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Generate impression based on findings. | Female 73 years old Reason: left TKA History: left TKA Components of a total left knee arthroplasty device are situated in near-anatomic alignment without radiographic evidence of hardware complication. There are extensive bone infarctions in the distal femur and proximal tibia.Contralateral right knee also shows a total knee arthroplasty device with bone infarctions. | Total left knee arthroplasty device without radiographic evidence of hardware complication. |
Generate impression based on findings. | Male 28 years old Reason: left knee pain History: left knee pain Bone mineralization is normal. Alignment is anatomic. Joint space is normal. There is a small joint effusion. No acute fracture is evident. | Small joint effusion. |
Generate impression based on findings. | Female 10 years old Reason: evaluate healing of fracture out fo cast History: left ankle fractureVIEWS: Left ankle AP, lateral and oblique 3/12/15 (3 views) Healing Salter-Harris 4 fracture of the distal tibia with periosteal reaction and callus formation is in anatomic alignment. | Healing fracture of the left tibia in anatomic alignment, as described. |
Generate impression based on findings. | Foot pain. Three views of the left foot reveal no acute fracture or malalignment. There is no soft tissue swelling. | No acute fracture is evident. |
Generate impression based on findings. | 69-year-old female patient with hematuria. ABDOMEN:LUNG BASES: Nonspecific right lower lobe pleural-based micronodule is noted (series 6 image 14).LIVER, BILIARY TRACT: Cholelithiasis without CT evidence of cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No renal calculi. Subcentimeter hypoattenuating lesions in the kidneys are too small characterize and likely represent cysts. No filling defects in the collecting systems on delayed images.RETROPERITONEUM, LYMPH NODES: 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:UTERUS, ADNEXA: Fullness in the lower uterine cavity is noted.BLADDER: No filling defects on delayed images.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No radiographic abnormalities to account for patient's hematuria.2.Nonspecific fullness of the lower uterine cavity. Recommend correlation with physical exam. |
Generate impression based on findings. | Male, 5 years old. Evaluate hip location History: cerebral palsyVIEWS: Pelvis AP, frogleg (2 views) 3/12/2015, 1253 VP shunt catheter is again noted.Persistent bilateral coxa valga deformity.Persistent right hip dislocation on AP view, with shallow acetabular angle.On frogleg view, the left hip is well directed into the acetabulum. | Bilateral coxa valga deformity with persistent right hip dislocation. |
Generate impression based on findings. | 82-year-old female patient with persistent polyp growth in a sitting: Status post removal presents with acute abdominal pain. Evaluate for perforation. Exam is not sensitive for detecting lesions in the bowel and solid organs due to the lack of oral and intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: Trace basilar atelectasis. Calcified granulomas noted.LIVER, BILIARY TRACT: Calcified granulomata. Status post cholecystectomy.SPLEEN: Splenic granulomata. PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Colonic diverticulosis without CT evidence of diverticulitis. Postsurgical changes from appendectomy. No free air to suggest bowel perforation.BONES, SOFT TISSUES: Multilevel degenerative changes affect the thoracolumbar spine. There is retrolisthesis of L1 on L2.OTHER: There is a round focus with peripheral calcification at the splenic flexure between the colon and the splenic hilum that may represent a calcified diverticulum versus a splenic artery aneurysm. PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Colonic diverticulosis without CT evidence of diverticulitis. Postsurgical changes from appendectomy. No free air to suggest bowel perforation.BONES, SOFT TISSUES: Multilevel degenerative changes affect the thoracolumbar spine. There is retrolisthesis of L1 on L2.OTHER: No free fluid in the pelvis. | 1.No CT evidence of colonic perforation in this limited examination.2.Calcification at the splenic flexure between the colon and the splenic hilum is favored to represent a calcified diverticulum and less likely a splenic artery aneurysm. |
Generate impression based on findings. | Painful right knee with abnormality adjacent to growth plate on MR. An ill-defined area of sclerosis is noted anteriorly and centrally within the tibial metaphysis abutting the physis. Within this sclerotic region, a 0.3 cm lucency is present with the suggestion of a central sclerotic focus (nidus).A 0.6 cm fibrous cortical defect is noted laterally in the distal femoral diametaphysis. | Sclerotic lesion with central lucency in anterior central tibial metaphysis most likely an osteoid osteoma. |
Generate impression based on findings. | 72 year-old female with history of right lumpectomy and adjuvant radiation therapy in 2005 for DCIS. History of benign biopsy in the left breast in 2014. History of breast carcinoma in maternal grandmother. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is mostly fatty replaced, unchanged in pattern and distribution. Stable postsurgical distortion, increased density, and skin thickening are present in the right breast. A marker clip from benign biopsy is present in the lower inner quadrant in the left breast. Coarse benign calcifications are present posterior to the marker clip. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, bilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Female, 7 years old. Evaluate fracture for healing Left tib fib fracture.VIEWS: Left tibia/fibula AP, lateral (2 views) 1308 Evaluation of osseous detail is again limited by overlying casting material.The oblique distal tibia fracture has persistent lateral displacement of the distal fracture fragment. There is increased local periosteal reaction.Medial bowing of the fibula and diffuse mineralization are again noted | Healing oblique distal tibial fracture with persistent lateral displacement of the distal fracture fragment. |
Generate impression based on findings. | Female 16 years old Reason: evaluate healing of fracture History: pubic ramus fractureVIEWS: Pelvis AP 3/12/15 (one views) Healing left pubic ramus fracture is in anatomic alignment. No healing fracture of the sacrum is noted. | Healing left pubic ramus fracture in anatomic alignment. |
Generate impression based on findings. | PHARYNX/LARYNX: There are post-treatment findings related to neck dissection and radiation therapy in the nasopharyngeal region. No discrete mass is identified. The oropharynx, hypopharynx, and larynx are unremarkable. The upper trachea and esophagus are unremarkable. There is no abnormal soft tissue mass or pathological enhancement.GLANDS: The postcontrast appearance of the salivary glands is unremarkable. The thyroid gland is unremarkable. ORAL CAVITY: The oral tongue and floor of mouth are unremarkable, within the limitations of this exam as there is artifact from dental amalgam.CERVICAL SOFT TISSUES: Postoperative changes are seen from bilateral neck dissection, was stable but along the deep margin of the right sternocleidomastoid muscle. There are no pathologically enlarged cervical lymph nodes.OTHER: The previously seen right internal jugular venous catheter has been removed. There is persistent nonopacification of the right internal jugular vein extending caudally from near the level the hyoid bone. There are mild spondylotic changes cervical spine with mild developmental narrowing of the central spinal canal. There is redemonstration of a left maxillary sinus mucosal retention cyst, which appears increased in size. | 1. Redemonstration of stable posttreatment and postoperative changes without measurable residual right nasopharyngeal tumor or cervical lymphadenopathy.2. Persistent nonvisualization of the majority of the right internal jugular vein, which may have been surgically ligated provided the prior neck dissection, or more likely chronically occluded. Prior exam did not demonstrate contrast opacification of the vessel despite the presence of an indwelling central venous catheter which has since been removed. |
Generate impression based on findings. | Female, 2 years old. CF; recent viral illness + RSV ; r/o pneumonia/infiltrates History: Persistent cough, fatigue, reduced appetite.VIEWS: Chest AP/lateral (two views) 3/12/2015 The cardiothymic silhouette is normal.Large lung volumes. Increased bronchial wall thickening, with scattered bronchiectasis.No pleural effusions, or pneumothorax. | Bronchial wall thickening and scattered bronchiectasis, compatible with a known diagnosis of cystic fibrosis. No evidence of pneumonia. |
Generate impression based on findings. | 59-year-old male patient with history of metastatic renal cancer. Evaluate for disease progression. CHEST:LUNGS AND PLEURA: Again seen are chronic left basilar interstitial opacities and volume loss. There is interval improvement and some scattered groundglass micronodules in the right upper lobe, compatible with prior inflammatory/infectious etiology. Other scattered micronodules are not significantly changed. Small left pleural effusion. No new suspicious nodules or masses.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Mild coronary artery calcifications noted. Cardiac size within normal limits without pericardial effusion.CHEST WALL: Expansile left posterior and anterior rib metastatic lesions and multiple lytic thoracic vertebral body lesions are again noted and not significantly changed.ABDOMEN:LIVER, BILIARY TRACT: Enlarging, now conspicuous, hypoattenuating lesion in segment 6 of the liver currently measures 1.9 x 2.3 cm (series 3 image 89), previously 1.7 x 1.3 cm. Otherwise, multiple liver cysts are again noted and are not significantly changed. Cholelithiasis without CT evidence of cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Right adrenal nodule currently measures 1.5 x 0.8 cm (series 3 image 90), previously 1.4 x 1.2 cm and not significantly changed given difference in technique.KIDNEYS, URETERS: Status post left nephrectomy. No evidence of local recurrence in the nephrectomy bed. No significant abnormalities in the right kidney.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Expansile, destructive lytic lesion involving the L1 vertebral body with resultant narrowing of the spinal canal appears similar compared to prior exam. Reference lesion measures 5.6 x 4.2 cm (series 3 image 104), previously 5.7 x 4.4 cm.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Lytic lesion involving the pelvis and sacrum are not significantly changed. Reference lesion in the sacrum measures 4.3 x 3.0 cm (series 3 image 168), previously 4.8 x 3.1 cm. Left iliac crest reference lesion measures 4.5 x 2.6 cm (series 3 image 150), previously 4.4 x 2.7 cm.OTHER: No significant abnormality noted. | Enlarging hypoattenuating lesion in segment 6 of the liver likely represents metastatic disease. Stable size of the osseous metastatic lesions with reference measurements as above. |
Generate impression based on findings. | Clinical question: evaluate sinuses. Signs and Symptoms: frequent sinus infections; chronic nasal congestion; mildly deviated nasal septum CT MEDTRONIC FUSION :Frontal sinuses are well pneumatized and unremarkable.Sphenoid sinus is well pneumatized and unremarkable. Patent bilateral sphenoethmoidal recesses.Ethmoid sinuses are well pneumatized and unremarkable.Maxillary sinuses are well pneumatized and unremarkable. Patent bilateral ostiomeatal units.Images through the nasal passage demonstrate moderate leftward deviation of the septum. There is a leftward projecting bony septal spur which is in wide contact and deforms the mucosa of the left inferior turbinate.Bilateral mastoid air cells and the middle ear cavities are well pneumatized and unremarkable.Unremarkable images through the orbits. | 1.No evidence of sinus disease.2.Leftward nasal septum deviation and a leftward projecting bony septal spur which is in wide contact and deforms the left inferior mucosa.3.Well pneumatized mastoid and middle ear cavities. |
Generate impression based on findings. | Female, 12 years old. History of necrotizing pancreatitis, with abdominal pain. Evaluate for pancreatic pseudocyst. ABDOMEN:LUNG BASES: Mild dependent atelectasis. No focal consolidation.LIVER, BILIARY TRACT: No focal liver lesions. No biliary ductal dilatation.SPLEEN: The splenic artery runs directly along the posterior wall of the large pancreatic pseudocyst. The splenic vein is not visualized, and large collateral vessels drain into the portal system, likely due to splenic vein occlusion or thrombosis. In particular, an enlarged short gastric vein (series 3, image 62) drains into the superior mesenteric vein.PANCREAS: A very large thin-walled, multilobulated fluid collection, consistent with a pancreatic pseudocyst measures up to 13.5 x 8.9 x 17.5 cm (series 3, image 45; series 8029, image 113), and extends posteriorly and inferiorly throughout the retroperitoneum, lateral to the left kidney, and adjacent to the descending colon.The uncinate process of the pancreas enhances normally, but the rest of the pancreatic tissue is not well visualized.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Mild medially-directed mass effect on the left kidney from the large pseudocyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Mass effect and anterior displacement of the stomach by the large pancreatic pseudocyst.No abnormal bowel wall thickening or evidence of obstruction.BONES, SOFT TISSUES: Injection granulomas of the anterior abdominal wall.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Moderate free pelvic fluid measures near water density. | 1. A large pancreatic pseudocyst extends throughout the peritoneum and has local mass effect on the stomach, pancreas, and left kidney.2. Probable splenic vein occlusion or thrombosis, with enlarged collateral vessels draining into the portal system.3. The pancreatic body and tail are not well visualized, possibly due to mass effect or prior inflammatory process.4. Moderate pelvic free fluid. |
Generate impression based on findings. | 68 year old with history of left mastectomy for breast cancer in 1999, presents today for routine follow up. No current breast complaints. Three standard views of the right breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is composed of scattered fibroglandular elements, unchanged in pattern and distribution. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in right breast. | No mammographic evidence of malignancy. As long as the patient's physical examination remains unremarkable, right unilateral diagnostic mammogram is recommended annually. Results and recommendations were discussed with the patient. BIRADS: 1 - Negative.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | Right wrist pain. Three views of the right wrist reveal no acute fracture or malalignment. There is no significant soft tissue swelling. | No acute fracture is evident. |
Generate impression based on findings. | 59 years, Male, Reason: met prostate cancer, rising PSA, evaluate for progression History: rising PSA. There are innumerable foci of increased radiotracer uptake within the calvarium, scapula, sternum, ribs and pelvis which correspond to diffuse sclerotic metastases on CT. Lesions within the manubrium, right eighth rib, left eighth rib and left ninth rib are new from the prior exam. Multiple lesions within the spine and pelvis are in similar distribution are unchanged. | Mild progression of diffuse osseous metastasis with new rib and manubrial lesions. |
Generate impression based on findings. | Low back pain. Right hip pain. Three views of the lumbar spine reveal disk space narrowing, vacuum disk phenomenon, and anterior osteophyte formation at L3/L4. There is mild disk space narrowing of L4/L5. No acute fracture is evident. Vertebral body heights are maintained. There is degenerative disk disease of the visualized lower thoracic spine.Single AP view of the pelvis reveals multiple surgical clips within the pelvis. There is moderate osteoarthritis of the bilateral hips. No acute fracture is evident.Two additional views of the right hip reveal no acute fracture. There is osteophyte formation at the hip and mild medial joint space narrowing. | 1. Degenerative disk disease of L3/L4.2. Moderate osteoarthritis of the bilateral hips. |
Generate impression based on findings. | Chronic sinonasal congestion; frontal headaches; leftward deviated nasal septum; OSA on CPAP. There is mild mucosal thickening in the bilateral maxillary sinuses, partial opacification of the ethmoid sinuses diffusely, and moderate left frontoethmoid recess and inferior left frontal sinus mucosal thickening and associated mild sclerosis and thickening of the sinus walls. The other paranasal sinuses are clear and the infundibulae are patent. The nasal cavity is clear. The nasal septum is deviated slightly to the left with an associated 3 mm wide spur. The lamina papyracea and ethmoid roofs are intact. The carotid grooves and optic canals are covered by bone. The nasopharynx, facial soft tissues, orbits, and imaged intracranial structures appear to be unremarkable. There is nonspecific mild left frontal scalp skin thickening. | 1. Scattered paranasal sinus opacification in a sporadic pattern with features suggestive of chronic sinusitis.2. The nasal septum is deviated slightly to the left with an associated 3 mm wide spur. 3. Nonspecific mild left frontal scalp skin thickening. |
Generate impression based on findings. | 22 year-old female with right elbow pain status post athletic injury. Three views of the right elbow demonstrate small joint effusion. Linear lucency through the head of the radius is suggestive of small nondisplaced intra-articular radial head fracture. Alignment is anatomic. | Findings are suggestive of nondisplaced intra-articular fracture of the radial head with small joint effusion. Follow-up radiographs are recommended for confirmation. |
Generate impression based on findings. | Hallux valgus. Intraoperative images of the left foot reveal two orthopedic screws within the first metatarsal and medial cuneiform affixing the first tarsometatarsal joint. There is flattening of the medial head of the first metatarsal with overlying soft tissue irregularity compatible with surgery. Alignment is anatomic. Foci of air within the soft tissues is post operative. No acute fracture is evident. | Postsurgical changes of bunion correction surgery. |
Generate impression based on findings. | 64-year-old female with recent right ankle fracture-dislocation status post reduction. Two views of the right ankle demonstrate overlying cast material, which limits fine bone detail. There is been interval reduction of the known right ankle fracture-dislocation, in near-anatomic alignment. The distal fibular fracture fragment projects mildly dorsally. There is redemonstration of post changes related to plate and screw placement in the first metatarsal. | Status post reduction of right ankle fracture-dislocation in near-anatomic alignment. |
Generate impression based on findings. | Stiff. Question of a healed fracture. Three views of the right ring finger reveal a sideplate and screw device affixing a middle phalanx fracture in near anatomic alignment. The fracture line is less distinct suggestive of healing. | Healing middle phalanx fracture. |
Generate impression based on findings. | There is acute hemorrhage extending from the previously seen necrotic mass inferomedially into the pons. There is increased mass effect on the fourth ventricle, however the basilar cisterns remain patent. Slight increase in size of the third and lateral ventricles is concerning for early obstructive hydrocephalus, but a component of further global cerebral volume loss cannot be excluded. There is no tonsillar herniation. Evaluation of the underlying, partially calcified tumor is limited as it is obscured by hemorrhage tracking superiorly. The tumor does, however, appear larger and the area of hyperattenuation measures 1.6 cm in transverse dimension, previously 1.1 cm, although evaluation is limited due to poor delineation of mass margins and the possibility of cranial tracking of blood products.A right frontal burr hole is unchanged. The visualized paranasal sinuses and mastoids/middle ears are clear. Disconjugate gaze is noted. | 1.Hemorrhage in the midbrain and pons arising from the known necrotic glioblastoma.2.Increased mass effect on the fourth ventricle with increase in size of third and lateral ventricles. While this is concerning for early obstructive hydrocephalus, a component of global cerebral volume loss cannot be excluded. No frank tonsillar herniation.3.Increase in size of underlying tumor suggested although evaluation is limited by adjacent hemorrhage. |
Generate impression based on findings. | Male 61 years old Reason: pre-op History: pain There is moderate to severe medial compartment joint space narrowing with near bone-on-bone apposition.Sclerotic changes in the distal femur from bone infarctions. Mechanical axis is approximately 8 degrees of varus. | Mechanical axis as detailed above. |
Generate impression based on findings. | 80 year-old female, surveillance of splenic artery aneurysm ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: Splenic artery aneurysm is not significantly changed and measures 1.6 x 1.4 cm and previously measured 1.5 0.4 cm (image 20 of series 3). Measurement of diameter from inner wall to inner wall was used for purposes of comparison with prior exams.PANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications of the abdominal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative changes of the thoracolumbar spine.OTHER: No significant abnormality noted | Unchanged splenic artery aneurysm. |
Generate impression based on findings. | Pain. Preop. Bone length radiographs are provided. There is 6 degrees of varus angulation. No acute fracture is identified. Three views of the right knee reveal severe medial compartment joint space narrowing. There is tricompartmental osteophyte formation and severe joint space narrowing of the patellofemoral joint. No acute fracture is evident. AP radiograph of the left knee also reveals severe medial compartment joint space narrowing and bilateral tibiofemoral compartment osteophyte formation. | 1. Varus angulation of the knee as described above. 2. Severe osteoarthritis of the right knee. |
Generate impression based on findings. | Female 32 years old Reason: r/o remaining abscess History: redness, swelling, copious purulent drainage. Subcutaneous tissues, fat and muscle planes appear normal with no visible fluid collections. No abnormal areas of vascularity. | No loculated fluid collections to suggest abscess in the area of redness and swelling along the left thigh. |
Generate impression based on findings. | The previously seen right-sided nasopharyngeal mass is no longer visualized, there is no significant residual asymmetry in appearance of soft tissues at this level.The ventricles and sulci are prominent, consistent with mild age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are scattered punctate foci and confluent areas of abnormal T2/FLAIR hyperintensity within the periventricular and subcortical white matter, which are nonspecific but may represent mild chronic small vessel ischemic changes. There is no pathological enhancement. A left frontal developmental venous anomaly is again incidentally noted. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is a persistent left maxillary sinus mucosal retention cyst. | 1. Interval complete resolution of right nasopharyngeal mass with no residual asymmetry in soft tissues.2. No acute abnormality. Probable mild chronic small vessel ischemic changes. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in mother at age 56. Two standard digital views of both breasts and additional MLO 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 subcentimeter benign intramammary in the left upper outer quadrant. Bilateral benign calcifications are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 83 years, Male. Reason: abdominal distension History: abdominal distension Mild ileus type gas pattern. There is a Dobbhoff tube with its tip projecting over the body of the stomach. Calcific density projecting of the urinary bladder likely represents a urinary bladder calculus. | Nonobstructive bowel gas pattern. Dobbhoff tube with tip projecting over the body of stomach. |
Generate impression based on findings. | Female 34 years old Reason: right distal radius fracture History: fracture There is an underlying comminuted minimally displaced fracture of the ulnar margin of the distal radial metadiaphysis. There is no change in alignment. There is a lucency in the distal radial metaphysis. There is some callus formation.There is dorsal soft tissue swelling and irregular. | Healing distal radius fracture. |
Generate impression based on findings. | 79 years, Male. Reason: eval OG History: eval OG There is a nasogastric tube with its tip projecting over the prepyloric stomach. Presumed common bile duct stent projects over the right upper quadrant. There is a nonobstructive bowel gas pattern. The pelvis is excluded from the field of view. | Nasogastric tube with its tip projecting over the prepyloric stomach. |
Generate impression based on findings. | History of breast cancer with recurrence in supraclavicular lymph node. There is no significant change in size of the right neck lymphadenopathy, with a dominant supraclavicular lymph node that measures up to 34 mm. There is associated stranding of the surrounding fat and apparent infiltration of the adjacent deltoid. There is a punctate calcification in the right floor of mouth, which may represent a calculus. The thyroid and major salivary glands are unremarkable. The osseous structures are unremarkable, aside from mild degenerative cervical spondylosis. The airways are patent. The imaged intracranial structures are unremarkable. There is fluid within the bilateral maxillary and ethmoid sinuses. There is scarring in the lung apices. | 1. No significant interval change in the right metastatic right neck lymphadenopathy with suggestion of extracapsular spread and/or lymphedema.2. Evidence of acute sinusitis. |
Generate impression based on findings. | Male 72 years old Reason: left THA History: left THA Two views of the left hip shows components of a total left hip arthroplasty device in near-anatomic alignment without radiographic evidence of hardware complication. The drain has been removed. Overlying skin suture staples are present. There are phleboliths in the pelvis. There are vascular calcifications.AP view of the pelvis shows aforementioned left hip arthroplasty device. Severe osteoarthritis affects the right hip with bone-on-bone apposition. There is a deformity of the femoral head. | Total left hip arthroplasty device as detailed above. |
Generate impression based on findings. | 36-year-old female with history of fibroadenoma, presents for ultrasound guided biopsy of right breast mass. Right ultrasound re-identified the target lesion for biopsy. The lesion to be targeted is a hypoechoic mass measuring 3.0 cm at the 1 o’clock position with mild increased vascularity, 2 cm from the nipple. The lesion was readily visible.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 lateromedial approach, three 12-gauge core needle (Celero) specimens were obtained of the lesion. Targeting was judged excellent. All specimens sank to the bottom of the prefilled container of 10% formalin. No specimens floated. Specimen quality was judged excellent.Specimens were sent to Pathology with an accompanying history sheet. Using continuous ultrasound-guidance a Bard ribbon 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 in the central posterior aspect of the lesion. 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. | Status post ACL reconstruction. Two views of the left knee reveal postsurgical changes of an ACL reconstruction with proximal and distal anchors. No acute fracture is identified. There is a small joint effusion. The bones are demineralized. | Postsurgical changes of ACL reconstruction. |
Generate impression based on findings. | Female 94 years old Reason: pain History: none Right wrist: Bone demineralized. Alignment is anatomic. There is mild joint space loss at the radiocarpal joint..Right hand: Bones are demineralized. Alignment is near-anatomic. There is mild to moderate interphalangeal joint space loss in moderate to severe first and second metacarpophalangeal joint space loss. No acute fracture is evident. | Osteoarthritis of the wrist and hand. |
Generate impression based on findings. | 53 years old Female. Reason: decision about continuation of this therapy versus switching to something else. History: metastatic breast CA on chemo, followup scan. Restaging, response to therapy. Pain and numbness left arm. RADIOPHARMACEUTICAL: 12.5 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 85 mg/dL. Today's CT portion grossly demonstrates stable numerous bilateral cervical lymph nodeswhich are abnormal in multiplicity, however, not enlarged by size criteria. Right Port-A-Cath terminates in the distal SVC. Numerous surgical clips are again noted in the left axilla. Stable mixed sclerotic and lytic lesion in the right proximal femur. Today's PET examination demonstrates interval increase in the hypermetabolic activity of the left sub-pectoral lymph node, current maximum SUV of 7.3, previously 4.2; suspicious for tumor recurrence. No significant interval change in the hypermetabolic activity in the right hilar lymph node. Mildly hypermetabolic cervical lymph nodes are again noted, for reference a right level II node has a maximum SUV of 1.9, previously 4.4, which is nonspecific.There is re-demonstration of diffuse thyroid uptake, right greater than left, with stable appearance of exophytic nodule posterior to the right thyroid lobe.No new suspicious hypermetabolic activity is identified. | Interval increased activity in the left chest wall sub-pectoral lymph node, suspicious for tumor recurrence.Stable right hilar mild FDG uptake, which is most likely due to inflammatory change. Interval decreased metabolic activity in the cervical small lymph nodes, which are most likely due inflammatory changes.Diffuse thyroid FDG uptake is most likely due to thyroiditis. |
Generate impression based on findings. | 91-year-old male patient with history of prostate cancer and weight loss. CHEST:LUNGS AND PLEURA: Moderate centrilobular emphysema is again noted. There are scattered bilateral micronodules, some of which are calcified, compatible with prior granulomatous disease.MEDIASTINUM AND HILA: Calcified hilar lymph nodes compatible with prior granulomatous disease. Moderate coronary artery calcifications. Cardiac size is within normal limits without pericardial effusion. Right thyroid nodule again noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Granulomata noted.SPLEEN: Splenic granulomata.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Left midpole heterogeneous mass measures 2.0 x 2.2 cm (series 3 image 115), previously 1.8 x 2.0 cm and remains suspicious for a renal neoplasm. Additional bilateral hypoattenuating renal lesions, some of which are too small to characterize, likely represent cysts.RETROPERITONEUM, LYMPH NODES: Interval decrease in size of a gastrohepatic, currently measuring 0.7 x 0.6 cm (series 3 image 104), previously 1.7 x 1.3 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE, SEMINAL VESICLES: Enlarged and heterogeneous prostate is again noted. There is a 2.4 x 1.8 cm mass (series 3 image 196), previously 3.0 x 2.5 cm, that is contiguous with the right posterior aspect of the prostate and seminal vesicles.BLADDER: No significant abnormality noted.LYMPH NODES: Interval decrease in size of pelvic lymph node in the right iliac chain the currently measures 0.5 x 0.6 cm (series 3 image 172), previously 1.0 x 0.8 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Again noted is a left hip screw device.OTHER: No significant abnormality noted | 1.Interval decrease in prostate mass and intra-abdominal lymph nodes. 2.Left renal midpole mass is slightly enlarged compared to prior examination and continues to be concerning for neoplasm. |
Generate impression based on findings. | 63 year old female status post left lumpectomy in 2014 for IDC, presents today for routine follow up. Patient received radiation and chemotherapy. No current breast complaints. No family history of breast cancer. Three standard views of both breasts, and two magnification views of the left lumpectomy site, were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. The linear marker has been placed on a scar overlying the upper outer left breast, with underlying postsurgical changes, including clips. There is demonstration of a stable, lobulated mass at the 9 o'clock position of the right breast. No dominant mass, suspicious microcalcifications or areas of nonsurgical architectural distortion in either breast. Skin thickening is noted of the left breast, likely related to radiation.Benign appearing lymph nodes are projected over the right axilla. Surgical clips are present within the left axilla. | Postsurgical changes of the left breast. Stable right breast mass. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral diagnostic mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: ND - Diagnostic Mammogram. |
Generate impression based on findings. | 72 year-old with history of left mastectomy for breast cancer and reconstruction 20 years ago. Skin redness and nodularity was noted at the left reconstructed breast. Skin over the region of interest was marked by Dr. Chhablani. The area to be studies is 12 - 1 o'clock position in the left reconstructed breast. Focused ultrasound is performed. Slight skin thickening is noted at the area of skin redness. There is no significant abnormalities at the marked area. | No sonographic evidence for malignancy.BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 52-year-old female with history of right wrist pain. Continued interval healing of a nondisplaced scaphoid fracture, evidenced by a band of sclerosis in the area of prior lucency. The previously described cortical step-off in the distal radius is no longer well visualized, compatible with interval healing. The benign-appearing elongated lesion in the metadiaphysis is unchanged. | Continued interval healing of nondisplaced scaphoid and distal radial fractures. |
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. Bilateral benign calcifications, including arterial calcifications are stable. Right breast asymmetries are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | 71 year-old female with left shoulder, elbow, and forearm pain. Two views of the left scapula thumbs are normal anatomic alignment. There is no evidence of fracture. There is mild osteophyte formation at the acromioclavicular joint. Periosteal changes are present in the scapular tip. Three views of the left elbow demonstrate normal anatomic alignment without significant joint effusion or discrete fracture identified. There is no significant soft tissue swelling.Two views of the left forearm are unremarkable. No evidence of fracture or malalignment. The bones are mildly demineralized. Limited view of the left wrist is unremarkable. | Mild periosteal changes in the scapular tip, without definitive fracture. If patient's pain corresponds to this region, further evaluation with CT is recommended. Unremarkable images of the left elbow and left forearm. |
Generate impression based on findings. | 60 year old female with a history of right mastectomy and sentinel lymph node biopsy in 2009 for IDC with DCIS, who has a complaint of a new right axillary/chest wall mass. No family history of breast cancer. Right ultrasound identified the target lesion for biopsy. The lesion to be targeted is a mixed echogenicity mass measuring at least 2.9 cm along the right axillary fold, with increased vascularity. The lesion was readily visible.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 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 axilla and chest wall were 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 inferolateral to superomedial approach, four 14-gauge core needle (Inrad) specimens were obtained of the lesion. Targeting was judged excellent. All specimens sank to the bottom of the prefilled container of 10% formalin. One specimen was fragmented. Specimen quality was judged excellent.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 mammogram was not obtained due to the location of this mass, and inability to visualize this area on mammogram. Postprocedural sonographic image demonstrates the clip centrally within the mass. 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 axillary lesion and clip placement. Pathology is pending at this time.BIRADS: 5 - Highly suggestive of malignancy.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 54-year-old female history of laryngeal cancer and smoking. Evaluate for lung metastasis. LUNGS AND PLEURA: No suspicious pulmonary lesions identified. No focal air space opacities or pleural effusions. Hyperattenuating punctate foci in bilateral bases is nonspecific but may represent aspirated barium. Mild scarring at the lung apices.MEDIASTINUM AND HILA: Heart size normal with no pericardial effusion. Mild coronary artery calcifications. No mediastinal lymphadenopathy. Tracheostomy tube in place. Scattered calcifications of the thoracic aorta. Incidental note is made of an aberrant right subclavian artery.CHEST WALL: Mild multilevel degenerative disease affects the thoracic spine.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Small splenule. | No evidence of metastatic disease to the lungs. |
Generate impression based on findings. | Fall with landing on right knee. Right knee pain. Four views of the right knee reveal no acute fracture or malalignment. There is no joint effusion. | No acute fracture is evident. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of uterine cancer diagnosed in mother. 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, including stable dense parenchyma in each upper outer quadrant. A few scattered benign calcifications have progressed in a benign fashion.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 80-year-old male with pain in right anterior neck and submandibular area. Evaluate for tumor or vascular abnormality In the region of of pain in the right submandibular area and right lateral neck there is a hypoechoic to nearly cystic tubular structure coursing along the right neck and connecting with the internal jugular vein. There is minimal vascularity noted within the structure except at the point of confluence with the internal jugular vein. The internal jugular vein appears patent with appropriate flow. Normal homogeneous echotexture of the visualized thyroid gland. | Findings most likely represent a superficial thrombosed venous collateral to the internal jugular vein. |
Generate impression based on findings. | 25 years, Female. Reason: Pt is a 25 yo with h/o chronic abdominal pain, associated to diarrhea. Please assess for stool burden. History: abdominal pain and diarrhea Average stool burden distributed throughout the colon. There is a nonobstructive bowel gas pattern. | Average stool burden distributed throughout the colon. |
Generate impression based on findings. | Pain. Two views of the cervical spine reveal no acute fracture. There is a reversal of the normal cervical lordosis. The vertebral body heights are preserved. A well corticated ossicle inferior to the anterior arch of C1 likely represents an accessory ossicle.Three views of the lumbar spine reveal moderate disk space narrowing at the L4/L5 and severe disk space narrowing at the L5/S1 levels. Vertebral body heights are maintained. Alignment is anatomic. No acute fracture is evident. There is heavy atherosclerotic calcification of the abdominal aorta. | 1. Reversal of the normal cervical lordosis.2. Degenerative changes of the lower lumbar spine as described above. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of cervical cancer. Family history of cervical cancer diagnosed in sister. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. Stable bilateral asymmetries. Benign-appearing lymph nodes project over both axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Back pain and cracking. History of breast carcinoma in situ. Please include a flexion/extension view to evaluate for spondylolisthesis. Four views of the lumbar spine reveal no acute fracture. The alignment is anatomic. There is disk space narrowing at L3/L4, L4/L5, and L5/S1. There is facet sclerosis and hypertrophy of the lower lumbar spine. There is a grade 1 anterolisthesis of L4 on L5 with flexion. | Grade 1 anterolisthesis of L4 on L5 with flexion and additional degenerative changes as described above. |
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. Scattered benign calcifications are present.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Left hip pain status post left hip replacement. Question of hardware displacement, other arthritis changes. Two views of the left hip reveal a total hip arthroplasty device in anatomic alignment without evidence of hardware complication. No acute fracture is evident. There is heterotopic ossification along the lesser and greater trochanters, unchanged. | Left total hip arthroplasty without evidence of hardware complication. |
Generate impression based on findings. | Patient patient says a splinter went in, now retained. Please evaluate for metal splinter in left thumb. Three views of the left hand reveal no acute fracture or malalignment. No radiopaque foreign body is identified. There is heterotopic bone adjacent to the first interphalangeal joint. A small calcification is noted adjacent to the ulnar styloid. There are extensive vascular calcifications. | No radiopaque foreign body is identified. |
Generate impression based on findings. | Clinical question: Altered mental status. Signs and symptoms: Altered mental status. Unenhanced head CT:No acute intracranial findings, CT however is insensitive for early detection of the acute nonhemorrhagic ischemic strokes.Extensive periventricular and subcortical low attenuation of white matter is highly suggestive of extensive age indeterminate small vessel ischemic strokes. Similar findings in bilateral basal ganglia is also noted. The findings were present on prior head CT exam from 2012 and demonstrate progression.Unremarkable intracranial content otherwise.Unremarkable barium and paranasal sinuses. Images through the or this demonstrate bilateral chronic blowout fractures of the lamina papyracea which was present on the right however the finding on the left is new since prior exam. | 1.No acute intracranial process.2.Extensive age indeterminate small vessel ischemic strokes |
Generate impression based on findings. | 52-year-old female patient with right lower quadrant pain x 3 to 4 weeks. Note that examination is limited by small intravenous contrast bolus. Given this limitation, the following observations can be made:ABDOMEN:LUNG BASES: Scarring and chronic appearing interstitial reticular opacities are noted in the right lower lobe. Cardiomegaly noted.LIVER, BILIARY TRACT: Heterogenous liver parenchyma suggestive of hepatic congestion/chronic liver disease. Sludge in the gallbladder noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Prominent scattered mesenteric lymph nodes.BONES, SOFT TISSUES: Severe S-shaped scoliosis of the thoracolumbar spine.OTHER: Intra-abdominal ascites.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: The appendix is visualized and is within normal limits.BONES, SOFT TISSUES: Severe S-shaped scoliosis of the thoracolumbar spine.OTHER: Intra-abdominal ascites. | 1.No acute intra-abdominal abnormalities to account for patient's pain.2.Cardiomegaly, ascites and findings compatible with hepatic congestion. Prominent mesenteric nodes are favored to be reactive to this process. |
Generate impression based on findings. | Painful right knee with abnormality adjacent to growth plate on MR. An ill-defined area of sclerosis is noted anteriorly and centrally within the femoral metaphysis abutting the physis. Within this sclerotic region, a 0.3 cm lucency is present with the suggestion of a central sclerotic focus (nidus).A 0.6 cm fibrous cortical defect is noted laterally in the distal femoral diametaphysis. | Sclerotic lesion with central lucency in anterior central femoral metaphysis most likely an osteoid osteoma. |
Generate impression based on findings. | 69 years old Male. Reason: needing staging. History: h/o recurrent HNC. RADIOPHARMACEUTICAL: 15.2 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 152 mg/dL. Today's CT portion grossly demonstrates dependent changes/atelectasis are seen in the lung bases. Mixed sclerotic and lytic lesions in the left hemipelvis. Several soft tissue nodules are seen in the midline of the back of the chest, right breast/chest wall and the right abdominal wall.Today's PET examination demonstrates no definite evidence of FDG avid tumor in the neck, chest, abdomen and pelvis. Diffuse and mild FDG uptake is seen in the patchy opacities in the lower lungs, which is most likely due to inflammatory change. There is decreased FDG uptake in the low attenuation lesion in the right kidney, suggestive of a renal cyst.Increased activity in the muscles in the neck, upper extremities, bilateral psoas and iliac muscles and proximal legs, which is most likely physiological.Mild FDG uptake is seen in the subcutaneous soft tissue nodules in the back of the chest, right breast/chest wall, and right abdominal wall, which are nonspecific.There is a no abnormal FDG uptake in the mixed sclerotic and lytic lesions in the left hemipelvis.Physiological activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.No definite evidence of FDG avid tumor.2.Subcutaneous soft tissue nodules with mild FDG uptake in the chest wall and right abdominal wall, which are nonspecific. Suggest clinical correlation. 3. Inflammatory changes in the lower lungs.4.Mixed and sclerotic lesions in the left hemipelvis with no increased metabolic activity. |
Generate impression based on findings. | 48 years, Female, Reason: Relapsed DLBCL History: 48Yrs female with relapsed DLBCL with bone involvement s/p ASCT 2/2012 in need of restaging.RADIOPHARMACEUTICAL: 14.7 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 102 mg/dL. Today's CT portion grossly demonstrates mildly enlarged bilateral jugular chain nodes and small right axillary nodes. There is a right chest port with tip at the cava atrial junction. A left adrenal adenoma is unchanged.Today's PET examination demonstrates mildly hypermetabolic bilateral jugular chain lymph nodes which are stable from the prior exam. A left level 2 node has an SUVmax of 3.1, unchanged.There are mildly hypermetabolic bilateral axillary nodes which are likely inflammatory. However, there is a new solitary moderately hypermetabolic (SUVmax 3.1) right axillary node.There are new mildly hypermetabolic pelvic nodes including a right internal iliac node (SUVmax 3.6) and a right external iliac node (SUVmax 2.7) | 1.New hypermetabolic pelvic lymph nodes suggest disease progression.2.Hypermetabolic cervical nodes are stable.3.Hypermetabolic right axillary node is new and may represent either neoplasm or infiltration from injection. |
Generate impression based on findings. | Knee injury. Question of fracture. Four views of the left knee reveals no acute fracture or malalignment. There are mild osteoarthritic changes of the knee. | 1. No acute fracture is evident.2. Mild osteoarthritis. |
Generate impression based on findings. | 27-year-old female with lower back pain. Two views of the lumbar spine demonstrate pars defects are present at L5- S1 without significant anterolisthesis. Normal anatomic alignment is maintained. There is no evidence of acute fracture. | Pars defects at L5-S1, without significant anterolisthesis. |
Generate impression based on findings. | A left frontal burr hole is again seen from previous biopsy. Again seen is a large heterogeneous left frontal lobe mass involving grey and white matter. There is minimal if any residual enhancement along the left anterolateral margin of the mass. There remains a persistent area of a near CSF signal intensity anteriorly within the mass which may represent a more cystic component. Again noted are foci of hemosiderin deposition, likely due to prior biopsy. There is slight further reduction in extent of associated T2/FLAIR hyperintensity surrounding the mass, especially compared back to the August exams. There is also slight decreased extent of localized mass effect upon the left frontal horn.On perfusion imaging, there is slightly focal elevated rCBV along the left anterolateral margin of the mass corresponding to faint residual ill-defined enhancement as seen on 13/50.The ventricles and sulci are otherwise stable. The cisterns remain patent. There is no midline shift. There are no new areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits.There is focal thickening of the medial right orbital roof extending into the superomedial right orbital wall. This measures 10 mm in greatest thickness with attenuation of portions of the T1 and T2 hypointense cortical signal, not significant change since the first available MR. Evaluating this area on corresponding prior CTs, there is diffuse osseous thickening even laterally along the right orbital roof with groundglass appearance of the bone. This is T1 hypointense and T1 and T2 weighted images with diffuse homogeneous enhancement. | 1. Redemonstration of large left frontal lobe tumor, with perfusion imaging suggesting also focal hyperperfusion along the left anterolateral margin of the mass corresponding to ill-defined residual enhancement. Continued attention to this area is recommended on follow-up exams.2. Subtle progressive decreased extent of surrounding FLAIR abnormality, with more conspicuous change compared back to August 2014 exams. Decreased mass effect upon the left frontal horn.3. Incidental note made of stable thickening of the supermedial left orbital roof with diffuse enhancement, corresponding to an area of osseous thickening and groundglass appearance on CT. This is most suggestive of fibrous dysplasia, with predominance of fibrous component. |
Generate impression based on findings. | Clinical question: New onset of headache, renal failure and right eye pain. Signs and symptoms: As above. Nonenhanced head CT:Detectable acute intracranial process. CT however is insensitive for early detection of acute nonhemorrhagic ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricles and the gray/white matter differentiation.Unremarkable calvarium, scalp, orbits, paranasal sinuses and the mastoid air cells. | Negative nonenhanced head CT. |
Generate impression based on findings. | Female 53 years old Reason: Confirm Dobbhoff tube placement History: as above There is a Dobbhoff tube with the tip projecting over the body of the stomach, with the guidewire still in place. The Dobbhoff tube appears kinked just distal to the guidewire. Epicardial pacer leads in place. Swan-Ganz catheter with tip in the main pulmonary artery. Two right-sided chest tubes and two left-sided chest tubes in place, positions unchanged. Sternal fixation hardware in place. Multiple surgical clips project over the hilum. Redemonstration of extensive bilateral diffuse pulmonary opacities appearing similar to the prior examination. Generalized paucity of bowel gas, unchanged. | Dobbhoff tube with the tip projecting over the body of the stomach, with the guidewire still in place. The Dobbhoff tube appears kinked just distal to the guidewire. |
Generate impression based on findings. | 57 year old with recent history of left breast pain, but no pain today. Whole breast ultrasound for left breast was performed. No abnormal findings are detected. | No sonographic evidence for malignancy. Clinical follow up is recommended. BIRADS: 1 - Negative.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | 66 years, Male, Reason: staging/mediastinal History: new dx RML lung cancer.RADIOPHARMACEUTICAL: 12.6 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 103 mg/dL. Today's CT portion grossly demonstrates a large right middle lobe mass as described on the prior CT. There are moderate coronary artery calcifications. Prominent right inguinal nodes appear similar to the prior exam. There is diffuse sclerosis and cortical thickening of the right hemipelvis which is not hypermetabolic and likely represents Paget's. The left adrenal gland is slightly nodular.Today's PET examination demonstrates a large right middle lobe hypermetabolic mass (SUVmax 12.8) consistent with patient's known adenocarcinoma. There are mildly hypermetabolic subcarinal (SUVmax 2.7) and right hilar lymph nodes. A right axillary node is also mildly hypermetabolic. Left adrenal gland is mildly hypermetabolic (SUV max 2.7). There is increased activity at the origin of the left hamstring tendons which likely reflect tendinopathy. There is increased activity along the lateral wall of the left ventricle which may reflect ischemia. | 1.Hypermetabolic right middle lobe mass consistent with patient's known adenocarcinoma.2.Mildly hypermetabolic subcarinal and right hilar nodes, tumor involvement cannot be excluded. There is also a minimally hypermetabolic right axillary node which is less suspicious for tumor.3.Mildly hypermetabolic left adrenal gland, which is slightly nodular. Although a benign etiology is favored, metastases cannot be excluded and continued follow up is recommended.4.Hypermetabolic lateral wall of the left ventricle is suggestive of ischemia. Correlation with EKG is recommended.5.Diffuse sclerosis and cortical thickening of the right hemipelvis which is not hypermetabolic likely represents Paget's disease.Findings discussed with Kimberly Gottlieb A.P.N. at 3:50 pm on 3/12/2015 |
Generate impression based on findings. | Fracture. There are postsurgical changes of the distal fibula with plate and syndesmotic screws without evidence of hardware complication. The fracture line is not clearly evident suggestive of near complete healing. Alignment is anatomic. The bones appear demineralized and there is soft tissue swelling about the lateral malleolus. | Orthopedic fixation of healing fractures. |
Generate impression based on findings. | Female 1 day old Reason: eval ETT placement History: intubated for MRI, right arm weakness.VIEW: Chest AP (one view) 3/12/15 at 1529 hrs. ET tube terminates below thoracic inlet. Aortic arch, cardiac apex and stomach are left-sided. Cardiac silhouette is normal in size and shape. Right upper lobe atelectasis. No effusions or pneumothorax. | ET tube positioning as described.Right upper lobe atelectasis. |
Generate impression based on findings. | Right fifth digit injuryVIEWS: Right hand AP and right fifth finger lateral and oblique 3/12/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | 79-year-old male with history of left leg pain, preop bone length assessment. Left bone length study reveals 4 degrees of varus angulation of the knee compared to the neutral mechanical axis. There is severe osteoarthritic effecting the left knee as well as moderate osteoarthritis affecting the left hip. | Four degrees of varus angulation of the knee compared to the neutral mechanical axis. |
Generate impression based on findings. | Pain. Three views of the right knee reveal no acute fracture or malalignment. There is minimal osteophyte formation of the lateral tibial femoral compartment and the patellofemoral compartment. The joint spaces are preserved.Three views of the left knee shows no acute fracture or malalignment. There is minimal osteophyte formation at the patellofemoral joint. There is mild joint space narrowing of the medial compartment.Three views of the lumbar spine demonstrates a grade 1/2 anterolisthesis of L3 on L4. The superior articular facet of L4 is indistinct. Vertebral body heights are maintained. | 1. Grade 1/2 anterolisthesis of L3 on L4.2. Mild osteoarthritis of the bilateral knees. |
Generate impression based on findings. | 50 year-old female with right knee pain and stiffness. Four views of the right knee demonstrate moderate osteoarthritis of the knee, most significant in the medial femorotibial compartment, with joint space narrowing, subchondral sclerosis, and osteophyte formation, which has progressed from remote films from 2007 and may be underestimated in these nonweightbearing images. No significant joint effusion. There is no fracture or malalignment evident. | Moderate osteoarthritis. |
Generate impression based on findings. | 41-year-old female with neck pain. Four views of the cervical spine demonstrate multilevel degenerative changes, including mild joint space narrowing and C3-C4, C4-C5, C5-C6 as well as mild anterior osteophyte formation. There is bilateral neural foramina narrowing of C5-C6. There is no evidence of malalignment or acute fracture. | 1.Mild multilevel degenerative disease of the cervical spine.2.Bilateral neural foramina narrowing of C5-C6. |
Generate impression based on findings. | Reason: source of fever History: neutropenic fever LUNGS AND PLEURA: Prior patchy groundglass opacities have progressed throughout the lungs with right upper lobe atelectasis or even fibrosis.The distribution is still upper lobe predominant.Small pleural effusions have developed.MEDIASTINUM AND HILA: No significantly enlarged mediastinal lymph nodes.Mild coronary calcifications are present, and there is a small pericardial effusion, unchanged since the prior study.Low-attenuation of the blood pool in the heart is consistent with known anemia.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Unchanged splenomegaly. | Progression of pulmonary opacities are suggestive of drug reaction, or diffuse pulmonary hemorrhage especially in light of the patient's thrombocytopenia and anemia. Although considered less likely, the etiologies still includes atypical infection although pleural effusions are uncharacteristic of pneumocystis pneumonia. |
Generate impression based on findings. | 60 -year-old male with history of bilateral hip pain, concern for arthritis. Two views of the right hip demonstrate mild joint space narrowing and osteophyte formation, compatible with minimal osteoarthritis. No evidence of fracture or malalignment. No significant soft tissue swelling.Two views of the left hip demonstrate joint space narrowing and ossify formation compatible with mild osteophyte is. No evidence of fracture or malalignment. No significant soft tissue swelling. | Bilateral mild osteoarthritis. |
Generate impression based on findings. | Rheumatoid arthritis. Three views of the right hand are provided. There are hardware components of a right total wrist arthroplasty and ulnar head prosthesis situated in near anatomic alignment without evidence of hardware complication. The wrist is held in flexion similar to the prior exam. Again seen is severe narrowing and mild deformities with secondary osteoarthritis at the second and fifth PIP joints. Three views of the left hand are provided. There is a flexion deformity at the first MCP joint. There is mild narrowing of the MCP joints. There is severe osteoarthritis and subluxation at the third PIP joint. No discrete erosions are identified. Three views of the right foot are provided. There is severe pes planovalgus deformity. There are unchanged small calcifications at the first interphalangeal joint with associated focal soft tissue swelling. No new discrete erosions are identified. Three views of the left foot are provided. There is a severe pes planovalgus deformity. Osteoarthritic and inflammatory arthritic changes throughout the midfoot appears similar to the prior study. There is a healed second metatarsal stress fracture. No discrete new erosions are identified. | Inflammatory and osteoarthritic degenerative changes as above, without significant progression. |
Generate impression based on findings. | 45-year-old female with right elbow pain, possible ulnar nerve compression. Four views of the right elbow demonstrate mild osteoarthritis. No significant joint effusion or soft tissue swelling. There is no discrete fracture or evidence of malalignment. | Mild osteoarthritis without acute fracture, malalignment, or joint effusion. |
Generate impression based on findings. | Status post laryngectomy for laryngeal cancer with postoperative radiation therapy. There are postoperative findings related to total laryngectomy, bilateral neck dissection, and tracheostomy, with a tracheostomy tube in position, as well as findings related to radiation therapy. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The remaining portions of the thyroid and major salivary glands are unremarkable. The airway inferior to the tracheostomy tube are patent. There is an aberrant right subclavian artery. There is mild plaque at the carotid bifurcations. There is multilevel degenerative cervical spondylosis. The imaged intracranial structures are unremarkable. There is scarring in the bilateral lung apices. | Post-treatment findings in the neck without discernible evidence of locoregional tumor recurrence. |
Generate impression based on findings. | 91 years, Male, Reason: eval for disease progression, hx of prostate cancer with rising psa History: pain, weakness, weight loss. Hypermetabolic right rib lesion is unchanged on the prior exam and is likely benign. Additional right rib lesions seen previously are not visualized on this exam. Regions of increased radiotracer uptake surrounding the left femur have resolved. No suspicious lesions are evident. | No definite evidence of osseous metastasis. |
Generate impression based on findings. | 50 year-old female with neck pain. Two views of the cervical spine demonstrate multilevel disk space narrowing, most pronounced at C3-C4 and C4-C5 and C5-C6. There is mild anterior osteophyte formation of C3 through C6. There is no evidence of cervical instability, acute fracture or malalignment. | Mild multilevel degenerative disease. No evidence of cervical instability. |
Generate impression based on findings. | 40 year-old male with history of left fourth metacarpal fracture. Three views of the left hand demonstrate a healing subacute oblique fracture through the mid-diaphysis of the fourth metacarpal, in anatomic alignment. There is no evidence of other fracture or malalignment. There is no significant soft tissue swelling. | Subacute oblique fracture of the fourth metacarpal in anatomic alignment. |
Generate impression based on findings. | Frontal sinus: The frontal sinus and frontoethmoidal recesses are clear.Anterior ethmoids: The anterior ethmoid air cells are clear.Maxillary sinuses: The right maxillary sinus is clear. There is polypoid mucosal thickening in the left maxillary sinus. The ostiomeatal units are clear.Posterior ethmoids: The posterior ethmoid air cells are clear.Sphenoid sinus: The sphenoid sinus and bilateral sphenoethmoidal recesses are clear. There is mild rightward nasal septal deviation. The nasal turbinate morphology is within normal limits. The nasal cavity is clear.The lamina papyracea are intact. The roof of the ethmoids is relatively symmetric. | Minimal mucosal thickening in the left maxillary sinus with polyp versus mucous retention cyst. Paranasal sinuses are otherwise clear. |
Generate impression based on findings. | Status post laryngectomy for laryngeal cancer with postoperative radiation therapy. There are postoperative findings related to total laryngectomy, bilateral neck dissection, and tracheostomy, with a tracheostomy tube in position, as well as findings related to radiation therapy. There is no evidence of measurable mass lesions or significant cervical lymphadenopathy based on size criteria. The remaining portions of the thyroid and major salivary glands are unremarkable. The airway inferior to the tracheostomy tube is patent. There is an aberrant right subclavian artery. There is mild plaque at the carotid bifurcations. There is multilevel degenerative cervical spondylosis. The imaged intracranial structures are unremarkable. There is scarring in the bilateral lung apices. | Post-treatment findings in the neck without discernible evidence of locoregional tumor recurrence. |
Generate impression based on findings. | History of CRT for tonsil/soft palate cancer in 2010, complicated by ORN of mandible requiring right fibular free flap in 2012, began treatment of deep neck space infection in 10/2014 with linezolid, but eventually required removal of mandibular hardware and neck debridement on 12/30. He started to develop facial edema and erythema concerning for persistent infection. Maxillofacial: There are postoperative findings related to segmental right mandibulectomy with fibular graft reconstruction with plate and screw fixation, as well as right neck dissection with apparent obliteration of the right internal jugular vein. There has been interval demineralization of the right mandibular ramus with associated pathological fracture and fragmentation. There is also development of extensive periosteal reaction along the right mandibular ramus and portions of the fibular graft. The fibular graft otherwise demonstrates fusion with the native bone and there is no evidence of hardware loosening. There is mild swelling of the adjacent masticator muscles, but no evidence of fluid collections or mass lesions. There is minimal mucosal thickening in the right maxillary sinus. The orbits and imaged intracranial structures are unremarkable. Neck: There is no evidence of significant lymphadenopathy in the neck. The airways are patent. The thyroid gland and remaining salivary glands are unremarkable. There is mild plaque at the carotid bifurcations. There are ossific bodies in the right subacromial bursa region. | 1. Postoperative findings related to segmental right mandibulectomy and reconstruction with interval demineralization of the right mandibular ramus with associated pathological fracture, as well also development of extensive periosteal reaction along the right mandibular ramus and portions of the fibular graft suggestive of osteomyelitis. The fibular graft otherwise demonstrates fusion with the native bone and there is no evidence of hardware loosening.2. Postoperative findings related to right neck dissection without evidence of significant lymphadenopathy in the neck. 3. Ossific bodies in the right subacromial bursa region are compatible with synovial osteochondromatosis. |
Generate impression based on findings. | 67-year-old female patient status post right nephrectomy for clear cell renal carcinoma. ABDOMEN:LUNG BASES: Moderate coronary artery calcifications are noted. No suspicious appearing pulmonary nodules.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post right nephrectomy without evidence of local recurrence. Left kidney is atrophic with numerous hypoattenuating subcentimeter lesions that are favored to represent cysts.RETROPERITONEUM, LYMPH NODES: No retroperitoneal lymphadenopathy. Moderate atherosclerotic changes effect the abnormal aorta and its branches.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Fibroid uterus.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. | No evidence of recurrent or metastatic disease. |
Generate impression based on findings. | Right knee pain.VIEWS: Right knee AP, lateral and oblique 3/12/15 (3 views) There no evidence of fracture, malalignment or soft tissue swelling. No joint effusion. Mild cortical irregularity of the distal and medial metaphysis of the right femur is of uncertain clinical significance. | No fractures. |
Generate impression based on findings. | 57 year-old female with right knee pain. Four views of the right knee demonstrates severe tricompartmental osteoarthritis of the right knee, with bone-on-bone joint space narrowing, extensive osteophyte formation, subchondral sclerosis and subchondral cysts. There is mild varus deformity of the knees bilaterally. There is no acute fracture or malalignment evident. Views of the left knee also demonstrate bone-on-bone degeneration, compatible with severe osteoarthritis. | Severe bone-on-bone osteoarthritis, right greater than left. |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (1/9/15) performed at Evanston Hospital. For comparison, digital mammographic images (2/23/12) are available. Two standard views of both breasts were obtained. The breast parenchyma is heterogeneously dense, unchanged in pattern and distribution. A scar marker is placed at lower inner right breast. Multiple benign calcifications, including skin calcifications are present in both breasts.No dominant mass, suspicious microcalcifications or areas of architectural distortion are noted in either breast. | No mammographic evidence of malignancy. BIRADS: 2 - Benign finding.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Male 7 days old Reason: eval line UA position History: premature infant UV removedVIEW: Abdomen and chest AP (two views) 3/12/15 at 1558 hrs. ET tube tip is at the right mainstem bronchus or carina. The UAC terminates at T9. NG tube tip is at the stomach. Interval the UVC removal. Cardiac silhouette size is normal. Large lung volumes and diffuse lung haziness are unchanged. No focal opacities, effusions or pneumothorax.Disorganized, nonspecific abdominal gas pattern. No evidence of obstruction, free air, pneumatosis intestinalis or portal venous gas. | Interval removal of UVC.Misplaced ET tube.Bilateral diffuse lung haziness and large lung volumes unchanged.Disorganized, nonspecific abdominal gas pattern. |
Generate impression based on findings. | 68-year-old female with pain in the left basilar joint. Three views of the left hand demonstrate joint space narrowing, subchondral sclerosis, and mild radial subluxation of the basilar joint. There is mild joint space narrowing of the radiocarpal and intercarpal joints, as well. There is no evidence of acute fracture or malalignment. There is no significant soft tissue swelling. | Moderate osteoarthritis of the wrist, most pronounced at the basilar joint. |
Generate impression based on findings. | 75-year-old female with history of metastatic breast cancer. Evaluate for response. CHEST:LUNGS AND PLEURA: Large right pleural effusion has become more loculated in the interval. Focus of gas density within this collection is likely iatrogenic. The adjacent pleural tissue demonstrates irregular thickening and enhancement compatible with biopsy proven metastatic disease. There is associated right basilar atelectasis. No suspicious pulmonary nodules. The left lung appears normal.MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. Minimal coronary artery calcifications. No mediastinal lymphadenopathy. Right cardiophrenic lymph nodes are no longer visualized.CHEST WALL: Mild multilevel degenerative disease affects the thoracic spine. No suspicious osseous lesions identified.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hepatic hypodensities are incompletely characterized, but appear stable when compared to prior and likely benign.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Small bilateral hypodensities are too small to characterize.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications of the abdominal aorta and its branches. There is focal mural thrombus within the proximal right common iliac artery.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. Malignant right pleural effusion has become loculated in the interval. Focus of gas within this collection is likely iatrogenic.2. Previously identified enlarged right cardiophrenic lymph nodes are no longer visualized.3. Unchanged hepatic lesions are likely benign.4. No measurable tumor. Fluid in the minor fissure obscures the previously noted pulmonary nodules/lymph nodes. |
Generate impression based on findings. | 37-year-old male with a history of bilateral shoulder and knee pain. Three views of the right shoulder are within normal limits. There is no evidence of acute fracture or malalignment. There are no significant degenerative changes.Three views of the left shoulder are within normal limits. There is no evidence of acute fracture or malalignment. There are no significant degenerative changes.Four views of the right knee show minimal tibial spine sharpening, unchanged from prior. No acute abnormality.Four views of the left knee show minimal to tibial spine sharpening, unchanged from prior. No acute abnormality. | No significant degenerative disease of the shoulders or knees. No acute abnormality. |
Generate impression based on findings. | Male 18 years old Reason: hx tib plateau fx s/p fixation and removal VIEWS: Left knee AP, lateral and oblique 3/12/15 (3 views) Healed tibial plateau fracture is in anatomic alignment. Round lucencies from previous hardware on the proximal diaphysis of the left tibia are still present. | Healed fracture, in anatomic alignment. |
Generate impression based on findings. | Redemonstrated is a burr hole in the right cranial vertex with a small amount of pneumocephalus and a clip in the medial right temporal lobe, compatible with recent biopsy. Again seen is diffuse hypoattenuation involving the white matter of the right temporal lobe extending to the insula and operculum. There is increased hypoattenuation involving the white matter of the right frontal lobe with sparing of the cortex, compared to the pre-biopsy study. No evidence of significant intracranial hemorrhage. Scattered foci of age indeterminate small vessel ischemic disease and lacunar infarcts are redemonstrated. There is mucosal thickening in the right greater than left sphenoid sinuses.There is no significant vascular narrowing. There is mild increased vascularity of the right cerebral hemisphere, which is likely reactive. The intracranial internal carotid arteries, middle and anterior cerebral arteries are otherwise grossly unremarkable. The vertebral arteries, basilar artery, and posterior cerebral arteries are also grossly normal in course and caliber. There is no evidence of flow-limiting stenosis or aneurysm. There are moderate atherosclerotic changes of the vertebral arteries and the cavernous portion of the internal carotid arteries. | 1. Diffuse vasogenic edema involving the right frontal lobe of uncertain etiology, possibly related to spread of the temporal lobe process or worsening infectious/inflammatory process. Mild increased vascularity of the right cerebral hemisphere, which is likely reactive. 2. Postbiopsy changes of the temporal lobe.3. Moderate atherosclerotic changes of the intracranial vessels without high grade stenosis.4. No significant vascular narrowing to suggest vasculitis. |
Generate impression based on findings. | 92 year-old male for assessment of aortic diameter, previously noted small aneurysm LUNGS AND PLEURA: Bibasilar dependent atelectasis. No suspicious nodules or masses are identified. No pleural effusion or pneumothorax.MEDIASTINUM AND HILA: Moderate cardiomegaly without pericardial effusion.Severe coronary artery calcification. Prominent 11-mm anterior subcarinal lymph node. Additional scattered subcentimeter mediastinal lymph nodes.The ascending aorta measures 4.2 cm. The aorta at the diaphragmatic inlet demonstrates fusiform dilation measuring up to 4 cm in diameter, similar to that seen on exam 1/16/2015, but slightly larger when compared to 10/17/14.CHEST WALL: Moderate degenerative changes affect the thoracic spine. No suspicious osseous lesions. No significant cardiophrenic, retrocrural, subpectoral or axillary lymphadenopathy. Minimal gynecomastia.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. Hypoattenuating lesion in the left kidney is unchanged from the prior exam 1/16/15. Bilateral atrophic kidneys. Diverticulosis without evidence of diverticulitis. Cholelithiasis is present. | Fusiform aneurysmal dilatation of the aorta at the diaphragmatic inlet measuring up to 4 cm. Aneurysmal dilatation of the ascending aorta measuring up to 4.2 cm. demonstrates no recent change from the prior exam demonstrates gradual increase in caliber when compared to CT 10/17/14. |
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