instruction stringclasses 1 value | input stringlengths 6 8.98k | output stringlengths 5 3.11k |
|---|---|---|
Generate impression based on findings. | Left facial droop (bells), also headache, hypertension. 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 mastoid air cells are clear. There is a small left maxillary sinus retention cyst. The skull and scalp soft tissues are unremarkable. | No evidence of acute intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | History of DLBCL s/p chemotherapy in presumed complete remission. There are stable postoperative findings related to right neck dissection. There are unchanged mildly prominent cervical lymph nodes. For example, a right level 2B lymph node measures 10 mm in short axis. The thyroid and major salivary glands are unremarkable. There are unchanged mildly prominent palatine tonsils. The major cervical vessels are patent. The osseous structures are unremarkable. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | Unchanged mildly prominent cervical lymph nodes. |
Generate impression based on findings. | 87-year-old female on Coumadin with history of altered mental status. Evaluate for intracranial hemorrhage. There is no evidence of acute intracranial hemorrhage. There is mild to moderate white matter hypoattenuation. The gray white differentiation is otherwise preserved. There is mild cerebral volume loss diffusely. There is no midline shift or herniation. There are prominent extra-axial CSF spaces, particularly in the left parietal convexity. The imaged paranasal sinuses and mastoid air cells are clear. There is a right frontal skull osteoma. There are bilateral lens implants. There is an incomplete posterior arch of C1, which is an anatomic variant. | 1. No evidence of acute intracranial hemorrhage.2. Mild to moderate white matter hypoattenuation likely representing chronic small vessel ischemic disease. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.3. Prominent extra-axial CSF spaces, particularly in the left parietal convexity may represent hygroma.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: is there a bleed or metastasis. History: history brain surgery as child for tumor, now breast cancer, +headache. There is a subcentimeter focus of hyperattenuation in the anterior left pontomedullary junction. There is a cystic area that measures up to approximate 4 mm in the left parietal lobe that appears to communicate with the left lateral ventricle and associated with region cerebral volume loss. There is thinning of the overlying calvarium. There is a small hypoattenuating defect anterior to this lesion, which may represent encephalomalacia. The ventricles are normal in size and configuration. There is no midline shift or herniation. The mastoid air cells are clear. There is a right maxillary sinus retention cyst. | 1. Nonspecific subcentimeter focus of hyperattenuation in the anterior left pontomedullary junction. Differential considerations include acute hemorrhage, cavernous malformation, or neoplasm, for example. A brain MRI without and with contrast would be useful for further characterization.2. A cystic area that measures up to approximate 4 mm in the left parietal lobe that appears to communicate with the left lateral ventricle and associated with region cerebral volume loss likely represents a porencephalic cyst. |
Generate impression based on findings. | Recent cognitive decline, seizure disorder, past aneurysm clipping. There are postoperative findings related to right internal carotid artery clipping and embolization. Streak artifact from the metal hardware obscures surrounding structures. There is no definite evidence of large 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 and mastoid air cells are clear. | Postoperative findings related to right internal carotid artery clipping and embolization. No evidence of intracranial mass lesions or stigmata of normal pressure hydrocephalus. |
Generate impression based on findings. | Metastatic head and neck cancer prior to treatment. There is no evidence of acute intracranial mass or abnormal enhancement. 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 nonspecific partial opacification of the mastoid air cells. The skull and scalp soft tissues are unremarkable. | No evidence of intracranial metastases. |
Generate impression based on findings. | Left-sided face and body numbness. There are punctate foci of high T2 signal in the left frontal lobe white matter. There is a nonspecific punctate focus of susceptibility effect in the right precuneus. There is no evidence of acute infarct, acute intracranial hemorrhage or mass. There is absence of the septum pellucidum. There is perhaps mild hypoplasia of the optic nerves. There is no midline shift or herniation. There is mild mucosal thickening and retention cyst formation in the maxillary sinuses. There is scattered nonspecific fluid signal in the left mastoid air cells. The skull and scalp soft tissues are unremarkable. | 1. Nonspecific punctate foci of signal abnormality in the left frontal lobe white matter, but no evidence of acute infarct.2. Absence of the septum pellucidum and possibly mild hypoplasia of the optic nerves may represent a mild form of septo-optic dysplasia. 3. A nonspecific punctate focus of susceptibility effect in the right parietal lobe may represent a chronic microhemorrhage. |
Generate impression based on findings. | Respiratory distressVIEW: Chest AP ET tube tip at the level of the carina. Cardiothymic silhouette normal. Bilateral patchy atelectasis increased in the right perihilar region. No pleural effusion or pneumothorax. G-tube in place. | Bilateral patchy atelectasis increased in the right perihilar region. |
Generate impression based on findings. | Abdominal painVIEW: Abdomen AP Disorganized nonobstructive bowel gas pattern. No abnormal bowel dilation. No pneumatosis or pneumoperitoneum. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Evaluate chest tubeVIEW: Chest AP 3/7/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Right central line and left chest tube unchanged. Cardiothymic silhouette normal. Bilateral patchy lung atelectasis not significantly changed. No pleural effusion or pneumothorax. Marked body wall edema. | Left chest tube with patchy atelectasis bilaterally unchanged. |
Generate impression based on findings. | ARDSVIEW: Chest AP 3/8/15 ET tube tip below thoracic inlet and above the carina. Left upper extremity PICC with tip in the SVC. Cardiothymic silhouette normal. The pneumomediastinum is not significantly changed. Bilateral patchy lung opacities increased from prior study. No evidence of pneumothorax. Multiple surgical sutures at the GE junction. | Bilateral patchy atelectasis increased from prior study. |
Generate impression based on findings. | Evaluate pneumothoraxVIEW: Chest AP 3/8/15 Left chest port in place. Left chest tube with surgical clips projected over the left perihilar region again noted. The left apical pneumothorax has decreased in size. Patchy atelectasis in the right lower lobe and left lower lobe. Minimal amount of subcutaneous emphysema in the left supraclavicular region. The epidural catheter again noted. Cardiothymic silhouette normal. | Left apical pneumothorax decreased in size when compared to the prior study. |
Generate impression based on findings. | Left chest tube with history of resection of posterior mediastinal massVIEW: Chest AP 3/8/15 Left chest tube in place. Multiple surgical sutures project over the left perihilar region. Cardiothymic silhouette normal. Bilateral lung atelectasis improved from prior study. No pleural effusion or pneumothorax. | Bilateral atelectasis improved from prior study. |
Generate impression based on findings. | Increased oxygen requirementVIEW: Chest AP 3/8/15 Tracheostomy tube in place. The vagal stimulator device in place. Multiple surgical clips at the GE junction and G-tube in place. Cardiothymic silhouette normal. Patchy opacities in the right upper lobe and left lower lobe medially minimally increased in the right upper lobe. No pleural effusion or pneumothorax. | Right upper lobe opacity likely atelectasis minimally increased from prior study. |
Generate impression based on findings. | Cough feverVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex, aortic arch and stomach left-sided. Minimal peribronchial wall thickening with subsegmental atelectasis in the left lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Cough feverVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Evaluate for pneumothoraxVIEW: Chest AP and abdomen AP 3/7/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. The esophageal temperature probe tip in the stomach. Umbilical catheters unchanged. Cardiothymic silhouette normal. Patchy atelectasis in the right upper lobe and left lower lobe. No pleural effusion or pneumothorax. Paucity of bowel gas within the abdomen. Marked body wall edema. Fracture involving the left proximal humerus again noted. | No evidence of pneumothorax. |
Generate impression based on findings. | Cough feverVIEWS: Chest AP and lateral 3/7/15 Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Female 86 years old; Reason: eval for obstruction, intraabdominal infection History: malignancy with mets, abdominal distention, vomiting and diarrhea ABDOMEN:LUNG BASES: Mild bibasal atelectasis.Reference right epicardial lymph node is stable and measures 2.9 x 1.6 cm (series 3, image 15), previously 3.0 x 1.4 cm. Additional small right epicardial lymph nodes appear subjectively stable. A reference left cardiophrenic lymph node is stable and measures 2.4 x 1.4 cm (series 3, image 19), previously 2.5 x 1.4 cm.LIVER, BILIARY TRACT: Nodular implant at the hepatic dome demonstrates a slight interval increase and measures 3.4 x 2.0 cm (series 3, image 30), previously 3.4 x 1.4 cm.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: Conglomerate of lymph nodes along the gastrohepatic ligament appear subjectively stable/mildly increased in size. The reference lymph node adjacent to the left renal vein measures 1.7 x 1.6 cm (series 3, image 51), previously 1.8 x 1.6 cm.BOWEL, MESENTERY: Gastric serosal mass measures approximately 4.1 x 2.9 cm (series 3, image 36), previously 3.9 x 2.8 cm, stable/slightly increased in size. Multiple mesenteric implants are again noted. The reference right lower quadrant nodule is stable and measures 2.4 x 2.1 cm (series 3, image 89), previously 2.4 x 2.2 cmReference implant adjacent to the splenic flexure measures 5.3 x 4.3 cm (series 3, image 53), previously 5.2 x 4.4 cm. Although stable in size compared to prior study there is persistent mass effect on the descending colon and new dilatation of the colon and small bowel proximally with collapsed distal colon, consistent with a partial colonic obstruction. Multiple additional mesenteric nodules are subjectively stable stable/mildly increased.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Bilateral gonadal vein thrombosis.PELVIS:UTERUS, ADNEXA: Status post hysterectomy and bilateral salpingo-oophorectomy.BLADDER: No significant abnormality noted.LYMPH NODES: Pelvic lymphadenopathy again noted. The reference left obturator lymph node is not significantly changed and now measures 2.5 x 1.6 cm (series 3, image 118), previously 2.6 x 1.4 cm. The reference left inguinal node is stable sloshed minimally increased and measures 1.6 x 1.4 cm (series 3, image 117), previously 1.5 x 1.3 cm.BOWEL, MESENTERY: See above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Mesenteric disease adjacent to the splenic flexure while stable in size exerts mass effect on the colon with new resulting partial bowel obstruction.2.In the lower thorax, epicardial lymph nodes and cardiophrenic lymph nodes are stable/mildly increased.3.In the abdomen, the gastric mass, nodular hepatic implant, mesenteric and omental disease as well as retroperitoneal and gastrohepatic lymphadenopathy are stable/ mildly increased.4.In the pelvis, pelvic lymphadenopathy and mesenteric and omental disease are stable/ mildly increased.5.Bilateral gonadal vein thrombosis.Discussed by myself Dr. Ward with Dr. Spiegel 3/8/15 at 8:10 a.m. |
Generate impression based on findings. | PainVIEWS: Right ankle AP, oblique and lateral No acute fracture or dislocation. There is a small ankle joint effusion. Marked soft tissue swelling about the ankle joint. | Marked soft tissue swelling without acute fracture. |
Generate impression based on findings. | RDSVIEW: Chest AP 3/7/15 Endotracheal tube has been removed in the interval. Cardiothymic silhouette normal. Minimal patchy atelectasis in the perihilar region and left lower lobe. No pleural effusion or pneumothorax. | Minimal patchy atelectasis bilaterally without pneumonia. |
Generate impression based on findings. | Evaluate ET tubeVIEW: Chest AP 3/7/15 ET tube tip at the level of the thoracic inlet. NG tube tip in the stomach. Right upper extremity PICC again noted. Cardiothymic silhouette normal. Patchy atelectasis in the left upper lobe and left lower lobe. No pleural effusion or pneumothorax. Multiple surgical clips in the right upper quadrant. Right thoracic scoliosis again noted. | ET tube tip at the level of the thoracic inlet. |
Generate impression based on findings. | Increased oxygen requirementVIEW: Chest AP and abdomen AP 3/7/15 ET tube tip immediately above the level of the carina. NG tube tip in the distal esophagus. The umbilical venous catheter tip in the left portal vein. Cardiothymic silhouette normal. Cardiac apex is left-sided. Diffuse atelectasis bilaterally representing RDS without pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Diffuse atelectasis bilaterally representing RDS. |
Generate impression based on findings. | Female 31 years old Reason: eval for appendicitis History: abdominal pain, nausea, anorexia, fever, chills ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Wedge-shaped areas of hypoattenuation in the right lower pole consistent with infection or vascular embolic phenomena. Mild fat stranding around the right lower pole. No hydronephrosis or hydroureter. Given limitations of contrast enhanced scans no obvious nephrolithiasis. In this clinical context pyelonephritis is favored.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. Appendix is normal.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Findings as above, favor focal pyelonephritis right lower pole kidney |
Generate impression based on findings. | PainVIEWS: Left hand AP, oblique and lateral There is an acute transverse fracture involving the head of the middle phalanx of the little finger. The distal fracture fragment is displaced dorsally and medially. There is associated soft tissue swelling at this region. The remainder of the examination is normal. | Acute fracture middle phalanx of the little finger. |
Generate impression based on findings. | FeverVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Minimal peribronchial wall thickening with subsegmental atelectasis in the right lower lobe. No pleural effusion or pneumothorax. G-tube in place. Right upper quadrant calcifications unchanged. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Male 71 years old; Reason: eval stool burden vs other intraabd process History: abd pain, bounceback ABDOMEN:LUNGS BASES: Bibasilar atelectasis.LIVER, BILIARY TRACT: Gallbladder is moderately distended containing a few large and several small gallstones. There is extensive fat stranding around the gallbladder suggestive of acute cholecystitis. There is mild diffuse intrahepatic biliary dilatation without evidence of extrahepatic biliary dilatation.The radiology resident on call bilirubin is not elevated, nevertheless I concerned for involving were resolving acute cholecystitis.No focal liver lesions are seen. Hepatic vasculature enhances normally.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There is minimal fat stranding and along the anterior pararenal space on the right however the epicenter of the fat stranding is around the gallbladder. The perirenal fat stranding is likely a secondary finding. The kidneys are intrinsically normal.RETROPERITONEUM, LYMPH NODES: Mild asymmetric atherosclerotic changes aorta. Some areas suggest a possible ulcerated plaque. No evidence of aneurysm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Prominent prostate gland.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. | Findings suggestive of acute cholecystitis as detailed above.Atherosclerotic disease. Prominent prostate. |
Generate impression based on findings. | Cough chest pain wheezingVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Hypoxia feverVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and aortic arch left-sided. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | PainVIEWS: Left foot AP, oblique and lateral No acute fracture or dislocation. No ankle joint effusion. | Normal examination. |
Generate impression based on findings. | Line placementVIEW: Chest AP and abdomen AP 3/7/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the distal esophagus. The umbilical venous catheter tip in the right atrium. The umbilical arterial catheter tip at T5/6. Cardiothymic silhouette normal. Bilateral diffuse atelectasis minimally improved from prior study. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Bilateral diffuse atelectasis improved from prior study. |
Generate impression based on findings. | Female 64 years old Reason: h/o neutropenic fever, eval for source of infection History: see above CHEST: Chest was done delayed and intravenous contrast is already washed out limiting sensitivity for vasculature. Given that limitation, following observations are madeLUNGS AND PLEURA: Areas of consolidation in the superior segment and posterior segment of the left lower lobe consistent with aspiration pneumonia.Groundglass opacities right apex, unchangedMEDIASTINUM AND HILA: Findings consistent with history of orthotopic heart transplant. Mild cardiomegaly unchanged. No pleural effusion. Coronary artery calcifications.Small nonpathologic sized nodes.Right subclavian line tip in the SVC RA junction.CHEST WALL: Postsurgical changes of right mastectomy. Postsurgical changes of sternotomy Right subclavian line. Old postsurgical changes and presumed catheter or graft superior aspect left chest wall. Surgical clips.ABDOMEN: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: Small shotty nodes. Minimal atherosclerotic calcification comment no evidence of aneurysm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Osteoporosis. Mild wedging vertebral body, probably L1.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: Calcified uterine fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Scattered diverticulosis coming evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Findings consistent with multifocal areas of consolidation in the left lung concerning for pneumonia. Other findings as above. |
Generate impression based on findings. | PainVIEWS: Right humerus AP and lateral No acute fracture or dislocation. | Normal examination. |
Generate impression based on findings. | PainVIEWS: Right elbow AP, oblique and lateral No acute fracture or dislocation. No elbow joint effusion. | Normal examination. |
Generate impression based on findings. | Line placementVIEW: Chest AP and abdomen AP 3/8/15 ET tube tip below thoracic inlet and above the carina. The umbilical venous catheter tip in the right atrium. The umbilical arterial catheter tip at T6. Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Patchy atelectasis bilaterally without focal pneumonia. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Lines placement as described above. |
Generate impression based on findings. | Respiratory distressVIEW: Chest AP 3/8/15 Cardiothymic silhouette normal. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | Respiratory distressVIEW: Chest AP 3/8/15 ET tube tip immediately above the carina. NG tube tip at the GE junction. The umbilical venous catheter tip in the right atrium. The umbilical arterial catheter tip at T6. Cardiothymic silhouette normal. Diffuse atelectasis bilaterally left greater than right. No large pleural effusion or pneumothorax. | Diffuse atelectasis bilaterally left greater than right. |
Generate impression based on findings. | MRSA reintubationVIEW: Chest AP 3/8/15 ET tube tip at the level of the thoracic inlet. NG tube tip in the distal esophagus. Right upper extremity PICC again noted. Cardiothymic silhouette normal. Patchy atelectasis in the left upper lobe and left lower lobe. No pleural effusion or pneumothorax. Multiple surgical clips in the right upper quadrant. Gastrostomy tube in place. Right thoracic scoliosis again noted. | ET tube tip at the level of the thoracic inlet. |
Generate impression based on findings. | Female 37 years old; Reason: eval acute process History: LUQ, RLQ pain, hematemesis Images are slightly degraded by motion artifact.ABDOMEN:LUNG BASES: Subtle nodularity in the right base is nonspecific and may be infectious/inflammatory. Mildly prominent cardiophrenic lymph nodes are nonspecific.LIVER, BILIARY TRACT: Hepatomegaly.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: Mighty prominent retro-peritoneal lymph nodes do not meet CT criteria for enlargement.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Hypoattenuating left ovarian lesions presumably represent follicular cysts.BLADDER: No significant abnormality noted.LYMPH NODES: Mildly prominent inguinal lymph nodes are nonspecific.BOWEL, MESENTERY: Oral contrast is identified only in the distal small bowel which limits interpretation. The appendix is identified in the right lower quadrant and is unremarkable.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No specific cause for patient's abdominal pain or hematemesis is identified. |
Generate impression based on findings. | CoughVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax. Levoscoliosis of the thoracic spine again noted. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | DesaturationVIEW: Chest AP 3/8/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Umbilical lines unchanged. Cardiothymic silhouette normal. Diffuse atelectasis bilaterally increased in the left lower lobe. There is a small left-sided pleural effusion. | Diffuse atelectasis increased in the left lower lobe with new small left-sided pleural effusion. |
Generate impression based on findings. | Female 53 years old Reason: eval for patellar discloation, fx History: fall, knee pain. Four views of the right knee show no acute fracture or dislocation. The patella is in normal position. The extensor mechanism is intact. There is tricompartmental osteophyte formation compatible with osteoarthritic changes. | No acute fracture or dislocation. |
Generate impression based on findings. | AML with pancytopenia and head contusion after fall. Motion artifact somewhat degrades image quality. There is a small left frontal scalp contusion. There is no evidence of acute intracranial hemorrhage, calvarial fracture 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 otherwise unremarkable. | 1. Small left frontal scalp contusion. 2. No definite evidence of acute intracranial hemorrhage or calvarial fracture.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 51 years old; Reason: r/o ischemia History: abd pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Normal liver. Phrygian cap configuration of the gallbladder. Cholelithiasis. No biliary dilatation.SPLEEN: No significant abnormality noted.PANCREAS: Highly atrophic pancreas with diffuse calcifications throughout consistent with chronic pancreatitis. No peripancreatic fluid collections or fat stranding.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.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: Prostatic calcifications noted. Not enlarged however.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Few scattered bone islands.OTHER: No significant abnormality noted. | 1.Stable findings of chronic pancreatitis. Cholelithiasis. No findings to account for acute abdominal pain. |
Generate impression based on findings. | Male 44 years old Reason: r/o fx History: ankle pain. There is a spiral/oblique fracture of the distal fibula with near anatomic alignment of the distal fracture fragment. The fracture line appears somewhat indistinct. There is mild soft tissue swelling over lateral aspect of the joint. | Distal fibula fracture as described above. |
Generate impression based on findings. | Evaluate NG placementVIEW: Chest AP 3/7/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. Cardiothymic silhouette normal. Patchy atelectasis in the left lung. No pleural effusion or pneumothorax. | NG tube tip in the stomach. |
Generate impression based on findings. | Male 63 years old Reason: Evaluate for osteomyelitis History: Left foot ulcer, pain, erythema, swelling. Three views of left foot show diffusely demineralization of the bones. A soft tissue defect compatible with patient's known ulcer is seen along the posterior plantar surface. There is no radiographic evidence of cortical destruction to suggest osteomyelitis. Scattered periarticular corticated defects may represent healed erosions if there is history of erosive arthritis. Degenerative arthritic changes affect the midfoot.Three views of the right foot show diffusely demineralized bones. There is no radiographically evidence of cortical destruction to suggest osteomyelitis. Degenerative arthritic changes affect the midfoot. | No radiographic evidence to suggest osteomyelitis. If further imaging is clinically warranted, an MRI or triphasic bone scan is recommended. |
Generate impression based on findings. | Female 58 years old; Reason: 58F with hematuria, concern for pyelo, need noncontrast, contrast, delayed images History: 58F with hematuria, concern for pyelo, need noncontrast, contrast, delayed images ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Diffuse hepatic steatosis. The gallbladder is distended. No biliary dilatation.SPLEEN: No significant abnormality noted.PANCREAS: 3-mm hypoattenuating focus within the distal pancreatic body. This may represent interdigitating fat however a small IPMN cannot be completely excluded.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No renal calculus, hydronephrosis or perinephric stranding. Symmetric uptake into the bilateral kidneys postcontrast administration. There is symmetric excretion of contrast and no filling defects are identified within the collecting system.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal variant subhepatic location of appendix without inflammatory changes.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: The uterus is absent or atrophic.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.Unremarkable appearance of the kidneys. No findings to explain patient's hematuria.2.Diffuse hepatic steatosis. Correlation with liver function tests is recommended.3.3-mm hypoattenuating focus within the distal pancreatic body. This may represent interdigitating fat however a small IPMN cannot be completely excluded. |
Generate impression based on findings. | Placement of metallic hardware at the mandibleVIEWS: Mandible AP and lateral Bilateral mandibular distraction devices are noted with no evidence of hardware failure. ET and NG tubes noted. | Bilateral mandibular distraction devices noted with no evidence of hardware failure. |
Generate impression based on findings. | Paresthesia. Evaluate for bleed or ischemia. There is streak artifact from the coil material in the circle of Willis region. 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. There is a left frontal paramedian extra-axial hyperattenuating lesion measuring 11 mm in width. There are vascular calcifications of the cavernous portion of the bilateral internal carotid arteries. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are otherwise unremarkable. There are bilateral lens implants. | 1. Sequale of circle of Willis aneurysm coil embolization, without definite evidence of acute intracranial hemorrhage within the limits of artifact. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern and no contraindications, MRI of the brain is recommended.2. An 11 mm wide left frontal paramedian extra-axial calcified lesion may represent a meningioma. MRI may be useful for further evaluation, if clinically warranted.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | VomitingVIEW: Abdomen AP 3/7/15 Gastrostomy tube noted. Multiple surgical clips in the right upper quadrant. Levoscoliosis of the lumbar spine noted. Bilateral hip dysplasia with superior lateral dislocation of the femoral heads bilaterally. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Male 47 years old Reason: 47 year old man with history of DLBCL s/p chemotherapy in presumed complete remission. History: Chronic abdominal pain. CHEST:LUNGS AND PLEURA: Few scattered micronodules, unchangedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Few punctate hypodensities, unchanged likely benign.SPLEEN: Accessory spleen noted.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small right of the pole renal cyst. Two other small hypodensities too small to characterize, unchanged likely cysts.RETROPERITONEUM, LYMPH NODES: Stable gastrohepatic ligament lymph nodes. No other retroperitoneal nodes.BOWEL, MESENTERY: Residual fat stranding in the mesenteric root and surgical clips, consistent with treated lymphoma. No measurable pathologic sized adenopathy. No new nodes.Bowel is unremarkable.BONES, SOFT TISSUES: Postsurgical changes anterior-abdominal wall.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Stable small right common iliac node and other stable nonpathologic size nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Findings of treated lymphoma with no new sites of disease. Small stable nodes right common iliac artery and mesenteric root. |
Generate impression based on findings. | Male 49 years old Reason: Trauma History: above. Three views of the right shoulder show no acute fracture or dislocation. There is minimal osteoarthritic changes of the glenohumeral joint.Three views of the ribs show no acute fracture or malalignment.Three views of the thoracic spine show no acute fracture or malalignment. The lumbar vertebral body heights and intervertebral disk spaces are preserved.Single AP view of the pelvis shows no acute fracture or dislocation. Mild degenerative osteoarthritis affects the bilateral hip joints. | No acute fracture or dislocation as described above. |
Generate impression based on findings. | Female 45 years old Reason: r/o fracture History: cannot bear weight, pain swelling. Mild soft tissue swelling along the medial aspect of ankle. However, there is no underlying fracture or dislocation. | No acute fracture or dislocation. |
Generate impression based on findings. | Male 23 years old Reason: r/o fracture History: pain, numbness, tingling. The right hand appears unremarkable without acute fracture or dislocation. | No acute fracture or dislocation. |
Generate impression based on findings. | Female 53 years old; Reason: eval for GB path, pancreatitis, obstruction History: epigastric abd pain, vomiting ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Status post cholecystectomy. Hypoattenuating area in the medial segment of the left hepatic lobe suggestive of focal fat.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypoattenuating right renal lesion is too small to characterize but likely represents a renal cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes within the stomach and jejunum. Intramural lipoma within the excluded stomach. Mild thickening of the right colon with adjacent stranding of the mesentery. There is moderate generalized ascites. The findings are suggestive of colitis.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: Please see above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace pelvic free fluid without loculation. | 1.Ascending colitis. Given the associated ascites consider infectious etiology. |
Generate impression based on findings. | Female 86 years old Reason: eval for right wrist fracture History: snuffbox tenderness after FOOSH. Three views of the right wrist show no acute fracture or dislocation. Moderate osteoarthritic changes affect the carpal bones and the metacarpophalangeal joints. | No acute fracture or dislocation. |
Generate impression based on findings. | Male 70 years old Reason: pt with HCC; needs surveillance scan off therapy for 6 wk holiday History: HFS CHEST:LUNGS AND PLEURA: Emphysematous changes and granulomatous disease right lung, unchanged. Basilar atelectasis or scarring.MEDIASTINUM AND HILA: Atherosclerotic disease with mild coronary artery calcification. Stable subcarinal lymph node.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multifocal hepatic lesions consistent with hepatocellular carcinomas in a background of cirrhotic liver. Index lesions as follows:Dominant lesion in posterior segment of the right lobe primarily hypoattenuating with some areas of internal and mural enhancing nodularity. Maximal dimension as measured on the portal venous phase series 10, 3.5 x 2.9 cm. Previously 3.9 x 3.4 cm.Hypervascular mass showing washout, located in the dome of the liver probably segment 4 A (series 9 image 29) shows its largest dimensions on the delayed images series 13 image 21,, probably slightly larger.Hypervascular mass washout the lateral segment left lobe showing maximal dimensions on the arterial phase series 9 image 39 may be slightly larger.An adjacent hypervascular focus seen in the subcapsular area of the lateral segment of the left lobe on the prior exam series 14 image 34 is not well seen on today's study.Ill-defined hypoattenuation in the anterior to posterior branch of the right portal vein seen on delayed series 13 image 33 with ill-defined margins is unchanged.No new lesions are seen.No evidence of portal or hepatic vein thrombus. No biliary dilatation.Cholelithiasis. Common hepatic duct 1.1-cm in diameter. No definite choledocholithiasis.SPLEEN: Mild splenomegaly unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic disease and mild focal dilatation of the distal abdominal aorta but maximal dimension 2.7-cm is seen on portal venous coronal image 61.Reference aortocaval node 1.7 x 1.2 cm series 10 image 124. Previously 2 x 1.2 cm.BOWEL, MESENTERY: Mild thickening right colon likely portal colapathy. Moderate generalized ascites unchanged.BONES, SOFT TISSUES: Scoliosis and degenerative changes.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Moderate generalized ascites unchanged.BONES, SOFT TISSUES: Large lipoma right gluteus region series 10 image 182, unchangedOTHER: No significant abnormality noted | Cirrhotic morphology with multifocal hepatic lesions as measured. Some lesions might be minimally increased in size. No new lesions seen.Other findings are stable including cholelithiasis, retroperitoneal adenopathy, splenomegaly and generalized ascites. |
Generate impression based on findings. | Male 71 years old Reason: r/o fx History: fall. Two views of the right hip and two views of the right femur show a fracture of the femoral neck with associated foreshortening and anatomic alignment of the distal fracture fragment. There is no dislocation of the hip joint. Moderate osteoarthritic changes affect the right hip.Single AP view of the pelvis shows aforementioned femoral fracture. Moderate osteoarthritic changes affect the right and left hips. | Femoral neck fracture as described above. |
Generate impression based on findings. | TraumaVIEW: Chest AP and pelvis AP The patient is lying on a back board. Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. No focal lung opacity. No pleural effusion or pneumothorax. Disorganized nonobstructive bowel gas pattern. The pelvis is partially obscured by bowel gas and within this limitation no acute fracture noted. The femoral heads are seated within the acetabula. | Pelvis partially obscured by bowel gas and within this limitation no acute fracture noted. |
Generate impression based on findings. | Female 56 years old Reason: r/o fx History: fall. Three view of the right thumb show no definite fracture or malalignment. 1 mm radiodensity along the ulnar aspect of the base of the proximal phalanx, seen only on the AP view, is unlikely to be an avulsion fracture fragment as there is no evidence of the site or overlying soft tissue swelling. However, this should be correlated with point tenderness. | No definite fracture or malalignment as described above. |
Generate impression based on findings. | New headaches and dizziness. Evaluate for intracranial abnormality. There is no evidence of acute intracranial hemorrhage or mass effect. There are a few internal carotid arteries calcifications. 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 acute intracranial hemorrhage or mass effect. 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. | TraumaVIEWS: Cervical spine AP and lateral The patient is rotated in this radiograph. There is a C-spine collar in place. The cervical spine is visualized from C1 to C5 in the lateral projection. Within these limitations described above, the alignment of the cervical spine is normal without acute fracture. There is mild prevertebral soft tissue swelling and this may be secondary to patient crying/swallowing. There is straightening of the cervical spine may be secondary to muscle spasm or C-spine collar in place. | Limited exam due to rotation and the entire cervical spine is not completely visualized in this exam. Recommend repeat radiograph as clinically indicated. |
Generate impression based on findings. | Headache. Evaluate for bleed. 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 acute 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 21 years old Reason: eval for interval change in position of bullet History: left ankle pain and numbness. There is no acute fracture or dislocation. Radiodensities within the ankle joint correspond to bullet fragments, and appear unchanged in position when compared to prior exam. | No interval change in bullet fragments as described above. |
Generate impression based on findings. | Female 58 years old Reason: Left Hip pain History: Left Hip pain. No acute fracture or dislocation. The hip joint appears unremarkable. | No acute fracture-dislocation. |
Generate impression based on findings. | Female 32 years old; Reason: abdominal pain - concern for incarcerated hernia with mesh from previous repair History: abdominal pain ABDOMEN:LUNG BASES: Trace bilateral pleural effusions.LIVER, BILIARY TRACT: Hepatomegaly.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 and mesenteric lymph nodes are likely reactive.BOWEL, MESENTERY: Contiguous long segment of extreme circumferential mural thickening and adjacent inflammatory changes involving the terminal ileum, cecum, ascending and proximal transverse colon. Unremarkable appearance of the proximal small bowel, in particular no evidence of obstruction.BONES, SOFT TISSUES: Anterior abdominal wall mesh with corkscrews staples consistent with prior hernia repair. Subcentimeter pocket of fluid in the deep subcutaneous tissues overlying the mass likely represents a small seroma.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Enlarged heterogeneous appearance to the uterus consistent with recent postpartum state.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: See above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Severe mural thickening and inflammation of the terminal ileum, cecum, ascending and proximal transverse colon . Differential considerations include infectious, inflammatory or ischemic. Favor infectious given the severe associated mural thickening. |
Generate impression based on findings. | Male 59 years old Reason: persistent hypoxia, pulmonary edema History: see above. PULMONARY ARTERIES: Technically adequate study without evidence of pulmonary embolus. There is no right heart strain.LUNGS AND PLEURA: Small bilateral pleural effusions with overlying compressive atelectasis. Scattered punctate micronodules.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy. Cardiac size is within normal limits. Caliber of the main pulmonary artery is within normal limits.CHEST WALL: Degenerative changes of the lower thoracic/upper lumbar spine with anterior vertebral body osteophytes and vacuum phenomena.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No pulmonary embolus.2.Bilateral small pleural effusions with overlying atelectasis.PULMONARY EMBOLISM: PE: No pulmonary embolus.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Status post fall. Evaluate for bleed. The images are degraded by patient motion. There is a small right frontal scalp contusion. There is no evidence of acute intracranial hemorrhage, mass effect or calvarial fracture. There is encephalomalacia in left MCA distribution and the bilateral cerebellar hemispheres, left greater than right, as well as ex vacuo dilatation of the left lateral ventricle. There are punctate dystrophic calcifications in the right cerebellar hemisphere. There are confluent areas of hypoattenuation in the periventricular and subcortical white matter. There is parenchymal volume loss. There is no midline shift or herniation. There is mild opacification of the right sphenoid sinus. The remaining imaged paranasal sinuses and mastoid air cells are clear. There is mild debris within the left external auditory canal, likely representing cerumen. The skull and extracranial soft tissues are otherwise unremarkable. | 1. Small right frontal scalp contusion. 2. No evidence of acute intracranial hemorrhage or skull fracture.3. Chronic infarcts in the left MCA territory and left greater than right cerebellar hemispheres and diffuse small vessel ischemic disease, which may have slightly progressed. 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. | Female 67 years old Reason: Evalulate for PE History: Shortness of breath s/p R distal subclavian vein. PULMONARY ARTERIES: Technically adequate study without evidence of a pulmonary artery embolus. There is no evidence of right heart strain.LUNGS AND PLEURA: There is bilateral apical scarring. There is moderate to severe centrilobular emphysema. Right lower lobe pulmonary micronodule (image 88/132). Scattered areas of bronchial wall thickening and ground glass opacity may be due to bronchiolitis, edema, or aspirate. Post XRT changes on the right anteriorly.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy. Heart size is within normal limits without evidence of pericardial effusion. There are mild coronary artery calcifications. Note is made of aortic atherosclerotic calcifications. The known right subclavian DVT is not well visualized on this study as the contrast was injected on the left. Please see prior ultrasound. CHEST WALL: Patient is status post right mastectomy. Multiple calcifications are noted in the left breast. There are no suspicious lesions in the visualized osseous structures. There are degenerative changes of the thoracic spine. Note is made of a right posterior intramuscular lipoma.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Multiple hepatic hypodensity 1cm and smaller. The largest is likely a cyst. The others are too small to characterize. These could be further evaluated with MR if clinical warranted. Pill fragment in stomach. Punctate pancreatic calcifications. | No pulmonary embolus. Emphysema. Scattered areas of bronchial wall thickening and ground glass opacity may be due to bronchiolitis, edema, or aspirate. A micronodule is noted in the right lower lobe. It is nonspecific but most likely benign. In smokers, however, 1 year CT follow up is recommended. PULMONARY EMBOLISM: PE: No pulmonary embolus.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 38 years old; Reason: eval acute infection/abscess History: abd pain, N/V/D, h/o Crohn's The study is limited by motion artifact.ABDOMEN:LUNG BASES: Bibasal atelectasis. Trace right pleural effusion.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: Caval filter in situ. One of the tines from the filter extends into the upper pole parenchyma of the right kidney. Appearance is however unchanged compared to prior study of 12/31/13. A previously described hypoattenuating lesion at the upper pole of the right kidney has resolved.BOWEL, MESENTERY: Gastrostomy tube within the gastric body. Concentric thickening of portions of the transverse colon as well as the descending colon with mild surrounding inflammatory changes, particularly along the length of the descending colon. The terminal ileum appears unremarkable. There is no bowel obstruction.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: IUD within the uterusBLADDER: 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 ascites. Diminutive appearance to the left common iliac, external iliac and femoral vessels with multiple collateral vessels identified in the subcutaneous tissues. | Mild thickening of the descending colon and portions of the transverse colon with mild associated inflammatory changes. This appearance can be seen with acute on chronic colitis, likely relating to patient's known inflammatory bowel disease. |
Generate impression based on findings. | Altered mental status. Evaluate for intracranial hemorrhage or stroke. 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. The cerebellar tonsils may be slightly low-lying, although assessment of this region is limited by beam-hardening artifact. The imaged paranasal sinuses and mastoid air cells are clear. There is a nasal septal defect that measures up to approximately 30 mm. The skull and extracranial soft tissues appear unchanged. | 1. No 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.2. The cerebellar tonsils may be slightly low-lying, although assessment of this region is limited by beam-hardening artifact. MRI may also be for further evaluation of this region.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 59 years old; Reason: eval acute process History: RLQ/R side, R flank pain, no blood in urine CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: Right-sided Port-A-Cath with tip in the distal SVC. Bibasal atelectasis. Asymmetric left gynecomastia is increasing compared to prior studies.ABDOMEN:LIVER, BILIARY TRACT: Patient is status post right hepatectomy. A previously described hypoattenuating lesion within segment two is not clearly visualized on today's study.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is mild right hydronephrosis and hydroureter to the level of the VUJ where there is a 6-mm obstructing calculus. There is an asymmetric nephrogram and mild perinephric stranding consistent with obstruction. There is a 3-mm non obstructing left renal calculus.RETROPERITONEUM, LYMPH NODES: Multiple enlarged portacaval lymph nodes are nonspecific and slowly enlarging compared to prior studies. Favor reactive etiology. BOWEL, MESENTERY: Contrast within the esophagus raising the possibility of gastro esophageal reflux.Left lower quadrant ileostomy with parastomal hernia versus double barrel ostomy and postsurgical changes related to total colectomy. There is a right lower quadrant paracentral hernia containing a loop of nonobstructed small bowel. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Previously described clustered mesenteric nodes in the right lower quadrant are mildly decreased in size.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Unchanged sclerotic focus in the left iliac wing. Nonspecific subcentimeter lucency in the right iliac crest is also unchanged. Stable heterogeneity of the sacrum.OTHER: No significant abnormality noted | 1.3-mm obstructing right VUJ calculus with mild right hydronephrosis and perinephric stranding.2.Asymmetric gynecomastia, increasing over prior studies. Underlying mass should be excluded. |
Generate impression based on findings. | Assaulted with loss of consciousness while intoxicated. CT HEAD: There is no evidence of acute intracranial hemorrhage, calvarial fracture 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. MAXILLOFACIAL CT: There is left cheek soft tissue swelling. There is no evidence of orbital or other maxillofacial fractures. There is no evidence of retrobulbar hematoma. The bilateral globes and ocular adnexa appear to be intact. The temporomandibular joints and dentition are intact. CT CERVICAL SPINE: There is no evidence of fracture. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. There is no significant spinal canal stenosis. The paravertebral soft tissues are unremarkable. | 1. No evidence of acute intracranial hemorrhage or calvarial fracture.2. Left cheek contusion, but no evidence of retrobulbar hemorrhage or maxillofacial fractures. 3. No evidence of 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. | Fall, left forehead injury. There is left scalp swelling and subcutaneous stranding. The underlying calvarium appears to be intact. There is no evidence of acute intracranial hemorrhage or mass. There is mild patchy cerebral white matter hypoattenuation, which may represent small vessel ischemic disease. 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 are bilateral lens implants. | Left frontal scalp contusion, but no evidence of acute intracranial hemorrhage or skull fracture. |
Generate impression based on findings. | Female 32 years old Reason: Neuroendocrine cancer with liver mets. s/p TheraSpheres History: compare to last CT CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Multifocal masses with distortion of hepatic vasculature but no focal biliary dilatation. Index lesions measured as follows:Largest lesion in the lateral segment of the left lobe, Series #7 Image 85, 8.6 x 7.3. Previously 7.6 x 7.2 cm.Midline lesion in the lateral segment of the left lobe measured on portal venous phase series 7 image 102, 6 x 5.4-cm. Previously 5.4 x 4.8 cm.Conglomerate lesion in the dome of the lateral segment of the left lobe segment 3, measured in the venous series 7 image 70 x 0.9 x 4.4 cm, previously 5.5 x 3.9 cm.Exophytic mass posterior segment right lobe poorly marginated series 7 image 118 estimated at 5.3 x 3.7 cm. Previously 4.4 x 3.5 cm.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: Persistent retroperitoneal nodes. Index aortocaval node or cluster of nodes measured on series 7 image 134, 1.9 x 1.4 cm. Previously 1.7 x 1.2 cm.BOWEL, MESENTERY: Carcinomatosis and ascites again seen. Index peritoneal implant in the left abdomen anterior to the left lobe of the liver can no longer be discerned as a separate measurable lesion. Overall, there is increase in the carcinomatosis and increasing ascites.BONES, SOFT TISSUES: Stable multifocal lytic lesions L2, L4, L5. Stable partial collapse L5.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXAE: No significant intrinsic abnormality noted. Adjacent carcinomatosis and ascitesBLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Increased ascites and carcinomatosis.BONES, SOFT TISSUES: Stable lytic lesions lumbar spine and pelvis. Index lesion L5 series 6 image 109, 3.3 x 2.6 cm. Previously 3.4 x 2.3 cm.OTHER: No significant abnormality noted. | Progression of disease in the liver and peritoneum. Retroperitoneal nodes more prominent as well. |
Generate impression based on findings. | Male 54 years old Reason: massive PE? cardiac tamponade? pneumo? cardiac arrest unknown etiology History: as above. PULMONARY ARTERIES: Technically adequate study. There is an acute appearing pulmonary embolus in the right main pulmonary artery. Additional acute appearing pulmonary emboli are seen in the right lower lobe pulmonary artery, right upper lobe subsegmental artery, and left lower lobe artery extending into segmental braches. The right ventricular chamber appears larger than the left ventricular chamber and is straightening of the intraventricular septum, which is suggestive of right heart strain.LUNGS AND PLEURA: There is a large right-sided hydropneumothorax. There is a small left-sided pleural effusion with overlying compressive atelectasis. Basilar focal air space opacities suggest atelectasis/aspiration/infection worse on the right. Pulmonary infarct may appear similarly.MEDIASTINUM AND HILA: There is pneumomediastinum tracking along the descending thoracic aorta to the diaphragmatic crus. Tracheostomy tube tip is located approximately 6 cm above the carina. There is no mediastinal or hilar lymphadenopathy. Moderate coronary artery calcifications are noted. Aspirated debris is noted in the central airways.CHEST WALL: Multiple bilateral acute appearing rib fractures are noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Note is made of gallstones. Trace perihepatic ascites. | 1.Bilateral acute appearing pulmonary emboli with evidence of right heart strain.2.Large right-sided hydropneumothorax with multiple anterior rib fractures and pneumomediastinum.3.Findings communicated to ED by Dr. Patel at 10:55pm 3/7/15.PULMONARY EMBOLISM: PE: Bilateral, predominantly upper lobe.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Right pulmonary artery.RV Strain: Yes. Contrast extravasation description:Supervising radiologist: Mikin PatelMinor or major extravasation: Minor Contrast type:20 cc of Omnipaque 350Amount extravasated: 20 ccLocation of extravasation: R ACSigns and symptoms: Local swelling, patient intubated and sedated, peripheral pulses intactTreatment given: Ice pakcsDischarge instructions given: Yes, patient admitted |
Generate impression based on findings. | History of prostate cancer, HTN, HLD, diastolic HF, CVA, OA, who presents with altered mental status. There is encephalomalacia in the bilateral cerebellar hemispheres, right greater than left. There are multiple punctate defects in the bilateral basal ganglia. There is extensive patchy cerebral white matter hypoattenuation. There is no evidence of acute intracranial hemorrhage or mass. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. There are scattered cerebrovascular calcifications. The mastoid air cells are clear. There is near complete opacification of the left maxillary sinus with associated sclerosis of the sinus walls. There is marked nasal deviation and spur directed to the left. There are partially-imaged enteric and endotracheal tubes. The skull and scalp soft tissues are unremarkable. | Chronic-appearing bilateral cerebellar hemisphere and basal ganglia lacunar infarcts, as well as small vessel ischemic disease, but no evidence of acute intracranial hemorrhage. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct. |
Generate impression based on findings. | CoughVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe and left lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | PainVIEWS: Right knee AP, oblique and lateral No acute fracture or dislocation. No knee joint effusion. There are cystic cortical well defined lesions involving the medial and lateral aspects of the distal femur likely to represent non-ossifying fibroma. | No acute fracture or dislocation. |
Generate impression based on findings. | PainVIEWS: Pelvis AP and frog leg No acute fracture or dislocation. No evidence of slipped capital femoral epiphysis. The femoral heads are seated within the acetabula. | Normal examination. |
Generate impression based on findings. | Altered mental status. Evaluate for bleed. There is no evidence of acute intracranial hemorrhage or mass effect. There are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with chronic small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There are vascular calcifications of the cavernous portion of the bilateral internal carotid arteries. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. There are bilateral lens implants. There is a partially-calcified pannus and erosions in the adjacent dens. | 1. No evidence of acute intracranial hemorrhage or mass effect.2. Diffuse age-indeterminate small vessel ischemic changes. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct.3. Partially-calcified pannus and erosions in the adjacent dens similar to the prior MRI. This may represent a manifestation of a crystallopathy or rheumatoid arthritis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Right Horner's syndrome 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. 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.Head CTA: There is minimal calcification in the carotid siphons. There is no evidence of significant steno-occlusive lesions or cerebral aneurysms. There is no evidence of venous sinus thrombosis.Neck CTA: There is no evidence of significant steno-occlusive lesions. 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. 5. No evidence of dissection or pseudoaneurysms. |
Generate impression based on findings. | Neurofibromatosis type 1 with headache. Evaluate for bleed. There is no evidence of acute intracranial hemorrhage or mass effect. The ventricles are mildly asymmetric, but without evidence of acute hydrocephalus. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull is unremarkable. There are innumerable dermal soft tissue nodules, compatible with neurofibromas. | 1. No evidence of intracranial hemorrhage or mass effect.2. Innumerable dermal nodules, compatible with neurofibromas. Evaluation for potential intracranial stigmata of neurofibromatosis is otherwise limited with 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. | Reason: if there are pockets of effusion to drainage History: sob LUNGS AND PLEURA: Very small effusion at left lung base, unchanged. The majority of the complete left hemithoracic opacification is due to consolidated lung and tumor. This is increased in comparison to 3/1/2015.Right pleural effusion has decreased, there is improved aeration in the right lower lobe however there is extensive persistent interstitial and ground glass opacity with areas of interlobular thickening which may be due to lymphangitic tumor spread. A new right-sided pleural drain is present. A trace right pneumothorax is seen.MEDIASTINUM AND HILA: Port tip in SVC. Right jugular Swan-Ganz catheter tip in right pulmonary artery. Trace pericardial fluid. Multiple mediastinal nodes are unchanged.CHEST WALL: Postoperative changes of mastectomy and breast reconstruction, with left breast prosthesis. A small fluid collection surrounding the left prosthesis in a fluid collection in the anterior chest wall, presumably a seroma, stable from the prior exam.Left internal mammary chain and intercostal lymphadenopathy is again seen. Tumor extends into the extrapleural fat anteriorly.Previously described hyperattenuating soft tissue and surrounding fat stranding along the inferolateral chest wall, suspicious for tract seeding along a site of prior biopsy appears stable to slightly more prominent from the prior exam.Left subpectoral and axillary lymphadenopathy. UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Small collection of pleural fluid at left base unchanged. Interval decrease in right effusion s/p pleural catheter placement.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | DesaturationVIEW: Chest AP 3/8/15 ET tube tip below thoracic inlet and above the carina. NG tube tip in the stomach. The umbilical arterial catheter tip at T7. Cardiothymic silhouette normal. Minimal patchy atelectasis in the right upper lobe. No pleural effusion or pneumothorax. | Minimal patchy atelectasis in the right upper lobe. |
Generate impression based on findings. | Abdominal pain elevated CRP ABDOMEN:LUNG BASES: No focal lung opacity or pleural effusion.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is incomplete rotation of the kidneys bilaterally with the pelvis facing anteriorly.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Minimally prominent mesenteric lymph nodes are noted.BOWEL, MESENTERY: The appendix is not discretely identified. There is marked inflammatory changes at the right lower quadrant increased from prior study. There is abnormal bowel wall thickening involving the small bowel loops at the right lower quadrant. The cecum, ascending colon, transverse colon and proximal portions of the descending colon demonstrate minimal bowel wall thickening. The previously noted fluid collection at the right lower quadrant and is smaller in size measuring approximately 2 x 1 cm. There is an additional low attenuation area somewhat oblong in shape at the right lower quadrant measuring approximately 4 x 2 cm with very faint enhancement.BONES, SOFT TISSUES: No significant abnormality notedOTHER: There is a small amount of free fluid in the deep pelvis. | Marked inflammatory changes at the right lower quadrant increased from prior study. The previously noted fluid collection at the right lower quadrant has decreased in size. There is an additional oblong shape low attenuation area at the right lower quadrant with minimal faint enhancement and this may represent a phlegmon or intraluminal fluid within a thickened bowel. |
Generate impression based on findings. | Evaluate for stroke. There are foci of hypoattenuation in the right basal ganglia, left posterior limb of the internal capsule and pons, similar to prior study. There are scattered punctate and confluent areas of abnormal low attenuation in the periventricular and subcortical white matter. 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. There is a right lens implant. | 1. No evidence of intracranial hemorrhage or mass effect.2. Small vessel ischemic disease and chronic lacunar infarcts in the right basal ganglia, posterior limb of the left internal capsule, and pons, similar to the prior study. Please note that CT is insensitive for the detection of acute nonhemorrhagic ischemic event. If there is continued clinical concern and 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. | Intracranial hemorrhage. Head CT: There is no significant interval change in the posterior left temporal lobe hyperattenuating hematoma with mild surrounding vasogenic edema. 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. Head CTA: There is no evidence of cerebral aneurysm, vascular malformation, active contrast extravasation, or significant steno-occlusive lesions. There is mild carotid siphon calcification. | 1. No significant interval change in the posterior left temporal lobe intraparenchymal hematoma with mild surrounding vasogenic edema. 2. No evidence of cerebral aneurysm, vascular malformation, active contrast extravasation, or significant steno-occlusive lesions. |
Generate impression based on findings. | Right Horner's syndrome 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. 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.Head CTA: There is minimal calcification in the carotid siphons. There is no evidence of significant steno-occlusive lesions or cerebral aneurysms. There is no evidence of venous sinus thrombosis.Neck CTA: There is no evidence of significant steno-occlusive lesions. 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. 5. No evidence of dissection or pseudoaneurysms. |
Generate impression based on findings. | History of myelofibrosis with headache. Evaluate for bleed. 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. There is minimal debris within the right external auditory canal, likely representing cerumen. The skull and extracranial soft tissues are unremarkable. There are bilateral temporomandibular joint degenerative changes. | 1. No evidence of acute intracranial hemorrhage or mass effect.2. Bilateral temporomandibular joint degenerative changes. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 36 years old Reason: 36yo female with Crohn's ileocolitis. Evaluate for active ileal disease History: abdominal disease ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Vaginal cone in place. Essure coils.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No findings of inflammatory bowel disease.No findings of inflammatory bowel disease. Specifically the terminal ileum is normal. No evidence of fibrofatty proliferation. No areas of wall hyper enhancement, wall thickening, stricture, sinus tracts or fistulae.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No CT findings of inflammatory bowel disease. Other findings as above. |
Generate impression based on findings. | Trauma. The images are mildly degraded by patient motion artifact. Nevertheless, 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 partial opacification of the ethmoid sinuses. The mastoid air cells are grossly clear. The skull and scalp soft tissues are unremarkable. | No discernible evidence of acute intracranial hemorrhage or skull fracture. |
Generate impression based on findings. | Increasing seizure frequency on Keppra. Evaluate for recurrence of pinealoblastoma. Redemonstrated are post-surgical findings related to pineoblastoma resection with right occipital lobe encephalomalacia and ex vacuo dilatation of the right occipital horn. There is no discernible evidence of measurable mass within the pineal region. A punctate calcification along the medial aspect of the right occipital lobe is unchanged. Low attenuation within the right frontal lobe along the track of a prior shunt catheter with a right frontal burr hole is again apparent. There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There is mild mucosal thickening within the right sphenoid sinus. The remaining imaged paranasal sinuses and mastoid air cells are clear. The orbits appear unchanged. | 1. Post-surgical findings related to pineoblastoma resection with no discernible evidence of a measurable mass within the pineal region. However, MRI may be more sensitive if there are no contraindications.2. 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. | ConstipationVIEW: Abdomen AP Disorganized nonobstructive bowel gas pattern. Minimal amount of fecal burden. Gastrostomy tube in place. There is scoliosis involving the thoracolumbar spine. The right femur is superiorly and laterally dislocated unchanged from prior study. | Minimal amount of fecal burden without obstruction. |
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 is absence of the septum pellucidum with suggestion of mild hypoplasia of the optic nerves. There is no midline shift or herniation. There is mild mucosal thickening and retention cyst formation in the maxillary sinuses. The remaining imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. CTA HEAD: The internal carotid arteries, 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 separate origin of the left subclavian artery, left common carotid artery, and brachiocephalic artery from the arch. 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. | 1. No acute intracranial abnormality. Absence of the septum pellucidum with suggestion of mild hypoplasia of the optic nerves may represent a mild form of septo-optic dysplasia. 2. No evidence of intracranial aneurysm or high grade stenosis.3. No evidence of high grade internal carotid artery stenosis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | CT HEAD: There is s persistent apparent focal hypoattenuation in the upper medulla. There is no evidence of intracranial hemorrhage or mass. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There is unchanged mild ossification of the dura 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.CTA HEAD: The internal carotid arteries, 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 separate origin of the left common carotid artery, brachiocephalic artery and left subclavian artery from the arch. 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.CTV HEAD: There are arachnoid granulations in the right distal transverse sinus. The superior sagittal sinus, inferior sagittal sinus, transverse sinuses, sigmoid sinuses, straight sinus, vein of Galen, internal cerebral veins, and several visualized cortical veins are patent. There is no evidence of venous thrombosis.OTHER: There is a left thyroid nodule measuring up to 4 cm producing left to right tracheal deviation. | 1. No 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.2. No evidence of intracranial aneurysm or flow-limiting stenosis. No evidence of vascular malformation or venous thrombosis.3. No evidence of flow-limiting stenosis of the bilateral internal carotid arteries.4. Nonspecific 4 cm left thyroid nodule with tracheal deviation. A thyroid ultrasound may useful for further evaluation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 85 years old Reason: soft tissue infection around PEG site History: purulent drainage around PEG site Extensive edema throughout the subcutaneous soft tissues surrounding the PEG tube without discrete drainable fluid collection. | Diffuse cellulitis surrounding the subcutaneous portion of the PEG tube. No drainable fluid collection. |
Generate impression based on findings. | Female 63 years old Reason: 63F with hx of left clear cell RCC s/p left partial nephrectomy in 2010. Now with new left flank pain History: left flank pain, history of RCC. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Postsurgical changes changes left kidney. Additional areas of cortical scarring left kidney, unchanged No evidence of recurrent neoplasm.Right kidney has a small exophytic hypoattenuating lesion off the anterior aspect of the lower pole maximal dimension 1.4 x 1.5 cm series 6 image 64 measuring fluid density consistent with a slightly higher than fluid density cyst without any enhancement.No evidence of stone seen along the course of the ureter. No hydronephrosis or hydroureter.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic changes, no evidence of aneurysm. No pathologic size nodes.BOWEL, MESENTERY: Bowel and mesentery and a large broad-based left abdominal wall hernia, unchanged.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: The enhancing lesion in the fundus common exophytic extending to the left adnexa, is consistent with leiomyoma, unchangedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Postsurgical changes left kidney. Previously seen nephrolithiasis and hydroureter on the right are resolved. Exophytic lesion lower pole right kidney likely cysts.Leiomyoma uterus.Broad-based left abdominal wall hernia nonobstructive, unchanged. |
Generate impression based on findings. | Female 21 years old Reason: eval for PE History: HgSS, tachycaric, hypoxic, chest pain. PULMONARY ARTERIES: Technically adequate study without evidence of a pulmonary embolus. There is no right heart strain.LUNGS AND PLEURA: A left lower lobe peripheral airspace opacity may represent chronic scarring, atelectasis, or may be related to infarct. There is bibasilar dependent atelectasis.MEDIASTINUM AND HILA: There is no mediastinal or hilar lymphadenopathy. Cardiomegaly.CHEST WALL: Multilevel central depressions of the superior and inferior endplates vertebral bodies are compatible with known sickle cell trait.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hepatomegaly. Atrophic spleen compatible with autoinfarction. | 1.No evidence of pulmonary embolus.2.Left basilar opacities likely reflect atelectasis and scarring. PULMONARY EMBOLISM: PE: No pulmonary embolus.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.