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Generate impression based on findings. | 72-year-old female patient with a history of endometrial cancer and left axillary node, head of pancreas nodule and pelvic mass. CHEST:LUNGS AND PLEURA: No significant abnormality noted.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Central venous catheter with tip at the cavoatrial junction. Mild to moderate coronary artery calcifications. Cardiac size is within normal limits without pericardial effusion.CHEST WALL: Enlarged left axillary lymph node measures 1.2 x 1.4 cm (series 3 image 14), previously 1.2 x 1.5 cm.ABDOMEN:LIVER, BILIARY TRACT: Cholelithiasis without CT evidence of cholecystitis. Subcentimeter hepatic cyst is unchanged compared to prior.SPLEEN: No significant abnormality noted.PANCREAS: Stable cystic lesion in the head of pancreas measures 0.7 x 1.4 cm (3 image 115). No pancreatic ductal dilatation.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral hypoattenuating lesions are too small to characterize and likely represent cysts.RETROPERITONEUM, LYMPH NODES: An enlarged lymph node in the left internal iliac area measures 2.4 x 2.7 cm (series 3 image 165), previously 1.6 x 1.8 cm.BOWEL, MESENTERY: There is a ventral hernia containing mesenteric fat and bowel. No evidence of obstruction or strangulation.There is subtle increased nodularity, particularly adjacent to the transverse colon as well as increasing triangular soft tissue density in the mesentry measuring 1.2 cm (series 3 image 121), previously 0.8 cm, compatible with increase in serosal and peritoneal disease.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: There is slight prominence of the posterior bladder wall. Attention on subsequent exams should be paid to this area.LYMPH NODES: Left internal iliac soft tissue mass measures 2.5 x 2.7 cm (series 3 image 165), previously 1.5 x 1.7 cm. BOWEL, MESENTERY: There is fluid tracking within the mesentery of the abdomen and pelvis.BONES, SOFT TISSUES: Moderate to severe multilevel degenerative changes affect the thoracolumbar spine.OTHER: No significant abnormality noted. | 1.Enlarging left pelvic node as well as findings concerning for increasing serosal and peritoneal metastatic disease.2.Cystic lesion in the pancreatic head favored to represent an IPMN.3.Slight prominence of the posterior bladder wall noted. Attention should be paid to this area on subsequent exams. |
Generate impression based on findings. | 91 year-old female with neck and right shoulder pain. Four views of the cervical spine demonstrate diffuse severe osteopenia. There is significant multilevel joint space narrowing most significant at C4-C5, C5-C6, C6-C7. There is no evidence of acute fracture.Three views of the right shoulder demonstrate severe demineralization and significant osteoarthritic disease including extensive subchondral cyst and osteophyte formation as well as joint space narrowing. A high riding humeral head is consistent with chronic rotator cuff tear. There is osteophyte formation of the acromioclavicular joint. Deformity of the mid third of the clavicle may relate to distant trauma. No acute fracture or malalignment is evident. | 1. Severe diffuse osteoporosis. 2. Severe multilevel degenerative disease of the cervical spine. Cross-sectional imaging is recommended for further characterization.3. Severe osteoarthritis of the right shoulder and evidence of chronic rotator cuff tear. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy. Two standard digital views of both breasts, with additional bilateral MLO views, 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. There is a stable mass within the upper outer left breast, which contains a ribbon-shaped clip. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Chest wall pain (unspecified) LUNGS AND PLEURA: No radiographic abnormality. Specifically no abnormal nodules, masses or air space abnormalities. No effusionsMEDIASTINUM AND HILA: No lymphadenopathy.The cardiac and pericardium are within limits.CHEST WALL: No discrete focal abnormality, however bilateral dense breasts may warrant dedicated imaging.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Normal exam |
Generate impression based on findings. | Female, 9 years old. Reason: Day 3 xray following Sitz Mark, please identify location of markers History: severe constipation, abdominal pain, nauseaVIEW: Abdomen AP (one view) 3/11/2015, 1325 Twelve Sitz markers identified mainly in region of the left and mid pelvis.Nonobstructive bowel gas pattern. No free air.Mild fecal accumulation. | Twelve Sitz markers overly the left and mid pelvis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Round markers have been placed on cutaneous lesions overlying both breasts. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed, with tomosynthesis, and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed, with tomosynthesis, and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. A cluster of calcifications is present in the central outer left breast, posterior depth. No suspicious masses, microcalcifications or areas of architectural distortion are present in the right breast. | Cluster of calcifications in the central outer left breast. Additional imaging including magnification views is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Clinical question: IPH. Signs and symptoms: IPH. Nonenhanced head CT:Revisualization of a previously seen large right cerebellar ischemic stroke without change.Acute hematoma likely mostly within the left sylvian fissure is again identified and within is some interval increased size along its posterior aspect. It measures at 72-mm in length and AP axis compared to prior study measurements of 50. The largest transverse axis of hematoma measures approximately 30 mm compared to prior study measurements of 20.There is resultant increased mass effect and deviation of midline to the right of approximately 9.8 mm compared to prior study measurements of 5.4-mm.increased mass affect is also evident by partial overlapping of the left medial temporal lobe over the basal cistern and upper left CP angle concerning for transtentorial herniation.There is no change in the normal size of ventricular system. Surrounding vasogenic edema demonstrates subtle interval increase in extent. Interval decrease in post procedural pneumocephalus. Findings of age indeterminate small vessel ischemic strokes are noted.Findings and concerns on this exam were discussed by phone with the neuro ICU staff Dr.MANSOUR, ALI #6229 at the time of review exam. | 1.Interval increased size of left hemispheric hematoma, surrounding vasogenic edema and overall associated mass effect as detailed.2.Mass effect includes deviation of midline to the right of approximately 9.8 mm and with effacement of basal cisterns and deviation of the left temporal lobe medially concerning for transtentorial herniation.3.Ventricular system remain within normal range.4.Age indeterminate small vessel ischemic strokes unchanged since prior study. |
Generate impression based on findings. | Head and neck cancer, follow-up CHEST:LUNGS AND PLEURA: Scattered moderate emphysematous changes including minimal basilar scarring. Scattered nonspecific micronodules without suspicious nodules or masses. No effusionsMEDIASTINUM AND HILA: No lymphadenopathy.The cardiac and pericardium are within limits other than mild to moderate coronary calcifications unchangedCHEST WALL: Mild to moderate degenerative changes without suspicious superimposed lytic or blastic lesionsABDOMEN: 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: Stable left suspected renal cystsPANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Unchanged mild to moderate compression deformities of L1 and L4 with superimposed moderate to and more severe degenerative disk changesOTHER: No significant abnormality noted. | No findings to suggest metastatic disease |
Generate impression based on findings. | Follow-up locally advanced non-small cell lung cancer. CHEST:LUNGS AND PLEURA: Severe centrilobular and paraseptal emphysema. No pneumothorax. Small loculated left pleural fluid collection at the base, perhaps minimally larger.Left costophrenic angle mass measures 5.1 x 3.5 cm (4/68), previously 3.2 x 2.2 cm on the most recent previous exam and 1.9 x 1.3 cm on the study of 5/7/2014.Basal and paramediastinal fibrotic changes appear similar to previous. Dependent debris in the bronchus intermedius again noted. MEDIASTINUM AND HILA: Large circumferential pericardial fluid collection similar in volume. Moderate cardiomegaly. The walls of the left ventricle appears thickened. Moderate coronary artery calcification. Right atrial enlargement.Chronic partially recanalized thrombus in the left lower lobe pulmonary artery; the degree of thrombosis along its inferior margin has increased compared to the previous study. Distal branches are unopacified, consistent with occlusion.Patulous thoracic esophagus containing debris.Previously measured lower left paratracheal region lymph node is stable at 4-mm (3/34). The previously measured subcarinal lymph node measures 8 mm, previously 7 mm (3/48).Heterogeneously enhancing left hilar lymph nodes are slightly larger [non-index lesions, having increased from 6-7 mm to 10-mm on the current study (3/50, 3/47)].CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Heterogeneous attenuation of the hepatic parenchyma. Previously seen hypoattenuating lesion in the right hepatic lobe is better marginated on the current study, 14 x 16 mm, previously 14 x 14 mm. There is a new second hypoattenuating lesion also in the right hepatic lobe measuring 12-mm (3/91). Unchanged subcentimeter hypoattenuating lesion left hepatic lobe (3/98).SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Hypoattenuating renal lesions, some of which appear to be cysts while others are too small to characterize.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification involving the aorta and its branches. 1.3 cm aneurysm at the bifurcation of the celiac artery (3/97).BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Cortical thickening of the right iliac wing in a pattern most consistent with Paget's disease.OTHER: No significant abnormality noted. | 1. Interval increase in size of left lower lobe mass.2. Left hilar lymph node enlargement of unclear etiology. A though these could be reactive given the presence of nearby chronic thromboembolism with slight interval progression, the possibility of nodal metastases cannot be excluded..3. Heterogeneous attenuation pattern of the liver with new and enlarging hepatic lesions which remain suspicious metastases despite the lack of FDG activity on recent PET scan. Recommend correlation with hepatic MRI or dedicated triple phase hepatic CT for further characterization.4. Chronic partially recanalized left lower lobe pulmonary embolus has slightly enlarged.5. Chronic circumferential pericardial effusion with signs of right heart strain and coronary artery disease.6. 1.3cm aneurysm at the bifurcation of the celiac artery. |
Generate impression based on findings. | Male 63 years old; Reason: renal cell carcinoma please provide measurements History: renal cell carcinoma CHEST:LUNGS AND PLEURA: No focal consolidation, pleural effusion, or suspicious nodularity. Stable left lower lobe micronodule is noted.MEDIASTINUM AND HILA: Heart size is normal with no pericardial effusion. Caliber of the great vessels is normal. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Large enhancing heterogeneous metastasis in region of the third posterior left rib, extending into the T3 vertebral body. There is known epidural extension by previous thoracic spine CT. The mass appears grossly unchanged in size, measuring 7.9 x 4.7 cm (series 3, image 15), from 7.6 x 5.4 cm previously.OTHER: No other significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No suspicious hepatic lesions are identified.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Left adrenal nodularity and does appear increased from the previous exam, measuring 15 mm (series 3, image 100), slightly more prominent than previously seen.KIDNEYS, URETERS: Centrally necrotic exophytic left renal mass is not significantly changed, measuring 3.5 x 3.3 cm (series 3, image 120), from previously 2.7 x 3.7 cm.RETROPERITONEUM, LYMPH NODES: Several small aortocaval and para-aortic lymph nodes are noted, stable, and not significantly enlarged by size criteria.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: 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.No significant interval change in complex left renal mass, compatible with renal cell carcinoma, and destructive metastasis in region of the left posterior third rib.2.Indeterminate left adrenal nodule; metastasis not excluded. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast excisional biopsy. 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy. 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 31 years old; Reason: metastatic breast cancer - baseline prior to starting treatment. bidimensional measurements per recist 1.1 History: history of lung and nodal mets CHEST:LUNGS AND PLEURA: Fibrotic changes and architectural distortion underlying the lung parenchyma of the left breast, likely related to history of radiation therapy. 7-mm pulmonary nodule just posterior to these changes (5:36). Micronodule in the right middle lobe (5:63) and left lung apex (3:13).MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: 1.9 x 1.7 cm collection in near surgical clips in the left breast is a slightly increased attenuation as compared to fluid (40 HU). This could be a postoperative stroma, but correlation with sonography is advised. Other irregular soft tissue density surrounding the surgical clips is nonspecific, measuring 2.5 x 1.2 cm (3:27), and may be related to scarring, with residual disease not excluded. Correlation with existing mammographic/sonographic imaging is suggested. Bilateral breast implants. 5-mm lymph node just lateral to the inferior most surgical clips in the left breast. Right axillary surgical clips are seen, probably from prior lymph node dissection.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 1.2-cm hypodensity in the mid right kidney is slight increased attenuation as compared to fluid, and further characterization with ultrasound could be performed.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No suspicious lytic or blastic osseous lesions. Correlate with same day bone scan.OTHER: No significant abnormality noted. | 1.9-cm collection near surgical clips in the left breast is of slightly increased attenuation compared to fluid. While this may represent a postoperative stroma, correlation with prior mammographic or sonographic imaging or further characterization is suggested.Similarly, a 2.5cm irregular soft tissue density surrounding the clips may be postsurgical, correlation with prior imaging or further characterization is suggested.Likely postradiation changes of the left lung and bilateral pulmonary nodules as described above, the largest measuring up to 7 x 5 mm. |
Generate impression based on findings. | 46-year-old male with ulceration of right first toe. Three views of the right foot demonstrate soft tissue swelling and subcutaneous gas along the plantar aspect of the left first metatarsophalangeal joint. The bony cortex is intact without evidence of erosion. There is no acute fracture or malalignment. A plantar heel spur is present. | Soft tissue swelling surrounding the first metatarsophalangeal joint, without bony evidence of osteomyelitis. |
Generate impression based on findings. | There is mild nonspecific prominence of the ventricles and sulci which may suggest mild global volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. 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. The midline structures and craniocervical junction are within normal limits. | Essentially unremarkable noncontrast MRI brain with perhaps mild global volume loss greater than expected for the patient's stated age. |
Generate impression based on findings. | Mesothelioma, please follow-up LUNGS AND PLEURA: Nodular pleural thickening in the right lower hemithorax again consistent with known mesothelioma. Reference measurements are as follows:1. At the level of the aortic arch (image 32 series 5), the two o'clock measurement remains 2 mm, unchanged. The 5 o'clock measurement is also unchanged at 6 mm.2. At the level of the main pulmonary artery (image 47 series 5), the 12 o'clock measurement remains 8 mm unchanged3. At the level of the right atrium (9 series 5), the 5 and 7 o'clock measurements remain 2.7 and 1.3 cm unchangedStable appearing nonspecific micronodules in the left lung. No pleural effusions or new intrapulmonary findings.A lower right paravertebral mass (image 76 series 5) measures 3.2 cm, unchanged. No new osseous adjacent involvement.MEDIASTINUM AND HILA: Stable extensive lymphadenopathy. The reference right hilar lymph node (image 48 series 5), remains 2.7 cm. The large subcarinal lymph node or conglomerate node (image 51 series 5) remains unchanged at 3.4 cm. Additional extensive mediastinal and hilar lymphadenopathy appears similar.Moderate coronary calcifications without additional pericardial or cardiac abnormalityCHEST WALL: Unchanged scattered cervical and supraclavicular lymphadenopathy other than a single lymph node in the left lower neck, currently measuring 1.4 cm, previously 1.0 cm (image 7 series 5). This may be partially due to differences in gantry angle and technique.Soft tissue nodule involving the right costovertebral junction at the level of the upper abdomen appears similar and unchanged (image 101 series 5). In addition the right chest wall involvement (image 69 series 5) remains 1.7 cm.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. Please correlate results with separately reported CT of the abdomen | Stable mesothelioma disease and involvement. Reference measurements provided |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. Family history breast carcinoma in her sister at age 68, and a maternal cousin at age 52. 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. A linear marker has been placed on a scar overlying the upper outer right breast. A round marker has been placed a cutaneous lesion overlying the right breast. Scattered benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 88 year-old male with history of left femur pain after multiple falls. Two views of the left femur demonstrate mild joint space narrowing and subchondral cyst formation of the left hip. There is no evidence of fracture or malalignment; no significant soft tissue swelling. | Minimal osteoarthritis of the left hip. No acute fracture or malalignment is evident. |
Generate impression based on findings. | Knee pain. Finger pain. Three views of the left ring finger reveal a fracture of the middle phalanx that is nondisplaced. No previous exams.Four views including weight-bearing of the right knee are unremarkable. | Oblique fracture left ring finger. Negative right knee examination |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of ovarian carcinoma. Family history of breast carcinoma in her maternal aunt. 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. Focal asymmetry is present within the central inner left breast. Scattered benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present in the right breast. | Focal asymmetry in the central inner left breast. Additional imaging including spot compression views and possible ultrasound is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 40 year-old male with history of cystic fibrosis now with persistent sinus tachycardia PULMONARY ARTERIES: Adequate pulmonary artery opacification without evidence of pulmonary embolism. The pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: Severe bilateral upper lobe predominant bronchiectasis and bronchial thickening consistent with the patient's known cystic fibrosis.Basilar centrilobular nodules, mucous plugging, tree in bud opacities with areas of groundglass opacities appear slightly increased when compared to the prior exam. Interval improvement in the nodular airspace opacities in the lung bases. No pleural effusion or pneumothorax. New nonspecific left apex nodule measuring 20 mm (series 10, image 16).MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. No appreciable coronary artery calcifications. Prominent right hilar lymph node measuring 14 mm (series 7, image 120). Prominent lymphoid tissue is noted in bilateral hila. Scattered subcentimeter mediastinal lymph nodes are present.CHEST WALL: Mildly prominent retrocrural lymph node measuring 8 mm is nonspecific. No cardiophrenic or axillary lymphadenopathy is present. Lytic lesion sclerotic borders in the left seventh rib is unchanged. Otherwise, the osseous structures are within normal limits. No suspicious osseous lesions.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Cholelithiasis without evidence of cholecystitis. Subcentimeter hypodense lesions in bilateral kidneys are too small to further characterize but presumably represent renal cysts. | 1.No evidence of pulmonary embolism.2.Slight interval increase in diffuse centrilobular nodules, mucous plugging, tree in bud opacities with areas of groundglass opacities compatible with infectious/aspiration bronchiolitis.3.Interval improvement in the nodular airspace opacities at the lung bases compatible with resolving pneumonia.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Shortness of breath with cough and wheezing LUNGS AND PLEURA: No significant abnormality noted, however mild bronchial wall thickening is observed. Specifically no masses or nodules. No effusionsMEDIASTINUM AND HILA: No lymphadenopathy.Mild coronary calcifications without additional cardiac or pericardial abnormalitySmall to moderate hiatal hernia with associated fatCHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No specific focal abnormality observed in this limited observation. A normal variant splenule is observed | No definite acute abnormality, however mild bronchial wall thickening is observed compatible with asthma and/or mild bronchiolitis |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of uterine carcinoma. Family history breast carcinoma in her maternal aunt, and uterine carcinoma in her mother. 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed, with tomosynthesis, and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 58 years old Female. Reason: restaging. History: restaging PET after CT with suspicious increase in fluid collection 2/20/15. S/p gastrectomy and adjuvant CRT. RADIOPHARMACEUTICAL: 14.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 73 mg/dL. Today's CT portion grossly demonstrates low density lesion in the left paraesophageal region in the superior mediastinum. A nodular density is seen in the right middle lobe. Linear densities in the lung bases are noted. Surgical sutures are seen in in the left upper quadrant of abdomen.Today's PET examination demonstrates several foci of increased activity in the left axilla, corresponding to the normal sized lymph nodes seen on CT. The SUVmax in the left axillary lymph nodes is 4.6. Minimal FDG uptake is seen in several normal sized lymph nodes in the right axilla. There is a minimal FDG uptake in the nodular density in the right middle lobe with SUVmax of 0.8.Minimal FDG uptake is seen in the low density lesion in the left superior mediastinal region.Three foci of increased activity are noted in the left lower quadrant of the abdomen, without definite CT correlation. These findings are nonspecific. Nonspecific mild increased activity is seen in the vagina.Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Moderately hypermetabolic lymph nodes in the left axilla, which are nonspecific.2.Minimal FDG uptake in the right middle lobe nodular density. Suggest follow-up with CT.3.No increased metabolic activity in the left paraesophageal low attenuation lesion in the superior mediastinum, suggesting it is probably benign.4.Other nonspecific findings as described above. |
Generate impression based on findings. | 55 year old male with history of cryptogenic cirrhosis and hepatocellular carcinoma, HTN, HPL, prior smoker who presents for coronary CTA as evaluation for liver transplant.CPT Code: 75574 Coronary arteries: LM: The left main coronary artery arises normally from the left sinus of Valsalva and bifurcates into the left anterior descending and left circumflex coronary arteries. There minimal atherosclerosis in the left main.LAD: The left anterior descending coronary artery courses normally in the anterior interventricular groove, supplying the diagonal and septal branches. There are no significant stenoses in the LAD. There is minimal atherosclerosis in the mid LAD. The distal LAD is small (and compensated for by a very large posterior descending artery).LCx: The left circumflex coronary artery is non-dominant. It courses normally in the left AV groove. It gives rise to the obtuse marginal and posterolateral branches. There are no significant stenoses in the LCx. There is minimal atherosclerosis in the proximal portion of the vessel.RCA: The right coronary artery is large and arises normally from the right sinus of Valsalva. It is the dominant coronary artery supplying a very large posterior descending artery. There are no significant stenoses in the right coronary artery. There is minimal atherosclerosis in the proximal vessel.Left Ventricle: The left ventricular late diastolic volume is normalRight Ventricle: Visually the right ventricular late diastolic volume is mildly dilatedLeft Atrium: Visually, the left atrial volume appears to be normal in size. There are four distinct pulmonary veins which drain normally into the left atrium. There is no evidence of left atrial appendage thrombus.Right atrium, vena cavae, and coronary sinus: The right atrial volume appears to be normal in size. The superior and inferior vena cavae are grossly normal. The coronary sinus is normal in size. Valves: There is no calcification on the aortic or mitral valves.Great vessels: The visualized portions of the thoracic aorta demonstrate no evidence of dissection or aneurysm. The aortic arch is not seen. The main pulmonary artery is normal in size.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion. | 1. There are no significant coronary artery stenoses present.2. There is mild coronary atherosclerosis.This portion of the report pertains to the heart and great vessels only. The remaining soft tissues of the thorax and upper abdomen will be interpreted by the attending chest radiologist and included as an addendum to this report. |
Generate impression based on findings. | 9 years old, Female, Reason: New patient exam for evaluation History: bilateral renal stones with flank pain BLADDER Wall Thickness: Normal. The decompressed bladder has a loop of bowel which abuts the anterior/superior surface. Contents: The bladder is compressed with normal internal components. Distal Ureter -- SFU Grade** Right: 0 Left: 0 Ureteral Jets Right: Not observed Left: Not observedKIDNEYS Cortical Echogenicity: Normal Medullary Echogenicity: Normal Pelvicaliceal System -- SFU Grade* Right: 0 Left: 0 Length*** Right: 8.3 cm Left: 9.0 cm Mean for age: 9.0 cm Range for age: 7.2 - 10.7 cmADDITIONAL OBSERVATIONS: No shadowing calculi are identified. | No hydronephrosis or shadowing calculi bilaterally.*SFU grading system: Grade 0: No hydronephrosis. Grade 1: The renal pelvis is visualized. Grade 2: A few but not all of the calices are identified in addition to the renal pelvis. Grade 3: Virtually all the calices are seen. Grade 4: Grade 3 and parenchymal thinning. **SFU grading system retrovesical ureter: Grade 0: No ureteral dilatation. Grade 1: Ureter less than 7 mm. Grade 2: Ureter is 7-10 mm. Grade 3: Ureter is over 10 mm. Fernbach SK, Maizels M, Conway JJ. Ultrasound Grading of Hydronephrosis: Introduction to the System used by the Society for Fetal Urology. Pediatric Radiology (1993) 23: 478-480.***Rosenbaum DM, Korngold E, Teele RL. Sonographic Assessment of Renal Length in Normal Children. AJR Am J. Roentgenol (1984) 142:467-469 |
Generate impression based on findings. | Cough LUNGS AND PLEURA: Gunshot pellets in the right upper and lower chest wall provided extensive artifact limiting sensitivity. Other than mild scarlike changes no additional intrapulmonary abnormality, specifically no nodules or masses observed. No effusionsMEDIASTINUM AND HILA: No lymphadenopathyMild coronary and annular calcifications without additional change or new abnormality involving the cardiac or pericardial appearance.Small hiatal herniaCHEST WALL: No significant abnormality noted other than minimal degenerative changes without additional suspicious lytic or blastic lesions.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Degenerative changes without superimposed new or acute pulmonary abnormality |
Generate impression based on findings. | Female, 10 years old. Reason: eval for fx History: ankle pain sportsVIEWS: Left ankle, AP, lateral, oblique (3 views) 3/11/2015, 1400 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy. 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. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy and cyst aspiration. Family history of breast carcinoma in her maternal aunt at age 50. Two standard digital views of both breasts were performed, with tomosynthesis, and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A stable mass is present within the upper outer left breast, with adjacent biopsy marking clip. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Weight loss, cough and right-sided chest pain LUNGS AND PLEURA: A large mildly spiculated right upper lobe mass is observed along the right pleural surface with associated thickening and osseous involvement. The mass measures 5.3 x 4.0 cm axially with extension towards the hilar region. Central heterogeneity suggest necrosis centrally. In addition, multiple additional small suspected satellite nodules are identified suggesting lymphangitic spread as well as a focal 1.1-cm spiculated nodule in the left upper lobe representing suspected contralateral disease. No definite effusionMEDIASTINUM AND HILA: Abnormal enlargement and heterogeneity of the thyroid and largely on the left with extension into the upper mediastinum, possibly goiter, however dedicated and complete imaging is needed. Scattered borderline lymphadenopathy. Four reference is a 1 cm lymph node in the right paratracheal position (image 21 series 3) at the level of the aortic arch.Mild cardiomegaly with with mild coronary calcifications.CHEST WALL: As described questionable mild fourth rib invasion. No additional lytic or blastic lesions observed in this mildly limited exam given extreme kyphosis involving the lower thoracic spine. Scattered marked degenerative changesUPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Multiple suspicious hypodensities in the liver, concerning for questionable additional metastatic disease, the largest measures approximately 6 cm in the left lobe. Adrenals specifically are unremarkable. | Suspicious right upper lobe mass with associated contralateral nodules and suspected lymphangitic spread of a primary malignancy. Additional lesions are observed in the liver |
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. Single cluster of calcifications in the upper outer left breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | There is mild prominence of the ventricles and sulci, likely relating to mild global volume loss. The cisterns remain patent. There is no midline shift or mass effect. There are no areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is opacification of an ethmoid air cell bilaterally. | Unremarkable contrast enhanced MRI brain. No MR evidence of intracranial metastatic disease. |
Generate impression based on findings. | Male, 57 years old, with history of lung cancer. A soft tissue nodule is identified just adjacent to and contiguous with the posterior margin of the left parotid gland measuring 16 x 11 mm (image 33 series 8), correlating to hypermetabolic uptake on PET.A bulky heterogeneous mass is present in the right supra-clavicular fossa measuring 57 x 55 mm (image 67 series 8).Extensive confluent mediastinal adenopathy, as well as extensive disease in the right lung, are better assessed on dedicated chest imaging.The aerodigestive mucosa is unremarkable allowing for the fact that some portions of the esophagus are difficult to distinguish from mediastinal adenopathy. The salivary glands and thyroid are otherwise unremarkable. The cervical vessels enhance normally. No concerning or frankly destructive osseous lesions are demonstrated within the field of view of this examination. | 1.Bulky supraclavicular and mediastinal metastatic deposits.2.A nodule along the posterior margin of the left parotid gland may also represent a site of metastatic adenopathy, less likely a primary parotid lesion. |
Generate impression based on findings. | Female; 60 years old. History: metastatic breast cancer. Focal increased activity in the sternum corresponds to large chest wall mass seen on recent CT which invades the sternum. No additional abnormal osseous foci are identified. | Increased sternal activity corresponding to large chest wall mass seen on recent CT, suspicious for metastasis. No new osseous lesions identified. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed, with tomosynthesis, and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Status post revision of right TEA 2012. There are components of a total elbow arthroplasty device in near anatomic alignment. There is no evidence of hardware complication or significant interval change. The proximal radius and ulna have been resected. No acute fracture is identified. | Right total elbow arthroplasty device without evidence of hardware complication. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed, with tomosynthesis, and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Scattered benign calcifications are present. Asymmetery is present in the upper outer right breast, which disperses to parenchyma on tomosynthesis images. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: metastatic prostate cancer on chemo eval for progression History: metastatic prostate cancer Multiple foci of increased radiotracer uptake are again noted throughout the axial skeleton, not significantly changed since the prior study. Specifically, abnormal uptake is noted in the sternum, calvarium, right proximal humerus, scapulae, thoracic spine, and right seventh and left eighth ribs. Findings are compatible with known metastatic disease. | No significant interval change in abnormal radiotracer activity as detailed above, consistent with stable metastatic disease. |
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. Asymmetry is present in the upper right breast. Additional asymmetry is seen in the lower, anterior right breast. No suspicious masses, microcalcifications or areas of architectural distortion are present in the left breast. | Asymmetries within the upper and lower right breast, as above. Correlation with prior mammogram is recommended. If prior mammograms cannot be obtained, additional imaging including spot compression views, and possible ultrasound, is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: OB - OLD FILM FOR COMPARISON |
Generate impression based on findings. | Global cerebral volume loss is noted. Symmetric enlargement of the ventricles compatible with generalized volume loss. Mild white matter hypodensities compatible with age indeterminate small vessel ischemic disease. No acute intracranial hemorrhage is identified. No evidence of acute infarction. No evidence of intracranial mass, mass-effect, or midline shift. The imaged portions of the paranasal sinuses and mastoid air cells are clear. Left parotid gland is not visualized, correlate with clinical/prior surgical history. The imaged portions of the orbits are intact. The osseous structures are unremarkable. There are scattered dystrophic calcifications of the tentorium and dura. | 1.Generalized cerebral volume loss.2.No acute intracranial abnormality. CTs not sensitive for detection of acute nonhemorrhagic ischemia. If high clinical suspicion of CVA, consider MRI. |
Generate impression based on findings. | There are stable posttreatment changes within the neck. PHARYNX/LARYNX: The nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The right submandibular gland appears overall lower in attenuation than the left and appears slightly smaller in volume. The postcontrast appearance of the salivary glands is otherwise unremarkable. The thyroid gland is unremarkable. ORAL CAVITY: The oral tongue and floor of mouth are unremarkable, within the limitations of this exam as there is artifact from dental amalgam.CERVICAL SOFT TISSUES: There are no pathologically enlarged cervical lymph nodes.OTHER: The right internal jugular vein is absent. There are mild scattered cervical spondylotic changes. There are persistent bilateral maxillary sinus mucosal retention cysts and mucosal thickening. There is mild atherosclerotic calcification along the carotid bifurcations. | Stable post-treatment changes, without evidence of mass or significant cervical lymphadenopathy. |
Generate impression based on findings. | Female, 10 years old. Reason: eval for interval change osteochondroma History: knee painVIEWS: Left knee AP, lateral (2 views) 3/11/2015, 1414 A broad-based exophytic osteochondroma arises from the posterior aspect of the distal left femoral metadiaphysis.No significant joint effusion or soft tissue swelling.No acute fracture or dislocation. | An osteochondroma arises from the posterior distal left femur. No prior images available for comparison. If prior outside images can be obtained, comparison can be made. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast carcinoma in her maternal aunt. Two standard digital views of both breasts were performed, with tomosynthesis, 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. Stable asymmetries in the left lateral breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history breast carcinoma in her sister at age 59. 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. A round marker has been placed on a cutaneous lesion overlying the upper outer left breast. Vascular calcifications are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Female; 75 years old. Reason: history of L UPJ obstruction, assess for renal function/change. The posterior abdominal radionuclide angiogram demonstrates decreased perfusion to the left lower pole. Sequential renal images show an enlarged left kidney. There is prompt uptake and excretion of the radiopharmaceutical by both kidneys. However, there is delayed tracer clearance in both kidneys prior to Lasix administration. After administration of Lasix, the right kidney demonstrates normal clearance (half time 12 seconds) but the left exhibits persistent delayed clearance of radiotracer (half time 22 seconds). The estimated contribution of the right kidney to total renal function is 47% and that of the left kidney is 53%, previously 57%. There are no abnormalities of the ureters or bladder. | 1.Delayed post-diuretic tracer clearance from the left kidney, compatible with persistent mild UPJ obstruction.2.Enlarged left kidney with decreased lower pole perfusion and decreased split function since prior exam, suggestive of worsening renal function. 3.Delayed tracer clearance from right kidney, which resolves status post diuretic administration. |
Generate impression based on findings. | Lower back pain. Question of fracture. There is severe degenerative disease at L4/L5 and L5/S1, which appears progressed from the prior exam. There is redemonstration of minimal anterolisthesis of L4 on L5. Multilevel anterior osteophytes are noted. Moderate to severe facet joint osteoarthritis is noted within the lower lumbar spine.Degenerative disk disease also effects the visualized lower thoracic spine. | Severe degenerative changes of the lower lumber spine, progressed from prior, as described above. |
Generate impression based on findings. | 42 years old Male. Reason: Evaluate disease status. History: 42 year old man with newly-diagnosed lymphoma, likely follicular. Evaluate extent of disease with particular attention to bones which were abnormal on recent MRI. RADIOPHARMACEUTICAL: 11.8 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 96 mg/dL. Today's CT portion grossly is unremarkable.Today's PET examination demonstrates numerous foci of increased activity in the cervical, thoracic, lumbar and sacral spine. Numerous foci of increased activity are seen in the bony pelvis. Multiple foci of increased activity also seen in in the proximal humeri, proximal femurs and both scapulae. Several foci of increased activity are also seen in bilateral ribs.Several mildly hypermetabolic lymph nodes are seen in the left side of the neck and bilateral axillary regions. | 1.Numerous hypermetabolic osseous lesions in the skeleton, highly suspicious for metastasis.2.Mildly hypermetabolic normal-sized lymph nodes in the neck and axillary regions, which are nonspecific. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast carcinoma her maternal grandmother. Two standard digital views of both breasts were performed, with tomosynthesis, and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy. Two standard digital views of both breasts were performed, with tomosynthesis, and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Cervicalgia. There is a posterior cervical sideplate with screws into the pedicles of C3-C6. There is a corpectomy of C4-C6 with an anterior sideplate and metal cage of bone graft. Amorphous bone graft material is also noted along the posterior aspect of the cervical spine. Alignment is unchanged. Numerous surgical clips and a tracheostomy tube are noted anteriorly. | Postoperative changes of anterior and posterior cervical fusion without significant interval change. |
Generate impression based on findings. | Altered mental status, patient unstable, artificial heart, CVVH Portable technique limits evaluation of subtle abnormalities. Please also note examination includes supratentorial structures and upper part of the posterior fossa.Again seen a small extra-axial collection in the right parieto-occipital region measuring up to 5 mm in thickness. No new intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. No midline shift or uncal herniation. Gray-white differentiation is maintained. Sulci and ventricles are within normal limits for age without evidence of hydrocephalus. No extra-axial collections. There is tiny focus of low-attenuation involving the right frontal corona radiata, axial image 13 of 26, and may represent a small watershed infarct.Extensive opacification of the visualized paranasal sinuses again seen. Calvarium is intact. There is edematous appearance of the visualized scalp soft tissues. | 1. Portable head CT demonstrates slight evolution of small subdural hematoma in the right parieto-occipital region. No new intracranial hemorrhage or new mass-effect is identified. Please note the lower posterior fossa was not imaged and previously seen areas of low-attenuation in the bilateral cerebellar hemispheres cannot be assessed. 2. Portable technique limits evaluation of subtle abnormalities. There is tiny focus of low-attenuation involving the right frontal corona radiata seen on a single slice, axial image 13 of 26 of series 1, not definitively seen on priors and may represent a tiny infarct. Above findings can be further assessed with follow-up CT or MRI as patient can tolerate. 3. Diffuse scalp edema. 4. Extensive sinus opacification which is incompletely assessed.Dr. Ali discussed findings with Dr. Martin on 3/11/2015 at 1455 hrs. |
Generate impression based on findings. | Status post total elbow arthroplasty 2006. Assess prosthesis. There is a total left elbow arthroplasty device with an interlocking screw within the proximal ulna in near anatomic alignment. There is interval increased bone resorption around the distal humeral component and new bone resorption around the ulnar component of the device. Suture anchor screws are noted within the medial and lateral epicondyles. No acute fracture is evident. | Interval increased lucency around the humeral and ulnar components of the left total elbow arthroplasty device is suspicious for loosening. |
Generate impression based on findings. | Limited imaging was obtained for stereotactic localization purposes. There is susceptibility artifact along the left temporal occipital calvarium relating to the extracranial portion of the stimulator. An extracranial electrode extends extracranially to more anteriorly and superiorly located susceptibility at the left posterior vertex. From this area, electrode enters via a left parietal burr hole and there is linear susceptibility coursing through the anterior aspect of the left precentral gyrus into the left ventral thalamus, approximately 8-9 mm from the midline. More caudally, there is additional susceptibility which extends into the left ventral midbrain. There are bandlike areas of susceptibility along the expected location of the substantia nigra bilaterally, slightly more dorsally positioned on the left. Just posteriorly, there is a prominent area of susceptibility which extends caudally from the posterior medial left thalamus into the left red nucleus region with associated volume loss and mild adjacent ex vacuo dilatation of the third ventricle. Overall, left cerebral peduncle is smaller in size than the right.The ventricles and sulci are otherwise within normal limits for age. The cisterns remain patent. There is no midline shift or mass effect. There is an additional area of focal encephalomalacia involving the right paramedian mid frontal lobe as well as the left frontal periventricular white matter extending to the medial cortex. There is susceptibility scattered in this area as well. Mild susceptibility is also noted in the right caudate head as compared to the left. There are no areas of pathological enhancement. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. | 1. Evidence of indwelling deep brain stimulator, with tip electrode in the ventral left thalamus, approximately 8-9 mm from midline.2. Susceptibility identified just caudal to the level of the left paramedian midbrain likely centered in the left red nucleus with associated encephalomalacia and volume loss. This may relate to previous lacunar infarct with possible associated hemorrhage, as there is focal rounded T2 hyperintensity identified just caudal to this location. Alternatively, perhaps the stimulator electrode previously extended more distally into this area. Please correlate with previous surgical report.3. Additional areas of encephalomalacia in the mid right greater than left frontal lobes, with associated susceptibility, extending to the ventricular margins. This is most suggestive of encephalomalacia with associated chronic hemosiderin deposition. |
Generate impression based on findings. | Postop. Prosthetic assessment. Two views of the right hip reveal a right total hip arthroplasty device situated in anatomic alignment. There is no evidence of hardware complication. No acute fracture is evident.An additional AP view of the pelvis reveals severe osteoarthritis of the left hip with subchondral sclerosis, osteophyte formation, and bone-on-bone apposition. There are calcified fibroids. | 1. Right hip total arthroplasty device without hardware complication.2. Severe left hip osteoarthritis. |
Generate impression based on findings. | Evaluate ankle fracture Three views of the left ankle reveal a comminuted fracture of the fibula and a comminuted fracture of the tibia. There is an intramaxillary 10 and the fibula. There is a sideplate with multiple screws fixing the fracture fragments of the tibia. The bones appear in near-anatomic alignment.Two additional views of the tibia and fibula again reveals the tibial side plate with multiple screws and the fibula intramaxillary pin. | Comminuted fractures of the left ankle in near-anatomic alignment. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of cervical carcinoma. 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. A mass is present in the central, slightly inner left breast. Scattered benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present in the right breast. | Mass within the central, slightly inner left breast. Additional imaging including spot compression views, and possible ultrasound, is recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EA - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Male; 69 years old. Reason: metastatic prostate cancer, evaluation of disease after 3 cycles of investigational therapy. New focus of increased activity in the right lower anterior 9th rib, with less intense foci of increased activity located in the right 7th and 8th ribs in a linear configuration. There has been interval increase in abnormal left manubrial activity. Region of increased activity in the posterior right 11th rib is unchanged and compatible with healed rib fracture discussed previously. Increased activity in the upper thoracic spine and multiple peripheral joints is not significantly changed and likely degenerative in nature. | 1.Interval increase in size of left manubrial lesion, suspicious for progression of metastatic disease. 2.New foci of increased activity in the lower right ribs as described above. These may represent fractures from prior trauma given their linear configuration but please correlate with patient history. |
Generate impression based on findings. | Postop. Prosthetic assessment. Two views of the left hip reveal a left total hip arthroplasty device situated in anatomic alignment. Minimal lucency around the acetabular component of the device is unchanged since the initial postop radiograph. There is small amount of heterotopic ossification about the greater trochanter, unchanged. No acute fracture is evident.Additional AP view of the pelvis reveals medial joint space narrowing of the right hip with osteophyte formation. | 1. Left total hip arthroplasty device without significant interval change.2. Moderate osteoarthritis of the right hip. |
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. Scattered benign calcifications are present. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 25 years old; Reason: r/o SBO; intraabdominal fluid collection History: abdominal tenderness and vomiting; subjective f/c; s/p ex lap 2/2 intestinal perforation and SBO 3/5 ABDOMEN:LUNGS BASES: Patchy atelectasis in the lung bases appearedLIVER, BILIARY TRACT: Enhancing right hepatic lobe lesion previously noted on MRI again may reflect a hemangioma on this nondedicated study. Gallbladder is unremarkable.SPLEEN: No focal splenic lesion.PANCREAS: Pancreas is unremarkable.ADRENAL GLANDS: No adrenal nodularity or thickening.KIDNEYS, URETERS: The kidneys enhance symmetrically without focal lesion. No hydronephrosis or renal mass.RETROPERITONEUM, LYMPH NODES: There are no lymphadenopathy is identified.BOWEL, MESENTERY: Proximal to the anastomotic site in the midline in the lower abdomen, there is short segment small bowel mild dilatation, measuring up to 3.7 cm in diameter. Distally, the small bowel is decompressed. Moderate mesenteric edema is also noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No other significant abnormality noted.PELVIS:UTERUS, ADNEXA: Prominence of the endometrium is likely physiologic. Follicles noted in bilateral adnexa.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: There is free fluid in the cul-de-sac, likely representing postoperative fluid without evidence of loculated abscess at this time. | Mild focal, short segment small bowel dilatation proximal to the anastomotic site may represent a mild focal ileus. Developing or low-grade obstruction cannot be excluded. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast aspirations. 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. Stable benign intramammary lymph nodes are present bilaterally. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 59 years old Female. Reason: lung cancer staging evaluation. History: lung nodule, staging evaluation. RADIOPHARMACEUTICAL: 10.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 109 mg/dL. Today's CT portion grossly demonstrates interval increase in size of the right lower lobe nodule. Groundglass nodule is seen in the right upper lobe. Today's PET examination demonstrates increased metabolic activity in the nodule in the right lower lobe with SUVmax of 1.95, increased as compared with prior study.There is no abnormal FDG uptake in the groundglass nodule in the right upper lobe. There is also no definite abnormal FDG uptake in the smaller nodule in the right lower lobe seen on recent diagnostic CT from 02/24/15.There is no abnormal FDG uptake in the lung hila or mediastinum to suggest nodal metastasis.There is no other evidence of FDG avid tumor. | 1.Increased metabolic activity in the right lower lobe, suspicious for lung cancer.2.Right upper lobe ground glass nodule on CT with no definite abnormal FDG uptake, slight increased size as compared with prior study. Suggest follow-up with CT.3.Nonvisualization of the smaller the right lower lobe nodule on PET. This nodule was seen on recent diagnostic Chest CT.4.No evidence of FDG avid nodal or distant metastasis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast carcinoma in her maternal aunt at age 74. Two standard digital views of both breasts, with additional bilateral CC and MLO views, were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Stable left intramammary lymph node is again seen. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Pain. Evaluate for arthritis. Five views of the left knee reveal a unicompartmental arthroplasty with replacement of the medial joint in anatomic alignment without evidence of hardware complication. There is patchy sclerosis of the lateral femoral condyle. No acute fracture is evident. Five views of the right knee reveal no acute fracture or malalignment. There is patchy sclerosis of the bilateral femoral condyles and the medial proximal tibial plateau. There is moderate joint space narrowing of the tibiofemoral compartments. | 1. Left knee medial unicompartmental arthroplasty without evidence of hardware complication.2. Patchy sclerosis in the right femoral condyles, right medial tibial plateau, and left lateral femoral condyle may be reactive sclerosis related to osteoarthritis or possibly may be due to osteonecrosis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Scattered benign calcifications are present. Stable asymmetry in the left medial breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Male; 36 years old. Reason: eval GB History: RUQ pain Angiographic images are unremarkable. Prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the liver is present. There is normal excretion of tracer into the intrahepatic ducts, common bile duct, and duodenum, indicating hepatobiliary patency. However, the gallbladder is not visualized after 3 hours of imaging, which likely represents cystic duct obstruction. | Findings suspicious for acute cholecystitis as detailed above. |
Generate impression based on findings. | Follow-up right apical lesion found to be concerning on prior outside PET/CT LUNGS AND PLEURA: Gross stability minimal improvement in decreased fullness observed involving the asymmetric right apical scarring previous described as a mixed density with solid components. When measured similarly, the lesion again measures 1.8 x 1.6 cm (image 11 series 5).As abnormality is again superimposed upon a moderate background of centrilobular emphysema with associated bronchiectasis and scattered subpleural cysts. Appearance again suggests early interstitial lung disease with associated mild volume loss in the leftNo superimposed acute new air space abnormality, no effusions. Interval resolution of small right hydropneumothoraxMEDIASTINUM AND HILA: Borderline cardiomegaly with severe coronary calcifications.No distinct lymphadenopathySmall hiatal herniaCHEST WALL: Scattered moderate degenerative changes without suspicious lytic or blastic lesionsUPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | No specific superimposed new findings to suggest an acute pulmonary process, such as pneumonia. See detail provided |
Generate impression based on findings. | Clinical question: Progressive endometrial cancer brain metastases. Signs and symptoms: As above. Unenhanced head CT:Examination demonstrate no evidence of abnormal parenchymal or meningeal enhancement to suggest metastases disease.Calvarium is also negative for any lytic or sclerotic lesion to suggest metastases.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray -- white matter differentiation.Unremarkable orbits, paranasal sinuses and mastoid air cells. | Negative unenhanced head CT. |
Generate impression based on findings. | 58 year old female, pre lung transplant evaluation. Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 minutes: 72.3 % of peak activity (normal >70 %)1 hour: 48.4 % of peak activity (normal 30-90 %) 2 hours: 19.3 % of peak activity (normal <60 %) 4 hours: 0.5 % of peak activity (normal <10 %) | Gastric emptying within normal limits. |
Generate impression based on findings. | Check for pneumonia. Hypersensitivity pneumonitis LUNGS AND PLEURA: Interval moderate improvement in the previously described subpleural reticular changes and traction bronchiectasis. Associated diminishing adjacent ground glass components are also markedly improved. No new superimposed focal air space abnormality. No effusions. No findings to suggest honeycombingMEDIASTINUM AND HILA: No lymphadenopathy. Questionable small pericardial effusion versus thickening unchanged. Cardiac and pericardium are otherwise unremarkableSmall hiatal herniaCHEST WALL: Scattered moderate degenerative changes and scoliotic curvature unchanged. No suspicious lytic or blastic lesions observedUPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Focal bandlike calcification through the body of the pancreas is again identified without evidence of interval change. Adjacent hypodensity cannot entirely be excluded, however consider dedicated imaging if further characterization is needed clinically | Interval improving basilar predominant interstitial changes likely representing residual chronic findings with interval resolution of a superimposed process and improved overall aeration. |
Generate impression based on findings. | Female, 17 years old. Reason: r/o Pulmonary hemorrhage, vasculitis History: 17 yo neuro lupus, chest pain LUNGS AND PLEURA: A few scattered small nodules along the fissures and additional scattered pulmonary micronodules measuring up to 2mm, compatible with intrapulmonary lymph nodes, postinfectious nodules, or other benign etiology.Scattered mild linear densities in the bilateral lower lobes, compatible with dependent subsegmental atelectasis.No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Scattered nonenlarged mediastinal and hilar lymph nodes.Normal cardiac size, without pericardial effusion.CHEST WALL: Mildly prominent bilateral axillary lymph nodes, nonspecific. UPPER ABDOMEN: No significant abnormality identified. | No acute abnormality. Specifically, no evidence of pulmonary hemorrhage or vasculitis. |
Generate impression based on findings. | 53-year-old male patient with history of abdominal pain radiating to left testicle that is intermittent. ABDOMEN:LUNG BASES: There is a soft tissue density in the posterior medial right lower lobe that appears to arise from the posterior mediastinum, is incompletely visualized, demonstrates heterogeneous enhancement, and measures 2.3 x 2.0 cm (series 8 image 3). There are two micronodules in the left lower lobe (series 7 images 9 and 18) and a 4 mm micronodule in the right middle lobe (series 7 image 6).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 nephrolithiasis. No hydronephrosis, mass lesion, or perinephric fat stranding. There is symmetric excretion of the kidneys delayed images.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No acute intra-abdominal abnormality to account for patient's symptoms.2.Partially visualized mass appears to be arising from the mediastinum. Recommend dedicated CT chest for further evaluation. |
Generate impression based on findings. | 75-year-old male with pulmonary fibrosis, right middle lobe pneumonia on admission now with worsening shortness of breath and increased O2 requirement LUNGS AND PLEURA: Bilateral pleural effusions are present. Severe basilar predominant bronchiectasis with superimposed groundglass opacities. Intralobular septal thickening with groundglass opacities. Underlying moderate paraseptal emphysema is noted. Tracheobronchomalacia is present.Multiple calcified lymph nodes along the right major fissure, the largest measuring 10mm in short axis. No pneumothorax. MEDIASTINUM AND HILA: Median sternotomy wires and fixation plates. Multiple calcified mediastinal and hilar lymph nodes are identified. Severe cardiomegaly without pericardial effusion. Severe coronary artery calcification. Atherosclerotic calcification of the aorta and branch vessels. Pulmonary artery enlargement and wall calcification suggestive of long-standing pulmonary artery hypertension. Left chest wall ICD with leads in right atrium, right ventricle, and coronary sinus. Rounded, 20 Hounsfield unit lesion in the right cardiophrenic angle measures 4.0 cm (series 4, image 73), previously 2.4 cm, probably a lymph node, enlarged but of unclear clinical significance.CHEST WALL: No suspicious osseous lesions. No significant axillary, cardiophrenic, or retrocrural lymphadenopathy.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Interlobular septal thickening with groundglass opacities and pleural effusions is compatible with pulmonary edema superimposed on chronic interstitial lung disease. A repeat examination after appropriate fluid management is recommended for more accurate evaluation for ILD progression. No specific signs of pneumonia; abnormality on chest radiograph confirmed be loculated fluid in the fissures. |
Generate impression based on findings. | Lung cancer, follow-up following chemotherapy CHEST:LUNGS AND PLEURA: Continued interval improvement of the large necrotic lingular mass, which again extends to left side of the mediastinum, currently measuring 4.5 x 4.1 cm (image 49 series 3) with additional decreased in fullness in left lobularity. Associated decreased size and flattening of the adjacent satellite nodule, previously 1.4 x 1 .2 cm, currently 1.1 x 0.8 cm (image 54 series 4).Additional scattered subcentimeter nodules remain stable. No pleural effusions are additional suspicious lesions. Mild upper lobe predominant centrilobular emphysemaMEDIASTINUM AND HILA: Interval continued improvement and now resolution of lymphadenopathy.The reference left hilar node is currently not measurable are visualized . The AP window node is currently 7 mm, previously 10 mm (image 45 series 3). Scattered calcified mediastinal lymph nodes unchangedCardiac and pericardial appearance unremarkableCHEST WALL: Old deformities involving the left seventh and eighth ribs, continued healing. Degenerative changes similarABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hemangioma in the dome of the liver unchanged. No suspicious hepatic lesions, gallbladder unremarkableSPLEEN: Old granulomatous disease exposureADRENAL GLANDS: Left adrenal nodule unchanged KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval improvement with decreased reference measurements and no new superimposed acute abnormalities |
Generate impression based on findings. | 72 year-old female status post T10-L2 spinal fusion. Two views of the lumbar spine demonstrate intrapedicular screws at T12 through L3 with posterior stabilization rods, not significantly changed when compared to prior. Associated laminectomy and underlying degenerative changes are stable. Alignment is near-anatomic. Interval removal of surgical drain. Multiple surgical clips lie anterior to the lower lumbar and sacral spine. There is no radiographic evidence of hardware complication. | Stable appearance of surgical fixation of T12 through L3, without radiographic evidence of hardware complication. |
Generate impression based on findings. | Male, 67 years old, history of base of tongue squamous cell carcinoma status post CRT with fibrosis, status post multiple esophageal dilatations with dysphagia and aspiration risk. Left lower lobe crackles noted on the exam. Treatment related findings are again seen including mild low attenuation thickening of the pharyngeal and supraglottic laryngeal mucosa, as well as volume loss and infiltration through the fascial planes of the neck and subcutaneous reticulation.Within this background, no definite evidence of any re-current mucosal tumor is seen. There is no pathologic adenopathy detected in the neck by size criteria.Note is made of reflux of enteric contrast material into the esophagus. The salivary glands demonstrate a normal posttreatment appearance. The thyroid is free of focal lesions. The cervical vessels enhance with mild atherosclerotic calcification of the carotid bifurcations. No concerning or frankly destructive osseous lesions are demonstrated. Interval loss of several mandibular teeth is noted. | 1. Redemonstration of a colitis findings in the neck with no evidence of recurrent mucosal tumor or pathologic adenopathy.2. Reflux of enteric contrast into the esophagus is noted incidentally. |
Generate impression based on findings. | Female 64 years old; Reason: r/o hematoma History: anemia ABDOMEN:LUNGS BASES: Minimal atelectasis/scarring in the lung bases.LIVER, BILIARY TRACT: No focal hepatic lesion. Gallbladder filled with contrast material.SPLEEN: Calcified splenic granuloma.PANCREAS: Hypodense pancreatic lesions better characterized on recent enhanced CT.ADRENAL GLANDS: No adrenal nodularity or thickening.KIDNEYS, URETERS: Status post left nephrectomy. In the right kidney, there are two areas of cortical heterogeneity without significant perinephric stranding. Appearance may be secondary to phase of contrast given recent contrast dose from neurointerventional procedure, though pyelonephritis should be excluded clinically. Right nephroureteral stent redemonstrated with stable mild right hydronephrosis. Stable subcentimeter right renal hypodensities, too small to further characterize. Punctate nonobstructing right renal stone.RETROPERITONEUM, LYMPH NODES: Status post aorto-bifemoral graft and right femoral-popliteal bypass graft. Large abdominal aortic aneurysm and femoral artery aneurysms are better characterized on recent dedicated CTA.BOWEL, MESENTERY: Bowel is normal in caliber without evidence of obstruction or ileus.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: New perihepatic high density free fluid, likely representing blood product. Upper abdominal drain enters right of midline and coils in the left upper quadrant.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Contrast material fills the bladder. Foley catheter are noted in the bladder lumen.LYMPH NODES: Single prominent stable nonspecific left pelvic lymph node.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Increased pelvic free fluid, now small to moderate in volume and of high density, which may represent hemorrhage from recent left femoral arterial access for aneurysm coiling. | 1.Small to moderate likely blood product in pelvis and Morison's pouch. No clear etiology is identified.2.Areas of wedge shaped hypodensities in the right kidney; while this may be artifactual from retained contrast, pyelonephritis should be excluded clinically.Findings related to on to Dr. Mansour at 4:26 p.m. on 3/11/2015. |
Generate impression based on findings. | 44-year-old female with history of AML, lung nodules status post chemotherapy. Please evaluate lung nodules from 1/4 and 1/14 LUNGS AND PLEURA: Interval decrease in size of right-sided nodules with surrounding groundglass (series 5, image 87 and 151). Persistent peripherally located right lower lobe nodule (series 5, image 199) appears similar to that seen on the prior CT 1/14/15 but increased since the CT 1/4/15. MEDIASTINUM AND HILA: No significant mediastinal hilar lymphadenopathy. The heart size is normal pericardial effusion. No appreciable coronary artery calcification. Right upper extremity PICC tip is at the superior vena cava.CHEST WALL: No axillary, retrocrural, or cardiophrenic lymphadenopathy. The osseous structures are within normal limits. No suspicious osseous lesions.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Unchanged hypodense lesions in the right lobe of the liver. | 1.Interval decrease in size of right-sided nodules with surrounding groundglass likely post-infectious. 2.Persistent peripherally located right lower lobe nodule likely infectious in etiology is unchanged since the prior exam. |
Generate impression based on findings. | HNC and CRT. CHEST:LUNGS AND PLEURA: Centrilobular emphysema. Mild paramediastinal radiation reaction. Dependent atelectasis in the costophrenic angles. Small left pleural fluid collection is new.MEDIASTINUM AND HILA: Circumferential proximal to mid esophageal wall thickening with interval stent placement. No pneumomediastinum. Normal heart size. Physiologic volume of pericardial fluid.Superior mediastinal perivascular fat infiltration new from the previous study of could be related to radiation therapy.Enhancing lymph nodes in the low right paratracheal (3/40) and subcarinal regions (3/46). For reference, a low right paratracheal lymph node measures 12 mm short axis, previously 5 mm, now suspicious for a nodal metastasis.Nonenlarged but enhancing hilar lymph nodes bilaterally unchanged.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: 17 mm subcapsular lesion in the anterior liver (3/77) and a second subcentimeter lesion near the portal hilum in the left lobe (3/92) are new from the previous examinations.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Nodular thickening left adrenal gland unchanged.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe, long segment stenosis of the superior mesenteric artery due to the atherosclerotic calcifications. Renal artery calcifications noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Gastrostomy tube retention device in the stomach.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. New indeterminate hepatic lesions, recommend dedicated hepatic CT for further characterization.2. Interval enlargement of low right paratracheal lymph node. Additional lymph nodes not significantly changed in size but have an abnormal enhancement pattern, indeterminate.3. No pulmonary metastases.4. Circumferential long segment proximal to mid esophageal thickening and periesophageal inflammatory changes with interval stent placement. |
Generate impression based on findings. | 76-year-old female with 3 week history of right hip pain requiring walker. Two views of the right hip demonstrates mild degenerative changes of the right hip, including subchondral sclerosis and joint space narrowing. There is no evidence of acute fracture or malalignment. | Mild degenerative changes without acute abnormality. |
Generate impression based on findings. | Cervical spine alignment is anatomic. Vertebral body heights are normal. There is no fracture or subluxation. There is no CT evidence of significant spinal canal or neural foraminal stenosis at any level. The visualized soft tissues in the neck appear normal. The partially visualized skull base appears normal. | No CT evidence of cervical spinal canal stenosis. If there is high clinical suspicion of extrinsic cord compression, a myelogram could be considered. |
Generate impression based on findings. | 12 years old, Female, Reason: Evaluate shunt setting, lumbo peritoneal shunt VIEWS: Shunt series: abdomen AP/lateral (two views) 3/11/15 Intraspinal catheter tip is at T8/T9 level. Catheter exits the spinal canal at L3-L4. There is no evidence of discontinuity or kinking of the shunt catheter. The programmable valve system is at approximately 60 millimeters water. Bowel gas pattern is nonobstructive and disorganized. | Valve set at 60 mm of water. No discontinuity or kinking of the shunt catheter. |
Generate impression based on findings. | CT HEAD:There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. CTA HEAD: There is a marked decrease in caliber of the bilateral internal carotid arteries just distal to the opthalmic arteries with narrowing and mild irregularity of the bilateral communicating segments as well as the M1 segments, right greater than left, and the A1 segments, left greater than right. There is also questionable mild narrowing of the bilateral P1 and proximal P2 segments of the posterior cerebral arteries. There is mild prominence of the bilateral lenticulostriate arteries suggestive of early collateralization. There is no evidence of aneurysm. | Findings suggestive of early/mild Moya Moya. Continued follow-up with MRA is suggested. |
Generate impression based on findings. | 75-year-old female with lumbar pain. Two views of the lumbar spine demonstrate mild scoliosis. Hardware components related to a total left hip arthroplasty are evident; redemonstration of increased density in the left acetabulum, presumably bone graft versus cement. No evidence of acute fracture or malalignment. | No evidence of acute fracture or malalignment. |
Generate impression based on findings. | Hip/back pain. Assess for osteoarthritis. Three views of the sacroiliac joints are unremarkable. Five views of the lumbar spine reveal no acute fracture. Alignment is anatomic. Vertebral body heights are maintained. | No specific evidence of osteoarthritis of the sacroiliac joints or lumbar spine. |
Generate impression based on findings. | No discrete mass is appreciated in the sublingual space. Please note prior MRI and PET studies are not available for comparison. There is irregular nodular contour involving the right submandibular gland anteroinferiorly which may be related to post surgical change. There is a 3-mm hyperdense structure within the right sublingual space presumably representing surgical clip. There is linear area of hypoattenuation more posteriorly which may represent a dilated duct. There is mild thickening in the overlying neck soft tissues. Small scattered lymph nodes are seen in the neck which are not suspicious by CT criteria.Remainder of the salivary glands are unremarkable. There are no thyroid masses. Cervical vasculature is patent. The partially imaged intracranial structures unremarkable.. The visualized portions of the paranasal sinuses and mastoid air cells are clear. No destructive osseous lesions.There are multiple bilateral lung nodules and a loculated appearing right pleural effusion. | 1.Postsurgical changes involving the right sublingual and submandibular spaces. Mild nodularity involving the right submandibular gland may be postsurgical. No discrete mass is appreciated to suggest gross residual tumor. Comparison with prior PET and MRI would be helpful however to better assess for residual tumor. No significant cervical lymphadenopathy.2.Loculated right pleural effusion and multiple bilateral lung nodules are partially visualized. Please refer to separate report for findings in the chest. |
Generate impression based on findings. | 65-year-old female with history of localized renal cancer, assess for recurrence CHEST:LUNGS AND PLEURA: Minimal bibasilar dependent atelectasis. MEDIASTINUM AND HILA: Reference right paratracheal lymph node is not significantly changed measuring 10 mm (series 3, image 31) with a fatty hilum favoring benign etiology. Additional scattered subcentimeter mediastinal lymph nodes. No significant hilar lymphadenopathy. Heart size is normal. No pericardial effusion. Mild coronary artery calcification. CHEST WALL: No significant abnormality 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: Amorphous soft tissue density in the left renal surgical bed, adjacent to the pancreatic tail and superior to the left renal pole is again noted. There is slight interval increase in soft tissue component , for example, series 3, image 92. This is nonspecific and may represent fat necrosis and postsurgical changes although local recurrence cannot be completely excluded. PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Amorphous lesion in the left renal surgical bed with slightly increased soft tissue components is of unclear etiology. A dedicated renal protocol examination is recommended given limitation in assessment by this technique protocoled for thoracic pathology. 2.No evidence of pulmonary metastasis. 3.Sensitivity of this examination to evaluate for local renal cancer recurrence is markedly limited due to timing and single phase of contrast. A dedicated renal protocol is recommended when feasible. |
Generate impression based on findings. | 54-year-old male with cervicalgia. Multilevel degenerative changes in the cervical spine, including disk space narrowing at C4/C5 and C5/C6, with anterior osteophyte formation. There is no evidence of acute fracture or malalignment. No significant soft tissue swelling. | There is no acute fracture or malalignment. |
Generate impression based on findings. | Head and neck cancer CHEST:LUNGS AND PLEURA: Unchanged postsurgical scarring observed in the right lung base secondary to resection. No suspicious new nodules or masses or evidence of recurrence yet two stable small sub centimeter nodules in the right lower lobe (arrows). No effusions. Mild scarring and/or atelectasis persists. MEDIASTINUM AND HILA: No lymphadenopathy.The cardiac and pericardium are within limitsSmall hiatal hernia and diaphragmatic Bochdalek herniaCHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable small subcentimeter hypodensities likely representing benign cysts, unchanged. Gallbladder unremarkableSPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts are all unchanged.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology. No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of interval change or metastatic disease. |
Generate impression based on findings. | Hand pain. Evaluate for inflammatory arthritis. Three views of the left hand reveal no acute fracture or or malalignment. No evidence of erosive change. Three views of the right hand reveal no acute fracture or malalignment. No evidence of erosive change. | No specific radiographic evidence of an inflammatory arthropathy. |
Generate impression based on findings. | 46 year old female with history of distal fibular fracture, status post surgical fixation. Three views of the right ankle again demonstrate sideplate and screws affixing the distal fibular fracture, in near-anatomic alignment. The fracture lines are nearly nonvisible, consistent with interval healing. There is also interval healing of the medial and posterior malleolar fractures. Unchanged appearance of mild tibiotalar osteoarthritis. A plantar heel spur is present. | Continued interval healing status post orthopedic fixation of distal fibular fracture in near-anatomic alignment. |
Generate impression based on findings. | 20 year-old female patient with GI bleed. Evaluate location. ABDOMEN:LUNG BASES: Left basilar atelectasis/scarring.LIVER, BILIARY TRACT: Again seen is focal fatty infiltration in the region of the ligament of teres.SPLEEN: No significant abnormality noted.PANCREAS: Findings suggestive of pancreatic divisum, a normal variant.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Numerous bilateral renal cysts, the majority of which are too small to characterize. Largest cystic lesions in both kidneys appear to be cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Again seen are multiple loops of thickened and matted small bowel, primarily ileum, in the pelvis. There is active extravasation of contrast into a loop of ileum in the pelvis that is located posteriorly (series 8 image 111). Again seen is a dominant rim enhancing fluid collection in the deep pelvis that measures 2.3 x 1.4 cm (series 10 image 128), not significantly changed compared to prior examination.Submucosal fat deposition in the cecum and descending colon are compatible with chronic inflammation.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: See above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Right lower extremity central venous catheter with tip in the inferior vena cava. | 1.Findings compatible with intraluminal gastrointestinal bleed in a loop of ileum that is matted and thickened in the pelvis.2.Additional findings appear similar compared to prior exam. |
Generate impression based on findings. | Metastatic thyroid cancer restaging CHEST:LUNGS AND PLEURA: Bilateral pulmonary nodules, the majority of which are unchanged however the index lesion on the left (5/37) has increased in size from 4 to 6-mm. Dominant lesion near the right hilum measures 15 mm, previously 12-mm (5/43, not index lesion). No new nodules or pleural fluid.MEDIASTINUM AND HILA: Postsurgical changes of a thyroidectomy. Small lymph node adjacent to the left jugular vein (3/4) not included in the scanning range previously, please refer to separately reported neck CT. Small mediastinal lymph nodes similar to previous. No pericardial fluid. Mild coronary artery calcifications. Upper normal heart size.CHEST WALL: Unchanged subtle sclerotic rib foci.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesions in the right lobe are too small to accurately characterize but were present previously in 2012 and are therefore likely benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Small nodule in the lateral limb of the right adrenal gland has been present since 2012, likely benign.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications of the aorta and its branches. Small lymph nodes are unchangedBOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Chronic thickening of the gastric antrum unchanged.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Although the majority of the pulmonary nodules are unchanged, a few measure larger. |
Generate impression based on findings. | Pain. Two views of the left femur reveal no acute fracture or malalignment.Two views of the right femur reveal no acute fracture or malalignment. | No specific findings to account for patient's symptoms. |
Generate impression based on findings. | 36-year-old female status post orthopedic fixation of trimalleolar fracture. Three views of the left ankle demonstrate interval placement of fibular sideplate and screw fixation of the distal fibular fracture as well as syndesmotic fixation screw and two K wires in the medial malleolus, in near-anatomic alignment. The fracture fragments of the lateral, posterior, medial malleolus are less conspicuous than on the previous study, indicative of interval healing. | Hardware components related to trimalleolar fracture fixation in near-anatomic alignment. Interval healing of fracture fragments. |
Generate impression based on findings. | Back pain. Two oblique views of the lumbar spine reveal no acute fracture or malalignment. There are bilateral iliac horns consistent with Fong's disease, " nail-patella syndrome". | 1. No acute fracture is evident.2. Bilateral iliac horns compatible with Fong's disease. |
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