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Generate impression based on findings. | 76 year old with history of left lumpectomy in 1993 for DCIS, status post radiation therapy. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. There are stable postsurgical changes in the left breast including architectural distortion, volume loss and dystrophic calcifications in the lumpectomy bed. There are scattered bilateral benign calcifications.No new masses or suspicious microcalcifications are present in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 23-year-old female with pain and swelling over the lateral and medial malleolus of the left ankle after falling off of a stage. Three views of the left ankle limited normal anatomic alignment. There is no evidence of acute fracture. There is moderate soft tissue swelling of the medial malleolus. | No acute fracture or malalignment. |
Generate impression based on findings. | Male, 4 months old. Respiratory distress. Evaluate for pneumonia.VIEW: Chest AP (one view) 3/11/2015, 1743 The aortic arch, cardiac apex, and stomach are left-sided.The cardiothymic silhouette is normal.Large lung volumes and moderate peribronchial thickening. Streaky perihilar opacities, most compatible with atelectasis. No pleural effusion or pneumothorax. | Bronchiolitis pattern. No specific evidence of pneumonia. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (2/2/15, 2/4/15), ultrasound images of left breast (2/4/15), images from ultrasound guided biopsy and post procedural left mammographic images (2/9/15) performed at St James Hospital. For comparison, digital mammographic images (10/10/13) are available. DIGITAL MAMMOGRAPHIC IMAGES (2/2/15, 2/4/15):The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Within the asymmetry at upper outer quadrant in the left breast, there is an area of developing dense tissue measuring approximately 3 x 2 cm. With tomosynthesis images, this density is likely an ill-defined mass. there are two clusters of developing calcifications at the vicinity of this mass.No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in the right breast. ULTRASOUND IMAGES OF LEFT BREAST (2/4/15):There is a microlobulated hypoechoic mass, measuring 29 x 7 mm, at 12 o'clock position, 6 cm from nipple, in the left breast, corresponding to the mass seen on the mammogram. There are a few linear hypoechoic structures extending from the main mass, suggesting ductal extension of this lesion.IMAGES FROM ULTRASOUND GUIDED BIOPSY AND POST PROCEDURAL LEFT MAMMOGRAPHIC IMAGES (2/9/15):Needle biopsy is performed under ultrasound guidance for the left breast mass at 12 o'clock position, which appropriate needle placement. A marker clip is placed within the mass. Post procedural left mammographic images show a marker clip is in the ill-defined mass.Per outside pathology report, the biopsy result was malignant, invasive ductal carcinoma, poorly differentiated, grade 3. | Biopsy proven left breast carcinoma. Given the presence of possible intraductal extension on ultrasound, breast MRI would be helpful in evaluating extent of disease.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 18 year-old male with pain and swelling over the lateral malleolus status post fall 3 days ago. Three views of the right foot and show normal anatomic alignment, without evidence of acute fracture or other abnormality.Two views of the right ankle demonstrate normal anatomic alignment and without evidence of fracture or acute abnormality. There is mild soft tissue swelling. | No acute fracture or malalignment. |
Generate impression based on findings. | 68 year-old female patient with history of spinal stenosis/scoliosis status post posterior spinal fusion with continued leukocytosis and shortness of breath. ABDOMEN:LUNG BASES: Bilateral pleural effusions with overlying atelectasis.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Two subcentimeter hypoattenuating lesions in the left kidney are too small to characterize and likely represent cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse anasarca is noted. T10 to S1 posterior fusion hardware noted. OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: Air in the bladder is likely iatrogenic.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Diffuse anasarca is noted. There is 4.8 x 5.5 x 10.2 cm (series 15 image 63 and series 81168 image 46) air-fluid collection without associated rim enhancement in the right lateral abdominal subcutaneous tissues.Subcutaneous air is noted in the soft tissues of the anterior right thigh. This air collection does not communicate with the fluid collection along the abdominal wall. Recommend correlation with prior instrumentation.Left hip arthroplasty with associated streak artifact that limits evaluation of adjacent structures.OTHER: No significant abnormality noted. | 1.Fluid collection in the right lateral abdominal subcutaneous tissues may represent a postoperative seroma, however, infection cannot be excluded.2.Bilateral pleural effusions. Please refer to dedicated CT chest PE performed the same day for complete chest details. |
Generate impression based on findings. | 51-year-old female with nontraumatic infection of the distal right third finger. Significant soft tissue swelling and soft tissue defect of the distal aspect of the third digit. Cortical indistinct along the palmar aspect of the distal tuft is suggestive of osteomyelitis. | Soft tissue defect and surrounding swelling of the distal third digit is compatible with stated history of felon. The cortex of the distal tuft appears indistinct along the palmar aspect, suggestive of osteomyelitis. |
Generate impression based on findings. | Status post hemi-crani, pupil inequality Interval postsurgical changes of left frontotemporoparietal craniectomy are seen with interval improvement in rightward midline shift from approximately 10 mm to 7 mm at the level of the foramen of Monro. Again seen is intraparenchymal hematoma centered within the left subinsular region measuring approximately 6.1 x 3.6 cm extending superiorly into the left frontal and parietal lobes. Again seen is subarachnoid hemorrhage within the left sylvian fissure with additional foci of subarachnoid hemorrhage in the left frontal and temporal lobes which demonstrate interval evolution. Interval improvement in previously seen left-sided uncal herniation is also noted. Again seen is hypoattenuation compatible with prior infarcts involving the right inferior cerebellar hemisphere. Multiple additional areas of hypoattenuation including the right pons and right anterior basal ganglia also again noted. Mild entrapment of the right lateral ventricle is again seen. No hydrocephalus. There is a left-sided surgical drain at the level of the craniectomy. | Interval postsurgical changes of left hemi-craniectomy and improvement in rightward midline shift from 10 mm to 7 mm at the level of the foramen of Monro and improvement in uncal herniation. |
Generate impression based on findings. | Female 54 years old Reason: HBV carrier, s/p chemo, on Baraclude, eval for lesions History: HBV LIVER: Coarse echotexture. 13.6 cm in length. No evidence of cirrhotic morphology. No focal lesions.Flow in the portal vein is hepatopedal, peak velocity .2 m/sec.GALLBLADDER, BILIARY TRACT: Gallbladder polyp .9 x 6 x 0.6 cm unchanged from 7/14/11.No gallstones. No intrahepatic or extrahepatic biliary dilatation. Common hepatic and common bile duct measured .3 cm diameter respectively.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Morphologically normal 10.2 cm in length.OTHER: Left kidney morphological 10.8 cm length.Spleen 9.4 cm in length.Evidence of ascites. | Coarse hepatic echotexture without evidence of focal lesions or cirrhotic morphology. No signs of portal hypertension. Stable size gallbladder polyp. |
Generate impression based on findings. | 65-year-old female with history of pleuritic chest pain and tachycardia. History of breast cancer now on tamoxifen. Evaluate for pulmonary embolus. PULMONARY ARTERIES: Technically adequate study to the level of the segmental branches. There is no evidence of acute pulmonary embolus or right heart strain.LUNGS AND PLEURA: There is mild bibasilar atelectasis. Mild diffuse bronchial wall thickening is present. No evidence of pulmonary infarction.MEDIASTINUM AND HILA: Heart size mildly enlarged. No pericardial effusion. No significant mediastinal lymphadenopathy. Mild coronary artery calcifications. Calcified lymph nodes in the left hilum likely the result of prior granulomatous disease. Right thyroid hypodensity measures 2.4 x 1.6 cm.CHEST WALL: Status post left mastectomy.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Large cholelithiasis is incompletely imaged. Splenic calcifications likely the result of prior granulomatous disease. | 1. No evidence of acute pulmonary embolus.2. Mild diffuse bronchial wall thickening may indicate bronchitis or reactive airways disease.3. 2.4 cm thyroid nodule is incompletely evaluated. If patient care warrants further imaging, a dedicated ultrasound is recommended.4. Cholelithiasis.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Right lower quadrant pain ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left renal cystRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Negative for acute, traumatic, inflammatory, or neoplastic process. |
Generate impression based on findings. | Female 93 years old Reason: eval for evidence of infectious process History: nausea, vomiting, diarrhea, leukocytosis with bandemia, elevated AG, elevated lactate ABDOMEN:LUNG BASES: Atelectasis. No effusions.LIVER, BILIARY TRACT: There is a new hypoattenuating lesion in segment 5 just dorsal to the gallbladder, measured on series 2 image 60, 2.6 x 2.4 cm.Hypoattenuating lesion in segment 4 A. series 3 image 35, .9 x 0.8 cm. Previously 1.2 x 0.9 cm. Second smaller hypoattenuating lesion in the left lobe in segment IVb serious image 40 is unchanged.No evidence of portal or hepatic vein thrombus or biliary dilatation.SPLEEN: No significant abnormality notedPANCREAS: Hypoattenuating pancreatic mass in the region of the pancreatic neck abutting the stomach and posterior margin of the lateral segment of left lobe of the liver seen on series 3 image 58 where it measures 4.1 x 2.5 cm. I believe on the previous scan measurements include normal pancreas as seen on series 11 image 47 and I remeasure it as 2.8 x 2.2 cm on that study.ADRENAL GLANDS: Bilateral adrenal thickening unchanged. Possible small nodule left adrenal gland unchanged.KIDNEYS, URETERS: Hypervascular mass in the upper pole measures 6.2 x 4.3 cm series image 40 increased compared to 9/28/10 when it measured 3.3 x 3.6 cm. Most consistent with renal cell carcinoma.Somewhat exophytic lesion off the posterior aspect of the right lower pole also has characteristics of a solid lesion measuring 1.5 x 1.4 cm series 2 image 65. Previously 1.4 x 1.4 cm.The left kidney also has a hypoattenuating lesion suspicious for neoplasm in the lateral aspect of the mid kidney series 2 image 47 measuring 1 cm in diameter proximal unchanged. The other lesions in the left kidney are likely cysts. There is no hydronephrosis.No new lesions.RETROPERITONEUM, LYMPH NODES: Atherosclerotic disease suggestion of some ulcerated plaque. No evidence of aneurysm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Loculated nonenhancing fluid collections without solid component seen in the right lower quadrant and right pelvic inlet slightly increased in extent compared to the prior exam. Etiology unknown. Differential diagnostic considerations include benign cystic neoplasms of the mesentery.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Masses in the pancreas and both kidneys as measured above. At least one new lesion in the liver differential diagnostic consideration includes a neoplasm or in this clinical context abscess. No other findings to explain signs of infection.Slightly increased size of loculated fluid collections in the right lower quadrant and mesentery. |
Generate impression based on findings. | Metastatic breast carcinoma CHEST:LUNGS AND PLEURA: Interval resolution of right upper lobe airspace opacity.MEDIASTINUM AND HILA: Interval increase in size of mediastinal adenopathy. Reference prevascular fluid focus best seen on image 19 of series 3 unchanged measuring 2.6 x 1.6 cm.CHEST WALL: Stable sclerotic bony metastases.ABDOMEN:LIVER, BILIARY TRACT: Interval increase in size and number of numerous confluent bilobar hepatic metastatic lesions. Reference hepatic dome lesion best seen on image 59 of series 3 now measures 3.3 x 2.3 cm; this is in comparison to 2.1 x 1.8 cm on 1/29/2015.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Interval increase in size of metastatic retroperitoneal adenopathy. Reference aortocaval lymph node best seen on image 119 of series 3 now measures 1.9 x 1.6 cm; this is in comparison to 1.1 x 1.0 centimeters on 1/29/2015BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable sclerotic bony lesions.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Interval increase in size of reference right obturator lymph node best seen on image 161 of series 3 measuring 1.6 x 2 cm; this is in comparison to 1.8 x 1.3 cm on 1/29/2015.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable sclerotic bony metastatic lesions.OTHER: No significant abnormality noted. | Progression of metastatic disease manifest by interval increase in size of mediastinal, retroperitoneal, and pelvic adenopathy as well as interval increase in size and number of bilobar hepatic metastases. |
Generate impression based on findings. | 20 year-old female with chest pain, evaluate for pulmonary embolism PULMONARY ARTERIES: Adequate pulmonary artery opacification without evidence of pulmonary embolism to the segmental arterial level. The main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: No pneumothorax. Small bilateral pleural effusions. Bilateral dependent atelectasis. New right middle lobe nodular ground glass opacities (series 9, image 193). New dense focal opacity in the lateral basal segment of the right lower lobe may represent infarct (series 9, image 180).MEDIASTINUM AND HILA: Heart size is top normal. No pericardial effusion. No coronary artery calcification. No significant mediastinal lymphadenopathy. Mildly prominent right hilar lymph node appears similar to the prior exam.CHEST WALL: Mildly prominent bilateral axillary lymph nodes. No significant retrocrural, cardiophrenic, or subpectoral lymphadenopathy. The osseous structures are within normal limits. No suspicious osseous lesions.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Status post cholecystectomy. Probable left renal cyst appears similar to the prior exam. Status post splenectomy. | 1.No direct evidence of acute pulmonary embolism.2.New focal opacity in the lateral basal segment of the right lower lobe is suggestive of infarct, possibly due to a recent small pulmonary embolus or vascular sludging/thrombosis secondary to sickle cell disease. 3.New right middle lobe nodular ground glass opacities are nonspecific and may represent early infarct, atelectasis, or infection. PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 35-year-old male patient status post renal biopsy and abdominal pain. Evaluate for bleeding from renal biopsy site. Exam is not sensitive for detecting lesions in the bowel and solid organs due to the lack of oral and intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral atrophic native kidneys.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Transplanted kidney noted in the left iliac fossa. There is a small to medium sized fluid collection inferior to the kidney (series 3 image 68 and coronal series 80232 image 72) that measures water density. There are no fluid levels in this collection. Note that a fluid collection was noted on prior ultrasound on 3/7/2015. | Nonspecific peritransplant low density fluid collection may represent urinoma or seroma and less likely hematoma. |
Generate impression based on findings. | Metastatic prostate cancer treated with 3 cycles of chemotherapy. There has been interval decrease in size bilateral cervical lymphadenopathy and partially imaged superior mediastinal lymphadenopathy. For example, the left supraclavicular lymphadenopathy now measures 23 x 20 mm, previously 86 x 53 mm, a right level 5A lymph node measures 7 x 5 mm, previously 19 x 14 mm, and a left level 5A lymph node measures 10 x 8 mm, previously 22 x 19 mm. The inferior portions of the left internal jugular artery are now patent. The left common carotid artery is surrounded the lymphadenopathy as well, but appears to be grossly patent. The airways are patent. The thyroid and major salivary glands are unremarkable. There is a sclerotic lesion in the partially-imaged manubrium. There is congenital fusion of the C2 and C3 vertebrae. There is multilevel degenerative spondylosis, including severe neural foramen stenosis at C3-4 bilaterally. There is a lipoma deep to the trapezius muscle, which measures up to approximately 55 mm. The imaged intracranial structures are unremarkable. There is a small retention cyst within the left maxillary sinus. The imaged portions of the lungs are clear. | 1. Interval decrease in size of the bilateral cervical lymphadenopathy and partially imaged superior mediastinal lymphadenopathy related to metastatic disease. 2. A lesion in the partially-imaged manubrium is compatible with metastatic disease. Please refer to the separate bone scan report for additional details. |
Generate impression based on findings. | 44-year-old female with history of swelling, pain, and fever. Evaluate for right axillary abscess. LUNGS AND PLEURA: Scattered nonspecific pulmonary micronodules are present. Mosaic attenuation of the lower lobes is nonspecific but may be secondary to obstructive small airways disease. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Heart size normal without pericardial effusion. Large mixed attenuation subcarinal mass with early internal calcifications measures 4.5 x 3.3 x 2.2 cm. An additional heterogeneous mass is present within the right hilum measuring 2.2 x 2.6 cm in maximum axial dimensions. Focus of air adjacent to the bronchus intermedius is nonspecific.CHEST WALL: There is an ovoid subcutaneous density measuring 1.3 x 1.6 cm in the right axilla which communicates with the overlying skin surface likely representing a resolving abscess. There is asymmetric breast tissue on the left.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Splenic microcalcifications likely the result of prior granulomatous disease. | 1. Small right axillary density communicating with the skin surface likely representing a resolving abscess.2. Bulky right hilar and subcarinal lymphadenopathy or mass is nonspecific, however given patient's large ischial fossa abscess, disseminated infection is a possibility. Follow-up is recommended.3. Asymmetric left breast tissue for which dedicated breast imaging is recommended.4. Focus of air density adjacent to the bronchus intermedius is nonspecific but likely represents a small diverticulum. |
Generate impression based on findings. | Metastatic SCLS to brain. Word finding difficulty. Falls. Head:No intracranial hemorrhage is identified. No intracranial mass or evidence of mass-effect. Please note noncontrast CT is insensitive for small metastatic lesions. Previously seen lesions involving the bilateral frontal lobes and MRI dated 1/6/2015 are not definitively appreciated. No midline shift or uncal herniation. Gray-white differentiation is maintained. There is global parenchymal volume loss commensurate with age. No hydrocephalus. No extra-axial collections. The visualized portions of the paranasal sinuses are clear. Mastoid air cells are clear. Calvarium is intact with nonspecific areas of lucency and no large destructive lesions. Small scalp lipoma noted at the vertex.Cervical Spine:There is no acute fracture or subluxation within the cervical spine. Vertebral body heights are normal. There is mild retrolisthesis of C3 on C4 and minimal retrolisthesis of C5 on C6. There is loss of normal cervical lordosis. Alignment is otherwise maintained.There are small foci of heterotopic ossification anterior to the anterior arch of C1. There are extensive degenerative changes throughout the cervical spine with severe loss of intervertebral disk space at the C3-C4, C5-C6, C6-C7, C7-T1 as well as the T1-T2 levels. There are prominent ventral osteophytes at the C3-C4 and C4-C5 levels. There is a posterior calcified disk osteophyte complex at the C3-C4 level.There is at least mild spinal canal stenosis at the C3-C4 and the C5-C6 levels. There is moderate right C3-4, moderate left C5-C6, and moderate right C6-C7 neural foraminal stenosis.Mild emphysematous changes in the lung apices. | 1. No evidence of intracranial hemorrhage or mass effect. Please note CT is insensitive for the detection of acute non-hemorrhagic infarcts as well as small metastatic lesions, and MRI with gadolinium should be considered if there is continued clinical suspicion. Previously seen lesions involving the bilateral frontal lobes on MRI dated 1/6/2015 are not definitively appreciated. 2. No acute fracture or subluxation within the cervical spine. Multilevel degenerative changes as detailed above. |
Generate impression based on findings. | 65-year-old male with liver failure. Evaluate hepatic inflow and outflow for obstruction. Limited exam due to patient body habitus. PORTAL VENOUS: The portal vein is patent with appropriate directional flow. Maximal velocity at 0.21 m/s. HEPATIC ARTERIES: Patent with appropriate directional flow. The resistive index for the right hepatic artery is 0.53. The resistive index for the left hepatic artery is 0.44.HEPATIC VEINS: Patent left, middle, and right hepatic veins with appropriate directional flow. INFERIOR VENA CAVA: The visualized IVC is patent with appropriate directional flow. OTHER: No significant abnormality noted. | Patent inflow and outflow vasculature of the liver. |
Generate impression based on findings. | 55 year old with history of right lumpectomy with adjuvant radiation therapy and chemotherapy in 2005. History of benign biopsy of the left breast in 2010. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Postsurgical architectural distortion and dystrophic calcifications are re-demonstrated in the right breast without significant change. There is a stable percutaneously placed biopsy clip marker in the lateral central left breast at 3 o'clock. A stable cyst is present in the left upper outer quadrant. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | There are stable post-treatment findings related to right tonsillectomy with flap reconstruction, bilateral neck dissection, radiation therapy, and right vocal cord augmentation. There is unchanged fatty degeneration of the right hemitongue, likely related to denervation. The airway is patent. The remaining salivary glands appear unchanged. The thyroid gland is atrophic. There is diffuse mild to moderate low attenuation plaque in the bilateral carotid arteries. The right internal jugular vein is not identified. The osseous structures are unchanged. The imaged intracranial structures are unremarkable. There is a stable subcutaneous lesion in the lower posterior neck measuring 23-mm, which likely represents a sebaceous cyst. There is radiation fibrosis in the bilateral lung apices. | 1. Stable post-treatment findings without convincing evidence of locoregional tumor recurrence or significant cervical lymphadenopathy.2. Contrast extravasation in the right arm without neurovascular compromise. The patient was treated with cold compresses and arm elevation. The patient was given discharge instructions. |
Generate impression based on findings. | Female 52 years old Reason: 52 y.o. female with a h/o total proctocolectomy in 2013, with non-healing perineal wound. Please eval for fistula, History: non-helaing perineal wound UTERUS, ADNEXAE: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Status post proctocolectomy. Colostomy left lower quadrant with large parastomal hernia containing omentum and small bowel but nonobstructive. No fluid in the hernia sac or in the peritoneal cavity.No fistulas are seen. No free or loculated fluid collections. Small nodes seen to mesentery.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Hypertrophied right kidney partially seen in the right abdomen. | Expected postsurgical changes. Nonobstructive parastomal hernia. No evidence of sinus tracts or fistulas. If there is a visible skin opening this could be evaluated under fluoroscopy with a fistulogram. |
Generate impression based on findings. | 41-year-old male with history of dog bite to the left lower leg. Moderate subcutaneous emphysema and soft tissue swelling along the posterior medial aspect of the mid leg. No radiopaque foreign body is identified. There is no evidence of fracture or malalignment. | Subcutaneous swelling and emphysema without acute fracture or foreign body. |
Generate impression based on findings. | 65 year old with history of right lumpectomy in 2000 for triple negative breast cancer followed by radiation and chemotherapy. No current breast complaints. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Post-lumpectomy and radiation changes including scarring, architectural distortion and mild skin thickening is unchanged in the right breast. Multiple loosely scattered benign calcifications are again seen within the central right breast. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 72-year-old male with history of bilateral knee pain, AVN; evaluate for progression of osteoarthritis. Four views of the left knee demonstrates normal mineralization. There is trace joint effusion. There is moderate to severe osteoarthritis, most pronounced in the medial femorotibial compartment. No acute fracture or malalignment.Four views of the right knee demonstrate normal mineralization. There is moderate osteoarthritis of the right knee and trace joint effusion. There is no acute fracture or malalignment. | Moderate/severe osteoarthritis of the left knee, moderate osteoarthritis of the right knee; bilateral trace joint effusions. |
Generate impression based on findings. | 29-year-old female patient with abdominal pain. Evaluate for appendicitis. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: There are subtle haziness of the gallbladder wall. No cholelithiasis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted. Bilateral ovaries appear within normal limits for patient's age.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No evidence of appendicitis or other bowel abnormality.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Free fluid in the pelvis likely physiologic. | Mild thickening versus inflammatory changes involving the gallbladder wall. Recommend right upper quadrant ultrasound for further evaluation as clinically indicated. |
Generate impression based on findings. | Metastatic thyroid cancer restaging. There are postoperative findings related to thyroidectomy and neck dissection with deformity of the right subglottic larynx posterolaterally. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The salivary glands are unremarkable. The major cervical vessels are patent. There are multiple periodontal lucencies. There is partial opacification of the right maxillary sinus with diffuse sclerosis of the sinus walls. The imaged intracranial structures are unremarkable. There are nodules in the partially-imaged lungs. | 1. Post-treatment findings in the neck without convincing evidence of locoregional tumor recurrence.2. Evidence of chronic sinusitis.3. Nodules in the partially-imaged lungs. Please refer to the separate chest CT report for additional details. |
Generate impression based on findings. | 25-year-old female with dyspnea PULMONARY ARTERIES: Suboptimal opacification of the pulmonary arteries limits evaluation for pulmonary embolism. Within these limitations, no large pulmonary emboli are noted in the main pulmonary arteries.LUNGS AND PLEURA: No pneumothorax or pleural effusion. No suspicious nodules or masses. No focal opacity. Moderate bronchial wall thickening is present. MEDIASTINUM AND HILA: Right hilar and subcarinal lymphadenopathy with a right subcarinal area lymph node measuring 2.0 cm (series 8, image 98). No significant mediastinal lymphadenopathy. The heart size is normal without pericardial effusion. No visible coronary artery calcification. CHEST WALL: Mildly prominent axillary lymph nodes. No significant retrocrural, subpectoral, or cardiophrenic lymphadenopathy. Sclerosis of the T9 vertebral body may represent a bone island.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.Motion artifact and suboptimal opacification of the pulmonary arteries limits the examination. Within these limitations, no large pulmonary emboli are noted in the main pulmonary arteries. Repeat examination was not performed per clinical service request (Dr. Jacobs).2.Moderate bronchial wall thickening raises the question of asthma in this age group. No evidence of pneumonia.3.Nonspecific hilar and mediastinal lymphadenopathy may be due to sarcoidosis.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 44-year-old male status post ORIF of the left elbow and left distal radius. Three views of the left elbow demonstrate a single K wire fixation of the comminuted corner process fracture. No significant callus formation is present. There is significant soft tissue swelling. The radiocarpal joint space appears widened, similar to prior exam.Three views of the left wrist demonstrate cast material which obscures fine bone detail. A sideplate and screws affixing a comminuted distal radial fracture, in near-anatomic alignment. There is no evidence of hardware complication. There is mild bony callus formation. The bones appear demineralized when compared to prior exam. The ulnar styloid fracture fragment is unchanged. | Status post ORIF of comminuted coronoid process and distal radial fractures; no radiographic evidence of hardware complication. |
Generate impression based on findings. | Cervical spine: There is surgical fusion of C4 to C6 with mature osseous bridging across the disc spaces. The screws, plate, and spacers are intact, without evidence of hardware complication. A 4 mm wide spur projects posteriorly from the C6 body into the spinal canal. There is moderate to severe neural foramen stenosis from C5 to T1 bilaterally due to uncovertebral spurs. There is mild straightening of the cervical spine alignment in the sagittal plane. The partially imaged intracranial structures are unremarkable. The soft tissues of the neck are unremarkable. The partially imaged lung apices are clear.Lumbar spine: The alignment is within normal limits. There is focal depression along the anterior right superior endplate of S1 that likely represents a node. There is no significant central canal or neural foraminal stenosis. The paraspinal soft tissues appear unremarkable. | 1.Mature surgical fusion of C4 to C6 without evidence of hardware complication, although there is moderate to severe neural foramen stenosis from C5 to T1 bilaterally due to uncovertebral spurs.2.No significant spinal canal or neural foramen stenosis in the lumbar spine. |
Generate impression based on findings. | Female 73 years old Reason: surveillance scans History: hx of renal cell cancer The exam is not sensitive for detecting lesions in the solid organs of vasculature due to the lack of intravenous contrast. Given those limitations, the following observations are made:CHEST:LUNGS AND PLEURA: Stable micronodules.Largest nodule seen abutting medial/inferior mediastinum series 5 image 59, 4 mm. Granuloma right base.MEDIASTINUM AND HILA: Stable multinodular goiter with particularly large left lobe.Mild atherosclerotic calcifications aortic arch. Minimal calcifications coronary artery.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No evidence of fatty liver. Given limitation of no intravenous contrast, no definite focal lesions.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy. No evidence of recurrent tumor in the renal fossa. Normal contour and texture to the left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Moderate atherosclerotic changes iliac arteries.PELVIS:UTERUS, ADNEXAE: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Midline abdominal scar.OTHER: Pessary. | No definite evidence of metastatic disease given limitations of no intravenous contrast. Findings as above are stable. |
Generate impression based on findings. | Male 12 years old Reason: follow up lung fields History: respiratory failureVIEW: Chest AP (one view) 3/12/15 at 757 hours. Thoracolumbar extra scoliosis, cholecystectomy surgical clips, ET tube and right-sided central line unchanged. Cardiac silhouette size is normal. Persistent chronic streaky opacity of the left upper lobe. No effusions or pneumothorax. | No change in chronic streaky opacity of the left upper lobe. |
Generate impression based on findings. | Female 6 months old Reason: 6 mos old HIE, failed extubation, please eval for pneumonia and ett placement VIEW: Chest AP (one view) 3/12/15 at 807 hours. ET tube tip is at the carina or right mainstem bronchus. Gastrostomy tube again noted. Cardiac silhouette size is normal. Persistent bibasilar opacities, likely atelectasis. No effusions or pneumothorax. | Persistent multifocal opacities. |
Generate impression based on findings. | Left submandibular gland stone and recurrent left submandibular gland infections. There is a left submandibular calculus that measures up to 16 mm. There is no evidence of associated ductal dilatation or surrounding inflammatory changes. The other major salivary glands appear unremarkable. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The thyroid appears unremarkable. The major cervical vessels are patent. The osseous structures are unremarkable. The airways are patent. The imaged intracranial structures are unremarkable. There are calcified subcentimeter calcified granuloma in the lung apices. | A left submandibular calculus measures up to 16 mm, without associated ductal dilatation or surrounding inflammatory changes to suggest acute infection. |
Generate impression based on findings. | 60 year-old male with multiple joint pains, concern for inflammatory arthritis. Two views of the left hand demonstrate mild joint space narrowing at the interphalangeal joints. A well-marginated lucency in the capitate and the head of the first metacarpal likely represent bone cysts. There is no evidence of fracture. No inflammatory erosions are present.Three views of the right hand demonstrate osteoarthritic narrowing at the radiocarpal, intercarpal, and interphalangeal joints. Well circumscribed lucency in the fifth metacarpal head likely represents a cyst. There are posttraumatic changes in the distal tuft of the fourth digit, with soft tissue swelling. No fracture or malalignment is present.Three views of the left foot demonstrate moderate osteoarthritis of the first metatarsophalangeal joint. Enthesophytes are present at the Achilles' tendon insertion. A plantar heel spur is present. There is evidence of midfoot osteoarthritis.Three views of the right foot demonstrate moderate osteophyte of the first metatarsophalangeal joint, as well as evidence of midfoot osteoarthritis. A plantar heel spur is present. | Imaging findings suggestive of osteoarthritis in the hands, right than left, as well as the feet. No radiographic suggestion of inflammatory arthritis. |
Generate impression based on findings. | Head: No intracranial hemorrhage or mass effect. There is global parenchymal volume loss. No hydrocephalus or extra-axial collections. Gray-white differentiation is maintained. There are scattered areas of hypoattenuation in the periventricular and subcortical white matter which are nonspecific but compatible with chronic small vessel ischemic changes. The visualized portions of the paranasal sinuses and mastoid air cells are clear. No evidence of acute fracture of the calvarium. Old fracture deformities noted involving the left medial orbital wall and left zygomatic arch. Small left parietal subgaleal hematoma.Spine: No evidence of acute fracture. Mild to moderate degenerative disease of the cervical spine, worst at C3/4 level with neural foraminal narrowing bilaterally right worse than left. No central canal stenosis is evident. Sclerotic focus at C6 body, possibly bone island. Alignment is anatomical. Vertebral body heights are preserved. No paraspinal soft tissue swelling. Lung apices are clear. Calcification involving the carotid arteries noted. | 1.No intracranial hemorrhage or mass effect. Please note CT is not sensitive for detection of acute nonhemorrhagic ischemia. If there is high clinical suspicion of infarct, consider MRI.2.Chronic left zygomatic arch and left medial orbital wall fractures. No acute fracture of the calvarium or cervical spine. |
Generate impression based on findings. | 35-year-old female with bilateral knee pain. Four views of the left knee demonstrate calcification of the medial collateral ligament, indicative of prior MCL injury. Sharpening of the tibial spine and minimal osteophyte formation is consistent with early, minimal osteoarthritis. There is no significant joint effusion or fracture. Four views of the right knee demonstrate osteophyte formation along the medial aspect of the distal femur, sharpening of the tibial spine, and along the inferior patella, consistent with early, minimal osteoarthritis. A small right joint effusion is present. | Bilateral minimal osteoarthritis of the knees. Small right joint effusion. |
Generate impression based on findings. | 69-year-old female with history of heel ulcer, concern for osteomyelitis. Two views of the left ankle demonstrate gas in the soft tissues overlying the heel. The cortex is fairly indistinct along the plantar aspect of the calcaneus. There is also cortical indistinctness of the lateral aspect of the calcaneus, immediately deep to the ulcer, compatible with osteomyelitis. There is mild soft tissue swelling about the ankle and along the dorsum of the foot. Arterial calcifications are noted within the soft tissues.Two views of the right ankle demonstrate cortical erosion along the posterior lateral calcaneus, consistent with osteomyelitis. A plantar heel spur is present. There is deep soft tissue ulceration of the right heel. Arterial calcifications are noted within the soft tissues. | Findings compatible with bilateral calcaneal osteomyelitis. |
Generate impression based on findings. | Clinical question: 31yoF with h/o fall onto back of head with ongoing HA, dizzyness, and blurry vision r/o hemorrhage vs other intracranial injury. Signs and Symptoms: HA, dizziness Nonenhanced head CT: There is no detectable acute posttraumatic intracranial, calvarial or soft tissues of the scalp findings. Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and gray to white matter differentiation for patient's stated age of 31.Unremarkable calvarium, scalp, orbits, paranasal sinuses and mastoid air cells.Debris likely wax buildup in the left external object canal is noted. | Unremarkable nonenhanced head CT. |
Generate impression based on findings. | Postop for bunion surgery. Evaluate for gangrene. There are two orthopedic screws affixing the first tarsometatarsal joint in near anatomic alignment from a bunion correction surgery. The proximal aspect of the screw entering the medial cuneiform appears to touch the navicular bone. There is postsurgical flattening of the medial head of the first metatarsal. Small fragments of bone along the first metatarsal base are likely post-surgical.There is a nondisplaced fracture of the lateral aspect of the base of the first digit proximal phalanx. There is soft tissue thickening along the dorsum of the foot along with small skin defects. However, there is no cortical destruction or foci of gas to suggest osteomyelitis. There is moderate to severe osteoarthritis of the hallus/sesamoid complex. The bones appear demineralized. | 1. Postsurgical changes of a bunion correction surgery with the proximal aspect of the medial cuneiform screw touching the navicular bone. 2. Nondisplaced fracture of the lateral base of the first digit proximal phalanx. 2. Soft tissue thickening along the dorsum of the foot may represent post-operative change or cellulitis. However, there is no specific evidence of osteomyelitis. |
Generate impression based on findings. | Reason: chronic sinusitis, immunosuppressed. There are postoperative findings related to endoscopic sinus surgery, including bilateral uncinectomy, sphenoidotomy, and internal ethmoidectomy. There is also evidence of septoplasty without significant nasal septal deviation. There is increased mucosal thickening within the bilateral maxillary sinuses. There is now moderate mucosal thickening within the ethmoid cavities, where there is scattered neo-osteogenesis. There is also moderate mucosal thickening within the sphenoid sinuses and complete opacification of the left frontal sinus and bubbly secretions within the right frontal sinus. There is thickening and sclerosis of the paranasal sinus walls. The ethmoid roofs are intact and nearly symmetric. The orbits walls and contents are intact. The optic canals and carotid grooves are covered by bone. There are postoperative findings related to cerebral aneurysm clipping. There are degenerative changes involving the left temporomandibular joint. | 1. Postoperative findings related to endoscopic sinus surgery with overall increased pansinus opacification suggestive of acute upon chronic sinusitis.2. Postoperative findings related to cerebral aneurysm clipping. 3. Degenerative changes involving the left temporomandibular joint. |
Generate impression based on findings. | Sinus disease and neutropenic fever. There is a small amount of fluid within the left maxillary sinus. There is also mild mucosal thickening in the bilateral maxillary sinuses and mild scattered opacification of the left ethmoid air cells. The other paranasal sinuses are essentially clear. The nasal cavity is clear. The nasal septum is deviated to the left with an associated spur. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. There is mild partial opacification of the bilateral mastoid air cells. | 1. Findings suggestive of acute sinusitis.2. Nonspecific mild partial opacification of the bilateral mastoid air cells. |
Generate impression based on findings. | Pancreatic lesion ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Fatty infiltration of the liver. 3 x 4.3 cm segment 6 hepatic lesion best seen on image 38 of series 10 demonstrating peripheral discontinuous nodular enhancement consistent with hemangioma.SPLEEN: No significant abnormality notedPANCREAS: 0.7 x 0.7 cm nonenhancing low attenuation focus arising from the inferior pancreatic head best seen on image 63 of series 8. This lesion is not associated with ductal dilatation or evidence for chronic pancreatic inflammation. Surrounding peripancreatic vasculature unremarkable.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Subcentimeter nonenhancing low attenuation focus within the inferior pancreatic head. This lesion is not associated with pancreatic ductal dilatation, chronic pancreatic inflammation, or surrounding vascular abnormality. Unfortunately, this lesion is too small to characterize on CT. Would recommend correlation with MR examination.Fatty infiltration of the liver.Benign right lobe hepatic hemangioma. |
Generate impression based on findings. | 67 year old male with right upper quadrant pain. Evaluate for cholecystitis. LIVER: Normal echogenicity of the liver measuring 19.6 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow.BILIARY TRACT: Normal echogenicity of the gallbladder. No gallbladder wall thickening. No pericholecystic fluid. Sonographic Murphy's sign is negative. No intra-or extrahepatic biliary ductal dilatation.PANCREAS: Visualized portions of the pancreas are normal in echogenicity with no evidence of pancreatic ductal dilatation.SPLEEN: Normal echogenicity of the spleen measuring 9.1 cm in length.RIGHT KIDNEY: Normal echogenicity of the right kidney measuring 10.5 cm in length. No hydronephrosis or shadowing calculi are noted. OTHER: Normal echogenicity of the left kidney measuring 12.4 cm in length. No hydronephrosis or shadowing calculi are noted. | Unremarkable examination. No evidence of cholecystitis. |
Generate impression based on findings. | Clinical question: Recent TIA versus stroke. Signs and symptoms:Left facial numbness/tingling, left arm numbness/tingling. Nonenhanced head CT:No detectable acute intracranial process. CT is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Tiny focus of low-attenuation in the left corona radiata similar to prior exam and of questionable clinical significance.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and grade I treatment initiation. Sequela of previously known gunshot wound to the head and orbits similar to prior exam. | No acute intracranial process. |
Generate impression based on findings. | 39-year-old female patient with left upper quadrant pain status post pancreatic cyst drainage. Assess for bleeding, worsening process, obstruction. Exam is not sensitive for detecting lesions in the solid organs due to the lack of intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: Left lower lobe consolidation and pleural effusion noted.LIVER, BILIARY TRACT: Status post cholecystectomy. Presumed clips are noted in the right paracolic gutter.SPLEEN: No significant abnormality notedPANCREAS: Status post placement of cystogastrostomy tube. Largest fluid collection with foci of air currently measures 7.4 x 5.1 cm (series 3 image 41), previously 7.9 x 4.8 cm. Air is again seen tracking along the lesser curvature and posteriorly to the spleen.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Enteric jejunostomy tube tip is in the jejunum. Broad-based ventral abdominal wall hernia can noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Bulky uterus, likely due to underlying fibroid disease.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. | Interval placement of cystogastrostomy tube with persistent peripancreatic collection. No evidence of hemorrhage or other complication in this limited noncontrast examination. |
Generate impression based on findings. | 81 year old with history of right breast cancer status post mastectomy in 1999. Patient received radiation and chemotherapy. No new breast complaints. Three standard views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in left breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, left unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female 54 years old Reason: unexplained hematuria History: hematuria. ABDOMEN:LUNG BASES: Few small scattered hypodense lesions in the liver are too small to characterize likely cysts.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Punctate foci hypoattenuating the right kidney too small to characterize likely cyst. No definite masses. No hydronephrosis hydroureter. No perinephric fat stranding.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Prominent veins noted in the adnexal right. There is a prominent left gonadal vein.BLADDER: Mostly collapsed. Wall thickness appropriate degree of distention. No fat stranding around the bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No definite findings to explain hematuria. Prominent gonadal vein on the left and left adnexal veins. |
Generate impression based on findings. | There is diffuse lymphadenopathy of the left cervical and supraclavicular lymph nodes more prominent on the left measuring up to 1.2-cm in diameter. There is diffuse enlargement of the left parotid gland likely due to underlying lymphadenopathy. The other salivary glands appear to be unremarkable. The thyroid gland also appears unremarkable. The airways are patent. The imaged intracranial contents are within normal limits. The paranasal sinuses and orbits are unremarkable. There is partially-imaged prominent soft tissue in the anterior mediastinum. The lung apices are clear. The usual cervical lordosis is lacking. The osseous structures are otherwise unremarkable. | 1. Diffuse left cervical and supraclavicular lymphadenopathy. Differential considerations include an atypical infection, autoimmune process, or neoplasm.2. Partially imaged prominent soft tissue in the anterior mediastinum likely represents thymic tissue. However, a dedicated chest CT may be useful for further characterization. |
Generate impression based on findings. | 55-year-old male with chronic diarrhea and abdominal pain ABDOMEN:LUNG BASES: Mild basilar scarring/atelectasis.LIVER, BILIARY TRACT: Status post cholecystectomy. Enlargement of the left hepatic lobe with prominence of the fissures and diffuse hypoattenuation suggesting cirrhosis.SPLEEN: Slightly enlarged with small nonspecific hypoattenuating lesion.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small, multicystic kidneys consistent with end-stage renal disease.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The small bowel is distended with oral contrast. No wall thickening, abnormal enhancement or focal lesion. The colon contains positive oral contrast likely from prior exam.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The small bowel is distended with oral contrast. No wall thickening, abnormal enhancement or focal lesion. The colon contains positive oral contrast likely from prior exam.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. No specific findings to account for the patient's chronic diarrhea and abdominal pain.2. Cirrhotic liver morphology.3. End-stage renal disease. |
Generate impression based on findings. | Renal carcinoma status post left partial nephrectomy ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Stable bilobar subcentimeter low attenuation foci. Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral subcentimeter nonobstructing renal calculi. Stable contour deformity involving left kidney consistent with partial nephrectomy. Stable low attenuation soft tissue focus at resection site best seen on image 78 of series 7 measuring 1.6 x 2.1 cm.; favor benign postoperative etiology.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable examination without evidence for acute, inflammatory, or metastatic process. |
Generate impression based on findings. | 53 years, Male, Reason: s/p RALP/BPLND on 10/31/15 with subsequent History: s/p RALP/BPLND on 10/31/15 with subsequent. The posterior abdominal radionuclide angiogram demonstrates prompt, perfusion and uptake of the left kidney and decreased perfusion and uptake of radiotracer on the right. Excretion of contrast the right kidney is delayed with normal excretion of the left kidney. The estimated contribution of the right kidney to total renal function is 34% and that of the left kidney is 66%. There are no abnormalities of the ureters or bladder.Following administration of the diuretic, there was no significant washout of tracer from right collecting system radiotracer into the bladder. The T1/2 washout from the dilated right collecting system was 69.8 minutes. | Delayed uptake and excretion of the right kidney compatible with obstruction. |
Generate impression based on findings. | 53-year-old male with history of right knee pain and left wrist pain; evaluate position of wrist screw. Four views of the right knee demonstrate mild joint space narrowing in the medial femorotibial compartment, consistent with mild osteoarthritis. There is a large joint effusion as well as significant soft tissue swelling around the right knee. No fracture or malalignment is evident.Three views of the left wrist demonstrate a surgical screw attaching the scaphoid to the lunate, without evidence of hardware complication; the alignment is similar to prior exam. No bony bridging is present. The widening of the scapholunate interval is stable. The head of the screw is slightly prepped of the scaphoid cortex, unchanged. | 1. Significant soft tissue swelling and large joint effusion of the right knee, without evidence of discrete fracture.2. Mild osteoarthritis of the right knee.3. Unchanged appearance of surgical fixation of the scaphoid and lunate. |
Generate impression based on findings. | Status post shunt placement. Evaluate ventricles. There is a right paramedian frontal approach ventricular shunt catheter with the tip in the right frontal horn. Expected postsurgical changes are seen along the shunt tract. Direct comparison of the ventricular system is limited due to motion artifact on the prior study; however, there is no significant interval change in the ventricular system. There are extensive areas of abnormal low attenuation in the periventricular and subcortical white matter, consistent with advanced chronic small vessel ischemic changes. There is no evidence of intracranial hemorrhage. The basal cisterns are patent. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | 1.No significant interval change in size of the mildly prominent ventricular system compared to 3/10/2015. No intracranial hemorrhage or new mass effect.2.Unchanged extensive periventricular and subcortical low-attenuation white matter, which may represent advanced chronic small vessel ischemic changes. |
Generate impression based on findings. | 70-year-old female patient with history of metastatic renal cancer to the lungs status post stereotactic radiosurgery. Evaluate for disease burden. CHEST:LUNGS AND PLEURA: Left subpleural apical mass measures up to 0.4 cm in size (series 6 image 10), previously 0.9 x 0.8 cm. Left apical scarring. Other scattered micronodules are not significantly changed from prior.MEDIASTINUM AND HILA: Interval decrease in size of left apical/paramediastinal mass, measuring 1.7 x 1.4 cm (series 4 image 11), previously 2.6 x 2.3 cm. Partial encasement of the left subclavian artery is again noted.CHEST WALL: Right breast post surgical clips again noted.ABDOMEN:LIVER, BILIARY TRACT: Hypoattenuating liver lesions and intrahepatic fat-containing lesions are unchanged compared to prior examination. Cholelithiasis without CT evidence of cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: 1.3 x 1.2 cm left adrenal nodule is not significantly changed.KIDNEYS, URETERS: Status post right nephrectomy with associated postsurgical clips. No evidence of local recurrence in the surgical bed.Left renal angiomyolipoma probably measures 2.8 x 2.8 cm (series 4 image 111), not significantly changed. Superior pole left renal cysts are not significantly changed.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Moderate to severe multilevel degenerative changes affect the thoracolumbar spine.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: Right paracentric fat-containing hernia is unchanged compared to prior exam.BONES, SOFT TISSUES: Moderate to severe multilevel degenerative changes affect the thoracolumbar spine. Grade 2 anterolisthesis of L5 on S1 again noted.OTHER: No significant abnormality noted. | 1.Interval decrease in size of left apical/paramediastinal mass compatible with metastatic disease.2.Stable scattered pulmonary micronodules.3.Status post right nephrectomy without evidence of local recurrence. |
Generate impression based on findings. | Head CT: There is diffuse subcortical white matter hypoattenuation suggesting small vessel ischemic disease. There is encephalomalacia in the superior right frontal lobe and in the left cerebellar hemisphere, likely chronic infarct. Mild prominence of the sulci and the ventricles indicates age related volume loss. There is no intracranial hemorrhage, extra-axial fluid collection, or subdural hematoma. There are no masses, mass effect, edema, abnormal parenchymal enhancement or midline shift. The paranasal sinuses and mastoid air cells are clear. Neck CT: There are postoperative findings related to total glossectomy with radiation and surgical flap reconstruction. There is a new, heterogeneously-enhancing, infiltrative, ulcerated mass in the treatment bed which measures approximately 6cm in greatest AP dimension. This mass extends anteriorly over the mandibular arch and there is irregularity of the underlying cortex. Additional cortical irregularity of the left mandibular ramus and posterior body may be related to radiation necrosis, as there is no adjacent soft tissue mass. The lymph nodes in the submental space appear to have increased in size with the largest measuring 15mm, previously 11mm. The cortical irregularity of the left mandibular ramus and posterior body is likely related to radiation. The thyroid gland is atrophic. There are emphysematous changes with scarring at the lung apices.Neck CTA: The patient has conventional 3 vessel arch anatomy. There is complete occlusion of the right common carotid artery immediately distal to its origin from the brachiocephalic trunk appearing stable from the prior examination. There is minimal reconstitution of the right internal carotid artery. There is atherosclerotic plaque affecting the left common carotid artery with a long segment of mild to moderate narrowing proximal to the bifurcation. Additionally, there is scattered calcified atherosclerotic plaque in the proximal internal left carotid artery, some of which is ulcerated and some of which forms a vascular web. The left internal jugular vein appears to have been sacrificed, stable from prior examinations. | 1.Tumor recurrence in the oral surgical bed measuring up to 6 cm and extending across the midline and to the tongue base. This mass extends anteriorly over the mandibular arch and there is irregularity of the underlying bone.2.Increased size of level 1A lymph nodes, which may be due to metastatic disease.3.Occlusion of the right common carotid artery, similar to the prior examination.4.Atherosclerotic plaque in the left common carotid artery and ulcerated atherosclerotic plaque in the proximal left internal carotid artery with mild to moderate narrowing.5.Small chronic cerebral and cerebellar infarcts and white matter small vessel ischemic disease. |
Generate impression based on findings. | 81 years, Male. Reason: assess bowel gas problem History: pain, ileus Limited study, patient's flanks and lateralmost aspects of abdomen are excluded in this exam. Multiple dilated air containing loops of small bowel with collapsed colon. Though this patient appears to be post-operative, these findings are worrisome for small bowel obstruction. Superficial skin stables are noted. | Bowel gas pattern suggestive of small bowel obstruction favored over ileus. Please refer to subsequent CT exam for additional findings. |
Generate impression based on findings. | 89 years, Male. Reason: evaluate for obstruction vs ileus History: abdominal pain, constipation Mild gaseous distention of the small bowel and large bowel suggestive of possible mild ileus-type gas pattern. Two curvilinear radiodensities project over the inferior pelvis, which are of uncertain significance. There are moderate degenerative changes of the lower lumbar spine. There is no evidence of pneumoperitoneum. | Possible ileus type gas pattern and below-average stool burden. |
Generate impression based on findings. | Hip dysplasia.VIEWS: Pelvis AP/frog leg (two views) 03/12/15 Blade plate and screws devices is present in the left proximal femur.The left femoral head is displaced from the dysplastic acetabulum. Right femoral valgus deformity is present. The femoral head is well directed into the acetabulum. Limited external rotation and abduction are present on the left. | Unchanged exam with left developmental hip dysplasia and limited range of motion. |
Generate impression based on findings. | 85 years, Male. Reason: NGT placement History: above Study is limited because the pelvis is not included in the field-of-view. There is a nasogastric tube with its tip projecting over the proximal stomach, just beyond the gastroesophageal junction. There is a G-tube with contrast that is coiled in the left upper quadrant, in the region of the colon. There is focal narrowing or filling defect in the tubing which may reflect incomplete filling or kinking in the tubing and clinical correlation is recommended. There is some retained contrast in the left hemicolon. IVC filter is unchanged in position. Degenerative arthritic changes affect the lower lumbar spine. | NG tube with its tip projecting over the proximal stomach, just beyond the GE junction. There is focal narrowing or filling defect in the tubing which may reflect incomplete filling or kinking in the tubing and clinical correlation is recommended. |
Generate impression based on findings. | 77 years, Female. Reason: hx partial SBO, assess status History: above. Nonobstructive bowel gas pattern with right lower quadrant ostomy unchanged in position. Interval decrease in residual left hemicolon contrast. Surgical clips project over the bilateral hemipelvis. Scoliosis of the lumbar spine. Punctate radiodensity in the liver shadow of uncertain clinical significance, may reflect air in the biliary system. | Nonobstructive bowel gas pattern. Punctate radiodensity in the liver shadow of uncertain clinical significance, may reflect air in the biliary system; clinical correlation with patient's history is recommended. |
Generate impression based on findings. | 68-year-old male patient with history of gastric cancer status post gastric bypass. Evaluate for recurrent disease. CHEST:LUNGS AND PLEURA: Multiple nonspecific micronodules are not significantly changed compared to prior.MEDIASTINUM AND HILA: Mild coronary artery calcifications again noted. Atherosclerotic changes affect the thoracic aorta. CHEST WALL: Right chest port with associated subcutaneous air and catheter tip in the right atrium.ABDOMEN:LIVER, BILIARY TRACT: Post surgical changes from partial left hepatic resection. Again seen are multiple hypoattenuating lesions the liver without significant interval change. Hemangioma is unchanged.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral punctate hypoattenuating renal lesions are too small to characterize and likely represent cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Postsurgical changes related to prior gastrectomy with Roux-en-Y esophagojejunostomy with esophagojejunal anastomosis again noted above the diaphragm. There is interval jejunojejunal anastomosis, mesenteric lymph node resection, and partial left hepatic lobe resection. There is a fluid collection with rim enhancement, intrinsic high attenuation, and foci of gas in the anterior mid abdomen that abuts the anterior abdominal wall and extends superiorly to the liver and inferiorly to the transverse colon that measures 6.6 x 11.4 (coronal series 80260 image 64).Interval placement of percutaneous jejunostomy tube.Multifocal mildly dilated loops of small bowel without transition point. Coronal images demonstrate angulation of the bowel loops.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged prostate, measuring up to 5.1 cm.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: As above.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.New fluid collection in the anterior abdomen favored to represent a postoperative collection, such as a hematoma, as opposed to an abscess.2.Multifocal small bowel dilatation and angulation of bowel loops without transition point likely due to adhesive disease. |
Generate impression based on findings. | Reason: GSW 2mo prior s/p rod placement with purulent drainage . Two views of the right tibia and fibula redemonstrate an intramedullary rod with interlocking screws affixing a comminuted fracture of the distal tibial diaphysis; the alignment appears unchanged. There is no radiographic evidence of hardware complication. There are numerous surrounding osseous and metallic bullet fragments. Vertical lucencies and callous formation along the lateral aspect of the proximal fracture are more pronounced compared to prior exam, and while may represent progressive fracture healing, osteomyelitis cannot be excluded. | Orthopedic fixation of distal tibial fracture in near-anatomic alignment. New findings along the lateral aspect of the proximal fracture may represent progressive healing, however, osteomyelitis cannot be excluded on this exam. |
Generate impression based on findings. | 64 year old female with history of right ankle pain status post fall. Two views of the right ankle demonstrate fracture-dislocation of the right ankle including fractures of the medial and lateral malleoli, with posterior displacement of the distal fibular fracture fragment. An additional small fracture fragment is present anterior to the distal tibia, without definite donor site. The ankle is dislocated posteriorly and laterally distal to the fracture. The bones appear diffusely demineralized. Partially visualized post-surgical changes related to plate and screw placement in the first metatarsal. There is significant associated soft tissue swelling, without definite disruption of the skin. A plantar heel spur is present. | Fracture-dislocation of the right ankle as detailed above. Post-reduction films are recommended. |
Generate impression based on findings. | 84-year-old female with history of right ankle pain (over the navicular bone and medial malleolus) status post fall. Three views of the right ankle demonstrate a fracture to the distal tip of the medial malleolus. A fleck of bone projected into a stent in the distal fibula may represent an avulsion fracture. A well corticated ossicle at the level of the deltoid is indicative of an old adult abdomen injury. A plantar heel spur is present. There is significant soft tissue swelling of the ankle.Four views of the right knee demonstrate severe osteoarthritis including near bone-on-bone joint space narrowing and significant osteophyte formation. Moderate/severe osteoarthritis affects the left knee. There is no joint effusion or fracture identified. | 1. Medial malleolus fracture; questionable fracture of the distal fibular tip.2. Severe right osteoarthritis, moderate to severe left osteoarthritis of the knees. No joint effusion or fracture. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. In the left upper outer quadrant, there are two circumscribed areas containing fat density, which likely represent prominent fat lobules or lipomas. 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: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 55 years, Female, Reason: 54 year-old female with regurgitation; rule out delayed gastric emptying History: as above. 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:1 hour: 52 % of peak activity (normal 30-90 %) 2 hours: 29 % of peak activity (normal <60 %) 4 hours: 2.9 % of peak activity (normal <10 %) | Gastric emptying within normal limits. |
Generate impression based on findings. | 81-year-old male with green drainage from midline incision status post recent partial cystectomy ABDOMEN:LUNG BASES: Basilar atelectasis and consolidation as well as coarse pleural calcifications.LIVER, BILIARY TRACT: No focal hepatic lesions. Status post cholecystectomy. Mild perihepatic ascites.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple foci of free intraperitoneal air likely from recent surgery. There are matted loops of small bowel along the anterior abdominal wall adjacent to the surgical incision with a gas and fluid collection insinuating itself between the small bowel loops measuring up to 9 cm in largest diameter. Gas and fluid also extends laterally within the bowel wall muscles.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER Catheter tip is in the residual bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Multiple foci of free intraperitoneal air likely from recent surgery. There are matted loops of small bowel along the anterior abdominal wall adjacent to the surgical incision with a gas and fluid collection insinuating itself between the small bowel loops measuring up to 9 cm in largest diameter. Gas and fluid also extends laterally within the bowel wall muscles. Partial colectomy and left lower quadrant stoma. Small soft tissue attenuating nodule along the right paracolic gutter is nonspecific and may be followed on subsequent imaging.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted | 1. Abdominal fluid collection as described above.2. Post operative changes of partial cystectomy and right hemicolectomy. |
Generate impression based on findings. | 50 years, Female, Reason: 50 y. o w extensive DCIS need T-99 at 7:30 am on 3/12 for SLBX History: RT breast DCIS.RADIOPHARMACEUTICAL: The right breast was prepared in a sterile manner. A total of 0.52 mCi Tc-99m filtered sulfur colloid was injected subcutaneously. Following injection, intraoperative probe localization was performed. No images were acquired. | Successful right breast injection for intraoperative identification of sentinel lymph node. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Scattered small asymmetries in both breasts are unchanged, at least some likely representing intramammary lymph nodes. Benign calcifications in both breasts, including mild arterial calcifications, are also stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign-appearing lymph nodes project over both axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 61 year old with history of left lumpectomy for breast cancer in February 2010 followed by radiation, presents today for routine follow up. No current breast complaints Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. Postsurgical changes with multiple surgical clips from prior left lumpectomy are stable. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Subarachnoid hemorrhage due to ruptured right posterior communicating artery aneurysm status post coiling with stent placement, right EVD placement c/b tract hemorrhage and catheter clogging requiring left EVD placement. EVD OTD now at 15 versus 10. There is streak artifact from coil embolization in the region of the right posterior communicating artery. There is a left frontal approach external ventricular drain with tip in the left frontal horn, which is unchanged in position. There is continued evolution of the bilateral right greater than left anterior frontal hematomas with left frontal one essentially resolved. The left cerebellar hematoma is also less conspicuous compared to prior studies.The diffuse subarachnoid hemorrhage is stable in size and appearance. There are layering blood products in the bilateral lateral ventricles. There is unchanged mild to moderate ventriculomegaly. No midline shift or evidence of brain herniation. There is partial opacification of the mastoid air cells, right greater than left. | 1. Unchanged ventricular size compared to 3/6/2015. 2. Continued evolution of diffuse subarachnoid hemorrhage, right greater than left anterior frontal and left peripheral cerebellar hematomas. |
Generate impression based on findings. | 47 year old with family history of breast cancer presents for routine diagnostic mammogram Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. In view of her dense breast, tomosynthesis would be beneficial in next screening mammogram. Results and recommendations were discussed with the patient.BIRADS: 1 - Negative.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Male 68 years old Reason: hx of cirrhosis per OSH records? elevated bilirubin History: see above LIVER: Coarse echotexture. No evidence of cirrhotic morphology. 16.8 cm in length. Prominent hepatic veins suggestive of right-sided heart failure.No focal lesions.Flow in the portal vein is hepatopedal.GALLBLADDER, BILIARY TRACT: Gallbladder surgically absent. No intrahepatic or extrahepatic biliary dilatation. Common bile duct .6 cm in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Morphologically normal 11.3 cm in lengthOTHER: Left kidney has a 1.7 x 1.9 cm cyst in the low pole. 10.4 cm in length. No hydronephrosis.Spleen unremarkable normal size 8.9 cm lengthbilateral pleural effusions.Moderate generalized ascites. | No evidence of cirrhotic morphology. Moderate generalized ascites, bilateral pleural effusions. Prominent hepatic veins suggestive of right-sided heart failure. Intrinsically normal liver. Left renal cyst. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional right CC view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign-appearing lymph nodes project over both axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 44-year-old male with history of testicular cancer status post chemotherapy CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are again noted. No suspicious nodules or masses. Left lower lobe suture is again noted.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Postoperative changes of retroperitoneal lymph node dissection. No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Scattered pulmonary micronodules. No lymphadenopathy. |
Generate impression based on findings. | 67-year-old female presents for routine screening mammography. History of bilateral breast biopsies. Family history of breast cancer diagnosed in maternal aunt at age 70. Personal history of colon cancer diagnosed at age 64. Patient complains of left breast tenderness. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Focal asymmetry in the right upper outer quadrant is stable. Scattered benign calcifications in both breasts are also stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign-appearing lymph nodes project over both axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 54 years old; Reason: Please evaluate if fluid collection has resolved from a possible anastomotic leak. Continues with drain in place and output is 5 cc/day for the last several weeks. History: currently none other than 5 cc output from drain. ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Subsegmental occlusion branch of right portal vein this less well seen but probably unchanged series 3 image 24.SPLEEN: No significant abnormality noted.PANCREAS: Homogeneous hypoattenuating near fluid density lesion in the posterior aspect of the proximal body of the pancreas measuring 1.5 x 1.2 cm on series to image abdomen calcification or solid component. No ductal dilatation. No additional pancreatic lesions. Possible IPMN. This could be evaluated further with MRCP or endoscopic ultrasound.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Status post right hemicolectomy with postoperative fat stranding diminishing compared to the prior scan. Minimal fat stranding is still present. Previously seen measured loculated fluid collection is collapsed around the pigtail catheter. Measurable component adjacent to the catheter 1.8 x 1.3 cm on series 2 image 64. Previously measured 4 x 3.8 cm.No new collections. No evidence of bowel wall thickening or dilatation.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 free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Marked decrease in size of abscess collapsed around the catheter. No new collections. Decrease in mesenteric fat stranding around the surgical region.2.Stable hypoattenuating fluid density lesion in the body of the pancreas. Rule out IPMN. (Message left with Megan Smith for Michele Rubin). |
Generate impression based on findings. | 81-year-old male with increasing oxygen requirement, tachycardia, recent postop PULMONARY ARTERIES: Pulmonary artery opacification is adequate to the segmental level without evidence of pulmonary embolism. Main pulmonary artery caliber is within normal limits.LUNGS AND PLEURA: Trace bilateral pleural effusion with dependent adjacent atelectasis. No pneumothorax. No suspicious nodules or masses. Calcified granuloma in the lingula. Bilateral pleural calcification and thickening anteriorly and at the lung bases, consistent with asbestos related pleural disease. Adjacent parenchymal bands and scarring is suggestive of asbestosis (asbestosis related lung disease).MEDIASTINUM AND HILA: Mild cardiomegaly. No pericardial effusion.Severe coronary artery calcifications.Atherosclerotic calcification of the aorta and its branches.No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary, retrocrural, or cardiophrenic lymphadenopathy. No supraclavicular or subpectoral lymphadenopathy. Moderate degenerative disease affects the thoracic spine with large anterior osteophyte noted at T7-T8.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Pneumoperitoneum is expected given history of recent surgery. Status post cholecystectomy. | 1.No evidence of pulmonary embolism.2.Trace pleural effusion with lateral dependent atelectasis.3.Evidence of asbestos exposure as described.Findings discussed with Blake Alberts at 1051 on 3/12/15.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Female, 19 years old. History of recurrent osteosarcoma s/p chemotherapy, amputation, bilateral thoracotomies. Off therapy evaluation LUNGS AND PLEURA: Postsurgical findings of a left upper lobe and right lower lobe resection, with stable local scarring.A punctate micronodule along the minor fissure (series 5, image 135) is stable from dating back to 10/2011. No new suspicious pulmonary nodules or masses.No focal consolidation. No pleural effusions.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion.No mediastinal or hilar lymphadenopathy.A punctate mineralized focus along the left cardiac border (series 3, image 62) is more conspicuous from prior and may represent postsurgical changes.CHEST WALL: Post-surgical sclerotic lesions of the bilateral ribs are again seen. No new focal osseous lesions.No axillary lymphadenopathy.UPPER ABDOMEN: No significant abnormality noted. | Stable exam, without evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 79-year-old male with history of anal cancer Evaluation of solid organ pathology is limited due to lack of IV contrast.CHEST:LUNGS AND PLEURA: Status post right upper lobectomy. Apical scarring. Unchanged mild right lower lobe bronchiectasis. No suspicious nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Scattered atherosclerotic calcifications of the aorta and coronary arteries.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine. Small fat containing umbilical hernia.OTHER: 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: Degenerative changes of the thoracolumbar spine. Small fat containing umbilical hernia.OTHER: No significant abnormality noted | No evidence of metastatic disease. Stable postoperative changes of right upper lobectomy. |
Generate impression based on findings. | 45 year old presents for pre-transplant screening. Hand-held ultrasound for both breasts was performed. Patient was on a wheelchair during the study. No abnormal findings including solid or cystic masses are detected in either breast. | No sonographic evidence for malignancy in both breasts. BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Patient complains of occasional right breast pain during her cycle. Family history of breast cancer diagnosed in sister age 54 and ovarian cancer diagnosed in maternal aunt in her 40s. 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. Multiple clusters of benign calcifications in both breasts have slowly and slightly progressed in a benign fashion. Many of these are compatible with fibroadenomatous calcifications. 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. | History of left mastectomy for invasive ductal carcinoma, mucinous type, and DCIS in 2011. History of multiple benign right breast biopsies. History of breast carcinoma in sister diagnosed at the age of 56 and two paternal aunts. No new breast complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. Four percutaneously placed clips are present within the right breast. Multiple calcifications are present including arterial calcifications. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in right breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 48 years, Female, Reason: preop MVR History: SOB/ edema. CHEST:LUNGS AND PLEURA: No focal consolidation or pleural effusion. No suspicious nodules or masses.MEDIASTINUM AND HILA: Mildly enlarged precarinal node measuring a 1.5 x 1.1 cm (9/27). Prominent thymic tissue.CHEST WALL: Prominent bilateral axillary nodes, the largest measuring up to 1.4 x 1.1 cm on the right (9/10).ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Rightward curvature of the spine centered at T11-T12.OTHER: No significant abnormality notedPELVIS: FemaleUTERUS, ADNEXA: Enlarged heterogeneous uterus with multiple areas of nodularity measuring 9.9 x 9.1 x 13.3 cm (80464/37 and 5/310).BLADDER: No significant abnormality notedLYMPH NODES: Prominent bilateral inguinal nodes.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: The vascular measurements will be listed as an addendum. | 1.Enlarged heterogeneous uterus most likely represents multiple leiomyomas, however a pelvic MRI is recommended for further evaluation.2.Prominent axillary, mediastinal and inguinal nodes are nonspecific. |
Generate impression based on findings. | 65-year-old female with history of breast cancer with recurrence in supraclavicular lymph nodes. Evaluate for extent of disease. CHEST:LUNGS AND PLEURA: There is mild biapical and parenchymal scarring. Postradiation changes are present in the anterolateral right lung. No suspicious pulmonary nodules are appreciated. No pleural effusions or pneumothorax.MEDIASTINUM AND HILA: The heart size is normal with no significant pericardial effusion. Moderate coronary artery calcifications are present. No mediastinal or hilar lymphadenopathy.Heterogeneously enhancing right supraclavicular lymph node conglomerate is incompletely imaged.CHEST WALL: Status post right mastectomy and axillary lymph node dissection.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Scattered calcifications are present, likely from prior granulomatous disease. No suspicious lesions are identified. No intra-or extra hepatic biliary ductal dilatation.SPLEEN: Small splenule.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications of the abdominal aorta and its branches. No significant retroperitoneal lymphadenopathy.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology. Scattered colonic diverticula without evidence of diverticulitis. Small fat-containing umbilical hernia.BONES, SOFT TISSUES: Moderate multilevel degenerative disease affects the thoracic spine.OTHER: No significant abnormality noted. | 1. Heterogenously enhancing right supraclavicular lymph node conglomerate compatible with patient's biopsy proven metastatic breast cancer is incompletely imaged. Please refer to same day neck CT for further details.2. No evidence of additional metastatic disease in the chest or imaged upper abdomen. |
Generate impression based on findings. | 79-year-old male patient with history of renal cell carcinoma on chemo holiday. Evaluate for progression. Exam is not sensitive for detecting lesions in the solid organs due to the lack of intravenous contrast. Given those limitations, the following observations are made:CHEST:LUNGS AND PLEURA: Lingular mass currently measures 3.0 x 2.3 cm (series 5 image 63), previously 2.5 x 2.1 cm. Moderate centrilobular emphysema. New small bilateral pleural effusions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Heart size is normal without pericardial effusion. Moderate coronary artery atherosclerotic calcifications are again noted.CHEST WALL: No axillary lymphadenopathy. Mild multilevel degenerative changes affect the thoracolumbar spine.ABDOMEN:LIVER, BILIARY TRACT: No suspicious liver lesion is identified in this limited examination.SPLEEN: The spleen is small and atrophic. Nonspecific hypoattenuating lesion is unchanged compared to prior.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Status post bilateral adrenalectomies.KIDNEYS, URETERS: Status post left nephrectomy. No evidence of recurrence seen in the left nephrectomy bed.Multiple hyperattenuating right renal lesions are not significantly changed compared to prior examination and are favored to be benign.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic changes affect the abdominal aorta and its branches. No significant retroperitoneal lymphadenopathy.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. | Interval increase in lingular pulmonary lesion compatible with metastatic disease and new bilateral pleural effusions. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy at age 28. History of chronic right nipple inversion. Family history of breast cancer diagnosed in mother at age 50. Patient reports right breast pain. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Scattered benign calcifications are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female, 7 years old. Reason: Evaluate degree of stool burden History: hx constipation and anorectal malformationVIEW: Abdomen AP (one view) 3/12/2015, 1016 Nonobstructive bowel gas pattern.Moderate stool burden. | Moderate stool burden. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of left benign breast biopsy in 2011. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Biopsy clip in the right central breast is unchanged in position. Benign calcifications in both breasts, including arterial calcifications, are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign-appearing lymph nodes project over both axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 64 years old Reason: patient is s/p radical cystectomy and ileal conduit. She is had several days of persistent nause and inability to tolerate PO. Eval for intraabdominal pain postop. History: As above ABDOMEN:LUNG BASES: Right lower lobe linear atelectasis.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: There is a 1.1 x 0.7 cm hypodense lesion in the tail of the pancreas, is seen on image number 50, series number 4. M.R.C.P. is recommended for further evaluation of this cystic appearing mass.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: There is moderate right-sided hydronephrosis despite the double J stent. Left kidney is unremarkable. Left double J stent is in place.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Right lower quadrant ostomy. Proximal small bowel loops are significantly dilated measuring up to 4.8 cm. Terminal ileum is collapsed. There appears to be a transition image number 103, series number 4. These findings are compatible with distal small bowel obstruction.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: Not visualized.BLADDER: Status post cystectomy.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Small amount of fluid in the pelvis.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Distal small bowel obstruction with transition point in the right lower quadrant.Dr. Aldertes was notified and acknowledged about the above findings at the time of the dictation. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts, additional two MLO views of both breasts, and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Scattered benign calcifications are present in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign-appearing lymph nodes project over both axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 55 years old Reason: Cirrhosis, eval for HCC History: Cirrhosis LIVER: Coarse echotexture with some nodular character. No discrete masses. 18.3 cm in length.Flow in the portal vein is hepatopedal, peak velocity .2 m/sec.GALLBLADDER, BILIARY TRACT: No intrahepatic or extrahepatic biliary dilatation. No evidence of gallstones.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Morphologically normal 11.4 cm in length.OTHER: Left kidney 13.2 cm in length.Splenomegaly 15.5 cm in length.No evidence of ascites. | Cirrhotic morphology. Splenomegaly. No evidence of ascites. |
Generate impression based on findings. | 81-year-old male with history of tongue cancer for screening CHEST:LUNGS AND PLEURA: Apical scarring/fibrosis likely due to radiation. Unchanged mild emphysema.Scattered calcified granulomata and mild basilar scarring/subsegmental atelectasis.Mild vascular bronchiectasis and areas of bronchial wall thickening are present, unchanged. No pleural effusion or pneumothorax. No suspicious new nodules or masses. Minimal tree in bud opacities in both lower lung zones may reflect bronchiolitis from aspiration or infection (series 4, image 57).A 10-mm nodule in the right lower lower lobe (series 4, image 63) is nonspecific and is favored to be post-infectious.MEDIASTINUM AND HILA: Unchanged scattered subcentimeter mediastinal lymph nodes.Calcified hilar lymph nodes suggestive of granulomatous disease.Heart size is normal. No pericardial effusion. Mild coronary artery calcification.CHEST WALL: No significant axillary, cardiophrenic, or retrocrural lymphadenopathy. No supraclavicular or subpectoral lymphadenopathy.No suspicious osseous lesions are identified. Healing right 10th rib fracture.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: Nonspecific thickening of the left adrenal gland. The right adrenal gland appears within normal limits.KIDNEYS, URETERS: Subcentimeter hypodense lesions in the kidneys are too small to further characterize but presumably represent renal cysts. No hydronephrosis.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcification of the aorta and its branches without evidence of aneurysmal dilatation.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.Gastrostomy tube is noted. Nonspecific soft tissue nodules in the anterior abdominal wall may reflect injection granulomas.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.New 10-mm nodular opacity in the right lower lobe is favored to be postinfectious in etiology. Attention to this nodule on follow-up studies is recommended.2.Minimal tree in bud opacities in the lung bases may represent bronchiolitis from aspiration or infection |
Generate impression based on findings. | 55-year-old with history of left breast cancer status post mastectomy presents for routine follow-up. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast. Multiple benign calcifications do not appear significantly changed, including fibroadenomatous calcifications.Benign appearing lymph nodes are projected over the right axilla. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, right unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Focal asymmetry in the right central breast is stable. Focal asymmetry in the left medial breast is less prominent. A skin fold versus skin lesion on the right MLO at the inferior posterior aspect of the image is noted. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign-appearing lymph nodes project over both axillae. | No mammographic evidence of malignancy. Bilateral focal asymmetries, not significantly changed. 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. | Male 29 years old Reason: CT angio pelvis to evaluate aorta and iliac vessels for kidney transplant History: Pre-kidney transplant evaluation ABDOMEN:LUNG BASES: New centrilobular nodular opacities in the right lower lobe suspicious for pneumonia.LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Enlarged spleen is unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Severely atrophic end-stage kidneys bilaterally.RETROPERITONEUM, LYMPH NODES: Atherosclerotic calcifications at the level of the aortic bifurcation and along the bilateral external iliac vessels. Calcification in the right iliac fall selector are present postsurgical changes from previous transplant.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Again noted are the erosive changes at the symphysis pubis.OTHER: 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 | Again noted moderate atherosclerotic calcifications involving the aortic bifurcation and bilateral proximal common iliac arteries, lateral external iliac arteries calcification, more on the right compared to the left. |
Generate impression based on findings. | Physician palpated a lump in the right breast. The skin over the palpable lump is marked by Dr. Chhablani. Focused ultrasound did not detect any abnormalities at the area of palpable concern. Just below the area of concern, there is a large dystrophic calcifications, which makes a strong shadowing. | No sonographic evidence of malignancy BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 43-year-old male patient with history of left renal cell carcinoma status post nephrectomy. Routine surveillance. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Cholelithiasis without CT evidence of cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Previously described hypoattenuating left adrenal nodule is no longer seen.KIDNEYS, URETERS: Status post left nephrectomy without evidence of local recurrence in surgical bed. Atrophic right kidney with multiple hypoattenuating lesions that are too small to characterize.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Findings compatible with renal osteodystrophy.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: Findings compatible with renal osteodystrophy. Degenerative changes affect L4-L5.OTHER: No significant abnormality noted. | No evidence of local recurrence or metastatic disease. |
Generate impression based on findings. | 14-year-old male with right foot and ankle injury.VIEWS: Right foot AP, oblique, lateral (3 views) 3/12/15 No significant soft tissue swelling. No fracture or malalignment is identified. | No fracture or malalignment. |
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