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Generate impression based on findings. | Left femur pain Hip: Interval placement of a new long stem limb salvage left femoral component articulating with the acetabular cup. Overlying surgical staples and similar heterotopic bone with a cerclage wire observed in the lateral soft tissues.Femur: The femoral stem demonstrates no discrete focal abnormality this limited view. Specifically no evidence of fracture. Atherosclerotic changes.Knee: The tibial component also appears intact with a well situated stem without evidence of complication. | Limb salvage total hip, femur and knee arthroplasty |
Generate impression based on findings. | Tachycardia, SOB. Evaluate for PE and pleural effusions. PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Small right pleural effusion, significantly decreased with placement of a right lung base chest tube.Large left pleural effusion, increased from prior.Numerous bilateral pulmonary metastases, increased in size and number. Reference nodules as follows:1. Right lower lobe nodule is 20 mm (series 9, image 88), previously 19 mm.2. Left lower lobe nodule is 17 mm (series 9, image 55), previously 15 mm.3. Other left lower lobe nodule may be obscured by the effusion.New patchy bilateral ground glass opacities with smooth and nodular thickening of the septal lines, likely represents pulmonary edema and lymphangitic spread of tumor. Associated peribronchovascular thickening.Diffuse pleural metastases with increased size of some areas of thickening.MEDIASTINUM AND HILA: Extensive mediastinal, cardiophrenic, and bilateral hilar lymphadenopathy, stable to mildly increased. The reference low right paratracheal lymph node is 17 mm, previously 16 mm (series 5, image 108).Normal heart size without pericardial effusion. No visible coronary artery calcification.Right chest port tip terminates in the right atrium.Small hiatal hernia.CHEST WALL: Pathologic fracture of manubrium metastasis, unchanged. Small nonspecific sclerotic foci in T7,T11, and T12 vertebral bodies, unchanged.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Significantly increased size of multiple hepatic metastases.Bilateral soft tissue renal lesions, likely metastases, mildly increased in size.Gastrohepatic lymphadenopathy. | 1. No evidence of pulmonary embolism.2. Significant interval progression of pulmonary as well as liver metastases.3. Small right and large left malignant pleural effusions.4. New patchy bilateral groundglass opacities with nodular and smooth septal thickening, likely represents edema and lymphangitic spread of tumor.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Right wrist pain. No radiographic abnormalities observed in this very limited exam. Specifically no evidence of a fracture or discrete malalignment. No gross soft tissue swelling however a lateral projection would be helpful if of concern. | Normal |
Generate impression based on findings. | Knee pain Moderate chondrocalcinosis and moderate osteoarthritic changes with acute fractures of the tibial spines. Moderate knee effusion. Additionally a transverse subacute fracture of the proximal fibula is also observed. Dr. Kurtz contacted. | Tibial spine fractures please correlate with history and concern for acute or subacute injury. |
Generate impression based on findings. | Knee pain Bilateral knees: Mild to moderate osteoarthritic changes are again observed without significant interval change. Mild narrowing, sclerosis and osteophytes are again observed. Probable small infarcts in the distal bilateral femoral diaphysis. | Mild to moderate osteoarthritis |
Generate impression based on findings. | 53 year-old female with right shoulder pain, history of fall. Evaluate for any fracture, dislocation or misalignment. No acute fracture or malalignment. Mild to moderate osteoarthritis affects the glenohumeral joint. | Osteoarthritis with no acute fracture or malalignment. |
Generate impression based on findings. | Osteo- radionecrosis Essentially unchanged appearance with similar defects observed in the last two lower left molars compatible with extensive dental periods. Scattered surgical clips and mild thinning of the left mandible is again observed without interval change. Relatively intact right mandible. Diffuse demineralization is limiting. Visualized portions of the sinuses are clear | Stable appearing mandible with sclerosis and changes suggesting osteonecrosis of the left mandible and less likely chronic infection or post treatment |
Generate impression based on findings. | Right upper quadrant pain, leukocytosis, and gallstone in gallbladder but no ultrasound findings of cholecystitis. Angiographic images are unremarkable. Prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is normal excretion of tracer into the intrahepatic ducts, common bile duct, gallbladder and duodenum, indicating patent common bile and cystic ducts. | Normal hepatobiliary imaging. No evidence of acute cholecystitis. |
Generate impression based on findings. | Confusion and intracranial hemorrhage. The subcentimeter hyperattenuating focus in the central pons with mild surrounding vasogenic edema is stable to minimally larger. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. There is a partially-imaged enteric tube. | The subcentimeter hemorrhagic focus in the central pons with mild surrounding vasogenic edema is stable to minimally larger. |
Generate impression based on findings. | Confusion. Lung cancer. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. There is a small retention cyst in the left maxillary sinus. The skull and scalp soft tissues are unremarkable. | No evidence of intracranial metastases. |
Generate impression based on findings. | Female 97 years old; Reason: r/o diverticulitis, cholangitis, biloma History: diffuse abd pain, biliary obstruction, hx of cholecystitis s/p drain The study is limited by motion artifact.ABDOMEN:LUNG BASES: Mild bibasilar atelectasis/scarring.LIVER, BILIARY TRACT: Cholelithiasis without CT evidence of acute cholecystitis. No biliary dilatation. No significant abnormality of the liver.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypoattenuating left renal lesion measuring 4.0 cm is consistent with a renal cyst. Additional hypoattenuating lesions are too small to characterize.RETROPERITONEUM, LYMPH NODES: Moderate/severe arteriosclerosis of the thoracic and abdominal aorta and branch vessels.BOWEL, MESENTERY: Moderate-sized hiatal hernia. Diverticulosis of the descending colon, sigmoid colon without CT evidence of diverticulitis. Small periumbilical hernia containing non obstructed bowel loop. Nonspecific perirectal/perineal fullness may represent rectocele.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Atrophic or absent.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Intramuscular fat attenuation lesion in the proximal left quadriceps muscle, suggestive of lipoma.OTHER: No significant abnormality noted. | 1.No evidence of biloma, cholangitis or diverticulitis.2.Moderate hiatal hernia.3.Cholelithiasis without CT evidence of acute cholecystitis. |
Generate impression based on findings. | Male 56 years old; Reason: 56M with rectal CA s/p LAR with colorectal anastomosis now with weight loss, persistent abdominal pain - please eval for possible anastomotic leak or other source of intraabdominal source of infection History: weight loss, persistent lower abdominal pain ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesions, one in the right hepatic lobe and one in the left hepatic lobe are too small to characterize but unchanged compared to prior CT 07/30/14SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Rectal tube in situ. Postsurgical changes from recent laparoscopic anterior resection with two separate anastomoses. The anastomosed bowel is opacified with rectal contrast. Contrast within the presacral space presumably relates to end-to-side anastomosis with pouch formation/redundant colon within the presacral space. Small pockets of air anterior to this appear to lie within bowel. While no definite leak is identified this cannot be excluded and correlation with single contrast fluoroscopy study would be helpful for clarification.Interval right lower quadrant diverting loop ileostomy formation. Dilated proximal small bowel loops with no transition point likely reflecting ileus.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: Bladder wall thickening, likely relates to non distention.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Please see above.BONES, SOFT TISSUES: Degenerative changes of the lumbar spine.OTHER: No significant abnormality noted. | 1.Postsurgical changes from recent laparoscopic anterior resection and diverting ileostomy. Rectally infused enteric contrast appears to be located within anastomosed bowel. While no definite leak is identified this cannot be completely excluded and if there is high/ongoing clinical suspicion further evaluation with single contrast fluoroscopy study would be helpful.2.Dilated proximal small bowel loops without transition point likely reflects ileus. Consideration can be given to small-bowel follow-through for further evaluation. |
Generate impression based on findings. | Male 34 years old; Reason: eval for obstruction History: abdominal pain/distention, vomiting, h/o pancolectomy for UC 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: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Multiple enlarged retroperitoneal nodes measuring up to 1 cm in short axis dimension. Multiple enlarged mesenteric lymph nodes measuring up to 8 mm in short axis dimension. These are likely reactive.BOWEL, MESENTERY: Enteric contrast remains within the stomach and proximal small bowel. Multiple dilated loops of small bowel measuring up to 3.8 cm. While no discrete transition point is identified the appearance is suspicious for partial small bowel obstruction. A loop of distal ileum demonstrates mural thickening consistent with inflammation (series 3, image 82). A second area of mural thickening and luminal narrowing is identified in the pelvis (series 3, image 115). No located fluid collection. No intra-abdominal free air. Postsurgical changes related to pancolectomy with end-to-end anastomosis of small bowel to anal verge.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Please see above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Dilated small bowel loops consistent with a small bowel obstruction. Two segments of mural thickening and luminal narrowing consistent with inflammation. Appearance is suspicious for inflammatory bowel disease/Crohn's. Consideration should be given to small-bowel follow-through for further evaluation. |
Generate impression based on findings. | acute right hemispheric syndrome, NIHSS-10-15. Onset 1 and 30 min ago There is high attenuation lesion likely within the right MCA M1 segment.However, there is no evidence of acute ischemic or hemorrhagic lesion.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | 1. Most likely a calcified thrombus on the right MCA M1 segment.2. OTherwise unremarkable. |
Generate impression based on findings. | Female 87 years old; Reason: pancreatitis with concern for peritonitis, pleural effusions History: pancreatitis, leukocytosis, effusions CHEST:LUNGS AND PLEURA: Moderate bilateral pleural effusions; left greater than right. There is associated bilateral compressive atelectasis. Left-sided chest drain in situ with tip in the left apex. Small hematoma surrounds the subcutaneous portion of the chest drain. Left upper lobe granuloma.MEDIASTINUM AND HILA: Intrathoracic stomach. Please seen below for description of related findings. Calcified hilar lymphadenopathy suggestive of prior granulomatous process.CHEST WALL: Moderate left glenohumeral joint effusion. Right-sided PICC with tip within the right atrium. Small focus of nonocclusive thrombus within the right axillary vein.ABDOMEN:LIVER, BILIARY TRACT: Cholecystectomy clips.SPLEEN: No significant abnormality noted.PANCREAS: The pancreatic head is enlarged and heterogeneous. There is a main branch IPMN with associated atrophy of the pancreatic body and pancreatic tail without calcifications. Peripancreatic mesenteric stranding is compatible with patient's known history of pancreatitis. Two peripancreatic fluid collections adjacent to the pancreatic tail. The largest measures 2.2 cm (series 3, image 78).A large cystic lesion herniates through the diaphragmatic hiatus and situates itself medial and inferior to the intrathoracic stomach. This cystic lesion appears to arise from the pancreatic neck/proximal body. This measures 5.3 x 7.9 cm (series 3, image 64) and has increased compared to prior study. It exerts moderate mass effect on the left heart.The splenic vein is patent. Splenic artery appears patent. Moderate ascites is noted. Nondependent, loculated fluid along the anterior abdominal wall with rim enhancement consistent with peritonitis.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mild diffuse distention of contrast opacified small bowel in the right lower quadrant compatible with ileus. No clear transition point is identified. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Rim enhancing pelvic fluid consistent with peritonitis.BONES, SOFT TISSUES: Diffuse anasarca. Severe degenerative disease affects the hips and sacroiliac joints.OTHER: No significant abnormality noted. | 1.Pancreatitis with peripancreatic fluid collections. The largest extends into the left hemithorax adjacent to the thoracic stomach and measures 7.9 cm in maximum dimension. While these may represent peripancreatic pseudocysts developing abscesses are not excluded.2. Heterogeneous appearance to the pancreatic head. Underlying pancreatic mass is not excluded and correlation with recent EUS is recommended regarding the need for additional imaging.3. Dilation of the main pancreatic duct without calcifications consistent with main branch IPMN.. |
Generate impression based on findings. | Chest pain. Evaluate for PE. EPIC history: dermatomyositis s/p chemo PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Septal lines suggestive of mild interstitial edema.Subsegmental atelectasis in the lingula.Calcified nodules consistent with healed prior infection.No suspicious pulmonary nodules.No pleural effusion.MEDIASTINUM AND HILA: Prominent nonspecific mediastinal lymph nodes. Moderate cardiomegaly without pericardial effusion. No visible coronary artery calcification.CHEST WALL: Right chest wall port tip in the SVC.Mild degenerative changes of the spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Cholecystectomy clips.Colonic diverticula. | No evidence of pulmonary embolism. Mild interstitial edema due to CHF.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 77 years old; Reason: r/o obstruction History: abd distension, n/v/bladder cancer with urostomy ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Subcentimeter hypoattenuating focus in the posterior right hepatic lobe is too small to characterize but is stable compared to prior study.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 6.1 x 5.3-cm bilobed hypoattenuating renal lesion is most consistent with a renal cyst. Hypoattenuating left renal lesion is too small characterize. Urinary diversion to a right lower quadrant urostomy.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Dilated proximal small bowel loops measuring up to 4.5 cm (series 3, image 68) with a transition point adjacent to the point of exit of patient's urostomy (series 3, image 76). Enteric contrast passes through this area. The distal small bowel and the large bowel are decompressed. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Partial small bowel obstruction secondary to adhesions in the region of patient's urostomy exit point. |
Generate impression based on findings. | Male 59 years old; Reason: source for sepsis, immunosuppressed History: florid sepsis CHEST:LUNGS AND PLEURA: Postsurgical changes relating to bilateral lung transplant. Bilateral pleural effusions, large on the right, mild on the left. There is deviation of the mediastinum to the left side with volume loss in the left lung, likely reflecting mass effect from the right pleural effusion. The right pleural effusion is heterogeneous with attenuation higher than the simple fluid, likely reflecting blood contents. There is bilateral volume loss within both lungs.Left-sided chest drain in situ with tip posteriorly at the level of the pulmonary veins.MEDIASTINUM AND HILA: Two left-sided central venous catheters with tip in the SVC/right atrium. Endotracheal tube in situ.CHEST WALL: Post sternotomy changes. There is a moderate right subpectoral/pectoral hematoma measuring approximately 12.1 x 4.4 cm (series 3, image 66) .There is a focal area of active extravasation of contrast in this region (series 3, image 41) consistent with active bleeding.ABDOMEN:LIVER, BILIARY TRACT: The liver is deviated towards the midline by the above described right pleural collection. Areas of infiltrative hypoattenuation involving the right hepatic lobe. There is no distortion of the hepatic vasculature which courses through this abnormality. This likely represents focal infarction/focal fat.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Focal bilateral wedge-shaped hypoattenuating areas within kidneys are nonspecific but likely focal infarction/infection.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Gastrojejunostomy tube in situ.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Small pockets of free intraperitoneal air may relate to gastrojejunostomy tube. Trace perihepatic fluid with layering material, , likely reflecting extension of hemorrhagic pleural fluid.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Foley catheter within the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Right inguinal fluid without loculation may relate to prior catheterization/hernia repair. Trace pelvic fluid without loculation. | 1.Active right subpectoral bleed with probable extension to the right pleural cavity. Complex large right pleural collection, likely representing hemothorax. There is resulting mediastinal deviation and volume loss within both lungs.2.Hepatic infarction/fat deposition.3.Bilateral renal infarction/infection.4.Punctate foci of free peritoneal air likely relate to gastrojejunostomy tube.Findings discussed by radiology resident with referring service at time of study as documented in stat consult. |
Generate impression based on findings. | Female 68 years old; Reason: r/o obstruction/abscess/colitis History: suprapubic abd pain, b/l flank pain The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made:ABDOMEN:LUNG BASES: Mild basal scarring/atelectasisLIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Nonspecific thickening of the left adrenal gland.KIDNEYS, URETERS: No renal calculus. No hydronephrosis. RETROPERITONEUM, LYMPH NODES: Moderate arteriosclerosis of the abdominal aorta and branch vessels. The distal aorta measures 2.6 cm immediately proximal to the bifurcation.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Enteric contrast passes to the rectum. There is a narrow neck paraumbilical hernia containing non obstructed loop of transverse colon. Sigmoid diverticulosis without CT evidence of diverticulitis. Apparent mural thickening involving the sigmoid colon and rectum without stranding of the adjacent mesentery is felt likely to relate to underdistention. The bowel wall is incompletely evaluated in the absence of intravenous contrast.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Please see above.BONES, SOFT TISSUES: Right total hip prosthesis in situ.OTHER: No significant abnormality noted. | No specific cause for patient's symptoms. |
Generate impression based on findings. | 10-year-old male with CVAVIEWS: Chest AP/lateral (two views) 3/6/15 20:19 The cardiothymic silhouette is normal. The aortic arch, cardiac apex and stomach are left-sided. No focal pulmonary opacity or pleural effusion. Right density projecting over the anterior left sixth rib likely represents a nipple shadow. | Normal examination. Density projecting over the anterior left sixth rib likely represents a nipple shadow. |
Generate impression based on findings. | 9-month-old female with chronic wound on heelVIEWS: Two views of the right ankle, AP and oblique (2 views), right foot AP and lateral (2 views) chest, AP (one view) 3/6/15 22:18 Foot and ankle: Soft tissue defect posterior to the calcaneus. Diffuse soft tissue swelling. The bone are diffusely demineralized although there is no discrete underlying cortical erosion or osteolysis. There is the suggestion of chronic periosteal reaction involving the calcaneus.Chest radiograph: Right PICC tip in the SVC. The cardiothymic silhouette is normal. Bronchial wall thickening and subsegmental atelectasis without consolidation or pleural effusion. | 1. Diffuse osseous demineralization as well as soft tissue defect and swelling without discrete erosion. If there is continued clinical concern for osteomyelitis MRI is recommended for further evaluation.2. Bronchiolitis without evidence of pneumonia. |
Generate impression based on findings. | Female 61 years old Reason: r/o new fracture History: back pain,. Evaluation is limited due to overlying gas and stool, particularly at the lower lumbar spine. Five views of the lumbar spine again show a compression fracture of L1 of indeterminate age, with approximately 50% loss of vertebral body height. Moderate to severe degenerative arthritic changes affect the L5/S1 joint. The bones appear demineralized.Two views of the hip show no acute fracture or malalignment. Mild osteoarthritic changes affect the left hip.Single AP view of the pelvis shows no acute fracture or dislocation. Mild osteoarthritic changes affect the bilateral hips. | Age indeterminate compression fracture of L1 without interval change. |
Generate impression based on findings. | Left-sided weakness and altered mental status. Evaluate for hemorrhage and ischemia. There is no evidence of acute intracranial hemorrhage or mass effect. There is parenchymal volume loss. The ventricles and basal cisterns are otherwise in size and configuration. There are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with mild age-indeterminate small vessel ischemic changes. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. There are bilateral lens implants. | Age-indeterminate small vessel ischemic disease without evidence of acute intracranial hemorrhage or mass effect. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern and there are no contraindications, MRI of the brain is recommended.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 20 years old Reason: eval for acute process, L jaw pain s/p ran onto someone's shoulder History: pain w/ mouth opening. There is no acute fracture or dislocation. Alignment is preserved. The temporomandibular joints appear unremarkable. | No acute fracture or dislocation. If additional imaging is clinically warranted, CT is recommended. |
Generate impression based on findings. | 10-year-old female with right knee painVIEWS: Right knee, AP, oblique, and lateral, and sunrise (4 views) 3/6/15 23:13 Alignment anatomic. No fracture is evident. A small joint effusion is noted. Fibrous cortical defect within the medial proximal fibula. | Small joint effusion without fracture or malalignment. |
Generate impression based on findings. | DesaturationVIEW: Chest AP and abdomen AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Umbilical catheters again noted. Cardiothymic silhouette normal. Patchy atelectasis right upper lobe improved from prior study. Minimal patchy atelectasis left lower lobe. No pleural effusion or pneumothorax. There is a urinary catheter in place. Paucity of bowel gas within the abdomen. No evidence of pneumoperitoneum. There is a loop of catheter projected over the nasopharyngeal region and may be external in location. | Right upper lobe atelectasis improved when compared to the prior study. |
Generate impression based on findings. | Metastatic lung cancer with liver mets. EGFR +, on Erlotinib now, but clinically PD, increased pain. Compare to previous study and evaluate disease status. CHEST:LUNGS AND PLEURA: Lingular mass abutting the left cardiac border is 33 x 27 mm (series 4, image 53), previously 30 x 27 mm.Increased left lung base patchy consolidation with bronchiectasis, likely post-radiation change and atelectasis.Left basilar pleural thickening/small loculated effusion, unchanged.Scattered areas of bronchial impaction in the right lung.No new suspicious pulmonary nodules.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Normal heart size without pericardial effusion. No visible coronary artery calcification.CHEST WALL: Small sclerotic focus in T8 vertebral body, unchanged, and suspicious for metastasis.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Interval increased size of some of the bilobar hepatic metastases.Reference left hepatic lobe lesion is 21 mm, previously 15 mm (series 4, image 103).SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No lymphadenopathy. Mild atherosclerotic disease of the abdominal aorta.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Sclerotic foci in the L2 and L5 vertebral bodies, unchanged, and suspicious for metastases. Left iliac wing metastasis, unchanged.OTHER: No significant abnormality noted. | Increased size of hepatic metastases. New left lung base patchy consolidation and mild bronchiectasis, likely related to posttreatment change. |
Generate impression based on findings. | Male 53 years old Reason: r/o fx/dislocation History: pain after fall. No acute fracture or dislocation. Note is made of surgical anchors within the humeral head. Moderate degenerative arthritic changes of the shoulder joint and mild degenerative arthritic changes affect the acromioclavicular joint. | No acute fracture or dislocation. |
Generate impression based on findings. | DesaturationVIEW: Chest AP ET tube tip at the level of the thoracic inlet. NG tube tip in the stomach. The esophageal temperature probe tip in the nasopharyngeal airway. Note that there is a loop of catheter at the nasopharyngeal airway and may represent a loop of the nasogastric tube. Umbilical catheters unchanged. Cardiothymic silhouette normal. Right upper lobe atelectasis new from prior study. No pleural effusion or pneumothorax. | Right upper lobe atelectasis new from prior study. There is a loop of catheter in the nasopharyngeal airway and may represent a loop of the nasogastric tube. |
Generate impression based on findings. | 3 year old male with history of right brachial plexus injury, concern for dysplasia. Compare development of the right upper extremity to the normal left upper extremity. Right shoulder: Normal alignment of the humerus with the humeral head situated within the glenoid cavity. Normal variant fragmentation of the humeral epiphysis. No evidence of fracture or dislocation.Left shoulder: Normal alignment of the humerus with the humeral head situated within the glenoid cavity. Normal variant fragmentation of the humeral epiphysis. No evidence of fracture or dislocation.Dependent atelectasis is noted in the lungs. | Normal examination. |
Generate impression based on findings. | Bronchiolitis evaluate lungVIEW: Chest AP and abdomen AP ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Right central line with tip in the SVC. There is a urinary catheter in place. Cardiothymic silhouette normal. Patchy atelectasis in the right lung and left lower lobe improved from prior study. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Bilateral patchy atelectasis improved from prior study. |
Generate impression based on findings. | 7 day old male, clamped chest tubeVIEW: Chest AP (one view) 3/6/15 18:09 Right chest tube is directed medially. ETT tip above the carina. Enteric tube side-port at the GE junction. UVC in the right atrium. The cardiothymic is normal.Streaky bilateral pulmonary opacities are unchanged. Small lucencies suggest PIE. Lucency at the right base suggests a trace residual pneumothorax. | Unchanged hazy lung opacities and PIE. Trace residual right pneumothorax. |
Generate impression based on findings. | 15-week-old female with respiratory distressVIEWS: Chest AP/lateral (two views) 3/7/15 4:13 A central venous catheter tip in the right atrium. ETT below the thoracic inlet. Enteric tube extends and view. Left chest tube catheter tip directed medially.Extensive bilateral pulmonary opacities and pleural effusions appear slightly worse than the prior exam. Unchanged left pneumothorax. | Increased bilateral pulmonary opacities and pleural effusions and unchanged left pneumothorax. |
Generate impression based on findings. | Female 49 years old Reason: fracture History: pain, swelling. There is no acute fracture or dislocation. There are scattered mild to moderate degenerative changes, which appear more increased distally and include a focal ossicle seen at the radiocarpal joint. Mild soft tissue swelling cannot be excluded. | No acute fracture or dislocation. |
Generate impression based on findings. | 15-week-old female, evaluate chest tube placementVIEW: Chest AP (one view) 3/6/15 21:06 ETT above thoracic inlet. Right central venous catheter tip in right atrium. Left chest tube is directed medially. Bilateral patchy airspace opacities and pleural effusions, slightly worse than on the prior exam. Left pneumothorax is not significantly change. | Decreased lung volumes and slightly worsened pulmonary opacities with unchanged left pneumothorax. |
Generate impression based on findings. | 29-year-old female with history of VP shunt and headache. Evaluate for hydrocephalus. There is an unchanged right frontal approach ventriculostomy catheter that terminates at expected location of the foramen of Monroe. There is an additional catheter which is incompletely imaged with tip located at the level of the foramen magnum. There is no significant change in ventricular size and configuration. There is no evidence of acute intracranial hemorrhage. There is an unchanged punctate calcification in the left frontal lobe. There is crowding at the foramen magnum with low-lying cerebellar tonsils. The imaged paranasal sinuses, mastoid air cells, and orbits are unremarkable. | 1. No evidence of acute intracranial hemorrhage.2. No significant interval change in the appearance of the shunted ventricular system3. Findings compatible with Chiari I malformation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | ARDSVIEW: Chest AP ET tube tip at the level of the thoracic inlet. Left upper extremity PICC with tip in the SVC. There is a gastrostomy tube in place with multiple surgical clips at the GE junction. Cardiothymic silhouette normal. There is a small amount of pneumomediastinum. The right apical pneumothorax is not significantly changed. Patchy atelectasis right lower lobe and left lower lobe. | Pneumomediastinum new from prior study. The small right apical pneumothorax is unchanged. |
Generate impression based on findings. | Mediastinal mass resectionVIEW: Chest AP Left chest port in place. There is a left chest tube in place. The epidural catheter again noted. The small left apical pneumothorax is unchanged. There is subcutaneous emphysema in the left supraclavicular region and left axilla. Cardiothymic silhouette normal. Patchy atelectasis in the right lower lobe and left lower lobe. | Left apical pneumothorax and subcutaneous emphysema not significantly changed. |
Generate impression based on findings. | Resection of posterior mediastinal massVIEW: Chest AP Left chest tube in place. There are surgical clips and staples projected over the left perihilar region. Cardiothymic silhouette normal. Bilateral patchy lung opacities increased in the interval with low lung volumes new from prior study. No pleural effusion or pneumothorax. | Bilateral patchy opacities likely atelectasis increased from prior study. |
Generate impression based on findings. | 96-year-old female with history of fall. Evaluate for intracranial hemorrhage. There is no evidence of acute intracranial hemorrhage. There is prominence of the sulci and ventricles that is most pronounced in the medial temporal lobes. There is mild periventricular and subcortical white matter hypoattenuation. There is no midline shift or mass-effect. The basal cisterns are patent. The imaged paranasal sinuses and mastoid air cells are clear. The orbits are unremarkable. The calvarium and soft tissues are within normal limits. | 1. No evidence of acute intracranial hemorrhage or skull fracture.2. Cerebral volume loss that is most pronounced in the medial temporal lobes is suggestive of Alzheimer's disease. 3. Probable mild age indeterminate ischemic small vessel disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 12-year-old male with recent flu infectionVIEW: Chest AP (one view) 3/7/15 3:03 ETT above the carina. A right PICC in the SVC. The cardiothymic silhouette is normal. Patchy bilateral pulmonary opacities and subsegmental atelectasis appear slightly improved from the prior exam. No pneumothorax.Thoracolumbar dextroscoliosis. | Improved pulmonary opacities. No pneumothorax. |
Generate impression based on findings. | Female 21 years old with myelopathy. Three views of the thoracic spine show no acute fracture or malalignment. The thoracic vertebral body heights and intervertebral disk spaces are preserved.Three views of the lumbar spine show no acute fracture. Alignment is preserved. | No acute fracture or dislocation. Alignment of the thoracic and lumbar spines is preserved. |
Generate impression based on findings. | DesaturationVIEW: Chest AP ET tube tip immediately above the carina. NG tube tip at the GE junction. Cardiothymic silhouette normal. Minimal patchy atelectasis right lower lobe. Again noted metallic hardware at the mandibles bilaterally. | Minimal patchy atelectasis right lower lobe. |
Generate impression based on findings. | 4-year-old male with history of drowsiness and altered mental status. There is no evidence of acute intracranial hemorrhage. The ventricles and sulci are no enlarged. The gray white differentiation is preserved. The basal cisterns are patent. There is no midline shift or mass effect. There is partial opacification of the right mastoid air cells and middle ear. There is diffuse paranasal sinus opacification with suggestion of fluid levels. The calvarium and scalp soft tissues appear to be intact. | 1. No evidence of acute intracranial hemorrhage.2. Partial opacification of the right mastoid air cells and middle ear may indicate otomastoiditis. 3. Diffuse paranasal sinus opacification with suggestion of fluid levels may represent acute sinusitis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 63-year-old with uncontrolled diabetes and hypertension now with progressive bilateral lower extremity weakness and slight right facial droop. Evaluate for acute CVA. There is no evidence of acute intracranial hemorrhage. There are areas of low attenuation in the right occipital lobe and left pons. There is also subtle hypoattenuation in the right centrum semiovale, and medial right basal ganglia. There are additional scattered areas of abnormal low attenuation in the periventricular and subcortical white matter. There is an extra-axial ossified mass along the left frontal convexity that measures up to 7 mm in width without significant mass effect upon the adjacent brain parenchyma. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | 1. No acute intracranial hemorrhage.2. An area of low attenuation in the right occipital lobe and pons likely represent age-indeterminate infarcts, but likely subacute or chronic. Subtle hypoattenuation in the right centrum semiovale and medial right basal ganglia may also age-indeterminate infarcts, but are likely chronic. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern and there are no contraindications, MRI of the brain is recommended.3. An extra-axial ossified mass along the left frontal convexity that measures up to 7 mm in width without significant mass effect upon the adjacent brain parenchyma may represent a meningioma or osteoma. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | IntubatedVIEW: Chest AP ET tube tip at the level of the thoracic inlet. Right upper extremity PICC with tip in the right atrium. Cardiothymic silhouette normal. Patchy atelectasis right lower lobe and left lower lobe improved from prior study. No pleural effusion or pneumothorax. | Bilateral patchy atelectasis improved from prior study. |
Generate impression based on findings. | Female 44 years old Reason: post op History: post op. Limited single AP view of the left shoulder show components of a reverse total shoulder arthroplasty situated in anatomic alignment without radiographic evidence of hardware complication. Discontinuity of the greater tuberosity as well as a bone fragment along the medial aspect of the humeral neck , presumably representing prior osteotomy, are unchanged from prior exam. The distal humerus appears intact. | Reverse left total shoulder arthroplasty. |
Generate impression based on findings. | Recent scalenectomy. Chest pain. Evaluate for PE. PULMONARY ARTERIES: No evidence of pulmonary embolism.LUNGS AND PLEURA: Small left pleural effusion. Adjacent small left lower lobe wedge-shaped groundglass opacity, suspicious for an infarct.Right upper lobe micronodule, most likely benign and post-inflammatory in a low risk patient.MEDIASTINUM AND HILA: Scattered small mediastinal lymph nodes. No hilar lymphadenopathy.Normal heart size without pericardial effusion. No visible coronary artery calcification.CHEST WALL: Post-surgical findings of left first rib resection with apical mild extrapleural soft tissue thickening, likely representing evolving hematoma and scarring.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No evidence of pulmonary embolism.2. Small left pleural effusion with adjacent wedge shaped ground glass opacity suspicious for a pulmonary infarct. Doppler ultrasound of the lower extremities may be considered to assess for DVT.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 19 year-old male found down on the street. Evaluate for hemorrhage. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is opacification of the left maxillary sinus, which is suggestive of retention cyst formation, but this is partially imaged. The remaining imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | No evidence of acute intracranial hemorrhage.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 63 years old Reason: S/p Lt knee unicompartmental arthroplasty History: S/p Lt knee unicompartmental arthroplasty. Hardware components of a left medial unicompartmental arthroplasty device are situated in near anatomic alignment with no radiographic evidence of hardware complication. Skin staples, surgical drain, and overlying foci of gas reflect recent surgery. | Left unicompartmental arthroplasty. |
Generate impression based on findings. | 48-year-old female with history of aneurysm clipping. Head CT: Streak artifact from aneurysm clip limits evaluation. There are postoperative findings related to right pterional craniotomy with an aneurysm clip in the expected location of the MCA bifurcation. There is an associated small mixed density subdural fluid collection measuring 5 mm, as well as a small amount of pneumocephalus. Tiny hyperdense foci adjacent to the aneurysm clip may represent minimal intraparenchymal hemorrhage. There is a moderate amount of subcutaneous emphysema adjacent to the craniotomy site tracking anteriorly into the right periorbital soft tissues. There is no evidence of midline shift or mass effect. The gray-white differentiation appears grossly preserved. There is mild mucosal thickening in the imaged paranasal sinuses. The mastoid air cells are clear.Head CTA: Assessment is limited due to streak artifact from the aneurysm clip. Nevertheless, the right MCA is opacified distal to the aneurysm clip. There is no evidence of significant intracranial stenosis or additional aneurysms. The right ophthalmic artery arises from the right cavernous internal carotid artery, which is an anatomic variant. | 1. Postoperative changes of right pterional craniotomy with aneurysm clip at the expected location of the right MCA bifurcation with a small subdural mixed density fluid collection, pneumocephalus, and perhaps minimal intraparenchymal hemorrhage adjacent to the aneurysm clip are postoperative in etiology. 2. Moderate postoperative subcutaneous emphysema tracks extends into the right periorbital soft tissues.3. The MCA branches distal to the aneurysm clip appear to be patent, although metal artifact limits assessment.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 44 years old; Reason: Evaluate for constipation History: N/V, no BM Postsurgical changes with median sternotomy.No pneumoperitoneum. Scattered air fluid levels. Stool in the rectum. Scattered dilated loops small bowel with gas in the colon favor ileus type pattern. If symptoms persist consider repeat radiographs or CT. | 1.Findings suggestive of an ileus. |
Generate impression based on findings. | Evaluate right pleural effusion. Shortness of breath. LUNGS AND PLEURA: Interval removal of right Pleurx catheter.Moderate loculated right pleural effusion with interval resolution of air. Associated pleural thickening.Left upper lobe perifissural nodule is significantly larger at 12 mm (series 5, image 33), previously 6 mm. The other innumerable bilateral pulmonary metastases, not significantly changed. New diffuse groundglass opacity in the left lung that may represent atypical edema, hemorrhage, or aspiration.Small left pleural effusion, increased from prior.Persistent right middle lobe atelectasis/consolidation.MEDIASTINUM AND HILA: Scattered small mediastinal lymph nodes, unchanged.Normal heart size without pericardial effusion., unchanged.Low-density blood pool consistent with anemia.No visible coronary artery calcification.Left PICC tip at the cavoatrial junction.CHEST WALL: Bilateral mastectomies and axillary lymph node dissection. No axillary lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Loculated moderate right pleural effusion with associated pleural thickening.2. New diffuse groundglass opacity in the left lung, may represent atypical edema, hemorrhage, or aspiration.3. Innumerable pulmonary metastases without significant interval change except for a left upper lobe nodule that is larger. |
Generate impression based on findings. | Female, 19 years old.Radiopaque foreign body evaluationSigns and Symptoms: Comments: Surgical Case Information | Procedure(s): Procedure(s) with comments: | LAPAROSCOPIC COLECTOMY | CYSTOSCOPY STENT PLACEMENT/EXCHANGE - cystoscopy, left stent placement ( 6x 22) | LAPAROSCOPIC SALPINGO OOPHORECTOMY - Procedure: Left Salpingectomy | Operating Room: CDOR 17 CENTRAL | Surgeon(s) and Role: | Panel 1: | * Lisa Marie Cannon, M.D. - Primary | * Megan Miller | * Benjamin C. James, M.D. - Fellow | * Neil H Hyman, M.D. - Assisting | Panel 2: | * Scott E. Eggener, M.D. - Primary | * Blake David Alberts, M.D. - Resident - Assisting | * Melanie Anne Adamsky, M.D. - Resident - Assisting | Panel 3: | * Sarah Collins, M.D. - Primary | Left nephrostomy catheter. Enteric tube terminates the region of the distal gastric body.There are postsurgical changes with multiple surgical staple lines in the abdomen and pelvis. There is scattered free intraperitoneal air. No unexpected radiopaque foreign body. | No unexpected radiopaque foreign body.Findings discussed with Dr. Miller by telephone in OR 17 at 2043 3/6/2015 by Dr. Alexander |
Generate impression based on findings. | Female 84 years old; Reason: assess for ileus, distention History: abd distention Mild gaseous distention of colon which contains small amount of stool.Enteric tube projects over the distal gastric body. Calcification of the pelvis, possibly representing uterine fibroids.Bilateral pulmonary space opacities suboptimally evaluated. | 1.Possible colonic ileus. |
Generate impression based on findings. | Male 67 years old; Reason: Dobbhoff placement History: s/p cardiac arrest, cooling and rewarming. Pending neurologic assessment. Dobbhoff placed for tube feeds. Enteric tube terminates in the antropyloric region. The bowel gas pattern is nonobstructive. | 1.Enteric tube terminates in the antropyloric region. |
Generate impression based on findings. | New onset seizure. There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No evidence of intracranial hemorrhage or mass effect.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 65 years old; Reason: US with Evidence of ? of Distal Obstruction of the Distal Bile Duct,. This Add CT with Attention to the Liver. History: US with Evidence of ? of Distal Obstruction of the Distal Bile Duct,. This Add CT with Attention to the Liver. ABDOMEN:LUNG BASES: Left basilar atelectasis.LIVER, BILIARY TRACT: Liver has normal morphology. No focal hepatic lesions. The hepatic and portal veins are patent.Gallbladder contains small calculi. Common bile duct is normal in caliber.SPLEEN: No significant abnormality noted.PANCREAS: Pancreatic duct measures 3 mm. no focal solid pancreatic mass is evident.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Probable bilateral renal cysts. No hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Cholelithiasis without biliary duct dilatation. If there is clinical suspicion for choledocholithiasis recommend M.R.C.P. |
Generate impression based on findings. | Traumatic brain injury from fall. Evaluate for intracranial hemorrhage or fracture. Head: There is no evidence of intracranial hemorrhage or mass effect. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. The cerebellar tonsils extend approximately 5 mm below the level of the foramen magnum and the posterior fossa compartment appears to be relatively small. The mastoid air cells are clear. The scalp soft tissues are unremarkable. There is no acute calvarial or facial fracture.Maxillofacial: There is no evidence of orbital or other maxillofacial fractures. There is no evidence of retrobulbar hematoma. The bilateral globe and ocular adnexa appear to be intact. The temporomandibular joints are intact. Aside from a punctate right maxillary sinus retention cyst, the paranasal sinuses are clear. | 1. No evidence of acute intracranial hemorrhage or mass effect. No acute calvarial or facial fracture.2. The cerebellar tonsils extend approximately 5 mm below the level of the foramen magnum and the posterior fossa compartment appears to be relatively small, which may indicate a Chiari 1 malformation.3. No evidence of maxillofacial fracture or retrobulbar hematoma.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 63 years old; Reason: eval for sbo, no bm in 1 week, hypoactive bowel sounds History: eval for sbo, no bm in 1 week, hypoactive bowel sounds Nonspecific bowel gas pattern. There is a pocket of gas within the colon in the right lower abdomen. There is mild gaseous distention of the stomach. The remainder of the abdomen is gasless. | 1.Nonspecific bowel gas pattern. |
Generate impression based on findings. | Male 57 years old; Reason: NG placement History: NG placement Severe gaseous distention of the colon which narrows in the left lower abdomen in the region of the patient's known sigmoid mass.Enteric tube terminates under the left hemidiaphragm in the region of the gastric body. | 1.Enteric tube terminates in the region of the gastric body |
Generate impression based on findings. | 43-year-old female with altered mental status. A well-defined region of encephalomalacia within the right occipital lobe appears similar to prior. There is no evidence of acute intracranial hemorrhage. There is advanced volume loss for age. No midline shift or mass-effect. The ventricular configuration and size is stable, with evidence of diffuse cerebral volume loss. The imaged paranasal sinuses are minimally opacified. There is partial opacification of bilateral mastoid air cells. There has been a left enucleation with globe prosthesis present. The right orbit is unremarkable. | 1. No evidence of acute intracranial hemorrhage. However, CT is insensitive for the detection of acute non-hemorrhagic infarction. An MRI may be obtained if clinically warranted and there are no contraindications.2. Advanced cerebral volume loss for age and a chronic right occipital lobe infarction appear unchanged.3. Partial opacification of bilateral mastoid air cells may represent mastoiditis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 76 years old; Reason: obstruction History: abdominal pain, vomiting Gas is noted throughout the colon with stool in the rectum. There is a mild dilated loops of small bowel in the upper abdomen.Severe degenerative changes affects the lower lumbar spine and hips. | 1.Dilated loops of small bowel and colon. |
Generate impression based on findings. | Male 64 years old; Reason: right femoral dialysis line placement History: uremia Mild gaseous distention of the small bowel loops.Right femoral vascular catheter. Postsurgical changes with clips and an IVC filter. Radiopaque foreign bodies are projected over the T12/L1 vertebral body.Postsurgical changes in the left hip. | Possible ileus |
Generate impression based on findings. | Upper left chest wall mass. CHEST:LUNGS AND PLEURA: Calcified nodules consistent with healed granulomatous disease. No suspicious pulmonary nodules. No evidence of pleural metastases.MEDIASTINUM AND HILA: Calcified mediastinal and hilar nodes consistent with healed prior infection. No lymphadenopathy.No visible coronary artery calcification. No pericardial effusion.Incompletely imaged right paraglottic mass, refer to same day CT soft tissue neck report for further details.Nonspecific thyroid nodule.CHEST WALL: Left medial chest wall mass invading the muscle is 19 x 35 mm (series 3, image 53), new from prior; suspicious for a metastasis.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Two hepatic hypodense lesions suspicious for metastases. A right hepatic lobe lesion is 15 x 12 mm (series 3, image 81).Cholelithiasis.SPLEEN: Unchanged severe splenomegaly with enlarged splenic vasculature. Few punctate nonspecific splenic hypodensities (series 3, image 78).Calcified splenic granulomas.Capsular calcification of the spleen with thin peripheral hypodensity, may be sequelae of remote hematoma/trauma.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Significant streak artifact from barium in the right colon obscures adjacent anatomy.BONES, SOFT TISSUES: Severe compression deformity of L2 vertebral body with grade 1 retrolisthesis and angulation of L1 on L2, unchanged.OTHER: No significant abnormality noted. | 1. Left medial chest wall mass invading the muscle is new from prior, suspicious for a body wall metastasis.2. Two hypodense hepatic lesions, suspicious for metastasis.3. Unchanged marked splenomegaly and L2 severe compression deformity.4. Right paraglottic mass, refer to same day CT soft tissue neck report for further details. |
Generate impression based on findings. | Female 42 years old; Reason: obstruction History: emesis Severe bilateral air space opacities.Percutaneous catheter terminates over the stomach body.Moderate colonic fecal matter in a nonobstructive pattern. No significant small bowel dilatation. | 1.Moderate colonic fecal matter.2.Suboptimal evaluation of free air and bowel obstruction consider decubitus radiographs. |
Generate impression based on findings. | 59-year-old male with history of prior stroke and balance problem There is no evidence of acute intracranial hemorrhage. There is mild periventricular and subcortical white matter hypoattenuation. The gray-white differentiation otherwise appears to be preserved. The basal cisterns are patent. No midline shift or mass effect. The mastoid air cells are clear. There is a small amount of fluid in the left maxillary sinus. There are partially-imaged postoperative findings in the anterior maxillary sinus regions. The imaged orbits are unremarkable. The scalp soft tissues are unremarkable. The calvarium is dolichocephalic. There is deficiency of the left mandibular condyle and glenoid fossa. There are | 1. No evidence of acute intracranial hemorrhage.2. Mild age indeterminate small vessel ischemic disease. Please note that CT is insensitive for the detection of acute nonhemorrhagic infarction. An MRI may be obtained if clinically warranted and there is no contraindication.3. Deficiency of the left mandibular condyle and glenoid fossa may be related to remote trauma. 4. A small amount of fluid in the left maxillary sinus may represent acute sinusitis in the appropriate clinical setting.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 35-year-old female status post aneurysm clipping now with altered mental status. Redemonstrated are postoperative changes of left pterional craniotomy with pneumocephalus and a small mixed attenuation subdural fluid collection. An aneurysm clip is present adjacent to the left anterior clinoid process. There is no mild hypoattenuation in the temporal and frontal lobes along the surgical approach. The imaged paranasal sinuses, mastoid air cells, and orbits are unremarkable. There is moderate periorbital soft tissue swelling which has increased. | 1. Postoperative findings of aneurysm clipping with mild hypoattenuation in the left temporal and frontal lobes along the surgical approach, which may represent edema.2. Increasing left periorbital swelling.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 29 years old; Reason: evaluate gas pattern History: abdominal pain The bowel gas pattern is nonobstructive. Small calcific density projects in the region of the right kidney. | 1.Nonobstructive bowel gas pattern |
Generate impression based on findings. | Male 76 years old; Reason: evaluation of adrenal lesion History: same ABDOMEN:LUNG BASES: There are pacer leads in the heart. There multiple subcarinal and mediastinal lymph nodes: Partially evaluated.LIVER, BILIARY TRACT: Liver is normal in morphology. There are at least two hypodense lesions in the liver a lesion near the dome of the liver near segment 8 ; the larger lesion measures 1.2 x 1.7 cm (image 22/series 6). The hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Right adrenal gland measures 4.4 cm while the left adrenal gland measures 3.2 cm. The right adrenal gland measures 5 Hounsfield units on a noncontrast exam and is characteristic of an adenoma.Left adrenal gland has washout characteristics measuring approximately 50% and thus is indeterminate. Its imaging features still favor an adenoma.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Right adrenal adenoma.2.Left adrenal lesion is considered indeterminate by washout characteristics but still favors adenoma.3.Indeterminate hepatic lesion. |
Generate impression based on findings. | 52-year-old female status post craniotomy for tumor resection. There are postoperative changes of left pterional craniotomy and resection of left middle cranial fossa mass. There is moderate pneumocephalus and a small amount of layering blood within the resection cavity. There is persistent extensive edema within the left temporal lobe. There is approximately 6 mm of rightward midline shift. There is uncal medialization. The imaged paranasal sinuses, mastoid air cells, and orbits are unremarkable. | 1. Interval postoperative changes of left middle cranial fossa tumor resection including pneumocephalus and a small amount of hemorrhage within the surgical cavity. 2. Persistent left temporal lobe edema and rightward midline shift. Assessment for residual tumor is otherwise limited on non-contrast CT.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 57 years old; Reason: r/o acute abnormalities History: s/p percutaneous drainage, abdominal pain ABDOMEN:LUNG BASES: Small bilateral pleural effusions.LIVER, BILIARY TRACT: A right percutaneous there is stent terminates within the duodenum. There is contrast within the biliary tree, previously injected.Extensive hematoma is noted surrounding the right hepatic lobe and in the peritoneum. SPLEEN: Extensive perisplenic hematomaPANCREAS: Pancreatic stent terminates within the duodenum.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Probable retained contrast within the renal collecting system.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Upright abdominal hematomaPELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Pelvic ascites and hematoma | 1.Large perihepatic, abdominal and pelvic hematoma possibly from recent PTC placement.2.Patient's known pancreatic or biliary mass is not evident |
Generate impression based on findings. | Male 42 years old; Reason: r/o stone History: ruq and right flank pain, hematuria The absence of intravenous and oral contrast limits evaluation of the solid organs and of the bowels. Given these limitations, the following observations were made: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: No significant abnormality noted.KIDNEYS, URETERS: Non obstructing right renal calculi. The largest is in the lower pole and measures 8 mm (series 3, image 46). There is no hydronephrosis or perinephric stranding. Punctate calcifications in the pelvis likely represents phleboliths. RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Non obstructing right renal calculi. |
Generate impression based on findings. | Chest pain, pleurisy. Evaluate for PE. PULMONARY ARTERIES: No to pulmonary embolism.LUNGS AND PLEURA: Small bilateral pleural effusions, greater on the right.Dense basilar dependent atelectasis and possibly aspiration.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.No pericardial effusion.No visible coronary artery calcification.CHEST WALL: Multiple wires enter the anterior upper abdominal wall and terminate under the central diaphragm. Mild soft tissue thickening around the wires within the subcutaneous tissues.Mild degenerative changes of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Postsurgical findings of prior cholecystectomy and gastric bypass surgery.Rim calcified distal splenic artery 9-mm aneurysm (series 7, image 236). | No evidence of pulmonary embolism. New small bilateral pleural effusions with dense dependent atelectasis and/or aspiration.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | And suturing following glass laceration. Injury occurred 7 days ago. Minimal irregularity involving the base of the fifth digit, correlating with the suspected laceration. Mild soft tissue swelling without underlying radiopaque foreign body or additional osseous abnormality.Ulnar minus variant observed | Soft tissue changes involving base of the fifth finger without underlying osseous acute abnormalities. No radiopaque foreign body observed |
Generate impression based on findings. | Female 49 years old; Reason: s/p capsule endoscopy, please eval that capsule passed. History: s/p capsule endoscopy Bowel gas pattern is nonobstructive. Endoscopic capsule device is noted near the suture line not significantly changed from prior. | 1.Endoscopic capsule projected near the staple line. |
Generate impression based on findings. | History of MEN1. No symptoms. Evaluate for bronchopulmonary neuroendocrine tumor. LUNGS AND PLEURA: No suspicious nodules or masses.No pleural effusion.MEDIASTINUM AND HILA: Scattered small mediastinal lymph nodes. No lymphadenopathy.Normal heart size without pericardial effusion. No visible coronary artery calcification.No mediastinal mass.CHEST WALL: Mild degenerative of the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Cholecystectomy clips.Pancreatic tail hyperenhancing lesion (series 4, image 78), better seen on prior MRI when it was characterized as a neuroendocrine tumor. | No intrathoracic evidence of a neuroendocrine tumor or other significant abnormality. Known pancreatic tail neuroendocrine tumor. |
Generate impression based on findings. | History of lung cancer on Aftinib. Please compare to prior scans. CHEST:LUNGS AND PLEURA: Postsurgical findings of left lower lobectomy and right upper lobe wedge resection, unchanged.Right lower lobe 4 mm solid nodule adjacent to the fissure has increased in size (series 4, image 31), previously 2 mm.Additional multiple bilateral solid and semisolid pulmonary nodules, not significantly changed.Reference right middle lobe nodule is 4 mm (series 4, image 52), unchanged. Stable diffuse groundglass opacity in the left lower lung, likely relates to post-radiation change.Right lower lobe peribronchial groundglass opacities (series 4, image 36) that were new on prior study, unchanged.MEDIASTINUM AND HILA: Reference precarinal lymph node is 5 mm, unchanged (series 3, image 98). No new lymphadenopathy.Normal heart size without pericardial effusion. No visible coronary calcification.Unchanged nonspecific hypodense thyroid nodules.Small hiatal hernia.CHEST WALL: Post-surgical osseous bridging between ribs, unchanged.Mild degenerative changes of the thoracic spine.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Endplate compression deformities of L3 and L4 with moderate to severe degenerative changes of the lumbar spine, unchanged.Previously noted left iliac bone sclerotic lesion is not included in the scan range.OTHER: No significant abnormality noted. | Increased size of a 4 mm right lower lobe solid nodule; otherwise, multiple solid and part solid nodules are not significantly changed. |
Generate impression based on findings. | 29-year-old female with history of nasal congestion. The paranasal sinuses and nasal cavity are clear. There is substantial rightward nasal septal deviation with a prominent nasal spur. The lamina papyracea are intact. The orbits are unremarkable. The mastoid air cells are clear. The imaged intracranial structures are unremarkable. | 1. No evidence of sinusitis. 2. Substantial rightward nasal septal deviation with a prominent nasal spur.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 47-year-old male with history of left-sided face and body numbness. Evaluate for intracranial hemorrhage. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. There is absence of the septum pellucidum. The ventricular system is not particularly enlarged. There is no midline shift or herniation. There is mild mucosal thickening in the maxillary sinuses. The mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | No evidence of acute intracranial hemorrhage or mass effect. Please note that CT is insensitive for the detection of acute non-hemorrhagic CVA. An MRI may be obtained if clinically warranted and there are no contraindications.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Posterior neck mass that has been increasing in size over the past 10 days with purulent drainage. There is a tumefactive lesion in the right posterior neck subcutaneous tissues that measures 30 x 50 mm. There is relatively low attenuation centrally within the lesion and surrounding subcutaneous fat stranding and skin thickening. The underlying paraspinal muscles appear to be intact. There is no evidence of significant cervical lymphadenopathy based on size criteria. There is an apparent subcentimeter polypoid lesion involving the left vocal cord. There is reflux of air into the right parotid ducts due to puffed cheek technique. Otherwise, the thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is multilevel degenerative cervical spondylosis. The remaining teeth are carious and many of these have associated periodontal lucencies. There is mild scattered paranasal sinus mucosal thickening. The imaged intracranial structures are unremarkable. There is extensive emphysema in the partially-imaged lungs. | 1. A tumefactive lesion in the right posterior neck subcutaneous tissues with an associated inflammatory reaction that measures up to 50 mm likely represents an infected inclusion cyst. However, a neoplastic process cannot be entirely excluded.2. An apparent subcentimeter polypoid lesion involving the left vocal cord may represent a fibroma or physiologic variant, for example. Laryngoscopy may be useful for further evaluation, if clinically indicated. 3. Extensive dental disease.4. Extensive emphysema in the partially-imaged lungs. |
Generate impression based on findings. | Pain, check for fracture Minimal degenerative changes without additional abnormality. Specifically no fracture or malalignment. | Minimal osteoarthritic changes |
Generate impression based on findings. | Twisted ankle years ago. Pain off-and-on, current swelling. Ankle: Persistent diffuse mild soft tissue swelling similar to prior exam with underlying chronic appearing deformity of the distal fibula and associated changes throughout the mortise. No new superimposed focal abnormalities to suggest an acute or subacute process.Foot: Moderate degenerative changes of the first MTP with hallux valgus deformity. Small bunion. The remainder of the foot is otherwise intact with only mild degenerative changes observed in the mid foot | Scattered mild to moderate degenerative changes and old deformities involving the ankle compatible with remote trauma |
Generate impression based on findings. | Ulcer (unspecified). Pain in both hips. Check for osteomyelitis Moderate degenerative changes with diffuse demineralization limiting sensitivity. No discrete focal osseous abnormalities to suggest or support osteomyelitis however serial imaging would be needed for confirmation given limitations described. Upper pelvis is obscured by extensive gas and stool.As well a focal ulceration is not clearly identified in given the anatomy, presumed to be posterior. Dedicated imaging and axial imaging should be considered again if suspicion is highExtensive atherosclerotic changes | Moderate degenerative changes with extensive limitations given clinical question posed. See detail and recommendation provided |
Generate impression based on findings. | CT HEAD: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are scattered atherosclerotic calcifications of the cavernous internal carotid arteries. The imaged paranasal sinuses and mastoid air cells are clear. There is a small right parietal scalp contusion. The skull and extracranial soft tissues are otherwise unremarkable. There is incomplete fusion of the posterior arch of C1. CTA HEAD: There are scattered mild atherosclerotic calcifications of the cavernous internal carotid arteries. The middle and anterior cerebral arteries are unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries are patent. There is no evidence of flow-limiting stenosis or cerebral aneurysm.CTA NECK: There is a common origin of the left common carotid artery, and brachiocephalic artery from the arch. There is a separate origin of the left subclavian artery. There is a retropharyngeal course of the bilateral cervical internal carotid arteries. The common carotid arteries and cervical internal carotid arteries are normal in course and caliber. Both vertebral artery origins are patent. There is no evidence of flow-limiting stenosis or occlusion.OTHER: There is a 6 mm sclerotic focus in the left posterior third rib. There is straightening of the usual cervical lordosis with mild degenerative changes. There is mild anterolisthesis of C2 on C3 and C3 on C4. | 1. Small right parietal scalp contusion, but no acute intracranial hemorrhage or skull fracture. 2. No evidence of intracranial aneurysm or flow-limiting stenosis. 3. Scattered mild atherosclerotic calcifications of the cavernous internal carotid arteries, but no evidence of flow-limiting stenosis of the bilateral internal carotid arteries.4. A 6 mm sclerotic focus of the left posterior third rib likely represents a bone island. However, given history of prostate cancer, metastasis cannot be entirely excluded and a bone scan may be helpful for further evaluation.Findings discussed with Dr. Bernard on 3/7/3015 at the time of dictation. |
Generate impression based on findings. | Female 78 years old; Reason: retroperitoneal hematoma History: acute drop in hemoglobin, tachycardia ABDOMEN:LUNG BASES: There are bilateral pleural effusions and atelectasis right, greater than left.LIVER, BILIARY TRACT: Liver is normal in morphology. There are layering calcified gallstones within the gallbladder.Small amount of perihepatic hematoma.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is a acute hematoma adjacent to the posterior inferior aspect of the right kidney measuring at least 6.0 x 4.3 cm. The hematoma extends along the retroperitoneum and right psoas muscle.RETROPERITONEUM, LYMPH NODES: Retroperitoneal hematoma as detailed aboveBOWEL, MESENTERY: Small amount of fluid adjacent to the colonBONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomyBLADDER: Foci of gas within the bladder, likely postsurgicalLYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Presacral hematoma.OTHER: No significant abnormality noted. | 1.Findings of a perinephric bleed with extension of the hematoma to the liver surface and pelvis.2.Cholelithiasis |
Generate impression based on findings. | Male 40 years old; Reason: r/o polycystic kidneys, ?Alport's has hearing loss also History: suggestion on prior CT exam, needs contrast enhanced study ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal in morphology. Well marginated fluid attenuating foci likely represent cysts. No solid hepatic lesions. Hepatic and portal veins are patent. Gallbladder is unremarkable.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left kidney is atrophic with multiple areas of parenchymal scarring. There are multiple scars within the right kidney.No hydronephrosis or nephrolithiasis in either kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Bilateral renal scarring, left greater than right causing overall atrophy of the left kidney. |
Generate impression based on findings. | Female 59 years old; Reason: LLQ pain, hx of diverticulitis. Assess for any abnormal pathology, abscess. Pt feels better now, but still some dull LLQ ache. History: LLQ pain intermittently. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Liver is normal morphology. Well marginated fluid attenuating lesions likely represent cysts. No biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subcentimeter fat-containing lesion in the upper pole of the left kidney represents a small angiomyolipomaRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There are scattered colonic diverticula. No pericolonic inflammation.Appendix is normal in caliber. Terminal ileum is normal. No bowel obstruction. No mesenteric inflammation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Diverticulosis but no CT findings of acute diverticulitis. |
Generate impression based on findings. | Pontine hyperattenuation c/f bleed, eval for enlargement History: Rapidly worsening confusion, partially corrected with lactulose enema. The subcentimeter hyperattenuating focus in the central pons with mild surrounding vasogenic edema is not significantly changed. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. There is a partially-imaged enteric tube. | The subcentimeter hemorrhagic focus in the central pons with mild surrounding vasogenic edema is not significantly changed. This may represent a form of osmotic demyelination. |
Generate impression based on findings. | 72-year-old male with history of TIA/CVA presenting with memory impairment. There is no evidence of acute intracranial hemorrhage. There is mild periventricular and subcortical white matter hypoattenuation. The grey-white matter differentiation otherwise appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. | 1. No evidence of acute intracranial hemorrhage.2. Mild white matter hypoattenuation likely compatible with age-indeterminant ischemic small vessel disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Head trauma 2 months ago, now with headache. There is no evidence of acute intracranial hemorrhage or mass. There is diffuse patchy cerebral white matter hypoattenuation. There is mild diffuse cerebral volume loss. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is a left lens implant. The skull and scalp soft tissues are unremarkable. | 1. No evidence of acute intracranial hemorrhage or skull fracture.2. diffuse patchy cerebral white matter hypoattenuation is nonspecific, but may represent small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | 62 year old male with history of stroke now on anticoagulation. There is no evidence of acute intracranial hemorrhage. Areas of encephalomalacia within the left occipital lobe and left cerebellar hemisphere likely represent chronic ischemic infarcts. There is moderate periventricular and subcortical white matter hypoattenuation. The grey-white matter differentiation otherwise appears to be intact. There is diffuse cerebral volume loss. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and scalp soft tissues are unremarkable. There are calcifications of the intracranial arteries. | 1. No evidence of acute intracranial hemorrhage.2. Areas of encephalomalacia in the left occipital lobe and left cerebellar hemisphere, likely representing chronic infarctions, and moderate probable small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 49-year-old male status post assault. Head: There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is mild right frontal scalp swelling without underlying calvarial fracture.Maxillofacial: There is a right periorbital hematoma and swelling associated with 6 mm medial displacement of right lamina papyracea fracture fragments and herniation of orbital fat. There is mild deformity of the right medial rectus muscle. There is a small amount of hemorrhage within the ethmoid air cells. There is no evidence of retrobulbar hematoma. The left orbit is unremarkable. There is left facial subcutaneous stranding and swelling of the zygomatic major muscle. The temporomandibular joints are intact. Tooth# 13 is absent. The orbits are intact. There is a small left nasal septal spur. The mastoid air cells are clear.Cervical Spine: There is a minimally displaced fracture of the C6 spinous process with sclerotic margins suggesting a chronic fracture. Otherwise, there is no evidence of acute fracture. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. There is mild degenerative spondylosis, but no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. | 1. Right periorbital hematoma with a medial orbital blow out fracture, but no evidence of retrobulbar hemorrhage.2. Left facial contusion.3. No evidence of acute intracranial hemorrhage or skull fracture.4. Chronic C6 spinous process fracture, but no evidence of acute cervical spine fracture or subluxation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Syncope. There is no evidence of acute intracranial hemorrhage or mass. There is mild patchy cerebral white matter hypoattenuation. The grey-white matter differentiation otherwise appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There are bilateral lens implants and scleral plaque. The skull and scalp soft tissues are unremarkable. There are bilateral temporomandibular joint degenerative changes. | 1. No evidence of acute intracranial hemorrhage or skull fracture.2. Mild patchy cerebral white matter hypoattenuation, which is nonspecific, but may represent small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.3. Diffuse mild cerebral volume loss.4. Bilateral temporomandibular joint degenerative changes. |
Generate impression based on findings. | Mycosis fungoides that progressed to cutaneous T cell lymphoma. Dysphagia. There is a bulky mass centered in the right nasopharynx that measures up to approximately 28 x 39 mm with associated airway narrowing. There is also a supraglottic mass that measures approximately 17 x 25 mm with associated airway narrowing. In addition, hyperattenuating material is present in the supraglottic airway. There is a subcentimeter hypoattenuating nodule in the right thyroid lobe and an exophytic nodule arising from the isthmus inferiorly that measures up to 15 mm. The salivary glands are unremarkable. There is mild plaque at the carotid bifurcations. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. There is calcified mediastinal and hilar lymphadenopathy. | 1. A mass centered in the nasopharynx and a supraglottic mass with associated airway narrowing likely represent neoplasm and less likely an unusual infection. 2. Evidence of aspiration with contrast material in the laryngeal airway.3. Nonspecific thyroid nodules. Thyroid ultrasound may be useful for further evaluation.4. Calcified mediastinal and hilar lymphadenopathy suggests prior granulomatous disease. |
Generate impression based on findings. | 66 year old female with history of altered mental status. There is no evidence of acute intracranial hemorrhage. There is mild periventricular and subcortical white matter hypoattenuation. The grey-white matter differentiation otherwise appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is plagiocephaly. There has been a left enucleation with a prosthesis in place. There is mild left preseptal fat stranding. | 1. No evidence of acute intracranial hemorrhage or mass effect. 2. Mild nonspecific white matter hypoattenuation may representing age-indeterminant small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.3. Mild left preseptal fat stranding may represent a cellulitis amidst otherwise chronic findings related to enucleation surgery.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 63 year-old female history of dizziness. Evaluate for ischemic changes. There is no evidence of acute intracranial hemorrhage. There is apparent hypoattenuation in the medulla. The ventricles are normal in size and configuration. There is no midline shift or herniation. There is unchanged mild ossification of the dural in the right middle cranial fossa. The imaged paranasal sinuses and mastoid air cells are clear. There is unchanged thinning of the superior right calvarium. | No evidence of acute intracranial hemorrhage. Apparent hypoattenuation in the medulla may represent an infarct or artifact. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. .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 female with history of HbSS, altered mental status, sepsis, and history of stroke. Evaluate for ischemia. There is extensive encephalomalacia of bilateral frontal lobes, superior temporal gyri, and superior parietal lobes, similar to the prior MRI. There is no evidence of acute intracranial hemorrhage. There is ex vacuo dilatation of the lateral ventricles. There is scattered paranasal sinus opacification with fluid levels. The mastoid air cells are clear. There is diffuse calvarial and maxillofacial skeleton thickening. | 1. Extensive bilateral cerebral hemisphere encephalomalacia related to chronic infarcts. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.2. No evidence of intracranial hemorrhage. 3. Suggestion of acute sinusitis.4. Diffuse calvarial and maxillofacial skeleton thickening is likely related to sickle cell disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 44-year-old male with history of sepsis. Evaluate for stroke. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. The ventricles are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses are clear. There is minimal opacification of the mastoid air cells. There is a nasal septal defect that measures up to approximately 30 mm. The skull and scalp soft tissues are unremarkable. | 1. No evidence of acute intracranial hemorrhage, mass or cerebral edema. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. An MRI may be obtained if clinically warranted and there are no contraindications.2. Minimal nonspecific opacification of the mastoid air cells. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 73-year-old female history of altered mental status. There is no evidence of acute intracranial hemorrhage or mass. The grey-white matter differentiation appears to be intact. There appears to be a nonspecific punctate focus of calcification in the right frontal lobe subcortical region. There is mild periventricular and subcortical white matter hypoattenuation. There is mild diffuse cerebral volume loss. There are extensive cerebrovascular calcifications. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. However, there is a sclerotic subcentimeter lesion in the posterior wall of the right maxillary sinus. There is probable cerumen in the left external auditory canal. The skull and scalp soft tissues are unremarkable. | 1. No evidence of acute intracranial hemorrhage. 2. Mild cerebral white matter hypoattenuation which is nonspecific, but most likely related to chronic small vessel ischemic disease and extensive cerebrovascular calcifications. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.3. A sclerotic subcentimeter lesion in the posterior wall of the right maxillary sinus may represent an ectopic dysmorphic tooth.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
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