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Generate impression based on findings. | History of base of tongue cancer, CRT. CHEST:LUNGS AND PLEURA: 5-mm scarlike nodular opacity in the posterior aspects of the right upper lobe (5/89) unchanged. Scarring in the lung apices unchanged. No pleural fluid or pneumothorax.MEDIASTINUM AND HILA: Possible faint calcification at the left main coronary artery. Nor... | No evidence of metastatic disease. Stable right upper lobe nodule. |
Generate impression based on findings. | Female 42 years old; Reason: pain Mild osteoarthritis affects the first MTP joint. There is an equivocal soft tissue defect at the tip of the great toe. We see no specific features of osteomyelitis. Otherwise, we see no specific findings to account for the patient's pain. | Mild osteoarthritis and equivocal soft tissue defect. |
Generate impression based on findings. | Osteosarcoma. 18 months off therapy. VIEWS: Right knee AP/lateral/internal oblique/external oblique (4 views), right femur AP/lateral (two views) 02/25/15 A long stem total knee endoprosthesis reconstruction of the distal femur is again seen. Surgical clips are present posterior to the femoral component of the prosthes... | Postoperative changes with no evidence of disease recurrence or complication. |
Generate impression based on findings. | 2-year-old male with cystic fibrosis, intermittent cough, evaluate for interval changeVIEWS: Chest AP/lateral (two views) 2/25/1511:19 The cardiothymic silhouette is normal. Bronchial wall thickening without focal pulmonary opacity, bronchiectasis or pleural effusions. | Bronchial wall thickening without focal pulmonary opacity or bronchiectasis. |
Generate impression based on findings. | right side sensorineural hearing loss, right side pulsatile tinnitus. NONCONTRAST CT HEADNo evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, in... | No evidence of acute ischemic or hemorrhagic lesion on this scan.Normal CT angiography of head and neckComment: Considering the patient's chief complaint was pulsatile tinnitus on the right, the patient might need to be evaluated at Neurointerventional Clinic (2-5004 or page 9287) for the necessity of performing diagno... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Stable focal asymmetries and calcific... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Clinical question: ICH. Signs and symptoms: Left forehead contusion. Unenhanced head CT:Examination demonstrates no detectable posttraumatic intracranial or calvarial findings. There is however a focus of soft tissue thickening in with high density in the right frontal supraorbital scalp may represent a focus of contus... | 1.No acute intracranial or calvarial posttraumatic findings.2.Right supraorbital soft tissue contusion.3.Tiny nonspecific focus of low attenuation in left periventricular frontal white matter which could represent an age indeterminate small vessel ischemic stroke. |
Generate impression based on findings. | 12-year-old male with blood tinged secretionsVIEW: Chest AP (one view) 2/21/15 10:36 Tracheostomy tube tip at the thoracic inlet. Elevation of the right hemidiaphragm with basilar atelectasis. The left lung is well aerated. The cardiothymic silhouette is unchanged. | Unchanged elevation of the right hemidiaphragm and basilar atelectasis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. There are bilateral b... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcificat... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female; 61 years old. Reason: RUQ Abdominal Pain. Evaluate for gallstones. LIVER: Liver is normal in size measuring 17.1 cm in length. Coarse and echogenic liver parenchyma compatible with fatty infiltration. Hepatic contour is normal. No focal hepatic lesions are evident. Portal venous flow is hepatopetal with a peak ... | 1.No gallstones or sonographic evidence of cholecystitis as clinically questioned.2.Fatty liver infiltration. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of archit... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. Stable bilateral benign skin calcifications. No suspicious ma... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Female, 31 years old. Evaluation of fine detail is limited due to portable technique. We see no retained foreign object. | We see no retained foreign object.These findings were discussed by telephone with Dr. Haney, the attending surgeon, on 2/25/2015 at 1139am. |
Generate impression based on findings. | Right lower lung nodules surveillance PET negative. LUNGS AND PLEURA: The right apical ground glass nodule measures 22 mm, previously 21-mm when remeasured (5/17).When high-resolution series, the right lower lobe partially marginated nodule is unchanged, measuring 17 x 30 mm (series 6 image 169), previously 18 x 29 mm ... | Indeterminate right lower lobe lesion is larger, the appearance and presence of probable bronchoceles elsewhere may indicate that this is also bronchogenic in origin (bronchogenic cyst, bronchocele), however no conclusive communication with an airway is identified. Suggest continued conservative imaging follow-up in 3 ... |
Generate impression based on findings. | Male; 60 years old. Reason: metastatic lung cancer, s/p chemo with disease progression and RT to chest and left adrenal. Recent PET scan showed left UPJ obstruction. Evaluate disease status. ABDOMEN:LUNG BASES: Please see separately dictated chest CT from same day for further details. LIVER, BILIARY TRACT: No suspiciou... | 1.Interval decrease in size of left adrenal metastasis. No new metastatic lesions identified in the abdomen/pelvis. Please see separately dictated chest CT report from same day. 2.Unchanged severely dilated left proximal collecting system, suggestive of chronic UPJ obstruction. |
Generate impression based on findings. | There is slight prominence of the sulci diffusely, much more conspicuous along the frontal lobes bilaterally as well as the anterior temporal lobes. There is also mild nonspecific prominence of the ventricles.. The basal cisterns remain patent. There is no midline shift or mass effect. There are ill-defined areas of T... | 1. No acute intracranial abnormality.2. Mild global volume loss suggested predominantly anteriorly with areas of well-defined as well as more conspicuous abnormal FLAIR hyperintensity in the frontal lobe white matter which are nonspecific but may relate to areas of gliosis or incomplete myelination. Additional patchy a... |
Generate impression based on findings. | 31-year-old male with history of Wilms tumor 16 months off therapy LIVER: Normal echogenicity. The liver measures 14.7 cm. No focal hepatic lesion. No intra-or extrahepatic ductal dilatation.GALLBLADDER, BILIARY TRACT: The gallbladder is mildly distended without wall thickening or pericholecystic fluid. No biliary duct... | No evidence of disease recurrence. Multiple unchanged right renal cyst as described above. |
Generate impression based on findings. | T2N2b squamous cell carcinoma of left tongue base treated with TFHX and radiation therapy completed in 2010. Much of the oral cavity is obscured by dental streak artifact. There is no significant interval change in the patchy focus of enhancement in the left tongue base, without definite evidence of measurable tumor. T... | 1. Stable post-treatment findings without definite evidence of oropharyngeal region tumor recurrence, within the limits of dental artifact. 2. No significant cervical lymphadenopathy. |
Generate impression based on findings. | 66 years, Male. Reason: r/o free air, eval dilation History: abd distention No pneumoperitoneum. Gas distended loops of predominantly large bowel measuring up to 6.3 cm in the ascending colon, previously 7.5 cm. Balloon type gastrostomy tube projects over the stomach. Residual contrast is noted within the descending an... | Mild improvement in colonic ileus without evidence of pneumoperitoneum. |
Generate impression based on findings. | 59 years, Male, Reason: GE junction carcinoma please compare to most recent imaging and provide index lesions for RECIST as required per study History: As above. CHEST:LUNGS AND PLEURA: Moderate to large bilateral pleural effusions are increased in size from the prior exam with right upper lobe masslike consolidation.M... | 1.Soft tissue thickening around distal esophageal stent appears similar to the prior exam.2.Mediastinal lymphadenopathy is slightly increased. Additional lymphadenopathy is not significantly changed.3.Increased moderate to large bilateral pleural effusions with masslike consolidation in the right upper lobe.4.Increased... |
Generate impression based on findings. | 58 years, Male. Reason: eval for dilated bowel History: distended abd, elevated bilirubin There is improved, yet persistent ileus type pattern. Left lower extremity central venous catheter tip noted projecting over the pelvis. Additional large bore catheter projects over the abdomen. | Improved, yet persistent ileus. |
Generate impression based on findings. | Status post fall, hit head, pain and ecchymosis to left frontal area 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. Sulci and ventricles are within normal limits for age without evidence of ... | 1. No evidence of acute intracranial hemorrhage or mass effect. No skull fracture. 2. No fracture or subluxation within the cervical spine. |
Generate impression based on findings. | Status post XLIF with spinal fusion, evaluate construct. Evaluation of the spine is slightly limited due to inability to optimally position the patient. There are intervertebral spacer devices at L1/2, L2/3, L3/4, and L4/5. The lumbar scoliosis seen on the prior study is perhaps slightly less pronounced on the current ... | Postoperative changes of spinal fusion as described above. Loss of height of L3 with associated fracture is better visualized on prior CT scan. |
Generate impression based on findings. | Reason: Patient with SOB, cough and endocarditis w/ concern for septic emboli History: As above LUNGS AND PLEURA: Lingular subsegmental atelectasis.Bilateral basilar scarring/discoid atelectasis.No suspicious pulmonary nodules or masses.Mild left pleural thickening.No pleural effusions.MEDIASTINUM AND HILA: Left-sided ... | 1.Lingular and basilar subsegmental atelectasis with mild left pleural and parenchymal scarring.2.No suspicious point nodules or masses. No specific evidence of infection or edema. |
Generate impression based on findings. | Evaluate for osteoarthritis for upcoming orthopedic appointment and possible knee replacement. Four views of the left knee are provided. Moderate osteoarthritis affects the knee, particularly the patellofemoral and medial compartments. Ossicles posterior to the knee joint likely represent loose bodies in a Baker's cyst... | Osteoarthritis. |
Generate impression based on findings. | Postop prosthetic assessment Two views of the left hip show components of a total hip arthroplasty device situated in near anatomic alignment without radiographic evidence of hardware complication.The AP view of the pelvis reveals the aforementioned left total hip arthroplasty. The bones appear demineralized suggesting... | Left total hip arthroplasty and other findings as above. |
Generate impression based on findings. | Patient has sickle cell of bilateral hip AVN status-post bilateral hip replacements, presented with 1.5 weeks of right hip pain. Evidence of fracture or cause of right hip pain? Two views of the right hip are provided. Again seen are components of a right total hip arthroplasty device appearing similar to those seen on... | Right total hip arthroplasty device as described above appearing similar to that seen on the prior study. I see no acute complications. |
Generate impression based on findings. | 57 year old woman with atypical chest pain referred to rule out CAD as cause. Cardiac risk factors include 20 year tobacco history. CPT Code: 75574 Coronary arteries: LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex co... | 1. There are no severe coronary artery stenoses present. 2. Non-obstructive (<50% stenosis), non-calcified coronary atherosclerosis is noted in the mid LAD, proximal diagonal 1 artery, and the mid right coronary artery. 3. Normal LV size with normal systolic function. 4. Mild left ventricular hypertrophy with mild left... |
Generate impression based on findings. | Evaluate status-post left total hip arthroplasty The AP view of the left hip reveals components of a total hip arthroplasty device situated in near anatomic alignment without radiographic evidence of complication. Skin staples, a drain, and foci of gas density within the soft tissues reflect recent surgery.The AP view ... | Left total hip arthroplasty and other findings as above. |
Generate impression based on findings. | Preop. Pain. Three views of the left knee are provided. Severe osteoarthritis affects the patellofemoral joint with near bone-on-bone apposition. There is also slight lateral translation of the patella relative to the femoral trochlea. Relatively mild osteoarthritis affects the tibiofemoral compartment. Overall, these ... | Osteoarthritis and mild valgus deformity as described above. |
Generate impression based on findings. | Shoulder pain Mild osteoarthritis affects the glenohumeral and acromioclavicular joints, appearing similar to the prior study. Alignment is within normal limits. | Mild osteoarthritis. |
Generate impression based on findings. | Pain status post left shoulder TSA Three views of the left shoulder and two views of the left humerus reveal components of a new total shoulder arthroplasty. There is slight anterior subluxation of the head of the humeral component with respect to the glenoid component. Discontinuity of the greater tuberosity likely re... | Total shoulder arthroplasty as described above. |
Generate impression based on findings. | Left shoulder pain. Rule-out dislocation. Patient states that it feels like it is out of place. Painful range of motion. Glenohumeral and acromioclavicular joint alignment is within normal limits. Small acromioclavicular joint osteophytes indicate mild osteoarthritis. I see no fracture. | Mild osteoarthritis without fracture or dislocation. |
Generate impression based on findings. | Medial pain status post fall. Rule out fracture/dislocation. I see no fracture or dislocation. I see no findings to account for the patient's pain. | Normal-appearing knee without fracture, dislocation or other findings to account for the patient's pain. |
Generate impression based on findings. | Humerus fracture. Concern for pathologic fracture. Three views of the left shoulder, two views of left humerus and 4 views of the left elbow are provided. There is a transverse fracture through a geographic lucent lesion of the proximal humeral metadiaphysis. The lesion has well-defined thin sclerotic margins and resul... | Nondisplaced fracture through simple bone cyst of the proximal humerus. |
Generate impression based on findings. | 69 year old woman with palpable right breast mass; two suspicious masses noted on mammogram and ultrasound. Right ultrasound re-identified the target lesions for biopsy. The first lesion to be targeted is a lobulated, hypoechoic mass measuring 12 x 12 x 10 mm at the 10 o’clock position with increased vascularity, 10 cm... | Successful ultrasound-guided core biopsy of the right breast lesions and clip placement. Pathology is pending at this time.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Malignant neoplasm of larynx, status post surgery and radiotherapy follow-up. There are post-treatment findings in the neck related to total laryngectomy and flap reconstruction, tracheostomy, as well as radiation therapy. There is no evidence of measurable tumor in the region of the treatment bed and no significant ce... | Post-treatment findings in the neck without definite evidence of tumor recurrence. |
Generate impression based on findings. | There is extensive encephalomalacia involving the left cerebral hemisphere, particularly in the frontal and parietal lobes and to a lesser degree in the temporal lobe, occipital lobe, and insular cortex similar to prior examination. There is ex vacuo dilatation of the left lateral ventricle which is unchanged. There i... | 1.No acute intracranial hemorrhage or mass-effect. However, please note that CT is insensitive for detection of early nonhemorrhagic stroke.2.Stable extensive left hemispheric encephalomalacia from old infarct. |
Generate impression based on findings. | Pain Three views of the right knee are provided. There is severe osteoarthritis particularly affecting the medial compartment where there is near bone on bone apposition. A 1.5-cm ossicle in the posterior aspect of the joint may represent a loose body. I see no large joint effusion.Three views of the left knee are prov... | Severe bilateral osteoarthritis. |
Generate impression based on findings. | Complains of C7 neuropathic pain on the left. Assess for osteophytes, signs of osteoarthritis. Severe degenerative disk disease affects C3/4 and C5/6. Moderate to severe degenerative disk disease affects C6/7 and C7/T1. Moderate degenerative disk disease affects C2/3. There is multilevel facet joint osteoarthritis and ... | Degenerative disk disease and other findings as described above. |
Generate impression based on findings. | PICC placement. Craniopharyngioma.VIEW: Chest AP (one view) 02/25/15, 1231 Left upper extremity PICC tip is at junction of superior vena cava and right atrium.Cardiothymic silhouette is normal. No focal lung opacities present. | PICC tip is located centrally. |
Generate impression based on findings. | Status post curettage of right distal femur chondrosarcoma. Evaluate for healing. There is an elongated defect along the lateral aspect of the distal femoral metadiaphysis with bone graft material in the underlying medullary space. Small densities within the soft tissues lateral to the distal femur presumably represent... | Postoperative changes of chondrosarcoma curettage and grafting as described above. |
Generate impression based on findings. | Left hip pain, new onset, no known insult or injury. I see no fracture or malalignment. There is slight prominence of the anterior aspect of the femoral head/neck junction on the frog leg view which may indicate a mild CAM deformity. I otherwise see no specific findings to account for the patient's pain. | Possible mild CAM deformity of the femoral head/neck junction, but otherwise no specific findings to account for the patient's pain. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | 71-year-old female with HCC, status post Therasphere administration. CHEST:LUNGS AND PLEURA: 7-mm left basilar nodule (series 11, image 66) unchanged. No new other nodules or parenchymal abnormality seen. No pleural disease.MEDIASTINUM AND HILA: Mild coronary artery calcification without adenopathy or other significant... | 1. Most hepatic mass lesions appears stable although one larger lesion is slightly smaller as reported above. 2. Cirrhotic morphology with portal hypertension varices unchanged and no new parenchymal lesions identified. 3. Cholelithiasis with distended gallbladder unchanged. 4. Extensive ascites without loculation. |
Generate impression based on findings. | Pain. Tibial plateau fracture? Three views of the left knee are provided. The bones appear demineralized presumably from disuse. Again seen is a comminuted intra-articular fracture of the proximal tibia with fracture fragment in near anatomic alignment. The fracture lines are less distinct on the current study than on ... | Healing proximal tibial fracture. |
Generate impression based on findings. | Chest pain, shortness of breath, pain in left lower leg. History of lupus. Question of PE. PULMONARY ARTERIES: There are new mostly eccentrically located, non-occlusive filling defects within the bilateral lower lobar and segmental pulmonary arteries, right greater than left. The main pulmonary artery is not enlarged. ... | Bilateral lower lobar/segmental pulmonary emboli are new compared to a 8/19/2014 study. However, the appearance of the filling defects are not consistent with an acute or chronic process and thus these are of indeterminate age. Findings communicated to Dr Sharp via phone in the ED at 1305 hrs. PULMONARY EMBOLISM: PE: P... |
Generate impression based on findings. | 7-year-old male with history of neuroblastoma, pre-ENCIT-1 study CHEST:LUNGS AND PLEURA: No pulmonary nodules or masses. No pleural effusion or pneumothorax. MEDIASTINUM AND HILA: Normal size heart with no pericardial effusion. Reference right hilar lymph node measures 8 mm (series 3, image 27) previously 10 mm. No med... | No significant interval change in retroperitoneal, paraspinal, and osseous metastatic disease. |
Generate impression based on findings. | 7-year-old female with fever, cough, wheezingVIEWS: Chest AP/lateral (two views) 2/25/15 12:59 Bronchial wall thickening and subsegmental atelectasis without consolidation or pleural effusion. The cardiothymic silhouette is normal. | Bronchiolitis without evidence of pneumonia. |
Generate impression based on findings. | 16 year-old male status post PICC placementVIEW: Chest AP (one view) 2/25/15 11:49 Left PICC tip is directed laterally within the SVC. NG tube tip and side-port in the stomach. The cardiothymic silhouette is unchanged.Interval increase in right pleural effusion and basilar opacity. | Left PICC tip in the SVC. Increased right pleural effusion and basilar opacity. |
Generate impression based on findings. | 14 year-old male with right wrist pain status post assaultVIEWS: Right wrist, AP, lateral, and oblique (3 views) 2/25/15 11:54 Soft tissue swelling is present about the wrist with displacement of the pronator quadratus fat pad. No visualized fracture or malalignment. | Soft tissue swelling without visualized fracture or dislocation. |
Generate impression based on findings. | 27-year-old female patient with history of ulcerative colitis, in complete remission, now with constipation and straining. Physical examination demonstrated small external hemorrhoids. There is prompt opacification of the rectum, sigmoid, and descending colon without significant abnormality.Trial straining showed appro... | Anterior rectocele visible during active evacuation. |
Generate impression based on findings. | 18 year-old female, evaluate for right ankle fractureVIEWS: Right ankle, AP, oblique, and lateral (3 views) 2/25/15 12:08 Alignment is anatomic. No fracture is evident. The ankle mortise is intact. | Normal examination. |
Generate impression based on findings. | 59 years old male with a history of esophageal carcinoma,currently receiving therapy on clinical trial and reassessment warranted. Please compare to previous imaging . RADIOPHARMACEUTICAL: 15.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 126 mg/dL. Today's CT portion of the neck demonstrates no significa... | 1.Interval progression of metastatic esophageal cancer with new metastasis in the lungs and in the abdominal gastrohepatic ligament. The primary esophageal tumor has increased in size and metabolic activity.2.Inflammatory changes/compression atelectasis in both lower lungs.Diagnostic CTs of the chest, abdomen, and pelv... |
Generate impression based on findings. | Clinical question: 48-year-old white female with no known PMH, with acute pulmonary hemorrhage a/w flue + MSSA PNA/no status post initiation of ECMO, difficulty accessing mental status. Signs and symptoms: Pinpoint pupils with minimal but equal reactivity. Requiring larger volumes of blood product. Nonenhanced head CT:... | 1.Several varying size acute parenchymal hematoma in bilateral cerebral hemispheres and a single hematoma in the left paramedian posterior cerebellar.2.There is extension of hemorrhage into the ventricular system extensively on the left and lesser degree in the right ventricle and minimally in the fourth.3.Effacement o... |
Generate impression based on findings. | Head and neck cancer and CRT. CHEST:LUNGS AND PLEURA: Right lower lobe spiculated nodule decreased in size but the spicules are oriented obliquely to the scanning plane. Solid portion of the nodule measures 7 x 9 mm (/54), previously 10 x 24 mm. Spiculation extending anterolaterally to the major fissure appears slightl... | 1. No new nodules or lymphadenopathy to suggest metastatic disease.2. Right lower lobe spiculated nodule decreased in size, favoring a postinfectious lesion.3. Stable nodular lesions at the lung apices, most likely nodular scarring.4. Above lesions may be followed in 3-4 months for stability. |
Generate impression based on findings. | 68 year old female with history of brainstem lesion and continuous vomiting. There is no evidence of acute intracranial hemorrhage. There is extensive periventricular and subcortical white matter hypoattenuation which is nonspecific but compatible with moderate chronic small vessel ischemic disease. The gray-white diff... | 1. No intracranial hemorrhage or mass effect.2. Moderate chronic small vessel ischemic disease.3. Please note left posterior medullary lesion seen on prior MRI is not well seen on CT and recommend follow-up MR for better evaluation. |
Generate impression based on findings. | 20 year-old female patient status post IPAA. There is prompt opacification of the J-pouch of normal static morphology with Omnipaque with retrograde filling to the ileostomy. Next, barium contrast was injected to opacify the J-pouch and proximal bowel. There was normal appearing peristalsis of the bowel proximal to the... | Properly functioning J-pouch. |
Generate impression based on findings. | Evaluation preoperatively for right middle lobe adenocarcinoma. CHEST:LUNGS AND PLEURA: There is a 26 x 19 mm right middle lobe pulmonary nodule with minimal surrounding ground glass opacity. There are scattered punctate calcified granulomas and non-calcified pulmonary micronodules which are non-specific. There is susp... | 1. Right middle lobe solid pulmonary nodule is compatible with provided diagnosis of lung cancer. Additional scattered punctate pulmonary micronodules are non-specific.2. No evidence of mediastinal or hilar lymphadenopathy by CT size criteria. |
Generate impression based on findings. | Reason: h/o HNC and CRT at another facility, compare to previous, measurements pls. History: none LUNGS AND PLEURA: Mild apical predominant centrilobular emphysema.No suspicious pulmonary nodules or masses.Mild periesophageal fat infiltration, likely post-radiation changes.Minimal dependent atelectasis. Previously desc... | 1. No significant change in mild mediastinal lymphadenopathy since the previous study. However, this area was partially included within the scanning range of neck CT dated 8/31/2014 and lymph nodes in this area are larger when comparing back to this remote exam, now at least mildly suspicious for nodal metastases. Cons... |
Generate impression based on findings. | Lung cancer status post chemoradiation. Check response. CHEST:LUNGS AND PLEURA: There is moderate apical predominant centrilobular emphysema. Right paramediastinal radiation fibrosis is similar to the prior examination. Focal area of thickening within the medial right middle lobe measures approximately 8 mm (image 57, ... | No significant interval change or new evidence of metastatic disease. |
Generate impression based on findings. | T3N2cM0 squamous cell carcinoma of the base of tongue treated with 3 cycles of induction chemotherapy with carbo/taxo, and 5/5 cycles of TFHx completed on 1/9/15. There has been interval decrease in size of the left tongue base lesion, which now measures up to approximately 5 mm, previously 15 mm. In addition, there ha... | 1. Interval decrease in size of the left tongue base squamous cell carcinoma and bilateral cervical lymph nodes.2. Unchanged subcentimeter partially calcified left thyroid nodule. Nevertheless, thyroid ultrasound may be useful for further characterization. |
Generate impression based on findings. | Recurrent paraganglioma post-MIBG Normal physiologic radiotracer distribution is seen in the salivary glands, myocardium, liver, bowel and bladder. Compared with 9/12/2014 there has been interval decrease in both the size and number of the numerous soft tissue and osseous lesions involving the legs, pelvic region, spin... | Overall interval decrease in number and size of the diffuse soft tissue and osseous lesions when compared with the exam from 9/12/2014. |
Generate impression based on findings. | 15 year old female with history of constipation, chronic narcotic pain medication since surgery. Evaluate degree of stool burdenVIEW: Abdomen AP (one view) 2/25/2015 Surgical clips in the left upper quadrant. Average stool burden. Nonobstructive bowel gas pattern. | Average stool burden with no obstruction. |
Generate impression based on findings. | Prostate cancer with Gleason 9 score. No abnormal osseous foci are identified to indicate metastatic disease. Increased activity within the mandible bilaterally may be related to dental disease. Increased activity within the bilateral frontal sinuses may be related to sinusitis. Increase renal cortical activity can be ... | No evidence of bone metastases. |
Generate impression based on findings. | There is mild nonspecific prominence of the ventricles and sulci are diffusely without definite anterior predominance. In addition, the frontal lobes appear somewhat diminutive in size with decreased white matter volume. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of ... | 1. Dysgenesis of the corpus callosum posteriorly with diminutive posterior body and splenium.2. Kinking of the upper cervical spinal cord at the C1-C2 level with suggestion of at least moderate narrowing of the spinal canal at this level. Findings may be developmental, and dedicated MRI of the cervical spine recommende... |
Generate impression based on findings. | 79-year-old female with history of chronic sinusitis. There is mild mucosal thickening along the inferior aspects of the bilateral maxillary sinuses and mild opacification of scattered ethmoid air cells. The sphenoid and frontal sinuses are clear. There are postoperative changes of left uncinectomy with patent bilatera... | 1. Mild mucosal thickening as detailed above. 2. Prior left uncinectomy with patent bilateral osteomeatal units.3. Polypoid soft tissue along the left middle turbinate. |
Generate impression based on findings. | Clinical question: Chronic sinusitis. Sinus and symptoms: Sinusitis. Nonenhanced maxillofacial CT:All paranasal sinuses are well pneumatized. There is only a single small focus of because of thickening in the dependent left maxillary sinus and without evidence of any additional findings of chronic or acute sinusitis. T... | 1.Negative CT of paranasal sinuses.2.Mild leftward nasal septum deviation and a bony septal spur which is in contact and deforms the mucosa of the left inferior turbinate. |
Generate impression based on findings. | Cough, shortness of breath, nodule, recurrent pleural effusions. Is the recurrence related to malignancy.RADIOPHARMACEUTICAL: 12 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 87 mg/dL. Today's CT portion grossly demonstrates a right-sided pleural effusion and subpleural reticulation within mild bronchiecta... | 1.Pleural thickening with diffuse nodular uptake, especially noted within the right upper mediastinal region and right posterior lung base, which could be due to tumor (such as mesothelioma or pleural metastases) or inflammatory changes.2.Nonspecific mild increased activity within mediastinal and hilar lymph nodes.3.In... |
Generate impression based on findings. | Reason: Metastatic thyroid cancer, follow up with measurements History: as above CHEST:LUNGS AND PLEURA: Multiple solid nodules of varying sizes are again seen throughout the lungs.A left lower lobe nodule measures 18 x 16 mm (series 5, image 78), previously 11 mm.A right lower lobe perihilar nodule now measures 32 x 2... | 1. Increase in size of multiple pulmonary metastatic nodules. Reference measurements as above. 2. Newly visualized right iliac lytic lesion with bony destruction and surrounding soft tissue mass, compatible with osseous metastasis, age indeterminate. |
Generate impression based on findings. | 75 years, Male. Reason: ILeus History: Ileus Again seen are multiple dilated loops of large and small bowel with residual enteric contrast in the colon. Enteric feeding tube tip projects over the expected location of the gastric antrum. Postsurgical changes from fundoplications surgery are noted. The lung bases are cle... | Findings compatible with ileus. |
Generate impression based on findings. | Female 69 years old Reason: pt with met breast CA to bone and liver, had g tube replaced this week and having increased focal pain deep to tube site History: focal abd pain near g tube site with fevers at home ABDOMEN:LUNG BASES: No pleural effusions. Minimal basilar atelectasis. Lung nodules seen on prior CT chest are... | 2.No defined leakage around the gastrostomy tube site (ascites about liver appears similar to prior exams). The gastric balloon is slightly retracted from the anterior gastric wall in teh gastric lumen.3.Multiple hepatic metastases which were initially responsive to therapy, (although not reported as such on previous e... |
Generate impression based on findings. | 79 years old female presents to evaluate extent of diagnosis for pancreatic cancer, status-post chemotherapy and radiation study on 2013. She presents with pancreatic mass enlarging on CT. RADIOPHARMACEUTICAL: 11.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 151 mg/dL. Today's CT portion grossly demonstr... | 1.Interval progression of pancreatic cancer with new metastasis in the left upper lobe of the lung and increased size of the pancreatic mass.2.Low-attenuation lesion with decreased metabolic activity in the left temporal lobe, suspicious for brain infarct.3.Diskitis or degenerative change in the L4/5 intervertebral dis... |
Generate impression based on findings. | Malignant neoplasm of tonsil (squamous cell), CRT follow-up. CHEST:LUNGS AND PLEURA: Mixed response in size of nodules (some larger, some smaller) but an increase in number.Left apical mass measures 4.1 x 5.8 cm (4/17), previously 2.7 x 2.6 cm.Reference right upper lobe nodule measures 11 mm, previously 7-mm. There are... | Though a few pulmonary nodules is appears slightly smaller, the majority are larger and there is an overall increase in number. Reference lesions measure larger. Interval worsening of lymphadenopathy. Thecal sac enhancement very poorly assessed by this technique but is at least mildly suspicious for metastatic disease ... |
Generate impression based on findings. | Clinical question: CVA. Signs and symptoms: CVA. Unenhanced head CT:No detectable acute intracranial process. CT however is intensity for early detection of acute nonhemorrhagic ischemic strokes.Multiple foci of encephalomalacia consistent with chronic ischemic strokes of bilateral Cipro hemispheres (left greater than ... | 1.No acute or new finding since prior exam from 2014.2.Multiple bilateral hemispheric (left greater than right) and small right cerebellar chronic ischemic strokes similar to prior study. |
Generate impression based on findings. | 37 years, Female. Reason: rule out bowel obstruction History: pain Nonobstructive bowel gas pattern with slightly less than average stool burden in the colon. There is mild sclerosis of the pubic symphysis, suggestive of mild degenerative changes. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 49 years, Female. Reason: pt w/ PTLD and abd LAD s/p ERCP for biliary stent removal w/ post-procedure LUQ abd pain; eval for free air or obstruction History: LUQ abd pain Granuloma is noted in the right lung based. Central venous catheter tip is in the right atrium. Cholecystomy clips are noted quadrant. A device proje... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Metastatic follicular thyroid carcinoma to lungs, on cediranib therapy. Neck: There are postoperative findings related to total thyroidectomy. There is no evidence of measurable locoregional tumor. There is no evidence of significant cervical lymphadenopathy. The salivary glands are unchanged. The airways are patent. T... | 1. No evidence of locoregional tumor recurrence of significant lymphadenopathy in the neck.2. No evidence of intracranial metastases. |
Generate impression based on findings. | 41-year-old female with history of Crohn's disease with ileostomy. Patient had lysis of adhesions in the past year now with new abdominal pain and recurrent obstructive symptoms. The scout film shows a nonobstructive bowel gas pattern. Fluoroscopic evaluation showed a focal, fixed narrowing of small bowel measuring at ... | 1.Short segment stricture in the distal small bowel as described above. 2.Multiple nonobstructive adhesions as described above.Findings discussed with clinical service at 1039 on 2/25/15. |
Generate impression based on findings. | 57-year-old with history of lymph node biopsy. Three standard views of both breasts and left spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious... | No mammographic evidence of malignancy. Interval significant decrease in symmetric axillary and intramammary lymph nodes. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign fin... |
Generate impression based on findings. | Clinical question: Could obscure a hemorrhage, CVA. Signs and symptoms: Headache and paresthesia. Unenhanced head CT:No acute intracranial finding. CT however is insensitive for early detection of an acute nonhemorrhagic ischemic stroke. There is widening of the left sylvian fissure with CSF density. The finding is bel... | 1.No acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.2.There is ex vacuo dilatation of the left sylvian fissure likely secondary to a chronic left frontal ischemic stroke.3.There are no prior exam available for comparison. Consider MRI if clinical concern for s... |
Generate impression based on findings. | T4N2cM1 squamous cell carcinoma of the right tonsil, status post chemoradiation therapy and hypofractionated radiation to left apical lung nodule. There are extensive post-treatment findings in the neck. There is no definite evidence of measurable mass lesions in the oropharyngeal region, although dental streak artifac... | 1. No definite evidence of measurable tumor in the oropharyngeal region or significant lymphadenopathy in the neck, although dental streak artifact somewhat limits the assessment.2. Continued increase in size of several metastases within the partially imaged upper lungs and upper mediastinal lymphadenopathy. Please ref... |
Generate impression based on findings. | Female 30 years old Reason: Evaluate for retained foreign body and fracture History: laceration. We have two views of the left forearm which show no fracture or radiopaque foreign body. We have two views of the right tibia/fibula which show no fracture. There is a 2-mm rounded density seen on the lateral view immediate... | No fracture or definite foreign body. If further imaging evaluation is clinically warranted, ultrasonography may be considered. |
Generate impression based on findings. | Female 57 years old; Reason: right 5th digit trauma. Rule out fracture History: decreased ROM and swelling right 5th digit. Bruising focally Two views of the right hand demonstrate a fracture through the base of the fifth finger proximal phalanx, with dorsal angulation of the distal fracture fragment. We suspect this f... | 1. Fifth finger proximal phalanx fracture, as above.2. Linear foreign body within the soft tissues volar to the ring finger distal phalanx.Findings discussed with Dr. Rossi-Foulkes by telephone on 2/5/15 at 3 p.m. |
Generate impression based on findings. | Female; 62 years old. Reason: evaluate for the SB thickening seen on last CT, push enteroscopy was normal. History: abdominal pain/constipation/abnormal CT. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Promine... | Interval resolution of long segment proximal small bowel infection/inflammation, without new acute abnormality identified. |
Generate impression based on findings. | Male 52 years old; Reason: Evaluate left hand pain. Left knee pain. LEFT HAND: Mild to moderate osteoarthritis affects the distal interphalangeal joints, particularly at the second and fifth fingers. Mild deformity of the index finger middle phalanx likely represents an old healed fracture. Tiny osteophytes are present... | Osteoarthritis. |
Generate impression based on findings. | Male 43 years old Reason: pain, fragments History: pain. We have 3 views of the right ankle that show a 12-mm elongated bone fragment in the soft tissues lateral to the distal fibula that may represent old trauma, but we see no findings to suggest an acute fracture. Tiny ankle joint osteophytes indicate mild osteoarthr... | Chronic appearing ossific density along the distal fibula, but no evidence of acute fracture. |
Generate impression based on findings. | Male 52 years old Reason: concern for avascular necrosis History: hip pain on prednisone. Two views of the right hip appear normal for patient's age without radiographic evidence of avascular necrosis. Tiny enthesophytes along the greater trochanter are not necessarily of any current clinical significance. | No evidence of avascular necrosis or other specific findings to account for patient's pain. If further imaging evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | Right upper quadrant abdominal pain. Per Epic Notes, patient has a history of celiac disease. Angiographic images are unremarkable. Prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is normal excretion of tracer into the intrahepatic ducts, common ... | 1.Normal hepatobiliary system.2.Abnormal reflux of tracer into the stomach from the proximal duodenum which can be a cause of gastritis secondary to bile reflux. |
Generate impression based on findings. | Female 80 years old Reason: follow up History: follow up. Previously seen tibial plateau fracture is less distinct on the current study than on the prior study, suggesting some interval healing. Moderate osteoarthritis affects the knee. There is a moderate-sized joint effusion. | Healing tibial plateau fracture. |
Generate impression based on findings. | Metastatic thymic cancer. Restaging. Status post right lower lobe wedge resection. CHEST:LUNGS AND PLEURA: There has been an interval right lower lobe wedge resection with removal of the previously identified largest right lower lobe pulmonary nodule. There is non-specific soft tissue density around the suture material... | 1. Interval right lower lobe wedge resection with non-specific soft tissue density around the suture material; given recent surgery, this likely represents post-operative change, including a small amount of blood product. Serial imaging would be helpful. 2. Multiple bilateral pulmonary nodules are otherwise unchanged. ... |
Generate impression based on findings. | 35 year old male status post proctocolectomy with J-pouch and diverting ileostomy. There is prompt opacification of the J-pouch of normal static morphology.Trial straining showed appropriate descent of the perineal floor; voluntary anal sphincter contraction demonstrated expected perineal elevation.Formal straining and... | Normal appearing and functioning J-pouch as described above. Findings discussed with Dr. Rubin. |
Generate impression based on findings. | Female 87 years old; Reason: Evaluate for fracture vs Lisfranc's dislocation left foot as well as left hallux History: Patient fell yesterday, now with pain and swelling of midfoot and left hallux The bones appear demineralized, suggesting osteopenia/osteoporosis. There is soft tissue swelling along the dorsal aspect o... | Soft tissue swelling and osteoarthritis, without fracture or dislocation. |
Generate impression based on findings. | Female 95 years old; Reason: Evaluate for for evidence of neural foraminal stenosis, degenerative changes or lytic lesions. Remote history of breast cancer. History: radicular pain thoracic spine area radiating to breast. THORACIC SPINE: The bones are demineralized. Again seen is severe kyphosis of the lower thoracic s... | 1. Opacity in the right upper lung is concerning for a neoplasm, and further evaluation with chest CT is recommended if clinically warranted.2. Severe thoracic kyphosis with multilevel degenerative disk disease. No lytic bone lesion is evident.Findings were discussed by phone with Dr. Blackman 12/25/15 at 3:45 p.m. |
Generate impression based on findings. | 63 year old woman with history of left breast cysts and aspiration 2014. History of mother with breast cancer. Three standard views of both breasts and CC and two ML spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense... | Left breast cyst but no mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Reason: Rectal carcinoma please assess thoracic area for diease involvement History: As above LUNGS AND PLEURA: 8 x 6 mm left lower lobe subpleural nodule with somewhat poorly defined margins is seen along the fissure (series 5, image 150). Additional scattered benign-appearing micronodules.No focal airspace consolidat... | 1. An 8 mm left lower lobe subpleural nodule may have a benign etiology such as an intrapulmonary lymph node, but should be followed closely in a patient with a known malignancy. Recommend 3 month followup CT imaging. Alternatively, outside imaging can be helpful for comparison if able to be obtained and submitted by t... |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Basilar reticular opacities with septal lines, bronchial thickening and mild bronchiectasis, likely chronic.MEDIASTINUM AND HILA: Moderately enlarged paratracheal and prevascular lymph nodes, likely reactive.CHEST WALL: Degenerative disease in the spine.Healing fracture of the manubrium and old... | Chronic incidental findings and no acute pulmonary abnormalities. |
Generate impression based on findings. | Evaluation preoperatively right completion pneumonectomy. CHEST:LUNGS AND PLEURA: Postsurgical changes of a right upper lobectomy. 3.8 x 4.6 cm right lower lobe mass at the resection site compatible with a localized recurrence, this extends to the right paravertebral pleural surface and is inseparable from the right ma... | 1. 4.6-cm right mass occurring at the right upper lobectomy resection site extending into the right lower lobe parenchyma, consistent with localized recurrence. No conclusive metastases.2. Asymmetric left breast soft tissue containing calcification nonspecific by CT however the asymmetry, density and presence of calcif... |
Generate impression based on findings. | Postoperative changes from previous right pterional craniotomy for aneurysm clipping are again seen, with two vascular clips in the right suprasellar cistern. There is an adjacent stable coil mass just medial to the aneurysm clips. The configuration of these structures is unchanged. Associated streak artifact limits e... | 1. Limited exam secondary to extensive streak artifact relating to previous treated aneurysms. No flow-limiting stenosis or definite aneurysm within limitations.2. Interval slight progression of intracranial atherosclerotic calcification.3. Stable left frontal approach ventriculostomy catheter with unchanged normal ven... |
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