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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...
1.Hepatic steatosis.2.Simple hepatic cysts without suspicious hepatic lesions. No evidence of hepatocellular carcinoma.
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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.
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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 mater...
Dobbhoff tube tip projects over the fundus.
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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 ...
No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram.
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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 retropec...
Bilateral retropectoral implants are noted and intact. No sonographic evidence for malignancy.BIRADS: 1 - Negative.RECOMMENDATION: NS - Routine Screening Mammogram.
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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...
Dobbhoff tube tip projects over the fourth portion of the duodenum.
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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.
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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.
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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 ne...
Total elbow arthroplasty as described above with new lucency at the cement bone interface along the ulnar component which is suspicious for loosening.
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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.
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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 c...
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 muco...
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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.
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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 post...
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.
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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.
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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, previo...
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.
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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 ...
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 lymphaden...
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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.
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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...
Stable bilateral supraclavicular/axillary masses consistent with nodal metastases. No new sites of metastatic disease.
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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.
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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 p...
Minimal degenerative arthritic changes without specific findings to account for the patient's pain.
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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...
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 c...
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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 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.
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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...
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.
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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 infe...
Mildly decreased metabolism in the left frontal lobe.
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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.
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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 fr...
Poorly defined mixed lucent sclerotic focus compatible with metastatic breast cancer as described above.
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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...
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 metas...
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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 ...
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.
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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.
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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 heterogeneousl...
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 a...
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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. N...
Nonobstructive bowel gas pattern.
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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 swellin...
Salter-Harris II fracture of the proximal phalanx of the middle finger.
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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 i...
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.
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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.
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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 intend...
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 routin...
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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 ...
No focal pulmonary opacity or pleural effusion.
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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 cal...
Healing pathologic fracture as described above.
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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.
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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 fo...
1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Small focus of encephalomalacia is present in the left periventricular white matter.
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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 lumba...
Degenerative disk disease and osteoarthritis as described above.
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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 ...
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.
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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.
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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 notedPA...
1.End-stage, atrophic native kidneys.2.Hepatomegaly.3.No specific findings to account for the patient's pain.
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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....
Normal ventilation and no discrete focal scintigraphic perfusion defect.
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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...
Postoperative changes and metastases appearing similar to the prior study.
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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 bilatera...
Increased bowel dilatation, which may represent worsening ileus or obstruction secondary to rectal impaction.
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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 pneumothor...
NG tube tip in gastric body. Unchanged pulmonary opacities without pneumothorax.
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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 ...
Stable minimal periatrial hypoattenuation, a nonspecific finding. No new or concerning intracranial findings.
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Status post fall, point tenderness, evaluate for fracture. Pain. I see no fracture or dislocation. Moderate osteoarthritis affects the hand.
Osteoarthritis without fracture evident.
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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.
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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...
No acute intracranial abnormality.
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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 measur...
1.Interval increase in segment 8 hepatic lesion with new local associated biliary dilatation. Slight interval increase in presacral mass. Grossly stable thoracic disease.
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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 ab...
Interval decrease in size of the bilateral multiloculated pelvic fluid collections.
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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.
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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.Refe...
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.
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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 ...
Degenerative arthritic changes as described above perhaps representing a combination of osteoarthritis and CPPD arthropathy.
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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 inf...
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 co...
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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 numbe...
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 unchang...
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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 o...
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.
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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 ...
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.
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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 aspe...
Lytic appearing lesion in the posterior left sixth rib suspicious for myelomatous deposition.
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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 periventricul...
1.Acute intracranial process.2.Small vessel ischemic strokes of indeterminate age of moderate degree.
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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 masto...
No evidence of acute ischemic or hemorrhagic lesion.
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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...
1.Unremarkable nonenhanced head CT.2.Left frontal and periorbital soft tissue thickening and hemorrhage without underlying bony abnormality.
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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. ...
Normal head and neck CTA.
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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 ...
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.
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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 ...
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 atten...
1.No acute intracranial process.2.Findings suggestive of mild age indeterminate small vessel ischemic strokes.
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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. T...
No evidence of acute ischemic or hemorrhagic lesion.
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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 calv...
Unremarkable nonenhanced head CT.
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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 ...
Stable ventricle size, VP shunt tip location since prior exam.No evidence of acute ischemic or hemorrhagic lesion.
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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 ce...
No evidence of acute ischemic or hemorrhagic lesion.If clinically indicated, brain MRI can be considered for further imaging evaluation.
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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...
No evidence of acute ischemic or hemorrhagic lesion.No change of minimal brain atrophy and mild non specific small vessel disease since prior exam.
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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 postoperative changes of a right frontal craniotomy as detailed.
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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 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.
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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 ...
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 r...
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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 craniot...
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.
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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.
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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 s...
Diffuse colonic wall thickening and adjacent fat stranding consistent with a mild pancolitis, infectious/inflammatory versus ischemic in etiology.
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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 silh...
Multifocal opacities concerning for pneumonia unchanged.
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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 pneumothor...
Interval worsening in multifocal opacities as described.
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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...
Ileus type bowel gas pattern.
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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 Dob...
Dobbhoff tube tip projects over the gastric body.
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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, wit...
No radiologic evidence of VP shunt malfunction.
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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.
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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.
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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 stap...
NG tube tip projects over the proximal gastric body.
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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 p...
Left femoral PICC tip either in the left atrium through a patent foramen ovale or in the right ventricle.
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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 siz...
Essentially stable marked ventriculomegaly with associated cortical thinning and calvarial deformity, with stable ventriculostomy catheter.Incidental mild left lateral periorbital soft tissue swelling.
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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 at...
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.
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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.
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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.
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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....
No unexpected radiopaque foreign bodies. Findings were discussed with attending surgeon, Dr. Lengyl, over phone, at 2037 on 3/2/15.
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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 ...
Evolution of right renal infarcts. No new infarcts identified.
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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 ap...
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 sugge...
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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 diaphragm...
Multifocal opacities and right diaphragmatic elevation unchanged.
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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. ...
Normal examination.
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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.
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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 co...
Thin left frontoparietal subgaleal hematoma without evidence of acute intracranial abnormality.
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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. Withi...
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.