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Generate impression based on findings. | Female 80 years old Reason: land hand pain , swelling, effusion History: eval for fracture. Three views of the left hand show soft tissue swelling along the dorsum of the hand and wrist, but we see no underlying fracture. The bones appear demineralized. Mild osteoarthritis affects the interphalangeal joints and moderate osteoarthritis affects the basilar joint. There is also chondrocalcinosis of the triangular fibrocartilage and likely of the second and fifth metacarpophalangeal joints. There are arterial calcifications in the wrist. | Soft tissue swelling and degenerative arthritic changes without fracture evident. |
Generate impression based on findings. | Visualization of the thorax is limited by the field of view and length of scan, which excludes substantial areas of the lungs.CHEST:LUNGS AND PLEURA: Left upper lobe micronodules and left lower lobe scar compatible with previous infection.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted. | No significant extra cardiovascular abnormalities in the visualized portion of the thorax. |
Generate impression based on findings. | 39-year-old female patient with infertility. Scout AP film of the pelvis was normal. Opacification of the uterine cavity revealed a normally oriented uterine cavity without mucosal irregularity or filling defects in the uterine cavity. Both tubes were freely opacified with free spillage on both sides into the pelvis, indicating tubal patency.TOTAL FLUOROSCOPY TIME: 0:55 minutes. | Normal uterine cavity and patent fallopian tubes. |
Generate impression based on findings. | HypoxiaVIEW: Chest AP Tracheostomy tube in place. NG tube tip in the stomach. Cardiothymic silhouette normal. Patchy atelectasis bilaterally and new in the right upper lobe in a background of chronic lung disease. The atelectasis in the right lower lobe has improved. | Right upper lobe atelectasis new from prior study with interval improvement in the atelectasis at the right lower lobe. |
Generate impression based on findings. | 62 years, Male. Reason: 62M w/ met h\T\N cancer, recent diarrhea, now constipation vs. low stool output 2/2 anorexia History: constipation vs. low stool output There is a desiccated stool ball in the rectum. There are a few prominent loops of small bowel in the left hemiabdomen, but no definite evidence of obstruction. | Desiccated stool ball in the rectum without definite evidence of bowel obstruction. Continue to follow radiographically as clinically indicated. |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Calcified right upper lobe granuloma compatible with previous infection.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted. | No significant extra cardiovascular abnormalities in the visualized portion of the thorax. |
Generate impression based on findings. | Female 30 years old Reason: evaluate for retained foreign body and fracture History: laceration. Three views of the left hand show no fracture or foreign body. | No fracture or foreign body evident. |
Generate impression based on findings. | Reason: Follow up exam to 8/6/14 which resulted possible signs of infection History: none LUNGS AND PLEURA: Mild apical predominant centrilobular emphysema. Scattered micronodules. No suspicious pulmonary nodules or masses.Minimal subsegmental atelectasis. Minimal basilar septal thickening, without significant pulmonary edema. Interval resolution of areas of left lower lobe consolidation. No new focal airspace consolidation.Interval resolution of previously seen pleural effusions. MEDIASTINUM AND HILA: Interval resolution of the previously seen substernal collection of fluid and gas. Minimal residual pericardial thickening and enhancement.The heart is normal in size. No visible coronary artery calcification. Status post mitral valve annuloplasty. LVAD and AICD in unchanged position.CHEST WALL: Status post median sternotomy.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Persistent focal hypoattenuating region within the spleen may represent a prior infarct. Gallstones. | 1. Interval resolution of substernal collection with mild residual pericardial thickening and enhancement.2 Resolution of small pleural effusions and left basilar consolidation.3. Very mild hypervolemia. |
Generate impression based on findings. | CHEST: Patchy pulmonary abnormalities including emphysema, scarring and mosaic perfusion are present. A complete CT scan of the chest was performed earlier on the same day which provides more complete evaluation of the extra cardiovascular structures. | Chronic pulmonary abnormalities, more completely evaluated on the complete thoracic CT scan performed earlier on the same day. |
Generate impression based on findings. | 55 years, Male. Reason: confirm PD stent absence History: pancreatic duct stent placed 2/13 Interval removal of temporary pancreatic duct stent. Common biliary duct stent is again noted. Nonobstructive bowel gas pattern. The lower portion of the pelvis is excluded from the field-of-view. | Interval removal of temporary pancreatic duct stent. |
Generate impression based on findings. | Male; 56 years old. Reason: Appendiceal cancer, please measure 1) right inguinal node and 2) anterior right hemipelvis lesion. Also evaluate lung micronodules. History: Status post 2 cycles of chemotherapy. CHEST:LUNGS AND PLEURA: New mild right perihilar bronchial wall thickening with some tree in bud and clustered nodular ground glass opacities seen distally. Findings most likely represent focal inflammation. Scattered pulmonary micronodules in the lateral right lung are unchanged. No suspicious pulmonary nodules or masses. No pleural effusions or focal areas of consolidation.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted. Left subclavian chest port tip at cavoatrial junction.ABDOMEN:LIVER, BILIARY TRACT: Nonspecific subcentimeter segment 5 hypodensity is unchanged from prior CT. No suspicious hepatic lesions or biliary ductal dilatation. Cholecystectomy clips.SPLEEN: Status post splenectomy.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant retroperitoneal or mesenteric lymphadenopathy. BOWEL, MESENTERY: Postsurgical changes s/p subtotal colectomy and left lower quadrant ostomy creation, with new dilatation of proximal small bowel loops up to 5.5 cm. Findings are compatible with small bowel obstruction, with possible transition point in the right lower quadrant and relatively decompressed distal bowel loops. Small amount of free interloop fluid is also present. No free air or focal fluid collection.BONES, SOFT TISSUES: No significant abnormality noted. OTHER: Scattered surgical clips and suture material in the upper abdomen.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted. BLADDER: No significant abnormality noted. LYMPH NODES: Reference right inguinal lymph node measures 4.0 x 2.9 cm, previously 3.5 x 2.6 cm (series 3, image 196).BOWEL, MESENTERY: Postsurgical changes s/p subtotal colectomy and left lower quadrant ostomy creation, with new dilatation of proximal small bowel loops up to 5.5 cm. Findings are compatible with small bowel obstruction, with possible transition point in the right lower quadrant and relatively decompressed distal bowel loops. Small amount of free interloop fluid is also present. No free air or focal fluid collection.BONES, SOFT TISSUES: Bilateral fat containing inguinal hernias. OTHER: Soft tissue nodule in the anterior right hemipelvis now measures 2.0 x 1.6 cm, previously 2.1 x 1.6 cm (series 3, image 172). | 1.Interval enlargement of right inguinal lymph node. Soft tissue nodule in anterior right hemipelvis is unchanged; please see reference measurements above. 2.Findings compatible with small bowel obstruction, possible transition point in right lower quadrant, and small amount of ascites. In the absence of other etiologies for ascites, the presence of free fluid can be worrisome for developing bowel ischemia. 3.Clustered nodular opacities in the right perihilar region, most likely representing inflammation/infection. |
Generate impression based on findings. | 67 years, Female. Reason: ALS, GI dysmotility History: constipation Nonobstructive bowel gas pattern with average stool burden in the colon. Surgical staples project over the contour of the stomach. Posterior fusion hardware projects over the lower lumbar spine. | Nonobstructive bowel gas pattern with average stool burden in the colon. |
Generate impression based on findings. | 73 years, Female. Reason: 73yoF with metastatic breast cancer, abdominal pain History: abdominal pain Gastrostomy tube tip projects over the gastric fundus. Partially visualized central venous catheter tip is noted in the superior vena cava. Vertebroplasty cement is noted in the L1 vertebral body. Compression deformity of the L3 vertebral body and destruction of the pedicles of L5 correlate with findings seen on prior CT spine. Nonobstructive bowel gas pattern with average stool burden in the colon. | Nonobstructive bowel gas pattern with average stool burden in the colon. |
Generate impression based on findings. | Visualization of the thorax is limited by the field of view and length of scan, which excludes substantial areas of the lungs.CHEST:LUNGS AND PLEURA: Mild posterior scarring in the right upper lobe.Mild bilateral lower lobe bronchiectasis.No acute abnormalities.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted. | Mild bronchiectasis and no acute pulmonary abnormalities. |
Generate impression based on findings. | 32 year-old female patient with infertility. Scout AP film of the pelvis was normal. Opacification of the uterine cavity revealed a normally oriented uterine cavity without mucosal irregularity or filling defects in the uterine cavity. Both tubes were freely opacified with free spillage on both sides into the pelvis, indicating tubal patency. Note was made of a retroverted uterus on lateral radiograph.TOTAL FLUOROSCOPY TIME: 0:22 minutes | Normal uterine cavity and patent fallopian tubes. |
Generate impression based on findings. | Female 30 years old Reason: eval for fracture History: s/p punched glass. Three views of the right hand show no fracture or foreign body. There is slight widening of the scapholunate interval that may represent ligamentous laxity or disruption, but may not be of current clinical significance. | No fracture or foreign body evident. Slight widening of the scapholunate interval of questionable significance. |
Generate impression based on findings. | Breast cancer history. Insomnia CHEST:LUNGS AND PLEURA: Marked interval progression in both size and number of numerous bilateral nodules and masses compatible with extensive pulmonary metastatic disease. Changes are greater in both lung bases and for reference, a right lower lobe nodule currently measures 2.3 cm in diameter (image 45 series 5) from a prior measurement of 1.4 cm. Multiple nodules are also more confluent and demonstrate increased lobular contours. No discrete effusions. Please note the previous reference nodule is difficult to distinguish from numerous confluent nodules currentlyMEDIASTINUM AND HILA: Multiple bilateral thyroid cysts without interval change, yet incompletely visualized.No lymphadenopathyMild coronary calcifications without additional cardiac or pericardial abnormalityCHEST WALL: Sclerotic expansile lesion in the right eighth rib and left ninth rib. More sclerotic focus is observed in the left seventh rib sternum. Diffuse numerous sclerotic abnormality throughout the thoracic and visualized lumbar spine, marked interval extensive progressionABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Mild fatty infiltration without discrete suspicious focal abnormality. Gallbladder unremarkableSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Scattered unchanged suspected renal cysts, on the leftPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Diffuse scattered confluent sclerotic lesions, see aboveOTHER: No significant abnormality noted. | Interval progression of extensive intrapulmonary bilateral metastatic foci and sclerotic osseous metastatic disease. Reference measurements provided |
Generate impression based on findings. | 62 year old female with h/o medial left knee pain. Evaluate for arthritis vs fluid vs fx. No erythema or effusion on exam. We have two views of the left knee. There is sharpening of the tibial spines suggestive of minimal osteoarthritis, which is essentially within normal limits for age. We see no fracture or joint effusion. Arterial calcifications in the posterior soft tissues are noted. | Sharpening of the tibial spines is suggestive of minimal osteoarthritis. Otherwise, we see no specific findings to account for the patient's pain. |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Small bilateral pleural effusions, decreased compared to the previous scan.Motion artifact due to respiration degrades pulmonary detail. No gross abnormalities are visible.MEDIASTINUM AND HILA: Moderate enlargement of the right thyroid lobe.No significant lymphadenopathy.CHEST WALL: Degenerative disease in the spine compatible with age.UPPER ABDOMEN: No significant abnormality noted. | Small pleural effusions, decreased compared to the previous scan. |
Generate impression based on findings. | Review of lung nodules. LUNGS AND PLEURA: A reference pulmonary nodule near the left hemidiaphragm measuring 5 mm is unchanged since 2012 (image 33, series 5) and likely benign in etiology. Two new micronodules on the prior examination are smaller in size and less conspicuous on this examination favoring a benign etiology (images 32 and 33, series 5). Additional scattered pulmonary micronodules are unchanged. No new pulmonary nodules are identified. Lingular scarring is unchanged. MEDIASTINUM AND HILA: The heart size is normal. There is no mediastinal or hilar lymphadenopathy. There are severe coronary artery calcifications. CHEST WALL: The patient is status post right thyroidectomy. There is a subcentimeter hypoattenuating left thyroid lesion, unchanged. There is no axillary lymphadenopathy. There are chronic left rib deformities, unchanged. Multilevel degenerative changes of the spine are noted. UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Scattered subcentimeter hepatic hypodensities are too small to characterize but unchanged and likely represents cysts. A partially imaged left renal cystic lesion is better characterized on prior MRI. | Interval decrease in size and conspicuity of two right upper lobe pulmonary micronodules favoring a benign process; these can be conservatively followed in 6 to 12 months if required. Additional pulmonary micronodules are unchanged and consistent with benign lesions. |
Generate impression based on findings. | 78 years, Female, Reason: eval for obstruction History: pt with abdominal distension and vomiting with prior abd surgery. ABDOMEN:LUNG BASES: Bibasilar atelectasis.LIVER, BILIARY TRACT: Punctate right hepatic hypodensity is stable. Mild intrahepatic biliary ductal dilatation is unchanged. Prominent common bile duct is unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple broad based wedge shaped regions of hypoattenuation, right greater than left, with minimal perinephric stranding. No renal stones or hydronephrosis.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications of the aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative changes of the spine with inferior endplate depression of L1 is unchanged.OTHER: No significant abnormality notedPELVIS: FemaleUTERUS, ADNEXA: Uterine fibroids. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Bilateral broad based regions of renal hypoattenuation, right greater than left. Differential includes vascular etiologies such as infarction as well as infection, correlate with UA. |
Generate impression based on findings. | Female 30 years old; Reason: assess for fracture History: left wrist pain Three views of the left wrist demonstrate no fracture or malalignment. We see no specific findings to account for the patient's pain. | No specific findings to account for the patient's pain. |
Generate impression based on findings. | 73 year old woman with personal history of ovarian cancer and bilateral benign biopsies. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Biopsy clips in the right breast at 9:00 and left breast at 3:00 are noted. No suspicious mass, microcalcifications, or areas of architectural distortion are seen in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | HEAD: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is diffuse global volume loss greater than expected for patient age, unchanged. There is mild nonspecific periventricular and subcortical white matter hypoattenuation, also unchanged. There is unchanged mild asymmetry of the lateral ventricles with a slightly smaller left lateral ventricle. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. CERVICAL: There is no acute fracture or traumatic subluxation. There is no prevertebral soft tissue swelling. There is no discrete osseous lesion. There are incompletely imaged posttreatment findings in the neck with extensive hypopharyngeal edema and associated airway narrowing, similar to prior examination. There are surgical staples in the right neck. There is no measurable mass lesion or significant cervical lymphadenopathy based on size criteria. There are atherosclerotic calcifications at bilateral carotid bifurcations.There are multilevel degenerative changes in the cervical spine with facet arthropathy. There is disk osteophyte complexes at C3-4, C4-5, C5-6 and C6-7. There is moderate left neural foraminal stenosis at C3-4 with increasing extent of ground glass attenuation adjacent to the left facet joint both anteromedially and posteriorly which is increased from the prior examination where there was only minimal similar abnormality. This has more conspicuously progressed since the April 2014 CT neck exam. | 1.No acute intracranial hemorrhage or skull fracture.2.No acute cervical spine fracture or subluxation.3.Multilevel cervical degenerative changes without significant change except for development of ground glass density along the left facet with likely a soft tissue inflammatory component, perhaps relating to CPPD.4.Posttreatment findings in the neck with extensive hypopharyngeal edema and associated mild to moderate airway narrowing, incompletely imaged, but similar to prior examination from 10/16/2014. |
Generate impression based on findings. | 84 year-old female with dysphagia to solids and occasionally liquids, evaluate for achalasia Scout radiograph of the chest shows a tortuous aorta. Density at the right cardiophrenic border is presumed to be a dilated esophagus. No focal pulmonary opacities.Test swallow of barium demonstrated narrowing at the gastroesophageal junction with delayed transit into the stomach. Additional swallows of contrast demonstrated a debris filled, dilated esophagus with "beak-like" narrowing at the gastroesophageal junction with little transit of contrast into the stomach. Fluoroscopic evaluation of esophageal peristalsis demonstrated a major motor abnormality of the esophagus with tertiary waves. The patient was instructed to sip on water and a delayed spot image was obtained demonstrating substantial emptying of the dilated esophagus with residual debris. TOTAL FLUOROSCOPY TIME: 2:56 minutes | 1.Dilated, debris-filled esophagus with obstructive, "beak-like" narrowing at the gastroesophageal junction consistent with achalasia. 2.Major motor abnormality of the esophagus as described above.Findings discussed with Dr. Konda, covering for Dr. Kavitt, at 1117. |
Generate impression based on findings. | Female 30 years old; Reason: Evaluate tenderness at dorsum of foot. There is perhaps mild swelling of the dorsal soft tissues over the midfoot, however this is equivocal. Tiny midfoot osteophytes indicate minimal osteoarthritis. We see no fracture or malalignment. | Equivocal mild dorsal soft tissue swelling with tiny underlying midfoot osteophytes. Otherwise no specific findings to account for the patient's pain. |
Generate impression based on findings. | Female 90 years old Reason: pain swelling post fall History: pain swelling. There is a predominantly transverse comminuted fracture of the surgical neck of the humerus with approximately 1 cm of medial displacement of the distal fracture fragment. The bones appear demineralized suggesting osteopenia. Severe osteoarthritis affects the glenohumeral joint. | Mildly displaced fracture of the surgical neck of the humerus as described above. |
Generate impression based on findings. | Female 90 years old; Reason: Fracture follow-up. History: pain Four views of the right elbow demonstrate two pins and a tension wire affixing an olecranon fracture in anatomic alignment. The fracture line is indistinct, indicating some interval healing. The bones are demineralized, suggesting osteopenia. | Orthopedic fixation of a healing olecranon fracture. |
Generate impression based on findings. | Male; 77 years old. Reason: evaluate transplanted kidney in patient w AKI on CKD History: elevated creatinine, nausea/vomiting RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No perinephric fluid collections KIDNEY: The transplant kidney measures 16.7 cm in length. There is a 2.3 x 2.3 x 3.5 cm simple appearing cyst in the upper pole. No shadowing caliculi or suspicious lesions evident.COLLECTING SYSTEM/URETER: There is marked hydronephrosis and the urothelium is thickened.URINARY BLADDER: Status post cholecystectomy.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels.The peak systolic velocity of the iliac artery is 1.0 m/sec. The peak systolic velocity at the anastomosis is 0.7 m/sec with a resistive index of 0.8. The renal artery is patent with a Doppler waveform which shows prompt systolic upstroke. The peak systolic velocity of the renal artery is 0.8 m/sec in the midportion and 0.9 m/sec distally with resistive indices of 0.77, and 0.74 respectively. Resistive indices within the arcuate arteries vary between 0.65 and 0.69. The renal vein is patent.OTHER: The native kidneys are not well visualized. There is hydronephrosis of both native kidneys. There is a 1.8 cm shadowing calcification seen in the right native kidney. | 1.Marked hydronephrosis of the transplant kidney with thickening of the urothelium, similar to the same day CT.2.Patent renal transplant vasculature. |
Generate impression based on findings. | There is redemonstration of multiple scattered foci of T2/FLAIR hyperintensity within the periventricular and subcortical white matter bilaterally, consistent with patient's known history of demyelinating disease. Many of these are oriented perpendicular to the long axis of the lateral ventricles. There is a single new lesion is visualized on 401/29 within the left corona radiata posteriorly. Many lesions demonstrate corresponding T1 hypointensity. No definite posterior fossa lesions are appreciated.The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. No extra-axial fluid collection is identified. The midline structures and craniocervical junction are within normal limits. | Redemonstration of demyelinating white matter lesions, with overall mild-moderate T1 as well as T2 burden of disease. Interval development of a single new lesion in the left posterior corona radiata. |
Generate impression based on findings. | Visualization of the thorax is limited by the field of view and length of scan, which excludes substantial areas of the lungs.CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Surgical staples in the area of the gastroesophageal junction. | No significant extra cardiovascular abnormalities in the visualized portion of the thorax. |
Generate impression based on findings. | There is mild leftward convexity of the mid cervical spine. The scout lateral view and the sagittal reformatted images demonstrate trace grade 1 anterolisthesis of C2 on C3 and C3 on C4, as well as minimal retrolisthesis of C4 on C5 through C6 on C7. There is also minimal grade 1 anterolisthesis of C7 on T1. There is reversal of the normal cervical lordosis centered at C3-C4. The vertebral body heights are well-maintained. There is multilevel disk space narrowing, to moderate and severe in degree from C5-C6 through C7-T1, with associated endplate irregularity. There are mild scattered ventral osteophytes.There is no acute fracture.At C1-C2, there is a normal relationship of the dens with the arch of C1.At C2-C3, there is uncovering of the disk with a minimal central disk protrusion. There is severe right facet arthropathy and uncovertebral hypertrophy. There is moderate-severe right foraminal narrowing.At C3-C4, there is uncovering of the disk with severe right facet arthropathy and uncovertebral hypertrophy. There is severe right foraminal narrowing.At C4-C5, there is uncovering of the disk with a mild diffuse posterior osteophyte disk complex with right greater than left uncovertebral hypertrophy and mild bilateral facet arthropathy. There is also mild ligamentum flavum thickening. There is mild central spinal canal stenosis as well as severe bilateral foraminal narrowing.At C5-C6, there is uncovering of the disk with a mild diffuse posterior osteophyte disk complex. There is significant bilateral uncovertebral hypertrophy contributing to overall moderate-severe right and moderate left foraminal narrowing. There is mild-moderate central spinal canal stenosis.At C6-C7, there is uncovering of the disk with a minimal diffuse posterior osteophyte disk complex there is overall mild to moderate central spinal canal stenosis. Bilateral uncovertebral hypertrophy contributes to moderate left and mild right foraminal narrowing.At C7-T1, there is uncovering of the disk with bilateral uncovertebral hypertrophy. There is mild-moderate right greater than left foraminal narrowing.The visualized intracranial structures and lung apices appear normal. There is partially visualized intracranial atherosclerotic calcification as well as along the proximal great vessels. There is also calcification along the carotid bifurcations bilaterally. There are degenerative changes involving the right temporomandibular joint | Multilevel mild degenerative grade 1 subluxations as detailed above, with overall moderate spondylotic changes resulting in up to mild-moderate central spinal canal stenosis at C5-C6 and C6-C7, as well as several scattered levels of high-grade foraminal narrowing as noted above. |
Generate impression based on findings. | Patient with history of NSCLC. CHEST:LUNGS AND PLEURA: The patient is status post right upper lobe resection. A right lower lobe pulmonary nodule measures 9 x 9 mm (image 44, series 7), previously 10 x 10 mm. Previously noted nodular opacities in the lingula are unchanged. There is new linear atelectasis/consolidation in the right lower lobe. Additional scattered pulmonary micronodules are unchanged. There is no pleural effusion or pneumothorax.MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. No mediastinal lymphadenopathy. Mildly prominent left hilar tissue measuring approximately 12 mm in the short axis (image 37, series 5) is unchanged. No coronary artery calcifications are noted on this non-gated examination.CHEST WALL: There is a partially calcified hypodense subcentimeter left thyroid nodule, unchanged. There are multilevel degenerative changes of the spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Scattered subcentimeter renal hypodensities are too small to characterize. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.The distal esophagus appears mildly thickened but is unchanged since a PET study from 7/11/2014. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. No significant change in size of a right lower lobe pulmonary nodule. 2. New right lower lobe linear atelectasis/consolidation; in the appropriate clinical context, this may represent subacute radiation pneumonitis and can continue to be followed. |
Generate impression based on findings. | Female 72 years old Reason: gi bleeding History: anemia, gi bleeding ABDOMEN:LUNGS BASES: Emphysematous changes with mild bibasilar atelectasis.LIVER, BILIARY TRACT: Hypodense lesion in the dome of the liver likely representing hepatic cyst. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Nonobstructing right renal stone. Bilateral hypodense renal lesions consistent with simple renal cysts.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Endoscopic capsule within the ascending colon. No evidence of intraluminal enhancement to suggest gastrointestinal bleeding.BONES, SOFT TISSUES: Moderate degenerative changes of the visualized spine.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of intraluminal enhancement to suggest gastrointestinal bleeding.BONES, SOFT TISSUES: Moderate degenerative changes of the visualized spine.OTHER: No significant abnormality noted. | No CT evidence of gastrointestinal bleeding. |
Generate impression based on findings. | 58 year-old female with a history of carcinoid and chronic diarrhea. Patient was unable to tolerate the full prescribed amount of oral contrast. The small bowel is suboptimally distended which somewhat limits evaluation.ABDOMEN:LUNG BASES: Calcified nodule in the right lower lobe likely from prior granulomatous disease. Mild basilar atelectasis.LIVER, BILIARY TRACT: There are several punctate arterially enhancing lesions in hepatic segments 6 and 7 which are isointense on the portal venous phase. An example lesion in hepatic segment 6 (series 9, image 50) measures 0.5 x 0.5 cm. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Tiny left adrenal nodule measures less than 10 HU on the noncontrast images and thus is compatible with a benign adenoma.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mild atherosclerotic disease of the abdominal aorta and its branches.BOWEL, MESENTERY: Postsurgical changes from prior right hemicolectomy. Ileocolonic anastomosis is noted in the midline. The proximal small bowel loops are suboptimally distended. The small bowel is of normal caliber without evidence of obstruction. No abnormal small bowel wall thickening or small bowel lesions are identified.An average amount of stool is present within the remaining distal colon without evidence of focal lesion. An enlarged nonspecific mesenteric lymph node (series 11, image 81) measures 0.7 x 1.4 cm. BONES, SOFT TISSUES: Postsurgical changes to the anterior abdominal wall without evidence of complication. Degenerative changes of the visualized thoracolumbar spine. Spinal fusion hardware at L4-L5. Foci of gas within the anterior abdominal wall likely related to injection.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the visualized thoracolumbar spine. Spinal fusion hardware at L4-L5. There is a nonspecific sclerotic focus within the right ilium adjacent to the SI joint (series 3, image 96). Nonspecific focus of subcutaneous soft tissue attenuation in the right gluteal soft tissues (series 11, image 95). | 1.Postsurgical changes of right hemicolectomy.2.Several punctate hepatic segment 7/6 hypervascular lesions are nonspecific but given history of carcinoid may represent carcinoid metastases. Recommend MRI for further evaluation. 3.Evaluation of small bowel mildly limited by suboptimal distention of the proximal small bowel. Within this limitation, no abnormalities identified in the small bowel.4.Nonspecific sclerotic focus within the right ilium adjacent to the SI joint, correlate with procedural history. |
Generate impression based on findings. | Female 80 years old Reason: Establish baseline placement of esophageal stent History: Esoph stent . A stent overlies the expected location of the esophagus with its proximal margin at the level of T3 and its distal margin at the level of T7. Mild degenerative arthritis affects the cervical spine. | Esophageal stent as above. |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Small scarlike opacities in micronodules, compatible with previous infection.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted. | No significant extra cardiovascular abnormalities in the visualized portion of the thorax. |
Generate impression based on findings. | Female; 57 years old. Reason: left lower abscess, diverticulitis? History: on chemo, vomiting, fever, abdominal pain. ABDOMEN:LUNG BASES: There is a spiculated right lower lobe mass with adjacent scarring that measures 3.4 x 2.6 cm, unchanged since recent chest CT and compatible with the patient's known history of primary lung carcinoma (series 5, image 5). Please see recent chest CT report from 2/9/2015 for further details. No pleural effusions. LIVER, BILIARY TRACT: Scattered subcentimeter hepatic hypodensities are incompletely characterized but not significantly changed.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Nodularity of the right adrenal gland appears more prominent compared to prior studies, although this finding was not well characterized previously due to abutting diaphragmatic crus which precluded accurate measurement. The lateral limb measures 1.2 x 1.0 cm and the medial limb measures 1.6 x 1.0 cm on today's study (series 4, image 29). Abnormal nodularity involving the medial limb of the left adrenal gland is also noted (series 4, image 29). KIDNEYS, URETERS: Scattered bilateral renal cysts, the largest of which is located in the right lower pole. Nonobstructive right renal calculus.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered colonic diverticula, with wall thickening involving the distal descending colon and surrounding mesenteric fat stranding. Intramural fluid collection at this site measures 2.5 x 1.2 cm (series 4, image 75). Findings likely represent acute diverticulitis and small intramural abscess formation. No evidence of bowel obstruction or perforation. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Heterogeneous, markedly enlarged fibroid uterus. BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Scattered colonic diverticula, with wall thickening involving the distal descending colon and surrounding mesenteric fat stranding. Intramural fluid collection at this site measures 2.5 x 1.2 cm (series 4, image 75). Findings likely represent acute diverticulitis and small intramural abscess formation. No evidence of bowel obstruction or perforation. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Findings compatible with acute diverticulitis of the distal descending colon with small intramural abscess. No free air. 2.Spiculated right lower lobe mass, consistent with the patient's known primary lung carcinoma. 3.Bilateral adrenal nodularity, right greater than left, which appears more prominent compared to prior studies and should be followed given the patient's history. Please see discussion and measurements above. Above findings relayed to the ER attending, Dr. Sharp, on 2/25/2015 at 16:30. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is unchanged encephalomalacia in the right parietal, occipital and temporal lobes with ex vacuo dilatation of the atrium of the right lateral ventricle. There is patchy periventricular and subcortical white matter hypoattenuation consistent with small vessel ischemic disease, unchanged. The ventricles and basal cisterns are unchanged. There is no hydrocephalus. There is no midline shift or herniation. There are atherosclerotic calcifications in the bilateral cavernous carotid arteries. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Nasogastric and endotracheal tubes are partly imaged. | 1.No acute intracranial hemorrhage or mass-effect.2.Unchanged encephalomalacia in the right cerebral hemisphere. |
Generate impression based on findings. | Male 66 years old Reason: prostate cancer Gleason 9 History: prostate cancer Gleason 9 ABDOMEN:LUNG BASES: No pleural effusions. No suspicious nodules or masses.LIVER, BILIARY TRACT: Diffuse fatty liver parenchyma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Mild nonspecific retroperitoneal adenopathy. Reference left periaortic lymph node measures 1.5 x 0.9 cm (series 3, image 57).BOWEL, MESENTERY: Mild dilatation of the third portion of the duodenum at the level of the superior mesenteric artery. Low suspicion for superior mesenteric artery syndrome, however, clinically correlate for recent weight loss.BONES, SOFT TISSUES: No evidence of bone metastases.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No evidence of bone metastases.OTHER: No significant abnormality noted | No evidence of metastatic disease. |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Bilateral upper zone subpleural scarring.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: Bilateral mammoplasties.UPPER ABDOMEN: Minor benign findings as detailed on an abdominal CT scan performed 3 days earlier. | No significant extra cardiovascular abnormalities in the visualized portion of the thorax. |
Generate impression based on findings. | The scout lateral view and the sagittal reformatted images demonstrate the lumbar spine to be in moderate central spinal canal stenosis normal sagittal alignment, with straightening of the normal lumbar lordosis. There is rotatory scoliosis of the visualized thoracolumbar spine, with apex coverage of the right at T12-L1 and to the left at L4. There is also significant left lateral translation of L4 on L5 measuring 11 mm. there is narrowing along the left aspect of the L5 and right aspect of the L4 vertebral body secondary to the scoliotic curvature. The vertebral body heights are otherwise well-maintained. There is multilevel disk space narrowing up to severe in degree, with multiple vacuum disks. Multilevel endplate degenerative changes including extensive sclerosis and irregularity is noted.There is no acute fracture.At T10-T11, there is no significant disk pathology or stenosis.At T11-T12, there is a mild posterior osteophyte disk complex with right foraminal/far lateral prominence. There is resultant moderate right and severe left foraminal narrowing. There is also mild bilateral facet arthropathy.At T12-L1, there is a trace posterior osteophyte disk complex with large left lateral osteophyte formation. There is moderate-severe left and minimal right foraminal narrowing.At L1-L2, there is a mild disk bulge with slight narrowing of the left lateral recess. There is minimal indentation of the ventral thecal sac with moderate bilateral foraminal narrowing.At L2-L3, there is a mild disk bulge with mild bilateral facet arthropathy and ligamentum flavum thickening. There is mild to moderate central spinal canal stenosis along with moderate right greater than left foraminal narrowing.At L3-L4, there is a diffuse posterior osteophyte disk complex with large right lateral osteophyte formation. There is bilateral facet arthropathy and ligamentum flavum thickening. There has been previous L4 laminectomy and therefore there is no significant central spinal canal stenosis. There is slight narrowing of the lateral recesses with moderate-severe right and moderate left foraminal narrowing.At L4-L5, the central spinal canal is widely patent due to the previous laminectomy. There is facet arthropathy with moderate diffuse posterior osteophyte disk complex. There is significant narrowing of the left and right lateral recesses with severe bilateral foraminal narrowing. There is uncovering of the left far lateral disk.At L5-S1, there are prominent left lateral osteophyte as well as bilateral facet arthropathy. There is at most a minimal posterior osteophyte disk complex with severe left foraminal narrowing.Limited views through the retroperitoneum demonstrate aortoiliac atherosclerotic calcification. There is atrophy of the paraspinal musculature. There is a large rounded fluid density structure associate with the interpolar right kidney posteriorly measuring at least 6.1 cm, with a small amount of higher density anteriorly which may relate to mineralization. There are additional probable multi-cystic structures of the lower pole of both kidneys. | 1. Multilevel moderate-severe degenerative disk disease as detailed above, with evidence of previous L4 laminectomy were central spinal canal is widely patent. Up to mild to moderate central spine canal stenosis at L2-L3 although there is scattered high-grade foraminal narrowing at multiple levels as noted above.2. Rotatory scoliosis of the thoracolumbar spine, with left lateral translation of L4 on L5.3. Partially visualized cystic structure associate with the right kidney which may contain thin calcification. Multicystic structures associated with the lower poles of both kidneys. Further evaluation could be obtained with ultrasound. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Almost complete interval resolution of the previously noted left apical spiculated nodule.This measures 5 mm on the current exam (image 10 40 series 4) previously measuring 12 mm.New adjacent groundglass nodule (image 13 series 4).New right perihilar nodular opacities (image 40 Series 4).New pleural based 12-mm nodule at the left costophrenic angle best noted on sagittal image 86. Additional nodules are noted along the diaphragmatic pleura at the left costophrenic angle.Scattered other pulmonary nodules and micronodules are stable.Scarring and atelectasis within the right middle lobe unchanged.No pleural effusions.MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy.Again noted is prominent fluid filled superior pericardial recess.Cardiac size is normal without evidence of a pericardial effusion.Mild coronary artery calcification.CHEST WALL: Mild degenerative changes with stable T10 hemangioma.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left renal hypoattenuating cortical lesion in is unchanged from the prior exam. However higher than expected Hounsfield units suggests this may be a complicated (hemorrhagic, mucinous) cyst or early renal neoplasm . This has progressively grown in size dating back to the prior exam dated 4/19/13. Recommend dedicated renal imaging with CT or MRI.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.G-tube in place.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No significant interval decrease and almost complete resolution of the previously noted left apical spiculated nodule.2.Demonstration of multiple new solid and groundglass nodules concerning for progression of metastatic disease.3.Progressive interval growth over two years of a hypoattenuating left renal cortical lesion suspicious of a primary renal neoplasm. Recommend dedicated MRI and/or CT imaging of the kidneys. |
Generate impression based on findings. | 54 years, Male. Reason: ng tube placed History: ftt Enteric feeding tube tip projects over the expected location of the gastric body. Nonobstructive bowel gas pattern. Please refer to chest radiograph obtained the same day for chest findings. | Enteric feeding tube tip projects over the expected location of the gastric body. |
Generate impression based on findings. | 68 years old Male with history of head and neck cancer ( Left buccal SCC). This study was performed for restaging. Chronic renal disease precluding ordering CT with contrast and/or MRI. RADIOPHARMACEUTICAL: 11.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 83 mg/dL. Today's CT portion grossly demonstrates soft tissue density in the right maxillary sinus. The thyroid is enlarged. The prostate is enlarged. Coarsened trabeculae and lucent areas are seen in the right proximal femur.Today's PET examination demonstrates a focus of increased activity in the left submandibular region, corresponding to a small lymph node seen on CT. The SUVmax in the lymph node is 4.8 on whole-body scan and 5.8 on the delayed neck scan. Additional small focus of increased activity, corresponding to a normal-sized lymph node seen in the left supraclavicular region with SUV Max of 2.9. Another focus of increased activity is seen in the left superior mediastinal normal-sized lymph node SUVmax of 3.8. Increased metabolic activity (SUVmax of 7.0) is seen in the right proximal femur, corresponding to the coarsened trabeculae, cortex and lucent areas seen on CT.Small focus increased activity is seen in the right shoulder joint is most likely due to degenerative change. There is no abnormal FDG uptake in the soft tissue density in the right maxillary sinus.Physiological activity is seen in the middle, spleen, stomach, intestines, kidneys, and bladder. | Multiple normal-size lymph nodes with mildly to moderate increase metabolic activity in the left neck and left superior mediastinum, which can be due to tumor or post-therapy/reactive change. The left submandibular lymph node is more suspicious for nodal metastasis.Intense FDG uptake in the right proximal femur, which can be due to Paget's disease or metastatic tumor. Suggest correlate with clinical history.No evidence of pulmonary metastasis. |
Generate impression based on findings. | 52-year-old male with metastatic lung cancer status post treatment. Compare with previous evaluate disease status. ABDOMEN:LUNG BASES: Bilateral pleural effusions left greater than right . See concurrent chest CT examination from 2/25/15 report.LIVER, BILIARY TRACT: Unchanged left hepatic lobe benign cyst. The prior noted vague segment 7 hypoattenuating lesion has slightly increased in size and conspicuity (series 7, image 33) and measures 2.6 x 2.2 cm compared with 3.0 x 2.2 cm previously. The lesion is more discrete and now abuts into the right hepatic vein and may be involving the venous structure. A lesion is seen in only in segment 3 and (series 7, image 72) measuring 0.9 x 0.9 cm. gallbladder and biliary tract appear normal.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The omental nodularity appearing 11/21/15 has progressed into a solid omental cake in the confluent nature from left lateral flank anteriorly and across midline to the subhepatic space. Aggregate disease now has maximum thickness of 3.4 cm (series 7, image 72) where previously it was punctate densities scattered in omental fat.. BONES, SOFT TISSUES: Scattered sclerotic foci again seen throughout the skeletal system consistent with metastatic disease.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The omental nodularity appearing 11/21/15 has progressed into a solid omental cake with a confluent nature from left lateral flank anteriorly and across midline to the subhepatic space. Aggregate disease now has maximum thickness of 3.4 cm (series 7, image 72) where previously it was punctate densities scattered in omental fat. The ascites is seen pooling in dependent pelvis to similar degree as previous examination.BONES, SOFT TISSUES: Scattered sclerotic foci are seen throughout the bony structures about the pelvis consistent with metastatic disease with similar distribution to prior examination.OTHER: No significant abnormality noted | 1. Increasing size and number of presumed liver metastatic lesions. 2. Increasing omental disease with now large omental cake mass. 3. Diffuse skeletal sclerotic foci consistent with metastatic disease unchanged in CT appearance -- nuclear medicine scintigraphy is a more accurate indicator of activity of skeletal metastatic disease. 4. Ascites unchanged. |
Generate impression based on findings. | 71 years, Male. Reason: NGT History: NGT Enteric feeding tube is advanced with tip projecting over the expected location of the gastric body.Sternotomy wires and contrast filled diverticula are unchanged. The pelvis is excluded from the field-of-view. | Enteric feeding tube is advanced with tip projecting over the expected location of the gastric body. |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Basilar scarring and subsegmental atelectasis, not significantly changed.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: Healed manubrial fracture, unchanged.UPPER ABDOMEN: No significant abnormality noted. | No significant extra cardiovascular abnormalities in the visualized portion of the thorax. |
Generate impression based on findings. | 71 years, Male. Reason: confirm dobhoff placement History: none Enteric feeding tube is advanced with tip projecting over the gastroesophageal junction.Sternotomy wires and contrast filled colonic diverticula are unchanged. The pelvis is excluded from the field-of-view. | Enteric feeding tube is advanced with tip projecting over the gastroesophageal junction. |
Generate impression based on findings. | Female 44 years old Reason: pain History: pain. Three views of the right hand show no fracture or malalignment. There is mild osteoarthritis of the proximal interphalangeal joint of the fifth finger with a tiny adjacent ossicle, perhaps due to remote trauma.We have 3 views of the right ankle. There is diffuse soft tissue swelling. We see no definite acute fracture. There is an ossicle along the posterior aspect of the talus that we suspect represents a normal variant os trigonum. There is a plantar calcaneal spur. | 1.No evidence of right hand fracture.2.Soft tissue swelling of the ankle and ossicle posterior to talus that we suspect represents a normal variant os trigonum. However, if there is strong clinical concern for fracture of the posterior process of the talus, CT may be considered. |
Generate impression based on findings. | Female 61 years old Reason: RUQ Abdominal Pain. For Gallbladder. History: RUQ Abdominal Pain. For Gallbladder. ABDOMEN:LUNG BASES: Left lower lobe nodule measuring up to 7 mm (series 4, image 12). Additional nonspecific micronodule in the left lower lobe (series 4, image 19). No pleural effusions.LIVER, BILIARY TRACT: No evidence of cholelithiasis or acute cholecystitis. Nonspecific, punctate segment 8 hypodensity (series 3, image 26). No biliary ductal dilatation or focal hepatic mass.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left midpole hypodense focus which is too small to characterize but likely represents a renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative changes of the thoracic spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Beam hardening artifact from right hip arthroplasty obscures visualization of much of the uterus/adnexa.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Right total hip arthroplasty.OTHER: No significant abnormality noted | 1.No evidence of cholelithiasis or acute cholecystitis as clinically questioned. No finding to explain patient's right upper quadrant abdominal pain.2.Left lower lobe pulmonary nodule measuring up to 7 mm. Recommend follow-up thoracic CT in 6-12 months to assess stability. |
Generate impression based on findings. | Male 67 years old Reason: evaluate cirrhosis, ascites History: abdominal pain, distension LIMITED ABDOMENLIVER: The liver measures 18.6 cm in length. The liver has a nodular contour. The parenchyma is diffusely increased in echogenicity and heterogeneous in echotexture. No focal mass is identified. There is no ascites. The portal vein is patent and demonstrates hepatopetal flow with a peak velocity of 0.3 m/sec.BILIARY TRACT: The gallbladder is decompressed by a percutaneous drain and is not well visualized. The common duct measures 0.7 cm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The imaged head of the pancreas is normal. The body and tail are obscured by bowel gas.KIDNEYS: The right kidney measures 9.2 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. The left kidney measures 10.8 cm. The cortex is echogenic. No shadowing calculi or hydronephrosis is present. SPLEEN: The spleen measures 15.2 cm. in length and contains a 2.8 cm calcification. | 1.Hepatosplenomegaly and cirrhotic liver morphology. No ascites.2.Echogenic kidneys compatible medical renal disease.3.Slightly increased velocity in the hepatic arteries which is nonspecific. |
Generate impression based on findings. | 71 years, Male. Reason: Confirm position of NGT History: none Enteric feeding tube tip projects over the expected location of the distal esophagus.Sternotomy wires and contrast filled colonic diverticula are unchanged. The pelvis is excluded from the field-of-view. | Enteric feeding tube tip projects over the expected location of the distal esophagus. |
Generate impression based on findings. | Male 56 years old Reason: pain History: pain. We have 4 views of the right knee. There is moderate to severe osteoarthritis of the right knee, particularly affecting the lateral compartment, that appears to have progressed when compared to the prior study. There is a valgus deformity of the right knee.Relatively mild osteoarthritis affects the left knee as seen on the frontal view. | Osteoarthritis. |
Generate impression based on findings. | CHEST: LUNGS AND PLEURA:Mild subpleural scarring and dependent atelectasis.MEDIASTINUM AND HILA: Large hiatal hernia.CHEST WALL: Pacemaker generator in the left anterior chest wall.Marked kyphosis with associated degenerative disease in the spine.UPPER ABDOMEN: Left renal cyst. | Large hiatal hernia and no acute extra cardiovascular findings in the chest. |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Small calcified granulomas compatible with previous infection.MEDIASTINUM AND HILA: Mildly enlarged nonspecific lymph nodes, likely reactive.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted. | No significant extra cardiovascular abnormalities in the visualized portion of the thorax. |
Generate impression based on findings. | 63 years, Female. Reason: Check NGT Placement History: Check NGT Placement Note that the pelvis is excluded from the field-of-view and the study is slightly limited due to patient motion. Enteric feeding tube is looped with tip projecting over the expected location of the gastric body. Vertically oriented skin staples and drain are partially visualized and project over the lower abdomen and pelvis. Degenerative disk disease affects the spine. | Enteric feeding tube is looped with tip projecting over the expected location of the gastric body. |
Generate impression based on findings. | Chemotherapy for non-small cell lung cancer, follow-up LUNGS AND PLEURA: Similar appearing right upper lobe. Visual cavitating mass (image 37 series 6) again measuring 2.9 x 2.2 cm. The associated solid component remains unchanged, and measuring 10 x 6 mm when measured similarly. Persistent thickening in the adjacent fissure with irregular nodular foci along the basilar pleural thickening. Persistent and mildly larger left pleural effusionScattered calcified granuloma without additional new intrapulmonary nodules or massesMEDIASTINUM AND HILA: Multicystic thyroid grossly unchanged and incompletely visualized.No lymphadenopathy.Calcified hilar and subcarinal lymph nodes, compatible with old healed granulomatous exposure.Moderate coronary calcifications. Cardiac and pericardium are otherwise unremarkableCHEST WALL: Interval mild increase in overall dimensions of the sclerotic focus along the right lateral margin of and the more punctate yet unchanged focus involving T3. Interval change may be partially due to treatment. No suspicious new lytic or blastic lesions observed. Mild scoliosis.Stable sclerotic right eighth ribUPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Please correlate with concomitant pending abdomen CT given greater sensitivity. | Interval stability in the right upper lobe cavitary nodule, reference measurements provided. Essentially unchanged sclerotic foci within thoracic vertebrae |
Generate impression based on findings. | Reason: Tonsillar cancer; follow up; with measurements History: as above CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.Minimal dependent atelectasis. No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size, with no pericardial effusion. No visible coronary artery calcification.Calcified mediastinal lymph nodes from prior granulomatous disease, without lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | CHEST: No significant abnormality noted in the extracardiovascular portions of the mediastinum.LUNGS AND PLEURA: Large bilateral pleural effusions with associated compressive atelectasis.MEDIASTINUM AND HILA: No significant extra cardiovascular abnormality noted.CHEST WALL: Status post median sternotomy.UPPER ABDOMEN: Please refer to the separate report of the abdominal findings. | Large pleural effusions and compressive atelectasis. |
Generate impression based on findings. | Female 62 years old Reason: s/p ORIF History: above . Four views of the left elbow show a plate and screws device affixing an olecranon fracture in near anatomic alignment. The fracture line is indistinct suggesting healing. We see no hardware complications. Mild osteoarthritis affects the elbow.Four views of the left shoulder show a plate and screws device affixing the proximal humerus in near anatomic alignment. The fracture line is indistinct suggesting healing. We see no hardware complications. The glenohumeral alignment is within normal limits. A small density within the soft tissues of the medial aspect of the humeral neck may represent a small fracture fragment, but is unchanged from the prior study. Mild deformities of the left third, fourth, fifth, and sixth ribs likely represent old healed fractures. | Orthopedic fixation of olecranon and proximal humerus fractures appearing similar to prior studies. |
Generate impression based on findings. | Female 54 years old Reason: pain History: pain. The bones appear slightly demineralized suggesting osteopenia. Osteoarthritis affects the midfoot. There may be mild soft tissue swelling about the ankle. | Mild midfoot osteoarthritis and possible soft tissue swelling about the ankle. |
Generate impression based on findings. | Male 44 years old Reason: ankle fracture History: ankle fracture. Three views of the left ankle show an oblique fracture of the distal fibula extending to the level of the tibiotalar joint with approximately one cortical width of lateral displacement of the distal fracture fragment. The fracture appears similar to that seen on the prior study. There is os trigonum posterior to the talus. | Distal fibular fracture appearing similar to the prior study. |
Generate impression based on findings. | 14-year-old male with respiratory distress, increasing oxygen requirement, constipation.VIEW: Chest AP and Abdomen AP (two views) 14:56 Gastrostomy tube is noted. VP shunt is seen coursing through the right hemithorax and abdomen with tip coiled in the pelvis.Cardiac silhouette is normal. Elevation of the right hemidiaphragm unchanged with atelectasis in the right upper lobe. No focal pulmonary opacity. No pleural effusion or pneumothorax. Small to moderate fecal burden. Nonobstructive bowel gas pattern.Thoracolumbar levoscoliosis continues. | No evidence of pneumonia or bowel obstruction. |
Generate impression based on findings. | Newly diagnosed right upper lung adenocarcinoma. For staging.RADIOPHARMACEUTICAL: 12.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 84 mg/dL. Today's CT portion grossly demonstrates the semi-solid right upper lobe mass which appears similar to the recent chest CT. Bilateral lung lesions corresponding with likely small pulmonary AVMs are better visualized and described on the recent chest CT. Small lymph nodes are noted in the precarinal and paratracheal regions. Today's PET examination demonstrates abnormal increased FDG avid activity within the right lung mass with an SUVmax of 4.2 indicating consistent with a primary lung malignancy. Abnormal increased FDG avid uptake is also visualized within a lesion in the right diaphragmatic crus with an SUV max of 6.0 and is highly suspicious for metastasis. Mildly increased activity within the hila bilaterally, precarinal and paratracheal regions are nonspecific. Mildly increased activity is noted within the superficial tissues of the left cheek. There is mild increased activity within the region of the vagina which may be related to inflammation. | 1.Abnormal increased FDG avid activity within superior lobe of the right lung is consistent with the patient's known primary lung malignancy.2.A hypermetabolic lesion within the right diaphragmatic crus is suspicious for metastasis.3.Mild mediastinal and hilar FDG avid activity, which is nonspecific. |
Generate impression based on findings. | Fall. Unable to walk. We see no fracture or malalignment. There is soft tissue swelling of the posterior ankle. The silhouette of the Achilles tendon is indistinct several centimeters above its insertion suspicious for a tear in the correct clinical context. | No fracture. Poorly-defined Achilles tendon suspicious for a tear in the correct clinical context. |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Small basilar scar like opacities.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Please see the report of the abdominal CT scan performed on the same day. | No significant extra cardiovascular abnormalities in the visualized portion of the thorax. |
Generate impression based on findings. | Female 38 years old; Reason: Evaluate neck pain with paresthesias/pain extending into BUE, hx MVA 2012 Minimal degenerative disk disease affects C5/C6 and C6/C7 with small posterior vertebral body osteophytes. There is perhaps mild neural foraminal narrowing on the right at C4/C5 and C5/C6 and on the left at C5/C6. | Minimal degenerative disk disease with mild neural foraminal narrowing, as described above. This may be better evaluated with cross sectional imaging, if clinically warranted. |
Generate impression based on findings. | Left total knee arthroplasty Two views of the left knee demonstrate hardware components of a left total knee arthroplasty device situated in near-anatomic alignment, without radiographic evidence of hardware complication. A surgical drain, soft tissue gas, and skin staples reflect recent surgery. | Postoperative changes of a left total knee arthroplasty. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. The basal cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. | Unremarkable noncontrast MRI brain. |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Elevation of the left hemidiaphragm with overlying subsegmental atelectasis.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: Status post median sternotomy.UPPER ABDOMEN: Please see the report for the abdominal CT scan performed on the same day. | No significant extra cardiovascular abnormalities in the visualized portion of the thorax. |
Generate impression based on findings. | Metastatic lung cancer, malignant pleural effusion. PD from Erlotinib. LUNGS AND PLEURA: There is a large, loculated right pleural effusion with compressive atelectasis of the right lower lobe. There are post-surgical changes of a partial right middle lobectomy. There is pleural thickening along the right lower hemithorax. MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. There is a mildly prominent right paratracheal lymph node measuring 7 mm in the short axis (image 28, series 4), which was hypermetabolic on a OSH PET. There is no hilar lymphadenopathy. There are moderate coronary artery calcifications.CHEST WALL: There is no axillary lymphadenopathy. Median sternotomy.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. The gallbladder is surgically absent. | 1. Loculated large right pleural effusion and right pleural thickening. 2. Prominent right paratracheal lymph node corresponding to hypermetabolic node on OSH PET. |
Generate impression based on findings. | Follow-up examination. Status post surgery. Again seen are postoperative changes of a bunion correction surgery, with screws in the first metatarsal and affixing the first tarsometatarsal joint and first intercuneiform joint in near-anatomic alignment. The first tarsometatarsal joint appears more indistinct on the current study, which may indicate some interval bony fusion.Deformity of the proximal phalanx of the second toe reflects prior trauma and surgery. | Postoperative changes of a bunion correction surgery, as described above. |
Generate impression based on findings. | Neuroblastoma, pre-ENCIT-1. There has been interval decrease in the size of the proximal MIBG avid femur lesions bilaterally as well as a decrease in the size of the distal right femur lesion. MIBG avid tumor previously visualized at the level of the mesenteric root is no longer visualized and has likely resolved. The left suprarenal MIBG avid lesion is stable. No other change is noted regarding the osseous metastases in the lower thoracic spine, upper lumbar spine, bilateral iliac bones and sacrum.There is normal physiologic radiotracer distribution seen in the salivary glands, myocardium, liver, bowel, and bladder. | Overall improvement in the osseous and soft tissue MIBG avid metastases. |
Generate impression based on findings. | CHEST:LUNGS AND PLEURA: Nonspecific noncalcified subpleural nodule measuring 9 mm the right upper lobe (series 10/110). This is indeterminate and a follow-up CT scan is recommended in approximately 3 months to confirm stability.Focal scarlike opacity in the lingula and left lower lobe.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: No significant abnormality noted. | Noncalcified 9 mm nodule in the right upper lobe for which a follow-up scan is recommended in approximately 3 months. |
Generate impression based on findings. | Postoperative changes are again seen from previous left hemiglossectomy, floor of mouth resection with flap reconstruction, and left neck dissection. There is again fatty atrophy of the residual right tongue, and mucosal thickening of the oropharynx and hypopharynx. There is persistent nonspecific soft tissue thickening at the level of the glottis with distortion of the left-sided laryngeal cartilages which is unchanged.PHARYNX/LARYNX: The nasopharynx, oropharynx, hypopharynx, and larynx are otherwise unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal focal soft tissue mass or pathological enhancement.GLANDS: The left submandibular gland is surgically absent. The postcontrast appearance of the remaining salivary glands is unremarkable. The thyroid gland is unremarkable. CERVICAL SOFT TISSUES: There are no pathologically enlarged cervical lymph nodes.OTHER: There is suggestion again of hypoattenuation along the posterior pituitary gland, better characterized on prior MRI. The previous left apical spiculated nodule is been biopsied in the interim. There is a few new areas of minimal nodularity along the left lung apex, with slight increase size of a right upper lobe pulmonary micronodule as well. Other scattered micronodules are again seen elsewhere in the right lung apex. | 1. Redemonstration of extensive postoperative changes, without definite evidence of local tumor recurrence or lymphadenopathy.2. Redemonstration of biapical pulmonary micronodules, with interval biopsy of spiculated left apical nodule. Suggestion of slight increased size of largest visualized right apical pulmonary nodule and new left apical micronodules concerning for progression of metastatic disease. Dedicated CT chest may be obtained for further evaluation. |
Generate impression based on findings. | Female 78 years old Reason: mets lung cancer, PD from Erlotinib. Pls evaluate dz status @ pelvis History: lung ca ABDOMEN:LUNG BASES: Large right pleural effusion. Full thoracic findings will be reported on separate CT chest study. LIVER, BILIARY TRACT: New focal area of relatively high attenuation adjacent to the dome of the liver and below the diaphragm which was not present on PET/CT from 2/6/2015. This finding is best seen on the coronal views (series 80284, image 45). Status post cholecystectomy. Segment 4b hypodensity likely represents a perfusion defect.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral hypodense renal foci which are too small to characterize and likely represent benign renal cysts.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diverticulosis of the descending and sigmoid colon without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.New nonspecific, focal area adjacent to the dome of the liver of uncertain clinical significance. If there has been a recent procedure in this area, favor benign etiology such as a resolving hematoma, however, malignant soft tissue infiltration cannot be excluded.2.No additional findings concerning for metastatic disease. |
Generate impression based on findings. | 74 years old male with a history of gastric cancer. Please assess prior to the start of therapy. RADIOPHARMACEUTICAL: 12.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 84 mg/dL. Today's CT portion of the neck demonstrates a mass in the left lobe of thyroid. Please see diagnostic CT reports for details of the chest, abdomen, and pelvis.Today's PET examination demonstrates intense FDG uptake in the mass of the left lobe of thyroid with SUVmax of 17.7. Several foci of increased activity is seen in the right internal mammary lymphatic chain with SUV Max of 2.1. Minimal FDG uptake in seen in the opacities in the right lower lobe. Multifocal FDG uptake is seen in the hepatic space, corresponding to the areas of perihepatic ascites seen on CT. Increased FDG uptake is also seen in the soft tissue of thickening of the peritoneum in the left abdomen adjacent to the stomach and spleen. Multiple foci of moderate FDG uptake is also seen in the lower abdomen and pelvis. Several foci of increased activity is seen in the left abdominal wall subcutaneous fat, corresponding to a soft tissue densities seen on CT. Diffuse FDG uptake is seen in the stomach which is most likely due to physiological activity or post therapy change.Non-specific foci of increased activity are seen in the prostate gland.Physiologic activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Multifocal peritoneal FDG uptake, predominantly in the perihepatic space and soft tissue thickening in the left upper abdomen, highly suspicious for peritoneal carcinomatosis.2.Intense hypermetabolic thyroid mass, suspicious for thyroid cancer versus metastasis.3.Normal-sized lymph nodes with mildly increased metabolic activity in the right internal mammary lymphatic chain, which are nonspecific.4.Nonspecific foci of increased activity in the prostate gland.5.Inflammatory changes in the right lower lung.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | Left ear pain, history previous stroke, but no focal findings. There is no evidence of acute intracranial hemorrhage or mass. There is unchanged encephalomalacia in the left corona radiata and scattered patchy mild cerebral white matter hypoattenuation. The ventricles are normal in size and configuration. There is a partially-empty sella. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. There are bilateral lens implants. | Chronic lacunar infraction and mild small vessel ischemic disease. No evidence of acute intracranial hemorrhage or mass. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | 5-month-old male NICU infant with pulmonary hypertension, RUL atelectasis VIEW: Chest AP (one view) 2/25/15 16:13 Tracheostomy tube tip at the thoracic inlet. Enteric tube tip and side-port in the stomach. The cardiothymic silhouette is normal. Interval increase in right upper lobe atelectasis in a background of chronic lung disease. No pneumothorax. | Increased right upper lobe atelectasis in a background of chronic lung disease. No pneumothorax. |
Generate impression based on findings. | Altered mental status, left sided weakness, and fall. History of drug and ETOH abuse. There is no evidence of acute intracranial hemorrhage or mass. There is moderate patchy cerebral white matter hypoattenuation, similar to the previous exam. There is also an unchanged subcentimeter defect in the left posterior limb if the internal capsule and encephalomalacia in the inferior left cerebellar hemisphere and left occipital lobe. The ventricles are unchanged in size and configuration, with predominant cerebellar vermian volume loss. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | 1. Chronic infarcts in the posterior circulation distribution and small vessel ischemic disease, but no evidence of acute intracranial hemorrhage or mass. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.2. Predominant cerebellar vermian volume loss may be related to alcohol abuse. 3. No evidence of skull fracture. |
Generate impression based on findings. | History of metastatic breast cancer on treatment. Compare to prior imaging, evaluate for response and extent of disease. There has been no interval change in the abnormal activity suspicious for osseous metastases within the skull base, spine or distal femur. No change in the activity within the humeral heads and knees bilaterally likely indicating degenerative changes. | Stable osseous metastases as described above. No new lesions. |
Generate impression based on findings. | 48 year old woman with chest pain referred to rule out coronary artery disease.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 coronary arteries. There are no significant stenoses present in the left main.LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There are no significant stenoses in the LAD. Minimal, non-calcified atherosclerosis is noted in the mid vessel.LCx: The left circumflex coronary artery is non-dominant. It courses normally in the left AV groove. It gives rise to the obtuse marginal branches. There are no significant stenoses in the LCx.RCA: The right coronary artery is large and arises normally from the right sinus of Valsalva. It is the dominant coronary artery supplying a posterior descending artery and a posterolateral branch. There are no significant stenoses in the right coronary artery. There is a non-calcified, non-obstructive plaque resulting in <25% stenosis in the mid RCA. There is minimal calcification in the distal RCA.Left Ventricle: The left ventricular late diastolic volume and LV wall thickness are normal.Right Ventricle: Visually the right ventricular late diastolic volume is within normal limits.Left Atrium: Visually, the left atrial volume appears to be normal in size. There are four distinct pulmonary veins which drain normally into the left atrium. There is no evidence of left atrial appendage thrombus.Right atrium, vena cavae, and coronary sinus: The right atrial volume appears to be normal in size. The superior and inferior vena cavae are grossly normal. The coronary sinus is normal in size. Valves: There is no calcification on the aortic or mitral valves.Great vessels: The visualized portions of the thoracic aorta demonstrate no evidence of dissection or aneurysm. The aortic arch is not seen. The main pulmonary artery is normal in size.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion. A modest amount of epicardial/ pericardial fat is present. | 1. There are no severe coronary artery stenoses present. 2. Mild burden of coronary atherosclerosis is present. 3. Modest burden of epicardial/ pericardial fat is present.This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report. |
Generate impression based on findings. | Visualization of the thorax is limited by the field of view and length of scan, which excludes substantial areas of the lungs.CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Please refer to the report of the abdominal CT scan performed on the same day. | No significant extra cardiovascular abnormalities in the visualized portion of the thorax. |
Generate impression based on findings. | Metstatic lung cancer. EGFR +, on Erlotinib, now progressive disease, baseline status for trial. There is no evidence of intracranial mass. The grey-white matter differentiation appears to be intact. There is no abnormal intracranial enhancement. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | No evidence of intracranial metastases. |
Generate impression based on findings. | There are stable postoperative and posttreatment changes which include effacement of fat planes in the right neck associated with scattered surgical clips. PHARYNX/LARYNX: The nasopharynx, oropharynx, hypopharynx, and larynx are otherwise unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The submandibular glands are diminutive in size. The postcontrast appearance of the salivary glands is otherwise unremarkable. The thyroid gland is unremarkable. ORAL CAVITY: The oral tongue and floor of mouth are unremarkable, within the limitations of this exam as there is artifact from dental amalgam.CERVICAL SOFT TISSUES: There are no pathologically enlarged cervical lymph nodes.OTHER: There are mild multilevel cerebral spondylotic changes, which appear stable. There is mild scattered mucosal thickening in the paranasal sinuses. | Stable posttreatment changes without evidence of local tumor recurrence or cervical lymphadenopathy. |
Generate impression based on findings. | 84 year old woman with severe aortic stenosis who presents for cardiac CT for evaluation prior to possible TAVRCPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with normal brachiocephalic branching pattern. The brachiocephalic vessels are very tortuous. There is mild atherosclerosis of the proximal left subclavian artery. No thoracic aortic dissection or aneurysm is noted. The thoracic aorta has mild tortuosity. No protruding aortic atheroma or thrombus is noted in the thoracic aorta. There is no significant calcification of the aortic root and aortic arch. There is mild to moderate calcification of the descending aorta. No aortic coarctation is noted. Aortic Annulus: Dimension: 28 mm x 22mm Perimerter: 81 mm Area: 4.6cm2Sinus of Valsalva: Width: 31mm x 32mm x 31mm Height: 19 mmSinotubular Junction: 27 x 28 mmAscending Aorta (4cm from annulus): 32 x 31 mm.Mid Aortic Arch: 29 x 29 mm.Descending Aorta: 23 x 23 mmAnnulus to LM Height: 12 mm Annulus to RCA Height: 14 mmAortic Leaflet Length: 15mmFluoroscopic Angle: RAO 4 CAU 7Aortic Valve: The aortic valve is trileaflet. There is moderate aortic valve calcification, which predominantly involves the right and non-coronary cusps. Mitral Valve: Moderate to severe posterior mitral annular calcification is noted. There is severe systolic anterior motion of the mitral valve leaflets. Left Ventricle: The left ventricular end-systolic volume is increased. There is a severe sigmoid septum associated with severe systolic anterior motion of the mitral leaflet. There is a resting perfusion defect in the LAD territory. There is no thrombus noted in the left ventricle. Right Ventricle: Visually the right ventricular end-systolic volume is within normal limits.Left Atrium: The left atrium is severely dilated. There are four distinct pulmonary veins which drain normally into the left atrium. There is no evidence of left atrial appendage thrombus.Right atrium, vena cavae, and coronary sinus: The right atrium is moderately dilated. The superior and inferior vena cavae are grossly normal. The coronary sinus is normal in size. Pulmonary Artery: Mildly dilated (31mm).Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary arteries: Because heart rate management was not attempted and nitroglycerine was not administered, this exam was not performed to optimally visualize the coronary arteries. However within the limitations of the study the following observations are made:LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There is moderate calcification of the left main coronary artery. LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There is severe calcification of the LAD. LCx: The left circumflex coronary artery courses normally in the the left AV groove. It gives rise to the obtuse marginal branches and a small AV circumflex branch. There is mild calcification of the LCx.RCA: The right coronary artery arises normally from the right sinus of Valsalva. It is the dominant coronary artery supplying a posterior descending artery and a posterolateral branch. There is severe calcification of the RCA. Coronary Bypass Grafts:None present. | 1. Severe aortic valve calcification 2. Thoracic aortic anatomy as above. 3. Severely tortuous brachiocephalic vessels. 4. Severely sigmoid septum associated with severe systolic anterior motion of the mitral leaflets. 5. Aortic valve leaflet greater than left main height. 6. Resting myocardial perfusion defect in LAD territory. 7. Biatrial enlargement. 8. Moderate to severe posterior mitral annular calcification. 9. Severe coronary artery calcification. 10. Mild pulmonary artery dilation. This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report. The abdomen/ pelvis CTA will be reported separately. |
Generate impression based on findings. | Visualization of the thorax is limited by the field of view and length of scan, which excludes substantial areas of the lungs.CHEST:LUNGS AND PLEURA: Pleural and pulmonary scarring in the left lower hemithorax, not significantly changed.MEDIASTINUM AND HILA: No significant abnormality noted in the extracardiovascular portions of the mediastinum.CHEST WALL: No significant abnormalities noted. UPPER ABDOMEN: Please refer to the report of the abdominal CT scan performed on the same day. | Scarring with pleural thickening a main left lower hemithorax, unchanged from previous. |
Generate impression based on findings. | Male; 74 years old. Reason: Gastric cancer please assess and provide index lesion measurements for RECIST please capture previous measurements from OSH imaging 2/13 series 2 image 64/68. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules, the largest of which measures 6 mm and demonstrates a more prominent appearance in the anterior right lung (series 4, image 61). Given its proximity to the minor fissure, this may represent an intrapulmonary lymph node. Trace right pleural effusion, slightly increased from previous CT. Dependent scarring/atelectasis.MEDIASTINUM AND HILA: Prominent heterogeneous left thyroid lobe, which can be further evaluated with thyroid ultrasound if clinically indicated. Normal heart size without pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Mild coronary calcifications. CHEST WALL: No significant abnormality noted. Left central venous catheter tip in mid SVC. ABDOMEN:LIVER, BILIARY TRACT: No focal hepatic lesions or biliary ductal dilatation. Portal vein is patent.SPLEEN: No significant abnormality noted. PANCREAS: No significant abnormality noted. ADRENAL GLANDS: Right adrenal nodule measures 1.3 x 1.2 cm (series 701, image 102) and appears more prominent compared to the prior CT. KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Enlarged peripancreatic lymph node measures 1.7 x 1.3 cm and does not appear significantly changed (series 701, image 102). BOWEL, MESENTERY: Stable perihepatic ascites and extensive mesenteric and omental soft tissue nodularity, compatible with peritoneal tumor spread. This soft tissue measures 6.5 cm in thickness in the left anterior abdomen on series 701, image 112. Multiple areas of underdistention vs narrowing in the stomach; correlate with patient history. No obstruction or free air. BONES, SOFT TISSUES: Nonspecific soft tissue attenuation in the left lateral anterior abdominal wall appears stable to slightly increased in density. Please correlate with patient history and physical exam.OTHER: Mild perihepatic ascites. PELVIS:PROSTATE, SEMINAL VESICLES: Hypoattenuating lesion in the prostate may represent prior TURP defect.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Please see above discussion. BONES, SOFT TISSUES: No significant abnormality notedOTHER: Improving pelvic ascites. | 1. Findings compatible with extensive peritoneal carcinomatosis and persistent perihepatic ascites as described above. Interval improvement in pelvic ascites.2. Stable enlarged peripancreatic lymph node and right adrenal nodule which appears more prominent. Please see reference measurements above.3. Prominent heterogeneous left thyroid lobe, which may be further evaluated with thyroid ultrasound imaging. Please refer to separate PET CT report from same day for additional details. |
Generate impression based on findings. | Male 54 years old Reason: assess for fx in pt with increased ground level falls History: increased falls. AP view of the pelvis shows no fracture. The bones appear slightly demineralized. Components of a left hip bipolar hemiarthroplasty device are situated in near anatomic alignment without radiographic evidence of hardware complication. Mild-to-moderate osteoarthritis affects the right hip. | No fracture evident. Left hemiarthroplasty and right hip osteoarthritis. |
Generate impression based on findings. | 49-year-old female with abdominal pain and vomiting, recent ventral hernia repair. Evaluate for small bowel obstruction. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality noted in liver parenchyma. Slight increased punctate density in dependent gallbladder may represent sludge or small stones. No intrahepatic or extrahepatic biliary duct dilatation seen.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Normal right adrenal gland. Left adrenal gland is diffusely thickened but unchanged in appearance dating back to 2/1/2010.KIDNEYS, URETERS: No left kidney is visualized in the retroperitoneum. As described on prior examinations more inferiorly anterior to the left psoas muscle in the pelvis is a cystic lesion with some dependent calcifications and may represent an end-stage hydronephrotic pelvic kidney. This is unchanged dating back to 2010 CT. Right kidney shows no abnormalities.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Repair of prior noted anterior abdominal wall ventral umbilical hernia. No recurrence of hernia seen. No abnormal fluid collections are seen in the anterior abdominal wall or in the adjacent abdomen. Expected thin soft tissue density in the umbo likely tract is seen consistent with soft tissue scarring from recent surgery.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Repair of the anterior umbilical ventral hernia without complication seen. 2. No change in loculated fluid collection anterior to left pelvic psoas muscle unchanged since 2010 and thought to represent endstage obstructed pelvic kidney. 3. No other abnormalities or changes seen and no findings seen to account for patient's symptomatology. No evidence of intestinal obstruction. |
Generate impression based on findings. | History of HCC: here for Theraspheres Mapping along with a MAA. The MAA tracer was identified in the liver. Thyroid gland, salivary gland, kidney and stomach activity most likely represents free technetium. No abnormal distribution of tracer activity was noted within the abdominal cavity. The liver to lung shunt fraction was 0.0394 (approximately 4%) | 1.Expected distribution of the MAA tracer in the liver and free technetium elsewhere as described above.2.Liver to lung shunt fraction of approximately 4% as described above. |
Generate impression based on findings. | headache 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 are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | fall and hit head, no LOC, dizziness No evidence of acute ischemic or hemorrhagic lesion.Underlying brain shows diffuse brain atrophy with small vessel ischemic changes, slightly progress since prior exam.Subtle scalp swelling along the vertex without underlying skull fracture.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 cells are clear. | No evidence of acute ischemic or hemorrhagic lesion.Underlying brain shows diffuse brain atrophy with small vessel ischemic changes, slightly progress since prior exam. |
Generate impression based on findings. | Clinical question:? Mass. Signs and symptoms: Short term memory loss. Nonenhanced head CT:There is no detectable acute intracranial process. The cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation is within normal for age.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, paranasal sinuses and mastoid air cells. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Rule out new CVA. Signs and symptoms: AMS. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive insensitive for early detection of acute nonhemorrhagic ischemic strokes. Examination however demonstrate patchy foci of periventricular and subcortical as well as basal ganglia and minimally of the pons which are highly suggestive of age indeterminate small vessel ischemic strokes. Although difficult to precisely compare with prior exam the overall appearance of this finding demonstrate interval progression.Mild prominence of cortical sulci and the ventricular system is noted.Unremarkable orbits, calvarium, paranasal sinuses and mastoid air cells. | 1.No acute intracranial process.2.Findings of moderate age indeterminate small vessel ischemic strokes as detailed. |
Generate impression based on findings. | Clinical question: Rule out ICH. Signs and symptoms: Fall with head trauma. Unenhanced head CT: There is no detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation for patient's stated age of 24.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | 36 years, Male. Reason: assess og tube placement History: s/p og tube Enteric feeding tube side hole projects over the fundus and tip projects over the expected location of the gastric body. Incompletely imaged bowel distension. Large lung volumes compatible with emphysema and scarring again noted. | Enteric feeding tube tip projects over the gastric body. |
Generate impression based on findings. | 64 years, Male. Reason: NJ tube placement History: s/p NJ tube placement Enteric feeding tube extends beyond the ligament of Treitz with tip in the lower abdomen. Nonobstructive bowel gas pattern. Right sided central venous catheter tip is at the cavoatrial junction, unchanged. Right pleural effusion and right airspace opacities are better evaluated on chest radiograph performed the same day. Bilateral total hip arthroplasties. | NJ tube extends beyond the ligament of Treitz with tip in the lower abdomen. |
Generate impression based on findings. | hydrocephalus, ventriculostomy, EVD clamped. No evidence of acute ischemic lesion.Minimal amount of IVH especially on the right lateral ventricle occipital horn, no change since prior exam.Right frontal approached ventriculostomy tube with the tip position on the right side foramen of Monroe, no change since prior exam.Ventricular size does not show any significant interval change.Multifocal low attenuation lesions indicate prior ischemic lesions, no change since prior exam.Left distal ICA to MCA intracranial stent, no change since prior exam.The paranasal sinuses and mastoid air cells are clear. | No change of ventricle size and EVD tube position since prior exam.No change of minimal IVH since prior exam.No acute ischemic lesion on this scan. |
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