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Generate impression based on findings. | Tachypnea, cough, fever. Left-sided crackles.VIEW: Chest AP (one view) 03/08/15, 1513 Left-sided central line tip is at junction of brachiocephalic veins.Cardiothymic silhouette is normal. Lung volumes are large. Mild peribronchial thickening is present. No focal air space disease is identified. | Bronchiolitis/reactive airways disease pattern. |
Generate impression based on findings. | Female 88 years old Reason: Abd pain, RLQ, r/o appy/sbo History: above 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: Multiple small stones in the right kidney. There is moderate right hydronephrosis and hydroureter. There is a 6 millimeter stone in the right distal ureter causing this hydronephrosis. There is also right-sided perinephric stranding. This has not significantly changed from previous CT. Bilateral small cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: 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 | Right distal ureteral stone causing moderate right hydronephrosis. Right nephrolithiasis. |
Generate impression based on findings. | dizziness, right lower extremity weakness. NONCONTRAST CT HEADNo evidence of acute ischemic or hemorrhagic lesion on this scan.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. CTA HEAD AND NECKThere is normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The bilateral vertebral artery origins are normal.There is normal contrast opacification through the bilateral common carotid arteries, carotid bifurcations, cervical internal/external carotid, and vertebral arteries. There is normal contrast opacification through bilateral ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.Bilateral Pcom arteries are patent and Acom artery is also patent.No evidence of aneurysm, significant stenosis, occlusive thrombus, dissection, or vascular malformation is noted.There is normal superficial and deep intracranial venous drainage.Diffuse enlargement of bilateral thyroid glands and isthmus indicating possible diffuse goiter. Regarding further imaging evaluation, ultrasonography can be considered. In addition, clinical correlation is recommended. | 1. Normal head and neck CT angiography.2. Diffuse thyroid enlargement as described above. |
Generate impression based on findings. | CT orbits:There is left periorbital soft tissue swelling with an associated small superficial soft tissue defect. There is no underlying abnormality of the globe or intraorbital contents, and there is no associated fracture. No radiopaque foreign body is identified.Minimal mucosal thickening is present within the lateral left maxillary sinus. Otherwise the remaining paranasal sinuses are clear. The osteomeatal complexes are normal with intact uncinate processes and clear infundibuli. The nasal turbinates are normal. The nasal septum demonstrates an S-shaped configuration and contains a small left sided septal spur. Note is made of a right concha bullosa. There also bilateral Haller cells. The cribriform plates are intact. \CT cervical spine:Cervical straightening is likely positional. There are no fractures or subluxations. The visualized intracranial and paraspinal contents are unremarkable. There are no significant degenerative changes or stenoses. | 1.There is left periorbital soft tissue swelling with an associated small superficial soft tissue defect. There is no underlying abnormality of the globe or intraorbital contents, and there is no associated fracture. No radiopaque foreign body is identified.2.Negative CT cervical spine. Specifically, there are no CT abnormality to explain the patient's cervical tenderness to palpation. |
Generate impression based on findings. | Admit from outside hospital for septic shock, now weaned from sedation, altered mental status. Evaluate for bleed, cerebral edema. 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 apparent fluid within the left sphenoid sinus. The remaining imaged paranasal sinuses and mastoid air cells are clear. There is debris within the bilateral external auditory canals, likely representing cerumen. There are prominent arachnoid granulations in the occipital bone. | 1. No evidence of acute intracranial hemorrhage, mass effect, or cerebral edema. However, non-contrast CT is insensitive for the detection of non-hemorrhagic acute infarct and intracranial infection.2. Apparent fluid within the left sphenoid sinus may represent acute sinusitis or may be related to intubation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male 67 years old Reason: bowel obstruction, perforation, scrotal mass History: See comments This study is limited due to lack of intravenous contrast.CHEST:LUNGS AND PLEURA: Endotracheal tube is in place. Bilateral small pleural effusions and atelectasis. Biapical scarring. Right middle lobe irregular shaped air space opacities, best seen on image number 50, series number 6. Etiology is unknown. Follow-up CT in 3 months is recommended.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, 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: Small amount of hepatic ascites is present.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: There is a large heterogeneous, high density collection extending from the scrotum to the left inguinal canal and then into the extraperitoneal spaces of the pelvis superiorly to the level of the iliac bifurcation. This likely represents a hematoma, however, a superimposed infection cannot be excluded. In the pelvis it measures 7 x 6 cm on image number 180, series number 4. In the left inguinal canal it measures 6-cm in diameter image number 29, series number 4.In addition there is a small collection on the right side adjacent to the right external iliac vessels measuring 3 x 2.7 cm on image number 184, series number 4. This likely represents hematoma.OTHER: Small amount of ascites in the pelvis. | Limited study due to lack of intravenous contrast. Large left scrotal/inguinal/pelvic hematoma. Superimposed infection cannot be excluded.Small right inguinal collection.Ill-defined right middle lobe air space opacity. This lesion is of uncertain etiology. Follow-up CT in 3 months is recommended. |
Generate impression based on findings. | 41 year-old female with history of chest pain. Evaluate for pulmonary embolism. Exam is limited by patient's body habitus.PULMONARY ARTERIES: Technically adequate study to the level of the lobar branches. No acute pulmonary embolus centrally. No evidence of right heart strain. Main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: The lung volumes are decreased. There is bilateral mosaic attenuation pattern with scattered predominantly groundglass opacities, right greater than left. Small right pleural effusion.MEDIASTINUM AND HILA: Mild cardiomegaly without evidence of pericardial effusion. No significant coronary artery calcifications. No mediastinal lymphadenopathy.CHEST WALL: Moderate right dextroscoliosis with associated chronic chest wall deformities and advanced multilevel degenerative disc disease.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. A left mid pole renal hypodensity is incompletely characterized on this study and may represent a cyst. | 1. Limited exam secondary to patient's body habitus. Within these limitations, no evidence of acute pulmonary embolus to the the level of the lobar branches. Peripheral acute embolus cannot be excluded.2. Bilateral mosaic attenuation pattern with scattered nodular groundglass opacities, right greater than left and small right pleural effusion. The findings are nonspecific although may represent a component of bronchiolitis or atypical infection, edema, hemorrhage or aspirate.PULMONARY EMBOLISM: PE: Negative centrally, indeterminate beyond the lobar level due to technical limitations secondary to patient body habitus.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female 18 days old Reason: Is there evidence of atelectasis History: increased O2, Pierre Robin sequence.VIEW: Chest AP (one view) 3/9/15 at 350 hours. ET tube terminates below the thoracic inlet. NG tube tip is at the stomach. Right upper extremity PICC tip is at the right internal jugular vein. Cardiac silhouette size is normal. Interval improvement in right lung aeration with persistent right lung base opacity and ill-defined atelectasis of the right upper lobe. Normal aeration of the left lung. | Interval improvement in right lung aeration as described. |
Generate impression based on findings. | Swelling, pain, fall. Question of fracture. Three views of the left tibia/fibula and left ankle reveal a nondisplaced fracture involving the posterior aspect of the distal tibia extending into the tibiotalar joint. The medial tibiotalar joint is not widened. There is marked soft tissue swelling about the ankle. | Nondisplaced fracture of the posterior distal tibia. |
Generate impression based on findings. | Female 18 days old Reason: assess PCVC placement History: 2 week old female s/p PCVC placement. Obstructed sleep apnea. Pierre Robin sequence.VIEW: Chest AP (one view) 3/8/15 at 2111 hrs ET tube terminates below thoracic inlet. NG tube tip is at the stomach. Right upper extremity PICC terminates at the right subclavian vein. Hardware of the mandible again noted.Cardiac silhouette is none sizable due to the complete atelectasis of the right lung. Normal aeration of the left lung | PCVC placement as described.Complete atelectasis of the right lung. |
Generate impression based on findings. | Female 39 years old Reason: Please eval for Occult infection source History: 39 F with Sarcoidosis, Sickle cell crisis, has had persistent Fevers x 4 days, Leukocytosis of 25k, tachycardia. She has low back pain, constipation, and new anemia CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Left thyroid nodule, nonspecific. Mild cardiomegaly.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Distal portal vein branches are attenuated. Main portal vein, right and left portal veins are patent. At the periphery of the liver, in the right lobe there is a linear hypodense area is seen on coronal image 47. Thrombosis of a distal right portal vein branch cannot be excluded.SPLEEN: Autosplenectomy.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Scarring of the right 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:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bone changes secondary to sickle cell disease.OTHER: No significant abnormality noted. | Linear peripheral hypodense area in the right lobe of the liver which may represent a thrombosed distal intrahepatic portal vein branch versus mild biliary dilatation. |
Generate impression based on findings. | Male 56 years old; Reason: 56 yo with HBV screen for HCC History: RUQ ache ABDOMEN:LUNG BASES: Scattered reticular opacities, likely atelectasis or scarring.LIVER, BILIARY TRACT: Cirrhotic morphology with umbilical vein collateralization. Prominent in size, but patent portal venous system. Gallbladder is decompressed.SPLEEN: Splenomegaly measuring up to 18 cmPANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 8-mm nonobstructive stone in the mid left kidney. Subcentimeter right renal hypodensity is too small to be accurately characterized, but likely is a cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: A prominent lymph nodes are likely related to chronic liver disease.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: Suggestion of diffuse small bowel wall thickening, which is nonspecific, and may be related to portal enteropathy or underdistention.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Cirrhosis with evidence of portal hypertension (splenomegaly and collaterals). No suspicious hepatic lesion.2.Nonspecific small bowel wall thickening, likely related to portal enteropathy. |
Generate impression based on findings. | Left ankle pain, post splint films. Assess reduction of tibiotalar joint. Two views of the left ankle demonstrate interval casting of a previously described nondisplaced fracture of the distal tibia in near anatomic alignment. The tibiotalar joint appears intact. | Interval casting of a posterior distal tibial fracture. |
Generate impression based on findings. | Female; 63 years old. Reason: eval for infection, rising white count, hypotension History: eval for infection, rising white count, hypotension CHEST:LUNGS AND PLEURA: Large bilateral pleural effusions with associated moderate bibasilar compressive atelectasis/consolidation, increased since 2/25/14; underlying infection cannot be excluded.MEDIASTINUM AND HILA: Bilateral jugular central venous catheter tips in the SVC. Stable small pericardial effusion. Moderate coronary artery calcifications.CHEST WALL: Renal osteodystrophy with superimposed degenerative changes of the osseous structures.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: End-stage native kidneys.RETROPERITONEUM, LYMPH NODES: Extensive atherosclerotic disease of the aorta and its branches involving both large and small vessels. Mild nonspecific retroperitoneal lymphadenopathy is similar to prior study.BOWEL, MESENTERY: Moderate amount of colonic stool, suggestive of constipation.BONES, SOFT TISSUES: Diffuse anasarca. Mottled appearance of the bones diffusely, most likely secondary to renal osteodystrophy though metastatic disease cannot be excluded.OTHER: New large acute hematoma within the peritoneum, mostly anteriorly measuring up to approximately 6.8 x 9.9 x 15.3 cm (AP x transverse x craniocaudal, series 4/111 and series 80328/104). Additional hematomas seen on prior study including inferior to the cecum in the right lower quadrant and in the left lower quadrant are grossly stable. Large amount of abdominopelvic ascites, mildly increased.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Large amount of colonic stool, suggestive of constipation.BONES, SOFT TISSUES: Mottled appearance of the bones diffusely, most likely secondary to renal osteodystrophy though metastatic disease cannot be excluded. | 1. New large intraperitoneal acute hematoma as detailed above.2. Large amount of abdominopelvic ascites, increased.3. Large bilateral pleural effusions with bibasilar atelectasis/consolidation, for which underlying infection cannot be excluded.Findings were discussed with Dr. Patel at 9:19 a.m. on 3/9/15. |
Generate impression based on findings. | Pain after injury. Question of fracture or dislocation. Three views of the right shoulder reveal multiple small osseous fragments projecting along the inferior margin of the glenoid; these may represent small fracture fragments or loose bodies. The shoulder is not dislocated. | Small osseous fragments along the inferior margin of the glenoid; these may reflect small fracture fragments or loose bodies. No shoulder dislocation is evident. |
Generate impression based on findings. | 73 year-old female with breast cancer. Left breast seed localization prior to partial mastectomy and sentinel node biopsy. On review of the prior studies, there is an approximately 3 cm spiculated mass in the left 12 o'clock breast, central depth with associated calcifications medial and posterior to the center of the mass. Target spiculated mass morphology with adjacent calcifications are located in the left breast in the upper outer quadrant region located in mid-breast 12 o’clock. The procedure, risks including bleeding and infection, and benefits of I-125 seed localization were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time out form was completed to confirm patient identity and site of procedure. The left breast was placed in an alphanumeric grid using superior to inferior approach. When the target was positioned in the aperture of the grid, the skin was cleansed with chlorhexidine. Local anesthesia was obtained using 2% Lidocaine. Using coordinates from the stereotactic images, and IsoAid preloaded breast localization needle was placed adjacent to the clip. Pre-deployment images confirmed good positioning of the needle with respect to the target. The I-125 seed was then deployed. Then, the needle was withdrawn and the skin entry site was closed with a Band-Aid.The post-deployment films confirmed that the seed was positioned at the site of the clip. The digital mammogram was annotated and reviewed with Dr. Jaskowiak prior to the patient's procedure. A bracelet was placed on the left wrist labeled with the patient's name, MRN, number of seeds placed, left breast and surgical date (3/9/2015). Post seed placement instructions were given to the patient. She tolerated the procedure well and left the Breast Imaging area in stable condition.Dr. Schacht performed the procedure.Orthogonal digital specimen radiographs revealed the mass, calcifications, clip and seed to be within the specimen. Calcifications were demonstrated at the initial specimen margins. Additional specimens were obtained and demonstrated benign appearing calcifications. | Successful seed localization of the left breast mass and associated calcifications.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 47-year-old female with shortness of breath, evaluate for pulmonary embolism PULMONARY ARTERIES: Adequate pulmonary artery opacification without evidence of pulmonary embolism. The main pulmonary artery is enlarged measuring 3.2 centimeters although measures less than the aortic caliber.LUNGS AND PLEURA: No pleural effusion or pneumothorax. Minimal bibasilar dependent atelectasis. Basilar predominant ground glass opacities with intralobular septal thickening may represent edema. Two nodules along the left major fissure (series 9, image 113, 114) measuring up to 5 mm they represent lymph nodes. MEDIASTINUM AND HILA: Mildly enlarged pretracheal and mediastinal lymph nodes measuring up to 1.1 cm (series 7, image 42, 75). No significant hilar lymphadenopathy. Heart size is normal. No pericardial effusion.CHEST WALL: No axillary, retrocrural, or cardiophrenic lymphadenopathy. No suspicious osseous lesions. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Small hiatal hernia. Hypodense lesion in the right lobe of the liver is unchanged from prior CT 12/17/14. | 1.No evidence of pulmonary embolism.2.Mild pulmonary edema and/or dependent atelectasis.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Patient had nasogastric tube for a long time with rising white count and hypotension. Evaluate for infection. The images are degraded by patient motion. Evaluation for abscess is limited by lack of intravenous contrast. There is mild opacification of the right ethmoid sinuses and debris within the right nasal cavity. There is also partial opacification of the left mastoid air cells. The temporomandibular joints and dentition are intact. The partially orbits are unremarkable. There are calcifications of the cavernous portion of the bilateral internal carotid arteries and scalp vessels. There is diffuse thickening and heterogeneity of the calvarium. | 1. Mild nonspecific opacification of the right ethmoid sinuses and left mastoid air cells. Evaluation for abscess is otherwise limited by lack of intravenous contrast. 2. The appearance of the calvarium is likely related to renal osteodystrophy. 3. Diffuse vascular calcifications are likely related to diabetic vasculopathy.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 53-year-old female with history right DCIS status post lumpectomy 1/2014. History of radiation and hormonal therapy. History of bilateral breast biopsies. Family history of cancer in mother diagnosed at age 68. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. A scar marker was placed over the right upper outer breast and right axilla and there is associated architectural distortion in the right upper outer quadrant. A biopsy clip is seen in the right upper outer quadrant. A biopsy clip is seen in the left upper outer and left lower outer quadrants. A few scattered benign calcifications are seen in both breasts. No dominant mass or suspicious microcalcifications in either breast. Benign appearing lymph nodes are projected over both axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.Mammography is optimally performed when prior studies are available to detect changes and would be useful in this case to ensure stability of the post-surgical appearance. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Right shoulder pain. Status post Bankart fracture of the right glenoid. Single axillary view of the right shoulder reveals no dislocation. Tiny osseous fragments project along the anterior aspect of the glenoid. | Tiny osseous fragments along the anterior glenoid may reflect fracture fragments or loose bodies. |
Generate impression based on findings. | Female 61 years old Reason: assess for esophageal abnormality; h/o esophageal dilation History: dysphagia; globus sensation in mid sternum Scout radiograph of the chest unremarkable.Double contrast visualization of the esophagus showed no morphologic abnormalities of the mucosal surfaces or mural contours. Mild narrowing was noted at the GE junction, likely within normal limits. A 13 mm barium tablet was transiently delayed at the GE junction, recreating the patient's symptoms, but passed into the stomach within 5 seconds. During the exam, no spontaneous or provoked gastroesophageal reflux was observed. Fluoroscopic evaluation of esophageal peristalsis demonstrated mild tertiary contractions as well as abruption of the primary peristaltic wave with proximal escape to the level of the cervical esophagus.TOTAL FLUOROSCOPY TIME: 1:39 minutes | 1.Mild narrowing at the level of the GE junction, likely within normal limits resulting in transient delay of a 13-mm barium tablet, recreating the patient's symptoms.2.Minor motor abnormality as detailed above. |
Generate impression based on findings. | Head CT:The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. The visualized portions of the paranasal sinuses and mastoid air cells are clear.Cervical spine CT:Straightening is likely positional. There are no fractures or subluxations. The visualized intracranial and paraspinal contents are unremarkable. There are no degenerative changes or stenosis. | 1.Negative unenhanced brain CT.2.Negative unenhanced cervical spine CT.3.Specifically, there are no CT findings to explain the patient's unresponsiveness. |
Generate impression based on findings. | Pain after injury. Question of fracture or dislocation. Three views of the right shoulder reveal no acute fracture or malalignment. | No acute fracture is evident. |
Generate impression based on findings. | Left upper quadrant abdominal pain 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: There is horseshoe kidney versus right cross fused ectopia. On the right side of the horseshoe kidney, there is high density material filling in the collecting system of the kidney. This appearance is suspicious for a neoplasm, however, due to lack of intravenous contrast, hematoma cannot be excluded. Small stones are noted within the right renal collecting system. The high density lesion within the collecting system measures 7.4 x 5.9 cm on image number 78, series number 3.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: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Limited study due to lack of intravenous contrast. High density mass within the collecting system of a horseshoe/cross fused ectopic kidney. Lack of intravenous contrast limits of evaluation, however, this lesion is suspicious for a neoplasm such as transitional cell carcinoma. Further evaluation with dedicated renal mass protocol CT is recommended to differentiate this lesion from hematoma. |
Generate impression based on findings. | Pain and swelling after struck by car on 3/7/2015. Question of fracture. Two views of the left tibia/fibula reveal no acute fracture or malalignment. There are degenerative changes of the knee. | No acute fracture is evident. |
Generate impression based on findings. | Male 92 years old Reason: r/o appy vs diverticulitis vs mesenteric ischemia History: RLQ pain, h/o afib ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Liver cysts are unchanged. Cholelithiasis without biliary dilatation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Bilateral renal cysts.KIDNEYS, 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:PROSTATE, SEMINAL VESICLES: Significantly enlarged prostate gland.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Significant enlarged prostate. Bilateral pleural effusions and dependent atelectasis. Cholelithiasis. |
Generate impression based on findings. | Reason: etiology right axillary masss and numnbness History: right axillary numbness, mass LUNGS AND PLEURA: Punctate calcified granuloma in the right lower lobe.MEDIASTINUM AND HILA: Left-sided dual-lead pacemaker with tips in the right atrial appendage and RV apex. The RV lead extends into the pericardial space, there is no evidence of pericardial effusion and this is presumably long-standing. Scattered small subcentimeter nodes.CHEST WALL: No evidence of right axillary mass. There are scattered small subcentimeter nodes. Mild degenerative change involving thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of right axillary mass. There are scattered small subcentimeter nodes. Other findings as above. |
Generate impression based on findings. | 59-year-old female with history of breast cancer. Evaluate for response. CHEST:LUNGS AND PLEURA: The lungs are slightly underinflated. Slightly increased postradiation changes of bronchiectasis and fibrosis in the right upper lung. Bilateral mosaic attenuation may be the sequela of bronchiolitis. Interval development of small right pleural effusion. Bilateral nonspecific pulmonary micronodules. MEDIASTINUM AND HILA: Heart size normal without pericardial effusion. No mediastinal or hilar lymphadenopathy. Mild coronary artery calcifications.CHEST WALL: Left chest port with tip in the high right atrium. Status post right mastectomy and right axillary dissection. Necrotic appearing lymph node in the right axilla has increased in size measuring 14 mm cm, previously 8 mm. Partially imaged right supraclavicular mass. Subcutaneous nodule posterior to the right scapula is unchanged.Mild multilevel degenerative disease affects the visualized thoracic spine. Unchanged presternal subcutaneous calcification.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: Small soft tissue nodule in left buttocks (image 125/132) was not within the field of view of prior. It is likely an injection granuloma though continued follow up is recommended given the history of soft tissue metastases.OTHER: No significant abnormality noted. | 1. Necrotic appearing right axillary lymph node has increased in size now measuring 14 mm.2. Right subclavicular mass only partially visualized.3. New small right pleural effusion.4. Other findings as above. |
Generate impression based on findings. | Male 30 years old Reason: r/o fistula vs obstruction History: abd pain ABDOMEN:LUNG BASES: Right lower lobe scarring.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral nephrolithiasis without evidence of hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is wall thickening of the rectosigmoid colon and skipped areas of the left colon compatible with patient's known history of Crohn's disease.In addition a long segment of the distal ileum including the terminal ileum demonstrates irregular wall thickening with skip areas, again compatible with active Crohn's disease. There is fibrofatty proliferation and multiple enlarged mesenteric lymph nodes compatible with Crohn's disease.Proximal to the inflamed distal ileal segments distal ileal loops demonstrate mild dilatation.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Please see discussion aboveBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | There is involvement of distal ileum including terminal ileum as well as rectosigmoid and left-sided colon with active Crohn's disease. MR enterography may helpful for further evaluation of small bowel involvement, clinically indicated.Bilateral renal stones. |
Generate impression based on findings. | Reason: evaluate neck for lymphadenopathy History: abnormal pet scan, h/o lymphoma Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. The left jugulodigastric node measures 13 mm short axis dimension and previously measured approximately the same. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. There is a 14 mm short axis dimension lymph node present in the left jugular chain below the level of the cricoid at the level of the thyroid gland which previously measured 9 mm short axis dimension there is a 9-mm short axis dimension lymph node present just below the level of the hyoid bone which previously measured 13 mm short axis dimension. There are number of smaller lymph nodes scattered throughout the soft tissues of the neck. Some have mildly enlarged and some have mildly decreased in size and many of them are stable.Within the visceral space the thyroid gland appears intact.The airway appears patent.The visualized intracranial structures which include the posterior fossa are intact. The visualized portions of the orbits are intact. The paranasal sinuses demonstrate partial opacification of the left maxillary sinus. The mastoid air cells are partially opacified but also somewhat underdeveloped and unchanged since the prior exam.The parotid and the submandibular glands appear intact.The visualized lung apices appear clear.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis.Small lymph nodes are also identified in the upper mediastinum measuring up to 9 mm short axis dimension axillary lymph nodes are identified measuring up to 11 mm short axis dimension and is not substantially different than on the prior exam | 1.There is waxing and waning of the size of lymph nodes in the soft tissues of the neck. A few lymph nodes are smaller but more appear to be slightly larger when compared with prior exam. Overall there is a mild degree of progression of lymphadenopathy. |
Generate impression based on findings. | Small foci of T2 hyperintensity are present within the left caudate as well as left cerebellar hemisphere without associated restricted diffusion, mass effect, or susceptibility abnormality. The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. | 1.No restricted diffusion to suggest the presence of acute ischemia.2.Two small foci of chronic small vessel ischemia in the left caudate as well as left cerebellar hemisphere. |
Generate impression based on findings. | Male 12 years old Reason: Eval lung fields History: aspiration event yesterday, difficult extubation.VIEW: Chest AP (one view) 3/9/15 at 631 hours. Cholecystectomy clips, central line, thoracolumbar dextroscoliosis and ET tube unchanged. Cardiac silhouette size is normal. Persistent left upper and left retrocardiac opacity. No effusions or pneumothorax. | No change in multifocal opacities. |
Generate impression based on findings. | 34-year-old female with shortness of breath PULMONARY ARTERIES: The main pulmonary artery measures 2.7 cm. Adequate pulmonary opacification without evidence of pulmonary embolism.LUNGS AND PLEURA: Basilar predominant groundglass opacities and interlobular septal thickening is nonspecific but compatible with edema. Trace left pleural effusion tracking along the major fissures. Nonspecific focal nodular opacities may represent atelectasis or atypical infection. Equivocal mild basilar bronchiectasis.MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion. Mild bihilar lymphoid prominence.CHEST WALL: No axillary, retrocrural, or cardiophrenic lymphadenopathy. No suspicious osseous lesions.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Splenule is noted. | 1.No evidence of pulmonary embolism.2.Widespread severe interstitial opacity presumably secondary to pulmonary edema.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Status post fracture.VIEWS: Right thumb AP and lateral 3/9/15. (Two views) Interval cast removal. Healing epiphyseal fracture of the proximal phalanx of the right first digit is in anatomic alignment. | Healing fracture in anatomic alignment after cast removal. |
Generate impression based on findings. | Reason: 70F with small cell ung cancer with concen for metstatic lesion to liver. History: possible liver leison, need path CHEST:LUNGS AND PLEURA: Severe emphysema.Mass in superior segment of left lower lobe (image 38/91 extends into the left perihilar location. For continued reference this measures 40 x 32 mm on image 44/139). A right middle lobe mass is presumably metastatic (image 60/91) and abuts the right atrium. It may be based in the pericardium rather than the lung.MEDIASTINUM AND HILA: Postop change involving the neck. Intrathoracic lymphadenopathy consistent with metastatic disease. For continued reference an AP window lymph node measures 30 mm on image 33/139. Portions are contiguous with the left hilar mass. Right hilar lymphadenopathy is also present (image 40/139).Mild coronary calcification.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No definitive hepatic metastasis is seen.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: Chronic appearing occlusion of the right common iliac artery is incompletely evaluated. Atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No definitive liver lesion is identified.Intrathoracic reference measurements as above. |
Generate impression based on findings. | 21 month old male. Eval line placement. S/p BHT.VIEW: Chest AP (one view) 3/9/2015 at 0200 ET tube with tip below thoracic inlet and above carina. Enteric tube with tip in the stomach.Patchy pulmonary opacities compatible with atelectasis, with increased lung volumes compared to prior. Cardiothymic silhouette is normal.Gaseous distention of the stomach is resolved.Contrast opacifies normal pelvocaliceal systems. | Enteric tube tip in the stomach, with resolved gastric distention. |
Generate impression based on findings. | 69 year old female status post left lumpectomy in 2013 for invasive lobular carcinoma, presents today for routine follow up. Patient received radiation and hormonal therapy (Tamoxifen). No current breast complaints. Family history of breast carcinoma in her mother and sister. Three standard views of both breasts, 2 spot magnification views of the left breast, and a spot compression ML view of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker has been placed on a scar overlying the upper central left breast with underlying postsurgical changes, including surgical clips. An asymmetry present within the upper right breast, anterior depth on ML view dissipates on spot compression imaging, compatible with superimposition of normal parenchymal tissue. Scattered benign calcifications are present. No dominant mass, suspicious microcalcifications or areas of nonsurgical architectural distortion in either breast. Benign appearing lymph nodes are projected over the right axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | CT Head: 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 unchanged 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.CTA Head: There are bilateral supraclinoid internal carotid artery aneurysm embolization coil masses. The associated metal artifact limits assessment of recurrent aneurysm. There is a 2 mm outpouching from the A2 segment of the right anterior cerebral artery. There appears to be moderate stenosis of the A2/3 segment of the right anterior cerebral artery versus artifact. There are calcifications in the bilateral carotid arteries siphons. The left vertebral artery is diminutive in size, which is a normal anatomic variant. There is fenestration of the basilar artery near the vertebrobasilar junction. | 1. Sequela of circle of Willis aneurysm coil embolization, without definite evidence of acute intracranial hemorrhage within the limits of artifact. 2. An 11 mm wide left frontal paramedian extra-axial calcified lesion may represent a meningioma. 3. A 2 mm outpouching from the A2 segment of the right anterior cerebral artery may represent an infundibulum or aneurysm. 4. Basilar artery fenestration.5. Apparent moderate focal stenosis of the A2/3 segment of the right anterior cerebral artery versus artifact. |
Generate impression based on findings. | Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.T12/L1: UnremarkableL1/2: UnremarkableL2/3: UnremarkableL3/4: Mild disc bulge and mild facet hypertrophy without significant stenosis.L4/5: Diffuse annular disc bulge and mild facet hypertrophy without significant stenosis.L5/S1: Unremarkable | Mild degenerative changes without significant stenoses. |
Generate impression based on findings. | Vaso-occlusive disease.EXAMINATION: Chest AP/lateral (two views) 03/08/15 Cholecystectomy clips are identified.Cardiac silhouette size is upper limits of normal. Streaky opacities are present in both lung bases and in the perihilar regions. No definite pleural effusion is seen. | Streaky opacities in both lung bases. |
Generate impression based on findings. | 21 Month old male. Trauma; TV fell on patientVIEW: Chest AP (one view) 3/9/2015 at 0008 hrs ET tube with tip at the level of the thoracic inlet.The aortic arch, cardiac apex, and stomach are left-sided.Opacities in the right upper lobe, with elevation of the minor fissure, as well as left lower lobe opacities.No pleural effusion or pneumothorax.Marked gaseous distention of the stomach, likely related to bag-mask ventilation.No displaced fractures are identified. | Opacities compatible with atelectasis. Marked gaseous distention of the stomach, likely related to bag-mask ventilation. |
Generate impression based on findings. | 86-year-old female status post fall. Pain to the left posterior shoulder girdle and proximal humerus with associated ecchymosis. Deformity of the left scapular body, likely secondary to fracture. There is associated medial displacement of the glenoid and resultant soft tissue deformity. The humeral head maintains its relationship with the glenoid. No discrete fracture is evident in the humerus. There are degenerative cysts in humeral head. A chronic-appearing fracture is present in the left fifth rib. | Fracture through the body of the left scapula. CT is recommended for further evaluation. |
Generate impression based on findings. | Reason: ho infiltrate on cxr, eval for infection vs infarct History: see above LUNGS AND PLEURA: Peripheral groundglass and airspace opacity in the right lower lobe (image 68/120). More dense airspace opacity in the medial right lower lobe (image 87/120).Bilateral centrilobular nodules with tree in bud opacity and bronchial wall thickening suggestive of bronchiolitis.Densely calcified right upper lobe nodule presumably a granuloma. 10-mm irregular nodule in right upper lobe (image 34/120) is nonspecific and is too small to be visible on comparison chest radiograph.Moderate left pleural effusion with left lower lobe atelectasis.Emphysema.Pleural calcification on the right likely from prior effusionMEDIASTINUM AND HILA: Right-sided aortic arch. Atherosclerotic calcification of the aorta and its branches. Status post CABG. Left-sided ICD. Severe coronary calcification. Scattered small nodes.CHEST WALL: Status post sternotomy. Degenerative change involving thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Punctate granulomas in the spleen. Status post cholecystectomy. Punctate bilateral renal calculi. No evidence of hydronephrosis. | 1. Peripheral groundglass and airspace opacities in the right lower lobe which may be due to aspirate or infection. The more lateral opacity, which correlates with the findings on CXR, has an appearance which could be seen with infarct or organizing pneumonia.2. 10-mm irregular nodule in right upper lobe is nonspecific but concerning for malignancy. Consider PET/CT if the patient's condition permits. Otherwise a 3 month follow up CT is recommended.3. Moderate left pleural effusion with left lower lobe atelectasis.4. Bilateral centrilobular nodules with tree in bud opacity and bronchial wall thickening suggestive of bronchiolitis, possibly related to infectious or aspiration bronchiolitis.5. Multiple other findings as above. |
Generate impression based on findings. | Male 85 years old Reason: evaluate ngt History: ngt. Suboptimal images due to motion artifact. NG tube tip appears to be in the proximal stomach. There are degenerative arthritic changes of the sacrum and bilateral hips. Note is made of vascular calcifications in the pelvis. There is an overlying catheter. | NG tube tip appears to be in the proximal stomach. |
Generate impression based on findings. | 86-year-old female with fall today, presenting with pain to the left posterior shoulder girdle and proximal humerus, with associated emesis. There is deformity of the body of the left scapula, suggestive of fracture. There is associated medial displacement of the glenoid and soft tissue deformity. The humeral head maintains a normal relationship with the glenoid.There are degenerative cysts in the humeral head. An old rib fracture is present in the left fifth rib. | Evidence of fracture two left scapular body. CT is recommended for further evaluation, when clinically feasible. |
Generate impression based on findings. | Male 77 years old Reason: evaluate for obstruction History: abdominal pain. Suboptimal study due to patient motion. There is mildly dilated small bowel seen in the left abdomen with some air suggested in expected region of rectum. There is a right upper quadrant gallstone, seen on prior CT. There are pelvic surgical clips consistent with cystoprostatectomy. Note is made of a right percutaneous nephrostomy in the transplant kidney, which was seen on the prior CT. Left femoral neck bone island. Partially imaged low lung volumes with patchy airspace opacities seen in the lung bases. | Mildly dilated small bowel seen in the left abdomen with some air in the rectum may reflect diffuse ileus, but partial small bowel obstruction cannot be excluded and correlation with patient's clinical history and continued follow up recommended. |
Generate impression based on findings. | Male, 75 years old, with encephalopathy. The examination was performed with a stereotactic frame in place for purposes of surgical navigation. Again seen is a large region of hypoattenuation involving prominently the white matter of the right anterior temporal lobe with spread superiorly into the operculum and insula on the right. No significant interval change is seen. No evidence of acute intracranial hemorrhage is seen. No impending brain herniation is detected. Periventricular hypoattenuation, along with more focal areas of lucency involving the left basal ganglia, brain stem and the cerebellum, may reflect prior ischemic injury. | Preoperative planning examination redemonstrates a large area of mostly white matter hypoattenuation centered in the right temporal lobe. |
Generate impression based on findings. | The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. Myelination is mature. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The mastoid air cells are clear. | Negative noncontrast brain MRI. Specifically, there are no MRI findings to explain the patient's seizure. |
Generate impression based on findings. | Female 49 years old Reason: See capsule History: Swallowed video capsule. Endoscopic capsule and patency capsule are again seen in the right abdomen, unchanged in position. Nonobstructive bowel gas pattern.Lung bases are clear. Right Port-A-Cath tip at the cavoatrial junction. Postsurgical changes in the right abdomen. Probable bone islands of the right iliac wing as seen on prior CT. Incompletely imaged right pelvic post traumatic sequale. | Endoscopy capsule and patency capsule still present in right abdomen, unchanged in position from prior exam. |
Generate impression based on findings. | 71-year-old female status post left mastectomy on 7/13/2012 4 IDC and DCIS. Patient received radiation, chemotherapy, and hormone therapy. History of stereotactic biopsy of the right breast with benign histology. Family history of breast cancer in sister, two maternal aunts, and 3 maternal cousins. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Biopsy clip is again noted within the right upper quadrant with stable adjacent faint calcifications. Scattered bilateral coarse benign calcifications have progressed in a benign fashion elsewhere.No new masses, new suspicious morphology microcalcifications or areas of architectural distortion in the right breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, unilateral right diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Left lateral ankle pain following twisting left ankle with swelling. Three views of the left ankle reveal no acute fracture or malalignment. There is mild soft tissue swelling about the lateral malleolus. | Soft tissue swelling without acute fracture. |
Generate impression based on findings. | Male, 75 years old, status post brain biopsy. Sequelae of recent biopsy are seen including a burr hole in the right cranial vertex, a small amount of pneumocephalus, and the presence of a biopsy marker along the medial right temporal lobe.Hypoattenuation is demonstrated affecting primarily the white matter of the right temporal lobe with spread to the operculum and insula without significant interval change.No evidence of significant intracranial hemorrhage is seen. No mass effect is detected. Scattered areas of age indeterminant microvascular and lacunar ischemia are redemonstrated similar to prior. | Expected findings status post biopsy of a right temporal lesion. |
Generate impression based on findings. | 34 year old female with known bilateral breast cysts. Family history of breast carcinoma in her paternal aunt. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Multiple partially circumscribed masses are present throughout both breasts. A dominant, partially obscured mass is present at the approximate 7 o'clock position of the right breast. Additionally, a partially circumscribed mass is present at the 8 o'clock position of the left breast. No suspicious microcalcifications or areas of architectural distortion in either breast. BILATERAL ULTRASOUND | Multiple bilateral simple appearing cysts. No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is suggested annually, but based on her age, clinical exams only until the age 40 could also be considered if her exam remains stable and benign. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | There are postoperative findings related to endoscopic sinus surgery. The frontal sinus and frontoethmoidal recesses are clear. The anterior ethmoid cavities are clear. The right maxillary sinus is clear. There is mild mucosal thickening of the left maxillary sinus. The neo-infundibulae are grossly patent. The posterior ethmoid cavities are clear. The sphenoid sinuses and bilateral sphenoethmoidal recesses are clear. There is no significant nasal septal deviation. The nasal turbinate morphology is within normal limits. The nasal cavity is clear. The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. There are post-surgical changes related to remote bifrontal craniotomy with areas of hypoattenuation in the frontal lobes and ex vacuo dilation of the right frontal horn. | 1. Sequela of endoscopic sinus surgery.2. Mild mucosal thickening of the left maxillary sinus. 3. Post-surgical changes related to remote bifrontal craniotomy with areas of hypoattenuation in the frontal lobes. A brain MRI may be useful for further evaluation if clinically indicated 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. | Female; 67 years old. Reason: preop redo MVR History: SOB VESSELS:See report from cardiac CT for measurements of vessels in the chest.SUPRARENAL ABDOMINAL AORTA: 1.7 X 1.8 cmINFRARENAL ABDOMINAL AORTA: 1.3 X 1.4 cmRIGHT COMMON ILIAC ARTERY: 9 X 7 mmRIGHT EXTERNAL ILIAC ARTERY: 7 X 7 mmRIGHT COMMON FEMORAL ARTERY: 7 X 6 mmLEFT COMMON ILIAC ARTERY: 8 X 8 mmLEFT EXTERNAL ILIAC ARTERY: 7 X 7 mmLEFT COMMON FEMORAL ARTERY: 7 X 7 mmScattered atherosclerotic plaques cause mild narrowing of the origin of the celiac artery, moderate narrowing of the origin of the SMA, mild to moderate narrowing of the origin of the left renal artery, and mild narrowing of the origins of the bilateral common iliac arteries.CHEST:Findings will be reported separately by an attending chest radiologist and included as an addendum to the cardiac CT report.ABDOMEN:LIVER, BILIARY TRACT: Mild hepatomegaly. Cholelithiasis.SPLEEN: Mild splenomegaly.PANCREAS: Mild diffuse dilation of the pancreatic duct without transition point evident. No focal pancreatic lesions.ADRENAL GLANDS: Mild nonspecific left adrenal gland thickening.KIDNEYS, URETERS: Tiny right kidney hypoattenuating lesion is too small to characterize but likely a benign cyst.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:UTERUS, ADNEXA: 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: Small amount of pelvic ascites. Right femur orthopedic hardware. | 1.No acute abdominopelvic abnormality.2.Hepatosplenomegaly.3.Cholelithiasis.4.Atherosclerosis of the abdominal aorta and its branch vessels, as detailed above.5.Noncardiac chest findings will be reported separately by an attending chest radiologist and included as an addendum to the cardiac CT report. |
Generate impression based on findings. | 20 year-old male in pedestrian versus MVA accident. Complains of "pain posteriorly and the lower portion of the cranium." Normal appearance of the calvarium and proximal cervical spine. No fracture is identified. | No acute fractures identified. |
Generate impression based on findings. | First MTP joint pain. Question of DJD versus gout versus pseudogout. Three views of the right foot reveal mild osteophyte formation and joint space narrowing of the first metatarsal phalangeal joint. No bone erosions are seen. No acute fracture is evident. There is a plantar heel spur. | Mild osteoarthritis of the first metatarsal phalangeal joint. |
Generate impression based on findings. | Redemonstrated is hypodensity within the white matter without associated mass effect. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. Sporadic foci of the mucosal thickening can be found within the paranasal sinuses. The mastoid air cells are clear. | 1.Stable small vessel ischemic disease of indeterminate ages.2.No acute intracranial hemorrhage.3.No intracranial mass, mass effect, or midline shift. |
Generate impression based on findings. | Female 44 years old Reason: Evaluate gas pattern History: emesis. Body habitus and portable technique limits evaluation. Partially imaged underinflated lung bases. There is a paucity of small bowel gas. There appears to be dilated loops of air containing bowel, measuring up to 5 cm, in the mid to left abdominal soft tissues, may be located in patient's ventral hernia, and appearance suggestive of interval increase in dilation from prior exam. Residual contrast in the right hemicolon. Findings suggestive of partial small bowel obstruction. Vascular calcifications are noted. | Partial small bowel obstruction with possible increase in dilated loops of small bowel in the ventral hernia. Follow up with CT is recommended for improved evaluation given patient's body habitus. |
Generate impression based on findings. | 78-year-old female with history of left mastectomy in 2008 for DCIS. No new breast complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable possible fibroadenolipoma and adjacent focal asymmetry in the right upper outer quadrant. Benign calcifications in both breasts have progressed in a benign fashion.No new mass, suspicious microcalcifications or areas of architectural distortion in the right breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, unilateral right diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Left shoulder pain. Question of DJD versus rotator cuff syndrome. Three views of the left shoulder reveal no acute fracture or malalignment. There is mild osteophyte formation at the acromioclavicular joint. | Mild degenerative changes of the acromioclavicular joint. |
Generate impression based on findings. | 20 year-old male in pedestrian versus MVA accident. Complaint of pain in from posterior lower ribs to the third/fourth lumbar vertebra level. Normal appearance of the lumbar spine. No evidence of fracture or dislocation. | No evidence of fracture or dislocation. |
Generate impression based on findings. | Female; 64 years old. Reason: please re-evaluate extent of metastatic disease in pt with metastatic pancreatic cancer History: diarrhea CHEST:LUNGS AND PLEURA: New diffuse patchy peripheral groundglass opacities with tree-in-bud, most suggestive of infectious bronchiolitis. Some of these opacities are more solid-appearing and may represent developing metastases.New solid, rounded nodules in both lung bases, compatible with metastases. For future reference, a metastatic nodule in the left lung base measures 22 x 12 mm (series 6/66).New enhancing pleural nodules in both posterior costophrenic angles, compatible with pleural metastases. New small to moderate pleural effusions.MEDIASTINUM AND HILA:Reference supraclavicular lymph node measures 6 x 6 mm, unchanged (series 4/12).New enlarged right hilar lymph node measures 12 mm in short axis (series 4/21), which may be reactive versus metastatic.Mild cardiomegaly. Moderate pericardial effusion, increased since prior. Chest wall port terminates at the cavoatrial junction.CHEST WALL: Sclerotic focus in the right lateral fifth rib is unchanged.ABDOMEN:LIVER, BILIARY TRACT: Pneumobilia is unchanged. Status post cholecystectomy. Liver demonstrates normal morphology and enhancement. Hepatic vessels are patent. There is increased narrowing of the main portal vein near the head of the pancreas, but the vessel remains patent.SPLEEN: No significant abnormality notedPANCREAS: Infiltrative hypoattenuating mass in the pancreatic tail has increased in size since prior study, currently measuring approximately 2.6 x 3.3 cm (series 4/95). There is increased dilation of the pancreatic duct in the atrophic pancreatic tail distal to the mass.Redemonstration of thrombosed splenic vein. ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post left nephrectomy. Multiple simple renal cysts in the right kidney.RETROPERITONEUM, LYMPH NODES: Increased retroperitoneal lymphadenopathy, especially in the aortocaval region are noted. Reference para-aortic lymph node measures 1.7 x 1 cm, previously 1.4 x 0.8 cm (series 4/02).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: New mild abdominopelvic ascites.PELVIS:Uterus and adnexa: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Multiple surgical clips along the left inguinal region.BOWEL, MESENTERY: Diverticula in the sigmoid colon without evidence of diverticulitis.BONES, SOFT TISSUES: Degenerative changes of the lumbosacral spine.OTHER: New mild abdominopelvic ascites. | 1. New pulmonary and pleural metastatic disease.2. Findings suggestive of infectious bronchiolitis.3. Enlarged right hilar lymph node may be reactive versus metastatic.4. Increased size of pancreatic tumor and retroperitoneal lymphadenopathy.5. New mild abdominopelvic ascites.6. Increased narrowing of the proximal main portal vein, which remains patent. |
Generate impression based on findings. | 20 year-old male in pedestrian versus MVA accident. Small wound along the anterior aspect of the hand, proximal to the carpal bones. Normal appearance of the osseous structures in the right hand and wrist. No evidence of fracture or dislocation. No significant soft tissue swelling is identified. | No acute fracture or malalignment. |
Generate impression based on findings. | 20 year-old male in pedestrian versus MVA accident. Patient complains of pain along the third PIP joint and first carpometacarpal joints of the left hand. Normal appearance of the osseous structures in the right hand and wrist. No evidence of fracture or dislocation. No significant soft tissue swelling is identified. | No acute fracture or malalignment. |
Generate impression based on findings. | 20 year-old male in pedestrian versus MVA accident. Patient complains of pain along the medial aspect of the left knee joint. Normal appearance of the osseous and soft tissue structures of the knee. No evidence of fracture or malalignment. No joint effusion is identified. | No evidence of fracture or malalignment. |
Generate impression based on findings. | 34-year-old female with recent fall after slipping on the eye as, left ankle and heel pain. No fracture or dislocation is identified. There is no significant soft tissue swelling. | No fracture or dislocation. |
Generate impression based on findings. | Status post slipped on ice and twisting of right ankle, patient describes pain and swelling in the lateral aspect of the right ankle. Lateral soft tissue swelling without acute fracture or dislocation. | Lateral soft tissue swelling without acute fracture or dislocation. |
Generate impression based on findings. | Reason: peds trauma History: tv fell on him ABDOMEN:LUNG BASES: Scattered consolidation at the bilateral lung bases, most compatible with dependent atelectasis.LIVER, 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: Enteric tube with tip in the stomach. Mildly dilated loops of small bowel may be related to mechanical ventilation.BONES, SOFT TISSUES: No fractures or osseous lesions noted.OTHER: No free air or free fluid.PELVIS:GENITAL: Right sided undescended testis.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No fractures or osseous lesions noted.OTHER: No significant abnormality noted | 1. No evidence of solid organ or hollow viscus injury. No free air or free fluid.2. Right sided undescended testis. |
Generate impression based on findings. | Fracture.VIEWS: Left ankle AP/lateral/oblique (3 views) 03/09/15 Cast has been removed. Alignment is anatomic. Salter fracture of distal fibula is healing. There is demineralization. | Healing fracture in anatomic alignment. |
Generate impression based on findings. | Reason: newly Dx Sigmoid mass with concern for primary Colon Ca; CT chest for staging purposis History: staging LUNGS AND PLEURA: Basal mild atelectasis and scarring with trace pleural effusions. No evidence of pulmonary metastases.MEDIASTINUM AND HILA: Hiatal herniaCHEST WALL: No significant abnormality noted. | No evidence of pulmonary metastases.There is ascites, pneumoperitoneum and a presumed bowel obstruction which is incompletely visualized on chest CT. This was communicated to Dr. Shogan by the on call radiology resident 8:10pm 3/8/15. Please see separate A/P CT report. |
Generate impression based on findings. | 58-year-old female with past medical history of diabetes, presenting with swelling of the right foot for 3 days, open sore to the fourth digit; patient denies pain. There is redemonstration of dorsal subluxation of the first metatarsal phalangeal joint. Chronic healed fracture deformity is of the second metatarsal and proximal second phalanx are stable in appearance.Multiple foci of gas in the dorsal soft tissues of the foot, new from prior exam, highly suspicious for infection. No definitive bone destruction is present to suggest osteomyelitis.There is significant degenerative disease of the foot. | 1.Interval development of foci of gas in the dorsal soft tissues of the foot, highly suspicious for infection. There is no definitive bony destruction to suggest osteomyelitis. However, if clinical suspicion for osteomyelitis persists, MRI is suggested.2.Chronic fracture deformities of the second metatarsal and proximal second phalanx are stable.3.Redemonstration of dorsal subluxation of the first metatarsophalangeal joint. |
Generate impression based on findings. | 69-year-old female with history of fall, pain in the left knee. A joint effusion is present. There is no fractures or malalignment. | Joint effusion without acute fracture or malalignment. |
Generate impression based on findings. | 65-year-old female with history of probable left breast fibroadenoma. Family history of breast cancer diagnosed in mother at age 39 and maternal aunt at age 70. No current breast complaint. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Ovoid 1.5 cm circumscribed mass in the left central breast, posterior depth, is stable. Scattered benign coarse calcifications in both breasts are also stable.No new mass, suspicious microcalcifications or areas of architectural distortion in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 37-year-old male with recent fall, pain in the right knee. No evidence of fracture or malalignment. No significant joint effusion or soft tissue swelling is present. | No evidence of fracture or malalignment. |
Generate impression based on findings. | 6 years old male. History: fused right kidney BLADDER Wall Thickness: Normal Contents: Distended and normal. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Observed Left: ObservedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Left: 0 Length*** Right: 8.4 cm Left: 6.3 cm Mean for age: 8.0 cm Range for age: 6.5 - 9.2 cmADDITIONAL OBSERVATIONS: Pole of the ectopic left kidney is fused to the lower pole of the right kidney. The left kidney is horizontally oriented and crosses the midline. The fused ectopic left kidney is slightly smaller in length than the right kidney. | Ectopic left kidney fused to the lower pole of the right kidney without evidence of hydronephrosis.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | Male, 85 years old, with right upper extremity swelling, probable DVT which may need anticoagulation. Need to reevaluate a left sided subdural hematoma seen in December of 2014. A hypoattenuating subdural collection along the left cerebral hemisphere has not significantly changed in quantity or distribution measuring between 4 to 5 mm in thickness. No new pathologic intra-cranial fluid collections are detected.An area of ill-defined hypoattenuation/encephalomalacia in the left frontal lobe has progressed in geographic extent. There has also been some progression of hypoattenuation along the left lateral ventricle extending into the left basal ganglia. Generalized periventricular hypoattenuation is not significantly changed. Additional scattered more focal lucencies including within the right thalamus, pons and cerebellum have not significantly changed. No evidence of any new or significant mass effect is seen.The osseous structures of the skull are intact. The subcutaneous tissues along the left parietal scalp are thickened and hyper attenuating similar to the prior examination which may reflect chronic scalp injury. | 1. A hypoattenuating subdural collection along the left cerebral hemisphere has not significantly changed in thickness or extent. No new intracranial hemorrhage is suspected.2. Progressive encephalomalacia within the left frontal lobe, as well as progressive hypoattenuation along the left lateral ventricle, are seen. These findings are age indeterminate but imply interval evolution of ischemic disease. |
Generate impression based on findings. | 67-year-old female with history of metastatic breast cancer on treatment for evaluation of response and extent of disease CHEST:LUNGS AND PLEURA: Multiple bilateral pulmonary nodules compatible with metastases are not significantly changed since the prior exam. Reference left lower lobe subpleural nodule measures 10 x 8 mm, previously 10 x 8 mm (series 5, image 33). Reference right lower lobe nodule is unchanged measuring 5 mm (series 5, image 45). No new pulmonary nodules or masses. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Stable to slightly increase in a subcentimeter prevascular lymph node (series 4 , image 33). Additional scattered subcentimeter mediastinal lymph nodes. The heart size is normal. No pericardial effusion. Calcified prevascular lymph node is unchanged. Normal variant direct origin of the left vertebral artery from the aorta is again noted.CHEST WALL: No supraclavicular, axillary, retrocrural, or cardiophrenic lymphadenopathy. Postsurgical changes of bilateral mastectomies and axillary lymph node dissections. Previously noted enlarged left axillary lymph node measures 14 mm in short axis, previously 16 mm (series 4, image 16).Sclerosis of the T4 vertebral body is not significantly changed. Focal sclerotic lesion in the T9 and L2 vertebral body and left scapula are unchanged.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Metastases in the right lobe of the liver appear stable. Reference anterior right lobe lesion measures 3.2 cm (series 4, image 107). Note that prior report indicates 2.2 cm for this measurement but upon my review and based on the saved key images, the prior measurement should be 3.2 cm. Other liver lesions are also stable.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Scattered subcentimeter hypodense lesions are too small to further characterize. Unchanged, probable right subcentimeter renal cyst.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: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable metastases with no new sites of disease. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previuos measurements History: none CHEST:LUNGS AND PLEURA: Right apical bronchiectasis and scarring, not appreciably changed. Mild bronchiolitis in the right lower lobe has resolved. Linear areas of scarring in the right upper and left lower lobes. Right pleural plaques. Unchanged subpleural nodular density at the right lung base (image 80/110), possibly an area of scarring. Calcified granuloma on the left. No evidence of pulmonary metastases.MEDIASTINUM AND HILA: Right tip at RA/SVC junction. Severe coronary calcification. No pathologically enlarged nodes.CHEST WALL: Postop change left chest with drain in soft tissues. No change in 10-mm right supraclavicular lymph node (image 18/143).ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Cholelithiasis. Stable nonspecific calcifications along the liver margin.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Nodularity the left adrenal gland unchanged in appearance.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic disease of the aorta and its branches, including the renal arteries.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Post op change in left chest wall. Otherwise stable CT with no change in borderline right supraclavicular lymph node. |
Generate impression based on findings. | Metastatic melanoma. Surveillance scan. CHEST:LUNGS AND PLEURA: Unchanged pulmonary nodules, including the right middle lobe reference nodule that is 0.6 x 0.7 cm (series 5, image 63), previously 0.6 x 0.8 cm and reference left lower nodule that is 0.6 x 0.7 cm (series 5, image 59), previously 0.5 x 0.6 cm.Other scattered nodules are unchanged.Mild subpleural reticulation diffusely suggestive of mild fibrosis, unchanged.MEDIASTINUM AND HILA: Scattered small mediastinal and left hilar lymph node, unchanged. No new lymphadenopathy.Mild coronary artery calcification. No pericardial effusion.CHEST WALL: No axillary lymphadenopathy.Mild degenerative changes of the thoracic spine.ABDOMEN:LIVER, BILIARY TRACT: Unchanged subcentimeter right hepatic lobe hypodensity, too small to characterize. No new hepatic lesions. Cholelithiasis.SPLEEN: No significant abnormality notedPANCREAS: Unchanged 1 cm hypoattenuating pancreatic tail lesion (series 3, image 93).ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Severe calcified atherosclerotic disease of the abdominal aorta with mural thrombus and a penetrating atherosclerotic ulcer (series 3, image 133), unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild degenerative changes of the thoracolumbar spine.Bilateral pars defects at L5-S1 with moderate degenerative disk disease at this level, unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: 1.4 x 1.2 cm right external iliac chain node, previously 1.5 x 1.2 cm (series 3, image 177).BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: Mild degenerative changes of the thoracolumbar spine.Bilateral pars defects at L5-S1 with moderate degenerative disk disease at this level, unchanged.OTHER: No significant abnormality noted | Stable examination with no new sites of disease. |
Generate impression based on findings. | 67-year-old female with history of lumpectomy 3/2014. Patient received radiation and hormonal therapy. History of additional bilateral breast biopsies with benign histologies. No new breast complaints. Three standard views of both breasts and additional laterally exaggerated, spot magnified laterally exaggerated and spot magnified mediolateral views of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A scar marker was placed over the left upper outer breast. Interval postsurgical changes of left outer quadrant lumpectomy including surgical clips and architectural distortion. Two biopsy clips are present in the right breast and one in the left breast. A few scattered benign calcifications including arterial calcifications in both breasts are stable. No new mass or suspicious microcalcifications in either breast. Left axillary surgical clips. | Expected postsurgical changes from left lumpectomy. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Fractures.VIEWS: Right forearm PA/lateral (two views) 03/09/15 A cast has been applied. Both bones fracture of the mid forearm is again seen. Minimal anterior angulation of the distal fracture fragments is noted. | Both bones fracture of mid forearm in cast. |
Generate impression based on findings. | Male, 63 years old, with history of T3N2c SCC or the left tonsil. The mucosal tissues of the supraglottic larynx remain edematous compatible with treatment effect. There is a persistent retropharyngeal effusion. Edema of the soft palate has improved. No tonsillar masses are identified without the benefit of IV contrast.A left level Ib reference node measures up to 6 mm in short axis dimension (image 33 series 8), previously 6 mm. A partially calcified left level 2 reference lymph node measures up to 11 mm short axis (image 32 series 8), previously 12 mm. A left level 3 calcified node measures up to 7 mm short axis (image 50 series 8), previously 8 mm. No new or progressive adenopathy is detected.Salivary glands and thyroid are unremarkable. Cervical vessels are not adequately assessed without contrast. No concerning lesions are demonstrated. The left mastoids are underpneumatized and there is patchy opacification of the right mastoids. Deformity of the nasal bone may reflect prior trauma. Deformity of the right mandibular condyle may reflect prior trauma or TMJ degenerative disease.Diffuse cerebellar atrophy is again seen. Right apical lung scarring is unchanged. | No evidence to suggest progressive disease in the neck. |
Generate impression based on findings. | Check fracture alignment Interval removal of cast material. The largely transverse and intra-articular distal radial and ulnar styloid fractures remain aligned. Fracture planes remain distinct compatible subacute timing. No definite callus formation. | Anatomic alignment preserved involving the distal radial and ulnar fractures |
Generate impression based on findings. | The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. There are no masses, mass effect or midline shift. The pituitary gland is normal in size. There is no evidence for intracranial hemorrhage or acute cerebral, brainstem or cerebellar infarction. No diffusion-weighted abnormalities are identified. Myelination is mature. There are no extraaxial fluid collections or subdural hematomas. Flow voids are present within the major vessels indicating patency. The mastoid air cells are clear. | Negative noncontrast brain MRI. Specifically, there are no MRI findings to explain the patient's seizure activity. |
Generate impression based on findings. | History of pain and check fracture healing Interval removal of cast material. The distal ulnar fracture continues to demonstrate near complete healing with bridging callus formation. No change in alignment or mild radiocarpal and more marked triscaphe osteoarthritic changes | Healing distal ulnar fracture and osteoarthritis |
Generate impression based on findings. | Fracture.VIEWS: Left elbow AP/lateral (two views) 03/09/15 Alignment is anatomic. The fracture has healed. | Healed lateral condyle fracture. |
Generate impression based on findings. | Pain Continued healing of the fourth metacarpal neck fracture without alteration alignment. Moderate to more pronounced degenerative changes of the first MTP with relative preservation of the mid foot and hindfoot structures. | Healing fourth metacarpal neck fracture |
Generate impression based on findings. | Pain Bilateral moderate right over left osteoarthritic changes with narrowing, sclerosis and osteophytes. Specifically a focal ossific densities are projected adjacent to the superior acetabulum bilaterally, and may represent a loose bodies. Only serial imaging will confirm. Relative preservation of the femoral head shapes bilaterally. Again asymmetric moderate to mild right over left SI joint degenerative changes with more moderate disease of the lower lumbar spine, incompletely visualized. | Moderate osteoarthritic changes involving the right hip and SI joint over the left side. See detail provided |
Generate impression based on findings. | 61 year old female with history of atypical ductal hyperplasia, presents for routine annual examination. No current breast complaints. History of benign left breast biopsy. No family history of breast cancer. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker has been placed on a scar overlying the upper outer left breast. Stable mass is present in the upper outer left breast, posterior depth. Stable bilateral asymmetries. Scattered benign calcifications are present. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Patient fell, check for fractures Moderate osteoarthritic changes more pronounced involving the medial compartment with narrowing, sclerosis and osteophytes. Small knee effusions are also observed without superimposed findings to support distinct intra-articular fractures. However an oblique non-displaced proximal right fibular fracture is observed, please correlate with patient's symptoms and site of pain | Proximal right fibular nondisplaced fracture. Dr. Weber contacted (4143) |
Generate impression based on findings. | 76-year-old female with multinodular goiter with recent CT noting mediastinal lymphadenopathy CHEST:LUNGS AND PLEURA: No pleural effusion or pneumothorax. Multiple micronodules measuring up to 5 mm are present and unchanged. Minimal bibasilar dependent subsegmental atelectasis.MEDIASTINUM AND HILA: Large multinodular thyroid gland with mass effect on the trachea narrowing the trachea to 10 mm. No significant mediastinal or hilar lymphadenopathy. Mild cardiomegaly without evidence of pericardial effusion.CHEST WALL: No subclavicular, axillary, retrocrural, or cardiophrenic lymphadenopathy.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hypodense lesion in the right lobe of the liver measuring 11 mm is unchanged and is likely benign (series 3, image 71). The gallbladder is within normal limits.SPLEEN: Splenules are noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple hypodense exophytic lesions in bilateral kidneys.PANCREAS: Cystic lesion in the tail of the pancreas measuring 1.8 x 1.2 cm is unchanged since the prior exam and 2012 A/P CT.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Scattered diverticula along a collapsed descending colon.BONES, SOFT TISSUES: Sclerosis of the endplates of L4 and L5 with bulky anterior osteophyte and vacuum disk phenomenon. Mild to moderate degenerative changes affect the spine. No suspicious osseous lesions are identified.OTHER: No significant abnormality noted. | No significant mediastinal lymphadenopathy as clinically questioned. On our review of the prior CT there does not appear to be significant lymphadenopathy and there has been no change. There may have been a transcription error on the prior report and "no" was omitted prior to "significant lymphadenopathy".Large goiter with mild tracheal compression is described above. |
Generate impression based on findings. | 72-year-old female with family history of breast cancer diagnosed in mother age 42, maternal aunt at age 62 and maternal grandmother at 62. The patient is on hormonal therapy. No current breast complaints. Three standard views of both breasts and two additional spot compression MLO view of the left breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Asymmetry in the left lower breast appears more prominent on the current examination standard view, although completely disperses on spot compression to normal parenchyma. No new mass, suspicious microcalcifications or areas of architectural distortion in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Shoulder pain Mild osteoarthritic changes without distinct superimposed acute abnormality. Changes include narrowing, sclerosis and osteophytes. No definite dislocation, however there is a mild anterior orientation of the humeral head, please correlate with physical exam and history | Mild osteoarthritis |
Generate impression based on findings. | Internal fixation Two screws fixate a proximal radial head fracture in anatomic alignment. Fracture plane remains distinct compatible with subacute timing | Radial head fracture fixation |
Generate impression based on findings. | Hand pain Mild osteoarthritis of the radiocarpal joint and first MCP with relative preservation of the remaining articulations. Mild ulnar subluxation of the radiocarpal joints also observed.Old questionable deformity of the second and fifth metacarpal diaphysis, possibly an old remote injury and fractures. Please correlate patient's history.Soft tissues are unremarkable | Mild osteoarthritic changes without acute superimposed abnormalities. Suspected old fractures |
Generate impression based on findings. | 78 year-old female with history of metastatic breast cancer. CHEST:LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules. Mild right dependent atelectasis. No focal air space opacities, pleural effusions, or pneumothoraxMEDIASTINUM AND HILA: Scattered prominent mediastinal lymph nodes. Reference right hilar lymph node measures 8 mm, previously 10 mm (image 42 series 3). Severe coronary artery calcifications.CHEST WALL: Status post left mastectomy. Surgical clips are present in bilateral axilla. Stable right breast calcifications. Scattered thyroid hypodensities. Hypodense lesion in the vertebral body of T11 remains stable since 8/10/12..ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatic steatosis. No suspicious lesions.SPLEEN: Small splenule present.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Tiny hypoattenuating renal foci are too small to characterize.PANCREAS: Several hypoattenuating foci seen throughout the pancreatic head and body unchanged and likely represent IPMNs.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications are seen the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes are appreciated throughout the spine. Hypodense lesion in the vertebral body of T11 remains stable since 8/10/12.OTHER: No significant abnormality noted. | 1. Unchanged CT with no definitive evidence of metastatic disease.2. Other findings as above. |
Generate impression based on findings. | Female 65 years old Reason: Metastatic cholangiocarcinoma please compare to previous scan and provide index lesion measurements History: As above CHEST:LUNGS AND PLEURA: Bilateral mild bronchiectasis, not significantly changed. No new nodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Patient's known cholangiocarcinoma in the inferior aspect of the right lobe of the liver is again noted and measures 8.1 by 5 cm on image number 123, series number 4, slightly increased in size the previous study. Bilobar cystic lesions in the liver are unchanged. Metallic biliary stents, unchanged.SPLEEN: Splenomegaly, unchanged.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: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Cystic right adnexal mass measures 5 x 4 cm on image number 174, series number 4, not significant change from previous study. Left ovarian cystic lesion is also unchanged.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. | Minimal interval increase in the size of the patient's known hepatic cholangiocarcinoma. No other significant change from previous study. |
Generate impression based on findings. | 58 years old female with a history of gastric resection and positive pathology for diffuse B cell lymphoma. Evaluating for metastatic disease. RADIOPHARMACEUTICAL: 14.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 79 mg/dL. Today's CT portion grossly demonstrates left pleural effusion and compression atelectasis in the left lung base, no significant change as compared with prior study. Ascites is noted in the perihepatic space. Surgical sutures are seen in the left upper quadrant of abdomen.Today's PET examination demonstrates increased metabolic activity is seen in the stomach with SUV Max of 4.7. Increased metabolic activity are seen in the soft tissue densities at gastrohepatic ligament and perigastric/peripancreatic right region with SUV Max of 3.9. Multiple foci of increased activity in a linear distribution are seen in the midline of anterior abdominal wall with SUV Max of 3.6, which are most likely due to post surgical change. Increased activity is seen along the transhepatic on the transabdominal catheter which is consistent with post-procedural change. Diffuse FDG uptake is seen in the compression left lower lung. A focus of increased activity is seen in the floor the pelvis, which is most likely due to retention FDG containing urine in the urethra or a diverticulum.The FDG uptake in the remaining portion of the body is physiological. Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1 .Increased metabolic activity in the soft tissue densities in the left upper quadrant of the abdomen at gastrohepatic ligament, peripancreatic and perigastric regions, suspicious for nodal metastasis.2. Increased metabolic activity in the stomach, which is nonspecific.3. Increased activity in the on the abdominal catheter is most likely due to post procedural change.4. Stable left pleural effusion.5. Other post procedural findings as described above. |
Generate impression based on findings. | Elbow pain following a fall Transverse olecranon fracture and old deformity of the radial neck. Suspected acute or subacute proximal ulnar lesion with a more remote radial abnormality. Mild distraction of the ulnar lesion is noted, approximately 3 mm. Please correlate with patient's known history. | Ulnar fracture with questionable old remote deformity of the radial neck. Pager 3715 contacted |
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