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Generate impression based on findings. | Male 32 years old Reason: hx of necrotizing pancreatitis c/b infected pseudocyst s/p AXIOS stent and double pigtail stent placement. Please eval pseudocyst. Last imaging 12/15 History: abdominal pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Gallbladder wall is diffusely thickened and measures up to 1.6 cm. This is likely secondary to acute cholecystitis. No evidence of intra-or extrahepatic biliary dilatation. Significant fat stranding is present around the gallbladder.SPLEEN: Unremarkable.PANCREAS: Interval resolution of the collection in the lesser sac. This is a gastrostomy tube is noted between the stomach and the lesser sac. Pancreas is atrophic, however, is enhancing without evidence necrosis. Small amount of fat stranding is noted around the pancreas.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small amount of fluid in the pelvis. Previously described fluid collection in the pelvis has resolved.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval resolution of the fluid collections in the pelvis and in the lesser sac. Small amount of ascites and fat stranding around the pancreas persists.Significant wall thickening of the gallbladder consistent with severe acute cholecystitis. Dr. Siddiqui was notified and acknowledged about the above findings at the time of the dictation. |
Generate impression based on findings. | 60 year-old female with injury to the left index finger, pain near the tip. There is a comminuted fracture of the tuft of the distal second phalanx, with mild radial and dorsal deviation of the fracture fragment. There is associated diffuse soft tissue swelling. | Comminuted fracture of the tuft of the left second distal phalanx with associated diffuse soft tissue swelling. |
Generate impression based on findings. | Male; 53 years old. Reason: staging CT: chest, abdomen, pelvis History: na CHEST: LUNGS AND PLEURA: Scattered pulmonary micronodules. No suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Normal heart size. No pericardial effusion. No visible coronary artery calcifications.CHEST 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: Prominent porta hepatis lymph nodes, but no enlarged lymph nodes by CT size criteria. BOWEL, MESENTERY: Moderate circumferential wall thickening of the rectum, compatible with the patient's known rectal cancer (AP by transverse by craniocaudal, series 4/200 and series 80351/66).BONES, SOFT TISSUES: Small bilateral fat containing inguinal hernias, right greater than left.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: A nonspecific right pelvic side wall lymph node measures 12 x 9 mm (series 4/179), and a nonspecific left pelvic sidewall lymph node measures 10 x 7 mm (series 4/190). BOWEL, MESENTERY: Moderate circumferential wall thickening of the rectum, compatible with the patient's known rectal cancer (AP by transverse by craniocaudal, series 4/200 and series 80351/66).BONES, SOFT TISSUES: Degenerative arthritic changes of the lumbosacral spine.OTHER: No significant abnormality noted | 1. Wall thickening of the rectum compatible with patient's known rectal cancer.2. Nonspecific pelvic sidewall lymph nodes; metastatic disease cannot be excluded. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts with tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Metastatic breast cancer treated with 4 cycles of chemotherapy. The left supraclavicular region subcutaneous fat stranding and skin thickening has essentially resolved. There is no evidence of mass lesions in the neck or significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is a lytic lesion in the T4 vertebral body without definite associated significant spinal canal stenosis. There is a left humerus rod is demonstrated on the scout image only. The airways are patent. There is a small right maxillary sinus retention cyst. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. | 1. The left supraclavicular region subcutaneous fat stranding and skin thickening has essentially resolved. 2. T4 vertebral body metastasis without definite associated significant spinal canal stenosis. However, a thoracic spine MRI may be useful for further evaluation, of clinically warranted. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Male 73 years old; Reason: kidney stone History: stone ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: 1.1 cm cystic lesion in the periphery of the right lobe of the liver is of fluid attenuation, but is too small to accurate characterize and may represent a small cyst or hemangioma. Cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left nephroureteral catheter pigtails in appropriate position with mild residual prominence of the collecting system with minimal fat stranding surrounding the collecting system. 8-mm stone, nonobstructing in the inferior left kidney.RETROPERITONEUM, LYMPH NODES: Calcification of the ectatic abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: Prostatomegaly measuring 4.3cm in axial dimension.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.1. | No obstructing nephroureterolithiasis. 8mm nonobstructing stone in the left kidney as described above. Fat stranding surrounding the left collecting system and stent - superimposed ureteritis not excluded. This can be correlated with lab values. |
Generate impression based on findings. | 29 years old female with metastatic colon cancer, status post hepatic resection. Evaluate for PET activity in the liver and the portion of the body. RADIOPHARMACEUTICAL: 12.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 86 mg/dL. Today's CT portion grossly demonstrates post surgical changes in the abdomen and post hepatic resection changes. The tip of the Port-A-Cath is in the SVC. A vascular stent is seen in the IVC adjacent to the right atrium. An IVC filter is noted.Today's PET examination demonstrates numerous foci of increased activity in the liver with SUV Max of 16.2 in the dominant lesion in the left lobe of liver. Two foci of increased activity are seen in the retroperitoneal cavity at aortocaval region and right paracaval region at the level 2 right renal hilum. The SUV Max in the aortocaval retroperitoneal lymph nodes is 17.3.A focus increased activity is seen in the subcutaneous fat in the right hip, which is consistent with granulomatous reaction following injections.A focus increased activity at the tip of the Port-A-Cath is most likely due to injection artifact. Physiological activity is seen in the spleen, kidneys, intestines and bladder. | 1.Multiple hepatic numerous hepatic metastases with increased metabolic activity2.Metastatic hypermetabolic retroperitoneal lymph nodes. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer in a daughter diagnosed at the age of 45. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. Scattered benign calcifications are present bilaterally. The right breast slightly smaller when compared to the left. Benign lymph nodes project over each axilla. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 72-year-old female with pain and swelling, concern for inflammatory/erosive disease. There is chondrocalcinosis of the triangular fibrocartilage and the hyaline cartilage in the wrist, suggestive of calcium pyrophosphate deposition disease. There are no acute fractures, malalignment, significant erosions or inflammation. | No acute abnormality or significant erosive/inflammatory arthritis. There is evidence of calcium pyrophosphate deposition disease in the wrist. |
Generate impression based on findings. | 51-year-old female with a history of right lumpectomy 2002 for IDC and DCIS. Patient received radiation, chemotherapy, and tamoxifen. Also with history of left benign biopsy 2009/2010 for PASH. History of breast cancer diagnosed in mother at age of 70. 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. Linear scar markers were placed over both breasts. Two circular skin markers were placed over the left axilla. Posttherapy volume loss, architectural distortion, increased density, and skin thickening in the right breast are stable. Biopsy clips in the left breast with adjacent fat necrosis also stable. No new mass, suspicious microcalcifications or new areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over both axillae. | Stable posttherapy changes bilaterally. 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. | 72-year-old female with pain and swelling, concern for inflammatory/erosive disease. Mild hallux valgus deformity. Mild osteoarthritic changes and degenerative cysts of the first metatarsal head. No significant bony erosions are present. No evidence of fracture or malalignment. | No acute abnormality. Mild hallux valgus deformity and mild osteoarthritic changes of the first metatarsal head. No significant erosive or inflammatory arthritis is identified. |
Generate impression based on findings. | 72-year-old female with pain and swelling, concern for inflammatory/erosive disease. There is positive ulnar variance and sclerosis of the medial aspect of the lunate, consistent with ulnar abutment syndrome.There is chondrocalcinosis of the triangular fibrocartilage and the hyaline cartilage in the wrist, suggestive of calcium pyrophosphate deposition disease. There are no acute fractures, malalignment, significant erosions or inflammation. | 1. Positive ulnar variance and associated sclerosis of the lunate is consistent with ulnar abutment syndrome. 2. Multifocal chondrocalcinosis in the wrist is suggestive of calcium pyrophosphate deposition disease. 3. There is no significant erosive/inflammatory arthritis. |
Generate impression based on findings. | 87 year-old female for evaluation of renal, adrenal, omental, and pulmonary masses CHEST:LUNGS AND PLEURA: Multiple scattered nonspecific micronodules are again noted (series 6, image 51). No new suspicious nodules. Right middle lobe atelectasis is again noted with air bronchograms. Unchanged sharply defined nodules in the left lung base measuring 2.1 x 1.6 cm (series 6, image 71). A 6-mm nodule of the right costophrenic angle is also unchanged (image 62/100). MEDIASTINUM AND HILA: Multiple hypodense lesions in bilateral thyroid lobes. No significant mediastinal or hilar lymphadenopathy. The heart size is normal. No pericardial effusion.CHEST WALL: Healing right seventh and left fifth rib fracture. No axillary, retrocrural, or cardiophrenic lymphadenopathy. Sclerotic focus in the T1 vertebral body. Greater than 50% compression deformity of T4. Vertebra plana of T6. Mild superior endplate depression of L3. Exaggeration of the usual thoracic kyphosis. These findings are not significantly changed since prior exam.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. The exam is moderately motion degraded.LIVER, BILIARY TRACT: Hypodense right lobe liver lesion, previously characterized as a hemangioma appears not significantly changed since the prior exam. Hyperattenuation mass at the inferior right liver lobe is unchanged (series 4, image 105). Hypodense subcentimeter lesion in the left the liver and series 4, image 86). No new lesions are identified.SPLEEN: Hypoattenuating mass in the spleen measuring 7.5 x 7.5 cm, previously 6.5 x 5.9 cm (series 4, image 92).ADRENAL GLANDS: Left adrenal mass measures 2.5 x 2.3 cm (series 4, image 106), previously measuring 2.5 x 2.3 cm. The right adrenal gland is normal in size and morphology.KIDNEYS, URETERS: A centrally hypodense left kidney mass measures 6.9 x 5 .6 cm, previously 6.8 x 6.0 cm (series 4, image 120). Multiple additional subcentimeter hypodense lesions in bilateral kidneys presumably representing cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mildly enlarged retroperitoneal lymph nodes.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Omental nodularity on the left is again noted and may represent carcinomatosis.BONES, SOFT TISSUES: Sclerotic focus in the T1 vertebral body. Greater than 50% compression deformity of T4. Vertebra plana of T6. Mild superior endplate depression of L3. Exaggeration of the usual thoracic kyphosis. These findings are not significantly changed since prior exam.OTHER: No significant abnormality noted. | 1.Stable pulmonary nodules not significantly changed since the prior exam.2.Right liver lobe lesion is unchanged. No new liver lesions. 3.Interval increase in size of splenic lesion.4.No significant interval change in left kidney lesion.5.Osseous abnormalities described above without significant interval change.6.Multiple other findings as above. |
Generate impression based on findings. | Bad breath and sinusitis. There are bilateral maxillary sinus fluid levels. There is a punctate right anterior ethmoid sinus osteoma. The other paranasal sinuses are clear. There are opacities in the bilateral middle meati. The nasal septum is deviated slightly to the left. There is slight deformity of the right frontal process of the maxilla.The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. | 1. Bilateral maxillary sinus fluid levels suggest acute sinusitis in the appropriate clinical setting.2. Nonspecific opacities in the bilateral middle meati may represent a nasal polyp or mucus secretions, for example.3. Slight deformity of the right frontal process of the maxilla may be due to a prior fracture. |
Generate impression based on findings. | Reason: has had 2 episodes of fecal incontinence History: see abouve Cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. No fractures are identified in the cervical spine. No significant stenosis from extension to flexion.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there are bilateral uncovertebral osteophytes present right more than left with encroachment of the right-sided exiting nerve roots within the neural foramen. There is some loss of disk space height and a minor disk bulge present at this level as well as some endplate osteophytes .At C4-5 there is loss of disk space height associated with a disk bulge and endplate and uncovertebral osteophytes. There is encroachment of the exiting nerve roots within the neural foramina bilaterally at this level due to osteophytes and disk material but worse on the right than the left side. There is partial effacement of spinal fluid ventral to the spinal cord at this level.At C5-6 there is loss of disk space height as well as endplate and uncovertebral osteophytes with narrowing of the neural foramina bilaterally.At C6-7 there is loss of disk space height and a diffuse disk bulge associated with small endplate and uncovertebral osteophytes.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.Atherosclerotic calcifications are present at the carotid bifurcations.Incidental note is made of partial empty sella.Thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord is normal in overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. There is multilevel loss of disk space height present.At T10-T11 there are endplate reactive changes present with endplate sclerosis and irregular endplates similar to extent relative to an MRI from 7/16/13. There are some endplate osteophytes at this level associated with a disk bulge and narrowing of the neural foramina bilaterally with encroachment of the exiting nerve roots.At T11-T12 there is a diffuse disk bulge present associated with ligamentum flavum hypertrophy and mild narrowing of the thecal sac.There is a 5-mm nodule present along the right upper lobe medially at the T5 vertebral body level.Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall height. The conus medullaris is intact. There is mild anterior subluxation of L4 on L5.At L5-S1 there is bilateral facet hypertrophy of a marked degree present associated with a diffuse disk bulge, loss of disk space height and narrowing of the neural foramina bilaterally. There is mild encroachment of the nerve roots within them the left neural foramen as a result of disk material and facet hypertrophyAt L4-5 there is loss of disk space height, vacuum disk phenomenon, diffuse disk bulge and a moderate degree of bilateral facet hypertrophy with a near effacement of the facet joints. There is mild anterior subluxation of L4 on L5. There is a marked narrowing of the thecal sac with effacement of spinal fluid the lateral recess is. There is narrowing of the neural foramina present at this level associated with a mild encroachment of the left-sided exiting nerve roots within the neural foramina. Overall there is a moderate degree of spinal stenosis present at this level.At L3-4 there is loss of disk space height, diffuse disk bulge, marked bilateral facet and ligamentum flavum hypertrophy with near obliteration of the thecal sac. There is associated narrowing of the neural foramina bilaterally at this level. There is mild encroachment of the exiting nerve roots within the neural foramina. Overall there is marked spinal stenosis at this level. Comparing in the upright position in which the patient was in a flexed position relative to the supine position, the thecal sac and narrows further in the supine position relative to the more flexed upright position. From the flexed upright position to the supine position there is slightly more anterior subluxation at the flexed positionAt L2-3 there is a diffuse disk bulge present associated with the some mild facet hypertrophy. There is no partial effacement of the fat of the lateral recesses at this level. There is mild narrowing of the neural foramina bilaterally at this level. There is a small air bubble associated with the right facet joint. Overall there is mild spinal stenosis at this level.At L1-2 there is no significant compromise to spinal canal or neural foramina.Atherosclerotic calcifications are present in the aorta and some of its branches. | 1.There is severe spinal stenosis present at L3-4 which appears to increase from flexion to more extended position associated with marked bilateral facet hypertrophy and a diffuse disk bulge.2.There is a moderate to severely there spinal stenosis at L4-5 associated with mild subluxation.3.There is bilateral encroachment of exiting nerve roots within the neural foramina at L3-4 and to a lesser degree left side neural foramina of L4-5 and L5-S1.4.There is mild spinal stenosis L2-35.There are degenerative changes present in the cervical spine which appears to be worse at C4-5 where there is encroachment of exiting nerve roots within the neural foramina.6.There is a pulmonary nodule present in the right upper lobe. If clinically appropriate a CT of the chest may be of further benefit in evaluating this. An email was sent to Dr Roitberg regarding the nodule. |
Generate impression based on findings. | There is a left frontoparietal hyperdense mass with associated adjacent parenchymal edematous hypodensity which involves gray matter and underlying white matter, with mild regional mass effect. There is no midline shift and basilar cisterns remain patent.Elsewhere there are hypodense foci within the white matter and left caudate without associated mass effect.The ventricles and sulci are normal in size. The visualized portions of the paranasal sinuses and mastoid air cells are clear. | 1.Left frontoparietal hematoma with adjacent edema. The differential diagnosis would include hemorrhagic transformation of stroke, hypertensive hemorrhage, hemorrhage from occult vascular malformation, or hemorrhagic metastasis.2.Small vessel ischemic disease of indeterminate ages.3.Results were discussed with Dr. Howes on 3/9/2015 approximately 2:25 p.m. |
Generate impression based on findings. | 2 days old, Female, Reason: placement of ETT History: hypoxiaVIEW: Chest AP (one view) 3/9/15 Endotracheal tube tip is approximately 1 cm above the level of the carina. UVC at the level of the diaphragm, unchanged. UAC tip at the level of T8, unchanged. NG tube in unchanged position.Unchanged near complete opacification of the left hemithorax. Unable to accurately evaluate the cardiac silhouette due to atelectasis left lung. Persistent right upper lobe atelectasis. No evidence of effusion or pneumothorax. | Persistent near complete atelectasis of the left lung and right upper lobe, not significantly changed. |
Generate impression based on findings. | Reason: History of metastatic breast cancer on treatment. Evaluate for response and extent of disease. History: History of metastatic breast cancer on treatment. Evaluate for response and extent of disease. CHEST:LUNGS AND PLEURA: Increased pulmonary metastases, again most evident in the superior left upper lobe (image 24/85).Referenced nodule measurements as follows:1. Right middle lobe nodule stable measuring 20 x 20 mm on image 48/85 (20 x 19 mm on prior). 2. Left apex nodular septal thickening now completely engulfed by left upper lobe mass and atelectasis (image 24/85) and is no longer measurable.New right upper lobe nodule consistent with metastatic disease. Multiple areas of interlobular septal thickening, nodularity, and centrilobular nodules consistent with metastatic disease, likely lymphangitic tumor spread (images 33, 45, 56/85 are the best examples).MEDIASTINUM AND HILA: Reference right hilar lymph node increased to 15 mm on image 35/128 (10 mm on prior).CHEST WALL:No significant abnormality noted.Right chest wall port with catheter tip in the SVC.Reference right axillary lymph node measures 11 mm on image 19/128, slightly increased.Extensive left breast skin thickening and nodularity has decreased. Reference left breast mass has significantly decreased measuring 13 x 11 mm on image 40/128 (27 x 20 mm on prior). Reference soft tissue nodule involving the left pectoralis major muscle measures 15 x 15 mm on image 31/128, unchanged.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Reference ill-defined hypoattenuating liver lesion measures 17 x 15 mm on image 71/128 (17 x 12 mm on prior). Other hypodense liver lesions are too small to characterize but stable. Right lobe vascular malformations redemonstrated.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: Bone island in L1 vertebral body unchanged.OTHER: No significant abnormality noted. | Extensive increase in pulmonary disease with multiple new sites. Significant decrease in left breast disease. Other findings grossly stable. |
Generate impression based on findings. | Reason: monitor sarcoidosis History: sarcoid history LUNGS AND PLEURA: Scattered benign appearing pulmonary micronodules, several calcified.No evidence of pulmonary sarcoidosis, or other significant pulmonary abnormality. MEDIASTINUM AND HILA: Symmetric hilar and mediastinal lymphadenopathy is unchanged, consistent with the provided history of sarcoidosis.Moderate coronary artery calcifications are present, and the heart is enlarged. No pericardial effusion seen.CHEST WALL: Mild degenerative abnormalities affect the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. New ascites is noted, which could be the sequela of heart failure. | 1. New ascites, possibly the result of heart failure.2. Stable mediastinal and hilar lymphadenopathy consistent with sarcoidosis, without lung parenchymal involvement. |
Generate impression based on findings. | The frontal sinus and frontoethmoidal recesses are clear. The anterior ethmoid air cells are clear. The maxillary sinuses are clear. The ostiomeatal units are clear. There is scattered opacification of the posterior ethmoid air cells. The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is minimal left-sided nasal septal deviation with a small spur. 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 is probable cerumen within the right external auditory canal. | Scattered nonspecific opacification of the posterior ethmoid air cells.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 48 year-old female with left groin pain, which radiates to the knee, for more than one week. Moderate bilateral osteoarthritis of the hip joints, including asymmetric joint space narrowing, subchondral sclerosis, subchondral cyst formation, as well as osteophytosis. There is no acute abnormality or malalignment. | No evidence of fracture, malalignment, or lytic lesion as clinically queried. Moderate osteoarthritic disease of the hip joints. |
Generate impression based on findings. | Tremors. Evaluate for DBS placement. Limited examination for pre-operative planning demonstrates bilateral transfrontal brain electrode lead placement with tips near the level of the subthalamic nuclei. There is no evidence of intracranial hemorrhage. There is no midline shift or herniation. The ventricles and basal cisterns are unchanged in size and configuration. There is a mucous retention cyst in the right sphenoid sinus. The extracranial soft tissues are unremarkable. | Limited CT examination for pre-operative planning with bilateral deep brain electrodes in position. |
Generate impression based on findings. | Female 71 years old Reason: hypercalcemia and elevated parathyroid. There is physiologic distribution of the radiopharmaceutical. No abnormal focus of activity consistent with an enlarged parathyroid gland is seen. The right thyroid lobe appears to measure 4.3 cm and the left lobe 3.4 cm in length. | No scintigraphic evidence for parathyroid adenoma. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. Benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Pain Four views of the right knee reveal no acute fracture or malalignment. The joint spaces are preserved.Four views of the left knee reveal no acute fracture or malalignment. There is mild joint space narrowing of the medial compartment with weight-bearing. | Mild osteoarthritis of the left knee. |
Generate impression based on findings. | Basketball player with no definite injury. Knee pain. Tenderness along patellar ligament and inferior patella. Pain with extension. Possible anterior drawer sign.EXAMINATION: Right knee AP/lateral/oblique (3 views) 03/09/15 A joint effusion is present. An indentation is noted in the articular surface of the lateral femoral condyle. No fracture is seen. | Joint effusion and lateral condylar notch sinus just anterior cruciate ligament injury. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of left breast benign biopsy in 1998. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Linear scar marker overlies the left breast. Round skin marker overlies the right breast. Stable focal asymmetry in the left breast at the 12 o'clock position. Unchanged subcentimeter mass in outer right breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female; 56 years old. Reason: Hx of FCL History: Compare to previous CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Mediastinal lymphadenopathy has mildly decreased. Index right paratracheal lymph node measures 1.6 x 1.1 cm, previously 1.8 x 1.3 cm (series 5/31).CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hepatomegaly. Fatty infiltration of the liver.SPLEEN: Splenomegaly. Spleen measures 15 cm.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal adenopathy has mildy decreased. Reference conglomerates left para-aortic lymph node measures 2.6 x 2.8 cm, previously 2.9 x 2.8 cm (series 5/17).BOWEL, MESENTERY: Extensive mesenteric adenopathy is grossly stable. Index central, extensive mesenteric adenopathy encasing the mesenteric vessels measures 7.6 x 3.4 cm, previously 7.6 x 3.4 cm (series 5/120).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: No significant abnormality noted. | Decreased mediastinal and retroperitoneal lymphadenopathy. Grossly stable mesenteric lymphadenopathy. No new sites of disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Three standard digital views of both breasts with tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Multiple skin markers overlie either breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. Asymmetry in the right outer breast has the appearance of normal parenchyma on tomosynthesis. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Intraoperative film. Single AP film of the pelvis demonstrates a right total hip arthroplasty device being constructed in the operating room. The acetabular component is complete while the femoral component is still in progress. There is a soft tissue defect about the right hip. | Intraoperative construction of a right total hip arthroplasty device. |
Generate impression based on findings. | Reason: evaluate ILD History: cough soboe fibrosis LUNGS AND PLEURA: Nonspecific peripheral predominant bilateral reticulonodular interstitial abnormality. No significant airtrapping on expiratory phase imaging. No significant honeycombing and only very mild equivocal bronchiectasis in scattered areas. Scattered punctate micronodules, most of which are calcified.MEDIASTINUM AND HILA: Multiple borderline mediastinal nodes. Status post CABG. Cardiomegaly. 3-lead left-sided pacemaker.CHEST WALL: Status post sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Cholelithiasis. Punctate granulomas in spleen. Retroperitoneal area of calcification in the left upper abdomen is incompletely visualized. | Nonspecific peripheral predominant bilateral reticulonodular interstitial abnormality. No significant honeycombing and only very mild equivocal bronchiectasis in scattered areas. The findings nonspecific. The imaging findings could be seen in NSIP or chronic hypersensitivity pneumonitis. They are not typical of UIP. |
Generate impression based on findings. | Pain. Evaluate left hand. Three views of the left hand reveal no acute fracture or malalignment. There is slight negative ulnar variance. | No specific findings to account for the patient's pain. |
Generate impression based on findings. | 35-year-old female with history of right medial breast pain for 4 months. 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. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes project over both axillae.SONOGRAPHIC | No mammographic or sonographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually starting age 40. Results and recommendation were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on findings. | Pain. Question of arthritis. Three views of the right knee reveal mild osteophyte formation and joint space narrowing of the lateral tibiofemoral compartment. No acute fracture or malalignment is evident. Single AP radiograph of the included left knee is grossly unremarkable. | Mild osteoarthritis of the right knee, predominantly of the lateral tibiofemoral compartment. |
Generate impression based on findings. | Female 67 years old Reason: Evaluate for parathyroid for adenoma vs hyperplasia History: hypercalcemia Posterior inferior to and abutting the right thyroid lobe there is focal increased radiotracer uptake measuring approximately 1.4 x 1.1 cm which persists on delayed images, consistent with parathyroid adenoma.The right thyroid lobe appears to measure 3.2 cm and the left lobe 2.7 cm in length. | Findings compatible with right parathyroid adenoma. |
Generate impression based on findings. | 85-year-old male with ILD seen chest radiograph LUNGS AND PLEURA: Biapical scarring. Patchy multifocal severe linear interstitial disease with traction bronchiectasis and honeycombing, worst in the apices. No pleural effusions. Mild mosaic pattern on expiratory sequence suggestive of mild air trapping. Severe left upper lobe volume loss. Pleural calcifications are noted bilaterally. No significant nodularity or ground glass opacity.Only a small portion of the bases was included on 12/16/2007, though the findings have definitively progressed.MEDIASTINUM AND HILA: Enlarged precarinal lymph node measuring 12 mm (series 5, image 33). Additional prominent mediastinal lymphadenopathy. No significant hilar lymphadenopathy. Median sternotomy s/p CABG. CHEST WALL: No axillary, retrocrural, or cardiophrenic lymphadenopathy. Implantable ICD in the left chest wall. Right curvature of the thoracic spine. No suspicious osseous lesions.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Left adrenal nodularity is unchanged. | Pulmonary fibrosis with severe traction bronchiectasis and honeycombing. The distribution is not typical of UIP/IPF though this is still a consideration, as is asbestosis, given the evidence of asbestos related pleural disease. Chronic hypersensitivity pneumonitis is an alternative consideration. |
Generate impression based on findings. | Knee pain. Four views of the right knee reveal no acute fracture or dislocation. There is narrowing of the lateral tibiofemoral compartment with standing. There is mild osteophyte formation at the lateral tibiofemoral and patellofemoral compartments.Three views of the left knee reveal lateral tibiofemoral compartment joint space narrowing with standing. There is osteophyte formation. No acute fracture is evident. | Moderate osteoarthritis of the bilateral knees. |
Generate impression based on findings. | 14-year-old female with migraines and right temporal arachnoid cyst, evaluate for change in size Redemonstrated is an extra-axial mass in the anteromedial right middle cranial fossa which is CSF intensity on all sequences without restricted diffusion, consistent with an arachnoid cyst. There has been no interval change in size or shape.The ventricles and sulci are normal in size. The cerebellar tonsils are in normal position. 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 subdural hematomas. Flow voids are present within the major vessels indicating patency. The paranasal sinuses and mastoid air cells are clear. | Stable right temporal arachnoid cyst. Otherwise unremarkable brain MRI. |
Generate impression based on findings. | 20 year-old female status post fall two days ago, presenting with pain, swelling, and decreased range of motion at the first digit, as well as second and third metatarsals. No acute fracture or malalignment. The soft tissues are unremarkable. | No acute fracture or malalignment. |
Generate impression based on findings. | Right shoulder pain, right upper extremity weakness. Three views of the right shoulder reveal no acute fracture or malalignment. | No specific findings to account for the patient's symptoms. |
Generate impression based on findings. | Reason: PER JUDY FISCHER AT THE DOCTOR'S OFFICE - CT MUST BE SEPARATE FROM OTHER REQUESTED CT SCANS/metastatic breast cancer History: assess response to 4 cycles of chemotherapy for metastatic breast cancer LUNGS AND PLEURA: Post-XRT changes in left upper lobe. Minimal scarring or atelectasis at the lung bases. Scattered punctate micronodules are unchanged and presumably postinflammatory. No new pulmonary nodules.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: Right chest port tip at RA/SVC junction. Postop change mastectomies. Spinal metastatic disease is stable.Previously noted left supraclavicular node now measures 9 x 7 mm on image 7/219 (20 x 14 mm on prior).UPPER ABDOMEN: Abdomen and pelvis will be reported separately. | Interval decrease in left supraclavicular lymph node. Stable thoracic spinal metastases. |
Generate impression based on findings. | Female; 65 years old. Reason: 65 y/o F with SLL with diffuse lymphadenopathy, please assess for progression. History: none CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: Left supraclavicular lymphadenopathy is stable. Reference lymph node measures 1.8 x 1.5 cm, unchanged (series 3/5).Prevascular lymphadenopathy is slightly decreased. Reference lymph nodes measures 1.9 x 0.8 cm, previously 2.2 x 1.1 cm (series 3/22).Retrocrural adenopathy is slightly decreased. Reference lymph node measures 2 x 1 cm, previously 2.2 x 1.3 cm (series 2/81).CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Stable intra and extrahepatic biliary ductal dilation without distal obstructing lesion evident, likely a chronic finding. Status post cholecystectomy. Hepatic vessels patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cyst.RETROPERITONEUM, LYMPH NODES: Retroperitoneal lymphadenopathy is grossly stable. Reference right para-aortic lymph node measures 3.1 x 1.7 cm, unchanged (series 3/105).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small ventral abdominal wall hernia containing a small portion of the transverse colon.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fibroid uterus.BLADDER: No significant abnormality noted.LYMPH NODES: Pelvic adenopathy. Reference left femoral lymph node measures 1.2 x 1.8 cm, unchanged (series 3/157).BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Bilateral inguinal hernia repair.OTHER: No significant abnormality noted. | Slightly decreased prevascular and retrocrural lymphadenopathy, but lymphadenopathy elsewhere in the chest, abdomen, and pelvis is grossly stable. No new sites of disease. |
Generate impression based on findings. | Reason: Horner's syndrome History: anisocoria LUNGS AND PLEURA: Azygos pseudo-lobe, normal variant, otherwise unremarkable. MEDIASTINUM AND HILA: Residual thymic tissue normal for age, otherwise unremarkable mediastinum.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No significant abnormality. Specifically, no evidence of an apical lung lesion. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts (12 images) were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 43-year-old male with cough, evaluate interstitial lung disease LUNGS AND PLEURA: Bilateral patchy basilar predominant ground glass and airspace opacities with moderate traction bronchiectasis. No honeycombing is evident. No pleural effusion or pneumothorax. No evidence of airtrapping on expiratory sequence. Some of subpleural sparing are noted. Post biopsy changes on the right.MEDIASTINUM AND HILA: Scattered mediastinal lymph nodes measuring up to 8 mm (series 3, image 37). No significant hilar lymphadenopathy. CHEST WALL: Heterogeneity and loss of height of T7 and 10 vertebral bodies may be early compression fractures. Mild degenerative changes affect the vertebral endplates at multiple levels. No axillary, cardiophrenic, or retrocrural lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Punctate calcifications in the left kidney likely represents nonobstructive renal stone. | Interstitial disease/fibrosis with ground glass opacity and traction bronchiectasis, consider NSIP. |
Generate impression based on findings. | Tachypnea and VSD. History of diaphragmatic hernia repair. Is there pulmonary edema?VIEW: Chest AP (one view) 03/09/15, 1401 Feeding tube tip is distal to GE junction and not included on image. Right upper extremity PICC is no longer seen. Opacity in right chest, extending to the level of right bronchus, persists. A bowel loop now extends two cm above the level of the right lateral diaphragm. Left heart border suggests that the cardiac silhouette size is enlarged. A pulmonary edema pattern is not present. | Continued opacity in the right chest with bowel loop now in right chest. Recurrent hernia cannot be excluded. |
Generate impression based on findings. | 49-year-old female with history of fractures in the middle phalanx of the third and fourth digits, 6 months ago. Three views of the left third digit demonstrate near-indistinct obliquely oriented fracture of the head and neck of the middle phalanx, consistent with interval healing; alignment is near-anatomic.Three views of the left fourth digit demonstrate near-indistinct obliquely oriented fracture through the neck of the middle phalanx, consistent with interval healing; alignment is near-anatomic. | Continued interval healing of third and fourth middle phalanx fractures. |
Generate impression based on findings. | Reason: metastatic breast CA to lung, mediastinum, liver. On chemo. Followup; History: cough, shortness of breath on exertion CHEST:LUNGS AND PLEURA: Stable mild reticulonodular opacities at the right apex.Moderate right pleural effusion, stable.Atelectasis and scarring in the left lower lobe, unchanged.MEDIASTINUM AND HILA: Reference a right paratracheal lymph node stable at 8 mm (image 32/141)A right hilar node measures 30 mm on image 47/141, unchanged. Prior report erroneously lists this measurement as 13 mm, presumably a transcription error. By my review of the old scan and the saved key images, it should be 30 mm on prior.Reference subcarinal lymph node is grossly stable at 20 mm on image 49/141. Calcified lymph nodes compatible with previous granulomatous infection.Moderate pericardial effusion, unchanged.No visible coronary artery calcifications.CHEST WALL: Left breast implant.Reference left axillary lymph node measures 10 mm on image 38/141, unchanged.Mixed lytic and sclerotic metastases in the upper thoracic vertebrae with partial collapse, unchanged.Pathological fracture in the lower sternum, and bilateral rib metastases also unchanged.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Continued increase in the size of right lobe hepatic metastasis measuring 69 x 58 mm on image 86/141 (6.0 x 4 .7 cm on prior). Other hepatic metastases are stable to marginally increased.SPLEEN: No significant abnormality noted..ADRENAL GLANDS: No significant abnormality noted..KIDNEYS, URETERS: Bilateral renal cysts, stable.PANCREAS: No significant abnormality noted..RETROPERITONEUM, LYMPH NODES: Reference retrocrural lymph node measuring 11 mm (image 83/141), stable. BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathologyNo gross abnormalities noted.d.BONES, SOFT TISSUES: Mixed lytic and sclerotic metastases in the upper thoracic vertebrae with partial collapse, unchanged.Pathological fracture in the lower sternum, and bilateral rib metastases also unchanged.OTHERNo significant abnormality noted.d. | Increase in hepatic disease though thoracic reference measurements are stable. |
Generate impression based on findings. | Redemonstrated is compression deformity of the L2 vertebral body, as demonstrated on 2014 lumbar spine x-ray, with mild residual edematous signal. There are no other compression fractures.There appears to be nerve root ectasia throughout the thoracolumbar spine without associated conus signal abnormality.There is heterogeneous marrow signal without associated STIR abnormality. Modic type I (edematous) discogenic reactive endplate changes are noted at L4/5 and L5/S1.The visualized intra-abdominal and paraspinal contents are unremarkable.T10/11: Disc bulge/protrusion, slight ligamentum flavum thickening, and facet hypertrophy encroach bilateral neural foramina.T11/12: Disc bulge without stenosis.T12/L1: UnremarkableL1/2: Diffuse annular disc bulge, posterior bowing of the vertebral body cortex secondary to compression, ligamentum flavum thickening, and mild bilateral facet hypertrophy. There is moderate bilateral neural foraminal stenosis.L2/3: Asymmetric bulge to the right and mild bilateral facet hypertrophy. There is mild to moderate left neural foraminal and moderate right neural foraminal stenosis.L3/4: Diffuse annular disc bulge, slight ligamentum flavum thickening, and mild bilateral facet hypertrophy. There is mild bilateral neural foraminal stenosis.L4/5: Asymmetric bulge to the right, ligamentum flavum thickening, and mild bilateral facet hypertrophy. There is mild to moderate left neural foraminal and moderate right neural foraminal stenosis.L5/S1: Asymmetric bulge to the left and mild bilateral facet hypertrophy. There is mild to moderate left neural foraminal and mild right neural foraminal stenosis. | 1.Redemonstrated is compression deformity of the L2 vertebral body, as demonstrated on 2014 lumbar spine x-ray, with mild residual edematous signal. There are no other compression fractures.2.There appears to be nerve root ectasia throughout the thoracolumbar spine without associated conus signal abnormality. This appearance can be seen following central stenosis, such as that which might have occurred due to the L2 compression fracture. It can be difficult to distinguish nerve root ectasia from prominent venous vascularity due to dural AV fistula at the level of the conus. However, given the known compression deformity combined with nerve root ectasia throughout the spinal canal and a lack of the conus signal abnormality, the former is favored. However, if the patient experiences progressive lower extremity weakness, the latter should be considered, and repeat MRI performed.3.There is heterogeneous marrow signal without associated STIR abnormality, thus this is felt to be a benign process. The differential diagnosis would most likely include anemia of any cause and/or chronic smoking.4.T10/11: Encroachment bilateral neural foramina.5.L1/2: Moderate bilateral neural foraminal stenosis.6.L2/3: Mild to moderate left neural foraminal and moderate right neural foraminal stenosis.7.L3/4: Mild bilateral neural foraminal stenosis.8.L4/5: Mild to moderate left neural foraminal and moderate right neural foraminal stenosis.9.L5/S1: Mild to moderate left neural foraminal and mild right neural foraminal stenosis. |
Generate impression based on findings. | New right sided painless neck mass with long smoking history and no recent infections. There is extensive right cervical lymphadenopathy. For example, a right level 2 lymph node measures 30 x 40 mm. There is mild diffuse enlargement of the palatine tonsils bilaterally. The thyroid and major salivary glands are unremarkable. There is mild plaque at the bilateral carotid bifurcations. There are multiple dental caries with associated periodontal lucencies. There is multilevel degenerative cervical spondylosis. The imaged intracranial structures and orbits are grossly unremarkable. There are emphysematous changes and apparent scattered subcentimeter ground glass opacities in the imaged portions of the lungs. | 1. Extensive right cervical lymphadenopathy may represent a neoplastic process, such as lymphoma or metastatic disease, versus perhaps less likely an inflammatory or infectious process.2. Nonspecific prominence of the bilateral palatine tonsils. Endoscopy may be useful for further evaluation.3. Extensive dental disease. 4. Emphysematous changes and apparent nonspecific scattered subcentimeter ground glass opacities in the imaged portions of the lungs. A dedicated chest CT may be useful for further evaluation. |
Generate impression based on findings. | 47-year-old male with acute left knee pain. A joint effusion is present. There is evidence of previous ACL reconstruction, with interference screws in the lateral distal femur and the medial proximal tibia. There is mild osteoarthritic disease in the left knee including subchondral sclerosis and osteophyte formation. There is no acute fracture or malalignment. A small focus of heterotopic bone is present in the anterior soft tissues, inferior to the patella. | Evidence of previous ACL reconstruction, without acute fracture or malalignment. A joint effusion is present. |
Generate impression based on findings. | 39 year old female who has a complaint of bilateral breast pain, greatest on the left. Family history of breast carcinoma in her sister at age 38. MAMMOGRAM: 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. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. ULTRASOUND: On physical examination, there is dense breast tissue in the upper outer quadrants bilaterally, with no discrete mass palpated. Targeted ultrasound was performed bilaterally for the patient's area of concern.In the left upper outer breast, in the patient's area of pain, there is dense parenchymal tissue, without discrete solid or cystic mass identified. No abnormal vascularity is identified on Doppler imaging.In the right upper outer breast, in the patient's area of pain, there is dense parenchymal tissue. No abnormal vascularity is identified on Doppler imaging. A 0.8 x 0.2 x 0.3 cm circumscribed cyst with thin internal septation and posterior acoustic enhancement is present at the 11 o'clock position, 2 cm from the nipple. No significant vascularity is associated with this cyst. | Dense parenchymal tissue in both upper outer quadrants, at the patient's stated areas of pain, without discrete abnormality. Right simple breast cyst.No mammographic or sonographic 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.Annual screening MRI could also be considered based on her family history. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 66 year old female with thyroid cancer, s/p remote partial thyroidectomy, left supraclavicular fossa nodes on previous US. Evaluate for abnormal nodes, masses RIGHT LOBE MEASUREMENTS: Status post right thyroidectomy with small amount of residual thyroid tissue measuring 0.3 cm x 0.5 cm x 0.8 cm with no internal vascularity or definite microcalcifications. LEFT LOBE MEASUREMENTS: Status post left thyroidectomy.ISTHMUS MEASUREMENTS: Post thyroidectomy. RIGHT LOBE: As above. LEFT LOBE: As above. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small lymph node in the right neck at level 2 measuring 0.4 cm x 0.2 cm x 0.8 cm. In the left neck at level 4 there is a hypoechoic nodule measuring 0.6 cm x 0.3 cm x 0.8 cm with no definite fatty hilum. Another lymph node in the left lateral neck at level 4 measures 0.8 cm x 0.4 cm x 1.2 cm. OTHER: There is asymmetric swelling of the left neck supraclavicular musculature with no definite masses identified. | 1. Likely asymmetric swelling of the left neck supraclavicular musculature with no definite masses identified. This can be further characterized on MRI if clinically warranted. 2. Multiple lymph nodes in the neck, however a nodule at level 4 in the left neck does not contain a fatty hilum and may represent an additional lymph node however attention to this region is recommend on subsequent imaging. |
Generate impression based on findings. | Female 51 years old Reason: Evaluate the location of the 10-11 enterocutaneous fistulae to the small bowel There is an extensive network of interconnected subcutaneous sinus tracts. At least 3 of the sinus tracts, which originate in the midline, are connected to an amorphous collection, which measures up to 15 cm in craniocaudal dimension, with a tract extending inferiorly from the collection for approximately 6.5 cm, into the left hemipelvis. This collection was better opacified than on the prior small bowel follow through exam. Of the 10 cannulated sinus tracts, 8 were interconnected, and two were blind ending. One of the more inferior sinus tracts appears to bifurcate with two tracts extending into the pelvis. The enterocutaneous fistula formation confirmed on the prior small bowel study was not able to be reproduced with certainty on this examination, it was difficult to ascertain whether the aforementioned amorphous collection was related to abnormal intraabdominal bowel or a collection/abscess cavity in the subcutaneous tissues. A diagram approximating the interconnected network of fistulas has been up loaded to PACS as image 3 of series 9999. | Extensive interconnected network of subcutaneous sinus tracts, at least three of which connect to a large amorphous collection as detailed above. This examination probably underestimates the extent of disease. The enterocutaneous fistula formation confirmed on the prior small bowel study was not able to be reproduced with certainty on this examination, it was difficult to ascertain whether the aforementioned amorphous collection was related to abnormal intraabdominal bowel or a collection/abscess cavity in the subcutaneous tissues. If clinically warranted, it may be useful to perform a contrast-enhanced CT exam for additional characterization of the subcutaneous tracts described. |
Generate impression based on findings. | 30 year-old female with family history of breast cancer diagnosed in sister at age of 27. Negative genetic testing. No current breast complaints. Three standard views of both breasts and additional CC and ML spot magnification 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. Calcifications are noted in both breasts. Loosely clustered amorphous calcifications in the right 3 o'clock position, some of which may represent milk of calcium. More scattered benign appearing calcifications in the left breast are seen.Benign appearing lymph nodes are projected over both axillae. | Indeterminate loosely clustered calcifications in the right 3 o'clock position for which stereotactic guided biopsy is recommended. Results and recommendations were discussed with the patient. Given her strong family history in a sister at 27, annual screening MRI should also be strongly considered. The patient is also a candidate for a research MRI and she will be contacted by Sharon Harris, our research coordinator, regarding this possibility. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: H - Percutaneous Biopsy/Aspiration. |
Generate impression based on findings. | Female, 53 years old, chronic nasal congestion and sinus pressure and pain, not improved with medical management. The frontal sinuses and frontoethmoidal recesses are clear. The ethmoid air cells are clear. The sphenoid sinuses are clear though the sphenoethmoidal recesses are not well seen.The maxillary sinuses are clear allowing for minimal mucosal thickening along the sinus floor on the right. The maxillary outflow pathways are unobstructed.The nasal septum is intact deviating gently towards the left. The nasal cavity is clear and the turbinates are unremarkable allowing for paradoxical curvature of the right middle turbinate. | No evidence of significant active sinus inflammatory disease. |
Generate impression based on findings. | Female 49 years old Reason: evaluate for obstruction History: dilated bowel on CXR, fever Air containing loops of small bowel are dilated up to 5 cm, new from the prior exam, with relative paucity of gas in the colon; these findings are suggestive of small bowel obstruction. There is no intramural or subdiaphragmatic air evident.Right-sided dual lumen catheter tip is in the cavoatrial junction. Right upper quadrant and left lower pelvis surgical clips are noted. Two right lower lung granulomas appear unchanged from the prior exam. An electronic device overlies the right hemiabdomen. | Small bowel obstruction with air containing loops of small bowel dilated to 5 cm. |
Generate impression based on findings. | Female 53 years old, evaluate for RFO following removal of RFO. Bibasilar airspace opacities likely reflect atelectasis. Previously seen retained hemostat is not identified on this exam. No retained radiopaque foreign object is identified. Prominent small and large bowel loops are nonspecific, and may reflect ileus; postoperative pneumoperitoneum cannot be excluded. | No retained radiopaque foreign object. These findings were discussed by telephone with Dr. Alverdy the attending surgeon on 3/09/2015 at 1523. |
Generate impression based on findings. | Pain. Evaluate for fracture. Three views of the left ankle reveal a non-displaced spiral fracture of the distal fibula. The fracture line appears indistinct. There is minimal periosteal reaction suggesting healing, unchanged. There are extensive vascular calcifications. | Redemonstration of a nondisplaced distal fibular fracture without significant interval change. |
Generate impression based on findings. | Spitting blood after forceful talking: evaluate sinuses for an abnormality. There is a right maxillary sinus retention cyst that measures up to 30 mm. The paranasal sinuses are otherwise clear. The nasal cavity is also clear. The nasal septum is deviated slightly towards the left. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. | Right maxillary sinus retention cyst. The paranasal sinuses are otherwise clear |
Generate impression based on findings. | 40 year-old female with history of benign lymph node in the right axilla. Family history of breast cancer diagnosed in mother age 65. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Circular skin markers were placed over both axillae. Stable 1.2 cm mass projecting over the right axilla. Stable focal asymmetries in the left upper outer quadrant.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 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. | 46 your old female with recent fall and ankle fracture, status post reduction in emergency department. Overlying cast material limits fine bone detail. A trimalleolar fracture is present, with a spiral fracture of the distal fibula, posterior malleolus fracture, and a nondisplaced comminuted fracture of the medial malleolus. The fracture fragments are in near anatomic alignment. | Status post reduction and casting of trimalleolar fracture in near anatomic alignment. |
Generate impression based on findings. | Female 86 years old Reason: chronic constipation abdominal pain, evaluate for stool burden and gas pattern History: abdominal bloating. Severe degenerative arthritic changes affect the lower lumbar spine and hips. There is a nonobstructive bowel gas pattern. There is a moderate stool burden. Radiodense material along the lateral aspect of the left femur may reflect internal ballistic material or external device. | Nonobstructive bowel gas pattern with moderate stool burden. |
Generate impression based on findings. | Female 61 years old Reason: metastatic breast cancer History: evaluate bone metastasis. Pt has completed 2 months of chemotherapy Multiple foci of increased radiotracer uptake in lower lumbar spine consistent with osseous metastatic disease. Foci of increased radiotracer in the left proximal humerus, and left distal humerus suspicious for metastatic disease. | Findings consistent with osseous metastatic disease in the lumbar spine and left humerus. |
Generate impression based on findings. | 65 year old male with HCV with elevated liver enzymes. LIVER: The liver is enlarged measuring 16.1 cm in length with slightly increased echogenicity. Portal vein is patient with appropriate flow and waveform. GALLBLADDER, BILIARY TRACT: The gallbladder is normal in echogenicity with no pericholecystic fluid. Gallbladder wall measures 1 mm in thickness. Common bile duct measures 2 mm in caliber. No intra or extrahepatic biliary ductal dilatation. PANCREAS: No significant abnormalities noted.KIDNEYS: Normal echogenicity of the right and left kidney. There is a 7 mm stone in the left kidney with no evidence of hydronephrosis bilaterally. OTHER: No significant abnormalities noted. | 1. Hepatic steatosis. 2. Left sided nephrolithiasis with no evidence of hydronephrosis. |
Generate impression based on findings. | 33-year-old female with history of breast cancer for follow-up of CT scan 1/12/15 CHEST:LUNGS AND PLEURA: Scattered small opacities in the right lobe are again noted, not significantly changed since the prior exam. There is an 8-mm pulmonary nodule (series 5, image 54) in the right upper lobe that may be post infectious or inflammatory in etiology. Additional scattered micronodules are seen bilaterally.MEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion. No significant mediastinal or hilar lymphadenopathy. CHEST WALL: Post surgical changes of a right mastectomy and right axillary lymph node dissection. No significant axillary, cardiophrenic, or retrocrural lymphadenopathy. Sclerotic focus in the right iliac wing and L3 vertebral body likely represents a benign bone island.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No focal liver lesions. The gallbladder normal limits. No intrahepatic or extrahepatic biliary ductal dilatation..SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Sub-centimeter hypodense lesion in the left kidney consistent with a simple benign 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: Sclerotic focus in the right iliac wing and L3 vertebral body likely represents a benign bone island.OTHER: No significant abnormality noted. | Unchanged scattered pulmonary opacities are nonspecific and may be postinfectious or inflammatory in etiology. Follow-up in 6 to 12 months is recommended to ensure stability. |
Generate impression based on findings. | Male, 59 years old, with altered mental status and possible left arm weakness. A small region of hypoattenuation along the posterior limb of the right internal capsule appears to be more prominent than on the prior examination.Elsewhere in the brain, nonspecific periventricular hypoattenuation is again seen, along with encephalomalacia of the inferior left temporal lobe.No intracranial hemorrhage or any abnormal extra axial fluid collection is detected. No significant parenchymal edema or mass effect is seen. The ventricles and sulci are prominent indicating some degree of cerebral and cerebellar volume loss.The osseous structures of the skull are intact allowing for what appears to be a surgical burr hole in the right frontal bone. | 1. A developing region of hypoattenuation within the posterior limb of right internal capsule could represent evolving acute or subacute ischemia. Correlation with MRI, if possible, should be considered.2. Redemonstration of nonspecific white matter hypoattenuation which may reflect age indeterminate microvascular ischemic disease, as well as presumed chronic cortical ischemia of the inferior left temporal lobe. |
Generate impression based on findings. | 57-year-old female with altered mental status There is no acute intracranial hemorrhage. Redemonstrated is encephalomalacia within the right posterior temporal-occcipital lobe and right basal ganglia. Chronic small lacunar infarct in the left frontal periventricular white matter is also unchanged. Mild periventricular and subcortical white matter hypoattenuation compatible with chronic small vessel ischemic disease. There is advanced global parenchymal volume loss. No hydrocephalus. There is no midline shift or mass-effect. Paranasal sinuses and mastoid air cells are clear. Calvarium is intact. | 1. No evidence of acute intracranial hemorrhage or mass effect. 2. Multiple bilateral chronic infarcts as detailed above. No CT evidence of acute territorial, cortical infarct. |
Generate impression based on findings. | Pain after fall. Four views of the left knee reveal severe tricompartmental osteophyte formation. There is severe medial tibiofemoral and patellofemoral joint space narrowing. There are several well corticated ossific densities within the lateral, medial, and suprapatellar joint spaces which may represent loose bodies. No fracture is evident. Vascular calcifications are noted. There is a large joint effusion. | 1. Severe osteoarthritis without acute fracture evident.2. Large joint effusion. |
Generate impression based on findings. | Left wrist pain. Assess for SLAC wrist. Four views of the left wrist reveal an intrascaphoid headless compression screw without evidence of hardware complication. No acute fracture is evident. There is relative sparring of the radiolunate joint. However, there is selective narrowing of the radioscaphoid articulation. | Selective narrowing of the radioscaphoid articulation which is suggestive of early scaphoid lunate advanced collapse. |
Generate impression based on findings. | Male; 81 years old. Reason: r/o SBO, eval cause of ongoing ileus, constipation History: Ab distention, nausea Limited evaluation of the solid organs without intravenous contrast.ABDOMEN:LUNG BASES: Scattered pulmonary micronodules, some of which are calcified. Mild bibasilar subsegmental atelectasis and/or scarring. Trace left pleural effusion. Severe cardiomegaly.LIVER, BILIARY TRACT: Nodular liver surface contour, most likely due to passive congestion and similar to prior MRI. High density material within the gallbladder is most likely due to sludge and/or gallstones. No biliary ductal dilation.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted. No bowel obstruction or evidence of ileus. Enteric tube tip in stomach.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Large amount of abdominopelvic ascites.PELVIS: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: Large amount of abdominopelvic ascites. | Findings suggestive of passive congestion. Large amount of abdominopelvic ascites. No bowel obstruction or evidence of ileus. |
Generate impression based on findings. | 18 years old, Female, Reason: Evaluate for fracture or other abnormality History: pain and swelling from injuryVIEWS: Right wrist PA, oblique, lateral (3 views) 3/9/15 No fracture or malalignment. No significant soft tissue swelling. | No fracture or malalignment. |
Generate impression based on findings. | 29-year-old female with right knee pain. There is no joint effusion, acute fracture, or malalignment. The soft tissues are unremarkable. | No evidence of acute fracture or malalignment. |
Generate impression based on findings. | 45 years, Female. Reason: Pancreatic pseudocysts on NJT feedings with persistent LLQ pain, please evaluate. There is a nasojejunal tube with its tip projecting past ligament of Treitz in the proximal jejunum. There is a nonobstructive bowel gas pattern. There is a generalized paucity bowel gas. Left upper quadrant cystgastrostomy tube in place. Embolization coil material is present in the left upper quadrant. Small right pleural effusion and left lower lobe atelectasis present. There is nonspecific thickening of the minor fissure. | Nonobstructive bowel gas pattern. Nasojejunal tube with its tip projecting over the proximal jejunum. |
Generate impression based on findings. | Reason: 06/14 follow up patchy infiltrate LUL, significant amount of consolidation and atelectasis LLL. History: follow up LUNGS AND PLEURA: Significant interval decrease, but not complete resolution of left upper lobe opacity with minimal residual interstitial thickening and nodularity. Left lower lobe consolidation has resolved. The left pleural effusion has resolved. A left bronchial stent is present. The appearance of minimal bronchial focal stenosis immediately peripheral to the stent, proximal to the takeoff of the left lower lobe bronchus, is unchanged (image 44/96).MEDIASTINUM AND HILA: Postop change from bilateral lung transplant. Mild coronary calcification. Scattered small nodes are unchanged. Nonspecific thickening of the distal esophagus is unchanged. Esophagus is fluid-filled.CHEST WALL: Status post sternotomy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Significant interval decrease, but not complete resolution of left upper lobe opacity with minimal residual interstitial thickening and nodularity. Left lower lobe consolidation and pleural effusion has resolved. Continued follow-up is recommended. |
Generate impression based on findings. | 20 year-old female with history of right shoulder pain and bilateral knee pain. Two views of the right shoulder fail to demonstrate acute fracture or malalignment. The joint space appears preserved. The soft tissues are unremarkable.Four views of the right knee reveal no acute abnormality. There is no evidence of fracture or malalignment. The soft tissues are unremarkable.Four views of the left knee reveal no acute abnormality. There is no evidence of acute fracture or malalignment. The soft tissues are unremarkable. | No acute abnormality of the bilateral knees or right shoulder. No fracture or malalignment is identified. The soft tissues appear unremarkable. |
Generate impression based on findings. | Male 16 years old Reason: Evaluate intracardiac mass seen on TTE History: 16 y/o M recently diagnosed with spinal mass, multiple DVTs in LUE now with mass seen on TTE. There is an hypodense, nonenhancing occupying mass in the left axillary vein, left internal jugular and left innominate vein as well IVC and azygos vein, which is getting into the right atrium, crossing the tricuspid valve and ending in the right ventricle. The right ventricle outflow tract appears to be free of occlusions. The occupying mass is continuous and smooth with mild lobulations at the level of the right atrium. Although the SVC appears to be almost completely occupied , since the exam was performed by injecting the contrast from the right antecubital vein, some patency persist.Pericardial and left pleural effusion, with dependent atelectasis of the left lung base is noted as well. The left atrium, left ventricle and aorta are patent. | 1.Likely massive thrombus of the left axillary, subclavian, IJ and innominate vein, as well azygos and IVC, which is and a the date 990,000 9099 thrombus getting into the right atrium and ventricle. The very unlikely possibility of intramural mass due to invasion or metastases may be contemplated.2.Pericardial effusion.3.Left pleural effusion.Dr. Peter Varga was present during the elaboration of this report and agrees with the findings. |
Generate impression based on findings. | 49 year old female status post right lumpectomy in 2011 for IDC with DCIS, presents today for routine follow up. She received radiation and chemotherapy. History of additional benign right breast biopsy. No current breast complaints. No family history of breast cancer. Three standard views of both breasts, and 2 spot compression 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 linear marker has been placed on a scar overlying the upper outer right breast with expected underlying postsurgical changes including surgical clips, and volume loss. A cylinder shaped biopsy clip is present in the central upper right retroareolar region. An asymmetry is present in the far posterior upper outer left breast, which disperses on spot compression imaging, compatible with superimposition of normal parenchymal tissue. No dominant mass, suspicious microcalcifications or areas of nonsurgical architectural distortion in either breast. Benign appearing lymph nodes are projected over the left axilla. Surgical clips are also noted within 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. | 44-year-old male with multiple myeloma on clinical ductile, evaluate myelomatous lesions and soft tissue structures anterior aspect of the distal esophagus. LUNGS AND PLEURA: Bibasilar atelectasis and/or scarring. No pleural effusion or pneumothorax. Nonspecific bilateral scattered micronodules measuring up to 3 mm.MEDIASTINUM AND HILA: Surgical clips are noted on the right of the esophagus (series 3, image 57). No significant mediastinal or hilar lymphadenopathy. Heart size is normal. No pericardial effusion. Hypodense lesion in the right lobe of the liver (series 3, image 100) measures 12 mm. There is a soft tissue nodule anterior to and possibly arising from the esophagus measuring 1.7 x 2.0 x 2.1 cm (series 3, image 64 and series 80243, image 82). Progress note from outside hospital notes a similarly described lesion to measure 2.6 x 2.5 x 2.0 cm.CHEST WALL: Multiple small lytic lesions scattered throughout osseous structures compatible with patients provided history of multiple myeloma. Lytic lesion in the T3 vertebral body. No significant axillary, or cardiophrenic, or retrocrural lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Prominent para-aortic lymph node measuring 7 mm is noted on the last image. | Possible decrease in size of soft tissue density mass anterior to and possibly arising from the esophagus. This likely represents a remnant of the resected lesion. A duplicated esophageal cyst may be considered. Outside hospital images may be submitted for proper consideration if clinically warranted. |
Generate impression based on findings. | Abdominal pain. Evaluate for intestinal obstruction. VIEWS: Abdomen name of views (two views) 3/9/2015 at 1538 hrs Interval placement of enteric tube, with proximal sideport above the level of the GE junction.Peritoneal dialysis catheter tip in upper mid pelvis. Surgical sutures in the right lower quadrant.Moderately dilated small bowel loops are unchanged from the prior exam. Very little distal gas is identified. | Enteric tube with proximal sideport above the level of the GE junction. Bowel obstruction. |
Generate impression based on findings. | Reason: spitting blood after forceful speaking History: as above LUNGS AND PLEURA: No evidence of significant hemorrhage or other cardiopulmonary abnormality. The central airways are normal.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No evidence of significant hemorrhage or other cardiopulmonary abnormality. The central airways are normal. |
Generate impression based on findings. | Right foot ulcer. Evaluation for osteomyelitis, non-healing foot ulcer. Three views of the right foot reveal mild joint space narrowing and osteophyte formation at the first metatarsophalangeal joint. There is a soft tissue irregularity along the medial first digit. There is no evidence of underlying cortical destruction. | Soft tissue irregularity along the medial great toe without evidence of osteomyelitis. |
Generate impression based on findings. | Male 34 years old Reason: H/o HL s/p 4 cycles of chemo; please restage History: masses CHEST:LUNGS AND PLEURA: Scattered micronodules are unchanged.MEDIASTINUM AND HILA: Small/borderline enlarged mediastinal lymph nodes are unchanged.CHEST WALL: Index left axillary lymph node measures 1.3 by 1.1-cm image number 27, series number 1001, slightly smaller compared to previous study.ABDOMEN:LIVER, BILIARY TRACT: Again noted multiple hypodense lesions in both lobes of the liver. Index lesion measures 2.6 x 2.2 cm on image number 92, series number 1001, slightly smaller compared to previous study. Other hypodense lesions are also smallerSPLEEN: Subcentimeter lesion in the spleen is unchanged. Spleen is normal in size.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Extensive retroperitoneal lymph nodes. Index left para-aortic node 1.3 x 1.2 cm on image number 105, series number 1001, decreased in size compared to previous study. Other retroperitoneal lymph nodes are also decreased in size compared to previous study.BOWEL, MESENTERY: Mesenteric adenopathy is also decreased in size compared to previous study.BONES, SOFT TISSUES: There is a sclerotic lesion in T10 vertebral body on the right side. This is also unchanged compared to previous study.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Index right inguinal node measures 11 mm in diameter image number 195, series number 1001, decreased in size compared to previous study. Other pelvic lymph nodes have decreased in size compared to previous study.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Previously noted expansile lytic lesion involving the right ischium bone and sclerotic lesion involving the left ischium are unchanged. Sclerotic lesions in the iliac bones and the lumbovertebral bodies are also grossly unchanged.OTHER: No significant abnormality noted | Slight interval decrease in the size of the index lesions and lymph nodes. Sclerotic bone lesions and right ischial expansile lesion are unchanged. There etiology is unknown but may present lymphoma involvement of the bone. |
Generate impression based on findings. | 65 year old male with new onset anuria. History of kidney transplant in 2005. Evaluate for hydronephrosis. RENAL TRANSPLANT: Right iliac fossa. LOCATION: Right iliac fossaPERITRANSPLANT TISSUES: No significant abnormality notedKIDNEY: No significant abnormality notedCOLLECTING SYSTEM/URETER: No significant abnormality notedURINARY BLADDER: No significant abnormality notedVASCULAR DOPPLER DATA: Color and spectral Doppler were performed on inflow and outflow vessels. Poor visualization of the right renal artery with increased resistive index up to 0.9 at the hilum with elevated indices at the anastomosis and just more proximal to that. OTHER: No significant abnormality noted | Findings are suspicious for significant renal artery stenosis involving the anastomosis and extending just proximal to that. Findings were discussed by interventional radiology attending Dr. Rakesh Navuluri with the transplant team, who are aware of the findings. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. Asymmetry in the far posterior depth of the medial breast on the CC view is indeterminate, but could represent a skin lesion. No suspicious microcalcifications or areas of architectural distortion are present. | Asymmetry in the medial breast, posterior depth, for which comparison with priors is recommended. If this finding cannot be proven stable, further evaluation with spot compression and possible ultrasound will be needed. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OA - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Female; 61 years old. Reason: metastatic breast cancer/liver and bone metastates History: assess response to 4 cycles of chemotherapy for metastatic Breast CA ABDOMEN:LIVER, BILIARY TRACT: Multiple hepatic metastases are unchanged. Reference right lobe lesion measures 2.3 x 2 cm, unchanged (series 3/96). No new liver lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Calcific arteriosclerotic disease of the aorta.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multiple metastatic foci within lumbar spine unchanged with partial collapse of the L2 vertebrae. No new osseous lesions identified.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Multiple calcified uterine fibroids.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Increased sclerosis of left ischium metastasis since prior study on 10/17/13, likely due to treatment change. OTHER: No significant abnormality noted. | 1. Stable hepatic and lumbar spine metastases.2. increased sclerosis of the left ischium metastasis since 10/17/13, likely due to treatment change.3. No new sites of disease in the abdomen and pelvis.4. See separate report from CT chest performed concomitantly. |
Generate impression based on findings. | 86-year-old female for follow-up of nodule noted on CT scan 4/9/2014 LUNGS AND PLEURA: Again noted is a smoothly marginated 9-mm nodule in the lingula not significantly changed since the prior exam. Numerous upper lobe ground glass lobular and peribronchial nodules. Reference measurements as follows:Right apical nodule (series 5, image 40) measures 9 mm, previously 9 mm. Left upper lobe reference nodule measures 11 mm (series 5, image 50), previously 11 mm.Lateral nodule in the left upper lobe the level of the aortic arch measures 9 mm (series 5, image 87), previously 9 mm.New left lower lobe pleural-based opacity with peribronchial nodules (series 4, image 54) may be related to aspiration or post-infectious in etiology.Bibasilar dependent atelectasis/scarring. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Atherosclerotic calcification of the aorta and its branches. Ascending aorta is stable in size. Minimal coronary artery calcifications. Heart size is normal. No pericardial effusion. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant axillary, retrocrural, or cardiophrenic lymphadenopathy. There is unchanged dextroscoliosis of the lower thoracolumbar spine. Sclerotic focus in the L1 body is unchanged and likely represents a benign bone island.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Pancreatic calcifications suggest chronic pancreatitis, unchanged. Punctate calcification in the right kidney may represent a non-obstructing stone. Previously noted hyperattenuating proteinaceous or hemorrhagic cyst in the interpolar region of the right kidney (series 3, image 80) is less conspicuous on today's study. Partially exophytic, isodense lesion in the interpolar region of the left kidney is unchanged (series 3, image 86). | 1.Unchanged left upper lobe groundglass nodule suspicious for adenocarcinoma in situ/MIA.2.Unchanged ground glass nodules likely representing atypical adenomatous hyperplasia as described above.3.Unchanged 9-mm nodule in the lingula.4.New left lower lobe opacity may reflect aspiration.5.Follow-up of these lesions are recommended in 12 months. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Known history of bilateral cysts. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Bilateral circumscribed masses compatible with history of known cysts. No new masses, microcalcifications or areas of architectural distortion are present. | Bilateral circumscribed masses compatible with history of known cysts. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Retropharyngeal abscess, tonsillar abscess: focal left side neck pain. There is swelling of the left palatine tonsil with diffuse surrounding fat stranding and mild oropharyngeal airway narrowing. There is also a hypoattenuating area that measures up to 10 mm in the lateral left tonsillar fossa. There is mild right tonsillolithiasis and perhaps a small amount of fluid in the tonsillar crypts. There is mild reactive left cervical lymphadenopathy. There is no evidence of a drainable fluid collection in the retropharyngeal space. The thyroid and major salivary glands are unremarkable. There appears to be mild narrowing of the superior left internal jugular vein. The cervical arteries are patent. There is reversal of the usual cervical lordosis. The imaged mastoid air cells and paranasal sinuses are clear. The imaged intracranial structures and orbits are unremarkable. The imaged portions of the lungs are clear. | Left palatine tonsillitis with evidence of a developing peritonsillar abscess that measures up to 10 mm and associated reactive left cervical lymphadenopathy and mild oropharyngeal airway narrowing. |
Generate impression based on findings. | 34 years old Male. Reason: evaluate for response. History of Hodgkin Lymphoma s/p 4 cycles of chemotherapy. For re-staging. RADIOPHARMACEUTICAL: 12 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 113 mg/dL. Today's CT portion of the neck demonstrates multiple small lymph nodes in the neck and a mucosal thickening of the maxillary sinuses. Please see diagnostic CT reports for details of the chest, abdomen, and pelvis.Today's PET examination demonstrates no evidence of FDG avid tumor in the neck, chest, abdomen and pelvis. There is interval complete resolution of hypermetabolic lesions in the body. Physiologic activity is seen in the liver, spleen, kidneys, intestines and bladder. There is no abnormal FDG uptake in the mucosal thickening in the maxillary sinuses and in the small lymph nodes in neck. There is also no abnormal FDG uptake in the low-attenuation lesions in the liver and in the lesions in the skeleton seen on CT. | 1.No evidence of FDG avid tumor on the current study.2.Interval complete resolution of FDG avid tumor seen on prior study.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral breast reductions in 1991. Family history of breast cancer diagnosed in two sisters. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Surgical clip again seen in the right axilla. Focal asymmetry in the right anterior breast is stable. Benign calcifications in both breasts are unchanged. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign appearing lymph nodes project over both axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 15 months old male, history of tracheostomy, concern for infection.VIEW: Chest AP (one view) 3/9/15 Tracheostomy and gastrostomy tube unchanged. The cardiothymic silhouette is normal. Large lung volumes are present. Pulmonary vascularity is abnormal secondary to chronic lung disease. Hazy opacity within the right lower lobe may represent infection and atelectasis. Opacity in the left lower lobe may represent atelectasis or infection. Streaky opacity in the right upper lobe may represent subsegmental atelectasis. No pleural effusion or pneumothorax. | Hazy opacity in the right and left lower lobes may represent infection and atelectasis. |
Generate impression based on findings. | 53 years old male presents with right hilar mass c/w primary lung cancer and cough. RADIOPHARMACEUTICAL: 10.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 96 mg/dL. Today's CT portion grossly demonstrates confluent right hilar tumor and mediastinal lymphadenopathy with epicenter in the paramediastinal right upper lobe. Today's PET examination demonstrates intense FDG uptake in the right hilar tumor and mediastinal lymphadenopathy in the right paratracheal, precarinal, and subcarinal regions. The SUVmax in the subcarinal lymph nodes is 11.2. There are numerous foci of increased activity in the skeleton in the proximal humeri, ribs, scapulae, sternum, spine, pelvis, and proximal femurs. SUV Max in the bony lesion in the left iliac wing is 6.5.Physiological activity is seen in the liver, spleen, kidneys, intestines, uterus and bladder. | 1.Hypermetabolic tumor in the right lung hilum with extensive metastatic lymphadenopathy in the right hilum and mediastinum.2.Extensive osseous metastasis in the skeleton. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Bilateral asymmetries are unchanged. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female; 57 years old. Reason: metastatic breast cancer History: abdominal pain- metastatic breast cancer CHEST:LUNGS AND PLEURA: Moderate predominantly upper lobe centrilobular emphysema. Minimal bibasilar subsegmental atelectasis. Scattered pulmonary micronodules are stable. No new suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: Stable prominent, nonspecific mediastinal and bilateral hilar lymph nodes. Reference largest lymph node in the precarinal space measures up to 15 mm in short axis, unchanged (series 3/37).Normal heart size without pericardial effusion. No visible atherosclerotic calcifications of the coronary arteries.CHEST WALL: Stable mildly enlarged right axillary and subpectoral lymph nodes. Stable prominent left axillary lymph nodes. Known right breast cancer better depicted on recent MRI breast dated 2/19/15. Increased sclerotic foci throughout the visualized skeleton, compatible with known diffuse osseous metastatic disease seen on bone scan from 2/26/15. The largest lesion is a lytic lesion at the inferior aspect of the L2 vertebral body. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small nonobstructing right renal stones. Focal cortical thinning of the right kidney midpole, which may be due to prior scarring versus infarct.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Increased sclerotic foci throughout the visualized skeleton, compatible with known diffuse osseous metastatic disease as seen on bone scan from 2/26/15. The largest lesion is predominantly lytic at the inferior aspect of the L2 vertebral body. OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Large fundal fibroid.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Increased sclerotic foci throughout the visualized skeleton, compatible with known diffuse osseous metastatic disease as seen on bone scan from 2/26/15. The largest lesion is predominantly lytic at the inferior aspect of the L2 vertebral body. OTHER: No significant abnormality noted. | 1. Right breast cancer, better depicted on recent MRI of the breast.2. Stable mildly enlarged right axillary and subpectoral lymph nodes.3. Increased diffuse osseous metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered benign calcifications, including arterial calcifications in both breasts are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 56 are old female with history of right knee pain. There is mild bilateral osteoarthritic changes including mild joint space narrowing, osteophyte formation, and sharpening of the tibial spines. No fracture or dislocation is evident. | Mild bilateral osteoarthritis. No evidence of fracture or malalignment. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Scattered benign calcifications in both breasts are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
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