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Generate impression based on findings. | 54 year old female with history of chronic Hep C and HIV, screening for cirrhosis and HCC. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: The liver has normal contour. Simple cysts in the liver are unchanged. No additional focal lesions are identified. Patent hepatic vasculature. A small, non-specific periumbilical vein is present without additional evidence of portal hypertension.No biliary ductal dilatation. SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal punctate nonobstructive calyceal calculi. RETROPERITONEUM, LYMPH NODES: Subcentimeter retroperitoneal lymph nodes similar to prior and not pathologically enlarged by size criteria. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1.Hepatic steatosis.2.Simple hepatic cysts without suspicious hepatic lesions. No evidence of hepatocellular carcinoma. |
Generate impression based on findings. | Shoulder dystocia.EXAMINATION: Left clavicle AP/axial (two views) 03/02/15 A feeding tube is present.The clavicle is normal in appearance. No fracture is identified. | Normal examination. |
Generate impression based on findings. | 81 years, Male. Reason: 81yo M with abd distension History: r/o obstruction Dobbhoff tube tip projects over the gastric fundus. Residual contrast noted in the descending colon. Diffuse gaseous distention of small and large bowel is again seen compatible with ileus type bowel gas pattern. Surgical clips and suture material project over the lower abdomen and pelvis. | Dobbhoff tube tip projects over the fundus. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. History of benign left breast biopsy in 1996. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There are a few, scattered areas of artifact which are not a significant limitation to this study. No solid or cystic mass identified. | No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female with dense breasts presents for whole breast ultrasound for dense breast screening. History of mother with breast cancer. 3-D whole breast ultrasound was performed for both breasts and images were reviewed on an independent workstation. There is no solid or cystic mass identified. Bilateral retropectoral implants are noted and intact. | Bilateral retropectoral implants are noted and intact. No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram. |
Generate impression based on findings. | 65 years, Male. Reason: Eval for Dobbhoff placement History: Dobbhoff placement Dobbhoff tube tip projects over the fourth portion of the duodenum. Support devices are unchanged. Again seen are multiple surgical clips and 8mm radiodensity projected over the pelvis. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Dobbhoff tube tip projects over the fourth portion of the duodenum. |
Generate impression based on findings. | Shoulder dystocia.VIEWS: Left humerus AP/lateral (two views) 03/02/15 The humerus is normal in appearance. No fracture seen.A feeding tube is present. | Normal examination. |
Generate impression based on findings. | 56 years, Male. Reason: constipation History: constipation G-tube projects over the gastric body. Nonobstructive bowel gas pattern. Slightly below average stool burden in the colon. | Nonobstructive gas pattern with slightly below average stool burden in the colon. |
Generate impression based on findings. | Male 72 years old Reason: eval prosthesis History: s/p TEA . Four views of the right elbow and two views of the right humerus again show components of a total elbow arthroplasty device situated in near anatomic alignment. There is lucency of the cement bone interface along the ulnar aspect of the prosthesis which is new when compared to the prior study and is concerning for loosening. Lucency along the cement bone interface of the humeral component may be slightly more prominent on the current study when compared to the prior study, but this is equivocal. Heterotopic bone formation along the distal humerus and within the soft tissues of the elbow appear similar and perhaps slightly matured when compared to that seen on the prior study. There is diffuse soft tissue swelling about the elbow, particularly along the posterior aspect of the elbow and dorsal aspect of the ulna, which is unchanged from the prior study. The proximal humerus is unremarkable. | Total elbow arthroplasty as described above with new lucency at the cement bone interface along the ulnar component which is suspicious for loosening. |
Generate impression based on findings. | 69 year old with known right breast cancer (2 sites) presents for ultrasound for right axilla. Focused ultrasound for right axilla was performed. There are two abnormal lymph nodes with cortical thickening. Non-hilar cortical flow is detected in each lymph node. | Two suspicious lymph nodes in the right axilla BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Encephalomalacia is present involving the right temporoparietal lobes, peri-insular brain, and right periorbital gyri. There are no findings of ventricular obstruction or hydrocephalus. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical territorial infarction. There are no extraaxial fluid collections or subdural hematomas. An air-fluid level is present in the left sphenoid sinus. Scattered foci of mucosal thickening is noted in posterior left ethmoid air cells. The remaining visualized Visualized portions of the paranasal sinuses and mastoid air cells are clear. An enteric tube is present via the left nares. | 1.Encephalomalacia is present involving the right temporoparietal lobes, peri-insular brain, and right periorbital gyri. This pattern is most suggestive of encephalomalacic changes due to remote trauma.2.No acute intracranial hemorrhage.3.An air-fluid level is present in the left sphenoid sinus.4.Scattered foci of mucosal thickening is noted in posterior left ethmoid air cells. |
Generate impression based on findings. | 36 years, Male. Reason: G-tube placement History: pain Water-soluble enteric contrast was injected into the gastrostomy tube by the requesting clinical service. Contrast seen pooling in the gastric fundus and in the jejunum. Nonobstructive bowel gas pattern. | Findings compatible with well-positioned gastrostomy tube. |
Generate impression based on findings. | There are postoperative findings related to endoscopic sinus surgery. There is overall interval less sinonasal opacification compared to 2011. In particular, there is now moderate bilateral maxillary sinus opacification, near complete opacification of the anterior ethmoid air cells, mild mucosal thickening of the posterior ethmoid air cells, moderate right and mild left sphenoid sinus mucosal thickening, and partial opacification of the frontoethmoid recesses with bubbly components. There are polypoid opacities in the nasal cavity, particularly on the left side. The nasal septum is essentially midline. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. | Persistent sinonasal polyposis and inflammation related to Samter syndrome, albeit less extensive compared to 2011.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 10-year-old female status post ASD repairVIEWS: Chest AP/lateral (two views) 3/2/15 15:07 Interval removal of right central venous catheter. Sternal wires are again noted. The cardiothymic silhouette is unchanged.Scattered basilar atelectasis without pleural effusion or pneumothorax | Scattered atelectasis without pleural effusion or pneumothorax. |
Generate impression based on findings. | Metastatic breast cancer. There has been overall interval decrease in size of the extensive infiltrative and necrotic lymphadenopathy in the neck and partially-imaged mediastinum. For example, a right level 5 lymph node measures 39 x 31 mm, previously 36 x 30 mm and a left level 5 lymph node measures 34 x 28 mm, previously 34 x 26 mm. The thyroid and major salivary glands are unchanged. There is persistent encasement of the left common carotid artery. There is absent opacification of the left internal jugular vein. There is a new filling defect in the superior right internal jugular vein. There is minimal degenerative cervical spondylosis. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | 1. Overall stable to slight increase in size of the extensive lymphadenopathy in the neck and partially-imaged mediastinum. 2. New thrombosis of the superior right internal jugular vein. |
Generate impression based on findings. | History of thyroid cancer with metastases. Head: There is subtle ill-defined intradiploic sclerosis in the left frontal bone that corresponds to an area of hypermetabolism on PET. Otherwise, there is no evidence of intracranial mass lesions. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. Neck: There are postoperative findings related to prior thyroidectomy and tracheostomy without evidence of local tumor recurrence. There is apparent atrophy of the right vocal fold, which may indicate recurrent laryngeal nerve palsy. There are no enlarged lymph nodes in the neck by size criteria. The salivary glands are unchanged. There is unchanged disproportionate prominence of the fat compartments within the right anterior triangle of the neck, suggestive of a lipoma. There is degenerative spondylosis. There are multiple nodules within the imaged portions of the lungs, which appear to be stable to slightly smaller. | 1. Subtle ill-defined sclerosis in the left frontal bone that corresponds to an area of hypermetabolism on PET likely represents metastatic disease. Otherwise, no definite intracranial metastases.2. Post-treatment findings in the neck without evidence of local thyroid cancer recurrence or cervical significant lymphadenopathy. 3. Numerous metastases in the partially imaged lungs appear to be stable to slightly smaller. Please refer to CT chest report for additional details. |
Generate impression based on findings. | Female 57 years old; Reason: left hip pain Very mild osteoarthritis affects the left hip. No malalignment is present. No other specific findings are present to account for the patient's pain. | Very mild osteoarthritis of the left hip. |
Generate impression based on findings. | Female 49 years old Reason: metastatic breast cancer - evaluate response to treatment with measurements per recist 1.1. History: adenopathy - patient also having neck CT CHEST:LUNGS AND PLEURA: Scattered nonspecific micronodules, unchanged. Reference 4 mm left lower lobe nodule (series 6, image 39). No pleural effusion.MEDIASTINUM AND HILA: Prevascular soft tissue mass measures 1.7 x 2.4 cm (series 4, image 23), previously 1.4 x 2.1 cm. Normal heart size without pericardial effusion. Central venous catheter with tip in the SVC.CHEST WALL: Inferiorly located left axillary soft tissue attenuation (series 4, image 14) measures 5.0 x 43 cm, previously 4.9 x 4.2 cm. Incompletely imaged soft tissue attenuation in left supraclavicular/axillary area has further ulcerated compared to prior study making comparison difficult (series 4, image 1). Additional amorphous right axillary mass measures 4.6 x 7.2 centimeters (series 4, image 14), previously 4.2 x 7.7 cm. Additional soft tissue seen along the anterior aspect of the left clavicular head, measures 1.4 x 2.0 cm (series 4, image 15), previously 2.0 x 3.0 cm There are postsurgical changes related to left mastectomy and reconstruction.ABDOMEN:LIVER, BILIARY TRACT: No biliary ductal dilatation or focal hepatic lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypodense renal lesions are unchanged and too small to characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No lytic or sclerotic lesions identified within the imaged axial or appendicular skeleton to suggest osseous metastasis.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No lytic or sclerotic lesions identified within the imaged axial or appendicular skeleton to suggest osseous metastasis.OTHER: No significant abnormality noted. | Stable bilateral supraclavicular/axillary masses consistent with nodal metastases. No new sites of metastatic disease. |
Generate impression based on findings. | Female 55 years old Reason: r/o bony path History: MVA last week with back and knee pains. Four views of the right knee show no fracture, malalignment, or joint effusion. Small osteophytes indicate mild osteoarthritis. Mild to moderate osteoarthritis also affects the proximal tibiofibular joint. | Mild osteoarthritis without fracture, malalignment, or joint effusion. |
Generate impression based on findings. | Female 50 years old Reason: s/p injury to right third MCP joint. persistent pain. History: above. There are tiny osteophytes along the second and third metacarpal heads and perhaps a tiny cyst in the distal pole of the scaphoid. We see no fracture, malalignment, or other specific findings to account for the patient's pain. | Minimal degenerative arthritic changes without specific findings to account for the patient's pain. |
Generate impression based on findings. | 51 year-old female with triple negative breast cancer with chest and abdominal adenopathy and liver metastases. New left sided neck adenopathy with pain. Pre-chemotherapy. CHEST:LUNGS AND PLEURA: Stable appearance to the right anterior subpleural lung changes most likely relating to prior radiation therapy. No new foci of pulmonary airspace disease is seen. No nodules or masses. No pleural disease.MEDIASTINUM AND HILA: Enlarged mediastinal nodes are again seen with minimal change. The reference pretracheal lymph node (series 4 come image 35) measures 1.5 x 1 .2 cm, previously 1.4 x 1.2 cm. anterior prevascular lymph node (representing an aggregate of two lymph nodes) measures 1.1 x 0.6 cm (series 4 come image 26) compared with previous 1.4 x 0.6 cm. Subcarinal lymph node (series 4 come image 40) shows minimal change measuring 1.8 by 1.1 cm, previously 1.7 x 0.9 cm. Scattered other smaller paraesophageal lymph nodes and bilateral hilar lymph nodes are unchanged.CHEST WALL: Status post bilateral mastectomy with left breast prosthesis in place. Right subpectoral fluid collection has slightly increased in size and measures 2.7 x 7.0 cm (series 4, image 59) compared previous 1.3 x 1.5 cm. left-sided chest wall Port-A-Cath is again seen with tip of the catheter in the distal superior vena cava. No enlarged left supraclavicular lymph node (series 4, image 3) measures 3.4 x 2 .6 cm, previously 1.3 x 0.9 cm.ABDOMEN:LIVER, BILIARY TRACT: Prior noted right hepatic dome lesion (series 4, image 75) now measures 2.0 x 1 .7 cm, previously 1.3 x 1.2 cm . Small subcentimeter hypodensity is seen in the isthmus to the caudate lobe, which in retrospect was a punctate hypodensity and now is increased in size to approximately 1 cm. No other hepatic mass lesions are seen. Gallbladder and biliary tract appear normal.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Several right kidney nonobstructing calyceal calculus is seen. No hydronephrosis. No abnormalities are seen today on the left kidney. RETROPERITONEUM, LYMPH NODES: Diffuse para-aortic, aortocaval and retrocaval adenopathy has increased in size since prior examination reference lymph node (series 4 come image 114) measures 2.2 x 1 .9 cm, previously 1.9 x 0.9 cm. Similarly enlarged lymph nodes in the hepatoduodenal ligament and porta hepatis have increased in size.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: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. Increasing size of existing liver presumed metastatic lesion and new right isthmus two caudate lobe lesion. 2. Increasing retroperitoneal and hepatoduodenal adenopathy, while stable mediastinal adenopathy. 3. Nonobstructing right punctate calyceal kidney stone disease unchanged. 4. Slight increase in size of right chest subpectoral fluid collection. |
Generate impression based on findings. | Female 33 years old Reason: ankle swelling History: L ankle swelling. Three views of the left ankle show mild diffuse soft tissue swelling as well as an ankle joint effusion. There are tiny densities distal to the medial malleolus and dorsal to the head of the talus which may be chronic in etiology, but could represent tiny avulsion fractures in the correct clinical context. | Tiny densities distal to the medial malleolus and dorsal to the head of the talus may be chronic in etiology, but, could represent tiny avulsion fractures in the correct clinical context. |
Generate impression based on findings. | Call back from screening mammogram for a small focal asymmetry in the left breast. An ML view and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. A small focal asymmetry at lower inner quadrant in the left breast disperses with spot compression. A focused ultrasound study for the left lower inner quadrant detected no abnormal findings. | No mammographic ro sonographic 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. | 21 years old Female. Reason: Medically intractable epilepsy since 2003, presurgical evaluation. History: Evaluate for functional deficit. The noncontrast CT portion of the study is not remarkable. The FDG PET imaging demonstrates mildly decreased FDG activity in the left frontal lobe including superior, middle and inferior frontal gyri and orbital frontal region.The FDG uptake in the remaining portion of the brain is physiological. Brown fat activity is seen in the neck. | Mildly decreased metabolism in the left frontal lobe. |
Generate impression based on findings. | Warm and swollen knee Orthopedic hardware of an ACL repair is noted, without radiographic evidence of hardware complication. A moderate sized joint effusion is present. No fracture or malalignment is evident. | Joint effusion. |
Generate impression based on findings. | Female 57 years old Reason: metastatic breast cancer History: hip lesion on bone scan. Two views of the left hip show a poorly defined mixed sclerotic and lucent lesion in the femoral neck, corresponding to increased uptake seen on recent bone scan, and compatible with metastatic breast cancer. We see no fracture or frank cortical destruction at this time. However, if patient complains of increasing hip pain, then cross-sectional imaging may be considered for further evaluation. | Poorly defined mixed lucent sclerotic focus compatible with metastatic breast cancer as described above. |
Generate impression based on findings. | Metastatic prostate cancer to the bones. Increased radiotracer uptake in the previously seen upper thoracic spine which become more confluent. Interval significant increase in the activity in the metastatic lesions within the left ischium and right posterior mid-thoracic ribs. The left ischial lesions appear similar to the prior exam. Additional abnormal focus of activity in the left scapula is new. New focus of activity in the lateral right ilium is also new.Tracer activity has decreased somewhat within the lower lumbar spine | 1.Increased activity within the known thoracic vertebral lesions and single lesion within the left ischium which have become more confluent. 2.New foci of abnormal increased activity within the right medial posterior mid-thoracic ribs, within the left scapula and lateral right ilium compatible with progression of metastases. |
Generate impression based on findings. | 86 year old with history of right lumpectomy for cancer in 1994. Patient received radiation and chemotherapy. Patient has also had two benign right breast biopsies. No new breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Stable architectural distortion and dystrophic calcifications are present within the right lumpectomy bed. Scattered benign calcifications are present bilaterally. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 21 years old; Reason: Evaluate fracture healing History: s/p ORIF Again seen are 3 orthopedic screws affixing an oblique fracture of the right little finger proximal phalanx in unchanged near-anatomic alignment. The fracture line is visible, though less distinct, compatible with some interval healing. | Healing fixed proximal phalanx fracture, as above. |
Generate impression based on findings. | Ms. Wozniak is a 69 year old female with a personal history of right lumpectomy in 1994 for breast cancer. Patient received radiation and chemotherapy. No new breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Stable volume loss, increased density and extensive dystrophic calcifications are present in the right lumpectomy bed and right axilla.There is no new mass, suspicious microcalcifications or areas of architectural distortion identified in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 102 years, Female. Reason: obstruction r/o History: abdominal pain Bilateral pleural effusions with scarring/atelectasis. Atherosclerotic calcification of the aorta and its branches.Residual contrast within the distal colon. Gastrojejunostomy tube tip appears to project over the expected location of the gastric body. Nonobstructive bowel gas pattern. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 13-year-old female with left middle finger pain, evaluate for proximal phalanx versus metacarpal fracture VIEWS: Left hand, PA, oblique, and lateral (3 views) 3/2/15 15:39 There is a fracture through the proximal phalanx of the middle finger extending from the metaphysis to the physis with overlying soft tissue swelling. | Salter-Harris II fracture of the proximal phalanx of the middle finger. |
Generate impression based on findings. | There is a slightly displaced fracture involving the left parietal bone, the inferior-most extent of which extends to the left lambdoid suture. Soft tissue swelling and scalp hematoma is noted overlying the fracture. There is no underlying brain parenchymal associated abnormality. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for acute intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The mastoid air cells are clear. | There is a slightly displaced fracture involving the left parietal bone, the inferior-most extent of which extends to the left lambdoid suture. Soft tissue swelling and scalp hematoma is noted overlying the fracture. There is no underlying brain parenchymal associated abnormality. |
Generate impression based on findings. | 64 years, Male. Reason: 64yoM NG tube new placement History: NG tube placement Nasogastric tube tip projects over the pyloric area. Cholecystectomy clips are noted in the right upper quadrant. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | Nasogastric tube tip projects over the pyloric area. |
Generate impression based on findings. | The colon is well distended. Moderate colonic tortuosity and mild redundancy of the left colon. Moderate residual fluid throughout the colon is well tagged with oral contrast. Small amount of residual tagged stool. Few diverticula. No polyps > 6 mm or colonic masses are identified. Note: CT colonography is not intended for the detection of diminutive colonic polyps (i.e., tiny polyps < 5 mm), the presence or absence of which will not change management of the patient.EXTRACOLONIC | No polyps > 6 mm or colonic masses are identified. Extracolonic findings as above.*OPTIONAL C-RADS CLASSIFICATION:C-1E- 2 (known)*(see full definitions in: Zalis et al. CT Colonography reporting and data system: a consensus proposal. Radiology 2005;236:3-9)C1: Normal or benign lesions (no polyps > 6mm). Continue routine screening.C2: Intermediate polyp (less than three 6-9mm polyps or can't exclude >6mm in technically adequate study. Surveillance CTC or colonoscopy recommended.C3: Polyp, possibly advanced adenoma. (polyp >10mm or >three 6-9mm). Colonoscopy recommended.C4: Colonic mass, likely malignant. |
Generate impression based on findings. | One day old male with increased oxygen requirementVIEW: Chest AP, abdomen AP (two views) 3/2/15 15:49 Umbilical venous catheter tip in the SVC/right atrial junction. NG tip and side-port in the stomach. The cardiothymic silhouette is upper limits of normal. No focal pulmonary opacity or pleural effusions. Disorganized bowel gas pattern without evidence of obstruction. No bowel pneumatosis or portal venous gas. | No focal pulmonary opacity or pleural effusion. |
Generate impression based on findings. | Male 41 years old Reason: Left humerus pathologic fracture through fibrous dysplasia History: above. Two views of the left humerus again show findings compatible with fibrous dysplasia of the left humerus and scapula. Also again seen is a transverse fracture through the distal humeral metaphysis with progression of callus formation, indicating some interval healing. | Healing pathologic fracture as described above. |
Generate impression based on findings. | Female 38 years old Reason: chronic upper back pain History: above. Small osteophytes project from the anterior aspect of the thoracic vertebrae. Evaluation of the upper thoracic vertebrae is slightly limited by overlying anatomy, but we otherwise see no specific findings to account for the patient's pain. | Small vertebral body osteophytes, but otherwise no specific findings to account for the patient's pain. |
Generate impression based on findings. | Reason: rule out bleed History: pain and tenderness after a recent fall, vision changes, headaches The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a hypodense focus present in the left periventricular white matter adjacent to left lateral ventricle which is associated with focal enlargement of the left lateral ventricle.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.Incidental note is made of partial empty sella | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Small focus of encephalomalacia is present in the left periventricular white matter. |
Generate impression based on findings. | Male 92 years old Reason: HIP PAIN History: Gout decreased ROM. We have 5 views of the lumbar spine. The bones appear demineralized, suggesting osteopenia. There is moderate multilevel degenerative disk disease throughout the lumbar spine, with moderate facet joint osteoarthritis predominantly affecting the lower lumbar spine. Vertebral body heights are preserved. We see no spondylolisthesis. There is hypertrophy of the spinous processes with mild associated degenerative arthritic changes. There are atherosclerotic calcifications of the abdominal aorta and common iliac arteries.We have a single AP view of the pelvis. The bones appear demineralized, suggesting osteopenia. Moderate osteoarthritis affects both hips. Atherosclerotic calcifications extend into both thighs. | Degenerative disk disease and osteoarthritis as described above. |
Generate impression based on findings. | Female 31 years old Reason: left knee pain History: left knee pain. We have 4 views of the left knee. There is a curvilinear lucency along the articular surface of the lateral tibial plateau with a step-off along the lateral limb of the plateau highly suspicious for a minimally depressed fracture. There may be a small joint effusion. There is minimal depression of the articular surface of the lateral femoral condyle which may reflect normal anatomy for this patient, but can also represent a mild impaction fracture that can be seen in patients with ACL disruption. | Findings suggestive of a minimally depressed lateral tibial plateau fracture and an equivocal deep sulcus sign raises the possibility of an associated ACL injury. MRI may be considered for further evaluation if clinically warranted. |
Generate impression based on findings. | Female 56 years old Reason: left shoulder pain and tingling History: as above. The shoulder is unremarkable with no specific findings to account for patient's shoulder pain and tingling. Mild degenerative disk disease affects the visualized thoracic spine. | Unremarkable shoulder with no specific radiographic findings to account for patient's shoulder pain and tingling. |
Generate impression based on findings. | 43-year-old female with epigastric pain and right CVA tenderness. ABDOMEN:LUNG BASES: Mild cardiomegaly. Minimal basilar atelectasis. LIVER, BILIARY TRACT: The liver is mildly enlarged. No focal hepatic lesions. The gallbladder appears unremarkable. The portal veins are patent.SPLEEN: No significant abnormality notedPANCREAS: Pancreatic parenchyma enhances normally.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: End-stage, atrophic kidneys with grossly unremarkable enhancement pattern. Subcentimeter hypodensities in the right kidney are too small to characterize.RETROPERITONEUM, LYMPH NODES: The abdominal aorta and its branches are tortuous.BOWEL, MESENTERY: Normal caliber bowel without evidence of obstruction. Appendix visualized and 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. Appendix visualized and unremarkable.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Trace free fluid is present in the pelvis, likely physiologic. | 1.End-stage, atrophic native kidneys.2.Hepatomegaly.3.No specific findings to account for the patient's pain. |
Generate impression based on findings. | Known PE on CT PE. Undergoing OHT work up. Please eval for more clots. A comparison chest radiograph is not available for review at the time of this report.The ventilation images show a uniform distribution of activity on single-breath and wash-in images. There is no abnormal Xe-133 retention during the wash-out phase. The perfusion images show a physiologic distribution of pulmonary perfusion. | Normal ventilation and no discrete focal scintigraphic perfusion defect. |
Generate impression based on findings. | Status post curettage and cementation for right supra-acetabular focus of metastatic thyroid cancer with fracture. Evaluate for progression. Again seen is cement within the right acetabulum and ilium compatible with curettage and grafting of metastatic thyroid cancer lesion. The pathologic fracture line remains visible, I see no specific findings to suggest progression. An overlying curvilinear metallic density presumably represents an embolization coil.A lucent lesion in the anterolateral aspect of the left iliac wing is compatible with an additional focus of metastatic thyroid cancer and appears similar to that seen on the prior study. | Postoperative changes and metastases appearing similar to the prior study. |
Generate impression based on findings. | 18-year-old male with respiratory failureVIEW: Chest, abdomen AP (two views) 3/2/15 15:56 ETT above the carina. Right PICC tip at the level of the tricuspid valve. A G-tube is again visualized. A zipper pull remains present in the proximal stomach. The cardiothymic silhouette is unchanged.Low lung volumes with bilateral basilar opacities, which may represent atelectasis or consolidation.Diffusely dilated bowel loops in the abdomen and pelvis are increased from the prior exam with moderate to large rectal stool collection. No bowel wall pneumatosis or free intraperitoneal air.Left hip fixation plate and wires along the pelvic wall are unchanged. | Increased bowel dilatation, which may represent worsening ileus or obstruction secondary to rectal impaction. |
Generate impression based on findings. | 19 day old male, evaluate NG tube placementVIEW: Chest AP, abdomen AP (two views) 3/2/15 15:56 Right PICC tip in the right atrium. ETT at thoracic inlet. NG tube tip in the stomach. The cardiothymic silhouette is normal.Bilateral pulmonary opacities likely representing atelectasis and PIE are again noted. No pneumothorax.The abdominal surgical drain has been removed. The bowel gas pattern is disorganized. | NG tube tip in gastric body. Unchanged pulmonary opacities without pneumothorax. |
Generate impression based on findings. | Female, 37 years old, headache with blurry vision. Minimal nonspecific peri-atrial hypoattenuation is unchanged. No new intracranial lesions are seen including no evidence of mass, mass effect, edema or loss of gray-white distinction. No intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. The ventricles are normal in size and morphology. The osseous structures are intact. The paranasal sinuses and mastoid air cells are clear. | Stable minimal periatrial hypoattenuation, a nonspecific finding. No new or concerning intracranial findings. |
Generate impression based on findings. | Status post fall, point tenderness, evaluate for fracture. Pain. I see no fracture or dislocation. Moderate osteoarthritis affects the hand. | Osteoarthritis without fracture evident. |
Generate impression based on findings. | 13-year-old male, status post immobilization, evaluate for healingVIEWS: Right hand, PA, oblique, and lateral (3 views) 3/2/15 16:27 A fracture line extends from the proximal metaphysis to the epiphysis of the distal phalanx of the thumb, appearing similar to the prior exam. | Salter II fracture of the base of the distal phalanx of the thumb, appearing similar to the prior exam. |
Generate impression based on findings. | No acute intracranial hemorrhage. There are no extraaxial fluid collections or subdural hematomas. No CT evidence of acute large territorial ischemia. No calvarial fractures. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | No acute intracranial abnormality. |
Generate impression based on findings. | Female 30 years old; Reason: 30 y/o female, colon ca on chemo. compare to prior \T\ planning for ostomy reversal eval for complications of this procedure. History: see above CHEST:LUNGS AND PLEURA: Left upper lobe nodule previously measured 1 cm x 0.4 cm, and now measures 0.9 x 0.5 cm. Lingular nodule previously measured 0.8 x 0.7 cm, now measures 0.9 x 0.8 cm (4:54). Other lesions appear stable. No new lesions. No effusions.MEDIASTINUM AND HILA: Portacatheter tip at the cavoatrial junction.CHEST WALL: A port is seen in the right chest wall.ABDOMEN:LIVER, BILIARY TRACT: Previously seen segment 8 reference lesion is again demonstrated. It appears bigger, as best evidenced when comparing coronal images. On coronal image 56, the lesion measures 4.3 cm, compared to 2.9 cm on CT from 9/2/2014. Additionally, there is adjacent new focal biliary dilatation (coronal image 55). Grossly stable caudate lobe lesion measuring 1.2 x 1.2 cm (3:83).SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right sided percutaneous nephroureterostomy with interval reduction in hydronephrosis. Atrophic left kidney compared to the right.RETROPERITONEUM, LYMPH NODES: Redemonstrated shotty pericaval and periaortic lymph nodes. The index left periaortic nodal area previously measured 0.8 x 0.7 cm, stable on today's exam. A cluster of left aortic nodes just above the bifurcation previously measured 1.1 x 1 cm, stable.BOWEL, MESENTERY: Ileostomy without evidence of obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Surgically absent.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Reference presacral nodular enhancing soft tissue mass previously measured 4.4 x 3.6 cm on sagittal image 74, and now measures 4.5 x 4.3 cm on sagittal image 59. Post surgical changes in the intra-abdominal wall, and injection sites. | 1.Interval increase in segment 8 hepatic lesion with new local associated biliary dilatation. Slight interval increase in presacral mass. Grossly stable thoracic disease. |
Generate impression based on findings. | Female 45 years old Reason: assess size of pelvic abscess collection History: s/p IR drain removal 2/5 ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomySPLEEN: No significant abnormality notedPANCREAS: No significant abnormality noted ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Large stool burden.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Mild leftward curvature of the lumbar spine.OTHER: Interval decrease in size in the multiloculated pelvic collections. Right-sided loculated collection has decreased in size and now measures 0.9 x 1.5 cm (series 3, image 108), previously 1.7 x 1.9 cm. There is an additional left-sided loculated fluid collection, which in retrospect, has been present on prior exams, however, was not well delineated secondary to adjacent unopacified small bowel. On the current study, the adjacent small bowel is well opacified and the left-sided fluid collection is better appreciated and measures 1.6 x 5.1 cm (series 3, image 109), previously 2.4 x 5.2 cm. Small amount of fat stranding persists. | Interval decrease in size of the bilateral multiloculated pelvic fluid collections. |
Generate impression based on findings. | 14-year-old female, evaluate for fractureVIEW: Right ankle, AP and lateral (two views) 3/2/15 15:30 No fracture or malalignment. Mild soft tissue swelling about the medial malleolus. | Mild soft tissue swelling without fracture or dislocation. |
Generate impression based on findings. | Reason: h/o met thyroid cancer, compare to previous, measurements pls History: as above CHEST:LUNGS AND PLEURA: Reference right lower lobe nodule measures 19 x 14 mm (series 6, image 42), previously 21 x 16 mm.Reference inferior left lower lobe nodule measures 27 x 22 mm (series 6, image 54), previously 29 x 24 mm.Reference left lower lobe nodule measures 21 x 19 mm (series 6, image 47), previously 23 x 20 mm.Additional non-reference nodules are slightly decreased in size. No new nodules are identified.Interval resolution of small left pleural effusion. Nodular pleural thickening appear similar to the prior exam.No focal airspace consolidation.MEDIASTINUM AND HILA: Reference left hilar lymph node measures 16 mm (series 4, image 32), unchanged.Reference right hilar lymph node measures 1.8 mm (series 4, image 39), unchanged.Additional non-reference mediastinal and hilar lymph nodes appear similar to the prior exam.The heart is normal in size, without pericardial effusion. Severe coronary artery calcification. Status post CABG.CHEST WALL: Status post median sternotomy. Tracheostomy in place.Degenerative disease of the thoracic spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis. Diffuse hypoattenuation of the liver parenchyma suggest hepatic steatosis. Probable flash filling hemangioma in the left hepatic lobe (series 4, image 80). Poorly defined hypoattenuating mass with a peripheral rim of enhancement at the hepatic dome has been present on multiple prior examinations dating back to the patient's initial study of 6/16/2010 and is incompletely assessed but may represent an atypical presentation of a hemangioma. SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the abdominal aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Diffuse pulmonary metastases, many of which are mildly decreased from the prior exam. Resolved small left pleural effusion. Stable mediastinal and hilar lymphadenopathy. No new sites of disease identified. |
Generate impression based on findings. | Knee pain Severe osteoarthritis affects the knee, particularly the patellofemoral joint, with narrowing of the lateral aspect of the joint. There is chondrocalcinosis. There is also suggestion of a small joint effusion.Osteoarthritis affects the right knee as seen on the frontal view. There may also be a loose body in the joint. | Degenerative arthritic changes as described above perhaps representing a combination of osteoarthritis and CPPD arthropathy. |
Generate impression based on findings. | 69 year-old female with poorly differentiated carcinoma in abdomen. Unknown primary. Staging. Right flank pain. CHEST:LUNGS AND PLEURA: Right upper lobe mass with solid and cystic components is seen more consistent with primary lung cancer although unusual metastatic focus cannot be differentiated. Solid components inferiorly (series 5, image 34) measured 2.0 x 2.3 cm. Largest measurement more cephalad is predominantly air-filled cavity measuring 3.3 x 2.6 cm (series 5, image 25).Elsewhere calcified granulomas are seen but no other evidence of parenchymal nodules worrisome for malignancy. No pleural disease.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: 1 cm medial right breast soft tissue density (series 3, image 56) of uncertain significance. No other evidence for soft tissue or skeletal significant abnormality seen. Catheter is seen coursing through the anterior chest wall and entering into the abdominal peritoneal cavity without complication.ABDOMEN:LIVER, BILIARY TRACT: No parenchymal mass lesions to suggest metastatic disease. Patient is status post cholecystectomy without other biliary tract abnormality.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Benign cystic change seen in the left kidney. No other abnormalities seen.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Stomach and small bowel show no abnormalities. Colon is filled with fecal material throughout. Adjacent to the mid descending colon (series 3, image 151) is a heterogeneous solid mass measuring 3.5 x 4.5 cm. This directly abuts the descending colon and extends to the left iliac is muscle. No other sites of potential metastatic disease are seenBONES, 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: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stomach and small bowel show no abnormalities. Colon is filled with fecal material throughout. Adjacent to the mid descending colon (series 3, image 151) is a heterogeneous solid mass measuring 3.5 x 4.5 cm. This directly abuts the descending colon and extends to the left iliac is muscle. No other sites of potential metastatic disease are seenOTHER: No significant abnormality noted. | 1. Large left paracolic mass consistent with known abdominal peritoneal mass -- directly abuts/invades descending colon. No other sites of abdominal/pelvic disease seen. 2. Right upper lobe lung parenchymal cystic/solid mass -- I would favor this being primary site of lung cancer, although uncommon metastatic lesion could have this appearance. 3. No etiology for patient's right flank pain identified. |
Generate impression based on findings. | Male 80 years old Reason: 80y/o duodeneal ca on chemo. compare to prior. History: see above CHEST:LUNGS AND PLEURA: There are multiple new ill-defined, spiculated nodules predominately in the right lung. An index Ill-defined, spiculated nodule in the right upper lobe measures 10 x 10 mm on image number 35, series number 9, new from previous study.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic metastases are again noted. Index right posterior lobe hepatic lesion measures 4.6 x 3.1 cm on image number 104, not significantly changed from previous study. The second more medial index lesion measures 4.1 x 3.4 cm on image number 104, again not significantly changed from previous study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cyst is unchanged.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Circumferential thickening of the duodenum is again noted. Soft tissue mass abutting the duodenum is unchanged measuring 2.7 x 2 . 9 cm on image number 116.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: Ill-defined hazy hypodensity in the left gluteal subcutaneous tissue, new from previous study. The etiology is unknown and may represent hematoma or infection. Follow-up imaging is recommended.OTHER: No significant abnormality noted | Limited study due to patient's motion at the time of the optimal phase imaging. Multiple, new ill-defined spiculated nodules predominately in the right lung suspicious for metastatic disease. Infectious etiology may also be considered, however, less likely.Liver metastases and index duodenum soft tissue mass is unchanged.Left gluteal hazy soft tissue density of unknown etiology, new from previous study. It may represent hematoma or infection. Clinical correlation is recommended. |
Generate impression based on findings. | Reason: follow-up of nsclc History: pain SOB CHEST:LUNGS AND PLEURA: Scarring and volume loss in the right apical area consistent with previous surgery.A focal area of atelectasis and scarring anteriorly in the right upper hemithorax is slightly enhancing and corresponds to an area of increased activity on a PET scan of the same day.Subpleural irregular nodule in the superior segment of the left lower lobe (series 6/53) not significantly changed.Additional subpleural scarlike opacities also unchanged.MEDIASTINUM AND HILA: Mildly enlarged nonspecific hilar lymphoid tissue, unchanged.Moderate coronary artery calcification.No pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Status post cholecystectomy with a dilated bile duct.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Catheter in the spinal canal.OTHER: No significant abnormality noted. | Focal atelectasis and scarring anteriorly in the right upper hemithorax with slightly increased opacity and enhancement likely corresponding to an area of suspected recurrence on the PET scan of the same day. Otherwise stable disease. |
Generate impression based on findings. | Male 24 years old; Reason: Right testicle no detectable blood flow, chronic infarct seen 12/27 would like to reevaluate. Stable moderate hydronephrosis on left side, history or right ureteral stricture. RIGHT KIDNEY: The right kidney measures 9.5 cm in length. The cortex is normal in echogenicity. No shadowing calculi or hydronephrosis is present. LEFT KIDNEY: The left kidney measures 11.5 cm in length. The cortex is normal in echogenicity. No shadowing calculi is identified. There is mild hydroureteronephrosis which appears similar to the prior CT.URINARY BLADDER: The bladder is normal ultrasound appearance. A right renal jet was visualized.TESTICULAR ULTRASOUND | 1.Mild left hydronephrosis and hydroureter appear similar to the prior CT.2.Atrophic, hypoechoic right testicle with no detectable internal flow on Doppler compatible with the given history of chronic infarct. |
Generate impression based on findings. | New pain without injury in region of left posterior ribs (approx. ribs 5-7) near the midline. Known myeloma. A lytic appearing lesion is seen in the posterior left sixth rib, which is not seen on the prior exam and is suspicious for a new myelomatous deposition. An old healed fracture is seen in the posterolateral aspect of the left seventh rib. The visualized vertebral body heights are preserved. | Lytic appearing lesion in the posterior left sixth rib suspicious for myelomatous deposition. |
Generate impression based on findings. | Clinical question: Rule out hemorrhage. Signs and symptoms: Increasing forgetfulness since approximately 3 p.m. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.There are mild to moderate degree of periventricular and subcortical low attenuation of white matter highly concerning for age indeterminate small vessel ischemic strokes. No convincing evidence of any significant interval change since prior exam.Unremarkable cerebral cortex, cortical sulci, ventricular system and the CSF spaces otherwise.Unremarkable orbits, calvarium and paranasal sinuses. | 1.Acute intracranial process.2.Small vessel ischemic strokes of indeterminate age of moderate degree. |
Generate impression based on findings. | motor vehicle accident, No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Clinical question: ICH? Signs and symptoms: Contusion. Nonenhanced head CT:No detectable acute posttraumatic intracranial or calvarial findings.There is scalp soft tissue and subgaleal increased density and volume in the left frontal and periorbital region suggestive of recent injury. No underlying bony abnormality and unremarkable images through the orbits.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation. | 1.Unremarkable nonenhanced head CT.2.Left frontal and periorbital soft tissue thickening and hemorrhage without underlying bony abnormality. |
Generate impression based on findings. | Motor vehicle accident NONCONTRAST CT HEADNo evidence of acute ischemic or hemorrhagic lesion on this scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. CTA HEAD AND NECKThere is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins are normal.There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. There is normal contrast opacification through bilateral ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.Bilateral Pcom arteries are patent and Acom artery is also patent.No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage. | Normal head and neck CTA. |
Generate impression based on findings. | Clinical question: Intracranial lesion. Signs and symptoms: Status post fall; left frontal hematoma and ataxia. Nonenhanced head CT:There is no detectable acute posttraumatic intracranial or calvarial findings.A tiny focus of hemorrhage and edema in the left supraorbital soft tissues of the scalp is noted.Unremarkable cerebral cortex, cortical sulci, ventricular system and the CSF spaces for patient's stated age of 81.Minimal periventricular and subcortical small vessel ischemic strokes of indeterminate age are detected.Unremarkable orbits, paranasal sinuses and mastoid air cells. | 1.No evidence of intracranial or calvarial posttraumatic findings.2.Tiny left super orbital soft tissue hemorrhage.3.Mild age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | headache, left upper extremity decreased sensation No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Clinical question: Rule out stroke or intracranial process. Signs and symptoms: Involuntary movement and twitching. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Mild periventricular and subcortical low attenuation of white matter could represent age indeterminate small vessel ischemic strokes considering patient's stated age of 71.The cortical sulci and ventricular system as well as the CSF spaces remains otherwise within normal for patient stated age.Unremarkable calvarium, orbits, paranasal sinuses and mastoid air cells. | 1.No acute intracranial process.2.Findings suggestive of mild age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | headache with increasing frequency of seizure No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Clinical question: Mass? Signs and symptoms: Headache and weakness for 3 days. Nonenhanced head CT:There is no detectable acute intracranial process, mass, mass effect or hydrocephalus.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium and soft tissues of the scalp.Unremarkable orbits, mastoid air cells and paranasal sinuses with the exception of small retention cyst in left maxillary signs. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | VP shunt malfunction, headache No evidence of acute ischemic or hemorrhagic lesion.Right temporo-occipital approached VP shunt tube and its tip location at the left lateral ventricle frontal horn, no change since prior exam.The right lateral ventricle, frontal horn maximum diameter was about 13mm which is stable since prior exam.No change of posterior fossa arachnoid cyst since prior exam.There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. Partial opacification of bilateral mastoid air cells. | Stable ventricle size, VP shunt tip location since prior exam.No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | Cardiac arrest No evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion.If clinically indicated, brain MRI can be considered for further imaging evaluation. |
Generate impression based on findings. | altered mental status, flattening of right side nasolabial fold. No evidence of acute ischemic or hemorrhagic lesion.Minimal diffuse brain atrophy which is age appropriate.Mild nonspecific small vessel ischemic disease, no change since prior exam.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion.No change of minimal brain atrophy and mild non specific small vessel disease since prior exam. |
Generate impression based on findings. | Clinical question: Status post craniotomy. Signs and symptoms: Headache. Nonenhanced head CT:Examination demonstrate postoperative changes of a right paramedian frontal craniotomy for removal of tumor.A surgical cavity containing small amount of air and blood in the right frontal lobe at the site of resection is noted. Expected residual pneumocephalus in the subarachnoid space and within the surgical cavity is noted. There regional mass-effect and subtle mass effect on the right frontal horn of lateral ventricle is present. There is however no deviation of midline or hydrocephalus. The size of ventricular system remains stable since prior MRI exam. Unremarkable intracranial contents otherwise.Calvarium demonstrate expected postoperative changes of craniotomy and unremarkable otherwise.Unremarkable images through the orbits, paranasal sinuses and mastoid air cells. | Expected postoperative changes of a right frontal craniotomy as detailed. |
Generate impression based on findings. | 56 years, Female, Reason: stone History: left lower flank pain. ABDOMEN:LUNG BASES: Diffuse groundglass opacities and mosaic attenuation. Intrapulmonary lymph node along the minor fissure.LIVER, BILIARY TRACT: Diffuse mild hypoattenuation suggest steatosis. Cholecystectomy clips.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No hydronephrosis. No stones. Left upper pole hypodensity is incompletely characterized.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcifications of aorta and branches.BOWEL, MESENTERY: Fecalization of distal bowel loops may reflect an incompetent ileocecal valve. No abnormally dilated small bowel seen. Debris within the stomach.BONES, SOFT TISSUES: Fat-containing umbilical hernia. Mild degenerative changes of the visualized spine.PELVIS: FemaleUTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. No renal stones or other findings to account for the patient's symptoms.2. Fecalized small bowel, may be chronic in nature/related to incompetent ileocecal valve. 3. Incompletely imaged diffuse groundglass opacities nonspecific but may reflect small airway disease. |
Generate impression based on findings. | 63 years, Male, Reason: Pt with history of NSCLC from OSH. Please evaluate for mets History: adenocarcinoma. ABDOMEN:LUNG BASES: For findings in the lungs, please see dedicated chest CT performed on the same day.LIVER, BILIARY TRACT: Left hepatic hypodensity measuring 1.4 cm (8/27) likely represents a cyst. Additional hepatic hypodensities are too small to characterize.SPLEEN: Peripheral hypodensity in the inferior spleen.PANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal mass measuring 5.0 x 5.0 cm (8/33), suspicious for metastasis.KIDNEYS, URETERS: Wedge-shaped peripheral hypodensities in the left kidney. Additional patchy peripheral hypodensities are also present in the right kidney.RETROPERITONEUM, LYMPH NODES: Left para-aortic lymph node measures 1.3 x 1.0 cm (8/40).There is aneurysmal dilatation of the proximal celiac artery measuring up to 2.4 cm (8/40) with areas of peripheral thrombus and atherosclerotic calcification. The hepatic artery appears patent. The splenic artery is not well visualizedBOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: See below.OTHER: Anasarca.PELVIS: MalePROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedBONES, SOFT TISSUES: Mild degenerative changes of the spine with multiple Schmorl's nodes. Diffuse osseous sclerosis. Multiple sclerotic foci in the ileum and illdefined areas of decreased attenuation as well.OTHER: Thrombosis of the left internal iliac artery. | 1.Large left adrenal mass likely represents metastatic disease.2.Retroperitoneal lymphadenopathy.3.Findings suspicious for osseous metastatic disease.4.Celiac artery aneurysm measuring up to 2.4 cm.5.Peripheral splenic hypodensity is nonspecific, possibly an infarct, metastatic lesion also a consideration.6.Bilateral renal peripheral renal hypodensities, left greater than right. Pyelonephritis is favored, although infarct may also be considered, multifocal metastatic disease another differential consideration.7.Thrombosis of the left internal iliac artery. |
Generate impression based on findings. | Clinical question: Worsening brain metastases. Signs and symptoms: Headache. Nonenhanced head CT:There is no detectable acute or new findings since prior exam. Focus of vasogenic edema in the right centrum semiovale with subtle regional mass effect demonstrate no change since prior exam. Left frontal paramedian craniotomy and underlying focus of parenchymal low-attenuation without appreciable mass effect or interval change is again noted. Ventricular system remain within normal size and without deviation of midline. Unremarkable calvarium otherwise.Unremarkable orbits, paranasal sinuses and mastoid air cells. | 1.No evidence of an acute or new finding since prior study.2.Stable focus of vasogenic edema in the right frontal with several regional mass-effect consistent with tumor.3.Postoperative changes of left frontal craniotomy and underlying parenchymal low-attenuation remains also stable. |
Generate impression based on findings. | Right hand injuryVIEWS: Right hand AP, lateral and oblique 3/2/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Male 59 years old Reason: RUQ abdominal pain and fever, please evaluate History: RUQ pain and fever ABDOMEN:LUNG BASES: Bibasilar atelectasis/scarring. No pleural effusion.LIVER, BILIARY TRACT: Hepatic steatosis with focal sparing in the gallbladder fossa. No focal hepatic mass or biliary ductal dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Subcentimeter hyperdense exophytic cortical lesion in the the left kidney (series 3, image 48) which is too small to characterize but does not meet the criteria for a simple cyst. RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the abdominal aorta and its branches. The visualized celiac artery, SMA, renal arteries, and IMA are patent.BOWEL, MESENTERY: No bowel obstruction or intraperitoneal free air. Normal appendix. There is mild prominence of the walls of the distal ileum, which could represent underdistention versus wall thickening secondary to an enteritis.BONES, SOFT TISSUES: Degenerative changes of the thoracic spine.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedBOWEL, MESENTERY: Diffuse mild colonic wall thickening and adjacent fat stranding most prominent in the left lower quadrant, appearance consistent with a mild pancolitis, infectious/inflammatory versus ischemic in etiology. Diverticula of the sigmoid and descending colon is present but diverticulitis is unlikely given the relatively diffuse colon involvement.BONES, SOFT TISSUES: Indeterminate soft tissue density within the right inguinal canal, which could represent complex fluid versus an undescended testicle. Degenerative changes of the lumbar spine. | Diffuse colonic wall thickening and adjacent fat stranding consistent with a mild pancolitis, infectious/inflammatory versus ischemic in etiology. |
Generate impression based on findings. | Female 2 years old Reason: evaluate for pulmonary effusion History: increasing respiratory distress after large fluid resuscitation; RSV and pneumoniaVIEW: Chest AP (one view) 3/2/15 at 2227 hrs. Left upper extremity central line tip is at the RA/SVC junction. Gastrostomy tube and surgical clips unchanged. Cardiac silhouette size is normal. Right upper and bibasilar opacities concerning for pneumonia unchanged. | Multifocal opacities concerning for pneumonia unchanged. |
Generate impression based on findings. | Male 12 years old Reason: collapse History: respiratory distressVIEW: Chest AP (one view) 3/2/15 at 2234 hrs. Skeletal deformity, central line, gastrostomy tube and cholecystectomy clips changed. Cardiac silhouette size is normal. Left upper and lower lobe opacities worsening in the interval. No effusions or pneumothorax. | Interval worsening in multifocal opacities as described. |
Generate impression based on findings. | 83 years, Male. Reason: abdominal distension; continues to pass gas and have liquid brown stool. c-diff pending History: abdominal distension Enteric catheter is coiled in the proximal stomach, tip directed towards the GE junction. Incompletely imaged catheters project over the mediastinum/lower thoracic spine. Diffuse gaseous dilatation of small and large bowel suggestive of ileus appearing similar to the prior exam. No free intraperitoneal air. | Ileus type bowel gas pattern. |
Generate impression based on findings. | 56 years, Female. Reason: assess Dobbhoff placement History: s/p Dobbhoff placement Bilateral pulmonary opacities and small pleural effusions as seen on recent chest radiograph. Right internal jugular central venous catheter tip is at the superior cavoatrial junction. TIPS and cholecystectomy clips are unchanged. A Dobbhoff tube tip projects over the gastric body. Centralized loops of air distended bowel suggestive of ascites. Please note that the pelvis is excluded from the field of view. | Dobbhoff tube tip projects over the gastric body. |
Generate impression based on findings. | 4-year-old male with increased seizure frequencyVIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 3/2/15 23:36 Left intracranial ventricular shunt catheter projects to left of the midline. The shunt tubing extends down the left neck, chest wall, abdomen, with its tip in the left lower abdomen. No discontinuity or kinking of the radiopaque portions of the shunt catheter. The abnormal shape of the skull is not significantly changed. The cardiothymic silhouette is normal. Low lung volumes and mild atelectasis without focal opacity. The bowel gas pattern is disorganized nonobstructive. A gastrostomy tube is again noted. Bilateral coxa valga deformities. | No radiologic evidence of VP shunt malfunction. |
Generate impression based on findings. | Abdominal pain and nausea. History of total colectomy for colitis.VIEWS: Abdomen supine/upright (two views) 03/02/15 Right lower quadrant stoma is noted. Surgical clips are present. Few dilated bowel loops are present in the lower abdomen. Air-fluid levels are noted. No free peritoneal air. | Abnormal bowel gas pattern with multiple air-fluid levels. |
Generate impression based on findings. | Respiratory distressVIEW: Chest AP (one view) 3/2/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Bilateral, granular diffuse haziness and ill defined right middle lobe opacity, likely atelectasis. No effusions or pneumothorax. | Superimposed right middle lobe a delay to see on a background of RDS or TTN. |
Generate impression based on findings. | 59 years, Female. Reason: NG adjustment History: NG NG tube is coiled in the stomach with tip projecting over the proximal gastric body. Partially visualized the prosthetic valves and median sternotomy wires. Bilateral nephroureteral stents in the right lower quadrant. Partially visualized pelvic drain and midline staples. Nonobstructive bowel gas pattern. Note that the pelvis is excluded from the field-of-view. | NG tube tip projects over the proximal gastric body. |
Generate impression based on findings. | 9 day old female status post PICC placement.VIEWS: Chest and abdomen AP (two views) 3/2/2015 18:13 Left femoral PICC tip either in the left atrium through a patent foramen ovale or in the right ventricle.Left sided aortic arch, cardiac apex and stomach. Normal cardiothymic silhouette. No focal pulmonary opacities. No pleural effusion or pneumothorax.Nonobstructive bowel gas pattern. | Left femoral PICC tip either in the left atrium through a patent foramen ovale or in the right ventricle. |
Generate impression based on findings. | Redemonstration of severe hydrocephalus with associated calvarial expansion and cortical thinning. Stable position of left temporoparietal catheter with ventriculostomy catheter tip is in the left paramedian aspect of the common lateral ventricle. The common lateral ventricle cavity is not significantly changed in size measuring 20 cm in transverse dimension (previously 21 mm). Additionally, there has been no significant interval change in the transverse dimension of the brain, including the mantle, which currently measures 22 cm, previously measuring 23 cm. The cortical mantle appears similar in thickness and is not uniform. There is small amount of new left lateral peri-orbital soft tissue swelling.Stigmata of holoprosencephaly again noted, which is likely lobar type. Marked thinning of the cerebral parenchyma and left-sided cystic encephalomalacia are not significantly changed. Prominent mass effect in the posterior fossa with effacement of the cerebellar fissures and the ambient cistern with downward displacement of cerebellar tonsils appearing similar to prior. No evidence of intracranial hemorrhage.Unchanged craniofacial abnormalities with macrocephaly and mid face hypoplasia. The right globe is absent and there is stable proptosis of the left globe. Prominent opacification of the paranasal sinuses appears similar to the prior. | Essentially stable marked ventriculomegaly with associated cortical thinning and calvarial deformity, with stable ventriculostomy catheter.Incidental mild left lateral periorbital soft tissue swelling. |
Generate impression based on findings. | Reason: tachy, desating History: same as above, r/o PE PULMONARY ARTERIES: No evidence of pulmonary embolism. The main pulmonary artery is enlarged, suggesting pulmonary hypertension.LUNGS AND PLEURA: Interval near complete resolution of previously visualized areas of dependent consolidation, likely related to prior atelectasis and/or aspiration. There is minimal residual ground glass opacity at the right apex (series 11, image 35), new from 01/2015, and likely inflammatory in etiology. Mild basilar subsegmental atelectasis/scarring.No new focal air space consolidation. No pleural effusions.Scattered benign appearing micronodules. No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: The heart is mildly enlarged, without pericardial effusion. Right heart enlargement and straightening of the intraventricular septum may relate to pulmonary hypertension. No visible coronary artery calcification.No, mediastinal or hilar lymphadenopathy.CHEST WALL: Right chest port, tip at the cavoatrial junction.Degenerative disease of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Right hydronephrosis, partially imaged. | 1. No evidence of pulmonary embolism.2. Interval resolution of previously visualized areas of consolidation, likely related to prior aspiration and/or atelectasis.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 10-year-old male with severe abdominal pain. Evaluate for obstruction.VIEWS: Abdomen supine and upright (two views) 3/2/2015 Small to moderate stool burden. Nonobstructive bowel gas pattern. No significant air fluid levels are present. | Normal examination. |
Generate impression based on findings. | 6-year-old female, bent pinkyVIEWS: Right hand, PA, right little finger, PA, lateral (3 views) 3/2/15 23:28 Complete transverse fracture of the distal aspect of the proximal phalanx of the little finger with volar and medial deviation of the distal fracture fragment. | Displaced little finger fracture as described above. |
Generate impression based on findings. | Female, 49 years old s/p vaginectomy and ureteral stent placement. RFO Trigger: Surgery length greater than 8 hours, multiple surgical teams. Suspected RFO Location: Pelvic/abdomen. Suspected RFO: None No unexpected radiopaque foreign bodies. Scattered foci of free air in the pelvis is expected in postsurgical setting. Nonobstructive bowel gas pattern. NG tube side-port and tip projects over the distal esophagus and proximal gastric body, respectively. Prosthetic valves, median sternotomy wires, and central venous catheter are noted. Bilateral nephroureteral stents emptying into presumed ileal conduit in the right lower quadrant. Pelvic drain, midline suture material and staples. Nonobstructive bowel gas pattern. | No unexpected radiopaque foreign bodies. Findings were discussed with attending surgeon, Dr. Lengyl, over phone, at 2037 on 3/2/15. |
Generate impression based on findings. | 37 years, Male, Reason: Assess for right renal ischemia, History: right flank pain. ABDOMEN:LUNG BASES: Thickening of the intraventricular septum appears similar to the exam. Minimal basilar dependent atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Wedge-shaped right renal hypodensities are less prominent than the prior exam and suggestive of infarcts. There is mild interval cortical thinning and scarring. No new infarcts are identified. Left renal hypodensities are too small to characterize but likely represent cysts. No hydronephrosis. Punctate nonobstructive calcification in the left renal pelvis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.PELVIS: MalePROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality noted | Evolution of right renal infarcts. No new infarcts identified. |
Generate impression based on findings. | History metastatic urothelial cancer with mets to the lungs. Evaluate for nodules and any focus of possible infection. LUNGS AND PLEURA: There is redemonstration of numerous suspicious pulmonary nodules. Multiple reference lesions are as follow:A right lower lobe cystic and groundglass lesions is similar in size and appearance measuring 30 x 17 mm (image 40, series 6), unchanged. A right middle lobe lesion measures 15 x 12 mm (image 50, series 6), previously 16 x 12 mm. A solid 6-mm nodule right lower lobe is unchanged (image 34, series 6). A nodular opacity within the left lower lobe has increased in size (image 52, series 6). An adjacent reference lesion within the left lower lobe is also increased in size measuring 15 mm in length, previously 12 mm (image 57, series 6).A mixed density solid nodule in the right costophrenic angle measures 16 x 10 mm (image 67, series 6), previously 16 x 10 mm. A nodule in the lateral aspect of the right costophrenic angle has become more cavitary (image 67, series 6). Multiple additional solid and groundglass nodules appear similar to the prior examination. There is no pleural effusion or pneumothorax. There is emphysema and upper lobe peripheral and peribronchial irregular cysts. MEDIASTINUM AND HILA: Heart size is normal. No significant pericardial effusion. There are severe coronary artery calcifications. No mediastinal or hilar lymphadenopathy by CT size criteria.CHEST WALL: Chronic T7 and T8 compression fractures.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Enlarging lesions in the left lower lobe most compatible with metastatic disease. 2. Innumerable solid, semi-solid, and groundglass nodules otherwise are similar in size and distribution, many of which may represent synchronous primary lung neoplasms, without significant interval change or specific findings to suggest new infection. |
Generate impression based on findings. | Male 18 years old Reason: Interval changes in PNA History: 18 y/o M with h/o CP, DD, epilepsy, intubated with PNAVIEW: Chest AP (one view) 3/3/15 at 548 hours. ET tube terminates above the carina. Right upper extremity central line tip is at the right atrium. Cardiac silhouette size is normal. Unchanged right diaphragmatic elevation and bibasilar opacities, likely atelectasis or pneumonia. | Multifocal opacities and right diaphragmatic elevation unchanged. |
Generate impression based on findings. | 7-month-old male, rule out fractureVIEWS: Cervical spine, AP and lateral (two views), chest, AP, abdomen, AP (two views) 3/3/15 0:42 Cervical spine: Straightening of cervical spine is likely due to patient positioning. The prevertebral soft tissues appear thickened, which is most likely due to expiratory phase/crying. No fracture is visualized.Chest and abdomen: The cardiothymic silhouette is normal. The cardiac apex, aortic arch and stomach are left sided. No focal air space will pass a few pneumothorax. No fracture or pneumothorax is visualized. Nonobstructive bowel gas pattern. | Normal examination. |
Generate impression based on findings. | Female 39 years old Reason: r/o fx History: ttp s/p fall. Six views of the lumbar spine show no acute fracture or posttraumatic subluxation. Lumbar vertebral body heights and intervertebral disk spaces are preserved. | No acute fracture or posttraumatic subluxation. |
Generate impression based on findings. | Streak artifact minimally limits evaluation. Left frontoparietal region subgaleal hematoma measuring 5 mm without evidence of depressed calvarial fractures. No acute intracranial hemorrhage. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There are no extraaxial fluid collections or subdural hematomas. Opacification of ethmoid air cells and maxillary sinuses. Scattered mastoid air cell opacification also noted. | Thin left frontoparietal subgaleal hematoma without evidence of acute intracranial abnormality. |
Generate impression based on findings. | Female 44 years old Reason: 44 y/o F w/ Hx of Diverticulitis c/b colostomy placement (2005), diabetes, asthma, and parastomal hernia who p/w sudden onset LLQ pain History: LLQ pain The exam is suboptimal secondary to the patient's body habitus with the left lateral abdominal soft tissues beyond the field-of-view. Within these limitations, the following observations can be made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Left lower quadrant colostomy with a large parastomal hernia containing small bowel. There is small bowel dilatation proximal to the parastomal hernia. Additional dilated as well as collapsed small bowel seen within the hernia sac. Fecalization of stool is present within the hernia sac. There is a definitive transition point within the hernia sac (series 9, image 93). Within this hernia sac there is associated mild mesenteric fluid and fat stranding which is nonspecific but may be seen in setting of evolving bowel ischemia. There is an additional nonspecific focal narrowing of small bowel entering the hernia sac (series 9, image 68), however, bowel is equally dilated proximal and distal to this point. No free extraluminal air or pneumatosis. No loculated fluid collection.BONES, SOFT TISSUES: Degenerative changes of the thoracic spine.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the lumbar spine. | 1.Findings consistent with a small bowel obstruction with transition point within the large parastomal hernia sac, evolving ischemia not entirely excluded given small mesenteric fat stranding and fluid in hernia sac. 2.Nonspecific additional transition point may be present at the inlet of the hernia sac as above. |
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