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Generate impression based on findings. | 51 year old female status post left lumpectomy in 2005 for HER-2 positive invasive ductal carcinoma with DCIS,presents today for routine follow up. Patient received radiation and chemotherapy. No current breast complaints. Family history of breast carcinoma in her maternal aunt and cousin. Three standard views of both ... | Stable postsurgical changes of the left 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 - Diagnos... |
Generate impression based on findings. | Female 79 years old Reason: Evaluate for degenerative changes. Worsening pain left SI joint past year or two. History: Worsening pain left SI joint past year or two. Bone mineralization is slightly decreased. There are mild to moderate osteoarthritic changes in the SI joints, left greater than right. There is sclerosis... | Osteoarthritis of the sacroiliac joints. |
Generate impression based on findings. | Cervical stenosis on MRI, assess bony anatomy The cervical vertebral bodies are appropriate height. Alignment is maintained. No fractures are identified in the cervical spine. No suspicious bony lesions are identified in the cervical spine. There is evidence of diffuse idiopathic skeletal hyperostosis with bulky anteri... | 1. Multilevel degenerative changes in the cervical spine as detailed above. There are multilevel disk osteophyte complexes, with at least moderate spinal canal stenosis at C3-C4, C4-C5, and C5-C6, better appreciated on prior MRI.2. Evidence of diffuse idiopathic skeletal hyperostosis. There is also ossification of the ... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is heterogeneously dense. No suspicious masses, microcalcifications or areas of archit... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 13-year-old male status post physeal bar resection Interval osteotomy with a defect extending through the majority of the physeal bar. There are small foci of residual bridging adjacent to the resection cavity as well as lateral to the osteotomy cavity. Gas is noted in the soft tissues, compatible with recent surgery. | Interval osteotomy removing the majority of the sclerotic physeal bar with small foci of residual bridging adjacent to the cavity as well as lateral to the cavity as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Stable benign intramammary lymph node... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 75 years old; Reason: 75 yo male with hx of liver resection for HCC; ultrasound shows liver nodule; please do CT liver triphasic and please evaluate for abnormalities and/or recurrence History: HCC ABDOMEN:LUNGS BASES: Evaluation of lung bases demonstrate areas of bibasilar scarring and peripheral fibrosis.LIVER, ... | 1. Numerous new arterially enhancing bilobar hepatic foci as described, differential considerations include regenerative nodules (particularly in wedge shaped area alongside postsurgical defect alluded to above) but considering patient's history of HCC resection and nodular configuration of the lesions, findings are wo... |
Generate impression based on findings. | 63 years, Male. Reason: 63 y/o dermatomyositis s/p g tube, concern for ileus History: not tolerating tube feeds Gastrostomy tube balloon projects over the gastric fundus near the gastroesophageal junction. Cholecystectomy clips noted. Nonobstructive bowel gas pattern with moderate stool burden in the rectum. | Gastrostomy tube balloon projects near the gastroesophageal junction. If there is concern for gastrostomy tube tip location, enteric contrast can be injected into the G tube and AP and lateral views can be obtained. |
Generate impression based on findings. | 45 years, Female. Reason: Pancreatic pseudocysts s/p cystogastrostomy tube placement and NJT with nausea/vomiting/diarrhea and abdominal cramping. Please evaluate for NJT placement, ileus/partial obstruction. History: As above NJ tube tip extends past the ligament of Treitz. Cyst gastrostomy tube noted. Suture material... | Enteric feeding tube tip extends beyond the ligament of Treitz. Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Scoliosis.VIEWS: Spine standing PA, spine right lateral bending, spine left lateral bending (3 views) 03/05/15 Right curve between T3 and T12 measures 55 degrees. Left curve between L1 and L5 measures 31 degrees. With right lateral bending the right curve decreases to 40 degrees. With left lateral bending the left curv... | Right thoracic and left lumbar curves with right curve decreasing from 55 degrees to 40 degrees with right lateral bending. |
Generate impression based on findings. | Male 67 years old Reason: prostate cancer and liver cancer History: please compare with last scans CHEST:LUNGS AND PLEURA: Mild dependent atelectasis. No pleural effusions. No suspicious nodules or masses. MEDIASTINUM AND HILA: Heart size is normal without pericardial effusion. No significant hilar or mediastinal lymph... | 1.Stable to mild decrease in size of the hepatic dome lesion given the single phase imaging. Recommend subsequent surveillance follow-up with dedicated liver protocol imaging.2.No new hepatic lesion identified.3.No new osseous lesions. |
Generate impression based on findings. | 78 years, Female. Reason: ngt placement History: ngt placement Dilated loops of small bowel measuring up to 3.4 cm not significantly changed since the prior exam. Interval placement of NG tube with tip projecting over the proximal gastric body. | Persistent small bowel dilatation compatible with small bowel obstruction. |
Generate impression based on findings. | Male 53 years old Reason: bilateral knee pain History: bilateral knee pain Right knee: Bone mineralization is normal. Alignment is anatomic. There are very tiny medial compartment osteophytes.Postsurgical changes, partially imaged with an IM nail with proximal interlocking screws. There is a healed fibular fracture.Cal... | Mild right, moderate left knee osteoarthritis. |
Generate impression based on findings. | Female 66 years old; Reason: Patient with recent fall and increased right shoulder pain, weakness Mild to moderate osteoarthritis affects the shoulder. There is no fracture or malalignment. | Osteoarthritis. |
Generate impression based on findings. | Knee pain Moderate osteoarthritis affects the right knee with small osteophytes, similar to prior. A possible small joint effusion is present.Moderate osteoarthritis affects the left knee, as seen on frontal views. | Moderate osteoarthritis, similar to prior. |
Generate impression based on findings. | Reason: Para-pneumonic process History: Chest pain LUNGS AND PLEURA: Small right pleural effusion and basilar atelectasis. Round, somewhat nodular opacities along the posterior right pleural surface have an appearance compatible with rounded atelectasis.Additional scattered benign appearing micronodules.The left lung i... | Small right pleural effusion. Round, opacities along the posterior right pleural surface have an appearance compatible with rounded atelectasis. 6 - 12 month imaging followup is recommended to ensure stability. |
Generate impression based on findings. | Right total hip arthroplasty revision. The right total hip arthroplasty device is situated in near-anatomic alignment, without radiographic evidence of hardware complication. Surgical drain and overlying devices reflect recent surgery.Degenerative arthritic changes are present in the visualized lower lumbar spine. Mark... | Right total hip arthroplasty. |
Generate impression based on findings. | 46 years, Female. Reason: s/p ureteral stent removal History: location of ureteral stent s/p kidney transplant Interval removal of abdominal drains and right pelvic nephroureterostomy stent. Nonobstructive bowel gas pattern. | Interval removal of abdominal drains and nephroureterostomy stent. |
Generate impression based on findings. | 57 years, Female. Reason: dilated bowel History: diffuse tenderness Nonobstructive bowel gas pattern. Less than average stool burden in the colon. | Nonobstructive bowel gas pattern without findings to account for patient's pain. |
Generate impression based on findings. | Lung cancer status for CRT. Evaluate response. CHEST:LUNGS AND PLEURA: Right upper lobe mass inseparable from the mediastinal and apical pleural surface with new internal air bronchograms is significantly smaller. It measures 33 x 36 mm, previously 55 x 61 mm (series 5, image 21). Faint ground glass opacities around th... | Significantly decreased size of right upper lobe primary lung malignancy and intrathoracic lymphadenopathy. No new sites of disease. |
Generate impression based on findings. | Male 72 years old Reason: knee djd? History: pain creps valgus Right knee: Bone mineralization is normal. There is genu valgus. There is severe right knee osteoarthritis with bone on bone apposition and tricompartmental osteophytes. There is a small joint effusion.Left knee: Bone mineralization is normal. There is genu... | Genu valgus and severe bilateral knee osteoarthritis |
Generate impression based on findings. | History of metastatic renal cancer. There is pathological fracture with near complete collapse of the C6 vertebral body with approximately 6 mm retropulsion into the spinal canal and associated severe spinal canal stenosis with apparent increase of the angular kyphosis. The associated soft tissue component appears to b... | 1. Osseous metastases, including severe spinal canal stenosis at C6 persists in association with the pathologic compression fracture and increased angular kyphosis.2. Multiple nonspecific thyroid nodules.3. Partially-imaged pulmonary metastases appear to be slightly smaller. Please refer to the separate chest CT report... |
Generate impression based on findings. | 39 year old with history of left mastectomy in 2005 for IDC. Known metastatic disease to the right hip. Patient received chemotherapy and radiation therapy. History of right breast augmentation. No new breast complaints Three standard and pushback views of the right breast were performed digitally and reviewed with the... | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 24 years old Reason: eval for lateral process of talus fx History: L ankle pain. There is a comminuted fracture of the lateral process of the talus extending to the posterior facet of the subtalar joint with approximately 3 mm of lateral displacement of the distal fracture fragment. There is soft tissue swelling a... | Comminuted fracture of the lateral process of the talus as described above. |
Generate impression based on findings. | 44 years, Female. Reason: Eval stool burden History: Constipation Nonobstructive bowel gas pattern with moderate stool burden in the colon, ascending colon greater than descending. | Nonobstructive bowel gas pattern with moderate stool burden. |
Generate impression based on findings. | 48-year-old male with history of Crohn's disease status post completion proctocolectomy now with abdominal pain, evaluate for infection. ABDOMEN:LUNG BASES: Mild basilar atelectasis. No pleural effusions. Scattered nonspecific pulmonary micronodules.LIVER, BILIARY TRACT: Hepatic steatosis without focal lesions. The gal... | 1.Expected postoperative changes of recent proctocolectomy and end ileostomy. 2.No evidence of bowel obstruction or abscess. Mild induration in the presacral space is thought to be postsurgical with prostatitis less likely, correlate clinically. 3.Hepatic steatosis. 4.Mildly distended gallbladder without adjacent infla... |
Generate impression based on findings. | Clinical question: Seizure day zero. Signs and symptoms: Seizure day zero with new seizure. Nonenhanced head CT:There is no detectable acute intracranial process. CT of is insensitive for detection of acute nonhemorrhagic ischemic strokes. There are extensive periventricular and subcortical low attenuation white matter... | 1.No acute intracranial process.2.Excessive age indeterminate small vessel ischemic strokes. |
Generate impression based on findings. | Follow-up abnormal CXR. RUL opacity. Smoker. LUNGS AND PLEURA: Severe upper lobe paraseptal emphysema with large left apical bulla. Mild centrilobular emphysema.Right upper lobe peribronchiolar nodular opacity is 14 mm (series 4, image 39), previously approximately 25 mm on prior CXR. It is favored to represent resolvi... | 1. Right upper lobe nodular opacity is significantly smaller compared to prior CXR. It is favored to represent a resolving infection; short term interval follow up in 3 months is recommended to confirm its continued involution.2. Right lung base groundglass opacities related to aspiration.3. Severe paraseptal emphysema... |
Generate impression based on findings. | 88-year-old male with history of fall. Extensive metallic artifact from patient's right cochlear implant limits evaluation of the right cerebral hemisphere. Within this limitation, there is no evidence of acute intracranial hemorrhage. There is mild periventricular and subcortical white matter hypoattenuation. The gray... | 1. Limited exam secondary to extensive artifact from right cochlear implant.2. No evidence of acute intracranial hemorrhage, mass, or mass effect.3. Mild chronic small vessel ischemic disease. |
Generate impression based on findings. | 69 year-old female with history of metastatic breast cancer, evaluate for progression. CHEST:LUNGS AND PLEURA: Upper lobe predominant centrilobular and paraseptal emphysema. Small right pleural effusion has resolved. Multiple bilateral pulmonary and subpleural nodules compatible with metastatic disease, decreased from ... | 1.Interval increase in size of non-specific right breast soft tissue mass. 2.Diffuse metastatic disease within the chest, abdomen, and pelvis overall significantly decreased from prior as described above. 3.Interval sclerosis of diffuse osseous metastatic disease which is likely treatment effect. 4.Stable infrarenal ab... |
Generate impression based on findings. | History of bilateral breast masses, likely cysts on exam. Three standard views of both breasts and bilateral spot views 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. Obscured masses... | Bilateral simple cysts. The patient admits to some pain related to the left breast cyst. If she desires, this could be aspirated for symptomatic relief. No mammographic evidence of malignancy. As long as the patient's physical examination remains benign, bilateral diagnostic mammogram is recommended annually. Results a... |
Generate impression based on findings. | Reason: 66F with smoking Hx eval for malignancy History: weight loss, 30+ yr 1/2ppd, pleuritic pain LUNGS AND PLEURA: Mild apical predominant centrilobular emphysema. A solid, noncalcified left upper lobe nodule measures 8 x 7 mm (series 5, image 26). Additional scattered calcified granulomas.Mild basilar scarring/atel... | An 8mm solid left upper lobe nodule appears grossly similar to the prior chest radiograph dated 12/2013 accounting for differences in technique. This may represent a noncalcified granuloma, but malignancy is not excluded. Annual screening is recommended given the smoking history and emphysema. |
Generate impression based on findings. | Anaplastic large cell lymphoma. There continued involution of the lesion left posterior superior neck subcutaneous tissues with residual tissue that measures 4 x 12 mm, previously 5 x 15 mm. There is no significant cervical lymphadenopathy. The Waldeyer ring structures are not enlarged. The thyroid gland and salivary g... | Continued incolvution of the treated left posterior upper neck subcutaneous lesion and no evidence of recurrent cervical lymphadenopathy. |
Generate impression based on findings. | Breast cancer. Again seen is widespread osseous metastatic disease involving the skull, thoracolumbar spine, numerous bilateral ribs, sacrum, iliac, and ischial bones, not significantly changed. There is likely urine contamination overlying the soft tissues adjacent to and overlying the right femoral diaphysis. No new ... | Widespread osseous metastatic disease without significant interval change. |
Generate impression based on findings. | Evaluate lung nodule gradeRADIOPHARMACEUTICAL: 12.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 75 mg/dL. Today's CT portion grossly demonstrates interval reduction in the size of the right medial lung base pulmonary nodule which measures 6 mm compared to 11 mm previously, indicating more likely an infec... | No FDG avid abnormal focus to indicate tumor activity. Specifically, the medial right lower lobe lung nodule demonstrates no appreciable FDG accumulation. Furthermore, it is decreasing in size and most likely represents a benign resolving post inflammatory nodule. However, tumor component cannot be entirely excluded an... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed with tomosynthesis and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this re... |
Generate impression based on findings. | Lower left intercostal area pain. Evaluate VAD pump damage, fluid collection, infection, rib fracture. CHEST:LUNGS AND PLEURA: Upper lobe predominant paraseptal emphysema, unchanged.New small right pleural effusion with adjacent discoid atelectasis.No evidence of infection or edema.MEDIASTINUM AND HILA: Increased sever... | 1. Unchanged soft tissue thickening along the LVAD drive line without loculated fluid collection to suggest abscess. No rib fracture or specific findings to explain the patient's symptoms.2. Small right pleural effusion. |
Generate impression based on findings. | Female 66 years old Reason: r/o fracture History: swelling. Three views of the right ankle show diffuse soft tissue swelling about the ankle joint, without evidence of fracture or dislocation. | Soft tissue swelling without underlying fracture evident. |
Generate impression based on findings. | Male 31 years old Reason: humeral shaft fx ORIF History: ORIF. Two views of the right humerus show two side plate and screws device is affixing a distal humerus fracture in near anatomic alignment without radiographic evidence of hardware complication. The fracture line appears less distinct when compared to the prior ... | Orthopedic fixation of a healing distal humeral fracture. |
Generate impression based on findings. | 44-year-old female with right lower quadrant pain and urinary tract infection, evaluate for appendicitis and renal stone. Exam somewhat limited by a paucity of intra-abdominal fat.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality... | 1.Exam mildly limited by paucity of intra-abdominal fat.2.No bowel obstruction or appendicitis. Above average stool burden in colon. 3.Mildly prominent right greater than left renal collecting systems, favor prominent extrarenal pelves. If clinically warranted, could be further evaluated with ultrasound. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of recurrent breast carcinoma in her sister at ages 31 and 39 (triple negative). Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obs... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Given her family history, please consider referral to cancer risk clinic, as she may benefit from additional testing including breast MRI.BIRADS: 2 - Benign finding.R... |
Generate impression based on findings. | Shortness of breath, hypoxia, and known PA hypertension. LUNGS AND PLEURA: Mild apical predominant centrilobular emphysema. Scattered benign appearing micronodules, unchanged. No new suspicious pulmonary nodules or masses.Mild basilar scarring/atelectasis. Scattered mosaic attenuation and groundglass, compatible with k... | 1. Scattered mosaic attenuation and groundglass, compatible with known pulmonary hypertension. 2. Mild emphysema.3. Scattered benign-appearing pulmonary micronodules and mildly prominent mediastinal lymph nodes are unchanged. |
Generate impression based on findings. | There are again postoperative changes from previous posterior fossa surgery. There are scattered punctate foci of intracranial susceptibility, not significantly changed. There is stable extensive ill-defined FLAIR hyperintensity along the margins of the surgical tract within the midline cerebellum. There has been furt... | 1. Evolving postoperative changes from previous posterior fossa surgery for tumor resection. Further decreased size and central cystic appearance of superior vermian lesion which does not demonstrate evidence of hyperperfusion.2. Stable pattern of white matter lesions which are nonspecific. |
Generate impression based on findings. | Right posterior parietal ventriculoperitoneal shunt with tip projecting into the frontal horn of the lateral ventricle. The shunt catheter exits the skull and courses through the subcutaneous tissues along the right lateral neck, right hemithorax and coursing along the left hemi abdomen abdomen with catheter tip coili... | Discontinuity of the catheter at the level of the neck. |
Generate impression based on findings. | Female 26 years old Reason: fracture or other cause of wrist pain History: Pain with palpation of the dorsal ulna Left forearm: Bone mineralization and alignment are normal. Small lucency in the ulnar styloid is unchanged and has nonaggressive features. No acute fracture.Left wrist: Bone mineralization is normal. Small... | Unremarkable left forearm and left wrist radiographs. |
Generate impression based on findings. | Male 74 years old; Reason: NHL, re-eval and compare to previous History: NHL CHEST:LUNGS AND PLEURA: Stable micronodules, best seen on maximum intensity projection images.MEDIASTINUM AND HILA: Index lymph node anterior to the right main bronchus previously measures 1.5 x 1 cm, now measuresthe same. No new nodes.CHEST W... | 1.Stable examination. |
Generate impression based on findings. | Female 54 years old Reason: r/o spur/abnormality History: heel pain with remote injury one year ago. Three views of right foot show no acute fracture or dislocation. Note is made a plantar calcaneal spur and enthesopathic changes along the posterior calcaneus. Mild degenerative arthritic changes affect the midfoot. | No acute fracture or dislocation. |
Generate impression based on findings. | 15 year old female with history of thyroid/neck ultrasound with normal thyroid lobes and isthmus. Posterior to the right lobe there is a round, well circumscribed homogeneously hypoechoic structure not vascularized. Question pain right thyroid, no nodules palpated in the neck. RIGHT LOBE MEASUREMENTS: 4.8-cm x 1.4 cm x... | Nonspecific hypoechoic subcentimeter structure along the posterior aspect of the inferior pole of the right thyroid lobe may represent a colloid cyst. |
Generate impression based on findings. | Male 68 years old Reason: history of right ankle fracture History: history of right ankle fracture. Three views of the right ankle show a spiral fracture of the distal fibula in near anatomic alignment. There is overlying callus formation suggestive of partial healing. There is diffuse soft tissue swelling about the an... | Partial healing of distal fibular fracture as described above. |
Generate impression based on findings. | Female, 52 years old. Ventral abdominal wall debridement. RFO trigger: BMI over 40 Suspected RFO location: ABDOMEN Name of suspected RFO: N/A Attending Surgeon name/pager: DR. HUSSAIN/ PAGER 9269 Body Mass Index (BMI): 56.38 The upper abdomen and the lateral abdominal tissues are excluded from the field of view. There ... | Based on the limited field of view, there are no unexpected radiopaque foreign object.Findings including the limited field of view were discussed by telephone with the attending surgeon, Dr. Mustafa Hussain, at 4:30 p.m. 3/5/2015. |
Generate impression based on findings. | CT CARD CORONARY ART CTA/CALC SCORE, 3/5/2015 2:25 PM Coronary arteries: LM: The left main coronary artery arises from the left sinus of valsalva, at the level of the sinotubular junction, and bifurcates into the left anterior descending and left circumflex coronary arteries. There are no severe stenoses present in the... | 1.There are no significant coronary artery stenoses present; however, there is diffuse mild multifocal mixed plaque in the mid to distal LAD, distal LCx, and mid to distal RCA.2. Mild aortic annulus calcification.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 14 year old male with gunshot wound to left arm. Evaluate for pneumothorax.VIEWS: Left humerus AP and Lateral, Left shoulder AP and Lateral, Chest AP (5 views) 3/5/2015 Radiopaque foreign body likely a bullet projecting over the noted along the anteromedial aspect of the proximal humerus representing the bullet. Alignm... | Based on these radiographs, bullet noted along the anteromedial aspect of the proximal humerus with no evidence of fracture or dislocation. Please note that a transthoracic left shoulder radiograph was subsequently obtained which confirmed that the bullet is actually along the posterior aspect of the proximal humerus. ... |
Generate impression based on findings. | Follow up post chemoradiation for cervical cancerRADIOPHARMACEUTICAL:11.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING):112 mg/dL. Today's CT portion grossly demonstrates cholecystectomy clips.Today's PET examination demonstrates no abnormal FDG activity to indicate tumor. | No abnormal FDG avid activity to indicate tumor. |
Generate impression based on findings. | Cephalic VeinMaximum velocities:Left: 45.7 cm/sec, 39.7 cm/sec, 45.1 cm/secMinimal velocities:Left: 21.6 cm/sec, 21.6 cm/sec, 19.8 cm/sec | Patent shunt. Cephalic vein velocities as above. |
Generate impression based on findings. | Male 69 years old Reason: S/p revision Lt TKA History: S/p revision Lt TKA Postsurgical changes in the left knee with a left knee arthroplasty in near-anatomic alignment. No acute fracture or dislocation. Skin suture staples and joint drain indicate a recent postoperative state. | Postsurgical changes in the left knee without radiographic evidence of hardware complication. |
Generate impression based on findings. | Small cell lung cancer clinical trial cycle 1 day 11. RADIOPHARMACEUTICAL: 12.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 93 mg/dL. Today's CT portion grossly demonstrates multiple right sided pulmonary nodules, many of which are adjacent to the right mediastinum. Multiple right hilar lymph nodes are n... | 1.Significant progression of size and metabolic activity of multiple right thoracic metastatic lesions. 2.No FDG avid tumor in the left thorax, extra-thoracically, or new hypermetabolic metastases. |
Generate impression based on findings. | Male 76 years old Reason: eval for arthritis /stenosis History: back pain Bone mineralization is normal. There is straightening of the lumbar spine. Degenerative disk disease affects the L3 - L4, L4 - L5 and L5 - S1 disk spaces with small ridge osteophytes. There are facet hypertrophic changes involving the lower lumba... | Degenerative changes as detailed above. |
Generate impression based on findings. | 69 years, Female, Reason: chemotherapy response History: cancer. CHEST:LUNGS AND PLEURA: Resolution of large right pleural effusion. Right lower lobe atelectasis. Right apical scar like opacity.MEDIASTINUM AND HILA: Right chest port tip terminates in the SVC. Small mediastinal nodes. Mild coronary artery calcifications... | 1.Age indeterminant right lower lobe pulmonary embolus. 2.Presacral nodule likely represents a metastases.3.Ill-defined soft tissue at the vaginal cuff may represent postsurgical change, however recurrent tumor cannot be excluded. There is also ill-defined periaortic which also may represent postsurgical change versus ... |
Generate impression based on findings. | 14 year male status post gunshot wound to left upper extremity.VIEWS: Left shoulder transthoracic (one views) 3/5/2015 Radiopaque foreign body likely bullet is again seen and projecting over the posterior aspect of the humerus. There is no evidence of fracture or dislocation. | Radiopaque foreign body likely bullet projecting over the posterior aspect of the humerus. No fracture or dislocation.Findings were discussed with Dr. Laura Humphries by phone on 3/5/2015 on 5:00 PM. |
Generate impression based on findings. | Male 67 years old Reason: History metastatic renal cancer on pazopanib, assess for disease status History: none CHEST:LUNGS AND PLEURA: Stable size of pulmonary metastatic disease. The reference left upper lobe lesion measures 0.7 x 0.6 cm (series 4, image 23), previously 0.8 x 0.6 cm.MEDIASTINUM AND HILA: Hypoattenuat... | 1.Interval increase in the size of the right renal mass. There is persistent extension of tumor thrombus into the right renal vein and IVC which is similar to previous contrast enhanced study from May 2014. 2.Stable chest, mediastinal, peritoneal, liver and osseous metastatic disease. |
Generate impression based on findings. | Corresponding to the area of extensive abnormal low density on CT centered in the right temporal lobe, there is extensive T2/FLAIR hyperintensity involving predominantly white matter, although there is some cortical involvement as well. There is localized sulcal effacement in this area. There is mild effacement of the... | 1. Extensive abnormal signal with gyral thickening and localized mass effect involving the right temporal lobe with areas of focal diffusion restriction in the right mesial temporal lobe and right insular cortex most suggestive of an infiltrative nonenhancing primary brain neoplasm. Perfusion imaging should be consider... |
Generate impression based on findings. | Male; 61 years old. Reason: Uncontrolled HTN with renal insufficiency, assess for RAS RIGHT KIDNEY: The right kidney measures 8.6 cm in length. No evidence of renal stone or hydronephrosis. There is a 2.8 x 2.6 x 2.6 cm hypoechoic, cystic lesion with a thin septation (previously 2.2 x 2.4 x 2.2 cm).LEFT KIDNEY: The lef... | 1.Normal renal vasculature without evidence of renal artery stenosis.2.Complex right upper pole renal cyst, stable. |
Generate impression based on findings. | Movement disorder with loss of balance and fall. The patient would not tolerate proper positioning and insisted on PET camera somewhat distant from his head. This limits the exam. However within this limitation there is apparent significantly decreased activity involving both putamen. Symmetric caudate activity is note... | Limited exam but considered more likely abnormal and suggestive of Parkinson's disease given the history. |
Generate impression based on findings. | Left hand tremor. There is minimal decreased activity within the posterior left putamen; when reviewing a recent MRI, this correlates with a T2 hyperintense area which may represent a prior lacunar infarct or prominent perivascular space. The remaining distribution of radiotracer is physiologic. | Negative examination. No evidence of nigrostriatal dopaminergic dysfunction. Given the history, these findings are suggestive of essential tremor. |
Generate impression based on findings. | Male; 68 years old. Reason: evaluate aortic aneurysm History: vague abdominal pain; patient has PAD and had enlarged abdominal aorta in 2011 AORTA:Irregular aortic wall with shadowing mural calcification.Aortic dimensions as follows:Proximal: 3.0 x 3.3 x 3.4 cmMid: 3.4 x 5.0 x 4.3 cmDistal: 4.4 x 4.2 x 4.4 cmRight ilia... | Aneurysmally dilated aorta, most significant in the distal portion which measures up to 4.4 cm. Aneurysmal dilation of the bilateral iliac arteries. |
Generate impression based on findings. | Rule out infection or signs of malignancy. Pre-transplant evaluation. Multiple teeth are absent. I see no large cavities, although dental caries would be better assessed with dedicated dental radiographs. A lucency at the root of the second right maxillary incisor is nonspecific and may in part be artifactual due to mi... | Lucency at the root of the right secondary maxillary incisor is nonspecific and may not be of any clinical significance. However, if there is strong clinical concern for infection, then dedicated dental radiographs may be considered. |
Generate impression based on findings. | Pain to proximal digit. Rule out fracture. There is dorsal dislocation of the middle phalanx with respect to the proximal phalanx. I see no fracture. | PIP joint dislocation. I see no fracture. |
Generate impression based on findings. | Pain. Fracture? I see no fracture or malalignment. I see no specific findings to account for the patient's shoulder pain. | No fracture or other findings to account for the patient's shoulder pain are evident. |
Generate impression based on findings. | Abrasions status post fall. Rule out fracture. Four views of the left elbow are provided. There is narrowing of the radiocapitellar articulation with underlying subchondral cysts indicating osteoarthritis. There is elevation of the anterior fat pad of the distal humerus indicating fluid within the joint. There is a ste... | Osteoarthritic changes as described above. There is mild deformity of the radial head that could conceivably represent a nondisplaced fracture if this corresponds to the site of the patient's pain; alternatively, it may represent the sequela of old trauma or osteoarthritis. Small density along the medial epicondyle of ... |
Generate impression based on findings. | Prior SAH grade 3, day#6, Post stent assisted coiling for the ruptured right distal ICA aneurysm. Decreased mental status, suspicious for vasospasm. NONCONTRAST CT HEADMild to moderate ventriculomegaly with IVH and left EVD inserted.Right EVD has been removed.Bilateral frontal lobe ICH appear to be stable.Amount of SAH... | 1. Stable post stent assisted coiling status of ruptured right distal ICA aneurysm, no change of mild to moderate ventriculomegaly, IVH amount and bilateral frontal ICH. 2. Left EVD tube location is stable, no change and the right EVD tube has been removed.3. Normal caliber of intracranial arterial system.4. No evidenc... |
Generate impression based on findings. | Post left total knee arthroplasty Components of a left total knee arthroplasty device are situated in near anatomic alignment without radiographic evidence of complication. Skin staples and foci of gas within the anterior soft tissues reflect recent surgery. | Postoperative changes of total knee arthroplasty as described above. |
Generate impression based on findings. | Left hip pain and right hip pain. Rule out occult fracture or avascular necrosis. Right knee pain/effusion, fever. Assess for complications status post right knee replacement. Two views of the left hip are provided. I see no fracture. I see no specific radiographic features of avascular necrosis. Mild osteoarthritis af... | 1.Mild osteoarthritis and chondrocalcinosis of the hips. I see no fracture or avascular necrosis. If there is strong clinical concern for fracture or avascular necrosis, then MRI may be considered for further evaluation.2.Unicompartmental right knee arthroplasty situated in near-anatomic alignment with nonspecific join... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of cutaneous burn involvement the left breast. Two standard digital views, with additional bilateral CC and MLO views, of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibrogland... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed with tomosynthesis and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Scattered benign calcifications are present. No suspicious masses, ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this r... |
Generate impression based on findings. | congestive heart failure, unresponsive 4 hours after ICU desation. No evidence of acute ischemic or hemorrhagic lesion.Minimal non specific small vessel ischemic disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collect... | No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | facial numbness and extremity numbness, new onset. No evidence of acute ischemic or hemorrhagic lesion.Multifocal focal encephalomalacias involving bilateral inferior parietal lobules and left cerebellar hemispheres.Brain MRI can be considered for further evaluation.The ventricles, sulci, and cisterns are symmetric and... | No evidence of acute ischemic or hemorrhagic lesion.Multifocal chronic ischemic lesions with encephalomalacia involving bilateral inferior parietal lobules and left cerebellar hemisphere as described above. |
Generate impression based on findings. | near syncope There is about 8mm sized soft tissue like attenuation on the right para and supraclinoid area subarachnoid space with stippled calcification (series 4, image 13/35). This lesion could represent partial volume artifacts for ectatic, tortuous and calcified distal ICA. However, possibility of calcified distal... | Prominent right distal ICA around anterior clinoid process, possibility of aneurysm or partial volume artifacts. Follow up imaging such as CTA or MRA can be considered for further evaluation.Otherwise unremarkable CT scan.discussed with Dr. Grueger |
Generate impression based on findings. | 84 years, Male, Reason: r/o aortic enteric fistula History: gi bleed. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Hepatic hypodensities are too small to characterize.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality... | Active hemorrhage in the distal pylorus. |
Generate impression based on findings. | Right hip pain. Right hip femoral acetabular impingement. There is a lucent lesion with sclerotic margins in the posteromedial aspect of the proximal tibial metaphysis with disruption of the overlying cortex. The lesion contains foci of ossification as well. Its appearance is benign. It may represent a healing nonossif... | No specific findings to account for the patient's pain. Measurements as above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. There is asymmetry within the outer right breast. No suspicious masses, micro... | Asymmetry within the outer right breast, visualized on the CC view. Correlation with prior mammograms is recommended. If prior mammograms cannot be obtained, further evaluation with true lateral and spot compression views, and possible ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluation... |
Generate impression based on findings. | 59 years, Male, Reason: eval for liver laceration History: right abdominal pain. CHEST:LUNGS AND PLEURA: Patchy opacities in the bilateral basis and right middle lobe. No pleural effusions. No suspicious nodules or masses.Lower lobe bronchiectasis bilaterally.MEDIASTINUM AND HILA: Scattered small mediastinal nodes with... | 1.Linear hypodensity in the hepatic dome is suspicious for laceration. No subcapsular fluid or hemorrhage is present and this is considered age indeterminate2.Lower lobe bronchiectasis with patchy basilar opacities, likely aspiration/infection. |
Generate impression based on findings. | Inflammation of the left buttock, perineum and left lower extremity. UTERUS, ADNEXA: Intrauterine device is visualized.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Note ... | Inflammation along the left perineum, vagina and left medial gluteal fold without loculated fluid collection or abscess. |
Generate impression based on findings. | Male 5 months old Reason: eval lung fields, expansion History: infant with tracheostomy, pulmonary HTN, chronic lung diseaseVIEW: Chest AP (one view) 3/5/15 1746 hrs. Tracheostomy tube terminates below thoracic inlet. NG tube tip is at the stomach. Cardiac silhouette size is normal. Right middle lobe atelectasis on a b... | Right middle lobe atelectasis on a background of chronic lung disease. |
Generate impression based on findings. | 34 years, Male. Reason: r/o bowel obstruction History: N/V, ab and back pain Probable mineralized debris in a diverticula in the left upper quadrant. Nonobstructive bowel gas pattern. Lung bases are clear. Average stool burden. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | syncopal episode, on coumadin with history of head trauma. No evidence of acute ischemic or hemorrhagic lesion.Evidence of prior right craniotomy with multiple surgical clips on the right distal ICA area with low attenuation on the right frontal lobe indicating chronic ischemic lesion.Small focal encephalomalacia on th... | Evidence of prior surgical clipping and multifocal ischemic lesions, no change since prior exam.No evidence of acute ischemic or hemorrhagic lesion. |
Generate impression based on findings. | RUQ and epigastric pain. Rule out cholelithiasis/cholecystitis, pancreatitis, SBO. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cholelithiasis with gallbladder wall thickening and pericholecystic inflammation indicating acute cholecystitis.SPLEEN: No significant abnormality notedPANCREAS: N... | 1.Findings compatible with acute calculus cholecystitis.2.Right adnexal cystic lesion, likely ovarian cyst, which can be correlated with pelvic ultrasound if clinically warranted. |
Generate impression based on findings. | 24 years, Male. Reason: SBO/ileus History: abdominal distension Low lung volumes. Bibasilar opacities. Tracheostomy tube and left IJ catheter is in place. Spinal fixation hardware is unchanged. Ventriculo-gall bladder catheter is again noted coiled in the right upper quadrant. Left pigtail catheter, vascular coils and ... | Decrease in degree of distention likely representing resolving obstruction when compared prior. |
Generate impression based on findings. | Female 4 years old Reason: r/o fracture History: tv fall on foot, non-weight bearingVIEWS: The fourth AP, lateral and oblique and left tibia-fibula AP and lateral 3/5/15 (5 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Pre-desaturations.VIEW: Chest AP (one view) 03/05/15, 1704 Tracheostomy tube tip is below thoracic inlet. Two feeding tubes are present. Giant omphalocele is again seen. Left upper extremity PICC has its tip in junction of brachiocephalic veins.Perihilar air space disease has worsened on the right. Focal opacity in the... | Worsening opacity on the right. Persistent left base opacification. |
Generate impression based on findings. | 81 years, Male. Reason: Ileus, distention History: Above Moderate cardiomegaly. Low lung volumes. Small right pleural effusion. No pneumothorax. No pneumoperitoneum. Scattered loops of gas distended small and large bowel. Nonobstructive bowel gas pattern. Probable bone island in the right femoral neck. | Findings compatible with ileus type bowel gas pattern. |
Generate impression based on findings. | 48 years, Female. Reason: eval if patency capsule is still in small bowel (stuck at stenotic anastomosis) or in colon or passed History: Crohn's' disease with anastomotic stricture Nonobstructive bowel gas pattern. Suture material projects over the right hemiabdomen. Radiopaque patency capsule is in the area of the sut... | Radiopaque patency capsule is in the area of the suture line, unchanged since the prior exam. |
Generate impression based on findings. | Male 14 months old Reason: pneumonia History: fever, tachycardic/tachypneicVIEWS: Chest AP/lateral (two views) 3/5/15 Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Peribronchial thickening and subsegmental atelectasis of both lung bases. No focal lung opacities. N... | Bronchiolitis pattern with superimposed subsegmental atelectasis at both lung bases. |
Generate impression based on findings. | multiple episode of epistaxis, eye pain and headache. 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 hemor... | Normal head CT scan. |
Generate impression based on findings. | 44-year-old male with tooth pain. Panorex view of the mandible demonstrates a large cavity affecting the right second mandibular molar. Reabsorption noted along the root of the left second mandibular molar with loss of bone along the alveolar ridge indicating periodontal disease. Partially erupted third maxillary molar... | Dental caries and periodontal disease as described above. If further evaluation is clinically indicated, then dedicated dental radiographs may be obtained. |
Generate impression based on findings. | Assess dislocation reduction, post reduction The previously seen PIP joint dislocation has been reduced to anatomic alignment. There is swelling of the soft tissues of the finger, but I see no fracture. | Reduction of PIP joint dislocation. |
Generate impression based on findings. | 48 years, Female. Reason: eval location of patency capsule History: Crohn's disease with anastomosis, stricture at anastomosis Nonobstructive bowel gas pattern. Suture material projects over the right hemiabdomen. Patency capsule projects over the area containing the sutures. | Patency capsule projects over the area of the suture material in the right hemiabdomen. |
Generate impression based on findings. | Pain, swelling. Fracture? Two views of the right femur are provided. I see no fracture or other specific findings to account for the patient's pain.Two views of the right tibia/fibula are provided. There is a transverse fracture of the proximal fibular diaphysis with fracture fragments in near-anatomic alignment. I see... | Proximal fibular fracture as above. |
Generate impression based on findings. | Shoulder pain. Possible AC joint separation.VIEWS: Right shoulder internal/external rotation (two views) 03/05/15 The humeral head is normally positioned with respect to the glenoid fossa. No fracture is identified. | Normal examination. |
Generate impression based on findings. | 72-year-old female status post fall. Evaluate for fracture. Left hip:Two views of the left hip demonstrate no acute fracture or malalignment. The left hip joint appears normal for patient's age. Small enthesophyte along the greater trochanter, which may not be of any clinical significance.Left femur:Two views of the le... | Degenerative changes as described above without fracture evident. |
Generate impression based on findings. | Female 25 years old Reason: s/p thoracotomy, chest tube placement, line placement History: port placementVIEW: Chest AP (one view) 3/5/15 at 1829 hrs. Left-sided chest tube, epidural catheter and left subclavian Port-A-Cath with the tip in the RA/SVC junction the note that. Subcutaneous emphysema is present. Cardiac si... | Status post surgery as described. |
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