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Generate impression based on findings. | Evaluate for small bowel obstruction No free air. Dilated small bowel, measuring up to 3.8 cm, with air seen distally in colon. While findings may reflect diffuse ileus, mid to distal colonic obstruction not entirely excluded. Left hemipelvic anastomotic suture material present. Bilateral total hip arthroplasties. Decreased osseous mineralization. | Findings suggestive of diffuse ileus. Mid to distal colonic obstruction another differential consideration and correlation with patient's clinical history and continued followup recommended. |
Generate impression based on findings. | Female; 87 years old. Reason: r/o worsening pancreatitis and assess stent location History: abdominal pain ABDOMEN:LUNG BASES: Moderate pleural effusions with associated compressive bibasilar atelectasis, similar to prior study. Intrathoracic stomach with endoscopic clip seen postero-inferiorly.LIVER, BILIARY TRACT: Status post cholecystectomy. Mild intrahepatic biliary ductal dilation.SPLEEN: No significant abnormality notedPANCREAS: Stable appearance of the enlarged and heterogeneous pancreatic head. Stable main branch IPMN with associated atrophy of the pancreatic body and tail without calcifications. Significant interval decreased size in left upper quadrant cysts, status post cystogastrostomy tube placement, tube located in stomach. A small residual rimmed fluid collection is seen in the left upper quadrant superior to the pancreas.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Nasojejunal tube in place.BONES, SOFT TISSUES: No significant abnormality notedOTHER: Mild upper abdominal ascites, decreased since prior study. Interval loculation and slight rim enhancement of some of the ascites along the left peritoneal surface measuring up to 6.3 x 1.9 cm (series 3/65).PELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedBONES, SOFT TISSUES: Diffuse anasarca.OTHER: Mild pelvic ascites, similar to prior study. Pelvic peritoneal enhancement, consistent with peritonitis, has slightly decreased. | 1. Pancreatitis with decreased peripancreatic fluid collection status post cystogastrostomy tube placement, cyst gastrostomy located in stomach. Small, residual rimmed fluid collection is seen in the left upper quadrant.2. Decreased upper abdominal ascites, but some of the ascites appears loculated with new rim enhancement along the left peritoneal surface as detailed above. Infection of this fluid cannot be excluded.3. Stable appearance of the enlarged and heterogeneous pancreatic head, underlying masslesion again not entirely excluded. Stable main branch IPMN with associated atrophy of the pancreatic body and tail without calcifications. |
Generate impression based on findings. | Evaluate for obstructive pattern, history of epigastric abdominal pain Paucity of small bowel gas, may reflect fluid containing loops. Moderate air seen distally in colon. No definitive evidence of bowel obstruction otherwise. No free air seen on decubitus imaging. Right upper quadrant clips. IVC filter present. Vascular ossifications and right iliac vascular stent. Decreased osseous mineralization, multilevel degenerative changes of spine, hip degenerative disease. Low lung volumes. | Paucity of small bowel gas, may reflect fluid containing loops. Moderate air seen distally in colon. No definitive evidence of bowel obstruction otherwise. No free air seen on decubitus imaging. |
Generate impression based on findings. | No acute intracranial hemorrhage. Stable appearing right cerebellar hypoattenuation compatible with prior infarct. Hypoattenuation of the subcortical and periventricular white matter compatible with age indeterminant small vessel disease. No evidence of mass, mass effect, or hydrocephalus. The imaged paranasal sinuses and mastoid air cells are clear. The imaged orbits are unremarkable. The osseous structures are unremarkable. | 1.No evidence of acute intracranial hemorrhage. CTs not sensitive for detection of acute nonhemorrhagic ischemia. If high clinical suspicion of CVA, consider MRI.2.Stable appearing right cerebellar hypoattenuation compatible with prior infarct.3.Subcortical and periventricular white matter age indeterminant small vessel disease. |
Generate impression based on findings. | Abdominal cramping. Prior partial bowel obstruction. History of Crohn's disease.VIEWS: Abdomen AP supine/upright (two views) 03/14/15 A small to moderate amount of feces is seen in the colon. Mildly to moderately dilated small bowel loops are present with air-fluid levels. No free peritoneal air is present. | Abnormal bowel gas pattern with dilated small bowel and air-fluid levels. The appearance is similar on prior exam and may be related to inflammation and partial obstruction at the level of the terminal ileum. |
Generate impression based on findings. | 8-month-old female with history of drooling, concern for foreign body.VIEWS: Chest AP/lateral; Soft tissue neck: AP/lateral (4 views) 3/13/15 Chest: The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. No pleural effusion or pneumothorax is present. Bronchial wall thickening is present suggestive of bronchiolitis/reactive airway disease. No pneumonia. No radiopaque foreign body is identified. No evidence of air trapping to suggest a radiolucent foreign body. Soft tissue neck: Star shaped radiopaque foreign body overlies the piriform sinus/upper esophagus measuring approximately 1.7 cm. This radiopaque foreign body is not identified on the AP view. | 1.7 cm star-shaped radiopaque foreign body overlies the piriform sinus/upper esophagus. A repeat lateral soft tissue neck is recommended if symptoms have resolved. If symptoms have not resolved a soft tissue CT neck is recommended.The findings were discussed with Dr. Senko in person 9:30 a.m. on the 3/14/15. |
Generate impression based on findings. | Male 45 years old; Reason: Evaluate for metastatic disease, history of headache CHEST:LUNGS AND PLEURA: Numerous bilateral pulmonary nodules, compatible with metastatic disease. Reference right lower lobe lung nodule, measuring 0.8 x 0.6 cm, image 65 series 4. Additional nodular focus located in medial left lower lobe submitted for reference, may be a lung nodule (versus metastatic adenopathy), measuring 2.4 x 1.2 cm, image 61 series 4.MEDIASTINUM AND HILA: Mediastinal and hilar lymphadenopathy. Reference left paratracheal/paraesophageal node seen measuring 1.9 x 1.5 cm, image 23 series 3. Reference left hilar adenopathy measuring 2.9 x 1.1 cm, image 41 series 3. Moderate to severe calcified coronary artery disease.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Hepatic metastatic disease with multiple hypoattenuating lesion seen, more pronounced in right lobe. Reference dominant right hepatic segment 8/5 mass, measuring 5.6 x 5 cm, image 88 series 3. Relatively more subtle 1.4 x 1.3 cm hepatic segment 4 lesion seen, image 87 series 3. Visualized portal veins patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Mild asymmetric left adrenal nodularity, nonspecific.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild calcified atherosclerotic disease.BOWEL, MESENTERY: Small sigmoid colon diverticulosis without evidence of acute diverticulitis. Normal appendix.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted.BLADDER: Air seen in bladder, correlate clinically for recent intervention.BONES, SOFT TISSUES: Mild spinal degenerative disease. Grade 1 anterolisthesis of L5 on S1. | 1. Findings compatible with pulmonary, nodal and hepatic metastatic disease.2. Air seen in bladder, correlate clinically for recent intervention. |
Generate impression based on findings. | Reason: source of worsening pain L ear/face. 30F with LVAD, ANC 0 s/p chemo for relapsed AML s/p syngeneic SCT x 2 History: neutropenic fever, worsening sharp constant pain L ear/face Mucous retention cyst in the atelectatic left maxillary sinus. Otherwise imaged paranasal sinuses and mastoid air cells are clear. Right ostiomeatal complex is patent. Left ostiomeatal complex is small due to atelectatic left maxillary sinus but is patent. There is stable severe rightward deviation of the nasal septum. The cribriform plate, fovea ethmoidalis and lamina papyracea appear normal. The imaged orbits are unremarkable. Bilateral middle ear cavities are clear. The imaged intracranial contents are remarkable. Evaluation of the neck is somewhat limited due to lack of contrast. Salivary and thyroid glands are unremarkable. The airway is patent. No cervical lymphadenopathy by size criteria. Right-sided port. Status post sternotomy. Lung apices are clear. Osseous structures are unremarkable. | 1.Atelectatic left maxillary sinus, likely sequela of prior sinusitis. No evidence of acute sinusitis.2.No cervical lymphadenopathy by CT size criteria. |
Generate impression based on findings. | Patella subluxation. Question of MPFL tear, cartilage wear. Evaluate for loose bodies. MENISCI: The medial and lateral menisci are intact.ARTICULAR CARTILAGE AND BONE: There is slight heterogeneity of the articular cartilage of the patella which may reflect minimal degeneration but, this is equivocal, and we see no discrete cartilage defects.LIGAMENTS: The collateral and cruciate ligaments are intact. EXTENSOR MECHANISM: The medial and lateral retinacular structures appear intact. There is flattening of the femoral trochlea, particularly superiorly, indicating dysplasia with slight lateral translation of the patella with respect to the central femoral trochlea. The Insall-Salvati ratio is approximately 1.1 which is within normal limits. The TT-TG distance is 13 mm, which is within normal limits.ADDITIONAL | Findings compatible with femoral trochlear dysplasia as described above. We see no discrete cartilage defects, loose bodies, or retinacular injury. |
Generate impression based on findings. | 51-year-old female with history of shortness of breath. Evaluate for PE. PULMONARY ARTERIES: No evidence of acute pulmonary embolus.LUNGS AND PLEURA: Mild left basilar subsegmental atelectasis of unknown etiology. No focal opacities, pleural effusions or pneumothorax.MEDIASTINUM AND HILA: Heart size normal without pericardial effusion. No evidence of right heart strain. Mild coronary artery calcifications. Scattered mildly enlarged mediastinal lymph nodes. Small left thyroid hypodensity.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | Left basilar subsegmental atelectasis with no evidence of acute pulmonary embolus. Other incidental findings as above.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | 49-year-old female with history of left retromolar squamous cell carcinoma. CHEST:LUNGS AND PLEURA: No focal opacities, pleural effusions, or suspicious nodules.MEDIASTINUM AND HILA: There is fusiform aneurysmal dilation of the central pulmonary arteries, worse in the left descending pulmonary artery which measures up to 2.4 cm. The main pulmonary artery measures 2.1 cm which is within normal limits. No significant pericardial effusion. No mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1. No evidence of metastatic disease.2. Aneurysmal dilation of the central pulmonary arteries, worse in the left descending pulmonary, with a normal-appearing main pulmonary artery. These findings are of uncertain clinical significance, although unchanged when compared to prior. |
Generate impression based on findings. | Progression of generalized age-related volume loss. There are areas of encephalomalacia within left greater than right parietal lobes, right frontal cortex, and left cerebellum from prior infarct. No acute intracranial hemorrhage is identified. No evidence of intracranial mass, mass-effect, or hydrocephalus. No intra- or extra-axial fluid collections. Gray-white matter differentiation is preserved. The imaged paranasal sinuses and mastoid air cells are clear. The imaged orbits are intact. The osseous structures are unremarkable. | 1.No acute intracranial abnormality. 2.Progression of volume loss with scattered chronic infarcts. |
Generate impression based on findings. | Hypoxia. History of neuroblastoma.VIEW: Chest AP (one view) 03/14/15, 0024 Right central line tip is at junction of superior vena cava and right atrium. Left upper extremity PICC tip is at junction of superior vena cava and right atrium. Surgical clips are noted in right upper quadrant.Cardiac silhouette size is normal. No focal lung opacity is present. | No focal lung opacity. Interval exchange of right central venous catheter. |
Generate impression based on findings. | 34 day old former 24 week gestational age patient with increased desaturation events.VIEWS: Chest and abdomen AP (two views) 03/14/15, 0900 Endotracheal tube tip is at thoracic inlet. Right PICC tip is in superior vena cava. PDA ligation clip is again seen. Feeding tube tip is at GE junction with side port in lower esophagus.Lung volumes are large with hemidiaphragms at the 10th posterior ribs. Hazy opacities are present bilaterally with focal opacity in right base. Cardiothymic silhouette is upper limits of normal in size.Bowel gas pattern is disorganized. Several mildly to moderately dilated loops are present. No pneumatosis intestinalis, portal venous gas, or free peritoneal air is present. | Focal opacity in right lower lobe may be atelectasis or pneumonia. Disorganized bowel gas pattern. |
Generate impression based on findings. | 18 day old male status post diaphragmatic hernia repair.VIEW: Chest AP (one view) 3/14/15 ET tube tip is between the thoracic inlet and carina. Left PICC tip is in the left axillary vein. NG tube has its proximal sidehole near the GE junction.Persistent right pneumothorax. Increased opacity of the right hemithorax likely represents increasing pleural fluid. Cardiothymic silhouette is normal. | Persistent right pneumothorax with increasing opacity of the right hemithorax consistent with accumulating pleural fluid. |
Generate impression based on findings. | 12-year-old female with pain and swelling, concern for fractureVIEWS: Left ankle AP, oblique, lateral (3 views) 3/14/15 Minimally displaced Salter-Harris two fracture of the posterior tibial metaphysis. Mild lateral soft tissue swelling is present. The ankle mortise joint is normal. | Minimally displaced Salter-Harris II fracture of the posterior tibial metaphysis. |
Generate impression based on findings. | 6-year-old female with pain and difficulty ambulating.VIEWS: Left ankle AP, oblique, and lateral (3 views) 3/14/15 No fracture or malalignment. Mild soft tissue swelling. The ankle mortise joint is maintained. | Mild soft tissue swelling without fracture or malalignment. |
Generate impression based on findings. | No acute diffusion-weighted abnormality is identified. There is multiple foci of scattered T2/FLAIR signal abnormality of the bilateral periventricular and subcortical white matter, compatible with chronic small vessel ischemic disease. Evolving prior right cerebellar infarct. There is no evidence for intracranial hemorrhage.There are no evidence of mass, mass effect, or hydrocephalus. Flow voids are present within the major vessels indicating patency. | 1.No evidence of acute infarction.2.Chronic small vessel ischemic disease.3.Evolving prior right cerebellar infarct. |
Generate impression based on findings. | Evaluate patency of TIPS VASCULAR: At hepatic venous end of TIPS, velocity measures 217 cm/sec. At midportion, velocity measures 240 cm/sec.TIPS portal venous velocity measures 132 cm/sec.Main portal vein velocity measures 46 cm/sec, normal direction flow seen.Expected reversal of flow in left portal vein, velocity measures 20 cm/sec.Common hepatic artery peak systolic velocity measures 113 cm/sec, resistive index measures 0.75.Left hepatic artery peak systolic velocity measures 71 cm/sec, resistive index measures 0.76.Right hepatic artery not reliably seen and assessed. Visualized IVC patent. Hepatic veins not well seen but patency suggested in middle and left hepatic veins, waveforms blunted.Patent splenic vein. Splenic artery not as well evaluated. ABDOMINAL AORTA: Not well evaluated.OTHER: Cirrhotic liver contour. Coarsened parenchymal echotexture. Incompletely imaged moderate ascites. | 1. TIPS overall patent but elevated velocities as above. Findings nonspecific but velocities are increased compared to 6/5/14 ultrasound exam, when portal segment velocity measured 100 cm/sec, mid segment velocity measured 120 cm/sec and hepatic vein segment velocity measured 140 cm/sec, velocities now measure 132 cm/sec, 240 cm/sec and 217 cm/sec, respectively. Normal directional flow in main and left portal veins. Based on these findings, early intrashunt stenosis is a consideration. 2. Blunted hepatic venous waveforms, may be related to underlying chronic liver disease.3. Cirrhotic liver contour with coarsened parenchyma, ascites present. |
Generate impression based on findings. | Male; 71 years old. Reason: esophageal compression/cancer, evaluate for malignancy/mets History: esophageal obstruction CHEST:LUNGS AND PLEURA: 11 mm spiculated nodule in the posterior segment of the right upper lobe, suspicious for primary lung cancer versus metastasis (series 5/42). Few scattered, nonspecific pulmonary micronodules are seen in both lungs. Mild centrilobular emphysema. No pleural effusion.MEDIASTINUM AND HILA: A mildly enlarged right hilar lymph node measures 13 mm in short axis (series 3/44) and is suspicious for metastasis.Circumferential, irregular intraluminal esophageal mass in the midesophagus over a craniocaudal length of 6.5-cm (series 80220/58) with appearance typical for esophageal cancer. Dilation with air-fluid level of the esophagus proximal to this mass. A prominent mediastinal lymph node adjacent to the distal esophagus measures 11 x 8 mm and is suspicious for metastasis (series 3/71).Tiny nonspecific hypoattenuating lesion in the right lobe of the thyroid gland. Normal heart size. No pericardial effusion. Severe coronary artery calcifications. CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Subcentimeter hypoattenuating lesion in the anterior right hepatic lobe is too small to accurately characterize but likely a cyst as it measures 14 Hounsfield units.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No significant abnormality notedRETROPERITONEUM, LYMPH NODES: Scattered, subcentimeter retroperitoneal lymph nodes diffusely are not pathologically enlarged by CT size criteria. However, there is mild diffuse fatty stranding around these nodes, which makes them highly suspicious for metastatic disease. For future reference, a left para-aortic lymph node measures 11 x 7 mm (series 3/19).PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | 1. Mid esophageal cancer as detailed above.2. Right hilar, mediastinal, and retroperitoneal lymph nodes suspicious for metastatic disease.3. 11 mm spiculated right upper lobe nodule, suspicious for primary lung cancer versus metastasis. |
Generate impression based on findings. | 10 month old male status post fall and concern for fractureVIEWS: Cervical spine: AP and lateral; chest and abdomen AP (4 views) 3/14/15 Cervical spine: Mild thickening of the adenoids. Nasopharynx efface on this image performed in expiration. Cervical spine is visualized to the level of C7. Alignment is preserved. No prevertebral soft tissue thickening. Chest and abdomen: The aortic arch, cardiac apex, and stomach are left-sided. The cardiothymic silhouette is normal. No pulmonary opacities. No pneumothorax or pleural effusion. Disorganized nonobstructive bowel gas pattern. No pneumatosis or pneumoperitoneum. | No fracture or malalignment. No acute cardiopulmonary abnormality. |
Generate impression based on findings. | VSD repair.VIEW: Chest AP (one view) 03/14/15, 0614 Epicardial pacer leads have been removed. Right internal jugular line has its tip at junction of superior vena cava and right atrium. Mediastinal surgical clips are seen.Cardiac silhouette size is upper limits of normal. Some streaky opacities are present bilaterally. No focal opacity is seen. No pneumothorax is identified. | Continued bilateral subsegmental atelectasis. |
Generate impression based on findings. | 14-year-old male with gunshot wound to left lower extremity. 11-mm bullet is again seen in the anterior soft tissues of the knee distal to the patella. Comminuted fracture of the anterior tibia at the level of the tibial tuberosity. Foci of gas and edema are seen in the soft tissues adjacent to the bullet and projectile tract. There may be foci of air within the patella ligament. Integrity of the patella ligament cannot be fully assessed secondary to streak artifact of the bullet. A marker is placed in the lateral aspect of the leg indicating entry wound of the bullet. No other fractures are identified.The vessels of the lower extremity opacify with contrast without evidence of pseudoaneurysm, occlusion, or thrombus. Foci of air are present adjacent to the anterior tibial artery (series 12, image 275), however the artery appears patent. No large hemorrhage or hematoma is present. | 1. Comminuted fracture of the anterior tibia at the tibial tuberosity.2. Bullet in the anterior soft tissues of the knee with subcutaneous emphysema and soft tissue swelling.3. Vessels of the lower extremity are without evidence of occlusion or aneurysm. |
Generate impression based on findings. | Reason: please evaluate pituitary gland, patient cannot have MRI to to bullet in head. History of central hypogonadism History: please evaluate pituitary gland, patient cannot have MRI to to bullet in head. History of central hypogonadism There is a metal foreign body located in the sella. This creates artifact. The pituitary is not readily evaluated. The metal foreign body occupies the upper two-thirds of the pituitary fossa including the expected location of the infundibulum. The A1 segments are identified and appear grossly intact but appear to abut the metal foreign body.. There is no indirect evidence for carotid cavernous fistula.The patient is status post right craniotomy. There is encephalomalacia along the right frontal lobe associated with ex vacuo effect along the right lateral ventricle. Incidental note is made of cavum septum pellucidum and cavum vergae.Atherosclerotic calcifications are present along the distal internal carotid arteries.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 sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.The pituitary gland cannot be evaluated due to a foreign metal body lodged in the pituitary fossa. However, given the location of the metal foreign body within the pituitary fossa, one may infer potential injury to the pituitary gland. Please correlate with the clinical history and timing of the patient's signs and symptoms relative to the arrival of the metal foreign body into the pituitary fossa. The condition of the adjacent optic chiasm is better evaluated clinically.2.The patient is status post right frontal craniotomy.3.There is encephalomalacia long the right frontal lobe. |
Generate impression based on findings. | Repeat right patellar dislocation. MENISCI: No significant abnormality noted.ARTICULAR CARTILAGE AND BONE: A subchondral contusion of the lateral femoral condyle is present. An anterolateral femoral condyle chondral defect is identified. Medial facet subchondral contusion is noted just at the insertion of the medial retinaculum.LIGAMENTS: The medial patellofemoral ligament appears attenuated at its femoral attachment. EXTENSOR MECHANISM: No significant abnormality noted.ADDITIONAL | Anterolateral femoral condyle chondral defect due to lateral patellar dislocation. |
Generate impression based on findings. | No suspicious tonsillar or mucosal space masses are seen. Right parotid and submandibular glands are mildly atrophic. Thyroid gland is unremarkable. The airway is patent. There is no cervical lymphadenopathy by CT size criteria. The imaged intracranial contents are unremarkable. Imaged paranasal sinuses and mastoid air cells are clear. Degenerative disk disease of the lower cervical spine with moderate bilateral neuroforaminal narrowing and mild central canal narrowing at C6/7 level. The lung apices are clear. | No evidence of locoregional recurrence. |
Generate impression based on findings. | Female; 74 years old. Reason: evaluate for fluid collections History: s/p esophagectomy for esophageal perforation CHEST:LUNGS AND PLEURA: Small left pleural effusion and mild left basilar subsegmental atelectasis. Small right hydropneumothorax with mild right basilar subsegmental atelectasis. Two right-sided chest tubes are in place with tips near the apex. Rounded opacity with soft tissue attenuation within the azygoesophageal recess is nonspecific but most likely due to postsurgical change (series 3/35); attention at follow-up is recommended.MEDIASTINUM AND HILA: Endotracheal tube tip terminates above the carina. Right jugular central venous catheter tip in the right atrium. Right upper extremity PICC tip in the SVC.Normal heart size. No pericardial effusion. Mild coronary artery calcifications. Mildly enlarged nonspecific mediastinal lymph nodes.Status post esophagectomy with inferior pneumomediastinum communicating with the right pneumothorax..CHEST WALL: Small complex fluid collection located subcutaneously in the left anterior chest wall measuring approximately 2.7 x 2.1 cm (series 3/13); this may represent a hematoma or seroma though infection cannot be excluded. Right rib thoracotomy changes. Body wall anasarca.ABDOMEN:LIVER, BILIARY TRACT: High density within the gallbladder may be related to sludge and/or stones.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Atrophy of the left kidney.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Percutaneous jejunostomy tube in place.BONES, SOFT TISSUES: Body wall anasarca.OTHER: No significant abnormality noted.PELVIS: Streak artifact from right hip arthroplasty hardware severely limits evaluation of the pelvis.UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Air within the decompressed bladder due to Foley catheter being in place.BONES, SOFT TISSUES: Body wall anasarca.OTHER: Mild nonspecific pelvic ascites. | 1. Postsurgical changes from esophagectomy with pneumomediastinum and right hydropneumothorax. Rounded opacity in the azygoesophageal recess is likely due to postsurgical change/hematoma, but attention at follow-up is recommended.2. No intra abdominal or pelvic loculated fluid collection to suggest abscess.3. Small left anterior chest wall subcutaneous complex fluid collection may represent a hematoma or seroma, for which underlying infection cannot be excluded. |
Generate impression based on findings. | Reason: anisocoria, decreased mental status, ?? vasospasm due to h/o SAH History: anisocoria, decreased mental status, ?? vasospasm Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. The patient is status post stent assisted embolic coil occlusion of a right PCOMA aneurysm.There is only mild narrowing of the proximal anterior cerebral arteries.The anterior communicating artery and the posterior communicating arteries are identified and are intact.CT head:There is a right frontal lobe hematoma present in the subacute phase which is stable since the prior exam on 3/13/15.A ventriculostomy tube courses through the left frontal lobe into the left lateral ventricle with tip near the region of foramen of Monro. The lateral ventricles are mildly dilated but stable.A small amount of newer intraventricular blood is present which was also present on the prior exam.Subarachnoid blood products continue to evolve.The patient is status post stent assisted embolic coil occlusion of a right PCOMA aneurysm.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells demonstrate opacification of right mastoid air cells and middle ear and partial opacification of the left mastoid air cells. The visualized portions of the orbits are intact.CT perfusion:Mean transit time, time to peak and, cerebral blood volume and cerebral blood flow maps do not identify any evidence for hypoperfused territory. There is hypoperfusion to the area of the right frontal hematoma. | 1.mild bilateral anterior cerebral artery vasospasm.2.right frontal hematoma continues to evolve3.status post ventriculostomy. The ventricles are stable in size. 4.continued evolution of subarachnoid and intraventricular blood products. |
Generate impression based on findings. | There is a right calvarial burr hole again seen with resolution of previously seen minimal pneumocephalus. A clip in the right medial temporal lobe is again identified. There is diffuse hypoattenuation in the white matter of the right temporal lobe in a vasogenic pattern extending into the insula and operculum without significant change. There is also extensive hypoattenuation involving the white matter in the right frontal lobe with sparing of the cortex, similar in extent to the most recent exam. There is also extension across midline via the genu of the corpus callosum which appears significantly thickened and hypodense, especially compared to baseline exam. For example, the genu of the corpus callosum now measures 2.1-cm AP, compared to prior MR measurement of 1.1-cm.There is no acute intracranial hemorrhage or worsening mass effect. There is persistent mild mass effect on the right lateral ventricle. There is no significant midline shift. An old right cerebellar lacunar infarct is again seen. There are mild chronic microvascular ischemic changes similar to prior exam. There are atherosclerotic calcifications in the bilateral cavernous carotid arteries and intracranial vertebral arteries. There is mild bilateral sphenoid sinus mucosal thickening. There is a nasogastric tube partly imaged. | 1. Postsurgical findings from right temporal lobe biopsy again seen with resolution of minimal pneumocephalus.2. Diffuse vasogenic pattern of abnormal low density in the right frontal and temporal lobes without significant change. No acute intracranial hemorrhage or worsening mass effect. However, comparing to baseline exam, there has been progression of abnormality across the genu of the corpus callosum, which is now significantly thickened and hypodense. Given the short interval time for this change, this is favored more to represent an inflammatory process including acute demyelination especially given prior areas of diffusion restriction, less likely infection, rather than previous proposed neoplasm.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female; 64 years old. Reason: evaluate for SBO History: nausea, vomiting, diarrhea ABDOMEN:LUNG BASES: Minimal bibasilar dependent subsegmental atelectasis. Small amount of contrast within the distal esophagus, suggestive of esophageal reflux.LIVER, BILIARY TRACT: Stable indeterminant subcentimeter hypoattenuating lesion in the right lobe of the liver (series 3/39).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: Mild calcific arteriosclerotic disease affects the aorta.BOWEL, MESENTERY: The stomach is severely distended with dilation of the proximal duodenum. There is a transition point involving the mid third portion of the duodenum where the SMA traverses anteriorly (series 3/65) with the distal duodenum and proximal jejunum decompressed. This constellation of findings raises the question of SMA syndrome as the cause of the gastric distention.Mid to distal small bowel loops are mildly dilated diffusely. Contrast opacifies all of the small bowel through the proximal colon. A loop of distal small bowel in the left lower quadrant is slightly more focally dilated with a transition point, suggesting adhesive disease causing mild grade partial obstruction of this loop (coronal series 80220/56).The colon is diffusely dilated and filled with fluid and air with transition point involving the proximal sigmoid colon immediately overlying the left psoas muscle (series 3/85), suggesting adhesive disease as the cause. This transition point is immediately posterior to the above-described small bowel transition point. The distal sigmoid colon and the rectum are relatively decompressed, but there is fluid and air seen within them, suggesting moderate grade partial obstruction. The transition point is proximal to a sigmorectal bowel anastomosis.Mild ascites raises the question of obstructive ischemia. No pneumatosis, portal venous gas, or free air.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.BOWEL, MESENTERY: Please see above; postsurgical changes in the rectosigmoid junction.BONES, SOFT TISSUES: Bilateral hip prosthesis.Degenerative changes affects the mid lumbar spine.OTHER: No significant abnormality noted. | 1. Severe gastric distention with findings raising the question of SMA syndrome as the cause.2. Findings suggestive of a mild grade partial small bowel obstruction and a moderate grade partial colon obstruction as detailed above.3. Ascites, developing obstructive ischemia not entirely excluded. No pneumatosis, portal venous gas, or free air. |
Generate impression based on findings. | There are unchanged posttreatment findings with improved aeration of the pharynx, and no evidence of mass lesions or significant cervical lymphadenopathy. A stable reference left level IIa lymph node measures 5 mm on series 8 image 33. The thyroid and major salivary glands are unremarkable. There is mild persistent narrowing of the oropharyngeal airway which may be due to the "puffed cheek" maneuver. The airways are otherwise patent. There is mild atherosclerotic calcification of the bilateral carotid bulbs again seen. The major cervical vessels are otherwise patent. The osseous structures show no focal lesions. There is mild to moderate cervical spondylosis with uncovertebral and facet hypertrophy without significant change. There is unchanged disk osteophyte complex at C7-T1 causing minimal spinal canal stenosis. There is loss of disk height at C5-6, C6-7 and C7-T1 again seen. The imaged intracranial structures are unremarkable. There is mild left sphenoid, bilateral maxillary and ethmoid sinus mucosal thickening. There are a few scattered micronodules in the bilateral lung apices; please refer to accompanying dedicated CT chest report for further details. | 1.No locoregional tumor recurrence or significant cervical lymphadenopathy.2.Please refer to dedicated accompanying CT chest report for further details. |
Generate impression based on findings. | 12-year-old female with lupus, pancreatic pseudocyst, and splenic thrombus seen on recent CT. Color and spectral Doppler were performed.Anechoic area within the pancreas measuring 2.2 x 1.3 x 0.8 cm represents small residual pseudocyst. The spleen is normal in echogenicity and size measuring 10.2 cm. The splenic artery has normal waveforms and is patent with a peak velocity of 0.3 m/sec. There is hepatopetal flow within the splenic vein. The splenic vein caliber is normal. No thrombus is identified.The main portal vein is patent demonstrating hepatopetal flow with a velocity of 0.2 m/sec. | Narrowing and compression of splenic vein resolved after drainage of pancreatic pseudocyst. |
Generate impression based on findings. | Reason: h/o HNC and CRT, compare to previous measurements History: none CHEST:LUNGS AND PLEURA: Scattered micronodules compatible with previous infection, unchanged.No suspicious nodules.MEDIASTINUM AND HILA: No significant lymphadenopathy.No visible coronary artery calcifications.No pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Multiple small hypoattenuating lesions in the left adrenal gland, probably benign adenomas, unchanged.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild atherosclerotic calcifications about the abdominal aorta and its branches.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. | No evidence of metastatic disease. |
Generate impression based on findings. | Reason: anisocoria, decreased mental status, ?? vasospasm due to h/o SAH History: anisocoria, decreased mental status, ?? vasospasm Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. The patient is status post stent assisted embolic coil occlusion of a right PCOMA aneurysm.There is only mild narrowing of the proximal anterior cerebral arteries.The anterior communicating artery and the posterior communicating arteries are identified and are intact.CT head:There is a right frontal lobe hematoma present in the subacute phase which is stable since the prior exam on 3/13/15.A ventriculostomy tube courses through the left frontal lobe into the left lateral ventricle with tip near the region of foramen of Monro. The lateral ventricles are mildly dilated but stable.A small amount of newer intraventricular blood is present which was also present on the prior exam.Subarachnoid blood products continue to evolve.The patient is status post stent assisted embolic coil occlusion of a right PCOMA aneurysm.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells demonstrate opacification of right mastoid air cells and middle ear and partial opacification of the left mastoid air cells. The visualized portions of the orbits are intact.CT perfusion:Mean transit time, time to peak and, cerebral blood volume and cerebral blood flow maps do not identify any evidence for hypoperfused territory. There is hypoperfusion to the area of the right frontal hematoma. | 1.mild bilateral anterior cerebral artery vasospasm.2.right frontal hematoma continues to evolve3.status post ventriculostomy. The ventricles are stable in size. 4.continued evolution of subarachnoid and intraventricular blood products. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild periventricular and subcortical white matter hypoattenuation which is nonspecific, likely representing chronic microvascular ischemic changes. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is a partial empty sella of incidental note. There is scattered ethmoid opacification and moderate right maxillary sinus opacification with bubbly secretions. There are periapical lucencies surrounding adjacent right maxillary molars. The skull and extracranial soft tissues are unremarkable. | 1.Mild chronic microvascular ischemic changes with no acute intracranial hemorrhage or mass-effect. CT is insensitive for detection of early nonhemorrhagic stroke.2.Finding suggesting acute sinusitis in the proper clinical setting, with periapical lucencies of of the adjacent right maxillary molars. Recommend correlation with dental exam. |
Generate impression based on findings. | There is no evidence of mass lesions or significant cervical lymphadenopathy. There is no large lipoma in the posterior neck soft tissues or mass. There is diffuse prominence of subcutaneous fat. There are scattered subcentimeter lymph nodes in the neck which are not enlarged by CT size criteria. The thyroid and major salivary glands are unremarkable.The major cervical vessels are patent. The osseous structures are unremarkable. There is a significantly developmentally slender spinal canal measuring up to 6-7 mm in AP dimension with scattered superimposed minimal spondylotic changes. There is developmental nonunion of the posterior arch of C1. The airways are patent. The imaged intracranial structures are unremarkable. There is a partial empty sella of incidental note. There is an old left lamina papyracea fracture deformity. There is a polyp versus mucus retention cyst in the right maxillary sinus. The imaged portions of the lungs are clear. | 1.No posterior neck mass, large lipoma or significant lymphadenopathy.2.Significantly slender spinal canal likely on a developmental basis with superimposed minimal spondylotic changes which can be better evaluated on MRI if clinically indicated. |
Generate impression based on findings. | NECK: There are unchanged posttreatment findings with no mass lesions or significant cervical lymphadenopathy. The thyroid and major salivary glands are unremarkable. The airways are patent. There is mild to moderate bilateral proximal internal carotid artery stenosis with atherosclerotic calcifications. There is dense calcification of the left vertebral artery origin. The major cervical vessels are otherwise patent. The osseous structures show no focal lesions with multilevel cervical degenerative changes again seen, worst at C6-7 where there is disk extrusion extending cranially with moderate spinal canal stenosis, and scattered high-grade neural foraminal stenoses. The imaged intracranial structures are unremarkable. The imaged portions of the lungs show emphysematous changes without discrete mass. Please refer to dedicated accompanying CT chest report for further details.HEAD: There is no suspicious intracranial enhancement, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is moderate left and minimal right maxillary sinus mucosal thickening. The skull and extracranial soft tissues are unremarkable. | 1.No locoregional tumor recurrence or significant cervical lymphadenopathy.2.No evidence of intracranial metastases.3.Please refer to dedicated accompanying CT chest report for further details. |
Generate impression based on findings. | Right ovarian cystic mass seen on pelvic sonography, history of metrorrhagia PELVIS:UTERUS, ADNEXA: Multiple bilateral T1 hyperintense lobulated foci seen in adnexa, largest seen on right, measuring 2.8 x 2.3 cm. These lesions are also T2 hyperintense and in the case of the aforementioned largest focus on the right, there is also a fluid-fluid level with a "T2 shading" effect suggested, similar findings are seen to a lesser extent in the other lesions on the left.Lobulated uterine contour with multiple fibroids, examples include largest wide-based subserosal fundal fibroid measuring 2.5 x 1.8 cm and left-sided uterine body calcified intramural fibroid, measuring 2.1 x 1.8 cm.Endometrial complex normal in size, c-section defect seen. No evidence of adenomyosis. Ventral pelvic soft tissue/subcutaneous postsurgical sequela.BLADDER: No significant abnormality noted.LYMPH NODES: No enlarged adenopathy. Small nonpathologically enlarged inguinal nodes.BONES, SOFT TISSUES: No significant abnormality noted. | 1. Bilateral adnexal cystic lesions with "T2 shading," appearance consistent with endometriomas. 2. Fibroid uterus. |
Generate impression based on findings. | Slammed little finger in car door. Laceration.VIEWS: Right hand PA, right little finger oblique/lateral (3 views) 03/14/15 The soft tissues of the distal phalanx of the little finger are irregular and swollen. No foreign body is identified. No fracture is seen. | Soft tissue injury. |
Generate impression based on findings. | Jammed little finger. Pain and swelling in proximal interphalangeal joint.VIEWS: Left hand PA, left little finger oblique/lateral (3 views) 03/14/15 Soft tissue swelling is present around the proximal interphalangeal joint of the little finger.A 2 mm bone fragment is noted anterior to the condylar surface of the proximal phalanx. The anterior condylar surface is slightly irregular and most likely represents the donor site of the fracture. | Fracture of the proximal phalanx of the little finger. |
Generate impression based on findings. | 52 years old Female. Dual point PET scan to re-evaluate mass for biopsy. History: Lung cancer patient needs evaluation for biopsy for tissue. RADIOPHARMACEUTICAL: 12.9 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 95 mg/dL. Today's CT portion grossly demonstrates right upper and middle lung dense consolidation and surgical sutures. There are numerous solid and non-solid nodules in both lung, which are new as compared with prior PET/CT study but are stable as compared with recent diagnostic chest CT. The dominant right upper lobe nodule ( series 4/78) and the reference right middle lobe nodule (series 4/93) are noted. The semisolid nodule in the left upper lobe (series 4/81) is seen. There is a low-attenuation lesion in the right lobe of liver which is consistent with hemangioma as demonstrated on CT.Today's PET examination demonstrates increased metabolic activity in the numerous new lung nodules demonstrated on CT. SUVmax in the right upper lobe dominant nodule is 12.46 on the early body PET imaging and 14.17 on the delayed chest PET imaging. SUVmax increase in the nodule is 13.4% from the whole-body PET to the delayed chest PET imaging. The SUV Max in the right middle lobe reference nodule is 4.41 on the early body PET imaging and 6.1 on the delayed chest PET imaging. The SUVmax increase in the nodule is 38% from the whole-body PET to the delayed chest PET imaging. The SUVmax in the solid component of left upper lobe semisolid reference nodule is 7 on the early body PET imaging and 7.69 On the delayed chest PET imaging. The SUVmax increase in the nodule is 9.8% from the whole-body PET to the delayed chest PET imaging.Lower one of the previously identified two large areas of increased activity in the right upper lung has resolved. Upper lesion in the right apex seen on prior study has decreased in size.Nonspecific normal sized lymph nodes in the neck with mild FDG uptake.Physiologic activity is seen in the liver, spleen, kidneys, intestines and bladder. | 1.Numerous new lung nodules with increased metabolic activity as compared with prior FDG PET study. The reference two nodules in the right upper lobe and right middle lobe with increased metabolic activity dual-time point PET/CT scans, highly suspicious for tumor. Other new hypermetabolic nodules in both lungs may be due to metastasis or inflammatory changes. 3. Post-therapy changes in the right lung. |
Generate impression based on findings. | Mild leftward convexity of the lumbar spine. Minimal 2-mm anterolisthesis of L5 over S1 vertebral body. Atherosclerotic calcification of the visualized abdominal aorta and iliac arteries. Surgical clips noted in the right upper quadrant, likely from prior cholecystectomy.T11/T12: Mild posterior disk bulge without evidence of neuroforaminal or central canal stenosis.T12/L1: Loss of disk height with vacuum phenomenon. No evidence of neuroforaminal or central canal stenosis.L1/2: Central disk extrusion with 12 mm cranial extension. Mild ligamentum flavum thickening. Mild bilateral neuroforaminal narrowing. Mild central canal stenosis.L2/3: Loss of disk height with vacuum phenomenon. Diffuse disk bulge and ligamentum flavum thickening. Moderate right and moderate to severe left neuroforaminal narrowing. Moderate to severe central canal stenosis.L3/4: Loss of disk height with vacuum phenomenon. Diffuse disk bulge and ligamentum flavum thickening. Moderate to severe right and moderate left neuroforaminal narrowing. Moderate central canal stenosis.L4/5: Diffuse disk bulge with right predominance. Bilateral facet hypertrophy. Paucity of ligamentum flavum on the right suggestive of possible prior surgery. Mild right neuroforaminal narrowing. Mild to moderate central canal stenosis. L5/S1: Loss of disc height with vacuum phenomenon. Uncovering of disc with superimposed disc bulge. Bilateral facet hypertrophy and ligamentum flavum thickening. Moderate right and moderate to severe left neuroforaminal narrowing. Mild to moderate central canal stenosis. | 1.2-mm grade 1 anterolisthesis of L5 over S1, which appears degenerative.2.Multilevel degenerative disc disease as above, most severe at L2/3, L3/4, and L5/S1 levels. |
Generate impression based on findings. | There is nonspecific asymmetric, right more than left, irregular partially enhancing tissue extending into the vallecula/tongue base. There is rim-enhancing subcutaneous fluid-density lesion measuring 8 mm superficial to the right parotid gland abutting the skin surface. The skin overlying the lesion also enhances. The parotid, salivary, and thyroid glands are unremarkable. There are no nasopharyngeal, oropharyngeal or laryngeal masses identified and the airway is patent. The imaged intracranial contents are unremarkable. The imaged paranasal sinuses and mastoid air cells are clear. The imaged orbits are unremarkable.There is no cervical lymphadenopathy by size CT criteria. Vascular calcification of the left carotid artery without significant stenosis. Centrilobular emphysema of the lung apices. Mild degenerative changes of the lower cervical spine. | 1.Nonspecific irregular partially enhancing soft tissue extending into the vallecula from the tongue base. Given the location this is likely lingula tonsillar lymphoid tissue. Please correlate with direct visualization.2.Small rim enhancing subcutaneous lesion with overlying skin enhancement adjacent to the right parotid gland, which may represent a sebaceous cyst. Correlate with direct visualization.3.No cervical lymphadenopathy. |
Generate impression based on findings. | Postoperative changes of left submandibular gland excision and left neck dissection. Previously seen left submandibular mass and submandibular gland are resected. There is stable small hypodense right thyroid nodule. Parotid glands are unremarkable. The airway is patent. There are no nasopharyngeal, oropharyngeal or laryngeal masses identified. The imaged intracranial contents are unremarkable. Right maxillary mucous retention cyst. Otherwise imaged paranasal sinuses and mastoid air cells are clear. Bilateral cataract surgery. There is no cervical lymphadenopathy by CT size criteria. Major cervical vessels are grossly patent. Osseous structures are unremarkable.There is 4-mm pulmonary micronodule at the right lung apex (series 7 image 70), which appears more conspicuous from prior study but likely due to slice selection differences. Please see dedicated chest CT report for additional details. | 1.Resection of the left submandibular mass with expected postoperative changes. 2.4-mm right apical pulmonary micronodule. Please see dedicated chest CT report for additional details.3.Nonspecific right thyroid lesion. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild periventricular and subcortical white matter hypoattenuation which is nonspecific, likely representing chronic small vessel ischemic disease. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is persistent chronic deformity of the left maxillary sinus, and old right lamina papyracea fracture deformity. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or mass-effect. CT is insensitive for detection of early nonhemorrhagic stroke. |
Generate impression based on findings. | Ankle pain.VIEWS: Left ankle AP/lateral/oblique (3 views) 03/14/15 Mild soft tissue swelling is noted laterally. No joint effusion is present. The bones are normal in appearance. A fracture is not identified. | Mild soft tissue swelling laterally. |
Generate impression based on findings. | Foot pain. Rule-out fracture.VIEWS: Left foot AP/lateral/oblique (3 views) 03/14/15 No soft tissue swelling is identified. The bones are normal in appearance. A fracture is not seen. | Normal examination. |
Generate impression based on findings. | Trauma.VIEWS: Cervical spine AP/lateral (two views) 03/14/15, 1701 at 1704 Vertebral body heights and disk spaces are maintained. No prevertebral soft tissue swelling is seen. No fracture or dislocation is present. | Normal examination. |
Generate impression based on findings. | Trauma.VIEW: Pelvis AP (one view) 03/14/15, 1659 The femoral head ossification centers are well directed into normally formed acetabula. No fracture is seen. | Normal examination. |
Generate impression based on findings. | Trauma.VIEW: Pelvis AP (one view) 03/14/15, 1903 Femoral heads are well directed into normally formed acetabula. No fracture is identified. | Normal examination. |
Generate impression based on findings. | 51 years old, Female, Reason: evaluate for PE History: hemoptysis PULMONARY ARTERIES: Technically adequate study to the first order subsegmental level. No pulmonary emboli are identified. Reflux of contrast hepatic veins suggest right heart disease. The main pulmonary artery and descending thoracic aorta are within normal limits.LUNGS AND PLEURA: Severe centrilobular emphysematous changes are present. New left lower lobe consolidation with air bronchograms suggestive of infection with adjacent atelectasis. No pleural effusion or pneumothoraxMEDIASTINUM AND HILA: The heart size within normal limits without evidence of pericardial effusion. There is no significant mediastinal, hilar, or cardiophrenic lymphadenopathy. Two mildly enlarged retrocrural lymph nodes are identified both measuring 1.0 cm (series 7, image to 279).CHEST WALL: No significant axillary lymphadenopathy. The osseous structures are normal.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No evidence of pulmonary embolism. 2. New left lower lobe consolidation suggests infection.3. Mildly enlarged retrocrural lymph nodes.4. Severe centrilobular emphysema.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Abdominal pain. Free fluid and right lower quadrant. ABDOMEN:LUNG BASES: Subsegmental atelectasis is seen in left lower lobe. No airspace disease is present. No pleural effusion is identified.LIVER, BILIARY TRACT: Enhancement is normal. No biliary ductal dilatation is identified. The gallbladder is distended and normal in appearance.SPLEEN: Normal in size and enhancement.PANCREAS: Normal in appearance.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Right renal cortical enhancement is abnormal with multiple regions of decreased attenuation in a lobar (medullary pyramid and surrounding cortex) distribution. The right kidney measures 10 cm in length. Grade 2 pelvicaliceal dilation is present. Enhancement of the left kidney is minimally heterogeneous. The left kidney measures 9 cm in length. Grade 1 pelvic dilation is present.Right ureter is mildly dilated from renal pelvis to just inferior to iliac crests. The urinary bladder is quite distended.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Duodenojejunal junction is normally positioned. No dilated bowel is seen.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No free peritoneal air or fluid is present in the upper abdomen.PELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Moderately distended.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No inflammatory changes are seen in the right lower quadrant. The appendix is normal in appearance.BONES, SOFT TISSUES: No significant abnormality notedOTHER: A small amount of free peritoneal fluid is present in the pelvis. | Right pyelonephritis. |
Generate impression based on findings. | There is diffuse thickening and enhancement of the soft tissues along predominantly the cartilaginous left external auditory canal which is significantly narrowed down to 1 mm, although there is also focal thickening along the osseous portion of the canal. The thickening along the posterior wall of the osseous portion of the canal abuts the scutum and the outer margin of the left tympanic membrane, with slight thickening of the upper pars flaccida. Several left preauricular and postauricular lymph nodes are seen. There is thickening of the soft tissue overlying the mastoid bone without osseous erosion or periosteal reaction at this time. Inflammatory changes and soft tissue thickening also extend into the medial auricle. No definite extension of inflammatory changes into deeper spaces of the neck is identified.LEFT TEMPORAL BONE: The remainder of the tympanic membrane is faintly visualized. The scutum remains sharp.The tympanic cavity and mastoid air cells are clear. The ossicular chain and tegmen tympani are intact.The inner ear structures have a normal morphology. The bony coverings of the cochlea, vestibule, semicircular canals, and facial nerve canal are intact. The vestibular aqueduct is within normal limits in size. No abnormalities of the osseous internal auditory canal are demonstrated.RIGHT TEMPORAL BONE: The external auditory canal is clear. The tympanic membrane is faintly visualized. The scutum remains sharp.The tympanic cavity and mastoid air cells are clear. The ossicular chain and tegmen tympani are intact.The inner ear structures have a normal morphology. The bony coverings of the cochlea, vestibule, semicircular canals, and facial nerve canal are intact. The vestibular aqueduct is within normal limits in size. No abnormalities of the osseous internal auditory canal are demonstrated. | Diffuse thickening of soft tissue along the walls of the left external auditory canal with severe narrowing of the cartilaginous portion down to a lumen at 1 mm. Mild involvement of the auricle with prominent pre-and postauricular soft tissue thickening and likely reactive lymph nodes, with extension along the mastoid without evidence of osseous erosions or periosteal reaction. Soft tissue thickening and enhancement does extend up to the scutum with mild thickening of the upper pars flaccida. These findings are concerning for early necrotizing external otitis without focal fluid collection or abscess at this time. |
Generate impression based on findings. | 35 years old, Male, Reason: r/o PE History: tachycardic, hemoptysis PULMONARY ARTERIES: Technically adequate study to the first order subsegmental level. No evidence of pulmonary embolus. No evidence of right heart strain.LUNGS AND PLEURA: Extensive right middle lobe opacity with air bronchograms compatible with atelectasis and consolidation come which is likely related to infection. Mild bibasilar atelectasis. Scattered groundglass opacities are present in the anterior left lower lobe may related to infection and/or aspiration.MEDIASTINUM AND HILA: Heart size is at the upper limits of normal without evidence of pericardial effusion. A hiatal hernia is present. 2.5-cm right hilar lymph node is present (series 6, image 131), which is likely reactive in etiology. No significant mediastinal internal mammary, cardiophrenic or retrocrural lymphadenopathy by CT size criteria. CHEST WALL: No significant abnormality noted. The osseous structures are normal.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1. No pulmonary embolism. 2. Right middle lobe consolidation concerning for infection. 3. Small hiatal hernia.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, significant scalp soft tissue swelling or skull fracture. However, there is diffuse grainy appearance with hypoattenuation in the right frontal, parietal and occipital lobes as well as the left occipital and parietal lobes. Apparent minimal sulcal effacement in the right cerebral hemisphere is felt to be due to the poor image quality, and not felt to be pathologic. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses are opacified. The mastoid air cells are clear. | 1.No acute intracranial hemorrhage or skull fracture.2.Apparent hypoattenuation predominantly in the right cerebral hemisphere which is heavily favored to be artifactual. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is a small focus of hypoattenuation in the left external capsule probably representing age indeterminate ischemic degenerative change. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is opacification of the lateral recess of the right sphenoid sinus. The skull and extracranial soft tissues are unremarkable. | Minimal probable age indeterminate ischemic degenerative changes with acute intracranial hemorrhage or skull fracture.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Female 43 years old; Reason: Evaluate for acute pancreatitis, history of abdominal pain ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Focal fat infiltration along the ligamentum teres. Hepatic segment 8/5 subcentimeter hypoattenuating lesion, too small to characterize. Patent portal veins, splenic vein and SMV. Gallbladder in contracted state.SPLEEN: No significant abnormality noted.PANCREAS: Mild periceliac haziness of fat and haziness of fat around uncinate process and near junction with pancreatic head, may be seen in setting of early acute pancreatitis. Homogeneous appearance of pancreatic parenchyma. No discrete fluid collection.ADRENAL GLANDS: Punctate calcification in or adjacent to left adrenal gland, may reflect prior inflammation or infection.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Mild periceliac haziness of fat, nonspecific but may be seen in setting of early acute pancreatitis. BOWEL, MESENTERY: Sigmoid colon diverticulosis without evidence of acute diverticulitis. Normal appendix.PELVIS:UTERUS, ADNEXA: Small pelvic free fluid, likely physiologic. Asymmetric prominence of right adnexa, may reflect underlying physiologic follicle(s) but correlation with pelvic sonography recommended. Heterogeneous uterus with underlying leiomyomatous disease, areas of irregular relatively decreased hypoattenuation may reflect fibroid degeneration/necrosis. BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Minimal degenerative spinal disease. Small 1.7 cm fat containing umbilical hernia. | 1. Mild periceliac haziness of fat and haziness of fat around uncinate process and near junction with pancreatic head, may be seen in setting of early acute pancreatitis. Findings discussed with ED physician Dr. Saint-Hilaire at 8:30 a.m. on 3/15/15.2. Probable physiologic dominant follicle in right ovary and fibroid uterus with areas of irregular relatively decreased hypoattenuation that may reflect fibroid degeneration/necrosis, these findings would be better characterized with dedicated pelvic sonography. |
Generate impression based on findings. | There is mild motion artifact limiting evaluation. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration; however, there is minimal asymmetry of the lateral ventricles with the left lateral ventricle being slightly more prominent than the right, likely normal variant. There is no midline shift or herniation. There is likely artifactual low density along the right cerebellum.There are prominent falcine dural calcifications. There are atherosclerotic calcifications in the cavernous carotids and intracranial vertebral arteries bilaterally. There is near complete opacification of the left maxillary sinus with hyperattenuating central debris suggesting probable inspissated secretions and less likely fungal colonization. The skull and extracranial soft tissues are unremarkable with exception of tiny scattered scalp soft tissue calcifications. | 1. Motion degraded study with no acute intracranial hemorrhage or mass effect. CT is insensitive for detection of early nonhemorrhagic stroke.2. Near complete opacification of the left maxillary sinus. Please correlate clinically.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 76 years old, Female, Reason: evaluate for PE, ILD History: SOB, hypoxia PULMONARY ARTERIES: Pulmonary opacification adequate to the early segmental level without evidence of pulmonary embolism. Main pulmonary artery is dilated measuring 3.1 cm (series 7, image 102) collection is seen the setting of pulmonary hypertension.LUNGS AND PLEURA: Small right pleural effusion with compressive atelectasis. Linear left basilar atelectasis. Persistent but improved focal areas of subpleural groundglass and air space opacity compared to prior exam. Calcified pulmonary nodules in the left upper and right lower lobes are unchanged. Noncalcified pulmonary nodule in the right middle lobe adjacent to the minor fissure measures 6 mm, unchanged in size (series 10, image 65).MEDIASTINUM AND HILA: Minimally enlarged pretracheal lymph nodes measure up to 1.0 cm (series 7, image 99), unchanged in size compared to prior exam.CHEST WALL: Moderate degenerative changes of the thoracolumbar spine. Median sternotomy hardware is present. UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Partially imaged known abdominal aortic dissection. | 1. No evidence of pulmonary embolism to the early segmental level.2. Small right pleural effusion and scattered groundglass opacities may related to infection and/or atelectasis.3. Partially visualized known abdominal aortic dissection.4. Unchanged pulmonary nodules.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Trauma. Middle finger tenderness.VIEWS: Left hand PA/lateral (two views) 03/14/15, 1918 and 1919 Mild soft tissue swelling is present around the proximal phalanx of the middle finger. No fracture is identified. The bones are normal in appearance. | Soft tissue swelling around the proximal phalanx of the middle finger. |
Generate impression based on findings. | There is a large peripherally enhancing fluid density necrotic mass within the right neck which extends from the right supraclavicular region up to the approximate C4 level, centered near the level of the larynx. The mass measures 6.6 x 8.9 cm in greatest axis dimensions, by 6.0 cm CC. There is a thick rind of enhancing soft tissue peripherally with multiple areas of nodularity. There is associated mild-moderate leftward deviation of the airway, although this remains patent. There is diffuse thickening of the right aryepiglottic fold with effacement of the normal right paraglottic fat. There is also abnormal enhancing soft tissue within the pre-glottic fat with diffuse thickening of the entire epiglottis. There is also mild thickening of the left aryepiglottic fold. The laryngeal cartilages appear relatively symmetric. The valleculae are near completely effaced. The right piriform sinus is also near completely effaced.Incidental note is made of medialization of the right common carotid artery and proximal internal carotid artery which likely is developmental with perhaps superimposed mass effect from the mass. The right internal jugular vein is visualized from the skull base down to just above the upper margin of the mass, where there is suggestion of an irregular filling defect within its lumen as seen on 7/34-40, likely thrombosed distal to the level of the mass with the possibility of direct tumor invasion not entirely excluded.The posterior lateral margin of the right greater cornu of the hyoid bone is somewhat indistinct and attenuated, and may be eroded. There is deformity of the posterior margin of the right submandibular gland due to the large mass. The right sternocleidomastoid muscle is indistinguishable from the mass and likely is directly infiltrated.A small amount of aerated debris is present within the dependent oropharynx and hypopharynx. The upper trachea and esophagus are unremarkable. There is scattered prominent left cervical lymph nodes along the jugulodigastric chain measuring up to 9 mm.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.OTHER: Emphysematous changes are noted within the lungs diffusely. The left vertebral artery originates directly from the aortic arch. There is minimal left carotid bulb atherosclerotic calcification. There are mild cervical spondylotic changes with a developmentally slender cervical spinal canal. There is a small right anterior ethmoid air cell probable osteoma. | 1. Findings most suggestive of a primary malignancy involving the supraglottic larynx with likely large necrotic pathologic lymph node or nodal conglomerate within the right neck, which is indistinguishable from overlying right sternocleidomastoid muscle which likely is directly infiltrated. Associated mass effect upon the airway which remains patent.2. Associated nonvisualization and thrombosis of the mid to distal right internal jugular vein. Direct tumor invasion cannot be entirely excluded.3. Mild questioned attenuation of the posterior cornu of the right hyoid bone. |
Generate impression based on findings. | 50 years old, Female, Reason: Evaluate for PE History: tachycardia, SOB, CP PULMONARY ARTERIES: Technically adequate study to the first-order subsegmental level without evidence of pulmonary embolism. No evidence right heart strain.LUNGS AND PLEURA: Mild bibasilar atelectasis present. No pleural effusion, pneumothorax, or dense consolidation. Previously noted right basilar opacities significantly improved, but minimally present.MEDIASTINUM AND HILA: Previously noted subcarinal lymph node is decreased in size measuring 0.8 cm (series 8 image 13), previously measuring 14 mm.CHEST WALL: Soft tissue nodule in the left breast is unchanged in size measuring 2.3 by 1.5 cm (series 8, image 62). Axillary lymphadenopathy is not significantly changed.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No evidence of pulmonary embolism.2.Mediastinal and axillary lymphadenopathy is not significantly changed.3.Resolution of right basilar opacity since 6/9/14.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | There is mild right anterior frontal superficial and deep scalp soft tissue swelling near the midline. There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull is intact. | Mild frontal scalp/subgaleal soft tissue swelling without intracranial hemorrhage or skull fracture.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Desaturations and abdominal pain.VIEWS: Chest AP/lateral (two views) 03/14/15, 2013 and 1957 Cardiothymic silhouette and pulmonary vascularity are normal. The aortic arch, cardiac apex, and stomach are left-sided. No focal lung opacity is present.Contrast material opacifies the upper pole renal collecting systems. | No pneumonia. |
Generate impression based on findings. | Right lower quadrant pain, evaluate for hernia or testicular cause of pain RIGHT TESTIS: Measures 4.9 x 3.3 x 2.3 cm. Echotexture mildly heterogeneous, no focal parenchymal lesion. No sonographic evidence of torsion or acute orchitis.LEFT TESTIS: Measures 4.3 x 2.9 x 2.5 cm. Echotexture heterogeneous, no focal parenchymal lesion. No sonographic evidence of torsion or acute orchitis.RIGHT EPIDIDYMIS: Symmetric epididymal vascularity.LEFT EPIDIDYMIS: Symmetric epididymal vascularity.OTHER: Located lateral to right testicle in thigh is oblong hypoechoic structure measuring 2.1 x 0.9 x 0.6 cm. Associated and surrounding vascularity suggested and appearance is consistent with an abscess. | Findings consistent with an abscess located lateral to testicle in right thigh as described. |
Generate impression based on findings. | Trauma.VIEWS: Lumbar spine AP/lateral (two views) 03/14/15, 2047 and 2049 Vertebral body heights and disk spaces are maintained. Alignment is normal. No fracture is identified.A moderate amount of feces is seen within the colon. | Normal examination. |
Generate impression based on findings. | 52 years old, Female, Reason: eval for blood clot History: chest pain PULMONARY ARTERIES: Pulmonary opacification is adequate to the first order subsegmental level without evidence of pulmonary embolism. No evidence of right heart strain.LUNGS AND PLEURA: No suspicious pulmonary nodules. Mild compressive bibasilar atelectasis is present.MEDIASTINUM AND HILA: There is extensive near confluent mediastinal lymphadenopathy which enhances minimally in the arterial phase and appears to have a more central low-density area concerning for necrosis. There is minimal mass effect on the central airways and right pulmonary arteries. This mass measures 4.6 x 3.3 cm (series 4, image 107), concerning for lymphoma or metastasis. A significantly enlarged heterogeneous left thyroid lobe is present measuring 3.2 x 4.2 cm (series 4, image 28).CHEST WALL: No significant axillary lymphadenopathy. Minimal degenerative changes of the thoracolumbar spine are present.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. No significant abnormality noted. | 1.No pulmonary embolism.2.Large confluent right mediastinal lymphadenopathy concerning for lymphoma or metastasis.3.Large heterogeneous left thyroid lobe is amenable to biopsy.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Trauma.VIEWS: Thoracic spine AP/lateral (two views) 03/14/15, 2046 and 2050 Vertebral body heights and disk spaces are maintained. No fracture is present. | Normal examination. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is minimal periventricular and subcortical white matter hypoattenuation which is nonspecific, representing chronic small vessel ischemic changes. There is crowding of soft tissue at the foramen magnum with low-lying cerebellar tonsils. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. There is heterogeneous appearance of the skull with tiny lucencies which may be secondary to demineralization and/or underlying blood dyscrasias. | 1. No acute intracranial hemorrhage. Minimal chronic small vessel ischemic changes. MR may be obtained if there remains clinical concern for an acute ischemic event.2. Low lying cerebellar tonsils with moderate crowding. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Tibial plateau tenderness. Motor vehicle collision with pedestrian.VIEWS: Left knee AP/lateral/oblique (3 views) 03/14/15, 2059, 2100, 2103 No joint effusion is seen. No fracture is identified. The bones are normal in appearance. A bone island is present in the proximal tibia. | Normal examination. |
Generate impression based on findings. | Male 36 years old Reason: s/p kidney transplant with drop in urine output Suboptimal exam secondary due to postoperative pneumoperitoneum.RIGHT ILIAC FOSSA TRANSPLANT KIDNEY: Measures approximately 9.4 cm. No hydronephrosis. Parenchymal echogenicity within normal limits. No shadowing intrarenal echogenic focus seen to suggest underlying nephrolithiasis. No perinephric fluid delineated.DOPPLER: Right iliac artery peak systolic velocity measures 146 cm/sec.Site of anastomosis not well visualized, possible peak systolic velocity of 32 cm/sec.Proximal renal artery peak systolic velocity measures 31 cm/sec and velocities at the mid portion and distally measure 47 cm/sec and 87 cm/sec, respectively. At the hilum, peak systolic velocity measures 192 cm/sec.Visualized renal vein patent.Intrarenal resistive indices measure 0.56 to to 0.73,Incompletely imaged stent. Some adjacent air suggested.BLADDER: Not visualized, may be secondary to contracted state, correlation with patient's history suggested. | Limited exam secondary due to postoperative pneumoperitoneum.Intrarenal resistive indices within normal limits. Site of anastomosis not well assessed. If there is clinical concern for stenosis, repeat sonographic imaging recommended. Visualized renal vein patent. No hydronephrosis or perinephric fluid delineated. |
Generate impression based on findings. | Motor vehicle collision and tibial plateau tenderness. No soft tissue swelling is identified. A joint effusion is not present. The bones are normal in appearance. Bone island in the proximal tibia is again visualized. | Normal examination. |
Generate impression based on findings. | Fall on outstretched hand with impact to elbow. Swelling of olecranon and elbow pain with extension/flexion.VIEWS: Left elbow AP/lateral/oblique (3 views) 03/14/15 A small joint effusion is present. No fracture is identified. The bones are normal in appearance. | Small joint effusion. |
Generate impression based on findings. | 63 years old, Female, Reason: concern for PE History: SOB, elevated D-dimer, PULMONARY ARTERIES: Technically adequate study to the level of the first or subsegmental pulmonary arteries without evidence of pulmonary embolus. The main pulmonary artery and descending thoracic aorta are within normal limits. Reflux of contrast into the hepatic veins suggest right heart insufficiency. LUNGS AND PLEURA: Basilar predominant atelectasis and septal thickening system with pulmonary edema. No pleural effusion or pneumothorax. No suspicious pulmonary nodules or masses are present.MEDIASTINUM AND HILA: Cardiomegaly without evidence of pericardial effusion. Minimally enlarged pretracheal lymph node measures 1.1 cm (series 4, image 123). No significant hilar, internal mammary, cardiophrenic from or retrocrural lymphadenopathy by CT size. Atherosclerotic calcifications are present in aortic arch and descending thoracic aorta. Apparent filling defect in the right internal jugular vein may represent mixing of nonopacified blood, although thrombus cannot be entirely excluded. Multiple thyroid nodules are present with calcification.CHEST WALL: No significant axillary lymphadenopathy by CT size criteria. Mild degenerative changes of the thoracolumbar spine are present.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Nonspecific hypoattenuating lesion in the spleen measures 1.2 x 1.2 cm (series 5 comment to 75). Multiple partially visualized hypodensities within the left kidney are incompletely characterized on this exam. | 1.No evidence of pulmonary embolism.2.Basilar predominant septal thickening likely represents mild pulmonary edema.3.Significant reflux of contrast hepatic veins suggest right heart insufficiency.4.Nonspecific mediastinal lymphadenopathy.5.Apparent filling defect in the right internal jugular vein may represent an exam nonopacified blood from although thrombus cannot be entirely excluded. This can be further evaluated with ultrasound if clinically warranted.6.Nonspecific partially visualized hypodensities in the spleen and left kidney are incompletely characterized on this exam. Ultrasound is recommended to further evaluate left kidney.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Worsening pressure ulcer. Any signs of osteomyelitis?VIEWS: Left foot AP/lateral (two views) 03/14/15, 1631 and 1632 A soft tissue defect is present on the posterior aspect of the heel. No bone destruction is identified. Demineralization is seen. A pes cavus deformity is noted. Muscular atrophy is present. | No bone destruction to suggest osteomyelitis. Soft tissue defect. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation.There is complete opacification of the left maxillary sinus and near complete opacification of the left ethmoid air cells, and partial opacification of the left frontal sinus. The left maxillary sinus opacification is equivocally greater than simple fluid density although this may be artifactual partially. There is minimal left sphenoid sinus mucosal thickening. There is asymmetric increased soft tissue attenuation superficial to the left maxillary sinus wall laterally and inferiorly which may represent subperiosteal phlegmon; this finding is incompletely imaged. The skull and extracranial soft tissues are unremarkable. There is no periosteal reaction. | 1.No acute intracranial hemorrhage or mass-effect.2.Extensive left paranasal sinus opacification as described above suggesting acute sinusitis in the proper clinical setting. Particularly, there is asymmetric prominent rind of increased soft tissue attenuation just superficial to the left maxillary sinus walls (incompletely imaged) which may represent subperiosteal phlegmon. The maxillary sinus walls however appears intact, although incompletely imaged. Etiologies for this finding could be secondary to subperiosteal spread of bacterial maxillary sinusitis, dental disease, or invasive fungal sinusitis. Recommend CT face with contrast for complete evaluation, as the entire extent of the left maxillary sinus is not included in the field-of-view on current exam.3.Findings were discussed with emergency room resident Dr. Saint-Hilaire over the telephone by Dr. Pranay Uppuluri at 11:20 AM today, who will notify the patient's inpatient physician. |
Generate impression based on findings. | Status post liver transplant with biliary atresia LIVER: Measures 13.9 cm. Heterogeneous coarsened echotexture.VASCULAR:Main portal vein patent with normal directional flow, velocity measures 20 cm/sec.Patent left portal vein with normal directional flow, velocity measures 21 cm/sec.Right portal vein patent with normal directional flow, velocity minimally decreased, measuring 14 cm/sec.Patent hepatic arteries.Peak systolic velocities of common hepatic, left hepatic and right hepatic arteries measure 49 cm/sec, 53 cm/sec and 44 cm/sec, respectively.Resistive indices of common hepatic, left hepatic and right hepatic arteries measure 0.58, 0.68, and 0.73, respectively.Visualized IVC patent. Hepatic veins not as well assessed but appear grossly patent. | Patent hepatic vasculature, see above.Liver measuring 13.9 cm with coarsened echotexture. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is nonspecific periventricular and subcortical white matter hypoattenuation, similar to prior exam, suggesting chronic small vessel ischemic changes. There is persistent diffuse prominence of the ventricular system which is similar to prior examination although likely commensurate with sulcal prominence. There is encephalomalacia in the right occipital temporal lobes without significant change. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage. Stable chronic small vessel ischemic changes and diffuse prominence of the ventricular system which may be ex vacuo in etiology without significant change. Right temporal occipital encephalomalacia.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. | No acute intracranial hemorrhage or skull fracture.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is minimal patchy periventricular white matter hypoattenuation which likely representing age indeterminate small vessel ischemic changes. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is diffuse thickening of the maxillary sinus walls with diminutive lumens, which may indicate chronic sinusitis. There is minimal opacification of the right anterior ethmoid air cell. Prominence of the lacrimal gland tissue is noted bilaterally in a symmetric fashion. | Mild age indeterminate small vessel ischemic changes with no acute intracranial hemorrhage or mass-effect. CT is insensitive for detection of early nonhemorrhagic stroke.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | There is redemonstration of a metallic density bullet fragment within the soft tissues or the right paramedian high convexity frontal scalp. The previous immediate posttraumatic changes have resolved. Associated streak artifact limits evaluation of surrounding structures. 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. There is mild patchy opacification of the air cells bilaterally. There is mild mucosal thickening in the left maxillary sinus with a focal mucosal retention cyst. | Interval resolution of previously seen immediate posttraumatic changes, with persistent bullet fragment in the right paramedian frontal scalp. No acute intracranial hemorrhage. |
Generate impression based on findings. | HEAD: There is no evidence of intracranial hemorrhage, mass, or cerebral edema. There is mild nonspecific prominence of the lateral ventricles. The remaining ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid air cells are clear. The skull and extracranial soft tissues are unremarkable. CERVICAL: There is a slightly prominent basion-dental interval measuring up to 9 mm without surrounding soft tissue infiltration or hematoma. Other craniovertebral measurements are within normal limits. There is no prevertebral soft tissue swelling. Incidental note is slight irregularity of the upper margin of the dens, which may contribute to the slightly prominent measurement. There is a normal osteoarticular relationship of C1 with C2 with slight asymmetric asymmetric appearance of the distance between the lateral masses of C1 and the odontoid process likely positional in etiology.Otherwise, there is straightening of the cervical lordosis. The vertebral body and disk space heights are well-maintained. There is no acute fracture. The axial images do not demonstrate any significant disk bulge, disk herniation, significant bony spinal canal or foraminal stenosis. The visualized intracranial structures and lung apices appear normal. | 1.No acute intracranial hemorrhage or skull fracture.2.The basion-dental interval appears somewhat prominent, just beyond the upper limits of normal (8.5 mm) at 9 mm. However, there is no surrounding soft tissue hematoma or fat infiltration. This is felt to be at the upper limits of normal, however correlation with clinical examination is strongly advised, and MRI of the cervical spine can be obtained if there is any clinical suspicion. Other craniovertebral measurements are within normal limits.3.Findings were discussed with Dr. Saint-Hilaire from the ED by Dr. Pranay Uppuluri at 9:30 a.m. today over the telephone.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Dobbhoff tube placement Dobbhoff tube seen in gastric antrum. Additional enteric tube seen with side-port in gastric body and tip located in same location as that of Dobbhoff tube, in gastric antrum. Incompletely imaged air containing nondilated small bowel and some air suggested in sigmoid colon, no definitive evidence of bowel obstruction on this nondedicated study. Nerve stimulator device seen. Please refer to concomitant chest radiography from same day for additional findings. | Enteric tubes as above. |
Generate impression based on findings. | Male, 36 years old. Retained foreign body Right-sided pelvic drains and right-sided nephroureteral stent. Nonobstructive bowel gas pattern.Sternotomy hardware and wires. Small left basilar atelectasis/consolidation.No unexpected radiopaque foreign body. | No unexpected radiopaque foreign body. Findings were relayed to attending surgeon Dr. Piotr Witkowski at 13:37 on 3/14/15 by the oncall radiology resident. Small left basilar atelectasis/consolidation. |
Generate impression based on findings. | Evaluation is limited due to lack of contrast. The thoracic spine is in normal alignment, with a normal thoracic kyphosis. The vertebral body and disk heights are well maintained. No worrisome focal marrow signal abnormality is appreciated. The spinal cord is of normal caliber and signal.There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the thoracic spine.There is pulmonary opacity at the right lung base, previously felt to represent radiation pneumonitis on CT.LUMBAR SPINE | Unremarkable noncontrast MR appearance of the thoracic and lumbar spine. |
Generate impression based on findings. | Fever and pressure ulcer on heel. VIEWS: Right ankle AP/lateral (two views) 03/14/15, 1954 and 1953 A soft tissue defect is noted posterior to the calcaneus. Demineralization is seen. A pes cavus deformity is present. No bone destruction is present. Replacement of muscles by fat is identified. | No evidence of osteomyelitis. |
Generate impression based on findings. | Female 28 years old; Reason: Assess for renal stone History: flank pain with hematuria ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Mildly prominent gallbladder, measuring 3.4 cm and containing some layering sludge. No secondary signs of acute cholecystitis.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No hydronephrosis. No perinephric fluid or stranding. No nonobstructing radiopaque intrarenal stone.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Multiple prominent mesenteric lymph nodes, measuring up to 8 to 9 mm around mesenteric root with minimal mesenteric fat haziness, findings may reflect underlying mesenteric adenitis. Fecalized distal ileum and distal ileum prominent measuring upper limits of normal at 3 cm, image 98 series 3, but tapers gradually both proximally and distally, nonspecific. Normal sized appendix, coronal image 50, no periappendiceal inflammation. Small to moderate stool burden. PELVIS:UTERUS, ADNEXA: Small pelvic free fluid and bilateral adnexal prominence, more pronounced on left side with 2.3 cm cystic focus seen, most likely physiologic findings including left-sided dominant follicle but these findings would be better evaluated with dedicated pelvic sonography.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Bilateral left greater than right sclerosis at level of sacroiliac joints. | 1. No hydronephrosis.2. Multiple prominent mesenteric lymph nodes, measuring up to 8 to 9 mm around mesenteric root with minimal mesenteric fat haziness, findings suggestive of mesenteric adenitis. 3. Fecalized distal ileum and distal ileum prominent measuring upper limits of normal at 3 cm, but tapers gradually both proximally and distally, findings may be due in part to an incompetent ileocecal valve but nonspecific and if there is clinical concern for underlying IBD/Crohn's disease, further evaluation such as with dedicated fluoroscopic small bowel series recommended. 4. Small pelvic free fluid and bilateral adnexal prominence, more pronounced on left side with 2.3 cm cystic focus seen, most likely physiologic findings including left-sided dominant follicle but these findings would be better evaluated with dedicated pelvic sonography.5. Normal appendix. |
Generate impression based on findings. | Desaturation.VIEW: Chest AP (one view) 03/15/15, 0251 Complete atelectasis of the left lung is noted and a left bronchus cut off sign is seen. The right lung is well aerated and herniates across the midline. Cardiac silhouette size cannot be evaluated.Vagal nerve stimulator device in left chest has leads extending into left neck. Right thoracic and left thoracolumbar curves are seen. Posterior spinal fusion instrumentation is present. | Complete atelectasis of left lung. |
Generate impression based on findings. | Female 48 years old; Reason: post surgical complications History: abdominal pain, vomiting, recent TAH, hx of cholelithiasis ABDOMEN:LUNGS BASES: Small basilar atelectasis.LIVER, BILIARY TRACT: Cholelithiasis with dominant calcified 2.4 cm stone, no secondary signs of acute cholecystitis. Area of hepatic segment IVb vague decreased hypoattenuation, similar to prior imaging, most likely focal hepatic steatosis given characteristic location and appearance. Bilobar hypoattenuating hepatic lesions, too small to characterize. SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable left adrenal nodule, characterized as benign lipid rich adenoma on prior CT study.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered subcentimeter mesenteric and retroperitoneal lymph nodes. BOWEL, MESENTERY: No secondary signs of acute appendicitis.PELVIS:UTERUS, ADNEXA: Small pelvic free fluid. Status post hysterectomy. Bilateral adnexal cysts with largest on right side measuring 3.9 x 3.6 cm (more inferiorly located) and 2.8 x 2.8 cm (more superiorly located). Left ovary heterogeneous appearance and contains smaller subcentimeter cystic foci. No gonadal vein thrombus delineated. Small vaginal air.BLADDER: Small air seen in bladder. BONES, SOFT TISSUES: Ventral abdominal subcutaneous induration. OTHER: No significant abnormality noted. | 1. Status post hysterectomy. Bilateral adnexal cysts with largest on right side and mildly complex, measuring 3.9 x 3.6 cm (more inferiorly located) and 2.8 x 2.8 cm (more superiorly located). These cystic foci may be benign complex or hemorrhagic cysts but further assessment with dedicated pelvic sonography recommended for improved characterization. Left ovary heterogeneous appearance and contains smaller subcentimeter cystic foci. Small pelvic free fluid.2. Small air seen in bladder, presumably postprocedural in etiology.3. Remainder of exam without significant change as above. |
Generate impression based on findings. | Respiratory failure and cerebral palsy. Intubated.VIEW: Chest AP (one view) 03/15/15, 0431 Endotracheal tube tip is above the thoracic inlet. A gastrostomy tube is present. Right upper quadrant surgical clips are noted.Right upper extremity PICC is coiled upon itself at the costal border.Cardiothymic silhouette is normal. Airspace disease in left lower lobe continues. Subsegmental atelectasis in the left upper lobe has decreased but persists. No focal opacity is present on the right. Cardiac silhouette size is normal.Right thoracic curve is again seen. | Persistent left lower lobe airspace disease may be pneumonia. |
Generate impression based on findings. | There is redemonstration of an area of increasingly expansile T2/STIR hyperintensity within the cervical cord, now extending from C3-C4 down to the C7-T1 level, previously from C4-C5 down to the upper C7 level. The mass demonstrate some mild heterogeneous intrinsic T1 hyperintensity. There is no convincing residual enhancement of the cervical cord mass. The mass remains right-sided within the cord, now measuring 1.4 x 1.0 cm in greatest axial dimensions on 601/15 at the C5-C6 level, compared to previous 1.0 x 0.6 cm at the same level. There is progressive now complete effacement of the CSF within the thecal sac from C4-C5 to C6-C7. Postoperative changes are seen, with scattered fluid signal and peripheral irregular enhancement along the surgical incision within the paraspinal soft tissues and musculature centered at the C5-C6 level, with evidence of wide bilateral C5 laminectomy. No significant epidural abnormality is seen.The cervical spine is in normal alignment, with straightening of the normal cervical lordosis. The vertebral body and disk heights are stable, with moderate multilevel disk narrowing from C4-C5 through C6-C7. No worrisome focal marrow signal abnormality is appreciated.There are similar appearing mild spondylotic changes along the mid to lower cervical spine with moderate-severe right foraminal narrowing at C4-C5 as well as moderate on the left C5-C6.THORACIC SPINE | 1. Since prior outside imaging, significant progression of cervical expansile intramedullary mass without definite enhancement, now extending from C3-C4 down to C7-T1. Complete effacement of CSF within the thecal sac from C4-C5 to C6-C7. Postoperative changes are noted from recent biopsy of now known tumor with likely postoperative fluid along the surgical incision.2. Also significant progression of additional upper thoracic expansile intramedullary mass which now extends from T2-T3 facet T9-T10 and possibly with minimal additional left lateral extension down to T10-T11. No definite corresponding enhancement, with near complete to complete effacement of CSF within the thecal sac at the levels of the mass. This likely representing additional neoplasm.3. Minimal grade 1 anterolisthesis of L4 on L5 which appears degenerative in etiology, along with severe facet arthropathy, with overall moderate-severe central spinal canal stenosis at this level with significant bunching of the cauda equina nerve roots. |
Generate impression based on findings. | Female 26 years old; Reason: acute abdomen History: abdominal pain, bloody peritoneal dialysate ABDOMEN:LUNGS BASES: Hypoattenuated appearance of intracardiac blood pool consistent with anemia.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right iliac fossa transplanted kidney, incompletely assessed on this noncontrast exam, improvement in previously seen perinephric stranding, unchanged mild fullness of collecting system. Markedly atrophic native kidneys.RETROPERITONEUM, LYMPH NODES: Subcentimeter retroperitoneal lymph nodes. BOWEL, MESENTERY: Scattered foci of pneumoperitoneum. Moderate abdominopelvic ascites, simple appearing. Right abdominal approach catheter seen with tip coiled in pelvis, just above uterus. Mild prominence of sigmoid colon with transition point near rectosigmoid colon, image 120 series 3, likely related to normal peristalsis but correlation with patient's clinical history recommended and attention on follow up recommended. Mildly prominent left-sided jejunum, measuring less than 3 cm and containing ingested contrast, likely within normal limits/related to peristalsis. Contrast did not reach distal small bowel and beyond into colon, probably due to timing of exam. Normal appendix.PELVIS:UTERUS, ADNEXA: Right greater than left adnexal prominence, measuring 3.8 x 3.2 cm on right and 3.2 x 2.1 cm on left in coronal plane, may be related to underlying physiologic follicles but further evaluation with dedicated pelvic sonography recommended.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Ventral abdominal subcutaneous induration seen, may reflect postprocedural sequela.OTHER: No significant abnormality noted. | 1. Right greater than left heterogeneous adnexal prominence, may be related to underlying hemorrhagic/physiologic follicles, further evaluation with dedicated pelvic sonography recommended.2. Scattered foci of pneumoperitoneum, presumably postprocedural in etiology, right abdominal approach catheter seen with tip coiled in pelvis. Moderate abdominopelvic ascites, simple appearing. 3. Right iliac fossa transplanted kidney, incompletely assessed on this noncontrast exam, improvement in previously seen perinephric stranding, unchanged mild fullness of collecting system. |
Generate impression based on findings. | VSD repair.VIEW: Chest AP (one view) 03/15/15, 0942 Right internal jugular line has been removed. Mediastinal surgical clips are again seen.Cardiothymic silhouette is normal. Subsegmental atelectasis is present in both lung bases. | Persistent subsegmental atelectasis. |
Generate impression based on findings. | HEAD: There is no intracranial mass or suspicious enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is trace right maxillary sinus mucosal thickening. The skull and extracranial soft tissues are unremarkable. There are bilateral lens implants. NECK: There are postoperative findings related to total thyroidectomy and right neck dissection. There is an unchanged centrally necrotic lymph node or mass inferior to the thyroid bed on the right measuring 18 x 20 mm (series 8 image 52) as well as an unchanged right pretracheal lymph node measuring 15 x 17 mm (series 8 image 62). Additional mildly prominent scattered cervical lymph nodes appear unchanged. There is unchanged fatty atrophy of the parotid glands. The right submandibular gland is surgically absent and right internal jugular vein has been ligated. The left internal carotid artery has a retropharyngeal course. The internal carotid arteries are patent. The osseous structures show no focal lesions. The airways are patent. There are numerous subcentimeter pulmonary nodules again seen, with similar appearance. | 1.Stable findings in the neck with two unchanged masses/enlarged lymph nodes, inferior to the right thyroidectomy bed and at the right paratracheal level with no new mass or worsening cervical lymphadenopathy.2.No evidence of intracranial metastases.3.Numerous bilateral pulmonary metastases again seen. Please refer to dedicated accompanying CT chest report for further details. |
Generate impression based on findings. | Wooden door fell on toes of right foot.EXAMINATION: Right foot AP/lateral/oblique (3 views) 03/14/15 The bones are normal in appearance. No fracture is identified. No significant soft tissue swelling is seen. | Normal examination. |
Generate impression based on findings. | Feeding difficulties.EXAMINATION: Abdomen AP (one view) 03/14/15 Feeding tube tip is at the duodenojejunal junction. Right upper quadrant drain is in place. Multiple surgical clips and staples are noted in right upper quadrant. An IVC stent is seen.Bowel gas pattern is disorganized. No significantly dilated bowel loops are present. | No evidence of obstruction. |
Generate impression based on findings. | Epigastric pain, no bowel movement in 5 days Right upper quadrant surgical clips, compatible with prior cholecystectomy. Average stool burden. Mildly prominent small bowel seen in both left and right abdomen measuring up to 4 cm on right side, air seen distally in colon. Findings are nonspecific and may be related to ileus but partial or developing small bowel obstruction not entirely excluded. | Mildly prominent small bowel seen in both left and right abdomen measuring up to 4 cm on right side, air seen distally in colon. Findings are nonspecific and may be related to ileus but partial or developing small bowel obstruction not entirely excluded. Correlation with patient's clinical history and continued follow-up recommended. |
Generate impression based on findings. | Decubitus ulcer. Evaluate for bone involvement.EXAMINATION: Left elbow AP/lateral (two views) 03/14/15 There appears to be a flexion contracture. Demineralization is noted. No bone destruction is seen. The soft tissues are thinned posterior to the olecranon. Muscular atrophy is noted. | No bone destruction. |
Generate impression based on findings. | Evaluate J-tube placement Left pelvic drainage catheter. Relative paucity of bowel gas with air containing bowel seen in right abdomen, may be located in mildly dilated (measuring 3.4 cm) small bowel or nondistended colon. Small air seen in pelvis may be located in rectum or underdistended bladder, correlate with clinical history for recent intervention. Additional mediastinal/thoracic and intra-abdominal postprocedural sequela. Left basilar atelectasis/consolidation and pleural effusion. Multilevel degenerative changes of spine. | Relative paucity of bowel gas, may reflect fluid containing bowel, small gas seen in right hemiabdomen as above.Left basilar atelectasis/consolidation and pleural effusion. |
Generate impression based on findings. | Marked skin thickening of the medial posterior upper thigh. There are foci of air within the posterior thickened skin (Series 80516, image 56 and 67). Extensive subcutaneous edema extends through the entire right lower extremity. A poorly organized fluid collection is present within the subcutaneous fat of the medial upper thigh measuring 4.3 x 1.2 cm (series 80516, image 67), which could represent phlegmon or early abscess formation. No gas is present within the deep tissues of the thigh or lower extremities. No osseous erosions are present to suggest osteomyelitis. Partially visualized heterogeneous soft tissue within the anterior pelvis may represent bowel, however intra-abdominal pathology cannot be excluded. | 1.Findings are most consistent with extensive cellulitis and possible early abscess formation.2.Partially visualized heterogeneous soft tissue collection within the anterior pelvis may represent bowel, however if there is clinical concern for intra-abdominal pathology abdominal CT is recommended. |
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