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Generate impression based on findings. | Status for 6 month robotic converted to open RUL for T3N1M0 stage IIIA moderate to poorly differentiated adenocarcinoma. LUNGS AND PLEURA: Small partially loculated right pleural effusion.Postsurgical findings of right upper lobectomy.Mild right paramediastinal bronchiectasis related to post-radiation change. There is ... | 1. Post-surgical findings of right upper lobectomy with paramediastinal post-radiation changes.2. Indeterminate micronodules. Short term interval follow-up in 3 months is recommended.3. Small partially loculated right pleural effusion. |
Generate impression based on findings. | 70 year-old male status post esophagectomy for assessment for anastomotic leak. Scout radiograph of the chest showed pneumoperitoneum and bibasilar atelectasis or consolidation. Nasogastric tube tip projects over the gastroesophageal junction.Single contrast evaluation of the esophagus demonstrates brisk transit of con... | No contrast extravasation to suggest an anastomotic leak. |
Generate impression based on findings. | Lung cancer, now following a nodule. CHEST:LUNGS AND PLEURA: Severe centrilobular emphysema. Posterior segment right upper lobe airways are thickened, with probable associated atelectasis. New 3-mm (3/40) solid nodule surrounded by a larger 7 x 9 mm area of spiculation or pseudo-spiculation right upper lobe posteriorly... | 1. Solid component of the dominant right upper lobe nodule is larger, consistent with known neoplasm. 2. The new smaller opacities in the right lobe appear to be associated with bronchial wall thickening and could be post inflammatory. Three month CT follow-up may be obtained to assess warm resolution.3. Mild right hil... |
Generate impression based on findings. | Hypoxemia. Evaluate for PE. PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Large bilateral pleural effusions with adjacent atelectasis.Septal lines and patchy bilateral groundglass opacities with peribronchovascular thickening consistent with pulmonary edema.Predominantly dependent lower lobe p... | 1. No evidence of pulmonary embolism.2. Large bilateral pleural effusions and pulmonary edema, possibly with superimposed aspiration.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 44-year-old female with bilateral biopsy proven fibroepithelial lesions presents for routine annual examination. No new breast complaints. Family history of breast carcinoma in her maternal aunt at age 31. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast ... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 32 year old with pelvic Ewing's sarcoma. LUNGS AND PLEURA: Scattered stable micronodules, most postinflammatory.Surgical sutures in the right upper and lower lobes.No suspicious nodules.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.No visible coronary artery calcification.No pericardial effusion.CHEST W... | No evidence of local recurrence or metastatic disease. |
Generate impression based on findings. | Male 69 years old; Reason: COLON CANCER S/P HEPATIC RESECTION JUNE 2014. EVALUATE FOR INTERVAL DISEASE History: COLON CANCER CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules. Nodules in the right lower lung are calcified.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Extensive aortic calci... | Overall no substantial interval change compared to prior no definite evidence of metastatic disease.1.Stable postoperative appearance following right hepatic lobectomy. No definite evidence of disease in the liver.2.Residual bladder wall thickening without pelvic adenopathy. |
Generate impression based on findings. | 77 years, Female, Reason: 76 show female with history of radiofrequency ablation of left renal mass in 2009. History: see above. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: Prominent pancreatic duct is unchan... | No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Severe constipation.VIEW: Abdomen AP (one view) 03/06/15 A moderate amount of feces is present at the hepatic flexure, a small amount in the transverse colon, and a moderate amount in the rectum. No significantly dilated bowel loops are present. | No significant change in stool burden in the interval. |
Generate impression based on findings. | Reason: Rule out pneumonitis. History: CMV infection/viremia, immunocompromised LUNGS AND PLEURA: Focal scarlike opacities are unchanged.No significant pulmonary or pleural abnormality, specifically no evidence of pneumonitis or viral infection. MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Right jugula... | No significant abnormality, except for a very small small pericardial fluid collection which may be physiologic in size but larger than before. |
Generate impression based on findings. | Testicular cancer orchiectomy on 3/6/15. Mildly enlarged retroperitoneal lymph node on imaging 3/5/15. LUNGS AND PLEURA: No suspicious pulmonary nodules or pleural effusion.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Anterior triangular mediastinal soft tissue likely represents thymic hyperplasia.Norm... | No evidence of intrathoracic metastases. |
Generate impression based on findings. | 49 years, Female, Reason: dissection protocol History: chest pain. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Mild cardiomegaly with hypertrophy of the left ventricle. No aortic dissection or aneurysm.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No signifi... | 1.No evidence of dissection.2.Cardiomegaly. |
Generate impression based on findings. | Reason: urothelial cancer, s/p surgery and chemotherapy, needs surveillance History: urothelial cancer, s/p surgery and chemotherapy, needs surveillance LUNGS AND PLEURA: Calcified granulomata, but no evidence of pulmonary or pleural metastases.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.No visible co... | No evidence of intrathoracic metastases or other chest abnormality. |
Generate impression based on findings. | HNC and CRT. CHEST:LUNGS AND PLEURA: Subcentimeter ground glass density micronodule in the superior segment of the left lower lobe decreased in density compared to the prior study, probably post inflammatory. No new or suspicious lesions.MEDIASTINUM AND HILA: Chest port tip at superior cavoatrial junction. No visible c... | No signs of metastatic disease or other acute abnormality. |
Generate impression based on findings. | Male 15 years old Reason: eval fracture History: s/p ORIFVIEWS: Right hand AP, lateral and oblique on 3/6/15 (3 views) Interval open reduction and internal fixation with two K wires of the boxer's fracture of the right fifth metacarpal noted. Periosteal reaction and callus formation around the healing fracture is prese... | Anatomic alignment of healing fracture as described after K wires placement. |
Generate impression based on findings. | Follow-up groundglass nodules. Dyspnea. LUNGS AND PLEURA: Mosaic attenuation of the lung parenchyma with background lung density chronically increased and areas of hypoperfusion. Additionally, there are probable areas of decreased ventilation in the lung bases within the subsegments affected by presumed metastatic calc... | No significant change in lymphadenopathy. Signs of pulmonary hypertension with probable metastatic calcification in the lung parenchyma related to chronic renal disease. In addition to previously described differential considerations of multicentric Castleman's disease or less likely lymphoma, amyloidosis related to re... |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: No sign metastases or other significant pulmonary/pleural abnormality.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy.Only mild coronary calcifications are present. The heart and pericardium otherwise ... | No sign metastases, or other significant abnormality. |
Generate impression based on findings. | 66 year old female with right shoulder pain. Assess fracture healing. Four views of the right shoulder again show an impacted proximal humerus fracture with slight lateral angulation of the distal fracture fragment. Small amount of callus formation adjacent to the fracture indicates attempted healing. | Healing proximal humerus fracture. |
Generate impression based on findings. | 58-year-old female with bilateral hip pain with history of moderate OA but not responding to intra-articular injection. Right hip:Two views of the right hip are provided. Moderate to severe osteoarthritis affects the right hip, progressed compared to prior.Left hip:Two views of the left hip are provided. Moderate to se... | Progression of bilateral hip osteoarthritis. |
Generate impression based on findings. | 30 year-old male with left ankle pain. Evaluate for fracture. Left ankle:Three views of the left ankle are provided. Oblique fracture through the distal fibula with slight posteromedial displacement of the distal fracture fragment. Vertical fracture through the "posterior malleolus" of the distal tibia with slight post... | Trimalleolar ankle fractures as described above. |
Generate impression based on findings. | There is a stable right parietal approach ventriculostomy catheter with tip terminating near the right foramen of Monro.. There is no visualized discontinuity or kinking of the catheter/reservoir system. The ventricular caliber is stable on the left and further decreased on the right. The left frontal horn remains 3.8... | Stable dilatation of left lateral ventricle with further decreased size of right lateral ventricle. Stable ventriculostomy catheter with no evidence of discontinuity or kinking of the visualized segments. |
Generate impression based on findings. | Reason: r/o ich History: left arm weakness, numbness The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a new 12mm hypodense focus present in the left inferior parietal lobule which was not present on the prior exam.There is an 11mm hypodense focus present along the lateral aspe... | 1.There is a new subtle hypodense focus present along the lateral aspect of the left hand motor area at the precentral gyrus . The possibility that this represents acute infarction cannot be excluded. If clinically appropriate MRI of the brain may be helpful for further evaluation2.There is a new lesion present in at t... |
Generate impression based on findings. | History of lung cancer on observation, compare to prior scans CHEST:LUNGS AND PLEURA: Postsurgical changes reflect prior left upper lobectomy.Using similar measurement technique on 3 mm slice thickness, the previously referenced mixed solid and ground glass nodule at the left apex measures 9 x 15 mm (4/27) as compared ... | Interval increased size of two reference pulmonary nodules: the solid right middle lobe nodule measures 8 mm in short axis, compared to 6 mm. Left upper lobe mixed groundglass and solid nodule is 9 x 15 mm, as compared to 8 x 13 mm. No new suspicious pulmonary nodules or pleural effusion. New low density focus of the l... |
Generate impression based on findings. | Lung mass with mets to the spine. Staging.RADIOPHARMACEUTICAL: 9.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 93 mg/dL. Today's CT portion grossly demonstrates lower cervical spinal fixation hardware. There is a left upper lobe paramediastinal lung nodule. Bilateral lower lobe interstitial and airspace ... | 1. Markedly hypermetabolic left upper lobe pulmonary nodule compatible with primary lung cancer.2. Ipsilateral mediastinal/hilar and contralateral supraclavicular hypermetabolic lymph nodes compatible with metastatic disease.3. Increased activity in T6 suspicious for tumor along hypermetabolic activity in the region of... |
Generate impression based on findings. | History of left shoulder dislocation. Severe osteoarthritis affects the glenohumeral joint. There appears to be slight anterior subluxation of the humeral head on the Grashey view, although alignment on the axillary view is within normal limits. There is deformity of the humeral head that likely represents chronic post... | Severe osteoarthritis and other findings as above. |
Generate impression based on findings. | The patient submitted an additional outside study for review. Submitted for review is a standard screening mammogram with tomosynthesis (2/13/15). For comparison, followup diagnostic mammogram and ultrasound (2/10/15) are available. Two standard views of both breasts with tomosynthesis were obtained. The breast parench... | Spiculated mass in the left breast for which further diagnostic imaging has been performed. BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Pain. Rule out fracture. There is perhaps mild soft tissue swelling about the PIP joint, but I see no fracture or malalignment. | No fracture evident. |
Generate impression based on findings. | 76 years old, Male, Reason: PT with cholangio; needs surveillance scan in 2 months History: none CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are roughly stable. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Severe coronary artery calcifications. Scattered mediastinal and hilar lymph nodes... | Progression of disease.1.Unchanged hepatic segment 5 mass compatible with patient's known cholangiocarcinoma with associated perfusion abnormalities and capsular retraction.2.New presumed liver metastasis.3.Interval enlargement of reference periportal lymph node. |
Generate impression based on findings. | The ventricles and sulci are prominent, consistent with mild age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, which are ... | 1. No MR evidence of intracranial metastatic disease.2. Nonspecific punctate and confluent areas of T2/FLAIR hyperintensity within the supratentorial white matter, with differential diagnosis including chronic small vessel ischemic changes, demyelinating disease, as well as infectious/inflammatory processes. |
Generate impression based on findings. | Female, 42 years old, status post cardiac arrest with no brainstem reflexes. Since the prior examination, diffuse cerebral edema has progressed with further loss of gray-white distinction, sulcal effacement, effacement of the basilar cisterns and ventricles. No evidence to suggest intracranial hemorrhage is seen. | Progressive cerebral edema compatible with diffuse hypoxic ischemic injury. |
Generate impression based on findings. | Lower extremity weakness. Question of infection in the spinal canal around the tip of the intrathecal catheter. Physiologic activity is present in the liver, spleen, and bone marrow. No abnormal leukocyte accumulation is identified to indicate an active infectious or inflammatory process. | No scintigraphic evidence of active infection or inflammation. |
Generate impression based on findings. | 31 year old female who has a complaint of thickening along the lateral aspect of her left breast x 1 month. No family history of breast cancer. MAMMOGRAM: Three standard views of both breasts, and two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast ... | No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually, to begin at age 40. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Proximal second digit swelling and tenderness to palpation.VIEWS: Right hand PA, right index finger oblique/lateral (3 views) 03/06/15 Soft tissue swelling surrounds the proximal small phalanx of the index finger. The bones are normal. No fracture is identified. | Soft tissue swelling. |
Generate impression based on findings. | Middle finger swelling of tip.VIEWS: Left hand PA, left middle finger oblique/lateral (3 views) 03/06/15 Soft tissue swelling is present around the distal phalanx of the middle finger. The bones are normal in appearance. No fracture is identified. No bone destruction is present. | Soft tissue swelling around the distal phalanx of the middle finger. |
Generate impression based on findings. | Shortness of breath, tachycardia. Rule out leak after Whipple procedure. ABDOMEN:LUNG BASES: Bilateral small pleural effusions (left greater than right) with overlying compressive atelectasis.LIVER, BILIARY TRACT: Simple cyst is unchanged. Pneumobilia. Portal vein is patent.SPLEEN: No significant abnormality notedPANCR... | Status post Whipple procedure with new poorly defined fluid collection near the surgical bed; plan is for attempted percutaneous drainage. Small bilateral effusions. Postsurgical changes in the upper abdomen which could be followed. Small lymph nodes. Findings discussed with Dr. Matthews at the time of dictation. |
Generate impression based on findings. | There are several discrete oval and minimally irregular areas of T2/FLAIR hyperintensity within the left frontal lobe white matter, more confluent in the left superior frontal gyrus. Additional foci are seen in the left cerebral white matter, especially the left periatrial white matter where the abnormality is more co... | Scattered areas of nonenhancing T2/FLAIR hyperintensity in the left cerebral white matter, most confluent in the left periatrial white matter with delineation of normal to somewhat prominent perivascular spaces. The findings are favored to represent areas of nonspecific gliosis which may in part simply relate to promin... |
Generate impression based on findings. | Abdominal pain and lactic acidosis. Assess for cause of acute abdominal pain and sepsis. ABDOMEN:LUNG BASES: Bilateral pleural effusions and patchy basilar pulmonary opacities are again partially visualized. Please refer to the CT of the chest that has since become available.LIVER, BILIARY TRACT: Status post cholecyste... | 1.No evidence of pyelonephritis or hydronephrosis.2.Abdominal pelvic ascites without evidence of a loculated fluid collection, bowel obstruction or free air.3.Possible complete collapse of the bladder around the Foley catheter which takes an atypical course. Less likely is perforation of the Foley catheter. Correlate c... |
Generate impression based on findings. | Male 15 months old Reason: cardiopulmonary assessment History: preop heart surgeryVIEWS: Chest AP/lateral (two views) 3/6/15 at 1146 hours Mediastinal clips are again noted. Cardiac silhouette size is enlarged but stable. Patchy opacity of the left lower lobe may represent pneumonia or atelectasis on a background of lu... | Left lower lobe opacity concerning for pneumonia or atelectasis as described. |
Generate impression based on findings. | 70 years, Male. Reason: 70M intubated in MICU with abdominal distension, low UOP History: 70M intubated in MICU with abdominal distension, low UOP Persistent retrocardiac opacity. NG tube tip projects over the gastric antrum. Vertebroplasty changes are again noted at L2. Scattered loops of air within the colon in a non... | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Pain Thumb: No radiographic abnormalityShoulder: Excessive calcific fragments and partially visualized deformity of the humoral head previously described on the recent CT. No change in fragment and gross anatomic alignment. The fragment donor site is not well visualized. Mild inferior displacement of the humeral head, ... | Unchanged Hill-Sachs fracture |
Generate impression based on findings. | Reason: r/o fracture History: fall, R facial trauma CT head:The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage i... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT of the maxillofacial bones is within normal limits.3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 4.Staphyloma of the right eye is stable.5.Dental caries |
Generate impression based on findings. | Right upper quadrant ultrasound. Evaluate for liver or biliary pathology. LIVER: The liver measures 14.7 cm in length. No intrahepatic biliary ductal dilatation or dominant masses. Liver echotexture is coarsened slightly. Portal vein is patent with flow towards the liver on color Doppler imaging.GALLBLADDER, BILIARY TR... | Status post cholecystectomy. No sonographic evidence of liver or biliary pathology. |
Generate impression based on findings. | Rule out PE, dyspnea on exertion, ILD, shortness of breath PULMONARY ARTERIES: The quality of this examination is diagnostic for pulmonary embolism. No pulmonary embolus is presentLUNGS AND PLEURA: Diffuse pulmonary fibrosis most concentrated at the bases with associated paraseptal emphysema. Peripheral honeycombing in... | No evidence of pulmonary embolus.Pulmonary fibrosis with overall appearance most consistent with a fibrosing NSIP pattern with diffuse edema in the spared lung parenchyma.PULMONARY EMBOLISM: PE: NoneChronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | DVT, chest pain with inspiration this morning. PULMONARY ARTERIES: Diagnostic quality study, no pulmonary embolus.LUNGS AND PLEURA: Small pleural effusions with associated atelectasis.MEDIASTINUM AND HILA: No visible coronary artery calcifications.CHEST WALL: Superior endplate deformity of L1 vertebral body unchanged a... | No evidence of pulmonary embolus. L1 superior endplate compression fracture has been described previously.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Male 67 years old; Reason: metastatic prostate cancer needs repeat exam for staging on treatment History: metastatic prsotate cancer CHEST:LUNGS AND PLEURA: No solid pulmonary lesion has developed. The pleural spaces remain clear. There is a new right sided pulmonary embolus (image 47; series 80264 and image 38; series... | New right pulmonary embolus. New thoracic adenopathy. Stable abdominal adenopathy. Sclerotic bony metastases. Dr. Smulewitz notified at the time of dictation. |
Generate impression based on findings. | Female 9 years old Reason: rule out fracture/dislocation History: painVIEWS: Pelvis AP and frog leg 3/6/15 (two views) Mild bilateral coxa valga deformity. Both femoral heads are well directed into a normally developed acetabulum. No evidence of SCFE or AVN. No fractures. | Normal examination. |
Generate impression based on findings. | Rotator cuff tear and pain. Ankylosing spondylitis history Shoulders: Bilateral marked near severe osteoarthritic changes with near bone-on-bone narrowing, bulky osteophytes and sclerosis. In addition flattening is observed along both humeral heads in a somewhat symmetric appearance and with questionable underlying cre... | Anchylosis finalize observed involving the lumbar spine with more minimal degenerative changes in the upper cervical spine. Bilateral shoulder osteoarthritis with questionable early AVN. See detail provided |
Generate impression based on findings. | Reason: emesis, status SAH and hydrocephalus History: emesis, c/f increase hydrocephalus, status SAH There are foci of encephalomalacia present involving the left inferior frontal gyrus and part of the left superior temporal gyrus extending into the left supramarginal gyrus. There is associated enlargement of the left ... | 1.The ventricles are enlarged but remain stable when compared to prior exam.2.Multiple foci of encephalomalacia are present in the left frontal lobes and to a lesser degree left temporal lobe, left parietal lobe and right frontal lobe as detailed above. Most likely these are related to prior ischemic cerebral infarctio... |
Generate impression based on findings. | Male 12 years old Reason: eval VP shunt History: HA, irritabilityVIEWS: Shunt series: Skull AP/lateral (two views), chest AP/lateral (two views), abdomen AP/lateral (two views) 3/6/15 Bilateral intracranial VP shunt valves are unchanged. Left-sided Strata valve P/L is 1.0 and the right-sided P/L is1.5 (unchanged). No e... | No evidence of VP shunt malfunction. |
Generate impression based on findings. | Female 32 years old Reason: cardiopulmonary assessment History: post op heart surgery, evaluate for effusionsVIEWS: Chest PA/lateral (two views) 3/6/15 at 1219 hrs. Sternal wire and pacemaker device with pacemaker leads as well cholecystectomy surgical clips are again noted. Cardiac silhouette size is enlarged but stab... | No effusions. |
Generate impression based on findings. | Pain Persistent Hill-Sachs fracture without evidence of interval change a new complication. Alignment preserved. Decreasing soft tissue swelling | Hill-Sachs fracture without evidence of interval change or new complication |
Generate impression based on findings. | Reason: eval for increasing hydrocephalus History: 12yo M with VP shunt presents with HA, irritability A left-sided and ventriculostomy catheter courses through the left parietal lobe into the trigone of left lateral ventricle remains in stable position. A right-sided ventricular catheter courses along the floor of the... | 1.Since the prior exam the lateral ventricles are slightly larger, however, on the prior exam are collapsed. Please correlate with clinical symptoms and signs.2.Chiari malformation.3.Cortical dysplasia and multiple cerebral deformities are stable. An MRI may help further assess this and it has not been done already in ... |
Generate impression based on findings. | Male 63 years old; Reason: gastric cancer s/p resection 4/2012 (pT4N3R1) s/p CRT adjuvant therapy done 12/2012. Now on surveillance. CT 1/2015 showed new subcentimeter liver lesions. Please evaluate interval change. History: none CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significa... | 1.Resolution of the right hepatic lobe lesion with new nonspecific subcentimeter hypodense segment 8 lesion. |
Generate impression based on findings. | Pain Interval continued healing of the distal tibial fracture without evidence of new complication. Superimposed mild degenerative changes. Decreased soft tissue swelling. | Healing distal tibial fracture |
Generate impression based on findings. | Reason: Fall with head strike History: Headache The CSF spaces are appropriate for the patient's stated age with no midline shift. A partially healed burr hole is present along the left frontal bone and is not substantially changed since the prior exam.No abnormal mass lesions are appreciated intracranially. No intracr... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | CLL. There has been overall interval increase in size of the extensive diffuse cervical, upper mediastinal, and bilateral axillary lymphadenopathy. For example, a right level 5A lymph node measures 11 mm in short axis, previously 5 mm, and a level 1B lymph node measures 14 mm in short axis, previously 9 mm. The partial... | Overall interval increase in size of the extensive diffuse cervical, upper mediastinal, and bilateral axillary lymphadenopathy. |
Generate impression based on findings. | Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. There are two new masses in the LEFT breast; one at upper outer quadrant and the other at upper inner quadrant. No suspiciou... | Two new masses in the LEFT breast; one at upper outer quadrant and the other at upper inner quadrant, for which spot compression views and possible ultrasound study are recommended. |
Generate impression based on findings. | Knee pain The oblique proximal fibular fracture appears mildly more prominent compatible with subacute timing and resorption along the fracture edges. Overall no significant change in alignment.Minimal osteoarthritic changes of the knee | Subacute proximal oblique right fibular fracture in near-anatomic alignment |
Generate impression based on findings. | Distal fibular fracture Moderate callus formation without significant change in alignment of the distal fibular fracture. Decreased soft tissue swelling. Persistent mild lateral displacement similar to prior study again observed. Overlying moderate degenerative ankle changes. Ankle mortise intact | Healing left distal fibular fracture |
Generate impression based on findings. | Male 75 years old; Reason: CLL History: Compare with prior scans CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Coronary calcifications.right paratracheal lymph node measures 1.9 x 0.9 cm (image 11/series 3) previously, 1.4 x 0.9 cm.Right subcarinal lymph node measures 2.7 x 1.7 cm (image... | 1.Increase in lymphadenopathy. |
Generate impression based on findings. | Male 48 years old; Reason: hx of Gleason 4+3 prostate cancer, evaluate for metastatic disease History: see above ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS:... | 1.No lymphadenopathy in the abdomen or pelvis. |
Generate impression based on findings. | Female 70 years old; Reason: 70 yr old patient with hx of ovarian cancer with rise in CA-125 had complained on SOB in the past but improving somewhat compare to 1-27-15 scan eval disease process History: SOB CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy. Refe... | 1.Slight increase in the size of the mesenteric nodal targets. |
Generate impression based on findings. | 36-year-old female with history of ITP and hypertension with possible sarcoidosis. ULTRASOUND KIDNEYSRIGHT KIDNEY: The right kidney measures 12 cm in length. Echotexture appears normal. No hydronephrosis, shadowing calculus or mass.LEFT KIDNEY: The left kidney measures 12 cm in length. Echotexture appears normal. No hy... | Normal examination. No evidence for renal artery stenosis. |
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. Benign-appearing lymph nodes project over the axillae.No suspicious masses, m... | 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: NSC - Screening Mammogram. |
Generate impression based on findings. | Lung cancer chemotherapy follow-up examination. CHEST:LUNGS AND PLEURA: Loculated right pleural fluid collection with thickening of both the parietal and visceral pleural surfaces minimally smaller.Right paramediastinal consolidation, presumably post-therapeutic. The majority of right lower and middle lobes are collaps... | Improvement in lymphadenopathy, size of right lung mass and size and number of pulmonary nodules. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are bilateral mammogram in ultrasound dated January 28, 2015 performed at Silver Cross Hospital. No studies were submitted for comparison. Per outside report, the patient has known bilateral breast carcinoma and has received 4 rounds of neoadjuvant chem... | Known bilateral breast malignancies. Biopsy marking clip noted centrally within a large asymmetry within the upper central left breast. Biopsy marking clip present within the upper outer, posterior right breast without significant mass identified. Per report the patient has received neoadjuvant chemotherapy. Treatment ... |
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 composed of scattered fibroglandular density. Small mass in the left upper outer breast may represent an intramammary lymph node.No ... | Small mass in the left upper outer breast may represent an intramammary lymph node. Comparison to prior studies is recommended and otherwise additional compression views/ultrasound may be needed.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | 70 year-old with nausea and vomiting. Hepatitis C cirrhosis. ABDOMENLUNG BASES: There is linear atelectasis at the lung bases. Tiny micronodules.LIVER, BILIARY TRACT: Cirrhotic appearing liver again noted. No focal enhancing lesions. There is no intrahepatic or extrahepatic biliary duct dilatation. SPLEEN: There is an ... | 1. No significant abnormality to explain nausea and vomiting.2. Cirrhotic liver morphology. |
Generate impression based on findings. | Invasive squamous cell carcinoma of the scalp status post excision on June 9, 2014. Neck: There are several subcentimeter nodules throughout the thyroid lobes bilaterally. There is no significant lymphadenopathy in the neck. There is multilevel degenerative spondylosis. There is a 6 mm calcified nodule in the right lun... | 1.Postoperative findings related to interval posterior scalp mass resection without discernible evidence of tumor in the treatment bed. 2.No significant lymphadenopathy in the neck.3.Unchanged thyroid nodules. |
Generate impression based on findings. | Female 48 years old; Reason: progression of disease History: abd pain, bladder symptoms CHEST:LUNGS AND PLEURA: Scattered pulmonary micro-nodules. The pleural spaces are clear.MEDIASTINUM AND HILA: Right chest wall port terminates at the cavoatrial junction.There is a small pericardial effusion.CHEST WALL: No significa... | 1.Decrease in the size of the pelvic mass. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Benign left breast biopsy in 1997. Family history of breast cancer in mother. Two standard digital views of both breasts with tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may ob... | 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: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign biopsy in right breast. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Postsurgical changes with architectural dist... | 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. | 45-year-old male with left lower quadrant pain and diarrhea. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality noted. Cholecystectomy.SPLEEN: No significant abnormality noted. Focus of accessory splenic tissue.PANCREAS: No significant abnormality notedADRENAL GLANDS: N... | No interval change. No bowel wall abnormality. |
Generate impression based on findings. | Lung cancer. One year after RLL for stage IA NSCLC. LUNGS AND PLEURA: Postsurgical finding of a right lower lobectomy.No suspicious pulmonary nodules.No pleural effusion with interval resolution of very small loculated pleural fluid at the right base.MEDIASTINUM AND HILA: Borderline enlarged subcarinal lymph node is un... | No evidence of recurrent or metastatic disease. Findings suggestive of esophagitis. |
Generate impression based on findings. | There has been interval expected evolution of multiple variably sized hypodense infarcts, with mild localized mass effect especially upon the right atrium.The ventricles and sulci are stable. There is no midline shift. There is no intracranial hemorrhage. There is no extraaxial fluid collection. The visualized portion... | Interval expected evolution of multiple scattered bilateral cerebral infarctions, without hemorrhagic transformation. |
Generate impression based on findings. | Determine etiology of abdominal pain after ventral hernia repair with mesh. The following observations are made given the limitations of an unenhanced study.ABDOMEN:LUNG BASES: No significant abnormality noted. Tiny bulla at the left lung base.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant... | Status post hernia repair with no evidence of recurrent hernia. No CT findings to explain abdominal pain. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of breast cancer in maternal aunt. Two standard digital views of both breasts with tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. An 8mm left retroareolar... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 77 year old female status post right mastectomy in 1994 for breast cancer, presents today for routine follow up. No current breast complaints. No family history of breast cancer. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed o... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 57 years old; Reason: metastatic breast cancer on Xeloda please assess response to treatment and compare to previous imaging History: metastatic breast CHEST:LUNGS AND PLEURA: Radiation changes in the left upper lobe. Ground glass nodule adjacent to left major fissure measuring 6 x 5 mm on image 27/series 5, unc... | 1.No stable size measurements of the reference lesions.2.Extensive osseous metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of left breast needle aspiration in 2005. 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. There is a stable... | Stable intramammary lymph node in the right breast. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Generalized abdominal pain and tympanic abdomen. Obstipation. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Ill-defined hypodense lesions in the right lobe liver probably represent metastases. For reference purposes, a segment 6 lesion measures 2.5 x 3.1 cm (image 56; series 3). No intrahepa... | Obstructing sigmoid mass presumably representing primary colon carcinoma. Liver metastases. Small pelvic lymph nodes. ER notified of these findings at the time of dictation (#45657). |
Generate impression based on findings. | Metastatic prostate cancer to the bones. Restaging evaluation. Again seen is multiple foci of osseous uptake with new lesions and increased uptake in others. There are new calvarial, sternal, right mid-femoral, and proximal left tibial lesions. Existing calvarial lesions appear more confluent with increased uptake. Add... | Progression of bone metastases. |
Generate impression based on findings. | Esophageal adenocarcinoma stage IV. Please assess and make direct comparison to OSH imaging on 2/3/15 and provide index lesion measurements for both scans for comparison. CHEST:LUNGS AND PLEURA: Mild apical predominant emphysema. Mild bronchial wall thickening. Scattered multiple bilateral micronodules/nodules suspicio... | Distant metastases with overall improvement. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Benign intramammary lymph nodes are present in the outer upper quad... | 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. | Persistent bacteremia. Evaluate for sources of infection. Physiologic activity is present in the liver, spleen, and bone marrow. An accumulation of radiotracer in the left forearm correlates to the injection site and is presumably infiltrated radiotracer. There is faint, minimal uptake within the right iliac fossa whic... | Minimal uptake within the right iliac fossa which is likely inflammatory without definite evidence of infection. |
Generate impression based on findings. | 19 year-old female with right R3 pain for one month in a rower. Evaluate for compression fracture. No acute fracture or malalignment. | Normal examination. |
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 composed of scattered fibroglandular density.No suspicious masses, microcalcifications or areas of architectural distortion are pres... | 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. | There is prominent hyperdensity along the right left tentorium with only very minimally hyperdense extra-axial material along the dorsal posterior fossa. Additional extra-axial hyperdensity is seen along the right aspect of the falx posteriorly and extending along the right parietal and temporal lobes, into the right ... | 1. Right greater than left acute subdural hemorrhage.2. Slight interval decreased prominence of the subarachnoid space is suggested although ventricles and sulci remain visualized. Decreasing attenuation of the deep gray nuclei suggestive of global hypoxic ischemic injury. Given clinical concern for HIE, close monitori... |
Generate impression based on findings. | 52 year old woman with history of right breast IDC s/p lumpectomy 2010. No current 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 composed of scattered fibroglandular density, unchanged in pattern and distribution. Posts... | 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. |
Generate impression based on findings. | Esophageal cancer. Restaging.RADIOPHARMACEUTICAL: 15 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 95 mg/dL. Today's CT portion grossly demonstrates prominent gastrohepatic lymph nodes. There are severe coronary artery calcifications. Today's PET examination demonstrates decreased size and metabolic activi... | 1.Overall, improvement in the primary esophageal lesion and regional lymph node metastases. No new lesions are identified.2.Hypermetabolic lesion in the left frontal lobe corresponding to known left precentral gyrus metastasis. |
Generate impression based on findings. | 19 year-old female with right knee pain. No acute fracture or malalignment. No joint effusion. | Normal right knee. |
Generate impression based on findings. | Reason: GIST restaging on chemo CHEST:LUNGS AND PLEURA: Interval resolution of left pleural effusion. Stable lung base scarring and band-like atelectasis.MEDIASTINUM AND HILA: Mild coronary artery calcification. Cardiac size is unremarkable. Previously described subcentimeter precarinal lymph node is smaller (image 40;... | Interval regression of disease with measurements given above. |
Generate impression based on findings. | Thyroid cancer, evaluate for recurrence. Tg not suppressed. There are postoperative changes related to total thyroidectomy and neck dissection. There is no discernible mass lesion in the thyroidectomy bed. There are scattered subcentimeter cervical lymph nodes that are not significantly enlarged. The salivary glands ar... | 1. Stable post-treatment findings in the neck without evidence of measurable locoregional tumor recurrence. 2. Scattered nonspecific lymph nodes in the neck, which are otherwise not particular enlarged. |
Generate impression based on findings. | Soft Tissues: Right lower limb soft tissue wound/ulceration and subcutaneous edema extending from the mid tibia through the ankle joint. Some areas of the ulcer appear to extend to the deeper soft tissues of the leg, approaching the bone (series 5, image 114). There is abnormal signal intensity within the distal right... | 1) Findings suggestive of osteomyelitis of the distal right tibia, with overlying deep soft tissue ulcerations as above.2) Left calf subcutaneous edema that may represent cellulitis although this is nonspecific, correlate with physical exam. 3) Right popliteal artery near complete occlusion, with opacification of only ... |
Generate impression based on findings. | 48-year-old female with back pain. Evaluate for DDD. Lumbar spine: Vertebral heights and intervertebral disk spaces are preserved. Alignment is anatomic. Multilevel small anterior osteophytes. Mild facet joint osteoarthropathy affects the lower lumber spine. Cholecystectomy clips. Incompletely visualized loops of bowel... | Mild degenerative arthritic changes of the lumbar spine. |
Generate impression based on findings. | Esophageal cancer. Please compare to prior PET per CALGB 80803 requirements.RADIOPHARMACEUTICAL: 13.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 105 mg/dL. Today's CT portion grossly demonstrates interval decrease in thickening of the distal esophageal wall. A prominent right paratracheal lymph node is ... | Interval decrease in size and metabolic activity of the distal esophageal tumor and regional lymph node metastases. No new FDG avid lesion is identified. |
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. Stable left axillary lymph node.No suspicious masses, microcalcifications or ... | 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: NSC - Screening Mammogram. |
Generate impression based on findings. | History of smoking prior right lower lobe nodule on 12/26/2011 chest CT. Shortness of breath. Weight loss. LUNGS AND PLEURA: The previously described well circumscribed right lower lobe nodule appears to contain punctate internal lipid attenuation, suggestive of but not pathognomonic for a hamartoma, and slightly incre... | 1. Interval development of an expansile endobronchial lesion and within the in the right lower lobe and ipsilateral inferior interlobar lymphadenopathy which causes slight compression of the airways. Differential considerations include malignancy such as mucinous adenocarcinoma or or an infectious process such as aller... |
Generate impression based on findings. | History of Gleason 4+3, evaluate for metastatic disease. No abnormal osseous foci are identified to indicate metastatic disease. Degenerative uptake is noted in the right acromioclavicular joint and ankles. | No evidence of bone metastases. |
Generate impression based on findings. | 62-year-old female with history of HCV complicated by cirrhosis, hypothyroidism who presents for worsening confusion. Evaluate for cerebral edema. There is a newly apparent subcentimeter focus of hyperattenuation in the pons with confluent surrounding hypoattenuation suggestive of edema. The grey-white matter different... | 1.Newly apparent subcentimeter focus of hyperattenuation in the pons. Differential considerations include hemorrhage, a vascular abnormality, or perhaps neoplasm. Further evaluation with MRI may be considered if clinically indicated.2.No convincing evidence of cerebral edema to suggest hepatic encephalopathy. However, ... |
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