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Generate impression based on findings. | Intractable epilepsy respiratory distressVIEW: Chest AP 2/27/15 Cardiothymic silhouette normal. Bilateral patchy lung opacities increased in the right upper lobe and right lower lobe. There are also patchy opacities at the left lower lobe. No pleural effusion or pneumothorax. There is a radiopaque foreign body projected over the fundus of the stomach. | Bilateral patchy lung opacities concerning for infection or aspiration. |
Generate impression based on findings. | 41 years, Female. Reason: Assess nasogastric tube placement History: as above Dobbhoff tube with tip projected over the gastric pylorus. Nonobstructive bowel gas pattern. | Dobbhoff tube with tip projected over the gastric pylorus. |
Generate impression based on findings. | 11 year old female with increased oxygen requirementsVIEW: Chest AP (one view) 2/26/15 23:28 Tracheostomy tube, tip at the thoracic inlet. Low lung volumes and basilar atelectasis appears similar to the prior exam. Thoracolumbar levoscoliosis is again noted. | Scoliosis and atelectasis without specific evidence of pneumonia. |
Generate impression based on findings. | Hit face and fall from standing No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent moderate chronic small vessel ischemic disease.There are no fractures identified involving the maxillofacial bones. Bilateral nasal bones, orbits, paranasal sinuses, and zygomatic arches remain intact. Visualized portion of the mandible including the temporomandibular joints are intact. There are degenerative changes at the right temporomandibular joint. Pterygoid plates are intact.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. There is large soft tissue hematoma involving the right forehead and periorbital soft tissues. No retrobulbar hematoma. Globes are intact. Lens appear in place. Evidence of left intraocular lens replacement. Calvarium is intact. | 1. No evidence of acute intracranial hemorrhage or mass effect. 2. No calvarial or orbital fracture.3. Soft tissue hematoma in the right periorbital and right forehead region. No retro-orbital hematoma.4. Moderate chronic small vessel ischemic disease. |
Generate impression based on findings. | 29 years, Female. Reason: Abdominal pain eval for constipation and bowel dilatation History: abdominal pain Surgical clips in the upper abdomen bilaterally. Suture material in the left upper quadrant. Tip of central catheter is projected over the left hilar region.Large bowel loops are distended with gas in the left upper quadrant, not significantly changed compared to prior study. A total of 24 Sitz markers are again noted and projected over the ascending, transverse, descending colon and rectum. Although there has been a mild degree of progression of the markers compared to prior study there is holdup in the left quadrant. This appears to be proximal to the region of colonic narrowing identified on recent CT. | Sitz markers have mildly progressed compared to prior study with holdup demonstrated in the left upper quadrant. |
Generate impression based on findings. | 17-year-old male with history of MVC. Evaluate for intracranial hemorrhage. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. The ventricles are within normal limits without evidence of hydrocephalus. The visualized portions of the paranasal sinuses and mastoid air cells are clear. The calvarium is intact. | No evidence of acute intracranial hemorrhage or mass effect. |
Generate impression based on findings. | Reason: LLL nodule. growth? History: cough LUNGS AND PLEURA: A round, well marginated sub pleural solid nodule measures 1.5 cm (series 5, image 85), unchanged. No calcification or fat density is identified within the nodule.An additional nodule in the superior segment of the left lower lobe measures 4 mm (series 4, image 139), unchanged.Additional scattered benign appearing micronodules are unchanged. No new suspicious pulmonary nodules or masses.No focal air space consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size, without significant pericardial effusion. No visible 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. No significant abnormality noted. | Left lower lobe 1.5 cm round, well marginated solid nodule is unchanged from 05/2014. Benign etiology is likely, although additional followup imaging in 12-18 months is recommended to confirm stability. |
Generate impression based on findings. | 83 years, Male. Reason: s/p dht placement History: s/p dht placement Dobbhoff tube is projected over the proximal gastric body and tip is pointing at the gastric fundus. Incompletely imaged central venous catheter with tip projected over the right atrium. Additional support lines overlie the patient. Multiple surgical staples are scattered over the thorax, abdomen and pelvis. Bowel gas pattern is unchanged compared to prior study. | Dobbhoff tube is projected over the proximal gastric body and tip is pointing at the gastric fundus. |
Generate impression based on findings. | Sciatica Severe degenerative disk disease affects the L5/S1 level. Bilateral spondylolyses are noted at L5 with a grade 2 anterolisthesis of L5 on S1. Moderate-severe facet joint osteoarthritis affects the lower lumbar spine. Small osteophytes project from the anterior aspects of the lumbar vertebral bodies. | Bilateral L5 spondylolyses with spondylolisthesis and degenerative changes, as described above. |
Generate impression based on findings. | Female 42 years old Reason: Neck pain and lumbar radiculopathy History: Neck pain and lumbar radiculopathy. We have two views of the cervical spine. There is straightening of the spine, but alignment is within normal limits. The cervical vertebral body heights and intervertebral disk spaces are normal. Paravertebral soft tissues are normal.We have two views of the lumbar spine. For the purposes of this study, we designate 5 non-rib bearing lumbar vertebrae with partial sacralization of L5. There is slight hyperlordosis of the lumbar spine. Narrowing of the L5/S1 intervertebral disk space may reflect transitional anatomy rather than degenerative disk disease. The remaining lumbar intervertebral disk spaces are within normal limits, as are the lumbar vertebral body heights. | Sacralization of L5 and slight straightening of the cervical spine, but otherwise no specific findings to account for patient's pain. |
Generate impression based on findings. | 58 years, Female. Reason: Eval gas pattern History: ileus Nonspecific basal air space opacities. Ingested enteric contrast material resides within large bowel. Persistent dilated gas-filled loops of small bowel projected over the central abdomen. Gas is identified within the rectum. The pattern is consistent with improving obstruction/ileus. | Improving obstruction/ileus pattern. |
Generate impression based on findings. | 60 year-old male with history of incoherent speech. There is no evidence of acute intracranial hemorrhage. Encephalomalacia involving the right temporal lobe with adjacent ex vacuo dilatation appears similar to the prior study. The ventricles and sulci are otherwise symmetric. There is no evidence of herniation. No midline shift or mass-effect. Deformities of the nasal bones, zygomatic arches, and right maxillary sinus are unchanged. The soft tissues of the scalp are normal. | 1. No evidence of acute intracranial hemorrhage or intracranial mass effect.2. Stable encephalomalacia of the right temporal lobe and chronic facial bone deformities as above. |
Generate impression based on findings. | 72 years, Female. Reason: history of constipation. Please count number and location of sitz markers. History: constipation Above-average stool burden. Nonobstructive bowel gas pattern. No Sitz markers are projected over the abdomen or pelvis. The stomach is excluded on this image. | Above-average stool burden. Nonobstructive bowel gas pattern. No Sitz markers are projected over the abdomen or pelvis. |
Generate impression based on findings. | Ms. Dietrichson is a 64 year old female with a personal history of right breast lumpectomy in 1997 for cancer followed by radiation and chemotherapy. She also has a personal history of bilateral cyst aspiration. No current breast related 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 density, unchanged in pattern and distribution. A linear marker was placed on the scar overlying the right breast. There are stable postsurgical changes including architectural distortion, increased density, and skin retraction present within the right lumpectomy site. Scattered benign calcifications are present bilaterally. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Stable postsurgical changes of the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 6-year-old female status post ORIF. Evaluate for fracture healing. VIEWS: Left elbow AP and Lateral (2 views) 2/27/2015 8:36 Interval removal of three K wires. Distal humeral fracture in near anatomic alignment with continued callus formation compatible with healing. | Continued healing of distal humeral fracture. |
Generate impression based on findings. | Thyroid cancer with metastases, compare to previous measurements CHEST:LUNGS AND PLEURA: Previously described left upper lobe endobronchial lesion demonstrates minimal decreased size at 16 mm (5/29), compared to 17-mm. A second reference lesion within the left upper lobe (5/56) adjacent to the diaphragm and left lateral chest wall is slightly larger at 8 x 10 mm, as compared to 7 x 8 mm.The remaining pulmonary lesions remain stable in size and number. No new pleural effusion.Stable changes reflecting right middle lobe resection and left lower lobectomy. Emphysema with basilar scattered cysts.MEDIASTINUM AND HILA: Postsurgical changes from prior thyroidectomy.The heart size remains normal. No interval pericardial effusion.No mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis or dependent high density sludge noted within the gallbladder.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Stable cortical irregularity of the lateral left eighth rib favoring posttraumatic etiology.OTHER: No significant abnormality noted. | Minimal change in size of the left upper lobe endobronchial lesion. Interval growth of second reference subpleural nodule now 8 x 10 mm, as compared to 7 x 8 mm. Additional pulmonary nodules stable in size and number.No interval lymphadenopathy. |
Generate impression based on findings. | Reason: s/p malignant peritoneal/pleural mesothelioma s/p resection and HIPEC and s/p pleurecomy/decortication and s/p adjuvant pem/carbo in 08/09 History: f/u Respiratory motion limits evaluation of the diaphragm (80219/20)LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.Scattered linear scarring/subsegmental atelectasis, unchanged.No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size, without pericardial effusion. No visible coronary artery calcification.Stable small mediastinal and hilar lymph nodes, some calcified from prior granulomatous disease. No lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Scattered splenic calcifications. | No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of unilateral left milky nipple discharge for the past 35 years. Family history of breast cancer in maternal niece and uterine cancer in mother. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. There is partial visualization of a radiopaque tube over the medial aspect of the posterior right breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of benign left breast biopsy in 2014. Family history of breast cancer in sister. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A cluster of calcifications are identified in the central left breast (far posterior depth) with an adjacent biopsy marker clip, at site of prior benign breast biopsy. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign lymph nodes project over both axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Maternal aunt and multiple cousins with breast cancer. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Bilateral, circumscribed masses in the lateral breasts are stable and likely represent lymph nodes. Oil cyst in the right inner breast 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, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | ESRD status post renal transplant in 3/2014 now with sinus pain and drainage. Please eval for infection. There is mild mucosal thickening within the bilateral sphenoid sinuses. The other paranasal sinuses are essentially clear. There is mild bubbly opacification of the anterior nasal cavity. The nasal septum is essentially midline. 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. The bone marrow of the skull appears to be mildly expanded and heterogeneous diffusely. There is partial opacification of the left mastoid air cells. | 1. Mild mucosal thickening within the bilateral sphenoid sinuses and mild bubbly opacification of the anterior nasal cavity, perhaps due to rhinosinusitis. 2. Partial opacification of the left mastoid air cells may represent mastoiditis. 3. Findings suggestive of renal osteodystrophy. |
Generate impression based on findings. | Ms. Williams is a 57 year old female with a personal history of benign right lumpectomy in 2000 and a benign left excisional biopsy for a papilloma in 2009. Family history of breast cancer in maternal aunt. She presents today for a short-term follow-up for multiple findings in the central left breast. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Focal asymmetry in the central left breast (mid depth) and in the superior left breast (posterior depth) are stable in appearance when compared to the prior exam. Both focal asymmetries are associated with internal calcifications and have previously been characterized as cysts on prior ultrasound exam. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in the left breast. | High probability benign cysts with internal layering calcium. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended in 6 months to confirm stability of these findings. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and cleavage view (11 images total) were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Bilateral, benign-morphology calcifications but 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, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. There is a focal asymmetry in the right lower inner breast, near the skin surface of the inframammary fold on the MLO view. Additional focal asymmetry is present in the central 12:00 position. No additional suspicious masses, microcalcifications or areas of architectural distortion are present. | Two focal asymmetries in the right breast for which spot compression views and possible ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Fall with head trauma Head: No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent moderate chronic small vessel ischemic changes.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Small torus palatinus noted. Calvarium is intact.Cervical Spine: The cervical vertebral bodies are appropriate height. Alignment is maintained. No fractures are identified in the cervical spine. No suspicious bony lesions are identified in the cervical spine.There are degenerative changes in the cervical spine with disk osteophyte complexes and ligamentum flavum thickening at C2-C3, C3-C4, C4-C5, C5-C6, and C6-C7. There is at least moderate spinal canal stenosis at C3-C4, C4-C5, and C5-C6. There is moderate to severe left C3-C4, moderate to severe C4-5 bilateral left greater than right, moderate to severe bilateral left greater than right C5-C6, moderate left C6-C7, and moderate left C7-T1 neural foraminal stenosis. Multilevel facet arthropathy.Distended air filled hypopharynx and upper esophagus noted. | 1. No evidence of intracranial hemorrhage or mass effect. Calvarium is intact.2. No acute fracture or subluxation within the cervical spine.3. Degenerative changes in the cervical spine with at least moderate spinal canal and neural foraminal stenosis at multiple levels as detailed above.4. Significantly distended air-filled hypopharynx and upper esophagus noted. |
Generate impression based on findings. | 16-year-old male with pain and decreased range of motion, movement at AC joint on exam. Evaluate for AC joint separationVIEWS: Right and left shoulder AP, right shoulder Zanca and axially view (right shoulder 3 views, left shoulder one view) 2/27/2015 9:10 Humeral head is well directed in the glenoid fossa. The AC joints are symmetric. No soft tissue swelling or joint effusion. No fracture or dislocation. Right thoracic curve is again seen. | No evidence of AC joint dislocation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign excisional biopsy 1978. History of mother with breast cancer. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable scattered benign-appearing calcifications bilaterally. 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, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 25 years old Reason: ro fracture, assess ACL graft History: hx of ACL repair in 2010. There are surgical tunnels in the distal femur and proximal tibia indicating prior ACL reconstruction. There is a small orthopedic button along the distal femur, securing the femoral portion of the graft. The knee otherwise appears normal.Left knee appears normal as seen on the frontal views. | Findings consistent with prior ACL reconstruction as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of colon cancer diagnosed at the age of 45. Family history of breast cancer in maternal grandmother. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications, including dermal calcifications, are present bilaterally. 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, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Invasive keratinizing squamous cell carcinoma of the esophagus. Head: There is no evidence of intracranial mass or abnormal enhancement. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. There is scattered paranasal sinus opacification. The skull and scalp soft tissues are unremarkable. Neck: There is an irregular and infiltrative mass involving of the cervical esophagus that measures up to approximately 30 mm in width and 60 mm in length, with protrusion of the party wall. There is right lower neck and upper mediastinal lymphadenopathy with hypermetabolism on PET and ill-defined margins. For example, a right level 4 lymph node measures up to 22 x 34 mm. There are also prominent left lower neck lymph nodes with hypermetabolism on PET that measure up to 7 x 8 mm. The thyroid and major salivary glands are grossly unremarkable. The major cervical vessels are patent. There is multilevel degenerative spondylosis of the cervical spine. There are bilateral tonsilloliths. The airways are patent. The imaged intracranial structures are unremarkable. There is a subcentimeter right apical pulmonary nodule. | 1. An irregular and infiltrative mass involving of the cervical esophagus corresponds to recently diagnosed squamous cell carcinoma.2. Bilateral lower neck and upper mediastinal lymphadenopathy, right larger than left, with suggestion of extracapsular extension, are compatible with metastatic disease.3. No evidence of intracranial metastases.4. Nonspecific subcentimeter right apical pulmonary nodule. |
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 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, 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, routine 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 and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Focal asymmetry is identified in the central left breast (far posterior depth), best seen on the CC view. No suspicious masses, microcalcifications or areas of architectural distortion are present in the right breast. Benign lymph nodes project over both axilla. | Focal asymmetry in the central left breast. Attempts should be made to obtain patient's prior mammograms for comparison purposes. If not possible, then additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OC - OLD FILM FOR COMPARISON |
Generate impression based on findings. | 63 years, Male, Reason: carcinoid tumor compare to last Ct \T\ measure 1) aortopulmonary node, 2) hepatic dome lesion, 3) right inguinal node and 4) L2 vertebral body lesion History: post 2 cycles of therapy. CHEST:LUNGS AND PLEURA: Nonspecific right apical ground glass opacity is unchanged measuring 8 mm (9/20), previously 8 mm. Left upper lobe ground glass nodule is unchanged. Mild centrilobular emphysema. No suspicious nodules or masses.MEDIASTINUM AND HILA: Right aortopulmonary window lymph node with a fatty hilum measures 1.4 by 0.6 m (7/38), previously 1.4 x 0.7 cm. Mediastinal surgical clips and lymph nodes are unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly is unchanged. Diffuse hepatic steatosis.Reference hepatic dome lesion measures 3.5 x 2.6 cm (6/17). This lesion measured 2.5 x 2.2 cm on the prior exam, however there was no arterial phase images on the prior exam. On the exam from 11/7/2014, upon remeasurement, this lesion measures 3.3 x 2.3 cm. Overall innumerable enhancing lesions (seen predominately on arterial phase) are unchanged since 11/7/2014.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cyst is unchanged. Additional hypoattenuating lesions are too small to characterize. Perirenal soft tissue attenuation adjacent to the right lower pole measures 1.3 x 1.1 cm (7/128) previously 1.2 x 1.0 cmRETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcifications of the aorta and its branches. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: See belowOTHER: No significant abnormality notedPELVIS: MalePROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality noted.LYMPH NODES: Reference right inguinal node measures 1.4 x 0.8 cm (7/196), previously 1.4 x 0.7 cm.BOWEL, MESENTERY: No significat abnormality noted.BONES, SOFT TISSUES: Multiple sclerotic lesions throughout the spine, pelvis and ribs are unchanged. A reference L2 vertebral body lesion measures 2.3 x 1.7 cm (7/120), previously 2.3 x 1.6 cm.OTHER: No significant abnormality noted. | 1.Overall stable examination with unchanged innumerable hepatic metastases, sclerotic bone metastases, reference lymph nodes and perirenal soft tissue nodule.2.Nonspecific groundglass opacities are stable. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal niece. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Left retroareolar ovoid mass and bilateral benign calcifications are 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, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Adenocarcinoma of the lung follow up. CHEST:LUNGS AND PLEURA: Surgical changes of a right lower lobe resection, with stable scarring adjacent to the suture line.Scattered benign appearing micronodules, some calcified, are unchanged. No new suspicious pulmonary nodules or masses.Mild basilar scarring/atelectasis. No focal airspace consolidation. No pleural effusions.Elevation of the left hemidiaphragm.MEDIASTINUM AND HILA: The heart is normal in size. Small pericardial fluid/thickening, unchanged. Mild coronary artery calcification.Scattered calcified mediastinal and hilar lymph nodes, from prior granulomatous disease. No lymphadenopathy.Stable nonspecific 1.4-cm hypodense right thyroid nodule.CHEST WALL: Degenerative disease of the thoracic spine.ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: Scattered splenic granulomas, unchanged.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative disease of the lumbar spine.OTHER: No significant abnormality noted. | No evidence of recurrent or metastatic disease. |
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 9.3. The breast parenchyma is composed of scattered fibroglandular density. A round right breast asymmetry is seen centrally on the MLO view. Scattered benign calcifications, including dermal calcifications, are present in the left breast. No suspicious microcalcifications or areas of architectural distortion are present. | Right breast asymmetry for which comparison to prior studies is needed. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. She complains of bilateral milky nipple discharge for the past 25 years. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. 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, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Male 57 years old Reason: r/o left sided fracture s/p fall History: pain s/p fall. No definite rib fracture or underlying rib abnormalities are identified. There is cardiomegaly. A right-sided CVC tip in is seen at the cavoatrial junction. Sternotomy hardware and wires are noted. ICD and LVAD positions are unchanged from the prior exams. Note is made of an IVC filter unchanged in position. | No acute rib fracture as clinically questioned. |
Generate impression based on findings. | Right hip pain. Possible avascular necrosis. There is curvilinear signal abnormality within both femoral heads indicating avascular necrosis. I see no subchondral fracture or articular surface collapse, nor do I see any marrow edema within the femoral heads.There is an approximately 1.5 cm focus of abnormal signal intensity within the posterior column of the acetabulum that disrupts the articular surface of the hip. This lesion is isointense to skeletal muscle on T1 weighted images, hyperintense on T2 weighted images, and shows peripheral rim enhancement following contrast administration. This corresponds to an approximately 1cm lytic defect seen in retrospect on the recent CT scan that erodes through the articular surface of the acetabulum. Review of the patient's records indicates a history of metastatic thymic carcinoma, and therefore this likely represents an additional focus of metastatic disease. Abnormal signal intensity and enhancement extends anteriorly from this lesion into the medial aspect of the hip joint, likely representing intra-articular extension of tumor. Additional adjacent signal intensity and enhancement within the posterior column of the acetabulum may simply represent peritumoral edema, although the degree of enhancement is concerning for tumor. The medial wall of the acetabulum appears intact. In total, the signal abnormality of this lesion extends in the AP dimension for approximately 3.5 cm, in mediolateral dimension for approximately 2.5 cm, and in the craniocaudal dimension for approximately 3.5 cm. There is a small right hip joint effusion with thin synovial enhancement indicating mild synovitis. The left hip joint is unremarkable. The remaining bone marrow signal intensity is unremarkable. Visualized musculature is unremarkable. There is mild edema within the subcutaneous fat laterally which is of doubtful clinical significance. There is also mild edema within the subcutaneous fat anterior to the femoral vessels that is nonspecific. Moderate degenerative disk disease affects the visualized lower lumbar spine. | 1.Focal lesion of the posterior column of the right acetabulum as described above presumed to represent a metastasis from the patient's known thymic carcinoma, with intra-articular extension into the hip.2.Bilateral femoral head avascular necrosis and other findings as described above. |
Generate impression based on findings. | Female 53 years old Reason: fx eval healing History: above. We have 3 views of the left wrist. The distal radius fracture is less distinct on the current study than on the prior study suggesting some interval healing, with a 4-5mm ossicle noted along the radial styloid. The ulnar styloid fracture line is also less distinct on the current study than on the prior study suggesting some interval healing.We have 3 views of the left hand. The previously seen fracture through the proximal diaphysis of the fourth metacarpal is less distinct on the current study than on the prior study suggesting some interval healing. The bones appear slightly demineralized. | Healing fractures as described above. |
Generate impression based on findings. | Male 64 years old Reason: lymphoma, please restage, after BMT History: please compare to last CT scan and follow on the renal mass CHEST:LUNGS AND PLEURA: Bibasilar atelectasis. Right lower lobe nodule, measuring 7 mm (series 5, image 51), is unchanged. Calcification along the right lateral pleura with associated scarring is unchanged. Left basilar pleural based nodule (series 5, image 57) is stable. No pleural effusions or consolidation.MEDIASTINUM AND HILA: Normal heart size without pleural effusion. No mediastinal lymphadenopathy. Reference right hilar node measures 1.3 x 1.2 cm (series 3, image 35), previously 1.3 x 1.1 cm. No coronary artery calcifications. Right central venous catheter with tip at the cavoatrial junction.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right upper pole renal exophytic indeterminate mass measures 1.6 x 1.1 cm (series 3, image 99), previously 1.5 x 1.2 cm.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia unchanged.BONES, SOFT TISSUES: Degenerative changes of the visualized spine. Again seen is a circumscribed lucency in the T9 vertebral body most likely a hemangioma.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Left fat containing inguinal hernia, unchanged.OTHER: No significant abnormality noted | 1.No new lymphadenopathy. Small hilar lymph node is stable.2.Right lower lobe lung nodule is unchanged.3.Indeterminate exophytic right renal lesion is stable in size, but could represent a small malignancy. |
Generate impression based on findings. | 68 year-old female patient with history of Crohn's disease presents with nausea and vomiting. Evaluate for obstruction. UPPER GI:Double contrast visualization of the esophagus showed no morphologic abnormalities of the mucosal surfaces or mural contours. During the exam, provoked reflux and emesis was noted. Fluoroscopic evaluation of esophageal peristalsis demonstrated cessation of the primary wave at the level of the aortic arch with proximal escape and occasional tertiary waves.The stomach was normal in size, shape, and position. Spontaneous emptying of contrast into the duodenal sweep was observed. The gastric mucosal surface was normal.The duodenal bulb and sweep were within normal limits. SMALL BOWEL FOLLOW-THROUGH:Scout radiograph showed a nonobstructive bowel gas pattern with moderate stool burden in the colon. Transit time to the colon was two hours. Fluoroscopic evaluation showed normal mucosa throughout the small bowel, with no ulcers, sinus tracts, fistulae, or adhesions. No separation of bowel loops was present to suggest fibrofatty proliferation. The terminal ileum and ileocecal valve were normal in appearance. No internal hernias or ventral hernias were evident. The ascending colon was grossly normal. TOTAL FLUOROSCOPY TIME: 4:01 minutes. | 1.Minor motility abnormality and provoked reflux.2.Mildly delayed transit through the small bowel without evidence of bowel obstruction or evidence of active Crohn's disease. |
Generate impression based on findings. | Seizures status post right craniotomy. There are postsurgical findings related to right-sided craniotomy for right temporal lobe tumor resection. There is pneumocephalus along the resection cavity and the right frontal convexity. Minimal hyperattenuation is noted along the resection margin, likely representing minimal blood products. There is vasogenic edema in the right parietal and temporal lobes similar to prior. An additional mass measuring 24 x 24 x 27 mm (AP x TR x CC) is present in the left parietal lobe with surrounding vasogenic edema similar to prior. There is decrease in mass effect on the right lateral ventricle. There is slightly improved right to left midline shift measuring 4 mm, previously 6 mm. No uncal herniation. There is minimal mucosal thickening of the bilateral maxillary sinuses. The remaining imaged paranasal sinuses and mastoid air cells are clear. | 1. Expected postsurgical findings related to right-sided craniotomy for right temporal lobe tumor resection. Slightly improved right to left midline shift measuring 4 mm. MRI can better assess for residual tumor.2. Left parietal mass measuring up to 27 mm with associated vasogenic edema as seen previously. |
Generate impression based on findings. | 12-year-old female with history of right elbow fracture. Evaluate for healing.VIEWS: Right elbow AP, oblique and lateral (3 views) 2/27/2015 9:30 Medial condylar fracture extends to the articular surface with the fracture fragment rotated and displaced anteriorly. The fracture fragment is approximately 2 cm in diameter. The margins of the humerus and fracture fragment are well corticated. Fullness posterior to the olecranon fossa is seen but no joint effusion is noted. | Nonunion of medial condylar fracture which extends to the articular surface with fracture fragment rotated and displaced anteriorly. |
Generate impression based on findings. | Male 53 years old Reason: 52 yo male with history of amyloidosis; pre-auto SCT evaluation History: evaluate. SKULL: We have two views of the skull showing a couple of small subcentimeter lucencies in the parietal calvarium.CERVICAL SPINE: We have two views of the cervical spine. The cervicothoracic junction is not well visualized due to overlying anatomy. The bones appear slightly demineralized, but we see no focal lytic lesions.THORACIC SPINE: We have a single view of the thoracic spine. The bones appear demineralized, but we see no focal lytic lesions.LUMBAR SPINE: We have two views of the lumbar spine. There are 4 non-rib bearing lumbar-type vertebrae and what we presume to be sacralization of L5. The bones appear slightly demineralized. Mild degenerative arthritic changes affect the lumbar spine, but we see no focal lytic lesions.RIBS: We have a single AP view of the ribs. The ribs appear demineralized, but we see no focal lytic lesions.PELVIS: We see no focal lytic lesions on the single AP view of the pelvis.UPPER EXTREMITY: We have two views of the right humerus. A poorly defined lucency within the proximal humeral diaphysis, in addition to more focal lesions in the humeral neck, are nonspecific but could represent myelomatous deposits.We have two views of the left humerus. The left humerus appears demineralized, but we see no definite lytic lesions.AP views of each forearm show no discrete lytic lesions. There is mild widening of the scapholunate interval bilaterally of questionable clinical significance.LOWER EXTREMITY: We have two views of the right femur. There is endosteal scalloping of the proximal and mid femoral diaphysis with poorly defined underlying lucencies that may represent multiple myeloma.We have two views of the left femur. There is endosteal scalloping of the proximal and mid femoral diaphysis with poorly defined underlying lucencies that may represent multiple myeloma.AP views of the bilateral tibia/fibula bones are unremarkable and we see no focal lytic lesions. | Demineralized bones with poorly defined lucencies and endosteal scalloping as described above that may reflect multiple myeloma |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No suspicious masses, microcalcifications or areas of architectural distortion are present. A few scattered benign calcifications are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 66 years, Male, Reason: metastatic prostate cancer, intrapulmonary LN. eval for progression History: prostate cancer, lung nodule. CHEST:LUNGS AND PLEURA: Nodular pleural-based mass along the posterior aspect of the left apex is increased in size from the prior exam measuring 1.4-cm is in thickness (3/16), previously 0.9 cm. There is also a new pleural-based mass along the right lower which measures 1.4 cm in thickness (5/67). There is diffuse sclerotic metastases in the ribs adjacent to these lesions, however no frank osseous destruction is evident.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Diffuse sclerotic metastases.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Bilateral adrenal nodules with a left-sided nodule measuring 3.1 x 2.1 cm (3/106) comminuted from the prior exam.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Small retroperitoneal nodes are unchanged with a reference right periaortic node measuring 0.7 x 0.4 cm (3/1.6), previously 0.9 x 0.8 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse sclerotic metastases, unchanged.OTHER: No significant abnormality notedPELVIS: MalePROSTATE, SEMINAL VESICLES: Right inguinal hernia is increased containing loops of bowel without evidence of obstruction.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse sclerotic metastases.OTHER: No significant abnormality noted. | 1.New bilateral adrenal nodules and pleural based masses, suspicious for neoplasm.2.Diffuse sclerotic metastasis and reference nodes are unchanged.3.Inguinal hernia containing loops of small bowel, increased since the prior exam. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Prior history of skin cancer. Two standard digital views, repeat bilateral MLO views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable asymmetry on the right CC view. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | History of stage IIIA mucinous adenocarcinoma of the uterus, s/p TAH/BSO 2009, with recurrence at vaginal cuff with acute vaginal bleeding, planned for surgery on 3/2/15, rule out distant metastasis.RADIOPHARMACEUTICAL: 4.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 97 mg/dL. Today's CT portion grossly demonstrates bilateral small pleural effusions with overlying compressive atelectasis. Scattered patchy opacities are noted in the right middle lobe, lingula and right upper lobe of the lungs. Small mediastinal lymph nodes are noted, including in the right paratracheal region. Mitral, tricuspid and aortic valve prostheses are visualized. A right central venous catheter terminates at the SVC/atrial junction. High density within the gall bladder may represent sludge or small gallstones. There is also gall bladder wall thickening which is nonspecific in the absence of IV contrast but could represent inflammation or edema. The right lower pelvis fluid collection appears similar to the recent MRI pelvis. There is thickening anterior to the vaginal cuff and posterior to the bladder, which corresponds to the region of enhancement on the pelvic MRI performed 2/25/25. High density in the vagina can be due to blood clot. Today's PET examination demonstrates normal sized bilateral level II/III lymph nodes with mild increased activity. A normal sized right sided parotid lymph node also has mild increased activity with SUVmax of 3.2, and is more likely inflammatory in etiology. Minimum activity is seen in the patchy lung opacities, also likely inflammatory. Thickening of the gallbladder wall has mild activity which is still nonspecific but could represent inflammation or edema. Mild activity is seen anterior to the vaginal cuff with an SUVmax of 3.9 on the left side. This is suspicious for possible tumor recurrence. Two lymph nodes in the left inguinal region with SUVmax 2.9 are suspicious for local metastases. A focus of increased left buttock skin thickening with an SUVmax of 6.9 more likely represents inflammation. Increased activity in the vagina may represent inflammatory change, clinical correlation may provide further information. | 1.Mild increased activity anteriorly along the left vaginal cuff suspicious for possible tumor recurrence. 2.Left sided inguinal lymphadenopathy is suspicious for possible lymph node metastases.3.Thickening of the gall bladder wall with mild activity is nonspecific but could represent inflammation or edema. Right upper quadrant ultrasound may provide further information if clinically warranted. |
Generate impression based on findings. | Age: 66 years. Sex : Male. Reason for study: Reason: r/o aspiration History: URI, oxygen requirement, cough. Fluoroscopic guidance was provided for an oropharyngeal motility study performed by the Speech Pathology section of the ENT service. The examination was recorded on videotape. No static or hard copy films were obtained. The exam was positive for penetration and negative for aspiration. FLUOROSCOPY TIME: One minute and forty two seconds | The exam was positive for penetration and negative for aspiration. Please see speech pathology report for additional findings and feeding recommendations. |
Generate impression based on findings. | Female 37 years old Reason: IV dedicated renal CT w/ cortical nephrogram and delayed phases; define mass R flank History: R flank pain; found to have large cyst ABDOMEN: The exam is limited secondary to lack of oral contrast. Evaluation of bowel pathology is suboptimal.LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Prominent pancreatic duct with mild atrophy the pancreatic parenchyma consistent with chronic pancreatitis. This is likely secondary to pancreatic divisum. No adjacent fat stranding or fluid collection to suggest acute pancreatitis.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No focal renal mass or perinephric fat stranding. No hydronephrosis or hydroureter. There is no ureteral filling defect visualized.RETROPERITONEUM, LYMPH NODES: Again seen is a thin-walled, well defined, hypoattenuating collection which may be retroperitoneal or centered in the right paracolic gutter. The fluid collection again measures 9.2 x 5.9 x 10.5 cm (series 3, image 81 and series 80296, image 57). The fluid collection has no solid components or apparent septations. Again, the lesion abuts the ascending colon but does not appear to be arising from the right ovary, right kidney or the ascending colon. The fluid collection is likely benign cystic lesions such as a lymphangioma, lymphocele, duplication cyst or mesenteric cyst such as a mesothelial/epithelial cyst. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Thin-walled fluid collection again seen without solid component or apparent septations. Differential is unchanged and includes a benign cystic lesions such as a lymphangioma, duplication cyst, mesenteric cyst such as a mesothelial/epithelial cyst, or lymphocele. 2.No focal renal mass or ureteral filling defect seen. No convincing findings to explain patient's reported gross hematuria. 3.Findings consistent with chronic pancreatitis likely secondary to pancreatic divisum. No specific evidence of acute pancreatitis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother (diagnosed in her 60s), maternal aunt (diagnosed in her 40s), and maternal cousin (diagnosed in her 30s). Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. 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, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother and maternal grandmother. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Innumerable diffuse punctate benign calcifications are seen in both breasts. Benign morphology mass in the left superior breast is stable. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Bilateral benign calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Reason: evaluate vessel stenosis, thrombosis, aneurysm, emboli History: acute ischemic stroke, A-fib, bacteremia Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. There is high-grade stenosis present at the left internal carotid artery origin with associated string sign which would effectively represent a 99% stenosis by NASCET criteria. There is opacification of the entire left internal artery which changes caliber at the level of the posterior communicating artery due to posterior communicating artery collateral supply.On the basis of NASCET criteria there is no significant stenosis at the right carotid bifurcation. There is no significant stenosis along the course of the vertebral arteries.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms are appreciated.There is opacification of the entire left internal artery which changes caliber at the level of the posterior communicating artery due to posterior communicating artery collateral supply.The anterior communicating artery and the posterior communicating arteries are identified and are intact. The right posterior communicating artery is tiny. The anterior communicating artery is medium-size area of the left A1 segment is very small and not readily seen to communicate with the left internal card artery. There is some supply to lenticulostriate originating from the left A1 segment which receive supply from the right anterior circulation.The right vertebral artery is slightly larger than the left vertebral artery areCT head:There is redemonstration of hypodensity involving gray and white matter located in the left medial frontal lobe involving superior frontal gyrus and cingulate gyrus measuring 67 x 34 mm and sagittal dimensions. There is a redemonstration of hypodensity involving gray and white matter located in the right postcentral gyrus measuring approximately 44 x 13 mm in axial dimensions. There is redemonstration of a 28 x 20 mm right supramarginal gyrus hypodensity involving both gray and white matter. Some punctate foci of hypodensity are present along the right angular gyrus. There is loss of gray white differentiation present along the left superior parietal lobule and along part of the the left superior internal parietal artery territory which are more subtle than the other hypodensities.Small foci of hypodensity are present along the posterior aspect of the right insular cortex as well as the the left caudate nucleus - along the suspected territory of the medial lenticulostriate branches.There is a focus of encephalomalacia present involving the left inferior parietal lobule.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Atherosclerotic calcifications are present along the distal vertebral arteries. | 1.There is a left internal carotid artery string sign present with high-grade proximal left internal artery stenosis. The left middle cerebral artery territory is supplied from via the posterior communicating artery. The left anterior cerebral artery territory is supplied via the anterior communicating artery. The arterial supply to the left superior internal parietal lobule is not readily determined on this exam.2.The left A1 segment is not readily identified.3.Multiple foci of subacute infarction are identified in the right middle cerebral artery territory as well as the left anterior cerebral artery territory (including left caudate). Left superior parietal lobule and the left superior internal parietal branch territory involvement involvement may be more recent. Although it is possible that all these infarcts are related to right ICA territorial thromboembolic event if one considers that the left superior parietal lobule was supplied via pial collaterals from the left superior internal parietal artery and the left superior internal parietal artery occlusion resulted in infarction of both territories, however, punctate foci of diffusion restriction on the recent MRI located in the left occipital lobe indicate left posterior cerebral artery supply from the vertebrobasilar circulation and therefore would have a different source.4.There is no evidence for hemorrhagic conversion.5.Encephalomalacia along the left inferior parietal lobule |
Generate impression based on findings. | Metastatic esophageal cancer. Evaluation for mets.RADIOPHARMACEUTICAL: 12.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 87 mg/dL. Today's CT portion grossly demonstrates lower cervical and upper thoracic circumferential esophageal thickening. There are enlarged right supraclavicular and prominent right upper paratracheal lymph nodes. There is an enlarged AP window lymph node. There is bibasilar atelectasis. A percutaneous jejunostomy tube with a moderate amount of pneumoperitoneum is noted, similar to the most recent examination.Today's PET examination demonstrates a markedly hypermetabolic circumferential mass of the lower cervical/upper thoracic esophagus (max SUV = 18.6). There are multiple markedly hypermetabolic lymph nodes in the right supraclavicular (max SUV = 16.3), right upper paratracheal, and upper left paraesophageal lymph node stations.There is mild, symmetric hypermetabolic activity within bihilar, lower right paratracheal, subcarinal, precarinal, and AP window lymph nodes (max SUV = 3.2).No FDG avid lesion is identified in the abdomen or pelvis. | 1.Markedly hypermetabolic upper esophageal thickening compatible with provided history of esophageal cancer.2.Markedly hypermetabolic right supraclavicular, upper left paraesophageal, and upper mediastinal lymph nodes compatible with metastatic disease.3.Mildly hypermetabolic, symmetric lower mediastinal and hilar lymph nodes are non-specific. These may be reactive or inflammatory in etiology with sarcoidosis a possibility. 4.No FDG avid tumor in the abdomen or pelvis. |
Generate impression based on findings. | Thyroid nodule FNA follicular neoplasm, low TSH. Concern for toxic nodule. The thyroid images demonstrate a large hypofunctioning nodule occupying most of the left thyroid lobe. There is otherwise uniform uptake within and enlarged right thyroid lobe. Uptake is also noted in a pyramidal lobe. The 4-hour radioactive iodine uptake is 16% and the 23-hour uptake is 28% (normal range 10-30% at 24-hours). | 1. Large hypofunctioning nodule within the left thyroid lobe; correlate with ultrasound/biopsy. 2. Overall thyroid uptake is upper limits of normal; in the setting of a low TSH, this is abnormal and is suggestive of Grave's disease considering an enlarged right thyroid lobe and presence of a pyramidal lobe. |
Generate impression based on findings. | Female 76 years old Reason: evaluate for disease progression History: ra. Three views of the left hand again show findings compatible with advanced rheumatoid arthritis. There has been progression of erosion within the distal radius and possibly along the base of the first metacarpal. There appears to be increased soft tissue swelling along the second and fifth metacarpophalangeal joints, with progression of erosion at the fifth metacarpophalangeal joint. Narrowing of the interphalangeal joints likely represents a combination of rheumatoid arthritis and osteoarthritis.Three views of the right hand show findings compatible with advanced rheumatoid arthritis. Soft tissue swelling adjacent to the proximal interphalangeal joints of the middle and ring fingers appear more pronounced on the current study than on the prior study. Otherwise, the hand appear similar to that seen in 2013.Three views of the left foot show findings of rheumatoid arthritis predominantly affecting the metatarsophalangeal joints interphalangeal joint of the great toe, appearing similar to the prior study. We see no evidence of disease progression.Three views of the right foot show findings of rheumatoid arthritis predominantly affecting the metatarsophalangeal joints, appearing similar to the prior study. There is a severe hallux valgus deformity. We see no evidence of disease progression. | Findings indicating advanced rheumatoid arthritis as described above, with progression of erosions of the left hand. |
Generate impression based on findings. | Ms. Cook is a 53 year old female with a personal history of benign right breast biopsy in 1999 and known bilateral breast calcifications. Family history of breast cancer in mother diagnosed at the age of 62. She has no current breast related complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Linear marker is placed on a scar overlying the right breast. Scattered benign calcifications are present bilaterally. There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | Bilateral benign calcifications. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Metastatic thyroid cancer, carcinoid tumor of the lung, and Hurthle cell cancer. Neck: There are postoperative findings related to total thyroidectomy. There is no evidence of mass lesions or significant cervical lymphadenopathy. The salivary glands are unchanged. The osseous structures are unchanged. The airways are patent. There are emphysematous changes in the partially-imaged lungs.Head: There is no evidence of intracranial mass lesions. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | 1. Stable postoperative findings in the neck without evidence of measurable tumor recurrence or significant lymphadenopathy in the neck, although the evaluation is limited by the lack of intravenous contrast.2. No evidence of intracranial metastases, although the evaluation is limited by the lack of intravenous contrast. |
Generate impression based on findings. | Limited neck ROM, previous C2-3 fracture with no surgical repair Moderate multilevel degenerative disk disease affects the cervical spine, predominantly at C5/6 and C6/7. The alignment is anatomic. There is no evidence of instability. | Degenerative disk disease without evidence of instability. |
Generate impression based on findings. | Chronic cough, nasal congestion. There is mild scattered mucosal thickening in the paranasal sinuses. The nasal cavity is clear. The nasal septum is deviated to the left with an associated spur. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The facial soft tissues appear to be unremarkable. There are bilateral lens implants. There are extensive degenerative changes involving the left temporomandibular joint and mild degenerative changes involving the right temporomandibular joint. The bilateral mastoid air cells and middle ear cavities are clear. There is a partially-empty sella. There is torus palatinus. | 1. Mild scattered paranasal sinus mucosal thickening.2. Extensive degenerative changes involving the left temporomandibular joint and mild degenerative changes involving the right temporomandibular joint.3. The nasal septum is deviated to the left with an associated spur. 4. Partially-empty sella. |
Generate impression based on findings. | Pain Mild osteoarthritis affects both hip joints, right greater than left. An intrauterine device is noted. | Osteoarthritis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother, diagnosed at age of 52. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Scattered benign calcifications are present bilaterally. 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, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 84 year old female with shortness of breath, pre-operative evaluation for TAVR. ANGIOGRAM: Please see accompanying cardiac CT report for description of thoracic aorta. Moderate atherosclerotic disease affects the abdominal aorta and its branches. There is no evidence of abdominal aortic aneurysm or dissection. The splenic artery and left gastric arteries share a common trunk with a separate origin of the common hepatic artery. The origins of the celiac axis, SMA, and renal arteries are patent. There is no significant tortuosity or circumferential atherosclerotic calcifications of the common/external iliac arteries. Thick non-circumferential atherosclerotic calcifications in the proximal right common iliac artery narrow the lumen to approximately 8 mm (series 406, image 15). VESSELS:SUPRARENAL ABDOMINAL AORTA: 2.1 x 2.6 cmINFRARENAL ABDOMINAL AORTA: 1.4 x 1.4 cmRIGHT COMMON ILIAC ARTERY: 8.2 x 9.2 mmRIGHT EXTERNAL ILIAC ARTERY: 7.3 x 8.1 mmRIGHT COMMON FEMORAL ARTERY: 6.4 x 6.4 mmLEFT COMMON ILIAC ARTERY: 9.5 x 10.6 mmLEFT EXTERNAL ILIAC ARTERY: 9.5 x 9.6 mmLEFT COMMON FEMORAL ARTERY: 8.2 x 10.1 mmABDOMEN:LUNG BASES: Please see accompanying cardiac CT report for description of pulmonary findings. LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: Splenic granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: Indeterminate left adrenal nodule (series 5, image 114) measures 1.5 x 2.3 cm.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Enlarged portacaval lymph node (series 5, image 121) measures 1.1 x 1.8 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small fat-containing umbilical hernia. Degenerative changes of the visualized thoracolumbar including mild anterior wedging of several thoracic vertebral bodies. OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Moderate atherosclerotic disease. Vascular measurements of the abdominal aorta and its branches as described above. Mild narrowing of the right common iliac artery to approximately 8 mm. Relatively small caliber of common femoral arteries. 2.Please see dedicated cardiac CT from same day for full details regarding the chest and thoracic aorta.3.Cholelithiasis.4.Indeterminate left adrenal nodule. Nonspecific enlarged porto-caval lymph node. 5.Degenerative changes of the spine including mild age indeterminate anterior wedging of several thoracic vertebral bodies.6.Minor contrast extravasation as described above. |
Generate impression based on findings. | Right shoulder pain No fracture or malalignment is seen. Minimal osteoarthritic changes affect the glenohumeral joint. The acromiohumeral interval is within normal limits. | Minimal osteoarthritis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in mother and maternal aunt. BRCA1 positive. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Benign morphology mass in the left medial breast is stable when compared to multiple prior exams. Scattered benign calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable benign morphology mass in the left breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of mother and daughter with breast cancer. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered, benign-appearing calcifications are noted. 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, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: Monitor of pulmonary nodule for transplant listing History: As above LUNGS AND PLEURA: Very faint focal ground glass nodular opacity in the anterior segment of left upper lobe measuring approximately 12 mm (series 5/116) has not significantly changed. This includes nodular fibrosis, atypical adenomatous hyperplasia and adenocarcinoma in situ.Scattered calcified and noncalcified micronodules are unchanged and compatible with previous infection.Mild basilar scarring, unchanged.Mild mosaic perfusion pattern suggestive of small airways disease.MEDIASTINUM AND HILA: Severe cardiomegaly with marked left atrial and left ventricular enlargement.Swan-Ganz catheter, ICD device an aortic balloon catheter in place.No pericardial effusion.No visible coronary artery calcifications.No significant lymphadenopathy.Large hiatal hernia.CHEST WALL: Left chest wall pacemaker generator.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Hypodense lesions in the liver as previously described, most likely cysts. | Persistent very faint left upper lobe 12-mm groundglass nodule with a differential diagnosis that includes nodular fibrosis, atypical adenomatous hyperplasia and adenocarcinoma in situ. Long-term follow-up is recommended for such lesions, because they tend to be extremely indolent, and even they have malignant potential it is not clear that they all become invasive. Those that do eventually become invasive usually take many years to do so. |
Generate impression based on findings. | Female 76 years old Reason: Standing views. Evaluate degree of osteoarthritis. History: Left knee pain . We have 4 views of the left knee. There is perhaps mild medial compartment narrowing but otherwise we see no frank osteoarthritic changes. Ossification along the medial femoral condyle likely reflects prior injury to the medial collateral ligament. There is also mild medial compartment narrowing of the right knee as seen on the frontal views. | Mild medial compartment narrowing may reflect very mild osteoarthritis. |
Generate impression based on findings. | Ms. Krolak submitted outside mammograms dated 07/10/2013 and 08/03/2009, from Pronger Smith Medical Care. Submitted outside studies were compared to the current mammogram dated 02/12/2015. The breast parenchyma is heterogeneously dense, which may obscure small masses. There is a focal asymmetry in the right upper outer breast, which was not definitively seen on prior examinations. There are no suspicious microcalcifications or areas of architectural distortion in either breast. | Focal asymmetry in the right breast. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Ms. Krolak submitted outside mammograms dated 07/10/2013 and 08/03/2009, from Pronger Smith Medical Care. Submitted outside studies were compared to the current mammogram dated 02/12/2015. The breast parenchyma is heterogeneously dense, which may obscure small masses. There is a focal asymmetry in the right upper outer breast, which was not definitively seen on prior examinations. There are no suspicious microcalcifications or areas of architectural distortion in either breast. | Focal asymmetry in the right breast. Additional imaging, including spot compression views and possible ultrasound, are recommended for further evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 12-year-old female, evaluate healing of left shoulder fractureVIEWS: Left shoulder, neutral, AP and Grashey (3 views) 2/27/15 10:29 Again visualized is a transverse fracture of the proximal humeral metadiaphysis with mild posterior and lateral angulation of the distal fracture fragment. No significant periosteal reaction or bridging callus formation. The humeral head is intact and glenohumeral joint alignment is normal. | Proximal humeral fracture with mild posterior and lateral angulation appearing similar to the prior exam. |
Generate impression based on findings. | pain with walking after injury during danceVIEWS: Right foot AP, oblique and lateral No acute fracture or dislocation. | Normal examination. |
Generate impression based on findings. | 64-year-old male metastatic prostate cancer to bone and pulmonary nodules for evaluation after treatment. CHEST:LUNGS AND PLEURA: There are scattered small nodular opacities with tree in bud appearance bilaterally common new from the prior exam with resolution of previous nodularity. The findings are consistent with bronchiolitis.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: See discussion bony structures below.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small, bilateral renal cysts. Extra renal pelves bilaterally with mild prominence of the collecting systems unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Extensive fecal material throughout colon.BONES, SOFT TISSUES: Widespread bony metastatic disease involving all visualized bony structures appear stable without gross pathologic fracture.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Soft tissue asymmetry in the region the right seminal vesicle measuring 2.2 x 4.6 cm on image 198/240 is stable.BLADDER: No significant abnormality notedLYMPH NODES: Right pelvic adenopathy. No significant change in right external iliac lymph node measuring 1.8 x 2 cm on image 192/240 or external iliac/femoral node on the right.BOWEL, MESENTERY: Extensive fecal material throughout colon.BONES, SOFT TISSUES: Widespread bony metastatic disease involving all visualized bony structures appear stable without gross pathologic fracture.OTHER: No significant abnormality noted | Findings in the lungs consistent with bronchiolitis.Stable metastatic disease involving bones and right pelvis. |
Generate impression based on findings. | Epilepsy and respiratory distress.VIEW: Chest AP (one view) 02/27/15, 0955 Endotracheal tube tip is in right brain stem bronchus. There appears to be a metal zipper tab in the gastric antrum.Airspace disease is present in the right lung. Left lower lobe opacity is a new finding and is most likely due to atelectasis from right mainstem bronchus intubation. Cardiothymic silhouette is normal.Right thoracic curve continues. Mildly dilated bowel is present in the upper abdomen. | Right mainstem bronchus intubation. |
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. | Male 46 years old Reason: hx relapsed hodgkins, s/p allo SCT day 100 eval disease status History: hx relapsed hodgkins CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Reference large mediastinal adenopathy now measures 11 . 4 x 11.4 cm on image number 38, series number 3, not significantly changed from previous study. The adenopathy encases the aortic arch, its branches, superior vena cava. The caliber of superior vena cava is very diminutive but patent. Small amount of thrombus is present within the superior vena cava. Interval removal of the central catheter.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver, unchanged. Focal liver lesions cannot be excluded with this single phase CT due to significant fatty infiltration.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: 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: No significant abnormality notedOTHER: No significant abnormality noted | There large infiltrative mediastinal adenopathy encasing the major vessels as described above, not significantly changed from previous study.Diffuse fatty infiltration of the liver, unchanged. |
Generate impression based on findings. | 72-year-old male with history of known SMA stenosis now with abdominal pain, evaluate for mesenteric ischemia. CT Angiography: Severe atherosclerotic disease affects the abdominal aorta and its branches. There is no evidence of aortic aneurysm or dissection. The origin of the celiac axis is patent. There is severe narrowing at the origin of the SMA with flow present distally. There is moderate narrowing of the origins of the bilateral renal arteries. ABDOMEN:LUNG BASES: Moderate coronary artery calcificationsLIVER, BILIARY TRACT: Low attenuation hepatic segment two lesion which shows discontinuous peripheral nodular enhancement compatible with benign hemangioma. Additional nonenhancing sharply marginated hepatic segment two lesion compatible with a benign cyst.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: There is a left adrenal nodule (series 10, image 59) measuring 1.9 x 2.2 cm which enhances and does not wash out. KIDNEYS, URETERS: Right renal simple cyst. Additional bilateral low-attenuation renal lesions too small to characterize. There is moderate left hydroureteronephrosis. There is a punctate (2 mm) calcific density in the region of the left ureterovesical junction which probably represents a passing calculus.RETROPERITONEUM, LYMPH NODES: See angiographic description above. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. No abnormal bowel wall thickening. No areas of abnormal enhancement. 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: Fat-containing right inguinal hernia and fat/fluid containing left inguinal hernia.OTHER: No significant abnormality noted | 1.Severe narrowing of the proximal SMA with flow present distally. No specific evidence of bowel ischemia.2.Left ureterovesical junction 2-mm calculus with associated moderate left hydroureteronephrosis.3.Left adrenal nodule which does not meet requirements for benign adenoma and is incompletely characterized. Metastasis cannot be excluded. |
Generate impression based on findings. | Ms. Ransmeier is a 39 year old female who initially presented with a palpable mass in the left superior breast. Prior ultrasound demonstrated a mixed echogenic lesion with internal calcifications, suggestive of fat necrosis versus an unusual galactocele. She presents today for a short-term ultrasound follow-up. Upon physical exam at the prior area of concern, a soft, mobile nontender mass is appreciated.A targeted left breast ultrasound was performed for the patient’s area of concern. In the left breast 12 o'clock location, approximately 4 cm from the nipple, there is now an echogenic lesion with punctate internal calcifications present, measuring approximately 1.2 x 0.7 x 1.2 cm. There is a minimal amount of associated vascularity. Findings are compatible with fat necrosis with dystrophic calcifications. No suspicious cystic or solid mass is identified. | Evolving fat necrosis with dystrophic calcifications in the left breast. As long as the patient's physical examination remains stable, a bilateral diagnostic mammogram with possible ultrasound is recommended in 6 months in order to confirm stability of these findings.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | Right leg limping.VIEWS: Pelvis AP/frog leg (two views), right tibia-fibula AP/lateral (two views) 02/27/15 The femoral head ossification centers are symmetric and well directed into normally formed acetabula. Femoral abduction and external rotation are performed symmetrically. A small amount of feces is seen in the rectosigmoid.The tibia and fibula are normal in appearance. No fracture is identified. | Normal pelvis and tibia-fibula. |
Generate impression based on findings. | S.O.B. and chest pain status post bronchial thermoplasty #1. History of iodine/CT dye allergy-SBP and rash. Premedicated. PULMONARY ARTERIES: Diagnostic 20 effusion without evidence of pulmonary embolus.LUNGS AND PLEURA: Motion artifact degrades image quality. Consolidation surrounding the airways of the right lower lobe may be post procedural. Intermittent areas of stenosis and bronchiectasis are seen within the right lower lobe bronchus and its branches. Assessment for pulmonary interstitial emphysema is limited.Mosaic attenuation of lung parenchyma.No pleural fluid or pneumothorax. MEDIASTINUM AND HILA: Normal heart size. No pericardial fluid or visible coronary artery calcification on this non-cardiac gated study. Mildly enlarged right hilar, interlobar and additional small regional lymph nodes nonspecific but in the postprocedural ascending are most likely reactive. Small right paratracheal chain lymph nodes are abnormal in multiplicity, nonspecific.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 embolus. Mild lymphadenopathy and extensive consolidation surrounding the airways of the right lower lobe may be post procedural and should be correlated with site of thermoplasty.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male 76 years old Reason: 75-year-old male patient with history of prostate cancer. Evaluate for progression History: NA CHEST:LUNGS AND PLEURA: Biapical scarring, unchanged. Calcified granuloma in the right lower lobe is unchanged. Subcentimeter noncalcified nodule in the right middle lobe is also unchanged.MEDIASTINUM AND HILA: Small mediastinal nodes are unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Stable subcentimeter lesions in the liver.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: 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: No significant abnormality notedOTHER: No significant abnormality noted | No significant change from previous study. |
Generate impression based on findings. | Male 45 years old Reason: HIP TOTAL ARTHROPLASTY PRIMARY UNCEMENT (Left HIP) . Components of a left total hip arthroplasty device are situated in near anatomic alignment. Gas density in the soft tissues reflects the surgical wound. A ringlike metallic density in the greater trochanter represents prior orthopedic intervention. Deformity and osteoarthritis of the right hip appears similar to that seen on the prior study. | Total hip arthroplasty (intra-operative) as above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 12 year old female with history of old avulsion injury of the right elbow. Medial condylar fracture traversing the articular surface with the distal fracture fragment displaced medially and anteriorly. The distal fracture fragment measures 1.7 cm x 1.5 cm. No joint effusion or soft tissue swelling is noted. | Medial condylar fracture with anterior and medial displacement of the distal fracture fragment. |
Generate impression based on findings. | Relapsed Hodgkin's s/p allo SCT. There are postoperative findings in the right lower neck. There is no significant cervical lymphadenopathy. For example, a right level 2 lymph node measures 8 mm in short axis, previously also 8 mm. There is unchanged mild prominence of the Waldeyer ring structures. The major salivary glands are unremarkable. There is mild atherosclerotic plaque at the carotid bifurcations. The osseous structures are unchanged. There is a partially imaged hyperattenuating mediastinal mass that encases the great vessels. | 1. No significant cervical lymphadenopathy.2. Partially imaged mediastinal mass. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | Male 71 years old Reason: Pt is a 70 y/o male with h/o urothelial cancer and h/o lung cancer, evaluate for recurrence, evaluate hydro History: urotheilal cancer, lung cancer CHEST:LUNGS AND PLEURA: Status post left upper lobectomy. Scattered micronodules and apical scarring, unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Small subcentimeter hypodensities, unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Small left adrenal gland is unchanged.KIDNEYS, URETERS: Bilateral renal cysts. Previously described bilateral hydronephrosis has resolved.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic calcifications involving the abdominal aorta and its major branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Status post cystoprostatectomy.BLADDER: Status post cystoprostatectomy. Neobladder is unremarkable.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Subcutaneous right gluteal benign-appearing lesion is unchanged.OTHER: No significant abnormality noted | Interval resolution of the bilateral hydronephrosis. |
Generate impression based on findings. | Multiple syncopal episodes and hitting head. Evaluate for bleed. There is no evidence of intracranial hemorrhage or mass effect. The ventricles and basal cisterns are unchanged in size and configuration. No hydrocephalus. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage or mass effect. If there is suspicion for acute ischemia, MRI can be considered for further evaluation. |
Generate impression based on findings. | Reason: Stage IVa NSCLC with pleural studding now s/p RT to proximal mass with good control of cough and dyspnea for routine surveillance eval History: none CHEST:LUNGS AND PLEURA: A right upper lobe perihilar soft tissue mass, with invasion into the adjacent mediastinum, now measures 3.5 x 2.8 x 3.4 cm (series 3, image 39; series 8024, image 32), decreased from the prior exam.Persistent mild associated obstructive consolidation and narrowing of the medial upper lobe bronchus.A right lower lobe soft tissue mass measures 4.7 x 3.7 cm (series 3, image 59), similar to the prior exam.Additional small pulmonary and subpleural nodules in the right hemithorax appears similar to the prior exam.Multiple small left pulmonary nodules measuring up to 6mm (series 4, image 16), are unchanged but suspicious for additional metastatic disease. No new pulmonary nodules are identified.Small right pleural effusion with extensive nodular pleural thickening compatible with metastasis, similar to the prior exam.MEDIASTINUM AND HILA: The heart is mildly enlarged, without pericardial effusion. No visible coronary artery calcification.The right upper lobe mass again causes pleural thickening/nodularity along the adjacent mediastinum, with loss of local mediastinal fat, suggestive of invasion. Enlarged mediastinal and hilar lymph nodes are again seen, similar to the prior exam. Reference low right paratracheal lymph node measures 16 mm (series 3, image 30), unchanged.CHEST WALL: Mild degenerative disease of the thoracic spine.A right supraclavicular lymph node measure 12 mm (series 3, image 15), unchanged.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Decrease in size of a right upper lobe soft tissue mass abutting the hilum and extending into the mediastinum, compatible with a known history of primary lung adenocarcinoma.2. Extensive metastatic disease throughout the right hemithorax is similar in appearance to the prior exam. Small nodules in the left lung are likely metastatic.3. No new sites of disease identified. |
Generate impression based on findings. | Male 67 years old Reason: Pt w/ necrotizing pancreatitis s/p multiple IR drains in fluid collections, most recent 12/29, please eval for resolution History: Abdominal abscess This study is limited due to lack of intravenous contrast.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable subcentimeter hypodensities in the liver. Cholelithiasis, unchanged.SPLEEN: No significant abnormality notedPANCREAS: Patient's known perisplenic collection near the tail of the pancreas has near completely resolved. Small amount of fluid and fat stranding is persistent in that area.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral atrophic kidneys with numerous hypodense lesions of various size and density. Lack of intravenous contrast precludes optimal characterization of these lesions. These are grossly unchanged.RETROPERITONEUM, LYMPH NODES: Infrarenal small abdominal aortic aneurysm measuring 2.7-cm in its largest AP dimension.BOWEL, MESENTERY: There is a double-J stent with both tips within the stomach.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: Transplant kidney in the right iliac fossa.OTHER: No significant abnormality noted | Limited study due to lack of intravenous contrast. New complete resolution of the patient's known collection near the pancreatic tail. |
Generate impression based on findings. | Male 69 years old Reason: Pt is a 68 y/o male with prostate cancer, hematuria, check CT urogram, delayed views, 3D reconstruction History: prostate cancer ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cirrhotic liver. Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral multiple stones largest measuring 10 mm in the upper pole of the right kidney. No evidence of hydronephrosis. Minimally complex right renal cyst measuring 5.3 x 5.2 cm. The cyst contains a thin septationRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.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: No significant abnormality notedOTHER: No significant abnormality noted | Cirrhotic liver.Bilateral nephrolithiasis. |
Generate impression based on findings. | Anisocoria, unresponsive pupils. Evaluate for bleed or herniation. Image quality is significantly degraded by motion artifact and portable technique. There is no definite evidence of intracranial hemorrhage or mass effect. There is global parenchymal volume loss. There is unchanged encephalomalacia in the right parietal, occipital and temporal lobes with ex vacuo dilatation of the atrium of the right lateral ventricle. There is patchy periventricular and subcortical white matter hypoattenuation consistent with small vessel ischemic disease, unchanged. The ventricles and basal cisterns are unchanged. There is no midline shift. There are atherosclerotic calcifications in the bilateral cavernous carotid arteries. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. Nasogastric and endotracheal tubes are partially imaged. | 1. Limited study due to motion artifact. No gross acute intracranial hemorrhage. No intracranial mass effect or herniation.2. Unchanged encephalomalacia in the right cerebral hemisphere. |
Generate impression based on findings. | Metastatic prostate cancer to bones. There are multiple osseous foci of uptake with slight increase in conspicuity of some lesions. Specifically, there is increased confluence and uptake within the bilateral ilia, pubic bones, spine, and proximal femurs. Metastatic lesions within the ribs also appear more confluent. | Stable distribution of numerous osseous metastatic lesions. No definite new lesions are identified. |
Generate impression based on findings. | Male 73 years old Reason: history of metastatic prostate cancer to bones, nodes reeval History: prostate cancer to bones CHEST:LUNGS AND PLEURA: Bilateral pulmonary nodules are overall unchanged. Index left lower lobe nodule measures 1.2 by 1 cm on image number 84, series number 5.MEDIASTINUM AND HILA: Small mediastinal lymph nodes, unchanged.CHEST WALL: Stable sclerotic foci in the proximal humeri, thoracic spine, sternum and ribs.ABDOMEN:LIVER, BILIARY TRACT: Mild biliary prominence is unchanged. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal cysts are unchanged. There is a punctate stone in the midright kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Sclerotic bone metastases are unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Previously described fluid collection in the anterior abdominal wall along the incision is smaller and now measures 4.6 by 1.9-cm on image number 170, series number 3. Stable sclerotic metastases to the pelvis.OTHER: No significant abnormality noted | Interval decrease in the size of the anterior abdominal wall fluid collection. Bone metastases are grossly stable. Lung nodules are also stable. |
Generate impression based on findings. | 12 year old female with right elbow varus deformity. Assess alignment.VIEWS: Right humerus AP and lateral (two views) 2/27/2015 10:55 Redemonstration of medial condylar fracture in the distal humerus as described on recent elbow radiograph. The proximal and mid humerus is normal in alignment with no evidence of fracture or dislocation. | Distal humeral medial condylar fracture with no other abnormality in the remaining humerus. |
Generate impression based on findings. | Female 25 years old Reason: 25F s/p lap chole c/b peritonitis/leak requiring takeback for ex lap washout with placement of drains x 3 all have been since removed. eval for any recurrence of intraabdominal collections History: s/p ex lap, washout for leak following lap chole. drains out, on oral abx, please eval for intraabdominal fluid collections ABDOMEN:LUNG BASES: Bibasilar atelectasis. Interval resolution of small left pleural effusion.LIVER, BILIARY TRACT: Findings compatible with fatty infiltration of the liver. Status post cystectomy. Plastic stent is present in the common bile duct with distal tip in the duodenum.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: Interval removal of enteric tube. Mild wall thickening of the loops of small bowel in the left upper quadrant, probably inflammatory in etiology. BONES, SOFT TISSUES: Midline abdominal surgical defect with a small loculated fluid collection at the anterior abdominal wall(series 3, image 19). Interval removal of previous peritoneal drains. OTHER: Scattered small loculated fluid collection in the left upper quadrant which are decreased in size with the largest now measuring 5.2 x 1.5 cm (series 3, image 96). There may be a foci of gas in the most medial fluid collection (Series 3, image 105)PELVIS:UTERUS, ADNEXA: Intrauterine device in place within the uterus.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Small loculated fluid collection in the pelvis which is decreased in size now measuring 5.1 x 2.0 cm (series 3, image 137). | Interval improvement in multiloculated abdominal fluid collection status post removal of intraperitoneal drains. Small residual scattered loculated fluid collections. |
Generate impression based on findings. | Nearly 2 year history of right neck/jaw swelling that was first noted in 2013 with fever and mild swelling to face. There is prominent right level 2B lymphadenopathy, measuring up to 3 cm. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. There is minimal scattered paranasal sinus mucosal thickening. The imaged portions of the lungs are clear. | Right upper cervical lymphadenopathy. Differential considerations include infectious, inflammatory or granulomatous, and neoplastic processes. |
Generate impression based on findings. | Ms. Martinez is a 68 year old female with biopsy proven malignancy within the right breast, 9 o'clock location. She had an ultrasound guided seed localization on 2/23/2015 in preparation for lumpectomy on 2/27/2015. Two specimen radiographs were obtained. The biopsy proven malignancy, Hydromark clip, and radioactive seed are all seen within the specimen. The biopsy-proven malignancy appears close to the inferomedial margin, which will be reexcised per conversation with Dr. Chhablani. | Specimen radiograph contains malignancy, biopsy clip and seed. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 65 year old woman with history of left breast surgery, patient unable to remember why and no clinical history in chart. Three standard views of both breasts and ML and CC spot magnification 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 density, unchanged in pattern and distribution. In the right breast, there are multiple round, circumscribed masses at the 6'o clock and 12'o clock position at central depth.In the left breast, linear scar markers delineate the upper breast and axillary scars. There are surgical clips with local architectural distortion in the left upper inner breast. At the 12' o clock position, there are grouped, punctate and linear calcifications.ULTRASOUND | 1. Right breast cysts.2. Left breast calcifications, not clearly benign in morphology. Short term followup is recommended with a left unilateral diagnostic mammogram in 6 months. Results and recommendation were discussed with the patient.3. Post-operative findings of left lumpectomy and left axillary surgery. BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - Followup at Short Interval (1-11 Months). |
Generate impression based on findings. | 44 year old woman with history of right breast/skin mass x 5 years. History of maternal aunts with breast cancer. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over the right axilla.SONOGRAPHIC | 1. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.2. Small area of focal skin thickening in the right medial breast without underlying mass or abscess.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 55 year old with known bilateral calcifications and cysts. History of bilateral biopsies and aspirations. No new 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 heterogeneously dense, unchanged in pattern and distribution. Diffuse benign calcifications are unchanged in both breasts. 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: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
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