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Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in mother at age 76. Personal history of recent 14 lb weight loss. 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. Scattered benign calcifications in both breasts are stable. Subtle architectural distortion is seen in the central aspect of right breast.No suspicious masses or microcalcifications are present. | Subtle architectural distortion in the central aspect of right breast. Spot compression views (with possible tomosynthesis images) and possible ultrasound study are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 20 year-old female with pain in the fourth metacarpal x 1 month. Three views of the left hand reveal no evidence of fracture or malalignment. There is no significant soft tissue swelling. The joint spaces are preserved. | No evidence of fracture or malalignment. |
Generate impression based on findings. | 49 year-old female with left elbow pain status post fall. Three views of the left elbow reveal normal anatomic alignment without evidence of fracture, joint effusion, or significant soft tissue swelling. | No evidence of fracture, malalignment, or joint effusion. |
Generate impression based on findings. | 67-year-old male with left knee swelling. Four views of the left knee reveal no significant joint effusion, fracture, or malalignment. The joint spaces are symmetric and well preserved. Significant vascular calcifications are present. | No evidence of fracture or malalignment. |
Generate impression based on findings. | 17 years old, Male, Reason: rule out testicular torsion History: Right testicular swelling Spectral and color Doppler of the inflow and outflow vessels was performed.RIGHT TESTIS: Enlarged heterogeneous right testicle with decreased to absent vascular flow on Doppler consistent with torsion. The right testicle measures 3.1 x 3.6 x 2.8 cm.LEFT TESTIS: Normal vascular flow seen on Doppler. Normal homogeneous appearance of the left testicle. The left testicle measures 4.0 x 2.8 x 1.9 cm.RIGHT EPIDIDYMIS: Enlarged hyperemic right epididymis is present. Right epididymis measures 4.9 x 3. 3 x 1.7 cm.LEFT EPIDIDYMIS: No significant abnormalities noted. Left epididymis measures 2.0 x 1.2 x 0.7 cm. Normal vascular flow seen on Doppler.OTHER: A small right hydrocele is present. | Enlarged heterogeneous right testicle with decreased to absent vascular flow consistent with testicular torsion. |
Generate impression based on findings. | The exam is limited due to streak artifact from surrounding stereotactic frame. The ventricles and sulci are within normal limits. Incidental note is made of prominent low-density areas within the choroid plexus in the atria, likely related to choroid plexus cysts and xanthogranulomas. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no definite areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. Subsequent imaging demonstrates bifrontal burr holes with placement of DBS electrodes with tips in the region of the the thalamic nuclei. Additional extracranial components of the electrodes are present along the right parietal scalp, with scattered subcutaneous emphysema. A small amount of extra-axial air is seen along the anterior aspects of the frontal lobes with mild flattening of the parenchyma. | Expected postoperative changes following bifrontal burr holes creation with placement of DBS electrodes. No acute intracranial hemorrhage. |
Generate impression based on findings. | Reason: 71y/o female with breast cancer; surgery 3/11/15 right breast re-excision lumpectomy and SNBX. 2 site injection: Please inject both peri-areolar and in skin adjacent to/below incision in right high axilla. History: right axillary mass and breast cancer; Inject 2 sites:both peri-areolar and in skin adjacent to/below incision in right high axilla RADIOPHARMACEUTICAL: The right areola and right axilla were prepared in a sterile manner. A total of 2 mCi Tc-99m filtered sulfur colloid was injected in four peri-lesional sites in both the right areolar and right axillary locations. A focus of increased activity is noted in the right upper breast, representing the sentinel node. This region was marked with an indelible marker. | Sentinel node identified in the right upper breast. |
Generate impression based on findings. | 19 yo female with ALL, b/l knee pain. VIEWS: Left knee AP, lateral (2 views) 3/10/2015, 1524 The osseous structures are normal.No joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | There is mild rightward angulation of the cranial cervical junction. The scout lateral view and the sagittal reformatted images demonstrate multilevel likely degenerative subluxations. There is 4-mm grade 1 retrolisthesis of C2 on C3, 3-mm grade 1 anterolisthesis of C3 on C4 and 2 mm of C4 on C5. There is also 4-mm grade 2 anterolisthesis of C6 on C7 and 3 mm of C7 on T1. There is no significant vertebral body compression deformity, although there is multilevel endplate irregularity, most significant at C5-C6 and C2-C3. There is an exaggerated cervical lordosis.There is no definite acute fracture. The dens is irregular in appearance possibly with underlying dysplasia. There is abnormal widening of the atlantodental interval even in a patient with Down's syndrome, measuring 8 mm. There is an irregularly shaped ossific density superior to the atlantodental interval which measures 11 x 7 mm in greatest axial dimensions, by 6 mm CC. This has some well corticated margins, and it is difficult to determine if this is displaced ligamentous mineralization versus less likely a chronic type I odontoid fracture. Due to the atlantoaxial subluxation, the bony central spinal canal is significantly narrowed, measuring 5 mm AP on 6/20 at the lower C1-C2 level. On coronal images, right occipital C1 lateral mass is slightly laterally located with respect to the right occipital condyle with misalignment of approximately 2 mm. On the left, the lateral mass of C1 is 10 mm medially displaced with respect to the left occipital condyle. There is severe degeneration of the left atlantoaxial joint nearly unrecognizable. There is mild lateral displacement of the right lateral mass of C2 with respect to the left. In the sagittal plane, there is significant posterior positioning of the lateral mass of C2 with respect to C1.At C2-C3, there is a prominent posterior osteophyte disk complex with slight left paramedian central prominence. There is left facet arthropathy as well as right greater than left uncovertebral hypertrophy contributing to overall moderate-severe spinal stenosis and moderate to severe right foraminal narrowing. There is ligamentum flavum thickening.At C3-C4, there is uncovering of the disk with a severe posterior osteophyte disk complex. There is severe left facet arthropathy with is moderate central spinal stenosis. There is left uncovertebral hypertrophy and severe left foraminal narrowing.At C4-C5, there is uncovering of the disk severe right facet arthropathy. There is also right uncovertebral hypertrophy with overall mild spinal canal stenosis. There is severe right foraminal narrowing.At C5-C6, there is a trace posterior osteophyte disk complex with mild central spinal canal stenosis. There is mild bilateral uncovertebral hypertrophy.At C6-C7, there is uncovering but this with ligamentum flavum thickening.At C7-T1, there is minimal uncovering of the disk.The visualized intracranial structures and lung apices appear normal. There is a partially visualized patulous esophagus. There is also partial visualization of the thickening and sclerosis of the maxillary sinus walls, with complete opacification of the lumen of the maxillary sinuses suggestive of chronic sinusitis. There is also fluid opacification of right mastoid air cells and middle ear. There is underpneumatization of the left mastoid. | 1. No definite acute fracture. Multilevel severe degenerative changes as well as subluxations as detailed above, with findings suggesting atlantoaxial and atlanto-occipital subluxations and instability; dynamic imaging may be helpful. Small ossific density just cranial to the atlantodental space is of uncertain origin, possibly to ligamentous or other dystrophic mineralization versus less likely sequela of chronic type I odontoid fracture.2. Moderate-severe central spinal canal narrowing at C1-C2 and C2-C3, and MRI of the cervical spine is recommended to evaluate for degree of associated cord compression.3. Multilevel scattered severe bilateral foraminal narrowing as detailed above.4. Incidental partially visualized patulous esophagus. Please correlate clinically, an esophagram may be obtained as clinically indicated.5. Severe right mastoid and middle ear fluid opacification. Please correlate clinically. |
Generate impression based on findings. | Bilateral shoulder replacements. Shoulder pain. Three views of the right shoulder are provided. There is a right reverse ball-and-socket shoulder arthroplasty device in near anatomic alignment without evidence of hardware loosening or failure. No acute fracture is evident. There is heterotopic ossification along the lateral aspect of the shoulder, unchanged. Three views of the left shoulder are provided. There is a left reverse ball-and-socket shoulder arthroplasty device in near anatomic alignment without evidence of hardware loosening or failure. No acute fracture is evident. | Bilateral reverse ball-and-socket shoulder arthroplasties without evidence of hardware complication. |
Generate impression based on findings. | Female; 57 years old. Reason: stage iii anal cancer s/p proctocolectomy in 2012 evaluate for disease recurrence History: anal cancer CHEST:LUNGS AND PLEURA: Stable scattered pulmonary micronodules. Stable emphysematous changes. Stable scattered linear atelectasis or scarring. No new or suspicious pulmonary nodules or masses. No pleural effusions.MEDIASTINUM AND HILA: Hypoattenuating subcentimeter nodule in the left lobe of the thyroid gland, stable to slightly decreased.Reference left supraclavicular lymph node measures 9 x 6 mm, previously 8 x 5 mm and not significantly changed (series 80224/6). The two lymph nodes adjacent to the reference node have decreased in size. No mediastinal or hilar lymphadenopathy. Calcified mediastinal lymph nodes, unchanged. Normal heart size. Minimal pericardial effusion/thickening.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Mild splenomegaly, unchanged. Small amount of soft tissue at the splenic hilum has increased medially with new extension into the lesser sac where it appears to exert mass-effect on the pancreatic tail. The new soft tissue is round in appearance and measures approximately 3.2 x 3.2 cm (series 80224/92).PANCREAS: The new round soft tissue described above is inseparable from the pancreatic tail. Otherwise, the pancreas appears within normal limits.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left parapelvic cyst, unchanged. RETROPERITONEUM, LYMPH NODES: Soft tissue density surrounding the aorta and IVC, unchanged. Subcentimeter scattered retroperitoneal lymph nodes are similar to prior study.BOWEL, MESENTERY: Status post total colectomy with end ileostomy.BONES, SOFT TISSUES: Left ileostomy. 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: Status post total colectomy with end ileostomy.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Previously described nonspecific soft tissue density has increased in the lesser sac as detailed above. In this setting of known familial adenomatous polyposis, this finding possibly due to desmoid type fibromatosis. Further evaluation with endoscopic ultrasound and biopsy is suggested to exclude other type of mass as it has grown in the interim. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in paternal aunt. 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 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: NSB - Screening Mammogram.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 70 year-old female with shortness of breath and dyspnea on exertion PULMONARY ARTERIES: Adequate pulmonary opacification with bilateral pulmonary emboli, most proximal location in bilateral main pulmonary arteries extending into bilateral segmental and subsegmental arteries. The main pulmonary artery measures 2.9 cm is borderline enlarged.LUNGS AND PLEURA: No pleural effusion or pneumothorax. Small subsegmental atelectasis in the right lower and left lower lobes may represent early infarcts. No focal consolidations. Scattered bilateral nonspecific micronodules.MEDIASTINUM AND HILA: The heart size is normal although the right heart is enlarged relative to the left. There is straightening of the interventricular septum suggestive of right heart strain. No pericardial effusion. Hypodense nodule in the right thyroid lobe. Enlarged mediastinal lymph nodes, the largest being a precarinal lymph node measuring 12 mm (series 6, image 88). Minimal coronary artery calcifications.CHEST WALL: No axillary, retrocrural, or cardiophrenic lymphadenopathy. Chest structures within normal limits. No suspicious osseous lesions.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis without CT evidence of cholecystitis. Nodularity to bilateral adrenal glands. | Positive for pulmonary embolism most proximal in bilateral main pulmonary arteries. Possible early infarcts in bilateral lung bases. Findings relayed to Dr. Weiss, pager 4145, at 1544 on 3/10/15.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Lobar.RV Strain: Positive. |
Generate impression based on findings. | 59-year-old male one year status post PSF + ACDF; assess fusion. Two views of the cervical spine again demonstrate anterior and posterior orthopedic devices affixing the cervical spine, similar to prior exams. There is no specific radiographic evidence of hardware complication. On the lateral projection, straightening of the cervical spine is grossly unchanged. Intervertebral disk spacers and graft material are again noted between C3 and C7 without evidence of complication. Presumed carotid arterial calcifications are again noted. | Cervical fixation appearing similar to the prior study. |
Generate impression based on findings. | Stage IIIC ovarian cancer s/p surgery and chemo, now with rising CA 125, assess for recurrence. RADIOPHARMACEUTICAL: 13.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 82 mg/dL. CT images through the chest, abdomen, and pelvis demonstrate a hypoattenuating lesion along the serosal margin of the right hepatic lobe and spiculated centrally hypoattenuating soft tissue in the right external iliac region correlating to findings on diagnostic CT performed the same day. Please see the separately dictated CT report for further description. Non-diagnostic quality CT images through the neck soft tissues show no significant abnormalities. Today's PET examination demonstrates increased metabolic activity in both the lesion along the serosal margin of the right hepatic lobe as well as the soft tissue nodule near the right external iliac region, consistent with multifocal tumor. Additionally, there is a small focus of questionable activity in the hepatic dome present on both corrected and uncorrected images which is nonspecific but may also represent a small tumor deposit. | 1. Hypermetabolism of lesions along the serosal margin of the right hepatic lobe as well as the soft tissue nodule near the right external iliac region are consistent with tumor. 2. Additional small focus of questionable activity in the hepatic dome may also represent a small tumor deposit but is nonspecific. |
Generate impression based on findings. | 19 yo female with ALL, b/l knee pain.VIEWS: Right knee AP, lateral (2 views) 3/10/2015, 1524 The osseous structures are normal.No joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 88 years old Female. Reason: LUL mass, most likely NSCLC. History: cough. RADIOPHARMACEUTICAL: 8.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 127 mg/dL. Today's CT portion grossly demonstrates a large mass in the left upper lobe. There is a small left pleural effusion. The abdominal aorta with calcifications is dilated.Today's PET examination demonstrates intense FDG uptake in the left upper lobe mass with SUVmax of 18.8, which is consistent with the patient's diagnosis of lung cancer. There is a focus of increased activity in the left lower lobe pleura or left hemidiaphragm at paraspinal region with SUVmax of 9.0, which is consistent with a metastasis.Several foci of increased activity is seen in the mediastinum at paratracheal, AP window, and subcarinal regions, corresponding to the small lymph nodes seen on CT. The SUVmax in the AP window lymph nodes is 4.4. A focus increased activity is seen in the left hilum with SUVmax of 3.3.Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Hypermetabolic mass in the left upper lobe, consistent with the patient's diagnosis of non-small cell lung cancer.2.Focal FDG activity in the left lower lobe pleura or left hemidiaphragm at paraspinal region, consistent with metastasis.3.Multiple small mediastinal lymph nodes and left hilar lymph node with mild to moderate FDG uptake, which may represent nodal metastasis. |
Generate impression based on findings. | 67 year-old female with elevated total bilirubin. Evaluate for Budd-Chiari syndrome. PORTAL VENOUS: Patent with appropriate directional flow, peak systolic velocity at 0.4 m/sec.HEPATIC ARTERIES: Patent with appropriate directional flow. Resistive index for the left hepatic artery is 0.75. Resistive index for the right hepatic artery is 0.84.HEPATIC VEINS: The left, middle and right hepatic veins are patent with appropriate directional flow. INFERIOR VENA CAVA: Patent with appropriate directional flow. OTHER: No significant abnormality noted. | The hepatic vasculature is patent with appropriate directional flow. Specifically the hepatic veins and IVC are patent. |
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. Benign calcifications in both breasts have slightly progressed on the right in a benign fashion.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.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 68-year-old male with known abdominal aortic aneurysm. The abdominal aorta is patent with appropriate directional flow. Abdominal aortic measurements:Proximal aorta: 2.4 cm x 2.5 cm x 2.4 cm.Mid aorta: 2.2 cm x 2.5 cm x 2.3 cm.Distal aorta: 3.0 cm x 3.1 cm x 3.3 cm.Right common iliac artery: 1.0 cm x 1.2 cm x 1.1 cm Left common iliac artery: 1.0 cm x 1.2 cm x 1.1 cm | Stable abdominal aortic aneurysm. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Benign calcifications including arterial calcifications are stable. New 21 mm circumscribed lobulated mass in the upper inner quadrant.No suspicious microcalcifications or areas of architectural distortion are present. | New 21 mm circumscribed lobulated mass in the left upper inner quadrant for which additional spot compression views and probable ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EA - Additional Mammo/Ultrasound Workup Required.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: ICH with SAH History: as above Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated. In general the intracranial vasculature has irregular wall walls . There is stenosis present along the proximal portion of the right superior division of the left middle cerebral artery. The left superior division MCA branches are attenuated. There is stenosis present along the proximal portion of the left inferior division of the left middle cerebral artery. Left middle cerebral artery M2 segment branches are identified along the lateral and SPECT of the hematoma. Some of the hematoma appears to course into the operculum on the left side.The anterior communicating artery and the posterior communicating arteries are identified and are intact. There is fetal origin of the right posterior cerebral artery with a hypoplastic right P1 segment. The left posterior communicating artery is very small.The right vertebral artery is a not identified within the right foramen transversarium of C1. It would appear that it fills via retrograde flow from the vertebrobasilar junction. The right posterior inferior cerebellar artery opacifies.CT head:There is redemonstration of a large left sylvian fissure hematoma associated with a couple Satellite hematomas in the left parietal lobe. The sylvian fissure hematoma appears similar in size when compared to the prior exam though the density is mildly changed.There is a redemonstration of encephalomalacia along the inferomedial aspect of the right cerebellar hemisphere as well as multiple hypodensities in the basal ganglia bilaterally. There is redemonstration of uncal herniation and midline shift. | 1.No evidence for aneurysm.2.Since the prior exam a left sylvian fissure hematoma appears to be relatively stable. It is associated with intraparenchymal blood in the left parietal lobe . There is associated left-sided uncal herniation and midline shift.3.There are foci of stenoses present along the superior division of the right middle cerebral artery proximally and the inferior division of the left middle cerebral artery proximally.4.Branches of the superior division of the left middle cerebral artery are attenuated. The possibility of and underlying lesion cannot be excluded. If clinically appropriate conventional angiography may help further evaluate this for underlying vascular lesion.5.There is occlusion of the distal right vertebral artery and with the suspected reverse filling of the intracranial portion of the right vertebral artery via the vertebrobasilar junction.6.Foci of hypoattenuation in the bilateral basal ganglia, which are suspicious for lacunar infarcts.7.Encephalomalacia in the right cerebellar hemisphere, likely related to prior infarct. |
Generate impression based on findings. | Female 59 years old; Reason: history of gallbladder cancer s/p resection 2/2013, evaluate interval change History: none CHEST:LUNGS AND PLEURA: No dominant lung lesion. The pleural spaces are clear.MEDIASTINUM AND HILA: Heart size is normal without a pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Status post cholecystectomy with multiple clips in the gallbladder fossa.Liver is normal in morphology. No suspicious hepatic lesions hepatic and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Small lymph node near the caudate lobe measures 1.1 x 0.6 cm (image 84/series 3) previously, 1.3 x 0.9 cm.BOWEL, MESENTERY: Small bowel is normal in caliber. Portion of colon herniates through the anterior wall hernia without obstruction.BONES, SOFT TISSUES: Surgical changes in the anterior bowel wall with a ventral hernia.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Multiple uterine fibroids some of which are calcified.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable exam. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of left benign breast biopsy. History of bilateral inverted nipples. 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. Biopsy clip in the left upper outer breast is unchanged in position. 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.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 12 years old Reason: fracture VIEWS: Right ankle AP, lateral and oblique. 3/10/15 (3 views) Healed fracture of the distal fibula in anatomic alignment. The distal fibular physis is almost completely fused. | Healed fracture of the distal fibula as described. |
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. Small round mass in the left upper outer quadrant is 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.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Reason: hx left lung CA, flank pain. Evidence of recurrent disease. Also pls assess spleen. PE? History: left flank pain, SOB, hx lung cancer. PULMONARY ARTERIES: Technically adequate exam for evaluation of pulmonary embolism. No pulmonary embolus is identified.LUNGS AND PLEURA: Stable pulmonary micronodules. No focal consolidation or pleural effusion. Status post left upper lobectomy.MEDIASTINUM AND HILA: Heart size is normal with no pericardial effusion. No significant mediastinal or hilar lymphadenopathy. Mild coronary artery calcifications.CHEST WALL: Degenerative changes affect the visualized spine.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Two stable hepatic cysts. Right renal cyst has enlarged. | No evidence of pulmonary embolism or other significant abnormality.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 49-year-old male patient with gross hematuria. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: A horseshoe kidney is again noted. Again seen are single ureters bilaterally. In addition to a right main and a left main renal artery there is an inferior accessory branch off the aorta on the right. There is a subcentimeter hyperattenuating lesion in the lateral right kidney that is not significantly changed in size compared to prior examination and likely represents a hemorrhagic cyst. Left renal subcentimeter lesion is too small to characterize and may represent a hemorrhagic cyst. No hydronephrosis, abnormal nephrograms, or renal calculi.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Horseshoe kidney with small bilateral likely hemorrhagic cysts. No suspicious mass lesions, hydronephrosis, or renal calculi. |
Generate impression based on findings. | Susceptibility artifact from the ventricular shunt somewhat limits evaluation. There is a right frontal approach ventricular shunt catheter with the tip terminating slightly left of midline, unchanged in position. Linear adjacent T2 hyperintense foci within the same region are suggestive of prior shunt tracts.There is irregularity of the body of the corpus callosum with narrowing of the proximal body as well as slight irregularity of the distal body, which may be related to prior shunt catheter placements. The lateral and third ventricles are slightly decreased in size. There is cortical thickening of the bilateral cerebral hemispheres, predominantly in the frontal lobes. The basal cisterns remain patent. There is no midline shift. There are no areas of abnormal signal. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. Redemonstrated is a prominent cisterna magna predominantly on the left. The cerebellar tonsils are at the level of the foramen magnum without abnormal morphology or evidence of Chiari malformation. Biphasic CSF flow is noted anteriorly and posteriorly at the level of the foramen magnum.CERVICAL SPINE | 1. Slight interval decrease in size of the lateral and third ventricles with slit-like appearance, raising the possibility of over shunting in the appropriate clinical setting. Please correlate clinically.2. Diffuse cortical thickening of the bilateral cerebral hemispheres, predominantly in the anterior distribution, which may represent pachygyria.3. Corpus callosal irregularity and thinning, likely due to prior shunt catheter placements.4. No evidence of Chiari malformation. Appropriate biphasic CSF flow anteriorly and posteriorly at the level of the foramen magnum. |
Generate impression based on findings. | 44 years, Female. Reason: NGT position History: high NGT output There is a Dobbhoff tube which is coiled within the stomach with the tip projecting over the proximal body of the stomach. Residual contrast material opacifies the majority of the right colon as well as the descending colon. There is a paucity of bowel gas. | Dobbhoff tube coiled in the stomach with the tip projecting over the proximal body of the stomach. |
Generate impression based on findings. | Pain and swelling. Question of plantar fibroma. No acute fracture or malalignment is evident. Plain film is insensitive for the detection of soft tissue abnormalities. | No acute fracture is evident. |
Generate impression based on findings. | 5 years old, Male, History: 5 y/o male with PD cath, known hematoma, concern for obstructionVIEW: Abdomen AP (one view) 3/10/15 Peritoneal dialysis catheter is coiled in the pelvis. NG tube is situated with tip in the stomach. Proximal side-port of the NG tube is at or above the GE junction. Interval placement of a Foley catheter with tip at the mid urethra.Again noted are moderately dilated small bowel loops measure up to 3.1 cm predominately situated in the left mid abdomen. Enteric contrast used for same day CT scan is now present within the colon extending to the rectum. Surgical changes are noted in the right lower quadrant consistent with prior appendectomy. | 1.Persistent moderately dilated small bowel loops with passage of enteric contrast into the colon. Mild partial small bowel obstruction cannot be excluded. 2.Enteric tube with proximal side-port at or above the level of the GE junction.3.Foley catheter is present tip at the mid urethra. |
Generate impression based on findings. | 54-year-old male patient with history of left lung cancer presents with flank pain. Evaluate for evidence of recurrent disease. ABDOMEN:LUNG BASES: Left lung base scarring. Please refer to dedicated CT chest PE for complete details.LIVER, BILIARY TRACT: Multiple hypoattenuating liver lesions compatible with cysts.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Interval enlargement of right upper pole simple renal cyst. Subcentimeter left renal lesions are unchanged in size prior MRI examination, the largest of which likely represents a hemorrhagic cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes affect the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Mild multilevel degenerative changes affect the thoracolumbar spine.OTHER: Right hydrocele. | 1.No acute intra-abdominal abnormality to account for patient's symptoms. 2.Enlarging right renal cyst and likely small left hemorrhagic cyst. |
Generate impression based on findings. | 49-year-old female with history of liver transplant. Evaluate vascular patency. PORTAL VENOUS: Patent with appropriate directional flow. Peak velocity up to 0.24 m/s. HEPATIC ARTERIES: The common, right and left hepatic arteries are patent with appropriate directional flow. Resistive index of the common hepatic artery measures 0.4. Resistive index of the left hepatic artery measures 0.5. Resistive index of the right hepatic artery measures 0.4. HEPATIC VEINS: The right, middle and left hepatic veins are patent with appropriate directional flow.INFERIOR VENA CAVA: Patent with appropriate directional flow.OTHER: Splenic vein is patent with appropriate directional flow. | The inflow and outflow vessels of the liver are patent with appropriate directional flow. |
Generate impression based on findings. | 22-year-old female with ankle pain and swelling after fall on ice last night. Three nonweightbearing views of the left ankle demonstrate normal anatomic alignment without evidence of acute fracture, significant joint effusion or soft tissue swelling. | No evidence of acute fracture or malalignment. |
Generate impression based on findings. | Reason: h/o squamous cell cancer, evaluate for metastatic disease History: h/o squamous cell cancer LUNGS AND PLEURA: Scattered benign appearing pulmonary micronodules, with no evidence of pulmonary metastases.Minimal right middle lobe scarring is present. MEDIASTINUM AND HILA: Scattered mediastinal lymph nodes are unchanged, and there is no evidence of lymphadenopathy.Mild coronary artery calcification is present, but the heart and pericardium otherwise appear normal.CHEST WALL: Several thoracic vertebral hemangiomas are stable.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Stable intrahepatic and biliary ductal dilatation, which may be related to a prior cholecystectomy. Gastrostomy tube unchanged. | No sign of metastases, or other significant abnormality. No significant change. |
Generate impression based on findings. | Status post fall with lateral malleolus tenderness. No acute fracture or malalignment is evident. There is a small amount of soft tissue swelling about the lateral malleolus. There is no joint effusion. | No acute fracture is evident. |
Generate impression based on findings. | Status post left total knee arthroplasty. There is a left total knee arthroplasty device in anatomic alignment. No acute fracture is evident. Foci of gas in the soft tissues is likely postsurgical. Surgical skin staples and a surgical drain are present. | Left total knee arthroplasty device in anatomic alignment. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: The maxillary sinuses are clear. The ostiomeatal units are clear.Posterior ethmoids: The posterior ethmoid air cells are clear.Sphenoid sinus: The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is mild leftward nasal septal deviation with a 3-mm leftward directed bony spur. There is a partially paradoxical right middle turbinate. The nasal turbinate morphology is otherwise within normal limits. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. | No CT evidence of acute sinusitis. Mild leftward nasal septal deviation. |
Generate impression based on findings. | 59-year-old male with esophageal cancer and pulmonary abscess status-post chemo radiation and antibiotic treatment. CHEST:LUNGS AND PLEURA: Previously noted right lower lobe thin-walled cavity with air-fluid level is no longer present. Debris is noted in the right lower lobe bronchus and distally. Right lower lobe opacity likely reflects aspiration.Interval resolution of focal groundglass opacity in the right upper lobe compatible with resolved aspiration. Small left pleural effusion bilateral dependent atelectasis. Mild apical paraseptal and centrilobular emphysema is again noted. Bibasilar linear scarring/atelectasis.MEDIASTINUM AND HILA: The mediastinum is shifted towards the right, likely related to underlying atelectasis and volume loss. Minimal pericardial effusion is noted. Severe coronary calcifications. Esophogogastric stent is unchanged in position traversing lobulated distal esophageal mass. This right paraesophageal mass is peripherally enhancing with central low density suggestive of fluid and necrosis, and contains small foci of air. There appears to be a fistulous connection to th right lower lobe bronchus (series 3, image 56-69).CHEST WALL: Healed right and left sixth through eleventh rib fractures. Right posterior thoracic wall lipoma is again noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Punctate calcification in the left kidney represents nonobstructive renal stone. No hydronephrosis.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Gastrojejunostomy tube is present.BONES, SOFT TISSUES: Mild degenerative changes affect the thoracolumbar spine.OTHER: No significant abnormality noted. | 1.Interval increase in size of right paraesophageal mass with peripheral enhancement and central hypoattenuation which may represent necrotic tumor. Foci of air within this collection is suggestive of a fistulous connection to the right lower lobe bronchus and possible communication to the esophageal lumen.2.Debris in the right bronchus with right lower lobe opacity compatible with aspiration.3.Decrease in size and near resolution of right lung cavitary lesion.Findings discussed with Dr. Villaflor at 1302 on 3/11/15. |
Generate impression based on findings. | Large cell lymphoma with left-sided pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: AbsentPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable right renal scarring.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterus absent or atrophic. No change in left adnexal cystic focus best seen on image 102 of series 4 measuring 2.4 x 1.4 cm.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination without evidence for acute, inflammatory, or neoplastic process. |
Generate impression based on findings. | 23 year old female with history of thyroid cancer s/p surgery, I131 ablation. Evaluation for abnormal masses. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy. LEFT LOBE MEASUREMENTS: Status post thyroidectomy. ISTHMUS MEASUREMENTS: Status post thyroidectomy. RIGHT LOBE: No nodules or masses are noted. LEFT LOBE: No nodules or masses are noted. ISTHMUS: No nodules or masses are noted. PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 2 benign appearing lymph node measures 2.1 cm x 0.8 cm x 0.3 cm.OTHER: No significant abnormality noted. | No residual or recurrent disease. No lymphadenopathy. |
Generate impression based on findings. | Male; 59 years old. Reason: Eval for stability of descending aortic aneurysm s/p repair History: s/p repair of thoracoabdominal aneurysm Postsurgical changes from graft repair of thoracoabdominal aortic aneurysm. No evidence of leak. The excluded aneurysm sac is unchanged in appearance since prior study. The distal thoracic aorta just proximal to the graft is slightly increased in size with slightly increased mural thrombus and measures up to 4.7 x 4.5 cm (series 8/410). Stable size of the suprarenal abdominal aorta measuring up to 3.9 x 3.7 cm. Stable dilation of the infrarenal abdominal aorta and aneurysms of the bilateral common iliac arteries with the right measuring up to 2 cm and the left measuring up to 1.6 cm.CHEST:LUNGS AND PLEURA: Mild emphysema. No suspicious pulmonary nodules or masses.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: 2.3 x 1.7 cm peripherally enhancing lesion in the medial right lobe of the liver (series 8/780) with central hypoattenuation and central punctate calcifications; the lesion is stable in size since prior studies and likely a partially sclerosing hemangioma. Smaller focus of arterial hyperenhancement in the left lateral segment of the liver (series 8/662) appears somewhat wedge-shaped and is most likely due to THAD.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: 1.6 x 1.9 cm hypoattenuating, enhancing mass arising from the cortex of the superior pole of the left kidney is stable in size since prior studies and suspicious for renal neoplasm. Small non obstructing left renal calculus.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Postsurgical changes from graft repair of thoracoabdominal aortic aneurysm. No leak.2. Slightly increased size of enlarged descending thoracic aorta as detailed above.3. Left kidney mass suspicious for renal neoplasm. |
Generate impression based on findings. | Reason: ro sbo History: nausea and vomiting ABDOMEN:LUNG BASES: No focal consolidation or pleural effusions.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: Ventriculoperitoneal shunt, suprapubic catheter, cecostomy, and Mitrofanoff catheter in place.No free air. A small amount of free pelvic fluid is noted.BOWEL, MESENTERY: Diffusely prominent small bowel loops filled with fluid, gas, and stool. The cecum is filled with stool and gas. Air is seen within the sigmoid and rectum. No pneumatosis intestinalis. BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Suprapubic catheter and Mitrofanoff catheter in place.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Diffusely prominent small bowel loops filled with fluid, gas, and stool. The cecum is filled with stool and gas. Air is seen within the sigmoid and rectum. No pneumatosis intestinalis. BONES, SOFT TISSUES: Small focus of air in the subcutaneous tissues anteriorly (series 3, image 81).OTHER: No significant abnormality noted | 1. Diffusely prominent small bowel loops and air seen within the sigmoid and rectum. No definite evidence of small bowel obstruction.2. Multiple drains and catheters within the abdomen/pelvis as detailed above. |
Generate impression based on findings. | 12 years old, Female, Reason: thumb injury, concern for fracture VIEWS: Left hand and thumb; hand PA, finger PA, finger lateral. (Three views) 3/10/15 Minimally displaced Salter-Harris II fractures of the dorsal aspect of the distal phalanx of the thumb as well as the volar aspect of the distal phalanx. Slight volar angulation of the distal phalanx is present. Mild soft tissue swelling is noted in the thumb. No other fractures are noted. | Two Salter-Harris II fractures of the base of the distal phalanx of the thumb. |
Generate impression based on findings. | RIGHT TESTIS: 3.6 x 2.6 x 2.7 cm. Within the right testicle at the level of the previously seen hypoechoic lesion is a 1.5 x 1.6 x 2.1 cm hyperechoic focus with an internal hypoechoic portion. LEFT TESTIS: 4.2 x 2.2 x 2.6 cm. Normal echotexture. The previously seen hypoechoic lesion is no longer identified. Dystrophic appearing calcifications redemonstrated.RIGHT EPIDIDYMIS: 5.9 x 2.6 x 4.4 cm and hypervascular.LEFT EPIDIDYMIS: 2.9 x 0.7 x 1.3 cm, normal in appearance. | Findings compatible with acute epididymitis on the right.Postsurgical changes in the right groin and testicle. Heterogeneous 1.6 cm hyperechoic focus with hypoechoic component in the testicle, entity most likely reflects a hematoma given patient's history, correlation with patient's procedural history recommended to confirm interval removal of entirety of previously seen focal hypoechoic lesion in right testicle, abscess is considered less likely as there is no evidence of increased vascularity.Interval resolution of hypoechoic left testicle lesion.Findings discussed with Dr Artz by telephone at 4:50 pm on 3/5/2015. |
Generate impression based on findings. | Abdominal pain; history of stones ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable segment 7 right lobe hepatic low attenuation lesionSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No change in nonobstructing subcentimeter right renal stones. The largest within the midportion of the kidney measures 0.5 x 0.3 cm. Punctate nonobstructing left renal stone also present. Interval resolution of left hydronephrosis and proximal left hydroureter.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Uterus absent or atrophic.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Interval resolution of left hydronephrosis and proximal left hydroureter. No change in subcentimeter nonobstructing right renal stones. Nonobstructing punctate left renal stone. |
Generate impression based on findings. | Male 58 years old; Reason: r/o acute process History: abd pain CHEST:LUNGS AND PLEURA: Nodule in the right lung base measures 1.7 x 1.3 cm (image 61/series 4). There is adjacent atelectasis. Additional nodular opacities are located in the right lung base. There is extensive right pleural nodularity.MEDIASTINUM AND HILA: Heart size is normal. There is a trace pericardial effusion. There are postsurgical changes in the anterior chest. Right cardiophrenic lymphadenopathy.Enlarged mediastinal lymphadenopathy persists with a right paratracheal lymph node measuring 2.4 cm, unchanged.CHEST WALL: Postsurgical changes from median sternotomy. Sclerotic changes in the tip of the right scapula.OTHER: ABDOMEN:LIVER, BILIARY TRACT: Multiple bilateral hepatic cysts. No suspicious hepatic lesions. Status post cholecystectomy. The hepatic and portal veins are patent.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Non obstructive punctate left renal calculus. No hydronephrosis in either kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small bowel is normal in caliber and course.BONES, SOFT TISSUES: Sclerotic lesion in the L2 vertebral body is unchanged.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Enhancing lesion in the left bladder baseLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No bowel obstruction.BONES, SOFT TISSUES: Sclerotic changes in the left ischium and inferior pubic ramus.OTHER: No significant abnormality noted | 1.Right lower lobe pulmonary lesions and mediastinal lymphadenopathy suspicious for metastatic disease.2.Sclerotic lesions in the right scapula, lumbar spine and pelvis. Further investigation with a bone scan is suggested to exclude metastatic disease.3.No bowel obstruction.4.No pneumothorax.5.Enhancing lesion in the left bladder base, further investigation is recommended. |
Generate impression based on findings. | 77 years, Female. Reason: eval for retained contrast History: see above There is continued passage of enteric contrast into the transverse colon and to the splenic flexure. Nonobstructive bowel gas pattern. Enteric feeding tube tip projects over the gastric body. Moderate right pleural effusion again noted. | Nonobstructive bowel gas pattern with transit of enteric contrast into the colon. |
Generate impression based on findings. | Postoperative changes are again seen from previous tracheostomy, laryngectomy and gastric pull through. There is partial fluid opacification of the gastric pull through. There is no abnormal discrete soft tissue mass or pathological enhancement.GLANDS: The postcontrast appearance of the salivary glands is unremarkable. The thyroid gland is unremarkable. ORAL CAVITY: The oral tongue and floor of mouth are unremarkable.CERVICAL SOFT TISSUES: There are no pathologically enlarged cervical lymph nodes.OTHER: There is partially visualized aortopulmonary window lymphadenopathy. Prominent ventral osteophytes are again present along the mid to lower cervical spine. Atherosclerotic calcifications are present at the carotid bifurcations. There are multiple solid nodules and pleural thickening within the imaged right lung apex, which appear more confluent. There is a stable truncated appearance of the left medial clavicle, likely postsurgical. | 1. No evidence of locoregional tumor recurrence or cervical lymphadenopathy.2. Suggestion of progression of right-sided pleural thickening and nodularity with incompletely imaged mediastinal lymphadenopathy. Please see separately dictated report for CT of the chest for further details. |
Generate impression based on findings. | 85-year-old male patient status post EVAR. ABDOMEN:LUNG BASES: Basilar atelectasis.LIVER, BILIARY TRACT: Status post cholecystectomy. Air is noted in the common bile duct and in the intrahepatic biliary system.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal cysts noted. No hydronephrosis or renal calculi.RETROPERITONEUM, LYMPH NODES: Abdominal aortic stent graft material extends into common iliac artery stents. Bilateral renal artery stents insert posteriorly into the aortic stent. Mid aneurysm sac measures 6.6 x 6.9 cm (series 12 image 81). There is no evidence of leak on delayed imaging.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes affect the thoracolumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Multilevel degenerative changes affect the thoracolumbar spine.OTHER: No significant abnormality noted. | 1.Postsurgical changes from endovascular aneurysm repair as described above without evidence of leak.2.Pneumobilia possibly due to prior intervention. |
Generate impression based on findings. | Clinical question: Rule out hemorrhage. Signs and symptoms: Acute confusion, poor historian possible fall. Nonenhanced head CT:No detectable acute intracranial process. CT however is been sensitive for early detection acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces. Mild periventricular and subcortical low attenuation of white matter is highly suggestive of age indeterminate small vessel ischemic strokes.Unremarkable calvarium, orbits and paranasal sinuses. | 1.No acute intracranial process.2.Mild age indeterminate small vessel ischemic strokes |
Generate impression based on findings. | Clinical question: Rule out new hemorrhage. Recent surgery. Signs and symptoms: vomiting and headaches. Nonenhanced head CT: Expected postoperative changes of a right anterior frontal and temporal craniotomy for clipping of an aneurysm. Focus of encephalomalacia in the anterior right temporal lobe is again noted without change. There is no detectable acute intracranial process since prior study. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Minimal epidural collection under the craniotomy flap similar to prior exam however with interval resolution of postoperative epidural air since prior study.Ventricular system remain within normal size and with maintained midline. | 1.No accurate new finding since prior exam. 2.Improvement of post operative changes of right anterior temporal and frontal craniotomy as detailed. |
Generate impression based on findings. | Clinical question: Evaluate for acute process. Signs and symptoms: Acute onset of headache. Nonenhanced head CT:There is no detectable acute intracranial process. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable calvarium, orbits, visualized paranasal sinuses and mastoid air cells. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Clinical question: Evaluate intracranial hemorrhage. Signs and symptoms: Recent brain surgery, fever and headache. Nonenhanced head CT:Extensive post operative changes of a wide left suboccipital craniectomy with placement of a metallic mesh at the craniectomy site is again noted. Surgical cavity in the left cerebellum containing tiny amount of hemorrhage remains identical to prior study. Subtle mass effect on the fourth ventricle remains identical to prior exam. Widening of the subarachnoid space on the left secondary to surgery also remains stable.Supratentorial ventricular system remain within normal size and with maintained midline similar to prior exam.No detectable acute intracranial hemorrhage or mass effect/midline shift is present.Interval resolution of post surgical pneumocephalus in supratentorial space. | 1.No evidence of new or acute finding since prior study.2.Stable post operative changes of left suboccipital craniectomy for removal of tumor as detailed. |
Generate impression based on findings. | Clinical question: Contusion. Signs and symptoms: As above. Nonenhanced head CT:Diffuse patchy foci of parenchymal low attenuation some containing acute blood product and consistent with multiple foci of contusion are again identified. There is subtle decreased density of the hemorrhage in the area of contusion in the right anterior temporal tip and no significant change in other location of hemorrhage.Ventricular system remain within normal size and maintained midline. Cortical sulci are visualized and appear stable in overall appearance since prior study. The basal cisterns remain widely patent. The calvarium and soft tissues of the scalp remain intact. Unremarkable images through the orbits, paranasal sinuses and mastoid air cells. | 1.Diffuse bilateral hemispheric hemorrhagic foci of contusion without significant interval change since prior study.2.No convincing evidence of any new hemorrhage.3.Stable normal size of ventricular system with maintained midline. |
Generate impression based on findings. | Clinical question: NF1, Chiari, hydrocephalus status post third ventriculostomy. Signs and symptoms: Headache and vomiting. Nonenhanced head CT:Images through posterior fossa demonstrates significant herniation of cerebellar tonsils through the foramen magnum with resultant complete effacement of subarachnoid space and flattening deformity of the tonsils. This finding appears stable since prior exam.Fourth ventricle is a small and in midline position however demonstrates subtle interval decreased size.Images through supratentorial space demonstrate significant hydrocephalus with questionable interval increased size. Subtle diffuse periventricular white matter no attenuation remains also grossly similar to prior study. There is near complete effacement of cortical sulci which is also nearly similar to prior exam.There is no evidence of midline shift or intracranial hemorrhage.Visualized orbits demonstrate prominence of optic nerve sheaths similar to prior studies and unremarkable otherwise.Visualized paranasal sinuses and mastoid air cells are unremarkable. | 1.No evidence of acute intracranial hemorrhage or midline shift. 2.Stable findings of Chiari malformation since prior study.3.Significant supratentorial hydrocephalus without convincing evidence of interval change.4.Extensive periventricular low-attenuation white matter without convincing evidence of change since prior exam.5.Generalized effacement of cortical sulci without change since prior study. |
Generate impression based on findings. | 35-year-old female patient with left lower quadrant pain and left ovary not visualized on ultrasound. Evaluate for tubo-ovarian abscess. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: 4-cm cystic structure in the area of the right ovary is noted. Soft tissue density in the expected location of the left ovary appears similar to prior examination without evidence of abscess formation.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix is well-visualized and is within normal limits.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Trace free fluid in the pelvis is likely physiologic. | Normal appearing left ovary, unchanged compared to prior examination. Likely physiologic right ovarian cyst, recommend correlation with recent pelvic ultrasound. |
Generate impression based on findings. | 77 years, Female. Reason: 77F admitted with partial SBO, assess for persistent obstruction History: see above There is a nonobstructive bowel gas pattern. There is a right lower quadrant ostomy in place. Residual contrast opacifies the majority of the large bowel. Surgical clips project over the bilateral hemipelvis. Persistent renal nephrograms suggest renal insufficiency. No evidence of pneumoperitoneum. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Altered mental status, status post coiling of basilar tip aneurysm Residual contrast from recent procedure limits evaluation for small hemorrhage. No obvious intracranial hemorrhage is appreciated. No intracranial mass or mass-effect is seen. Evidence of stent-assisted coiling of basilar tip aneurysm is noted. There is a right transfrontal VP shunt catheter with tip at the level of the left frontal horn. Unchanged ventricular system caliber without evidence of hydrocephalus. There is evidence of prior right frontotemporal craniotomy for aneurysm clipping in the right paraclinoid region. Unchanged areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but compatible with chronic small vessel ischemic disease.The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. | Residual contrast from recent procedure limits evaluation for small hemorrhage. No obvious hemorrhage or mass effect is appreciated. No hydrocephalus. If there is suspicion for acute ischemia, consider MRI for further evaluation. |
Generate impression based on findings. | RFO trigger: Incorrect count Suspected RFO location: Abdomen Name of suspected RFO: lap sponges Attending Surgeon name/pager: Dr. Choi/9578 Body Mass Index (BMI): 20.28 There is a nasogastric tube with its tip projecting over the fundus of the stomach. Diffuse dilatation of both large and small bowel likely reflecting postoperative ileus/residual air from prior obstruction. No lap sponge identified. Right lower quadrant ostomy in place. Previously identified edematous colon has been resected. Metallic instrument projecting over the right lower quadrant confirmed to be external to the patient. No unexpected radiopaque foreign object identified. | 1.No unexpected radiopaque foreign object identified.2.Diffuse dilatation of both large and small bowel likely reflecting postoperative ileus/residual air from prior obstructionThese findings were relayed to Dr. Choi via telephone at 18:00 on 3/10/2015 by the radiology resident on call. |
Generate impression based on findings. | Clinical question: AMS, concern for acute CVA. Signs and symptoms: AMS. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection acute nonhemorrhagic ischemic strokes.Extensive low attenuation of left hemispheric white matter and ex acute dilatation of the left lateral ventricle similar to prior MRI exam and consistent with a large chronic ischemic change. Minimal right periventricular white matter low-attenuation suggestive of age indeterminate small muscle ischemic strokes similar to prior MRI exam.Unremarkable images through posterior fossa.Unremarkable calvarium, soft tissues of the scalp, orbits, visualized paranasal sinuses and mastoid air cells. | 1.No acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes2.Chronic appearing ischemic changes similar to prior MRI exam. |
Generate impression based on findings. | 69 years, Female. Reason: h/o abdominal pain, shock, ruling out luminal pathology before considering mesenteric ischemia History: see above There is a nasogastric tube with its tip projecting over the body of the stomach. There is a nonobstructive bowel gas pattern. Centralization of the bowel gas pattern suggests ascites. Right femoral central venous catheter tip projects over the confluence of iliac veins. Degenerative changes affect the lower lumbar spine and sacroiliac joints. There are incompletely imaged bilateral pleural effusions. There is an endotracheal tube in place with the tip terminating approximately 3 cm above the carina. | Nonobstructive bowel gas pattern with findings suggestive of ascites. Bilateral pleural effusions. |
Generate impression based on findings. | Clinical question: Patient with history of left MCA stroke, now with worsening symptoms: Signs and symptoms: As above. Nonenhanced head CT:There is no detectable acute intracranial process. CT however is insensitive for early detection of acute non-hemorrhagic ischemic strokes.There is a large well demarcated focus of low-attenuation in the left basal ganglia consistent with a chronic lacunar infarct. This region demonstrated edema on prior exam and interval change consistent with progression of the stroke chronic phase.The examination is otherwise unremarkable. Unremarkable cerebral cortex, cortical sulci, ventricular system and CSF spaces. The gray -- white matter differentiation remains feeding normal.Calvarium and soft tissues of the scalp as was orbits, visualized paranasal sinuses and mastoid air cells are unremarkable. | 1.No acute intracranial process.2.Large chronic left basal ganglia lacunar infarct with ex vacuo dilatation of adjacent ventricle.3.Unremarkable exam otherwise. |
Generate impression based on findings. | 53-year-old male patient with concern for cholangiocarcinoma on recent ERCP. ABDOMEN:LUNG BASES: Mosaic attenuation in the lung bases may be due to expiratory phase imaging. Right lung base scarring. Small left pleural effusion. There is a 9-mm soft tissue nodule in the left lower lobe (series 9 image 15).LIVER, BILIARY TRACT: There is diffuse intrahepatic biliary ductal dilatation, trace pneumobilia and a stent coursing from the common hepatic duct into the common bile duct and extending to the duodenum. No mass lesion seen. Cholelithiasis and vicarious excretion of contrast into the gallbladder noted. Enlarged porta hepatis lymph node measuring 1.5 cm is noted (series 10 image 35) and is nonspecific.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Horseshoe kidney noted. Heterogeneously enhancing lesion in the upper pole of the right kidney measures 1.5 x 1.5 cm (series 10 image 58).RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate, measuring approximately 5 cm.BLADDER: Diffuse urinary bladder wall thickening.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Continued intrahepatic biliary duct dilatation without CT evidence of an obstructive lesion to suggest cholangiocarcinoma.2.Suspicious lesion in the upper pole of the right kidney concerning for a primary renal neoplasm.3.Left lower lobe nodule. Recommend follow up as clinically indicated.4.Diffuse urinary bladder wall thickening may be secondary to enlarged prostate. Recommend clinical correlation for possible cystitis. |
Generate impression based on findings. | 53 years, Female. Reason: r/o acute abnormalities History: abdominal pain There is a nonobstructive bowel gas pattern. Cholecystectomy clips project over the right upper quadrant. Suture material is seen in the left upper quadrant. There are mild degenerative changes the lower lumbar spine. The lung bases are clear. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | 89 years, Male. Reason: 89yo M s/p pancreatic duct stent, assess for passage. History: pancreatitis There is a pancreatic duct stent in place, position unchanged from the prior CT examination. Common bile duct stent position also unchanged. There is a nonobstructive bowel gas pattern. Respiratory motion blurring limits evaluation of the lung bases and upper abdomen. There are severe degenerative changes of the lower lumbar spine sacroiliac joints. | Pancreatic duct stent and common bile duct stent positions unchanged from the CT examination. |
Generate impression based on findings. | 26 years, Female. Reason: 26yo with Bradbury-Eggleston syndrome, h/o gastroparesis. Abd pain, n/v. R/o obstruction, obstipation History: abd pain, NV There is a nonobstructive bowel gas pattern. Left chest wall generator with pacemaker leads in expected location. Undissolved pills are noted in the left quadrant. | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | 42 year-old recall from screening for distortion in the left breast. An ML view, MLO view and two 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. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the left breast. The area of distortion seen on the screening MLO view is not reproducible today on any of the images. This is felt to represent overlap of normal tissues on the screening view. A few scattered benign calcifications are present. | 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. | Trauma, R/O intracerebral hemorrhage No evidence of acute ischemic or hemorrhagic lesion on this scan.However, if clinically indicated, brain MRI can be considered since petechial hemorrhage can be found higher sensitivity and specificity with MRI scan.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The mastoid air cells are clear. Right maxillary sinus and ethmoid sinus show fluid collection. | No evidence of acute ischemic or hemorrhagic lesion.Brain MRI can be considered if clinically indicated. |
Generate impression based on findings. | 5 month old female. Tachypnea, fever, incr WOB. Eval for pneumonia VIEWS: Chest AP/lateral (two views) 3/10/2015, 1804 The aortic arch, cardiac apex, and stomach are left-sided.The cardiomediastinal silhouette is normal.Peribronchial thickening and increased lung volumes compatible with reactive airway disease or bronchiolitis.No pleural effusions or pneumothorax. | Reactive airway disease/bronchiolitis pattern. No evidence of pneumonia. |
Generate impression based on findings. | 48-year-old female with chest pain and shortness of breath PULMONARY ARTERIES: Pulmonary artery opacification without evidence of pulmonary embolism. Pulmonary artery measures 2.0 cm, within normal limits.LUNGS AND PLEURA: No pleural effusion or pneumothorax. Small bleb in the right lower lobe and scattered cysts. Nonspecific micronodule in the right lower lobe. No suspicious nodules or masses. No focal consolidation or bronchiectasisMEDIASTINUM AND HILA: The heart size is normal. No pericardial effusion. Minimal coronary artery calcifications. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary, retrocrural, or cardiophrenic lymphadenopathy. There are numerous collateral vessels in the right anterior chest wall. The proximal subclavian and brachiocephalic vein may be occluded or stenosed. The osseous structures are within normal limits.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Left adrenal adenoma is unchanged. Stable thickening of the right adrenal gland. Hypoattenuating lesion in the right lobe of the liver is unchanged. Enteric contrast is noted within the jejunum. | No evidence of pulmonary embolism.PULMONARY EMBOLISM: PE: Negative. Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Reason: r/o fx History: pain and swelling. 13 year old female.VIEWS: Left knee AP, lateral, oblique (3 views) 3/10/2015, 1837 Knee joint effusion.No significant soft tissue swelling.The osseous structures are normal. | Joint effusion, with no acute fracture. |
Generate impression based on findings. | 13 years old, Male, History: traumaVIEWS: Left tibia-fibula AP, lateral; left knee AP, lateral; left femur AP, lateral; right femur AP, lateral. (Eight views) 3/10/15 Left tibia-fibula: No fracture or malalignment.Left knee: No fracture or malalignment. Left femur: The femoral head is well seated within the acetabulum. No fracture or malalignment.Right femur: The femoral head is well seated within the acetabulum. No fracture or malalignment. | Normal examination. No fracture is identified. |
Generate impression based on findings. | hypertension with headache No evidence of acute ischemic or hemorrhagic lesion.No change of moderate degree non specific small vessel ischemic disease.The ventricles, sulci, and cisterns are symmetric and unremarkable. The gray-white matter differentiation is normal. There is no mass effect, edema, midline shift, intra- or extra-axial fluid collection/acute hemorrhage. The osseous structures are unremarkable. The paranasal sinuses and mastoid air cells are clear. | No evidence of acute ischemic or hemorrhagic lesion.Moderate degree non specific small vessel ischemic disease. No change since prior exam. |
Generate impression based on findings. | 13 years old, Male, Reason: Concern for Fracture History: Pediatric TraumaVIEWS: Pelvis AP, C-spine AP and lateral, chest AP (4 views) 3/10/15 Pelvis: No evidence of fracture or malalignment. Femoral heads are well directed into the acetabula.C-spine: No subluxation or acute fracture. Vertebral heights and disk spaces are normal. No significant prevertebral soft tissue swelling. Straightening of the cervical spine is likely positional from c-collar.Chest: The aortic arch cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. No focal air space opacity, pleural effusion, or significant pneumothorax. | Normal chest, cervical spine and pelvis. |
Generate impression based on findings. | 10 month old. Female. Rule out osteo of left tarsals/phalynx - 5 digits History: L abscess, cellulitis left lower extremity, swelling from just below knee to toesVIEWS: Left foot, AP, lateral, oblique (3 views) 3/10/2015, 1914 Diffuse soft tissue swelling of the foot.The osseous structures are normal. | Soft tissue swelling with no radiographic evidence of osteomyelitis. |
Generate impression based on findings. | right facial droop with weakness 3D time of flight MOTSA MRA brain images with maximum intensity projections of the anterior/posterior intracranial circulation demonstrate normal ICAs, MCAs and ACAs. Vertebrobasilar system appears to be normal.3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries. | Normal brain MRA and Neck MRA.Specifically there is no evidence of arterial significant luminal stenosis or aneurysm formation. |
Generate impression based on findings. | 10 months. Female. Rule out osteo involvement of left tib/fib History: L abscess, cellulitis left lower extremity, swelling from just below knee to toesVIEWS: Left tibia/fibula, AP, lateral (2 views) 3/10/2015, 1912 Soft tissue swelling of the lower leg, mainly at the anterior and lateral aspects.The osseous structures are normal. | Diffuse soft tissue swelling, without radiographic evidence of osteomyelitis. |
Generate impression based on findings. | Neck CTA: The left common carotid and right brachiocephalic trunk are tortuous in the supraclavicular space but are patent without significant stenosis, aneurysm, or dissection. There is antegrade flow in the bilateral vertebral arteries, within the bilateral common, internal and external carotid arteries. There is mild calcification of the bilateral carotid bifurcations without significant stenoses by NASCET criteria. There is a small infundibulum at the left posterior communicating artery origin. The right P1 segment appears hypoplastic with dominant supply via the right posterior communicating artery. Otherwise, the partially visualized vasculature of the brain demonstrates no significant stenosis. There is mild degenerative disc disease affecting the cervical spine. There is mild amount of debris in the trachea, but the lung apices are clear. Fluid-levels in the paranasal sinuses again seen. | Tortuous intracranial and extracranial vasculature including within the supraclavicular spaces. There are mild atherosclerotic changes. No significant stenosis, dissection or vascular malformation is appreciated in the neck. |
Generate impression based on findings. | 59 years, Female. Reason: NGT placement History: as above Limited study; the pelvis not included in the field-of-view. There is a nasogastric tube with its tip projecting over the antrum of the stomach. Please refer to same day chest radiograph for thoracic findings. | NG tube tip and projecting over the antrum stomach. |
Generate impression based on findings. | 10 months. Female. Rule out L ankle osteo involvement of abscess History: Abscess, cellulitis left lower extremity, swelling from just below knee to toesVIEWS: Left ankle AP, lateral (2 views) 3/10/2015,1913 Diffuse soft tissue swelling around the ankle.The osseous structures are normal. | Diffuse soft tissue swelling, with no radiographic evidence of osteomyelitis. |
Generate impression based on findings. | 33-year-old male patient with fever, diaphoresis, persistent vomiting. Evaluate for acute infectious process. ABDOMEN:LUNG BASES: Diffuse bilateral ground glass opacities in the right lung base noted.LIVER, BILIARY TRACT: Severe fatty infiltration of the liver. Nonspecific prominence of porta hepatis and portocaval lymph nodes.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral subcentimeter hypoattenuating lesions in the kidneys are too small to characterize and likely represent cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small hiatal hernia.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Ground glass opacities in the right lung base raise concern for infectious etiology versus aspiration.2.No acute intra-abdominal abnormalities to account for patient's symptoms. |
Generate impression based on findings. | 12 year old male. r/o PNA, PTX History: fever, cough, right sided painVIEWS: Chest PA/lateral (two views) 3/10/2015, 1947 The aortic arch, cardiac apex, and stomach are left-sided.The cardiomediastinal silhouette is normal.Mild peribronchial thickening and increased lung volumes compatible with reactive airway disease or bronchiolitis.No focal pulmonary opacities, pleural effusions, or pneumothorax. | Reactive airway disease/bronchiolitis pattern. No evidence of pneumonia. |
Generate impression based on findings. | 13 year old male. Eval for ileus History: swollen, firm abdomenVIEW: Abdomen AP (one view) 3/10/2015, 2043 Lumbar-peritoneal shunt tips project over the T12-L1 disc space and left lower quadrant. Gastrostomy tube in place.Pneumoperitoneum, and subcutaneous gas in the left abdominal wall likely related to recent shunt placement.Diffuse gaseous distention of small and large bowel, without evidence of obstruction. | Diffuse gaseous distention of small and large bowel, without evidence of obstruction.Likely postsurgical pneumoperitoneum and subcutaneous gas |
Generate impression based on findings. | 40 year-old seen with recent wrist fracture, post splinting. Interval casting of the right wrist, resulting in obscuration of fine bone detail. The previously described fracture line is not well-visualized on this study. The bones are in anatomic alignment. | Interval splinting of right wrist nondisplaced fracture in near-anatomic alignment. |
Generate impression based on findings. | 48 year-old female with pain and swelling in the right wrist status post fall. There is an oblique, nondisplaced distal radius fracture with associated soft tissue swelling. The carpal bones are intact without evidence of fracture or malalignment. The joint spaces in the wrist and visualized portions of the hand are well-preserved. | Nondisplaced oblique distal radius fracture and associated soft tissue swelling. |
Generate impression based on findings. | 16 year old female. Fall with sciatic nerve pain.VIEWS: Lumbar spine AP, lateral (2 views) 3/10/2015, 2031 No post-traumatic subluxation or acute fracture identified.Straightening of the lumbar lordosis likely related to pain.The vertebral body and disc space heights are maintained. No spondylolysis or spondylolisthesis. Partially visualized nonobstructive bowel gas pattern. | No acute fracture or subluxation. |
Generate impression based on findings. | 13 years old, Male, Reason: Intra-Abdominal Injury History: Pediatric Trauma ABDOMEN:LUNG BASES: Mild partially visualized patchy groundglass and tree in bud opacities in the left lower lobe may represent atelectasis and/or aspiration.LIVER, BILIARY TRACT: No significant abnormality noted. No focal hepatic lesion. No evidence of hepatic traumatic injury. The portal vessels appear patent. The gallbladder is normal in appearanceSPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality noted. No traumatic injury.KIDNEYS, URETERS: No significant abnormality noted. The kidneys enhance symmetrically.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant bowel wall edema, pneumatosis, or free air.BONES, SOFT TISSUES: No fracture is identified.OTHER: No free fluid or hemoperitoneum.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No obstruction, significant bowel wall edema, pneumatosis, or free air.BONES, SOFT TISSUES: No fractures identified.OTHER: No free fluid or hemoperitoneum. | 1.No solid organ injury, free fluid, or hemoperitoneum. No fractures identified. 2.Mild patchy groundglass opacities in the left lower lobe may represent atelectasis and/or aspiration. |
Generate impression based on findings. | 57-year-old male with right knee and hamstring pain. No evidence of fracture, malalignment, or joint effusion or significant soft tissue swelling. The joint space is preserved. | No acute fracture or malalignment is evident. |
Generate impression based on findings. | 51-year-old female patient with abdominal sacrocolpopexy 3 days prior. Now with leukocytosis. ABDOMEN:LUNG BASES: Mild elevation of the right hemidiaphragm with right lung base atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mildly dilated loops of small bowel with collapsed loops of bowel distally in the pelvis. No definite transition point is seen.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Low anterior abdominal wall collection measures 3.2 x 6.4 cm (series 3 image 11) with fluid tracking anteriorly to the skin staples (series 3 image 110). Foci of air within the collection as well as adjacent inflammatory fat stranding is noted. Air is seen tracking laterally along the anterior abdominal musculature.OTHER: Small amount of free fluid in the pelvis may be postsurgical in etiology. | 1.Subcutaneous fluid collection and air raise concern for infection.2.Nonspecific mild small bowel dilatation without transition point may represent mild reactive ileus. |
Generate impression based on findings. | Alignment is anatomical. No evidence of acute fracture or subluxation. Vertebral body heights are preserved. The visualized intracranial contents are unremarkable. No paraspinal soft tissue swelling. No mass or significant spinal canal stenosis is identified. Mild degenerative changes of the cervical spine, most notable at C6/7 level with mild bilateral neuroforaminal narrowing. Minimal degenerative changes of the lower lumbar spine with mild facet hypertrophy. Retained contrast in the bowel is noted from recent abdominal CT abdomen/pelvis. Cystic adnexae are partially visualized, refer to recent CT abdomen/pelvis report. | 1.Minimal degenerative changes of the cervical spine and lower lumber spine. 2.No mass or significant spinal canal stenosis is identified. 3.No specific findings to account for the patient's pain. |
Generate impression based on findings. | Female 27 years old; Reason: eval for stone History: chronic rt CVAT ABDOMEN:LUNGS BASES: Low-density cardiac blood pool is can be seen in anemia.LIVER, BILIARY TRACT: No focal hepatic lesion.SPLEEN: Noncontrast appearance of the spleen is normal.PANCREAS: No focal pancreatic lesion.ADRENAL GLANDS: No adrenal thickening or nodularity.KIDNEYS, URETERS: No renal or ureteral stone. No hydronephrosis or perinephric stranding.RETROPERITONEUM, LYMPH NODES: No lymphadenopathy.BOWEL, MESENTERY: Bowel normal in caliber without evidence of obstruction or ileus.BONES, SOFT TISSUES: No suspicious osseous lesion.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Coarse calcific densities in the bilateral adnexa and left uterine fibroid.BLADDER: There is thickening of the urachal remnant near the insertion on the bladder dome, compatible with urachal diverticulum.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Normal in caliber without evidence of obstruction or ileus.BONES, SOFT TISSUES: No suspicious osseous lesion.OTHER: Multiple pelvic phleboliths. | No evidence of renal or ureteral stone. No other abnormalities to account for patient's symptoms. |
Generate impression based on findings. | 64 year-old female with tachycardia and dyspnea PULMONARY ARTERIES: Adequate pulmonary artery opacification without evidence of pulmonary embolism. The pulmonary artery measures 3.2 cm. The aorta measures 3.5 cm.LUNGS AND PLEURA: No pleural effusion or pneumothorax. No suspicious nodules or masses. Minimal bibasilar scarring/atelectasis and scattered foci of mucus impaction.MEDIASTINUM AND HILA: Scattered subcentimeter mediastinal lymph nodes. Prominent lymphoid tissue in bilateral hila. The heart size is normal, however there is hypertrophy of the left ventricular wall with focal thinning at the apex. No pericardial effusion. Moderate to severe coronary artery calcifications.CHEST WALL: The osseous structures are within normal limits. No significant axillary, retrocrural, or cardiophrenic lymphadenopathy. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Hypodense subcentimeter lesions in bilateral kidneys are too small to further characterize presumably represent benign cysts. | No evidence of pulmonary embolism. Enlarged pulmonary arteries suggestive of pulmonary artery hypertension.Moderate to severe coronary artery calcification.Left ventricular hypertrophy with thinning at the apex may represent a prior infarct.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 21-year-old male with pain over the "tarsal bones while running," swelling on the lateral side of the first toe. No acute fracture or malalignment is evident. There is no significant soft tissue swelling.There are degenerative changes including osteophyte formation at the talonavicular joint, as well as a talar beak and positive "C-sign," suggesting abnormal mechanics of the foot. | No evidence of fracture or malalignment. A talar beak and positive "C-sign" are suggestive of tarsal coalition in this 21-year-old male. CT of the foot is recommended for further evaluation. |
Generate impression based on findings. | 16 year old female. Pain s/p fall on ischial tuberosity.VIEWS: Pelvis, AP, frogleg (2 views) 3/10/2015, 2011 No post-traumatic fracture or dislocation.The femoral heads are well directed into the acetabula. | No acute fracture or dislocation. |
Generate impression based on findings. | 69-year-old recalled from screening for a focal asymmetry in the right breast. Three standard views and spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The area of focal asymmetry in the right upper inner quadrant largely disperses on spot compression. A few scattered benign calcifications are noted. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast. ULTRASOUND | 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: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Headaches, status post craniotomy. Compared to MRI dated 2/24/2014, interval postsurgical changes of resection of right parietal extra-axial mass extending into the scalp are seen. Expected postsurgical changes include air and blood products within the surgical bed. There is hypoattenuation within the right parietal lobe which is largely similar to the preoperative study and compatible with gliosis related to prior treatment with component of edema. Additional areas of hypoattenuation in the periventricular and subcortical white matter nonspecific but compatible with chronic small vessel ischemic changes. There is no significant mass effect, midline shift, or herniation. There is an osseous defect which is related to craniectomy and recurrent tumor. Evidence of prior right parietal craniotomy is also noted. There is diffuse opacification of the left frontal sinus and partial opacification of the bilateral ethmoid and maxillary sinuses. There is hyperdensity involving the left frontal sinus which may related to inspissated secretions and/or chronic fungal colonization. Mastoid air cells are clear. | Expected postsurgical changes of resection of extra-axial right parietal mass compatible with known recurrent meningioma. MRI can better assess for residual tumor. |
Generate impression based on findings. | 57 year old female with right frontal meningioma status post resection with post-operative aphasia., There are postoperative findings related to right orbitofrontal craniotomy for resection of a right sphenoid wing meningioma. There is subjacent pneumocephalus and mild diffuse subarachnoid hemorrhage as well as apparent packing material within the right frontal sinus. The right orbital roof appears intact. There is extensive swelling within the right frontal scalp soft tissues. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. There postoperative findings related to prior ethmoidectomies and uncinectomies. There is mucosal thickening within the bilateral maxillary sinuses, left greater than right, as well as secretions / fluid or mucosal thickening within the sphenoid sinuses. | 1.Postoperative findings related to right orbitofrontal craniotomy for resection of a right sphenoid wing meningioma. 2.Mild diffuse subarachnoid hemorrhage.3.Non-specific paranasal sinus opacification likely represents a combination of secretions and packing material, although CSF could have a similar appearance. |
Generate impression based on findings. | 16 year old female with history of MALS status post surgery now with diffuse abdominal pain, dehydration. CT Angiography: There is no evidence of aortic aneurysm, dissection, or significant stenosis. The origins of the great vessels, celiac axis, SMA, and renal arteries are patent. Given the scan protocol, it is weighted towards the arterial phase. The veins are not well evaluated but grossly there is no evidence of portal vein thrombus or large vessel venous mesenteric occlusion.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of significant celiac artery narrowing. |
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