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Generate impression based on findings. | Right diaphragmatic hernia repair.VIEW: Chest AP (one view) 03/15/15, 1008 Endotracheal tube tip is above the carina. Feeding tube side-port is at GE junction. Left upper extremity PICC tip is lateral to costal border.Right pleural effusion is slightly larger. Air is again seen in the pleural space. The small right lun... | Postoperative changes (expected hydropneumothorax) with no evidence of complication. |
Generate impression based on findings. | Evaluate for small bowel obstruction, history of abdominal distention and uterine malignancy Suboptimal exam due to overlying leads and artifact as well as patient positioning and motion artifact.Right upper quadrant and lower quadrant postprocedural sequela.Small to moderate stool, particularly in right colon. Relativ... | Gaseous distention of stomach. Small to moderate stool, particularly in right colon. Relative paucity of small bowel gas, gas seen distally in colon. No definitive evidence of bowel obstruction. Colonic diverticula. |
Generate impression based on findings. | 35 day old former 24 week gestational age patient with increased work of breathing. Is there evidence of atelectasis or pulmonary edema?VIEW: Chest AP (one view) 03/15/15, 1013 Endotracheal tube tip is just above thoracic inlet. Feeding tube tip is distal to the GE junction and not included on the image. Right central ... | Complications from surfactant deficiency. Probable small layering right pleural effusion. |
Generate impression based on findings. | 61 years old, Male, Reason: evaluate extent of fracture History: R femoral head fracture Pelvis: Redemonstration of a right intertrochanteric fracture with fracture fragments in near-anatomic alignment. Severe osteoarthritis affects the right hip. Moderate osteoarthritis affects the left hip. Moderate degenerative chan... | Intertrochanteric fracture with fracture fragments in near anatomic alignment. No other fractures. |
Generate impression based on findings. | 34 years old, Male, Reason: fracture History: knee pain No fracture or malalignment. Joint effusion is present. | Joint effusion without fracture or malalignment. |
Generate impression based on findings. | Enteric tube replaced Coiled Dobbhoff tube seen, portion of coiled tube not included in field of view, the tip extends retrograde and upward and is located in the gastric fundus. Incompletely imaged air containing small and large bowel, may reflect mild diffuse ileus. IVC filter and right-sided coil embolization materi... | Dobbhoff tube coiled upon itself as described. |
Generate impression based on findings. | Evaluate for obstruction, history of constipation Moderate to large stool burden, particularly in right abdomen. Mild diffuse nondilated gaseous prominence of small bowel, likely secondary to stool burden/constipation. Rounded radiodensity above left greater trochanter, of uncertain clinical significance, may be locate... | Moderate to large stool burden, see above. |
Generate impression based on findings. | Generalized abdominal pain Multiple surgical clips and staples. Cholecystectomy clips. Drainage catheter placement, tip located in left upper quadrant. Prominent air containing small and large bowel, appearance suggestive of postoperative ileus. Bowel displaced into right lower abdomen, may be secondary in part to asci... | Bowel gas pattern suggestive of postoperative ileus. Please refer to subsequent CT exam from same day for findings. |
Generate impression based on findings. | 54 years old, Female, Reason: ankle History: Fall with pain on lateral malleolus No widening of the ankle mortise joint during stress view. Obliquely oriented minimally displaced distal fibular fracture is again seen. | No widening of ankle mortise joint during stress view. Distal fibular fracture. |
Generate impression based on findings. | 54 years old, Female, Reason: r/o fx History: pain and ttp on lateral aspect of ankle Left ankle: Obliquely oriented minimally displaced fracture of the distal fibula. The distal fracture fragment is minimally posteriorly displaced. Soft tissue swelling is present along the lateral malleolus. No additional fracture is ... | Obliquely oriented minimally displaced fracture of the distal fibula with adjacent soft tissue swelling. |
Generate impression based on findings. | There is no significant interval change in the ill-defined conglomerate left level 4 lymph nodes measuring 13 x 12 mm. There is an unchanged low attenuation nodule in the right thyroid lobe. The major salivary glands show no focal lesions.The major cervical vessels remain patent. The osseous structures show no focal l... | 1.Stable findings in the neck with no significant change in left level 4 lymphadenopathy.2.Unchanged nonspecific right thyroid nodule.3.Extensive emphysema and multiple micronodules. Please refer to accompanying dedicated CT chest report for further details. |
Generate impression based on findings. | Enteric tube repositioning Suboptimal study secondary to motion artifact. Enteric tube seen with tip now in proximal duodenum. Nonobstructive bowel gas pattern. Mildly prominent air containing small and large bowel. Moderate to large tool burden. Please refer to concomitant chest radiography from same day for additiona... | Enteric tube as above. |
Generate impression based on findings. | 51 years old, Female, Reason: Evaluate for fracture History: pain, difficulty weight bearing Pelvis and hips: Calcifications consistent with phleboliths are present in the pelvis. No acute fracture or malalignment. Mild osteoarthritis of the hips bilaterally.Lumbar spine: The vertebral heights and disk spaces are maint... | No acute fracture or malalignment. |
Generate impression based on findings. | 63 years old, Female, Reason: Eval for dislocation History: Pain The humeral head is situated at the glenoid surface. No evidence of dislocation. Vertically oriented fracture through the greater tuberosity. Previously described transverse fracture of the humeral head is not well seen on this exam. No other fracture ide... | No evidence of dislocation. Vertically oriented fracture through the greater tuberosity. |
Generate impression based on findings. | Hypoxia. 2-year-old former 24 week gestational age patient.VIEW: Chest AP (one view) 03/15/15, 1036 Left upper extremity PICC tip is in superior vena cava. Surgical clips are noted at the GE junction. A gastrostomy tube is present.Air space disease is seen in right upper and left lower lobes. Decreased opacity is prese... | Multifocal opacities may be pneumonia. |
Generate impression based on findings. | 63 years old, Female, Reason: r/o fx- s/p fall History: pain and swelling, unable to move arm Humerus: Comminuted, predominantly transverse fracture of the of the humeral head with minimal medial displacement of the distal fracture fragment. No distal fracture is identified. Left shoulder: Again seen is the comminuted ... | Comminuted, predominantly transverse fracture of the humeral head with minimal medial displacement of distal fracture fragment. There is a vertically oriented portion of the fracture through the greater tuberosity. |
Generate impression based on findings. | Removal of bullet from left knee.VIEWS: Left knee AP/lateral (two views) 03/15/15 A cast obscures bone detail. The bullet has been removed. Irregularities of the anterior tibial cortex from fracture are again seen. | Removal of bullet. Fracture of proximal tibia. |
Generate impression based on findings. | Enteric tube placement Enteric tube seen extending into gastric fundus, guidewire present. Nonobstructive bowel gas pattern. Pelvis excluded. Incompletely imaged bilateral nephroureteral stents. | Enteric tube as above. |
Generate impression based on findings. | 53 years old, Male, Reason: eval for acute process History: atraumatic pain/swelling Moderate joint effusion without evidence of acute fracture. No malalignment. There are vascular calcifications within the soft tissues of the knee. | Moderate joint effusion without evidence of acute fracture or malalignment. |
Generate impression based on findings. | 42 years old, Male, Reason: eval for postop complications History: pain s/p shoulder surgery 3/2/15 Horizontal lucency of the medial aspect of the proximal diaphysis of the left humerus likely represents a screw tract from prior fixator device. No acute fracture or malalignment. | Horizontal lucency of the left humerus likely represents a screw tract from prior fixator device. No acute fracture or malalignment. |
Generate impression based on findings. | Images are somewhat limited by patient motion. This transitional lumbosacral anatomy, with partial sacralization of L5 vertebra. For the purposes of this exam from the last fully formed disk at the L5-S1.The lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body and disk heights are wel... | 1. Transitional lumbosacral anatomy noted. It surgeries to be contemplated, correlation with plain films of the entire spine is recommended.2. Incidental fatty filum. Normal conus termination. This has been associated with tethered cord and clinical correlation is recommended.3. No significant spondylotic changes. |
Generate impression based on findings. | There is no significant cervical lymphadenopathy. The reference lymph node in the left level 3 chains measures 3 mm, stable. There are few slightly prominent lymph nodes in the left neck more superiorly which are not enlarged by CT size criteria. There are unchanged mild treatment related findings within the neck. The... | Stable reference level 3 lymph node on the left with no significant cervical lymphadenopathy or mass. |
Generate impression based on findings. | 87 years old, Female, Reason: Evaluate for fracture, joint effusion History: R wrist swelling pain The bones appear diffusely demineralized. Soft tissue swelling is noted about the wrist. No acute fracture or malalignment. Degenerative are of the carpal joints are present. | Soft tissue swelling without acute fracture or malalignment. Degenerative changes of the carpal joints are present. |
Generate impression based on findings. | 53 years old, Male, Reason: eval for acute process History: atraumatic pain No acute fracture or malalignment. The ankle mortise joint is maintained. Mild degenerative changes affect the midfoot. | No acute fracture or malalignment. |
Generate impression based on findings. | 53 years old, Female, Reason: evaluate for fracture History: R wrist pain and bruising Minimally displaced transverse fracture of the ulnar styloid. The distal fracture fragment is minimally medially displaced. Subtle transverse lucency of the distal radius may represent a nondisplaced fracture, or normal variant. Mild... | Minimally displaced transverse fracture of the ulnar styloid. Subtle transverse lucency of the distal radius may represent a nondisplaced fracture. If there is clinical concern for distal radius fracture follow-up radiograph in 7 to 10 days recommended. |
Generate impression based on findings. | 82 years old, Male, Reason: patient fell with syncope, tenderness at mid axillary line on L, assess for FRX History: patient fell with syncope, tenderness at mid axillary line on L, assess for FRX Surgical clips project or the mediastinum. Median sternotomy hardware is present and intact. No pneumothorax or large pleur... | No displaced rib fracture. |
Generate impression based on findings. | 27 years old, Female, Reason: r/o fx History: pain at MCP No acute fracture or malalignment. No significant soft tissue swelling is noted. | No acute fracture or malalignment. |
Generate impression based on findings. | 55 years old, Female, Reason: r/o fracture History: fall and elbow pain Left elbow: There is elevation of the anterior-posterior fat pads indicating a joint effusion. No acute fractures identified, however joint effusion is worrisome for an occult fracture.Right wrist: No acute fracture or malalignment. While corticate... | No fracture is evident, however elevation of the anterior and posterior fat pads is worrisome for an occult fracture, most likely the radial head. Follow up radiographs in 7 to 10 days is recommended to further evaluate. |
Generate impression based on findings. | 22 years old, Female, Reason: Fx? History: Hand pain s/p trauma No acute fracture or malalignment. There may be mild soft tissue swelling about the thumb. | No acute fracture or malalignment. |
Generate impression based on findings. | 27 years old, Male, Reason: eval for fracture History: knee pain after MVC Right knee: No acute fracture or malalignment. No joint effusion is present.Left knee: No acute fracture or malalignment. No joint effusion is present. | No acute fracture or malalignment. |
Generate impression based on findings. | Female 58 years old; Reason: evaluate for progression or stability of lung nodules History: evaluate for metastatic disease CHEST:LUNGS AND PLEURA: Pulmonary metastatic lung nodules, stable to mildly increased in size. Reference cavitating lung nodule located in the superior segment of left lower lobe measures 0.8 x 0.... | 1. Findings consistent with worsening peritoneal/mesenteric metastatic disease. As described above, increasing pelvic soft tissue nodularity and left upper quadrant soft tissue nodularity, latter without significant change from prior January 8, 2015 CT study but demonstrating interval increase in size from May 25, 2014... |
Generate impression based on findings. | Female 42 years old; Reason: 42 yo F s/p renal txp x 2 presented to OSH with abdominal pain, ?early appendicitis on CT scan, needs repeat imaging to evaluate for evolving appendicitis vs transplant pyelonephritis per transplant surgery recs History: s/p renal txp x 2, acute abdominal pain periumbilical, bilateral LQ, f... | 1. Moderate degree fat stranding and inflammation centered at junction of appendiceal tip and sigmoid colon as described. Given patient's reported history of early appendicitis on a prior imaging study, findings favored to represent acute appendicitis with diverticula-laden sigmoid colon secondarily involved. However, ... |
Generate impression based on findings. | There is right lamina papyracea fracture with air-fluid/blood levels in the right ethmoid sinuses. There is intraorbital fat herniating through the defect with bowing of the right medial rectus muscle into the fracture defect; please correlate clinically for evidence of medial rectus entrapment. There are mildly displ... | 1.Right medial orbital wall blowout fracture with herniation of intraorbital fat and medial rectus into the fracture defect. Please correlate for signs of right medial rectus muscle entrapment.2.Mildly displaced comminuted right nasal bone fractures, with likely more subtle left-sided ones.3.Extensive right periorbital... |
Generate impression based on findings. | Female 36 years old; Reason: s/p EUS with FNA of mediastinal mass. Now with SOB, back pain, unable to take deep breaths. Evaluate for pneumothorax History: SOB, chest tightness, back pain CHEST:LUNGS AND PLEURA: Left greater than right bibasilar consolidation and atelectasis. Small left pleural effusion. Mild biapical ... | 1. As seen on prior PET imaging, left posterior mediastinal and upper quadrant masses, correlate with results of FNAB.2. Indeterminate hepatic lesions as above.3. Left greater than right bibasilar consolidation and atelectasis. Small left pleural effusion. Mild biapical scarring/nodularity. Small patchy air space disea... |
Generate impression based on findings. | There is a heterogeneously enhancing enlarged right level Ib lymph node measuring 22 x 13 mm on series 6 image 34. There are mildly enlarged bilateral retropharyngeal lymph nodes measuring up to 10 mm. There are an increased number of bilateral cervical lymph nodes which are not enlarged by CT size criteria. The thyro... | 1.Heterogeneously enhancing enlarged right level Ib lymph node measuring 22 x 13 mm, and enlarged 10-mm bilateral retropharyngeal lymph nodes which are worrisome for metastasis.2.Nonenlarged prominent bilateral cervical lymph nodes which are more numerous than usually seen, nonspecific, but remain suspicious. PET CT ma... |
Generate impression based on findings. | Female 51 years old; Reason: Evaluate for source of abdominal pain including cholecystitis, appendicitis, ovarian torsion - PO and IV contrast please History: Acute R-sided abdominal pain ABDOMEN:LUNGS BASES: Incompletely imaged soft tissue asymmetry in left breast, image 1 series 8, nonspecific. Small atelectasis in l... | 1. Right sided hydronephrosis with obstructing right ureteral stone as described. 2. Indeterminate hepatic segment 4 lesion. 3. Incompletely imaged soft tissue asymmetry in left breast, nonspecific, may be correlated mammographically. |
Generate impression based on findings. | Male 59 years old; Reason: sob, edema on cxr History: sob CHEST:LUNGS AND PLEURA: Postsurgical changes related to bilateral lung transplants. Bilateral right greater than left pleural effusions. Interval decrease in size of right-sided pleural effusion, now moderate in size, with new scattered gaseous foci. Persistent ... | 1. Accounting for differences in technique, essentially stable area of right subpectoral/pectoral hemorrhage, extending into pleural cavity. Interval decrease in size of right-sided pleural effusion with new scattered gaseous foci seen, consistent with hydropneumothorax. Persistent small left pleural effusion. Underlyi... |
Generate impression based on findings. | Female 44 years old; Reason: Evaluate for abscess History: s/p parastomal hernia repair, rising WBC and chills Suboptimal study secondary to patient's body habitus, portions of the patient's lateralmost abdomen are not included in the field-of-view. ABDOMEN:LUNGS BASES: Right greater than left atelectasis.LIVER, BILIAR... | 1. Suboptimal study secondary to patient's body habitus, portions of the patient's lateralmost abdomen excluded in the field-of-view. 2. Mildly prominent small bowel and air and fluid containing colon seen, appearance suggestive of postprocedural ileus at this time. Sites of focally dilated small bowel with intervening... |
Generate impression based on findings. | Female 62 years old; Reason: evaluate for cause of abdominal pain and distention, chronic constipation ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No signi... | 1. Average stool burden. Colonic diverticulosis without acute diverticulitis.2. Focus of air in bladder, presumably related to recent intervention. Correlation with patient's history recommended. |
Generate impression based on findings. | Female 49 years old; Reason: appendiceal rupture History: abdominal pain, nausea, vomiting ABDOMEN:LUNGS BASES: Incompletely imaged lung fields demonstrate numerous pulmonary nodules, without significant change. Stable reference right middle lobe lung nodule measuring 6 x 5 mm, image 15 series 4. Essentially stable ref... | 1. Findings consistent with acute colitis with marked wall thickening, particularly involving transverse colon and beyond to level of rectum.2. Cecal mass with adjacent mesenteric nodularity increased in prominence. Peritoneal/omental nodularity, likely reflecting carcinomatosis.3. Innumerable hepatic metastases, demon... |
Generate impression based on findings. | Male 57 years old; Reason: Evaluate for obstruction History: distension, vomiting ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Small splenule. PANCREAS: Areas of marked fatty atrophy involving pancreas, primarily uncinate process, pancreatic head a... | 1. Fat stranding about the proximal duodenum and pancreatic head. Findings may reflect acute duodenitis, peptic ulcer disease or acute pancreatitis, although the latter would be unusual in the setting of the patient's reported normal lipase level. Associated gastric distention suggests partial outlet obstruction, at le... |
Generate impression based on findings. | Female 57 years old; Reason: Evaluate for SBO vs post op infection/complication History: feculent emesis ABDOMEN:LUNGS BASES: Small dependent bibasilar atelectasis. Sites of subcentimeter pleural-based nodularity, nonspecific. For example, 4 mm left lower lobe pleural-based nodule, image 7 series 4. LIVER, BILIARY TRAC... | 1. Status post distal pancreatectomy for previously visualized main duct IPMN, associated surgical clips and fluid/stranding seen. Loculated bilobed (versus 2 collections adjacent to one another) fluid collection seen in expected region of pancreatic neck, extending along suture line, as described. Resultant mild narro... |
Generate impression based on findings. | Female 45 years old; Reason: 45yo F with recent cholecystectomy complicated by cystic artery bleeding with ex lap and indwelling JP drain now with sudden increased in serosanguinous output and abdominal pain, concern for bleeding. History: abdominal pain, increasing serosanguinous drain output ABDOMEN:LUNGS BASES: Smal... | 1. Status post cholecystectomy and hematomas seen, in Morison's pouch, in gallbladder fossa, in central abdomen and near drainage catheter intraabdominal entry site. If there is clinical concern for active hemorrhage, this would be better assessed with dedicated CT angiography recommended. 2. Small abdominopelvic ascit... |
Generate impression based on findings. | Female 48 years old; Reason: Evaluate for infectious process History: abdominal pain , n/v/d ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: Status post distal pancreatectomy and some calcification seen, sugg... | 1. No evidence of small bowel obstruction. 2. Status post distal pancreatectomy and some calcification seen, suggestive of chronic calcific pancreatitis. Chronically thrombosed splenic vein and varices seen. 3. Ventral abdominal hernia formation as above. |
Generate impression based on findings. | Dobbhoff tube placement Dobbhoff tube seen with tip extending just beyond gastroesophageal junction. Nonobstructive gas pattern suggested. Gastric band is seen in a near transversally oriented position, suspicious for slippage. Associated reservoir and tubing incompletely seen. Spinal fixation hardware and neurostimula... | Enteric tube as above.Appearance suggestive of slipped gastric band, correlation with patient's clinical history recommended and further evaluation with dedicated upper GI may be considered. |
Generate impression based on findings. | Evaluate stool burden, assess for bowel obstruction No evidence of bowel obstruction. Moderate stool burden. Multilevel degenerative changes of spine and scoliosis. Bilateral hip degenerative disease. Decreased osseous mineralization. Vascular calcifications. | 1. Moderate stool burden, no bowel obstruction. |
Generate impression based on findings. | Dobbhoff tube placement Suboptimal exam due to patient motion artifact. Dobbhoff tube located in gastric body. Dilated small bowel with air noted distally in colon, findings suspicious for partial or evolving small bowel obstruction. Enthesophyte formation along left iliac wing. | Enteric tube as above.Dilated small bowel with air noted distally in colon, findings suspicious for partial or evolving small bowel obstruction and continued follow up recommended. |
Generate impression based on findings. | Abdominal distention Upper abdominal surgical clips. Mild gastric gaseous distention. Nonobstructive bowel gas pattern. Intrauterine device present. Please refer to concomitant chest radiography from same day for additional findings. | Nonobstructive bowel gas pattern. |
Generate impression based on findings. | Dobbhoff tube placement, altered mental status Dobbhoff tube seen with tip extending into distal gastric body, guidewire present and tubing kinked near tip of guidewire. Nonobstructive bowel gas pattern. Similar to prior study is apparent displacement of bowel into lower portion of abdomen, of uncertain clinical signif... | Enteric tube as above. |
Generate impression based on findings. | Dobbhoff tube placement Dobbhoff tube seen with tip located in gastric fundus. Small residual enteric contrast suggested, may be from patient's recent OPM. Paucity of bowel gas, small air and stool in ascending colon, no definitive evidence of bowel obstruction. Please refer to subsequent chest radiography for addition... | Enteric tube as above. |
Generate impression based on findings. | Female 62 years old; Reason: Evaluate for renal calculi, upper urinary tract lesions History: microscopic hematuria ABDOMEN:LUNGS BASES: Small dependent bibasilar atelectasis. LIVER, BILIARY TRACT: Hepatic calcified granuloma. Nonvisualization of gallbladder, presumably related to prior cholecystectomy. Mild intrahepat... | 1. Subcentimeter 7 mm left intrarenal hypoattenuating focus with Hounsfield units of 4 on noncontrast study, 31 HU in the corticomedullary phase and 8 HU in the excretory phase, a cystic/mildly enhancing papillary type renal cell carcinoma is a consideration based on these findings. |
Generate impression based on findings. | Female 43 years old; Reason: 43 year old female, femoral hernia, please evaluate for abnormalities History: hernia ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Patent portal veins and splenic vein. Wedge shaped hypoattenuating defect in hepatic segment 6, image 39 series 3, while may refl... | 1. Chronically thrombosed infrahepatic IVC. Enlarged azygos vein and multiple collateral vessels seen in expected region of infrahepatic IVC and varices in ventral, posterior and inguinal soft tissues. 2. Wedge shaped hypoattenuating defect in hepatic segment 6, area of ischemia/evolving infarct a consideration. 3. Rig... |
Generate impression based on findings. | Female 63 years old; Reason: s/p Hartmann's, preop evaluation H ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: Status post splenectomy, stable splenule.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, UR... | 1. No extraluminal enteric contrast seen to suggest a leak. Satisfactory opacification of rectal stump achieved with retrograde instillation of rectal contrast. Ingested contrast did not reach colostomy during course of the exam.2. Small parastomal hernia, no bowel obstruction. 3. Left-sided colonic diverticula without... |
Generate impression based on findings. | Female 67 years old; Reason: Evaluate for HCC History: +cirrhosis ABDOMEN:LUNGS BASES: Punctate right lower lobe calcified granuloma. Subcentimeter juxtaphrenic lymph nodes.LIVER, BILIARY TRACT: Status post cholecystectomy. No arterially enhancing focus seen in liver. No hepatic mass delineated.SPLEEN: Measures 9.5 cm ... | 1. No evidence of suspicious liver mass. |
Generate impression based on findings. | Male 58 years old; Reason: New diagnosis of mycosis fungoides History: Erythroderma CHEST:LUNGS AND PLEURA: Apical pleural scarring/nodularity. Upper lobe predominant mild emphysematous disease. No pleural effusion. No suspicious lung nodule or mass. MEDIASTINUM AND HILA: Small mediastinal lymph nodes. Reference pretra... | 1. Mildly prominent mediastinal and inguinal lymph nodes. No pathologically enlarged adenopathy otherwise.2. Please refer to concomitant CT soft tissues neck exam from same day for additional findings. |
Generate impression based on findings. | Male 60 years old; Reason: Evaluate Type A dissection for change in size over time History: S/p ascending aortic replacement for type A dissection CHEST:LUNGS AND PLEURA: Stable centrilobular and paraseptal emphysema. Status post sternotomy.MEDIASTINUM AND HILA: Esophagus deviated to the left, similar in appearance to ... | 1. Type A dissection status post repair without interval change in craniocaudal extent as described. Proximal descending aorta mildly increased in prominence, measuring 5.2 cm, previously measured 4.4 cm, interval decrease in amount of peripheral intramural hematoma or thrombus in descending aorta. Ascending aortic and... |
Generate impression based on findings. | Female 72 years old; Reason: Evaluate for calculi, upper urinary tract lesions History: Microhematuria ABDOMEN:LUNGS BASES: No significant abnormality noted.LIVER, BILIARY TRACT: Diffuse marked hepatic steatosis, making evaluation for underlying liver lesion suboptimal. Status post cholecystectomy.SPLEEN: No significan... | 1. No radiopaque urolithiasis, renal cysts as above.2. Calcified fibroid uterus. 3. Diffuse marked hepatic steatosis |
Generate impression based on findings. | Female 52 years old; Reason: assess for metastatic disease, history of endometrial cancer status post lung resection CHEST:LUNGS AND PLEURA: Enlarging pleural-based left lower lobe lung nodule, measuring 1.2 x 1 cm, image 67 series 5, previously measured 0.7 x 0.6 cm. Unchanged 4 mm left lower lobe lung nodule, image 4... | 1. Interval enlargement of the left lower lobe lung nodule that was discovered new on the earlier 11/8/14 CT exam, nodule now measures up to 1.2 cm, suspicious for pulmonary metastatic disease. Additional subcentimeter lung nodules stable. |
Generate impression based on findings. | Female 63 years old; Reason: 63 yr old female with stage IIIC fallopian tube cancer, '08 TAH/BSO and chemotherapy. S/p 14 cycles cabozantinib. Please assess disease status and compare with baseline scan. CHEST:LUNGS AND PLEURA: Biapical pleural nodularity/scarring. Moderate centrilobular upper lobe predominant emphysem... | 1. Mild to moderate jejunal wall thickening, may be due in part to underdistention and no adjacent fat stranding seen but correlation with patient's clinical history recommended to exclude underlying enteritis. Alternating areas of mild small bowel dilatation, measuring up to 3.5 cm, and narrowing visualized in multifo... |
Generate impression based on findings. | Reason: evaluate for hemorrhagic stroke History: headache similar to headache before last stroke There is redemonstration of an area of hypoattenuation at the interface of the left internal capsule and basal ganglia.Hypodensity in the right middle frontal gyrus with associated volume loss consistent with encephalomalac... | 1.Right frontal lobe focus of encephalomalacia is related to a cerebral infarction from last May.2.Chronic lacunar infarction at the left internal capsule related to a prior hemorrhage.3.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular rela... |
Generate impression based on findings. | Reason: ICH History: pmh of CVA p/w episode of unresponsiveness, R gaze deviation There is encephalomalacia present along the left temporal lobe and the left parietal lobe. There is associated ex vacuo effect on the left lateral ventricle. This is stable since the prior exam.There is a focus of encephalomalacia present... | 1.There is encephalomalacia present along the left middle cerebral artery territory involving left temporal lobe and the left parietal lobe as well as a watershed territory between the left to middle and posterior cerebral arteries.2.There is a small focus of encephalomalacia in the right parietal lobe which is also st... |
Generate impression based on findings. | Reason: encephalitis, r/o hemorrhage History: as above There is redemonstration of hypodensity predominantly involving white matter of the right frontal and temporal lobes with extensions into the right external capsule and the posterior limb of the right internal capsule. This is similar in extent compared to yesterda... | 1.Progressive white matter lesions involving the right hemisphere is similar in extent compared to yesterday's exam but has progress over the last week. Etiology is uncertain and the findings are not specific for a particular entity. Given its rapid progression and the lack of neoplasm on biopsy, an inflammatory condit... |
Generate impression based on findings. | Reason: lesion History: headache The CSF spaces are appropriate for the patient's stated age with no midline shift. The left lateral ventricle is smaller than the right lateral ventricle.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the ... | 1.No evidence for acute intracranial hemorrhage mass effect or edema. |
Generate impression based on findings. | Reason: evaluate for subacute ischemic stroke History: right leg weakness x 3 days The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a mild degree are present.No abnormal mass lesions are appreciated intracranially. No intrac... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.Periventricular and subcortical white matter changes of a mild degree are nonspecific. At this age they are most likely vascular related. 3.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Reason: hx of HOCM with ?subcortical strokes History: gait abnormality MRA brain:Antegrade flow is present in the distal internal carotid arteries, the distal vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries.There is no evidence for intracranial aneurysm or cerebr... | 1.No evidence for intracranial aneurysm nor intracranial cerebrovascular occlusive disease.2.No convincing evidence for cervical cerebrovascular occlusive disease. |
Generate impression based on findings. | Arterial insufficiency. Necrotic toes. ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: Status post cholecystectomy.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Endstage kidneys.RETROPERITONEU... | Severe infrapopliteal calcific occlusive disease with runoff bilaterally via very diseased posterior tibial arteries. Endstage kidneys. |
Generate impression based on findings. | Male 59 years old Reason: CT venogram to assess portal vein vasculature AND assess volumetrics of the liver to assess for liver size. Assess colon for tumor burden. History: s/p hepatectomy. Please also assess colon for tumor burden. ABDOMEN:LUNG BASES: Cardiomegaly with left atrial enlargement. Small bilateral pleural... | 1. Stable postoperative changes from right hepatectomy with stable perihepatic fluid collection status post drain catheter placement.2. Stable biloma adjacent to the left lobe of the liver with drainage catheter and left percutaneous biliary drain catheter in place.3. Small bowel obstruction with transition point in th... |
Generate impression based on findings. | Female 12 years old Reason: eval for fracture/dislocation after twisting right ankle while walking History: pain and swelling right ankleVIEWS: Right ankle AP, lateral and oblique 3/15/15 (3 views) Soft tissue swelling and joint effusion, with no evidence of fracture or malalignment. | Soft tissue swelling and joint effusion as described. |
Generate impression based on findings. | Female 15 years old Reason: injured lt foot fri dancing r/o fx History: swellingVIEWS: Left foot AP, lateral and oblique 3/15/15 (3 views) There is no evidence of fracture, malalignment, joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Female 9 years old Reason: rule out megacolon History: abdominal pain, diarrheaVIEW: Abdomen AP (one view) 3/15/15 at 2127 hrs. Gastrostomy tube and multiple surgical sutures are again noted. Nonspecific bowel distention. No evidence of free air or obstruction. | Nonspecific bowel distention. |
Generate impression based on findings. | malaise and fatigue The CSF spaces are appropriate for the patient's stated age with no midline shift. Periventricular and subcortical white matter hypodensities of a moderate degree are present.No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified wit... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.3.Periventricular and subcortical white matter changes of a moderate degree are nonspecific. At this age they are most likely vascular related. |
Generate impression based on findings. | 10 month old term female with new onset seizure, mild hyperglycemia, and hyponatremia with excessive water intake. There is no evidence of intracranial hemorrhage. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The imaged paranasal sinuses and mastoid ai... | No evidence of intracranial hemorrhage. |
Generate impression based on findings. | There are no fractures. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.Disc desiccation is present throughout.T10/11: Ligamentum flavum thickening and mild bilateral facet hypertro... | 1.T11/12: Disc bulge/protrusion causes slight anterior cord flattening without intrinsic cord signal abnormality or stenosis.2.L4/5: Trace anterolisthesis L4 on L5, severe left facet hypertrophy, and moderate right facet hypertrophy. There is mild left neural foraminal stenosis. Reactive edema can be found within the m... |
Generate impression based on findings. | 17-year-old male with pain to the medial and lateral malleolus.VIEW: Left ankle oblique varus stress view (one view) 3/15/15 Redemonstrated is a curvilinear ossification adjacent to the distal tip of the fibula which may represent a normal variant or an avulsion fracture. No other fractures are identified. The ankle mo... | The ankle mortise joint is maintained in varus stress. Curvilinear ossification adjacent to the distal tip of the fibula may represent a normal variant or an avulsion fracture. |
Generate impression based on findings. | Injured left hand playing football. Pain and swelling to fifth digit. Question of fracture. Three views of the left hand show no acute fracture or malalignment. There is soft tissue thickening in the base of the fifth digit. | Soft tissue swelling without acute fracture. |
Generate impression based on findings. | Male, 18 years old. Reason: Evaluate for possible GI infection or abnormalities in bowel pattern History: Fever, increased stoolVIEW: Abdomen AP (one view) 3/15/2015, 1231 Gastrostomy tube in place.Nonobstructive bowel gas pattern.Leftward thoracolumbar curve is mildly increased from prior. Bilateral hip joint narrowin... | No evidence of bowel obstruction. |
Generate impression based on findings. | 27 years, Female. Reason: ileus, constipation History: abd pain, nv There is a nonobstructive bowel gas pattern. Cholecystectomy clips project over the right upper quadrant. | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | Shortness of breath. Altered mental status The CSF spaces are appropriate for the patient's stated age with no midline shift. There is mild asymmetry of the lateral ventricles the right is smaller compared to the left.Exam is mildly compromised by patient motionNo abnormal mass lesions are appreciated intracranially. N... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction.3.Exam is mildly compromised by patient motion which may obscure more subtle abnormalities. |
Generate impression based on findings. | All of the paranasal sinuses are clear as are the bilateral mastoid air cells and middle ear cavities and there are no air-fluid levels. The bilateral maxillary sinus ostia are patent as are the bilateral frontoethmoidal and sphenoethmoidal recesses. The lamina papyracea are intact bilaterally. The floor of the anteri... | The nasal septum is deviated leftward with a left-sided septal spur. Otherwise negative CT scan of the sinuses. |
Generate impression based on findings. | Motor vehicle accident one week ago with pain to the entire ring finger. Question of fracture. Three views of the right hand show no acute fracture or malalignment. A previously described right fourth metacarpal fracture is healed. | No acute fracture is evident. |
Generate impression based on findings. | Female; 87 years old. Reason: rupture AAA History: possible rupture AAA CHEST:LUNGS AND PLEURA: Moderate upper lobe predominant paraseptal and centrilobular emphysema. Diffuse groundglass opacity, most suggestive of pulmonary edema. Small pleural effusions. Mild nonspecific left basilar atelectasis/consolidation.MEDIAS... | 1. Pseudoaneurysm of the suprarenal abdominal aorta which appears to be contained on the current examination, though there has been interval increased retroperitoneal hemorrhage since 3/13/15. Findings are highly concerning for further impending rupture.2. Occluded left common carotid artery.3. Findings suggestive of m... |
Generate impression based on findings. | 17 year-old male with ankle pain after fallVIEWS: Left ankle: AP, oblique, lateral; tibia-fibula: AP, lateral (5 views) 3/15/15 Left ankle: There is a 4-mm curvilinear ossification adjacent to the distal tip of the fibula which may represent a normal variant or avulsion fracture. Moderate soft tissue swelling is noted ... | Curvilinear ossification adjacent to the distal tip of the fibula may represent a normal variant or an avulsion fracture. |
Generate impression based on findings. | There are multiple dental caries with scattered periapical lucencies noted. A periapical lucency over ADA #5 is seen with overlying cortical dehiscence. This communicates with a rim-enhancing collection of fluid immediately anterior to the right maxilla measuring 24 x 16 x 12 mm. The overlying subcutaneous soft tissue... | 1.Periapical abscess of ADA #5.2.Associated right facial abscess. |
Generate impression based on findings. | 58 day old twin ex-37 week female with rib fractures of multiple ages and concern for non accidental trauma. There is no evidence of intracranial hemorrhage. 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 cell... | No evidence of intracranial hemorrhage or skull fracture. |
Generate impression based on findings. | 66-year-old female with history of right sided throat pain for 1.5 months, evaluate for abscess or mass There is slight asymmetric prominence of the lymphoid tissue at the right base of tongue, which is nonspecific, but may be postinflammatory in etiology. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subgl... | Mild asymmetric prominence of right base of tongue lymphoid tissue which is nonspecific but possibly post inflammatory in etiology without other specific findings to account for patient's symptoms. |
Generate impression based on findings. | Pain to right hip since last night. No trauma. Question of hip fracture. Two views of the right hip show no acute fracture or malalignment. There are vascular calcifications. Mild osteoarthritis affects the right hip.Additional AP view of the pelvis reveals no acute fracture. Mild osteoarthritis affects the left hip. | No acute fracture is evident. |
Generate impression based on findings. | 30 years, Female. Reason: source of worsening abd pain. 30F with LVAD; admitted with neutropenic fever; relapsed AML after chemo; s/p syngeneic SCT x 2 History: neutropenic fever, epigastric and lower abd pain wrapping to back LVAD and sternotomy wires in place. There is a nonobstructive bowel gas pattern. | There is a nonobstructive bowel gas pattern. |
Generate impression based on findings. | Mild mucosal thickening with lobular components can be within bilateral maxillary sinuses. Bilateral ostiomeatal units remain patent.Bilateral sphenoid sinuses and sphenoethmoidal recesses are clear.Mild mucosal thickening can be within a few anterior bilateral ethmoid air cells.Mild mucosal thickening is present with... | 1.Mild mucosal thickening with lobular components can be within bilateral maxillary sinuses. Bilateral ostiomeatal units remain patent.2.Mild mucosal thickening can be within a few anterior bilateral ethmoid air cells.3.Mild mucosal thickening is present within the inferior bilateral frontal sinuses. The left frontoeth... |
Generate impression based on findings. | 47-year-old male for pre-LVAD workup LUNGS AND PLEURA: No pleural effusion or pneumothorax. Minimal bibasilar dependent atelectasis. Scattered nonspecific micronodules measuring up to 4 mm (series 6, image 26).MEDIASTINUM AND HILA: Swan-Ganz catheter tip is in the right descending pulmonary artery. Moderate cardiomegal... | 1.Moderate cardiomegaly.2.Swan-Ganz catheter tip is in the right descending pulmonary artery. 3.Hyperattenuating focus in the superior pole left kidney may represent a hyperdense or hemorrhagic cyst or calcification, incompletely assessed. |
Generate impression based on findings. | Reason: eval for ICH History: AMS 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 demo... | 1.No evidence for acute intracranial hemorrhage mass effect or edema.2.CT is insensitive for the early detection of acute nonhemorrhagic cerebral infarction. |
Generate impression based on findings. | Right hip pain and decreased ambulation. Evaluate for occult fracture. CT images of the right hip reveal no acute fracture. Alignment is anatomic. Mild osteoarthritis affects the right hip and right sacroiliac joint.There are vascular calcifications. The urinary bladder is distended. | Osteoarthritis without acute fracture evident. |
Generate impression based on findings. | 13-week-old male with history of BPD and increased work of breathing, concern for pneumoniaVIEWS: Chest AP/lateral (two views) 3/15/15 The cardiothymic silhouette is normal. No pulmonary opacity to suggest pneumonia. Bronchial wall thickening compatible with reactive airway disease/bronchiolitis. | Reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | 23 years, Female. Reason: sbo History: worsened abd pain w/nv Slightly above average stool burden. There is a nonobstructive bowel gas pattern. There is mild gaseous distention of the stomach. Cholecystectomy clips are seen in the right upper quadrant. | Slightly above average stool burden. |
Generate impression based on findings. | Reason: Evaluate for posterior circulation occlusion History: Coma with bilateral loss of CN reflexes after GTC, heroin use Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the a... | 1.There is poor discrimination of gray and white matter which is a nonspecific finding. It could be within the range of normal, however given the patient's clinical history further evaluation with MRI or a follow-up CT of the head may be helpful to further assess this.2.No evidence for aneurysm.3.No evidence for cervic... |
Generate impression based on findings. | Male 38 years old Reason: right sided peri-anal pain, concern for perianal/rectal abscess, fistula History: right sided buttock pain PELVIS:PROSTATE, SEMINAL VESICLES: Fat-containing left inguinal hernia.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: Short segmen... | Right sided infra-levator perianal fistula/fistulae as described without drainable fluid collection to indicate an abscess. MRI can be considered for more detailed evaluation. |
Generate impression based on findings. | 90 female with right hip pain after fall. Single view of the pelvis demonstrates a right femoral neck fracture, with superolateral displacement of the distal fracture fragment. There is mild bilateral osteoarthritis of the hip joints. The bones appear demineralized, suggestive of osteopenia.Two views of the right hip d... | 1. Right femoral neck fracture as detailed above.2. Mild osteoarthritis of the hips.3. Severe osteoarthritis of the right knee. |
Generate impression based on findings. | 79 years, Male. Reason: ileus vs FOS History: Distention There is diffuse dilatation of the small bowel measuring up to 4 cm in maximal diameter as well as diffuse gaseous distention of the large bowel with the transverse colon measuring up to 12 cm in diameter. These findings may reflect diffuse ileus, colonic pseudoo... | Diffuse dilatation of both large and small bowel, which may reflect diffuse ileus, colonic pseudoobstruction or distal obstruction. |
Generate impression based on findings. | Decrease in the size of the tongue base enhancing lesion now measuring 3.4 x 1.6 cm (series 9 image 14), previously 3.4 x 2.5 cm. There is decrease in the size of the right palatine tonsil enhancing lesion now measuring 2.3 x 2.4 cm (series 9 image 8), previously 2.7 x 3.0 cm. There is also decrease in the mass-effect... | 1.Decrease in the size of the tongue base and right palatine tonsil lesions.2.Decrease in the size of the bilateral cervical lymphadenopathy. |
Generate impression based on findings. | 12-week-old concern for NEC, bloody stoolsVIEWS: Abdomen AP, left lateral decubitus (two views) 3/16/15 NG tube with tip in the gastric antrum.Coarse opacities are present in the lung bases. Persistently dilated loops of bowel without evidence of pneumatosis, free air, or portal venous gas. Barium is noted within the r... | Persistently dilated bowel loops without obstruction. |
Generate impression based on findings. | 56-year-old male with altered mental status Redemonstrated is a right trans-frontal tract as well as periventricular and subcortical white matter, thalami, basal ganglia, internal capsules, left cerebral peduncle, and pontine hypodensities. No abnormal mass lesions are appreciated intracranially. No acute hemorrhage is... | No CT evidence of acute intracranial process that would explain the patient's symptoms. |
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