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Generate impression based on findings. | Male 60 years old Reason: renal cancer with bone metastases History: renal cancer Increased review tracer uptake in the posterior left ninth rib appears similar to prior examination, consistent with patient's known pathologic fracture. No new suspicious osseous lesions. Findings consistent with partial right nephrectom... | Stable radioisotope uptake in the known left ninth rib pathologic fracture. No evidence of new osseous metastatic disease. |
Generate impression based on findings. | Male 56 years old Reason: 56M with rectal cancers/p LAR/DLI, please eval for anastomotic leak History: please eval for anastomotic leak, foul smelling drainage per anus Following retrograde administration of barium into the rectum and distal colon via the transanal inserted 14-French Coley catheter: There was prompt op... | 1.Large presacral collection arising posterior to the colorectal anastomosis, most consistent with a contained leak.2.Luminal narrowing of the pre-anastomotic large bowel, perhaps related to inflammation or stricturing.These findings were relayed to Dr. Kakuku 11:00 13/13/2015 |
Generate impression based on findings. | 62-year-old male with colon cancer metastatic to liver. CHEST:LUNGS AND PLEURA: Any left upper lobe on image 37/116 there is a 1.5 x 2.5 cm partly solid and irregularly marginated mass. The findings are worrisome for a primary lung cancer. No other focal pulmonary parenchymal abnormality.MEDIASTINUM AND HILA: No signif... | .Stable hepatic masses. The largest represents a hemangioma.Findings worrisome for primary left upper lobe lung cancer.Stable appearance of rectum and sigmoid wall thickening with mesenteric stranding |
Generate impression based on findings. | Female; 64 years old. Reason: Location of GI bleed History: Bloody stools ABDOMEN:LUNG BASES: Moderate cardiomegaly. Low-density cardiac blood pool from anemia. Severe coronary calcifications. IVC and hepatic veins are engorged, with reflux of contrast, compatible with right heart failure. LIVER, BILIARY TRACT: Two sub... | Continued small bleed from the terminal ileum despite coil embolization.Findings discussed with Dr. Wachtel at 1:19 p.m. on 3/13/15. |
Generate impression based on findings. | Male 10 years old Reason: eval elbow alignment History: elbow dislocationVIEWS: Left elbow AP and lateral 3/13/15 (two views) Cast material obscures fine bone details. Healing fracture is in anatomic alignment. | Healing fracture in anatomic alignment. |
Generate impression based on findings. | Reason: dizziness, bleed? History: as above The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.The visualized portions of the paranasal si... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Malignant neoplasm of the prostate with back pain CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Subcentimeter thyroid nodules. No significant mediastinal adenopathy.CHEST WALL: Diffuse widespread osseous metastasesABDOMEN:LIVER, BILIARY TRACT: Probable liver cysts.SPLEEN: No significant ... | Widespread bony metastases. Correlate with bone scan. |
Generate impression based on findings. | 67-year-old female with history of bladder cancer -- surveillance ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No enhancing lesions. Gallstones appear stable.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKID... | No substantial interval change and no definite evidence of residual or recurrent disease. |
Generate impression based on findings. | 32-year-old female with a two medic hip pain times several months. Two views of the left hip demonstrate normal anatomic alignment. There is no evidence of acute fracture or malalignment. There is perhaps mild prominence of the anterior aspect of the femoral head-neck junction, suggestive of mild CAM deformity of quest... | Possible mild CAM deformity of uncertain clinical significance. No acute findings to account for the patient's pain. |
Generate impression based on findings. | 55-year-old male with relapsed multiple myeloma with rising creatinine and elevated bilirubin. LIMITED ABDOMENLIVER: Coarse echogenicity of the liver measuring 16.9 cm in length. No focal hepatic lesions.BILIARY TRACT: Status post cholecystectomy. Mild prominence of the common bile duct with no intrahepatic biliary duc... | 1. Course echogenicity of the liver suggestive of parenchymal dysfunction/fatty infiltration. Patent hepatic inflow and outflow vasculature.2. Increased echogenicity of the kidneys suggestive of parenchymal dysfunction. 3. Mild prominence of the common bile duct with no intrahepatic ductal dilatation. |
Generate impression based on findings. | Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.Disc desiccation with mild disc height loss are present at L4/5 and L5... | 1.L4/5: There is a left central to right foraminal disc protrusion with prominent annular tear causing mild right lateral recess and mild proximal right neural foraminal stenosis.2.L5/S1: There is a central disc protrusion which abuts, flattens, and compresses bilateral S1 nerve root sheath origins (left somewhat great... |
Generate impression based on findings. | 62 year-old female with that pain status post fall from counter-height stool. Three views of the thoracic spine demonstrate tiny vertebral body osteophytes, but no fracture. Moderate degenerative disk disease affects the visualized cervical spine.Five views of the lumbar spine demonstrate mild degenerative disk disease... | Degenerative arthritic changes as described above. No acute fracture is evident. |
Generate impression based on findings. | Female 36 years old Reason: h/o ileocolonic crohns s/p resection with low mag. Please eval transit time and length of remaining small. History: low mag. Scout radiograph showed a nonobstructive bowel gas pattern. Transit time to the colon was 55 minutes. Patient is status post multiple small bowel resections and status... | Patient ileocecectomy with end to side anastomosis. |
Generate impression based on findings. | Female 36 years old Reason: Evaluate for nausea, history of UC with IPAA. Need to evaluate for adhesions causing abdominal distension, bloating and nausea History: Nausea with vomiting Scout radiograph showed a nonobstructive bowel gas pattern. Suture material projects over the lower pelvis, presumably related to prior... | 1.Findings consistent with small bowel adhesive disease without evidence of obstruction.2.Expected pre-anastomotic dilatation of the small bowel. |
Generate impression based on findings. | Follow-up. Three views of the left ankle show mild diffuse soft tissue swelling, which has decreased. There are unchanged tiny densities distal to the medial malleolus which are likely chronic in etiology. No acute superimposed fracture is identified. | Improvement in soft tissue swelling without acute fracture. |
Generate impression based on findings. | Reason: evaluate for autoimmune pancreatitis History: abdominal pain, CT in Oct 2014 suggesting pancreas abnormality ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted. Parallel course of the cystic duct with borderline low insertion on the common duct.SPLEEN: Occlusion at origin of splenic vein redemonstra... | 1.No definite evidence of autoimmune pancreatitis, further described above. If clinical concern persists, can correlate with IgG serologies. |
Generate impression based on findings. | Malignant neoplasm of the kidney, follow-up. CHEST:LUNGS AND PLEURA: Multiple diffuse parenchymal lung nodules are unchanged bilaterally. Reference lesion in the right lower lobe again measures 6 mm (image 57; series 5). Left lower lobe atelectasis has resolved. MEDIASTINUM AND HILA: Left hilar adenopathy has regressed... | Marked interval regression of disease. Reference measurements are given above. |
Generate impression based on findings. | Male 67 years old Reason: evaluate Dobbhoff placement History: Dobbhoff placement There is a Dobbhoff tube with its tip projecting over the body 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 ... | Dobbhoff tube tip projecting over the body of the stomach. |
Generate impression based on findings. | No definite large osseous defect is seen ovaries, specifically along the cribriform plate. There is focal attenuation along the cribriform plate on coronal image 80358/73, although this is a symmetric finding and the bone appears more contiguous on the sagittal reformatted images.Frontal sinus: The frontal sinus and f... | No definite skull base bony defect. Nuclear medicine cisternogram may be more sensitive for CSF leak. |
Generate impression based on findings. | 55-year-old female with frequent asthma exacerbation, dyspnea, for workup of ILD LUNGS AND PLEURA: No pleural effusion or pneumothorax. No suspicious nodules or masses. No focal consolidation. No evidence of air trapping.MEDIASTINUM AND HILA: Heart size is normal. No pericardial effusion. Mild coronary artery calcifica... | No specific evidence of interstitial lung disease. No acute cardiopulmonary abnormality. |
Generate impression based on findings. | Male 35 years old Reason: 35M with UC s/p TAC/IPAA c/b recurrent SBO with creation of ileostomy. now with abdominal pain and nausea History: s/p J-pouch c/b SBO, with creation of ileostomy. now returning with abd pain, nausea. CT without concerning findings. please further eval. Scout radiograph showed a nonobstructive... | Dominant left upper quadrant adhesion resulting in partial small bowel obstruction as detailed above. |
Generate impression based on findings. | 27-year-old female with history of right shoulder pain status post altercation; tenderness to palpation over the AC joint. Three views of the right shoulder demonstrate a 3-cm corticated ossicle along the anterior aspect of the acromion, likely representing a normal variant os acromiale. No acute fracture is evident. T... | Ossicle along the anterior acromion process likely represents a normal variant os acromiale. No acute fracture is evident. If further evaluation is clinically warranted, MRI may be considered. |
Generate impression based on findings. | 60 year-old female with lower back pain. Two views of the lumbar spine demonstrate mild demineralization of the bones, suggestive of osteopenia. There is minimal leftward curvature of the lumbar spine. Mild degenerative disk disease is present at L4-5. There is moderate facet joint osteoarthritis affecting the lower lu... | Degenerative disk and facet joint osteoarthritis as described above. |
Generate impression based on findings. | Reason: h/o VPS for NPH History: surveillance of ventricles The CSF spaces are appropriate for the patient's stated age with no midline shift. There is a ventriculostomy tube course into the right frontal lobe into the right lateral ventricle with tip adjacent to the septum pellucidum. The temporal horns of the lateral... | 1.No evidence for acute intracranial hemorrhage, mass effect or edema.2.Although the lateral ventricles appear slightly larger in the current exam this can be accounted for on the basis of ex vacuo effect due to a recent lacunar infarct adjacent to the left lateral ventricle. The third ventricle is stable.3.Chronic lac... |
Generate impression based on findings. | The cervical spine is in normal alignment, with a normal cervical lordosis. There is moderate disk narrowing at C5-C6 and moderate-severe disk narrowing at C6-7. Disk desiccation is present at these levels as well as along the upper cervical spine. The vertebral body and disk heights are otherwise well-maintained. No ... | 1. No definite pseudomeningocele identified or other evidence of CSF leak along the cervical spinal canal.2. Redemonstration of diffuse smooth pachymeningeal enhancement as partially visualized on prior outside MRI brain, also involving the entire visualized spine on current exam. 3. Mild-moderate spondylotic changes a... |
Generate impression based on findings. | History of metastatic GI cancer admitted for osteonecrosis and osteomyelitis. There are postsurgical findings related to right partial mandibulectomy. There appears to have been interval resolution of the fluid collection in the treatment bed, although metal hardware artifact partially obscures this region. There is di... | 1.Postsurgical findings related to right partial mandibulectomy with persistent cellulitis, but apparent interval resolution of the abscess in the treatment bed, although metal hardware artifact partially obscures this region. 2. Persistent cortical irregularity and bone marrow sclerosis in the remaining portions of th... |
Generate impression based on findings. | There are no fractures. The marrow signal is benign. Benign hemangiomas are noted within T11, T12, and L1 vertebral bodies. The conus is normal in signal and morphology and terminates at an appropriate level.There are numerous small T2 hyperintense foci present within the visualized liver. Additionally, there is a sol... | 1.There are numerous small T2 hyperintense foci present within the visualized liver. Additionally, there is a solitary 14 mm T2 hyperintense focus within the kidney. Although these most likely represent simple cysts, they are incompletely evaluated given lumbar spine MRI acquisition technique. Thus, recommendation is m... |
Generate impression based on findings. | Reason: Hx of PSC rule out changes and cholangiocarcinoma History: PSC ABDOMEN:LIVER, BILIARY TRACT: Redemonstrated slight irregularity and beading noted diffusely affecting the intrahepatic biliary system appearing similar to the prior study, consistent with the stated history of primary sclerosing cholangitis. No sig... | 1.No significant interval change in findings compatible with known history of primary sclerosing cholangitis. |
Generate impression based on findings. | 47-year-old male with NIDCM, getting workup for LVAD LIVER: Normal echogenicity of the liver measuring 17.3 cm in length. No focal hepatic lesions. Portal vein is patent with appropriate directional flow; peak velocity at 0.3 m/sec.GALLBLADDER, BILIARY TRACT: Normal echogenicity of the gallbladder. No pericholecystic f... | 1. Longitudinally oriented echogenic structure within the midabdominal aorta likely representing patient's intraaortic balloon pump. 2. Left inferior pole renal cyst. |
Generate impression based on findings. | There is mild nonspecific prominence of the lateral ventricles. The ventricles and sulci are otherwise within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There is a dystrophic calcification along the right sylvian fissure. There are no areas of abnormal attenuation. Th... | Mild nonspecific prominence of the lateral ventricles. Otherwise, unremarkable noncontrast CT brain, with incidental possible partially empty sella. |
Generate impression based on findings. | Female 57 years old Reason: Lung Transplant Evaluation History: dyspnea Visually there was significant and progressive gastric emptying. Using anterior and posterior geometric means, residual gastric activity at the following postprandial intervals was calculated as follows:30 mins: 70.3 % of peak activity (normal >70 ... | Gastric emptying within normal limits. |
Generate impression based on findings. | Male 56 years old Reason: staging exam History: prostate cancer newly diagnosed Small foci of increased radiotracer uptake in the left posterior 11th rib, as well as in the left parietal bone, which are suspicious for osseous metastases. | Multiple small foci which are suspicious for osseous metastases. |
Generate impression based on findings. | There are no fractures. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.Disc desiccation is present throughout the lumbar spine sparing the L3/4 level.T12/L1: UnremarkableL1/2: Trac... | 1.L1/2: Trace retrolisthesis L1 on L2 and mild right neural foraminal stenosis.2.L4/5: Grade 1 anterolisthesis L4 on L5, severe left facet hypertrophy, moderate facet hypertrophy, and bilateral facet effusions. There is moderate left neural foraminal and mild right neural foraminal stenosis.3.L5/S1: Small right postero... |
Generate impression based on findings. | Interval postoperative changes are seen from T3-T8 bilateral laminotomies, with extensive edema in the paraspinal musculature and overlying soft tissues. At these levels, the previously confluent T1 hyperintensity relating to epidural lipomatosis is no longer identified, with scattered areas of heterogeneous signal li... | 1. Interval extensive postoperative changes along the upper to mid thoracic spine relating to multilevel laminotomies, although without significant improvement in MR appearance of the thecal sac caliber, with possible slight effacement of the ventral CSF signal within the thecal sac at the cervical thoracic junction. P... |
Generate impression based on findings. | History hepatocellular carcinoma now status post Therasphere treatment. CHEST:LUNGS AND PLEURA: Moderate centrilobular and paraseptal emphysema, unchanged. MEDIASTINUM AND HILA: No hilar or mediastinal lymphadenopathy. Severe atherosclerotic calcifications of the coronary arteries. Moderate hiatal hernia. Subcentimeter... | 1.Multiple arterially enhancing hepatic lesions compatible with HCC as detailed above, not significantly changed from prior. 2.Cirrhotic morphology of the liver with findings compatible with portal hypertension. |
Generate impression based on findings. | 27-year-old male patient with right lower quadrant pain x 3 weeks. Evaluate for bowel disease. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant ab... | Prominent mesenteric lymph nodes in the right lower quadrant raise question of mesenteric adenitis given the absence of any other findings to account for patient's symptoms. |
Generate impression based on findings. | Reason: History of small cell lung cancer. History: dizziness. The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Atheroscleroti... | 1.No intracranial mass lesions are appreciated to suggest brain metastases. No evidence for acute intracranial hemorrhage, mass effect or edema. |
Generate impression based on findings. | Reason: MRI MRA showed possible left temporo-occipital AVM History: left facial pain, numbness and facial droop Left internal carotid artery: There is opacification of the left anterior and middle cerebral arteries. There is a 2.2x1.0x1.2 cm compact arteriovenous malformation just deep to the left temporoparietal sulcu... | 1.There is a 2.2x1.0x1.2 cm compact arteriovenous malformation just deep to the left temporoparietal sulcus which is supplied via left angular artery branches for the most part and a tiny supply from a pial collateral from the left temporoccipital artery. Venous drainage is superficial with the dominant draining vein h... |
Generate impression based on findings. | Stable appearing left vallecula from 12/12/2014 study. There is thickening of the preepiglottic soft tissue without measurable mass, likely post treatment changes.Continued decrease in the size of the left level 3 nodal mass. Left level 3a lymph node measures 1.3 x 0.7 cm (series 8 image 48) previously measured 2.4 x ... | 1.Continued interval reduction of the cervical lymphadenopathy.2.Stable appearing left vallecula from 12/12/2014 study. No evidence of locoregional recurrence. |
Generate impression based on findings. | Chest pain and tachycardia. PULMONARY ARTERIES: Technically limited examination due to inadequate contrast opacification despite attempt at repeat scanning. No filling defects are identified in the main pulmonary arteries or lobar branches. Segmental and subsegmental emboli may not be visible on this examination due to... | Limited examination without evidence of pulmonary embolus to the lobar level. Filling defect in the distal esophageal lumen could be a potential cause of chest pain and is of unclear etiology as it is isoattenuating to soft tissue. This could be retained food products, a polyp or a mass. Correlation with esophagram or ... |
Generate impression based on findings. | 74-year-old female patient with epigastric pain. Please comment on pancreas and kidneys. Patient with acute renal failure. Exam is not sensitive for detecting lesions in the solid organs due to the lack of intravenous contrast. Given those limitations, the following observations are made:ABDOMEN:LUNG BASES: There is a ... | 1.No abnormalities noted in the kidneys or pancreas in this limited noncontrast examination. 2.Questionable gastric antrum thickening may be due to peristalsis and is of uncertain clinical significance. An upper endoscopy can be obtained if there is clinical concern for pathology.3.Pleural based micronodule can be foll... |
Generate impression based on findings. | Images are motion degraded through the skull base and posterior fossa. The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdu... | Images are motion degraded through the skull base and posterior fossa. Given this caveat, no acute CT abnormality to explain the patient's symptoms. |
Generate impression based on findings. | Low back pain with right lower extremity radiculopathy. Evaluate for spondylolisthesis, fracture, DDD. Three views of the lumbar spine reveal no acute fracture. Alignment is anatomic. Vertebral body heights are maintained. There is mild narrowing at the L5/S1 level which may represent degenerative disease or incomplete... | Mild narrowing of L5/S1 as above. |
Generate impression based on findings. | Pain. Four views of the left foot reveal no acute fracture. There is ankylosis of the fifth digit DIP joint. There are multiple accessory ossicles in the foot. There is a well corticated calcification superior to the posterior calcaneus which is likely chronic in etiology, possibly post-traumatic. There is a mild pes c... | Mild pes cavovalgus deformity. |
Generate impression based on findings. | 68 year old female who was recalled from screening mammogram for left breast mass. Family history of breast carcinoma in her mother and sister. An ML view and 3 spot compression 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 fibr... | High probability benign mass within the central slightly outer left breast. As long as the patient's physical examination remains normal, left unilateral diagnostic mammogram is recommended in 6 months. Results and recommendation were discussed with the patient.BIRADS: 3 - Probably benign finding.RECOMMENDATION: 3B - F... |
Generate impression based on findings. | 71-year-old female patient with history of bladder cancer status post cystectomy. Surveillance imaging. ABDOMEN:LUNG BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No signi... | Postsurgical changes from cystectomy and Indiana pouch without evidence of recurrent or metastatic disease. |
Generate impression based on findings. | 79-year-old female with orbital marginal zone lymphoma and known abdominal aortic aneurysm. Recent lower abdominal pain. Evaluate for lymphadenopathy. CHEST:LUNGS AND PLEURA: Mild pleural thickening of the left lung is unchanged. Calcified granuloma in the left lung is unchanged. No new suspicious pulmonary masses or n... | The reference lymph nodes are stable with no evidence of metastatic disease. |
Generate impression based on findings. | Female; 36 years old. Reason: HCC fibrolamellar type, evaluate interval change prior consideration of clinical trial. History: none LUNGS AND PLEURA: Stable right lower lobe mixed density mass measures 11.5 x 10.4 cm, previously 11.5 x 10.4 (series 14/59). Associated compressive atelectasis adjacent to the mass. Adjace... | No significant interval change in multiple index lesions. No new sites of disease. |
Generate impression based on findings. | 40 year-old female with lumbosacral pain status post fall. Five views of the lumbar spine demonstrate mild to moderate facet joint osteoarthritis affecting the lower lumbar spine. The lumbar vertebral body heights are preserved, as are the intervertebral disk spaces. The sacrum is not completely visualized, although we... | Findings suggestive of acute compression fracture of T12. We see no fracture of the lumbar spine or visualized sacrum. |
Generate impression based on findings. | COPD and pulmonary nodules. LUNGS AND PLEURA: Severe centrilobular emphysema. No pleural fluid or pneumothorax.New 22 x 20 mm (4/33) irregular nodule with air bronchograms. Lesion extends to lateral pleural surface which is slightly tented. This lesion occurs adjacent to the previously seen 5-mm nodule which has now be... | New indeterminate 22-mm irregular nodule within the right upper lobe. Morphology is suspicious for malignancy however this could potentially be postinflammatory or infectious (atypical mycobacteria for example). If the referring clinical service has outside prior examinations which can be obtained and submitted for com... |
Generate impression based on findings. | A patient submitted outside study for review. Submitted for review are digital mammographic images (11/12/14), ultrasound images of left breast and left axilla (11/12/14), images from ultrasound guided biopsy of the left breast and left axilla with specimen radiograph and post procedural left mammographic images (11/12... | Biopsy proven left breast cancer with metastatic left axillary lymph node. In view of the presence of diffuse skin thickening and trabecular engorgement of the left breast, breast MRI should be considered for pre-treatment assessment.BIRADS: 6 - Known cancer.RECOMMENDATION: X - No Letter. |
Generate impression based on findings. | Tenderness in the T7 area. Question of fracture. Two views of the thoracic reveal a mild anterior wedge deformity of either the T6 or T7 vertebral body. This appears similar to a radiograph from 1/20/2015. No acute fracture is evident. | Mild anterior wedging of either the T6 or T7 vertebral body, similar to a prior radiograph from 1/20/2015. |
Generate impression based on findings. | 46-year-old male with right ankle pain and tenderness over the lateral malleolus status post fall. Three views of the right ankle demonstrate mild soft tissue swelling. No underlying acute fracture is evident. Mild deformity of the medial malleolus may reflect old trauma. A normal variant os trigonum is present posteri... | Mild soft tissue swelling and other findings as above, without acute fracture. |
Generate impression based on findings. | Recurrent squamous cell carcinoma in the right infratemporal fossa, tumor progressing on chemo/RT based on radiation resimulation. There are postoperative findings related to partial right mandibulectomy with graft reconstruction. Although incompletely imaged, there has been interval increase in size of the ill-defined... | 1. Although partially-imaged, the recurrent tumor centered in the right infratemporal fossa with associated perineural spread appears to have increased in size. 2. New fluid collection in the right masseter muscle and retromolar trigone region with associated demineralization of the right mandible and formation of peri... |
Generate impression based on findings. | 37-year-old male status post fracture, follow-up. Two views of the left knee demonstrate orthopedic screws affixing a comminuted intra-articular fracture of the proximal tibia, in near anatomic alignment. Some of the fracture lines appear less distinct, suggestive of some interval healing. There is no radiographic evid... | Orthopedic fracture fixation of the pelvis and knee as described above. |
Generate impression based on findings. | The ventricles and sulci are within normal limits. There is no midline shift or mass effect. There is no intracranial hemorrhage. There are no areas of abnormal attenuation. There is no extraaxial fluid collection. The visualized portions of the paranasal sinuses and mastoids/middle ears are grossly clear. There is an... | 1. No acute intracranial abnormality. Incidental empty sella.2. No acute fracture or subluxation. |
Generate impression based on findings. | Male 50 years old with abdominal pain. Nonobstructive bowel gas pattern. No specific radiographic evidence account for patient's pain. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Pain. Evaluate right shoulder. Three views of the right shoulder reveal a fracture of the greater tuberosity of the humeral head in near anatomic alignment, as seen on the prior exam. There is no evidence of dislocation.Additional views of the right humerus reveal the aforementioned humeral head fracture. | Humeral head fracture as described above. |
Generate impression based on findings. | 60 year-old male patient with history of metastatic renal cell carcinoma. CHEST:LUNGS AND PLEURA: Scattered micronodules appear similar compared to prior examination. No suspicious pulmonary nodules. Peripheral lingular scarring.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Cardiac size is within norma... | Stable examination without new sites of disease. Unchanged left posterior rib lesion. |
Generate impression based on findings. | There is redemonstration of postoperative changes related to left neck dissection. There is stable decreased musculature along the left floor of mouth. The left submandibular gland is surgically absent. There is scarring along the small left sternocleidomastoid muscle. PHARYNX/LARYNX: The nasopharynx, oropharynx, hypo... | 1. Stable postoperative changes within the left neck, without evidence of recurrent disease.2. Chronic left internal jugular vein nonvisualization which may be due to surgical ligation . |
Generate impression based on findings. | 56-year-old male with malignant melanoma and metastatic disease post interferon therapy. Evaluate response. CHEST:LUNGS AND PLEURA: No change in 4 mm nodular density at the right base.MEDIASTINUM AND HILA: Small superior mediastinal lymph node unchanged measuring 0.8 x 0.9 cm on image 25/218. There are other smaller ly... | Stable CT of the chest abdomen and pelvis with nonenlarged mediastinal nodes and borderline upper abdominal adenopathy as well a small stable right lung nodule. |
Generate impression based on findings. | 75-year-old male with history of squamous cell carcinoma of the tongue. CHEST:LUNGS AND PLEURA: No suspicious pulmonary lesions are identified. There is minimal pleural nodularity along the posterior aspect of the left hemithorax appearing similar to prior.MEDIASTINUM AND HILA: The heart size is normal without pericard... | 1. No evidence of metastatic disease.2. Near complete resolution of anterior abdominal wall fluid collection. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: None change basilar scarring.No suspicious nodules.MEDIASTINUM AND HILA: No significant lymphadenopathy.No visible coronary artery calcification.No pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: A... | No sign of metastatic disease. |
Generate impression based on findings. | Male 60 years old Reason: prostate cancer History: back pain Increased radiotracer uptake involving multiple vertebral bodies in the cervical, thoracic and lumbar spine, as well as throughout the pelvis, bilateral proximal femurs, multiple ribs and right proximal humerus consistent with extensive osseous metastatic dis... | Extensive osseous metastatic disease. On CT, lesion occupies greater than 50% of the right femoral neck. Extensive focus noted in the right proximal humerus, consider dedicated imaging to evaluate for possible impending fracture. |
Generate impression based on findings. | Malignant neoplasm of the prostate. Weight loss. The following observations are made given the limitations of an unenhanced study.ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedAD... | Right lower quadrant soft tissue abnormality possibly representing an appendiceal mass as discussed above; consider chronic appendicitis versus appendiceal carcinoma. Dr. Dale informed of these findings at the time of dictation. |
Generate impression based on findings. | Recurrent head and neck CA in the right infratemporal fossa, tumor progressing on chemo/RT, evaluate for metastases. CHEST:LUNGS AND PLEURA: Interval development of scattered solid nodules. A lesion in the right lower lobe is centrally cavitary (4/67). Largest expansile endovascular lesion near the right costophrenic a... | New pulmonary nodules and mild hilar lymphadenopathy suspicious for metastatic disease. |
Generate impression based on findings. | Reason: vertebral or basilar disease History: pontine stroke Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no signifi... | 1.No evidence for aneurysm.2.There is 60% stenosis based on NASCET criteria present along a 1.5 cm segment of the proximal right internal carotid artery.3.Persistent trigeminal artery on the right side.4.Multilevel degenerative changes are present along the cervical spine with moderate to spinal stenosis suspected at C... |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of colon cancer. 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 o... | 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. | Reason: 72 y/o m with COPD, CAD s/p CABG and MV/AV repairs, with pulmonary nodules, eval for progression compared to OSH chest CT 12/14. History: long smoking history (50 pack years) LUNGS AND PLEURA: At least 3 poorly defined pulmonary nodules which were present in the left lung have decreased or resolved. However som... | 1.Resolution of several left lung nodules and appearance of right lung nodules, suggestive of an inflammatory etiology, possibly related to aspiration.2. Calcified pleural plaques with pleural thickening and basilar scarring and small loculated effusions, consistent with previous asbestos exposure. Two to the patient's... |
Generate impression based on findings. | Encephalomalacia and gliosis is present involving the left occipital lobe with ex-vacuo dilatation of the adjacent left occipital horn. Overlying this region has been prior craniotomy. Elsewhere there is hypodensity within the white matter without associated mass effect. Otherwise the remaining portions of the ventric... | 1.Encephalomalacia and gliosis is present involving the left occipital lobe with ex-vacuo dilatation of the adjacent left occipital horn most likely secondary to remote infarction. Overlying this region has been prior craniotomy. 2.Small vessel disease of indeterminate ages. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History benign right breast biopsy. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. No suspicious masses, microcalcifi... | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | 78-year-old female with malignant neoplasm of the lung LUNGS AND PLEURA: Postsurgical changes of a right lower lobectomy. Small right pleural effusion and mild basilar atelectasis. Multiple pleural nodules are better seen on today's study given presence of of IV contrast. These are probably unchanged from the prior exa... | 1.Postoperative findings of right lower lobectomy, without evidence of localized tumor recurrence at the resection site. 2.Nodularity to the right pleura as described above; pleural metastases cannot be excluded.3.Stable mildly prominent mediastinal lymph nodes; nodal metastases cannot be excluded.4.Small right pleural... |
Generate impression based on findings. | 64-year-old male with history of base of tongue squamous cell carcinoma. CHEST:LUNGS AND PLEURA: Multiple tree in bud opacities within the right upper lobe. No suspicious pulmonary lesions identified. No pleural effusions.MEDIASTINUM AND HILA: The heart size is normal a small pericardial effusion, increased in volume. ... | 1. No evidence of pulmonary metastatic disease.2. Tree in bud opacities in the right upper lobe are likely the sequela of aspiration bronchiolitis.3. Small pericardial fluid collection increased in volume. |
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. No suspicious masses, microcalcificati... | 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. | Styloid tenderness. Slipped on ice and landed on wrist. Pain second through fourth metacarpals and radial to ulnar head. Question of fracture. Three views of the left wrist reveal mild soft tissue swelling about the wrist. No acute fracture is evident. There is a well corticated ossicle adjacent to the lateral distal r... | 1. Soft tissue swelling without acute fracture.2. Degenerative changes as above. |
Generate impression based on findings. | Undifferentiated connective tissue disease and history of pneumonia. Borderline low DLCO evaluate for fibrosis. Dyspnea. LUNGS AND PLEURA: No evidence of pulmonary fibrosis. Scarring and mild bronchiectasis in the anterior right upper lobe. Equivocal bronchiectasis in the right middle lobe the medial segment. Mild line... | 1. Mild bronchiectasis but no evidence of interstitial fibrosis. 2. Severe atherosclerotic calcification of the coronary arteries. 3. Indeterminate T7 vertebral body sclerotic focus of unclear etiology. If the patient is experiencing pain in this region, further assessment may be made with bone scan, though a degenerat... |
Generate impression based on findings. | Joint pain. Evaluate for OA versus RA. Three views of the right hand reveal no acute fracture. There is joint space narrowing and osteophyte formation of the basilar joint. There is subluxation of the radiocarpal joint. There is chondrocalcinosis of the triangular cartilage. There are chronic appearing erosions of the ... | Constellation of findings are compatible with an inflammatory arthritis. |
Generate impression based on findings. | The ventricles and sulci are normal in size. There are no masses, mass effect or midline shift. There is no evidence for intracranial hemorrhage or acute cerebral or cerebellar cortical infarction. There are no extraaxial fluid collections or subdural hematomas. visualized portions of the paranasal sinuses and mastoid... | Negative unenhanced brain CT. |
Generate impression based on findings. | Pain. Preop. Three views of the left knee are provided. Again seen is cement within the distal femur, presumably due to treatment of a giant cell tumor. Thin lucency surrounding the cement appears similar to that seen on the prior study and is of doubtful clinical significance. I see no radiographic evidence of tumor r... | Postoperative changes of a giant cell tumor treatment and osteoarthritis 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. No suspicious masses, microcalcifications or areas of architectural distortion are pre... | 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. Family history of breast cancer in a niece at age 28. 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 distrib... | Left breast focal asymmetries for which further evaluation with spot compression and possibly ultrasound are recommended.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EB - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Left ankle pain: Evaluate for stress fracture versus degenerative changes. Pain in the navicular area in the medial malleolus. Right ankle pain: Pain in the navicular area and base of fifth metatarsal. Evaluate for stress fracture versus degenerative changes. Three views of the left ankle reveal no acute fracture or ma... | No specific radiographic findings to account for the patient's pain. |
Generate impression based on findings. | 55-year-old female presents for 6 month follow-up of right breast mass. History of benign right breast biopsy. Family history of breast carcinoma in her sister. Family history of ovarian and cervical carcinoma in her sister. Three standard views of the right breast were performed digitally and reviewed with the aid of ... | Stable right breast asymmetry. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually, due July 2015. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening ... |
Generate impression based on findings. | 85 years, Male, Reason: h/o BCC skin and lung mets, compare to previous, measurements pls History: non. CHEST:LUNGS AND PLEURA: Status post right wedge resection. Nodularity adjacent to the suture material is unchanged. Multiple bilateral nodules are increased in size. A right upper lobe nodule measures 1 cm (image 28;... | 1.Progression of pulmonary metastasis.2.Cystic dilatation of the main pancreatic duct with multiple cystic lesions are stable. |
Generate impression based on findings. | Status post ankle ORIF Again seen is a plate and screws affixing a distal fibular fracture in near-anatomic alignment. The fracture is perhaps slightly less distinct on the current study than on the prior study, suggesting some interval healing. Also again seen is an orthopedic screw affixing a medial malleolus fractur... | Orthopedic fixation of healing ankle fractures as above. |
Generate impression based on findings. | 81 years, Male. Reason: eval NGtube location post advancement History: NGT advancement There is a nasogastric tube, which has been advanced, with its tip and sideport projecting over the proximal stomach. Dilated loops of jejunum are partially imaged on this examination. Please refer to same day chest radiograph for th... | NG tube sideport overlies the proximal stomach. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign biopsies and bilateral breast reduction. Family history of breast cancer in an 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 fibrogl... | 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. | Six weeks postop. Evaluate bilateral hip pinning for femoral neck fractures. Two views of the right hip reveal three Knowles pins within the right femur. A bandlike lucency is again visualized partially traversing the medial cortex of the femoral neck, though less distinct than the prior study.Two views of the left hip... | Orthopedic fixation of a nondisplaced left femoral neck fracture and right femoral neck stress fracture. |
Generate impression based on findings. | Reason: 72 y/o with esophageal ca and known PE s/p esophageal resection 2/20/15 now with chest pain please evaluate for pgoression of PE, esophageal leak, History: see above CHEST:LUNGS AND PLEURA: Interval partial resolution of several subpleural opacities in the right lung and subsegmental atelectasis that may have b... | Status post gastric interposition with no sign of recurrent disease.Interval resolution of right lower lobe pulmonary embolus.New small nonspecific left pleural effusion. |
Generate impression based on findings. | 75-year-old male with right upper lobe nodule, cough LUNGS AND PLEURA: Right upper lobe nodule measures 14 x 21 mm, previously 18 x 22 mm (series 5, image 41). On the coronal sequence, the nodule measures 12 mm, previously 11 mm (series 80256, image 89). On the sagittal sequence, the nodule measures 11 x 17 mm, previou... | Overall, no significant change in size of right upper lobe nodule abutting the minor fissure with measurements detailed above. This nodule has been present and has increased in dimension and density over time; an indolent neoplastic process cannot be excluded. |
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 pre... | 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 re... |
Generate impression based on findings. | Basal cell carcinoma. Neck: There are postoperative findings related to partial left anterior maxillectomy, left turbinectomy, partial septectomy, and left orbital floor reconstruction. There is a lytic defect with persistent ill-defined soft tissue along the medial aspect of the left maxillary alveolus that contains a... | 1. Extensive postoperative findings related to left maxillectomy with persistent nonspecific soft tissue containing a cystic component along the medial aspect of the left maxillary alveolus and soft tissue in the left cheek subcutaneous tissues, but no evidence of intraorbital tumor involvement or significant lymphaden... |
Generate impression based on findings. | There is a stable right frontal approach ventriculostomy catheter with the tip near the left foramen of Monro. The ventricles and sulci are stable, again with disproportionate dilatation of the lateral and third ventricles with respect to sulcal prominence. There is no midline shift or mass effect. There is no intracr... | Stable ventricular caliber with disproportionate dilatation of the lateral and third ventricles consistent with known history of NPH. No change in ventriculostomy catheter position. |
Generate impression based on findings. | 74-year-old female patient with recent diagnosis of small lymphocytic lymphoma prior left axillary lymph node biopsy needs initial staging to evaluate disease burden. CHEST:LUNGS AND PLEURA: Scarring noted in the lingula. No suspicious pulmonary lesions.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy. Mod... | 1.Enlarged mesenteric lymph nodes. 2.Mildly enlarged left axillary lymph node with surrounding inflammatory changes may be from prior biopsy.3.Subtle hypoattenuating splenic lesions are nonspecific and can be followed on subsequent imaging. |
Generate impression based on findings. | Pain. Evaluate right shoulder. Three views of the right shoulder reveal no acute fracture or dislocation. There is mild osteophyte formation at the acromioclavicular joint and glenohumeral joint. There is chondrocalcinosis in the glenohumeral joint. | Mild osteoarthritis of the glenohumeral and acromioclavicular joints. |
Generate impression based on findings. | Right rotator cuff pain. Three views of the right shoulder reveal no acute fracture or dislocation. The bones appear demineralized. There is minimal osteoarthritis of the acromioclavicular joint. The acromiohumeral distance is mildly decreased. | Mild acromioclavicular joint osteoarthritis. |
Generate impression based on findings. | There is redemonstration of a ring-enhancing mass demonstrating discontiguous new diffusion restriction in the posterior left superior frontal gyrus. There is a slight hyperintensity consistent with vasogenic edema and may in part represent posttreatment changes as well. Although the enhancing margin of the mass is so... | 1. Interval increase of size of ring enhancing mass in the left superior frontal gyrus and now with diffusion restriction. Increased surrounding abnormal signal which could represent a combination of worsening vasogenic edema and/or posttreatment changes.2. Stable appearance of other scattered T2/FLAIR hyperintense foc... |
Generate impression based on findings. | AsthmaVIEWS: Chest AP and lateral Cardiothymic silhouette normal. Cardiac apex, aortic arch and stomach left-sided. Peribronchial wall thickening with subsegmental atelectasis in the right lower lobe. No pleural effusion or pneumothorax. | Bronchiolitis or reactive airway disease. |
Generate impression based on findings. | ConstipationVIEW: Abdomen AP Disorganized nonobstructive bowel gas pattern. No Sitz markers are identified. Minimal amount of fecal burden in the descending colon. | No Sitz markers are identified. |
Generate impression based on findings. | Female; 63 years old. Reason: rule out aortoenteric fistula History: bloody bowel movements, pancreatic complex cyst, recent anticoagulation with renal artery thrombus ABDOMEN:LUNG BASES: Small right pleural effusion. Mild bibasilar subsegmental atelectasis.LIVER, BILIARY TRACT: Pneumobilia. An anterior branch of the r... | 1. Acute thrombi within the abdominal aorta which raises possibility of aortic-enteric fistula given clinical history and close anatomic apposition of transverse duodenum and aorta. Consider upper endoscopy for further evaluation.2. Right kidney lower pole infarct.3. Large acute necrotic collection replacing most of th... |
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