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Generate impression based on findings. | Male 32 years old Reason: pain to finger hx of glass injury evaluate for cause or glass History: pain and erythema There is soft tissue swelling involving the palmar aspect of the distal middle finger. There is slight decreased attenuation in this region indicating soft tissue swelling. No radiopaque foreign body.The underlying bony cortex is intact. | Soft tissue swelling without radiopaque foreign body. |
Generate impression based on findings. | 50 year old with palpable lump in the left breast 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. A triangular marker is placed at upper outer quadrant of left breast, indicating the area of palpable concern. There is an area of encapsulated breast tissue at upper upper quadrant at the site of palpable concern, consistent with fibroadenolipoma. No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted elsewhere in either breast. With physical exam, a mobile lump was palpated at two o'clock position in the left breast. Focused ultrasound visualized encapsulated iso-and hyper echoic structures, measuring 35 x 18 mm, corresponding to the fibroadenolipoma on the mammogram. | No mammographic or sonographic evidence of malignancy. Fibroadenolipoma in the left breast. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. In view of the patient's dense breasts, tomosynthesis would be beneficial at the next screening study. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in mother at age 40, maternal aunt, and maternal second cousin. 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. Small circumscribed masses in both breasts compatible with intramammary lymph nodes. There is an asymmetry in the left upper breast on the MLO view. On MLO tomosynthesis this is a lateral breast finding. No suspicious microcalcifications are present. Benign-appearing lymph nodes project over both axillae. | Asymmetry in the left upper breast, for which additional views including laterally exaggerated CC view and spot compression views are recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Male 32 years old Reason: hx of testicular cancer, evaluate for metastatic disease, please pay close attention to liver abnormality seen on previous CT scan from 8/28/14. History: see above ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality noted. Specifically no focal liver lesions are seen.SPLEEN: Mild splenomegaly, unchanged.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Postsurgical changes secondary to retroperitoneal lymph node dissection. No evidence of enlarged lymph nodes by CT criteria.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Bladder wall thickening.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of metastatic disease. |
Generate impression based on findings. | Female 46 years old Reason: bilateral cmc thumb pain History: as above Right hand: Bone mineralization is normal. Alignment is anatomic. Mild osteoarthritic changes affects the first carpometacarpal joint with tiny osteophytes. Mild osteoarthritis affects the second metacarpophalangeal joint with tiny osteophytes. No acute fracture or dislocation.Left hand: Bone mineralization is normal. Alignment is anatomic. Moderate osteoarthritic changes affect the first carpometacarpal joint with osteophytes. Mild osteoarthritis affects the second and third metacarpophalangeal joints. | Bilateral carpometacarpal osteoarthritis, left worse than right. |
Generate impression based on findings. | 14-year-old female evaluate healing of foot. Left foot amputation with infected stump.VIEWS: Left ankle AP, lateral (two views) 3/12/15 Two screws affix the calcaneus and a portion of the talus to the tibia and fibula without evidence of hardware complication. Amputation of the mid and forefoot has been performed. The talotibial joint space is obliterated. No cortical destruction of the osseous structures to suggest osteomyelitis. | Tibiotalar joint arthrodesis without evidence of hardware complication or osteomyelitis. |
Generate impression based on findings. | Female 66 years old Reason: eval flow History: aortic dissection, AKI RIGHT KIDNEY: 9.1 cm in length. Normal echogenicity. No evidence of hydronephrosis hydroureter. Normal blood flow on color Doppler imaging.LEFT KIDNEY: 9.9 cm length. Normal echogenicity. No hydronephrosis hydroureter. Normal blood flow on limited color Doppler imaging.URINARY BLADDER: Collapsed.OTHER: No significant abnormalities noted. | Normal kidneys. Blood flow seen to both kidneys. |
Generate impression based on findings. | Female 74 years old Reason: Hepatic mass on US please rule our HCC with triphasic CT and assess pancreatic cysts History: autoimmune hepatitis Axial CT images are obtained through the abdomen and pelvis after administration of oral contrast and 120 ml intravenous Omnipaque 350 . Coronal reformats were also generated and reviewed. Noncontrast CT images also obtained through the abdomen. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Cirrhotic liver. No focal liver lesions suspicious for hepatocellular carcinoma. Heterogeneous appearance of the liver with multiple hypodense lesions in both lobes. However none of these enhance at the arterial phase to suggest hepatocellular carcinoma.An index focal hypodense lesion measures 1.8 x 1.6 cm near the gallbladder image number 37, series number 12.SPLEEN: No significant abnormality notedPANCREAS: There is a 1.8 by 0.9 cm cystic lesion in the head of the pancreas likely chronic in with the pancreatic duct compatible with air branch type I PMN. Pancreatic duct is normal in size. No definite solid components is noted within this lesion. There are some other punctate cystic lesions within the pancreas.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS: Artifacts from bilateral hip prosthesis limit the evaluation of the pelvis.UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Cirrhotic, heterogeneous liver with no focal lesions suspicious for hepatocellular carcinoma per CT criteria.Multiple cystic lesions in the pancreas, largest compatible with branch type I PMN. |
Generate impression based on findings. | Female 70 years old Reason: Look for pancreatic atrophy. History: Increased flatus suggesting malabsorption. LIVER: 15.6 cm in length. Normal echotexture. No focal lesions.Flow in the portal vein is hepato- pedal, peak velocity .2 m/secGALLBLADDER, BILIARY TRACT: Gallbladder is contracted with shadowing consistent with multiple gallstones in a contracted gallbladder. There is no tenderness to compression. No fluid is seen in the gallbladder fossa.No intrahepatic or extrahepatic biliary dilatation. Common bile measures .4 cm in diameter.PANCREAS: No significant abnormalities noted.RIGHT KIDNEY: Morphologically normal 10.8 cm in length.OTHER: Left kidney morphologically normal 10.7 cm in length.Spleen 7 cm in length.No evidence of ascites. | Cholelithiasis in a contracted gallbladder. No biliary dilatation. |
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, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 13-year-old female with right anterior ankle sprain.VIEWS: Right ankle AP, oblique and lateral (3 views) 3/12/15 Small joint effusion is present. No fracture or malalignment. | Small joint effusion without fracture. |
Generate impression based on findings. | 75-year-old male, evaluate for hernia or fluid collection, or other cause of pain Evaluation of solid organ pathology is limited due to lack of IV contrast.CHEST:LUNGS AND PLEURA: Innumerable new bilateral pulmonary nodules and masses. Moderate right pleural effusion. For reference a right middle lobe nodule measures 1.5 cm in diameter (image 56, series 5).MEDIASTINUM AND HILA: Multiple enlarged mediastinal lymph nodes. The largest right paratracheal lymph node measures 2.5 cm diameter (image 36, series 3). 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: Multiple prominent retroperitoneal lymph nodes are nonspecific.BOWEL, MESENTERY: Multiple mildly enlarged mesenteric root lymph nodes are nonspecific. The small bowel is normal in caliber.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Moderately distended.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Small lipoma in the muscles anterior to the right hip.OTHER: No significant abnormality noted | 1. Numeral bilateral pulmonary nodules and masses consistent with progression of metastatic disease. 2. Moderate right pleural effusion. 3. Nonspecific retroperitoneal and mesenteric lymph nodes. |
Generate impression based on findings. | 27 year-old female with thyroid cancer with suspicious node posterior to carotid. Evaluate for change in node. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy.LEFT LOBE MEASUREMENTS: Status post thyroidectomyISTHMUS MEASUREMENTS: Status post thyroidectomyRIGHT LOBE: No significant abnormality noted.LEFT LOBE: In the left thyroidectomy bed there is redemonstration of multiple hypoechoic avascular nodules. Two of these are located at the midpole, one of which measures 0.4 cm x 0.2 cm x 0.8 cm, and the other measures 0.2 cm x 0.2 cm x 0.4 cm. The other two foci are located at lower pole, one of which measures 0.4 cm x 0.3 cm x 0.4 cm, and the other measures 0.4 cm x 0.3 cm x 0.6 cm. These are not significantly changed compared to prior study. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: No lymphadenopathy is noted. OTHER: Hypoechoic focus posterior to the right carotid artery measures 1.0 cm x 0.6 cm x 0.8 cm previously measured 1.0 cm x 0.6 cm x 0.5 cm. An additional adjacent hypoechoic focus measures 0.5 cm x 0.3 cm x 0.6 cm which was retrospectively seen and appears unchanged. | 1. Stable hypoechoic nodules in the right neck posterior to the carotid artery. 2. Hypoechoic foci in the left thyroidectomy bed unchanged. |
Generate impression based on findings. | Female 69 years old Reason: 69 y/o F with chronic pseudoobstruction here with small bowel dilation, concern for volvulus or obstruction, please no PO contrast History: abdominal distention. The exam is not sensitive for detecting lesions in the pelvis to lack of oral contrast and in the solid organs of vasculature due to the lack of intravenous contrast.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Marked diffuse liver. Distended gallbladder.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: Diffusely dilated small bowel no discrete transition zone to suggest mechanical obstruction. No signs of volvulus. No intramural or free air.Greater than average stool burden throughout the colon.No intramural air or free air and bowel. Nasogastric tube in proximal gastric body. No free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXAE: Multifocal uterine calcifications consistent with leiomyomata.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: As in the abdomen, dilated small bowel at the transition zone favoring ileus. Colonic diverticulosis. No free or loculated intraperitoneal fluid.BONES, SOFT TISSUES: Discogenic disease L. 23.OTHER: No significant abnormality noted | Favor ileus. No signs of volvulus. No intramural air or free air. Sensitivity for ischemia is limited by lack of intravenous contrast no small bowel wall thickening is seen.Moderate stool burden.Diffuse fatty liver. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral benign biopsies in 2004. 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 clips in both breasts are unchanged in positions. Benign calcifications in both breasts, including arterial calcifications, are stable. Small asymmetries in both breasts are also stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | Stable benign calcifications and asymmetries bilaterally. 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. | 64-year-old female with follow-up of left lower lobe 9 mm nodule LUNGS AND PLEURA: The previously noted left lower lobe 9 mm nodule in the left lower lobe is not seen. Severe centrilobular emphysema is again noted. Calcified subpleural granuloma in the left upper lobe. Additional calcified and noncalcified nonspecific micronodules. Bibasilar scarring and atelectasis is again noted and not significantly changed since the prior exam.MEDIASTINUM AND HILA: Calcified thyroid nodule is again noted. Unchanged subcentimeter mediastinal lymph nodes. No significant hilar lymphadenopathy. Moderate coronary artery calcifications. Severe at the calcification of the aorta and its branches. Mitral valve prosthesis and tricuspid valve prosthesis is noted. Sternotomy wires and plates in place. CHEST WALL: Sclerotic lesion in the T5 vertebral body is unchanged. No suspicious osseous lesions.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Scattered diverticula without evidence of diverticulitis. | 1.Previously noted 9-mm nodule in the left lower lobe is not seen on the current study.2.Severe centrilobular emphysema with bibasilar scarring and atelectasis is unchanged since prior exam. |
Generate impression based on findings. | 81-year-old female evaluate kidney size, worsening CKD ULTRASOUND KIDNEYSRIGHT KIDNEY: Small echogenic right kidney measures 7.7 cm, consistent with medical renal disease. Likely small cysts. No hydronephrosis.LEFT KIDNEY: Small echogenic left kidney measures 7.6 cm, consistent with medical renal disease. Likely small cysts. No hydronephrosis.OTHER: No significant abnormalities noted. | Small echogenic kidneys with lack of diastolic flow consistent with severe chronic kidney disease. |
Generate impression based on findings. | 57 years old Female. Reason: evaluate for progression History: breast cancer, increasing tumor marker. RADIOPHARMACEUTICAL: 11.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 114 mg/dL. Today's CT portion grossly demonstrates interval increase in size of the left pleural effusion. New groundglass opacities in the left lower lung. The patient is s/p bilateral hip replacements.Today's PET examination demonstrates new diffuse and nodular pleural FDG uptake in the in the left hemithorax with SUVmax of 11.3 in the left anterior pleural thickening. Multiple new foci of increased activity are seen in the mediastinal AP window and the subcarinal regions. A focus of increased activity in is seen in the T10 vertebral body or adjacent of soft tissue. A new focus increased activity is seen in the right 10th rib with SUVmax of 4.8, corresponding to lytic lesion seen on CT. A new focus increased activity is seen in the C3/C4 vertebra with SUVmax of 7.1.Physiological activity is seen the liver, spleen, kidneys, intestines and bladder. | New diffuse and nodular pleural increased activity with pleural effusion, suspicious for tumor.New osseous lesions in the C-spine and T-spine as well as right 10th rib, suspicious for metastasis.Multifocal hypermetabolic small lymph nodes in the mediastinum, suspicious for metastasis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign left breast biopsy in 2003. Personal history of skin cancer diagnosed at age 35. Family history of breast cancer diagnosed in paternal grandmother at age 60, two paternal first cousins in their 40s, and paternal aunt at age 50. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution on the right. A few scattered benign calcifications in both breasts. Multiple, bilateral benign small circumscribed masses are present in both breasts, greater on the right and are stable when compared to prior right breast mammogram. A left axillary distortion is seen. No suspicious masses, microcalcifications or areas of architectural distortion are present. Benign-appearing lymph nodes project over both axillae. | Left axillary distortion may relate to a prior biopsy. A technical repeat of the left MLO with any surgical scar marked is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: R - Technical Repeat Views. |
Generate impression based on findings. | Distal radius fracture.VIEWS: Left wrist PA/lateral (two views) 03/12/15 The cast has been removed.Sclerosis and callus formation are noted at the radial metaphyseal fracture site. Alignment is near-anatomic. | Continued healing of distal radial fracture. |
Generate impression based on findings. | Female 35 years old Reason: evaluate thickening seen on CT in proximal jejunal History: crohn's disease, nausea, vomiting Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the colon was 45 minutes. Fluoroscopic evaluation showed normal mucosa throughout the small bowel, with no ulcers, sinus tracts or fistulae. No separation of bowel loops was present to suggest fibrofatty proliferation. There was fixed narrowing of the distalmost terminal ileum, measuring approximately 3 mm in diameter during maximal distention, in a bird beak configuration. Contrast passed through the ileocecal valve, there was intermittent mild prestenotic dilatation. The patient did not take a bowel prep and multiple filling defects were evident within the colon as well the distal small bowel, somewhat limiting evaluation. The remaining small bowel was unremarkable, and no fixed narrowings were evident in the region of jejunum previously noted to be abnormal on the CT examination from 6/20/2014.TOTAL FLUOROSCOPY TIME: 5:53 minutes | 1.Fixed narrowing of the distal terminal ileum, likely reflecting chronic sequelae of the patient's known Crohn's disease.2.Remaining small bowel normal in caliber and morphology. |
Generate impression based on findings. | 53 year old male with thyroid cancer. Evaluate for change in nodule. RIGHT LOBE MEASUREMENTS: Status post thyroidectomy. LEFT LOBE MEASUREMENTS: Status post thyroidectomy. ISTHMUS MEASUREMENTS: Status post thyroidectomy. RIGHT LOBE: Hypoechoic nodule in the right thyroid bed measures 5 mm x 6 mm x 3 mm previously measured 5 mm x 3 mm x 5 mm. LEFT LOBE: No nodules or masses noted. ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Right neck level 2 lymph node measures 1.6 cm x 0.3 cm x 1.0 cm. OTHER: No significant abnormality noted. | Stable hypoechoic nodule in the right thyroidectomy bed. |
Generate impression based on findings. | Female 74 years old Reason: 74 year-old female with radiation history for nasopharyngeal carcinoma, OPM noted aspiration and possible cervical esophageal stricture. Esophagram with low volume contrast to minimize aspiration risk. to assess stricture. History: as above. Single contrast evaluation of the cervical esophagus showed a transition point at approximately the level of the mid-C5 vertebral body to the cervicothoracic junction. There is relative narrowing of the cervical esophagus with a short segment of narrowing seen at the level of the cervicothoracic junction measuring 3 mm in length by 3 mm in diameter (series 3). The patient coughed and a small amount of aspiration was observed during the examination.TOTAL FLUOROSCOPY TIME: 1:06 minutes. | Relative narrowing of the cervical esophagus with a short segment of narrowing seen at the level of the cervicothoracic junction as described above. The patient coughed and a small amount of aspiration was observed during the examination. |
Generate impression based on findings. | MALT lymphoma CHEST:LUNGS AND PLEURA: Biapical scarring and bilateral emphysema unchanged. Interval decrease in size of right lung soft tissue mass lesions. Right upper lobe mass best seen on image 43 of series 3 now measures 4.9 x 4.7 cm; this is in comparison to 5.5 x 5.1 cm on 10/2/2014. Right parahilar mass best seen on image 40 of series 3 now measures 2.8 x 4 cm; this is in comparison to 4.4 x 3.8 cm on 10/2/2014.MEDIASTINUM AND HILA: Stable mildly enlarged lymph nodes.CHEST WALL: No significant abnormality noted.ABDOMEN: Significant motion artifact.LIVER, BILIARY TRACT: Stable cholelithiasisSPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Stable abdominal aortic ectasia.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Interval decrease in size of right lung soft tissue masses. No new adenopathy. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of left breast cyst removed in 1994. Family history of breast cancer diagnosed in 3 maternal aunts. 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. 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 and MRI are recommended annually. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female 21 years old Reason: stress fracture? impingement? History: hip pain Bone mineralization is normal. Alignment is anatomic. No acute fracture or dislocation. No evidence of a stress fracture. There is subtle subchondral cystic change in the pubic symphysis predominantly on the left. | Mild symphysis pubis degenerative changes. No evidence of left hip fracture as clinically questioned. |
Generate impression based on findings. | Male 75 years old Reason: evaluate for small bowel cancer recurrence, he is off chemp x 3 months History: none CHEST:LUNGS AND PLEURA: Mild apical emphysema, unchanged.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Post-surgical changes in the mesentery and small bowel 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 | No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | History of right mastectomy for breast cancer presenting with pain and palpable area of concern in the left breast and axilla. Three standard views of the left breast and two spot compression views were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. This includes no mass under the palpable marker in the left outer breast. Stable focal asymmetry in the left outer breast. Biopsy clip noted near a normal sized left axillary lymph node.ULTRASOUND | No mammographic evidence of malignancy. Clinical correlation is recommended for the patient's areas of pain and palpable concern. If there is continued concern for a palpable mass on physical exam, then referral to breast surgery should be considered. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.If additional imaging is desired, surveillance MRI could be considered based on the patient's breast density and her history of breast cancer.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Male 80 years old Reason: follow up for urothelial cancer History: urothelial cancer This study is limited due to lack of intravenous contrast.CHEST:LUNGS AND PLEURA: Index left lower lobe nodule measures 4.1 by 3.3 cm on image number 16, series number 5, slightly increasing size compared to previous study. Index right lower lobe nodule is significant increase in size and now measures 2.5 x 1.8 cm in image number 16, series number 5. Bilateral other lung nodules have also increased in size compared to previous study. There is also interval development of new nodules in both lungs. An index new nodule measures 10 by 9 mm on image number 41, series number 5 in the right upper lobe.MEDIASTINUM AND HILA: Index precarinal node measures 1.5 x 1.1 cm image number 41, series number 3, slightly smaller compared to previous study.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Previously described soft tissue density adjacent to the cholecystectomy clips has not significantly changed and now measures 2.4 x 2.7 cm on image number 94, series number 3. The etiology of this lesion is unknown and cannot be further characterized due to local intravenous contrast.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Soft tissue density around the left adrenal gland is unchanged measuring 1.6 x 1.1 cm image number 101, series number 3.KIDNEYS, URETERS: Status post left nephrectomy. Right lower pole stone, unchanged.RETROPERITONEUM, LYMPH NODES: Infrarenal abdominal aortic aneurysm measuring 3.9 by 3 cm on image number 139, series number 3, unchanged.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 | This study is limited due to lack of intravenous contrast. Interval increase in the size of the bilateral lung metastases with interval development of new lung nodules.Index mediastinal lymph node is smaller. Abdominal findings are stable. |
Generate impression based on findings. | 66 years, Male, Reason: Evaluating disease status History: Rectal pain with growing rectal mass..RADIOPHARMACEUTICAL: 14.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 85 mg/dL. Today's CT portion grossly demonstrates bilateral opacification of the bilateral maxillary sinuses, similar to the prior exam. A small right pleural effusion is new from the prior exam. Patchy basilar opacities seen previously have nearly resolved. A right upper lobe granuloma is unchanged. There are severe coronary artery calcifications which are unchanged. Right-sided chest port with tip in the SVC is unchanged. A small amount of peri-hepatic ascites is new from the prior exam. Small retroperitoneal and peripancreatic lymph nodes are noted. Thickening within the rectum is increased from the prior exam.Today's PET examination demonstrates numerous hypermetabolic hepatic lesions which are new from the prior exam with an SUV max of 12.3. There are also multiple hypermetabolic peritoneal implants along the liver capsule as well as along the surface of a bowel loop in the left lower quadrant. A few hypermetabolic peripancreatic and periportal lymph nodes are new from the prior exam. There is also new pelvic lymphadenopathy including hypermetabolic nodes along the pelvic sidewalls bilaterally. Hypermetabolic thickening of the rectosigmoid has increased since the prior exam. There is also skin thickening and increased activity along the gluteal crease in the midline which is new. A hypermetabolic subcutaneous nodule seen on the prior exam has resolved. | 1.Numerous hypermetabolic liver lesions, increased from the prior exam and likely representing neoplasm.2.New peritoneal carcinomatosis and ascites.3.Progression of rectosigmoid lymphoma.4.Hypermetabolic retroperitoneal and pelvic lymphadenopathy has increased.5.Hypermetabolic gluteal fold thickening is suspicious for cellulitis, correlate with exam. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in maternal aunt and maternal cousin. 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. Circumscribed bilateral masses, benign calcifications and left focal asymmetry 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. | End-stage renal disease. Prerenal transplant assessment for aortic and iliac atherosclerotic disease ABDOMEN:LUNG BASES: Moderate cardiomegaly.LIVER, BILIARY TRACT: Subcentimeter peripheral segment 4 low attenuation focus; favor benign etiology. Status post cholecystectomy.SPLEEN: Spleen absent.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral renal atrophyRETROPERITONEUM, LYMPH NODES: Mild abdominal aortic ectasia.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Nonviable right iliac fossa renal transplant.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate vascular calcification involving the common iliac arteries bilaterally. Extensive calcification involving the right external iliac artery. No significant atherosclerotic calcification involving the left external iliac artery. | Moderate vascular calcification involving the common iliac arteries bilaterally. Extensive calcification involving the right external iliac artery. No significant atherosclerotic calcification involving the left external iliac artery. |
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. A few scattered benign calcifications in both breasts and slightly progressed in a benign fashion compared to prior 2007 exam.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 77-year-old male patient with history of bladder cancer status post cystectomy and creation of neobladder and 2007. Staging evaluation and consideration of distal ureterectomy with reimplant of right ureter. Evaluation of solid organs and lymphadenopathy is limited by lack of intravenous contrast.ABDOMEN:LUNG BASES: Chronic basilar reticulations and atelectasis. LAD stent noted. Sternotomy hardware again noted and loss of the T8 vertebral body.LIVER, BILIARY TRACT: Status-post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophic kidneys with bilateral perinephric fat stranding. Right percutaneous nephrostomy and nephroureterostomy tubes again noted. The nephroureterostomy tube tip is in the neobladder.RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal lymphadenopathy. Mild to moderate atherosclerotic changes affect the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Status-post prostatectomy.BLADDER: Neobladder appears unchanged compared to prior examination.LYMPH NODES: No significant pelvic lymphadenopathy.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 34-year-old female with right elbow pain. Three views of the right elbow demonstrate moderate anterior and posterior joint effusions. Alignment is anatomic. No fracture is evident. However, occult fracture is not excluded. | Moderate anterior and posterior joint effusions. While no discrete fracture is identified, occult fracture is suspected. |
Generate impression based on findings. | 50 year-old female with mammographic abnormality and extensive non-mass enhancement within the right breast on MRI. Recent benign right breast biopsies. Additional tissue is requested. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is an irregular, hypoechoic mass measuring 2.4 cm at the 11 o’clock position with increased apical vascularity, 4 cm from the nipple. The lesion was readily visible. Tubular extension of this mass is noted just lateral to the index lesion measuring 1.3 x 1.1 x 0.6 cm with echogenic halo and mild peripheral vascularity.PROCEDURE: The procedure and its risks, including bleeding, infection, and failure to diagnose, and expected benefits of ultrasound-guided core biopsy with percutaneous placement of a marking clip and post-procedure unilateral mammogram were discussed with the patient. Questions were answered. Consent was obtained both verbally and in writing. The time-out form was completed to confirm patient identity and side/type of procedure.The right breast was cleansed with chlorhexidine over the target area. Transducer was sterilely sheathed. Local anesthesia was obtained using 2% lidocaine superficially, with 1% lidocaine with 1:100,000 epinephrine at depth. A 3 mm incision was made in the skin with a #11 scalpel blade. Using aseptic technique, continuous ultrasound guidance and a mediolateral approach, 7 12-gauge core needle (Celero) specimens were obtained of the lesion. Targeting was judged very good. Three specimens sank to the bottom of the prefilled container of 10% formalin. Specimen quality was judged very good.Specimens were sent to Pathology with an accompanying history sheet. Using continuous ultrasound-guidance a Hydromark clip was placed into the lesion in the usual manner. Pressure was held over the biopsy site until all bleeding subsided. The skin incision was closed with a Steri-Strip. Post-procedure digital right CC and ML views revealed the percutaneously placed clip to be in the expected location at the site of biopsy. No evidence of hematoma or other complication.A pressure dressing was positioned over the biopsy site and an ice pack positioned over the pressure dressing. Post-procedure instructions were reviewed with the patient both verbally and in writing. She tolerated the procedure well with no evident complications and left the Breast Imaging Department in stable condition.The procedure was performed by Dr. Happ. Dr. Schacht was present during the procedure at all times. | Successful ultrasound-guided core biopsy of the right breast lesion and clip placement. Pathology is pending at this time.BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of uterine cancer diagnosed at age 59. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Previously seen focal asymmetry in the right upper outer quadrant is no longer visualized. Oval circumscribed mass in the left upper outer quadrant is stable and may represent an intramammary lymph node.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. | For the purposes of numbering, there are 5 lumbar type vertebral bodies. Vertebral body heights are maintained. Again seen is dextroscoliosis of the lumbar spine with apex at L2 and levoscoliosis with apex at L4-L5 similar to prior MR. There is evidence of prior right-sided laminotomies at L4-L5 and L5-S1 levels. Extensive degenerative changes are seen throughout the lumbar spine with diminished disk spaces and vacuum disk phenomena at T12-L1, L1-L2, L2-L3, L4-L5, and L5-S1 levels. No evidence of acute fracture. Unchanged grade 1 anterolisthesis of L4 on L5 and L5 on S1. Multilevel degenerative changes are seen with disk bulges, ligamentum flavum buckling, and facet arthropathy as seen on prior MRI. Individual levels as below:At L1-2 there is moderate to severe left neural foraminal stenosis similar to prior. No significant spinal canal stenosis. Moderate left facet arthropathy.At L2-3 there is moderate to severe left neural foraminal stenosis similar to prior. No significant compromise to the spinal canal. There is bilateral facet arthropathy.At L3-4 there is moderate right and mild left neural foraminal stenosis. No significant spinal canal stenosis. There is right worse than left facet arthropathy.At L4-5 there is severe right neural foramina stenosis, similar to prior. No significant spinal canal stenosis. Prior right laminotomy. No significant spinal canal stenosis. Advanced right facet arthropathy.At L5-S1 there is severe right neural foramina stenosis and moderate left neural foramina stenosis. Prior right laminotomy. No significant spinal canal stenosis. There is bilateral facet arthropathy, advanced on the right.Mild fatty atrophy noted involving the right lower lumbar spine paraspinous musculature. | 1. Multilevel degenerative changes and scoliosis appear similar to prior MRI. No acute compression fractures.2. No high grade spinal canal stenosis at any level, which was better assessed on prior MRI. 3. Multilevel neural foramina stenosis as detailed above-- worse on the left at L1-L2 and L2-L3 and on the right at L4-L5 and L5-S1. 4. Advanced facet arthropathy, worse at the right L4-L5 and L5-S1 levels. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Breast volume has decreased bilaterally, likely due to nursing status on prior exam.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 58 year-old male with head and neck cancer CHEST:LUNGS AND PLEURA: Scar-like opacity in the left lower lobe is unchanged measuring 15 x 11 mm (series 5, image 89).Previously noted adjacent 7-mm nodule in the left lower lobe is not present on the current study and likely represents resolved atelectasis.There is debris in the left lower lobe and segmental bronchi which appears more proximally located when compared to the prior exam. Bronchial thickening is again noted bilaterally. Unchanged scar like opacities in the right middle lobe.No pleural effusion or pneumothorax. Moderate upper lobe predominant centrilobular emphysema is again noted.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion.Severe coronary artery calcifications.Reference right paratracheal lymph node measures 5 mm, (series 3, image 31), previously 5 mm.Reference subcarinal lymph node measures 7 mm, (series 3, image 37), previously 7 mm.Scattered additional subcentimeter mediastinal and hilar lymph nodes.Moderate stenosis of the left common carotid artery is again noted. CHEST WALL: Degenerative changes affect the thoracic and lumbar spine. No suspicious osseous lesions.No axillary, retrocrural, or cardiophrenic lymphadenopathy.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Nonobstructing 6-mm stone in the left kidney.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Severe atherosclerotic calcification of the aorta and branch vessels without evidence of aneurysmal dilatation.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Persistent scar like opacity in the upper lobe. Interval resolution of adjacent 7-mm nodule.2.Mild bronchial thickening with associated debris in the lower lobe is increased since prior exam and suggestive of chronic aspiration.3.No evidence of metastases. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in a maternal cousin. Patient complains of bilateral breast pain, left greater than right. Two standard digital views of both breasts and additional MLO and CC 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. Benign calcifications are present in both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. 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: NSB - Screening Mammogram. |
Generate impression based on findings. | 10-year-old female status post bilateral VDROsVIEWS: Pelvis AP and frog leg (two views) 3/12/15 Bilateral femoral varus derotational osteotomies appear healed. Bilateral blade plate and screw devices are present without evidence of hardware complication. Both femoral heads are well directed into their respective acetabula. No acute fracture or dislocation is present. Partially imaged VP shunt catheter. | Bilateral VDROs appear similar to the prior exam without complication. |
Generate impression based on findings. | 30 year-old male with history of right third toe fracture. There is redemonstration of a comminuted fracture of the distal phalanx involving the tuft and base of the phalanx, in near-anatomic alignment. The fracture at the base is not well-visualized on this study, indicative of interval healing. The degree of soft tissue swelling has decreased. | Interval healing of fracture of the third distal phalanx as detailed above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in mother and cervical cancer diagnosed in daughter. 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. Benign calcifications in both breasts 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. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 36-year-old female with explant left total hip. AP view of the pelvis and two views of the left hip show no acute fracture. Postoperative changes of a left total hip arthroplasty removal and cement spacer placement appear similar to those seen on the prior study. Three cerclage wires fixing a proximal femoral fracture with new callus formation since prior exam. There is proximal migration of the femur. Postsurgical changes including surgical staples are present in the soft tissues. Partial visualization of hardware components related to a right total hip arthroplasty device, in near anatomic alignment. The bones are severely demineralized. | Postoperative changes and findings compatible with sickle cell anemia as described above. No evidence of acute fracture. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Scattered calcifications including arterial calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Prostate carcinoma with rising PSA CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No change in extensive sclerotic skeletal metastases.ABDOMEN:LIVER, BILIARY TRACT: Bilobar subcentimeter low-attenuation foci unchanged; favor benign etiology.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Stable left renal cysts.RETROPERITONEUM, LYMPH NODES: Stable retrocaval reference lymph node best seen on image 117 of series 3 measuring 0.8 x 0.7 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Stable widespread sclerotic bony metastatic lesions.OTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: Stable reference right external iliac lymph node best seen on image 169 of series 3 measuring 0.7 x 0.6 cm.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No change in extensive sclerotic bony metastasis.OTHER: No significant abnormality noted | Stable examination. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable focal asymmetry in the left upper outer quadrant.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in mother at age 53, maternal great aunt at age 40, maternal cousin at age 22, and paternal great aunt at age 79. BRCA mutation. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.Please see the separately dictated MRI for those results. BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Circular markers are placed over both breasts. New heart monitoring device projects over and partially obscures the left upper inner quadrant. Subcentimeter benign masses in the central left breast, mid depth, are stable. Benign calcifications in both breasts are also 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: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A circular skin marker was placed over the right upper outer quadrant. Asymmetry in the right upper breast is stable. Benign calcifications in both breasts, including arterial calcifications, are also 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: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 55-year-old male with shortness of breath and cough LUNGS AND PLEURA: No pleural effusion or pneumothorax. Focal groundglass opacity likely represents atelectasis or scarring adjacent to an osteophyte associated with the nearby vertebral body. Subpleural scar-like nodule in the left lower lung (series 9, image 131) measures 6 mm. Multiple scattered nonspecific micronodules. No significant bronchial wall thickening.MEDIASTINUM AND HILA: The heart is normal. No pericardial effusion. Minimal coronary artery calcification. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: Mild degenerative changes affect the structures. No suspicious osseous lesions are identified.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Multiple scattered nonspecific micronodules. No evidence for pneumonia or other significant abnormality. |
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. Stable asymmetries in the left breast.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male 67 years old Reason: s/p Dobbhoff replacement History: hypernatremia There is a Dobbhoff tube with its tip projecting over the antrum of the stomach. There is mild gaseous distention of multiple loops of small bowel as well as gas within the colon consistent with mild ileus. The heart is enlarged. Pacemaker leads in expected location. | Dobbhoff tube with its tip projecting over the antrum of the stomach. |
Generate impression based on findings. | Status post elbow hardware removal. Interval removal of orthopedic hardware affixing the olecranon. There are chronic changes of the radial head. Soft tissue swelling is noted about the elbow along with foci of gas which is presumably postoperative. No acute fracture is evident. The bones appear demineralized. | Hardware removal as described above. |
Generate impression based on findings. | Pain at C5. Question of DJD. Degenerative disk disease is noted with disk space narrowing at the C4/C5 and C5/C6 levels, similar to the prior study. Mild bony neuroforaminal narrowing at these levels is also noted due to endplate spurring. No acute fracture is evident. | Degenerative disease of the lower cervical spine as described above. |
Generate impression based on findings. | Cough. Rule out acute chest.VIEWS: Chest PA/lateral (two views) 03/12/15 Cardiothymic silhouette and pulmonary vascularity are normal. The aortic arch, cardiac apex, and stomach are left-sided.Mild peribronchial thickening is present. Subsegmental atelectasis is seen in the right upper lobe. No focal air space disease is present. No pleural effusion is identified.Bone changes from sickle cell anemia are noted. | Bronchiolitis/reactive airways disease pattern.No pneumonia or evidence of acute chest. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in maternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. New focal asymmetry is present in the left upper outer breast.Stable bilateral asymmetries elsewhere.No suspicious microcalcifications or areas of architectural distortion are present. | Left focal asymmetry for which further evaluation with spot compression and possible ultrasound is recommended. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Clinical question: Chronic rhinitis. Signs and symptoms: Nasal congestion and discharge. Medtronic sinus CT:Examination demonstrates no evidence of acute or chronic sinus disease.Patent bilateral ostiomeatal units of maxillary sinuses and bilateral sphenoethmoidal recess of the sphenoid sinus.There is a thin band of soft tissue and calcific density traversing the right maxillary sinus in a vertical plane which is believed to represent a anatomical variation.Images through the nasal passage demonstrate fine corrugated appearance of the mucosal surface in particular of the turbinates and unremarkable otherwise.Bilateral mastoid air cells and middle ear cavities remain well pneumatized. | 1.No evidence of acute or chronic sinus disease.2.A thin soft tissue and bony septation traverses the right maxillary sinus and a coronal plane and traversing the entire sinus AP represent an anatomical variation.3.Fine corrugated appearing mucosal lining of the nasal passage. |
Generate impression based on findings. | 62-year-old female with history of T3 N0 EBV positive nasopharyngeal squamous cell carcinoma status post chemoradiation CHEST:LUNGS AND PLEURA: Reference left lower lobe subpleural nodule is unchanged measuring 4 mm (series 4, image 157). Additional scattered nonspecific micronodules. No suspicious nodules or masses are identified.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. No visible coronary artery calcification.No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No suspicious osseous lesions. No significant axillary, cardiophrenic and retrocrural lymphadenopathy. Interval removal of left-sided chest port. Reference nodule in the retroareolar right breast (series 3, image 48) is unchanged and measures approximately 13 x 8 mm.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Exostosis of the left iliac bone posteriorly. No suspicious osseous lesions are identified. Anterior osteophyte at T10-11.OTHER: No significant abnormality noted. | Stable examination without definitive evidence of metastases. Unchanged reference measurements as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. BRCA mutation carrier. History of MRI guided biopsy in the left breast in 2009. Family history of breast cancer diagnosed in sister at age 26. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Biopsy clip in the left lower inner breast is unchanged in position. A few scattered benign calcifications have slightly progressed over the years. The 7-mm mass in the left central breast is stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of right breast aspiration in 2011. Family history of breast cancer diagnosed in sister at age 55. 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. Small asymmetries in both breasts are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A circular skin marker was placed over the right lower inner breast. A few scattered benign calcifications in both breasts are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. Family history of breast cancer diagnosed in maternal aunt and ovarian cancer diagnosed in paternal grandmother. 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. Biopsy clips in the right upper outer breast are unchanged in positions.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. | 72-year-old female with history of bronchiectasis, MAI. LUNGS AND PLEURA: Mild biapical scarring. Mild emphysema in the upper lobes, left greater than right. No pleural effusion or pneumothorax. Diffuse bronchiectasis with mucus plugging most pronounced in the upper lobes. There are scattered areas of tree-in-bud opacity most notable in the right lower lobe. MEDIASTINUM AND HILA: Multiple hypodense thyroid nodules are increased in size since the prior exam. Scattered subcentimeter mediastinal lymph nodes. No significant hilar lymphadenopathy. The heart size is normal. No pericardial effusion. Moderate coronary artery calcification.CHEST WALL: No significant axillary, cardiophrenic, or retrocrural lymphadenopathy. The osseous structures are within normal limits. No suspicious osseous lesions.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Increase in diffuse bronchiectasis and mucous plugging with increased tree in bud opacities is nonspecific but consistent with clinical diagnosis of MAI. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Examination slightly limited by patient's left shoulder immobility. Two standard digital views of both breasts and additional left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Benign calcifications are present in both breasts, including arterial 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. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 69-year-old male, follow-up RCC CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are unchanged.MEDIASTINUM AND HILA: Atherosclerotic calcifications of the coronary arteries. No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Multiple unchanged hypoattenuating hepatic lesions likely represent cysts.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: Surgical clips and soft tissue in the left adrenal bed appear unchanged.KIDNEYS, URETERS: Status post left nephrectomy. Surgical clips in the renal bed and retroperitoneum are again noted.RETROPERITONEUM, LYMPH NODES: Index left retroperitoneal lymph node measures 9 x 7 mm, not significantly changed (image 101, series 3).BOWEL, MESENTERY: The small bowel is normal in caliber.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 | No significant change from the prior study. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in maternal aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable focal asymmetry in the right upper outer breast. Scattered benign 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. | 38-year-old male patient with history of metastatic renal cell carcinoma. Evaluate for progression of disease. CHEST:LUNGS AND PLEURA: Reference left lower lobe pulmonary nodule currently measures 5.1 x 3.3 cm (5 image 81), previously 2.9 x 2.2 cm. The remainder of the pulmonary nodules have also grossly increased in size.MEDIASTINUM AND HILA: Heart size is within normal limits without pericardial effusion. Scattered small mediastinal lymph nodes. Reference right hilar lymph node measures 1.4 x 1.5 cm (series 3 image 54), previously 2.2 x 1.7 cm.A second right hilar lymph node located laterally measures 2.6 x 3.5 cm (series 3 image 50), previously 3.3 x 2.4 cm. There is similar compression of the right little airway compared to prior.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: There is diffuse fatty infiltration of liver. No hepatic lesions are seen.SPLEEN: Status post splenectomy.PANCREAS: Status post distal pancreatectomy.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status post left nephrectomy. Enhancing soft tissue within the left nephrectomy bed has increased in size and currently measures 7.4 x 7.0 cm (series 3 image 104), previously 5.6 x 4.7 cm. No abnormalities identified in the right kidney.RETROPERITONEUM, LYMPH NODES: Enlarged left retroperitoneal lymph node near the left nephrectomy surgical bed measures 1.9 x 0.9 cm (series 3 image 98), previously 1.0 x 0.4 cm.BOWEL, MESENTERY: Fluid collection adjacent to the greater curvature of the stomach measures 5.0 x 5.5 cm (series 3 image 91), previously 5.1 x 4.6 cm. There is mild interval increase in peripancreatic lymph nodes.BONES, SOFT TISSUES: Mild multilevel degenerative changes affect the thoracolumbar spine.OTHER: Surgical changes in the abdominal wall with ventral laxity again 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. | Mixed response with interval decrease in reference right hilar lymph nodes and interval increase in pulmonary lesions, abdominal lymph nodes, as well as left renal bed mass. |
Generate impression based on findings. | 75-year-old male, renal cell carcinoma, SBRT to mediastinum CHEST:LUNGS AND PLEURA: Unchanged 5-mm left lower lobe micronodule (image 18, series 4).MEDIASTINUM AND HILA: Heterogeneous right thyroid nodule measures 3.4 cm and previously measured 3.0 cm (image 10, series 3.). Reference right subcarinal lymph node measures 9 x 6 mm and this measured 8 x 11 mm (image 62, series 3).Scattered coronary arterial calcifications.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Unchanged small enhancing splenic lesion.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Status-post right nephrectomy. Small left renal cyst.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: Distended and otherwise unremarkable.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Stable reference measurements. Slightly enlarged right thyroid nodule. |
Generate impression based on findings. | The cervical spine is in normal alignment, with straightening of the normal cervical lordosis. The vertebral body and disk heights are well-maintained. No worrisome focal marrow signal abnormality is appreciated. There is a focus of T1 and T2 hypointensity along the right paramedian inferior endplate of C5, likely a focus of nonspecific sclerosis such as a bone island. The spinal cord is of normal caliber and signal.At C3-C4, there is a very shallow central disk protrusion which indents the ventral thecal sac.At C4-C5, there is a trace disk bulge with slight right paracentral prominence. This abuts the ventral aspect of the cord without significant mass effect. There is no significant foraminal narrowing, although there is mild central spinal canal stenosis.At C5-C6 and C6-C7, there is a minimal shallow central disk protrusion without stenosis.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the remainder of the cervical spine. The vertebral artery flow voids are visualized and appear symmetric. | Very minimal cervical spondylotic changes, with mild central spinal canal stenosis at C4-C5 and abutment of the ventral cord without significant deformity. |
Generate impression based on findings. | Head: There are no masses, mass effect, or abnormal parenchymal enhancement. There is no intracranial hemorrhage. The ventricles and sulci are normal in size. The skull base foramina are grossly unremarkable. There is mild opacification of the ethmoid air cells and a small mucus retention cyst in the left maxillary sinus. There is mild rightward septal deviation. Neck: The patient is status post left nasal ala resection and there is decreased thickening and stranding of the subcutaneous soft tissues, presumably from evolving post-radiation changes. The underlying soft tissue thickening appears to have decreased from the prior examination. Dehiscence of the left infraorbital nerve canal appears stable from the prior examination. The thyroid and salivary glands are unremarkable. There is no significant cervical lymphadenopathy. The major cervical vasculature is patent. Mild degenerative disc disease affects the cervical and upper thoracic spine. The lung apices are unremarkable. There is a right dual lumen chest port and the internal jugular veins are patent. | Stable appearance of left nasal ala resection with further resolution of regional treatment effect. |
Generate impression based on findings. | 63 years, Male, Reason: assess for bony mets History: prostate cancer. Increased activity within the right aspect of the L3 vertebral body and bilaterally within the L4 vertebral body. There is also increased activity along the right aspect of a lower cervical vertebral body.There is subtle mildly increased activity within the lateral aspect of the right eighth and left ninth ribsPeripheral foci of increased activity within the bilateral shoulders is likely degenerative. | 1.Foci of increased activity within the lumbar spine and lower cervical spine are likely degenerative.2.Foci of increased activity along the bilateral ribs is also most likely degenerative, however continued follow-up of these regions is recommended to exclude neoplasm.3.No definite suspicious areas to suggest osseous metastatic disease. |
Generate impression based on findings. | Clinical question: Evaluate sinuses. Signs and symptoms cord frequent sinusitis; barotrauma with flying; deviated nasal septum exam. Medtronic sinus CT:Frontal sinuses demonstrate minimal mucosal thickening in the dependent portion of right sinus.Ethmoid sinuses demonstrate minute bilateral tiny foci of mucosal thickening. Sphenoid sinus demonstrate minute mucosal thickening along its anterior wall with resultant occlusion of bilateral sphenoethmoidal recesses.Right maxillary sinus demonstrate a very large retention cyst measuring 25 x 31-mm in transaxial dimensions. This cyst occupies a significant portion of right maxillary sinus without bony remodeling. Mucosal thickening at the level of the right ostiomeatal unit results in compromise of its lumen.Left maxillary sinus demonstrate mild patchy mucosal thickening and a retention cyst measuring approximately at 19 x 22 on coronal images. The left ostiomeatal unit remains patent.Images through the nasal passage demonstrates significant leftward nasal septum deviation and a leftward projecting bony septal spur which is in contact with the mucosal of the left middle and inferior turbinates with resultant mild deformity. There is decreased caliber of left nasal passage secondary to deviation of nasal septum and a smaller size of left nasal valve.Bilateral visualized mastoid air cells and middle ear cavities remain well pneumatized.Unremarkable images through the orbits. | 1.Extensive chronic bilateral maxillary sinus disease and including retention cysts and occluded right ostiomeatal unit.2.Minute chronic sinusitis of other paranasal sinuses as detailed.3.Significant leftward nasal septum deviation, leftward projecting bony septal spur which is in contact and mildly deforms the mucosa of the left middle and inferior turbinates. |
Generate impression based on findings. | Radius fracture.VIEWS: Left wrist PA/lateral (two views) 03/12/15 The cast has been removed.Sclerosis at and callus formation around the radial metaphyseal fracture have increased. Alignment is near anatomic. | Healing distal radial fracture. |
Generate impression based on findings. | Male 55 years old Reason: OA History: OA Right knee: Moderate to severe osteoarthritis affects the right knee with near bone-on-bone apposition. There are tricompartmental osteophytes. No acute fracture or malalignment. No joint effusion.Left knee: Moderate osteoarthritis affects left knee with moderate medial compartment joint space narrowing, and tricompartmental osteophytes. No joint effusion. No acute fracture or malalignment. | Moderate to severe right knee and moderate left knee osteoarthritis. |
Generate impression based on findings. | Male 44 years old Reason: knee pain, ankle pain History: same Right lower extremity: There is diffuse soft tissue swelling. The underlying tibia and fibula are intact. No evidence of osteomyelitis or acute fracture.Right ankle: There is moderate midfoot osteoarthritis. The joint space the ankle is normal. No acute fracture or malalignment. Is soft tissue swelling.Note is made of an Achilles tendon insertion enthesophyte. | Soft tissue swelling without underlying fracture. |
Generate impression based on findings. | Pain. Preop for right total hip arthroplasty with Stryker robotic system. CT images of the right hip reveal osteonecrosis of the right femoral head with articular collapse. There is moderate medial joint space narrowing.CT images of the pelvis demonstrate moderate left hip osteoarthritis. Limited images of the bilateral knees are unremarkable. | AVN of the right femoral head with collapse as described above. |
Generate impression based on findings. | 59 year-old female with melena evaluate for source of small bowel bleeding ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Unchanged dilatation of the common bile duct. Cirrhotic liver morphology. Status post cholecystectomy. Possible calcified lymph node in the porta hepatis. Gastroesophageal varices are again noted. The portal vein is normally opacified. Perihepatic ascites.SPLEEN: Splenomegaly.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small bilateral renal cysts. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The small bowel is distended with oral contrast. No evidence of contrast extravasation or mass lesion.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate abdominal ascites.PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: The small bowel is distended with oral contrast. No evidence of contrast extravasation or mass lesion.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate pelvic ascites. | 1. Cirrhosis and gastroesophageal varices consistent with portal hypertension. No active GI bleed or bowel lesion identified.2. Moderate abdominal and pelvic ascites. |
Generate impression based on findings. | Reason: evaluate sinuses History: chronic nasal congestion; sinus pain/pressure versus headache Mild right maxillary and trace left maxillary sinus mucosal thickening. There is also small focal thickening of the left sphenoid sinus. The osteomeatal complexes are normal with intact uncinate processes and patent infundibuli. The intersphenoid septum is normal. Bilateral sphenoethmoidal recess are patent. There is mild right deviation of the nasal septum. The cribriform plate, fovea ethmoidalis and lamina papyracea appear normal. The orbits are unremarkable. The imaged mastoids are clear. The osseous structures are unremarkable. Limited view of the intracranial structures are unremarkable. | Mild right maxillary and trace left maxillary sinus mucosal thickening. There is also small focal thickening of the left sphenoid sinus. Otherwise normal exam. |
Generate impression based on findings. | Paralysis agitans. Intra-operative CT. Limited intra-operative CT of the head demonstrates a pre-existing right frontal approach deep brain stimulator electrode and interval placement of a left frontal approach deep brain stimulator electrode with tips in the region of the subthalamic nuclei. There is no acute intracranial hemorrhage. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift. There is minimal opacification in a right posterior ethmoid air cell. The imaged paranasal sinuses and mastoid air cells are clear. | Pre-existing right frontal approach deep brain stimulator electrode with interval placement of a left frontal approach deep brain stimulator electrode, with tips in the region of the subthalamic nuclei. |
Generate impression based on findings. | 44-year-old female with history of left breast Phyllodes tumor status post excision. History of right breast fibroadenoma and benign, enlarged right axillary lymph node. No family history of breast cancer. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A linear marker has been placed in the scar overlying the upper outer left breast with mild expected underlying postsurgical changes. A stable benign morphology mass is again present within the central outer right breast, corresponding to a fibroadenoma on prior imaging. Additionally, there is a stable enlarged right axillary lymph node. This lymph node has been biopsied in the past with benign results. No new dominant mass, suspicious microcalcifications or areas of nonsurgical architectural distortion in either breast. Benign appearing lymph nodes are projected over both axillae. | Stable postsurgical changes of the left breast. Stable right breast mass and right axillary lymph node. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Avascular necrosis.VIEW: Pelvis AP (one view) 03/12/15 The left femoral head is flattened, sclerotic, irregular, and broadened. The femoral neck is also broadened. The joint space is widened. Lateral uncovering of the femoral head is present. The femoral head height is increased in comparison to the prior exam. The acetabular roof is flattened.The right hip is normal. A moderate amount of feces is present in the rectosigmoid. | Increase in ossification of left femoral head. |
Generate impression based on findings. | 83-year-old male patient with history of microscopic hematuria. ABDOMEN:LUNG BASES: Scattered pulmonary micronodules and basilar scarring.LIVER, BILIARY TRACT: Multiple small hypoattenuating lesions in the liver parenchyma are too small to characterize and likely represent cysts.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: There are multiple hypoattenuating lesions in the bilateral kidneys, some of which are too small to characterize. The largest of which is in the left lower pole and measures water density. No filling defects are seen in the visualized collecting systems on delayed images.RETROPERITONEUM, LYMPH NODES: No significant retroperitoneal lymphadenopathy. Moderate atherosclerotic changes affect the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Dextroscoliosis and multilevel degenerative changes affect the thoracolumbar spine.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No filling defects are seen in the bladder on delayed imaging.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Dextroscoliosis and multilevel degenerative changes affect the thoracolumbar spine.OTHER: No significant abnormality noted. | No radiographic abnormalities to account for patient's microscopic hematuria. |
Generate impression based on findings. | 40 year-old female with diarrhea, nausea, abdominal pain after EGD ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: The gallbladder is collapsed and poorly visualized. No focal hepatic lesion. Mild hepatic biliary prominence which is of unclear etiology.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Atherosclerotic calcification of the iliac bifurcation.BOWEL, MESENTERY: Paucity of mesenteric fat. Nonspecific apparent sigmoid wall thickening, which may relate to underdistention or underlying colitis. The small bowel is normal caliber. No evidence of perforation.BONES, SOFT TISSUES: Multiple lytic bone lesions consist with multiple myeloma.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Paucity of mesenteric fat. Nonspecific apparent sigmoid wall thickening, which may relate to underdistention or underlying colitis. The small bowel is normal caliber. No evidence of perforation.BONES, SOFT TISSUES: Multiple lytic bone lesions consist with multiple myeloma.OTHER: No significant abnormality noted | 1. Nonspecific apparent sigmoid wall thickening, which may be due to underdistention or underlying colitis. No evidence of perforation.2. Atherosclerotic calcification of the iliac bifurcation, pronounced for the patient's age.3. Mild intrahepatic biliary prominence, correlate with liver function tests. |
Generate impression based on findings. | Male, 16 years old. Trauma to left mandible.VIEWS: Mandible Panorex (1 views) 3/12/2015 No evidence of fracture or temporomandibular joint dislocation.No significant soft tissue abnormality or focal dental lesions. | No radiographic evidence of traumatic injury. |
Generate impression based on findings. | Status post right mastectomy for breast cancer in 1980, presents today for routine follow up. No current 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 composed of scattered fibroglandular elements, unchanged in pattern and distribution. Biopsy clips in the 3 o'clock and 8 o'clock positions are again noted. Scattered benign calcifications do not appear significantly changed. Oval benign morphology mass in the left 8 o'clock position with biopsy clip is unchanged. 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: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | There are bilateral enlarged submandibular, submental, and jugulodigastric chain lymph nodes. For reference, right level 1B lymph node measures 2.3 x 1.4 cm (series 6 image 41), and left level 2A lymph node measures 1.9 x 1.2 (series 6 image 49). There are scattered bilateral supraclavicular lymph nodes, but none of them are pathologic by CT size criteria. There is partially imaged para-aortic lymph node measuring at least 0.8-cm (series 6 image 1).There is symmetric enhancing prominence of posterior nasopharyngeal soft tissue, likely relating to adenoids. There is asymmetric prominence of the palatine tonsils, right greater than left. Left thyroid lobe is enlarged measuring 3.2 x 2.7 cm (series 6 image 22) with focal rounded area off the inferomedial left pole. There is also an oval enhancing nodule measuring 1.7 x 0.6 cm at the isthmus (series 6 image 24). Along the lateral inferior left pole, there is mild heterogeneity and hypoenhancement suggested, although this could be artifactual.The airway is patent. Right Port-A-Cath is noted. The lung apices are clear. The imaged intracranial contents are unremarkable. | 1.Bilateral cervical lymphadenopathy, concerning for lymphoma recurrence given the provided history. 2.Prominence of adenoidal soft tissue and palatine tonsils, which may also represent lymphoma involving Waldeyer's ring vs. reactive lymphoid tissue.3.Enlarged left thyroid lobe with possible inferior pole nodule and isthmus nodule. Please correlate with thyroid function tests. These findings can be better evaluated with thyroid ultrasound, if clinically indicated. |
Generate impression based on findings. | Metastatic progressive breast cancer with superior mediastinal adenopathy and left supraclavicular adenopathy, rule out brain metastases. There is interval increase in size of the ill-defined left supraclavicular lesion, which measures approximately 14 x 20 mm, previously 16 x 11 mm. There is also increase in the upper mediastinal lymphadenopathy. The thyroid and major salivary glands are unremarkable. The major cervical vessels are patent. There is no significant interval change in the sclerotic lesions in the manubrium, T1 vertebra, and C6 vertebra with associated endplate deformity of the C6 vertebral body and mild retropulsion of bone in to the spinal canal. The imaged intracranial structures are unremarkable. The imaged portions of the lungs are clear. There are partially-imaged bilateral breast implants. | 1. Interval increase in size of the left supraclavicular and upper mediastinal lymphadenopathy. Please refer to the separate chest CT report for additional details.2. No significant interval change in the appearance of the osseous metastases. |
Generate impression based on findings. | Female 17 years old Reason: AO root dissection and enlargement Partial visualization of the lung parenchyma shows no evidence of focal opacities effusions or pneumothorax.Aorta: The aortic arch is left sided. The brachiocephalic vessels branch normally from the arch. Visualized portions of the aorta demonstrate no evidence of dissection or aneurysm. Largest dimensions of the thoracic aorta are as follows:Sinuses of Valsalva: 28.4 mm Ascending: 22.3 mm Arch 20.4 mm Descending 17.3 mmPulmonary Artery: Main PA 19.5 mmRight PA 14.4 mm Left PA 15.6 mmVena Cavae: The SVC is normal in size and without structural abnormality. The IVC is normal in size and without structural abnormality.Pericardium: The pericardium is normal in thickness. There is no pericardial effusion. in visualized portion of itCoronary Artery: Both present and patent. | Normal targeted angio ct of the ascending aorta with no evidence of dissection or aneurysm.Dr. Peter Varga was present during the elaboration of this report and agrees with the findings. |
Generate impression based on findings. | 22-year-old male with history of polymyositis. Evaluate for methotrexate toxicity. LUNGS AND PLEURA: Redemonstrated are diffuse centrilobular groundglass nodules which are slightly more conspicuous when compared to the prior CT. There are also scattered subpleural reticular opacities. No evidence of air trapping on expiratory images. No bronchiectasis or honeycombing.MEDIASTINUM AND HILA: Heart size normal no pericardial effusion. No coronary artery calcifications. Small hiatal hernia.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. Diffuse bilateral centrilobular ground glass nodules and subpleural reticulation have slightly increased in conspicuity. These findings are nonspecific but may indicate progressive early interstitial lung disease. Findings are not typical for methotrexate lung toxicity.2. Small hiatal hernia. |
Generate impression based on findings. | 65 -year-old female with history of nasal ala cancer s/p chemoradiation. LUNGS AND PLEURA: Scattered calcified granulomata.No suspicious nodules or masses.MEDIASTINUM AND HILA: Right chest port tip is in the SVC.Calcified mediastinal lymph nodes suggestive of prior granulomatous disease.No evidence of mediastinal or hilar lymphadenopathy.Heart size is normal. No pericardial effusion. Mild coronary artery calcification.CHEST WALL: No significant axillary, cardiophrenic or retrocrural lymphadenopathy. Mild degenerative disease affects the thoracic spine. No suspicious osseous lesions are identified. UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Nonspecific chronic right hemidiaphragm elevation. No significant lymphadenopathy. | No evidence of metastases or other significant abnormality. |
Generate impression based on findings. | 71 years old Female. Reason: evaluate extent of disease. History: abdominal pain, new diagnosis of adenocarcinoma, possible metastatic gallbladder cancer and also with a large adnexal mass. RADIOPHARMACEUTICAL: 14.4 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 84 mg/dL. Today's CT portion grossly demonstrates right ovarian complex cystic mass and retroperitoneal and pelvic metastatic adenopathy. There is an ill-defined hypodense lesion in the right lobe of liver. There is a small right pleural effusion. Today's PET examination demonstrates several foci of increased activity in the mediastinal subcarinal region on the bilateral lung hila. The SUVmax in the subcarinal focal uptake(corresponding to a small lymph node seen on CT) is 7.2. There is no definite CT correlation in the the hilar abnormal FDG uptake. The two foci of increased activity are seen in the liver, one which corresponding to the low-attenuation lesion seen on CT. The SUVmax in the liver lesion 14.95.Multiple hypermetabolic lymph nodes are seen in the porta hepatis, porta hepatis, peripancreatic area, mesentery, and retroperitoneal cavity. Hypermetabolic lymph nodes are also seen in the bilateral common iliac regions. The increased activity is seen in the large pelvic mass with central photopenic area, consistent with the patient's diagnosis of ovarian cancer with a central necrosis.Several foci of increased activity are seen in the neck and the bilateral axillary regions, corresponding to the normal-sized lymph nodes seen on CT. | 1.Hypermetabolic large mass in the pelvis, consistent with the patient's diagnosis of ovarian cancer.2.Nodal metastasis in the abdomen and pelvis.3.Hepatic metastasis.4.Hypermetabolic lymph nodes in the mediastinum and bilateral lung hila, suspicious for nodal metastasis.5.Probable inflammatory lymph nodes in the neck and axillary regions. |
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. Compare ventricular size. 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 right frontal hematoma. The diffuse subarachnoid hemorrhage is stable in size and appearance. There is continued evolution of the layering blood products in the bilateral lateral ventricles, right greater than left. There is unchanged mild ventriculomegaly. No midline shift or evidence of brain herniation. There is partial opacification of the mastoid air cells, right greater than left. | 1. Unchanged mildly dilated ventricles.2. Continued evolution of diffuse subarachnoid hemorrhage and right anterior frontal hematoma. |
Generate impression based on findings. | 63 years, Female, Reason: melanoma - multiple lesions of unclear etiology seen on CT scan. Request PET to assess for hypermetabolic activity that would suggest active cancer. History: pt with melanoma and new skin mets - please eval disease status and compare to previous imaging.RADIOPHARMACEUTICAL: 12.1 MCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 106 mg/dL. Today's CT portion grossly demonstrates a right parieto-occipital craniotomy. Left adrenal nodule is grossly similar to prior CT. Status post right total knee arthroplasty. Minimal left basilar atelectasis.Today's PET examination demonstrates 3 hypermetabolic liver lesions within the right and left hepatic lobes, suspicious for metastases. There is a focus of increased activity in the left mid abdomen which is surrounded by a conglomerate of small bowel loops. Diffuse increased activity within the colon is likely related to patient's diabetes. There is mild activity within the left adrenal nodule (SUVmax 2.1). There is mild activity within bilateral inguinal lymph nodes which are not particularly enlarged. There is also a focus of linear increased activity within the subcutaneous tissues along the posterior aspect of the right shoulder which likely corresponds to prior biopsy site. Mild activity in the adjacent right axillary nodes is likely inflammatory. | 1.Hypermetabolic liver lesions are suspicious for metastases.2.Focus of increased activity within the left mid abdomen which is surrounded by small bowel loops is suspicious for metastases.3.Left adrenal gland is only mildly hypermetabolic and neoplasm is considered unlikely.4.Postsurgical changes in the subcutaneous tissues of the right posterior shoulder.5.Mildly hypermetabolic bilateral inguinal and right axillary lymph nodes are likely inflammatory. |
Generate impression based on findings. | Female 57 years old Reason: eval frac History: pain There is a fracture through the base of the cyst proximal phalanx the fracture fragments and mild dorsal angulation. There is some callus formation indicating ongoing healing. | Healing fifth proximal phalanx fracture. |
Generate impression based on findings. | Male, 15 years old. Evaluate for SCFE History: 1 week hip painVIEWS: Pelvis AP, frogleg (2 views) 3/12/2015, 1339 The osseous structures and joint spaces are normal.The femoral heads are well directed into the acetabula. Normal alignment of the epiphyses and respective metaphyses. Near complete growth plate closure at the femoral heads. | No evidence of SCFE or other acute abnormality. |
Generate impression based on findings. | Left fifth toe proximal phalanx fracture. There is redemonstration of a fracture of the distal fifth digit proximal phalanx. The fracture line is indistinct suggestive of healing. Alignment is anatomic. | Healing fifth digit proximal phalanx. |
Generate impression based on findings. | Ankylosing spondylitis B27 positive. Five views of the cervical spine reveal mild straightening of the normal cervical lordosis. There is no significant syndesmophyte formation. Vertebral body heights are maintained. No acute fracture is evident.Single AP view of the pelvis reveals mild sclerosis about the bilateral sacral iliac joints. There is fusion of the superior right sacroiliac joint, increased from the prior study. The left SI joint is unfused. There is medial joint space narrowing of the bilateral hips. There is decreased sclerosis of the pubic symphysis. No acute fracture is evident. There is patchy sclerosis of the bilateral femoral necks.Five views of the lumbar spine reveal no acute fracture. There is anterior osseous bridging of L5/S1, new since the 2005 study. | 1. Increased ankylosis of the superior right sacroiliac joint.2. New anterior L5-S1 syndesmophyte formation.3. Patchy sclerosis of the bilateral femoral necks; if the patient reports hip pain, MRI may be considered for further evaluation. |
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