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Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Paternal aunts 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. Symmetric prominent lymph nodes are present in each axilla. | 1. No mammographic evidence of malignancy in the breasts. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.2. Prominent symmetric axillary lymph nodes for which correlation with physical exam and history of any underlying systemic causes is recommended. BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of colon cancer, diagnosed approximately 20 years ago. 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. Linear markers were placed on scars overlying both breasts. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms are submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 11 day old male with PICC pulled back 1 cm, evaluate placement.VIEW: Chest AP (one view) 2/27/2015 14:58 Left upper extremity PICC has been retracted with tip located in the left internal jugular vein. Interval removal of umbilical venous catheter. Cardiothymic silhouette is upper limits of normal. No focal pulmonary opacities. No pleural effusion or pneumothorax. | Left upper extremity PICC tip located in the left internal jugular vein. |
Generate impression based on findings. | 36-year-old male with opacity noted right lower lung field on CXR and dilated veins noted on anterior abdominal and chest wall. Evaluate for IVC patency, portal HTN, masses. CHEST:LUNGS AND PLEURA: Mild basilar scarring without consolidation or pleural effusions. Calcified granuloma in the left lung base.MEDIASTINUM AND HILA: Complete SVC stenosis just superior to right atrium with markedly enlarged azygous vein and extensive venous collateralization. Normal heart size. No hilar or mediastinal lymphadenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Status-post cholecystectomy. The portal venous system is patent.SPLEEN: No significant abnormality notedPANCREAS: Pancreatic duct is mildly dilated throughout its course to the ampulla.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: End-stage atrophic kidneys with multiple cysts.RETROPERITONEUM, LYMPH NODES: A left femoral vein central venous catheter is present with its proximal tip in the IVC. The IVC is patent. Markedly enlarged azygos and hemiazygos venous systems are present.BOWEL, MESENTERY: Postsurgical changes of partial duodenectomy with Billroth II gastrojejunostomy and right hemicolectomy with right lower quadrant ileostomy and left lower quadrant mucous fistula. Small bowel is mildly dilated throughout suggestive of ileus without obstructionBONES, 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: See aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Complete SVC stenosis just superior to right atrium with extensive venous collateralization. Etiology uncertain, but may be related to prior catheter. 2.Postsurgical changes of partial duodenectomy with Billroth II gastrojejunostomy and right hemicolectomy with right lower quadrant ileostomy and left lower quadrant mucous fistula. Mildly dilated small bowel suggesting ileus without obstruction. 3.No evidence of pneumonia or portal hypertension as clinically questioned. |
Generate impression based on findings. | Bone metastases. Activity is again noted in the thoracolumbar spine and right humerus. The activity within the T12 vertebral body has become more prominent in the interim. The abnormal increased of activity in a right lateral 8th thoracic rib has also become more prominent. There is a questionable new focus of activity in the lateral right 7th thoracic rib. Activity within the knees and shoulders is likely degenerative in etiology. Activity in the lower pelvic region on initial images is no longer visible on post-void, post-cleaning spot images and likely reflects artifact from tracer in the urine. | Interval increased intensity of the T12 vertebral body lesion and the right 8th rib and questionable new lesion in the right 7th rib represents possible progression of metastases. |
Generate impression based on findings. | Grey-white differentiation appears decreased diffusely, although cortex remains discernible in terms of difference in attenuation with respect to white matter. Is a small focus of abnormal density along the left caudate head. No definite abnormal attenuation is appreciated along the globus pallidus or putamen at this time.The ventricles and sulci are prominent, consistent with mild age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is prominent fluid in the visualized pharynx and posterior nasal cavity. There is a focal area of nonspecific subgaleal thickening along the left posterior parietal region. | No acute intracranial hemorrhage. Diffuse decreased gray white differentiation, suggesting diffuse hypoxic ischemic injury. Small area of focal low-density in the left caudate which may represent an age indeterminate lacunar infarct. MRI could be obtained for further evaluation, as clinically indicated. |
Generate impression based on findings. | Female 41 years old Reason: 41yo female with advanced stage cervical cancer, completed radiation 8/2014, right LE doppler showed reduced venous flow but no DVT, please evaluate vasculature for pelvic DVT versus extrinsic compression of vein from pelvic mass History: Right groin pain, right LE pain, right LE edema, pain worse with walking Exam is limited secondary to lack of oral contrast, making evaluation of bowel pathology suboptimal. Within these limitations, the following observations are made:CHEST:LUNGS AND PLEURA: The exam is suboptimal secondary to motion artifact. There are bibasilar atelectasis/consolidations which may represent infectious etiology. MEDIASTINUM AND HILA: Mild cardiomegaly. Heart size was normal in size on previous exam. Interval development of small pericardial effusion. There appears to be on incompletely imaged tubular structure within the proximal esophagus (series 6, image 1). The clinical service was contacted and the patient is not intubated and has no external tube in place. The etiology is unclear. CHEST WALL: Right chest wall port with tip at the cavoatrial junction. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Moderate right hydronephrosis despite nephroureteral stent in place. No left hydronephrosis.RETROPERITONEUM, LYMPH NODES: Prominent retroperitoneal lymph nodes. Reference left periaortic lymph node measures 1.2 x 0.8 cm (series 6, image 120).BOWEL, MESENTERY: No evidence of bowel obstruction. No intraperitoneal free air.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Ill-defined lesion at the expected location of the cervix with adjacent radiation pellets.BLADDER: No significant abnormality noted.LYMPH NODES: Pelvic lymphadenopathy along the right inguinal and right external iliac chains. Reference right inguinal lymph node measures 1.9 by 1.6 cm (series 6, image 200).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Marked increase in size of the right pelvic mass which invades the pelvis side wall and encases the vasculature including the right common and external iliac veins and arteries. The mass abuts the right iliac without cortical destruction. The mass measures 6.9 x 4.1 cm (series 6, image 169), previously 3.8 x 3.8 cm (series 4, image 77 on outside imaging). Soft tissue edema in the proximal right lower extremity is noted.OTHER: No significant abnormality noted. | 1.Marked increase in size of the right pelvic mass which invades the pelvis side wall and encases the vasculature including the right common and external iliac veins and arteries. 2.New bibasilar atelectasis/consolidations which may represent infectious etiology. 3.Interval development of mild cardiomegaly with small pericardial effusion. 4.Moderate right hydronephrosis despite nephroureteral stent in place.5.There is an incompletely imaged tubular structure within the proximal esophagus with unclear etiology. The clinical service was contacted and the patient has not had previous surgery in that area, is not intubated, and has other no external tube in place. Findings were discussed by telephone with the clinical service, Dr. Jennifer Rosenbaum, at 3:50 p.m.. on 2/27/2015. |
Generate impression based on findings. | 45 years, Female. Reason: 45yo known pancreatitis w/pseudocyst with recent drainage. Increasing abd distention. Eval for r/o obstruction, ileus, volume overload History: abd distention Nonspecific patchy basal opacities. Nasointestinal feeding tube in situ. Gastrocystostomy stent is projected over the left upper quadrant. Embolization coils projected over the left upper abdomen. Enteric contrast opacifies the large bowel. Prominent small bowel loops , likely reflecting ileus pattern. Displacement of bowel loops from the right upper quadrant likely secondary to hepatomegaly. | Prominent central small bowel loops, likely reflecting ileus pattern. |
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. A subtle area of architectural distortion is identified in the right superior breast (best seen on the CC view). No suspicious masses, microcalcifications or areas of architectural distortion are present in the left breast. | Subtle area of architectural distortion 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. | Female 76 years old Reason: OGT History: intubated Enteric tube with tip projected over the proximal gastric body. Intravenous contrast material opacifies the bilateral collecting systems and bladder. Nonobstructive bowel gas pattern. | Enteric tube with tip projecting over the proximal gastric body. |
Generate impression based on findings. | 66 years, Female. Reason: Evaluate bowel gas pattern, stool burden History: abdominal pain, constipation Surgical clips projected over the right quadrant. Venous catheter in situ. Multiple prominent gas filled loops of small and large bowel likely reflecting an ileus pattern. The lower pelvis is not imaged. | Multiple prominent gas filled loops of small and large bowel likely reflecting an ileus pattern. |
Generate impression based on findings. | Male 59 years old; Reason: eval dht placement History: dht placement Dobbhoff tube terminates at the antropyloric region.Multiple lines tubes and support devices project over the chest and abdomen.Upper abdominal bowel gas pattern is nonobstructive.Cardiomegaly and left lower lobe pulmonary opacity. | 1.Enteric tube terminates at the antropyloric region. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in maternal aunt and cousin. 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. Scattered benign punctate calcifications are present in the right breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | PHARYNX/LARYNX: The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The right submandibular gland is somewhat more rounded and larger than the contralateral side, underlying a skin surface marker. Just cranially, there is a small 1.0-cm right level Ib lymph node which has a fatty hilum. The postcontrast appearance of the salivary glands is otherwise unremarkable. The thyroid gland is unremarkable. ORAL CAVITY: The oral tongue and floor of mouth are unremarkable, within the limitations of this exam as there is artifact from dental amalgam.CERVICAL SOFT TISSUES: There are no pathologically enlarged cervical lymph nodes.OTHER: Postoperative changes are seen from previous anterior surgical fusion of C5 and C6, with prominent degenerative changes at C6-C7. There is trace atherosclerotic calcification at the right carotid bifurcation. | No evidence of cervical lymphadenopathy. Slight asymmetric prominence of the right submandibular gland underlying the skin surface marker in area of patient's palpable concern, with more superficial normal sized nonpathologic lymph node. |
Generate impression based on findings. | 50 year old woman with history of bilateral breast cysts. Complains of cyclical bilateral breat pain. Three standard views of both breasts along with CC and ML compression views of the breasts bilaterally 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. Multiple partially obscured masses are seen in the breasts bilaterally. No suspicious microcalcifications or areas of architectural distortion in either breast. SONOGRAPHIC | Bilateral simple cysts but no mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, given the complex appearance of the patient's breasts, 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. | Female 43 years old Reason: 43 F with UC s/p J pouch now with anal stenosis and high frequency bowel movements. S/p EUA today and unable to determine location of proximal lumen History: anal stenosis, frequent BM Omnipaque flowed freely through the J-pouch. There is a focal area of approximately 60% luminal narrowing approximately 6 cm from the anal verge. The pouch appears featureless and rigid suggestive of ongoing inflammation. There is an abnormal fistulous connection between the right anterolateral aspect of the pouch and an adjacent loop of small bowel, likely mid ileum. | 1. Focal stenosis of the J-pouch approximately 6 cm from the anal verge. Rigid featureless appearance to the pouch suggestive of ongoing inflammation.2. Abnormal fistulous connection between the pouch and an adjacent loop of mid ileum.The imaging appearance is suspicious for inflammatory bowel disease. |
Generate impression based on findings. | 57 year old presents for routine mammogram. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements. There is a small benign intramammary lymph node in the left upper outer quadrant.No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Headaches, HTN, mild proptosis, and history of PCOS. There is no evidence of acute intracranial hemorrhage or mass. 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 imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | No evidence of acute intracranial hemorrhage, mass, or cerebral edema. |
Generate impression based on findings. | Effusion and osteoarthritis Near severe osteoarthritis affects the left knee with medial joint space narrowing and tricompartmental osteophytes. These findings have progressed since 2008. A moderate joint fusion is present. Chondrocalcinosis of the menisci is notedNear severe osteoarthritis affects the right knee as seen on the frontal view, which has also progressed compared to the prior study. Chondrocalcinosis of the menisci is noted. | Near severe osteoarthritis and chondrocalcinosis. |
Generate impression based on findings. | Male; 33 years old. Reason: status of transplant graft. History: pain over transplant site RENAL TRANSPLANT: LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: Again seen is a complex fluid collection along the posterior aspect of the transplanted kidney. When measured similarly it is 1.9 x 1.8 x 0.6 centimeters (previously 1.8 x 1.9 x 0.8 cm).KIDNEY: The transplant kidney measures 12.9 cm in length. The cortex is increased in echogenicity. No shadowing caliculi or suspicious lesions evident.COLLECTING SYSTEM/URETER: There is persistent mild dilation of the transplant collecting system.URINARY BLADDER: The bladder wall appears thickened however the bladder is not fully distended.VASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels.The iliac artery and anastomoses are patent. The peak systolic velocity of the iliac artery is 0.9 m/sec. The peak systolic velocity at the anastomosis is 0.8 m/sec with a resistive index of 0.80. The renal arteries are patent with velocities of 0.4-0.9 m/sec (resistive indices 0.73-0.79). The segmental arteries are patent with velocities of 0.2-0.3 m/sec (resistive indices 0.57-0.72).The arcuate arteries are patent with velocities of 0.2 m/sec (resistive indices 0.69-0.73).The iliac vein and renal vein are patent. OTHER: No significant abnormality noted | 1.Patent renal transplant vasculature.2.Mild hydronephrosis, unchanged compared to the prior ultrasound.3.Stable size of peritransplant hematoma. |
Generate impression based on findings. | There is a stable right frontal approach ventriculostomy catheter, with its tip near the right foramen of Monro. There is no interval increase in extent of parenchymal hemorrhage surrounding the catheter in the right frontal lobe, with the hematoma now measuring 1.6-cm transverse by 2.8 cm AP, compared to previous 1.2 x 2.1 cm. There is also suggestion of linear areas of possible layering of blood products of varying ages within the hematoma cavity. There has been slight interval increase in size of the lateral ventricles including the temporal horns compared to the previous exam. The increasingly casted third and fourth ventricles are also very minimally increased in size. There remains diffuse bilateral scattered subarachnoid blood products within the sulci and additional hemorrhage in the ventricles. Streak artifact is again seen from a right juxtasellar coil mass.There is no midline shift or mass effect. There is no extraaxial fluid collection. There is slight focal prominence of extra-axial space along the left superolateral posterior fossa. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is slight under pneumatization of the right mastoid air cells. | 1. Stable right frontal ventriculostomy catheter with slight interval increased size of the lateral ventricles.2. Interval increase in size of right frontal pericatheter parenchymal hematoma.Dr. Yang contacted Dr. GINA BRADLEY on 2/27/2015 3:32 PM with these findings, and the referring service confirmed it was aware. |
Generate impression based on findings. | Reason: sputum + MAI, also need to r/o bronchiectasis History: cough LUNGS AND PLEURA: Moderate apical predominant centrilobular emphysema.No suspicious pulmonary nodules or masses. Moderate scattered basilar scarring/subsegmental atelectasis, decreased in prominence from the prior exam. No focal airspace consolidation.Mild bronchial wall thickening. No evidence of bronchiectasis.No pleural effusions.MEDIASTINUM AND HILA: The heart is enlarged, without significant pericardial effusion. No visible coronary artery calcification. The main pulmonary artery measures 3.9 cm in diameter, unchanged, suggestive of pulmonary hypertension.Mildly prominent mediastinal and hilar lymph nodes appear similar to the prior exam. A right paratracheal lymph node measures 13 mm (series 3, image 21).CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Mild basilar scarring without evidence of acute inflammatory or infectious process. No evidence of bronchiectasis.2. Marked enlargement of the pulmonary artery suggests pulmonary hypertension.3. Moderate centrilobular emphysema. |
Generate impression based on findings. | Left ankle fracture The oblique fracture of the distal fibula with approximately one shaft width posterolateral displacement of the distal fracture fragment is again seen, with increased callus formation reflecting some interval healing.The posterior subluxation of the talus relative to the long axis of the tibia with associated posterior malleolar fracture is again seen, with increased callus formation reflecting some interval healing.The horizontal fracture of the medial malleolus with slight lateral displacement of the distal fracture fragment is similar to the prior study, with sclerotic margins along the fracture line. The defect in the calcaneus, presumably related to prior external fixation, is again noted. Deformity of the distal tibial diaphysis reflecting old injury is incompletely visualized but appears similar to prior. | Ankle fracture/subluxation, as described above. |
Generate impression based on findings. | Female 69 years old; Reason: eval for acute change History: abdominal pain Contrast from prior CT scan now resides within the colon. There is mucosal thickening of the small bowel loops in the right lower abdomen.Postsurgical changes with a surgical staple line in the right upper abdomen and multiple abdominal clips.IVC filter is in place. Gastrostomy tube projects over the stomach.Postsurgical changes in the left hip and pelvis with sclerotic left pelvic lesion. | 1.Abnormal small bowel mucosal pattern in the right lower abdomen.2.No plain film radiographic findings of obstruction.3.Consider further evaluation with MR enterography for evaluating the small bowel. |
Generate impression based on findings. | Female 58 years old Reason: ? gallstones, chronic abscess History: Abd pain after colonoscopy ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No focal hepatic mass or biliary ductal dilatation. No ascites. No cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: Abrupt dilatation of the distal pancreatic duct from the level of the body to the tail (series 4, image 33). This finding is suspicious for malignancy and further characterization with MRCP is recommended.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild small bowel dilatation measuring up to 2.4 cm (series 80212, image 72) without a transition point and with stool distally. This may represent a component of ileus. No intraperitoneal free air. No intra-abdominal fluid collection.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Distended bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Abrupt dilatation of the distal pancreatic duct is suspicious for malignancy. Further characterization with MRCP is recommended.2.Mild dilatation of the small bowel which is suggestive of ileus.3.No evidence of cholelithiasis or intra-abdominal fluid collection, as clinically questioned.The findings were discussed by telephone with Dr. Cifu, from the clinical service, at 4 p.m.. on 2/27/2015. |
Generate impression based on findings. | Pain after crush injury in the long and ring fingers. No fracture or malalignment is evident. Otherwise, no specific findings to account for the patient's pain are seen. | No fracture or malalignment. |
Generate impression based on findings. | Female 42 years old; Reason: s/p shoulder arthroscopy, continued pain and decreased ROM Rotator cuff anchor noted in the humeral head. No fracture or malalignment is present. Mild acromioclavicular joint osteoarthritis is noted, similar to prior. The humeral head is demineralized, possibly secondary to disuse. | No specific radiographic findings to account for the patient's pain. |
Generate impression based on findings. | Shoulder pain No fracture or malalignment is seen. Minimal osteoarthritis affects the glenohumeral joint. Otherwise, no specific findings to account for the patient's pain. | No specific findings to account for the patient's pain. |
Generate impression based on findings. | Shortness of breath. The comparison chest radiograph performed on 2/27/2015 demonstrates cardiomegaly but no focal pulmonary opacities or pleural fluid. The ventilation images show a delayed wash-in of activity on single-breath and wash-in images. There is diffusely retained Xe-133 during the wash-out phase. The perfusion images show scattered small match defects. No evidence of a mismatched defect. | Delayed washout on ventilation images with a low probability scan for a PE. |
Generate impression based on findings. | Reason: H/o AML and presumed fungal pneumonia, improved on Ambisome then remained stable on oral agents. Now back on Ampho x 2 weeks, please eval for improvement. History: fungal pna LUNGS AND PLEURA: Persistent right lower lobe consolidation is not significantly changed from the prior exam.Scattered right basilar subsegmental atelectasis/scarring, unchanged. Small right partially loculated pleural effusion is decreased.Mild left lung subpleural scarring, decreased in prominence from the prior exam. Mild centrilobular and paraseptal emphysema.MEDIASTINUM AND HILA: The heart is normal in size, without pericardial effusion. Severe coronary artery calcification. Hypoattenuation of the blood pool, suggestive of anemia.No mediastinal or hilar lymphadenopathy.Right arm PICC, tip at the cavoatrial junction.CHEST WALL: Mild degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Diffusely hyperdense liver parenchyma. Correlate with medication history. | Stable right lower lobe consolidation, with decreased associated right pleural effusion. No new areas of infection or other acute abnormality identified. Recommend follow-up to complete radiographic resolution. |
Generate impression based on findings. | 19 year-old female with intermittent acute abdominal pain, nausea, and vomiting evaluate for intussusception, volvulus, ovarian cyst. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal round low attenuation lesion probably benign cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Appendix is well-visualized and unremarkable. No intraperitoneal free air or free fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Adnexa are not well visualized.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Appendix is well-visualized and unremarkable. No intraperitoneal free air or free fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No specific findings to account for patient's pain.2.Adnexa are not well visualized. If there is clinical concern for adnexal pathology, recommend pelvic ultrasound. |
Generate impression based on findings. | Postoperative changes are seen from previous right frontal craniotomy/cranioplasty with underlying right frontal lobe hypoattenuating encephalomalacia. There is diffuse enlargement of the bony sella, with associated abnormal soft tissue mass filling the sella and suprasellar cistern. The mass demonstrates diffuse homogeneous enhancement best appreciated the dedicated orbit images. The mass measures 2.1-cm transverse by 1.9-cm AP by 2.7 cm CC, with possibly a few areas of heterogeneity centrally versus artifact. The mass has a bilobed appearance on coronal images, with greater caudal extent of the sella floor on the right as compared to the left. The internal carotid arteries are minimally splayed distally, with elevation of the A1 segments. The optic chiasm is difficult to delineate on this CT exam but is likely significantly elevated.The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear.The intracranial internal carotid arteries are normal in course and caliber. The left A1 segment is hypoplastic. The middle and anterior cerebral arteries are otherwise unremarkable. The post-PICA left V4 segment is developmentally diminutive. The vertebral arteries, basilar artery, and posterior cerebral arteries are otherwise normal in course and caliber. The right vertebral artery is dominant. There is no evidence of flow-limiting stenosis or aneurysm.CTA NECK | 1. Large enhancing bilobed appearing mass centered in the sella with extensive suprasellar extension and presumed elevation of the optic chiasm although this is not well delineated on CT, and MRI sella is recommended for further evaluation. This most likely represents a pituitary macroadenoma. Mild splaying and elevation of adjacent intracranial vasculature without narrowing.2. Unremarkable CTA of the head and neck.3. Right frontal postoperative changes with underlying encephalomalacia along the right frontal lobe. |
Generate impression based on findings. | Female 71 years old Reason: dislocation History: fracture humeral head . Four views of the right shoulder show a transverse comminuted fracture of the surgical neck of the right humerus with the distal fracture fragment in near anatomic alignment. | Comminuted humeral fracture. |
Generate impression based on findings. | Female 27 years old; Reason: signs of obstruction History: abdominal pain Mild gaseous distention of small bowel in the left upper abdomen. There is colonic gas scattered throughout the colon. The bowel gas pattern is nonobstructive. No definite intraperitoneal free air. | 1.Nonobstructive bowel gas pattern |
Generate impression based on findings. | Reason: 67y/o with h/o AML, who has recently undergone a stem cell transplant and is immunosuppressed. Has persistent cough for about 3 weeks. History: persistent cough in an immunosuppressed host. LUNGS AND PLEURA: Scattered benign-appearing micronodules and calcified granulomas are unchanged.Apical pleural scarring, stable. Right middle lobe subpleural scarring is stable from the prior exam, compatible with prior radiation therapyNo focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size, with small pericardial fluid/thickening, stable. Moderate coronary artery calcification. Hypoattenuation of the blood pool, suggestive of anemia. Right IJ central venous catheter, tip at the cavoatrial junction.Scattered small calcified mediastinal and hilar lymph nodes from prior granulomatous disease. No lymphadenopathy.CHEST WALL: Surgical changes and skin thickening of the right breast, and status post right axillary lymph node dissection.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of infection or other acute abnormality. |
Generate impression based on findings. | Pain. Evaluate for leg length discrepancy The femoral heads, femoral condyles, tibial plateaus, and ankle mortises are symmetric in the craniocaudal plane when comparing right and left. Moderate osteoarthritis affects the knee joints bilaterally, particularly at the lateral compartments. Calcifications projecting over the pelvis may represent uterine fibroids. | No leg length discrepancy apparent. |
Generate impression based on findings. | Facial swelling, poor dentition, new periorbital involvement. There are multiple dental caries. There is an apparent crescentic low-attenuation area overlying the left maxillary alveolus, which appears focally dehiscent. There is also extensive stranding and swelling of the overlying facial soft tissues, including the left preseptal region. However, there is no evidence of postseptal involvement. Indeed, the bilateral orbital contents are unremarkable and the orbital walls are intact. There is opacification of the bilateral ethmoid air cells and left maxillary sinus with suggestion of fluid components. There is left suprahyoid reactive lymphadenopathy. The middle ears and mastoid air cells are clear. The imaged intracranial structures appear to be unremarkable. | Dental caries associated with acute sinusitis and facial cellulitis with possible early abscess formation, but no evidence of post-septal extension. |
Generate impression based on findings. | History of marginal zone lymphoma. Re-evaluation.RADIOPHARMACEUTICAL: 15 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 82 mg/dL. Today's CT portion grossly demonstrates small level II lymph nodes. There is redemonstration of a left paramediastinal opacity with air bronchograms and associated hilar enlargement, similar to the prior examination. Today's PET examination demonstrates mild diffuse activity within the left paramediastinal opacity (max SUV = 3.9, previously 4.8). No FDG avid lesion is identified in the neck, abdomen, or pelvis. | Slight decrease in activity of the left paramediastinal opacity which likely is inflammatory or post-therapeutic change. No evidence of FDG avid tumor. |
Generate impression based on findings. | Left knee pain The left knee is status post ACL repair. Small osteophytes are noted. No fracture or malalignment is present. No large joint effusion is evident.The right knee is status post ACL repair as well, as seen on frontal views. | Small left knee osteophytes, without fracture or malalignment. |
Generate impression based on findings. | Left total knee arthroplasty. The left total knee arthroplasty device is situated in near anatomic alignment, without radiographic evidence of hardware complication. Soft tissue gas, skin staples, and surgical drain reflect recent surgery. | Left total knee arthroplasty. |
Generate impression based on findings. | There is no evidence of mass lesions or significant cervical lymphadenopathy. There is mild prominence of the bilateral palatine tonsils. There is mild diffuse enlargement of thyroid gland with a subcentimeter left thyroid lobe hypoattenuating nodule. There are a few nonspecific subcentimeter bilateral parotid gland soft tissue attenuation nodules likely representing nonenlarged intraparotid lymph nodes. The major salivary glands are otherwise unremarkable. There is minimal atherosclerotic calcification in the left carotid bifurcation. The right vertebral artery is hypoplastic. The major cervical vessels are patent. The osseous structures show no focal lesions. The airways are patent. The trachea appears normal in caliber. The cervical esophagus is collapsed an inadequately assessed but appears within normal limits. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | 1.No suspicious neck masses or evidence of airway narrowing. No apparent upper esophageal or tracheal abnormality. May consider esophagram/swallow study for evaluation of dysphagia if clinically indicated.2.Mild diffuse thyroid enlargement with subcentimeter left thyroid lobe hypoattenuating nodule. No significant associated tracheal narrowing.3.Mild prominence of the bilateral palatine tonsils without focal masses. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with slightly progressed moderate age-related volume loss. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are confluent areas of abnormal low density in predominantly the middle to inferior frontal periventricular and subcortical white matter, which appear progressed and may relate to moderate chronic small vessel ischemic changes although given the location of findings, there is also possibility of post traumatic encephalomalacia. There may be minimal cortical involvement on the right. There is no extraaxial fluid collection. There is mild mucosal thickening in the diminutive maxillary sinuses. There is underpneumatization of the mastoids. The remainder of visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There are large filling defects in the external auditory canals, likely cerumen. | No acute intracranial hemorrhage. Progression of abnormal low density in the white matter of the middle to intervention lobes which may relate to post traumatic encephalomalacia and/or small vessel ischemic changes. If there remains clinical concern for an acute ischemic event, MRI of the brain is recommended. |
Generate impression based on findings. | Female 74 years old Reason: 74 yo feamle who was found to have a abnormality of pancreas on PET Scan. EUS done here 6cm distal pancreas mass. Needs Pancreas protocol Ct Scan to evaluate lesion. History: none ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Wedge-shaped, nonspecific hypodensity in the right lobe of the liver measuring 2 x 1.5 cm on image number 50, series number 10 is unchanged compared to CT dated 12/7/2010. No other focal liver lesions.SPLEEN: No significant abnormality notedPANCREAS: Patient's known large uniloculated cystic mass in the body and tail of the pancreas measures 5.8 x 5 cm on image number 48, series number 10 and, increased in size compared to previous study. This cystic mass is suspicious for a mucinous cystadenoma/carcinoma. Note definite solid component is noted within this lesion. The remainder of the pancreas is unremarkable. ADRENAL 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: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 | Interval increase in the size of the uniloculated, well-defined cystic lesion in the body/tail of the pancreas suspicious for a mucinous cystic neoplasm.Nonspecific wedge-shaped hypodensity in the liver is unchanged. |
Generate impression based on findings. | 80 years, Male, Reason: History of melenic stools, Hgb at admission 6.1, EGD/Colonscopy with 2 small AVM cauterized, no evidence of active bleelding or obvious source of bleeding. Please evaluate History: As above. ABDOMEN:LUNG BASES: Mild basilar atelectasis. Mitral valve calcifications.LIVER, BILIARY TRACT: Calcifications in the right hepatic lobe.SPLEEN: Small splenule.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Severe right-sided hydronephrosis and parenchymal loss, likely chronic. There are a few small calcifications along the right renal pelvis. There are a few small punctate left renal calcifications without hydronephrosis.RETROPERITONEUM, LYMPH NODES: Moderate atherosclerotic calcifications of the aorta with mild aneurysmal dilatation of the infrarenal aorta measuring 3.3 x 3.2 cm. scattered small retroperitoneal lymph nodes.BOWEL, MESENTERY: Metallic focus along the distal transverse colon. Right lower quadrant ostomy. Diverticulosis with minimal fat stranding adjacent to the sigmoid colon. No active bleed is identified.BONES, SOFT TISSUES: Mild degenerative changes of the spine.OTHER: No significant abnormality notedPELVIS: MalePROSTATE, SEMINAL VESICLES: Status post cystoproctectomy. Penile implant with reservoir within the left inguinal canal.BLADDER: Status post cystoproctectomy with diverting loop ileostomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: See aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No evidence of active gastrointestinal hemorrhage.2.Severe right-sided hydronephrosis which is likely chronic.3.Mild aneurysmal dilatation of the infrarenal abdominal aorta.4.Contrast extravasation as above. |
Generate impression based on findings. | Metastatic prostate cancer, evaluate of disease as baseline for initiation of investigational therapy. There are multiple foci of abnormal uptake within the left 3rd rib, left 4th rib, left scapula, and proximal right humerus. Activity within the left third rib has become more confluent to involve nearly the entire rib. Activity within the left 4th rib, left scapula, and proximal right humerus is new from the prior examination. Degenerative uptake is noted in the shoulders, sternoclavicular joints, and knees. | Progression of osseous metastatic disease. |
Generate impression based on findings. | Female 74 years old Reason: 74 yo feamle who was found to have a abnormality of pancreas on PET Scan. EUS done here 6cm distal pancreas mass. Needs Pancreas protocol Ct Scan to evaluate lesion. History: none ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Wedge-shaped, nonspecific hypodensity in the right lobe of the liver measuring 2 x 1.5 cm on image number 50, series number 10 is unchanged compared to CT dated 12/7/2010. No other focal liver lesions.SPLEEN: No significant abnormality notedPANCREAS: Patient's known large uniloculated cystic mass in the body and tail of the pancreas measures 5.8 x 5 cm on image number 48, series number 10 and, increased in size compared to previous study. This cystic mass is suspicious for a mucinous cystadenoma/carcinoma. Note definite solid component is noted within this lesion. The remainder of the pancreas is unremarkable. ADRENAL 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: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 | Interval increase in the size of the uniloculated, well-defined cystic lesion in the body/tail of the pancreas suspicious for a mucinous cystic neoplasm.Nonspecific wedge-shaped hypodensity in the liver is unchanged. |
Generate impression based on findings. | Male 65 years old Reason: staging exam History: prostate cancer This study is performed for research purposes. | Research CT. |
Generate impression based on findings. | esophageal cancer on chemotheraphy, reduced cognitive ability. No evidence of acute ischemic or hemorrhagic lesion on this scan.No evidence of abnormal enhancement.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion on this scan.No evidence of abnormal enhancement |
Generate impression based on findings. | Female 62 years old Reason: eval OA History: above. Four views of the right shoulder show tiny osteophytes and sclerosis of the glenohumeral joint. No acute fracture or dislocation. | Mild osteoarthritis of the glenohumeral joint. |
Generate impression based on findings. | Female 57 years old Reason: 57 yo female with newly dx Pancreatic Neuroendocrine Tumor. Pancreas Neuroendocrine. History: Abdominal Pain ABDOMEN:LUNG BASES: A subcentimeter cyst in the inferior aspect of the right lobe of the liver.LIVER, BILIARY TRACT: No significant abnormality noted. There is an accessory left hepatic artery arising from the left gastric artery.SPLEEN: No significant abnormality notedPANCREAS: There is a 2.8 x 1.7 cm mass in the head of the pancreas causing moderate intrahepatic and common bile duct dilatation and mild pancreatic ductal dilatation.This mass does not invade the SMA and SMV. However, posteriorly it indents the left renal vein between the aorta and IVC. Left renal vein is patent, however, imaging of the left renal vein cannot be excluded. The caliber of the left renal vein is smaller when the mass abuts and Indents. Adrenal 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: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 | Large mass in the head of the pancreas causing moderate biliary and mild pancreatic ductal dilatation. The mass indents the left renal vein. Renal vein invasion cannot be excluded. |
Generate impression based on findings. | Female 52 years old Reason: Evaluate left knee for DJD History: Left knee pain x 6 mos. Four views of the left knee show a small effusion is seen in the suprapatellar pouch. There are tricompartmental osteophytes affecting the left knee. There is narrowing of the patellofemoral compartment with near bone on bone apposition.There is chondrocalcinosis seen at the lateral compartment of the right knee on the frontal views as well as tricompartmental osteophytes. | Moderate osteoarthritis of the left as described above. |
Generate impression based on findings. | 48 year-old male with epigastric pain radiating to the back with normal lipase, evaluate for chronic pancreatitis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Punctate hypodensity in hepatic segment 4a/4b is too small to characterize but similar to prior. Status post cholecystectomy. Perhaps minimal intrahepatic biliary ductal dilatation. No extrahepatic biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: The pancreatic duct does not appear be dilated. The pancreatic parenchyma enhances normally. No calcifications are noted within the pancreas. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Status post roux en Y now with concern for bile duct leak. Angiographic images are unremarkable. Prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is normal excretion of tracer through the hepaticojejunostomy. However, there is progressive accumulation of radiotracer in the region of anastomosis, along the medial edge of the liver, and into a JP drain. Activity near the anastomosis may be a combination of intraluminal GI activity, bile duct activity, and a biloma. | Findings compatible with bile duct leak.Findings communicated via phone to A. Suah prior to dictation. |
Generate impression based on findings. | 88 years old, gentleman, with a history of severe mitral regurgitation and Atrial fibrillation. He is planned for mitral valve repair and cryo maze for Atrial fibrillation. He is now referred for cardiac CT.CPT: 75572 Aortic and Aortic Root. There is a left sided aortic arch with normal brachiocephalic branching pattern. No thoracic aortic dissection or aneurysm is noted. The thoracic aorta has no significant tortuosity. No protruding aortic atheroma or thrombus is noted in the thoracic aorta. There is mild calcification of the aortic arch and descending aorta. No aortic coarctation is noted. There is mild atherosclerosis the proximal brachiocephalic vessels. Sinus of Valsalva: 40x40x39mmSinotubular Junction: 36x35mmAscending Aorta: 35 x 36 mm.Aortic Arch: 29 mm.Descending Aorta: 26 x 26 mm.Left Ventricle: The left ventricle is normal in size with mild hypertrophy. There is a resting myocardial perfusion defect involving the LAD territory.Right Ventricle: The right ventricle is normal in size. Left Atrium: The left atrium is severely dilatated. There are four distinct pulmonary veins which drain normally into the left atrium. There is a filling defect in the distal most tip of the left atrial appendage, which could represent either thrombus or just poor flow. Right atrium, vena cavae, and coronary sinus: The right atrium is severely dilatated. The superior and inferior vena cavae are dilated. Coronary sinus is dilatated.Aortic Valve: The aortic valve is probably tri-leaflet and mildly calcified.Mitral Valve: Moderate calcification of posterior mitral annulus. Pulmonary Artery: The main pulmonary artery is normal in size. Pericardium: The pericardium is normal in thickness. There is no pericardial effusion.Coronary arteries: Because heart rate management was not attempted and nitroglycerine was not administered, this exam was not performed to optimally visualize the coronary arteries. However within the limitations of the study the following observations are made:LM: The left main coronary artery arises normally from the left sinus of Valsalva and trifurcates into the left anterior descending, ramus, and left circumflex coronary arteries. There is mild calcification of the left main coronary artery. LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There is severe calcification of the LAD. LCx: The left circumflex coronary artery courses normally in the the left AV groove. It gives rise to the obuse marginal branches and a small AV circumflex branch. There is mild calcification of the LCx.RCA: The right coronary artery arises normally from the right sinus of Valsalva. It is the dominant coronary artery supplying a posterior descending artery and a posterolateral branch. There is mild calcification of the RCA. Coronary Bypass Grafts:None present. | 1. Aortic root mildly dilated. Thoracic aorta with mild calcification but without aneurysm or dissection. 2. Mild left ventricular hypertrophy. 3. Severe LAD calcification with evidence of large, resting perfusion defect in the usual territory of the left anterior descending artery. 4. Severe biatrial dilation. 5. Moderate posterior mitral annular calcification. This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report. The abdomen/ pelvis CTA will be reported separately. |
Generate impression based on findings. | Female 55 years old Reason: eval for mass causing bleeding History: recurrent GI bleeds Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the colon was one hour. Fluoroscopic evaluation showed normal mucosa throughout the small bowel, with no large masses, ulcers, sinus tracts, fistulae, or adhesions.There are filling defects within the stomach and terminal ileum likely representing food debris.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: 4.09 minutes | Normal examination of the small bowel and proximal colon. Etiology for the patient's small bowel bleeding is not evident on the current exam. Given the patient was not NPO prior to examination follow up enterography is suggested for further evaluation of the bowel mucosa. |
Generate impression based on findings. | 1-year-old male, fall to hands and knees, with forearm painVIEWS: Right forearm, AP and lateral (two views) 2/27/15 16:43 Nondisplaced transverse fracture of the mid-diaphysis of the radius and slight buckling of the mid-diaphysis of the ulna. | Nondisplaced mid-diaphyseal fractures of the radius and ulna. |
Generate impression based on findings. | Reason: fracture/dislocation, chronic arthritic changes? inflamed, effusion, warm No fracture or malalignment is seen. A moderate-sized joint effusion is present.No significant degenerative changes are noted. Vascular calcifications are present in the soft tissues. | Moderate sized joint effusion, without acute abnormality otherwise evident. |
Generate impression based on findings. | Fracture Interval cast placement obscures fine osseous detail. Again seen is the fifth metacarpal diaphyseal fracture, now in gross anatomic alignment, improved compared to prior. | Interval reduction and casting of the fifth metacarpal fracture. |
Generate impression based on findings. | Female 42 years old; Reason: 42 yo F with SLE with R knee pain started one month ago after she heard a crack in her knee while getting out of car History: as above; no warmth or swelling No fracture or malalignment is present. A moderate-sized joint effusion is present. No significant degenerative changes are otherwise noted. | Moderate-sized joint effusion, without acute abnormality otherwise evident. |
Generate impression based on findings. | 60 years old Male. Reason: evaluate for PE as part of pre-lung transplant evaluation History: shortness of breath. The comparison chest radiograph performed on 02/26/2015 demonstrates diffuse bilateral interstitial changes and air space opacities, predominantly in the mid and lower lungs.The ventilation images show decreased ventilation in the lower lungs on "single-breath images". There is mild abnormal Xe-133 retention during the wash-out phase in the lung bases. The perfusion images show multiple moderate to large-sized perfusion defects in the lower lungs, which match with decreased ventilation on the "single breath" ventilation images and radiographic opacities. | Intermediate probability for pulmonary embolism.Please note that ventilation portion of the study is limited. |
Generate impression based on findings. | Forehead hematoma, check for fracture Osseous structures are intact. Specifically sinuses are fully visualized and well aerated. No definite soft tissue focus to support the hematoma, however CT evaluation would be more sensitive. | Normal |
Generate impression based on findings. | Pain Hand and wrist: Incomplete extension of the digits with diffuse moderate soft tissue swelling most pronounced on the dorsal aspect. Underlying this osseous structures are significant for demineralization however no discrete focal acute abnormality is observed. Moderate degenerative changes involving the base of the first of more mild changes of the radiocarpal joint with chondrocalcinosis. Specifically remote-appearing well corticated changes observed involving the first IP articulation, compatible with old remote trauma. | Diffuse swelling without distinct underlying acute osseous abnormalities superimposed upon mild to moderate degenerative changes |
Generate impression based on findings. | Reason: Known history of CLL and PE, now with cough accompanied by dry right basilar crackles and wheeze. ? Etiology History: As above LUNGS AND PLEURA: New small scattered areas of focal bronchiectasis and mucous plugging in the middle lobe and lingula, and to lesser extent than the lower lobes, with scattered mild bronchial wall thickening throughout the lungs.Scattered benign-appearing micronodules are stable. No suspicious pulmonary nodules or masses.Mild basilar scarring/subsegmental atelectasis. No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size, without pericardial effusion. No visible coronary artery calcification. A small linear calcification is adjacent left main coronary artery, but not clearly within the vessel.Very mildly enlarged mediastinal and hilar lymph nodes are unchanged from the prior exam.CHEST WALL: Status post left axillary lymph node dissection.Stable small hypodensities in the T9 and L1 vertebral bodies.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. A lobulated hyperdensity at the posterior and superior aspect of the spleen is unchanged in size and increased in density from the prior exam dated 07/2014, and likely represents a subcapsular hematoma. | Mild diffuse, scattered bronchial wall thickening and focal areas of bronchial mucous plugging, most prominent in the middle lobe and lingula, but also seen in the lower lobes. Findings are compatible with infection, most likely bacterial, however the differential diagnosis also includes MAI infection. |
Generate impression based on findings. | Male 79 years old Reason: intraabdominal or retroperitoneal bleeding History: s/p fall on coumadin; LBP Exam is limited secondary to lack of oral and intravenous contrast. Lack of intravenous contrast makes the evaluation of solid organ and vascular pathology suboptimal. Lack of oral contrast makes evaluation of bowel pathology suboptimal. Within these limitations the following observations can be made:ABDOMEN:LUNG BASES: Limited exam secondary to motion artifact. Bilateral pleural effusions with overlying consolidation/atelectasis. Calcified granuloma at the right lung base.LIVER, BILIARY TRACT: There are multiple subcentimeter low attenuation foci scattered in the liver, which are too small to characterize, but likely cysts. Redemonstrated is a peripheral lesion at the junction of the left and right hepatic lobes which is similar in size now measuring 2.0 x 1.3 cm (series 4, image 43), previously 2.0 x 1.4 cm. This lesion is incompletely evaluated on the current noncontrast exam, however, previous contrast enhanced examination showed this lesion had discontinuous peripheral nodular enhancement suggestive of a hemangioma. No intrahepatic or extrahepatic biliary ductal dilatation delineated. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Nodular thickening of both adrenal glands, unchanged. Indeterminate right adrenal nodule is again seen and appears similar in size (series 4, image 45). KIDNEYS, URETERS: Multifocal cortical thinning and scarring bilaterally is again noted. Multiple small subcentimeter hyperdense and hypodense foci in both kidneys are too small to characterize, but likely cysts. No hydronephrosis. RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and its branches. IVC filter in place but incompletely assessed secondary to lack of intravenous contrast.BOWEL, MESENTERY: No evidence of bowel obstruction or intraperitoneal free air. No intraabdominal or retroperitoneal fluid collection to suggest a hematoma.BONES, SOFT TISSUES: Anasarca. Small umbilical hernia containing fat. Degenerative changes of the visualized spine.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: No significant abnormality notedBOWEL, MESENTERY: Scattered colonic diverticula. No evidence of bowel obstruction or intraperitoneal free air.BONES, SOFT TISSUES: Mixed sclerotic and lytic lesions within the pelvis, most prominent in the right pelvis, best seen on coronal image (series 8038, images 40-50). The extent of involvement has increased since prior examination. Small presacral edema. Degenerative changes of the visualized spine.OTHER: Tortuous tubular structures in the pelvis which are suspicious for varices versus collapsed bowel. | 1.No evidence of hematoma.2.Interval increase in the mixed sclerotic and lytic abnormalities within the pelvis, most prominent in the right hemipelvis, correlate with patient's clinical history to assess for underlying infiltrative process or metastatic disease. Nuclear medicine bone scintigraphy may be obtained if clinically indicated.3.Bilateral pleural effusions with overlying atelectasis/consolidation. |
Generate impression based on findings. | Reason: Eval for PE History: tachycardia PULMONARY ARTERIES: Exam is significantly limited by motion artifact and suboptimal differential contrast opacification of the pulmonary arteries. Within these limitations, there is a large central filling defect in the enlarged left lower lobe pulmonary artery extending into its segmental branches. There are additional filling defects of the right lower lobe segmental arteries, which represent additional emboli. The main pulmonary artery is normal in caliber. No evidence of right heart strain.LUNGS AND PLEURA: Bilateral subpleural areas of groundglass and consolidation (series 9, images 72, 76) are suspicious for infarct, with a possible component of hemorrhage.Moderate linear subsegmental atelectasis and dependent atelectasis. Very small left pleural effusion.MEDIASTINUM AND HILA: The heart is normal in size, without pericardial effusion. No visible coronary artery calcification. Right arm PICC, tip low in right atrium.No mediastinal or hilar lymphadenopathy.Small hiatal hernia.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. Abdominal free fluid and foci of free intraabdominal air correspond with known recent prior surgery. | Large pulmonary emboli in the bilateral lower zone pulmonary arteries. Bibasilar subpleural opacities are suspicious for infarcts.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Lobar.RV Strain: Negative. |
Generate impression based on findings. | Three year old with anemia, fever, thrombocytosis, and bone pain. Evaluate for masses. CHEST:LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Heart size is normal with no pericardial effusion. No mediastinal or hilar adenopathy.CHEST WALL: Chest wall is normal. Several mildly enlarged axillary lymph nodes are present, right greater than left.ABDOMEN:LIVER, BILIARY TRACT: Liver is normal. No focal hepatic lesions. No intra-or extrahepatic biliary ductal dilatation. Mildly distended gallbladder with no evidence of cholecystitis.SPLEEN: The spleen is normal.PANCREAS: Normal pancreas with no evidence of pancreatic ductal dilatation.ADRENAL GLANDS: Normal.KIDNEYS, URETERS: Normal.RETROPERITONEUM, LYMPH NODES: There are several prominent lymph nodes in the right lower quadrant anterior to the psoas muscle measuring 8 mm in short axis (series 4, image 75). No surrounding fat stranding or free fluid. The appendix is well visualized in the right lower quadrant and appears normal.BOWEL, MESENTERY: Focal thickening of the terminal ileum near the ileocecal valve (series 4, image 81). No surrounding soft tissue stranding. Bowel is normal in caliber with no evidence of obstruction.BONES, SOFT TISSUES: No suspicious osseous lesions. Soft tissues are normal.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Normal.BLADDER: Normal.LYMPH NODES: Prominent lymph nodes in the right lower quadrant as noted above. In addition an enlarged right inguinal lymph node is seen (series 4, image 95). BOWEL, MESENTERY: Bowel is normal in caliber with no evidence of obstruction.BONES, SOFT TISSUES: No suspicious osseous lesions. Soft tissues are normal.OTHER: No significant abnormality noted | Findings compatible with an infectious or inflammatory enteritis with reactive lymph nodes. |
Generate impression based on findings. | Male 18 years old Reason: evaluate for kidney stone History: LUQ and L CVA TTP Exam is limited secondary to lack of oral and intravenous contrast. Lack of intravenous contrast makes the evaluation of solid organ and vascular pathology suboptimal. Lack of oral contrast makes evaluation of bowel pathology suboptimal. Within these limitations the following observations can be made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydronephrosis or perinephric fat stranding. No evidence of obstructing renal stone.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal appendix. No evidence of bowel obstruction or intraperitoneal free air.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality noted | 1.Limited exam secondary to lack of oral and intravenous contrast. Within these limitations, there are no findings to explain patient's left upper quadrant pain.2.No evidence of obstructing renal stone or hydronephrosis. |
Generate impression based on findings. | Female 27 years old Reason: cause of abdominal pain History: abdominal pain, history of AML. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No biliary ductal dilatation or focal hepatic mass.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: Diffuse colonic enhancement and wall thickening which extends throughout the entirety of the colon. Regions of mild pericolonic fat stranding present and most prominent in the right ascending colon. These findings are compatible with a diffuse colonic infectious/inflammatory etiology such as pseudomembranous colitis. This is especially likely given the patient's immunosuppressed status and history of AML. No evidence of discrete fluid collection to suggest abscess.BONES, SOFT TISSUES: Multiple subcutaneous soft tissue nodules as well as superficial subcutaneous air (series 3, image 65) are noted within the anterior superficial abdominal tissues, likely secondary to medicinal injections.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedBOWEL, MESENTERY: Diffusely enhancing large bowel suspicious for pancolitis as above.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small amount of free fluid within the pelvis which may be physiologic or reactive in etiology. | Diffuse colonic wall thickening and enhancement consistent with a pancolitis such as pseudomembranous colitis. |
Generate impression based on findings. | Reason: PE History: tachy, hypoxic PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: Areas of consolidation throughout the dependent portions of the right middle and lower lobes. Patchy right basilar air space opacities are increased from prior same day chest radiograph, and compatible with aspiration. Significant atelectasis involving the left upper and lower lobes, increased from same day chest radiograph, and compatible with mucous plugging. The left lower lobe is nearly completely collapsed. The right upper lobe remains clear.Scattered bronchi containing aspirated material, with prominent obstruction of the right descending bronchus, and bronchial wall thickening.Very small bilateral effusions.MEDIASTINUM AND HILA: The heart is mildly enlarged, with left ventricular hypertrophy, small pericardial fluid. Mild coronary artery calcification. No mediastinal or hilar lymphadenopathy.Patulous, very dilated esophagus.CHEST WALL: Mild degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No evidence of pulmonary embolism.2. Consolidation and atelectasis involving multiple lung lobes. Increasing patchy air space opacity at the right lung base is compatible aspiration and possible pneumonia. Extensive atelectasis throughout the left lung is compatible with mucous plugging.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 8 year old male with fever, tachypnea, secretions. Evaluate for effusion or atelectasis.VIEW: Chest AP (one view) 2/28/2015 3:28 Thoracolumbar levoscoliosis is again seen with associated elevation of the right hemidiaphragm. Surgical clips in the left upper quadrant. Cardiothymic silhouette is normal. Bilateral peribronchial thickening with left lower lobe subsegmental atelectasis unchanged. No pleural effusion or pneumothorax. | Reactive airway disease or bronchiolitis pattern. |
Generate impression based on findings. | 8 year old male status post traumaVIEWS: Lumbar spine AP and lateral (2 views) 2/27/2015 Alignment is normal. Vertebral body height and disk spaces are maintained. No fracture or dislocation. No spondylolysis. Gaseous distention of the stomach is again seen. Small to moderate fecal burden with no evidence of obstruction. | Normal examination. |
Generate impression based on findings. | 8 year old male status post traumaVIEWS: Cervical spine AP and lateral (two views) 2/27/2015 18:58 Straightening of the cervical spine likely related to c-collar placement. Vertebral body heights and disk spaces are maintained. No evidence of fracture or dislocation. No prevertebral soft tissue thickening.Adenoids are mildly to moderately moderately enlarged with mild narrowing of the nasopharyngeal airway. | Normal examination. |
Generate impression based on findings. | Male 38 years old Reason: r/o fxr History: bite. There is mild soft tissue swelling about the first and second fingers. There is no acute fracture or dislocation. There is no evidence of a radiopaque foreign body. | No evidence of acute fracture, dislocation, or radiopaque foreign body. |
Generate impression based on findings. | Female 64 years old Reason: eval for widening of medial clear space History: R distal fibula fracture. Again seen is a nondisplaced distal spiral fibular fracture with soft tissue swelling overlying the lateral ankle. The medial and lateral aspects of the ankle mortise joint are preserved without evidence of widening. | Right fibular fracture as described above. |
Generate impression based on findings. | Reason: assess for pulmonary abnl, pulm hemorrhage History: SOB, hemoptysis; history ILD, LUL adenocarcinoma, esophageal bleed 2013, can't get contrast to r/o PE LUNGS AND PLEURA: Basilar predominant subpleural fibrosis with honeycombing and bronchiectasis, similar in appearance to the prior exam. No new areas of opacity to suggest hemorrhage.No pleural effusion. The reference left upper lobe subsolid nodule measures 10 x 6 mm (series 5, image 59), unchanged from 2012.The previously described posterior right upper lobe solid nodule measures 5 mm (series 5, image 85), unchanged from 2012 and compatible with a granuloma or lymph node. Additional scattered micronodules and calcified granulomas are unchanged. No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: The heart is enlarged, without significant pericardial effusion. Severe coronary artery calcification. The main pulmonary artery severely enlarged, suggestive of pulmonary hypertension.Scattered calcified mediastinal and hilar lymph nodes, unchanged. No new lymphadenopathy.Patulous, dilated esophagus.CHEST WALL: Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Cholelithiasis. | Extensive interstitial lung disease in a UIP pattern, compatible with the known history of collagen-vascular disease, not significantly changed from the prior exam. No new areas of opacity to suggest hemorrhage, and no evidence of other acute superimposed process. |
Generate impression based on findings. | There are predominantly low density bilateral frontal convexity extra-axial fluid collections again seen. The collection on the left measures up to 8 mm in maximal thickness, and the collection on the right measures up to 4 mm in maximal thickness. While these collections are not changed significantly in terms of maximal thickness, they extend more posteriorly into the parietal convexity as compared to prior examination, consistent with mild interval worsening. There is no significant midline shift or herniation.There is no new or acute intracranial hemorrhage. Areas of encephalomalacia in the left middle and superior frontal gyri are unchanged. There is mild ventricle and subcortical white matter hypoattenuation which is nonspecific but unchanged, likely representing chronic microvascular ischemic changes. The ventricles are unchanged. There is no hydrocephalus. There are atherosclerotic vascular calcifications in the bilateral intracranial vertebral and internal carotid arteries. Bilateral parietal burr holes again seen. There is nasal septal deviation again noted to the left. There is mild right maxillary sinus mucosal thickening. Lens implants. | 1.Mildly worsened bilateral frontal and parietal convexity extra-axial collections with mild local mass effect. No definite hyperdensity within the collections to suggest acute traumatic hemorrhage.2.Chronic left ACA-MCA watershed territory infarcts.Findings were discussed with resident Dr. Tripp from the ED over the telephone at 8:29 a.m. today.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 60 years old Reason: r/o fx History: pain Three views of the right shoulder again show a vertically oriented fracture of the greater tuberosity of the humeral head with minimal lateral displacement of the fracture fragment. There is no evidence of dislocation. There is small osteophyte formation of the glenohumeral and acromioclavicular joints. | Humeral head fracture as described above. |
Generate impression based on findings. | 8-year-old male status post traumaVIEWS: Pelvis AP (one views) 2/27/2015 18:59 Angiocatheter overlies the pelvis.The femoral heads are well directed into normally formed acetabula. No evidence of fracture or dislocation. Small to moderate fecal burden in the lower abdomen and pelvis with no evidence of obstruction. | Normal examination. |
Generate impression based on findings. | Female 64 years old Reason: is there a fracture History: ankle pain sp fall. Three views of the right ankle show a nondisplaced distal fibular spiral fracture without definite evidence of intra-articular extension. There is soft tissue swelling about the lateral aspect of the ankle and a small anterior tibiotalar joint effusion. A well corticated ossicle anterior to the talus is unchanged from prior exam and likely reflects prior trauma. Note is made of a calcaneal spur. | Nondisplaced distal fibular fracture as described above. |
Generate impression based on findings. | 8 year old male status post traumaVIEWS: Thoracic spine AP and lateral (two views) 2/27/2015 Alignment is normal. Vertebral body heights and disk spaces are maintained. No evidence of fracture or dislocation. Gaseous distention of the stomach is noted. Small to moderate fecal burden in the upper abdomen. | Normal examination. |
Generate impression based on findings. | Female 60 years old Reason: r/o fx History: arm pain. There is a vertically oriented lucency involving the greater tuberosity of the humeral head highly suspicious for humeral head fracture. There is no definite evidence of dislocation. Mild degenerative arthritic changes affect the glenohumeral joint. | Vertically oriented lucency along the greater tuberosity of the humeral head highly suspicious for humeral head fracture. Dedicated shoulder radiographs are recommended for further characterization. |
Generate impression based on findings. | 15-year-old male with right knee pain. Evaluate for right tibial plateau fracture. A comminuted fracture of the tibial plateau posteriorly extends to the articular surface (series 5, image 89; series 80340, image 29) with about 2 mm displacement of the fracture fragment. The articular cortex of the fracture fragment is displaced superiorly by about 1 mm to the cortex of the rest of the tibia. Small joint effusion is noted. Anterior soft tissue swelling is present. The proximal fibula and distal femur as well as the patella are intact. | Comminuted fracture of the posterior tibial plateau with displacement as described above. |
Generate impression based on findings. | 79-year-old male with history of fall. Evaluate for hemorrhage. No intracranial hemorrhage is identified. There is moderate periventricular and subcortical white matter hypoattenuation which is likely secondary to chronic small vessel ischemic disease. There is age-related volume loss. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. No extra-axial collections. Ventricles are within normal limits without evidence of hydrocephalus. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | 1. No acute intracranial hemorrhage.2. Moderate chronic small vessel ischemic disease which has progressed since 2007. |
Generate impression based on findings. | Female 42 years old Reason: r/o fx History: pain. Three views of the left ankle show mild soft tissue swelling predominantly about the lateral aspect of the ankle, without evidence of an underlying fracture or dislocation. | No acute fracture or dislocation. |
Generate impression based on findings. | Female 30 years old Reason: r/o malignancy History: mass . No acute fracture or dislocation. No definite mass is seen on this radiograph. There is no joint effusion or bony lesion to suggest underlying malignancy. | No evidence of malignancy on radiographs. If further imaging is clinically warranted, a dedicated MRI or CT is recommended. |
Generate impression based on findings. | Male 23 years old Reason: r/o fracture History: MVC. 3 views of the cervical spine show no acute fracture or dislocation. The cervical vertebral body heights and intervertebral disk spaces are preserved. The prevertebral soft tissues are within normal limits.3 views of the thoracic spine show no acute fracture or subluxation. The thoracic vertebral body heights and intervertebral disk spaces are preserved. Four views of the lumbar spine show no acute fracture or subluxation. The lumbar vertebral body heights and intervertebral disk spaces are preserved. | No acute fracture or dislocation. |
Generate impression based on findings. | 76 year old female history of subarachnoid hemorrhage. Bilateral frontal ventriculostomy catheters are unchanged in position. Right frontal hematoma surrounding the drainage catheter is stable in size and appearance. There is a small amount of air within the nondependent aspect of the left lateral ventricle which may be related to EVD manipulation. Diffuse bilateral subarachnoid hemorrhage extending into the ventricles appears similar to prior. Small amount of hemorrhage extends to the dorsal cervicomedullary cistern. A tiny amount of air is present in the extra-axial space of the left frontal region which is likely postoperative in etiology. A coil mass is present adjacent to the right aspect of the cavernous sinus. There has been no change in ventricular size and configuration. No new hemorrhage or CT evidence of large vascular distribution infarct. There is no midline shift. The visualized paranasal sinuses, mastoid air cells, and orbits are unremarkable. The calvarium and soft tissues of the scalp are within normal limits. | 1. Stable extensive bilateral subarachnoid and intraventricular hemorrhage with slight evolution. Ventricular size remains similar to prior.2. Unchanged bilateral frontal ventriculostomy catheters with associated right frontal hematoma. |
Generate impression based on findings. | Male 58 years old Reason: r/o fracture History: foot pain s/p fall. Mild degenerative changes affect the midfoot and tarsophalangeal joints. A thin lucency traversing the base of the first metatarsal is only seen on one view and could conceivably represent a non-displaced fracture if this correlates with point tenderness on physical exam. | Lucency at the base of the first metatarsal could represent a non-displaced fracture if this correlates with point tenderness on physical exam. |
Generate impression based on findings. | 76-year-old female with history of EVD placement. There has been interval placement of a left frontal ventriculostomy catheter. Right ventriculostomy catheter with surrounding hemorrhage is unchanged measuring approximately 2.9 x 1.6 cm. Diffuse bilateral subarachnoid hemorrhage extending into the ventricles appears similar to prior. A tiny amount of air is present in the extra-axial space of the left frontal region which is likely postoperative in etiology. A coil mass is present in the right paraclinoid region. There has been no change in ventricular size and configuration. No new hemorrhage or large vascular distribution infarct. There is no midline shift. The visualized paranasal sinuses, mastoid air cells, and orbits are unremarkable. The calvarium and soft tissues of the scalp are within normal limits. | 1. Interval placement of left ventriculostomy catheter with small amount of postoperative pneumocephalus in the left frontal region. Similar caliber of the ventricular system.2. Unchanged right frontal hematoma surrounding the right frontal EVD. 3. Stable appearing extensive bilateral subarachnoid hemorrhage extending into the ventricles. |
Generate impression based on findings. | Reason: r/o pe History: chest pain PULMONARY ARTERIES: Very small weblike defects in some segmental and subsegmental right-sided pulmonary arteries, compatible with small webs, likely a sequela of prior chronic emboli. A filling defect in a left lower lobe subsegmental pulmonary artery (series 7, image 222) and a questionable apparent filling defect in a lingular artery (series 7, image 161) compatible with very small subsegmental emboli of uncertain chronicity and clinical significance.LUNGS AND PLEURA: No suspicious pulmonary nodules or masses. Mild basilar subsegmental scarring/atelectasis and dependent atelectasis. No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size, without significant pericardial region. No visible coronary artery calcification.No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypoattenuation of the hepatic parenchyma, compatible with fatty liver. | Two very small subsegmental emboli in the left lung of uncertain chronicity and clinical significance. Very small weblike defects in some right segmental and subsegmental pulmonary arteries, compatible with small webs, likely sequelae of prior emboli. No other acute abnormality.PULMONARY EMBOLISM: PE: Positive.Chronicity: Indeterminate.Multiplicity: Multiple.Most Proximal: Subsegmental.RV Strain: Negative. |
Generate impression based on findings. | Male 51 years old Reason: r/o traumatic injury History: knee pain. There is a nondisplaced fracture of the proximal fibular diaphysis with overlying callus formation suggestive of partial healing. There is a small joint effusion. Mixed lytic/sclerotic appearing lesion in the distal femur likely represents a prior bone infarct. | Healing proximal fibula fracture as described above. |
Generate impression based on findings. | 1-year-old male with nondisplaced mid diaphyseal fracture of the radius and ulna. Evaluate for fracture/dislocation.VIEWS: Right elbow AP and lateral (two views) 2/27/2015 Again seen is nondisplaced fracture of the mid diaphysis of the radius. Alignment is intact. No joint effusion or soft tissue swelling. | Elbow is normal. |
Generate impression based on findings. | Male 54 years old Reason: assess for bony mets to Right hip History: metastatic thyroid cancer, Right hip pain. 2 views of the right hip show lytic appearing lesions, one near the lesser trochanter, and one in the proximal diaphysis of the femur, compatible with patient's known metastatic thyroid carcinoma. There is no definite evidence of an impending fracture. | Femoral metastatic disease as described above, without definite evidence of an impending fracture. |
Generate impression based on findings. | 1-year-old male status post fall from standing with nondisplaced mid diaphyseal fractures of the radius and ulna. Evaluate for fracture.VIEWS: Right wrist PA and lateral (two views) 2/27/2015 Wrist is intact with normal alignment. No joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 16-year-old female with history of patellar dislocation. Evaluate patella. VIEW: Left knee sunrise (one view) 2/28/2015 1:30 Well corticated osseous fragment seen along the inferomedial aspect of the patella is again seen which represents an accessory ossification center, a normal variant. No evidence of patellar fracture. | Normal examination. |
Generate impression based on findings. | 16 year-old female cheer leading injury, felt knee pop in and out with tenderness over inferior patella. Evaluate for fracture. VIEWS: Left knee AP, oblique, lateral (3 views) 2/27/2015 22:24 Small joint effusion is noted. The patellar ligament is thickened. Crescent shaped cortical irregularity is seen along the articular surface of the lateral aspect of the lateral femoral condyle. Internal derangement cannot be excluded. Well corticated osseous structure just inferior to the patella is likely an accessory ossification center, normal variant. | Based on the findings, ligamentous injury cannot be excluded. Recommend MRI for further evaluation. Findings were discussed with ED physician Dr. Benjamin Heilbrunn by phone on 2/28/2015 at 9:55 AM. |
Generate impression based on findings. | Female 74 years old Reason: mention of mild inflammatory changes along SI joints on 2013 film, though joints patent, please evaluate for change History: mention of mild inflammatory changes along SI joints on 2013 film, though joints patent, please evaluate for change. There is some subchondral sclerosis of the right sacroiliac joint, which is not significantly changed from the prior exam and compatible with degenerative changes. The left sacroiliac joint is difficult to evaluate on this study.Moderate degenerative changes affect the visualized lower lumbar spine. | Degenerative changes of the right sacroiliac joint appearing similar to the prior study. The left sacroiliac joint is difficult to visualize on this study and if further imaging is clinically warranted, an MRI is recommended. |
Generate impression based on findings. | Female 50 years old Reason: s/p orif History: none Overlying cast material obscures fine bone detail. A sideplate and screws device affixes a distal fibular fracture in near-anatomic alignment with two syndesmotic screws in position. Two K wires affix a medial malleolus fracture in near anatomic alignment. The fracture lines are somewhat indistinct suggestive of partial healing. | Orthopedic fixation of distal fibular and medial malleolar fractures as described above. |
Generate impression based on findings. | 8-year-old male with history of trauma. 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. There is mild mucosal thickening involving the maxillary sinuses. The mastoid air cells are clear. The calvarium and soft tissues of the scalp are within normal limits. No orbital fracture or retrobulbar hematoma. | No evidence of acute intracranial hemorrhage or calvarial fracture. |
Generate impression based on findings. | Female 48 years old Reason: eval for fracture, OA, erosion History: L shoulder pain, effusion. Four views of the left shoulder show a questionable loose body in the inferior axillary pouch. Otherwise there is no fracture or dislocation. | No acute fracture or dislocation. |
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