. | Female, 23 years old, status post tumor resection. Findings are seen compatible with recent left occipital craniotomy and resection of tumor from the left cerebellar hemisphere. A resection cavity is present within the left cerebellum containing largely hypoattenuating fluid but with a few small areas of hyperattenuati... | Expected findings status post tumor resection from the left cerebellar hemisphere. |
Generate impression based on findings. | 58 years, Male. Reason: bilious emesis, placement of NJT and OGT History: as above Bilateral pleural effusions.There a naso- jejunal feeding tube with tip projected far beyond the ligament of Treitz, over the right lower quadrant. Interval insertion of a second enteric feeding tube. The tip is projected over the proxim... | Interval insertion of a second enteric feeding tube with tip projected over the proximal gastric body. |
Generate impression based on findings. | 24-year-old male with VHR pre-B cell ALL now with productive cough and crackles on exam.VIEWS: Chest PA/lateral (two views) 2/24/2015 10:43 Right upper extremity PICC tip in the right brachiocephalic vein.Cardiac silhouette is normal. No focal pulmonary opacities. Linear streaky retrocardiac opacity likely atelectasis.... | Atelectasis in the left lung base with no evidence of pneumonia. |
Generate impression based on findings. | Reason: H\T\N cancer in follow-up CT neck:The right sternocleidomastoid muscle is atrophic and the right jugular vein is absent. There is infiltration of the fat planes surrounding the right carotid space. Some mild atherosclerotic narrowing is present at the distal right common carotid arteryWithin the suprahyoid neck... | 1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy. There are infiltrative changes in the right neck which are suspected to be postsurgical in nature and have been stable since prior exams.2.Opacity in the trachea is suspected to represent secretions .3.An op... |
Generate impression based on findings. | Male 66 years old Reason: clincial trial patient,please give bi-dimensional measurements History: hx of metastaic prostate cancer CHEST:LUNGS AND PLEURA: Right apical scarring and emphysema.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Bi... | No significant change from previous study. |
Generate impression based on findings. | 13-year-old male with fracture.VIEWS: Right humerus AP and lateral (two views) 2/24/2015 10:46 Healing fracture through a lucent lesion in the proximal humeral metaphysis which is in near-anatomic alignment. Periosteal reaction is noted in the proximal humerus | Healing pathological fracture involving the proximal humerus. |
Generate impression based on findings. | 53-year-old female with history of chronic sinusitis. There is minimal mucosal thickening along the inferior aspect of the right maxillary sinus. There is periapical lucency surrounding the right second maxillary molar. The remaining paranasal sinuses are clear. The ostiomeatal complexes, frontoethmoidal, and sphenoeth... | 1. Mild mucosal thickening involving the inferior right maxillary sinus which may be odontogenic in origin given periapical lucency of adjacent right second maxillary molar tooth. Paranasal sinuses are otherwise clear.2. Rightward nasal septal deviation and small septal perforation.3. Opacification of few air cells inv... |
Generate impression based on findings. | Male 36 years old Reason: Evaluate for progression History: Kaposi's sarcoma CHEST:LUNGS AND PLEURA: Bilateral bronchial wall thickening with new small ground glass opacity in the right lower lobe likely secondary to aspiration bronchiolitis. Volume loss, atelectasis and traction bronchiectasis of the right middle lobe... | 1.Heterogeneous right renal mass with new vascular involvement. These findings are atypical for lymphoma and favor other malignant etiology. If definitive diagnosis will affect the patient's clinical management, recommend percutaneous renal biopsy for further catheterization. 2.Worsening bronchial wall thickening and b... |
Generate impression based on findings. | Male 82 years old Reason: gastric cancer resected 2010 evalaute for disease development History: gastric cancer CHEST:LUNGS AND PLEURA: Stable micronodules.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Ill-defined new hypodensity adjacent... | New subcentimeter liver lesion adjacent to the clips in the left lobe of the liver. MRI of the liver may be helpful for further characterization of this lesion. Otherwise no significant change from previous study. |
Generate impression based on findings. | Reason: multiple small nodules, TNTC. Please eval compared to old images. has had 2 TBBx that are non-dx History: weight loss LUNGS AND PLEURA: Mild centrilobular emphysema.Innumerable subcentimeter ground glass nodules of varying sizes throughout the lungs. There is suggestion of cavitation within a majority of these ... | 1. Innumerable subcentimeter ground glass nodules of varying sizes throughout the lungs, grossly similar to the prior exam dated 01/2015, although direct comparison is difficult. Probable cavitation in a majority of these lesions. Differential considerations include disseminated infection, particularly granulomatous in... |
Generate impression based on findings. | 55-year-old female. Metastatic lung cancer. Brain mets status post 1 line of therapy. Compare to previous study and evaluate disease status. LUNGS AND PLEURA: Right lower lobe mass measures 5.9 x 3.8 cm, previously 3.9 x 3.4 cm (series 6, image 85). Additional nodules in the right lung also appear increased since the p... | 1.Interval increase in size of right lower lobe mass, likely primary lung neoplasm.2.Interval increase in size and number of right lung nodules, suspicious for metastatic disease. |
Generate impression based on findings. | There is trace mucosal thickening extending into and opacifying the left frontoethmoidal recess. There is trace left maxillary sinus mucosal thickening. The ostiomeatal complexes are otherwise patent. The remaining paranasal sinuses are clear. There is no air-fluid level or bubbly secretions within the paranasal sinus... | Trace mucosal thickening as described above. Otherwise no significant paranasal sinus disease. |
Generate impression based on findings. | 42 year old with left breast pain. Family history of breast cancer in her maternal grandmother and 3 paternal aunts. Patient has a history of benign biopsied fibroadenoma in the right breast. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 63 years, Male, Reason: 63 yo male with hx of mesenteric mass; please evaluate for abnormalities History: mesenteric mass. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL G... | Calcific mesenteric mass is stable. |
Generate impression based on findings. | Female 63 years old; Reason: mETASTATIC RECTAL CANCER TO VULVA ON CHEMOTHERAPY HOLIDAY. eVALUATE FOR DISEASE PROGRESSION History: RECTAL CANCER CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right chest wall port with tip in the right atrium.A... | 1.Interval increase in right inguinal lymphadenopathy as described above. |
Generate impression based on findings. | No acute intracranial hemorrhage or evidence of mass, mass-effect, or midline shift. Extensive chronic white matter disease and parenchymal volume loss is unchanged compared to the previous examination and consistent with multiple sclerosis. The visualized portions of the paranasal sinuses and mastoid air cells are cl... | 1.No acute intracranial hemorrhage or CT evidence of a mass as clinically questioned.2.Significant chronic white matter disease and volume loss is unchanged and consistent with longstanding advanced multiple sclerosis. |
Generate impression based on findings. | 55 years, Female, Reason: mets lung cancer. s/p one line tx,, pls c./w previous study and evaluate dz status. History: lung ca. ABDOMEN:LUNG BASES: For findings in the lung, please see dedicated chest CT performed on the same day.LIVER, BILIARY TRACT: Mild hepatomegaly.SPLEEN: No significant abnormality notedPANCREAS: ... | No evidence of metastatic disease in the abdomen or pelvis. |
Generate impression based on findings. | Neuroblastoma pre-transplant evaluation.VIEW: Mandible panorex (one view) 02/24/15 Examination is limited due to motion. No large bone defect is seen. | Markedly limited exam due to motion. |
Generate impression based on findings. | 49-year-old female with history of ovarian cancer. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Single small spiculated nodules in the lateral left breast (series 2, image 31). Left axillary surgical clips.ABDOMEN:LIVER, BILIARY TRACT: No si... | 1.Postsurgical changes of interval hysterectomy, resection of bilateral ovarian masses, and omental debulking.2.New non-specific moderate circumferential sigmoid colon wall thickening.3.Stable small spiculated left breast nodule. |
Generate impression based on findings. | Evaluation of lung mass right side. The comparison chest radiograph performed on /24/2015 demonstrates a mass in the right mid-lung without other acute cardiopulmonary abnormality.The ventilation images show a mild decreased right lung activity on single-breath and wash-in images. There is no abnormal Xe-133 retention ... | Mild decreased ventilation and perfusion in the right lung compared to the left lung. |
Generate impression based on findings. | Age: 79 years. Sex : Male. Reason for study: Reason: aspiration risk History: dysarthria. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. No static or hard copy films were obtained. The exam w... | The exam was positive for penetration and negative for aspiration. Please see speech pathology report for additional findings and feeding recommendations. |
Generate impression based on findings. | Female 88 years old; Reason: left frontal headache and recent nosebleed - please evaluated left frontal sinus for infection The right frontal sinus appears more opacified than the left, likely secondary to hypoplasia. The maxillary sinuses appear clear. A postoperative defect in the left temporoparietal skull is better... | No specific features of sinusitis. However, CT may be considered if further evaluation is clinically warranted. |
Generate impression based on findings. | 42 years, Female. Reason: rule out constipation History: abdominal pain Cholecystectomy clips noted. Nonobstructive bowel gas pattern. Moderate stool burden. | Moderate stool burden. |
Generate impression based on findings. | 64 years, Male. Reason: kidney stone History: stone There is a rounded opacity projected over the expected location of the right renal pelvis. This measures 5 mm in short axis dimension and is consistent with patient's known ureteropelvic junction stone. Nonobstructive bowel gas pattern.Staple projected over the right ... | 5-mm opacity projected over the right ureteropelvic junction consistent with patient's known stone. |
Generate impression based on findings. | 63 year old female with history of left breast lumpectomy in November 2009 for IDC/DCIS. Patient received radiation, chemotherapy, and hormonal therapy. History of right lumpectomy for carcinoma in 1998. History of thyroid cancer diagnosed at the age of 46. No current breast complaints. Three standard views of both bre... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 43 years old Reason: eval OG History: eval OG Multiple support lines and tubes including an LVAD device are projected over the patient. Partially imaged tubing projected over the region of the lower esophagus is incompletely imaged. Coiling of the feeding tube within the distal esophagus is not excluded and furt... | Partially imaged tubing projected over the region of the lower esophagus is incompletely imaged. Coiling of the feeding tube within the distal esophagus is not excluded and further evaluation with chest and upper abdomen radiograph is recommended. |
Generate impression based on findings. | Female 62 years old; Reason: left flank pain History: One week of pain The bones are demineralized, suggesting osteopenia. Moderate degenerative disk disease affects the lower thoracic spine. There is slight anterior wedging of one of the lower thoracic vertebral bodies, seen on the lateral view, with associated kyphos... | Postoperative changes of the lumbar spine appearing similar to prior. Degenerative disk disease and kyphoscoliosis, as described above. |
Generate impression based on findings. | 56 year old with history of right breast ductal carcinoma status post lumpectomy and axillary node dissection with adjuvant chemotherapy. Status post left mastectomy in 2011 for invasive ductal carcinoma. No current breast complaints. Three standard views of the right breast were performed digitally and reviewed with t... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | MAXILLOFACIAL: There is moderate left greater than right nasal soft tissue swelling. There is a minimally displaced left nasal bone fracture (series 8 image 123). There are blood products in the anterior nasal cavity; please correlate clinically to evaluate for possible cartilaginous nasal septal hematoma. No other ac... | 1.Minimally displaced left nasal bone fracture with nasal soft tissue swelling.2.Moderate anterior nasal cavity blood products, correlate clinically for possible component cartilaginous nasal septal hematoma.3.No evidence of acute traumatic injury to the head or cervical spine.4.Possible small posterior falcine meningi... |
Generate impression based on findings. | Reason: Pt with a history of NSCLC s/p chemoradiation now with NED. Please compare to prior scan for surveillance. History: NSCLC surveilance CHEST:LUNGS AND PLEURA: Right paramediastinal radiation fibrosis with traction bronchiectasis unchanged. Upper lobe predominant paraseptal emphysema is stable.No new suspicious p... | No interval change. No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Status post posterior spinal fusion. Fusion status? Again seen are posterior rods with screws entering the T9 through T12 vertebrae. I see no hardware complications. Moderate multilevel degenerative disk disease affects the thoracic spine also appearing similar to the prior study. | Postoperative and degenerative changes appearing similar to the prior study. |
Generate impression based on findings. | Follow-up Again seen is a small linear density dorsal to the head of the talus compatible with a small avulsion fracture. This appears similar to that seen on the prior study accounting for slight positional and technical differences. | Small density dorsal to the head of the talus likely representing a minimally displaced avulsion fracture, appearing similar to the prior study. |
Generate impression based on findings. | Right wrist pain, erythema, warmth, swelling and restricted range of motion. Status post fall. Evaluate for fracture. There is diffuse soft tissue swelling about the wrist. I see no definite acute fracture. The lunate bone appears sclerotic suggesting avascular necrosis, perhaps with slight loss of height volarly. Ther... | Soft tissue swelling without definite acute fracture. Findings compatible with avascular necrosis of the lunate and arthritic changes as described above. If there is strong clinical concern for acute fracture, repeat radiographs or cross-sectional imaging may be considered. |
Generate impression based on findings. | Redemonstrated are postoperative changes related to multiple bilateral prior craniotomies. There are associated scalp defects at the left frontal craniotomy site measuring 8 mm in width and left posterior parietal craniotomy site running longitudinally along the lambdoid suture measuring 14 mm in width. The left front... | Postoperative changes related to multiple bilateral prior craniotomies with associated scalp defects at the left frontal and left posterior parietal craniotomy sites. No evidence of exposed hardware. |
Generate impression based on findings. | There is a stable right parietal approach ventriculostomy catheter with the tip just terminating to the left of midline adjacent to the body of the left lateral ventricle. There is interval placement of an additional left anterior parietal approach subdural drainage catheter which courses just deep to the calvarium po... | 1. Stable right parietal approach ventriculostomy catheter. Stable right lateral ventricle.2. New left-sided subdural drainage catheter with decreased left-sided subdural collection. Focal air in the left hemicranium secondary to the recent procedure well with mild mass effect. Decreased localized mass effect with reex... |
Generate impression based on findings. | Pain. Fracture. Evaluation of fine detail is limited by overlying cast/splint. There is an oblique fracture of the distal fibula extending to the level of the tibiotalar joint, with approximately 5 mm of posterior displacement of the distal fracture fragment. There is widening of the medial tibiotalar gutter to approxi... | Distal fibular fracture and other findings as described above. |
Generate impression based on findings. | Low back pain. Spondylolisthesis? There is a slight rightward curvature of the lumbar spine. There is mild multilevel degenerative disk disease with relative sparing of L2/3 and L3/4. Facet joint arthritis affects the lower lumbar spine, and there is a grade 1 anterolisthesis of L4 relative to L5. Vertebral body height... | Degenerative arthritic changes with grade 1 anterolisthesis of L4 as described above. |
Generate impression based on findings. | Reason: r/o PE History: CP, SOB, more acute since 2/20 when he had biopsy; hx heart transplant PULMONARY ARTERIES: No evidence of a pulmonary embolus. The pulmonary artery is normal caliber.LUNGS AND PLEURA: Mild left basilar atelectasis with minimal pleural thickening.No suspicious pulmonary nodules or masses.No pleur... | No evidence of a pulmonary embolus. No acute cardiopulmonary abnormalities identified.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 71 years old; Reason: hx urothelial cancer, s/p surgery and chemotherapy, on surveillance History: hx urothelial cancer, s/p surgery and chemotherapy, on surveillance ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality not... | 1.No evidence of recurrence or metastatic disease. |
Generate impression based on findings. | Reason: hx urothelial cancer, s/p surgery and chemotherapy, on surveillance History: hx urothelial cancer, s/p surgery and chemotherapy, on surveillance LUNGS AND PLEURA: Left upper lobe calcified granuloma.Mild centrilobular emphysema with large lung volumes.No sign of pulmonary or pleural metastases.MEDIASTINUM AND H... | No evidence of thoracic metastases, or other significant chest abnormality. |
Generate impression based on findings. | Acute left hip pain. Evaluate for hip osteoarthritis. Mild osteoarthritis affects the left hip. Mild chronic-appearing enthesopathic changes are noted along the left iliac wing and ischium. I see no fracture. | Mild osteoarthritis. |
Generate impression based on findings. | Weakness D - 1, 2 Degenerative arthritic changes affecting the hand and wrist appear similar to those the seen on the prior study. I see no fracture or malalignment. Arterial calcifications are noted within the soft tissues of the wrist. | Degenerative arthritic changes appearing similar to those seen on the prior study. |
Generate impression based on findings. | 80 year-old lady with a recent fall, now with bruising and underlying pain, mostly ulnar side. Pain at site of injury, swelling, redness. Bruising on forearm and elbow. Three views of the left elbow are provided. I see no fracture, malalignment, or joint effusion. There is soft tissue swelling medially.Two views of the... | Soft tissue swelling without fracture evident. |
Generate impression based on findings. | Slammed thumb in door. Partial avulsion of the tip.VIEWS: Left hand PA, left thumb PA/lateral (3 views) 02/24/15 The thumb fingertip has been avulsed. A bridge of tissue is present laterally and posteriorly. The tuft protrudes into the defect. No bone abnormality is seen. | Soft tissue avulsion. |
Generate impression based on findings. | Mandibular fracture status post fixation Again seen is a plate and screw device affixing the right mandibular body in near-anatomic alignment. The underlying fracture is less distinct on the current study than on the prior study, suggesting some interval healing. There is also a fracture through the posterior aspect of... | Healing mandibular fractures as above. |
Generate impression based on findings. | FeverVIEW: Chest AP Cardiothymic silhouette normal. Minimal patchy atelectasis in the right middle lobe. No pleural effusion or pneumothorax. G-tube, portal vein stent and multiple surgical clips in the right upper quadrant again noted. | Minimal patchy atelectasis in the right middle lobe. |
Generate impression based on findings. | Female 22 years old Reason: 22 yr old patient with ovarian cancer s/p exp lap, RSO, omentectomy, and staging 12-19-14. baseline scan prior to treatment History: none CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality not... | Status post resection of large pelvic mass. Small amount of low density fluid in the bilateral adnexa, nonspecific. Borderline enlarged retroperitoneal lymph nodes are stable. Slight interval decrease in the size of the right paradiaphragmatic and left pelvic lymph node.Left retroperitoneal cystic lesion which likely r... |
Generate impression based on findings. | PICC placementVIEW: Chest AP and abdomen AP Cardiothymic silhouette normal. No focal lung opacity. No pleural effusion or pneumothorax. The endotracheal tube has been removed in the interval. NG tube removed in the interval. Placement of a left lower extremity PICC with tip in the SVC. Disorganized nonobstructive bowel... | Placement of left lower extremity PICC with tip in the SVC. |
Generate impression based on findings. | Leg length discrepancyVIEWS: Pelvis AP The right femoral epiphysis is slightly smaller in size in comparison to the left side. No acute fracture or dislocation. Both the acetabula are normal. | Normal acetabular development bilaterally with minimal asymmetry to the right femoral epiphysis slightly smaller than the left. |
Generate impression based on findings. | Reason: low back pain History: low back pain Five lumbar type vertebral bodies are presumed to be present. There is approximately 25% loss of vertebral body height at L5.The patient is status post L4-5 surgery with instrumentation along the spinous processes of L4 on L5. There are findings suggestive of prior laminotom... | 1.The patient is status post interspinous fusion with NuVasive clamp. There is some new ossification at the laminotomy sites of L4-5.2.There are degenerative changes present in the lumbar spine worse at L5-S1 and L4-5 where there is moderate spinal stenosis at L4-5 and encroachment of exiting nerve roots at the neural ... |
Generate impression based on findings. | Reason: pt with a history of met renal cell cancer, please assess for disease progression History: met RCC LUNGS AND PLEURA: Benign-appearing micronodules and linear scarring, but no sign of metastases.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Moderate coronary artery calcifications are pre... | No evidence of thoracic metastases. Abdominal findings to be characterized by a follow-up MRI. |
Generate impression based on findings. | Male 54 years old Reason: Peritoneal mesothelioma. Please compare to prior exam per recist criteria. History: Peritoneal mesothelioma CHEST:LUNGS AND PLEURA: Dependent atelectasis at the lung bases. Right middle lobe nodule is unchanged.MEDIASTINUM AND HILA: Borderline enlarged mediastinal lymph nodes. An index posteri... | Interval significant increase in the diffuse omental and mesenteric soft tissue masses consistent with patient no history of mesothelioma.Posterior borderline enlarged mediastinal lymph nodes are stable. |
Generate impression based on findings. | Female 37 years old Reason: Pre-Kidney Transplant, scheduled Living donor surgery 3/5/15 pt with chronic umbilical abdomen pain s/p PD cath placement 11/2014 History: CT scan with po contrast only r/o umbilical hernia The study is limited due to lack of intravenous contrast.ABDOMEN:LUNG BASES: No significant abnormalit... | Limited study due to lack of intravenous contrast. Bilateral significantly enlarged kidneys with numerous cysts of various size in density consistent with adult onset polycystic kidney disease.Small amount of ascites and peritoneal dialysis catheter. |
Generate impression based on findings. | Pierre Robin. Possible hip dysplasia.VIEW: Pelvis AP standing (one view) 02/24/15 Femoral head ossification centers are well directed into normally formed acetabula.A moderate amount of feces is present in rectosigmoid. | Normal examination. |
Generate impression based on findings. | Male 83 years old Reason: history of bladder cancer with ileal conduit, assess for recurrence History: none CHEST:LUNGS AND PLEURA: Stable micronodules.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: ... | No significant change from previous study. |
Generate impression based on findings. | Male 35 years old; Reason: S/P resection of high grade malignant peripheral nerve sheath tumor involving the small bowel. Evaluate for recurrence of disease. History: S/P resection of high grade malignant peripheral nerve sheath tumor involving the small bowel. Evaluate for recurrence of disease. CHEST:LUNGS AND PLEURA... | 1.No evidence of recurrence or metastatic disease. |
Generate impression based on findings. | Status post early February 2015 right thyroid lobectomy for goiter. There are post-operative changes related to a right thyroid lobectomy and isthmusectomy with soft tissue that is isoattenuating to muscle in the surgical bed. There are subcentimeter thyroid nodules in the remaining left thyroid lobe. There is effaceme... | Post-operative changes related to right thyroid lobectomy and isthmusectomy with relief of mass effect on the trachea at the level of the thyroid. Effacement of the valleculae and partial effacement of the left oropharynx along the prominent base of tongue, which is nonspecific but may relate to reactive lymphoid tissu... |
Generate impression based on findings. | Male 66 years old; Reason: history metastatic prostate cancer CHEST:LUNGS AND PLEURA: Unchanged subcentimeter right upper lobe lung nodule, image 37 series 4, nonspecific. No pleural effusion. Status post partial right lung resection. MEDIASTINUM AND HILA: Stable to mild interval decrease in size of prominent left hila... | 1. Stable to mild interval decrease in size of reference nodes as above. |
Generate impression based on findings. | Pain and swelling. Basketball injury.VIEWS: Left ankle AP/lateral/oblique (3 views) 02/24/15, 1159, 1200, 1201 Moderate soft tissue swelling is present laterally. The tibia is normal in appearance. An oblique fracture of the posterior fibular metaphysis extends into the physis. | Salter fracture distal fibula. |
Generate impression based on findings. | Back pain. Lumbar spondylolisthesis. Evaluate for preop planning of fusion. The bones appear demineralized, suggesting osteopenia. Severe degenerative disk disease affects L4/5. There is a grade 2 anterolisthesis of L4 relative to L5. Based upon the overall length of the L4 vertebra, I suspect that there is a bilateral... | Severe degenerative disk disease at L4/5 with a grade 2 anterolisthesis that may be due to an underlying spondylolysis. |
Generate impression based on findings. | Reason: r/o intracranial bleed History: left facial droop. on heparin gtt The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualize... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Male 74 years old Reason: 74M history of bladder cancer, status post cystectomy/neobladder. Surveillance imaging History: history of bladder cancer ABDOMEN:LUNG BASES: Unremarkable.LIVER, BILIARY TRACT: Subcentimeter liver lesions are unchanged. These lesions are too small to accurately characterize. Cholelithiasis, un... | Interval development of multiple large masses in the pelvis as described above suspicious for metastatic disease. |
Generate impression based on findings. | Fell. Fracture? Evaluation of the lower cervical spine and cervicothoracic junction on the lateral views is limited by overlying anatomy. The bones appear demineralized. I see no fracture or prevertebral soft tissue swelling. There is severe multilevel degenerative disk disease. There is moderate multilevel facet joint... | Degenerative arthritic changes as described above without fracture evident. If there is strong clinical concern for cervical spine fracture, then CT is recommended. |
Generate impression based on findings. | Male 72 years old Reason: urothelial cancer, on surveillance History: urothelial cancer, on surveillance CHEST:LUNGS AND PLEURA: Calcified micronodules are unchanged.MEDIASTINUM AND HILA: Small mediastinal lymph nodes are unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant... | Right upper pole renal lesion suspicious for a small renal cell carcinoma. Further evaluation with renal mass protocol CT or MR is recommended. |
Generate impression based on findings. | 13-week-old former 27 week gestational age patient with pleural effusion.VIEW: Chest AP (one view) 02/24/15, 1108 A moderate size left pneumothorax has developed in the interval. Mediastinum is shifted. No pleural fluid is identified. Left lung is compressed. Hazy opacity on the right is most likely in part due to atel... | Development of moderate left pneumothorax. |
Generate impression based on findings. | Pain on palpation of lumbar spine. Rule out lumbar vertebrae fracture status post MVA. I see no fracture or malalignment. Mild degenerative disk disease affects L2/3, L3/4, and perhaps L5/S1. There are posterior vertebral body osteophytes at L3/4. Vertebral body heights are preserved. There is mild facet joint osteoart... | Mild degenerative arthritic changes as described above; no fracture is evident. |
Generate impression based on findings. | Female 34 years old , hematuria and flank pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abno... | No evidence of renal stones. |
Generate impression based on findings. | Knee pain Four views of the right knee are provided. Severe osteoarthritis affects the knee, particularly the lateral and patellofemoral compartments. There is a moderate sized joint effusion. There is a geographic lucent lesion within the fibular head measuring approximately 4 cm in craniocaudal dimension and resultin... | 1.Severe osteoarthritis.2.Right fibular head lesion lucent lesion is nonspecific. It may simply represent an intraosseous ganglion, but other entities such as giant cell tumor of bone cannot be excluded. A malignant lesion is considered less likely. It can be further evaluated with MRI. |
Generate impression based on findings. | Reason: Tonsillar cancer; compare to previous with measurements. CT neck:The patient is status post right neck surgery with a right radical neck dissection and a myocutaneous flap placement. There is adjacent infiltration of the soft tissues surrounding the right carotid space which is likely treatment related. There i... | 1.No evidence for local recurrence or neck lymphadenopathy on the basis of CT size criteria for lymphadenopathy2.No evidence for brain metastases.3.Air space opacities are present in the right upper lung field. Please refer to CT of the chest of the same date for further comments. |
Generate impression based on findings. | Staging malignant pleural mesothelioma status post right pleural biopsy.IMAGES: Submitted for interpretation are soft copy FDG PET/CT images from the skull base through the thighs dated 2/3/15 from HighTech. (The nonenhanced CT images were obtained solely for purposes of completing the PET scan, are not of diagnostic q... | 1.Several abnormal hypermetabolic right pleural-based foci, consistent with mesothelioma.2.No convincing contralateral or extrathoracic mesothelioma tumor activity.3.Possible right prostate focus raises the question of prostate cancer although FDG is insensitive and nonspecific for this. Clinical correlation and with p... |
Generate impression based on findings. | Right ankle fracture status post reduction Evaluation of fine detail is limited by overlying cast material. Again seen is an oblique fracture of the distal fibula with approximately 5 mm of posterior displacement of the distal fracture fragment. Also again seen is widening of the medial tibiotalar gutter to approximate... | Distal fibular and posterior malleolar fractures with widening of the medial tibiotalar gutter indicating deltoid ligament injury. |
Generate impression based on findings. | Lower back pain for several years. For the purposes of this study I will designate 5 lumbar vertebrae with hypoplastic ribs at L1. Vertebral body heights and intervertebral disk spaces appear normal for age. Mild facet joint osteoarthritis affects L5/S1. Alignment is within normal limits. | Mild facet joint osteoarthritis as above. |
Generate impression based on findings. | Status post left total knee arthroplasty Components of a left total knee arthroplasty device are situated near anatomic alignment without radiographic evidence of hardware complication. Skin staples, a drain, and foci of gas density within the soft tissues reflect recent surgery. | Postoperative changes of total knee arthroplasty as above. |
Generate impression based on findings. | The right uterine artery was embolized using multiple 4 mm coils. Post-embolization angiogram demonstrated no flow beyond the coils.The Ann Roberts catheter was used to select the left internal iliac artery and multiple left internal iliac angiograms were performed to attempt to select the left uterine artery to reass... | Successful coil embolization of right uterine artery branch supplying uterine AVM.PLAN: The patient will be admitted overnight for pain control and observation. |
Generate impression based on findings. | History of sarcoma of left upper extremity status post excisional lymph node biopsy with positive lymph node. Please evaluate for metastatic disease. RADIOPHARMACEUTICAL: 14.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 93 mg/dL. Today's CT portion grossly demonstrates post-surgical changes in the left a... | 1. Hypermetabolic activity within the left axilla and multiple foci within the left upper arm and proximal forearm are consistent with recurrent sarcoma. 2. No suspicious FDG avid lesion is identified in the head/neck, abdomen, pelvis, or lower extremities. |
Generate impression based on findings. | There are multiple areas of wedge shaped abnormal low density throughout the cerebral hemispheres bilaterally with loss of gray-white differentiation. The most confluent area is in the left frontal lobe with an additional prominent area in the left posterior parietal lobe. There is no significant associated volume los... | No acute intracranial hemorrhage. Numerous areas of wedge-shaped and ill-defined abnormal low density throughout the cerebral hemispheres bilaterally with associated loss of gray-white differentiation and sulcal effacement. Findings are concerning for multifocal possibly embolic recent infarcts, and MRI of the brain is... |
Generate impression based on findings. | Status post fall. Evaluate for bleed. Redemonstrated is a thin hyperattenuating band along the right falx, measuring approximately 3 mm in width. There is a left posterior temporal occipital subgaleal hematoma, unchanged. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shi... | 1. Stable appearance of 3 mm right-sided falcine subdural hematoma.2. Left posterior temporal occipital scalp/subgaleal small hematoma. |
Generate impression based on findings. | 4-year-old male with history of neuroblastoma, status post induction chemo therapy, history of ascites, rule out VOD LIVER: The liver measures 13 cm. No focal hepatic lesions. GALLBLADDER, BILIARY TRACT: No biliary ductal dilatation. The gallbladder appears normal without wall thickening or pericholecystic fluid.PANCRE... | Moderate abdominal ascites. Patent vasculature without evidence of VOD. |
Generate impression based on findings. | Lower abdominal pain. Nausea and vomiting. Repeat evaluation for appendicitis.EXAMINATION: Sonogram abdomen/appendix 02/24/15 The appendix is no longer visible. The patient indicates that she can no longer point with one finger to the exact location of pain. A few lymph nodes are noted in right lower quadrant. | Appendix no longer visualized. |
Generate impression based on findings. | Male 56 years old Reason: metastatic renal cancer on long term everolimus, assess for progression History: none Limited exam secondary to lack of intravenous contrast. Evaluation of solid organs and vascular pathology is suboptimal.CHEST:LUNGS AND PLEURA: Innumerable bilateral pulmonary metastatic lesions, which are gr... | Limited exam secondary to lack of intravenous contrast making evaluation of solid organs suboptimal. Within these limitations, patient is status post right nephrectomy with stable size of the metastatic lung nodules and surgical bed lesions when compared to prior exam. Lesions may be slightly increased in size since ex... |
Generate impression based on findings. | Female 60 years old Reason: pain and swelling History: pain. Two views of the right hip show mild osteoarthritis.AP view of the pelvis shows mild osteoarthritis of both hips. Degenerative arthritic changes affect the lower lumbar spine. | Mild osteoarthritis. |
Generate impression based on findings. | Female 69 years old Reason: bunion History: pain. We have 4 views of the left foot. The bones appear demineralized. There are chronic arthritic changes of the first metatarsophalangeal joint likely representing a combination of long-standing rheumatoid arthritis and osteoarthritis with a bony excrescence projecting fro... | Arthritic changes as described above appearing similar to those seen on prior studies. |
Generate impression based on findings. | Patient with Intractable pruritus and facial nodules. Previously diagnosed with IgG4 related disease. Please evaluate for involvement of salivary glands, pancreas, hepatobiliary system and retroperitoneal area.RADIOPHARMACEUTICAL: 12.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 134 mg/dL. Today's CT por... | Increased FDG avid activity in the lymph nodes within the parotid glands bilaterally and in the mediastinum and hilar regions. The differential diagnosis includes IgG4-RSD, sarcoidosis, lymphoma and less likely metastatic tumor. |
Generate impression based on findings. | Postoperative changes from previous T2-L1 posterior spinal fusion are again noted, with mild residual rotatory scoliosis. Susceptibility artifact is noted from the spinal instrumentation which limits evaluation of surrounding structures.There is redemonstration of a slightly heterogeneous dorsal epidural collection ex... | 1. Interval expected evolution of dorsal epidural hematoma from C3 to T1, with overall stable size and persistent superimposed mid cervical spondylotic changes and reversed cervical lordosis contributing to overall at least moderate central spinal stenosis with near complete effacement of CSF space.2. Cervical cord sig... |
Generate impression based on findings. | 85-year-old male with history of bladder cancer status post cystectomy and ileal conduit urinary diversion in February 2014. CHEST:LUNGS AND PLEURA: Mild apical predominant emphysema. There is a solid pulmonary nodule in the right lower lobe (series 6, image 75) measuring 1.2 x 1.0 cm, unchanged since 4/1/2014. Additio... | 1.Interval resection of left upper pole renal mass without evidence of local recurrence.2.Postsurgical changes of cystectomy and ileal conduit. 3.Nonspecific 1.2-cm right lower lobe pulmonary nodule stable since 4/1/2014. If prior outside examinations are available, these may be helpful to evaluate for stability. In th... |
Generate impression based on findings. | Malignant pleural mesothelioma. The comparison chest radiograph performed on 2/24/2015 demonstrates a moderate right pleural effusion and overlying compressive atelectasis. The ventilation images show delayed activity in the right lower lung single-breath and wash-in images. There is no abnormal Xe-133 retention in the... | 1. Fairly symmetric ventilation and perfusion images as quantified above.2. Probable hepatic steatosis. |
Generate impression based on findings. | Reason: s/p sarcoma resection 10/2013 History: s/p sarcoma resection LUNGS AND PLEURA: No evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Mild aortic root calcification is present, but no visible coronary calcifications, the heart and pericardium otherw... | No evidence of metastases, or other significant abnormality. |
Generate impression based on findings. | Male 67 years old Reason: eval OA deformity History: L foot pain. We have 3 views of the right foot. There is a moderate to severe pes planus deformity. The midfoot lies in abduction and there is relative adduction of the forefoot. There is a silastic implant replacing the first metatarsophalangeal joint. There are def... | Foot deformities and postoperative changes as described above. |
Generate impression based on findings. | Stage IV Hodgkin's lymphoma status post completion of 6 cycles of ABVD in 2010 now with increased lymph nodes noted via OSH CT scan and elevated LDH.RADIOPHARMACEUTICAL: 14.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 117 mg/dL. Today's CT portion grossly demonstrates diffuse lymphadenopathy including t... | Recurrence of significantly increased FDG avid tumor in the neck, chest, abdomen, pelvis and inguinal regions. |
Generate impression based on findings. | 26 year old male with ALL, prior fungal pneumonia. Assess for interval change. LUNGS AND PLEURA: There has been mild interval increase in right lung base consolidation as well as development of new dependent atelectasis in the bilateral costophrenic angles. The previously described mycetoma is not definitively visualiz... | Mild interval increase in right lower lobe consolidation with new dependent atelectasis in the costophrenic angles. Findings are compatible with the clinical diagnosis of fungal pneumonia. |
Generate impression based on findings. | There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage. There are no extraaxial fluid collections or subdural hematomas. The ventricles and sulci are normal in size. The visualized portions of the paranasal sinuses and mastoid air cells are clear. There is nonspecific sligh... | Negative unenhanced brain CT. |
Generate impression based on findings. | 86 year old with history of right lumpectomy in 2002 for DCIS. Patient received radiation and hormonal therapy. No new breast complaints. Three standard views of both breasts with two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is co... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Cirrhosis, TIPS, evaluate for lesion and TIPS patency LIMITED ABDOMENLIVER: Cirrhotic morphology, liver measures 16.5 cm. No discrete liver lesion. Mild intrahepatic biliary duct dilatation.BILIARY TRACT: Status post cholecystectomy.PANCREAS: Not well seen due to overlying bowel gas.SPLEEN: Measures 11 cm. RIGHT KIDNEY... | 1. Patent TIPS, velocity mildly decreased compared to prior exam. 2. Cirrhotic liver, no focal lesion delineated. Mild intrahepatic biliary duct dilatation. |
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