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Generate impression based on findings. | Status post total hip arthroplasty. Two views of the right hip and three views of the pelvis show a right total hip arthroplasty device in near anatomic alignment without evidence of hardware complication. There appears to be a posterior fusion defect at the lumbosacral junction of doubtful clinical significance. The pelvis otherwise appears normal. | Right total hip arthroplasty in near anatomic alignment. |
Generate impression based on findings. | Female 59 years old; Reason: NHL, re-eval and compare to previous History: NHL CHEST:LUNGS AND PLEURA: Reticular opacities and focal right basilar bronchiectasis are unchanged. No dominant lung lesion. The pleural spaces are clear.MEDIASTINUM AND HILA: Left chest wall pacer with leads terminating in the heart.Heart size is enlarged.CHEST WALL: Sclerotic changes in the T3 vertebral body with subtle superior endplate compression deformity. This is unchanged since prior.ABDOMEN:LIVER, BILIARY TRACT: Liver morphology suggestive of chronic liver disease.. Well marginated cystic lesions in segment 4 of the liver are unchanged. The hepatic and portal veins are patent.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: Small retroperitoneal lymph nodes are unchanged. Prominent portacaval lymph nodes possibly due to chronic liver disease.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Stable exam; no change in the sclerotic changes of the T3 vertebral body.2.Finding suggestive of chronic liver disease. |
Generate impression based on findings. | Reason: PE History: SOB, Back pain, chest pain, hx of DVT, lung ca, ovarian ca The comparison chest radiograph demonstrates no significant pulmonary masses, airspace opacities, or pleural effusions. The ventilation portion of the exam was mildly limited as the patient was not able to tolerate the ventilation mask. Allowing for this limitation, there is symmetric activity on wash-in images. There is minimal retention of radiotracer during the wash-out phase. The perfusion portion of the exam shows bilateral large mismatched perfusion defects. | High probability of pulmonary embolism. |
Generate impression based on findings. | Female 65 years old Reason: For IRB 12-2221, must use water only for oral contrast prep. Must include arterial phase Chest and Upper Abdomen. Call HIRO for questions 2-9172. Re-evaluate disease status following new systemic therapy compared to prior scan and provide bi-dimensional History: Stage IV melanoma CHEST:LUNGS: Postsurgical changes in the right upper lobe with unchanged adjacent nodularity that measures 1.9 x 1.2 cm (series 8 image 30), previously 1.8 x 1.0 cm. Curvilinear soft tissue adjacent to the right lower lobe suture line is also not significantly changed measuring 1.1 x 2.7 cm (Series 8 image 72), previously 1.1 x 2.4.MEDIASTIUM: No mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality notedABDOMEN: LIVER, BILIARY TRACT: Hypervascular arterially enhancing lesions in the left lobe of the liver with appearance of focal nodular hyperplasia are not significantly changed. Redomonstration of multiple hepatic hypodense lesions. The reference lesion measures 9 x 7 mm (series 9 image 86), previously 9x9 mm. Additional similar appearing lesions in segment 6 and 8 are also unchanged. These have progressive enhancement on the venous phase suggestive of hemangiomas. SPLEEN: No significant abnormality noted PANCREAS: No significant abnormality noted ADRENAL GLANDS: No significant abnormality noted KIDNEYS, URETERS: 7 mm fat density in the superior pole of the left kidney compatible with angiomyolipoma is unchanged (previously 7mm). RETROPERITONEUM, LYMPH NODES: No significant abnormality noted. BOWEL, MESENTERY: No significant abnormality noted. BONES, SOFT TISSUES: No significant abnormality noted OTHER: No significant abnormality noted PELVIS: PROSTATE, SEMINAL VESICLES: No significant abnormality noted BLADDER: No significant abnormality noted LYMPH NODES: No significant lymphadenopathy. Reference right external iliac lymph node measures 8 x 4 mm (series 9 image 173), previously 7 x 6mm. BOWEL, MESENTERY: No significant abnormality noted BONES, SOFT TISSUES: No significant abnormality noted OTHER: No significant abnormality noted | 1.Stable examination without lymphadenopathy in the chest, abdomen, and pelvis.2.Post surgical changes in the right lung with nodularity along the surgical suture lines which may represent rounded atelectasis. |
Generate impression based on findings. | 80 years old female with a history of lung ca s/p resection. Please re-stage. RADIOPHARMACEUTICAL: 10.6 mCi F-18 fluorodeoxyglucose (FDG). BLOOD GLUCOSE (FASTING): 120 mg/dL. Today's CT portion of the neck and pelvis demonstrates no significant pathology. Please see diagnostic CT reports for details of the chest, abdomen, and pelvis.Today's PET examination demonstrates multiple foci of mildly to moderately increased metabolic activity in the mediastinal prevascular space, and right low paratracheal regions as well as in the bilateral lung hila, corresponding to normal-sized small lymph nodes seen on CT. The SUV Max in the left hilar region is 5.2.There is a moderate FDG uptake in the left adrenal nodule with SUV Max of 5.5 (the liver SUV Max is 4.7).Three foci of increased activity are seen in the small intestines in the left mid abdomen and pelvis without definite CT correlation. These findings are nonspecific.Physiological activity is seen the liver, stomach, spleen, kidneys, intestines, ureters and bladder. | 1.No definite evidence of FDG avid tumor.2.Multiple normal-sized small mild/moderate hypermetabolic lymph nodes in the mediastinum and lung hila, which are nonspecific.Diagnostic CTs of the chest, abdomen, and pelvis also performed at today's visit will be reported separately. |
Generate impression based on findings. | Female; 64 years old. Reason: hematuria History: hematuria ABDOMEN: Within the limits of a non-IV contrast enhanced examination which limits the ability to evaluate solid parenchymal organs and vascular structures, the following observations can be made:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small hypoattenuating lesion (6 Hounsfield units) in the left kidney midpole is likely a cyst but is incompletely characterized without intravenous contrast. Kidneys are symmetric in size and attenuation. No perinephric stranding. No hydroureteronephrosis. No GU calculi evident.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Degenerative arthritic changes of the spine.OTHER: No significant abnormality notedPELVIS:UTERUS, ADNEXA: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Degenerative arthritic changes of the spine.OTHER: No significant abnormality noted | No GU calculi or other significant abnormality evident within the limits of a non-IV contrast enhanced examination.. These findings do not obviate the need for cystoscopy as clinically indicated. |
Generate impression based on findings. | Pain Two views of the right hip, two views of the left hip, and AP view of the pelvis show severe osteoarthritis affecting both hip joints. Mixed lucency/sclerosis in both femoral heads may represent avascular necrosis with articular surface collapse along the superior aspect of both femoral heads. | Severe osteoarthritis and possible osteonecrosis as described above. |
Generate impression based on findings. | Male 62 years old Reason: HCC, on therapy, eval for dz, compare to previous, please assess with triphasic liver/Section thickness: 2.5 mm or less and provide index lesion measurements for RECIST as per clinical trial History: As above CHEST:LUNGS: Unchanged left upper lobe micronodule measures 4mm (series 11 image 117), previously 4mm. MEDIASTIUM: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN: LIVER, BILIARY TRACT: Cirrhotic morphology liver. Post ablation cavity in segment 8 with unchanged subtle nodular arterial enhancement along the superomedial margin. The cavity measures 2.4 x 1.6 cm (series 9 image 26), previously 3.1 x 1.6cm. Peripheral segment 5 ablation cavity is also unchanged (series 12 image 105). Subcapsular segment 2 arterially enhancing lesion is not significantly changed measuring 1.2 x 1.2 cm (series 9 image 20), previously 1.2 x 1.2cm. However, this lesion now demonstrates delayed washout compatible with HCC. SPLEEN: No significant abnormality noted PANCREAS: No significant abnormality noted ADRENAL GLANDS: No significant abnormality noted KIDNEYS, URETERS: No significant abnormality noted RETROPERITONEUM, LYMPH NODES: No significant abnormality noted. BOWEL, MESENTERY: Post-surgical changes from small bowel resection without evidence of obstruction. BONES, SOFT TISSUES: Post-surgical changes in the lumbar spine. OTHER: No significant abnormality noted PELVIS: PROSTATE, SEMINAL VESICLES: No significant abnormality noted BLADDER: No significant abnormality noted LYMPH NODES: No significant abnormality noted BOWEL, MESENTERY: Post surgical changes as described BONES, SOFT TISSUES: Post surgical changes in the lumbar spine OTHER: No significant abnormality noted | 1. Segment 2 arterially enhancing lesion now demonstrates washout on the delayed images compatible with hepatocellular carcinoma. 2. Stable post-ablative changes in segment 8 with stable indeterminant peripheral enhancement. |
Generate impression based on findings. | Follow-up talus fracture Three views of the left foot fail to visualize the previously seen talus fracture. The bones appear in anatomic alignment. | Talus avulsion fracture not seen |
Generate impression based on findings. | Right knee pain. Four views of the right knee show moderate osteoarthritis, particularly affecting the medial compartment with joint space narrowing and osteophyte formation. There is varus deformity of the knee. There appears to be a moderate joint effusion. Mild osteoarthritis affects the left knee as seen on the frontal view. | Osteoarthritis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in mother at age 38. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD, version 9.3. Tomosynthesis images are also obtained. The breast parenchyma is almost entirely fatty, unchanged in pattern and distribution. Benign calcifications in both breasts, including arterial calcification, or stable. Benign intramammary lymph node in the left upper outer quadrant is also stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | 17-month-old male with concern for nonaccidental trauma.VIEWS: Right shoulder: internal and external rotation; left shoulder: Internal and external rotation (4 views) 3/16/15 Right shoulder: Corner fracture is again seen at the proximal humeral metadiaphysis.Left shoulder: Corner fracture of the proximal humerus is again seen with periosteal reaction of the proximal humerus. No additional fracture is identified. | Bilateral corner fractures of the proximal humeri. |
Generate impression based on findings. | 77 year old female with history of chest pain. PULMONARY ARTERIES: Multiple eccentric filling defects within the right upper and lower lobar arteries compatible with acute pulmonary emboli.LUNGS AND PLEURA: Subpleural mixed ground glass and airspace opacities are present within the right upper and lower lobes without air bronchograms. There is a small right pleural effusion.MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. No evidence of right heart strain. Mild coronary artery calcifications. No significant mediastinal lymphadenopathy.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Left renal cortical calcification. | 1. Multiple acute pulmonary emboli in the right upper and lower lobar arteries with findings suggestive of early pulmonary infarction in the right upper and lower lobes.Discussed with Dr. Shappell at 1455 on 3/16/15.PULMONARY EMBOLISM: PE: Positive.Chronicity: Acute.Multiplicity: Multiple.Most Proximal: Lobar.RV Strain: Negative. |
Generate impression based on findings. | Male, 13 years old. R/o fracture. Football hit the right hands, right 5th finger and base of the finger pain , swelling for 2 daysVIEWS: Right hand, PA, lateral, oblique (3 views) 1323 hrs Mild widening of the physis of the fifth proximal phalanx may represent a nondisplaced Salter-Harris 1 fracture.No other evidence of fracture or dislocation. | Possible nondisplaced Salter-Harris 1 fracture of the fifth proximal phalanxl.Findings discussed via telephone with Dr Shi on 3/16/2015 at 1:45 PM. |
Generate impression based on findings. | CT CHEST AND UPPER ABD W, 3/15/2015 10:51 AM CHEST:LUNGS AND PLEURA: Stable left upper lobe groundglass/scarlike opacity (6/20). Left lower lobe subpleural nodule measures 7 mm, previously 6-mm (6/72). Other scattered punctate micronodules are stable. Emphysema. Previously new small peripheral irregular subpleural opacity in the right upper lobe has involuted and is most consistent with scarring or atelectasis (image 25/111).MEDIASTINUM AND HILA: Scattered small subcentimeter lymph nodes are unchanged. Coronary calcification.CHEST WALL: Degenerative change involving the thoracolumbar spine with stable compression fractures at multiple levels. ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Stable presumed left hepatic cyst.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: Atherosclerotic calcification of the aorta and its branches.BOWEL, MESENTERY: Absence of enteric contrast material markedly limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: Degenerative spinal changes and compression fractures unchanged. | No definitive evidence of metastases. |
Generate impression based on findings. | 31 year old female who has a complaint of right breast mass x 4 weeks. Family history of breast carcinoma in her maternal grandmother. MAMMOGRAM: Three standard views of both breasts, and 2 spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A triangular marker has been placed on the palpable area of concern in the lower inner right breast. Mild cutaneous thickening is noted in the region, with no discrete mass identified on mammogram. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over the left axilla.ULTRASOUND: On physical examination, a 1.5 cm area of cutaneous thickening is noted at the 4 o'clock position of the right breast. A targeted right ultrasound was performed for the patient’s area of concern. At the 4 o'clock position of the right breast, 6 cm from the nipple, there is a circumscribed, parallel hypoechoic intradermal mass measuring 2.1 x 0.3 x 2.3 cm. Mild surrounding vascularity is appreciated. These findings are consistent with sebaceous cyst. | Circumscribed, parallel intradermal mass at the 4:00 position of the right breast, consistent with sebaceous cyst. Patient should return to her physician, Dr. Blanchard, for further clinical management as indicated. Results and recommendation discussed with the patient. BIRADS: 2 - Benign finding.RECOMMENDATION: C - Clinical Correlation Needed. |
Generate impression based on findings. | Pain Three views of the left knee reveal severe osteoarthritis affecting the knee with near bone-on-bone apposition of the medial femoral compartment with underlying sclerosis. Minimal osteoarthritis affects the right knee as seen on the frontal view. | Osteoarthritis. |
Generate impression based on findings. | Reason: 68M w/ ICM, significant smoking hx and hx of leukemia, for LVAD vs Transplant eval History: SOB LUNGS AND PLEURA: Moderate right pleural effusion with adjacent consolidation and atelectasis. No pneumothorax.Diffuse groundglass opacity likely exaggerated by underinflation although mosaic attenuation is present.. No suspicious nodules or masses.MEDIASTINUM AND HILA: Enlarged low right paratracheal lymph node measuring 17 mm (series 4, image 35). Additional scattered subcentimeter mediastinal lymph nodes.Moderate cardiomegaly. No pericardial effusion.Severe coronary artery calcification. Right internal jugular central venous catheter and left chest port tips are in the right atrium.CHEST WALL: No significant axillary, cardiophrenic, or retrocrural lymphadenopathy. Moderate degenerative disease affects the thoracic spine.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. Mild perihepatic and perisplenic ascites. Enlarged gastrohepatic ligament lymph nodes measuring 17 mm (series 4, image 94). | 1.Moderate right pleural effusion with adjacent atelectasis, no convincing evidence of pneumonia.2.Mild amount of abdominal ascites.3. Groundglass opacity may be artifact of underinflation, atypical infection such as pneumocystis or viral pneumonia is considered unlikely. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Right hip pain. Two views of the right hip and an AP view of the pelvis show severe osteoarthritis of the right hip. Note is made of a penile prosthesis and surgical clips in the pelvis. Mild osteoarthritis affects the left hip. Moderate to severe degenerative arthritis affects the lower lumbar spine. | Osteoarthritis. |
Generate impression based on findings. | Male, 13 years old. Rule out fracture and Osgood Schlatter Disease. Bilateral anterior knee pain for 3 weeks, football for 3 yearsVIEWS: Left knee, AP, lateral, oblique (3 views) 3/16/2015, 1331 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Fluoroscopy: There was no evidence of CSF leak on fluoroscopic imaging performed immediately after contrast injection. There are post-operative findings related to left L2-L4 hemi-laminectomies. CT: There is normal alignment, with a normal lumbar lordosis. The vertebral body heights are well-maintained. Centered at the L2-L3 level there is a 33 x 17 mm simple appearing fluid collection within the left superficial paraspinal soft tissues just deep to the dermis. This collection does not fill with contrast on early or delayed CT imaging. There is no evidence of CSF leak. There is atherosclerotic calcification of the aorta. There is no acute fracture although there is diffuse osteopenia. Limited views through the retroperitoneum demonstrate no gross abnormalities. There is endplate degenerative change and loss of disc height with vacuum disc phenomena at T11-L4. T11-T12: There is extruded calcified disc material at the T11-T12 level extending inferiorly to the inferior third of the T12 body. T12-L1: There is a mild disc bulge as well as mild ligamentum flavum thickening without significant spinal canal stenosis. L1-L2: There is a disc bulge as well as minimal facet arthropathy and mild ligamentum flavum thickening resulting in unchanged mild spinal canal stenosis and bilateral neural foramen narrowing. There are small foci of air within the right aspect of the spinal canal, possibly within disc material or vascular. L2-L3: There is a left hemi-laminectomy as well as a disc bulge and minimal facet arthropathy but with some mild to moderate ligamentum flavum thickening resulting in unchanged moderate spinal canal stenosis and bilateral neural foramen narrowing. L3-L4: There is a left hemi-laminectomy as well as a disc bulge with a superimposed right paracentral and foraminal extrusion that extends cranially to the mid L3 level as well as mild facet arthropathy and ligamentum flavum thickening resulting in improved but persistent moderate spinal canal stenosis and bilateral neural foramen narrowing with mild right lateral recess effacement. L4-L5: There is a disc bulge as well as minimal facet arthropathy and moderate ligamentum flavum thickening resulting in unchanged bilateral neural foramen and lateral recess narrowing as well as mild triangulation of the thecal sac without significant spinal canal stenosis.L5-S1: There is a disc bulge asymmetric to the right with superimposed small central disc protrusion as well as relatively minor facet arthropathy but with some ligamentum flavum thickening resulting in unchanged mild spinal canal stenosis and bilateral neural foramen narrowing. In addition, the right nerve root sleeve does not fill with contrast as well as the left. | 1.There is no myelographic evidence for CSF leak There is a 33 x 17 mm simple appearing fluid collection within the left superficial paraspinal soft tissues at the L2-L3 level which does not fill with contrast on early or delayed imaging. It appears remote from the thecal sac. 2.Multi-level degenerative changes as detailed above are mainly unchanged from the prior MRI. There are post-operative findings at L2-L4 with somewhat improved but persistent spinal canal stenosis at these levels. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of ovarian cancer diagnosed in paternal aunt. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Linear scar marker was placed over the right upper outer breast. Circular skin marker was placed over the lower inner left breast. New subcentimeter circumscribed masses in the lateral breasts bilaterally likely represent cyst or benign intramammary lymph nodes.No suspicious masses, microcalcifications or areas of architectural distortion are present. | New probable bilateral cysts and/or intramammary lymph nodes. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on findings. | Male, 13 years old. Rule out fracture and Osgood Schlatter Disease. Bilateral anterior knee pain for 3 weeks, football for 3 yearsVIEWS: Right knee, AP, lateral, oblique (3 views) 3/16/2015, 1333 The osseous structures and joint spaces are normal.No significant joint effusion or soft tissue swelling. | Normal examination. |
Generate impression based on findings. | Fracture evaluation 3 views of the left hand reveal a nondisplaced healing fracture of the proximal aspect of the first metacarpal. There is new bone formation. | Healing first metacarpal fracture |
Generate impression based on findings. | 63-year-old male with history of bladder cancer, interval examination. Evaluate for extent of metastatic disease. Within the limits of a non-IV contrast enhanced examination, the following observations can be made:ABDOMEN:LUNG BASES: No significant abnormality notedLIVER, BILIARY TRACT: No significant abnormality noted in the liver parenchyma, although lack of IV contrast limits ability to evaluate. Marked dilatation of intrahepatic and extra hepatic bile ducts are again seen similar in appearance to prior examination. Intrahepatic calcified ductal stones are seen in the distal bile duct. Distal biliary stent crossing into the duodenum is seen unchanged. Gallstones in the gallbladder again seen without other complication.SPLEEN: No significant abnormality notedPANCREAS: Appearance is similar to prior examination with diffuse parenchymal and ductal calcifications seen and a dilated pancreatic duct. No other changes are seen. Lack of IV contrast limits ability to evaluate pancreatic parenchyma.ADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: No change in appearance of the kidneys bilaterally with extensive vascular calcification. Punctate calcifications more centrally may be vascular calcifications or calcifications in calices without obstruction. No significant renal masses are seen although lack of IV contrast limits ability to evaluate renal parenchyma.RETROPERITONEUM, LYMPH NODES: No enlarged lymph nodes identified. Dense atherosclerotic calcifications are again seen in the aorta and iliac arteries unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality noted. BLADDER: No abnormality detected -- no focal wall thickening. Examination is limited by lack of IV contrast material.LYMPH NODES: No enlarged lymph nodes seen.BOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Postsurgical changes again seen in right femur. No other significant abnormality seen.OTHER: No significant abnormality noted | 1. Within limits of a non-IV contrast enhanced examination, no evidence of recurrent or metastatic bladder cancer. 2. Cholelithiasis and choledocho lithiasis with biliary stents in position all unchanged. 3. Dense and diffuse calcifications within the pancreas unchanged. |
Generate impression based on findings. | 11-year-old male with history of fracture, VIEWS: Left elbow AP and lateral (two views) 3/16/15 Overlying splint material obscures fine bone detail. Alignment is anatomic. A displaced fracture fragment measuring 1.2 cm is in the anterior soft tissues of the elbow. The donor site may be from the clinoid process of the ulna. | Chronically displaced fracture fragment is present in the anterior soft tissues of the elbow. Alignment is anatomic. |
Generate impression based on findings. | Right upper lobe nodules since 2012. LUNGS AND PLEURA: 7 x 9mm (reference level) anterior segment right upper lobe subsolid nodule unchanged in size and density (5/106). Largest transaxial measurement on the current exam is 7 x 11mm, probably unchanged allowing for differences in scan variability.MEDIASTINUM AND HILA: No visible coronary artery calcification on this non-cardiac-gated study.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of IV and enteric contrast material limits sensitivity for abdominal pathology. No significant abnormality noted. | Right upper lobe nodule unchanged and remains moderately suspicious for an indolent primary adenocarcinoma. Low dose CT recommended in 6-12 months. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional MLO views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female; 55 years old. Reason: Metastatic pancreas cancer please assess extent of disease and provide index lesion measurements for RECIST as required by study History: As above CHEST:LUNGS AND PLEURA: Numerous bilateral pulmonary metastases, most of which have mildly increased in size. No new lesions. Reference left lower lobe lesion measures 2.8 x 3 cm (series 5/64), previously 2.4 x 2 .2 cm. Reference right lower lobe lesion measures 2.5 x 1.9 cm (series 5/71), previously 2.5 x 1.9 cm. Interval resolution of small pleural effusions.MEDIASTINUM AND HILA: Small adherent thrombus in the left innominate vein, similar to prior study. Mediastinal and bilateral hilar lymph nodes have increased in size and are now pathologically enlarged. For future reference, a precarinal lymph node measures 1.9 x 1.3 cm (series 3/40).CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Mild pneumobilia. Status post cholecystectomy. New 9 x 9 mm hypoattenuating lesion in the posterior right hepatic lobe (series 3/100) is suspicious for metastasis. Additional smaller hypoattenuating lesions in both lobes of the liver are too small to characterize but stable.SPLEEN: No significant abnormality noted.PANCREAS: Status-post Whipple procedure. Stable appearance of the remaining pancreatic parenchyma which is atrophic with parenchymal calcifications. No ductal dilatation. ADRENAL GLANDS: Unchanged hyperplastic appearing left adrenal gland.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Interval enlargement of peripancreatic mesenteric lymph node measuring 2.8 x 2.3 cm (series 3/118), previously measuring 2.5 x 1.8 cm. Additional smaller mesenteric lymph nodes inferiorly have also increased in size. Increased conglomerate portacaval lymphadenopathy with increased encasement of and tumor infiltration along the celiac artery (e.g. series 3/94).Stable subcentimeter retroperitoneal lymph nodes.Extensive aortobiiliac atherosclerotic disease. BOWEL, MESENTERY: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.BONES, SOFT TISSUES: Visualized osseous structures stable in appearance. No suspicious osseous lesions. | 1. Interval increased size of pulmonary metastases.2. Interval enlargement of mediastinal and bilateral hilar lymph nodes, which are now pathologically enlarged.3. New small right hepatic lesion suspicious for metastasis.4. Interval increased mesenteric and portacaval lymphadenopathy. |
Generate impression based on findings. | Male, 5 years old. History of rhabdomyosarcoma left orbit; end of therapy; assess for pulmonary metastasis LUNGS AND PLEURA: No pulmonary nodules or masses. Mild bronchial wall thickening. No focal consolidation. No pleural effusion.MEDIASTINUM AND HILA: The heart is normal in size without pericardial effusion.No mediastinal or hilar lymphadenopathy.CHEST WALL: Left chest port located anteriorly at the lower thorax, with catheter tip at the cavoatrial junction.No focal osseous lesions.UPPER ABDOMEN: No significant abnormality noted. | No evidence of metastatic disease. |
Generate impression based on findings. | Two views of the left knee reveal a depressed medial tibial plateau fracture with sclerosis. This depression is new from the previous exam of January 30.calcifications. | Depressed medial tibial plateau fracture |
Generate impression based on findings. | 24-year-old male status post spinal surgeryVIEWS: Thoracolumbar spine PA and lateral (two views) 3/16/15 Pedicle screws traverse the posterior elements of T11 through L2 with tips in the vertebral bodies without complication. Surgical gauze overlying the field. A large soft tissue defect is noted. | Interval placement of pedicle screws of T11 through L2 with tips in the vertebral bodies without complication. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of bilateral breast reductions in 2007. Family history of cancer diagnosed in maternal aunt at age 80. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. New right upper outer quadrant, posterior depth, focal asymmetry. Stable circumscribed masses bilaterally. Scattered benign calcifications in both breasts have progressed in a benign fashion.No suspicious masses, microcalcifications or areas of architectural distortion are present. | New right upper outer quadrant, posterior depth, focal asymmetry, for which additional views, including spot compression views. BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: EC - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | 47 years old female with a history of metastatic breast cancer. Restaging breast cancer. RADIOPHARMACEUTICAL: 12.1 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): N/A Today's CT portion grossly demonstrates stable lymph nodes in the left axilla and multiple lytic bony lesions in the pelvis. Diffuse decreased attenuation of the liver, consistent with fatty infiltration.Today's PET examination demonstrates interval decreased metabolic activity in the left breast lesions, left axillary lymph nodes in the right inguinal lymph nodes. There is also interval decreased metabolic activity in the multiple pelvic lytic lesions. A hypermetabolic left upper breast mass (SUVmax = 4.4 currently, 8.1 previously). The hypermetabolic focus is seen in the left posterior breast has also decreased in metabolic activity. Several hypermetabolic enlarged left axillary and subpectoral lymph nodes have mildly decreased in metabolic activity (SUVmax = 2.7, currently, and 5.3 on prior study). Increased activity seen in the T5 vertebral body seen on prior study has resolved. The left T6 transverse process lesion has decreased in metabolic activity (SUVmax = 3.8 currently and 7.9 on prior study). Leftposterior 6th rib is not seen. The lesions in the left scapular tip, right proximal femur, and throughout the sacrum andpelvis have decreased in metabolic activity. Mildly increased activity in a right inguinal lymph node has decreased.Increased activity at the umbilicus likely inflammatory has decreased. Increased cutaneous foci ofactivity in the anterior abdomen and hips likely from injection sites have decreased.Stable mild FDG uptake in the normal sized lymph nodes in the right axilla. | 1.Interval improvement of the hypermetabolic tumor in the left breast, and left axillary and right inguinal lymph nodes.2.Interval improvement of the multiple bony lesions in the thoracic spine, pelvis, left ribs, and right proximal femur. |
Generate impression based on findings. | Reason: s/p hepatectomy. evaluate liver. The patient is status ex vivo hepatectomy on 3/4/15 and roux-en-Y hepaticojejunostomy x 3 on 3/5/15. Angiographic images are unremarkable. There is prompt clearance of radiotracer from the blood pool and uniform accumulation of the tracer by the surgically reconstructed liver remnant. Tracer is seen progressively accumulating within a curvilinear structure adjacent to the liver remnant, consistent with hepaticojejunostomy drainage given the patient's surgical history. | Observed passage of radiotracer through the patient's hepaticojejunostomy without evidence of complication. |
Generate impression based on findings. | Reason: cause of patient's shortness of breath. History: dyspnea, orthopnea. LUNGS AND PLEURA: Mosaic attenuation of the lungs is again noted. Mild paraseptal emphysema. Bronchial wall thickening is present.Scattered nonspecific calcified and noncalcified micronodules. No suspicious nodules masses. Slightly increased scarring/atelectasis in the left lobe. The central airways are patent.MEDIASTINUM AND HILA: Moderately enlarged mediastinal and hilar lymph nodes including a conglomerate of left paratracheal lymph nodes is unchanged.The heart size is normal. Trace pericardial fluid. No visible coronary artery calcification. Mitral annulus calcification is present.CHEST WALL: Mild degenerative disease affects the thoracic spine. No suspicious osseous lesions. No significant hilar, subpectoral, cardiophrenic, or retrocrural lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Mild thickening of the left adrenal gland is unchanged. | 1. Moderately enlarged mediastinal and hilar lymph nodes are nonspecific but may be due to lymphoma, occult infection such as histoplasmosis, or less likely amyloid deposition.2. Mild emphysema, lower lung zone predominant mosaic attenuation and bronchial thickening, likely due to small airways disease. No significant interval change since the prior exam. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable intramammary lymph node in the upper outer right breast. Stable focal asymmetry in the central lateral right breast. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | 42 year old female who was recalled from screening mammogram for right breast asymmetry and prominent right axillary lymph nodes. Patient denies history of right axillary surgery. No family history of breast cancer. An ML view and two spot compression views of the right breast were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. The previously identified right breast asymmetry partially disperses to normal parenchyma on spot compression views. No dominant mass, suspicious microcalcifications or areas of architectural distortion in the right breast. The right axilla is not well visualized on today's mammogram.ULTRASOUND: A targeted right ultrasound was performed for the mammographic area of concern. At the 8 o'clock position of the right breast, 2 cm from the nipple, there are two adjacent simple cysts,with the largest measuring 0.5 cm, corresponding to the asymmetry on prior mammogram. Bilateral axillary ultrasound was also performed. Multiple prominent lymph nodes are present with the axillae bilaterally. All lymph nodes are highly vascular, suggesting reactive nature. | Simple cyst at the 8:00 position of the right breast, corresponding to mammographic asymmetry. Prominent bilateral axillary lymph nodes, suggestive of reactive nature. No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | 58-year-old female with history of metastatic breast cancer. CHEST:LUNGS AND PLEURA: Left lower lobe mixed solid and cavitary nodule appear similar to prior with the cavitary portion measuring approximately 8 mm, previously 8 mm (image 54 of series 4). No other pulmonary nodules are noted. No pleural effusions.MEDIASTINUM AND HILA: Right hilar lymph node measures 17 mm, previously 17 mm, when using comparable measurements(image 35 of series 3). The heart size is normal with small pericardial effusion. Status post right thyroidectomy. No mediastinal lymphadenopathy.CHEST WALL: Status post left mastectomy and axillary lymph node dissection. No evidence of axillary lymphadenopathy.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: 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. | Stable right lower lobe pulmonary nodule and right hilar lymph node. |
Generate impression based on findings. | Other 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. This is stable and compared to the previous exam.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 demonstrate some mucosal thickening in the maxillary sinuses.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin. Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.Incidental note is made of an impacted molar extending through the floor of the right maxillary sinus. | 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 mild degree are nonspecific. At this age they are most likely vascular related. 4.The exam is stable when compared to the prior exam from 5 days ago |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of cervical cancer diagnosed at the age of 38. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable focal asymmetry in the left upper outer quadrant. Focal lateral retroareolar duct ectasia.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Significant swelling and trismus of right jaw: right facial swelling and pain. There are multiple maxillary and mandibular dental caries associated with periodontal lucencies. There is stranding in the right cheek subcutaneous tissues and buccal fat pad. There is also diffuse swelling of the right masticator muscles. There is a subcentimeter focus of relatively low attenuation in the region of the right retromolar trigone, where there is adjacent mild periosteal reaction along the anterior aspect of the mandibular ramus. There is mild right suprahyoid lymphadenopathy. There is mild mucosal thickening in the right maxillary sinus. There is perhaps slight hyperattenuation of the right parotid gland. The salivary glands are otherwise unremarkable and there is no evidence of radioattenuating calculi or ductal dilatation. The major vascular structures appear to be patent. There are subcentimeter hypoattenuating foci in the bilateral thyroid lobes. The imaged intracranial structures are orbits are unremarkable. | 1. Extensive dental disease associated with right facial cellulitis and masticator space cellulitis with possible subcentimeter phlegmon or early abscess formation in the right retromolar trigone region with possible adjacent osteomyelitis, as well as possible mild right parotitis and right maxillary sinusitis.2. Nonspecific subcentimeter hypoattenuating foci in the bilateral thyroid lobes. Ultrasound may be useful for further evaluation. |
Generate impression based on findings. | 50 year old female. Fallopian tube cancer. CHEST:LUNGS AND PLEURA: Scattered pulmonary nodules, including the right lower lobe reference 3 mm nodule (series 4, image 51), unchanged and likely post-inflammatory.MEDIASTINUM AND HILA: No mediastinal or hilar lymphadenopathy.Severe coronary artery calcification.Trace pericardial fluid.Right chest wall port tip terminates at the cavoatrial junction.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: Scattered subcentimeter hypoattenuating foci in the liver are too small to characterize, unchanged and likely cysts. Cholecystectomy clips.SPLEEN: Nonspecific 1 cm ill-defined hypodensity in the spleen (series 3, image 83), not significantly changed from 9/2014.PANCREAS: Fatty atrophy of the pancreas.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Right renal 1.7 x 0.9 cm angiomyolipoma, unchanged.RETROPERITONEUM, LYMPH NODES: Mild calcified atherosclerotic disease of the abdominal aorta.BOWEL, MESENTERY: Angular configuration of bowel likely related to adhesive disease without evidence of bowel obstruction. BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Unchanged catheter entering the left abdomen with tip in the pelvis. No fluid collections.PELVIS:UTERUS, ADNEXA: Status post hysterectomy and salpingo-oophorectomy. BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Angular configuration of bowel likely related to adhesive disease without evidence of bowel obstruction. BONES, SOFT TISSUES: Mild degenerative changes of the thoracolumbar spine. Sclerotic focus in L4, unchanged, likely a bone island.OTHER: No significant abnormality noted. | Stable examination with no new sites of disease. |
Generate impression based on findings. | 15 year old male. Asthma and cough.VIEWS: Chest PA/lateral (two views) 3/16/2015, 0934 The cardiothymic silhouette is normal.Mild peribronchial thickening and mildly increased lung volumes compatible with reactive airway disease or bronchiolitis.No focal pulmonary opacities, pleural effusions, or pneumothorax.The aortic arch, cardiac apex, and stomach are left-sided. | Reactive airway disease/bronchiolitis pattern. |
Generate impression based on findings. | Reason: evaluate for bleed History: AMS. Cardiac arrest 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.There are streak artifacts present from tubing left in the gantry of the scannerAtherosclerotic calcifications are present along the distal internal carotid arteries. | 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.Streak artifacts from tubing surrounding the patient's head create artifacts which may obscure subtle abnormalities4.Use of portable scanner is associated with more noise than conventional CT. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of benign right breast biopsy. Family history of ovarian cancer diagnosed in maternal grandmother. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. Biopsy clip in the right upper outer breast is unchanged in position. Adjacent amorphous calcifications have increased in a segmental distribution.No suspicious masses or areas of architectural distortion are present. | Increase in right upper outer amorphous calcifications in a segmental fashion. Additional spot magnification views are recommended for additional evaluation.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: ED - Additional Mammo/Ultrasound Workup Required. |
Generate impression based on findings. | Reason: History metastatic prostate cancer, increasing sx and PSA, assess for disease progression History: bony pain, sacrum There is a new faint focus of activity in the right mid-proximal femoral diaphysis. Additional faint foci in the more distal right femur correlate to orthopedic fixation. The focus in the left mid-distal femoral diaphysis demonstrates increased activity compared with the prior study. Overall the other foci of increased activity in the pelvis, spine, and proximal right femur are otherwise not significantly changed. Scattered areas of degenerative radiotracer uptake are also unchanged. | 1. New faint focus of activity in the right mid-proximal femoral diaphysis is suspicious for a new tumor deposit. 2. Increased activity of the metastatic focus in the left mid-distal femoral diaphysis since the prior study. 3. Other lesions in the pelvis, spine, and right hip do not appear significantly changed since the prior study. |
Generate impression based on findings. | Reason: hx of lung ca and AVM of brain please re-evaluate History: see above The patient is status post frontal craniotomy. There is encephalomalacia present along the left frontal lobe. Surgical clips are present along the medial to the left frontal lobe.There is redemonstration of encephalomalacia along the left occipital lobe including the lingual gyrus.No abnormal enhancing mass lesions are appreciated intracranially to suggest brain metastases .There are small extra-axial collection is present adjacent to the frontal lobes bilaterally.Atherosclerotic calcifications are present along the distal internal carotid arteries. Atherosclerotic calcifications are present along the distal vertebral arteries.The visualized portions of the paranasal sinuses demonstrate a minor opacity in the right sphenoid sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. The eyeball lenses are thin. | 1.No evidence for acute intracranial hemorrhage, mass effect or edema.2.There is no evidence for brain metastases. Please note that MRI is more sensitive in detecting brain metastases than CT.3.The patient is status post frontal craniotomy and surgical clip placement adjacent to the left frontal lobe.4.Foci of encephalomalacia in the left frontal lobe and left occipital lobe have not changed since the prior exam.5.There are small subdural effusions present intracranially. These were present on the prior exam as well and has not changed significantly. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts, additional left MLO view, and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Benign bilateral calcifications, predominately dermal calcifications.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Female 69 years old; Reason: /o HNC ca and bladder mass, h/o CRT, compare to previous, measurements pls CHEST:LUNGS AND PLEURA: Moderate to severe centrilobular emphysema. Right middle lobe opacity which may represent atelectasis/scarring. This is somewhat more prominent than on prior studies. MEDIASTINUM AND HILA: Mild coronary artery calcifications. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: Stable bilateral adrenal nodularity.KIDNEYS, URETERS: Left renal scarring is again noted.RETROPERITONEUM, LYMPH NODES: Moderate arteriosclerosis of the abdominal aorta with eccentric mural thrombus. Moderate arteriosclerosis of the aortic branch vessels. BOWEL, MESENTERY: Diverticular disease without CT evidence of diverticulitis.BONES, SOFT TISSUES: Retention clip from prior G-tube again noted in the anterior abdominal wall. OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: Previously described bladder masses have resolved.LYMPH NODES: Bilaterally prominent common iliac chain lymph nodes. A reference node on the left measures 1.0 x 0.8 cm (series 3, image 146), previously 0.7 x 0.7 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Previously described bladder masses have resolved.2.Bilaterally prominent common iliac chain lymph nodes. |
Generate impression based on findings. | 66 years, Male. Reason: location of OG tube History: new OG Pelvis is not included in the field-of-view. There is a nasogastric tube with its tip projecting over the antrum of the stomach. Again seen is a paucity of bowel gas, which is incompletely evaluated on this examination. Please refer to same day chest radiograph for thoracic findings. | Nasogastric tube with its tip projecting over the antrum of the stomach. |
Generate impression based on findings. | Reason: Assessing for tumor location History: has T3N2c BOT cancer CHEST:LUNGS AND PLEURA: No pleural effusion or pneumothorax. Multiple scattered calcified nodules compatible with prior granulomatous disease. No suspicious nodules or masses.MEDIASTINUM AND HILA: Heart size is normal. Trace pericardial effusion. Severe coronary artery calcification.Calcified enlarged lymph nodes, particularly subcarinal, compatible with prior granulomatous disease. Additional noncalcified subcentimeter mediastinal and hilar lymph nodes.CHEST WALL: No axillary, cardiophrenic, or retrocrural lymphadenopathy. Mild degenerative disease affects the thoracolumbar spine. No suspicious osseous lesions.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: A few scattered subcentimeter hypodense lesions in the liver are too small to further characterize. Punctate calcifications in the liver compatible with prior granulomatous disease.SPLEEN: Punctate calcifications in the spleen compatible with prior granulomatous disease.ADRENAL GLANDS: Thickening of the left adrenal gland.KIDNEYS, URETERS: Nonobstructing renal stone in the inferior pole of the right kidney.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant lymphadenopathy. Mild atherosclerotic calcification of the aorta without evidence of aneurysmal dilatation.BOWEL, MESENTERY: Absence of enteric contrast material limits sensitivity for GI pathology.No gross abnormalities noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.No evidence of metastatic disease.2.Evidence of prior granulomatous disease. |
Generate impression based on findings. | Reason: eval for progression History: prostate cancer The focus of increased activity involving posterior left 10th rib first observed on 6/3/2014 remains unchanged. No discrete new areas of uptake are identified. Scattered areas of degenerative radiotracer uptake are also unchanged. | Unchanged nonspecific focal increased uptake in the posterior left 10th rib. No new discrete lesions to specifically suggest progression of disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of colon cancer diagnosed at age of 45. Family history of breast cancer diagnosed and maternal grandmother and aunt. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. Stable benign intramammary lymph node in the left upper outer breast. Scattered benign calcifications are stable.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male, 79 years old, oral cavity cancer restaging. A rim resection of the left anterior mandible has been performed with excision of the previously seen gingival space mass at this location. Although this is the first postoperative examination, no definite evidence of locally recurrent tumor is seen.Postoperative findings are also seen within the left floor of mouth and left submandibular space. The submandibular gland has been resected along with a previously demonstrated prominent level Ib lymph node. On the present examination, no pathologic adenopathy is detected by size criteria.The residual salivary glands are unremarkable. Hypoattenuation within the medial right thyroid lobe is of uncertain significance but probably unchanged.The cervical vessels enhance normally. Lung apices are unremarkable. No new concerning or frankly destructive osseous lesions are demonstrated. Mild cervical spondylosis is seen.On limited intracranial imaging, the ventricular atria are prominent similar to the prior examination. | 1.Postoperative findings compatible with left mandibular gingival space tumor resection and left neck dissection.2.No evidence of local tumor recurrence or new pathologic adenopathy is seen. |
Generate impression based on findings. | Pain and tenderness. Fall 3 weeks ago. Three views of the pelvis reveal a total hip arthroplasty in anatomic alignment No evidence of complicationsNote is made of deformity of the left ischium secondary to an old fracture. | Left total hip arthroplasty in anatomic alignment. No acute fractures or dislocations. |
Generate impression based on findings. | 51 years, Female. Reason: eval abdomen, r/o sbo History: gib Gas filled loops of large bowel with a paucity of small bowel gas. No definite evidence of obstruction. | No definite evidence of obstruction. |
Generate impression based on findings. | Reason: ho esoph cancer sp chemorads ck response History: none CHEST:LUNGS AND PLEURA: Calcified right lower lobe granuloma.No suspicious nodules or effusions.MEDIASTINUM AND HILA: No significant lymphadenopathy.Mild thickening of the midesophagus, unchanged.No visible coronary artery calcification.No pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Subcentimeter hypodensities, unchanged, likely benign.\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: Degenerative disease in the spine.OTHER: No significant abnormality noted. | Mild residual thickening of the midesophagus with no sign of metastatic disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. History of left breast aspiration in 2009. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Circular skin markers were placed over both breasts.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Female 31 years old Reason: bladder healed s/p cystomy on 3/8 History: none. Scout film demonstrated no abnormal calcification.Cystografin was administered by gravity via the Foley catheter and maximal distention was achieved at 375 cc, at which point the examination was terminated secondary to patient discomfort.No mucosal abnormality was evident. A slight irregularity of the right superolateral aspect of the bladder contour likely reflects site of injury. Otherwise, no evidence of vesicoureteral reflux or extravasation of contrast.Post void examination demonstrated negligible residual contrast.Fluoroscopy time: 30 seconds. | Normal cystogram, as above. |
Generate impression based on findings. | Malignant neoplasm of tonsil. CHEST:LUNGS AND PLEURA: Stable punctate micronodules, some of which are calcified. No new pulmonary nodules.MEDIASTINUM AND HILA: Calcified nodes consistent with healed granulomatous disease. Mild coronary artery calcifications.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Multiple hepatic hypodensities are too small to characterize but stable and presumably benign.SPLEEN: Calcified granulomas.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 markedly limits sensitivity for GI pathology.Small hiatal hernia.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No evidence of pulmonary metastases. |
Generate impression based on findings. | History of T2N1 esophageal cancer squamous cell carcinoma status post chemoradiation. History also includes NPH and bilateral subdural hematomas. There is unchanged patchy stranding of the fat adjacent to the right aspect of the lower cervical esophagus, which is likely treatment-related. Otherwise, the esophagus appears grossly unremarkable, without evidence of measurable mass lesions or significantly enlarged cervical lymph nodes in the neck based on size criteria. The thyroid and salivary glands appear unchanged. There are vascular calcifications within the carotid bulbs bilaterally. There is minimal mucosal thickening in left maxillary sinus. There is unchanged multilevel degenerative spondylosis and 3 mm retrolisthesis of C4 on C5. There is a partially imaged ventricular shunt in the right neck subcutaneous tissues. There is a right lens prosthesis, which may be partially calcified. There is a chronic left medial orbital wall defect with herniation of orbital fat. There are bilateral pulmonary emphysematous changes, apical scarring, and a subcentimeter calcification in the left lung apex. | Post-treatment findings in the neck without evidence of measurable locoregional tumor recurrence or significant cervical lymphadenopathy. |
Generate impression based on findings. | 64-year-old male with history of laryngeal cancer status post CRT. CHEST:LUNGS AND PLEURA: Scattered pulmonary micronodules are unchanged. No suspicious pulmonary nodules identified. No pleural effusions.MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. Mild coronary artery calcifications. No mediastinal lymphadenopathy.CHEST WALL: Resolved fluid collection in the right anterior chest wall.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Unchanged hepatic dome hypoattenuating lesion and segment 5 presumed hemangioma.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: Right adrenal calcifications. The left adrenal gland is unremarkable.KIDNEYS, URETERS: Bilateral renal cysts.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. | No evidence of metastatic disease. |
Generate impression based on findings. | Female 66 years old Reason: high alk phos level History: high levels LIVER: The liver measures 12.6 cm in length and demonstrates coarsely hyperechoic echotexture. The main portal vein is patent and demonstrates normal directional flow with peak velocity of 0.2 m/sec.GALLBLADDER, BILIARY TRACT: Unremarkable appearance of the gallbladder without gallstones, gallbladder wall thickening or pericholecystic fluid.PANCREAS: The pancreatic head and proximal body are unremarkable. The distal body and tail are poorly visualized due to bowel gas.KIDNEYS: The right kidney measures 9.9 cm. The left kidney measures 10.4 cm. There is no hydronephrosis or shadowing stone.OTHER: The spleen measures 9.5 cm in length. | Coarsely hyperechoic liver echotexture suggestive of chronic liver disease/cirrhosis. |
Generate impression based on findings. | Status post osteogenic sarcoma Two views of the right femur reveal resection of the distal three fourths of the femur and replacement with a prosthesis. There is a hinged type restrained prosthesis at the knee. No evidence of tumor recurrence. No change from previous exam of February 2014 | Resection of the distal three fourths of the femur and replacement with prosthesis in anatomic alignment. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. A circular skin marker was placed over the right outer central breast. Scattered benign calcifications bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 2 - Benign finding.RECOMMENDATION: NSA - Screening Mammogram. |
Generate impression based on findings. | Reason: lung cancer sp chemorads ck response History: axillary pain CHEST:LUNGS AND PLEURA: Extensive opacity in the left apical region, improved compared to previous, consistent with radiation reaction.Extensive bilateral lower lobe bronchiectasis with increased peribronchial opacity and bronchiolitis on the current examination suggestive of aspiration and infection.A previously described 6 mm cystic lesion in the right upper lobe which had increased in size is not clearly visualized on the current exam probably due to motion artifact, but continued follow-up is recommended.MEDIASTINUM AND HILA: Small amount of lymphoid tissue in the left hilum measuring 8 mm, unchanged.Slightly increased left inferior pulmonary ligament lymph node, now 9 mm, increased from 6 mm previously.No visible coronary artery calcification.No pericardial effusion.CHEST WALL: No significant abnormality noted.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Hepatic steatosis.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.Stable disease. 2. Increased and bronchiolitis at the left base suggestive of aspiration and infection. |
Generate impression based on findings. | Lumbarization of S1 is noted with a rudimentary S1/2 disc and bilateral S1 pseudoarthroses.Alignment is anatomic. There are no fractures or subluxations. The marrow signal is benign. The conus is normal in signal and morphology and terminates at an appropriate level. The visualized intra-abdominal and paraspinal contents are unremarkable.Disc desiccation is present at L4/5 and L5/S1.There is a degree of congenital narrowing of the central canal from L2/3 through L5/S1.T12/L1: UnremarkableL1/2: UnremarkableL2/3: UnremarkableL3/4: UnremarkableL4/5: There is a central to left paracentral disc extrusion resulting in severe left lateral recess, moderate right lateral recess, moderate central canal stenosis.L5/S1: There is a central disc protrusion which abuts and slightly flattens bilateral S1 nerve root sheath origins. | 1.Lumbarization of S1 is noted with a rudimentary S1/2 disc and bilateral S1 pseudoarthroses.2.There is a degree of congenital narrowing of the central canal from L2/3 through L5/S1.3.L4/5: There is a central to left paracentral disc extrusion resulting in severe left lateral recess, moderate right lateral recess, moderate central canal stenosis.4.L5/S1: There is a central disc protrusion which abuts and slightly flattens bilateral S1 nerve root sheath origins. |
Generate impression based on findings. | Reason: assess for spread of cancer beyond head and neck History: front of mouth SCC CHEST:LUNGS AND PLEURA: No suspicious nodules or masses. Central airways are patent. No pneumothorax or pleural effusion.Bibasilar dependent atelectasis. Interval increase in mildly cystic appearance of the left lung base may represent scarring. Scattered calcified and noncalcified nonspecific micronodules.MEDIASTINUM AND HILA: Streak artifact from left chest wall ICD with leads limits evaluation. Partially visualized right floor of mouth lesion consistent with the patient's diagnosis of squamous cell carcinoma.Tracheostomy tube tip is in place.No significant mediastinal or hilar lymphadenopathy.Heart size is normal. Trace pericardial effusion.The ascending aorta is dilated measuring 4.1 cm on non-gated CT. Severe coronary artery calcification.CHEST WALL: No significant axillary, cardiophrenic, or retrocrural lymphadenopathy. No significant subpectoral or supraclavicular lymphadenopathy. Mottled appearance to the thoracic and lumbar spine is unchanged since the recent PET/CT. The largest lytic lesion measures 1.5 x 2.0 cm in the left L2 vertebral body (series 80245, image 80). Mild leftward curvature of the thoracic spine. Moderate degenerative disease affects the thoracolumbar spine worst at L3-L4.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: Nonspecific segment 6 hypodensity may represent a hemangioma.SPLEEN: Bilateral nephroureterostomy tubes with unchanged right greater than left hydronephrosis.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: Mottled appearance to the thoracic and lumbar spine is unchanged since the recent PET/CT. The largest lytic lesion measures 1.5 x 2.0 cm in the left L2 vertebral body (series 80245, image 80). Mild leftward curvature of the thoracic spine. Moderate degenerative disease affects the thoracolumbar spine worst at L3-L4.OTHER: No significant abnormality noted. | 1.No specific evidence of pulmonary metastatic disease.2.Mottled appearance of the bone with a lytic lesion in the left L2 vertebral body is unchanged since the recent PET CT; this may reflect localized osteoporosis however myeloma cannot be ruled out.3.Mildly ectatic ascending aorta measuring up to 4.1 cm. |
Generate impression based on findings. | 8 year-old male with increased work of breathing and clot in left arm PULMONARY ARTERIES: Pulmonary artery opacification is adequate to the first or subsegmental level with no evidence pulmonary embolism. The main pulmonary artery is dilated measuring 2.6 cm, which can be seen in the setting of pulmonary hypertension. The ascending aorta measures 2.2 cm.LUNGS AND PLEURA: The right lung is small with significant postsurgical changes. Chronic right apical pneumothorax. A defect is present within the superior long indicating a bronchopleural fistula, which is likely chronic. Right pulmonary cysts and bronchiectasis. Bronchial wall thickening may be chronic in the right lung, although can be consistent with a bronchitis. Small left pleural effusion with underlying compressive atelectasis. Septal thickening , and a nodular groundglass opacities scattered throughout the left lung may be infectious or inflammatory etiology.MEDIASTINUM AND HILA: The mediastinum is slightly shifted to the right. No significant mediastinal lymphadenopathy is identified. Postsurgical changes in the mediastinum are noted.CHEST WALL: Multiple collateral vessels are noted in the right chest. Thoracolumbar spine is normal. Significant postsurgical changes of the right chest wall are again noted.UPPER ABDOMEN: The spleen is prominent measuring 9.4 cm. No significant abnormality noted within the partially visualized parenchyma of the upper abdomen. | 1.No pulmonary embolism.2.Dilated main pulmonary may be related to pulmonary hypertension.3.Small left pleural effusion with scattered groundglass and nodular opacities which may be infectious in etiology.4.Extensive postsurgical changes of the right hemithorax. Chronically small right lung with bronchiectasis and apical pneumothorax. |
Generate impression based on findings. | RFO No unexpected radiopaque foreign body seen. Partially visualized nasogastric tube. Scattered surgical staples. Partially visualized ureteral tube tip projects over the expected location of the bladder. | No unexpected radiopaque foreign body.Findings discussed with Dr. Becker at 3:06 p.m. on 3/16/2015. |
Generate impression based on findings. | Male, 63 years old, history of supraglottic cancer (T2N2c SCC of the larynx), follow-up exam. Treatment related findings are again seen including mucosal hyperemia and edema involving the soft palate and palatine tonsils, base of tongue and supraglottic larynx. There remains a small soft tissue defect within the right paramedian base of tongue which may reflect prior instrumentation. No evidence of locally recurrent tumor is seen. For reference purposes, enhancing tissue at the base of the epiglottis continues to measure approximately 17 mm in transverse dimension which, accounting for differences in technique, is unchanged.No definite pathologic adenopathy is detected. A reference right level 2 lymph node measures approximately 7 mm in short axis (image 36 series 7), previously 8 mm.The salivary glands demonstrate a normal post-treatment appearance. A stable subcentimeter hypoattenuating lesion is seen in the left lower pole of the thyroid.At least moderately severe stenosis is evident at the carotid bifurcations. Severe centrilobular and paraseptal emphysema is evident at the lung apices. Scarring/soft tissue thickening persists within the left lung apex. Multilevel cervical spondylosis is again seen with severe stenosis at C5-6 and moderate stenosis at C3-4. Both segment branches show chronic deformity similar to prior. No worrisome osseous lesions are detected. | Treatment related findings are demonstrated in the neck with no evidence of locally recurrent tumor or pathologic adenopathy. |
Generate impression based on findings. | Reason: pt with metastatic breast cancer please assess disease status and compare to previous imaging. There has been continued interval increase in activity and extent involving the patient's known right humeral metastasis, now status post pathologic fracture and orthopedic fixation. Abnormal radiotracer uptake now extends to involve the majority of the distal humeral diaphysis. There are no new sites of radiotracer uptake to specifically indicate new sites of disease. | 2. Increased activity and extent of radiotracer uptake in the patient's right known right humeral metastasis status post pathologic fracture and orthopedic fixation. These findings may represent increased tumor burden, healing fracture, or some combination thereof. 2. No new sites of disease identified. |
Generate impression based on findings. | Tuberous sclerosis. Follow-up right subpulmonic pneumothorax.VIEWS: Chest AP/lateral (two views) 03/16/15 No definite pneumothorax is seen. Abnormal contour of the right hemidiaphragm persists. Linear and a few nodular opacities are present. Right apical pleural thickening is noted. Cardiac silhouette size is normal.Vagal nerve stimulator device remains in place with its leads extending into the left neck. A fine staple line is seen at the right base. | No pneumothorax identified. Continued postoperative changes. |
Generate impression based on findings. | History of T4bN1 left tonsil squamous cell carcinoma, status post treatment via CRT. There are post-treatment changes findings in the neck. There is interval resolution in the soft tissue thickening along the right palatine fossa and posterior oropharyngeal wall. There are no measurable mass lesions in the oropharynx. There is no significant cervical lymphadenopathy according to size criteria. The major salivary glands and thyroid gland are unchanged. The airways are patent. The carotid arteries and jugular veins are patent. The imaged intracranial contents are unremarkable. There is mild left maxillary sinus mucosal thickening, decreased from the prior exam. There is unchanged degenerative disease of the cervical spine. The imaged lung apices are unremarkable. | 1. Interval resolution in the soft tissue thickening along the right palatine fossa and posterior oropharyngeal wall, suggestive of a prior inflammatory process, without convincing evidence of tumor recurrence.2. No evidence of significant cervical lymphadenopathy. |
Generate impression based on findings. | Reason: eval for video capsule endoscope History: above Redemonstrated LVAD device in place. Redemonstrated cardiomegaly and pulmonary edema and pleural effusions, not significantly changed. G-tube tip balloon projects over the expected location of the stomach. Capsule endoscopic device not definitively identified, although limited by overlying LVAD device and EKG leads. | Capsule endoscopic device not identified given limitations above. |
Generate impression based on findings. | Tachycardia and S.O.B. rule out PE. PULMONARY ARTERIES: Diagnostic quality infusion. No pulmonary embolus is identified.LUNGS AND PLEURA: Small pleural effusions, right greater than left. Mild groundglass opacity, bronchial wall thickening and septal thickening, suggestive of edema/hypervolemia. Bronchial wall thickening is most pronounced in the right lower lobe, where branching high-density opacities are appreciated, in association with a pleural retraction and subpleural atelectasis, suggesting chronic barium aspiration. Mild emphysema.MEDIASTINUM AND HILA: Mildly prominent lymphatic tissue may be reactive, nonspecific.CHEST WALL: No significant abnormality noted.UPPER ABDOMEN: Absence of enteric contrast material markedly limits sensitivity for abdominal pathology. Limited scanning range. | No evidence of pulmonary embolus. Bronchial wall thickening and ground glass opacity suggestive of aspiration. In addition, there may be mild superimposed hypervolemia.PULMONARY EMBOLISM: PE: Negative.Chronicity: Not applicable.Multiplicity: Not applicable.Most Proximal: Not applicable.RV Strain: Not applicable. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of sarcoid. Family history of breast cancer diagnosed in maternal grandmother, aunt, and cousin. Patient reports occasional left breast pain. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A few scattered benign calcifications have slightly progressed in a benign fashion.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Male; 46 years old. Reason: 45M with history of nasopharyngeal CA s/p . Routine surveillance evaluation. History: history of nasopharyngeal CA s/p XRT LUNGS AND PLEURA: No suspicious pulmonary lesions identified. No pleural effusions.MEDIASTINUM AND HILA: The heart size is normal without pericardial effusion. No significant coronary artery calcifications. No significant mediastinal or hilar lymphadenopathy.CHEST WALL: No axillary lymphadenopathy.UPPER ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. Cholelithiasis without evidence of acute cholecystitis. | 1. No evidence of metastatic disease.2. Cholelithiasis. |
Generate impression based on findings. | metacarpal fracture. Three views of the right hand reveal the nondisplaced fracture of the mid diaphysis of the fifth metacarpal. The fracture is indistinct consistent with healing. No change in position previous. | Healing nondisplaced metacarpal fracture |
Generate impression based on findings. | 33 year old who is 9 week pregnant with biopsy proven left breast cancer (IDC grade 3) presents for mammographic evaluation. Three standard views of both breasts with two spot compression views of the left breast were performed digitally and reviewed with the aid of R2 CAD, 9.3. The breast parenchyma is extremely dense, limiting the sensitivity of mammogram A triangular marker is placed at 12 o'clock position of left breast, indicating the area of palpable lump. There is a metallic marker clip at posterior 11 o'clock position in the left breast. On CC view, a mass-like density is vaguely seen around the marker, but this density is not appreciated in any other views. No suspicious calcifications or architectural distortions are present in the left breast. No suspicious mass, suspicious microcalcifications or suspicious areas of architectural distortion are noted in right breast. | Biopsy proven cancer in the left breast at 11 o'clock position with clip placement within the lesion.No mammographic evidence for malignancy in the right breast. BIRADS: 6 - Known cancer.RECOMMENDATION: B - Surgical Consultation. |
Generate impression based on findings. | 52 years old Male. Reason: as above History: s/p kidney transplant. Now with transplant nephrectomy. With PTLD. Evaluate for any metastatic disease. RADIOPHARMACEUTICAL: 11.3 mCi F-18 fluorodeoxyglucose (FDG).BLOOD GLUCOSE (FASTING): 108 mg/dL. Today's CT portion grossly demonstrates several enlarged lymph nodes in the left superior mediastinum, right retrocrural space, right retroperitoneal cavity and the right pelvis. A transplant kidney is seen in the right iliac fossa. There is a pleural thickening in the left lower lobe. Scar-like opacities are seen in the lower lungs.Today's PET examination demonstrates increased metabolic activity in the lymphadenopathy in the left superior mediastinum, left lower posterior mediastinal para-aortic region, right retrocrural space, retroperitoneal cavity and in the right pelvis at right common iliac and external iliac lymphatic chains. Increased activity in the periphery of the transplant kidney is noted. A hypermetabolic lymph node is seen in the right inguinal region. For reference, the SUV Max of the right common iliac lymph nodes is 12.1.Physiologic activity is seen in the liver and intestines. The intense bone marrow is most likely due to bone marrow proliferation. No native kidney activity is seen. | 1.Hypermetabolic lymph nodes in the mediastinum, abdomen and pelvis as well as in the right inguinal regions, consistent with patient's diagnosis of lymphoma.2.Decreased activity in the transplant kidney with only peripheral uptake, suggestive failure of the transplant kidney. |
Generate impression based on findings. | Male 62 years old; Reason: rule out infection History: abdominal pain, nausea ABDOMEN:LUNG BASES: Mild bibasal atelectasis.LIVER, BILIARY TRACT: Mild low density thickening of the gallbladder wall. No gallstones are identified however CT is less sensitive than ultrasound for their detection and can miss up to 30% of gallstones.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Mild symmetric perinephric stranding. No hydronephrosis.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:PROSTATE/SEMINAL VESICLES: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: Nonspecific mildly prominent right external iliac lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | 1.Mild gallbladder wall thickening without gallstones. This may be chronic however ultrasound is more sensitive for detection of gallstones and therefore excluding acute cholecystitis. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Family history of breast cancer diagnosed in sister. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses. Bilateral subcentimeter upper outer quadrant intramammary lymph nodes. A few scattered benign calcifications.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 2 - Benign finding.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Right wrist pain and swelling Three views of the right wrist reveal no evidence of any fractures or dislocations. There is some mild degenerative change at the triscaphe joint. | No fractures or dislocations. |
Generate impression based on findings. | Fracture.VIEWS: Right little finger PA/lateral/oblique (3 views) 03/16/15 The nondisplaced volar plate avulsion injury of the middle phalanx is again seen. The fracture fragment is very small. | Nondisplaced volar plate avulsion of the middle phalanx of the little finger. |
Generate impression based on findings. | Reason: rule out perforation History: abdominal pain, vomiting Oral contrast is noted within the bowel, of unclear timeframe as no prior comparisons are available. Air-fluid levels and prominent/mild dilation of small bowel loops, particularly in the left mid and upper quadrant with gas clearly seen in the large bowel, but not definitively over the rectum. No free intraperitoneal air on the upright film. | Findings suggestive of partial small bowel obstruction as detailed above. |
Generate impression based on findings. | Reason: pt with metastatic breast cancer please assess disease status and compare to previous imaging History: MBC CHEST:LUNGS AND PLEURA: Interstitial opacity at the right apex consistent with radiation reaction, unchanged.Superior segment right lower lobe subpleural nodule (series 4/46) measuring 13 x 8 mm, slightly increased.Right middle lobe anterior cardiophrenic angle nodule (series 4/80) 11 x 9 mm, increased from 6 x 8 mm previously.MEDIASTINUM AND HILA: Enlarged inhomogeneous thyroid gland.Index AP window lymph node measures 10 mm, slightly increased and other mediastinal nodes have more obviously increased in size.A right hilar lymph node measures 17 mm in short axis (series 3/43) increased from 6 mm previously.Severe coronary artery calcification.No pericardial effusion.Small sliding hiatal hernia.CHEST WALL: Large heterogeneous enhancing right chest wall mass with local muscle invasion measuring 11.9 x 6 .2 cm, increased from 8 x 4.7 cm previously.New markedly enlarged left axillary lymph nodes measuring up to 26 mm in short axis diameter.Collapse of the T12 vertebral body and sclerosis of the right fifth rib lesion appearing similar to prior study.ABDOMEN: Absence of enteric contrast material limits sensitivity for abdominal pathology. LIVER, BILIARY TRACT: New large hepatic metastases involving both lobes, measuring up to 32 mm in diameter.Large calcified gallstone in the gallbladder.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Multiple bilateral renal cysts.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. | Marked progression of disease in the lungs, mediastinum and liver. |
Generate impression based on findings. | 54 year old asymptomatic female presents for diagnostic examination. History of benign left breast biopsy. Family history of breast carcinoma in her paternal grandmother. Three standard views of both breasts were performed digitally and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density, unchanged in pattern and distribution. A biopsy clip is again noted within the upper outer left breast. No dominant mass, suspicious microcalcifications or areas of architectural distortion in either breast. Benign appearing lymph nodes are projected over both axillae. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient.BIRADS: 2 - Benign finding.RECOMMENDATION: NS - Screening Mammogram. |
Generate impression based on findings. | Three Views of the right hand reveal no evidence of any acute fractures or dislocations. | Negative for fracture or dislocation |
Generate impression based on findings. | Patient fell. Four views of the left elbow are r unremarkable. No joint effusion. No fractures or dislocations. | Negative left elbow examination |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Personal history of bladder cancer diagnosed in 2008. Two standard digital views of both breasts were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is composed of scattered fibroglandular density. Benign calcifications bilaterally.No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, bilateral screening mammogram is recommended annually. Results and recommendation were discussed with the patient. Mammography is optimally performed when prior studies are available to detect changes. If the patient's prior mammograms can be submitted, then an addendum to this report will be made.BIRADS: 2 - Benign finding.RECOMMENDATION: NSB - Screening Mammogram. |
Generate impression based on findings. | Reason: gastroperesis vs obstruction, would like to see if stomach has changed in size History: distended stomach Redemonstrated left retrocardiac opacity/cardiomegaly. Nasogastric tube tip projects over the gastric antrum. Interval decrease in gastric distention. Moderate degenerative changes of the lower lumbar spine. | Interval decrease in gastric distention compared to most recent abdominal radiograph. |
Generate impression based on findings. | Injured second toe two weeks ago . History of diabetes Three views of the second toe reveal soft tissue swelling and wide spread gas in the soft tissues. No gross bone destruction is seen. | Widespread gas in the soft tissues. I do not see any gross bone destruction. In a patient with diabetes this subcutaneous gas is worrisome for osteomyelitis. |
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 with significant disc loss at L4/5.T12/L1: UnremarkableL1/2: There is a shallow left paracentral disc protrusion without significant associated mass-effect or resulting stenosis. There is also slight ligamentum flavum thickening and minimal bilateral facet hypertrophy. There is no is significant central or neural foraminal stenosis.L2/3: Asymmetric bulge to the left, ligamentum flavum thickening, and mild bilateral facet hypertrophy. There are no significant stenoses.L3/4: Trace anterolisthesis L3 on L4, asymmetric bulge to the right, ligamentum flavum thickening, moderate left facet hypertrophy, and moderate to severe right facet hypertrophy. There is mild right neural foraminal stenosis.L4/5: As demonstrated previously, there has been previous right hemilaminectomy and partial right facetectomy. There is asymmetric bulge to the left, left ligamentum flavum thickening, and mild to moderate bilateral facet hypertrophy. There is moderate left lateral recess and moderate left neural foraminal stenosis.L5/S1: There is a left paracentral disc extrusion which abuts bilateral S1 nerve sheath origins, flattening the right, with flattening and slight posterior displacement of the left. There is also ligamentum flavum thickening and mild bilateral facet hypertrophy. There is mild bilateral neural foraminal stenosis. | 1.L1/2: There is a shallow left paracentral disc protrusion without significant associated mass-effect or resulting stenosis.2.L3/4: Mild right neural foraminal stenosis.3.L4/5: There has been previous right hemilaminectomy and partial right facetectomy. There is moderate left lateral recess and moderate left neural foraminal stenosis.4.L5/S1: There is a left paracentral disc extrusion which abuts bilateral S1 nerve sheath origins, flattening the right, with flattening and slight posterior displacement of the left. There is mild bilateral neural foraminal stenosis. |
Generate impression based on findings. | 53-year-old male with history of left tonsillar squamous cell carcinoma. CHEST:LUNGS AND PLEURA: Scattered calcified and noncalcified micronodules appearing similar to prior. No suspicious pulmonary lesions identified. No pleural effusions.MEDIASTINUM AND HILA: The heart size is normal with no pericardial effusion. There are moderate coronary artery calcifications. No significant mediastinal lymphadenopathy. Calcified hilar nodes are present, likely the sequela of prior granulomatous disease.Right hilar lymph node measures 10 mm, previously 10 mm (image 52 series 4).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: Stable renal cysts.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Scattered atherosclerotic calcifications of the abdominal aorta and branches. Stable appearing small retroperitoneal lymph nodes.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. | Asymptomatic female presents for routine screening mammography. Family history of uterine cancer diagnosed in maternal aunt. Two standard digital views of both breasts and tomosynthesis were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is heterogeneously dense, which may obscure small masses, unchanged in pattern and distribution. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSC - Screening Mammogram. |
Generate impression based on findings. | Reason: 44 yo w buttock infection, AMS and catatonia History: MRI w punctate infarcts Neck CTA: There is opacification of the aortic arch, great vessels from the aortic arch and carotid arteries and vertebral arteries. There is no stenosis identified of the great vessels from the aortic arch. On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is 40% narrowing at the origin of the right internal carotid artery. There is irregular atherosclerotic plaque present along the proximal left internal carotid artery.There is no significant stenosis along the course of the vertebral arteries.The left common carotid artery originates from the innominate artery.Brain CTA: There is opacification of the distal internal carotid arteries, the distal vertebral arteries and the proximal anterior middle and posterior cerebral arteries. No aneurysms or intracranial stenosis is appreciated.In the cavernous carotid arteries and the supraclinoid internal carotid arteries are irregular bilaterally with mild narrowing and dilation. The right A1 segment is somewhat irregular with mild narrowing and dilation. This is not change substantially when compared with prior exam.The anterior communicating artery and the posterior communicating arteries are identified and are intact. There is a fetal origin of the right posterior cerebral artery with a small right P1 segment. The left posterior communicating artery is small. The intercommunicating artery is medium-sized. The right A1 segment is small compared to the left A1 segment. It has not changed substantially since the prior exam.There is extracranial origin of the right posterior inferior cerebellar artery. CT head: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.Atherosclerotic calcifications are present along the distal internal carotid arteries.Incidental note is made of a impacted right maxillary molar which extends into the inferior aspect of the right maxillary sinus. | 1.There is irregular atherosclerotic plaque present at the origin of the left internal carotid artery.2.On the basis of NASCET criteria there is no significant stenosis at the carotid bifurcations. There is mild atherosclerotic narrowing at the origins of the internal carotid arteries. 3.No evidence for intracranial cerebral occlusive disease. |
Generate impression based on findings. | Asymptomatic female presents for routine screening mammography. Two standard digital views of both breasts and additional left MLO view were performed and reviewed with the aid of R2 CAD 9.3. The breast parenchyma is almost entirely fatty. No suspicious masses, microcalcifications or areas of architectural distortion are present. | No mammographic evidence of malignancy. As long as the patient's physical examination remains normal, routine screening mammogram is recommended annually.BIRADS: 1 - Negative.RECOMMENDATION: NSA - Screening Mammogram. |
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