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Generate impression based on findings. | 63 year old female with recent peritoneal bleed now with drop in hemoglobin. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: Moderate left and small right pleural effusions with associated atelectasis.LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: End-stage native kidneys.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic disease of the aorta and its branches involving both large and small vessels.BOWEL, MESENTERY: Interval placement of enteric tube with tip in gastric body.BONES, SOFT TISSUES: Diffuse anasarca. Renal osteodystrophy with superimposed degenerative changes of the osseous structures.OTHER: New collection in the right lower quadrant inferior to the cecum (series 3, image 106) measuring 7.4 x 9.8 cm with an attenuation of 45HU compatible with acute hematoma. Additional new blood products along the right anterior inferior abdominal wall. Redemonstration of moderate ascites with additional evolving intraperitoneal hematoma in the left lower quadrant and pelvis appearing similar in quantity to prior.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Renal osteodystrophy with superimposed degenerative changes of the osseous structures.OTHER: Transplant kidney in the right iliac fossa. New collection in the right lower quadrant inferior to the cecum (series 3, image 106) measuring 7.4 x 9.8 cm with an attenuation of 45HU compatible with acute hematoma. Additional new blood products along the right anterior inferior abdominal wall. Redemonstration of moderate ascites with additional evolving intraperitoneal hematoma in the left lower quadrant and pelvis appearing similar in quantity to prior. | 1.New acute hematoma in the right lower quadrant inferior to the cecum. Additional new blood product along the right anterior inferior abdominal wall. 2.Redemonstration of moderate ascites with additional evolving intraperitoneal hematoma in the left lower quadrant and pelvis.3.End-stage kidneys and renal osteodystrophy.4.Moderate left pleural effusion, small right pleural effusion, and moderate pericardial effusion. Anasarca. |
Generate impression based on findings. | One day old male with bilious emesis. Follow-up of UGI.VIEW: Abdomen AP (one view) 2/26/2015 1:23 Feeding tube tip in the stomach. UVC catheter tip has been retracted in the right atrium. Residual contrast material is again seen in the stomach and small bowel. Decreased amount of gas in the stomach with gas seen in the distal small bowel loops. | Unchanged bowel gas pattern. |
Generate impression based on findings. | 62 year old female with right lower extremity edema and history of lymphadenopathy, evaluate for abdominal or pelvic mass. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Numerous abnormally enlarged para-aortic lymph nodes are present. For reference, a left para-aortic lymph node (series 3, image 51) measures 1.9 x 2.7 cmBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: A small fat containing umbilical hernia is present.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Several masslike lesions are present within the uterus, some of which contains coarse calcifications and are likely fibroids. One of the masses extending into the endometrial cavity is incompletely characterized. Fluid is present within the endometrial cavity.BLADDER: No significant abnormality notedLYMPH NODES: Numerous bilateral abnormally enlarged iliac and inguinal lymph nodes are present. For reference, a left external iliac lymph node (series 3, image 85) measures 2.2 x 2.4 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: A small amount of free fluid is present in the pelvis. | 1.Multiple enlarged retroperitoneal and pelvic lymph nodes suspicious for lymphoma.2.Several uterine masses which may represent fibroids but are incompletely characterized. Fluid is also present within the endometrial cavity. Recommend pelvic ultrasound for further evaluation.Findings discussed by on call resident with Dr. Druelinger at 7:56 p.m. on 2/26/2015. |
Generate impression based on findings. | Female 68 years old Reason: hx hilar cholangiocarcinoma, please eval biliary system. R/o portal-biliary fistula History: na ABDOMEN:LUNG BASES: Interstitial reticular thickening unchanged.LIVER, BILIARY TRACT: Slight decrease in intrahepatic biliary dilatation with interval exchange of metallic common bile duct stent with a plastic common bile duct stent. Previously measured index mass at the confluence of the hepatic biliary ducts has decreased in size and now measures 2.3 x 1.7 cm (series 11, image 52), previously 2.5 x 2.5 cm. Infiltrative mass in the right lobe of the liver, grossly unchanged. No evidence of porto-biliary fistula.Status post cholecystectomy.Interval increase in the abdominal ascites. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral small renal hypodensities are unchanged and likely represent renal cysts.RETROPERITONEUM, LYMPH NODES: Reference periportal lymph node is stable measuring 1.5 x 1.2 cm (series 11, image 61) previously 1.7 x 1 cm. Stable index aortocaval lymph node measures 1.2 x 0.6 cm (series 11, image 66), previously 1.4 x 0.6 cm. Reference para-aortic node measures 1.3 x 1.2 cm (series 11, image 59), previously 1.3 x 1.0 cm. Atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Interval increase in the peritoneal fat stranding most prominent adjacent to the descending colon. No evidence of obstruction or intracranial free air.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: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No evidence of porto-biliary fistula as clinically questioned.2.Interval decrease in the size of the patient's known common bile duct mass.3.Reference lymph nodes are grossly stable.4.Slight interval increase in peritoneal fat stranding and ascites. Peritoneal carcinomatosis not excluded. |
Generate impression based on findings. | 87 year old female with history of diverticulitis now with right lower quadrant pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy. Dilation of the common duct with possible pseudo-gallbladder, likely related to the prior cholecystectomy, appears unchanged. Bilateral intrahepatic and extrahepatic pneumobilia, present on the prior exam and seen since the exam from 9/1/2007.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Atrophic kidneys with left greater than right renal scarring. Bilateral subcentimeter low-attenuation renal lesions too small to characterize but not significantly changed. No nephrolithiasis or hydronephrosis.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Small hiatal hernia. Normal caliber bowel without evidence of obstruction. Appendix visualized and unremarkable. Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Thoracolumbar scoliosis with severe degenerative changes. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small hiatal hernia. Normal caliber bowel without evidence of obstruction. Appendix visualized and unremarkable. Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: Thoracolumbar scoliosis with severe degenerative changes. Right hip total arthroplasty which causes adjacent metallic streak artifact. Degenerative changes of the left hip.OTHER: No significant abnormality noted | 1.No acute findings to account for the patient's pain.2.Colonic diverticulosis without evidence of diverticulitis.3.Chronic findings including pneumobilia, renal scarring, and severe degenerative changes of the visualized osseous structures appearing similar to prior. |
Generate impression based on findings. | 16-month-old male with fever and respiratory distressVIEW: Chest AP (one view) 2/25/15 17:18 Lower extremity PICC tip extends to the junction of the SVC and right atrium. The cardiothymic silhouette is normal. Bronchial wall thickening without evidence of pneumonia. Dilated bowel loops are again noted in the upper abdomen. | Bronchial wall thickening without evidence of pneumonia. |
Generate impression based on findings. | 55 years, Male. Reason: Dobbhoff placement Lung bases are clear. Incompletely imaged right apical air space disease. Dobbhoff tube tip projects over the proximal gastric body. Mildly dilated loops of small and large bowel suggestive of ileus. Note that the pelvis and portion of the left hemiabdomen is excluded from the field-of-view. | Dobbhoff tube tip projects over the proximal gastric body. Ileus type bowel gas pattern. |
Generate impression based on findings. | Reason: r/o PE History: SOB, h/o PE PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Moderate apical predominant centrilobular emphysema. Basilar atelectasis/scarring, most prominent in the middle lobe, unchanged. Mild to moderate dependent atelectasis. No focal airspace consolidation. No pleural effusions.Scattered benign appearing micronodules are stable from 2007. No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: The heart is normal in size, without pericardial effusion. Mild coronary artery calcifications.No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted.Small hiatal hernia. | No evidence of pulmonary embolism or other acute abnormality to account for the patient's symptoms.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male 59 years old Reason: Assess for abscess History: Pain and induration at site of surgical lymph node bx ABDOMEN:LUNG BASES: Bibasilar atelectasis/scarring, unchanged. Increased, nonspecific posterior subpleural fat is noted.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left upper pole hypodense lesion consistent with a simple cyst. Right nephrolithiasis, unchanged.RETROPERITONEUM, LYMPH NODES: IVC filter in place.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: 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: Nonspecific left inguinal fluid collection with internal foci of air measuring approximately 4.8 x 1.6 cm (series 3, image 155). The collection starts just inferior to the skin laterally and extends medially to a depth of 3.7 cm. The fluid collection appears to track towards the inguinal canal near the scrotum best seen on coronal images (series 80268, image 85). Multiple hyperdense foci in the anterior subcutaneous tissues consistent with prior injection sites. Bilateral hip arthroplasties.OTHER: No significant abnormality noted | Nonspecific left inguinal fluid collection which tracks towards the inguinal canal to the scrotum. This may represent a postoperative seroma/hematoma with surrounding inflammatory changes, however, superimposed infection cannot be excluded. |
Generate impression based on findings. | 10-month-old female with increased work of breathingVIEWS: Chest AP/lateral (two views) 2/25/15, 2:25 The cardiothymic silhouette is normal. The aortic arch, cardiac apex, and stomach are left-sided. Bronchial wall thickening and subsegmental atelectasis of the lingula and right middle lobe without evidence of pneumonia or pleural effusion. No pneumothorax. | Bronchiolitis without evidence of pneumonia. |
Generate impression based on findings. | 12-year-old female status post foreign body removal along palmar aspect of handVIEWS: Right hand PA, oblique, and lateral (3 views) 2/25/15 19:56 No radiopaque foreign body or fracture. Alignment is anatomic. The physes are fused with a bone age of 17. | No radiopaque foreign body or fracture. |
Generate impression based on findings. | 15 year-old male with abdominal distention, evaluate for ileusVIEW: Abdomen AP (one view) 2/26/15 4:28 Enteric tube is coiled in the stomach with its tip at the GE junction. The G-tube is not well visualized. Dilated loops of large bowel are again noted likely due to chronic ileus. No small bowel dilatation or evidence of obstruction.Left thoracolumbar curve. Bilateral hip dysplasia. | Dilated large bowel consistent with chronic ileus. |
Generate impression based on findings. | 12-year-old male with pain in upper thigh, severe tenderness for 5 days. Evaluate for evidence of trauma to right femur.VIEWS: Right femur AP and Lateral (two views) 2/25/2015 16:57 Alignment is normal. No evidence of fracture or dislocation. No soft tissue swelling or joint effusion. | Normal examination. |
Generate impression based on findings. | RDSVIEW: Chest AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Right central line in place. Cardiothymic silhouette normal. Diffuse atelectasis bilaterally without pleural effusion or pneumothorax. | Diffuse atelectasis bilaterally not significantly changed. |
Generate impression based on findings. | Female 81 years old Reason: eval for AAA vs obstruction History: abdominal distention, hypotensive, recent defib placement yesterday ABDOMEN: Exam is limited secondary to lack of oral and intravenous contrast. Evaluation of vascular and solid organ pathology is suboptimal without intravenous contrast. Evaluation of bowel pathology is suboptimal without oral contrast. Within these limitations, the following observations were made:LUNG BASES: Bibasilar scarring and bronchiectasis.LIVER, BILIARY TRACT: Multiple, nonspecific hypodensity lesions within the liver are incompletely characterized. Favor benign cysts. Small perihepatic fluid collection.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Scarred kidneys bilaterally.RETROPERITONEUM, LYMPH NODES: Defibrillator leads in place. Atherosclerotic calcifications of the aorta and its branches.BOWEL, MESENTERY: No evidence of obstruction or intraperitoneal free air. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Large multiseptated, cystic pelvic lesion extending superiorly into the abdomen which likely represents an ovarian cystic neoplasm. The mass is best seen on sagittal view (series 8029, image 66) and measures 2.3 x 1.3 centimeters. On coronal images, the mass measures 1.4 cm. The mass abuts the posterior wall of the bladder with a preserved fat plane. The mass also abuts the anterior wall of the sigmoid colon and several small bowel loops in the right lower quadrant. Bilateral ovaries are visualized.BLADDER: The mass abuts the posterior wall of the bladder with a preserved fat plane.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The mass abuts the anterior wall of the sigmoid colon and several small bowel loops in the right lower quadrant.BONES, SOFT TISSUES: Fat-containing right inguinal hernia. Slight spondylolisthesis of L4 on L5. Wedge compression of the T11 vertebral body of indeterminate age.OTHER: No significant abnormality noted | Limited examination secondary to lack of intravenous and oral contrast making evaluation of solid organ and bowel pathology suboptimal. Within these limitations, there is a large multiseptated, cystic pelvic lesion extending superiorly into the abdomen which likely represents an ovarian cystic neoplasm. |
Generate impression based on findings. | 14-year-old female with increased respiratory support.VIEW: Chest AP (one view) 2/26/2015 5:25 Cardiothymic silhouette is normal. Interval improved aeration of the right lung lower lung with persistent basilar opacity likely combination of consolidation and atelectasis. Left base hazy opacity slightly improved. No pneumothorax. | Interval improved aeration of bilateral lung bases. |
Generate impression based on findings. | 14 year old female with increased home O2 requirement. Evaluate for pneumonia.VIEW: Chest AP (one view) 2/25/2015 Gastrostomy tube is again seen.Cardiothymic silhouette is normal. Right lobe opacity likely a combination of consolidation and pleural effusion. Improved aeration of the left lung. No pneumothorax.Disorganized nonobstructive bowel gas pattern. Persistent thoracolumbar dextroscoliosis. | Likely consolidation and pleural effusion in the right lower lobe. Interval improved aeration of the left lung. |
Generate impression based on findings. | 17 month old male, rule out pneumonia and obstructionVIEWS: Chest AP, abdomen AP, abdomen left lateral decubitus (3 views) 2/26/15 5:37 The cardiothymic silhouette is normal. No focal pulmonary opacity or pleural effusion. The bowel gas pattern is normal without evidence of obstruction. Moderate rectal stool burden. | Nonobstructive bowel gas pattern. No evidence of pneumonia. |
Generate impression based on findings. | HypoxiaVIEW: Chest AP 2/26/15 ET tube tip at the level of the thoracic inlet. NG tube tip in the distal esophagus. Right central line in place. There is a left upper extremity PICC with tip in the left axillary vein. There is a catheter projected over the left hemithorax at the level of the left lower lobe. Cardiothymic silhouette normal. Diffuse atelectasis bilaterally not significantly changed. | Diffuse atelectasis bilaterally not significantly changed. |
Generate impression based on findings. | Reason: SOB, hypoxia History: r/o PE PULMONARY ARTERIES: There is a saddle pulmonary embolus, with extension of the clot into the lobar and segmental pulmonary arteries of the left upper, lower and right middle and lower lobes. There is significant relative enlargement of the right ventricle compared to the left (series 7, image 238), compatible with marked right heart strain. The main pulmonary artery is enlarged, suggestive of pulmonary hypertension. LUNGS AND PLEURA: Mild centrilobular emphysema.Moderate basilar scarring/atelectasis. No focal air space consolidation or specific evidence of pulmonary infarct. No pleural effusions.Scattered benign appearing micronodules, some calcified.MEDIASTINUM AND HILA: The heart is normal in size, with a markedly dilated right ventricle. The right ventricle measures approximately 5.7 cm in diameter; the left ventricle measures approximately 1.4 cm in diameter. Reflux of contrast into the IVC and hepatic veins. Small pericardial effusion. Moderate coronary artery calcification.No mediastinal or hilar lymphadenopathy.CHEST WALL: Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. | Saddle pulmonary embolism with extension into the lobar and segmental branch arteries bilaterally, and with marked associated right heart strain. No specific evidence of pulmonary infarct.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Main.RV Strain: Positive. Findings were discussed by the radiology resident on call with Dr Tataris via telephone at 7:58 pm 2/25/2015. |
Generate impression based on findings. | 71 years, Male. Reason: ng tube Dobbhoff tube tip projects over the proximal gastric body. Relative paucity of bowel gas throughout the abdomen. Sternotomy wires and contrast filled diverticula are noted. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip projects over the proximal gastric body. |
Generate impression based on findings. | Female 58 years old Reason: ? intra-hepatic abscess History: h/o ab pain similar ABDOMEN:LUNG BASES: Right basilar atelectasis.LIVER: Near complete resolution of the heterogeneous fluid containing collection measuring 0.8 x 0.8 cm (series 3, image 25), previously 5.7 x 3.8 cm. Additional focus of inferior to the region of the ligamentum teres has decreased in size and measures 1.0 x 1.0 cm (series 3, image 31), previously 1.6 x 1.4 cm. Hepatic vasculature is patent. SPLEEN: Indeterminant hypoattenuating lesion in the posterior spleen measuring up to 2.1 cm (series 3, image 30), previously 2.1 cm. Differential considerations include complex cyst, hemangioma or less likely infectious or neoplastic etiology.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: Intramural low-density lesion within the gastric wall is not significantly changed in size measuring 2.0 x 1.8 cm (series 3, image 26), previously 1.9 x 1.6 cm. No evidence of bowel obstruction or intraperitoneal free air. BONES, SOFT TISSUES: Multi-level degenerative changes of spineOTHER: 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: Multi-level degenerative changes of spine.OTHER: No significant abnormality noted | 1.Previously drained posterior hepatic fluid collection is nearly resolved. Additional subcentimeter hypoattenuating lesion within the posterior right hepatic lobe is slightly decreased in size.2.Intramural low-density lesion within the gastric wall is unchanged in size. Differential considerations include a duplication cyst, GIST or the sequela of a gastric ulcer. Endoscopy is recommended to further characterize.Findings concerning follow-up were discussed by telephone with the emergency medicine physician, Dr. Cheema, on 2/26/2015 at 10:15 a.m. |
Generate impression based on findings. | Prematurity increased vent requirementsVIEW: Chest AP 2/26/15 Tracheostomy tube in place. Cardiothymic silhouette normal. NG tube removed in the interval. Patchy atelectasis in the left lower lobe. No pleural effusion or pneumothorax. | Minimal patchy atelectasis in the left lower lobe. |
Generate impression based on findings. | 75 years, Female. Reason: NGT placement History: s/p ex-lap, HIPEC NG tube tip projects over the gastric body. Midline surgical staples. Four surgical drains are noted - one in the right hemiabdomen, one in the left hemiabdomen, and two with tips projecting over the midline pelvis. Air distended loops of small and large bowel. Follow-up radiographs are recommended to evaluate for partial small bowel obstruction. Stellate calcifications noted in the right hemiabdomen. | NG tube tip projects over the gastric body. |
Generate impression based on findings. | 14-year-old female with desaturation. Evaluate for new opacity.VIEW: Chest AP (one view) 2/25/2015 19:47 Cardiothymic silhouette is normal. No significant interval change in the right lower lobe opacity likely combination of consolidation and atelectasis. Left basilar hazy opacity unchanged. No pneumothorax. | No interval change in right lower opacity, and left lung basilar hazy opacity. |
Generate impression based on findings. | Female 51 years old Reason: eval metallic foreign body prior to MRI brain History: as above. Two views of the right forearm show a sideplate and screws device affixing a distal radius fracture in anatomic alignment. There is residual deformity at the distal diaphysis of the radius compatible with a healed fracture. No acute fracture or malalignment. | Orthopedic fixation of a healed distal radius fracture as described above. |
Generate impression based on findings. | 78 years, Male. Reason: assess stool burden History: constipated, distended abdomen The lung bases are clear. Residual contrast is noted throughout the colon. Greater than average stool burden. Nonobstructive bowel gas pattern. Right total hip arthoplasty device and overlying surgical clips are noted. The bones appear demineralized suggestive of osteopenia. Heterotopic calcification over the right lower quadrant. | Moderate stool burden. |
Generate impression based on findings. | 64 years, Female. Reason: NGT adjustment Patient motion artifact mildly limits the examination. Enteric feeding tube has been pulled back with tip projecting over the gastric fundus and sidehole just beyond the gastroesophageal junction. Nonobstructive bowel gas pattern. Lower portion of the pelvis is excluded from the field-of-view. Healing right rib fractures are again noted. | Enteric feeding tube has been pulled back with tip projecting over the gastric fundus and sidehole just beyond the gastroesophageal junction. |
Generate impression based on findings. | 59 years, Male. Reason: evaluate og tube Motion degrades the quality of the examination. NG tube side port projects over the gastric body with tip over the gastric antrum. Right femoral vascular catheter tip projects over the L5 level. Nondilated loop of small bowel with otherwise relative paucity of bowel gas.Right greater than left, basilar predominant, patchy airspace opacities better evaluated on chest radiograph. | NG tube tip projects over the gastric antrum. |
Generate impression based on findings. | Male 67 years old Reason: Patient with hx of gout, now with R. hand and R. knee pain, please evaluate for erosions History: As above. Three views of the left foot show a questionable erosion of the first metatarsal head raising the possibility of gouty arthritis. There is a mild hallux valgus deformity with mild osteoarthritis of the first metatarsophalangeal joint.Three views of the right foot show a slight hallux valgus deformity with the underlying subchondral cyst. There is narrowing of the first metatarsophalangeal joint. There are no erosions or other radiographic evidence specific for inflammatory arthritis.Four nonweightbearing views of the left knee show no erosions or other radiographic evidence specific for inflammatory arthritis. Mild osteoarthritis affects the right knee joint.Four nonweightbearing views of the right knee show a small effusion and a narrowed medial compartment with severe osteophytes compatible with mild to moderate osteoarthritis. There are no erosions or other radiographic evidence specific for inflammatory arthritis.Three views of the left hand show no erosions or other radiographic evidence specific for inflammatory arthritis. There is widening of the scapholunate lunate interval with rotary subluxation of the scaphoid.Three views of the right hand show no erosions or other radiographic evidence specific for inflammatory arthritis. Scaphoid deformity and sclerosis is suggestive of prior trauma. | Questionable erosion of the first metatarsal head of the right foot may reflect underlying gouty arthritis. Left foot, bilateral knees, and bilateral hands show no erosions or other radiographic evidence specific for inflammatory arthritis. |
Generate impression based on findings. | 64 years, Female. Reason: NGT History: NGT Enteric feeding tube is looped in the stomach with tip projecting over the gastric fundus. Nonobstructive gas pattern. The lower portion of the pelvis is excluded from the field-of-view. Central venous catheter tip projects over the cavoatrial junction. | Enteric feeding tube is looped in the stomach with tip projecting over the gastric fundus. |
Generate impression based on findings. | NONCONTRAST CT HEADThere is 41mm x 18mm x 27mm sized left basal ganglia ICH with minimal surrounding edema and mass effects.There is no evidence of acute ischemic lesion on this scan.Left lateral ventricle especially frontal horn appears to be deformed due to mass effect. Otherwise ventricular system appears to be 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. CTA HEAD AND NECKThere is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins are normal.There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. There is normal contrast opacification through bilateral ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.Bilateral Pcom arteries are patent and Acom artery is also patent.No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage. | 1. Left basal ganglia ICH with subtle mass effects as described above.2. No evidence of arterial stenosis, or aneurysm or occlusion or evidence of dissection. |
Generate impression based on findings. | 72 years, Female. Reason: dht placed Enteric feeding tube tip projects over the gastric body. Nonobstructive bowel gas pattern. Support devices and right pleural effusion are unchanged. Interval removal of vertically oriented skin staples. Pelvis is excluded from the field-of-view. | Enteric feeding tube tip projects over the gastric body. |
Generate impression based on findings. | Headache, change in mental status Compared to 11/20/2014, there is slight decrease in size of the ventricular system compared to prior. Right parietal approach ventriculostomy catheter is unchanged. Dysmorphic appearance of the brain parenchyma is unchanged with tip near the interhemispheric fissure. There appears to be dysgenesis of the corpus callosum. The frontal horns are oriented in a parallel fashion. The bodies and occipital horns of the bilateral lateral ventricles are dilated and seems to communicate with a large CSF filled space. The cerebellum is somewhat towering and wraps around the brainstem. There is breaking of the tectum. There is atrophy of the bilateral parietal and occipital lobes. The calvarium is also dysmorphic and is elongated and narrowed in transverse dimension on coronal view. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | 1. Compared to 11/20/2014, slight decrease in size of the ventricular system. 2. No intracranial hemorrhage or mass effect.3. Again seen is dysmorphic appearance of the brain parenchyma which can be better assessed with MRI if clinically indicated. There are features of Chiari 2 malformation with dysgenesis of the corpus callosum. |
Generate impression based on findings. | Reason: eval PE. Chest pain. PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Scattered benign appearing micronodules, measuring up to 4 mm (series 10, image 73) stable from the prior CT exam. No suspicious pulmonary nodules or masses.Basilar subsegmental atelectasis, unchanged. No new focal air space consolidation. No pleural effusions.MEDIASTINUM AND HILA: Thickening of the distal esophagus, increased from prior, with esophageal stent in place and increasing extension of tumor into the lumen of the stent. The upper end of the stent is directed against the lateral wall of the esophagus, and the distal end is directed against the wall of the stomach.The heart is normal in size, without pericardial effusion. No visible coronary artery calcification.Scattered subcentimeter mediastinal lymph nodes are unchanged. A low paraesophageal lymph node measures 9mm (series 7, image 152), not significantly changed.CHEST WALL: Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Mildly prominent gastrohepatic lymph nodes, partially calcified, not significant changed from the prior exam.Multiple hypodense lesions throughout the liver appear similar to the prior exam. | 1. No evidence of pulmonary embolism.2. Increasing distal esophageal wall thickening, compatible with a known diagnosis of gastroesophageal cancer, with prominent paraesophageal and gastrohepatic lymph nodes, similar to the prior CT exam.3. The upper end of the stent is directed against the lateral wall of the esophagus, and the distal end is directed against the wall of the stomach.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 67 years old Reason: fall History: possible seizure. The C6 through T1 vertebral bodies and cervicothoracic outlet are not well visualized on this examination due to patient positioning and overlying anatomy. Anterior vertebral body osteophytes are seen at C3, C4, and, possibly, C5. There is no acute fracture or malalignment. | Limited study of the cervical spine demonstrates no acute fracture or malalignment. |
Generate impression based on findings. | 88 years, Female. Reason: Evaluate stool burden, assess for obstruction History: Constipation Left retrocardiac opacity. Cardiac leads in the right atrium and right ventricle. Calcified uterine fibroids are noted. No significant stool burden. Nonobstructive bowel gas pattern. Right total hip arthoplasty device is noted without evidence of hardware complication. Overlying skin staples reflect recent surgery. Osteopenia with moderate degenerative changes affect the lumbar spine, particularly at the L4-L5 level. | No significant stool burden. |
Generate impression based on findings. | Female 90 years old Reason: eval dislocation History: eval dislocation. Again seen is an impacted comminuted fracture of the surgical neck of the right humerus with minimal medial displacement of the distal fracture fragment. The bones appear demineralized. | Impacted fracture of the right humeral surgical neck as described above. |
Generate impression based on findings. | Male 40 years old Reason: r/o fx History: tib pain after fall with lac. A soft tissue defect, compatible with patient's known laceration, and swelling is seen along the anterior aspect of the tibia. There is no underlying fracture or dislocation. | Anterior tibial soft tissue swelling and defect compatible with patient's known laceration without underlying fracture or dislocation. |
Generate impression based on findings. | Male 62 years old Reason: assess for fx History: pain after fall. Four views of the right knee and a single sunrise view of the right knee show no acute fracture or dislocation. There is an enthesophyte at the quadriceps tendon and osteophytes of the patella. | Degenerative changes as described above without evidence of acute fracture or dislocation. |
Generate impression based on findings. | 58 year-old female with known multiple calcifications in both breasts presents for annual mammogram. History of stomach cancer. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A metallic clip is again identified at lower outer quadrant in the right breast. Multiple calcifications in both breasts, right greater than left, are unchanged. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted 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 recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 64 years, Male. Reason: assess for colitis History: abdominal pain, sepsis Right-sided central venous catheter with tip projected over the right atrium. Cholecystectomy clips noted. Multiple mildly prominent gas-filled bowel loops throughout the abdomen in an ileus pattern. There is a paucity of bowel gas in the descending colon however gas is identified within the rectum. | Multiple mildly prominent gas-filled bowel loops throughout the abdomen in an ileus pattern. If there is ongoing clinical concern, CT abdominal imaging should be considered for further evaluation. |
Generate impression based on findings. | 74 years, Female. Reason: assess for obstipation, ileus History: 74 y.o. woman with scleroderma and recent severe pneumonia. History of constipation, now with early satiety. Bilateral pleural effusions, left greater than right. Superimposed infection is a consideration. Percutaneous enteric tube projects over the left lower quadrant. Relative paucity of bowel gas throughout the abdomen. | Nonspecific bowel gas pattern. |
Generate impression based on findings. | 64 year old who is called back from screening mammogram An ML view and a spot compression view of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Architectural distortions seen on tomosynthesis are not well visualized on the regular mammogram. The distortions are present at upper inner left breast on tomosynthesis.Focused ultrasound was performed. Detected is an ill-defined hypoechoic lesion, measuring 8 x 6 mm, with increased blood flow at 10 o'clock position, 4 cm from the nipple in the left breast. This lesion appears corresponding to the tomosynthesis findings. | Hypoechoic lesion in the left 10 o'clock position, likely corresponding to the tomosynthesis findings. Ultrasound guided biopsy is recommended. Results and recommendations were discussed with the patient. BIRADS:4 - Suspicious Abnormality. RECOMMENDATION:H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Male 54 years old Reason: pain History: pain. Hardware components of a left bipolar hip hemiarthroplasty device are situated in near anatomic alignment with no radiographic evidence of hardware complication. There is no evidence of an acute fracture or dislocation. Note is made of heterotopic bone formation within the adjacent soft tissues, unchanged from the prior exam. Mild osteoarthritis affects the pubic symphysis. | Left hip hemiarthroplasty without evidence of fracture or dislocation. |
Generate impression based on findings. | 25-year-old male with right lower quadrant abdominal pain. ABDOMEN:LUNG BASES: Scattered nonspecific pulmonary micronodules. No suspicious nodules or masses.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: 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: Normal caliber bowel without evidence of obstruction. The appendix is well-visualized and unremarkable. No intraperitoneal free air or fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. The appendix is well-visualized and unremarkable. No intraperitoneal free air or fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No acute findings to account for the patient's symptoms. |
Generate impression based on findings. | Female 66 years old Reason: fx? History: fall, diffuse bruising. Three views of the left ankle show soft tissue swelling about the lateral aspect of the ankle. A well corticated ossicle about the medial malleolus may be related to old trauma. A fracture of the base of the fifth metatarsal is partially visualized.Three views of the left foot show a fracture of the proximal fifth metatarsal that is intra-articular. There is soft tissue swelling about the lateral aspect of the foot. | Intra-articular fracture of the base of the fifth metatarsal. |
Generate impression based on findings. | Female 64 years old Reason: assess for metastatic disease, h/o stage IB2 cervix cancer s/o chemoradiation History: rectovaginal fistula CHEST:LUNGS AND PLEURA: Basilar atelectasis. No suspicious pulmonary masses or nodules. No pleural effusion. MEDIASTINUM AND HILA: Central venous catheter is incompletely imaged and the catheter tip appears to be turned upward into the left innominate vein. Nonspecific hypodense focus in the lower pole of the left thyroid lobe measuring up to 7 mm (series 3, image 7). Nonspecific, small mediastinal lymph nodes.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy. No biliary ductal dilatation or focal hepatic mass.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Loss of the fat plane between the posterior vagina wall and the sigmoid colon. However, no definite evidence of rectovaginal fistula.BONES, SOFT TISSUES: Degenerative changes of the thoracic spineOTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Omentum-containing ventral abdominal hernia. BONES, SOFT TISSUES: Degenerative changes of the lumbar spine most notably at L5/S1.OTHER: No significant abnormality noted. | 1.No evidence of metastatic disease.2.Central venous catheter is incompletely imaged and tip appears to be turned upward into the left brachiocephalic vein. Recommend chest radiograph with increased field of view to include the neck to definitively assess position, if clinically indicated. Findings were discussed by telephone with the clinical service, Libby Hassenfritz, at 1:00 p.m.. on 2/26/2015. |
Generate impression based on findings. | There is mild dolichoectasia of the basilar artery which is significantly tortuous at the level of the internal auditory canals to abut nonenhancing nonspecific T2 hypointense soft tissue along the porus acousticus extending dorsally towards the ventral cerebellum. The soft tissue appears grossly similar to prior exams, although there are significant differences in technique. The left seventh and eighth cranial nerves are visualized in the distal internal auditory canal but not well delineated proximally or along its cisternal portions, likely postoperative.The internal auditory canals are symmetrical and normal in size and signal intensity. The inner ears are normal, with normal T2 signal and no pathological enhancement. No abnormal mass or abnormal enhancement is seen within the cerebellopontine angle, cisterns bilaterally or within the internal auditory canals.There has been previous left occipital craniotomy and there is a small focus of encephalomalacia involving the posterior lateral left cerebellar hemisphere. The ventricles and sulci are within normal limits for age. The cisterns remain patent. There is no midline shift or mass effect. There are stable scattered scattered punctate and confluent areas of T2/FLAIR hyperintensity in the periventricular and subcortical white matter as well as within the right cerebellar white matter which are unchanged and most likely represent chronic small vessel ischemic changes. There are no areas of pathological enhancement. 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 are within normal limits. There is bilateral elongation of the globes in the AP dimension with a focal outpouching of the posterior sclera consistent with bilateral staphyloma. There is redemonstration of prominent fluid signal along the tip of the dens as well as at the slightly asymmetrically widened left craniocervical junction, only partially visualized on the prior exams. A smaller amount of fluid is noted along the right craniocervical junction. Correlation with recent CT demonstrates ill-defined mineralization along the dens. | 1. Unremarkable MR appearance of the internal auditory canals. Prominent nonenhancing nonspecific soft tissue along the porus acusticus extending posteriorly which abuts the dolichoectatic and tortuous basilar artery, likely postoperative in etiology. Proximal left seventh and eighth cranial nerves are not well delineated.2. Postoperative changes from previous left occipital craniotomy with small area of stable left cerebral encephalomalacia.3. Stable chronic small vessel ischemic changes.4. Interval slight increased widening of the left craniocervical junction with evidence of fluid within the joint as well as surrounding the dens. Previous CT demonstrated mineralization along the dens, and findings a relate to an inflammatory arthritis such as CPPD. Please correlate clinically. |
Generate impression based on findings. | Female 24 years old Reason: back pain, cc use of steroids, concern for compression fracture History: back pain . Vertebral body heights and intervertebral disk spaces are preserved. There is no acute fracture. Alignment is within normal limits. | No acute fracture or malalignment. |
Generate impression based on findings. | 83 year old with high probability benign focal asymmetry presents for short-term follow up. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Focal asymmetry at upper aspect on MLO view becomes smaller and subtler. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in left breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended in 6 months. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 58 year-old female with hematuria, fever, and lower abdominal pain. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: Basilar atelectasis.LIVER, BILIARY TRACT: There is diffuse, homogenous low-attenuation of the liver compatible with fatty infiltration. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No nephrolithiasis or hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The proximal small bowel is dilated up to 4 cm in diameter up until a possible transition point in the left midabdomen (series 3, image 64) after which the small bowel is relatively decompressed suggestive of small bowel obstruction. There is diffuse mesenteric fat stranding as well as a small amount of scattered mesenteric fluid. No intraperitoneal free air, pneumatosis, or portal venous gas.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Lobular uterus with coarse calcifications most compatible with uterine fibroids.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The proximal small bowel is dilated up to 4 cm in diameter up until a possible transition point in the left midabdomen (series 3, image 64) after which the small bowel is relatively decompressed suggestive of small bowel obstruction. There is diffuse mesenteric fat stranding as well as a small amount of scattered mesenteric fluid. No intraperitoneal free air, pneumatosis, or portal venous gas.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate amount of free fluid in the pelvis. | 1.Findings suggestive of high grade small bowel obstruction with associated mesenteric stranding, small amount of mesenteric fluid, and pelvic free fluid. No free intraperitoneal air or portal venous gas.2.No nephrolithiasis or hydronephrosis.3.Hepatic steatosis. |
Generate impression based on findings. | Painful thumb. Moderate osteoarthritis affects the basilar joint and mild osteoarthritis affects the interphalangeal joint of the thumb. No fracture or malalignment is present. | Osteoarthritis. |
Generate impression based on findings. | Fullness on radial dorsal wrist Moderate osteoarthritis affects the basilar joint and triscaphe joint. No fracture or dislocation is present. The soft tissues are unremarkable. | Osteoarthritis. |
Generate impression based on findings. | Reason: ? history of ILD on outside CT scan which we are trying to obtain, now worsening symptoms. ILD protocol History: cough. shortness of breath. hypoxia, crackles on exam LUNGS AND PLEURA: Uniformly distributed diffuse groundglass opacity with multiple small radiolucent areas. The groundglass opacity actually represents a very fine reticulonodular pattern, which is most apparent using a narrow window settings on the thin sections. There is also fine nodularity of the pleural fissures.No evidence of fibrosis.Increased opacity in the groundglass areas on the expiration scan suggesting air trapping in the radiolucent areas.No pleural effusions.MEDIASTINUM AND HILA: Moderately large mediastinal lymph nodes measuring up to 11 mm in diameter.No visible coronary artery calcification. No pericardial effusion.CHEST WALL: Congenital partially bifid vertebra at T9.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | A very fine reticulonodular pulmonary opacity producing a groundglass appearance, with multiple small lucent areas due to airtrapping.Moderate mediastinal lymphadenopathy and fine nodularity of the pleural fissures is also present. These findings raise the question of sarcoidosis or a sarcoid-like reaction to inhaled material. Other forms of hypersensitivity pneumonitis are also possible. |
Generate impression based on findings. | Left hip pain LEFT HIP: The left total hip arthroplasty device is situated in near anatomical alignment without radiographic evidence of hardware complication and appearing similar to prior. There is heterotopic bone noted superior to the greater trochanter, similar to prior.PELVIS: Mild to moderate osteoarthritis affects the right hip. The ground glass lesion in the proximal right femur most compatible with fibrous dysplasia is unchanged since 2004. | Left total hip arthroplasty, without evidence of complication. |
Generate impression based on findings. | Esophageal adenocarcinoma T3N3M0 on chemotherapy with neck lymphadenopathy. The known esophageal mass is beyond the field of view of this exam. There are post biopsy findings in the right lower neck with interval decrease in size of an ill-defined right paratracheal lesion, which measures 7 x 10 mm, previously 14 x 20 mm. There are several lymph nodes in the upper mediastinum and left supraclavicular region, which have also decreased in size. The major salivary glands and thyroid are unremarkable. There is mild plaque at the carotid bifurcations. There is a left internal jugular venous catheter. There are mild to moderate degenerative changes of the cervical spine. A left upper lobe scar-like opacity and right upper lobe peripheral opacities is unchanged. | Interval decrease in size of a right neck metastatic lesion and decrease in size of left supraclavicular and upper mediastinal lymph nodes. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Reason: eval for PE History: chest pain, tachycardia, elevated dimer PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Scattered benign-appearing micronodules. No suspicious pulmonary nodules or masses.No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size, with a pericardial effusion. No visible coronary artery calcification. Scattered calcified mediastinal and hilar lymph nodes from prior granulomatous disease. No lymphadenopathy.Small hiatal hernia.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of pulmonary embolism or other acute abnormality to account for the patient's symptoms.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Mandibular distractor placement.VIEWS: Skull AP/lateral (two views) 02/26/15 Mandibular distractors are in place. There is a tracheostomy tube. Less than 3 mm of distraction is present bilaterally. | Postoperative change. |
Generate impression based on findings. | NONCONTRAST CT HEADThere is 41mm x 18mm x 27mm sized left basal ganglia ICH with minimal surrounding edema and mass effects.There is no evidence of acute ischemic lesion on this scan.Left lateral ventricle especially frontal horn appears to be deformed due to mass effect. Otherwise ventricular system appears to be 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. CTA HEAD AND NECKThere is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins are normal.There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. There is normal contrast opacification through bilateral ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.Bilateral Pcom arteries are patent and Acom artery is also patent.No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage. | 1. Left basal ganglia ICH with subtle mass effects as described above.2. No evidence of arterial stenosis, or aneurysm or occlusion or evidence of dissection. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | There are post-treatment findings including left base of tongue and floor of mouth resection with myocutaneous flap reconstruction and denervation left hemitongue atrophy and mandibulotomy with hardware. There is increased size of ill-defined mass centered within the left parapharyngeal space adjacent to the surgical bed, as well as the left parotid gland and masticator space tumors. There is also increase in size of cervical adenopathy. For example, a right level 2B lymph node measures 11 x 17 mm, previously 9 x 14 mm. There are multiple bilateral posterior lower neck subcutaneous and intramuscular soft tissue nodules, which have also increased in size. For example, a nodule in the left lower neck paraspinal muscles measures 22 x 20 mm, previously 17 x 11 mm. There are multiple unchanged hypoattenuating lesions in the thyroid gland. However, the anterior aspect of the thyroid gland now appears to be invaded by an adjacent mass. There is a right internal jugular venous catheter. The left internal jugular vein remains occluded. The remaining major vessels in the neck are patent. There are partially imaged right pleural nodules. Subcentimeter sclerotic foci in the C5 and T1vertebral bodies appear to be unchanged and may represent enostoses. | 1.Continued interval tumor progression of extensive metastatic disease in the neck.2.Partially imaged right pleural nodules may also represent metastatic disease. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is extremely dense, limiting the sensitivity of mammography and increasing the importance of physical examination, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSD - Screening Mammogram. |
Generate impression based on findings. | headache, dizziness NONCONTRAST CT HEADNo evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECKThere are multiple small neck lymph nodes which could represent reactive in nature.There is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins are normal.There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. There is normal contrast opacification through bilateral ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.Bilateral Pcom arteries are patent and Acom artery is also patent.No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage. | No evidence of acute ischemic or hemorrhagic lesion on this scan.No evidence of aneurysm, significant stenosis, occlusion, dissection or vascular malformation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Stable focal asymmetry is present at the 12 o'clock position of the right breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: eval for PE, post op changes/cyst/abscess History: L axillary pain. s/p bilateral lung transplant on 2/3/15 PULMONARY ARTERIES: There are multiple acute pulmonary emboli within the right middle lobe artery and the segmental arteries of the right upper lobe and left upper and lower lobes. The main pulmonary artery is upper normal in caliber. No evidence of right heart strain. LUNGS AND PLEURA: Findings of an interval bilateral lung transplant.Scattered benign-appearing micronodules. No suspicious pulmonary nodules or masses.Basilar atelectasis/consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size, without pericardial effusion. Minimal coronary artery calcification.New mildly prominent mediastinal soft-tissue is adjacent to surgical clips and presumably post-operative. No mediastinal or hilar lymphadenopathy.CHEST WALL: Status post sternotomy. Small fluid density collections along the left anterior chest wall (series 8, image 203) are likely post-operative.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Scattered subcentimeter hepatic hypodensities, likely benign cysts. | 1. Multiple acute pulmonary emboli in the lobar and segmental branches of the right upper and middle lobe and left upper and lower lobe arteries. Bibasilar atelectasis without definite evidence of infarct.2. Interval findings of a recent lung transplant with likely postoperative small fluid/soft tissue density collections in the chest wall and mediastinum.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Lobar.RV Strain: Negative. Findings were discussed by the radiology resident on call with the medicine resident at approximately 1:30 AM 2/26/2015. |
Generate impression based on findings. | 33-day-old male status post mandibular distractionVIEWS: Skull, AP and lateral (two views) 2/25/15 16:32 A mandibular distraction devices is again visualized affixing the mandible without evidence of hardware complication. An OG tube extends inferiorly beyond the field-of-view. | Mandibular distraction device without evidence of hardware complication. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Call back from screening mammogram for a small focal asymmetry in the right breast. An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The small focal asymmetry seen on the screening mammogram in the right breast is not well visualized on this current study. Focused ultrasound did not detect any abnormalities. | High probability benign focal asymmetry in the right breast. Follow up with right unilateral diagnostic mammogram is recommended in 6 months. Results and recommendations were discussed with the patient. BIRADS: 3 - Probably benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 64-year-old female with history of metastatic HCC. There is redemonstration of a large hyperenhancing multilobulated mass centered within the left masticator space measuring 5.4 x 3.3 cm in maximal AP dimensions and 5.7 cm in the craniocaudal dimension. Anteriorly this mass extends and involves the left pterygopalatine fossa, left posterior nasal cavity, and left posterior maxillary sinus. Medially the mass narrows and completely effaces the left nasal cavity and upper oropharyngeal airway. Posteriorly, the mass abuts the internal carotid artery, although there is no significant luminal narrowing. Inferiorly, the mass effaces the parapharyngeal fat. Laterally the mass invades the mandible. Superiorly the mass invades the sphenoid and and temporal bones. There does not seem to be any orbital or intracranial extension. There is osseous erosion of the perpendicular plate of the ethmoid, the ethmoid air cells, the walls of the maxillary sinus, and the medial aspect of the left mandibular ramus. Compared to prior CT, there is slight increase in erosion of the residual pterygoid plates on the left.There is opacification of the left mastoid air cells, the ethmoid air cells, the left sphenoid and left frontal sinuses. Left frontal sinus opacification is new. Overall the mass appears somewhat similar to the prior MRI account for technical differences. Scattered lytic lesions are present within the calvarium, also likely representing metastatic disease. | Redemonstration of large multilobulated enhancing mass centered within the left masticator space with adjacent osseous destruction compatible with metastatic disease. There is near complete effacement of the left nasal passage which may account for the patient's stated symptom of obstructive sensation. |
Generate impression based on findings. | Recurrent sinusitis treated medically without resolution. There are lobulated opacities in the bilateral maxillary sinuses and minimal mucosal thickening in the right ethmoid sinuses. The other paranasal sinuses are clear. The nasal cavity is also clear. The nasal septum is deviated slightly towards the left and there is a 3 mm wide leftward directed spur. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. | Probable retention cysts within the bilateral maxillary sinuses and minimal mucosal thickening in the right ethmoid sinuses. |
Generate impression based on findings. | 66 year old with history of left lumpectomy in 2011 for carcinoma. Patient received radiation therapy. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Stable postsurgical architectural distortions are present in the left breast. Coarse bilateral calcifications and bilateral focal asymmetries are stable. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Evaluation for malignancy is limited by lack of intravenous contrast. There are subcentimeter round T1 hypointense lesions involving the L3 and L4 vertebral bodies which are nonspecific. No large destructive lesions are appreciated. There is minimal retrolisthesis of L1 on L2 and L2 on L3. There is severe loss of disc height at L1-L2 and L2-L3 with endplate degenerative changes. The vertebral body heights are well-maintained. The distal spinal cord and conus are within normal limits with the conus terminating at the L1-L2 level.T12-L1: No significant disc bulge, herniation, spinal canal or foraminal stenosis. Prominent right lateral osteophyte. L1-L2: Disc bulge with bilateral facet arthropathy, thickening of the ligamentum flavum and effacement of the thecal sac, contributes to mild to moderate spinal canal stenosis and mild left foraminal stenosis. No significant right foraminal stenosis.L2-L3: Disc bulge with bilateral facet arthropathy, thickening of the ligamentum flavum and effacement of the lateral recesses and mild spinal canal stenosis. There is mild bilateral foraminal stenosis. L3-L4: Disc bulge with moderate facet arthropathy and thickening of the ligamentum flavum , contributes to mild to moderate spinal canal stenosis and mild bilateral foraminal stenosis. L4-L5: Right paracentral disc extrusion with inferior migration posterior to the L5 vertebra with mild impingement of the descending right L5 nerve root in the lateral recess. Moderate bilateral facet arthropathy and thickening of the ligamentum flavum contributes to mild spinal canal stenosis and moderate to severe right and mild to moderate left foraminal stenosis.L5-S1: Mild disc bulge eccentric to the right. Minimal right foraminal narrowing. No significant spinal canal or left foraminal stenosis. Partially imaged is a T2 hyperintense lesion in the right kidney, likely representing a cyst. | 1. Evaluation for malignancy is slightly limited due to lack of intravenous contrast. Small T1 hypointense lesions are seen at L3 and L4 vertebral body which are nonspecific. Findings can be correlated with bone scan. No large destructive lesion is appreciated. No epidural tumor. Prior imaging is not available and repeat study with contrast can be considered as clinically indicated. 2. Degenerative spondylosis of the lumbar spine with up to mild to moderate spinal canal stenosis as detailed above. 3. Right paracentral disc extrusion at L4-L5 with suspected impingement of the descending right L5 nerve root. Additional levels of foraminal stenosis as above.4. Partially imaged right renal cystic lesion, likely representing a cyst. Renal ultrasound may be considered for further evaluation. |
Generate impression based on findings. | known left basal ganglia ICH follow up. Aphasia. No significant interval change of left basal ganglia ICH (42mm x 17mm x 30mm) with minimal surrounding edema and minimal mass effects since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no midline shift. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No significant interval change of the left basal ganglia ICH with minimal surrounding edema and mass effects since prior exam. |
Generate impression based on findings. | Altered mental status. There is no evidence of acute intracranial hemorrhage or mass. There are small low attenuation areas in the bilateral basal ganglia and corona radiata. The grey-white matter differentiation otherwise appears to be grossly intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is an unchanged lucency in the left parietal calvarium with fat-attenuation component, which likely represent a hemangioma. However, there are partially imaged endotracheal and enteric tubes with surrounding hyperattenuating material in the upper aerodigestive track. There is also diffuse opacification of the paranasal sinuses and mastoid air cells. | 1. No evidence of acute intracranial hemorrhage or mass. Low attenuation areas in the bilateral basal ganglia and corona radiata may represent lacunar infracts of indeterminate age. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.2. Partially imaged endotracheal and enteric tubes with surrounding hyperattenuating material in the upper aerodigestive track, which likely represents hemorrhage. |
Generate impression based on findings. | Male 82 years old; Reason: Constipation, concern for SBO History: above ABDOMEN:LUNGS BASES: Left basilar atelectasis and chronic elevation left hemidiaphragm.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small two cyst left kidney, unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Previously seen small bowel dilatation is markedly diminished. There is no evidence of mechanical obstruction. The marked submucosal edema and hyper-enhancement in the ileocolic anastomosis in the right upper quadrant, see axial image 79, has markedly diminished. There is minimal fat stranding in the adjacent mesenteric fat. No intramural air or free air. No frank ascites or loculated fluid.BONES, SOFT TISSUES: Degenerative changes lumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Osseous degenerative changes.OTHER: Right hydrocele unchanged. | 1.Resolution of previously seen small bowel obstruction. Marked decrease in submucosal edema in the small bowel at the ileocolic anastomosis.2.Other findings as above are unchanged from the prior exam. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. A small circumscribed mass with a metallic clip in the upper inner quadrant of the left breast is stable. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 43 years, Female. Reason: Constipation Nonobstructive bowel gas pattern with mild to moderate stool burden. Bilateral tubal ligation and cardiac closure device are again noted. | Nonobstructive bowel gas pattern with mild to moderate stool burden. |
Generate impression based on findings. | Reason: evaluate chest mass History: smoking LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.Mild basilar subsegmental scarring/atelectasis.Excess pleural fat is noted, with associated mild scarring.MEDIASTINUM AND HILA: The heart is normal in size. Small pericardial fluid. Moderate coronary artery calcification.No mediastinal or hilar lymphadenopathy.CHEST WALL: Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Coarse calcifications in the right kidney are partially visualized, similar to the prior CT exam dated 09/2006. | No suspicious pulmonary nodules or masses. A previously described masslike opacity seen on recent chest radiograph may relate to superimposition, bony spurring, and basilar subsegmental atelectasis. |
Generate impression based on findings. | 70-year-old male patient with elevated left hemidiaphragm. Evaluate for paralysis. Surgical clips are again noted projecting over the mediastinum. There is persistent elevation of the left hemidiaphragm with overlying basilar opacity, suggestive of atelectasis. On inspiration and exhalation there is symmetric and appropriate movement of the hemidiaphragms (cine series 3).FLUOROSCOPY TIME: 0:33 minutes. | No left hemidiaphragm paralysis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Multiple benign calcifications are unchanged in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. Scattered benign calcifications are unchanged in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign biopsy in the right breast in 2014. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. A percutaneously paced clip is present in the right posterior upper outer aspect. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 35-year-old male with history of Crohn's disease with revision of ileocolectomy on 1/24/2015 with phlegmon on recent CT. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Small low attenuation lesion within hepatic segment 6 is not significantly changed compared to the 2012 exam and most likely represents a benign hemangioma.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: Postsurgical changes of prior ileocecectomy with right upper quadrant anastomosis.The previously described fat containing lesion in the right abdomen compatible with omental infarct (coronal series, image 63) measures 3.9 x 6.2 cm, previously 5 x 8 cm. The adjacent inflammatory stranding has decreased.The previously described small pocket of fluid adjacent to the ileocolonic anastomosis (series 5, image 62) measures 1.4 x 2.1 cm, previously 1.5 x 2.9 cm. The adjacent inflammatory fat stranding has also decreased.Mildly prominent right upper quadrant mesenteric lymph nodes are again present and are likely reactive.Normal caliber small and large bowel without evidence of obstruction. BONES, SOFT TISSUES: Postsurgical changes to the anterior abdominal wall. OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: See above. BONES, SOFT TISSUES: Sclerotic lesion in the left superior acetabulum likely benign bone island. OTHER: No significant abnormality noted | 1.Postsurgical changes of ileocecectomy.2.Previously described omental infarct and small fluid collection adjacent to the ileocolic anastomosis both decreasing in size. No evidence of enteric contrast extravasation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Time average mean velocities: Right middle cerebral artery: 118 cm/sec.Right internal carotid artery: 85 cm/sec.Left middle cerebral artery: 129 cm/sec.Left internal carotid artery: 130 cm/sec. | Normal time average mean velocities of intracranial blood vessels as described above (<180 cm/sec). |
Generate impression based on findings. | Male 61 years old Reason: TEA 6 months History: none . Hardware components of a left total elbow arthroplasty device are seen. There has been substantial movement of the proximal humerus prosthesis stem with lateral displacement and cortical erosion which may reflect loosening or infection. There is heterotopic bone formation in the surrounding soft tissues. | Left total elbow arthroplasty with interval displacement of the humeral component and associated cortical erosion which may reflect loosening or infection. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 41-year-old male with history of multiple septal surgeries, now with persistent septal deviation and snoring. Evaluate for degree of septal deviation and amount of remaining bone. Examination is obtained for operative planning. There is mild mucosal thickening of bilateral maxillary sinuses as well as scattered ethmoid air cells. Thin septations noted within the bilateral maxillary sinuses. The sphenoid and frontal sinuses are clear. The ostiomeatal units, sphenoethmoidal, and frontoethmoidal recesses are patent. There is significant leftward deviation with a prominent septal spur which nears the medial wall of the maxillary sinus and superior posterior aspect of the left inferior turbinate. Small bilateral concha bullosa. The lamina papyracea are intact. The orbits and visualized intracranial structures are unremarkable. Incidentally noted is a lytic lesion involving the superior lateral right orbit with sclerotic margins and internal fat attenuation. | 1. Significant leftward nasal septal deviation with a prominent left septal spur which narrows the left nasal passage. 2. Minimal mucosal thickening of the paranasal sinuses as above.3. Lytic lesion involving the right superolateral orbit with fat attenuation favored to represent a dermoid/epidermoid. |
Generate impression based on findings. | 62 years, Female. Reason: evaluate stool burden History: Left sided pain after BMs Nonobstructive bowel gas pattern with below average stool burden in the colon. There are nondilated air filled loops of jejunum in the left lower quadrant with questionable thickened folds. Calcified uterine fibroids noted in the pelvis. | Nonobstructive bowel gas pattern with below average stool burden in the colon. Questionable thickened jejunal folds in the left lower quadrant may be due to underdistention, however, recommend clinical correlation for possible enteritis. CT scan may be obtained if clinically indicated. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. A circumscribed mass at upper outer quadrant in the right breast is stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 50 years old Reason: bilateral knee pain with walking and going up and down stairs. ? OA History: bilateral knee pain . Four views of the left knee show no evidence of fracture, dislocation, or joint effusion.Four views of the right knee show no evidence of fracture, dislocation, or joint effusion. | Bilateral knees appear normal without specific radiographic findings to account for patient's pain. |
Generate impression based on findings. | HypoxiaVIEW: Chest AP Tracheostomy tube in place. NG tube tip in the stomach in the giant omphalocele. Cardiothymic silhouette normal. The left lung is obscured by the omphalocele. Minimal atelectasis in the right upper lobe. Multiple bowel loops in the omphalocele. | Minimal patchy atelectasis in the right upper lobe. |
Generate impression based on findings. | Evaluate reflux. The left kidney demonstrates heterogeneous parenchymal activity with large regions of mildly decreased activity throughout, most notably in the lateral left upper and lower poles. Overall the left kidney is larger than the right with a focal lobular enlargement of the upper portion representing an anatomic variant. On the right is a very small cortical defect in the mid right upper pole and possibly the inferior pole. Overall the parenchymal defects on the right are much less extensive than on the left. The estimated contribution of the right kidney to total renal function is 51.8 % and that of the left kidney is 48.2%. | 1.Numerous bilateral renal parenchymal defects, although the left is significantly worse than the right. The appearance on the right is suggestive of a small scar. The left could also represent scars but is suspicious for more active pyelonephritis.2.Although the left parenchymal impairment is more significant than the right it is also slightly larger, and so the relative parenchymal functional contribution of both kidneys is symmetric. |
Generate impression based on findings. | 67-year-old female with metastatic ampullary adenocarcinoma with history of duodenal stent placed in September now with nausea and vomiting. Evaluate for stent occlusion. Scout radiograph demonstrates a biliary stent with pneumobilia, duodenal stent, percutaneous biliary drain, and multiple surgical clips in the right hemiabdomen. Nonobstructive bowel gas pattern. The lung bases are clear.There is mildly delayed but spontaneous emptying of contrast into the duodenal sweep through a patent duodenal stent. At the proximal end of the duodenal stent, contrast is noted outside the stent, presumably in between the stent wall and bowel wall; the proximal aspect of the stent appears to be located in the distal stomach, allowing contrast to surround the stent. There is relative narrowing of the stent lumen at the proximal portion of the stent, narrowed to approximately 10 mm in diameter. Correlation with CT demonstrates heterogenous soft tissue attenuation/debris in this area which could explain the luminal narrowing. TOTAL FLUOROSCOPY TIME: 2:53 minutes | Patent duodenal stent with relative luminal narrowing as described above. Findings may be due to neoplasm ingrowth versus debris. |
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