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Generate impression based on findings. | Male 52 years old; Reason: renal tx hematoma/mass History: hematuria ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Hepatic and splenic calcified granulomata, likely reflecting prior granulomatous disease.SPLEEN: Stable in size.PANCREAS: Prominent pancreas stable in size, nonspecific, corre... | 1. Findings suspicious for urothelial malignancy. Again visualized is high attenuation material in collecting system of transplanted right iliac fossa kidney, extending to ureterovesical junction, associated enhancement seen.2. Remainder of exam also without significant change as described. |
Generate impression based on findings. | A 66 year old male candidate for mitral valve repair because of significant regurgitation. CPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with normal brachiocephalic branching pattern. No thoracic aortic dissection or aneurysm is noted. The thoracic aorta has mildly tortuous. No protruding aortic ... | 1. There is mild aortic valve calcification, which predominantly involves the non-coronary cusp. 2. No mitral annular calcification is noted.3. Mild left ventricular and moderate left atrial dilatation.4. Mild global degree of coronary artery calcification.5. Normal thoracic aorta anatomy.This portion of the report per... |
Generate impression based on findings. | Postoperative changes are seen from left occipital craniotomy and gross total resection of a left cerebellar tumor. A slightly irregular resection cavity is present within the left cerebellum containing CSF signal intensity fluid. Mild scattered marginal areas of diffusion restriction with associated susceptibility ex... | 1. Partial resection of left cerebellar mass with expected postoperative findings, with decreased mass effect upon and effacement of the fourth ventricle. Evaluation for residual mass is difficult. This would be better assessed utilizing 3-D T2 FLAIR images on follow-up imaging once immediate postoperative is resolved,... |
Generate impression based on findings. | Male, 62 years old, altered mental status. Extensive periventricular hypoattenuation is seen along with additional scattered more focal lucencies in the periventricular regions as well as the left thalamus/internal capsule. Chronic infarctions of the left cerebellum and left occipital lobe are seen.No definite parenchy... | Evidence of old cortical and age indeterminate microvascular ischemic disease. Although no CT evidence of acute territorial ischemia is evident on this examination, if clinical concern persists, further imaging with MRI would be appropriate. |
Generate impression based on findings. | Female 69 years old; Reason: evaluate for cancer recurrence and hernia History: ovarian cancer - normal exam but increased abdominal symptoms and hernia on exam ABDOMEN:LUNG BASES: Reticular opacities, likely atelectasis or scarring and some areas of architectural distortion involving the right middle lobe and lingula.... | 1.No definite evidence of recurrence. Ventral hernia as described above. |
Generate impression based on findings. | Female 59 years old; Reason: 59 y/o female with metastatic CRC; receiving chemotherapy; new onset abdominal pain History: Abdominal pain CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary masses, the largest of which contain gaseous foci, likely reflecting underlying cavitation. Reference left lower lobe lesion stabl... | Stable to mild interval decrease in size of pulmonary metastatic lesions, which internal cavitation seen.Remainder of exam unchanged. |
Generate impression based on findings. | Female 27 years old Reason: Evaluate LLQ pain; possible renal stone; but concern for GI process as well; previously thought do to hemorrhagic ovarian cyst, but cyst resolved on U/S and pain remains History: LLQ shooting pains and more severe pain in back and abdomen radiating into groin and leg ABDOMEN:LUNG BASES: No s... | Unremarkable study. |
Generate impression based on findings. | Female 81 years old Reason: r/o fx History: pain after fall. Three views of the right wrist show soft tissue swelling. There is chondrocalcinosis of the wrist. There is severe osteoarthritis of the basilar joint and the trapezioscaphoid articulation. We see no fracture.Two views of the right forearm show the aforementi... | Osteoarthritis and chondrocalcinosis of the wrist. We see no fracture. |
Generate impression based on findings. | Male 44 years old Reason: advanced pancreatic cancer. asses for need of duodenal stent History: worsening abd distention and ascites CHEST:LUNGS AND PLEURA: Left lower lobe atelectasis. Stable micronodules.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, B... | Interval increase in the size of the patient's known pancreatic head cancer. Interval development of moderate amount of ascites and interval worsening of the small bowel wall thickening. |
Generate impression based on findings. | Female 65 years old Reason: right wrist pain History: as above. There is widening of the scapholunate interval to approximately 6 mm indicating ligament disruption with severe narrowing of the radioscaphoid articulation. There is also mild osteoarthritis of the basilar joint and trapezioscaphoid articulation. There is ... | Arthritic changes as described above suggest a combination of CPPD arthropathy and osteoarthritis with scapholunate ligament disruption. |
Generate impression based on findings. | Male 58 years old Reason: concern for compartment syndrome History: swelling, elevated CK. Mild osteoarthritis affects the hip. There may be mild soft tissue swelling, but we see no acute abnormalities. | Osteoarthritis of the hip. Please note, we cannot confirm or exclude compartment syndrome on the basis of radiographs. |
Generate impression based on findings. | Female 64 years old Reason: OA and osteoporosis hx. LBP w/ neuropathic symptoms. ? DDD vs. compression fx vs. other History: see above. Moderate facet joint osteoarthritis affects the lower lumbar spine with relatively mild facet joint osteoarthritis affecting the upper lumbar spine. There is mild degenerative disk dis... | Facet joint osteoarthritis and degenerative disk disease. We see no compression fracture. |
Generate impression based on findings. | Male 63 years old Reason: swelling History: knee swelling. Mild to moderate osteoarthritis affects the knee and this appears to have progressed when compared to the prior study. A small density adjacent to the medial epicondyle of the distal femur is unchanged and may reflect prior injury. There may be a small joint ef... | Progression of osteoarthritis. Other findings as above. |
Generate impression based on findings. | Female 34 years old Reason: rule out arthritic changes History: pain. Mild osteoarthritis affects the left knee and has progressed when compared to the prior study.Mild osteoarthritis also affect the right knee as seen on the frontal view. | Mild osteoarthritis. |
Generate impression based on findings. | Male 55 years old Reason: s/p head and neck reconstruction, please evaluate position of plate and bone History: s/p head and neck reconstruction. We have a Panorex radiograph of the mandible. A plate and screw device affixes bone graft to the underlying maxilla in gross anatomic alignment. We see no hardware complicati... | Postoperative changes of bone graft fixation to the maxilla as described above. |
Generate impression based on findings. | Male 25 years old Reason: shoulder pain, evaluate for dislocation History: pain and decreased ROM. There is a minimally displaced fracture through the greater tuberosity associated with a lipohemarthrosis. There is slight inferior "pseudosubluxation" of the humeral head, but we see no frank dislocation. | Greater tuberosity fracture.These findings were verbally relayed to Maricela Sandoval, APN on 2/24/2015 at 1747. |
Generate impression based on findings. | Male 45 years old; Reason: r/o fx History: bilateral rib pain from 5 down after MVA approx 2 months ago, getting worse We see no fracture or other specific findings to account for the patient's rib pain. | No rib fracture evident. |
Generate impression based on findings. | Pain. Fracture? The bones are demineralized suggesting osteopenia/osteoporosis. I see no fracture. Mild osteoarthritis affects the glenohumeral and acromioclavicular joints. There is spurring of the anterior acromial process. There is narrowing of the acromiohumeral interval which may reflect chronic rotator cuff tear ... | Degenerative arthritic changes of the shoulder as described above without acute fracture evident. |
Generate impression based on findings. | 32 year-old female with right lateral ankle pain status post injury last night. Evaluate for fracture. Rounded opacity anterior to the tibiotalar joint suggests a joint effusion, but I see no fracture or malalignment of the ankle. There is mild soft tissue swelling along the lateral aspect of the ankle. | Soft tissue swelling and tibiotalar joint effusion without fracture evident. |
Generate impression based on findings. | MCP pain. Evaluate for fracture. Seen only on the oblique views a punctate density along the dorsal and radial aspect of the first metacarpal head. The clinical significance of this finding is uncertain although the possibility of a tiny avulsion fracture fragment is considered. I see no fracture line, and alignment of... | Punctate density adjacent to the first metacarpal head is of uncertain significance, although the possibility of a tiny avulsion fracture fragment is considered. |
Generate impression based on findings. | Left foot pain for one week after starting exercise program There is a mild hallux valgus deformity. Alignment is otherwise within normal limits. I see no fracture. The bones appear slightly demineralized. | Mild hallux valgus deformity but otherwise no specific findings to account for the patient's pain. If there is clinical concern for stress fracture, repeat radiographs may be obtained in 7 to 14 days. |
Generate impression based on findings. | Ulcer right index finger. Evaluate for "osteo" distal and middle phalanx. Evaluation of the fingers is limited due to inability to place the hand flat on the cassette. There is loss of soft tissue along the tip of the index finger, with osteolysis of the underlying distal phalanx compatible with osteomyelitis. I see no... | Findings suggestive of osteomyelitis of the distal phalanx of index finger, and possibly of the distal phalanx of the ring finger. Other abnormalities as described above. |
Generate impression based on findings. | The right anterior division of the internal iliac artery was embolized using a gelfoam slurry until near stasis was achieved. The post-embolization angiogram confirmed these findings.LEFT UTERINE ARTERY EMBOLIZATION | 1. Successful embolization of the anterior division of the internal iliac artery bilaterally.2. Placement of right internal jugular triple lumen temporary venous catheter.PLAN: Discharge from procedure area in good condition, temporary line ok to use. |
Generate impression based on findings. | Hip pain radiating to the knee. Osteoarthritis? Two views of the right hip are provided. Severe osteoarthritis affects the right hip with bone-on-bone apposition superiorly. The bones are demineralized suggesting osteopenia/osteoporosis. Severe degenerative disk disease affects the visualized lower lumbar spine.Four no... | Severe osteoarthritis of the hip. |
Generate impression based on findings. | Inflammatory arthritis? Hypertrophic arthropathy? Osteoarthritis? History of lymphoma. Three views of the right hand are provided. Mild to moderate osteoarthritis affects the distal interphalangeal joint of the fifth finger. The hand otherwise appears normal with no specific radiographic features of inflammatory arthri... | Degenerative arthritic changes as described above, overall mild. I see no specific radiographic features of inflammatory arthritis or hypertrophic osteoarthropathy. |
Generate impression based on findings. | 55 years, Female, Reason: mets lung cancer. s/p 2 cycles of ABT-7-- + Docetaxel. Pls c/w previous study and evaluate tx response. History: lung ca. ABDOMEN:LUNG BASES: For findings in the lung, please see dedicated chest CT performed on the same day.LIVER, BILIARY TRACT: Right hepatic hypodensity is too small to charac... | 1.Focal hypoattenuating hepatic lesion has a nonspecific appearance and while stable, a metastases cannot be excluded. Recommend dedicated liver MRI for further evaluation if clinically warranted.2.Sclerotic lesion in the left femoral head and neck is suspicious for a metastases. Sclerotic focus in the right acetabulum... |
Generate impression based on findings. | altered mental status There is no evidence of acute ischemic or hemorrhagic lesion.A small calcific density on the dural surface of right parahippocampal gyrus posterior aspect is seen without evidence of surrounding mass like density or edema indicating benign nature, comparing to prior scan, it appears to be a bit la... | There is no evidence of acute ischemic or hemorrhagic lesion.Increase in size of the calcific density on the dural surface of right parahippocampal gyrus since prior study in 2004. If clinically indicated, brain MRI can be considered. |
Generate impression based on findings. | altered mental status No evidence of acute ischemic or hemorrhagic lesion.Moderate non specific small vessel ischemic disease with moderate diffuse brain atrophy which are age appropriate.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-a... | No evidence of acute ischemic or hemorrhagic lesion.Non specific small vessel ischemic disease. |
Generate impression based on findings. | Fall down stairs No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air ... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | syncope, evaluation for possible cerebrovascular accident No evidence of acute ischemic or hemorrhagic lesion.There are patchy bihemispheric low attenuations on periventricular white matter and centrum semiovale, indicating non specific small vessel ischemic disease.The ventricles, sulci, and cisterns are symmetric and... | No evidence of acute ischemic or hemorrhagic lesion.Small vessel ischemic disease. |
Generate impression based on findings. | worst headache of life No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures a... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Clinical question:CVA signs and symptoms: CVA Nonenhanced head CTthere is no detectable acute intracranial process. CT however he is insensitive for early detection of acute nonhemorrhagic ischemic strokes.The cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation is wi... | No acute intracranial process. Please see above comments. |
Generate impression based on findings. | Clinical question: AMS and hypoxia, now intubated,? ICH in setting of thrombocytopenia. Signs and symptoms: As above. Nonenhanced head CT:There is no evidence of acute intracranial process. CT however is been sensitive for early detection of acute nonhemorrhagic ischemic strokes.The cerebral cortex, cortical sulci, ven... | No acute intracranial process. |
Generate impression based on findings. | Clinical question: Rule out ischemia, hemorrhage. Signs and symptoms headache. Unenhanced head CT:There is no acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There is very extensive periventricular and subcortical low attenuation of white matter with re... | 1.No acute intracranial process. Please see above comments.2.Interval increased size of supratentorial ventricular system with no change in the position of right frontal approach ventricular catheter. |
Generate impression based on findings. | Clinical question: Headache worse rule out intracranial bleed or fracture. Signs and symptoms: Headache. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of accurate nonhemorrhagic ischemic strokes.The cerebral cortex, cortical sulci, ventricular syste... | 1.Unremarkable nonenhanced head CT.2.Extensive pansinusitis.3.Bilateral otitis media. |
Generate impression based on findings. | 75 years, Female, Reason: abscess History: epigastric pain. ABDOMEN:LUNG BASES: Basilar atelectasis. Severe coronary artery calcifications.LIVER, BILIARY TRACT: Large gallstone with adjacent fat stranding, suspicious for acute cholecystitis. There is adjacent colon in this region, however no significant wall thickening... | Cholelithiasis with pericholecystic inflammatory changes is suggestive of acute cholecystitis, with a focal colitis considered less likely. |
Generate impression based on findings. | Rule out fracture I see no fracture. Mild osteoarthritis affects the acromioclavicular joint. Note is again made of metastatic disease to the left third rib from the patient's known prostate cancer. | No fracture evident. Osteoarthritis and metastatic disease as described above. |
Generate impression based on findings. | Clinical question: 69-year-old male with history of mechanical fall, on anti-coagulation, and without hemorrhage. Signs and symptoms : As above. Unenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.The cerebral corte... | Negative nonenhanced head CT. |
Generate impression based on findings. | Female 57 years old Reason: pelvic mass, e/o met dx? History: pelvic mass, bloating, pain CHEST:LUNGS AND PLEURA: Moderate left pleural effusion. Small right upper lobe tree in bud opacity which may represent infection, please correlate clinically. No suspicious pulmonary masses or nodules.MEDIASTINUM AND HILA: Heart s... | 1.Moderate ascites with carcinomatosis as above.2.Probable left adnexal mass which is suspicious for malignancy. Further characterization with pelvic ultrasound is recommended.3.Moderate left pleural effusion. |
Generate impression based on findings. | Fall off scaffolding, evaluate for bleed Head: No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus.Ther... | 1. No evidence of acute intracranial hemorrhage or mass effect. 2. No fracture or subluxation within the cervical spine.3. No fracture or subluxation within the thoracic spine.4. There is facet arthropathy at the left T11-T12 level with fragmentation which is most likely chronic.5. Two 1 cm right lung nodules. Recommen... |
Generate impression based on findings. | 85 years, Female, Reason: 85 y/o F with colitis, and PNA, eval PNA for abscess vs effusion, vs interval change of colitis vs SBO History: SOB, abdominal pain,. CHEST:LUNGS AND PLEURA: Small bilateral pleural effusions, right greater than left. Left basilar atelectasis and right basilar atelectasis/consolidation.MEDIAST... | 1.Nonspecific colitis of the proximal colon with persistent ileus. No abscess or evidence of obstruction.2.Increased small bilateral pleural effusions with right basilar consolidation/atelectasis.3.Likely sacral decubitus ulcer with inflammatory changes extending to the coccyx. While there is no osseous destruction evi... |
Generate impression based on findings. | 82 years, Male. Reason: Dobbhoff placement History: Dobbhoff placement Dobbhoff tube tip projects over the gastric antrum. Guidewire is still in place. Multiple surgical clips are noted in the pelvis. Nonobstructive bowel gas pattern. Residual contrast material from prior examination is noted within the colon. | Dobbhoff tube tip projects over the gastric antrum. |
Generate impression based on findings. | 55 years, Male. Reason: Looking for free air History: Sepsis Lung bases are clear. No pneumoperitoneum. Nonobstructive bowel gas pattern. | No evidence of pneumoperitoneum. |
Generate impression based on findings. | Male 74 years old Reason: eval for intraabdominal pathology History: abdominal pain Limited examination secondary to lack of intravenous contrast. Evaluation of solid organ and vascular pathology is suboptimal. Within these limitations, the following observations were made:ABDOMEN:LUNG BASES: Small bilateral pleural ef... | 1.Limited examination secondary to lack of intravenous contrast making the evaluation of solid organ and vascular pathology suboptimal. Within these limitations, there is no acute abnormality to account for the patient's abdominal pain. 2.Small bilateral pleural effusions related to patient's known malignancy, unchange... |
Generate impression based on findings. | Patient with pancreatic cancer. Reporting new onset shortness breath, tachycardia to 120, denying chest pain, cramping in legs, and extremely tired. PULMONARY ARTERIES: There is a new saddle pulmonary embolus with clot extending into multiple bilateral lobar pulmonary arteries including the right middle lobe, right low... | 1. New saddle pulmonary embolus with large clot burden extending into all lobar pulmonary arteries with evidence of right heart strain. 2. New opacity in the inferior right upper lobe is compatible with hemorrhage/infarction. 3. Patient admitted through the emergency department. PULMONARY EMBOLISM: PE: YesChronicity: A... |
Generate impression based on findings. | 95 year-old female with aortic stenosis -- preop for TAVR for evaluation ABDOMEN:LUNG BASES: Moderate sized Left and small right pleural effusion again seen with left basilar atelectasis.LIVER, BILIARY TRACT: Pneumobilia again seen. Prior cholecystectomy. Within the limits of arterial phase images only, liver parenchym... | Diffuse atherosclerotic changes in the aorta, common iliac and femoral arteries. Mild tortuosity is seen with substantial calcification and peripheral atherosclerotic plaques, greatest in the common femoral arteries bilaterally, which narrow arterial luminal diameters. See specific measurements above. |
Generate impression based on findings. | Six year old female with periumbilical abdominal pain, vomiting. Evaluate for obstruction or constipation.VIEW: Abdomen AP (one view) 2/24/2015 Moderate fecal burden. Nonobstructive bowel gas pattern. | Moderate fecal burden with no obstruction. |
Generate impression based on findings. | 13-year-old female status post fall, hip pain. Evaluate for fracture or avulsion.VIEWS: Pelvis AP (one views) 2/24/2015 Normal alignment. No soft tissue swelling or joint effusion. No fracture or dislocation. | Normal examination. |
Generate impression based on findings. | 50 years, Female. Reason: Placement of NG tube History: As above Central venous catheter tip is in the left atrium. NG tube side port projects over the proximal gastric body with tip in the fundus. Multiple surgical clips, staples, and suture material project over the right hemiabdomen. Dilated loops of air filled smal... | Findings consistent with ileus type bowel gas pattern. NG tube tip projects over the gastric fundus. |
Generate impression based on findings. | 13 year old female tripped and fell on knee, pain. Evaluate for fractureVIEWS: Right knee AP, oblique, lateral (3 views) 2/24/2015 Normal alignment. No soft tissue swelling or joint effusion. No evidence of fracture or dislocation. | Normal examination. |
Generate impression based on findings. | 51 years, Male. Reason: kidney stone left History: stone No abnormal patient's to suggest nephrolithiasis. Nonobstructive bowel gas pattern. | No definite nephrolithiasis. |
Generate impression based on findings. | Reason: eval for shunt disruption, intrathoracic abscess History: shunt infection LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Mild basilar subsegmental atelectasis/scarring. No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size, without pericardial effu... | 1. Shunt tubing terminates in the axilla as it courses downward from the neck, with thin-walled, multiloculated, simple fluid collection near its termination point, compatible with a CSF collection.2. Short segments of possible catheter tubing identified within the lumen of the colon.3. Incompletely characterized 2cm l... |
Generate impression based on findings. | 53 years, Male. Reason: Worsening abdominal pain, free air History: Worsening abdominal pain Examination is limited by patient body habitus. Nonobstructive bowel gas pattern with centralization of bowel loops compatible with ascites. Cholecystectomy clips project over the right quadrant. Basilar opacities may represent... | Limited examination with nonobstructive bowel gas pattern. If there is continued clinical concern for pneumoperitoneum a left lateral decubitus radiograph can be obtained. |
Generate impression based on findings. | 66-year-old male that evaluate anatomy prior to mitral valve replacement. ABDOMEN:LUNG BASES: See chest CT report for complete details. No significant abnormality seen in lung bases.LIVER, BILIARY TRACT: Within limits of an arterial phase contrast image two the liver common no parenchymal abnormalities are seen come al... | 1. CT arteriogram reveals minimal tortuosity of aorta and left common and external iliac artery (greater than right external iliac artery). Measurements of selected artery sites as above. 2. No significant narrowing or aneurysmal dilatation identified. 3. No other extravascular significant abnormality seen. |
Generate impression based on findings. | Right wrist injury with pain. Evaluate for fracture. There is diffuse soft tissue swelling. I see no underlying fracture. Moderate osteoarthritis affects the basilar joint and the triscaphe joint. Small densities within the periarticular soft tissues likely represent chondrocalcinosis. | Soft tissue swelling and degenerative arthritic changes without fracture evident. |
Generate impression based on findings. | No acute facial bone fracture is identified. There is right maxillary soft tissue subcutaneous stranding and hematoma. The temporomandibular joints are intact.No orbital fracture is identified. There is subtle dehiscence involving the cribriform plate, likely developmental. The globes are intact. There is no evidence ... | Right malar soft tissue hematoma. No maxillofacial fractures. |
Generate impression based on findings. | 24 years, Male. Reason: s/p ventriculo-gallbladder shunt History: s/p ventriculo-gallbladder shunt Nonobstructive gas pattern. Two shunt catheters course along the right lateral chest wall in the subcutaneous tissues. The previously seen shunt has a distal tip that terminates in the subcutaneous tissues. There has been... | New shunt courses along the right lateral chest wall and is coiled over the expected location of the gallbladder. |
Generate impression based on findings. | Male 78 years old Reason: r/o R hip dislocation History: R leg internally rotated, pain 10/10, recent hip hemi-arthroplasty 2/7/15. We have two views of the right hip showing hardware components of a right bipolar hemiarthroplasty device situated in near anatomic alignment. We see no fracture or dislocation. Note is ma... | Right hip hemiarthroplasty without dislocation. |
Generate impression based on findings. | Male 68 years old Reason: eval shunt placement History: shunt protrusion. Again seen is an intracranial shunt with its tip coiling and terminating in the right axilla. Note is made of old healed fractures of the right sixth, seventh, eighth, and ninth ribs. Surgical clips, suture material, and possibly a fragment of sh... | Shunt tubing terminating in the right axilla and other findings as described above. |
Generate impression based on findings. | Male; 35 years old. Reason: Known bilateral adrenal masses, most recent scan one year ago, would like to assess for interval growth. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hypodense lesion in the inferior right liver measures 2.4 x 1.3 cm and demonstrates peripheral discontinuous nodu... | 1.Numerous bilateral adrenal adenomas, consistent with adrenal adenomatosis and not significantly changed since March 2014. Correlate for signs of Carnie complex.2.Inferior right liver hemangioma. |
Generate impression based on findings. | Newly diagnosed high grade prostate cancer Foci of increased activity are noted within the left maxillary/ethmoid sinus region as well as in the left frontal calvarium which are nonspecific.Single focus of increased activity noted in the right lower rib is nonspecific but more likely represents a site of fracture. Dege... | 1.Foci of increased activity within the left maxillary/ethmoid sinus region and left frontal calvarium are nonspecific and can be further evaluated with head CT. 2.Nonspecific right lower rib focus likely represents a site of fracture. |
Generate impression based on findings. | Rheumatoid arthritis. Pain RIGHT HAND: Minimal osteoarthritis affects the distal interphalangeal joints. Tiny osteophytes at the second metacarpophalangeal joint are noted, without erosions or other specific features of inflammatory arthritis.LEFT HAND: Minimal osteoarthritis affects the distal interphalangeal joints. ... | Mild degenerative arthritic changes, without radiographic features of rheumatoid arthritis. |
Generate impression based on findings. | Pleuritic chest pain, shortness of breath. Evaluate for PE. PULMONARY ARTERIES: Technically adequate study to the segmental level without evidence of an acute pulmonary embolus. The main pulmonary artery is slightly enlarged measuring approximately 31 mm in diameter which may be seen in the setting of pulmonary arteria... | 1. No evidence of an acute pulmonary embolus. 2. Mild centrilobular emphysema. In the lung bases there are thin-walled lucencies which could represent focal emphysema or cysts; anatomic detail is limited by exam noise. 3. Right lower lobe pulmonary micronodule is probably benign; a follow up CT in 12 months is suggeste... |
Generate impression based on findings. | 26 year-old female history of MVC. There is slight straightening of the cervical spine. There is no acute fracture or subluxation. Vertebral body heights and intervertebral disc spaces are preserved. The prevertebral soft tissues are within normal limits. The airway is patent. The imaged portions of the lung apices are... | 1.Slight straightening of the cervical spine which may be secondary to patient positioning or muscle spasm, but otherwise no acute fracture or subluxation.2.We cannot exclude the possibility of a soft tissue injury such as interspinous ligaments, anterior and posterior longitudinal ligaments as well as muscles by CT. I... |
Generate impression based on findings. | Clinical question: Evaluate right frontal mass. Signs and symptoms: Right frontal mass. Pre-and post enhanced head CT:Examination demonstrate a rather well demarcated slightly higher density mass abutting the right aspect of falx and inner table of the skull in the right anterior/inferior frontal region. It demonstrate... | 1.Right anterior/inferior paramedian frontal meningioma measuring 30 x 30 x 37-mm with mild surrounding vasogenic edema and regional mass-effect.2.Meningioma left cavernous sinus measuring at approximately 24 mm in transaxial dimensions with extension into the left upper cerebellopontine angle cistern and prepontine ci... |
Generate impression based on findings. | 8-month-old female with complex history now febrile. Evaluate for pneumoniaVIEW: Chest AP (one view) 2/24/2015 22:40 Left-sided central venous catheter tip in the right atrium. Enteric tube tip at third portion of the duodenum. Partially visualized left percutaneous biliary drain tip in the right upper quadrant. IVC st... | No evidence of pneumonia as clinically questioned. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is persistent moderate diffuse cerebral white matter hypoattenuation which may represent chronic small vessel ischemic changes. There is no intracranial hemorrhage, within the limitations of only postcontrast imaging. Th... | 1. Redemonstration of extensive post treatment changes within the neck including mild diffuse thickening of the visualized esophageal wall. No evidence of focal mass to suggest recurrence or cervical lymphadenopathy.2. No intracranial metastases. Probable chronic small vessel ischemic changes. |
Generate impression based on findings. | R/O avascular necrosis History: 20 yo M with sickle cell, with bilateral hip pain RIGHT HIP: The bones are overall slightly dense, compatible with the history of sickle cell disease. Additional density in the femoral head may represent avascular necrosis or simply overlap of bony structures. We see no subchondral fract... | Bony changes of sickle cell disease with equivocal findings of avascular necrosis, without subchondral fracture or articular surface collapse. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Ms. Morgan is a 33 year old female presenting for a palpable lump in the right breast. However, on examination today, patient does not palpate any abnormality. History of prior right breast surgical biopsy. Three standard views of both breasts and two left spot magnification views were performed digitally and reviewed ... | 4-mm cluster of amorphous calcifications in the left breast. Presumed post biopsy distortion in the right breast. Attempts to obtain patient's prior mammograms will be made in order to confirm stability of these findings. If not possible, than a stereotactic biopsy of the left breast calcifications is recommended for f... |
Generate impression based on findings. | Male 32 years old Reason: eval fracture History: fall on ice. There is soft tissue swelling about the middle phalanx of the middle finger. We see no fracture or malalignment. | Soft tissue swelling without fracture. |
Generate impression based on findings. | Male 51 years old Reason: eval fracture History: fell off scaffolding, no deformity, diffuse tenderness. We see no acute fracture. A small ossicle just above the left T12 costovertebral junction appears chronic in etiology and is of doubtful current clinical significance. The thoracic vertebral body heights are preserv... | No acute fracture; other findings as above. |
Generate impression based on findings. | Status post resection of olfactory groove meningioma There are immediate postsurgical changes of redo bifrontal craniotomy for resection of residual extra-axial mass. There are expected postsurgical changes including air and blood products within the surgical bed involving the bilateral frontal lobes extending to the a... | 1. Expected postsurgical changes related to re-resection of residual extra-axial bifrontal mass with small amount of hemorrhage in the resection bed. There is mass effect on the bilateral frontal lobes, lateral ventricles, and callosal genu which was present on prior. No significant midline shift or transtentorial hern... |
Generate impression based on findings. | History of subarachnoid hemorrhage and ventriculomegaly. There has been interval resolution of the subarachnoid hemorrhage. Likewise, the intraventricular hemorrhage has essentially resolved. There is no evidence of acute intracranial hemorrhage. There is persistent dilatation of the entire ventricular system, with a r... | 1.Interval resolution of the subarachnoid and intraventricular hemorrhage without evidence of new intracranial hemorrhage. 2.No significant change in the ventriculomegaly with ventricular shunt in position.3.Multiple foci of encephalomalacia likely related to infarcts.4.Distal left internal carotid artery stent. |
Generate impression based on findings. | Female 25 years old Reason: eval for abscess History: swelling, erythema. Again seen is a reconstruction of the proximal and mid humerus by a longstem endoprostheses device. There is lateral positioning of the head of the prosthesis in relation to the glenoid, but this is unchanged from the prior study. There is minima... | Postoperative changes as described above. No specific radiographic findings to suggest abscess. |
Generate impression based on findings. | There is straightening of the cervical spine which may reflect patient positioning or muscle spasm. Otherwise, alignment is within normal limits without fracture. Vertebral body heights and disk spaces are preserved. There is no significant central canal or neuroforaminal compromise. There is mild reticulation of the ... | No fracture or other significant abnormalities to account for the patient's pain. |
Generate impression based on findings. | Male 56 years old Reason: colon cancer compare to last CT \T\ measure 1) RLL nodule and 2) LUL nodule History: post 2 cycles of chemo CHEST:LUNGS AND PLEURA: Reference left upper lobe nodule is slightly increased in size and measures 1.4 x 1.2 cm (series 4, image 51), previously 1.2 x 1.1 cm.Reference right lower lobe ... | 1.Limited examination secondary to lack of intravenous and oral contrast. Within these limitations, there is interval worsening of pulmonary metastatic disease.2.Stable disease in the abdomen and pelvis. |
Generate impression based on findings. | Pt with history of renal transplant, smoking, remote breast ca w/ recent CT PE that showed lung masses and scattered nodules concerning for infection vs malignancy. Now s/p 2 days of broad spectrum antibiotics with no improvement in breathing. Please compare for improvement. LUNGS AND PLEURA: Patchy areas of tree in bu... | Interval increase in size of a left lower lobe masslike consolidation which may represent infarction due to angioinvasive aspergillosis or other agents. Additional pulmonary opacities are otherwise without significant change and have an appearance more suggestive of endobronchial spread of infection with the exception ... |
Generate impression based on findings. | 21 year-old female with history of postpartum headache. Evaluate for venous sinus thrombosis. Head: There is no evidence of edema, intracranial hemorrhage or mass. The grey-white matter differentiation is preserved. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged... | 1. No evidence of venous congestive encephalopathy.2. No evidence of acute dural venous thrombosis. |
Generate impression based on findings. | 52 year old woman with history of left breast papilloma, lumpectomy scheduled 2/25/15 On review of the prior studies, there is a lobulated mass in the left breast at 6:00, posterior depth with a biopsy clip in place.The procedure, risks including bleeding, mistargeting and infection, and benefits of needle-wire localiz... | Successful needle localization of the left breast mass.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Clinical question: Follow-up on subarachnoid hemorrhage. Signs and symptoms: Resuming Plavix. Nonenhanced head CT:There is trace residual subarachnoid hemorrhage in the right sylvian fissure. There is complete resolution of the small hemorrhage in the dependent occipital horns since prior exam.Trace residual subarachno... | 1.No acute new finding since prior exam. 2.Interval significant decreased subarachnoid hemorrhage with trace residual as detailed.3.Stable exam otherwise. |
Generate impression based on findings. | 1-year-old male with abdominal distention, evaluate bowel gasVIEW: Abdomen AP (one view) 2/24/151 16:36 A moderate two large colonic stool burden is noted in the right hemiabdomen. A small amount of gas is seen in the distal small bowel without dilated loops or other evidence of obstruction. No bowel wall pneumatosis, ... | Moderate to large colonic stool burden without evidence of obstruction. |
Generate impression based on findings. | 52 year old woman with history of abnormal mammograms and benign biopsy of 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Multiple circu... | Benign bilateral masses, many previously seen to be cysts but no mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually given the complex mammographic findings. Results and recommendation were discussed with the patient. ... |
Generate impression based on findings. | Female 18 years old Reason: mid-epigastric pain, biliary colic in nature, evaluate biliary tree History: same LIVER: 18.2 cm in length. Normal echotexture. No focal lesions.Flow in the portal vein is hepatopedal, peak velocity .3 m/sec.GALLBLADDER, BILIARY TRACT: Cholelithiasis. Gallbladder is not distended although th... | Cholelithiasis. No evidence of cholecystitis. |
Generate impression based on findings. | 12-year-old male, right knee pain and swellingVIEWS: Left knee, AP, oblique, and lateral (3 views) 2/24/15 17:26 Soft tissue swelling is present anterior to the patellar ligament. There may be a small joint effusion. Alignment is anatomic. No fracture or joint effusion. | Soft tissue swelling adjacent to patellar ligament and possible small joint effusion without fracture or dislocation. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: There is scattered trace mucosal thickening in the anterior ethmoids.Maxillary sinuses: There is trace mucosal thickening in the maxillary sinuses, with a tiny mucosal retention cyst in the left. The ostiomeatal units are clear,... | No CT evidence of acute or chronic sinusitis. Minimal scattered trace mucosal thickening as noted above. Mild to moderate leftward nasal septal deviation. |
Generate impression based on findings. | Male 62 years old Reason: baseline exam for heart transplant evaluation. LIVER: 14.3 cm in length. Coarse heterogeneous echotexture of the liver. No evidence of nodularity to the liver surface to suggest cirrhosis. No focal lesions.Flow in the portal vein is hepatopedal, peak velocity .2 m/sec.GALLBLADDER, BILIARY TRAC... | Coarse liver texture. No definitive cirrhotic morphology. |
Generate impression based on findings. | FeverVIEW: Chest AP ET tube, NG tube, right PICC and posterior spinal fusion rods again noted. Cardiothymic silhouette normal. Left lower lobe opacity unchanged. Probable small left pleural effusion. Right lung atelectasis improved in the interval. | Left lower lobe opacity unchanged. |
Generate impression based on findings. | Reason: 77M s/p kidney transplant 2001 p/w acute leukemia History: acute leukemia LUNGS AND PLEURA: Scattered benign-appearing nodules, some calcified. No suspicious pulmonary nodules or masses.Mild basilar scarring, with traction bronchiectasis. Moderate dependent atelectasis.No focal airspace consolidation. No pleura... | Mild basilar pulmonary scarring and traction bronchiectasis, without other acute abnormality. |
Generate impression based on findings. | Patient with pulmonary M. abscessus who is failing therapy. Productive cough. LUNGS AND PLEURA: There is upper lobe predominant bronchial wall thickening and bronchiectasis with extensive mucus plugging, increased from the prior exam. There is significantly increased upper lobe predominant tree in bud opacities which a... | 1. Bilateral upper lobe bronchiectasis with mucous plugging is compatible with history of cystic fibrosis. 2. Worsening upper lobe predominant tree-in-bud opacities is consistent with superinfection from atypical bacteria such as mycobacterium. |
Generate impression based on findings. | 17-day-old male, on HFOVVIEW: Chest AP (one view) 2/25/14 4:29 Right central venous catheter tip extends to the cavoatrial junction. ETT is below the thoracic inlet, above the carina. NG tube extends to the stomach.The cardiothymic silhouette is upper limits of normal. Extensive bilateral pulmonary opacities with sligh... | Extensive bilateral pulmonary opacities with round lucencies at the lung bases which may represent interstitial emphysema. No pneumothorax. |
Generate impression based on findings. | 4-month-old female with crackles, tachypnea and desaturation. Evaluate for pneumonia.VIEW: Chest AP (one view) 2/25/2015 1:54 Left-sided aortic arch, cardiac apex and stomach. Cardiothymic silhouette is normal. Peribronchial thickening with linear band like opacity in the right mid lung and bilateral lung bases likely ... | Reactive airway disease or bronchiolitis pattern. |
Generate impression based on findings. | 17-day-old male on HFOVVIEW: Chest AP (one view) 2/24/15 18:18 ETT tip is at the thoracic inlet. NG tube tip in the stomach. Right central venous catheter tip at the cavoatrial junction.The cardiothymic silhouette is upper limits of normal. Diffuse bilateral pulmonary opacities are again noted without pneumothorax. | Diffuse bilateral pulmonary opacities without significant interval change. No pneumothorax. |
Generate impression based on findings. | Male; 32 years old. Reason: RLQ pain s/p multiple surgeries including parastomal hernia repair and ventral hernia repair (7/28/14) ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedA... | 1.Postsurgical changes s/p hernia repairs with nonobstructive adhesions in the right lower quadrant that may explain the patient's symptoms.2.Unchanged right renal pelvic calculus and associated chronic changes as described above. |
Generate impression based on findings. | Pain RIGHT KNEE: Severe osteoarthritis affects the right knee with bone on bone apposition at the medial tibiofemoral compartment. There is mild varus deformity. These findings appear to have slightly progressed when compared to the prior study. Small joint effusion is present.LEFT KNEE: Severe osteoarthritis affects t... | Severe osteoarthritis |
Generate impression based on findings. | 59-year-old recalled from screening for a new mass in the right breast. An ML view, CC view and multiple spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. The finding from sc... | Benign right breast oil cysts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually, due for this patient in November 2015. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMME... |
Generate impression based on findings. | Female 26 years old Reason: eval fracture History: L TMJ tenderness s/p MVA . We see no fracture. The temporomandibular joint alignment is within normal limits. A linear lucency overlying the right mandibular angle is likely artifactual. | No fracture, dislocation, or other findings to account for patient's temporomandibular joint tenderness. |
Generate impression based on findings. | Male 85 years old; Reason: s/p right distal femur replacement, evaluate for loosening/hardware complications Two views of the right femur and two views of the right knee demonstrate reconstruction of the distal femur with a long stem endoprosthesis device. Heterotopic bone formation along the distal femur appears simil... | Right femur reconstruction without evidence of acute complication. |
Generate impression based on findings. | Male 41 years old Reason: R thumb lack of IP flexion History: as above mallet finger. We have 3 views of the right thumb. We see no fracture or malalignment. | No fracture or other findings to account for patient's symptoms. |
Generate impression based on findings. | Left ankle fracture Again seen is an oblique fracture through the distal fibula extending to the tibiotalar joint with approximately 3 mm of lateral displacement of the distal fracture fragment, appearing similar to that seen on the prior study. On the oblique view, the fracture appears slightly less distinct, which ma... | Ankle fractures, as described above, appearing similar to the prior study, though there may be slight interval healing of the fibular fracture. |
Generate impression based on findings. | Reason: mets lung cancer. s/p 2 cycles of ABT-7-- + Docetaxel. Pls c/w previous study and evaluate tx response. History: lung ca LUNGS AND PLEURA: Right upper lobe spiculated subpleural nodule is decreased in size, now measuring 2.3 x 2.0 x 3.5 cm (series 7, image 34; coronal image 21), previously measuring 3.3 x 3.0 x... | Interval decrease in size of a right upper lobe spiculated subpleural nodule, with persistent central necrosis and a new focus of gas within the lesion. Findings consistent with response to treatment. No new sites of disease. |
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