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Generate impression based on findings. | Pain lower back Extensive gas and stool limits sensitivity. Otherwise the lumbar spine appears intact without evidence of focal abnormalities, specifically the vertebral bodies, disk spaces and alignment are preserved. Moderate scoliosis | Scoliosis without discrete focal abnormality superimposed upon mild degenerative changes |
Generate impression based on findings. | Male 56 years old Reason: PEG displaced overnight, attempted to secure tract with red rubber History: eval for position of red rubber securing prior PEG site. The study is limited due to lack of intravenous contrast.ABDOMEN:LUNG BASES: Dependent atelectasis at the lung bases.LIVER, BILIARY TRACT: No significant abnorma... | Limited study due to lack of intravenous contrast. G-tube is in place.Atrophic kidneys and left lower quadrant transplant kidney. Large air-containing gluteal collection in the pelvis fistulizing to the skin.Compression fracture of L4 vertebral body. |
Generate impression based on findings. | FractureVIEWS: Left tibia and fibula AP and lateral There is periosteal reaction along the middle and distal aspect of the tibia indicative of a healing fracture. The alignment is anatomic. The overlying cast has been removed in the interval. | Healing tibial fracture in anatomic alignment. |
Generate impression based on findings. | FractureVIEWS: Right wrist AP and lateral Healing fractures involving the distal radius and ulna are again noted with sclerosis and periosteal reaction. The alignment is anatomic. The overlying cast has been removed in the interval. | Healing distal forearm fractures as described above. |
Generate impression based on findings. | Foot pain following fall. Patient heard pop Foot: No radiographic abnormality. Ankle: An oblique essentially nondisplaced distal fibular fracture is observed with mild overlying diffuse soft tissue swelling. Mortise remains symmetric and intact. | Distal fibular fracture |
Generate impression based on findings. | PICC placementVIEW: Chest AP Placement of a left upper extremity PICC with tip in the right atrium. Multiple surgical clips in the GE junction. Cardiothymic silhouette normal. Right upper lobe opacity increased in the interval. Patchy atelectasis left lower lobe. | Left PICC tip in the right atrium. Right upper lobe opacity concerning for pneumonia. |
Generate impression based on findings. | New diagnosis of multiple myeloma, please evaluate SKULL: Diffusely mottled appearance throughout the entire skull suspicious for numerous confluence lesionsCERVICAL SPINE: Moderate osteoarthritic changes largely involving C4 through C6 with preservation of alignment. Disk space narrowing, osteophytes and sclerosis are... | Diffuse osseous changes in largely involving the skull suspicious for myelomatous involvement in the appropriate clinical setting and labs. Additionally a partially healed right rib fracture is also suspicious |
Generate impression based on findings. | Prematurity oxygen dependentVIEW: Chest AP Cardiothymic silhouette normal. NG tube removed in the interval. Minimal patchy atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax. | Minimal patchy atelectasis in the right lower lobe and left lower lobe. |
Generate impression based on findings. | Male 40 years old Reason: eval for wrist deformity History: carpal tunnel. Note is made of an ulnar positive variance without changes to suggest ulnar abutment. Otherwise, there is no acute fracture or dislocation. | Ulnar positive variance without radiographic associated degenerative changes of the lunate. |
Generate impression based on findings. | Ms. James is a 78 year old female with a personal history of benign left breast biopsy in April 2013. Patient also currently complains of long-standing pain in the left breast for the past six years. She has no new current breast related complaints. Three standard views of both breasts were performed digitally and revi... | No mammographic evidence of malignancy. Patient's long-standing breast pain should be managed clinically. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDAT... |
Generate impression based on findings. | 59 years, Male. Reason: NG tube placement History: NG tube placement Three biliary drains project over the right upper quadrant. Additional surgical drain tip projects over the right upper quadrant. Nasogastric tube tip projects over the gastric antrum. Nasojejunal tube tip projects over the proximal jejunum. Relative ... | NG tube tip projects over the gastric antrum. Nasojejunal tube tip projects over the proximal jejunum. |
Generate impression based on findings. | 4-year-old male with neurogenic bladder. BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* R... | Normal examination. *SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesica... |
Generate impression based on findings. | Female 47 years old Reason: 47 F with HCC on sorafenib, please eval for interval change since prior CT. History: none CHEST:LUNGS AND PLEURA: Interval development of very large pleural effusion and in atelectasis of the right lung other than part of its upper lobe. Again noted bilateral pulmonary masses consistent with... | Interval development of significant amount of right-sided pleural effusion and near complete atelectasis of the right lung. Interval increase in the size of the most of the metastatic lung lesions.Index lesion in the left lobe of the patient has slightly increased in size compared to previous study. There are new enhan... |
Generate impression based on findings. | Pain No significant interval definitive change. Minimal bridging callus formation appears similar to prior exam with minimal sclerotic densities along the fracture edges. The overlying ORIF sideplate is otherwise unchanged the evidence of complication. Persistent moderate diffuse soft tissue swelling | ORIF of the middle second right phalanx without interval change or new findings of interval healing |
Generate impression based on findings. | Epigastric pain, retained food in stomach on EGD after 12 hours of fasting. Evaluate for gastroparesis. Visually there was progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 70 % of retention 60... | Gastric emptying at the upper limits of normal. |
Generate impression based on findings. | 81-year-old. History of smoking and RUL opacities and RML nodule. Evaluate for change. LUNGS AND PLEURA: Interval resolution of patchy right upper lobe opacities, which likely represented aspiration.Stable 8 mm right middle lobe nodule (series 5, image 61) since 5/2014.Mild lower lobe bronchiectasis.Stable scattered ca... | Interval resolution of right upper lobe nodular opacities, which were most likely aspiration. 8 mm right middle lobe nodule is unchanged from 5/2014, likely benign; continued follow-up in 1 year is recommended to confirm stability. |
Generate impression based on findings. | Mandible pain, right side. Patient got punched A nondisplaced fracture through the mandibular angle is identified with extension to the impacted right third molar. No definitive second lesion is observed. Visualized portions of the sinuses are unremarkable and clear. | Right mandibular angle fracture, nondisplaced |
Generate impression based on findings. | Female 50 years old; Reason: pain There is no fracture or malalignment. No joint effusion is evident. Otherwise, no specific findings are seen to account for the patient's pain. | No specific findings to account for the patient's pain. |
Generate impression based on findings. | Reason: r/o c-spine fx History: fall CT head:There is a hypodensity present involving the inferior aspect of the left cerebellar hemisphere associated with some mild mass effect. It measures approximately 43 by 35 mm axial dimensions.Periventricular and subcortical white matter hypodensities of a moderate degree are pr... | 1.No evidence for cervical spine fracture.2.Findings suggest subacute infarction involving the left posterior inferior cerebellar artery territory. Please correlate with the patient's clinical symptoms. There is no associated hemorrhagic conversion appreciated.3.Degenerative changes are present in the cervical spine wi... |
Generate impression based on findings. | Hand pain and fracture repair Interval surgical placement of two K wires affixing a comminuted right distal metacarpal fracture in gross anatomic alignment. Decreasing soft tissue swelling. | Surgical fixation of a right boxer's fracture |
Generate impression based on findings. | 74 years old Female. Reason: initial staging evaluation. History: new follicular lymphoma. RADIOPHARMACEUTICAL: 13.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 84 mg/dL. Today's CT portion grossly demonstrates opacification of the left maximal sinus. There is a mass in the left breast. There are large l... | 1. Extensive hypermetabolic lymphadenopathy in the neck and abdomen, osseous hypermetabolic lesion in the right scapula, hypermetabolic mass in the left breast and hypermetabolic masses in the liver, consistent with the patient's diagnosis of lymphoma.2. Mucosal involvement of the tumor in the pharynx and retropharynge... |
Generate impression based on findings. | Reason: r/o c-spine fx History: fall CT head:There is a hypodensity present involving the inferior aspect of the left cerebellar hemisphere associated with some mild mass effect. It measures approximately 43 by 35 mm axial dimensions.Periventricular and subcortical white matter hypodensities of a moderate degree are pr... | 1.No evidence for cervical spine fracture.2.Findings suggest subacute infarction involving the left posterior inferior cerebellar artery territory. Please correlate with the patient's clinical symptoms. There is no associated hemorrhagic conversion appreciated.3.Degenerative changes are present in the cervical spine wi... |
Generate impression based on findings. | Male 59 years old Reason: RUQ US to evaluate gallbladder and biliary tree History: RUQ pain, fever LIVER: Liver measures 21 cm, enlarged. Diffuse fatty infiltration of the liver. No focal liver lesions.BILIARY TRACT: No evidence of gallstones. Gallbladder is unremarkable. No evidence of intra-or extrahepatically or dil... | Diffuse fatty infiltration of the liver and hepatomegaly. Gallbladder is unremarkable. |
Generate impression based on findings. | Female 46 years old Reason: RUQ pain after eating, eval for Choledocholithiasis History: pain LIVER: Liver measures 15 cm. Normal echogenicity. No focal liver lesions.BILIARY TRACT: Gallbladder is unremarkable. No evidence of intra-or extrahepatic biliary dilatation.PANCREAS: Not well-visualized due to overlying bowel ... | Unremarkable study. |
Generate impression based on findings. | Male 66 years old Reason: eval for advanced heart failure, eval kidney echotexture History: mild transaminitis, chronic kidney disease LIVER: Liver measures 18.5 cm. no focal lesions. Hepatic veins and IVC are dilated.GALLBLADDER, BILIARY TRACT: Cholelithiasis and sludge in the gallbladder. Gallbladder wall is mildly t... | Small amount of ascites. Mild hepato- splenomegaly. Dilatation of the IVC and hepatic veins are compatible with heart failure.Cholelithiasis and sludge in the gallbladder. |
Generate impression based on findings. | Male 64 years old Reason: 64M with flank to groin pain, assess for stone History: 64M with flank to groin pain, assess for stone ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Nonspecific, subcentimeter hypodense lesion in the right lobe of the liver likely represents a cyst, however, cannot ... | No evidence of renal stones or hydronephrosis. |
Generate impression based on findings. | Male 69 years old Reason: HCC please assess and provide target lesion measurements for RECIST History: As above CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Post operative changes r... | Slight interval increase in the size of the one of the index lesions in the liver. The second index lesion is similar in size but it's enhancement has decreased within the interval. The third lesion is not visualized on today's study.Peritoneal carcinomatosis, unchanged. |
Generate impression based on findings. | 74 years old Female. Reason: evaluate for recurrence. History: pharynx cancer. RADIOPHARMACEUTICAL: 11.0 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 88 mg/dL. Today's CT portion grossly demonstrates numerous stable predominantly calcified bilateral hilar and mediastinal lymph nodes. Scattered nodular opa... | No convincing evidence of FDG avid tumor.1.Interval slight decreased metabolic activity in the pharyngeal mucosa, which may be due to inflammatory change. However tumor cannot be excluded.2.New a hypermetabolic focus in the right lower neck without CT correlation, which is non-specific.3.Stable hypermetabolic mediastin... |
Generate impression based on findings. | Reason: history of right orbit gastric cancer met s/p RT in \R\5 2014. Eval interval change History: right eye ptosis The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identifi... | 1.There is infiltration within the right orbit which was also present on the prior exam and remains unchanged. There is subtle asymmetry in the cavernous sinuses which has not changed and is non-specific. MRI may help further evaluate for subtle changes.2.No evidence for acute intracranial hemorrhage mass effect or ede... |
Generate impression based on findings. | Male 56 years old; Reason: 56 y/o male with anal ca. please compare to prior CT History: anal ca CHEST:LUNGS AND PLEURA: Scattered reticular opacities, likely atelectasis or scarring.MEDIASTINUM AND HILA: Central line tip at the cavoatrial junction. Minimal coronary artery calcifications. Grossly stable right retrocrur... | 1.Stable examination as described above. |
Generate impression based on findings. | Male, 41 years old, history of esthesioneuroblastoma with new left parotid fullness. Head:No mass effect, focal edema or suspicious enhancement is seen to suggest brain parenchymal metastatic disease. The bones of the calvarium and skull base are intact. Neck:Evidence of sinonasal surgery is again seen including partia... | 1.No specific or concerning findings are seen to account for the reported new left parotid fullness. At most, a small intraparotid lymph node may be slightly larger than on the prior examination, but this lymph node is still quite small and shows no aggressive features.2.Redemonstration of findings related to sinonasal... |
Generate impression based on findings. | 52 year-old female with colon cancer and chemotherapy. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules unchanged since 1/9/15. No new nodules, masses or evidence of air space disease is seen. Mild bibasilar atelectasis seen. No pleural disease.MEDIASTINUM AND HILA: No change in appearance of the thyroid with s... | 1. Stable nonspecific scattered pulmonary micronodules. 2. Solitary large hepatic parenchymal mass most consistent with colon metastasis -- slightly decreased in size compared with 12/22/14. 3. Slightly prominent left periaortic retroperitoneal lymph nodes unchanged since 12/22/14 -- size alone does not merit diagnosin... |
Generate impression based on findings. | 68 year-old female with meningioma, last surveillance in 2009, evaluate for disease progression Redemonstrated is a left parietal extra-axial hyperdense mass present currently measuring approximately 15 x 22 mm, stable in appearance. The CSF spaces are appropriate for the patient's stated age with no midline shift. No ... | 1.Left parietal extra-axial mass which is compatible with a meningioma demonstrating no significant interval change.2.There are now a few foci of hypodensity within the white matter and left caudate head consistent with small vessel disease. |
Generate impression based on findings. | Female 56 years old; Reason: s/p gastric bypass (1/8/15) and small bowel resection (1/31/15) evaluate for stricture History: abdominal pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Stable subcentimeter hypoattenuating lesions are too small to characterizeSPLEEN: No significant abnormal... | 1.Status post gastric bypass. No obstruction. |
Generate impression based on findings. | 65-year-old male with hepatitis C virus and advanced fibrosis. Screen for HCC. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Liver contour: Smooth contour with normal sized caudate lobe and without radiographic evidence to demonstrate cirrhotic morphology. Features of portal hypertension: No... | 1. Normal examination of the abdomen and pelvis without CT changes to suggest cirrhotic liver morphology and no evidence for liver neoplasia. CT is not sensitive in detecting underlying cirrhosis. |
Generate impression based on findings. | Pain 5th MT, enthesiopathy/acc. growth.EXAMINATION: Left foot standing AP/lateral/oblique (3 views), right foot standing AP/lateral/oblique (3 views) 03/02/15 Bones are normal in appearance. No fracture is identified. Alignment is anatomic. | Normal examinations. |
Generate impression based on findings. | Head and neck cancer, tracheostomy, persistent sinus tachycardia. PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Interval insertion of a tracheostomy tube, tip 4 cm above the carina. Small amount of dependent debris in the trachea.Multifocal patchy consolidation and nodular opacities in the bil... | No evidence of pulmonary embolism. Multifocal consolidation consistent with pneumonia, possibly related to aspiration.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Interval resection of locally recurrent squamous cell carcinoma. Neck: There are interval post-treatment findings related to resection of a right neck mass. There is an area of ill-defined soft tissue with a low attenuation center in the surgical bed anterior to the right carotid arteries, that measures up to approxima... | 1. Interval post-treatment findings related to resection of a right neck mass. There is an area of ill-defined soft tissue with a low attenuation center in the surgical bed anterior to the right carotid arteries, that measures up to approximately 3 cm, with mild overlying skin nodularity. This may represent recurrent t... |
Generate impression based on findings. | Vaso-occlusive disease. Evaluate for osteomyelitis.EXAMINATION: Right shoulder internal/external rotation (two views) 03/02/15 is The humeral head is normal in appearance. It is well directed into the glenoid fossa. No fracture or bone destruction is identified. | Normal examination. |
Generate impression based on findings. | 15-year-old patient with colon cancer and chemotherapy. Compare to prior. CHEST:LUNGS AND PLEURA: No abnormal parenchymal nodules, masses or airspace disease. No pleural disease.MEDIASTINUM AND HILA: Normal Thymus. No mediastinal mass is otherwise seen and no adenopathy.CHEST WALL: Right anterior chest wall Port-A-Cath... | 1. Postoperative changes in the right colon. Clearing of the prior noted presumed postoperative changes seen on 12/10/14 examination. 2. Decrease in size and prominence of prior noted right adnexal abnormality, most likely physiologic changes evolving. 3. Small amount of mesenteric fluid in the cul-de-sac, to a degree ... |
Generate impression based on findings. | Female 68 years old; Reason: Bilateral lower quadrant pain left greater than right. Evaluate for evidence of diverticulitis or colitis. History: Progressive abdominal pain with chronic diarrhea. ABDOMEN:LUNG BASES: Coronary artery calcifications.Calcified right lower lobe granuloma. Emphysematous changes.LIVER, BILIARY... | No acute abnormalities to account for patient's symptoms. 1 cm hepatic hypodensity of uncertain significance. |
Generate impression based on findings. | History of DVT and recurrent pleural effusion. Evaluate for chronic clot burden. The comparison chest radiograph performed on 3/2/15 demonstrates bibasilar interstitial edema and small pleural effusions.The ventilation images show a diffuse decreased ventilation to the entire right upper lobe on single breath image whi... | 1.High probability for pulmonary embolism.2.Regarding clot burden, this would be considered a medium embolic load and predominantly right-sided. |
Generate impression based on findings. | All of the paranasal sinuses are clear as are the bilateral mastoid air cells and middle ear cavities and there are no air-fluid levels. The bilateral maxillary sinus ostia are patent as are the bilateral frontoethmoidal and sphenoethmoidal recesses. The lamina papyracea are intact bilaterally. The floor of the anteri... | A right-sided septal spur is noted. Otherwise negative CT scan of the sinuses. |
Generate impression based on findings. | Ms. Carr is a 67 year old female with a personal history of left breast mastectomy in May 2013 for adenoid cystic carcinoma. She has a family history of breast cancer in her maternal aunt. She has no current breast complaints. Three standard views of the right breast with one right spot compression view were performed ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | NG placement at 1140.VIEW: Abdomen AP (one view) 03/02/15, 1245 Feeding tube tip is at the GE junction. Right lower extremity PICC is no longer visualized. Multiple dilated bowel loops are seen in the giant omphalocele. | Feeding tube tip at GE junction. |
Generate impression based on findings. | Reason: follow up PNA, s/p heart/kidney transp History: none LUNGS AND PLEURA: Interval resolution of right lung consolidation, with only mild scarring or atelectasis in the middle lobe. Mild basilar subsegmental scarring/atelectasis. Scattered benign appearing micronodules. No suspicious pulmonary nodules or masses. N... | Interval resolution of right-sided pneumonia, without new acute abnormality. |
Generate impression based on findings. | Male 79 years old Reason: pt with h/o Type B aortic dissection, AAA, RCIA aneurysms History: asymptomatic CHEST:CT Angiography: Left-sided aortic arch with normal branching of the brachiocephalic vessels. There is diffuse ectasia of the thoracic aorta with the largest diameter in the ascending aorta measuring 4.4 cm (s... | 1.Stable diffuse ectasia with focal aneurysmal accentuations of the thoracic and abdominal aorta and its branch vessels as described above. 2.Stable dissection involving the SMA and unchanged focal high-grade stenosis of the celiac artery, both of which are patent. |
Generate impression based on findings. | Distal fibular fracture. Weight-bearing for fracture assessment. Again seen is an oblique fracture of the distal fibula with fracture fragments in near-anatomic alignment. I see no additional fracture. Ankle joint alignment is within normal limits. There is mild soft tissue swelling. | Distal fibular fracture as above. |
Generate impression based on findings. | Male 27 years old; Reason: multiple metacarpal fractures MIDDLE FINGER: There is a fracture through the 3rd metacarpal neck, with approximately 60 degrees of volar angulation of the distal fracture fragment. There is also a non-displaced fracture through the base of the 3rd metacarpal, only seen on the lateral view. No... | 3rd and 4th metacarpal fractures, as above. |
Generate impression based on findings. | 49-year-old female with history of laparoscopic Roux-en-Y gastric bypass for obesity complicated by ileus which resolved now with episodes of emesis and fever. ABDOMEN:LUNG BASES: Mild basilar atelectasis and trace left pleural effusion. LIVER, BILIARY TRACT: No focal hepatic lesions. Status post cholecystectomy.SPLEEN... | 1.Postsurgical changes of gastric bypass surgery without contrast extravasation.2.Partial small bowel obstruction of the alimentary limb. No associated free air or free fluid.3.Nonspecific focus of gas within the bladder, correlate with history of recent instrumentation.Findings communicated with physician assistant Po... |
Generate impression based on findings. | Reason: Malignant Neoplasm of the base of the tongue; follow up; with measurements History: as above CHEST:LUNGS AND PLEURA: Apical pleural scarring, compatible with post radiation reaction, unchanged.No suspicious pulmonary nodules or masses.Mild basilar scarring/subsegmental atelectasis is increased from prior and ma... | No evidence of metastatic disease. |
Generate impression based on findings. | 83 years old Female. Reason: staging History: left pulmonary nodules. RADIOPHARMACEUTICAL: 10.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 85 mg/dL. Today's CT portion grossly demonstrates a cavitary nodule in the superior segment of the left lower lobe. There is a nodular density in the left lingular l... | 1.Hypermetabolic hypermetabolic cavitary nodule in the superior segment of the left lower lobe, consistent with lung cancer. 2.Minimal FDG activity in the nodular density in the left lingular lobe, which is consistent with inflammatory change.3.No definite evidence of FDG avid nodal metastasis or distant metastasis. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is nonspecific periventricular and subcortical white matter hypoattenuation. Additionally, there are or focal chronic infarcts in the right cerebellar hemisphere, and in the left frontal lobe. The ventricles and basal cisterns are unchange... | 1.No acute intracranial hemorrhage or mass effect. CT is insensitive for detection of early nonhemorrhagic stroke.2.Small vessel ischemic changes and unchanged old infarcts. |
Generate impression based on findings. | History of mycobacterial disease. Chronic cough. RA on immunosuppression, cavitating nodules, assess for growth of nodules. LUNGS AND PLEURA: Small ill-defined clustered peribronchiolar nodules in the right upper lobe (series 4, image 36), right basilar peripheral nodular interstitial thickening, and thick walled cysti... | Unchanged clustered right upper lobe peribronchiolar nodules and right base cystic thick-walled lesion, consistent with an indolent infection, such as MAI. These findings are similar to prior exam with no new sites of infection. |
Generate impression based on findings. | Female 67 years old Reason: Recurrent breast cancer on palliative Tamoxifen; restaging in 1-month History: See Above CHEST:LUNGS AND PLEURA: Bilateral calcified granulomas and scattered pulmonary nodules are unchanged. Slight interval increase in the peripheral wedge-shaped area in the left upper lobe compatible with f... | Stable destructive lesion in the left femoral head compatible with metastatic disease. No new areas of metastatic disease. |
Generate impression based on findings. | Knee pain. Joint pain in the hands. RIGHT HAND: Moderate to severe osteoarthritis affects the right hand, particularly at the DIP and PIP joints, and similar to prior. Mild osteoarthritis affects the MCP joints. No specific features of rheumatoid arthritis or chondrocalcinosis are seen.LEFT HAND: Severe osteoarthritis ... | 1. Findings compatible with erosive osteoarthritis of the hands, left worse than right, and slightly progressed compared to 2011.2. No specific findings in the knees to account for the patient's pain. |
Generate impression based on findings. | Question of PE on CT without contrast. Evaluate for PE. The comparison chest radiograph performed on 3/2/2014 demonstrates bilateral small to moderate pleural effusions and non-specific bilateral lower lobe opacities.The ventilation images show a uniform distribution of activity on single-breath and wash-in images. The... | Small to moderate perfusion defects within the bilateral lower lobes with corresponding effusion and opacity on chest radiograph is non-specific, intermediate probability for pulmonary embolus. |
Generate impression based on findings. | 47 year-old female with gastric cancer and chemotherapy break. Compare to prior CT. CHEST:LUNGS AND PLEURA: Scattered micronodules, many which are calcified are again seen. No new nodules or evidence of airspace disease. No pleural disease.MEDIASTINUM AND HILA: Small, normal-sized lymph nodes seen in the anterior and m... | 1. Postoperative changes about the stomach with similar appearance to prior examinations. 2. Stable appearance to small subcentimeter lymph nodes in the abdomen as measured and described above. 3. Again, extensive fecal material seen throughout colon with colonic and rectal distention. |
Generate impression based on findings. | Male 30 years old Reason: R/o acute fracture after ski accident History: Decreased ROM and pain. Three views of the left shoulder show no fracture or malalignment.Four nonweightbearing views of the left knee show no fracture or malalignment.Four nonweightbearing views of the right knee show no fracture or malalignment. | No fracture or malalignment. No specific findings to account for the patient's pain. |
Generate impression based on findings. | Female 72 years old Reason: left hip pain History: left hip pain and pain and swelling about the right foot, evaluate for fracture 3-5 metatarsals. We have 3 views of the right foot. The bones appear demineralized, suggesting osteopenia, but we see no fracture. Small midfoot osteophytes indicate mild osteoarthritis.We ... | Degenerative arthritic changes as described above. We see no fracture. |
Generate impression based on findings. | 15-year-old male, history of boxer's fractureVIEWS: Right hand, PA, oblique, and lateral (3 views) 3/2/15 13:43 Interval removal of splint. There is persistent soft tissue swelling about the hand. A boxer's fracture of the fifth metatarsal with volar angulation of the distal fragment is again visualized. The fracture l... | Boxer's fracture and persistent soft tissue swelling as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views and tomosynthesis of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Circumscribed, typically benign appearing mass in the left posterior... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this re... |
Generate impression based on findings. | Female 43 years old Reason: Bilateral first MTP pain and right second toe pain History: ? Etiology. We have 3 views of the right foot. Two screws are noted within the distal diaphysis of the first metatarsal, presumably affixing a healed osteotomy. Minimal osteoarthritic changes affect the first metatarsophalangeal joi... | Postoperative and mild osteoarthritic changes as above. |
Generate impression based on findings. | 2-year-old female with history of fall from bunk bed. Evaluate for skull fracture. There is a moderate sized right parietal subgaleal hematoma and probable skin laceration. There is no evidence of underlying acute intracranial hemorrhage or calvarial fracture. The ventricles and sulci are symmetric. The gray-white diff... | Moderate sized right parietal subgaleal hematoma and probable skin laceration without underlying calvarial fracture or intracranial hemorrhage. |
Generate impression based on findings. | History of metastatic colon cancer. Evaluate for new bony metastatic disease with special attention to the left shoulder/acromion/clavicle. New onset point tenderness. There are increased foci of uptake within the anterior right 8th rib and the proximal and mid right femur. Increased uptake within the mid-thoracic spin... | Multiple metastatic bone lesions. |
Generate impression based on findings. | Female 62 years old Reason: Fracture healing History: s/p cast immobilization. Three views of the right hand again show a nondisplaced fracture of the fifth metacarpal diaphysis appearing similar to that seen on the prior study. | Fifth metacarpal fracture appearing similar to the prior study. |
Generate impression based on findings. | Male 69 years old Reason: LESION History: PAIN. We have 3 views of the pelvis. There is poorly defined sclerosis in the right sacral wing that is nonspecific and could represent a marrow replacing lesion or a healing stress fracture. We see no additional lesions. Minimal osteoarthritis affects the hips. Calcifications ... | Poorly defined sclerosis in the right sacral wing is nonspecific and could represent an intramedullary lesion, healing stress fracture, or sequelae of prior radiation therapy. |
Generate impression based on findings. | 73-year-old male with metastatic esophageal cancer status post esophagectomy and chemotherapy. Evaluate treatment response. CHEST:LUNGS AND PLEURA: There is been an increase in size and number of the multiple pulmonary nodules bilaterally. The right basilar reference nodule (series 10284, image 69) measures 3.1 x 1 .7 ... | 1. Increase in size and number of diffuse pulmonary nodules. 2. Mixed response in lymph nodes with increase in size of thoracic mediastinal lymph nodes, and slight decrease in retroperitoneal, periaortic lymph nodes. 3. Stable appearance to right obturator internus with no change in size since 11/10/14, but decreased e... |
Generate impression based on findings. | Right-sided thoracotomy with chest wall resection and right upper lobectomy and mediastinal lymph node dissection. EPIC history: basal cell carcinoma on left chest with open wound LUNGS AND PLEURA: Post-surgical findings of right upper lobectomy for resection of lung mass. No evidence of residual/recurrent or metastati... | 1. Interval en bloc resection of right upper lobe subpleural mass. No evidence of recurrent/residual disease or metastases.2. Large left chest wall open wound with soft tissue thickening at its base related to patient's known basal cell carcinoma. Sclerosis of the underlying left clavicle may represent chronic osteomye... |
Generate impression based on findings. | 75-year-old male with history of dilated small bowel now with abdominal pain, evaluate for carcinoid in the mesentery. ABDOMEN:LUNG BASES: Severe emphysema. There is a masslike area of consolidation in the right lower lobe with spiculated margins (series 12, image 26) measuring 1.8 x 3.2 cm which is nonspecific but sus... | 1.No mesenteric or small bowel enhancing lesions are identified.2.Several nonspecific subcentimeter hyperenhancing hepatic lesions.3.Severe pulmonary emphysema. Right lower lobe masslike consolidation suspicious for malignancy, recommend dedicated chest CT for further evaluation. |
Generate impression based on findings. | MAXILLOFACIAL: There is significant interval worsening of non-expansile paranasal sinus disease without osseous remodeling or erosions. There is complete opacification of the right maxillary sinus with scattered foci of central hyperattenuation. There is mild left maxillary and moderate to severe bilateral ethmoid sin... | 1.Significant interval worsening of pansinus mucosal thickening with central hyperattenuation in the right maxillary sinus suggesting either noninvasive allergic fungal sinusitis and/or inspissated secretions.2.No osseous erosions to suggest osteomyelitis in the calvarium or facial bones.3.Unremarkable CT of the brain. |
Generate impression based on findings. | Male 49 years old; Right rib pain s/p contusion Radiopaque BB markers are noted at the right lower rib cage, in the location of the patient's stated pain. No rib fracture is evident.No pneumothorax is present. Mild degenerative disk disease affects the thoracolumbar spine. Cholecystectomy clips are noted. | No rib fracture evident. |
Generate impression based on findings. | Female 70 years old; Reason: h/o HNC and CRT, compare to previuos images History: has lump in groin CHEST:LUNGS AND PLEURA: Biapical fibrosis. Consolidation and air bronchograms posterior aspect of the right apex with post radiation subpleural fibrotic and bronchiectatic changes in the anterior chest wall of the right ... | 1. New 1.1 x 1.1 cm irregular pulmonary nodule in the left upper lobe (5:90) is suspicious for new metastatic disease.2. Stable fibrotic and postradiation changes in the lungs as described above. Stable right apical consolidation. 3. No definitive correlate to "lump in groin." |
Generate impression based on findings. | Reason: evaluation of spontaneous pneumo/blebs History: evaluation of spontaneous pneumo/blebs LUNGS AND PLEURA: Small scattered lucencies with apical predominance, best seen on MINIP, compatible with centrilobular emphysema. A previously described left perifissural air space cyst is not seen on this exam, now with a l... | Mild centrilobular emphysema. A previously described left perifissural air space cyst is not seen on this exam, likely representing air previously loculated within the fissure rather than a bulla. No discrete apical bullae are identified, apart from small subpleural cysts at the right base. |
Generate impression based on findings. | Left knee pain Very mild osteoarthritis affects the left knee, with small osteophytes and minimal medial joint space narrowing. No joint effusion is evident.Note is made of a Pelligrini-Stieda lesion in the right knee, indicating prior MCL injury. Orthopedic staple noted in the medial proximal right tibia. | Very mild left knee osteoarthritis. |
Generate impression based on findings. | T4N1 gingival squamous cell carcinoma status post docetaxel+cis+5-FU and TFHX completed on 9/13/13. The exam is limited by the lack of intravenous contrast and streak artifact from dental hardware. There are stable postoperative findings related to resection of the right marginal mandibulectomy with bone graft and meta... | No definite evidence of locoregional tumor recurrence or significant lymphadenopathy, although the exam is limited by the lack of intravenous contrast. |
Generate impression based on findings. | Patient with metastatic melanoma status post 4 cycles of Pembro. There is no evidence of intracranial hemorrhage or abnormal intraparenchymal enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is moderate mucosal thickening of the bilatera... | 1. No evidence of intraparenchymal mass. 2. Unchanged 7 mm dural based mass overlying the left cerebral convexity. While this has the typical appearance of a meningioma, a metastasis could potentially have a similar appearance. Continued follow-up imaging is suggested. 3. 2 mm right parietal dermal nodule, which may be... |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: There is mild mucosal thickening of the right maxillary sinus. The left maxillary sinus is clear. The ostiomeatal units are clear.Posterior ethmoids: The posterior ethm... | Mild mucosal thickening or small mucous retention cyst of the right maxillary sinus. |
Generate impression based on findings. | The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mas... | Negative unenhanced brain CT. Specifically, there are no CT findings to explain the patient's altered mental status. |
Generate impression based on findings. | Left lower extremity radiculopathy Leftward curvature of the lumbar spine is noted. Moderate degenerative disk disease affects the L3/L4 level. Moderate to severe facet joint hypertrophy affects the lower lumbar spine. No spondylolisthesis is evident.A left total hip arthroplasty device is partially visualized. Degener... | Degenerative changes of the lower lumbar spine, as described above. |
Generate impression based on findings. | Tonsillar SCC staging. Assess for nodal and metastatic spread.RADIOPHARMACEUTICAL: 10.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 77 mg/dL. Today's CT portion grossly demonstrates an ill-defined mass within the region of the right pharyngeal wall, right base of tongue, and into the right aryepiglottic ... | 1. Markedly hypermetabolic mass centered within the right pharyngeal wall which is consistent with tumor with metastatic involvement of multiple bilateral level II-IV lymph nodes.2. Mild to moderate hypermetabolic activity within right hilar, subcarinal, and portocaval lymph nodes is non-specific; this may represent in... |
Generate impression based on findings. | Female 98 years old Reason: r/o fx History: fall. We have 4 views of the left elbow. The bones are demineralized suggesting osteopenia. We see no fracture, malalignment, or joint effusion. There is chondrocalcinosis of the elbow joint. | Chondrocalcinosis. We see no fracture. |
Generate impression based on findings. | Female 51 years old Reason: pt with metastatic melanoma s/p 4 cycles of Pembro History: met melanoma CHEST:LUNGS AND PLEURA: Index right middle lobe nodule now measures 7 mm in diameter image number 45 series number 5, not significantly changed from previous study. Left lower lobe is no longer visualized.MEDIASTINUM AN... | Significant interval decrease in the size of the multiple index lesions. Some of index lesions have completely resolved. |
Generate impression based on findings. | 59-year-old male with facial weakness. No detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes. Redemonstrated is prominence of the cortical sulci, ventricular system, cerebellar and vermian folia disproportionate for patient's stated age of 57 wi... | 1.No acute intracranial hemorrhage.2.Small vessel disease of indeterminate ages. If there is continued clinical concern for acute ischemia, MRI would be recommended.3.Redemonstrated is prominence of the cortical sulci, ventricular system, cerebellar and vermian folia disproportionate for patient's stated age of 57 with... |
Generate impression based on findings. | Triple negative breast cancer with progressive disease and new neck adenopathy, please measure using Recist criteria and immune related response criteria, rule out brain metastases. Head: There is a patchy area of hyperattenuation in the left pons that measures up to approximately 10 mm. The grey-white matter different... | 1. Metastatic left supraclavicular lymphadenopathy with suggestion of extracapsular extension. Upper mediastinal lymphadenopathy also likely represents metastatic disease. Please refer to the separate chest CT report for additional details.2. A patchy area of hyperattenuation in the left pons that measures up to approx... |
Generate impression based on findings. | Male 63 years old; Reason: Restaging cholangiocarciona History: NA CHEST:LUNGS AND PLEURA: Mild centrilobular emphysema. Right middle lobe pulmonary micronodules likely represent intrapulmonary lymph nodes.MEDIASTINUM AND HILA: Stable to slight interval increase in prominent subcarinal lymph node measuring 1.1 x 2.3 cm... | 1.Grossly stable to slight interval increase in borderline enlarged hilar and mediastinal lymph nodes as described above.2.Stable appearance of the common bile duct, further detailed above. No specific evidence of metastatic disease.3.Post ablation changes in the retroperitoneum and right kidney. |
Generate impression based on findings. | Female 86 years old Reason: pre op L knee fusion History: previous antibiotic spacer. AP view of the left femur, two views of the left knee and an AP view of the left tibia/fibula again show an antibiotic cement spacer affixed between the distal femur and proximal tibia via an intramedullary rod. There is lucency about... | Antibiotic spacer as described above, with findings suggestive of loosening of the intramedullary rod within the distal femur. |
Generate impression based on findings. | Hiccups and abdominal pain. Evaluate gastric emptying after vagotomy. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 59.0 % of peak activity (normal >70 %)1 hour: 42.1 % of peak activity (normal 30-90 %) 2 hours: 14.9 % ... | Gastric emptying within normal limits. |
Generate impression based on findings. | 14-year-old male, evaluate healing of fracture.VIEWS: Right clavicle axial (1 view) 3/2/2015 14:36 Again seen is a vertically oriented fracture through the mid clavicular diaphysis with inferior and posterior displacement of the distal fracture fragment. Periosteal reaction is present compatible with healing. | Healing displaced midclavicular fracture as described above. |
Generate impression based on findings. | Metastatic breast cancer.RADIOPHARMACEUTICAL: 13.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 90 mg/dL. Today's CT portion again grossly demonstrates multiple stable sclerotic osseous lesions involving the spine. A left arm port catheter tip extending to the cavoatrial junction is stable in position. St... | 1.No definite evidence of FDG avid tumor.2.Slight decrease in the activity within the left adnexal region likely representing a functional ovarian cyst. However given to persistency of the activity, ultrasound is recommended for further evaluation. |
Generate impression based on findings. | 60 year-old female with acute onset dysarthria, left sided facial droop, right upper extremity weakness yesterday at 6:10 a.m., somewhat improved today, unable to obtain MRI secondary to pacemaker No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal hernia... | 1.No CT evidence of acute territorial, cortical infarct.2.No acute cranial hemorrhage. |
Generate impression based on findings. | 16 year old female with abdominal pain and early satietyEXAMINATION: MR enterography without and with IV contrast 3/2/15 14:12 ABDOMEN:LIVER, BILIARY TRACT: Normal signal intensity, without focal lesion or biliary ductal dilatation.SPLEEN: Normal splenic morphology and enhancement.PANCREAS: Uniform pancreatic enhanceme... | No evidence of inflammatory bowel disease. Interval resolution of colonic wall thickening/inflammation. Moderate to large stool burden. |
Generate impression based on findings. | Patient with a recent PE this admission but would like eval for smaller clots and chronic thromboembolic disease. The comparison chest radiograph performed on 3/2/2015 demonstrates a wedge-shaped focal opacity within the right middle lung compatible with a large pulmonary infarct better seen on the recent previous ches... | Two triple matched defects in the right lung and multiple small to moderate VQ mismatches in the lung bases bilaterally correlating with the patient's known PEs diagnosed by recent CT. Note that superimposed new thromboembolic disease cannot be excluded on the basis of this exam. |
Generate impression based on findings. | The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. Fluid is present within a few right mastoid air cells, a... | Fluid is present within a few right mastoid air cells, also demonstrated in 2012. Otherwise negative unenhanced brain CT. |
Generate impression based on findings. | Right pulsatile tinnitus for the past 2 years. Right: The external auditory canal is patent. The middle ear cavity is well-pneumatized and clear. There is minimal opacification of the mastoid air cells. The ossicular chain is intact. The inner ear structures are unremarkable. The facial nerve describes a normal course,... | No evidence of semicircular dehiscence, venous diverticulum or dehiscence, or temporal bone mass lesions. |
Generate impression based on findings. | Call back from screening mammogram for a new cluster of calcifications in the left breast. An ML view and two spot magnification views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. There is a new cluster of amorphous calcifications at posterior lower outer quadrant, measuring 9 m... | Indeterminate cluster of calcifications at posterior lower outer quadrant in the left breast. Stereotactic core needle biopsy is recommended. Results and recommendations were discussed with the patient.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Reason: R/o PE History: SOB, O2 requirement, diffuse pain PULMONARY ARTERIES: Exam is somewhat limited by decreased spatial resolution and patient body habitus. Within these limitations, no pulmonary embolus is identified to the segmental level. The main pulmonary artery is enlarged, suggestive of pulmonary hypertensio... | 1. No evidence of pulmonary embolism to the segmental level.2. New upper zone groundglass and nodular opacities bilaterally may relate to respiratory bronchiolitis in a smoker. In a nonsmoker, findings may represent hypersensitivity pneumonitis. Less likely considerations include atypical infection such as viral or aty... |
Generate impression based on findings. | 96 year-old female who fell and struck the floor without loss of consciousness Examination demonstrates no acute intracranial hemorrhage, mass-effect, midline shift or hydrocephalus. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes however. Redemonstrated is mild periventricular low attenu... | 1.No acute CT evidence for intracranial process.2.Mild age indeterminate small vessel ischemic disease.3.Presumed pituitary adenoma within the sella with extension into the right cavernous sinus, flattening/inferior displacement of the floor of the sella. There is no extension into the basal cistern and no detectable m... |
Generate impression based on findings. | 54-year-old female with a history of lumpy breast. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is mostly fatty replaced. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in eithe... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Reason: anatomic evaluation History: trach dependent,mmultiple prior surgeries LUNGS AND PLEURA: S/P right pneumonectomy with large pleural cutaneous defect. Packing material and a small amount of fluid in the right chest cavity. Large 1-2 cm open communication between the right bronchial stump and the right hemithorax... | S/P right pneumonectomy with large pleural cutaneous defect. Packing material and a small amount of fluid in the right chest cavity. Large 1-2 cm open communication between the right bronchial stump and the right hemithorax. Air also extends anteriorly around the posterior aspect of the aortic root. Packing material is... |
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