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Generate impression based on findings. | Altered mental status, rule out bleed No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent chronic small vessel ischemic changes and progressed since 8/25/2007. In particular, there is an area of hypodensity in the left frontal lobe involving the left middle and inferior frontal gyrus with possible sulcal effacement. No definite volume loss.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | 1. No evidence of intracranial hemorrhage or mass effect. Compared to 2007, there is a new but age-indeterminant hypodensity in the left frontal lobe with suggestion of mild sulcal effacement. Finding may represent a subacute to chronic infarct and MRI should be considered for further evaluation as clinically indicated. No volume loss to definitively suggest that this is chronic.2. Moderate chronic small vessel ischemic disease which has progressed since 2007. |
Generate impression based on findings. | Female 44 years old Reason: position of PleurX within empyema requested by Interv Pulm? Readmit of 44F with metastatic breast ca with fever 102; empyemia; little drainage from PleurX History: Fever, empyema; little drainage from PleurX. LUNGS AND PLEURA: Again seen are innumerable bilateral pulmonary nodules compatible with patient's known metastatic breast cancer. A right-sided large multiloculated pleural collection appears to have somewhat decreased in size when compared to the prior exam. There is interval increase in a loculated right subpulmonic pneumothorax. A right-sided Pleurx catheter is unchanged in position. A small left sided pleural effusion is unchanged. There is persistent collapse of the right middle lobe. MEDIASTINUM AND HILA: Left-sided CVC tip terminates at the cavoatrial junction. There is soft tissue infiltration of the right mediastinum with scattered micronodules within the mediastinal fat, grossly unchanged from prior exam. Note is made of a small hiatal hernia.CHEST WALL: Note is made of bilateral axillary surgical clips in anterior chest wall surgical clips compatible with lymph node dissections and bilateral mastectomies. Vertebral body heights and intravertebral disk spaces appear preserved. UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Interval mild decrease in size of right sided multiloculated pleural collection and increase in right subpulmonic pneumothorax, with Pleurx catheter unchanged in position. |
Generate impression based on findings. | Assess for increased edema/swelling No intracranial hemorrhage is identified. As seen on recent MRI from 2/24/2015, there is a lesion involving the left occipital resection cavity with local mass effect which may represent necrosis related to treatment versus tumor recurrence. No interval change. There is sulcal effacement and mass effect on the left lateral ventricle atrium which is partially effaced. There is minimal rightward midline shift at the level of the mass. No transtentorial herniation. No hydrocephalus. No extra-axial collections. Evidence of prior left parieto-occipital craniotomy. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | As seen on recent MRI from 2/24/2015, there is a lesion involving the left occipital resection cavity with mass effect which may represent necrosis related to treatment versus tumor recurrence. No interval change. No evidence of acute hemorrhage. |
Generate impression based on findings. | NECK: There is a large 87 x 52 x 38 mm heterogeneously enhancing conglomerate mass in the left level 2 cervical chain on series 3 image 126, with areas of central non-enhancement suggesting possible necrosis. There is clear evidence of extracapsular spread and lack of fat planes between the mass adjacent sternocleidomastoid suggesting invasion of the muscle. The left mandible and mastoid are intact and show no focal erosions. Left parotid gland in its inferior aspect is likely involved. The mastoid air cells are clear. No pathologic lymphadenopathy within the right neck is appreciated.The distal left external carotid artery and branches are partially encased within the mass. The left internal carotid artery is mildly medially and anteriorly displaced without encasement. However, the vessels do not show evidence of gross invasion or evidence of rupture. The left internal jugular vein is not seen from the origin of the left jugular foramen distally and occluded. Other vascular findings are more thoroughly described on the prior CT angiogram of the head and neck.There is a hyperenhancement in the left posterior submandibular space and the superolateral aspect of the left submandibular gland and abutting the left mandibular ramus measuring up to 12 x 27 mm on series 3 image 107/coronal series 80396 image 33. This may be related to contiguous tumor spread.The thyroid gland is heterogeneous and contains tiny calcifications as well as a dominant left thyroid hypoattenuating nodule which is less than a centimeter in size. There is a stable calcified pretracheal lymph node in the upper mediastinum. There are emphysematous changes in the imaged upper lungs. The upper mediastinal esophagus is patulous and mildly distended with air. There are mild cervical degenerative changes as described on the prior CT angiogram report without significant change.HEAD: There is redemonstration of encephalomalacia in the right superior and middle temporal gyri, as well as the right inferior parietal lobule. There is periventricular and subcortical white matter hypoattenuation without significant interval change. There are foci of hypoattenuation in the right basal ganglion the left internal capsule without significant interval change. There is mild right and moderate to severe left maxillary sinus mucosal thickening. There is trace left sphenoid sinus mucosal thickening. The calvarium is intact. | 1.Large heterogeneously enhancing exophytic left-sided conglomerate neck mass centered at level 2 extending from the left mastoid inferiorly to C4-5 level with minimal central necrosis. There is extracapsular spread and invasion of the left sternocleidomastoid muscle. No osseous erosions in the left mastoid or the left mandible to suggest osseous invasion. 2.Abnormal enhancement extends medial to the left mandibular ramus into the left submandibular space and posterior superior aspect of the left submandibular gland which may be related to direct tumor spread versus and an additional lesion. MRI may be helpful to better visualize the submandibular gland and submandibular space. No other discrete mass within the oral cavity, pharyngeal or laryngeal soft tissues is appreciated. No significant right cervical lymphadenopathy. Mass causes displacement of the left internal carotid artery anteromedially. The left external carotid artery appears to be coursing medially and peripheral to the mass versus possibly being engulfed by the mass. No evidence of arterial compromise in this region.3.Left internal jugular vein appears occluded.4.No evidence of intracranial metastases.5.Heterogeneous and mildly nodular thyroid gland which can better evaluated with ultrasound as clinically indicated.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 63 years old Reason: Evaluate for pulmonary embolus History: Persistent tachycardia, desaturation to low 90s on room air, recent ortho surgery. PULMONARY ARTERIES: Examination is mildly limited by patient's body habitus and suboptimal opacification of the pulmonary artery. Within this limitation, there appears to be a filling defect within the right upper lobe apical segment artery consistent with an acute pulmonary embolus (series 3, images 85 and 90). Main pulmonary artery size is within normal limits. There is no evidence of right heart strain. No left-sided pulmonary emboli are noted.LUNGS AND PLEURA: There is bilateral lower lobe consolidations which may be due to aspiration or infection. There are scattered patchy ground glass opacities seen in the bilateral lungs (series 10, images 33, 36, 52), the largest of which measures 1.2 cm in diameter (series 10, image 52). These nodules are concerning for infectious versus neoplastic etiology. Note is made of a large solid pulmonary nodule in the left lower lobe (series 10, image 63). MEDIASTINUM AND HILA: There is no evidence of mediastinal or hilar lymphadenopathy. Cardiac size is within normal limits without evidence of right heart strain.CHEST WALL: Severe degenerative disease of the thoracic spine is noted with flowing anterior osteophytes. Midthoracic vertebral body hemangioma is noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Note is made of a fatty appearing liver. | 1.Right upper lobe acute pulmonary embolus.2.Bibasilar airspace consolidations may be due to aspiration or infection.3.Multiple bilateral ground glass opacities as described above suspicious for infectious versus neoplastic etiology. Follow-up imaging to resolution is recommended.PULMONARY EMBOLISM: PE: Right upper lobe apical segment pulmonary embolus.Chronicity: Acute appearing.Multiplicity: No.Most Proximal: Not applicable.RV Strain: No. Findings verbally related by telephone to Dr. Blake Burkert on 3/1/2015 at 1245pm. |
Generate impression based on findings. | Left arm pass pointing since this a.m. Rule out ICH. 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. 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. | No evidence of acute 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. |
Generate impression based on findings. | Female 56 years old Reason: Evaluate RUQ for cholecystitis, biliary duct dilation History: elevated LFTs, hx of cholelithiasis, epigastric pain LIVER: Liver measures 13 cm. No focal liver lesions. Normal echogenicity.BILIARY TRACT: Gallbladder is distended with multiple stones. There is mild to moderate gallbladder wall thickening. These findings are compatible with acute cholecystitis. No evidence of injury or extrahepatic biliary dilatation.PANCREAS: Pancreatic head is unremarkable.SPLEEN: No significant abnormalities noted. Spleen measures 9 cm.RIGHT KIDNEY: No significant abnormalities noted. Right kidney measures 10 cm. Left kidney measures 9.2 cm.OTHER: No significant abnormalities noted. | Acute cholecystitis with cholelithiasis.Dr. Keren was notified and acknowledged about these findings at the time of the dictation. |
Generate impression based on findings. | Male 48 years old Reason: eval for cholecystitis History: right upper quadrant abdominal pain Focused evaluation of the gallbladder was performed because the patient already had a CT abdomen and pelvis. There is gallbladder wall thickening, measuring up to 4 mm, layering biliary sludge and pericholecystic fluid consistent with acute cholecystitis. Common bile duct measures 7-mm. No evidence of intra-or extrahepatic biliary dilatation. | Acute cholecystitis. |
Generate impression based on findings. | Male 24 years old; Reason: eval for testicular torsion History: R testicular pain, absent cremasteric reflex RIGHT TESTIS: 2.9 x 2 x 4 cm normal echogenicity without evidence of any focal lesions.LEFT TESTIS: 2.8 by 2 x 4.4 cm. Normal echogenicity without evidence of any focal lesions.RIGHT EPIDIDYMIS: No significant abnormalities noted.LEFT EPIDIDYMIS: No significant abnormalities noted.OTHER: Bilateral varicoceles. | No evidence of testicular torsion is questioned. Bilateral varicoceles. |
Generate impression based on findings. | Status post fall, evaluate for bleed No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. There is global parenchymal volume loss appropriate for age. No hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent mild chronic small vessel ischemic changes.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. Soft tissue swelling in the left forehead region noted. | No evidence of intracranial hemorrhage or mass effect. No calvarial fracture. |
Generate impression based on findings. | Male 81 years old Reason: 81yo M w/ aspiration PNA, now w/ dobhoff placed History: as above Residual enteric contrast is noted in the colon segments. Enteric feeding tube tip projects over the gastric fundus/ gastric body. The pelvis is excluded from the field of view. Incompletely imaged bowel demonstrates gaseous distention which may represent diffuse ileus. No free air. Stable lung findings. | Enteric tube with its the in the proximal stomach/gastric body |
Generate impression based on findings. | Female 78 years old Reason: constipation History: abd discomfort, no bm Nonobstructive bowel gas pattern. Residual enteric contrast noted in the transverse and descending colon. No free air. | No free air. |
Generate impression based on findings. | Female 62 years old Reason: evidence of PE and evidence of ILD? History: patient admitted with significant hypoxia, reported CP at home, tachycardic and relatively hypotensive. Concern for PE, and CXR was confcerning for possible ILD. PULMONARY ARTERIES: Technically adequate study without evidence of acute pulmonary embolus. Pulmonary artery caliber is 32 mm in diameter.LUNGS AND PLEURA: There is upper lobe predominant emphysema. Dense reticular interstitial lung changes are compatible with underlying interstitial lung disease. No definite evidence of honeycombing. Bibasilar scarring is noted. No pleural effusion or pneumothorax. Right upper lobe calcified pulmonary nodule likely reflects prior granulomatous disease.MEDIASTINUM AND HILA: There are mildly prominent right paratracheal, perivascular, and bilateral hilar lymph nodes. A reference paratracheal lymphnode measures 10 mm (series 7, image 65). Right hilar calcifications likely reflect prior granulomatous disease. Heart size is upper limits of normal with mild enlargement of the right heart chamber. There are moderate coronary artery calcifications.CHEST WALL: Degenerative changes of the thoracolumbar spine with vacuum phenomena seen at lower thoracic vertebral body. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No acute pulmonary embolus.2.Upper lobe predominant emphysema.3.Dense reticular interstitial lung changes compatible with interstitial lung disease.4.Mildly prominent paratracheal, perivascular, and hilar lymph nodes may be inflammatory or infectious in nature. PULMONARY EMBOLISM: PE: No PE.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 76 years old Reason: NG History: NG Enteric feeding tube projects over the pyloric area. The pelvis is excluded from the field of view. Nonobstructive bowel gas pattern. Left lower lobe opacity is again noted. | No free air. |
Generate impression based on findings. | Female 68 years old Reason: abdominal distension, assess for ileus History: abdominal distension, assess for ileus Air distended colon is again noted. No air is in the rectum. Mildly dilated small bowel loops. This may represent an ileus or obstruction. No free air. | Small bowel ileus or obstruction. CT is recommended for further evaluation. |
Generate impression based on findings. | Ataxia, headache. History of trigeminal neuralgia. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter particularly in the left periatrial region which are nonspecific but favored to represent chronic small vessel ischemic changes. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | 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. |
Generate impression based on findings. | Male 53 years old Reason: R/o VAD driveline fracture History: driveline fault alarms Low lung volumes with nonspecific raise her opacities that may represent atelectasis. AICD and LVAD pump are unchanged compared to prior examination. Nonobstructive bowel gas pattern. No free air. | No free air. |
Generate impression based on findings. | Male 83 years old Reason: abdominal pain and distension History: abdominal pain, distension The tip of the enteric tube is curled in the gastric fundus, unchanged from previous study. There is increased distention of small bowel and colonic loops with air. These findings are present ileus. However obstruction cannot be excluded. CT of the abdomen pelvis may be helpful for further evaluation. | Interval worsening of the gaseous distention of the bowel segments which may represent an ileus versus obstruction. CT of the abdomen and pelvis may be helpful for further evaluation. No free air. |
Generate impression based on findings. | Male 59 years old Reason: dht positioning History: dht positioing Enteric tube terminates at the antropyloric region, unchanged from previous study. Multiple lines, tubes and support devices project over chest and abdomen. Cardiomegaly and left lower lobe pulmonary opacity, unchanged. | No free air. |
Generate impression based on findings. | Female 69 years old Reason: recent cystectomy, now with abdominal distension, assess for ileus versus obstruction History: see above Nonobstructive bowel gas pattern. No free air. Bilateral double-J stents project over the kidneys and the ureters. No free air. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Female 71 years old Reason: 71 y/o lady w/ nausea/vomiting History: nausea/vomiting Nonobstructive bowel gas pattern. No free air. Multiple phleboliths in the pelvis. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 18 years old Reason: Evaulate for toxic megacolon, history of colitis History: abd pain and fever Nonobstructive bowel gas pattern. No free air. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 64 years old Reason: ileus? History: abd distension Nonobstructive bowel gas pattern. No free air. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 45 years old Reason: r/o PE History: SOB, tachycardia, new O2 requirement. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. Pulmonary artery caliber is within normal limits. There is no evidence of right heart strain.LUNGS AND PLEURA: There are patchy areas of airspace opacities and interstitial reticular airspace opacities in the right lower lobe, left upper and left lower lobes of the lungs are possibly due to infection/aspiration with underlying interstitial lung disease.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy. Heart size is within normal limits.CHEST WALL: There is some endplate degenerative changes of couple of mid thoracic vertebral bodies.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple incompletely evaluated liver lesions are noted, particularly in the left lobe of the liver and are new when compared to CT abdomen from October of 2010.. These would be better evaluated with dedicated liver imaging. | 1.No acute pulmonary embolus.2.Airspace and interstitial opacities may be due to infection/aspiration, with possible underlying interstitial lung disease.3.Incompletely evaluated liver lesions, particularly in the left lobe of the liver. Dedicated liver imaging is recommended.PULMONARY EMBOLISM: PE: No pulmonary embolus.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male 66 years old Reason: Pt undergoing transplant work up. He has a small thoracic aortic aneurysm on his CT Chest wo and needs a full study to further eval before proceding with OHT History: Hx of thoracic aortic aneurysm CHEST:LUNGS AND PLEURA: Mild emphysema scattered micronodules.MEDIASTINUM AND HILA: There is a filling defect in the right lower lobe pulmonary artery that extends to the posterior segmental branches compatible with pulmonary embolus.Severe coronary artery calcifications. AICD is unchanged. Again seen is aneurysmal dilatation of the thoracic aorta immediately proximal to the diaphragm with adherent thrombus measuring up to 4.2 cm in AP dimension. Severe atherosclerotic changes affect the aorta and its branches.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cyst.RETROPERITONEUM, LYMPH NODES: Diffuse atherosclerotic calcifications involving the abdominal aorta and its major branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: 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 | Distal thoracic abdominal aortic aneurysm as described above. Diffuse atherosclerotic changes involving the abdominal aorta and its branches.Right lower lobe pulmonary artery embolus. |
Generate impression based on findings. | There are stable posttreatment/postsurgical changes in the neck without evidence of mass lesions or significant cervical lymphadenopathy. There is ill-defined soft tissue thickening and enhancement in seen involving the right floor of mouth and sublingual space measuring approximately 35 x 17 mm, unchanged. It was shown to not have significant FDG activity on the prior PET/CT. Therefore, it is favored to represent posttreatment change. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures show no focal lesions. There is disk osteophyte complex at C5-6 again seen. The airways are patent. The imaged intracranial structures are unremarkable. There is a right chest wall port. Please refer to dedicated accompanying CT chest report for further details. | Stable exam with no evidence of tumor recurrence or significant cervical lymphadenopathy.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 66 years old Reason: rule out PE History: tachypnea, malignancy, shortness of breath. Study is limited by patient motion artifact.PULMONARY ARTERIES: Technically adequate opacification of the pulmonary artery without evidence of acute pulmonary embolus to the subsegmental level. There is no evidence of right heart strain.LUNGS AND PLEURA: Left upper lobe ground glass opacity is new from the prior study and measures approximately 10 mm in diameter (series 11, image 16). A left lower lobe subpleural nodule is new from the prior exam measures 7 mm (series 11, image 64) and may reflect tumor, less likely a pulmonary infarct. There is bibasalar dependent atelectasis. No evidence of infection. There is no pleural effusion.MEDIASTINUM AND HILA: Previously enlarged superior mediastinal lymph node is not as well visualized on this exam, in part due to artifact from bone and contrast injection, but measures approximately 15 mm along its short axis (series 8, image 68) and previously measured approximately 18 mm along its short axis. Mild coronary artery lesions are noted. The heart size is within normal limits.CHEST WALL: A large right soft tissue breast mass is again seen and measures approximately 96 x 15 mm (series 8, image two a one) and previously measured 98 x 60 2 mm, and differences in measurement may be in part due to patient positioning. There is persistent overlying skin thickening and internal air extending to the lateral surface, which may be due to a tract from recent biopsy; however, given the persistence since prior exam, this may be due to fistula formation and an underlying infection cannot be entirely excluded. There are small masses in the left breast.Again seen are enlarged axillary, internal mammary, and subpectoral lymph nodes. Reference right axillary lymph node/lymph node conglomerate appears to have decreased in size and measures 39 x 23 mm (series 8, image 129) previously measured 47 x 29 mm , and appears somewhat heterogeneous suggestive of necrosis. A reference left axillary lymph node/lymph node conglomerate measures 30 x 25 mm (series 7, image 62) and previously measured 34 x 34 mm, appears to have slightly decreased in size. Again seen is severe kyphosis of the thoracic spine with diffuse osseous metastatic disease within the visualized axial and appendicular bones. There is loss of height of presumed L1, T8, and T6 vertebral bodies, which is unchanged from the prior exam. There is partial extension of the L1 vertebral body collapse into the spinal canal. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No acute pulmonary embolus.2.No interval change of large right breast mass with extensive metastatic involvement including the contralateral breast and diffuse axillary and appendicular skeletal involvement.3.Possible new right breast fistula with underlying infection of the above. Clinical correlation is recommended.4.Interval decrease in reference right and left lymphadenopathy, with questionable necrosis of right axillary lymph node conglomerate.PULMONARY EMBOLISM: PE: No pulmonary embolus.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male 36 years old Reason: stone History: n-v, hematuria spasmodic abdo pain on right This study is limited due to lack of oral and intravenous contrast. Bowel loops cannot be optimally evaluated.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Evaluation of the bowel loops is very limited due to lack of oral and intravenous contrast. Within these limitations there is mild wall thickening involving the cecum and the terminal ileum. Mild fat stranding around the cecum. Appendix cannot be visualized with this limited study.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Limited study due to lack of oral and intravenous contrast. Mild wall thickening involving the cecum and terminal ileum which cannot be optimally evaluated. The appendix is not visualized. Acute appendicitis and other acute inflammatory conditions involving the right lower quadrant cannot be optimally evaluated with this limited CT. If there is clinical concern, contrast enhanced CT is recommended for further evaluation. |
Generate impression based on findings. | Male 53 years old Reason: assess for necrotizing pancreatitis, abscess History: abd pain since 3am, N/V, hx pancreatitis; elevated lipase \T\ lactate ABDOMEN:LUNG BASES: New bilateral pleural effusion and dependent atelectasisLIVER, BILIARY TRACT: There is mild biliary prominence up to the intrapancreatic portion of the common bile duct.SPLEEN: No significant abnormality notedPANCREAS: Pancreas is diffusely images with small amount of peripancreatic fluid consistent with acute pancreatitis. No evidence of necrosis. A total development of dysmorphic calcifications in the uncinate process, compatible with chronic pancreatitis.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:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Acute on chronic pancreatitis without evidence of necrosis or pseudocyst formation. Small amount of fluid around the pancreas extending inferiorly along the left pararenal fascia. |
Generate impression based on findings. | Female 19 years old Reason: Appendicitis vs. TOA? History: Abdominal pain, RLQ ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix is slightly enlarged with an appendicolith at its base. Walls of the appendix is mildly thickened. These findings are compatible with early acute appendicitis. There is minimal fat stranding around the appendix.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: Small amount of free fluid in the pelvis. | CT findings compatible with acute appendicitis. |
Generate impression based on findings. | Fall, rule out bleed No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. There is encephalomalacia in the right frontal lobe similar to 7/1/2008. There is also encephalomalacia involving the right anterior temporal lobe, which is new since prior. There is diffuse supratentorial as well as infratentorial parenchymal volume loss including the cerebellar vermis and to a lesser degree the cerebellar hemispheres. No hydrocephalus. No extra-axial collections.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. | 1. No evidence of intracranial hemorrhage or mass effect. 2. Advanced supratentorial and infratentorial parenchymal volume loss. Encephalomalacia in the right frontal lobe is unchanged. Encephalomalacia in the right anterior temporal lobe is new since 2008 and may be related to prior trauma. |
Generate impression based on findings. | There are posttreatment findings related to total thyroidectomy and bilateral neck dissection with no detectable mass or significant cervical lymphadenopathy. There is a stable small left tonsillolith, and a small air-filled left internal laryngocele. The major salivary glands show no focal lesions. The osseous structures show no focal lytic or blastic lesions. The airways are patent. The imaged intracranial structures are unremarkable. Please refer to dedicated accompanying CT chest report for further details. The left internal jugular vein appears to continue as the left vertebral vein superiorly. The major cervical vessels are otherwise patent. There is right chest wall port. | 1.Posttreatment findings without evidence of locoregional tumor recurrence or significant cervical lymphadenopathy.2.Please refer to separate CT chest report for findings in the chest. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Fever, altered mental status, rule out shunt malfunction There is no evidence of acute intracranial hemorrhage. Again seen is absence of the septum pellucidum with monoventricle appearance of the lateral ventricle superiorly. The bilateral frontal and occipital lobes are unfused. There is no significant change in size of the dilated lateral ventricle measuring 82 mm compared to 85 mm in the same plane. Small extra-axial collection along the bilateral convexities measure approximately 9 mm in diameter are not significantly changed since 1/18/2014. Right transfrontal VP shunt catheter is again seen with tip within the left aspect of the lateral ventricle and unchanged. No new mass or mass effect. Severely diminished brain parenchymal volume is noted particularly involving the bilateral posterior temporal, occipital, and parietal lobes. Diffuse calvarial thickening is noted which may be related to chronic shunting or anti-seizure medications. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. | 1. No evidence of acute intracranial hemorrhage or mass effect. Unchanged size and appearance of the shunted ventricular system and small extra-axial collections. The visualized portion of the shunt catheter is intact.2. Extensive volume loss involving the posterior temporal, occipital, and parietal lobes. Dilated ventricles limit evaluation of the parenchyma. There is normal separation of the frontal and occipital lobes. The septum pellucidum is not seen superiorly which may be related to chronic severe hydrocephalus or other developmental entities and can be correlated with history and prior MRI if available. |
Generate impression based on findings. | There is an unchanged large infiltrative mass within the thyroid bed measuring up to 65 mm on series 8 image 42 which appears similar to December 2014. The mass again is noted to and invade the paraglottic and glottic tissues, trachea, and thyroid cartilage. The airway inferior to the tracheostomy is patent although superiorly it remains narrowed circumferentially by tumor within the airway. There is an subcutaneous nodule overlying the manubrium measuring 27 x 22 mm which has grown from 21 x 14 mm in December 2014; there is associated lysis of the underlying manubrium suggesting invasion of the manubrium with irregular and disrupted cortex similar to prior. A left paratracheal lymph node measuring 28 x 18 mm is unchanged from December 2014. A subcentimeter left level 3 lymph node on series 8 image 42 is stable. The parotid and submandibular glands are unremarkable. There is mild mucosal thickening involving the paranasal sinuses. There is an incompletely imaged right chest wall port. Imaging of the brain demonstrates no evidence of parenchymal metastasis. Again seen is a large lytic lesion involving the left frontal calvarium measuring approximately 45 x 49 mm, series 14 image 26, and right parietal lesion measuring 28x 33 mm, image 29 series 14. Both lesions demonstrate extension into the intracranial epidural space and scalp. No new bony lesions are identified. The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no evidence of intracranial hemorrhage or abnormal extra-axial fluid collection. | 1. Compared to most recent exam from 2/13/2015, there is no appreciable interval change. However, compared to the more remote exam from December 2014, there appear to be slight interval worsening with enlarging metastatic subcutaneous lesion abutting the manubrium superficially with osseous erosion. 2. Again seen is the large infiltrative mass within the thyroid bed with invasion of the upper airways. Also again seen are large lytic lesions involving the left frontal and right parietal bones with mild epidural extension and not appreciably changed.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 14-week-old former 27 week gestational age patient with pleural effusion. Where is chest tube located?VIEW: Chest crosstable lateral (one view) 03/01/15, 0723 Left chest tube tip is located anteriorly. Feeding tube tip is in stomach. Central line has its tip at junction of superior vena cava and right atrium. Left anterior pneumothorax is identified. Diffuse lung opacities are seen. Heart border cannot be visualized. | Chest tube tip located anteriorly. |
Generate impression based on findings. | Respiratory distress. 10-day-old former 30 week gestational age patient.VIEWS: Chest and abdomen AP (two views) 03/01/15, 0825 Feeding tube tip is in the stomach and side-port is at GE junction. Umbilical venous line tip is at level of left hepatic vein. Endotracheal tube has been removed.Cardiothymic silhouette size is normal. Bilateral perihilar air space disease is present. The periphery is without opacity.Bowel gas pattern is disorganized. Multiple mildly dilated featureless loops are seen. No pneumatosis intestinalis, portal venous gas, or free peritoneal air is present. | Central lung opacities. Probable early NEC. |
Generate impression based on findings. | Male 75 years old Reason: r/o stone History: RUQ pain, vomiting, Abd ultrasound benign, LFTs wnl; hx stones 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: Nonobstructing right upper pole renal stone. In addition there is a subcentimeter high density lesion in the upper pole of the right kidney, best seen on image number 40, series number 3. This lesion is new from previous study but cannot be alterably characterized due to lack of intravenous contrast. Nonobstructing left renal stones are also present. No evidence of urethral stones. There is a stone in the bladder.There is also an ill-defined hypodense lesion in the midpole of the left kidney which cannot be optimally characterized with this noncontrast study. This lesion measures 1.5 cm on image number 42, series number 3.RETROPERITONEUM, LYMPH NODES: Borderline enlarged retroperitoneal lymph nodes. An index left aortic node measures 9 mm in diameter image number 50, series number 3. These are new from previous study.BOWEL, MESENTERY: There are multiple significantly enlarged mesenteric lymph nodes of uncertain etiology and significance. An index node measures 2.8 by 1.5-cm in image number 58, series number 3. Compared to CT from 2005 these adenopathy have increased in size and number.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Small stone on the left side of the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Bilateral lung obstructing nephrolithiasis. Small stone in the bladder.Subcentimeter new high density lesion in the upper pole of the right kidney which cannot be optimally characterized due to lack of intravenous contrast. An ill-defined hypodense lesion in the mid left kidney is also indeterminate in origin.Interval increase in the size and number of retroperitoneal and mesenteric adenopathy. The etiology and significance of these nodes is uncertain, however, lymphoma cannot be excluded.These findings were discussed with and acknowledged by Dr. Kerem at the time of the dictation. |
Generate impression based on findings. | Constipation and fever. Dilated bowel on chest radiographVIEW: Abdomen AP (one view) 03/01/15, 1029 A gastrostomy tube is present. Surgical clips are seen in left upper quadrant. Moderate to large amount of feces is present in rectosigmoid. Small to moderate amount is seen in the rest of the bowel. No significantly dilated bowel loops are noted. Left thoracolumbar curve is present. | Moderate to large amount of feces in rectosigmoid. |
Generate impression based on findings. | Female 63 years old Reason: PE History: CHest pain; SOB. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus to the subsegmental level. Pulmonary artery caliber is within normal limits. There is no evidence of right heart strain.LUNGS AND PLEURA: No pleural effusions or focal air space opacities. No evidence of pneumothorax. There is dependent bibasilar atelectasis.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy. Cardiac size is within normal limits there are mild coronary artery calcifications.CHEST WALL: Small focus of air anterior to the right first costochondral junction likely reflective of degenerative changes of rather than pneumomediastinum.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Note is made of cholecystectomy clips. | No pulmonary embolus.PULMONARY EMBOLISM: PE: No pulmonary embolus to the subsegmental level.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male 37 years old Reason: Hx of ALL on chemo History: Dyspnea, tachycardia, neutropenic fevers, diarrhea This study is limited due to lack of intravenous contrast.CHEST:LUNGS AND PLEURA: There are upper lobe predominance centrilobular groundglass nodules bilaterally throughout the lungs. There is also accompanying groundglass opacity bilaterally.MEDIASTINUM AND HILA: Scattered mediastinal adenopathy. Index paratracheal node measures 2 x 1.2 cm on image number 27, series number 3.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral mildly enlarged kidneys. Correlation with renal function tests is recommended.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Limited study due to lack of intravenous contrast. Bilateral groundglass nodules and opacities predominantly in the upper lobes. Scattered mediastinal enlarged lymph nodes. These findings are nonspecific and may represent respiratory bronchiolitis, hypersensitivity pneumonia versus other infectious etiology given patient's image status. |
Generate impression based on findings. | Female 18 years old Reason: Appenicitis? History: RLQ pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: 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 | Unremarkable study. |
Generate impression based on findings. | Male 61 years old Reason: R/o kidney stone, ureteral obstruction History: Acute kidney injury, Hydronephrosis on renal US ABDOMEN:LUNG BASES: Bilateral moderate pleural effusions and dependent atelectasis. Mild cardiomegaly.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is left-sided hydronephrosis with left extrarenal pelvis and normal left ureter. No evidence of stones. Etiology of this left hydronephrosis is uncertain.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Generalized anasarca.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Left moderate hydronephrosis with transition point at the level of the left UPJ. The etiology is unknown and this CT is limited due to lack of intravenous contrast. No stones are identified to explain the obstruction. This may be secondary to UPJ obstruction, however, a neoplasm at that location cannot be excluded. Further evaluation with contrast-enhanced CT is recommended.Generalized anasarca.Dr. Mikolajczyk was notified and acknowledged about these findings at the time of the dictation. |
Generate impression based on findings. | Male 76 years old Reason: R/O PE History: 76 yo M with hx ptx s/p chest tube and vats pleurodesis, worsening hypoxia and tachypnea. PULMONARY ARTERIES: Patient artifact limits evaluation. Within this limitation there is no evidence of pulmonary embolus to the subsegmental level. Pulmonary artery caliber is within normal limits. There is no evidence of right heart strain.LUNGS AND PLEURA: There is right-sided pneumothorax with associated lung collapse and two chest tubes, one anterior and one posterior, in place. The tip of the anterior chest and appears to be embedded in the right mediastinum and may be occluded, and the tip of the posterior chest tube appears to be embedded in the superior soft tissues near the apex of the lung. There is moderate to severe emphysema with apical blebs and cysts. There is a small left pleural effusion with overlying compressive atelectasis and a small right sided pleural effusion. MEDIASTINUM AND HILA: There is no hilar or mediastinal lymphadenopathy. There is moderate coronary artery calcifications. Cardiac size is within normal limits.CHEST WALL: Note is made of sternotomy wires. Mild to moderate degenerative changes affect the thoracolumbar spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Questionable distention and surrounding stranding of the gallbladder is better evaluated on same day CT abdomen/pelvis. | 1.No pulmonary embolus.2.Right sided pneumothorax with two chest tubes. The tip of the more anterior chest tube appears to be embedded in the the right mediastinum and may be occluded due to this reason. The tip of the posterior chest tube appears to be embedded in the right apical soft tissues and may be occluded. 3.Questionable cholecystitis, which is better evaluated on same day CT abdomen/pelvis.PULMONARY EMBOLISM: PE: No acute pulmonary embolusChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. These findings were verbally relayed to Dr. Joseph Wynne on 3/1/2015 at 106pm. |
Generate impression based on findings. | Slammed left index finger in door.EXAMINATION: Left index finger PA/lateral (one view) 02/28/15 Skin irregularity is noted over the distal fingertip. The bones are normal in appearance. No fractures identified. | No fracture. |
Generate impression based on findings. | Female 42 years old Reason: r/o PE as well as assess for aortic dissection; assess mediastinal mass (thought to be post-surgical changes at Northwestern) History: R chest pain; Tetrology of fallot repair as a child, recent diagnosis CHF; mediastinal mass seen on CXR yesterday CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No evidence of pulmonary embolus. Cardiomegaly. Significantly enlarged main pulmonary artery measuring 3.3-cm in diameter. Postsurgical changes involving the heart and main pulmonary artery. Ectatic and tortuous ascending aorta measuring 3.6-cm in its maximal AP dimension. All caliber descending thoracic aorta. This isCHEST WALL: No significant abnormality noted.Cirrhotic liver. Focal liver lesions cannot be excluded with this limited study. Splenomegaly. | No evidence of pulmonary embolus. Significantly enlarged main pulmonary artery, ectatic and tortuous ascending aorta and postsurgical changes involving the heart. Cirrhosis and portal hypertension. |
Generate impression based on findings. | Male 76 years old Reason: R/O obstruction, evaluate j-tube placement History: J-tube dependent, worsening consitpation/ abdominal distension, ?small bowel dilation on KUB ABDOMEN:LUNG BASES: Chest section of the dated separately.LIVER, BILIARY TRACT: Distended gallbladder with mild gallbladder wall thickening. Acute cholecystitis cannot be excluded. Correlation with ultrasound findings is recommended.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: Significant amount of stool in the colon without evidence of small bowel obstruction. G-tube is in place.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Possible acute cholecystitis. Correlation with ultrasound findings is recommended.No evidence of small bowel obstruction.Chest CT findings would be dictated separately. |
Generate impression based on findings. | Male 35 years old Reason: r/o pe History: chest pain with abdominal pain. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. Pulmonary artery caliber is within normal limits. There is no evidence of right heart strain.LUNGS AND PLEURA: No focal air space opacity, pleural effusion, or pneumothorax. There is bibasilar dependent atelectasis.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy. Cardiac size is within normal limits. Mild coronary artery calcifications. Main airways are patent.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. There is mild prominence of the pancreatic head with punctate calcifications. Please refer to same day CT abdomen for further evaluation. | No pulmonary embolus.PULMONARY EMBOLISM: PE: No pulmonary embolus.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 48 years old Reason: SBO? History: abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Mild hepatomegaly, unchanged.SPLEEN: No significant abnormality notedPANCREAS: Changes secondary to distal pancreatectomy and chronic pancreatitis, unchanged.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Fat containing ventral hernia, unchanged. No evidence of small bowel obstruction.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 | No evidence of small bowel obstruction. |
Generate impression based on findings. | Male 70 years old Reason: r/o PE History: SOB. PULMONARY ARTERIES: Exam is limited to to patient motion artifact. Within this limitation, there is no evidence of pulmonary embolus to the subsegmental level. Pulmonary artery measures 35 mm in diameter. Right cardiac chamber is mildly enlarged.LUNGS AND PLEURA: Right apical ground glass opacities (series 11, image 26) are nonspecific and may be inflammatory, infectious, neoplastic in etiology. There is bibasilar atelectasis. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: There are prominent right hilar, subcarinal, and left prevascular lymph nodes. A reference enlarged left mediastinal lymph node in the AP window measures 2.6 x 1.9 cm (series 9, image 11). Scattered right hilar and mediastinal calcifications likely reflect prior granulomatous disease. Cardiac size is mildly enlarged.CHEST WALL: Severe degenerative changes of the thoracolumbar spine with anterior osteophytes and facet joint osteoarthritis.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Mildly enlarged pulmonary artery and right cardiac chamber without evidence of pulmonary embolus to the subsegmental level.2.Enlarged mediastinal and hilar lymph nodes and right apical pulmonary ground glass opacities as described above may be inflammatory, infectious, neoplastic in etiology. Follow to resolution is recommended.PULMONARY EMBOLISM: PE: No pulmonary embolus.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Fall, rule out bleed 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 prominent but within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent mild chronic small vessel ischemic changes. There is mild vertebrobasilar dolichoectasia.There is mild mucosal thickening involving the right maxillary sinus. Mastoid air cells are clear. Calvarium is intact. | No evidence of acute intracranial hemorrhage or mass effect. No skull fracture. |
Generate impression based on findings. | Male 35 years old Reason: evidence of malignancy or other GI cause of unintentional wt loss over past several months? History: admitted for acute on chronic pancreatitis, significant wt loss over past year, history of vascular disease as well ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Pancreatic duct is dilated with multiple parenchymal and ductal calcifications. Pancreas is also mildly enlarged. There are inflammatory changes in the fat surrounding the pancreas. These findings are consistent with acute on chronic pancreatitis.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:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Acute on chronic pancreatitis. |
Generate impression based on findings. | 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 hydrocephalus. No extra-axial collections. There is mild left greater than right maxillary sinus mucosal thickening. Mastoid air cells are clear. Calvarium is intact. Prominent periapical lucency noted involving a partially visualized left maxillary molar tooth. | 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. |
Generate impression based on findings. | Male 48 years old Reason: r/o abscess or other intraabdominal etiology for pain/infection History: diffuse abd pain, leukocytosis, tachycardic Limited study due to lack of intravenous contrastABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Significant hepatomegaly. Gallbladder is distended with significant amount of pericholecystic fat stranding consistent with acute cholecystitis. No evidence of biliary dilatation.SPLEEN: Moderate splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: Right adrenal adenoma and diffuse and left adrenal gland.KIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Limited study due to lack of intravenous contrast. Acute cholecystitis which may also be perforated.Hepato- splenomegaly.Right adrenal adenoma and infuses the left adrenal gland. |
Generate impression based on findings. | Female 86 years old Reason: r/o dissection History: back pain CHEST:LUNGS AND PLEURA: Right middle lobe peripheral nodule opacity now measures 1.1 x 0.9 cm on image number 77, series number 11, not significantly changed from CT dated September 2014. Redemonstration of a large right upper lobe nodular opacity now measuring 3.6 by 2.2 cm in image number 31, series number 11, increase in size compared to the previous study. This lesion is suspicious for a neoplasm such as a primary lung malignancy. Severe emphysema.MEDIASTINUM AND HILA: No evidence of thoracic abdominal aortic aneurysm. Prominent arteries enlarged. Cardiomegaly. Diffuse atherosclerotic changes involving the thoracic aorta and coronary arteries.CHEST WALL: Postoperative changes from left apical plombage. Multiloculated and partially calcified fat containing collections in the left posterior lateral and posterior chest wall are unchanged.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral hypodense lesions likely representing benign and complex cysts.RETROPERITONEUM, LYMPH NODES: Aneurysmal dilatation of the upper abdominal aorta measures 4.1 centimeter in largest AP dimension, not significantly changed. There are severe atherosclerotic changes involving the aorta and its major branches. Severe stenosis is present at the origin of the celiac trunk and SMA. IMA is not visualized. Left renal artery is not visualized. Severe stenosis at the origin of the right renal artery. Focal dissection involving the distal abdomen aorta for a short segment.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval increase in the size of the right upper lobe mass suspicious for a primary lung cancer. Right middle lobe opacity is unchanged.Upper abdominal aortic aneurysm and severe diffuse atherosclerotic changes are again noted. Left renal arteries not visualized. Significant stenosis at the origin of the celiac trunk, right renal artery and SMA. Focal dissection of the distal abdominal aorta for a short segment. |
Generate impression based on findings. | The frontal sinuses are hypoplastic. The right frontal sinus is totally opacified. The bilateral anterior and posterior ethmoid air cells are predominately incompletely opacified with mild aeration present in the anteriormost ethmoid air cell. There are tiny foci of gas and a few ethmoid air cells suggesting possible bubbly secretions, and mild hyperdensity in some ethmoid air cells suggesting either inspissated secretions or fungal colonization. There is also expansile nature of the opacification in the ethmoids. There is moderate mildly hyperdense opacification of the right maxillary sinus with minimal frothy secretions. There is a moderate left maxillary sinus air-fluid level with frothy secretions and minimal mucosal thickening as well. There is mild right sphenoid mucosal thickening. There is minimal left sphenoid mucosal thickening with frothy secretions. There is near complete opacification of the middle meatus and loss of the nasal cavity is well.There is no osseous erosion by the maxillary sinus walls or lamina papyracea. Aside from mild expansile nature in the ethmoid sinuses, there is no significant remodeling of the bones in the sinonasal cavity. The anterior skull base is intact. The mastoid air cells are clear. | 1.There is extensive bilateral ethmoid, right maxillary and right frontal sinus opacification with hyperdense secretions, which may be due to inspissated secretions versus fungal colonization; overall imaging findings and provided history suggest allergic fungal sinusitis.2.Air-fluid levels with frothy secretions in the left maxillary and sphenoid sinus, which may suggest a component of acute left sinusitis in the appropriate clinical setting. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Syncope, rule out bleed Head: No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. There is global parenchymal volume loss which is again seen. No hydrocephalus. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent chronic small vessel ischemic changes.There is mild mucosal thickening involving the right sphenoid sinus. Mastoid air cells are clear. Calvarium is intact.Cervical spine: The cervical vertebral bodies are appropriate height. There is minimal retrolisthesis of C5 on C6. Alignment is otherwise maintained. No fractures are identified in the cervical spine. No suspicious bony lesions are identified in the cervical spine.Multilevel degenerative changes are seen particularly at C4-C5 and C5-C6 with severe loss of intravertebral space, vacuum phenomena, sclerosis, and osteophyte formation. There is mild spinal canal stenosis at C4-C5 related to disk osteophyte complex and to a lesser degree at C5-C6. There is mild to moderate right C5-C6 neural foraminal stenosis. There is also mild right C3-C4 and mild left C4-C5 neural foraminal narrowing.Limited evaluation of the lungs demonstrates biapical scarring with calcifications. | 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. No acute fracture or traumatic subluxation within the cervical spine. Degenerative changes are seen as detailed above. |
Generate impression based on findings. | Female 68 years old Reason: abdominal pain, h/o jejununal resection - assess for abdominal infection, mesenteric ischemia History: abdominal pain, h/o jejununal resection - assess for abdominal infection, mesenteric ischemia This study is limited due to lack of intravenous contrast. ABDOMEN:LUNG BASES: Volume loss and scarring in the native right lung. Left-sided small to moderate pleural effusion.LIVER, BILIARY TRACT: Liver has nodular contours and enlarged left lobe which may be compatible with chronic liver disease.SPLEEN: No significant abnormality notedPANCREAS: Calcifications in the pancreas may be secondary to chronic pancreatitis.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is moderate to significant amount of ascites. Significant wall thickening involving the proximal jejunal segment is consistent with patient's known history of post transplant lymphoproliferative disorder. There is mild ileus, however, no evidence of bowel obstruction. BONES, SOFT TISSUES: Generalize anasarca.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Significant amount of ascites.BONES, SOFT TISSUES: Generalize anasarca.OTHER: No significant abnormality noted | Limited study due to lack of intravenous contrast. Significant focal wall thickening involving the jejunum consistent with patient's known history of lymphoma. Other smaller deposits in the anterior abdominal wall and peritoneum which are hot on PET cannot be well seen on this noncontrast study. Significant amount of ascites. Moderate left-sided pleural effusion. Mild ileus. |
Generate impression based on findings. | Female 72 years old Reason: r/o obstruction History: pain This study is limited due to lack of intravenous contrast.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Stomach is distended. Again noted mildly dilated right lower quadrant small bowel loops measuring up to 3.2 cm with decompressed more distal loops including the terminal ileum. Dilated right lower quadrant small bowel loops contain stool-like material, again indicating some level of obstruction. Small amount of fluid is present between the loops. Small amount of fat stranding in the right lower quadrant is slightly improved.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: Please see discussion aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Focally dilated right lower quadrant small bowel loops with decompressed distal including the terminal ileum. Further evaluation with MR enterography may be helpful. A distal partial obstruction cannot be excluded. |
Generate impression based on findings. | Female 28 years old Reason: r/o acute intraabdominal process History: acute abdomen, diarrhea, vomiting, cervical motion tenderness on GYN exam ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Diffuse fatty infiltration of the liver. Mild hepatomegaly.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Bilateral ovarian cysts. If there is a clinical concern for ovarian pathology a follow-up transvaginal ultrasound may be helpful for further evaluation of the ovaries.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Bilateral ovarian cysts. If there is a clinical concern for ovarian pathology a follow-up transvaginal ultrasound may be helpful for further evaluation of the ovaries. |
Generate impression based on findings. | Male 43 years old Reason: eval for primary lesion History: brain mass CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Benign right renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No CT evidence of a neoplasm in the chest, abdomen or pelvis. |
Generate impression based on findings. | Male 54 years old Reason: r/o ischemia History: abdominal pain, with vomiting, diarrhea, hypotension ABDOMEN:LUNG BASES: Bilateral dependent atelectasis/scarring.LIVER, BILIARY TRACT: Small hypodense lesions in the liver are nonspecific but are most likely benign.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: Large stomach with layering debris raises the possibility of delayed gastric emptying.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate.BLADDER: Diffusely thickened bladder wall.LYMPH NODES: Pelvic adenopathy, likely reactive.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Severe infectious/degenerative changes involving the left hip joint. Decubitus ulcers posteriorly.OTHER: No significant abnormality noted | Possible delayed gastric emptying. Chronic degenerative changes involving the left hip joint. No signs of ischemia involving the small bowel segments. |
Generate impression based on findings. | Male 70 years old Reason: r/o diverticulitis History: LLQ abdominal pain ABDOMEN:LUNG BASES: Chest CT will be dictated separately.LIVER, BILIARY TRACT: Chronic liver disease. Focal liver lesions cannot be excluded with this single phase CT.SPLEEN: Significant splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cyst. Atrophic left kidney with multiple stones and hydronephrosis. There is a stone in the left renal pelvis causing left-sided hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Appendix measures 7-mm in diameter, at the upper limit of its normal size. No significant periappendiceal fat stranding. This likely represents a normal appendix, however, if there is a clinical concern for appendicitis an early acute appendicitis cannot be excluded.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Appendix measures 7-mm in diameter, at the upper limit of its normal size. No significant periappendiceal fat stranding. This likely represents a normal appendix, however, if there is a clinical concern for appendicitis an early acute appendicitis cannot be excluded.Atrophic left kidney with multiple stones and mild to moderate hydronephrosis. Cortical scarring is also present.Cirrhosis and portal hypertension. |
Generate impression based on findings. | Female 58 years old Reason: eval intraabdominal infection, fluid collections, free pelvic/abd fluid, bowel obstruction History: fevers, tachycardia, known partial bowel obstruction, clear discharge from vagina s/p negative vesciovaginal fistula test ABDOMEN:LUNG BASES: Bilateral moderate pleural effusions and dependent is aLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral mild caliectasis, more prominent on the right compared to the left.RETROPERITONEUM, LYMPH NODES: Borderline enlarged retroperitoneal lymph nodes.BOWEL, MESENTERY: Again noted mild dilatation of the small bowel loops in the left upper quadrant measuring up to 4 cm in diameter. These small bowel loops demonstrate mild wall thickening. There is decompression of the small bowel distal to these segments, however, oral contrast freely extends into the distal small bowel and colon. Also noted wall thickening of the left-sided colon. Small amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterus is very heterogeneous. An underlying neoplasm cannot excluded with this single phase CT. Further evaluation with transvaginal ultrasound is recommended. Multiple calcified leiomyomas within the uterus.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Ascites demonstrates loculation in the pelvis measuring 6.6 x 3 .5 cm.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Wall thickening of the left-sided colon and proximal jejunal segments of uncertain etiology. Ischemia cannot be excluded.Proximal dilated small bowel loops with mild distal decompression. This may represent a mild partial small bowel obstruction.Borderline enlarged, nonspecific retroperitoneal lymph nodes.Heterogeneous uterus. Further valuation with pelvic ultrasound is recommended to exclude a neoplasm.Loculation of the ascites in the pelvis as described above. |
Generate impression based on findings. | Female 29 years old Reason: r/o stone History: hematuria, flank pain 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: Interval opening of significant right-sided hydronephrosis with dilated right ureter. There are multiple calcifications within the right ureter representing stones. Largest measures 8mm in diameter on image number 137, series number 3. Previously seen right ureteral stent is not visualized.Multiple small stones in the left kidney without evidence of hydronephrosis.RETROPERITONEUM, 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 | Significant right-sided hydronephrosis and hydroureter secondary to multiple large distal ureteral stones.Small left renal stones without evidence of hydronephrosis. |
Generate impression based on findings. | Female 39 years old Reason: r/o stone History: R flank pain, hematuria ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality noted. Small splenule.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 8mm nonobstructing stone in the left kidney. No evidence of stones in the right kidney.RETROPERITONEUM, 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 | 8mm nonobstructing stone in the left kidney. No evidence of hydronephrosis bilaterally. |
Generate impression based on findings. | Male 63 years old Reason: h/o esopahgeal carcinoma w/ brain mets, restaging History: seizures CHEST:LUNGS AND PLEURA: Index right middle lobe nodule measures 11-mm in diameter on image number 44, series number 4, decreased in size compared to previous study.Index left lower lobe subpleural nodule now measures 10 by 8 mm on image number 53, series number 4, decreased in size compared to previous study.MEDIASTINUM AND HILA: Right paraesophageal node now measures 3.4 by 2.2 cm on image number 61, series number 3, decreased in size compared to previous study. Other intrathoracic nodes have also slightly decreased in size compared to previous study.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Fat containing right inguinal hernia. | Interval decrease in the size of the lung nodules and mediastinal adenopathy as described above. |
Generate impression based on findings. | Female 59 years old Reason: concern for MM, dermatomyositis. hip pain History: hip pain. Two views of the left hip show lucencies within the femoral head and neck and proximal femoral diaphysis suspicious for myelomatous deposits. There is no acute fracture or malalignment.Three views of the sacroiliac joints again show the aforementioned lucencies within the femur as well as lucencies of the femoral head, neck, and proximal diaphysis suspicious for myelomatous deposits. There is no acute fracture malalignment. | Lytic appearing lesions suspicious for myelomatous deposits as described above. |
Generate impression based on findings. | Female 63 years old Reason: History of metastatic thyroid cancer, compare to previous, measurements please History: as above CHEST:LUNGS AND PLEURA: Index left lower lobe nodule measures 7-mm in diameter on image number 67, series number 5, not significantly changed in size. Other multiple bilateral lung nodules are also grossly unchanged. Tracheostomy tube is unchanged.MEDIASTINUM AND HILA: Diffuse encasing soft tissue around the trachea is unchanged. This mass extends into the superior mediastinum and possibly to the retrosternal space.CHEST WALL: Index soft tissue mass in the subcutaneous tissues of the anterior chest wall between the clavicular heads has not increased in size and now measures 2.7 x 2.4 cm image number 15, series number 3. A smaller nodule on the right side of this mass is also increased in size.ABDOMEN:LIVER, BILIARY TRACT: Mild biliary prominence and subcentimeter liver lesions are unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal stone, unchanged. Bilateral renal hypodensities are too small to characterize but most likely represent cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Right inguinal adenopathy is unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval increase in the anterior chest wall masses. Again noted is the extension of the patient's known thyroid mass into the mediastinum.Right renal stone is unchanged. |
Generate impression based on findings. | Male 64 years old Reason: COLON CANCER ON CHEMOTHERAPY History: EVALUATE RESPONE CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Index right hepatic lobe lesion measures 1.3 x 1.2 cm on image number 95, series number 9, smaller in size compared to previous study. Other bilobed lower hepatic metastases are also decreased in size compared to previous study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Renal hypodense lesions are unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Circumferential soft tissue mass involving the cecum and ileocecal bowel is now smaller measuring 3.1 x 2.8 cm on image number 154, series number 9. Pericecal lymphadenopathy is also smaller measuring 1.2-cm in diameter image number 152, series number 9.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Bilateral inguinal adenopathy, unchanged.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval decrease in the size of the cecal mass and hepatic metastases. |
Generate impression based on findings. | Female 43 years old , abdominal pain This study is limited the to lack of intravenous contrast.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Subcentimeter hypodense lesions throughout the liver cannot be characterized with this noncontrast study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: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 | Limited study due to lack of intravenous contrast. Subcentimeter small hypodense lesions in the liver cannot be optimally characterized with this noncontrast CT. No CT findings to explain patient's acute abdominal pain. |
Generate impression based on findings. | Male 44 years old Reason: pt with melanoma on Temodar please eval response to therapy and compare to previous imaging History: met melanoma CHEST:LUNGS AND PLEURA: Index left lower lobe mass measures 3 by 1.7 cm on image number 44, series number 4, not significantly changed from previous study. Right middle lobe mass measures 7.1 x 5.6 cm on image number 65, series number 4, increased in size compared to previous study. Most of the other bilateral lung nodules also increased in size compared to previous study.MEDIASTINUM AND HILA: Index subcarinal lymph node measures 1.4 by 0.8 cm on image number 50, series number 3, not significantly changed from previous study.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Changes secondary to avascular necrosis of the femoral heads, again noted.OTHER: No significant abnormality noted | Interval increase in the size of the most of the bilateral lung nodules. |
Generate impression based on findings. | Male 59 years old Reason: 59 y/o male with colon ca with mets, receiving chemo. please compare to prior CT History: colon ca with mets CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Index subcarinal lymph node is unchanged measuring 1.2 by 1.1-cm image number 44, series number 3.ABDOMEN:LIVER, BILIARY TRACT: Index lesion in the right hepatic lobe measures 1.6 x 1.4 cm on image number 92, series number 3, not significantly changed from previous study. Diffuse fatty infiltration of the liver is unchanged.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Index right retrocaval node measures 8mm in diameter image number 105, series number 3, smaller compared to previous study.BOWEL, MESENTERY: Index pericecal lymph node measures 1.5 x 1.4 cm on image number 151, series number 3, slightly smaller compared to previous study.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Right-sided fat containing inguinal hernia is unchanged. | Slight interval decrease in the size of the index pelvic lymph nodes in the abdomen. Otherwise no significant change from previous study. |
Generate impression based on findings. | Male 63 years old Reason: Hx of Follicular NHL History: Evaluate disease; compare w previous CHEST:LUNGS AND PLEURA: Mild emphysema, unchanged. Scattered bilateral micronodules are unchanged.MEDIASTINUM AND HILA: In the mediastinal lymph node measures 9 mm in the image number 52, series number 3 not significantly changed from previous study.CHEST WALL: Index left supraclavicular lymph node is smaller measuring 1.2 by 1 cm image number 13, series number 3. Other mediastinal lymph nodes are stable.Index left axillary node now measures 1.6 by 1.2-cm on image number 32, series number 3, slightly decreased in size compared to previous study. Other bilateral axillary lymph nodes also slightly decreased in size compared to previous study.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Index aortocaval lymph node measures 13 x 7 mm on image number 124, series number 3, significant decrease in size compared to previous study. Other retroperitoneal lymph nodes are also significant decrease in size.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Compression fracture of L2 vertebral body is unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Index left external iliac lymph node measures 1.1 x 1 cm image number 184, series number 3, significantly decreased in size compared to previous study. Other pelvic lymph adenopathy also significantly decreased in size compared to previous study.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Significantly decreased in size left supraclavicular, left axillary, abdominal and pelvic adenopathy as described above. Mediastinal lymph nodes are grossly stable. |
Generate impression based on findings. | There is no retropharyngeal edema or soft tissue swelling. There is no evidence of abscess or significant cervical lymphadenopathy. There is no thickening of the epiglottis. There are scattered prominent bilateral cervical lymph nodes which are subcentimeter in size, and likely reactive. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear.Of incidental note, there is apparent 2 x 1.6 cm aneurysmal dilatation of the right subclavian artery on series 80396 image 206. There are surgical clips in this region suggesting prior intervention. | 1.No retropharyngeal abscess or significant cervical lymphadenopathy.2.Suspect 2 x 1.6 cm aneurysmal dilatation of the right subclavian artery. There are surgical clips in this region suggesting prior intervention. Recommend correlation with prior history, and follow-up as clinically warranted.Findings were discussed with Dr. Tataris from the ED over the telephone at 9 AM today. |
Generate impression based on findings. | Female 38 years old Reason: s/p cervical laminectomy and fusion History: s/p cervical laminectomy and fusion . Postoperative changes with laminectomies of the C3, C4, C5, C6, and C7 vertebral bodies. Fusion hardware including vertebral body screws of C3, C4, C5, C6, and C7 appear to be in position without radiographic evidence of hardware complication. There is no focal fracture or malalignment. Again seen are anterior osteophyte formations at C4, C5, C6, and C7, which, in a patient of this age, suspicious for early diffuse idiopathic skeletal hyperostosis, but does not appear significantly changed from the prior study. | Postsurgical changes of the cervical spine as described above. |
Generate impression based on findings. | Fall No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. There is global parenchymal line loss without evidence of hydrocephalus. No extra-axial collections. There are extensive areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent advanced chronic small vessel ischemic changes. There is a chronic lacunar infarct in the right corona radiata.There is patchy mucosal thickening involving the paranasal sinuses with small air-fluid level in the left maxillary sinus. Mastoid air cells are clear. Calvarium is intact. | No evidence of acute intracranial hemorrhage or mass effect. Advanced chronic small vessel ischemic disease as seen on recent MRI. |
Generate impression based on findings. | Worsening left visual acuity, hypertensive urgency. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There is volume loss involving the right posterior callosal body which may be related to remote ischemic injury.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact. Images of the orbits demonstrate a small deformed right globe. There is hyperdense material within the left lobe which may represent silicone injection. | 1. No evidence of intracranial hemorrhage or mass effect. Please note MRI would be more sensitive for detection of acute ischemia or posterior reversible encephalopathy syndrome.2. Right globe is diminutive and deformed which may be related to prior globe rupture from trauma or other injury. Hyperdense posterior chamber of the left globe is compatible with prior surgery such as injection of silicone or other material. Correlate with history. |
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 demonstrates slight interval evolution. Diffuse bilateral subarachnoid hemorrhage extending into the ventricles appears similar to prior. A coil mass is present in the right paraclinoid region. There is minimal interval decrease in size of the ventricular system. Small amount of intraventricular air again seen. No new hemorrhage or CT evidence of large vascular distribution infarct. There is no midline shift or uncal herniation. The visualized paranasal sinuses, mastoid air cells, and orbits are unremarkable. The calvarium and soft tissues of the scalp are within normal limits. | Slight evolution of extensive bilateral subarachnoid and intraventricular hemorrhage. Slight evolution of right frontal intraparenchymal hematoma. Minimal interval decrease in size of the ventricular system. No new mass-effect or herniation. |
Generate impression based on findings. | There has been interval improvement in cervical, supraclavicular and upper mediastinal adenopathy. For example, there is a right tracheoesophageal groove lymph node on series 7 image 63 which measures 7 mm in short axis, 9 mm previously. There is a left supraclavicular lymph node on series 7 image 61 measuring 9 mm in short axis, previously 17 mm. There is a left supraclavicular lymph node on series 7 image 59 measuring 10 mm in short axis, previously 17 mm. There is a 18 x 11 mm left supraclavicular lymph node on series 7 image 57, previously 25 x 12 mm. There is unchanged moderate bilateral carotid bifurcation calcified plaque. The major vessels of the neck are otherwise patent. There is a stable subcentimeter low-attenuation right thyroid lobe nodule. The salivary glands are within normal limits and show no focal lesions. There is mild cervical degenerative spondylosis, similar to prior exam. The airways are patent. The imaged intracranial structures are within normal limits. There is moderate left maxillary sinus mucosal thickening, slightly worsened from prior exam. There is emphysematous change of the lung apices. There is a left chest wall pacemaker. The patient is status post median sternotomy. There is a stable nonspecific right anterior chest wall soft tissue attenuation nodule partly imaged on series 7 image 76. | Response to interval therapy with improvement in cervical, supraclavicular and upper mediastinal adenopathy compared to CT 1/16/2015 as detailed above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 63 yo male with dermatomyositis and altered mental status. No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. Cavum pellucidum and vergae incidentally noted. No extra-axial collections. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but favored to represent chronic small vessel ischemic changes.The visualized portions of the paranasal sinuses are clear. There is moderate opacification of the bilateral mastoid air cells. Calvarium is intact. | 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 clinical suspicion. |
Generate impression based on findings. | 61 years old Male. Reason: fracture, History: pain, decreased ROM. There is no evidence of acute fracture or dislocation. Mild degenerative changes are noted in the glenohumeral joint. | No evidence of acute fracture or dislocation. |
Generate impression based on findings. | Female 32 years old Reason: fracture History: fell . There is no acute fracture or dislocation. Vertebral body heights and intervertebral disk spaces are maintained. There is no prevertebral soft tissue swelling. There is straightening of the cervical spine. | No acute fracture or dislocation. |
Generate impression based on findings. | Female 91 years old Reason: 91 y/o F with arm swelling eval for DVT History: as above. Two views of the left shoulder show moderate to severe degenerative arthritic changes of the glenohumeral and acromioclavicular joints. There is no evidence of acute fracture or dislocation. The bones appear demineralized. A DVT cannot be ruled out on radiographic studies.Two views of the forearm show diffuse soft tissue swelling and reticulation along the entire length of the forearm. The bones appear demineralized, but there is no cortical disruption to suggest underlying osteomyelitis.. There is no acute fracture or dislocation. A DVT cannot be ruled out on radiographic studies. | Diffuse soft tissue swelling and reticulation of the forearm. A DVT cannot be ruled out on radiographic studies as clinically questioned. If there is continued concern evaluation with ultrasound or CT with contrast is recommended. |
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. Chronic small lacunar infarct in the left frontal periventricular white matter is also unchanged. Mild periventricular and subcortical white matter hypoattenuation compatible with chronic small vessel ischemic disease. There is advanced global parenchymal volume loss. No hydrocephalus. There is no midline shift or mass-effect. Paranasal sinuses and mastoid air cells are clear. Calvarium is intact. | 1. No evidence of acute intracranial hemorrhage or mass effect. 2. Multiple bilateral chronic infarcts as detailed above. No CT evidence of evolving acute infarct compared to 2/28/2015. |
Generate impression based on findings. | Female 64 years old Reason: R/o osteo History: Right 2nd digit and third left with hx ssti, discoloration drainage. Two views of the right hand. Tubing artifact overlies the right wrist. There is some soft tissue reticulation along the distal aspect of the second digit without definite underlying osseous erosion to suggest osteomyelitis. Again seen is amputation of the distal third finger. Again seen are sclerotic tuft of the second through fifth metacarpals. No acute fracture or malalignment.Two views of the left hand. There is some soft tissue swelling about the third digit with gas seen within the lateral soft tissues suspicious for infection. However there is no underlying bone erosion to suggest osteomyelitis. Again seen are sclerotic tuft of the second through fifth metacarpals. No acute fracture or malalignment. | No radiographic evidence of osteomyelitis as clinically questioned. Soft tissue gas is seen along the lateral aspect of the left third digit and is compatible with cellulitis. If further imaging is clinically warranted, an MRI or triphasic bone scan is recommended. |
Generate impression based on findings. | 66 years, Female, Reason: evaluate for obstruction, abscess History: abdominal distention, left sided pain, vomiting. ABDOMEN:LUNG BASES: Left basilar opacity is new from the prior exam.LIVER, BILIARY TRACT: Cholecystectomy clips. Hepatic hypodensity is too small to characterize. Prominent common bile duct without obstructing lesions evident. Perfusional abnormality in the left hepatic lobe.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcifications of aorta and its branches.BOWEL, MESENTERY: No evidence of bowel wall thickening or dilatation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: FemaleUTERUS, ADNEXA: Foley catheter. Status post hysterectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | While there is no intra-abdominal pathology on this exam, there is a new left basilar opacity which may represent atelectasis versus infarct/hemorrhage given patient's recent pulmonary embolus and may account for patient's current pain.Findings discussed with Dr. Dong Bo at 8:30 a.m. on 3/2/2015 |
Generate impression based on findings. | 41 year old female with right epigastric abdominal pain. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes of proctocolectomy and right lower quadrant ileostomy. Orally administered contrast rapidly progresses through the J-shaped stomach, jejunum, and ileum to the right lower quadrant ileostomy without evidence of obstruction or intrinsic abnormality. No hernias are identified. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality noted with physiologic changes seen in the left adnexa.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Postsurgical changes of proctocolectomy and right lower quadrant ileostomy. Orally administered contrast rapidly progresses through the J-shaped stomach, jejunum, and ileum to the right lower quadrant ileostomy without evidence of obstruction or intrinsic abnormality. No hernias are identified. BONES, SOFT TISSUES: Sclerotic lesion within the right iliac bone is unchanged and likely represents a benign bone island.OTHER: No significant abnormality noted | 1.Status post proctocolectomy with right lower quadrant ileostomy without evidence of bowel obstruction or other intrinsic bowel abnormality seen. No hernias are identified. 2.No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | 53 years old Female. Reason: Worsened EF. History: Cardiac sarcoidosis. RADIOPHARMACEUTICAL: 10.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 83 mg/dL. Today's chest CT portion grossly demonstrates two new nodules in the left upper lobe and left lingular lobe. Mild cardiomegaly is noted.Today's PET examination demonstrates intense FDG uptake in the left lingular nodule with SUV Max of 9.2. There is also increased metabolic activity in the smaller left upper lobe lung nodule with SUV Max of 3.7. There are several foci of increased metabolic activity in the left lung hilum and mediastinal AP window regions without definite CT correlation.There is a persistent increase of FDG activity in the cardiac chambers and great vessels, suggesting decreased cardiac function. | 1.Two new lung nodules in the left upper and lingular lobes, suspicious for lung cancer. However, granulomatous disease and sarcoidosis should be included in the differential diagnosis.2.Multifocal abnormal FDG uptake in the mediastinal AP window and left lung hilum without definite CT correlation on the non-diagnostic CT, which can be due to metastasis.Please note that the cardiac part of the study will be reported by Dr. Rupa Mehta Sanghani. |
Generate impression based on findings. | Reason: PE? 46F breast ca and mesothelioma admitted with progressive dyspnea History: progressive SOB PULMONARY ARTERIES: No evidence of pulmonary embolism. Main pulmonary artery is mildly enlarged.LUNGS AND PLEURA: New large right pleural effusion with adjacent atelectasis. Left subpulmonic fluid collection appears similar to the prior exam.Near complete consolidation of the left lung, increased from prior, with partial aeration of the upper lobe. Left lung airway obstruction at the segmental and subsegmental level is increased from prior. Areas of subpleural groundglass with local septal thickening in the right upper lobe (series 9, image 42) are new. Left hemithorax visceral and parietal thickening, with coarse nodular septal thickening compatible with tumor. Due to significant consolidation along with suboptimal contrast opacification on this nondedicated study, measurements of pleural thickening cannot be obtained on this exam.MEDIASTINUM AND HILA: The heart is normal in size. Moderate pericardial effusion, increased from prior. No visible coronary artery calcification.Mediastinal lymphadenopathy. Reference right paratracheal lymph node measures 17 mm (series 7, image 12), unchanged.Bilateral cardiophrenic lymph nodes are mildly enlarged, slightly more prominent from the prior exam.CHEST WALL: Right chest port, tip in the right atrium. Postoperative changes of mastectomy and breast reconstruction, with left breast prosthesis. A small fluid collection surrounding the left prosthesis in a fluid collection in the anterior chest wall, presumably a seroma, stable from the prior exam.Left internal mammary chain and intercostal lymphadenopathy is again seen. Tumor extends into the extrapleural fat anteriorly (series 7, image 106).Previously described hyperattenuating soft tissue and surrounding fat stranding along the inferolateral chest wall, suspicious for tract seeding along a site of prior biopsy (series 7, image 41) appears stable to slightly more prominent from the prior exam.Left subpectoral and axillary lymphadenopathy. Reference left axillary lymph node measures 18 mm (series 7, image 117), previously 15 mm.several small left low cervical lymph nodes are increased from prior (series 7, image 11).UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Parasplenic fat stranding and a small amount of adjacent soft tissue nodularity (series 7, image 285) appears similar to prior. Small left para-aortic lymph nodes measure 11 mm (series 7, image 316), partially visualized. | 1. No evidence of pulmonary embolism.2. New large right pleural effusion and progressive consolidation of the left lung, with increasing adenopathy, compatible with progression of disease.3. New areas of subpleural groundglass in the right upper lobe may be inflammatory in etiology.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 59 years, Male, Reason: diverticulitis? SBO? History: abd pain, constipation, active guarding. Lung cancer. ABDOMEN:LUNG BASES: Multiple metastatic nodules bilaterally, many of which are increased in size. A reference left lower lobe nodule is unchanged measuring 1.4 x 1.2 cm (4/23), previously 1.5 x 1.1 cm. However, multiple nodules are increased including a large left lower lobe nodule which measures 1.7 x 1.4 cm (4/12), previously 1.3 x 1.0 cm.LIVER, BILIARY TRACT: Multiple liver metastases are slightly increased including a left hepatic lobe lesion measuring 6.7 x 6.1 cm (3/25), previously 5.7 x 4.7 cm. Intrahepatic biliary ductal dilatation on the left is similar to the prior exam.SPLEEN: Splenic vein is thrombosed, similar to the prior exam.PANCREAS: A necrotic mass in the body of the pancreas is increased measuring 3.6 x 2.4 cm (3/38), previously 3.1 x 2.3 cm.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hypodensities are too small to characterize.RETROPERITONEUM, LYMPH NODES: A gastrohepatic node measures 2.5 x 2.0 cm (3/30), previously 1.9 x 1.7 cm.BOWEL, MESENTERY: Distended colonic loops are consistent with recent Golytely bowel preparation. No evidence of small bowel obstruction.BONES, SOFT TISSUES: Mild degenerative changes of the visualized spine.OTHER: No significant abnormality notedPELVIS: MalePROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Sclerotic lesion in the right ilium is unchanged from 10/26/2012 and presumably benign.OTHER: No significant abnormality noted | 1.No evidence of small bowel obstruction.2.Overall progression of disease with increase in size of metastatic lesions in the liver, pancreas, lungs and retroperitoneal lymph nodes.3.Splenic vein thrombosis is unchanged. |
Generate impression based on findings. | 41 year old female with colicky abdominal pain, evaluate for renal stone. Within the limits of a non IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made: ABDOMEN:LUNG BASES: Scattered micronodules and small nodules are present in the lung bases some of which are new from the 2014 exam. The largest is in the left lower lobe (series 4, image 2) and measures 6 mm. No consolidation or pleural effusions.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Two punctate nonobstructive calyceal are present within the left kidney, the largest of which measures 4 mm (series 3, image 52). There is again slight prominence of the left renal pelvis which appears similar to prior. No hydronephrosis, hydroureter, or obstructing ureteral stones. Previously seen left UVJ stone is no longer present.RETROPERITONEUM, LYMPH NODES: Scattered mildly prominent retroperitoneal and mesenteric lymph nodes which may be reactive.BOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Visualized portion of the appendix is unremarkable.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: Normal caliber bowel without evidence of obstruction. Visualized portion of the appendix is unremarkable.BONES, SOFT TISSUES: Small sclerotic bone lesions probably benign bone islands.OTHER: No significant abnormality noted | 1.Two nonobstructive left renal calyceal calculi the largest of which measures 4 mm. No hydronephrosis or obstructing calculi.2.Left lower lobe 6mm nonspecific pulmonary nodule, recommend 12 month follow up. |
Generate impression based on findings. | 69-year-old female status post cystectomy and ileal conduit postoperative day 10 now with bacteremia, ileus, and vaginal leakage. ABDOMEN:LUNG BASES: Trace right pleural effusion and bibasilar atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral subcentimeter low attenuation renal lesions too small to characterize. Status post cystectomy and ileal conduit formation. Bilateral nephroureteral stents are present which traverse the ileal conduit and with distal tips outside the patient's body. A Foley catheter is present with tip in the ileal conduit. The right renal pelvis and proximal ureter is mildly dilated. Delayed images demonstrate symmetric excretion of contrast which traverses the nephroureteral catheters and is not seen in the ureters or ileal conduit. No evidence of excreted contrast extravasation. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes of ileal conduit formation. Enteric contrast passes rapidly through the stomach, small bowel, and proximal colon without evidence of obstruction.BONES, SOFT TISSUES: Midline abdominal postsurgical changes. Right lower quadrant ileal conduit with surrounding inflammatory changes including a 2.5-cm fluid collection within the abdominal wall along the lateral aspect of the conduit (series 7, image 103). Though CT is unable to characterize fluid collections, no evidence of wall formation, internal foci of gas, or significant adjacent inflammatory changes to suggest abscess.OTHER: There is a large, partially loculated pelvic fluid collection which abuts the ileal conduit and extends superiorly into the right abdomen along the right psoas. The collection measures approximately 11.5 x 10.2 cm in axial dimension (series 7, image 126). The collection contains mottled foci of air. PELVIS:UTERUS, ADNEXA: Status post hysterectomy. Air is present within the vagina/perineum. The aforementioned pelvic fluid collection abuts the vaginal cuff.BLADDER: No significant abnormality notedLYMPH NODES: Pelvic fluid obscures evaluation for lymph nodes.BOWEL, MESENTERY: Postsurgical changes of ileal conduit formation. Enteric contrast passes rapidly through the stomach, small bowel, and proximal colon without evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Fat-containing lesion within the left adductor musculature most likely lipoma. | 1.Postsurgical changes of cystectomy and ileal conduit formation. No extravasation of excreted contrast is seen.2.Large postsurgical pelvic fluid collection which extends into the abdomen along the right psoas muscle. Contained mottled foci of gas suggest that the collection may be infected. 3.Status post hysterectomy. Given history, suspect aforementioned fluid collection communicates with the vagina. 4.Postsurgical changes to the abdominal wall including fluid along the lateral aspect of the ileal conduit without specific CT evidence for additional abscess.Findings communicated by on call radiology resident to urology service at 5:30 p.m. on 3/1/2015. |
Generate impression based on findings. | 74-year-old female with left lower quadrant abdominal pain. ABDOMEN:LUNG BASES: Scattered pulmonary micronodules are present in the lung bases the largest of which measures 4 mm.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenic granulomata.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Multiple bilateral round low attenuation renal lesions compatible with simple cysts. Additional bilateral subcentimeter low attenuation renal lesions too small to characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia. Orally administered contrast progresses rapidly through the stomach, small bowel, and colon without evidence of obstruction. Minimal colonic diverticulosis. There is a short segment of possible colonic wall thickening involving the sigmoid colon (series 3, image 100) without significant adjacent inflammatory changes.Small mildly prominent mesenteric lymph nodes are present which are nonspecific. The largest measures 8 mm in short axis (series 3, image 73). BONES, SOFT TISSUES: Small fat-containing umbilical hernia.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small hiatal hernia. Orally administered contrast progresses rapidly through the stomach, small bowel, and colon without evidence of obstruction. Minimal colonic diverticulosis. There is a short segment of possible colonic wall thickening involving the sigmoid colon (series 3, image 100) without significant adjacent inflammatory changes.Small mildly prominent mesenteric lymph nodes are present which are nonspecific. The largest measures 8 mm in short axis (series 3, image 73).BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.No specific findings to account for the patient's pain.2.Mild colonic diverticulosis.3.Nonspecific segment of apparent mild thickening of the sigmoid colon wall which may simply represent fecal material or collapsed bowel. However, cannot exclude mild inflammation or mass, recommend correlation with colonoscopy screening. |
Generate impression based on findings. | 41-year-old female with rectal pain evaluate for perirectal abscess. Per ER physician, perirectal abscess spontaneously drained prior to the exam. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hepatomegaly. Diffuse low-attenuation of the liver compatible with hepatic steatosis. Status post cholecystectomy with mild expected prominence of the common bile duct. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right nephroureteral stent in place. No hydronephrosis. The kidneys enhance symmetrically. Minimal perinephric stranding is present.RETROPERITONEUM, LYMPH NODES: Mildly prominent retroperitoneal and mesenteric lymph nodes are nonspecific and appear similar to prior.BOWEL, MESENTERY: Postsurgical changes of colectomy and left lower quadrant end ileostomy. Orally administered contrast progresses through the stomach and the proximal small bowel without evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomy. Left adnexal changes stable to decreased in size and likely physiologic.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: There is soft tissue thickening/phlegmon along the bilateral gluteal clefts in the perianal region (series 3, image 112) with a combined width of 2.2 cm and without drainable fluid collections. Mild dependent edema is present.OTHER: A small amount of pelvic free fluid is present in the presacral region, stable to slightly increased. | 1.Soft tissue thickening along the bilateral gluteal clefts in the perianal region which is nonspecific but compatible with inflammation related to stated history of recently drained perianal abscess.2.Hepatomegaly with hepatic steatosis.3.Small amount of pelvic free fluid, stable to slightly increased.4.Postsurgical changes of colectomy and ileostomy without evidence of obstruction.5.Nonspecific minimal perinephric stranding, correlate with urinalysis for evidence of infection. |
Generate impression based on findings. | 33 years, Male. Reason: abdominal pain. N/V. assess for obstructive gas pattern and stool burden History: as above Note that the far lateral right abdomen is excluded from the field-of-view. Nonobstructive bowel gas pattern with below average stool burden in the colon. | Nonobstructive bowel gas pattern with below average stool burden in the colon. |
Generate impression based on findings. | photophobia, right parietal pain,, known cavernoma There is about 11mm sized relatively well circumscribed high attenuation lesion on the left frontal lobe just caudal to caudate head/genu which may represent cavernoma with internal hemorrhage or calcification. There is no evidence of surrounding edema or mass effects.Brain MRI can be considered for further evaluation.Otherwise there is no other area of acute hemorrhage or ischemic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no edema, midline shift, intra- or extra-axial fluid collection. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | 11mm sized high attenuation lesion on the left frontal lobe just caudal to caudate head/genu area which may represent cavernoma with possible internal hemorrhage. Brain MRI can be considered for further imaging evaluation.Otherwise unremarkable. |
Generate impression based on findings. | 68 years, Male. Reason: NGT History: see above Enteric feeding tube is looped in the stomach with tip projecting over the gastric fundus. Nonobstructive bowel gas pattern. The pelvis is excluded from the field-of-view. Suture material projects over the right lower quadrant. The lung bases are clear. | Enteric feeding tube is looped in the stomach with tip projecting over the gastric fundus. |
Generate impression based on findings. | Male 61 years old Reason: 61M with NHL and c/o LLQ pain, recent PET with evidence of PD and elevated LDH. History: Evaluation of Abdominal pain ABDOMEN:LUNG BASES: Exam limited by motion artifact making evaluation of fine parenchymal detail suboptimal. Within these limitations, there is bibasilar atelectasis/scarring. No pleural effusion.LIVER, BILIARY TRACT: No evidence of biliary ductal dilatation or focal mass lesion within the hepatic parenchyma.SPLEEN: Decrease splenic size, now measuring 11 cm, without focal lesion.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: While the relatively diffuse retroperitoneal patchy infiltration posterior and lateral to the kidney has markedly decreased in predominately cleared , there has been an increase in the solid right peri-renal soft tissue aggregate now measuring up to 7 mm (series 3, image 50) -- this is in a similar, but less severe, appearance as seen on 9/26/14 CT examination.. Wedge-shaped area of hypoattenuation in the right renal parenchyma has resolved. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: There is no evidence of retroperitoneal lymphadenopathy on the basis of size criteria.BOWEL, MESENTERY: Slightly enlarged left perirectal nodularity measuring 1.7 x 3.1 cm (series 3, image 128), previously 0.9 x 1.8 cm. This focus corresponds to increased hypermetabolic activity on PET examination from 2/19/2015. Marked interval decrease in the peritoneal nodularity, including the previously seen peritoneal nodule along the left lateral pararenal fascia. BONES, SOFT TISSUES: Interval resolution of the soft tissue mass in the subcutaneous fat of the right anterior thigh and the peripheral concentric hyperattenuating enlargement of the right psoas muscle . Sclerotic lesion in the left iliac bone is stable. OTHER: Incompletely imaged central venous catheter with tip at the cavoatrial junction.PELVIS:PROSTATE, SEMINAL VESICLES: Mildly enlarged prostate.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Fat-containing right inguinal hernia now demonstrates a decreased nodularity. OTHER: No significant abnormality noted | 1.Mixed response with improvement in most sites of lymphomatous involvement but interval increase in the left peri-rectal and right posterior peri-renal disease -- see above discussion. 2.No focal abnormality to account for patient's symptomatology. |
Generate impression based on findings. | 81 years, Male, Reason: eval leak History: s/p hepaticojejunostomy, bile in drain. Residual barium is noted within the stomach and colon on scout images. There are midline and right midabdomen staples as well as multiple surgical drains. There is mild dilatation of small bowel loops up to 3.7 cm. | 1.CT abdomen and pelvis not performed due to residual barium within the stomach and colon. Recommend serial abdominal radiographs and repeat CT when barium clears.2.Mildly dilated small bowel loops may be related to ileus or obstruction. |
Generate impression based on findings. | 10-year-old male with puncture wound.VIEWS: Right shoulder AP external and internal rotation (two views) 3/1/2015 Sof tissue defect is seen above the acromioclavicular joint although no radiopaque foreign body is present.No soft tissue swelling or joint effusion. Alignment is normal. No evidence of fracture or dislocation. | Soft tissue defect above the acromioclavicular joint with no evidence of radiopaque foreign body. |
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