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Generate impression based on findings. | 16 month old female with history of head injury. There is a large right occipital subgaleal hematoma without underlying calvarial fracture. No evidence of acute intracranial hemorrhage. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. The gray-white differentiation is maintained. N... | Large right occipital subgaleal hematoma without underlying calvarial fracture or intracranial hemorrhage. |
Generate impression based on findings. | 12-year-old male with respiratory insufficiency.VIEW: Chest AP (one view) 2/28/2015 3:27 Right PICC tip in the SVC. Gastrostomy tube is noted. Cardiothymic silhouette is unchanged. Patchy right middle lobe opacities are improved. Slight improvement in linear left upper lobe linear opacities most likely atelectasis. Tho... | Decreased right middle lobe opacity. |
Generate impression based on findings. | Female 28 years old Reason: assess for splenomegaly, diverticulitis, or other cause of LLQ abdominal pain History: LLQ abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Nonspecific mild periportal edema. Prominent liver measuring up to 20 cm in length (coronal images series 8038, ... | 1.Focal ill-defined, wedge-shaped hypoechoic areas within the renal parenchyma suspicious for bilateral pyelonephritis. 2.Large stool burden. Correlate with patient for history of constipation. 3.No evidence of splenomegaly or diverticulitis as clinically questioned.Findings were discussed with the clinical service Dr.... |
Generate impression based on findings. | 10-year-old female with history of CSF leak after LP now complaining of headaches and blurry vision. There is no evidence of acute intracranial hemorrhage. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. The gray-white differentiation is maintained. No evidence of extra-axial coll... | 1. No intracranial hemorrhage or extra-axial collections. No obvious CT evidence of intracranial hypotension.2. Postoperative changes of suboccipital craniectomy for Chiari 1 decompression. |
Generate impression based on findings. | Evaluate Dobbhoff tube Enteric tube seen coiled in stomach with tip located in proximal gastric body, tube is kinked approximately 12 cm from tip in distal gastric body. Nonobstructive bowel gas pattern. Compared to prior study, interval improvement in spinal alignment, previously described scoliosis is likely position... | Enteric tube as above, repositioning should be considered if tube does not seem to be functioning appropriately, may be secondary to kinking of tube as described. |
Generate impression based on findings. | Enteric tube placement Suboptimal study due to patient motion artifact. Enteric tube seen with distal portion kinked at expected region of side-port, tip directed upward/retrograde and located in distal esophagus, repositioning recommended. Left basilar/retrocardiac consolidation. Please note that right hemithorax not ... | Enteric tube as above, repositioning recommended. |
Generate impression based on findings. | 60-year-old male with history of unsteadiness. There is no evidence of acute intracranial hemorrhage. There is mild global parenchymal volume loss. The ventricles are slightly prominent for the degree of volume loss and minimally progressed since 2012. There are calcifications of the visualized distal vertebral and int... | 1. No intracranial hemorrhage, mass, or mass effect.2. Prominence of the ventricular system which is favored to be due to volume loss. However, correlate with clinical findings for possible component of communicating hydrocephalus/NPH. |
Generate impression based on findings. | Evaluate enteric tube, recently advanced Suboptimal study due to patient's body habitus. Status post sternotomy. Enteric tube seen with tip approximately 4 cm beyond the gastroesophageal junction, side-port appears to be at the level of the gastroesophageal junction, further advancing by approximately 4 cm recommended.... | Enteric tube as above, further advancing recommended. |
Generate impression based on findings. | Female 68 years old Reason: eval fusion History: s/p L1-5 XLIF. Interval placement of bone grafts at L1/L2, L2/L3, L3/L4, L4/L5, and L5/S1. There is marked scoliosis of the lower lumbar spine, unchanged from the prior exam. Moderate to severe degenerative changes including multilevel anterior vertebral body osteophytes... | Postoperative changes of the lower lumbar spine as described above. |
Generate impression based on findings. | Dobbhoff tube placement, assess positioning Dobbhoff tube seen with tip in gastric fundus. Residual contrast seen in right colon. Incompletely imaged bowel demonstrates gaseous distention, may reflect diffuse ileus. Postsurgical sequela seen in lower abdomen. Please refer to recent CT chest imaging for additional findi... | Enteric tube as above. |
Generate impression based on findings. | 32 year old female with history of MS and unwitnessed fall. Evaluate for hemorrhage. There is no evidence of acute intracranial hemorrhage or calvarial fracture. Extensive areas of hypoattenuation in the white matter are compatible with patient's history of advanced multiple sclerosis. There is advanced parenchymal vol... | 1. No evidence of acute intracranial hemorrhage or calvarial fracture.2. Marked white matter disease and volume loss compatible with patient's history of multiple sclerosis and better evaluated on recent MRI. |
Generate impression based on findings. | Generalized abdominal pain Above average stool burden. No evidence of bowel obstruction. Mediastinal shift towards right, reflecting volume loss, incompletely imaged postsurgical scarring. Please note that multiple bilateral pulmonary metastases seen on earlier CT chest imaging not well delineated on this nondedicated ... | Large stool burden, correlate clinically for constipation. No bowel obstruction. |
Generate impression based on findings. | Nausea and vomiting No free air seen on submitted erect view. Incompletely imaged mild gaseous distention of colon (pelvis excluded on submitted image), stable to minimally improved from prior study. Basilar atelectasis/airspace disease, particularly on left. Subcentimeter radiodensity in right humeral head, may be scl... | No free air.Incompletely imaged bowel without significant change, see above. |
Generate impression based on findings. | 48 year-old male with history of fall. Evaluate for hemorrhage. There is no evidence of acute intracranial hemorrhage. The gray-white differentiation is preserved. No midline shift or mass effect. No extra axial fluid collections are identified. The ventricles are within normal limits without evidence of hydrocephalus.... | 1. No evidence of acute intracranial hemorrhage or calvarial fracture.2. Small lipoma within the left parietal scalp similar to 2006. |
Generate impression based on findings. | 0-day-old male (32 week gestational age patient) with increasing respiratory distress, increasing O2 requirement. Evaluate UVC tip placementVIEWS: Chest and abdomen AP (two views) 2/28/2015 8:30 Umbilical venous catheter tip in the right atrium.Left sided aortic arch, cardiac apex and stomach. Cardiothymic silhouette i... | UVC tip in the right atrium. |
Generate impression based on findings. | HEAD: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns 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 extracranial soft tissues are unremarkable. NECK: ... | 1.No significant change in nonspecific ill-defined soft tissue prominence inferior to the thyroidectomy bed which may represent postsurgical change. An ultrasound of this region may be useful for further characterization. No new or enlarging neck mass or significant cervical lymphadenopathy is seen. 2.Left parotid flui... |
Generate impression based on findings. | Colonic distention Percutaneous gastrostomy tube, tube projects over region of gastric body. Moderate gastric gaseous distention. Air containing small and large bowel. Appearance suggestive of diffuse ileus.Lumbosacral degenerative disease.Please refer to concomitant chest radiography from same day for additional findi... | Moderate gastric gaseous distention, for which continued follow-up suggested. Air containing small and large bowel, appearance suggestive of diffuse ileus. |
Generate impression based on findings. | Assess stool burden, history of abdominal pain and constipation Mildly below average stool burden. No bowel obstruction. Right-sided postsurgical spinal hardware including transpedicular screws/rod device again seen. Hip degenerative disease. | No bowel obstruction. |
Generate impression based on findings. | 14-week-old female with increased work of breathing. Evaluate for pneumothorax and size of pleural effusion.VIEW: Chest AP (one view) 2/28/2015 7:48 Right central venous catheter tip in the right atrium. Feeding tube with the side port at the GE junction. Cardiothymic silhouette is normal. Hazy lung opacities are seen ... | Bilateral hazy pulmonary opacities, increased on the left with likely increased left pleural effusion. Left pneumothorax no longer seen. |
Generate impression based on findings. | Abdominal pain status post ERCP Residual contrast in portions of colon, particularly hepatic flexure. Nonobstructive bowel gas pattern. Common bile duct stent. Please note that evaluation for free air suboptimal as only supine imaging was performed.Incompletely imaged sternotomy and additional left mediastinal/hilar ra... | Nonobstructive bowel gas pattern. If there is concern for free air, please note that this would be better assessed with dedicated upright or decubitus radiographic imaging or CT. |
Generate impression based on findings. | Female 41 years old Reason: Persistent fevers, neutropenic patient, assess for infectious source History: Persistent fevers, history of lymphoma. 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 o... | Limited exam secondary to lack of oral and intravenous contrast. Within these limitations, a hydropic gallbladder is seen, nonspecific. The patient had a recent abdominal ultrasound exam on 2/23/2015, which showed no evidence of gallstones or acute cholecystitis. Ultrasound imaging may be repeated or nuclear medicine s... |
Generate impression based on findings. | Abdominal distention/constipation Moderate stool burden, greater than on prior study. No bowel obstruction. Hepatomegaly. Bilateral hip dysplasia present. | Nonobstructive bowel gas pattern, moderate stool burden. |
Generate impression based on findings. | J-tube placement, assess for ileus or obstruction Left-sided percutaneous enteric tube, seen in left mid abdomen medially, projecting over bowel measuring up to 5.3 cm, uncertain whether stomach or dilated jejunum. Please note that more accurate determination of exact location of tube could be achieved with imaging fol... | Very large stool burden, likely reflecting constipation. Additionally, prominent bowel seen in abdomen centrally at location of percutaneous enteric tube as described, uncertain whether reflects stomach or dilated small bowel, correlation with patient's clinical history and continued follow up recommended. |
Generate impression based on findings. | Male 61 years old Reason: cause of abdominal pain, mid epigastric, supraumbilical, assess for mass History: Abdominal pain ABDOMEN:LUNG BASES: Mild centrilobular emphysema with mild bronchial wall thickening.LIVER, BILIARY TRACT: No focal hepatic mass or biliary ductal dilatation.SPLEEN: No significant abnormality note... | 1.Focal enhancement of the small bowel and adjacent mesentery suggestive of infectious/inflammatory process such as enteritis. Follow up to resolution. 2.Possible rectal wall thickening versus underdistention. This could represent an infectious, inflammatory, or malignant process, however correlation with direct visual... |
Generate impression based on findings. | Assess for residual stone fragments in right ureter following right percutaneous nephrolithotomy Suboptimal study due to patient motion artifact and body habitus. Right-sided percutaneous catheter in right mid abdomen. Moderate to large stool burden, particularly in right abdomen, no bowel obstruction. No radiopaque de... | Suboptimal assessment for radiopaque right-sided urolithiasis due to overlying stool, no definite radiodensity seen on right side. If there is continued clinical concern, imaging with CT recommended.Left-sided staghorn calculi. |
Generate impression based on findings. | NG tube placement Enteric tube seen with side-port at level of gastric body. Nonobstructive bowel gas pattern. Vascular calcifications.Please refer to concomitant chest radiography from same day for additional findings. | Enteric tube as above. |
Generate impression based on findings. | Flatulence, pain Suboptimal exam due to patient's body habitus, lateralmost aspects of abdomen excluded. Side-port of the enteric tube seen approximately 5 cm beyond gastroesophageal junction. Degree of bowel dilatation, primarily colon, stable to mildly increased, for example, in left abdomen, bowel measures up to 9.4... | Enteric tube as above.Stable to mild increase in degree of colonic dilatation, findings may again reflect colonic ileus versus colonic obstruction. |
Generate impression based on findings. | Male 59 years old Reason: assess for traumatic injury History: pain Exam is limited secondary to lack of intravenous contrast. Lack of intravenous contrast makes the evaluation of solid organ and vascular pathology suboptimal. Exam is also limited by motion artifact. Within these limitations the following observations ... | 1. Small perihepatic ascites. Evaluation of solid organs suboptimal without intravenous contrast and solid organ injury cannot be entirely excluded on the basis of this exam. If there is continued clinical concern for intraabdominal injury, repeat evaluation with a contrast-enhanced CT imaging is recommended.2. Scatter... |
Generate impression based on findings. | Reason: h/o met pap thyroid ca, compare to previous, measurements pls History: none CHEST:LUNGS AND PLEURA: Redemonstration of numerous pulmonary metastases, several of which appear slightly smaller compared to the prior exam, some with new cavitary component (series 4, image 54).Reference left upper lobe nodule measur... | 1. Large number of pulmonary metastases, several of which have slightly decreased in size and some with new cavitary component. Findings suggest response to therapy.2. Stable mild prominence of multiple mediastinal lymph nodes. |
Generate impression based on findings. | Female 45 years old Reason: 45yo with necrotizing pancreatitis w/pseudocyst c/b R pleural effusion. Recent procedures R thora 2/23, IR embolization of L gastric artery 2/24, ERCP/EUS 2/25 with cystogastrostomy tube placement R chest tube placed 2/26th. Now with fevers, hypotension History: evaluate for abscess/perforat... | 1.Multiple peripancreatic fluid collections are again seen and decreased in size status post cyst gastrostomy.2.Intralobular septal thickening and air space opacities likely representing pulmonary edema. Additional left upper lobe ground glass opacity may suggest superimposed infection or atelectasis.3.Bilateral locula... |
Generate impression based on findings. | There has been significant interval reduction of mucosal thickening within the left maxillary sinus with only trace mucosal thickening now present in the bilateral maxillary sinuses. There is mild new scattered ethmoid with trace frontal and sphenoid sinus mucosal thickening. The mastoid air cells remain clear. There ... | 1.Significant interval improvement in left maxillary sinus mucosal thickening compared to 12/1/2014.2.Mild new scattered bilateral ethmoid and frontal sinus mucosal thickening.3.Persistent periapical lucency surrounding the ADA tooth 15, incompletely imaged, and may represent periapical abscess.I personally reviewed th... |
Generate impression based on findings. | Reason: metastatic Prostate cancer. Please provide bi-dimentional measurements per RECIST 1.1 criteria History: metastatic Prostate cancer CHEST:LUNGS AND PLEURA: A subpleural nodular opacity in the right lower lobe is increased from the prior exam, now measuring 15 x 9 mm (series 7, image 56), suspicious for malignanc... | 1. A 1.5 cm right lower lobe nodule is increased from prior, with right hilar lymphadenopathy, suspicious for malignancy including primary lung neoplasm or metastasis. 2. See same-day nuclear medicine bone scan for additional details regarding osseous metastases. |
Generate impression based on findings. | 62 year old female with history of incontinence. Evaluate for NPH or acute process. There is no evidence of acute intracranial hemorrhage. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. The gray-white differentiation is maintained. No evidence of extra-axial collections. The vent... | No acute intracranial hemorrhage, mass, mass effect or evidence of hydrocephalus. |
Generate impression based on findings. | Finger back during dodgeball 1.5 weeks ago. Paronychia. Rule-out fracture.VIEWS: Left hand PA, left middle finger oblique/lateral (3 views) 02/28/15 Soft tissue swelling is seen around the distal phalanx of the middle finger. The bones are normal in appearance. No fracture is identified. | Soft tissue swelling around distal phalanx of middle finger. |
Generate impression based on findings. | 91-year-old female with history of fall. Head: There is a resolving right parietal subgaleal hematoma. There is no evidence of intracranial hemorrhage. There is extensive periventricular and subcortical white matter hypoattenuation compatible with chronic small vessel ischemic disease. A small lacunar infarct is presen... | 1. No evidence of acute intracranial hemorrhage or calvarial fracture.2. Extensive small vessel ischemic disease appearing similar to prior.3. No acute cervical spine fracture or subluxation.4. Moderate to severe degenerative disease of the cervical spine worse at C3-4 and C4-5 resulting in at least moderate spinal can... |
Generate impression based on findings. | Female 57 years old Reason: evaluate esophageal ulcer, GIST tumor History: planning for surgical resection of GIST ABDOMEN:LUNG BASES: Small right pleural effusion. Right upper lobe predominant airspace consolidation with extension into the lingula is suspicious for pneumonia. Incompletely imaged right middle lobe nodu... | 1.Esophageal stent is patent with an ulcer/defect as described above. 2.Ill-defined surrounding soft tissue mass around the stent consistent with the patient's known GIST tumor. 3.Left upper lobe airspace consolidation is suspicious for pneumonia. |
Generate impression based on findings. | 3-year-old female with history of penetrating trauma. Evaluate for carotid sheath injury. There is a common origin of the left common carotid and brachiocephalic trunk which is a normal variant. The vasculature of the neck is within normal limits. There are tiny foci of apparent outpouching in the oropharyngeal airway ... | No evidence of cervical vascular injury. |
Generate impression based on findings. | There has been resolution of minimal pneumocephalus seen on the prior examination status post placement of right transfrontal ventriculostomy shunt catheter, which terminates at the foramen of Monro. There is no significant soft tissue stranding, air or fluid collection along the imaged catheter tract. The ventricles ... | 1.No acute intracranial hemorrhage, mass effect or change in ventricular caliber. 2.Expected postsurgical changes with unchanged right transfrontal ventricular catheter position. No significant inflammatory changes or air or fluid collection along the imaged ventricular catheter tract. I personally reviewed the Images ... |
Generate impression based on findings. | 13-year-old male with seizures.VIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 2/28/2015 VP shunt tip is to the right of midline in the inferior portion of the middle cranial fossa. Shunt tubing exits the right parietal bone, courses along the right head a... | No evidence of shunt malfunction. |
Generate impression based on findings. | Female 43 years old Reason: 43 y/o F with metastatic neuroendocrine tumor with symptoms of SBO, please evaluate. History: abdominal pain, nausea, vomiting ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Multiple hepatic lesions consistent with metastatic disease are again noted. The previously... | 1.Marked wall thickening of the terminal ileum and cecum is again seen with mild increase in degree of the cecal wall thickening. There is mild prominence of the upstream small bowel with decrease in the passage of contrast distally into the colon. While this may be secondary to timing, partial small bowel obstruction ... |
Generate impression based on findings. | 56 year old female with history of headache, neck pain, and subjective fever. ? meningitis, mass, on immunosuppression. There is no evidence of acute intracranial hemorrhage. There is moderate periventricular and subcortical white matter hypoattenuation, which is nonspecific, but compatible with age indeterminate small... | 1. No intracranial hemorrhage or mass effect. No noncontrast CT evidence of abscess or empyema. If clinically indicated, MRI and LP can be considered. 2. Moderate periventricular and subcortical white matter hypoattenuation which is nonspecific and may represent advanced chronic small vessel ischemic disease. Treatment... |
Generate impression based on findings. | Female, 28 years old, pregnant and BMI greater than 50, assess for RFO Suboptimal exam due to patient's body habitus and portions of upper abdomen and left greater than right lateralmost abdomen having been excluded on submitted image. Epidural catheter seen. No unexpected radiopaque foreign body delineated within the ... | No unexpected radiopaque foreign body seen within limitations of exam, as above. |
Generate impression based on findings. | Reason: hx of head and neck cancer, compare to previous with measurements. History: as above CHEST:LUNGS AND PLEURA: Multiple pulmonary metastases are similar in appearance the prior exam. Reference right lower lobe nodule measures 8 mm (series 6, image 81), unchanged. No new pulmonary nodules identified.Mild subsegmen... | Stable metastatic disease, including multiple pulmonary nodules, mediastinal and hilar lymphadenopathy, and extensive bony metastases, all similar in appearance to the prior exam. Reference measurements as above. The mass in the neck is incompletely evaluated. See same day CT neck report for additional details. |
Generate impression based on findings. | Reason: h/o tonsil ca and CRT, compare to previous, measurements plan History: none CHEST:LUNGS AND PLEURA: Scattered benign-appearing micronodules, unchanged. A small left upper lobe ground glass nodule (series 4, image 23) is decreased in prominence from the prior exam, may be infectious/inflammatory in etiology. No ... | No evidence of metastatic disease. |
Generate impression based on findings. | Male 29 years old; Reason: Sbo History: Abdominal distention, diffuse tenderness ABDOMEN:LUNGS BASES: Left greater than right pleural effusions with underlying compressive atelectasis. Relatively dense appearance of pleural effusions, underlying hemorrhage not entirely excluded. Peripheral nodularity seen in right midd... | 1. Suboptimal exam without IV contrast. 2. Diffusely mildly dilated small bowel with relative collapse of colon, air and fluid seen in colon including rectum, differential considerations include a partial small bowel obstruction or ileus. Progression of enteric contrast on current study was poor. 3. Stable to mild inte... |
Generate impression based on findings. | Sickle cell anemia. Admitted for vaso-occlusive crisis. Now with abdominal distention.VIEW: Abdomen AP (one view) 02/28/15, 1142 and 1141 Cholecystectomy clips are present. Bone changes from sickle cell anemia are noted.The urinary bladder is moderately to markedly distended. Mildly dilated bowel loops are present. | Urinary bladder distention. |
Generate impression based on findings. | 13-year-old male with history of seizure. Redemonstrated is a right posterior approach ventriculoperitoneal shunt catheter coursing through the right lateral ventricle with the tip directed inferiorly towards the pons. Ventricular configuration sized is unchanged. There is no evidence of acute intracranial hemorrhage. ... | Stable VP shunt and ventricular configuration. No evidence of acute intracranial hemorrhage, mass or mass effect. |
Generate impression based on findings. | Male 45 years old; Reason: 45 year old M with von Hippel Lindau and known head of pancreas lesion, please evaluate for extent of disease and/or characteristics. Recent open right adrenalectomy with regional lymphadenectomy. Postoperative changes expected. History: Pancreas protocol CT ABDOMEN:LUNGS BASES: Small bilater... | 1. Arterially enhancing pancreatic lesions, one of which is more pronounced and larger in appearance, suspicious for small neuroendocrine tumors.2. Stable left adrenal enhancing lesion, likely a pheochromocytoma given patient's history of Von Hippel-Lindau disease.3. Status post right adrenalectomy and lymphadenectomy,... |
Generate impression based on findings. | 57-year-old female with history of CVA. There is no evidence of acute intracranial hemorrhage. Encephalomalacia within the right posterior temporal-occcipital lobe appear similar to prior. Encephalomalacia in the right basal ganglia is also again seen. Small lacunar infarct in the left frontal periventricular white mat... | 1. No evidence of acute intracranial hemorrhage or mass effect. 2. Chronic infarcts including the right posterior temporal and occipital lobe and right basal ganglia which were present on CT from 2006. Small lacunar infarct in the left basal ganglia is chronic but new since remote prior. Please note that CT is insensit... |
Generate impression based on findings. | Reason: PE? History: chest pain, SOB PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is normal in caliber.LUNGS AND PLEURA: No suspicious pulmonary nodules or masses.Mild dependent atelectasis. No focal airspace consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is norm... | No evidence of pulmonary embolism or other acute abnormality to account for the patient's symptoms.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Increasing swelling of the bilateral neck for 5 weeks, worse last night with SOB. Neck biopsy revealed adenocarcinoma. NECK: There is extensive bilateral cervical lymphadenopathy with multiple matted nodal masses throughout the jugular chains and posterior triangles. Exact measurements of individual lymph nodes are dif... | 1.Extensive bilateral cervical lymphadenopathy and retropharyngeal lymphadenopathy that results in airway narrowing are compatible with adenocarcinoma metastases.2.Extensive edema in the neck may be related to venous hypertension from bilateral jugular vein occlusion secondary to nodal mass compression and/or lymphedem... |
Generate impression based on findings. | Male 60 years old; Reason: h/o VPS for NPH; evaluate for pseudocyst at catheter tip History: abdominal pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No ... | 1. Trace pelvic ascites. No evidence of CSFoma. |
Generate impression based on findings. | Female 67 years old; Reason: Metastatic thyroid cancer; compare to previous with measurements CHEST:LUNGS AND PLEURA: Again visualized pulmonary and pleural metastatic disease.Accounting for differences in technique and positioning, mild interval decrease in size of reference left apical mass, measuring 2.2 x 2 cm, ima... | 1. Interval resolution of previously seen small right pleural effusion. Pulmonary and pleural metastatic disease. Mixed response again visualized with many sites stable to mildly decreased in size but again seen is mild interval increase in size of at least one nodule, submitted for reference is a right upper lobe nodu... |
Generate impression based on findings. | Thoracic syrinx and lipomatosis. Preoperative planning.VIEWS: Thoracic spine AP/lateral/swimmer's (3 views), lumbar spine AP/lateral/lumbosacral junction lateral (3 views) 02/28/15 Thoracic vertebral body heights and disk spaces are normal. No segmentation anomalies are seen. There may be a right thoracic curve.Lumbar ... | Normal thoracic and lumbar spine. |
Generate impression based on findings. | Metastatic lung cancer. EGFR +, on Erlotinib, now progressive disease, baseline status for trial. There is no evidence of intracranial mass. The grey-white matter differentiation appears to be intact. There is no abnormal intracranial enhancement. The ventricles are normal in size and configuration. There is no midline... | No evidence of intracranial metastases. |
Generate impression based on findings. | Left leg trauma/pain/gait abnormality.VIEWS: Left femur AP/lateral (two views) 02/28/15 The femur is normal in appearance. No fracture is seen. No soft tissue swelling is identified. | Normal examination. |
Generate impression based on findings. | Left leg trauma/pain/gated abnormality.VIEWS: Pelvis AP/frog leg (two views) 02/28/15 The round, smooth femoral heads are well directed into normally formed acetabula. No fracture is identified. | Normal examination. |
Generate impression based on findings. | Two month old male with history of mandibular distraction. Per chart, post drainage of facial abscess. There are postsurgical changes of mandibular distraction with mandibular osteotomies and placement of plate and screws. The left anterior screws are not deeply seated within the bone; correlate with surgical findings.... | 1. Postsurgical changes from mandibular distraction as detailed above. The left anterior screws are not deeply seated within the bone; correlate with surgical findings. Hardware appears otherwise intact and without complication. Postsurgical changes of left facial abscess drainage with no discrete residual fluid collec... |
Generate impression based on findings. | 41 year old female with history of persistent fevers. A small left maxillary sinus retention cyst is present. There is minimal mucosal thickening of the left frontal and right sphenoid sinus. No air-fluid levels. The remaining paranasal sinuses are clear. No evidence of an aggressive sinonasal process.There are bilater... | Minimal paranasal sinus mucosal thickening similar to 1/21/2015. There is a small left maxillary sinus retention cyst with minimal mucosal thickening within the left frontal and right sphenoid sinuses. No air-fluid levels. No evidence of an aggressive sinonasal process. |
Generate impression based on findings. | 69-year-old female with history of breast cancer. Evaluate for metastatic disease. No intracranial mass or mass effect. No pathologic enhancement to suggest metastatic disease to brain. There is a large area of encephalomalacia within the lateral aspect of the right temporal lobe which is unchanged. There is no evidenc... | 1. No CT evidence of metastatic disease to brain. If clinically indicated MRI can be considered for more sensitive evaluation.2. Right temporal lobe encephalomalacia which may be postsurgical but is unchanged since 2006. |
Generate impression based on findings. | Diffuse large B cell lymphoma in CR after 6 cycles of R-CHOP completed in 7/2014. There is no significant interval change in the irregular soft tissue lesion in the left supraclavicular fossa, which measures approximately 12 x 16 mm. There is no evidence of significant cervical lymphadenopathy elsewhere in the neck. Th... | Persistent left supraclavicular lesion compatible with treated lymphoma, without evidence of disease progression. |
Generate impression based on findings. | Newly diagnosed leukemia. There is moderate opacification of the ethmoid sinuses diffusely. There is mild mucosal thickening in the bilateral frontoethmoid recesses and inferior frontal sinuses. There is mild mucosal thickeing in portions of the sphenoid sinuses as well. The maxillary sinuses are essentially clear. The... | Scattered paranasal sinus opacification in a sporadic pattern. |
Generate impression based on findings. | Head injury last night: reports blurred vision and nausea. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. However, the posterior fossa appears to be relatively small and the cerebellar tonsils up to 9 mm inferior to the foramen magnum. The vent... | 1. No evidence of acute intracranial hemorrhage or skull fracture.2. Small posterior fossa and low-lying cerebellar tonsils are suggestive of Chiari I malformation. Further evaluation via a brain and spine MRI may be useful. |
Generate impression based on findings. | The last formed disk space is referred to as L5-S1, consistent with prior exam. There are immediate postoperative findings related to interval L1 -- L5 interbody fusion with placement of disk spacer devices at L1-L2, L2-L3, L3-L4, and L4-L5, including foci of retroperitoneal air, paravertebral swelling and edema. Ther... | Immediate postoperative findings related to L1-5 XLIF. Interbody cages are well positioned without evidence of complication. Levoscoliosis appears relatively improved and can be further assessed with standing radiographs. Spinal canal and neural foraminal stenosis as above which can be further assessed with MRI. I pers... |
Generate impression based on findings. | There are stable posttreatment findings without recurrent tumor or significant cervical lymphadenopathy. There is an unchanged left level 2 lymph node measuring 5 x 4 mm on series 8 image 39. The patient is status post right thyroid lobe resection with no focal lesions in the small left thyroid lobe. The major salivar... | 1.Stable posttreatment findings without evidence of recurrent tumor or significant cervical lymphadenopathy.2.Please refer to accompanying dedicated CT chest report for further details.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns 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 extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns 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 extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or mass-effect. If there is persistent suspicion for subarachnoid hemorrhage, consider lumbar puncture for further evaluation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | There is interval placement of a left posterior frontal burr hole. There is interval development of a large intraparenchymal hemorrhage in the left frontoparietal region that measures up to approximately 40 mm with a small amount of associated subarachnoid hemorrhage. There is local mass effect on the left lateral ven... | 1. Post-surgical findings related to left parietal lobe mass biopsy with extensive new intraparenchymal hemorrhage and a small amount of subarachnoid hemorrhage in the left frontoparietal region with rightward midline shift measuring 5 mm.2. New left frontotemporal convexity subdural hematoma measuring 5 mm in width. 3... |
Generate impression based on findings. | There are immediate postoperative findings related to C3-C6 laminoplasty. Spinal canal is increased in size and decompressed. Resection of the spinous processes is noted. Bone grafts appear well-positioned without displacement into the spinal canal. Expected postsurgical changes include extensive subcutaneous strandin... | 1.Expected postsurgical changes of C3 to C6 laminoplasty as detailed above with interval decompression of the previously seen spinal canal stenosis from C3 to C6. There is also improvement in the right C4-5 and proximal aspect of neural foraminal stenosis at the right C5-C6 level.2.Enlarged multinodular thyroid gland i... |
Generate impression based on findings. | HEAD: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is scattered ethmoid sinus mucosal thickening. The imaged mastoid air cells are clear. The skull and extracranial soft t... | 1.No new or enlarging metastatic soft tissue lesions in the neck.2.Stable to minimally smaller right paratracheal lymph node. Otherwise, no significant interval change in metastatic disease including soft tissue mass in the right thyroid bed. Please refer to separate report for findings in the chest.3.Osseous metastase... |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is extensive nonspecific patchy periventricular and subcortical white matter hypoattenuation which is nonspecific, more focal in the bilateral centrum semiovale and the white matter adjacent to the frontal horns. The ventricles and basal c... | No evidence of intracranial hemorrhage or mass effect. Moderate small vessel ischemic disease which is likely chronic. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.I personally reviewed the Images and/or procedur... |
Generate impression based on findings. | Tongue squamous cell carcinoma, status post surgery, radiation, re-irradiation, and stereotatic RT to lung lesion, treated with docetaxel for metastatic disease. Neck: The images are degraded by patient motion. There are post-treatment findings in the neck. There is an enhancing mass within the left trapezius muscle, w... | 1. Interval increase in size of the intramuscular metastasis.2. No evidence of intracranial metastases.3. Partially-imaged cavitary left lung mass. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | There is evidence of prior bilateral uncinectomy, widening of the maxillary infundibulae, partial resection of the ethmoid air cell complex, and widening of the left sphenoethmoidal recess. The frontal sinuses are hypoplastic. The prior mild mucosal thickening of the ethmoid air cells has resolved. The sphenoid sinuse... | Postoperative findings related to prior endoscopic sinus surgery with minimal residual mucosal thickening of the paranasal sinuses that has improved. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is patchy nonspecific periventricular and subcortical hypoattenuation as well as prominent hypoattenuation in the white matter adjacent to frontal horns. There is moderate diffuse global volume loss. There is no hydrocephalus. There is no ... | 1.No acute intracranial hemorrhage or mass effect. Please note, CT is insensitive for detection of early nonhemorrhagic stroke. If there is high clinical suspicion for acute ischemia, MRI can be considered for further evaluation.2.Unchanged hypoattenuation within the anterior frontal lobes which may represent posttraum... |
Generate impression based on findings. | NONCONTRAST: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is patchy nonspecific periventricular and subcortical hypoattenuation with prominent hypoattenuation in the white matter adjacent to frontal horns which may represent posttraumatic encephalomalacia versus prior ischemic injury... | 1.Mild partially calcified atherosclerotic plaque in the left carotid bifurcation without flow-limiting stenosis. Mild atherosclerotic changes in the intracranial circulation without flow-limiting stenosis. 2.Bilateral fetal origin of the posterior cerebral arteries with hypoplastic basilar artery which apparently ends... |
Generate impression based on findings. | Male 51 years old Reason: fracture History: MVC. Again seen on AP and lateral views is a nondisplaced proximal fibular fracture with overlying callus formation suggestive of partial healing. Increased Thickened wavy periosteal reaction in the distal tibia is compatible with changes from chronic osteomyelitis, as seen o... | Changes compatible with healing proximal fibular fracture and chronic osteomyelitis as described above. |
Generate impression based on findings. | Checked playing hockey. Hit the ice and boards on right shoulder.VIEWS: Right shoulder internal/external rotation (two views) 02/28/15, 1436 and 1437 The humeral head is well directed into the glenoid fossa. No fracture is seen. The acromioclavicular distance appears increased. | Probable acromioclavicular joint injury. |
Generate impression based on findings. | Female 55 years old Reason: eval fracture, FOOSH History: eval fracture. Two views of the humerus are provided. A possible cortical step-off of the radial head seen only on the internal rotation humerus film may represent an occult radial head fracture, however this is equivocal.Four views of the elbow show a small joi... | Joint effusion with questionable radial head cortical step-off seen only on the internal rotation humerus film, which may represent an occult radial head fracture. Follow-up imaging in 7-10 days is recommended. |
Generate impression based on findings. | Shortness of breath and chest pain. History of cancer and previous clot. Hemoptysis. PULMONARY ARTERIES: Main, right and left pulmonary artery caliber is normal. No filling defects are seen in the segmental arteries.LUNGS AND PLEURA: Scattered groundglass opacities are present predominantly in the lower lobes and middl... | No pulmonary embolus. Scattered groundglass opacities most likely inflammatory or infectious. |
Generate impression based on findings. | Productive cough, fever, wheezing.VIEWS: Chest AP/lateral (two views) 02/28/15 Lung volumes are large. Mild peribronchial thickening is seen. Subsegmental atelectasis is noted in right middle lobe. No focal air space disease is present.Cardiothymic silhouette and pulmonary vascularity are normal. | Bronchiolitis/reactive disease pattern. |
Generate impression based on findings. | Male 25 years old Reason: injury History: pain. Four views of the left knee show a possible small joint effusion in the suprapatellar pouch. Otherwise there is no evidence of acute fracture or dislocation. | No acute fracture or dislocation. |
Generate impression based on findings. | 23-year-old female with history of trauma. Evaluate AC joint. Three views of the right shoulder and axillary view of right shoulder show a contour abnormality of the greater tuberosity of the humeral head compatible with an impaction fracture. There is mild surrounding soft tissue swelling. The glenohumeral joint align... | Humeral head impaction fracture as described above. |
Generate impression based on findings. | Status post artificial heart, bleed on prior CT Compared to 2/27/2015, there is no significant change in small subdural hematoma involving the right posterior parieto-occipital convexity. Subdural collection measures up to 4 mm in thickness and associated with minimal local mass effect. No new hemorrhage or new mass-ef... | 1. No significant change in small subdural hematoma in the right parieto-occipital region with minimal local mass effect. No new hemorrhage or new mass-effect.2. Artifact related to portable technique limit evaluation of the parenchyma. There are small hypodensities involving the bilateral inferior cerebellar hemispher... |
Generate impression based on findings. | Female 41 years old Reason: L ankle pain/swelling History: pain/swelling. There is soft tissue swelling about the ankle. There is an acute appearing medial malleolar fracture with inferior displacement of the distal fracture fragment. The ankle mortise is preserved. Small osteophyte formation is noted at the tibiotalar... | Medial malleolar fracture as described above. |
Generate impression based on findings. | Sitz markers placed at 3:12 p.m.VIEW: Abdomen AP (one view) 02/28/15, 1811 24 Sitz markers are seen in the mid abdomen.Rectal tube has been removed. A gastrostomy tube is present. Feeding tube is coiled upon itself in the stomach with tip in fundus.Left thoracolumbar curve and bilateral developmental hip dysplasia are ... | Administration of Sitz markers. Development of bowel dilation after removal of rectal tube. |
Generate impression based on findings. | Female 77 years old Reason: eval fracture History: /sp fall. Four views of the left knee show a small joint effusion in the suprapatellar pouch and soft tissue reticulation along the superior aspect of the patella. Extensor mechanism appears to be intact. Tiny osteophytes affect the medial compartment. | No acute fracture or dislocation. |
Generate impression based on findings. | Shortness of breath and chest pain. Rule-out pneumonia.VIEWS: Chest PA/lateral (two views) 03/01/15 Cardiothymic silhouette is normal. Subsegmental atelectasis is seen in left upper lobe. No other focal opacity is present.Right thoracic and left thoracolumbar curves are most likely positional. | No pneumonia. Subsegmental atelectasis in left upper lobe. |
Generate impression based on findings. | Glioma, worsening ataxia As seen on recent MRI dated 2/16/2015, there is a infiltrating mass involving the pons extending into the midbrain. There is an area of necrosis with peripheral hyperdensity which may represent small hemorrhage and/or mineralization but not clearly changed since 2/16/2015, allowing for differen... | 1. Compared to MRI from 2/16/2014, there is no clear change in patient's infiltrating pontine glioma with area of necrosis. There is peripheral rim of hyperdensity compatible with mineralization with possible small component of blood products. No frank intraparenchymal hematoma or new mass-effect is appreciated. If cli... |
Generate impression based on findings. | Female 85 years old Reason: r/o fxr, osteo, gas gangrene History: marked swelling, erythema, tenderness . Three views of the left ankle show diffuse soft tissue swelling and reticulation about the ankle. The bones appear diffusely demineralized, but there is no definite cortical disruption to suggest infection. | No radiographic evidence of osteomyelitis. If further imaging is clinically warranted, an MRI or triphasic bone scan is recommended. |
Generate impression based on findings. | Abdominal pain. Possible appendicitis. History of diarrhea, nausea and vomiting. ABDOMEN:LUNG BASES: No focal opacity is seen. A pleural effusion is not present.LIVER, BILIARY TRACT: Liver enhancement is normal. The gallbladder is incompletely distended. No biliary ductal dilatation is identified.SPLEEN: Enhancement an... | No evidence of appendicitis. Probable colitis. |
Generate impression based on findings. | Male 34 years old Reason: ? osteo History: pain over 4th metatarsal a/w cellulitis. There is a mild hallux valgus deformity. There is diffuse swelling about the forefoot without a definite soft tissue defect or ulceration is radiographically evident. The cortices of the bones are preserved without evidence of disruptio... | No significant osteomyelitis. If further imaging is clinically warranted, an MRI or a triphasic bone scan is recommended. |
Generate impression based on findings. | Chest tube placement. 14-week-old former 27 week gestational age patient with history of chylothorax.VIEW: Chest AP (one view) 02/28/15, 1414 A left chest tube has been placed.Right central line tip is in right atrium. Feeding tube side-port is at the GE junction.A small to moderate left basilar pneumothorax is seen. T... | Small to moderate left hydropneumothorax. |
Generate impression based on findings. | Male 70 years old Reason: r/o fracture History: shoulder pain. There is no acute fracture or dislocation. Moderate degenerative arthritic changes affect the glenohumeral and acromioclavicular joints. | Degenerative arthritic changes of the glenohumeral and acromioclavicular joints without evidence of underlying acute fracture or dislocation. |
Generate impression based on findings. | NONCONTRAST: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns 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 extracranial soft tissues are unremarkable.... | 1.No flow limiting stenosis or intracranial aneurysm.2.No acute intracranial hemorrhage or mass-effect.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 35 years old Reason: assess for foreign body History: laceration from broken glass . There are soft tissue irregularities along the lateral aspect of the middle phalanx of the fourth finger compatible with lacerations in the superficial soft tissues. No radiopaque foreign body is seen. No acute fracture or disloca... | No radiopaque foreign body, acute fracture, or dislocation. |
Generate impression based on findings. | Female 53 years old Reason: r/o steroid-induced necrosis History: pain. There is no acute fracture or dislocation. No radiographic evidence of avascular necrosis. Mild to moderate degenerative arthritic changes affect the hip joints. | No radiographic evidence of avascular necrosis. If there is continued clinical concern, an MRI is more sensitive for early detection of osteonecrosis. |
Generate impression based on findings. | Female 53 years old Reason: eval for fx, dislocation; slammed hand in car door History: pain over 1st metacarpal and snuffbox tenderness. There is no acute fracture or dislocation, in particular there is no definite scaphoid fracture. There is mild to moderate osteoarthritis of the basilar and interphalangeal joint of ... | No acute fracture or dislocation. |
Generate impression based on findings. | There are unchanged posttreatment findings in the neck with no evidence of tumor recurrence or significant lymphadenopathy. There is an unchanged nonspecific soft tissue nodule on series 8 image 47 in the right upper back measuring 6 mm. The left parotid gland appears atrophic but unchanged from the prior exam. The re... | No locoregional tumor recurrence or significant cervical lymphadenopathy. Please refer to dedicated accompanying CT chest report for further details regarding pulmonary metastases.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 54 years old Reason: ? pulmonary embolus. History: shortness of breath, anxiety. PULMONARY ARTERIES: Technically adequate study without evidence of a pulmonary embolus. Pulmonary caliber is within normal limits.LUNGS AND PLEURA: Severe upper lobe predominant centrilobular and paraseptal emphysema appears not signi... | No acute pulmonary embolus.PULMONARY EMBOLISM: PE: None.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Headache, chest pain, right lower extremity tingling/numbness. CVA No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocep... | 1. No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts, and MRI should be considered if there is continued clinical suspicion.2. Moderate chronic small vessel ischemic disease which has progressed since 2009. |
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